Violence study of healthcare workers and systems in the Caribbean:ViSHWaS-Caribbean study

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.

Dissemination of Traditional Chinese Medicine in Latin America and the Caribbean: the Cases of Peru, Chile, and Cuba

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.

Designing a Drought Monitoring System for Caribbean SIDS

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).

性别地理:论美国加勒比裔小说中的跨国家园

在美国加勒比裔小说中,“家”的空间表征体现为一种非同质性的跨国家园制作过程,它挑战了传统意义上的空间划分与性别划分之间的关系。一方面,跨国移民的家园概念发生在祖籍国和东道国之间的社会场,并不断模糊化;另一方面,性别和地理的跨国缠绕催生了性别模式的变异,女性移民关于遗忘和记忆的家园叙事呈现出驳色的文本意义:其美国家园绘制彰显了开放性和前进性色调,却在有意无意间保留了加勒比家园底色;男性的家园怀旧叙事则关联家庭私域,呈现出封闭性和降维趋势,表达了主体性退隐或丧失的危机。由此,加勒比裔作家颠覆了男性/公共域和女性/私人域之间的齐整对立,动摇了传统的性别权力结构,再现了跨国空间中新的性别运作模式。

加勒比地区色彩的成因与演变

本文揭示了加勒比地区由聚落到城镇化住屋色彩的成因与演变,分析了多彩纯色设计的规则,对于文化地域传统色彩的保留与发扬,以及旅游业的发展都具有重要意义。

拉美新一轮经济改革及其前景

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.

古巴来信:论卡彭铁尔小说的戏剧性、仪式性与历史性

古巴是加勒比海地区的文学重镇,也是社会主义国家文学中不可或缺的重要分支。然而,由于其地理的遥远和语言的障碍,古巴文学在我国的翻译和研究尚处于筚路蓝缕的起步阶段。本文以古巴20世纪知名作家卡彭铁尔的短篇小说为研究对象,以他的《学生》《昏暗的祭典》以及《圣雅各之路》为研究样本,分析其中体现的戏剧性、仪式性与历史性。卡彭铁尔的小说创作代表了一个国家、一个时代和一个民族的美学特征。他用天马行空的想象与瑰丽奇绝的景观展现了古巴人民曾经遭受过的深沉苦难与他们在激情燃烧的岁月里对于社会主义国家的真挚信仰。

论牙买加·金凯德《小地方》中的生态意识

《小地方》分别从大自然被对象化和客体化、国外资本操控击破当地生态保护的底线两个方面揭批殖民主义和资本主义新殖民体制下的旅游业对加勒比岛国安提瓜自然环境的破坏。通过叙述者的强势身份、视角翻转的叙述策略、愤怒的自我表达等角度探讨作家金凯德对环境污染的愤怒,同时展现金凯德心怀维护生态正义的愿景,渴望重获故土归属感。

中国电动汽车走向拉丁美洲和加勒比地区市场:市场现状、发展机遇与挑战

拉丁美洲和加勒比地区作为电动汽车新兴市场,正迅速发展。目前,中国电动汽车产业正积极拓展拉美市场,市场占有份额快速攀升,产业布局逐渐扩大。在这一过程中,“一带一路”倡议、中国产业的自身优势以及拉美国家出于环保和发展经济而实施的多项电动汽车推广政策,都显著促进了中国电动汽车产业在拉美的蓬勃发展。然而,仍然存在一些挑战,如直接购车补贴不足、充电设施不足、消费者认知有限,以及拉美国家电动汽车本地制造化政策和地缘政治等方面的阻碍等。为进一步深化中拉在电动汽车领域的合作与交流,需加强沟通与合作,致力于构建透明而稳定的制度框架,借助“一带一路”倡议,强化技术合作和人才交流,并积极促进技术创新,提升产品在当地市场的适应性。

