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1.
Nutrients ; 12(11)2020 Oct 30.
Article in English | MEDLINE | ID: mdl-33143309

ABSTRACT

Small Island Developing States (SIDS) have high and increasing rates of diet-related diseases. This situation is associated with a loss of food sovereignty and an increasing reliance on nutritionally poor food imports. A policy goal, therefore, is to improve local diets through improved local production of nutritious foods. Our aim in this study was to develop methods and collect preliminary data on the relationships between where people source their food, their socio-demographic characteristics and dietary quality in Fiji and Saint Vincent and the Grenadines (SVG) in order to inform further work towards this policy goal. We developed a toolkit of methods to collect individual-level data, including measures of dietary intake, food sources, socio-demographic and health indicators. Individuals aged ≥15 years were eligible to participate. From purposively sampled urban and rural areas, we recruited 186 individuals from 95 households in Fiji, and 147 individuals from 86 households in SVG. Descriptive statistics and multiple linear regression were used to investigate associations. The mean dietary diversity score, out of 10, was 3.7 (SD1.4) in Fiji and 3.8 (SD1.5) in SVG. In both settings, purchasing was the most common way of sourcing food. However, 68% (Fiji) and 45% (SVG) of participants regularly (>weekly) consumed their own produce, and 5% (Fiji) and 33% (SVG) regularly consumed borrowed/exchanged/bartered food. In regression models, independent positive associations with dietary diversity (DD) were: borrowing/exchanging/bartering food (ß = 0.73 (0.21, 1.25)); age (0.01 (0.00, 0.03)); and greater than primary education (0.44 (0.06, 0.82)). DD was negatively associated with small shop purchasing (-0.52 (95% CIs -0.91, -0.12)) and rural residence (-0.46 (-0.92, 0.00)). The findings highlight associations between dietary diversity and food sources and indicate avenues for further research to inform policy actions aimed at improving local food production and diet.

2.
Article in English | MEDLINE | ID: mdl-32742667

ABSTRACT

Background: Mental disorders are the leading cause of years lived with disability worldwide. While over three-quarters of people with mental disorders live in low- and middle-income countries (LMICs) and effective low-cost interventions are available, resource commitments are extremely limited. This paper seeks to understand the role of philanthropy in this area and to inform discussions about how to increase investments. Methods: Novel analyses of a dataset on development assistance for health were conducted to study philanthropic development assistance for mental health (DAMH) in 156 countries between 2000 and 2015. Results: Philanthropic contributions more than doubled over 16 years, accounting for one-third (US$364.1 million) of total DAMH 2000-2015. However, across health conditions, mental disorders received the lowest amount of philanthropic development assistance for health (0.5%). Thirty-seven of 156 LMICs received no philanthropic DAMH between 2000 and 2015 and just three LMICs (Antigua and Barbuda, Grenada, Saint Vincent and the Grenadines) received more than US$1 philanthropic DAMH per capita over the entire period. Eighty-one percent of philanthropic DAMH was disbursed to unspecified locations. Conclusions: Philanthropic donors are potentially playing a critical role in DAMH, and the paper identifies challenges and opportunities for increasing their impact in sustainable financing for mental health.

3.
Rev Panam Salud Publica ; 44: e71, 2020.
Article in Spanish | MEDLINE | ID: mdl-32684915

ABSTRACT

Objective: To determine the time pattern of adolescent fertility rates (AFRs) in the countries of the Region of the Americas, categorizing them to evaluate their mobility and differences, and to produce a forecast for 2023. Methods: Ecological and descriptive study of a time series of AFRs in 32 countries, from 1960 to 2019, based on information from the World Bank and the Pan American Health Organization (PAHO). Trends in the AFR were estimated using a linear regression model (Prais-Winsten method). Differences were evaluated between two subperiods (1960-1989 and 1990-2019) and among four categories of the AFR for 2019 by testing related samples and analysis of variance, respectively. The AFR for 2023 was predicted with autoregressive integrated moving average (ARIMA) models. Results: The AFR time series for the sample was non-stationary and the annual average trend was downward (coefficient = -1.173; p < 0.001; R2 adjusted = 0.968), dropping from 124 per 1 000 in 1960 to 56.1 per 1 000 in 2019. The countries with the largest and smallest annual trend were Saint Vincent and the Grenadines (-2.783) and Argentina (0.017). Between subperiods (1960-1989 compared to 1990-2019) there were no statistically significant differences between the AFR in Uruguay and Argentina, but there were significant differences among the four categories of AFR for 2019. The average AFR for the sample should continue declining to 2023, but it could increase in eight countries. Conclusions: The time series is largely non-stationary, with a downward trend to 2023. There has been an uneven decline in AFRs, with significant differences among the four groups of countries categorized by their AFR in 2019. The lowest AFRs correspond to two countries in North America, five in the non-Latin Caribbean, and one in South America. The highest AFRs correspond to countries in the Latin Caribbean and in Central and South America.

