BACKGROUND Violence against healthcare workers(HCWs)in the Caribbean continues to prevail yet remains underreported.Our aim is to determine the cause,traits,and consequences of violence on HCWs in the Caribbean.AIM To...BACKGROUND Violence against healthcare workers(HCWs)in the Caribbean continues to prevail yet remains underreported.Our aim is to determine the cause,traits,and consequences of violence on HCWs in the Caribbean.AIM To determine the cause,traits,and consequences of violence on HCWs in the Caribbean.METHODS This research adopted an online cross-sectional survey approach,spanning over eight weeks(between June 6th and August 9th,2022).The survey was generated using Research Electronic Data Capture forms and followed a snowballing strategy to contact individuals using emails,social media,text messages,etc.Logistic regression analysis was performed to evaluate the variables that influence violence,including gender,age,years of experience,institution type,and night shift frequency.RESULTS The survey was completed by 225 HCWs.Females comprised 61%.Over 51%of respondents belonged to the 21 to 35 age group.Dominica(n=61),Haiti(n=50),and Grenada(n=31)had the most responses.Most HCWs(49%)worked for government academic institutions,followed by community hospitals(23%).Medical students(32%),followed by attending physicians(22%),and others(16%)comprised the most common cadre of respondents.About 39%of the participants reported experiencing violence themselves,and 18%reported violence against colleague(s).Verbal violence(48%),emotional abuse(24%),and physical misconduct(14%)were the most common types of violence.Nearly 63%of respondents identified patients or their relatives as the most frequent aggressors.Univariate logistic regression analyses demonstrated that female gender(OR=2.08;95%CI:1.16-3.76,P=0.014)and higher frequency of night shifts(OR=2.22;95%CI:1.08-4.58,P=0.030)were associated with significantly higher odds of experiencing violence.More than 50%of HCWs felt less motivated and had decreased job satisfaction post-violent conduct.CONCLUSION A large proportion of HCWS in the Caribbean are exposed to violence,yet the phenomenon remains underreported.As a result,HCWs’job satisfaction has diminished.展开更多
Traditional Chinese medicine(TCM) arrived from China to Latin America and the Caribbean in the 1840s due to the massive migration of Chinese people to the region. In a few years, the press noticed the presence of Chin...Traditional Chinese medicine(TCM) arrived from China to Latin America and the Caribbean in the 1840s due to the massive migration of Chinese people to the region. In a few years, the press noticed the presence of Chinese herbalists practicing in different cities and countries regardless of the demographic weight of the Chinese community. The fascination with Chinese doctors implicated not only the press but also the literature, a phenomenon particularly observed in Cuba. In the first decades of the 20th century, the reactivation of Chinese immigration to the region fostered an anti-Chinese climate that materialized in more significant migratory restrictions and control of their businesses, such as what happened with Chinese herbalists. These herbalists who practiced inside and outside the Chinese community started to object to criticism and persecution by the conservative press and professional doctors. Despite this, Chinese doctors will continue to maintain their support of a significant number of ill persons. This work seeks to illuminate the historical relevance of TCM in Latin America and the Caribbean, focusing on the cases of Peru, Chile, and Cuba. This last country was far from China culturally and geographically, but as in many other small towns in the region, Chinese medicine presented an alternative to the treatment of illnesses.展开更多
Software piracy,illegal software duplication,seems to beas rampant as an epidemic disease all over the world andboth software publishers and government officials are frus-trated.The loss for the software publishers du...Software piracy,illegal software duplication,seems to beas rampant as an epidemic disease all over the world andboth software publishers and government officials are frus-trated.The loss for the software publishers due to the unau-thorized copying of computer programs amounted to ■1.6 bil-lion in the U.S.The figure could reach ■7.5 billion if over-seas markets were included.Some countries such as Italy展开更多
