Benthic and fish community composition on mesophotic reefs in Grand Cayman.

Mesophotic Coral Ecosystems (MCEs) represent unique ecological habitats that range from 30 to 150 m deep, harbouring phylogenetically distinct species and offering refuge for many taxa during times of environmental stress. Yet owing to inaccessibility of ecosystems at these depths, most MCEs remain unexplored, with quantifications of ecological communities in these habitats lacking across many regions. Here, using open- and closed-circuit technical diving, we quantified benthic and fish community composition at four mesophotic reef sites (45 m depth) in Grand Cayman. We show significant differences in benthic community composition over a small spatial scale driven by disparate coverage of sponges, crustose coralline algae, and sand/rubble, yet consistent patterns of macroalgal dominance representing >50% coverage at each site and low hard coral cover at an average of 2.4%. Reef fish species richness, biomass, and density was consistent across sites, however the relative contribution of individual species to community composition differed significantly. Macrocarnivores were found to be the dominant contributors to biomass, with invertivores the most speciose, and omnivores and planktivores at the highest densities, consistent with previous descriptions of mesophotic fish assemblages in other regions. Similarly, the low hard coral cover and high macroalgae and sponge cover of the benthic communities also appear ecologically similar to several described mesophotic reefs yet is not uniform across the Caribbean. The ecological organisation of Grand Cayman's MCEs may result from a variety of factors such as isolation from other major land masses, geology, local geography, and anthropogenic activity at both the local and global scale and highlight the importance of continued exploration and documentation of MCE communities.

Epidemiology of Salmonella enterica subspecies enterica serotypes, isolated from imported, farmed and feral poultry in the Cayman Islands.

Non-typhoidal Salmonellae (NTS) are common foodborne pathogens throughout the world causing acute gastroenteritis. Compared to North America and Europe, there is little information on NTS in the Caribbean. Here we investigated the prevalence and characteristics of NTS present in the local poultry of the Cayman Islands to determine the public health risk. In total, we collected 156 samples. These were made up of boot swabs of 31 broiler farms and 31 layer farms (62 samples), paper bedding from 45 imported chick boxes, and 49 pooled cecum samples from feral chickens, each sample representing 10 individual chickens. Salmonella was isolated using the ISO 6579 protocol and isolates were characterized using Whole Genome Sequencing (WGS) analysis. Eighteen Salmonella isolates were obtained and comprised six S. enterica subspecies enterica serotypes and one subspecies houtenae serotype. Serotypes were: S. Kentucky (n = 9), S. Saintpaul (n = 5), S. Javiana (n = 1), S. Senftenberg (n = 1), S. Poona (n = 1) and S. Agona (n = 1). S. Kentucky strains were all ST152 and clonally related to poultry strains from the United states. S. Saintpaul ST50 strains showed clonality to North American strains. Over half of the strains (n = 11) contained resistance genes to at least two antibiotic groups and five strains were MDR, mainly those from imported day-old chicks. The blaCMY-2 gene was found in S. Kentucky from day-old chicks. Strains from feral poultry had no acquired AMR genes. While serotypes from feral poultry have been identified in human infections, they pose minimal risk due to their low virulence.

Prostate cancer screening by prostate-specific antigen (PSA); a relevant approach for the small population of the Cayman Islands.

INTRODUCTION: The common tool for diagnosing prostate cancer is prostate-specific antigen (PSA), but the high sensitivity and low specificity of PSA testing are the problems in clinical practice. There are no proper guidelines to investigate the suspected prostate cancer in the Cayman Islands. We correlated PSA levels with the incidence of prostate cancers by tissue diagnosis and proposed logical protocol for prostate screening by using PSA test in this small population. MATERIALS AND METHODS: A total of 165 Afro Caribbean individuals who had prostate biopsy done after the investigations for PSA levels from year 2005 to 2015 were studied retrospectively. The patients were divided into subgroups by baseline PSA levels as follows: <4, 4.1-10, 10.1-20, 20.1-50, 50.1-100, and >100 ng/mL and were correlated to the age and presence of cancer. RESULTS AND DISCUSSION: Benign lesions had lower PSA levels compared to cancer which generally had higher values. Only three cases that had less than 4 ng/mg were turned out to be malignant. When PSA value was more than 100 ng/mL, all the cases were malignant. Between PSA values of 4-100 ng/mL, the probability of cancer diagnosis was 56.71% (76 cancers out of 134 in this range). Limitation of PSA testing has the risk of over diagnosis and the resultant negative biopsies owing to poor specificity. Whereas the cutoff limit for cancer diagnosis still remains 4 ng/mL from our study, most of the patients can be assured of benign lesion below this level and thus morbidity associated with the biopsy can be prevented. When the PSA value is greater than 100 ng, biopsy procedure was mandatory as there were 100% cancers above this level. On the background of vast literature linking PSA to prostate cancer and its difficulty in implementing in clinical practice, we studied literature of this conflicting and complex topic and tried to bring relevant protocols to the small population of Cayman Islands for the screening of prostate cancer. In this study, a total of 165 Afro Caribbean individuals who had prostate biopsy done after the investigations for PSA levels from year 2005 to 2015 were studied retrospectively. As a result of this research work, it can be concluded that a benign diagnosis can be given with a fair certainty when the PSA was below 4 ng/mL and a level of 100 ng/mL can be very unfavorable for the patients. This study helped to solidify the cancer screening protocols in Cayman Islands. CONCLUSION: The PSA level can reassure and educate the patients towards the diagnosis of cancer of prostate in Cayman Islands. Benign diagnosis can be given with a fair certainty when the PSA was below 4 ng/mL and a level of 100 ng/mL can be very unfavorable for the patients. This study helped to solidify the cancer screening protocols in Cayman.