4.
Article in Spanish | PAHO-IRIS | ID: phr-52464

ABSTRACT

[RESUMEN]. Objetivo. Conocer la evolución temporal de las tasas de fecundidad en adolescentes (TFA) de los países de la Región de las Américas, categorizándolas para evaluar su movilidad, sus diferencias y generar una predicción para 2023. Métodos. Estudio ecológico y descriptivo de una serie temporal de la TFA de 32 países, de 1960 a 2019, basado en información del Banco Mundial y de la OPS. Se estimaron tendencias de la TFA con un modelo de regresión lineal (método de Prais-Winsten), se evaluaron diferencias entre 2 subperíodos (1960-1989 y 1990-2019) y entre 4 categorías de la TFA de 2019 mediante pruebas de muestras relacionadas y ANOVA, respectivamente, y se hizo una predicción de la TFA para 2023 con modelos ARIMA. Resultados. La serie temporal de la TFA de la muestra fue no estacionaria, la tendencia media anual fue decreciente (coeficiente = -1,173; p < 0,001; R2 ajustada = 0,968) y disminuyó de 124 por 1 000 en 1960 a 56,1 por 1 000 en 2019. Los países con mayor y menor tendencia anual fueron San Vicente y las Granadinas (-2,783) y Argentina (0,017). Entre subperíodos (1960-1989 frente a 1990-2019) no hubo diferencias estadísticamente significativas entre las TFA en Uruguay y Argentina; sí las hubo entre las cuatro categorías de la TFA de 2019. La TFA media muestral mantendría una disminución para 2023, pero en 8 países podría aumentar. Conclusiones. La serie temporal es mayoritariamente no estacionaria, con tendencia decreciente para 2023. Hay disminución desigual de las TFA, con diferencias significativas entre los cuatro grupos de países categorizados con la TFA de 2019. Las menores TFA corresponden a 2 países de Norteamérica, a 5 del Caribe no latino y a 1 sudamericano, y las mayores, a países del Caribe latino y de Centro y Sudamérica.


[ABSTRACT]. Objective. To determine the time pattern of adolescent fertility rates (AFRs) in the countries of the Region of the Americas, categorizing them to evaluate their mobility and differences, and to produce a forecast for 2023. Methods. Ecological and descriptive study of a time series of AFRs in 32 countries, from 1960 to 2019, based on information from the World Bank and the Pan American Health Organization (PAHO). Trends in the AFR were estimated using a linear regression model (Prais-Winsten method). Differences were evaluated between two subperiods (1960-1989 and 1990-2019) and among four categories of the AFR for 2019 by testing related samples and analysis of variance, respectively. The AFR for 2023 was predicted with autoregressive integrated moving average (ARIMA) models. Results. The AFR time series for the sample was non-stationary and the annual average trend was downward (coefficient = -1.173; p < 0.001; R2 adjusted = 0.968), dropping from 124 per 1 000 in 1960 to 56.1 per 1 000 in 2019. The countries with the largest and smallest annual trend were Saint Vincent and the Grenadines (-2.783) and Argentina (0.017). Between subperiods (1960-1989 compared to 1990-2019) there were no statistically significant differences between the AFR in Uruguay and Argentina, but there were significant differences among the four categories of AFR for 2019. The average AFR for the sample should continue declining to 2023, but it could increase in eight countries. Conclusions. The time series is largely non-stationary, with a downward trend to 2023. There has been an uneven decline in AFRs, with significant differences among the four groups of countries categorized by their AFR in 2019. The lowest AFRs correspond to two countries in North America, five in the non-Latin Caribbean, and one in South America. The highest AFRs correspond to countries in the Latin Caribbean and in Central and South America.


[RESUMO]. Objetivo. Conhecer a evolução temporal das taxas de fecundidade de adolescentes (TFA) nos países da Região das Américas, classificando-os para avaliar a mobilidade da TFA e as diferenças entre países e gerar uma previsão para 2023. Métodos. Estudo ecológico descritivo de uma série temporal da TFA em 32 países, de 1960 a 2019, com base em informações do Banco Mundial e da OPAS. Estimamos as tendências da TFA com um modelo de regressão linear (método de Prais-Winsten), avaliamos as diferenças entre 2 subperíodos (1960-1989 e 1990-2019) e entre 4 categorias de países com base na TFA de 2019 por testes de amostras relacionadas e ANOVA, respectivamente, e realizamos uma previsão da TFA para 2023 por meio de modelos ARIMA. Resultados. A série temporal da TFA na amostra foi não estacionária; a tendência média anual foi decrescente (coeficiente=-1,173; p<0,001; R2 ajustado=0,968), diminuindo de 124 por 1000 em 1960 para 56,1 por 1000 em 2019. Os países com a maior e menor tendência anual foram São Vicente e Granadinas (-2,783) e Argentina (0,017). Na comparação entre os subperíodos (1960-1989 vs. 1990-2019), não houve diferenças estatisticamente significativas entre a TFA no Uruguai e na Argentina; porém, houve diferenças significativas entre as quatro categorias de países classificados com base na TFA de 2019. A TFA média da amostra deverá manter a tendência de queda até 2023, mas poderá aumentar em 8 países. Conclusões. A série temporal é predominantemente não estacionária, com uma tendência decrescente até 2023. Observa-se uma diminuição desigual na TFA, com diferenças significativas entre os quatro grupos de países classificados com base na TFA de 2019. As TFAs mais baixas são observadas em dois países da América do Norte, cinco do Caribe não latino e um da América do Sul, e as mais altas são observadas em países do Caribe latino e da América Central e do Sul.


