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1.
Addict Behav ; 153: 108001, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38447411

ABSTRACT

BACKGROUND: Alcohol use is pervasive in the Caribbean; however, the prevalence and correlates of alcohol use and drinking problems in the elderly have not been extensively studied. METHODS: Data were obtained from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study, a cohort study of Caribbean people from Puerto Rico, Barbados, Trinidad, and Tobago, and the U.S. Virgin Islands, collected between 2013 and 2018 (baseline study sample, ages 60+, n = 811). Descriptive statistics were used to compare the differences in drinking status (current vs. former vs. never), alcohol problems (Cut-down, Annoyed, Guilty, and Eye-opener (CAGE) scale score ≥2 vs. <2), and binge drinking days (0 days vs. 1-2 days vs. ≥3 days) across sample characteristics. Logistic regression analyses estimated the association of these alcohol measures with sociodemographic (e.g., sex), psychological (depression), and cultural (e.g., religion) correlates. RESULTS: Thirty-six percent were 70 + years of age, 64 % were female, and 41 % had less than a high school education. Alcohol problems (≥2 CAGE score) was 21 %. Binge drinking ≥3 days was 30.6 %. Never attending religious services (vs. attending once a week or more) was associated with almost three times higher odds of alcohol problems (adjusted Odds Ratio: OR = 2.88, 95 % CI = 1.02, 8.15) four times higher odds of increasing binge drinking days (aOR = 4.04, 95 % CI = 1.11, 14.96). College education was protective against both the outcomes. CONCLUSION: We provide current estimates of alcohol problems among elderly Eastern Caribbean people. Among the sociodemographic, psychological, and cultural correlates examined, religious attendance was significant. Replicate longitudinal studies using DSM-5 alcohol dependence are recommended.


Subject(s)
Alcohol-Related Disorders , Alcoholism , Binge Drinking , Humans , Female , Aged , Middle Aged , Male , Binge Drinking/epidemiology , Binge Drinking/psychology , Cohort Studies , Prevalence , Alcohol Drinking/epidemiology , Alcohol Drinking/psychology , Alcoholism/epidemiology , Alcohol-Related Disorders/epidemiology , Puerto Rico/epidemiology
2.
World J Clin Cases ; 12(3): 488-494, 2024 Jan 26.
Article in English | MEDLINE | ID: mdl-38322459

ABSTRACT

BACKGROUND: Laparoscopic colectomy is widely accepted as a safe operation for colorectal cancer, but we have experienced resistance to the introduction of the FreeHand® robotic camera holder to augment laparoscopic colorectal surgery. AIM: To compare the initial results between conventional and FreeHand® robot-assisted laparoscopic colectomy in Trinidad and Tobago. METHODS: This was a prospective study of outcomes from all laparoscopic colectomies performed for colorectal carcinoma from November 29, 2021 to May 30, 2022. The following data were recorded: Operating time, conversions, estimated blood loss, hospitalization, morbidity, surgical resection margins and number of nodes harvested. All data were entered into an excel database and the data were analyzed using SPSS ver 20.0. RESULTS: There were 23 patients undergoing colectomies for malignant disease: 8 (35%) FreeHand®-assisted and 15 (65%) conventional laparoscopic colectomies. There were no conversions. Operating time was significantly lower in patients undergoing robot-assisted laparoscopic colectomy (95.13 ± 9.22 vs 105.67 ± 11.48 min; P = 0.045). Otherwise, there was no difference in estimated blood loss, nodal harvest, hospitalization, morbidity or mortality. CONCLUSION: The FreeHand® robot for colectomies is safe, provides some advantages over conventional laparoscopy and does not compromise oncologic standards in the resource-poor Caribbean setting.

3.
Cureus ; 16(1): e53149, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38420056

ABSTRACT

Mpox is a viral zoonotic disease that is endemic in Central and West Africa and belongs to the Orthopoxvirus genus. A global outbreak of mpox began in May 2022, mainly due to the transmission of the clade 11b virus through person-to-person contact with the lesions or scabs of a person infected with mpox. The data on mpox infection in the Caribbean is sparse. Here we report the clinical features and follow-up of the first two confirmed cases of mpox in Trinidad and Tobago (T&T). Both patients were men who have sex with men (MSM) who presented with genital lesions and expressed concern about increased stigma towards their already marginalized community.

