Diabetes self-management and social support during the COVID-19 pandemic: Perspectives of older adults living in Barbados.

Purpose: Diabetes mellitus (diabetes) is a major health concern in Barbados. In 2013, the reported prevalence (18.7%) was double global levels, with diabetes accounting for 10.4% of total deaths in 2016. Barbados has a rapidly aging population and older adults living with diabetes are more at risk of developing complications. Poorly managed diabetes represents a high burden for individuals and society due to direct healthcare costs for treatment, and to indirect costs due to loss of productivity from disability and premature mortality. Good diabetes self-management promotes glycemic control. Self-management is enhanced by social support and challenged by external shocks. This study explored the role of social support in diabetes self-management among older people in Barbados during the COVID-19 pandemic. Methods: Qualitative secondary thematic analysis of semi-structured individual telephone interviews with adults aged 65-84 years living with diabetes in Barbados during a partial COVID-19 lockdown period. Sampling was purposive, aided by gatekeepers who provide services to elderly people. Verbatim interview transcripts coded using an inductive method were subjected to thematic analysis by three qualitative researchers using NVIVO software. Results: Four organising themes: "Balance", "Social Capital", "Resilience", and "Adaptations to COVID-19", informed the global theme "Adaptive Diabetes Self-Management Response", which captures resilience mechanisms of older adults who balanced facilitators including self-reliance and religious faith, and barriers such as perceived ageist discrimination in workplace policies designed to reduce COVID-19 exposure. Accordingly, elderly Barbadians living with diabetes were resilient, selectively incorporating available social support mechanisms to maintain self-management and overall well-being during the COVID-19 pandemic. Conclusion: The emergent evidence for resilience among older persons in this setting is important for informing health system interventions to improve quality of life for PLWD. The views of the elderly should be explicitly considered in policies designed to enhance the self-management of chronic health conditions.

Challenges and Opportunities for Risk Management of Volcanic Hazards in Small-Island Developing States

The explosive volcanic eruptions of La Soufrière volcano, St Vincent and the Grenadines, in April 2021 caused the displacement of thousands of people, resulting in heavy disruption of livelihoods and economic activities, destruction of critical infrastructure, and volcanic ash deposits that affected the entire mountainous island of St Vincent and the neighboring island of Barbados. The resulting triple crisis in the region included volcanological risks, the prevailing COVID-19 pandemic, and hydrometeorological risks due to the approaching hurricane season. This article analyzes the scientific and operational activities that The University of the West Indies Seismic Research Centre undertook after effusive activity was detected in December 2020, as well as the actions taken during an official response mission of the United Nations, led by the Joint Environment Unit of the United Nations Environment Programme and the United Nations Office for the Coordination of Humanitarian Affairs in Geneva and upon request for international environmental assistance from the Government of St Vincent. It examines the interplay and collaboration between these 2 organizations and other disaster risk reduction agencies. The article also highlights how the interconnected, systemic nature of risks and disasters emphasizes the ultimate need for regional coordination and collaboration across sectors, including scientific monitoring networks, national, regional, and international emergency preparedness and response agencies, academia, and the private sector. The presented case study for elucidating the ongoing lahar hazard at La Soufrière volcano supports a long-term view for planning and mitigation in this challenging topography. This will help to ensure that the volcanic risks in the Caribbean region are appropriately considered a major component of the multihazard approach undertaken by national authorities and scientists to manage community safety and sustainable economic development through adequate means of disaster risk reduction and emergency preparedness.