Subject(s)
Adolescent , Reproductive Health , Family Planning (Public Health) , Latin America , Adolescent , Reproductive Health , Family Planning (Public Health) , Latin America , Reproductive Health , Family Planning (Public Health)
5.
Zookeys ; 926: 95-131, 2020.
Article in English | MEDLINE | ID: mdl-32336922

ABSTRACT

The Lesser Antilles, in the Eastern Caribbean, is inhabited by three Iguana species: the Lesser Antillean iguanaIguana delicatissima, which is endemic to the northernmost islands of the Lesser Antilles, the introduced common iguana from South America, Iguana iguana iguana, represented also by the two newly described endemic subspecies Iguana iguana sanctaluciae from Saint Lucia and Iguana iguana insularis from Saint Vincent and the Grenadines, and Grenada, and the introduced Iguana rhinolopha from Central America. Drawing on both morphological and genetic data, this paper describes the Iguana populations from Saba and Montserrat as a new species, Iguana melanoderma. This species is recognized on the basis of the following combination of characteristics: private microsatellite alleles, unique mitochondrial ND4 haplotypes, a distinctive black spot between the eye and tympanum, a dorsal carpet pattern on juveniles and young adults, a darkening of body coloration with aging (except for the anterior part of the snout), a black dewlap, pink on the jowl, the high number of large tubercular nape scales, fewer than ten medium sized-triangular dewlap spikes, high dorsal spikes, and lack of horns on the snout. This new melanistic taxon is threatened by unsustainable harvesting (including for the pet trade) and both competition and hybridization from escaped or released invasive alien iguanas (I. iguana iguana and I. rhinolopha) from South and Central America, respectively. The authors call for action to conserve Iguana melanoderma in Saba and Montserrat and for further research to investigate its relationship to other melanistic iguanas from the Virgin Islands and coastal islands of Venezuela.

7.
Nutrients ; 12(2)2020 Jan 31.
Article in English | MEDLINE | ID: mdl-32024025

ABSTRACT

Many Small Island Developing States of the Caribbean experience a triple burden of malnutrition with high rates of obesity, undernutrition in children, and iron deficiency anemia in women of reproductive age, driven by an inadequate, unhealthy diet. This study aimed to map the complex dynamic systems driving unhealthy eating and to identify potential points for intervention in three dissimilar countries. Stakeholders from across the food system in Jamaica (n = 16), St. Kitts and Nevis (n = 19), and St. Vincent and the Grenadines (n = 6) engaged with researchers in two group model building (GMB) workshops in 2018. Participants described and mapped the system driving unhealthy eating, identified points of intervention, and created a prioritized list of intervention strategies. Stakeholders were also interviewed before and after the workshops to provide their perspectives on the utility of this approach. Stakeholders described similar underlying systems driving unhealthy eating across the three countries, with a series of dominant feedback loops identified at multiple levels. Participants emphasized the importance of the relative availability and price of unhealthy foods, shifting cultural norms on eating, and aggressive advertising from the food industry as dominant drivers. They saw opportunities for governments to better regulate advertising, disincentivize unhealthy food options, and bolster the local agricultural sector to promote food sovereignty. They also identified the need for better coordinated policy making across multiple sectors at national and regional levels to deliver more integrated approaches to improving nutrition. GMB proved to be an effective tool for engaging a highly diverse group of stakeholders in better collective understanding of a complex problem and potential interventions.


Subject(s)
Child Nutrition Disorders/prevention & control , Nutrition Policy , Policy Making , Systems Analysis , Adolescent , Caribbean Region/epidemiology , Child , Child Nutrition Disorders/epidemiology , Child Nutrition Disorders/etiology , Child, Preschool , Diet/adverse effects , Feeding Behavior , Female , Humans , Jamaica/epidemiology , Male , Saint Kitts and Nevis/epidemiology , Saint Vincent and the Grenadines/epidemiology , Stakeholder Participation , Young Adult
8.
Terminology | DeCS - Descriptors in Health Sciences | ID: 033216

ABSTRACT

A self-governing state of the Windward Islands in the West Indies, comprising Saint Vincent and the northern islets of the Grenadines. Its capital is Kingstown. It is one of the original homes of the Carib Indians supposed to have been sighted by Columbus in 1498. It was in English hands from 1627 till held by the French 1779-83. Saint Vincent subsequently became a British possession and, with other nearby British territories, was administered by the Governor of the Windward Islands till 1959. It attained a measure of independence in 1969 but achieved full independence as Saint Vincent and the Grenadines in 1979. Saint Vincent was the 4th century Spanish martyr on whose feast day Columbus discovered the island. Grenadines is derived from the Spanish kingdom of Granada. (From Webster's New Geographical Dictionary, 1988, p1054 & The Europa World Year Book 1993, p2441)


Estado autónomo de las Islas de Barlovento en las Indias Occidentales, que comprende a San Vicente y las islitas de las Granadinas. Su capital es Kingstown. Es una de las sedes originales de los indios caribes que supuestamente fueron avistados por Colón en 1498. Fue posesión inglesa desde 1627 hasta que pasó a manos francesas desde 1779 hasta 1783. A continuación San Vicente se convirtió en una posesión británica y, junto a otros territorios británicos de las proximidades, fue administrado por el Gobernador de las Islas de Barlovento hasta 1959. Obtuvo cierta independencia en 1969 pero adquirió la plena independencia como San Vicente y las Granadinas en 1979. San Vicente fue un mártir español del siglo 4, en cuyo día de fiesta Colón descubrió la isla. Granadinas se deriva del reino español de Granada.