新形势下中拉伙伴关系如何提质升级

中国与拉美主要国家均建立“全面战略伙伴关系”,具有层次高、升级快的特点。当前,中美竞争加剧和俄乌冲突背景下,美国在意识形态和价值观上孤立中国,并巩固美拉合作以排挤中国,给中拉伙伴关系带来挑战。拉美“左转”虽有利于中拉整体合作,但并不意味着拉美国家对中国核心利益的支持力度会明显提升,可由结点国家升级为支点国家。新形势下中拉伙伴关系进入高质量发展阶段,以构建中拉命运共同体为目标,用提质实现继续升级:首先,通过产能合作和建构价值链实现更高层次的经济合作;其次,加强综合安全和全球治理合作;最后,在利益和安全共同体基础上通过建构共有观念寻求共同价值构建价值共同体。

Clinical outcomes after major hepatectomy are acceptable in low-volume centers in the Caribbean

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.

Spatiotemporal assessment of particulate matter(PM_(10) and PM_(2.5)) and ozone in a Caribbean urban coastal city

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.

Evidence of Correlation between High Frequency Geomagnetic Variations and Seismicity in the Caribbean

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 correlation between hourly earthquakes distribution and high-frequency 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.

BRI Alluring for Latin American Countries——Interview with ECLAC Executive Secretary Alicia Bárcena

THE UN Economic Commission for Latin America and the Caribbean(ECLAC)is one of the institutions that has done in-depth study on the relationship between China and the Latin American and Caribbean region over the last few years.In mid-December,its executive secretary Alicia Bárcena visited Beijing to participate in an Advisory Council meeting of the Belt and Road Forum for International Cooperation(BRFIC),with the intention of finding new ways of better exploiting the initiative sponsored by the Chinese government to benefit countries related.

Caribbean “substitution culture” is a barrier to effective treatment of persons with diabetic foot infections

Diabetes-related amputation rates are high in the Caribbean. Many authorities have identified independent risk factors for diabetes-related amputations, but cultural factors remain underappreciated. We coined the term “Caribbean substitution culture” to describe the attitude of patients with diabetic foot infections in which they refuse to access medical care, instead voluntarily choosing to substitute “bush medicines” or other alternative therapies in the place of conventional treatment. Recognizing that the Caribbean substitution culture is a barrier to effective treatment of diabetic foot infections is the first step in curbing these practices. In this paper, we discuss the issues related to the Caribbean substitution culture, including the demographics of the population at risk, the alternative therapeutic practices and potential public health strategies to combat this practice.

New Records of Marine Macroalgae on the Caribbean on Coast of Costa Rica

The results obtained in this study highlight that further the macroalgae diversity in this region is even higher than what is reported to date. Here we present eight new records of marine macroalgae collected from the Caribbean coast of Costa Rica between March 2011 and May 2019. The morphological characteristics of Bryocladia cuspidata, Ceratodictyon variabile, Gracilaria hayi, Padina boergesenii, Zonaria tournefortii, Sargassum furcatum, Chaetomorpha aerea, and Bryopsis pennata var. secunda are described. The genera Bryocladia and Zonaria are reported for the first time for this region.

A New Species of Dallasiellus Berg (Hemiptera: Heteroptera: Cydnidae) from Caribbean

The genus Dallasiellus Berg (Hemiptera: Cydnidae) is revised with the description of a new species from Caribbean, Dallasiellus varaderensis nov. sp. A diagnosis of species is based on external morphology of males and genitalia examination. Dorsal view of adults and parameres are illustrated. Notes about their biology and host plants are briefly discussed.

Two New Species of the Genus Dictyota (Phaeophyceae: Dictyotales) from the Mexican Caribbean

During a molecular characterization of the genus Dictyota J. V. Lamouroux (Phaeophyceae, Dictyotales) along the Mexican coasts of the Gulf of Mexico and the Mexican Caribbean, using psbA and cox1 genes, it was found that two particular collections did not match with the sequences published for a total of 39 species of Dictyota. For each gene, both collections diverged in high-uncorrected “p” distance values with respect to other related species. This high genetic divergence was corroborated by morphological analysis. Hence, we proposed Dictyota mayae J. Lozano-Orozco & Sentíes and Dictyota pedrochei J. Lozano-Orozco & Sentíes as new species.

