Complex presentations in people with diabetes: Does HbA1c help or hinder?

HbA1c measurement is widely used for diagnosis/ management/remission of diabetes with international schemes certifying comparability. A) 75 year-old Chinese female with type 2 diabetes was admitted in April 2020 with Covid-19 and diabetic ketoacidosis. Glucose was 35mmol/l and HbA1c 150mmol/mol with previous HbA1c of 45mmol/mol on metformin and alogliptin. She was treated for ketoacidosis and once-daily Lantus introduced along with supportive management of viral illness. B) 68 year-old Afro-Caribbean with type 2 diabetes on metformin before admission, presented with new onset, jerky ballistic movements of high amplitude in right arm, 10-15 movements every 5 min. Admission glucose was >33mmol/l, ketones 1.8mmol/l and HbA1c >217mmol/ mol. Hemichorea-hemiballism, a hyperglycaemia related movement was diagnosed and insulin commenced. Glucose decreased to 8-20mmol/ l, reaching 5-15mmol/ l by time of discharge. Ballistic movements resolved when glycaemic control improved with HbA1c 169mmol/mol, 25 days after discharge. C) Several days before admission, a female with diabetes over 20 years required attention from paramedics on four occasions for hypoglycaemia. Months beforehand metformin was replaced by gliclazide due to chronic kidney disease with HbA1c 50mmol/mol, and she was transfused six weeks before admission for microcytic anaemia. Gliclazide was discontinued and her diet modified which prevented further hypoglycaemic episodes. Variant haemoglobin, beta-thalassaemia which can overestimate glycaemia;undetected by HbA1c HPLC method, invalidated HbA1c as did the blood transfusion. These cases highlight that inadequate understanding of HbA1c can lead to acute presentations of dysglycaemia. As HbA1c accuracy can be affected by multiple factors, clinical assessment and triangulation are key to the management of such patients.

Cash transfer in the Covid-19 pandemic in Latin America and the Caribbean

Este artigo apresenta resultados parciais de uma investigação em desenvolvimento por pesquisadores de universidades brasileiras, argentinas e uruguaias. Os programas de transferência de renda são vistos como medidas sociais para mitigar a pobreza, bem como para diminuir o aumento do desemprego, do trabalho informal e do desperdício de renda. A metodologia de pesquisa foram estudos bibliográficos e documentais;dados secundários;acesso a sites e dados da Comissão Econômica para a América Latina e o Caribe. A discussão enfoca concepções, modalidades e o debate sobre Programas Focalizados de Transferência de Renda e Renda Básica Universal como referência para discutir a realidade dos programas de transferência de renda na América Latina e Caribe. Os resultados apontaram para a ampliação dos programas focalizados de transferência de renda;criação de programas emergenciais para atender as consequências econômicas e sociais geradas pela pandemia de Covid-19, mas não foi identificada a implementação da Renda Básica Universal e Incondicional.Alternate :Este artículo presenta resultados parciales de una investigación en desarrollo por investigadores de universidades brasileñas, argentinas y uruguayas. Los programas de transferencias monetarias son vistos como medidas sociales para mitigar la pobreza, así como para disminuir el aumento del desempleo, el trabajo informal y el desperdicio de ingresos. La metodología de investigación fueron estudios bibliográficos y documentales;Datos secundarios;acceso a sitios web y datos de la Comisión Económica para América Latina y el Caribe. La discusión se centra en las concepciones, modalidades y el debate sobre los Programas de Transferencias Monetarias Focalizadas y la Renta Básica Universal como referencia para discutir la realidad de los programas de transferencias monetarias en América Latina y el Caribe. Los resultados señalaron la ampliación de los programas de transferencias monetarias focalizadas;creación de programas de emergencia para atender las consecuencias económicas y sociales generadas por la pandemia del Covid-19, pero no se identificó la implementación de la Renta Básica Universal e Incondicional.Alternate :This article presents partial results of an investigation under development by researchers at Brazilian, Argentine and Uruguayan Universities. The cash transfer programs are seen as social measures to mitigate poverty, as well as to decrease the rise of unemployment, informal work and waste of income. The research methodology were bibliographic and documental studies;secondary data;access to websites and data from the Economic Commission for Latin America and the Caribbean. The discuss focus on conceptions, modalities and the debate on Focalized Cash Transfer Programs and Universal Basic Income as reference to discuss the reality of cash transfer programs in Latin America and the Caribbean. The outcomes pointed out the enlargement of the focalized cash transfer programs;creation of emergence programs to meet the economic and social consequences generated by the Covid-19 pandemic, but it was not identified the implementation of the Universal and Unconditional Basic Income.