Estado autônomo das Ilhas de Barlavento nas Índias Ocidentais, incluindo São Vicente e as ilhotas do norte das Granadinas. Sua capital é Kingstown. É um dos lares originais dos Índios Caraíbas que se supõe ter sido avistado por Colombo em 1498. Esteve em poder dos ingleses de 1627 até ser ocupado pelos franceses entre 1779 e 1783. São Vicente tornou-se uma possessão britânica subsequentemente e, com outros territórios britânicos próximos, foi administrado pelo governador das Ilhas de Barlavento até 1959. Atingiu uma média independência em 1969, mas alcançou independência total como São Vicente e Granadinas em 1979. São Vicente foi um mártir espanhol do século IV e foi no dia de sua festa que Colombo descobriu a ilha. O nome Granadinas deriva do Reino Espanhol de Granada.

9.
Am J Med Genet A ; 182(3): 527-531, 2020 03.
Article in English | MEDLINE | ID: mdl-31821705

ABSTRACT

Nephronophthisis-19 (NPHP19) due to truncating mutations in the DCDC2 gene has only been described previously in two patients. We describe a new case in a patient from the island country of Saint Vincent and the Grenadines, in the West Indies. This condition is a renal-hepatic ciliopathy with phenotypic characteristics that include hepatosplenomegaly, hepatic fibrosis with bile cholestasis, increased kidney echogenicity, and end-stage renal disease.Here, we report a 13-year-old African-Caribbean female with areas of absence of heterozygosity suggesting parental consanguinity or identity by decent due to the founder effect, harboring a novel homozygous pathogenic variant (c.383C>G, p.S128*) in exon 3 of DCDC2. Her phenotype is consistent with the other two known cases of NPHP19, however, this patient also presents psychiatric symptoms. These psychiatric findings were not present in the first two documented cases, and we discuss possible etiologies of these symptoms. Our study presents the first patient from the West Indies with NPHP19, and also highlights the need to investigate the frequency of pathogenic variants within at-risk populations.

10.
Rev. panam. salud pública ; 44: e71, 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1127117

ABSTRACT

RESUMEN Objetivo. Conocer la evolución temporal de las tasas de fecundidad en adolescentes (TFA) de los países de la Región de las Américas, categorizándolas para evaluar su movilidad, sus diferencias y generar una predicción para 2023. Métodos. Estudio ecológico y descriptivo de una serie temporal de la TFA de 32 países, de 1960 a 2019, basado en información del Banco Mundial y de la OPS. Se estimaron tendencias de la TFA con un modelo de regresión lineal (método de Prais-Winsten), se evaluaron diferencias entre 2 subperíodos (1960-1989 y 1990-2019) y entre 4 categorías de la TFA de 2019 mediante pruebas de muestras relacionadas y ANOVA, respectivamente, y se hizo una predicción de la TFA para 2023 con modelos ARIMA. Resultados. La serie temporal de la TFA de la muestra fue no estacionaria, la tendencia media anual fue decreciente (coeficiente = -1,173; p < 0,001; R2 ajustada = 0,968) y disminuyó de 124 por 1 000 en 1960 a 56,1 por 1 000 en 2019. Los países con mayor y menor tendencia anual fueron San Vicente y las Granadinas (-2,783) y Argentina (0,017). Entre subperíodos (1960-1989 frente a 1990-2019) no hubo diferencias estadísticamente significativas entre las TFA en Uruguay y Argentina; sí las hubo entre las cuatro categorías de la TFA de 2019. La TFA media muestral mantendría una disminución para 2023, pero en 8 países podría aumentar. Conclusiones. La serie temporal es mayoritariamente no estacionaria, con tendencia decreciente para 2023. Hay disminución desigual de las TFA, con diferencias significativas entre los cuatro grupos de países categorizados con la TFA de 2019. Las menores TFA corresponden a 2 países de Norteamérica, a 5 del Caribe no latino y a 1 sudamericano, y las mayores, a países del Caribe latino y de Centro y Sudamérica.(AU)