There are limited drought studies for the Caribbean. This is concerning since drought is not only one of the most devastating disasters in the region, but it is also one of the least understood disasters. Very few pap...There are limited drought studies for the Caribbean. This is concerning since drought is not only one of the most devastating disasters in the region, but it is also one of the least understood disasters. Very few papers analyze new ways to identify and monitor this disaster. Another major arguable gap in research is the Caribbean’s sole focus on the meteorological drought and disregard of the agricultural drought. This is an important omission because of the significant negative impacts drought has on the Caribbean occurs in the agricultural and forestry sectors. Not considering this in drought monitoring systems in the Caribbean means that a major part of the phenomena is overlooked. Therefore, this study has focused on bridging this gap. It has sought to establish a system to strengthen drought’s early warning. To accomplish this, three predetermined conditions of drought, precipitation, land surface temperature and vegetation conditions were used to derive the Standard Precipitation Index (SPI), the Temperature Condition Index (TCI) and the Vegetation Condition Index (VCI), in order to analyze drought conditions. The drought vulnerability map found that the SPI, TCI and VCI all correlated with past drought events. The study also produced an agricultural drought map. This study, therefore, aims to build resilience by providing accurate information on the duration, intensity and spatial variability of droughts in Caribbean Small Island Developing States (SIDS).展开更多
Currently,a new round of economic reform is catching up pace in Latin American and the Caribbean countries.This round of reform coincides with a new wave of leftist governments in this region.Driven by the severe econ...Currently,a new round of economic reform is catching up pace in Latin American and the Caribbean countries.This round of reform coincides with a new wave of leftist governments in this region.Driven by the severe economic dilemma and social conflicts,Latin American and Caribbean countries have initiated a new round of economic reform by strengthening the state's role in the economy,transforming production modes,improving fiscal and monetary functions,and emphasizing income distribution and social equality,which achieved both economic and social effects.This round of reform has had a certain impact at both the regional and global levels,not only activating the sluggish integration of this region,but also reflecting the development demands of the Global South for transformation and independence.The adjustment of interests brought about by the new round of economic reform in Latin America and the Caribbean will also bring new development opportunities for Sino–Latin American relations.展开更多
BACKGROUND Major hepatectomies are routinely performed because they are often the only curative treatment for metastatic liver disease.There has been a trend to concentrate major hepatectomies in referral hospitals th...BACKGROUND Major hepatectomies are routinely performed because they are often the only curative treatment for metastatic liver disease.There has been a trend to concentrate major hepatectomies in referral hospitals that perform these operations at high volumes.These high volume referral centers are usually located in developed countries,but many patients in developing nations are not able to access these centers because of financial limitations,lack of social support and/or travel restrictions.Therefore,local hospitals are often the only options many of these patients have for surgical treatment of metastatic liver disease.This is the situation in many Caribbean countries.AIM To determine the clinical outcomes after major liver resections in a low-resource hepatobiliary center in the Caribbean.METHODS We prospectively studied all patients who underwent major liver resections over five years.The following data were extracted:patient demographics,diagnoses,ECOG status,operation performed,post-operative morbidity and mortality.Statistical analyses were performed using SPSS ver 16.0 RESULTSThere were 69 major liver resections performed by two teams at a mean case volume of 13.8 major resections/year.Sixty-nine major hepatic resections were performed for:colorectal liver metastases 40(58%),non-colorectal metastases 9(13%),hepatocellular carcinoma 8(11.6%),ruptured adenomas 4(5.8%),hilar cholangiocarcinomas 4(5.8%),hemangiomata 2(2.9%),trauma 1(1.5%) and hepatoblastoma 1(1.5%).Twenty-one patients had at least one complication,for an overall morbidity rate of 30.4%.There were minor complications in 17(24.6%)patients,major complications in 11(15.9%) patients and 4(5.8%) deaths.CONCLUSION There are unique geographic,political and financial limitations to healthcare delivery in the Caribbean.Nevertheless,clinical outcomes are acceptable in the established,low-volume hepatobiliary centers in the Eastern Caribbean.展开更多
