An investigation into the impact of the COVID-19 pandemic on the mental health and the study habits of medical students of the University of the West Indies.

The COVID-19 pandemic has caused increased anxiety among medical students due to the uncertainty of the long-term effects on the future of medical education. There are currently insufficient studies aimed at investigating the changes in the mental health and studying habits of medical students during public health emergencies such as this pandemic, as well as methods that can be incorporated to appropriately manage anxiety effectively. To investigate the psychological impact and associated factors on medical students during the pandemic. This retrospective, cross-sectional study consisted of 291 medical students of the faculty of medical sciences at the university of the West Indies, St. Augustine campus, Trinidad and Tobago. The mental health and study habits of said students were assessed with the use of questionnaires via an online survey platform. Data of our study showed that 56% of the students were experiencing increased stress and anxiety. Students of 82.8% experienced irregular sleeping habits and 76.3% of participants experienced a change in eating habits brought on by the pandemic. Participants of 67.4% studied less than 4 hrs. a day, 61.5% were less productive, 62.2% showed an inability to focus and avoid distractions in their study environment during the COVID-19 pandemic. There is a need for proper supportive strategies to assist students in effectively managing anxiety and depression during public health emergencies such as COVID-19. It is suggested that all universities, colleges and education bodies alike implement a pandemic preparedness course as well as an accessible online support forum.

The Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study: Design, Methods, and Baseline Characteristics.

Noncommunicable diseases (NCDs) account for a higher proportion of mortality and morbidity in the Caribbean and US territories-majority-minority communities-than in the United States or Canada. Strategies to address this disparity include enhancing data collection efforts among racial/ethnic communities. The ECHORN Cohort Study (ECS), a regional adult cohort study, estimates prevalence and assesses risk factors for NCDs in two United States territories and two Caribbean islands. Here, we describe the cohort study approach, sampling methods, data components, and demographic makeup for wave one participants. We enrolled ECS participants from each participating island using random and probability sampling frames. Data components include a clinical examination, laboratory tests, a brief clinical questionnaire, and a self-administered health survey. A subset of ECS participants provided a blood sample to biobank for future studies. Approximately 2961 participants were enrolled in wave one of the ECS. On average, participants are 57 years of age, and the majority self-identify as female. Data from the ECS allow for comparisons of NCD outcomes among racial/ethnic populations in the US territories and the US and evaluations of the impact of COVID-19 on NCD management and will help highlight opportunities for new research.

Annual Report 2021. Jamaica, Bermuda, and Cayman Islands: Responding to COVID-19 and Preparing for the Future

This Pan American Health Organization/World Health Organization Annual Report outlines contributions and achievements in Jamaica, Bermuda, and the Cayman Islands in the year 2021. The report also reinforces PAHO/WHO's core mission, through focus on the country level, recognizing that progress toward sustainable development hinges on improved health at the local and national levels. In 2021, PAHO/WHO supported Jamaica, Bermuda and the Cayman Islands on their path toward disaster risk reduction as well as the ongoing implementation of Phase II of the Smart Health Care Facilities in the Caribbean Project. This project, which aims to enhance the resilience of health facilities to ensure continuity of service delivery before, during and after hazards, such as hurricanes, has led to the upgrade of nine facilities so far. Working toward the upcoming restructuring of the Jamaican Ministry of Health and Wellness (MOHW) and Regional Health Authorities (RHAs) and health care reform in Jamaica, the country signed a technical cooperation agreement with PAHO to provide a national voluntary contribution, with projects developed to strengthen public financial management and results-based management, as well as a strategic plan for health information systems and a concept note for policy on health research. PAHO supported Jamaica’s efforts as the pandemic impact underscored the need to include mental health in emergency and disaster management, as well as activities that contributed to achieving milestones in tobacco control and road safety. Furthermore, PAHO assisted with initiatives to tackle the high prevalence of Noncommunicable Diseases (NCDs) in the population and promote better nutrition, such as the National Infant and Young Child Feeding Policy and Strategic Plan and front-of-package labelling.

Annual Report 2021. The Bahamas, and Turks and Caicos Islands: Responding to COVID-19 and Preparing for the Future

In 2022 the Pan American Health Organization (PAHO) is celebrating its 120th anniversary. Operating as the independent specialized health agency of the inter-American system, PAHO provides technical cooperation to its Member States to address communicable and noncommunicable diseases and their causes, strengthen health systems, and respond to emergencies and disasters throughout the Americas. In addition, in its capacity as the World Health Organization’s Regional Office for the Americas, PAHO participates in the United Nations Country Team, collaborating with other United Nations agencies, funds, and programs to contribute to the achievement of the Sustainable Development Goals (SDGs) at country level. At the subregional level, PAHO works with integration mechanisms to position health and its determinants on the political agenda. The 2021 Country Annual Reports reflect PAHO’s technical cooperation in countries and territories in implementing the Country Cooperation Strategies, responding to their needs and priorities, and operating within the framework of PAHO’s regional and global mandates and the SDGs. Under the overarching theme of Responding to COVID-19 and Preparing for the Future, they highlight PAHO’s actions on the COVID-19 pandemic and its continuing efforts in priority areas such as health emergencies, health systems and services, communicable diseases, noncommunicable diseases and mental health, health throughout the life course, and health equity. They also provide a financial summary for the biennium 2020-2021.