SUMMARY Objective. To determine the time pattern of adolescent fertility rates (AFRs) in the countries of the Region of the Americas, categorizing them to evaluate their mobility and differences, and to produce a forecast for 2023. Methods. Ecological and descriptive study of a time series of AFRs in 32 countries, from 1960 to 2019, based on information from the World Bank and the Pan American Health Organization (PAHO). Trends in the AFR were estimated using a linear regression model (Prais-Winsten method). Differences were evaluated between two subperiods (1960-1989 and 1990-2019) and among four categories of the AFR for 2019 by testing related samples and analysis of variance, respectively. The AFR for 2023 was predicted with autoregressive integrated moving average (ARIMA) models. Results. The AFR time series for the sample was non-stationary and the annual average trend was downward (coefficient = -1.173; p < 0.001; R2 adjusted = 0.968), dropping from 124 per 1 000 in 1960 to 56.1 per 1 000 in 2019. The countries with the largest and smallest annual trend were Saint Vincent and the Grenadines (-2.783) and Argentina (0.017). Between subperiods (1960-1989 compared to 1990-2019) there were no statistically significant differences between the AFR in Uruguay and Argentina, but there were significant differences among the four categories of AFR for 2019. The average AFR for the sample should continue declining to 2023, but it could increase in eight countries. Conclusions. The time series is largely non-stationary, with a downward trend to 2023. There has been an uneven decline in AFRs, with significant differences among the four groups of countries categorized by their AFR in 2019. The lowest AFRs correspond to two countries in North America, five in the non-Latin Caribbean, and one in South America. The highest AFRs correspond to countries in the Latin Caribbean and in Central and South America.(AU)


RESUMO Objetivo. Conhecer a evolução temporal das taxas de fecundidade de adolescentes (TFA) nos países da Região das Américas, classificando-os para avaliar a mobilidade da TFA e as diferenças entre países e gerar uma previsão para 2023. Métodos. Estudo ecológico descritivo de uma série temporal da TFA em 32 países, de 1960 a 2019, com base em informações do Banco Mundial e da OPAS. Estimamos as tendências da TFA com um modelo de regressão linear (método de Prais-Winsten), avaliamos as diferenças entre 2 subperíodos (1960-1989 e 1990-2019) e entre 4 categorias de países com base na TFA de 2019 por testes de amostras relacionadas e ANOVA, respectivamente, e realizamos uma previsão da TFA para 2023 por meio de modelos ARIMA. Resultados. A série temporal da TFA na amostra foi não estacionária; a tendência média anual foi decrescente (coeficiente=-1,173; p<0,001; R2 ajustado=0,968), diminuindo de 124 por 1000 em 1960 para 56,1 por 1000 em 2019. Os países com a maior e menor tendência anual foram São Vicente e Granadinas (-2,783) e Argentina (0,017). Na comparação entre os subperíodos (1960-1989 vs. 1990-2019), não houve diferenças estatisticamente significativas entre a TFA no Uruguai e na Argentina; porém, houve diferenças significativas entre as quatro categorias de países classificados com base na TFA de 2019. A TFA média da amostra deverá manter a tendência de queda até 2023, mas poderá aumentar em 8 países. Conclusões. A série temporal é predominantemente não estacionária, com uma tendência decrescente até 2023. Observa-se uma diminuição desigual na TFA, com diferenças significativas entre os quatro grupos de países classificados com base na TFA de 2019. As TFAs mais baixas são observadas em dois países da América do Norte, cinco do Caribe não latino e um da América do Sul, e as mais altas são observadas em países do Caribe latino e da América Central e do Sul.(AU)


Subject(s)
Humans , Adolescent , Family Planning (Public Health) , Reproductive Health/statistics & numerical data , Time Series Studies , Epidemiology, Descriptive , Ecological Studies , Latin America/epidemiology
11.
Zootaxa ; 4608(2): zootaxa.4608.2.1, 2019 May 20.
Article in English | MEDLINE | ID: mdl-31717144

ABSTRACT

The Lesser Antilles, in the Eastern Caribbean, were long considered to have only two species in the genus Iguana Laurenti 1768: the Lesser Antillean iguana Iguana delicatissima, which is endemic to parts of the Lesser Antilles, and the Common green iguana Iguana iguana, which also occurs throughout Central and South America. No subspecies are currently recognised. However, herpetologists and reptile collectors have pointed out strong physical differences between some of the island populations of Iguana iguana and those from the continent. Drawing on both morphological and genetic data, this paper describes two subspecies of the Common green iguana Iguana iguana from the southern Lesser Antilles, specifically the countries of Saint Lucia Iguana iguana sanctaluciae and Iguana iguana insularis from St Vincent the Grenadines, and Grenada. The form on the island of Saint Vincent has not been identified. The new subspecies are described based on the following unique combination of characters: Presence of high median and medium to small lateral horns on the snout; Small subtympanic plate not exceeding 20% of the eardrum size; Two or three scales of decreasing size anterior to the subtympanic plate; Fewer than ten small to medium triangular gular spikes; Medium sized dewlap; Low number of small to medium dispersed nuchal tubercles; Dark brown iris, with the white of the eye visible; Oval, prominent nostril; Short and relatively flat head; High dorsal spines; No swelling of the jowls in reproductively active males.                Iguana iguana sanctaluciae has in adults vertical black stripes on body and tail and a black dewlap whereas Iguana iguana insularis is pale grey or creamy white in adults.                Both subspecies are globally threatened by unsustainable hunting (including the pet trade) and by invasive alien species,     including hybridization from invasive iguanas from South and Central America (I. iguana iguana and I. rhinolopha, considered here as full species) that have become established in all three countries. The authors call for stronger measures to conserve the remaining purebred Iguana i. insularis and Iguana i. sanctaluciae ssp. nov. throughout their ranges and for further research to identify other cryptic species and subspecies of Iguana in the Lesser Antilles.