A Review of Prevalence, Antimicrobial Susceptibility Patterns and Molecular Characteristics of Methicillin-Resistant Staphylococcus aureus (MRSA) in the Caribbean

Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen causing infections resulting in severe morbidity and mortality worldwide. To date, the true nature and extent of MRSA infections in the Caribbean are not well understood. This is a review of the limited studies in the Caribbean describing the prevalence, epidemiology, and molecular characteristics of MRSA in hospitalized and non-hospitalized patients. Relevant articles were searched and extracted from PubMed and Mendeley and a narrative review of the findings was constructed. An aggregate of 24 articles, from 1999 to 2020, was found from 10 of 27 countries. Majority of the studies were from Trinidad and Tobago (29%) and Jamaica (21%) while 50% were from Barbados, Dominican Republic, Martinique, Haiti, Cuba, St. Kits & Nevis, Guadeloupe, and Guyana. Approximately 75% of investigations were conducted on hospitalized patients versus 20% on outpatients. The data revealed geographical differences in the prevalence of MRSA within the Caribbean;20% - 100% of Staphylococcus aureus clinical isolates from hospitalized patients and outpatients were resistant to methicillin, macrolides, and fluoroquinolones, but susceptible to several non-beta lactam antibiotics, due to the widespread occurrence of CA-MRSA clone ST8 SCCmec IV, PVL positive. There was moderate prevalence of ST72 SCCmec V (14% - 25%) in both hospital and community settings in a few of the countries while ST30 SCCmec IV, PVL positive, was moderately prevalent (27%) only in Dominican Republic. Also, there was moderate prevalence of HA-MRSA ST5 SCCmec II (18%) in community settings in the Dominican Republic and Martinique, but high prevalence of HA-MRSA ST239 SCCmec III (60%) in hospitalized patients in Cuba and Trinidad & Tobago. The epidemiologic profile of MRSA in both hospital and community settings is changing in the Caribbean. Epidemiological studies on outpatient settings and the implementation of stringent hospital infection control measures are needed in the region.

Improving Resilience and Recovery to the Travel and Tourism Industry in the Caribbean

Travel and tourism is key for the sustainability of Caribbean economies, driving employment and revenue generation for many of the states. The ongoing COVID-19 pandemic, catalysed by travel, drastically debilitated the Caribbean economies, causing significant economic and job losses, disruptions of crucial services and threatened regional health security. The pandemic reiterated the need for the inclusion of health as a critical part of the travel and tourism sector. The Regional Tourism and Health Program (THP), via surveillance and response, capacity building, standards, partnerships, travellers’ health recognition award and mobile app, is crucial for the recovery of the tourism sector by improving the health and safety of Caribbean people, contributing toward strengthened resilience of Caribbean tourism and the sustainability of its economies. The research seeks to highlight the impact that COVID-19 has had on specific industries core to Caribbean tourism, and how these challenges were addressed utilizing the various tools and products created through the THP. Due to COVID-19, the Program has repurposed and expanded many of its tools for a more robust response, to boost travellers’ confidence and re-establish healthier, safer return to travel in the Caribbean. This innovative program, the first global effort of its kind, continues to strive toward bolstering sustainable tourism and health security, lending toward improved economic stability in the Caribbean. Through these tools, 7836 persons were trained, 789 businesses were registered on THP’s land-based visitor surveillance system, 1190 alerts on incoming cruise ships were issued to Member States and 108 tourist facilities were awarded the Healthier, Safer Tourism Stamp. This paper will discuss the tools within the Program and illustrate how the THP can support the Caribbean’s preparedness and response to COVID-19 and other public health threats, and improve the recovery and sustainability of Caribbean tourism.