Observing Caribbean Elections During the Pandemic: Challenges and Best Practices

This paper examines how the practice of international election observation in the Commonwealth Caribbean was affected by the COVID-19 pandemic. Many countries were faced with the decision on whether to conduct or delay elections during the pandemic. Between March 2020 and June 2022, 10 out of 12 Commonwealth Caribbean countries held elections. All these countries, except for Barbados, have had their elections observed by at least one regional or international organization during the last two decades. The closure of borders and the various quarantine requirements had practical implications for maintaining this trend during the pandemic. Most countries that regularly invite international observers did not have their pandemic held elections observed. This paper considers the reasons for the absence of observers in some elections and explores the adjustments observer groups have had to make during the last two years. The discussion also explores how Caribbean countries were able to indicate their commitment to holding free and fair elections in the absence of observers. For the countries that had observers, the discussion examines how these missions navigated issues of cost, shorter invitation periods, challenges in international travel, the recruitment of suitable observers and local pandemic protocols and conditions. (English) [ FROM AUTHOR]

A Bibliometric Analysis of COVID-19 Scientific Literature From the English-Speaking Caribbean.

The COVID-19 pandemic has led to a global crisis and has affected the Caribbean islands, leading to significant health and socioeconomic consequences in this region. Efforts to mitigate the burden of this disease have led to an accelerated amount of research in the English-speaking Caribbean (ESC). This bibliometric analysis aimed to evaluate the COVID-19-related scientific literature from the ESC nations. A total of 175 articles were included and analyzed from an initial PubMed search (n = 638) for COVID-19-related scientific literature from the ESC nations published between January 1, 2020, and June 30, 2022. Microsoft Excel 2016 (Microsoft Corporation, Redmond, Washington) and the VOSviewer (version 1.6.18) were used to characterize countries, authorship, journals, affiliations, and keywords of the COVID-19-related articles. Trinidad and Tobago (38%), Jamaica (22%), Barbados (20%), and Grenada (15%) contributed to the greatest number of publications. The University of the West Indies (UWI) campuses in Trinidad and Tobago, Jamaica and Barbados, and St. George's University in Grenada were the most prolific institutions. Srikanth Umakanthan from the UWI was the most prolific author. Cureus, SN Comprehensive Clinical Medicine, and Frontiers in Public Health were the first three most productive journals; 59% of the 175 articles had either the first or last author affiliated with an institution in the ESC, and 19% of the articles were country-focused: Trinidad and Tobago (16/175), Jamaica (9/175), Barbados (5/175), and Antigua and Barbuda (2/175). Among the top themes of research, 27% were outbreak response and rearrangements, epidemiological studies (23%), clinical management (23%), and medical education (13%). Over the last two years, an interest stimulated by the pandemic has expanded the research in ESC countries. However, gaps in the knowledge exist, especially in the epidemiology of COVID-19 complications in the sub-populations of chronic non-communicable diseases, post-COVID syndrome, and the long-COVID syndrome in the region. Hence, there is enormous scope for more research across the region.

Personal protective equipment (PPE) related adverse skin reactions among healthcare workers at the main COVID-19 isolation center in Barbados.

Background: The use of personal protective equipment (PPE) reduces the risk of transmission of infectious agents significantly among healthcare workers (HCWs). The study aimed to investigate the prevalence and characteristics of PPE-related adverse skin reactions among HCWs working at the main COVID-19 isolation center in Barbados. Methods: A cross-sectional web-based online survey was conducted during April to June 2021 which recorded demographic information, details of PPE use and adverse skin reactions including severity and duration of onset of symptoms. Results: Most of the respondents used PPE for consecutive days (77.9%), 1-6 h/day (59.2%), and more than a year (62.5%). Fewer than half of the participants (45.6%) experienced adverse skin reactions from the use of PPE. The reactions were mostly observed in the cheeks (40.4%) and nose bridges (35.6%). Females had more reactions than their male counterparts (p = 0.003). The use of N95 masks and a combination of surgical and N95 masks produced adverse effects predominantly in the ears (60%) and cheeks (56.4%). Binary logistic regression showed that female HCWs (OR = 5.720 95% CI: 1.631, 20.063), doctors (OR = 5.215 95% CI: 0.877, 31.002), and longer duration of PPE use (>1 year) (OR = 2.902 95% CI: 0.958, 8.787) caused a significantly higher prevalence of adverse skin reactions. Conclusion: The PPE-related skin reactions were common among HCWs which mainly occurred due to prolonged use. Preventive measures inclusive of appropriate training of HCWs on the use of PPE are recommended to minimize these adverse events.