COVID-19 and Food Insecurity in Latin America and the Caribbean

The objective was to determine the prevalence of household food insecurity (FI) in Latin America and the Caribbean (LAC) during the COVID-19 pandemic. Secondary analysis was performed using the waves 1 to 3 of the 2020 COVID-19 High Frequency Phone Surveys in 13 LAC countries. The countries with the highest FI in the first wave were Honduras (60.3%), Peru (58.1%) and Ecuador (57.9%). Likewise, the countries with the greatest differences in the prevalence of FI between the first and last waves in percentage points (PP) were Peru (-29), Guatemala (-27.7) and Bolivia (-21.8). LAC countries face a great burden of FI.Copyright © 2022 Taylor & Francis Group, LLC.

Declaration of Cuernavaca

The National Public Health Institutes (NPHI), members of the Latin American Regional Network of the International Association of National Institutes of Public Health, met face to face at the headquarters of the National Institute of Public Health of Mexico, in the City of Cuernavaca, from October 5 to 7, 2022, with the participation of the directors or their representatives of the NPHIs of Bolivia, Brazil, Colombia, Costa Rica, El Salvador, Mexico, Peru and Suriname and representatives of the South American Sub regional Program (SAM), and the Central American Sub regional Program (CAM) of the Pan American Health Organization (PAHO), the Organization of the Amazon Cooperation Treaty (OTCA), the Andean Health Agency/Hipolito Unanue Agreement (ORAS/CONHU) and the Central American Integration System (SICA/COMISCA), analyzing the role of the NPHI in combating health inequities;in confronting the global climate and environmental crisis;combating hunger, food insecurity and malnutrition;successes and challenges in responding to the Covid-19 pandemic;strengthening and continuous improvement of integrated disease surveillance and preparedness for health emergencies;as well as the various existing regional and sub-regional health cooperation programs, noticing that: 1. In the current scenario, the dominating development model is a generator of growing social inequalities, which determine serious inequities in the health conditions of our peoples. 2. Likewise, the current model of production and consumption, adopted at the global level, has increased hunger, food insecurity and malnutrition that possibly constitute nowadays the main health problem in our region. 3. The environmental crisis, which is also a product of the current global development model, has a significant impact on human and animal health and the interaction between both. 4. The NPHIs have played a role of major relevance in confronting the Covid-19 pandemic, not fully applying, however, their full potential for research and for proposing national plans for the disease control. 5. Health surveillance systems, in most of our countries, suffer from significant fragmentation between various sectors and within the health sector itself, implying, in any case, reactive actions that do not allow for anticipating the emergence of new pathologies or health emergencies. 6. The various regional and sub regional cooperation agencies and programs offer an enormous capacity for synergies and mutual cooperation.

COVID-19 Vaccine Willingness among African, Caribbean, and Black People in Ottawa, Ontario

Vaccines have been identified as a crucial strategy to control the spread of COVID-19 and reduce its impact. However, there are concerns about the acceptance of vaccines within African, Caribbean, and Black (ACB) communities. Based on a community sample of ACB people in Ottawa, Ontario (n = 375), the current study aimed to use logistic regression analysis and identify factors associated with COVID-19 vaccine willingness. A multivariate analysis shows that ACB people who believed that the ACB population is at a higher risk for COVID-19 were more likely to be willing to receive the vaccine compared to those who did not (OR = 1.79, p < 0.05). ACB people who had received at least one dose of the COVID-19 vaccine were more likely to be willing to receive it in the future (OR = 2.75, p < 0.05), and trust in government COVID-19 information was also positively associated with vaccine willingness (OR = 3.73, p < 0.01). In addition, English-speaking respondents were more willing to receive the vaccine compared to French-speaking respondents (OR = 3.21, p < 0.01). In terms of socioeconomic status, ACB people with a post-graduate degree (OR = 2.21, p < 0.05) were more likely to report vaccine willingness compared to those without a bachelor's degree. Based on these findings, we discuss implications for policymakers and directions for future research. [ FROM AUTHOR] Copyright of COVID is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Experiences of patients from minority ethnic backgrounds in the stem cell transplant pathway during COVID-19