4.
Eye (Lond) ; 2024 Feb 07.
Article in English | MEDLINE | ID: mdl-38326486

ABSTRACT

BACKGROUND: Little was known about the population coverage and causes of sight impairment (SI) registration within the Caribbean, or the extent to which register studies offer insights into population eye health. METHODS: We compared causes of SI registration in the Trinidad and Tobago Blind Welfare Association (TTBWA) register with findings from the 2014 National Eye Survey of Trinidad and Tobago (NESTT), and estimated registration coverage. Cross-sectional validation studies of registered clients included interviews, visual function and cause ascertainment in July 2013, and interviews and visual function in July 2016. RESULTS: The TTBWA register included 863 people (all ages, 48.1%(n = 415) male) registered between 1951 and 2015. The NESTT identified 1.1%(75/7158) people aged ≥5years eligible for partial or severe SI registration, of whom 49.3%(n = 37) were male. Registration coverage was approximately 7% of the eligible population of Trinidad. Nevertheless, there was close agreement in the causes of SI comparing the register and population-representative survey. Glaucoma was the leading cause in both the register (26.1%,n = 225) and population-based survey (26.1%, 18/69 adults), followed by cataract and diabetic retinopathy. In the validation studies combined, 62.6%(93/151) clients had severe SI, 28.5%(43/151) had partial SI and 9.9%(15/151) did not meet SI eligibility criteria. SI was potentially avoidable in at least 58%(n = 36/62) adults and 50%(n = 7/14) children. CONCLUSION: We report very low register coverage of the SI population, but close agreement in causes of SI to a contemporaneous national population-based eye survey, half of which resulted from preventable or treatable eye disease.

5.
Skin Health Dis ; 4(1): e307, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38312243

ABSTRACT

Skin diseases in Trinidad and Tobago, demonstating differences in Hospital vs Primary Care Dermatology Clinics, paediatric age groups and use of laboratory services. This figure illustrates, (a) combined percentage in range of skin diseases from all sites, n = 1309. Other diseases included CTD (connective tissue disease), papular urticaria, prurigo, rosacea and pityriasis rosea. (b) Paediatric dermatology conditions seen in one PCHF (primary care health facility) versus hospital clinics. (c) Comparison of waiting times, source of referrals and use of pathology in all PCHF versus hospital clinics.

6.
BJR Open ; 6(1): tzad002, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38352180

ABSTRACT

Objectives: This article seeks to determine the prevalence of a complete circle of Willis (CoW) and its common morphological variations in a south Trinidad population, while also investigating the influence of gender, age, and ethnicity on CoW morphology. Methods: A prospective, descriptive, cross-sectional study was done on the magnetic resonance images for consecutive patients who had a brain MRI/magnetic resonance angiography at a tertiary health institution in south Trinidad between October 2019 and September 2020. Patients with significant cerebrovascular disease and/or a history of prior neurosurgical intervention were excluded. Results: A complete CoW was seen in 24.3%, with more complete circles observed in younger participants (≤45 years) and Afro-Trinidadians. No gender predilection for a complete CoW was demonstrated. The most common variations in the anterior and posterior parts of the circle were a hypoplastic anterior communicating artery (8.6%, n = 13) and bilateral aplastic posterior communicating arteries (18.4%, n = 28), respectively. Conclusions: Significant variations exist in the CoW of a south Trinidad population with a frequency of complete in 24.3%, and more complete circles in younger patients and Afro-Trinidadians. Gender did not influence CoW morphology. Advances in knowledge: Structural abnormalities in the CoW may be linked to future incidence of cerebrovascular diseases and should therefore be communicated to the referring physician in the written radiology report. Knowledge of variant anatomy and its frequency for a particular populations is also required by neurosurgeons and neuro-interventional radiologists to help with preprocedural planning and to minimize complications.

