Determining the Impact of Hurricane Dorian and the Covid-19 Pandemic on Moral Distress in Emergency Medical Providers at the Rand Memorial Hospital: Moral distress in emergency medical personnel.

OBJECTIVES: The aim of this work was to determine the impact of Moral Distress (MD) in emergency physicians, nurses, and emergency medical service staff at the Rand Memorial Hospital (RMH) in the Bahamas, and the impact of Hurricane Dorian and the COVID-19 pandemic on Moral Distress. METHOD: A cross-sectional study utilizing a 3-part survey, which collected sociodemographic information, Hurricane Dorian and COVID-19 experiences, as well as responses to a validated modified Moral Distress Scale (MDS). RESULTS: Participants with 2 negatively impactful experiences from COVID-19 had statistically significantly increased MD compared to participants with only 1 negatively impactful experience (40.4 vs. 23.6, P = 0.014). Losing a loved one due to COVID-19 was associated with significantly decreased MD (B = - 0.42, 95% CI -19.70 to -0.88, P = 0.03). Losing a loved one due to Hurricane Dorian had a non-statistically significant trend towards higher MD scores (B = 0.34, 95% CI -1.23 to 28.75, P = 0.07). CONCLUSION: The emergency medical staff at the RMH reported having mild - moderate MD. This is one of the first studies to look at the impact of concurrent disasters on MD in emergency medical providers in the Bahamas.

Research methods challenges: A case study of preparedness in The Bahamas.

Disaster research is essential for developing more robust and contextualised policies. It is, therefore, no surprise that multilateral organisations like the United Nations and the World Bank have called for enhanced disaster-related frameworks, legislation and policies in developing countries using quality data. However, internal and external researchers and practitioners often face significant challenges collecting data in these nations because of a range of problems including, but not limited to, incomplete sampling frames, inadequate infrastructure or unstable governments. This reality leads one to question: is the cart coming before the horse? This study explored individual and household (IH) preparedness in The Bahamas - a small island developing state in the Caribbean. An online survey was used, and 629 Bahamians opted to participate. However, the researchers faced many barriers to collecting representative data. This case study, therefore, discusses the range of methodological challenges faced by the researchers and their impact on this study. Contribution: This article substantially contributes to the disaster literature by exploring the challenges associated with conducting IH preparedness research in The Bahamas. This article also reminds practitioners and academics of the issues associated with collecting data in developing nations and its implications for policy enhancement and development. Furthermore, the authors present various recommendations ranging from enhanced funding to recognising the need for methodological innovation to support continuous research in countries like The Bahamas.

Systematic surveillance tools to reduce rodent pests in disadvantaged urban areas can empower communities and improve public health.

Rodents are notorious pests, known for transmitting major public health diseases and causing agricultural and economic losses. The lack of site-specific and national standardised rodent surveillance in several disadvantaged communities has rendered interventions targeted towards rodent control as often ineffective. Here, by using the example from a pilot case-study in the Bahamas, we present a unique experience wherein, through multidisciplinary and community engagement, we simultaneously developed a standardised national surveillance protocol, and performed two parallel but integrated activities: (1) eight days of theoretical and practical training of selected participants; and (2) a three-month post-training pilot rodent surveillance in the urban community of Over-the-Hill, Nassau, The Bahamas. To account for social and environmental conditions influencing rodent proliferation in the Bahamas, we engaged selected influential community members through a semi-structured interview and gathered additional site-specific information using a modified Centers for Diseases Control and Prevention (CDC) exterior and interior rodent evaluation form, along with other validated instruments such as tracking plates and snap trapping, to test and establish a standardised site-specific rodent surveillance protocol tailored for the Bahamas. Our engagement with community members highlighted poor disposal of animal and human food, irregular garbage collection, unapproved refuse storage, lack of accessible dumpsters, poor bulk waste management, ownership problems and structural deficiencies as major factors fuelling rodent proliferation in the study areas. Accordingly, results from our pilot survey using active rodent signs (that is, the presence of rodent runs, burrows, faecal material or gnawed material) as a proxy of rodent infestation in a generalized linear model confirmed that the variables earlier identified during the community engagement program as significantly correlated with rodent activities (and capturing) across the study areas. The successful implementation of the novel site-specific protocol by trained participants, along with the correlation of their findings with those recorded during the community engagement program, underscores its suitability and applicability in disadvantaged urban settings. This experience should serve as a reference for promoting a standardised protocol for monitoring rodent activities in many disadvantaged urban settings of the Global South, while also fostering a holistic understanding of rodent proliferation. Through this pilot case-study, we advocate for the feasibility of developing sustainable rodent control interventions that are acceptable to both local communities and public authorities, particularly through the involvement of a multidisciplinary team of professionals and community members.

The influence of socioenvironmental risk factors on risk-taking behaviors among Bahamian adolescents: a structural equation modeling analysis.