The impact of Covid-19 on education equity: A view from Barbados and Jamaica.

The outbreak of Covid-19 worldwide has presented an unprecedented challenge for the equity-in-education agenda, especially in developing countries of the Global South (e.g., the English-speaking Caribbean). This article examines the impact school closures have had in Jamaica and Barbados, and highlights the emerging disparities the global pandemic has had on education. The central organizing questions are as follows: Who was affected by school closures in Barbados and Jamaica? How did the Ministries of Education (MOEs) support curriculum and instruction during the pandemic? What challenges does Covid-19 present for MOEs? What are the implications for education after Covid-19? School closure data suggest a gender disparity, with more males than females out of school due to Covid-19 from preprimary to secondary school in Barbados and Jamaica. MOEs in the region responded to school closures primarily by increasing access to technology to facilitate remote learning. Some of the challenges with continuing education for students during Covid-19 were due to a lack of infrastructure and amenities to support remote learning. Implications for education post-Covid-19 are considered.

Caribbean Children and the COVID-19 pandemic: A call for data-driven planning

Objective: There are few published reports concerning the impact of the COVID-19 pandemic on children in the Caribbean. The specific impacts of COVID-19 on Caribbean children aged 0-19 are examined. Method(s): Using standardized online questionnaire , primary data and published reports the burden of COVID-19 among children is evaluated. Result(s): Most islands have pediatric specialists, but few have designated pediatric hospitals. The higher number of cases among children is notable in islands with large populations such as Cuba, Jamaica, Trinidad, the Dominican Republic, and Haiti. The proportion of children among all cases in these islands range from 0.6%- 16.9% compared with a global case rate of 20.2%. As of August 2021, there were 33 cumulative deaths among children in Haiti, Jamaica, in Trinidad and Barbados. The case fatality rates (CFR) for 0-9-year-old and 10-19-year-old were 2.8 and 0.7 for Haiti, 0.1 and 0.2 for Jamaica, and 0 and 0.14 for Trinidad compared with and globally. Higher CFRs in Haiti may be related to the testing strategy, which may not identify all cases. However, low socioeconomic status and a poor healthcare system may have had an impact. Conclusion(s): Overall COVID-19 prevalence and mortality in children were consistent with global estimates. A standardized regional assessment and the multidimensional impact of the COVID-19 pandemic among children warrants further examination in light of limited resources and the potential lifelong impact of secondary effects.

Sounds of Vacation: Political Economies of Caribbean Tourism

Issues of sensory pleasure and entertainment, emotional economy, corporate and commercial hospitality, curating of sounds, and the staging of bodies have all been the focus of multiple studies that demonstrate how each aspect is meticulously constructed, produced, and managed to provide paying clients with what they expect-or rather, have been directed to expect. [...]even as Susan Harewood critiques "Eurocentric knowledge" and constructions of "Little England" in Barbados, she describes the decisions of renowned Barbados musician Richard Layne to perform a repertoire of reggae covers by UB40, the celebrated band from Birmingham, England, whose connections to the Caribbean were through their English and European city life as a hub of migration. Through the focus on labor and economy in these all-inclusive hotels, the authors offer some excellent starting points for further studies.

Influence of Harvest Time on the Chemical Profile of Pereskia aculeate Mill. Using Paper Spray Mass Spectrometry.