Background: Stem cell transplantation is a potentially life-saving intervention for patients with blood cancer. Research suggests that there are existing disparities in access, care and treatment experiences, with patients identifying with a minority ethnic heritage reporting greater disadvantage compared to patients from white British, Irish or Northern European backgrounds. Although we know that the COVID-19 pandemic has been challenging for patients, less is known about the experiences of patients from specific ethnic communities. Method(s): In this research, we undertook 1-1, semi-structured interviews with eight patients within the stem cell transplant pathway who identify with a minority ethnic background. Interviews took place online, between May and November 2021. The interview questions explored views on aspects of the pandemic, including access and experience of care delivery, intervention, mental health and financial impact. Interviews were transcribed verbatim and analysed using reflexive thematic analysis. Result(s): The majority of patient participants were female (75%), and identified with a Black African or Caribbean heritage (75%). Four themes were identified from the data: (1) 'Lack of suitable donors' described the challenges of finding a stem cell donor and the importance of raising awareness of stem cell donation specifically within minority ethnic communities;(2) 'Experiences of care' explored patients' experiences of the healthcare system from pre-diagnosis to post-treatment, including how the COVID-19 pandemic had made some aspects of care easier but acted to disrupt others;(3) 'Intense and unpredictable process' described the nature of living with blood cancer and how this has impacted upon patients' lives including the extent to which they had been able to access and make use of advice to help keep them safe during the pandemic;and (4) 'Coping mechanisms' identified the factors which helped patients' to understand and adjust to living with their diagnosis and the treatment process. Conclusion(s): Patients in the stem cell transplant pathway often experience intense treatment regimens, debilitating symptoms and long hospital stays, which has a significant impact on their lives. Minority ethnic patients describe facing additional challenges in relation to health inequalities both within and outside of the pandemic. Seeking support from family, peers or community organisations can help buffer the negative impacts of living with blood cancer and multiple disadvantages, but such support was more difficult to access during the pandemic. This had psychological consequences for patients who are already within an intense emotional journey. Pandemic recovery plans should address mental health support as a priority.

Tropical Conditions and Outbreak of COVID-19

Background: The new novel Coronavirus 2019 (nCOV-19 or COVID-19) has caused an unprecedented pandemic in humans. All nations have heightened their surveillances after the quick diagnosis of potential cases of the COVID-19. Objective(s): Recent statistics have mentioned that virus outbreak in tropical countries is relatively low compared to cold nations. To support this conclusion, we considered the six main tropical regions to investigate the pandemic distribution at the initial phase. Method(s): Chi-square test was applied to understand the correlation between outbreak and temperature changes. Significant probability P-value was set to P<0.01. P-values were calculated to both positive and death cases. Result(s): Out of 1211562 infected cases, 41776 cases (3.45%) were registered at hightemperature countries (P<0.0001) and 1161786 cases (96.55%) at other countries like European countries or the USA. Moreover, only 1433 mortality cases (2.2%) happened, and the remaining 97.8% of mortality happened among other nations. Conclusion(s): Similar to other respiratory viruses like flu and influenza, there is a low outbreak of COVID-19 in tropical nations compared to the other countries. Apart from weather conditions, it is also recommended to follow the serious preventive measures imposed by governments to survive this novel epidemic.Copyright © 2020

PERSPECTIVES ON ENVIRONMENTAL EDUCATION AND ENVIRONMENTAL JUSTICE FOR A LATIN AMERICA AND THE CARIBBEAN POST-COVID-19

Latin America and the Caribbean is between regions the world with the highest number of Covid-19 deaths. What is certain is that some factors allow the continent to suffer more damage and have greater difficulty in facing the pandemic, the objective of this research situated in the field of Fundamentals of Environmental Education is to understand this situation at first, and then seek to point out alternatives for the region. These alternatives are found from the horizon of environmental justice for the post-Covid-19. The study follows a methodological approach of Philosophical Hermeneutics. as perspectives the study points to: adoption of Eco socialism, change in the energy mix;change in consumption practices;change in human-nature relations, new ways of bringing nations together, overcoming the colonialist model;strengthening of potential and overcoming the discourse of poverty;Latin American solidarity as a possibility to overcome social exclusion;the reinvention of more democratic political systems with the effective participation of the population;appreciation of Latin American identity, based on the recognition of Traditional Peoples;and facing the postponement of the discussion on climate change. © 2023, University of Cienfuegos, Carlos Rafael Rodriguez. All rights reserved.

