The impact of COVID-19 restrictions on crime and its implications for public health: a case study from a small developing country.

BACKGROUND: Crime has been described as a public health issue in Trinidad and Tobago, a small developing nation. COVID-19 restrictions, aimed at maintaining public health safety by limiting disease spread, may have negatively impacted crime rates due to an alteration of social and economic conditions. This study evaluates the implications of these restrictions on crime dynamics and hence their impacts on overall public health. METHODS: Employing interrupted time series analysis with seasonal autoregressive integrated moving average with exogenous factor (Seasonal Autoregressive Integrated Moving Average with Exogenous Variables) models, monthly data on murders, sexual offences, and motor vehicle larcenies from January 2013 to June 2023 were analysed. RESULTS: The study found a decrease in murders and motor vehicle larcenies with the onset of restrictions, followed by an inverse trend correlating with the easing of measures. Sexual offences showed no significant change in response to the restrictions. CONCLUSIONS: While COVID-19 restrictions initially influenced certain crime rates, the effect varied across crime types. Policy interventions based on lessons learned from the COVID-19 pandemic must be done to strategically reduce and prevent crime without having the negative side effects of the pandemic.

Conservative therapy significantly reduces patients' chronic venous disease symptoms: A Caribbean insight into the VEIN Act Program.

OBJECTIVES: We sought to determine the baseline demographic and clinical characteristics of patients with Chronic Venous Disease (CVD) across the Caribbean, and to evaluate patients' compliance to conservative therapy and the effectiveness of such therapy in reducing patients' CVD symptoms. METHOD: Patients were enrolled into the VEIN Act Program, and their demographic data, CVD symptoms (and their intensity) and CEAP C-classification was recorded at the first visit. Patients were prescribed conservative therapy, and symptom intensity and patient compliance and satisfaction evaluated at a follow-up visit. RESULTS: We enrolled 193 patients into the study, most of which (76%) were female, between 39-78 years (80%) and within the C2-C4a classes (56.1%). Pain (61.1%) and heaviness (58.5%) were the most common symptoms. Patient compliance to the prescribed treatment was relatively high for all modalities (>75%) and most patients (92.1%) were at least somewhat satisfied with their treatment. CONCLUSIONS: Patient compliance to conservative therapy for management of CVD is high across the Caribbean, and such therapy is effective in reducing intensity of CVD symptoms.

An Evaluation of a Modified CTAS at an Accident and Emergency Department in a Developing Country.

OBJECTIVES: To review the modified Canadian Triage and Acuity Scale used in an accident and emergency department in Trinidad and Tobago. DESIGN AND METHODS: A cross-sectional study was carried out. Times from assignment of triage category to being seen by a physician were collected from the patient notes on the days of presentation and compared to the reference standards. Times from decision to admit to obtaining a bed were also recorded. RESULTS: 200 patients were included in the study. The median waiting time for patients in the immediate/blue category was 3 minutes (range = 3); for the red category, it was 31.2 minutes (range = 121.8); in the yellow category, it was 61.8 minutes (range = 805.2). The overall admission rate was 30.5%, with an admission rate of 25% for the blue category; 20% of patients in the red category waited more than 4 hours for a hospital bed. CONCLUSION: The patients assigned to the blue category were being seen almost immediately. Less critical persons wait longer than the reference times and this may be due to structural factors such as staffing. The admission rates per category highlighted a low admission rate for the blue category (25%), which is unusual. This study highlights the need for a further study to review clinical presentation, assignment to triage category, and outcomes.

Risk Factors Associated with Preterm Neonatal Mortality: A Case Study Using Data from Mt. Hope Women's Hospital in Trinidad and Tobago.

Preterm neonatal mortality contributes significantly to the high incidence of death among children under five years of age. Neonatal mortality also serves as an indicator of maternal health in society. The aim of the study is to examine the risk factors for preterm neonatal mortality at the neonatal intensive care unit (NICU) at Mount Hope Women's Hospital in Trinidad and Tobago (MHWH). In this retrospective study, we included infants (N = 129), born < 37 weeks gestational age, between 1 January and 31 December 2015. Two binary logistic regression models (infant and maternal variables) were constructed to identify predictors of preterm neonatal mortality. Roughly 12% of the infants died after being admitted to the NICU. The binary logistic regression (infant model) had an excellent fit (area under the curve (AUC): 0.904, misclassification rate: 11.7%) whilst the maternal binary logistic model had a fair fit (AUC: 0.698). Birth weight, length of time on the ventilator and obstetric complications proved to significantly influence the odds of preterm neonatal death. The estimated models show that improvement in neonatal as well as maternal variables has direct impact on preterm neonatal mortality.

Attitude Towards Alzheimer's Disease Among Undergraduate Students of University of the West Indies, Trinidad and Tobago.

BACKGROUND: Alzheimer's disease is most common among the dementias and is characterized by gradual declines in functional and cognitive abilities. Caregivers including family members play a key role in providing critically needed care for these patients. OBJECTIVE: This study compared the knowledge and attitudes of pre-healthcare and non-medical undergraduate students towards patients with Alzheimer's disease. MATERIALS AND METHODS: A cross-sectional study was conducted involving quota sampling of 691 undergraduate students (369 pre-healthcare and 322 non-medical). A 28-item questionnaire was utilised comprising of closed-ended questions and some based on a scale rating. The students' knowledge of Alzheimer's disease was arranged into categories such as: 0 for no knowledge about Alzheimer's disease, 1 for very little knowledge about Alzheimer's disease, 2 for fair knowledge about Alzheimer's disease and 3 for great knowledge about Alzheimer's disease. STATISTICAL ANALYSIS: The data was analysed using the computer software SPSS and the Chi squared test of independence was also used to determine which knowledge variables were independent of student's status. RESULTS: Overall, 40.01% of the students have great or fair knowledge of Alzheimer's disease, with that of pre-healthcare students being satisfactory (54.47%). Pre-healthcare students have a more positive attitude towards Alzheimer's disease and 82.2% of students wished to take advantage of predictive test for Alzheimer's disease. Age and genetics were identified as risk factors of the disease. CONCLUSION: Pre-healthcare students had greater understanding of Alzheimer's disease and depicted a more empathetic and caring attitude towards patients. This can be attributed mainly to their knowledge and exposure toward the disease.

Estimating the proportion of true null hypotheses when the statistics are discrete.

MOTIVATION: In high-dimensional testing problems π0, the proportion of null hypotheses that are true is an important parameter. For discrete test statistics, the P values come from a discrete distribution with finite support and the null distribution may depend on an ancillary statistic such as a table margin that varies among the test statistics. Methods for estimating π0 developed for continuous test statistics, which depend on a uniform or identical null distribution of P values, may not perform well when applied to discrete testing problems. RESULTS: This article introduces a number of π0 estimators, the regression and 'T' methods that perform well with discrete test statistics and also assesses how well methods developed for or adapted from continuous tests perform with discrete tests. We demonstrate the usefulness of these estimators in the analysis of high-throughput biological RNA-seq and single-nucleotide polymorphism data. AVAILABILITY AND IMPLEMENTATION: implemented in R.