This study evaluated the physicochemical characteristics and the production of bioactive compounds of Pereskia aculeata Mill. at different harvest times. Here, we performed a qualitative evaluation of the chemical profile by paper spray mass spectrometry (PSMS), the phenolic acid and flavonoid profile by high-performance liquid chromatography (HPLC), antioxidant activity, total carotenoids, total phenolic compounds, total flavonoids, total anthocyanins, color characteristics, total soluble solids (TSS), total solids (TS), pH, and total titratable acidity (TTA). The chemical profile was not affected, with the exception of 4,5-dimethyl-2,6-octadiene and azelaic acid, which was only identified in the leaves harvested during the winter. The content of four phenolic acids and three flavonoids were analyzed; out of these, no significant amounts of ellagic acid and quercetin were detected. There was no difference in production of bioactive compounds between seasons, reflecting the antioxidant activity, which also did not differ. Brightness, chroma, and leaf pH were the only physicochemical characteristics that did not vary between seasons.

How should small island developing states approach long-term sustainable development solutions? A thematic literature review

Purpose>This review article aims to outline the challenges that small island developing states (SIDS) face in developing long-term sustainability with particular reference to the implications for policymakers and tourism stakeholders who have to operate with limited resources.Design/methodology/approach>The study sought to determine how SIDS should develop and implement policies and plans for sustainable tourism through a thematic review of the literature. The data were gathered from previous studies that examined how SIDS should accomplish this.Findings>The findings indicate that the best approach for long-term sustainable tourism requires the development of a system for effective monitoring and policies that are implemented promptly through good governance. Developing sustainable tourism through quantifiable indicators has become critical given the growing need to understand the potential impacts of tourism development on destinations. This review also reveals that long-term sustainability of cultural resources can be achieved by compiling an inventory of existing tangible resources and involving stakeholders during the development phase to increase their attention and awareness of the critical nature of resource conservation.Originality/value>This review determines how SIDS should develop and implement policies and plan for sustainable tourism and how to mitigate the challenges associated with unsustainable conditions.

Bookshelf 2021

Covid-19 has continued to affect book reviewing this year, as reviewers whom we had to remind wrote us back saying everything from "I'm stuck in Dakar" or "I crushed my right index finger in an anchor mishap two months ago [and] ... typing was problematic for a number of weeks" to "in the midst of the pandemic I fell and broke my leg in two places," not to mention people's frequent child-care/remote learning challenges (for some books, we had to identify and ask as many as nine potential reviewers before one agreed) or the difficulties of getting books from publishers to reviewers in pandemic-bombed Brazil. Rowman & Littlefield Publishers, 2020, cloth US$ 79.00) Celia Sánchez Manduley: The Life andLegacy of a Cuban Revolutionary, by Tiffany A. Sippial (Chapel Hill: University of North Carolina Press, 2020, paper US$29.95) Staging Discomfort: Performance and Queerness in Contemporary Cuba, by Bretton White (Gainesville: University Press of Florida, 2020, cloth US$ 85.00) The World That Fear Made: Slave Revolts and Conspiracy Scares in Early America, by Jason T. Sharples (Philadelphia: University of Pennsylvania Press, 2020, cloth US$ 45.00) Afrocubanas: History, Thought, and Cultural Practices, edited by Devyn Spence Benson & Daisy Rubiera Castillo (Lanham MD: Monster in the Middle (New York: Riverhead Books [Penguin/Random House], 2021, cloth US$27.00), is the second novel by Virgin Islands-born Tiphanie Yanique-in "Bookshelf 2014," we called her first one, the multiple prize-winning Land of Love and Drowning, "a gem," and this one is as well. In the fictional town of Pleasantview, we meet Syrian shopkeepers, Muslimeen converts, Pentecostal churchgoers, street gang members, Hindus with roadside fruit and vegetable stands, sex workers trafficked from Venezuela and Colombia, lawyers, politicians, and police, as well as myriads of Black women, but the focus, always, is on family relations-misogyny, poverty, violence, and the allure and perils of migration (to New York, Barbados ...)

NEHA SECOND VICE-PRESIDENTIAL CANDIDATE PROFILES

In 2001, she began her Environmental Health journey as an Environmental Health Specialist (EHS) with Contra Costa County, Health Services Department, Environmental Health Services in California. Additionally, she is a U.S. Food and Drug Administrations (FDA), Office of Training, Education and Development Food Safety Subject Matter Expert and Temporary Food Establishments Course Trainer. A place where a practitioner in Oregon can seek advice on an EH issue and get advice from practitioners across the country or globe. Because despite geography EH issues and solutions are universal. * I believe that a mentoring program for our emerging members and students is key to the advancement of our profession.