Seasonal influenza vaccination in the Americas: Progress and challenges during the COVID-19 pandemic.

BACKGROUND: Vaccination is one of the most effective measures to prevent influenza illness and its complications; influenza vaccination remained important during the COVID-19 pandemic to prevent additional burden on health systems strained by COVID-19 demand. OBJECTIVES: We describe policies, coverage, and progress of seasonal influenza vaccination programs in the Americas during 2019-2021 and discuss challenges in monitoring and maintaining influenza vaccination coverage among target groups during the COVID-19 pandemic. METHODS: We used data on influenza vaccination policies and vaccination coverage reported by countries/territories via the electronic Joint Reporting Form on Immunization (eJRF) for 2019-2021. We also summarized country vaccination strategies shared with PAHO. RESULTS: As of 2021, 39 (89 %) out of 44 reporting countries/territories in the Americas had policies for seasonal influenza vaccination. Countries/territories adapted health services and immunization delivery strategies using innovative approaches, such as new vaccination sites and expanded schedules, to ensure continuation of influenza vaccination during the COVID-19 pandemic. However, among countries/territories that reported data to eJRF in both 2019 and 2021, median coverage decreased; the percentage point decrease was 21 % (IQR = 0-38 %; n = 13) for healthcare workers, 10 % (IQR = -1.5-38 %; n = 12) for older adults, 21 % (IQR = 5-31 %; n = 13) for pregnant women, 13 % (IQR = 4.8-20.8 %; n = 8) for persons with chronic diseases, and 9 % (IQR = 3-27 %; n = 15) for children. CONCLUSIONS: Countries/territories in the Americas successfully adapted influenza vaccination delivery to continue vaccination services during the COVID-19 pandemic; however, reported influenza vaccination coverage decreased from 2019 to 2021. Reversing declines in vaccination will necessitate strategic approaches that prioritize sustainable vaccination programs across the life course. Efforts should be made to improve the completeness and quality of administrative coverage data. Lessons learned from COVID-19 vaccination, such as the rapid development of electronic vaccination registries and digital certificates, might facilitate advances in coverage estimation.

Addressing Health Inequities and Disparities in Children With Kidney Disease in Disadvantaged Areas: the Latin American and Caribbean Experience.

Purpose of Review: Compared with high-income countries, healthcare disparities and inequities are more evident in low, lower-middle, and upper-middle-income countries with poorer housing and nutrition conditions. At least 20% of Latin America and the Caribbean are low and lower-middle-income countries. Despite the majority of the other countries being upper-middle income, the United Nations Children's Fund had classified all the regions as "less developed," with limited access to health care for the most vulnerable, the children. Latin America and the Caribbean regions represent an extensive territory with communication limitations and an unstable socio-political and economic environment. After considering the vast population affected by poverty worldwide and the long-term impact of kidney disease starting in childhood, it is crucial to better understand and analyze the multifactorial limiting conditions in accessing specialized care such as pediatric nephrology in disadvantaged areas. Recent Findings: Constraints in accessing basic healthcare in rural areas make it impossible to receive specialized pediatric nephrology care including dialysis and transplantation. Disturbingly, incidence and prevalence figures of acute kidney injury, chronic and end-stage kidney disease in some Latin American and the Caribbean countries are unknown, and these conditions still represent a death sentence for underprivileged populations. However, the monumental efforts of the dedicated healthcare providers and stakeholders that pioneered the actions in the past 50 years have shown remarkable progress in developing pediatric nephology services across the continent. Summary: In this review, we compile some of the latest evidence about the care of children and adolescents with kidney conditions in Latin America and the Caribbean, along with the experiences from the field in the care of these patients facing adverse conditions. We also highlight recommendations to address inequities and disparities.