Air pollution has become a critical issue in urban areas,so a broad understanding of its spatiotemporal characteristics is important to develop public policies.This study analyzes the spatiotemporal variation of atmos...Air pollution has become a critical issue in urban areas,so a broad understanding of its spatiotemporal characteristics is important to develop public policies.This study analyzes the spatiotemporal variation of atmospheric particulate matter(PM_(10) and PM_(2.5))and ozone(O_(3))in Barranquilla,Colombia from March 2018 to June 2019 in three monitoring stations.The average concentrations observed for the Móvil,Policía,and Tres Avemarías stations,respectively,for PM_(10):46.4,51.4,and 39.7μg/m^(3);for PM_(2.5):16.1,18.1,and 15.1μg/m^(3) and for O_(3):35.0,26.6,and 33.6μg/m^(3).The results indicated spatial and temporal variations between the stations and the pollutants evaluated.The highest PM concentrations were observed in the southern part of the city,while for ozone,higher concentrations were observed in the north.These variations are mainly associated with the influence of local sources in the environment of each site evaluated as well as the meteorological conditions and transport patterns of the study area.This study also verified the existence of differences in the concentrations of the studied pollutants between the dry and rainy seasons and the contribution of local sources as biomass burnings from the Isla Salamanca Natural Park and long-range transport of dust particles from the Sahara Desert.This study provides a scientific baseline for understanding air quality in the city,which enables policy makers to adopt efficient measures that jointly prevent and control pollution.展开更多
An analysis between the hourly distribution of earthquakes in three areas of the Caribbean and the high-frequency variations of the geomagnetic field is presented. The number of earthquakes selected for each zone is b...An analysis between the hourly distribution of earthquakes in three areas of the Caribbean and the high-frequency variations of the geomagnetic field is presented. The number of earthquakes selected for each zone is between 10,000 and 43,000, which guarantees a statistically significant distribution. The hourly distributions of seismicity in all areas show a bay-shape distribution with a significant increase in the number of earthquakes at night, from 11 PM to 5 AM. For example, in eastern Cuba 36.7% of earthquakes occur at that time, representing 11.7% over 25% in the absence of any time preference. Geomagnetic disturbances were compiled from several years to be able to make a statistically significant hourly distribution of their occurrence, being determined by sudden changes in the magnetic field at a short period of 1 minute. In this sense, geomagnetic data were processed between the years 2011-2016, recorded by the geostationary satellite GOES13 and the magnetic ground station SJG in San Juan, Puerto Rico. The result shows a significant </span><span style="font-family:Verdana;">correlation between hourly earthquakes distribution and high-frequency </span><span style="font-family:Verdana;">geomagnetic variations. The time-varying conductivity response of Earth’s interior also correlates with seismicity. The theory behind this correlation could be related to the piezoelectric phenomena and the electromagnetic force induced when the magnetic field is disturbed.展开更多
文摘BACKGROUND Violence against healthcare workers(HCWs)in the Caribbean continues to prevail yet remains underreported.Our aim is to determine the cause,traits,and consequences of violence on HCWs in the Caribbean.AIM To determine the cause,traits,and consequences of violence on HCWs in the Caribbean.METHODS This research adopted an online cross-sectional survey approach,spanning over eight weeks(between June 6th and August 9th,2022).The survey was generated using Research Electronic Data Capture forms and followed a snowballing strategy to contact individuals using emails,social media,text messages,etc.Logistic regression analysis was performed to evaluate the variables that influence violence,including gender,age,years of experience,institution type,and night shift frequency.RESULTS The survey was completed by 225 HCWs.Females comprised 61%.Over 51%of respondents belonged to the 21 to 35 age group.Dominica(n=61),Haiti(n=50),and Grenada(n=31)had the most responses.Most HCWs(49%)worked for government academic institutions,followed by community hospitals(23%).Medical students(32%),followed by attending physicians(22%),and others(16%)comprised the most common cadre of respondents.About 39%of the participants reported experiencing violence themselves,and 18%reported violence against colleague(s).Verbal violence(48%),emotional abuse(24%),and physical misconduct(14%)were the most common types of violence.Nearly 63%of respondents identified patients or their relatives as the most frequent aggressors.Univariate logistic regression analyses demonstrated that female gender(OR=2.08;95%CI:1.16-3.76,P=0.014)and higher frequency of night shifts(OR=2.22;95%CI:1.08-4.58,P=0.030)were associated with significantly higher odds of experiencing violence.More than 50%of HCWs felt less motivated and had decreased job satisfaction post-violent conduct.CONCLUSION A large proportion of HCWS in the Caribbean are exposed to violence,yet the phenomenon remains underreported.As a result,HCWs’job satisfaction has diminished.