Subject(s)
Iguanas , Animals , Caribbean Region , Islands , Male
12.
Am J Phys Anthropol ; 169(3): 482-497, 2019 07.
Article in English | MEDLINE | ID: mdl-31125126

ABSTRACT

OBJECTIVES: From a genetic perspective, relatively little is known about how mass emigrations of African, European, and Asian peoples beginning in the 16th century affected Indigenous Caribbean populations. Therefore, we explored the impact of serial colonization on the genetic variation of the first Caribbean islanders. MATERIALS AND METHODS: Sixty-four members of St. Vincent's Garifuna Community and 36 members of Trinidad's Santa Rosa First People's Community (FPC) of Arima were characterized for mitochondrial DNA and Y-chromosome diversity via direct sequencing and targeted SNP and STR genotyping. A subset of 32 Garifuna and 18 FPC participants were genotyped using the GenoChip 2.0 microarray. The resulting data were used to examine genetic diversity, admixture, and sex biased gene flow in the study communities. RESULTS: The Garifuna were most genetically comparable to African descendant populations, whereas the FPC were more similar to admixed American groups. Both communities also exhibited moderate frequencies of Indigenous American matrilines and patrilines. Autosomal SNP analysis indicated modest Indigenous American ancestry in these populations, while both showed varying degrees of African, European, South Asian, and East Asian ancestry, with patterns of sex-biased gene flow differing between the island communities. DISCUSSION: These patterns of genetic variation are consistent with historical records of migration, forced, or voluntary, and suggest that different migration events shaped the genetic make-up of each island community. This genomic study is the highest resolution analysis yet conducted with these communities, and provides a fuller understanding of the complex bio-histories of Indigenous Caribbean peoples in the Lesser Antilles.


Subject(s)
Continental Population Groups/genetics , Continental Population Groups/history , Adult , Chromosomes, Human, Y/genetics , DNA/genetics , DNA, Mitochondrial/genetics , Female , Genetics, Population , History, 15th Century , History, 16th Century , History, 18th Century , History, 19th Century , History, Ancient , Human Migration/history , Humans , Male , Saint Vincent and the Grenadines , Trinidad and Tobago
13.
Open Access Maced J Med Sci ; 7(6): 920-924, 2019 Mar 30.
Article in English | MEDLINE | ID: mdl-30976334

ABSTRACT

BACKGROUND: Dysmenorrhea occurs as one of the symptoms of menstruation. While not necessarily a condition that plagues every woman, it is known to cause significant distress. Absenteeism from school and work as well as general discomfort are some of its adverse effects. AIM: This study aims to investigate the effects of certain diets on the prevalence and severity of dysmenorrhea. METHODS: Questionnaires was given to 478 women ranging from ages 1-55. The survey was centred around the age of menarche, presence and incidence of dysmenorrhea as well as how it is related to certain diets. RESULTS: Majority of the participants (81.74%) belonged to the age groups of 11-15 and 16-20. 45.5% of the participants attested to dysmenorrhea at each menstrual cycle. statistical correlation between diet and dysmenorrhea was insignificant (p > 0.05). Consumption of caffeinated beverages correlated with dysmenorrhea (p < 0.05). Although not statistically significant (p > 0.05), the study reported dysmenorrhea in a large proportion of participants who consumed high quantities of sugars. CONCLUSION: No relationship was established between diet and the incidence and severity of dysmenorrhea amongst the sample screened in Saint Vincent and the Grenadines. However, it appears that diet high in sugars might benefit from further research.

14.
J Laparoendosc Adv Surg Tech A ; 29(1): 94-97, 2019 Jan.
Article in English | MEDLINE | ID: mdl-30133332

ABSTRACT

PURPOSE: There remains a critical need for the provision for pediatric humanitarian aid worldwide. Historically, the emphasis of global pediatric health needs has been focused on infectious diseases. Today, we are witnessing a shift in this paradigm, with growing attention being paid toward the surgical needs of children. The use and deployment of minimally invasive surgery (MIS) in these austere environments with its concomitant reduction in length of hospitalization, pain, and morbidity is logical. The goal of this study was to report our deployment strategy and review our experience with pediatric MIS during humanitarian missions to determine if it is safe, feasible, and efficacious. METHODS: As part of the World Pediatric Project (WPP), data were collected retrospectively from the general pediatric surgery (GPS) team missions from January 2007 to January 2017. All cases were performed at a single medical center in the Eastern Caribbean Island Nation of St. Vincent and the Grenadines (SVG). Data included patient demographics, diagnosis, procedure, conversion to open procedure, complications, and postoperative course. The teams utilized a dedicated WPP operating theater, prepositioned and deployed GPS supplies, and MIS resources. All anesthesia, surgical, and nursing personal were board certified and trained professionals functioning as part of the WPP team. RESULTS: One hundred thirty-four children underwent general and thoracic pediatric surgical procedures during the study period. Mean age 9.2 years (2-19 years). Thirty-seven children underwent MIS procedures (27%). There were no conversions to open procedures. There were only two postoperative complications, cellulitis following laparoscopic appendicostomies, which required intravenous antibiotics and were discharged on a course of oral antibiotics. The postoperative course for all children was uneventful and no child required readmission. There were no technical failures in the MIS systems or instrumentation. CONCLUSIONS: Our retrospective review supports the use of MIS techniques as part of GPS humanitarian missions. We have found it to be a safe, feasible, and effective modality that may reduce length of stay, pain, and morbidity compared with open procedures in these remote environments. Although our MIS systems and instrumentations functioned effectively, concerns regarding the storage and sustainability for future missions are significant. Onsite health care partners, redundant systems, and remote technical support access could potentially alleviate these concerns.