7.
Microbiol Resour Announc ; 13(3): e0099923, 2024 Mar 12.
Article in English | MEDLINE | ID: mdl-38299841

ABSTRACT

Here, we announce the complete genome of a previously undescribed papillomavirus from a betta fish, Betta splendens. The genome is 5,671 bp with a GC content of 38.2%. Variants were detected in public databases. This genome is most similar to papillomaviruses that infect sea bass (52.9 % nucleotide identity).

8.
Cureus ; 16(2): e54601, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38384868

ABSTRACT

INTRODUCTION: This retrospective study investigated the effectiveness and safety of left distal transradial access (LDTRA) in patients with cardiovascular disease in Trinidad undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). METHOD: Procedural parameters, including technical success and safety outcomes such as vascular complications and radial artery occlusion (RAO), were assessed in 111 consecutive patients undergoing CAG or PCI from January 2023 to June 2023 at the Eric Williams Medical Sciences Complex, Trinidad and Tobago. Eighty-eight patients underwent LDTRA, while 23 received left transradial access (LTRA). RESULTS: There was no difference in procedural success with LDTRA compared to LTRA, 90.9% vs. 100%, p-value 0.202, non-significant (ns). LDTRA was associated with shorter fluoroscopy times (8.4 ± 6.8 minutes vs. 12.4 ± 7.7 minutes, p-value = 0.02), procedural duration (26.7 ± 18 minutes vs. 35.8 ± 20 minutes, p-value = 0.04), and hemostasis time (142 ± 41 minutes vs. 186 ± 44 minutes, p-value < 0.05). There were no significant differences in procedural-related complications (8% for LDTRA vs. 4.3% for LTRA, p-value = 0.476, ns). There were no reported cases of RAO. In the subgroup of patients with prior coronary artery bypass grafting (CABG), the fluoroscopy and procedure times were similar for both access sites; however, LDTRA was associated with a shorter hemostasis time (128 ± 30 minutes vs. 194 ± 39 minutes, p-value = 0.01). CONCLUSIONS: LDTRA is effective and safe for coronary procedures and is associated with a shorter hemostasis time. This study may prove clinically pertinent in a limited-resource Caribbean setting.

9.
Glob Ment Health (Camb) ; 11: e17, 2024.
Article in English | MEDLINE | ID: mdl-38390248

ABSTRACT

Mental health conditions among people living with HIV (PLWH) are important to address as they adversely affect quality of life, impede adherence to HIV treatment and increase mortality. Planning for integrating mental health care in resource-limited HIV care settings requires substantial effort. Learning networks are a useful way to exchange knowledge between countries about best and current practices in planning mental health care for PLWH. This paper describes the launch of a mental health learning network within a global health implementing center and the lessons learned across participating members from six countries: the United States, Jamaica, Trinidad and Tobago, Zimbabwe, Malawi and India. Lessons learned from the learning network sessions spanned four broad domains: (i) the need for routine and integrated mental health data collection, (ii) developing standardized protocols to implement mental health care, (iii) adequate training and supervision of health care staff and (iv) prioritization of mental health care integration by program funders. We find that time and resource constraints can be barriers to shared leadership and sustainability of learning networks. Prioritizing learning networks as an important component of integrated HIV and mental health care programs is one of the potential strategies to ensure long-term continuity.