COVID-19 and financial institution stability: stress testing the Eastern Caribbean currency union

PurposeThis paper aims to simulate the potential impact of increasing non-performing loans (NPLs) on capital adequacy, interest income and firm value of banks and credit unions in the Eastern Caribbean Currency Union (ECCU) using stress tests. Design/methodology/approachA financial stress testing model was deployed at the levels of individual financial intermediary (FI), sectoral loan portfolio composition, individual member country, and the ECCU collectively, to investigate the impact of NPL shocks on FI stability. FindingsThe authors find that shocks impact the capital adequacy of banks less than that of credit unions, but that firm value of banks is more susceptible to increases in NPLs. Interest income responses to NPL shocks were linked to credit exposure from the tourism sector, which also reduced capital adequacy more than other economic sectors. Findings show that while the COVID-19 pandemic occasioned some increase in NPLs, the magnitude of impact was significantly mitigated by pro-stability policies including loan repayment moratoria and restructuring, guidance on the distribution of profits and deleveraging by financial institutions leading up to 2020. Originality/valueThe paper is among the first to use stress testing on the Caribbean in response to the COVID-19 pandemic. Past studies which have used stress test models in the region have not explicitly investigated the impact of credit shocks on risk-weighted assets or interest income as done herein, nor do they include credit unions in the modeling. The results offer novel evaluations as well as implications for FIs in other developing economies, especially those that share a comparable financial and economic architecture.

Responding to the COVID-19: Technology and Tertiary Education

The COVID-19 pandemic demonstrated sharply the increasing interaction between scientific and technological know-how/capability and international relations. The pandemic forced the closure of schools across the Caribbean, including tertiary institutions. Many colleges and universities turned to technological tools and altered their pedagogy to enable continuity of teaching and learning. One such institution was The University of the West Indies (UWI) which faced many challenges and introduced adaptations to address this issue. As UWI continues to manoeuvre in the pandemic, it remains important to understand the impact of the pandemic on the University and the efficacy of actions taken to tackle the pandemic. This chapter will also highlight some of the issues that universities should address as they re-envision post-COVID-19 education. The pandemic provides a rare opportunity to reshape tertiary education so that the framework readily facilitates assessing different teaching and learning styles/formats, inclusive curricula, and the online challenges. This study was done by looking at the measures put in place at the University of the West Indies, St. Augustine Campus. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Introduction

The introduction sets the contextual framework for understanding the relevance of global security, its threats and concerns for the Caribbean. Unconventional security challenges commonly classified as "low politics” or "soft” issues are being recognized as "hard security” challenges in the twenty-first century. In fact, many of the supposed "new” threats addressed are old/long-standing: diseases, migration and refugees, human trafficking and crime, but deeply altered by globalization. Globalization increases the borderlessness of international relations, thereby redesigning and changing security issues in new and unanticipated ways. Compounding this situation is the recent COVID-19 pandemic which has been extremely disruptive within the global system. With dwindling support by the West towards non-Western countries and increasing insecurities, it becomes critical for the Caribbean region to advance its own path cognizant of its peculiarities. As such, the region must become proactive and seek ways of tackling these ʼnew' security threats or imminent ones. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Conclusion

Some policy conclusions and recommendations, geared toward Caribbean policy-makers, are made with the aim of capitalizing on the changing dynamics within the region. The research offers revisionist perspectives for policy-makers and technocrats within the English-speaking Caribbean. In the twenty-first century, the member states of the region have identified a number of shared security problems and have endorsed regional goals and approaches to address them;however, progress toward solutions has been slow. This book seeks to understand better the various approaches and framings of some security concerns at national and regional levels with a view to assessing efficiency. It is important to identify and proffer frameworks and approaches geared to better address some of these security challenges in the Caribbean region. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Factors associated with severe SARSCOV- 2 infection in people of Black ethnicities living with HIV in the UK