Subject(s)
Laparoscopy , Medical Missions , Adolescent , Child , Child, Preschool , Female , Humans , Laparoscopy/adverse effects , Male , Operating Rooms , Postoperative Complications/etiology , Retrospective Studies , Saint Vincent and the Grenadines , Thoracoscopy/adverse effects , Young Adult
15.
Lancet ; 392(10159): 1859-1922, 2018 11 10.
Article in English | MEDLINE | ID: mdl-30415748

ABSTRACT

BACKGROUND: How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted life-years (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severity of ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. METHODS: We used data for age-specific mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Socio-demographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. FINDINGS: Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1-7·8), from 65·6 years (65·3-65·8) in 1990 to 73·0 years (72·7-73·3) in 2017. The increase in years of life varied from 5·1 years (5·0-5·3) in high SDI countries to 12·0 years (11·3-12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1-33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8-15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9-6·7), from 57·0 years (54·6-59·1) in 1990 to 63·3 years (60·5-65·7) in 2017. The increase varied from 3·8 years (3·4-4·1) in high SDI countries to 10·5 years (9·8-11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4-1·7) in Saint Vincent and the Grenadines (62·4 years [59·9-64·7] in 1990 to 63·5 years [60·9-65·8] in 2017) to 23·7 years (21·9-25·6) in Eritrea (30·7 years [28·9-32·2] in 1990 to 54·4 years [51·5-57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6-2·3) in Algeria to 11·9 years (10·9-12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4-78·7]) and males (72·6 years [69·8-75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7-50·2] for females and 42·8 years [40·1-45·6] for males). Globally, in 2017, the five leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8-43·5) for communicable diseases and by 49·8% (47·9-51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8-43·0), although age-standardised DALY rates decreased by 18·1% (16·0-20·2). INTERPRETATION: With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low SDI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of health. FUNDING: Bill & Melinda Gates Foundation.


Subject(s)
Communicable Diseases/epidemiology , Disabled Persons/statistics & numerical data , Global Burden of Disease/statistics & numerical data , Life Expectancy/trends , Mortality/trends , Aged , Female , Global Burden of Disease/trends , Health Status , Healthy Lifestyle/physiology , Humans , Male , Mortality, Premature/trends , Prevalence , Quality-Adjusted Life Years , Risk Factors , Socioeconomic Factors , Wounds and Injuries/epidemiology , Wounds and Injuries/mortality
16.
Washington, D.C.; PAHO; 2018-09. (PAHO/HSS/18-035).
in English, Spanish | PAHO-IRIS | ID: phr-49488

ABSTRACT

The Strategic Fund is a regional technical cooperation mechanism for pooled procurement of essential medicines and strategic public health supplies in the Americas. The Strategic Fund was created in 2000 by the Pan American Health Organization (PAHO) at the request of the Member States. Since then, the Fund has worked with countries to improve access to medicines and other health technologies, by strengthening demand planning and the organization of national supply management systems, while facilitating access to affordable strategic public health supplies through a pooled procurement mechanism. In accordance with 2016-2017 mandates of the PAHO Governing Bodies, the technical cooperation program of work in support of participation of Member States in the Fund has focused on: a) increasing the response capacity and efficiency of operations of the Fund in countries; b) the development of national and regional market intelligence; and c) the strengthening of the key alliances and strategic partnerships. As of December 2017, 32 countries in Latin America and the Caribbean have signed participation agreements with the PAHO Strategic Fund (Argentina, The Bahamas, Barbados, Belize, Bermuda, Bolivia, Brazil, the British Virgin Islands, Chile, Colombia, Costa Rica, the Dominican Republic, Ecuador, El Salvador, Grenada, Guatemala, Guyana, Haiti, Honduras, Jamaica, Nicaragua, Panama, Paraguay, Peru, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago, Turks and Caicos Islands, Uruguay, and Venezuela).


Subject(s)
Access to Essential Medicines and Health Technologies , Health Systems , Americas , Health Services , Access to Essential Medicines and Health Technologies
17.
Article in English | MEDLINE | ID: mdl-29627969

ABSTRACT

PURPOSE: Different students may adopt different learning approaches: namely, deep and surface. This study aimed to characterize the learning strategies of medical students at Trinity School of Medicine and to explore potential correlations between deep learning approach and the students' academic scores. METHODS: The study was a questionnaire-based, cross-sectional, observational study. A total of 169 medical students in the basic science years of training were included in the study after giving informed consent. The Biggs's Revised Two-Factor Study Process Questionnaire in paper form was distributed to subjects from January to November 2017. For statistical analyses, the Student t-test, 1-way analysis of variance followed by the post-hoc t-test, and the Pearson correlation test were used. The Cronbach alpha was used to test the internal consistency of the questionnaire. RESULTS: Of the 169 subjects, 132 (response rate, 78.1%) completely filled out the questionnaires. The Cronbach alpha value for the items on the questionnaire was 0.8. The score for the deep learning approach was 29.4± 4.6, whereas the score for the surface approach was 24.3± 4.2, which was a significant difference (P< 0.05). A positive correlation was found between the deep learning approach and students' academic performance (r= 0.197, P< 0.05, df= 130). CONCLUSION: Medical students in the basic science years at Trinity School of Medicine adopted the deep learning approach more than the surface approach. Likewise, students who were more inclined towards the deep learning approach scored significantly higher on academic tests.