10.
Cureus ; 16(1): e52581, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38371068

ABSTRACT

Cardiovascular diseases (CVD) are a major public health concern in the Caribbean. Cardiovascular care in the Caribbean revealed encouraging improvements but still less than expectations. This study aims to gain insight into CVD and identify gaps in cardiovascular care in the Caribbean compared to high-income countries. More specifically, this review reports on the epidemiology, CVD risk factors, management practices, and patient outcomes (quality of life (QOL) and mortality). A systematic review of peer-reviewed articles was conducted to assess the CVD of individuals in the Caribbean from 1959 to 2022.Using multiple search engines and keywords, a systematic review of relevant peer-reviewed CVD articles was conducted using the necessary inclusion and exclusion criteria. Relevant data of studies were classified by title, publication year, location, type and size of samples, and results. Further analysis grouped patients by epidemiological profile, CVD risk, management, and selected outcomes (quality of life and inpatient mortality).  From the initial review of 1,553 articles, 36 were analyzed from Trinidad and Tobago (20), Barbados (4), Jamaica (7), along with the Bahamas (2), British Virgin Islands (1), Bonaire (1), and one article from a Caribbean study. The social environment of fast food, sedentary jobs, and stress determinants are postulated to be precursors for an increase in CV risks. CVD in the Caribbean reveals a high prevalence of CV risks, suboptimal care, poor compliance, and high inpatient mortality compared with high-income countries. Greater efforts are required to improve CVD care at all stages, including in the social environment.

11.
Pathogens ; 13(2)2024 Feb 10.
Article in English | MEDLINE | ID: mdl-38392899

ABSTRACT

Eight hunting dogs were visited by a state veterinarian on the island of Tobago, Trinidad and Tobago, West Indies, as owners reported anorexia and paralysis in five of their dogs. The veterinarian observed a combination of clinical signs consistent with tick-borne illness, including fever, anorexia, anaemia, lethargy and paralysis. Blood and ticks were collected from each dog and submitted to a diagnostic laboratory for analysis. Microscopic analysis revealed a mixed infection of intracytoplasmic organisms consistent with Babesia spp. (erythrocyte) and Ehrlichia spp. (monocyte), respectively, from one dog, while a complete blood count indicated a regenerative anaemia (n = 1; 12.5%), non-regenerative anaemia (n = 4; 50%), neutrophilia (n = 3; 37.5%), lymphocytosis (n = 2; 25%), thrombocytopaenia (n = 3; 37.5%) and pancytopaenia (n = 1; 12.5%). DNA isolated from the eight blood samples and 20 ticks (16 Rhipicephalus sanguineus and 4 Amblyomma ovale) were subjected to conventional PCR and next-generation sequencing of the 16S rRNA and 18S rRNA gene for Anaplasma/Ehrlichia and Babesia/Theileria/Hepatozoon, respectively. The DNA of Ehrlichia spp., closely related to Ehrlichia canis, was detected in the blood of three dogs (37.5%), Anaplasma spp., closely related to Anaplasma marginale, in two (25%), Babesia vogeli in one dog (12.5%) and seven ticks (35%) and Hepatozoon canis and Anaplasma spp., in one tick (5%), respectively. These findings highlight the need to test both the vector and host for the presence of tick-borne pathogens when undertaking diagnostic investigations. Further studies are also warranted to elucidate the susceptibility of canids to Anaplasma marginale.

12.
Int J Stroke ; : 17474930241234528, 2024 Feb 28.
Article in English | MEDLINE | ID: mdl-38346937

ABSTRACT

BACKGROUND: Global access to acute stroke treatment is variable worldwide, with notable gaps in low and middle-income countries (LMIC), especially in rural areas. Ensuring a standardized method for pinpointing the existing regional coverage and proposing potential sites for new stroke centers is essential to change this scenario. AIMS: To create and apply computational strategies (CSs) to determine optimal locations for new acute stroke centers (ASCs), with a pilot application in nine Latin American regions/countries. METHODS: Hospitals treating acute ischemic stroke (AIS) with intravenous thrombolysis (IVT) and meeting the minimum infrastructure requirements per structured protocols were categorized as ASCs. Hospitals with emergency departments, noncontrast computed tomography (NCCT) scanners, and 24/7 laboratories were identified as potential acute stroke centers (PASCs). Hospital geolocation data were collected and mapped using the OpenStreetMap data set. A 45-min drive radius was considered the ideal coverage area for each hospital based on the drive speeds from the OpenRouteService database. Population data, including demographic density, were obtained from the Kontur Population data sets. The proposed CS assessed the population covered by ASCs and proposed new ASCs or artificial points (APs) settled in densely populated areas to achieve a target population coverage (TPC) of 95%. RESULTS: The observed coverage in the region presented significant disparities, ranging from 0% in the Bahamas to 73.92% in Trinidad and Tobago. No country/region reached the 95% TPC using only its current ASCs or PASCs, leading to the proposal of APs. For example, in Rio Grande do Sul, Brazil, the introduction of 132 new centers was suggested. Furthermore, it was observed that most ASCs were in major urban hubs or university hospitals, leaving rural areas largely underserved. CONCLUSIONS: The MAPSTROKE project has the potential to provide a systematic approach to identify areas with limited access to stroke centers and propose solutions for increasing access to AIS treatment. DATA ACCESS STATEMENT: Data used for this publication are available from the authors upon reasonable request.