Comparative cost of diets for low-income families in the Caribbean

[ABSTRACT]. Objective. To assess the ability of low-income families to obtain a standard basket of healthy foods before and during the COVID-19 pandemic. Methods. The costs of 191 food items were averaged from supermarkets, municipal markets, wholesalers, and community food outlets in high- and low-income areas in three Caribbean countries. The analysis compared foods not only by selecting high- and low-ranked commodities but by the proportions of those foods, by food group, that will be required to meet a low-cost, nutritionally balanced diet of 2 400 kcal. Results. The main finding was that low-income households will need between 22% and 47% of their earnings to obtain a healthy diet. Despite higher food prices in Saint Kitts and Nevis, low-income households there will need a smaller proportion of their income to obtain a similar basket of foods than in Jamaica or Saint Vincent and the Grenadines. Conclusions. While the COVID-19 pandemic has added economic stressors to low-income households the basic vulnerability of the poor to obtain a healthy diet remains. Despite country variations, the findings point to the need for an increase in the minimum wage, particularly in Jamaica. It is essential to embed policies that ensure reduced economic and social vulnerability at the household level.

[RESUMEN]. Objetivo. Evaluar la capacidad de las familias de bajos ingresos para obtener una cesta estándar de alimentos saludables antes y durante la pandemia de COVID-19. Métodos. Se promediaron los costos de 191 alimentos en supermercados, mercados municipales, mayoristas y puestos de venta de alimentos en la comunidad en zonas de altos y bajos ingresos de tres países del Caribe. En el análisis se compararon los comestibles por grupo de alimentos mediante una selección de productos de alto y bajo rango, así como por las proporciones necesarias para tener un régimen alimentario nutricionalmente equilibrado de 2 400 kcal y de bajo costo. Resultados. La conclusión principal fue que los hogares de bajos ingresos necesitan entre 22% y 47% de sus ingresos para tener un régimen alimentario saludable. A pesar de los elevados precios de los alimentos en Saint Kitts y Nevis, los hogares de bajos ingresos necesitarán una proporción menor de sus ingresos para obtener una cesta de alimentos similar en Jamaica o San Vicente y las Granadinas. Conclusiones. La vulnerabilidad básica de las personas pobres para tener un régimen alimentario saludable persiste, a lo que se suma que la pandemia de COVID-19 ha agregado factores económicos estresantes a los hogares de bajos ingresos. A pesar de las variaciones entre países, los resultados apuntan a la necesidad de incrementar el salario mínimo, particularmente en Jamaica. Es esencial incorporar políticas que garanticen una reducción de la vulnerabilidad económica y social a nivel de los hogares.

[RESUMO]. Objetivo. Avaliar a capacidade das famílias de baixa renda de adquirir uma cesta básica de alimentos saudáveis antes e durante a pandemia de COVID-19. Métodos. Calculou-se a média do custo de 191 produtos alimentícios em supermercados, mercados municipais, atacadistas e estabelecimentos comunitários em áreas de alta e baixa renda em três países do Caribe. A análise comparou os alimentos não apenas pela escolha de produtos classificados em posição alta e baixa, mas também pelas proporções desses alimentos, por grupo alimentar, necessárias para ter uma alimentação de baixo custo e nutricionalmente equilibrada, com 2 400 kcal. Resultados. A principal constatação foi que as famílias de baixa renda precisarão gastar entre 22% e 47% de sua renda para ter uma alimentação saudável. Apesar do maior preço dos alimentos em Saint Kitts e Nevis, as famílias de baixa renda nesse país precisarão usar uma menor proporção da renda para comprar uma cesta de alimentos semelhante à adquirida na Jamaica ou em São Vicente e Granadinas. Conclusões. Embora a pandemia de COVID-19 tenha agregado fatores de estresse econômico às famílias de baixa renda, persiste a vulnerabilidade subjacente das pessoas pobres em relação à obtenção de uma alimentação saudável. Apesar das variações entre os países, as constatações indicam a necessidade de um aumento do salário mínimo, sobretudo na Jamaica. É essencial a incorporação de políticas que reduzam a vulnerabilidade econômica e social no âmbito familiar.

Tourists perceptions of Caribbean islands facing environmental threats before the COVID-19 health crisis: Holbox Island and Archipelago of Bocas del Toro.

Knowledge gaps exist in the socio-ecological systems of small touristic islands in Latin America. Understanding tourists' perceptions of their environmental knowledge can help plan actions to prevent natural capital loss necessary for local economies. Tourists' perceptions of a touristic hotspot, Holbox Island, were documented. Surveys demonstrated that tourists are aware of their environmental impacts and are interested in minimizing these. Results were compared with results on Bocas del Toro, Panama. Tourists' perceptions had similarities among sites driven by similarities in tourists' populations with a common geographic origin. Tourists lack site-specific knowledge to steer them towards environmentally conscious decisions in both regions. Findings suggest the need to promote local actions to gain tourists' understanding about their destination and support education programs on island conservation. Addressing these needs can help build resilience to overcome the adverse socio-environmental effects of tourism, environmental disasters, and health crises as COVID-19 on small islands.