Perceived COVID-19 Vaccine Pressure in the Caribbean: Exploring a New Stressor-Strain Phenomenon in the Pandemic.

This research introduced the new construct of 'perceived COVID-19 vaccine pressure' (i.e., the psychological strain associated with societal demands on vaccine taking) and examined the initial psychometric properties of a newly proposed measure. The study surveyed 411 Barbadian respondents to examine their level of perceived COVID-19 vaccine pressure using an online survey modality. The results revealed strong and robust psychometric properties for the scale and its unidimensionality. Younger and employed respondents as well as those working in the tourism and hospitality and government (public) sectors experienced the greatest internalised vaccine pressure relative to other respondent groups. Only initial/preliminary evidence of the scale's validity and reliability was revealed by this cross-sectional study. A follow-up study (using CFA on a new sample) is needed to provide stronger evidence for its validity and reliability. Understanding the dynamics of perceived or internalised vaccine pressure might help explain the positive or negative effects of societal pressure and its implications for vaccine hesitancy and other vaccine-related attitudes and behaviours. The study is the first to conceptually discuss and empirically examine the mental health strain occasioned by societal demands placed on individuals to take a COVID-19 vaccine.

COVID-19 Vaccine Intent Among Health Care Professionals of Queen Elizabeth Hospital, Barbados.

INTRODUCTION: Due to increased exposure risk and the potential impact of COVID-19 infection, health care professionals (HCP) are a target group for COVID-19 vaccination. This study aimed to examine the acceptability of COVID-19 vaccines among HCP at the Queen Elizabeth Hospital, Barbados. DESIGN AND METHODS: A cross-sectional survey of HCP was conducted between February 14 and 27, 2021 using an online questionnaire. The questionnaire included demographic information, knowledge of novel coronavirus, intention to accept the COVID-19 vaccination, vaccine literacy (VL), and perceptions and attitudes regarding COVID-19 vaccines. Mean VL scores were calculated. The relationship between socio-demographic variables and vaccine intent was assessed using a multivariable logistic regression model. RESULTS: Of 343 HCPs, 55.1% indicated they would accept the COVID-19 vaccine if it were available; 44.9% expressed hesitancy towards the COVID-19 vaccine. We assessed the impact of socio-demographic factors and previous vaccine behavior on vaccine intent; after adjustment of the multivariable logistic regression model, non-Barbadian nationality and previous flu vaccine uptake were statistically significant predictors of reported intent to take the COVID-19 vaccine. Persons who indicated that they would take the vaccine had a higher mean vaccine literacy score [3.46 95% CI (3.40, 3.52)] than those who were not ready to take the vaccine immediately [3.23 95% CI (3.15, 3.30)]. VL scores were higher among the 29.5% of HCPs who believed vaccines should be mandatory. CONCLUSION: This study highlighted vaccine hesitancy among HCPs in the sole public tertiary hospital of Barbados. As HCP perceptions may help or hinder the campaign to promote vaccine uptake in Barbados, vaccine promotion programs targeting HCPs are needed to ensure the success of the country's COVID-19 vaccination drive.

Forecasting Covid-19 New Cases in Barbados

The crisis of COVID-19 is growing and has devastating implications for many countries around the world. In this research article, the ANN technique was applied to analyze daily COVID-19 cases based on new cases of COVID-19 in Barbados for the period 1 January 2020 – 25 March 2021. The out-of-sample forecast covers the period 26 March 2021 – 31 July 2021. The residuals and forecast evaluation criteria (Error, MSE and MAE) of the employed model suggest that the model is stable in forecasting COVID-19 cases in Barbados. The results of the study imply that that daily COVID-19 cases in Barbados are likely to remain relatively low over the out-of-sample period. The government should continue to implement strong control and preventive measures in order to save lives despite the projected relatively low COVID-19 case volumes.