基金funded by ANID—Millennium Science Initiative Program (No. NCS2022_053)。
文摘Traditional Chinese medicine(TCM) arrived from China to Latin America and the Caribbean in the 1840s due to the massive migration of Chinese people to the region. In a few years, the press noticed the presence of Chinese herbalists practicing in different cities and countries regardless of the demographic weight of the Chinese community. The fascination with Chinese doctors implicated not only the press but also the literature, a phenomenon particularly observed in Cuba. In the first decades of the 20th century, the reactivation of Chinese immigration to the region fostered an anti-Chinese climate that materialized in more significant migratory restrictions and control of their businesses, such as what happened with Chinese herbalists. These herbalists who practiced inside and outside the Chinese community started to object to criticism and persecution by the conservative press and professional doctors. Despite this, Chinese doctors will continue to maintain their support of a significant number of ill persons. This work seeks to illuminate the historical relevance of TCM in Latin America and the Caribbean, focusing on the cases of Peru, Chile, and Cuba. This last country was far from China culturally and geographically, but as in many other small towns in the region, Chinese medicine presented an alternative to the treatment of illnesses.
文摘Software piracy,illegal software duplication,seems to beas rampant as an epidemic disease all over the world andboth software publishers and government officials are frus-trated.The loss for the software publishers due to the unau-thorized copying of computer programs amounted to ■1.6 bil-lion in the U.S.The figure could reach ■7.5 billion if over-seas markets were included.Some countries such as Italy
文摘There are limited drought studies for the Caribbean. This is concerning since drought is not only one of the most devastating disasters in the region, but it is also one of the least understood disasters. Very few papers analyze new ways to identify and monitor this disaster. Another major arguable gap in research is the Caribbean’s sole focus on the meteorological drought and disregard of the agricultural drought. This is an important omission because of the significant negative impacts drought has on the Caribbean occurs in the agricultural and forestry sectors. Not considering this in drought monitoring systems in the Caribbean means that a major part of the phenomena is overlooked. Therefore, this study has focused on bridging this gap. It has sought to establish a system to strengthen drought’s early warning. To accomplish this, three predetermined conditions of drought, precipitation, land surface temperature and vegetation conditions were used to derive the Standard Precipitation Index (SPI), the Temperature Condition Index (TCI) and the Vegetation Condition Index (VCI), in order to analyze drought conditions. The drought vulnerability map found that the SPI, TCI and VCI all correlated with past drought events. The study also produced an agricultural drought map. This study, therefore, aims to build resilience by providing accurate information on the duration, intensity and spatial variability of droughts in Caribbean Small Island Developing States (SIDS).
文摘Currently,a new round of economic reform is catching up pace in Latin American and the Caribbean countries.This round of reform coincides with a new wave of leftist governments in this region.Driven by the severe economic dilemma and social conflicts,Latin American and Caribbean countries have initiated a new round of economic reform by strengthening the state's role in the economy,transforming production modes,improving fiscal and monetary functions,and emphasizing income distribution and social equality,which achieved both economic and social effects.This round of reform has had a certain impact at both the regional and global levels,not only activating the sluggish integration of this region,but also reflecting the development demands of the Global South for transformation and independence.The adjustment of interests brought about by the new round of economic reform in Latin America and the Caribbean will also bring new development opportunities for Sino–Latin American relations.