Annual Report 2020. Universal Health and the Pandemic. Resilient Health Systems. The Bahamas and Turks and Caicos Islands

Founded in 1902 as the independent specialized health agency of the inter-American system, the Pan American Health Organization (PAHO) has developed recognized competence and expertise, providing technical cooperation to its Member States to fight communicable and noncommunicable diseases and their causes, to strengthen health systems, and to respond to emergencies and disasters throughout the Region of the Americas. In addition, acting in its capacity as the World Health Organization’s Regional Office, PAHO participates actively in the United Nations Country Team, collaborating with other agencies, the funds and programs of the United Nations system to contribute to the achievement of the Sustainable Development Goals (SDGs) at country level. This 2020 annual report reflects PAHO’s technical cooperation in the countries for the period, implementing the Country Cooperation Strategy, responding to the needs and priorities of the country, and operating within the framework of the Organization’s regional and global mandates and the SDGs. Under the overarching theme of Universal Health and the Pandemic – Resilient Health Systems, it highlights PAHO’s response to the COVID-19 pandemic as well as its continuing efforts in priority areas such as communicable diseases, noncommunicable diseases, mental health, health throughout the life course, and health emergencies. It also provides a financial summary for the year under review.

2020 family medicine postgraduate examinations at The University of the West Indies: successes and challenges in the time of COVID-19 pandemic.

Little has been published regarding postgraduate assessments during the COVID-19 pandemic. There is an urgent need to graduate well-trained specialists including family physicians who play a key role in patient care. The successes and challenges encountered in mounting qualifying 2020 Family Medicine examinations during the COVID-19 pandemic at the University of the West Indies are described in this paper. Human resource, planning, use of technology and virtual environments are discussed, which enabled successful examinations at this multicampus regional site.

Use of whole slide imaging (WSI) for distance teaching.

BACKGROUND: Time, travel and financial constraints have meant that traditional visiting teaching engagements are more difficult to accomplish. This has been exacerbated with the advent of the COVID-19 pandemic. The use of digital pathology and whole slide imaging (WSI) as an educational tool for distance teaching is underutilised and not fully exploited. This paper highlights the utility and feedback on the use of WSI for distance education/teaching. MATERIALS AND METHODS: Building on an existing relationship with the University of the West Indies (UWI), pathologists at University Health Network, Toronto, provided distance education using WSI, a digitised slide image hosting repository and videoconferencing facilities to provide case-based teaching to 15 UWI pathology trainees. Feedback was obtained from residents via a questionnaire and from teachers via a discussion. RESULTS: There was uniform support from teachers who felt that teaching was not hampered by the 'virtual' engagement. Comfort levels grew with each engagement and technical issues with sound diminished with the use of a portable speaker. The residents were very supportive and enthusiastic in embracing this mode of teaching. While technical glitches marred initial sessions, the process evened out especially when the slide hosting facility, teleconferencing and sound issues were changed. CONCLUSIONS: There was unanimous endorsement that use of WSI was the future, especially for distance teaching. However, it was not meant to supplant the use of glass slides in their current routine, daily practice.

SARS-CoV-2 outbreak on the Caribbean islands of the Dutch Kingdom: a unique challenge

[ABSTRACT]. As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic progresses, countries are depending on one another to acquire knowledge regarding effective measures to contain the virus. Public health measures to suppress transmissions have proven successful in Singapore, Hong Kong and Taiwan. Implementing and adhering to these interventions is challenging, with governments struggling to find a balance between necessary mitigation and suppression strategies, and interruptions of social-economic activities. While large high-income countries are struggling to keep their health systems and economies moving forward, small island developing states are facing even more significant challenges. Many Caribbean islands, including the six islands within the Dutch Kingdom, have been quick to implement stringent public health measures, yet they are facing unique challenges.

[RESUMEN]. A medida que avanza la pandemia de síndrome respiratorio agudo severo por coronavirus 2 (SARS-CoV-2), los países dependen unos de otros para adquirir conocimientos sobre las medidas eficaces para contener el virus. Las medidas de salud pública dirigidas a suprimir la transmisión han demostrado su eficacia en Singapur, Hong Kong y Taiwán. La aplicación y la adhesión a esas intervenciones representa un desafío, ya que los gobiernos necesitan encontrar un equilibrio entre las estrategias de mitigación y supresión necesarias y la interrupción de las actividades socioeconómicas. Al tiempo que los países grandes y de altos ingresos luchan por mantener sus sistemas de salud y sus economías en funcionamiento, los pequeños estados insulares en desarrollo se enfrentan a retos aún más importantes. Muchas islas del Caribe, incluidas las seis islas del Reino de los Países Bajos, han aplicado medidas de salud pública estrictas de manera rápida, pero se enfrentan a desafíos singulares.