Use of an Adaptive e-Learning Platform as a Formative Assessment Tool in the Cardiovascular System Course Component of an MBBS Programme.

BACKGROUND: Technology-enhanced learning includes the adaptive e-learning platform, a data-driven method with computer algorithms, providing customised learning enhancing critical thinking of individual learners. "Firecracker" - an online adaptive e-learning platform, and assessment software, promotes critical thinking, helps prepare students for courses and high-stakes examinations, and evaluates progress relative to co-learners. The objectives of this study were to determine the usage rates of Firecracker, examine the performance of Firecracker formative quizzes, identify the correlation between Firecracker use and performance with that of performance at summative course assessments, and assess students' satisfaction with Firecracker usage. METHODS: Study participants were Year-2 MBBS (Bachelor of Medicine, Bachelor of Surgery) students (n=91) of the Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Barbados. The Firecracker Administrator uploaded quizzes covering basic science content in the Cardiovascular System course. Access, usage, and performance on Firecracker formative quizzes were retrieved from the Firecracker dashboard. A questionnaire sought the views of study participants. RESULTS: Seven sets of quizzes were administered over nine weeks, with weekly student completion rates ranging from 53% to 73%. Mean quiz scores ranged from 52% to 72%. Students completing >4 quiz sessions compared to those completing ≤4 demonstrated significantly better performance in Firecracker quizzes (P<0.01), final examinations (P<0.01) and in-course assessment plus final examination (P<0.05) scores. Correlations between overall Firecracker performance and in-course assessment marks (P<0.05); between total overall Firecracker performance and final examination (P<0.01); and overall Firecracker performance and total course marks (P<0.01) were all significant. Most students (70%) were happy using Firecracker and felt it complemented coursework (78%) and prepared them for course exams (58%) (P<0.01). CONCLUSION: Overall, Firecracker was perceived very positively and welcomed by the students. Students were satisfied with the Firecracker as a formative assessment tool, and its use correlated with improved performance in the course examinations.

Dengue Fever and Severe Dengue in Barbados, 2008-2016.

Analysis of the temporal, seasonal and demographic distribution of dengue virus (DENV) infections in Barbados was conducted using national surveillance data from a total of 3994 confirmed dengue cases. Diagnosis was confirmed either by DENV-specific real time reverse transcriptase polymerase chain reaction (rRT-PCR), or non-structural protein 1 (NS1) antigen or enzyme linked immunosorbent assay (ELISA) tests; a case fatality rate of 0.4% (10/3994) was observed. The prevalence rate of dengue fever (DF) varied from 27.5 to 453.9 cases per 100,000 population among febrile patients who sought medical attention annually. DF cases occurred throughout the year with low level of transmission observed during the dry season (December to June), then increased transmission during rainy season (July to November) peaking in October. Three major dengue epidemics occurred in Barbados during 2010, 2013 and possibly 2016 with an emerging three-year interval. DF prevalence rate among febrile patients who sought medical attention overall was highest among the 10-19 years old age group. The highest DF hospitalisation prevalence rate was observed in 2013. Multiple serotypes circulated during the study period and Dengue virus serotype 2 (DENV-2) was the most prevalent serotype during 2010, whilst DENV-1 was the most prevalent serotype in 2013. Two DENV-1 strains from the 2013 DENV epidemic were genetically more closely related to South East Asian strains, than Caribbean or South American strains, and represent the first ever sequencing of DENV strains in Barbados. However, the small sample size (n = 2) limits any meaningful conclusions. DF prevalence rates were not significantly different between females and males. Public health planning should consider DENV inter-epidemic periodicity, the current COVID-19 pandemic and similar clinical symptomology between DF and COVID-19. The implementation of routine sequencing of DENV strains to obtain critical data can aid in battling DENV epidemics in Barbados.