Background: The COVID-19 pandemic has disproportionally affected people of black ethnicities, who have been at greater risk of SARS-CoV-2 acquisition, morbidity and mortality than those of white ethnicity. We describe factors associated with severe COVID-19 infection in the GEN-AFRICA cohort of people of black ethnicities living with HIV in the U.K. Method(s): First reported episodes of COVID-19 up to October 2022 were ascertained by direct questioning and/or medical records review. Pre-pandemic immune-virological and comorbidity status was based on measurements obtained prior to 01/2020 and used to identify risk factors for severe (requiring hospitalisation or resulting in death) COVID-19, using logistic regression Results: COVID-19 status was available for 1806 (72%) of 2503 GEN-AFRICA participants (mean age 49.2 [SD 10.2] years;56% female;80% sub-Saharan African and 14% Caribbean ancestry, median CD4 count 555 [IQR 400-733] cells/mm3;93% undetectable HIV RNA [<200 copies/ mL]);573 (32%) reported a clinical illness consistent with COVID-19;63 (3.5%) experienced severe COVID-19 (hospitalisation 59;death 4). Those who experienced severe COVID-19 were older, more often male, had lower CD4 counts and fewer had undetectable HIV RNA;they more often had prior AIDS, hypertension, diabetes mellitus and chronic kidney disease. Region of ancestry, nadir CD4 count, and obesity were not associated with severe COVID-19. In multivariable analysis, CD4 count <350 cells/mm3, diabetes mellitus and chronic kidney disease were associated with increased odds of severe COVID-19 (Table). Sex and a pre-pandemic HIV RNA were associated with severe disease although this did not reach statistical significance. By October 2022, 1534 (88%) of this sample had received >=1 dose of SARS-CoV-2 vaccine;those who experienced severe COVID-19 were less likely to report vaccination (77% vs. 89%, p=0.01). Conclusion(s): By the end of October 2022, nearly onethird of people of Black ethnicities with HIV in this sample had experienced COVID-19;3.5% had developed severe COVID-19 disease. Pre-pandemic immunovirological and comorbidity status were associated with severe COVID-19. Black populations with less favourable HIV control than observed for GEN-AFRICA participants may have suffered greater COVID-19 morbidity and mortality. (Table Presented).

Bearing witness through pandemic borders and film: convergent media, mobility and Windrush Betrayal.

This paper examines the role of convergent media and the film, Windrush Betrayal (2020), in representing and challenging borders, mobilities and UK government immigration policies. Print and digital news provide important contexts for exploring media geographies of current events. Documentary film is also a provocative medium for investigative analyses that go beyond more general headline reporting. This study seeks to expand on earlier studies by examining how complementary mediums such as digital news media and film can respond to each other and become part of dynamic transnational conversations around place and identity. Media formats have been pushed to incorporate new settings and styles as Covid-19 restrictions have been implemented and alternative approaches utilised in media production. Adopting innovative techniques for filming in response to pandemic restrictions, Windrush Betrayal illustrates the ongoing impacts of immigration policies on Caribbean Diaspora populations in the UK. This paper provides a timely opportunity to tease out the ways in which changes in government immigration policies, media work practices and the production of migration narratives can highlight hidden geographical stories and marginalised voices.

Pharmacovigilance in the Caribbean Countries: an Overview.

Purpose of overview: The constant surge in accessing essential medicines creates a greater need for continuous monitoring of usage. The inability to source active pharmaceutical ingredients during the COVID-19 pandemic resulted in drug shortages that increased online requests for medications. E-commerce and social sites have opened the floodgate for the marketing of falsified, substandard, and unregistered pharmaceuticals, making them easily accessible to consumers with the click of a button. A high prevalence of such products with compromised quality highlights further the need for enhanced post-marketing vigilance of safety and quality within the pharmaceutical industry. This review aims to assess the extent to which pharmacovigilance (PV) systems in selected Caribbean countries conform to the minimum World Health Organization (WHO) requirements, highlight the importance of PV in ensuring the safer use of medicines across the Caribbean region, and identify opportunities and challenges in building comprehensive PV systems. Recent Findings: The review finds that while major advancements in PV and adverse drug reaction (ADR) monitoring have occurred in Europe and other parts of the Americas, little has been done in the Caribbean region. Only a few countries in the region are active members of the WHO's global PV network, and ADR reporting is minimal. The reason for low reporting includes a lack of awareness, commitment, and participation of healthcare professionals, manufacturers, authorized distributors, and the general consumers. Summary: Nearly all established national PV systems do not fully conform to the minimum PV requirements by the WHO. Legislation, regulatory framework, political commitment, adequate funding, strategies, and incentives to encourage reporting of ADRs are needed to build sustainable PV systems in the Caribbean.