13.
Cardiol Ther ; 13(1): 191-203, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38285330

ABSTRACT

INTRODUCTION: Trinidad & Tobago has the highest prevalence of cardiovascular disease (CVD) in the Caribbean and clopidogrel is a ubiquitously used treatment. Yet, the extent of genetically mediated clopidogrel resistance is unknown. To determine this, we investigated whether the association between CYP2C19*2 and CYP2C19*3 genetic variants and clopidogrel resistance holds, and calculated the frequencies of these in the Trinidadian CVD population. METHODS: Demographic data, clinical data, and a saliva sample were collected under informed consent from 22 patients with CVD on dual anti-platelet therapy whose biochemical resistance to clopidogrel is known, and a further 162 patients accessing the main public CVD clinic in Trinidad and who are either currently being treated or are likely to be treated with clopidogrel. A polymerase chain reaction (PCR) and restriction enzyme digestion procedure was used to genotype each patient for the CYP2C19*2 and CYP2C19*3 allelic variants. Genotype was compared to known clopidogrel resistance in the 22 patients, and to disease status and clopidogrel usage in the larger cohort. RESULTS: CYP2C19*2 genotype was concordant with clopidogrel resistance. CYP2C19*2 was detected in 61.1% (99/162) of patients and CYP2C19*3 was undetected. Clopidogrel was the most prescribed antiplatelet therapy (42%). A total of 120 people presented with coronary artery disease (CAD) and 52.5% of these (n = 63/120) are currently prescribed clopidogrel. 63.5% (40/63) of patients with CAD who are prescribed clopidogrel carry the CYP2C19*2 allele; ten homozygous and 30 heterozygous. Indian patients comprised 65% of the cohort and were four times more likely to carry the CYP2C19*2 allele than African patients. CONCLUSIONS: A large proportion of Trinidadian patients with CVD who are prescribed or may be prescribed clopidogrel carry genetic variants associated with clopidogrel resistance. These results emphasize the clinical need for further investigation into whether CYP2C19*2 genotype should guide clopidogrel use for the cardiovascular disease population in Trinidad & Tobago. A slide deck is available for this article.

14.
PLoS Negl Trop Dis ; 18(1): e0011859, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38194417

ABSTRACT

Mayaro virus (MAYV) is a mosquito-borne Alphavirus that is widespread in South America. MAYV infection often presents with non-specific febrile symptoms but may progress to debilitating chronic arthritis or arthralgia. Despite the pandemic threat of MAYV, its true distribution remains unknown. The objective of this study was to clarify the geographic distribution of MAYV using an established risk mapping framework. This consisted of generating evidence consensus scores for MAYV presence, modeling the potential distribution of MAYV in select countries across Central and South America, and estimating the population residing in areas suitable for MAYV transmission. We compiled a georeferenced compendium of MAYV occurrence in humans, animals, and arthropods. Based on an established evidence consensus framework, we integrated multiple information sources to assess the total evidence supporting ongoing transmission of MAYV within each country in our study region. We then developed high resolution maps of the disease's estimated distribution using a boosted regression tree approach. Models were developed using nine climatic and environmental covariates that are related to the MAYV transmission cycle. Using the output of our boosted regression tree models, we estimated the total population living in regions suitable for MAYV transmission. The evidence consensus scores revealed high or very high evidence of MAYV transmission in several countries including Brazil (especially the states of Mato Grosso and Goiás), Venezuela, Peru, Trinidad and Tobago, and French Guiana. According to the boosted regression tree models, a substantial region of South America is suitable for MAYV transmission, including north and central Brazil, French Guiana, and Suriname. Some regions (e.g., Guyana) with only moderate evidence of known transmission were identified as highly suitable for MAYV. We estimate that approximately 58.9 million people (95% CI: 21.4-100.4) in Central and South America live in areas that may be suitable for MAYV transmission, including 46.2 million people (95% CI: 17.6-68.9) in Brazil. Our results may assist in prioritizing high-risk areas for vector control, human disease surveillance and ecological studies.