文摘BACKGROUND Major hepatectomies are routinely performed because they are often the only curative treatment for metastatic liver disease.There has been a trend to concentrate major hepatectomies in referral hospitals that perform these operations at high volumes.These high volume referral centers are usually located in developed countries,but many patients in developing nations are not able to access these centers because of financial limitations,lack of social support and/or travel restrictions.Therefore,local hospitals are often the only options many of these patients have for surgical treatment of metastatic liver disease.This is the situation in many Caribbean countries.AIM To determine the clinical outcomes after major liver resections in a low-resource hepatobiliary center in the Caribbean.METHODS We prospectively studied all patients who underwent major liver resections over five years.The following data were extracted:patient demographics,diagnoses,ECOG status,operation performed,post-operative morbidity and mortality.Statistical analyses were performed using SPSS ver 16.0 RESULTSThere were 69 major liver resections performed by two teams at a mean case volume of 13.8 major resections/year.Sixty-nine major hepatic resections were performed for:colorectal liver metastases 40(58%),non-colorectal metastases 9(13%),hepatocellular carcinoma 8(11.6%),ruptured adenomas 4(5.8%),hilar cholangiocarcinomas 4(5.8%),hemangiomata 2(2.9%),trauma 1(1.5%) and hepatoblastoma 1(1.5%).Twenty-one patients had at least one complication,for an overall morbidity rate of 30.4%.There were minor complications in 17(24.6%)patients,major complications in 11(15.9%) patients and 4(5.8%) deaths.CONCLUSION There are unique geographic,political and financial limitations to healthcare delivery in the Caribbean.Nevertheless,clinical outcomes are acceptable in the established,low-volume hepatobiliary centers in the Eastern Caribbean.
文摘Air pollution has become a critical issue in urban areas,so a broad understanding of its spatiotemporal characteristics is important to develop public policies.This study analyzes the spatiotemporal variation of atmospheric particulate matter(PM_(10) and PM_(2.5))and ozone(O_(3))in Barranquilla,Colombia from March 2018 to June 2019 in three monitoring stations.The average concentrations observed for the Móvil,Policía,and Tres Avemarías stations,respectively,for PM_(10):46.4,51.4,and 39.7μg/m^(3);for PM_(2.5):16.1,18.1,and 15.1μg/m^(3) and for O_(3):35.0,26.6,and 33.6μg/m^(3).The results indicated spatial and temporal variations between the stations and the pollutants evaluated.The highest PM concentrations were observed in the southern part of the city,while for ozone,higher concentrations were observed in the north.These variations are mainly associated with the influence of local sources in the environment of each site evaluated as well as the meteorological conditions and transport patterns of the study area.This study also verified the existence of differences in the concentrations of the studied pollutants between the dry and rainy seasons and the contribution of local sources as biomass burnings from the Isla Salamanca Natural Park and long-range transport of dust particles from the Sahara Desert.This study provides a scientific baseline for understanding air quality in the city,which enables policy makers to adopt efficient measures that jointly prevent and control pollution.
文摘An analysis between the hourly distribution of earthquakes in three areas of the Caribbean and the high-frequency variations of the geomagnetic field is presented. The number of earthquakes selected for each zone is between 10,000 and 43,000, which guarantees a statistically significant distribution. The hourly distributions of seismicity in all areas show a bay-shape distribution with a significant increase in the number of earthquakes at night, from 11 PM to 5 AM. For example, in eastern Cuba 36.7% of earthquakes occur at that time, representing 11.7% over 25% in the absence of any time preference. Geomagnetic disturbances were compiled from several years to be able to make a statistically significant hourly distribution of their occurrence, being determined by sudden changes in the magnetic field at a short period of 1 minute. In this sense, geomagnetic data were processed between the years 2011-2016, recorded by the geostationary satellite GOES13 and the magnetic ground station SJG in San Juan, Puerto Rico. The result shows a significant </span><span style="font-family:Verdana;">correlation between hourly earthquakes distribution and high-frequency </span><span style="font-family:Verdana;">geomagnetic variations. The time-varying conductivity response of Earth’s interior also correlates with seismicity. The theory behind this correlation could be related to the piezoelectric phenomena and the electromagnetic force induced when the magnetic field is disturbed.