Phenomenological study of teachers lived experience teaching remotely in Jamaica during the COVID-19 pandemic

This qualitative interpretive phenomenological study focused on teachers lived experiences teaching remotely online during the COVID-19 pandemic. The problem is that primary school teachers in Jamaica had limited resources and were suddenly pushed into a teaching environment that most were unfamiliar with. The teachers also had limited or no internet access to support online teaching. The findings were significant because it sums up the experiences of primary school teachers teaching online during the COVID-19 pandemic. Data were collected via Zoom and Microsoft Teams virtual interviews using semi-structured questions with a purposeful sample of 15 teachers with varying years of teaching experience. The data were transcribed verbatim and analyzed manually using the van Kaams method to help develop themes and uncover the essence of primary school teacher experiences. Five themes emerged from the semi-structured interview of 15 teachers. They were (a) uncertainty and confusion teaching online, (b) challenging/difficult teaching online, (c) lack of computer and limited or no internet access, (d) stressful overall, and (e) long working hours. Based on this study, there were several recommendations for leaders at the Ministry of Education. Two recommendations were to engage school leaders in conversations that inform digital policies and provide professional development on the effective use of digital devices and virtual instruction. Teachers should also integrate digital learning within the curriculum at least once weekly to familiarize students with the educational platform. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Characterization of patients with COVID-19 in pinar del rio, March 2020 - March 2021

Introduction: the study of the characteristics of patients with COVID-19 makes it possible to determine risk groups in specific populations and to outline strategies by the institutions to improve the quality of care for these patients. Background: to characterize patients with COVID-19 in Pinar del Rio between March 2020 and March 2021. Methods: an observational, descriptive and cross-sectional study was carried out in patients diagnosed with COVID-19 in the province of Pinar del Rio between March 2020 and March 2021. The sample consisted of 450 patients who met the inclusion and exclusion criteria. Descriptive statistics were used for data analysis. Results: female patients predominated (56%), with a history of arterial hypertension (24,6%). A high incidence of COVID was found in individuals with between two and five chronic non-communicable diseases (40,2%). Of all patients diagnosed with COVID-19, 49% were passive smokers. Conclusions: COVID-19 occurred mainly in patients with several chronic diseases, as well as in those exposed.

Resilient Coping is More Important Than Previous Virtual Learning Experience: Predicting Pharmacy Student Stress During the COVID-19 Pandemic.

Purpose: The COVID-19 pandemic precipitated a swift transition to online learning in medical and health sciences. This study investigated the associations of previous experience with online learning, current confidence with online learning, and resilient coping skills with perceived stress reported by pharmacy students during the emergency transition to online learning. Methods: Undergraduate pharmacy students (N=113, response rate = 41%) completed an online, self-report, cross-sectional survey during April-June 2020. Measures included Likert items measuring prior experience and current comfort levels with online learning, the Brief Resilient Coping Scale (BRCS), and the Perceived Stress Scale 10-Item Version (PSS-10). Experience, comfort with online learning, reported scores, and internal consistency for the BRCS and PSS-10 were summarized. A linear regression model examined the associations of prior experience with online education, gender, and resilient coping with perceived stress. Results: Of the 113 respondents (78% female, mean age 22.3 years), > 50% had only occasional prior experience with online learning, coursework, and examinations, but 63% expressed confidence with online learning. Mean PSS-10 and BRCS scores were 23.8 and 13.3, respectively, and both scales demonstrated good internal consistency (α > 0.80). BRCS score was the single predictor of the PSS-10 score (r2 = 0.18, p < 0.001). Female gender was not a significant predictor (p = 0.11). A multiple regression model explained moderate variation in perceived stress (adjusted R2 = 0.19). Conclusion: PSS-10 and BRCS scores indicated moderate levels of stress and coping skills among students during online teaching. Most students had some prior exposure to online learning, coursework, and examinations. Higher resiliency scores, but not prior online learning experience, predicted lower perceived stress.