Subject(s)
Alphavirus , Mosquito Vectors , Animals , Humans , Brazil , French Guiana , Guyana
15.
J Biol Eng ; 18(1): 2, 2024 Jan 05.
Article in English | MEDLINE | ID: mdl-38183146

ABSTRACT

BACKGROUND: Effluents from Food Services Establishments (FSEs) contain primarily Fats, Oil and Grease (FOG) which severely impact on sewers and the environment when released in high concentrations. In Trinidad & Tobago, it is estimated that approximately 231,304 kg/day of unaccounted for FOG bearing wastewaters from FSEs, are released into the environment with no viable treatment in the country. This research explored the optimization of physico-chemical processes for the treatment of FOGs for subsequent release into sewers. RESULTS: Bench-scale studies analysed the characteristics of FSE's effluents from three popular sources, conducted the treatment of these effluents using Jar Tests, and subsequently confirm results via a pilot plant study. Characterization showed the mean concentration of the parameters examined to be; FOG (511 mg/l ± 116 mg/l), Suspended Solids (446 mg/l ± 146 mg/l), Chemical Oxygen Demand (2229 mg/l ± 963 mg/l) and pH (6 ± 0.3). Jar Tests were conducted using Poly-aluminium Chloride (PACl) as coagulant, anionic and cationic polyelectrolytes as flocculant aids with suitable pH adjustments of samples to determine the isoelectric point for the coagulant. Effluent results showed FOG removal levels of 99.9% and final effluent concentration of 0.17 mg/l. This was attained using PACl concentration of 250 mg/l, a 0.1% low cationic polyelectrolyte (CP 1154) at 4 mg/l with the pH of sample adjusted to 8. The pilot plant achieved a 97.4% removal of FOG (residual of 16.8 mg/l) using the same coagulant dosing, and pH value, but increasing the strength of the flocculant aid to 0.1% medium cationic (CP1156) at 5 mg/l. CONCLUSION: Experimentation showed high concentrations of emulsified FOG can be efficiently removed to levels below the permissible requirements (20 mg/l) for entry into sewer systems in Trinidad and Tobago using coagulation, flocculation and sedimentation techniques. Pilot scale study also revealed that a higher strength and/or dose of the cationic polyelectrolyte and increased times in primary and final tanks were required to attain the desired results as in the bench level study, where equipment limitations in the flocculation tank were faced. This is in alignment with theory where factors critical for agglomeration is equipment type and density charge. It is, concluded that the optimum combination of chemicals and the respective dosages attained at the bench level study should prove effective should the right equipment be made available.

16.
Article in English | PAHO-IRIS | ID: phr-59158

ABSTRACT

The prevalence of snakebite envenoming and its understated impact on health and socioeconomic well-being in the Caribbean demand urgent attention. As a One Health challenge, this issue intersects human, animal, and environmental health, necessitating a multifaceted approach for comprehensive management. Despite the Caribbean’s rich biodiversity and cultural mosaic, there is a scarcity of data on the epidemiology and impact of snakebites in the region. This gap in knowledge, coupled with the absence of systematic records or survey-based studies, hampers the development of effective interventions. In countries such as Belize, Saint Lucia, and Trinidad and Tobago, among others, venomous snakes pose a significant threat, particularly to those in rural agricultural settings. Snakebite envenoming not only inflicts a direct health burden, evidenced by high rates of mortality and morbidity among humans, but also precipitates profound financial repercussions. The cost of clinical management for those affected and the loss of productivity due to long-term sequelae are considerable. Moreover, the impact on domestic animals, primarily livestock, translates into tangible economic losses for rural households, who rely on these animals for sustenance and income.