Subject(s)
Academic Performance , Learning , Students, Medical , Cross-Sectional Studies , Curriculum , Education, Medical, Undergraduate , Humans , Saint Vincent and the Grenadines , Surveys and Questionnaires
18.
Psychiatr Q ; 89(4): 801-815, 2018 12.
Article in English | MEDLINE | ID: mdl-29704089

ABSTRACT

Harmful alcohol use encompasses a spectrum of habits, including heavy episodic drinking (HED) which increases the risk of acute alcohol-related harms. The prevalence of HED in Saint Vincent and the Grenadines (SVG) is 5.7% among the overall population aged 15 years and older and 10.2% among drinkers. Responsible Beverage Service interventions train alcohol servers to limit levels of intoxication attained by customers and decrease acute alcohol-related harms. The objectives of this study were to determine bar tenders' and rum shopkeepers' knowledge of and attitudes toward problem drinking and willingness to participate in server training. Researchers used convenience and purposive sampling to recruit 30 participants from Barraouile, Kingstown, and Calliaqua to participate in semi-structured interviews designed to explore study objectives. Results and conclusions were derived from grounded theory analysis. Heavy episodic drinking is common but not stigmatized. Heavy drinking is considered a "problem" if the customer attains a level of disinhibition causing drunken and disruptive or injurious behavior. Bartenders and rum shopkeepers reported intervening with visibly intoxicated patrons and encouraging cessation of continued alcohol consumption. Participants cited economic incentives, prevention of alcohol-related harms, and personal morals as motivators to prevent drunkenness. Respondents acknowledged that encouraging responsible drinking was a legitimate part of their role and were favorable to server training. However, there were mixed opinions about the intervention's perceived efficacy given absent community-wide standards on preventing intoxication and limitations of existing alcohol policy. Given respondents' motivation and lack of standardized alcohol server training in SVG, mandated server training can be an effective strategy when promoted as one piece of a multi-component alcohol policy.


Subject(s)
Alcohol Drinking/ethnology , Alcoholic Intoxication/ethnology , Alcoholism/ethnology , Commerce , Health Knowledge, Attitudes, Practice/ethnology , Adult , Alcohol Drinking/prevention & control , Alcoholic Intoxication/prevention & control , Alcoholism/prevention & control , Humans , Male , Saint Vincent and the Grenadines/ethnology
19.
20.
Rev Panam Salud Publica ; 41: e41, 2017 Jun 08.
Article in English | MEDLINE | ID: mdl-28614466

ABSTRACT

Objective: To characterize high-risk human papillomavirus (HPV) infections in a sample of women in two small English-speaking Caribbean countries: Saint Kitts and Nevis and Saint Vincent and the Grenadines. Methods: Sexually active women ≥ 30 years old attending primary care health facilities participated in the study. Each participant had a gynecological examination, and two cervical specimens were collected: (1) a specimen for a Papanicolaou (Pap) test and (2) a sample of exfoliated cervical cells for HPV DNA testing, using the HPV High Risk Screen Real-TM (Sacace). High-risk HPV genotypes were assessed in 404 women in Saint Kitts and Nevis and 368 women in Saint Vincent and the Grenadines. Results: High-risk HPV was detected in 102 of 404 (25.2%) in Saint Kitts and Nevis and in 109 of 368 (29.6%) in Saint Vincent and the Grenadines. High-risk HPV genotypes 52, 35, 51, 45, and 31 were the most common high-risk types in Saint Kitts and Nevis. In Saint Vincent and the Grenadines, the most common high-risk HPV genotypes were 45, 35, 31, 18, and 51. Current age was found to be significantly associated with high-risk HPV infection in both countries. In addition, in Saint Vincent and the Grenadines, high parity (> 3 pregnancies) and having had an abnormal Pap smear were found to be independent risk factors for high-risk HPV. Conclusions: These results contribute to the evidence on HPV prevalence for small island states of the Caribbean and support the accelerated introduction of the 9-valent HPV vaccine in the two countries and elsewhere in the English-speaking Caribbean. Use of the study's results to guide the development of policy regarding implementation of HPV testing as the primary screening modality for older women is recommended.


Subject(s)
Papillomavirus Infections/epidemiology , Adult , Aged , Cervix Uteri/virology , Cross-Sectional Studies , Female , Humans , Middle Aged , Papanicolaou Test , Papillomavirus Infections/diagnosis , Papillomavirus Infections/virology , Prevalence , Risk Assessment , Saint Kitts and Nevis/epidemiology , Saint Vincent and the Grenadines/epidemiology , Vaginal Smears
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