Cayman Islands: cervical cancer increases.

A recent study of the incidence of cervical cancer in the Cayman Islands found that there had been a dramatic increase in the rate from 19.2/100,000 women during the first year of the 6 years studied to 62.6/100,000 women during the last year of the study. Well over 50% of the cases (58.6%) were women under the age of 40 years. 75% of the cases (75.9%) did not have a Pap smear within 5 years of the diagnosis. The mean annual age-adjusted incidence of cervical cancer during the study period was 42.7/100,000 women over 20 years of age, which is the highest reported incidence in the Caribbean. Further details of the study can be obtained from Dr. P. Maoris, George Twon Hospital, PO Box 915, Grand Cayman, Cayman Islands; phone: 0135 949 0190; e-mail: maourisp@cand.ky

Education Law, 1983 (No. 35 of 1983) of 22 December 1983.

PIP: Among other things, this Act provides that education is compulsory in the Cayman Islands for all children above the age of 4 years 9 months and below the age of 16 and that all children who possess Caymanian Status are to be admitted free, i.e., no payment of any tuition fees. It also specifies that parents have a duty to have their children of school age attend school and to register their children before they attain school age.^ieng

Migration transition in small Northern and Eastern Caribbean states.

PIP: 1 area of intra-Caribbean migration that has been overlooked is the "migration transition"--the transformation of rapidly modernizing societies from net labor exporters to net labor importers. This article assembles 8 case studies to 1) briefly present a spectrum of migration experiences in the Caribbean, 2) uncover some transitions under way, 3) pinpoint the forces that underlie the migration transition, and 4) point out some of the more important policy implications of labor migration reversals. The 8 island societies sampled for illustration purposes include 1) the Bahamas and the US Virgin Islands as post-migration transition societies (Zelinsky's advanced society), 2) the British Virgin Islands and the Cayman Islands as undergoing transition (Zelinsky's late transitional society), and 3) Anguilla, St. Kitts-Nevis, Turks and Caicos, and Montserrat as premigration transition societies (Zelinsky's early transitional society). Population data for the islands were derived primarily from the West Indian censuses and government statistics. These 8 historical sketches reveal certain commonalities. All are at various stages in a long-term economic restructuring to displace traditional staple crops with more income elastic, high value export services. In such societies, population growth and progress along the migration transition is an increasing function of this kind of successful export substitution. In addition, along the migration and economic transitions, such insular economies exhibit a relatively large public sector (20-30% of all activity), declining unemployment, increasing fiscal autonomy, and are committed to a development strategy remarkably similar to the "successful" model of the Bahamas and the US Virgin Islands. Cursory evidence suggests that, because of intersectoral competition for land and labor, there is an inverse relationship between farm effort/manufacturing employment and tourism intensity. This review suggests that small islands undergoing rapid growth imperatives also experience a similar set of self-reinforcing socioeconomic and environmental imbalances. Particularly for post-transition and transition societies, these spillovers include increasing real estate speculation and inflation because of tourism and the allied development of retirement colonies of affluent North Americans, wage pressures and skilled manpower shortages, and increasing vulnerability to international business cycles.^ieng

Penal Code (Amendment) (No. 2) Law, 1987 (No. 26 of 1987), 30 December 1987.

This Law raises to sixteen the age at which consent is no defense in prosecutions for unlawful and indecent assault upon a woman. It also raises to sixteen the age below which having sex with a woman is an offense and removes from this offense the defense of consent.

Matrimonial Causes Rules, 1986, 30 January 1987.

These Rules are made under Section 4 of the Matrimonial Causes Law, 1976 and contain provisions on applications for leave to present a petition for divorce, documents to accompany the petition, information to be contained in the petition, service of the petition, pleadings subsequent to the petition, directions for trial, security for costs, decrees, and enforcement of orders, among other things. The Rules also stipulate that when "it appears that there is a child of the marriage under the age of sixteen, the record shall show specifically that the question of provision for such child has been considered and dealt with by the Court."

Attaining higher coverage: obstacles to overcome. English-speaking Caribbean and Suriname.

PIP: In 1983, 8 (42%) of the 19 English-speaking Caribbean countries (including Suriname) achieved at least 50% coverage with 3 doses of diphtheria-pertussis-tetanus (DPT) vaccine among children under 1 year of age and 6 countries (32%) had at least 50% coverage with 3 doses of trivalent oral polio vaccine (TOPV). In addition, 10 countries (53%) achieved over 75% DPT coverage and 11 (58%) achieved over 75% TOPV coverage. Despite this record of progress, several factors continue to impede further gains in immunization coverage. Of particular concern is the high dropout rate. As many as 25% of infants receive their 1st dose of DPT and TOPV but do not return to complete their course of immunization. There is also a need for each health center to estimate its annual target population for immunization every year through analysis of the total live births from the previous year in the health center's catchment area (minus infant mortality). Monthly target figures can thus be computed and coverage monitored. A further problem has been a reluctance on the part of some health workers to administer vaccines simultaneously. This does not reduce effectiveness or increase the risk of complications, and reduces the number of visits needed to complete the immunization schedule. An unresolved question is whether to immunize ill or malnourished children. Decisions on this matter should take into account the availability and accessibility of health care services, the ability to follow-up children who are not immunized, and the likelihood that children will return for subsequent immunizations. Finally, a number of immunizations performed by private practitioners and institutions are not reported. Both public and private health care providers should agree on a standardized reporting format to allow better estimation of coverage.^ieng