Subject(s)
Snake Bites , Environmental Health , Caribbean Region
17.
Data Brief ; 52: 109966, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38226043

ABSTRACT

This data article explores the factors that contribute to cost overrun on public sector projects within Trinidad and Tobago. The data was obtained through literature research, and structured questionnaires, designed using open-ended questions and the Likert scale. The responses were gathered from project actors and decision-makers within the public and private construction industry, mainly, project managers, contractors, engineers, architects, and consultants. The dataset was analysed using frequency, simple percentage, mean, risk impact, and fuzzy logic via the fuzzy synthetic evaluation method (FSE). The significance of the analysed data is to determine the critical root causes of cost overrun which affect public sector infrastructure development projects (PSIDPs), from being completed on time and within budget. The dataset is most useful to project and construction management professionals and academia, to provide additional insight into the understanding of the leading factors associated with cost overrun and the critical group in which they occur (political factors). Such understanding can encourage greater decisions under uncertainty and complexity, thus accounting for and reducing cost overrun on public sector projects.

18.
AIDS Care ; 36(3): 351-357, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37128186

ABSTRACT

This study aimed to elucidate the intrinsic and extrinsic resilience resources among people living with HIV (PLWH) during the Covid pandemic. Autoethnographic video diaries from 29 PLWH from Argentina, UK, Philippines, Zimbabwe, and Trinidad and Tobago were included. Data were thematically analysed and validated with community partners and a video was co-produced. PLWH displayed a readiness to adopt healthy behaviours and engage in optimistic and constructive thinking about the future. Hobbies and daily activities, supportive relationships with peers living with HIV, family and friends, opportunities to mobilise and contribute to their communities in meaningful ways, supportive healthcare providers and reliable access to antiretroviral treatment helped foster psychological resilience among PLWH. The extrinsic resilience resources also supported positive physical health outcomes among PLWH through improved medication adherence.


Subject(s)
COVID-19 , HIV Infections , Resilience, Psychological , Humans , Pandemics , HIV Infections/drug therapy , HIV Infections/epidemiology , HIV Infections/psychology , Anti-Retroviral Agents/therapeutic use
19.
Am J Vet Res ; 85(2)2024 Feb 01.
Article in English | MEDLINE | ID: mdl-38029514

ABSTRACT

OBJECTIVE: This study aimed to develop a sound database for the hematological reference intervals of thoroughbred foals in Trinidad, West Indies from birth to 1 month of age. ANIMALS: 89 foals. METHODS: Whole blood samples were taken from 89 foals throughout Trinidad at approximately 1 day, 1 week, and 1 month of age. These foals were examined to be classified as healthy or free from disease. Complete blood count (CBC), microscopic analysis of blood smears, and conventional PCR for Theileria equi and Babesia caballi were performed. RESULTS: Of the 89 foals, 67 were deemed healthy and suitable for establishing reference intervals. Foals in this study had lower mean hemoglobin and hematocrit values for all 3 times of sampling when compared to their North American counterparts. Age had a significant effect on hemoglobin, hematocrit, white blood cell (WBC), neutrophil, and platelet counts of the foals from birth to 1 month of age. CLINICAL RELEVANCE: Variations in reference intervals can occur due to differences in demographic, physiological, and environmental factors such as age, gender, breed, and geographical location. Given the changes in the hematological values over time, this study provides clinicians with valuable information that can be used to monitor the health status of newborn foals and detect disease conditions.


Subject(s)
Babesia , Horse Diseases , Theileria , Animals , Horses , Trinidad and Tobago/epidemiology , Blood Cell Count/veterinary , Hemoglobins , Animals, Newborn , Horse Diseases/epidemiology
20.
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