Background: Adolescents' risk-taking behaviors can have profound impacts on their future health. Few studies have established a relationship between multiple social environmental factors and adolescent risk behaviors. We used structural equation modeling to examine the role of parental monitoring and environmental risks on adolescents' behavioral intentions and risk behaviors. Methods: Data were collected through the baseline survey of a national implementation project among 2205 Grade 6 students in 24 government schools in The Bahamas in 2019. Structural equation modeling examined relations among parental monitoring, environmental risk factors, behavioral intentions, and risk behaviors. Results: Students had engaged in various delinquent, substance use, and sexual risks. In the structural equation model, parental monitoring demonstrated direct negative (protective) effects on behavioral intentions and risk behaviors, whereas environmental risk factors had a direct positive effect on adolescent behavioral intentions and risk behaviors. The model had an R2 value of 0.57 for adolescent risk behaviors. Conclusion: Parental monitoring and environmental risk factors had strong influences on risk-taking behaviors of early adolescents. Future adolescent health behavior interventions should consider offering additional prevention resources to early adolescents who are exposed to multiple environmental risk factors.

Microbialite Accretion and Growth: Lessons from Shark Bay and the Bahamas.

Microbialites provide geological evidence of one of Earth's oldest ecosystems, potentially recording long-standing interactions between coevolving life and the environment. Here, we focus on microbialite accretion and growth and consider how environmental and microbial forces that characterize living ecosystems in Shark Bay and the Bahamas interact to form an initial microbialite architecture, which in turn establishes distinct evolutionary pathways. A conceptual three-dimensional model is developed for microbialite accretion that emphasizes the importance of a dynamic balance between extrinsic and intrinsic factors in determining the initial architecture. We then explore how early taphonomic and diagenetic processes modify the initial architecture, culminating in various styles of preservation in the rock record. The timing of lithification of microbial products is critical in determining growth patterns and preservation potential. Study results have shown that all microbialites are not created equal; the unique evolutionary history of an individual microbialite matters.

Effects of Teacher Training and Continued Support on the Delivery of an Evidence-Based HIV Prevention Program: Findings From a National Implementation Study in the Bahamas.

BACKGROUND: Few studies have investigated the effects of teacher training and continued support on teachers' delivery of evidence-based HIV prevention programs. We examined these factors in a national implementation study of an evidence-based HIV risk reduction intervention for adolescents in the sixth grade in the Bahamas. METHODS: Data were collected from 126 grade 6 teachers and 3,118 students in 58 government elementary schools in the Bahamas in 2019-2021. This is a Hybrid Type III implementation study guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) model. Teachers attended 2-day training workshops. Trained school coordinators and peer mentors provided biweekly monitoring and mentorship. We used mixed-effects models to assess the effects of teacher training and continued support on implementation fidelity. RESULTS: Teachers who received training in-person or both in-person and online taught the most core activities (27.0 and 27.2 of 35), versus only online training (21.9) and no training (14.9) (F = 15.27, p < .001). Teachers with an "excellent" or "very good" school coordinator taught more core activities than those with a "satisfactory" coordinator or no coordinator (29.2 vs. 27.8 vs. 19.3 vs. 14.8, F = 29.20, p < .001). Teachers with a "very good" mentor taught more core activities and sessions than those with a "satisfactory" mentor or no mentor (30.4 vs. 25.0 vs. 23.1; F = 7.20; p < .01). Teacher training, implementation monitoring, peer mentoring, teachers' self-efficacy, and school-level support were associated with implementation fidelity, which in turn was associated with improved student outcomes (HIV/AIDS knowledge, preventive reproductive health skills, self-efficacy, and intention to use protection). CONCLUSION: Teachers receiving in-person training and those having higher-rated school coordinator and mentor support taught a larger number of HIV prevention core activities. Effective teacher training, implementation monitoring, and peer mentoring are critical for improving implementation fidelity and student outcomes.

Exploring effects of multi-level factors on transitions of risk-taking behaviors among middle-to-late adolescents.

Adolescents experiment with risk behaviors, including delinquency, substance use, and sexual activity. Multi-level social factors, such as having high-risk peers, neighborhood risks, and parental monitoring, influence adolescents' behaviors. We modeled transition patterns in Bahamian adolescents' risk behaviors across three high school years and examined the effects of multi-level factors. We collected data from 2,564 Bahamian adolescents in Grade 10 and follow-ups through Grade 12. We used latent transition model to identify adolescents' risk statuses. Further analyses used multinomial logistic regression to explore the effects of multi-level factors on assignment to those latent statuses and transitions. We identified four distinct statuses: "low risk" (47.9% of the sample at baseline), "alcohol use" (36.8%), "alcohol use and sexual activity" (5.5%), and "high risk" (9.8%). Males were more likely to be in higher-risk statuses at baseline and to transition from a lower-risk status in Grade 10 to a higher-risk status in Grade 11. Social risk factors were significantly associated with higher-risk statuses at baseline. Neighborhood risk and peer risk involvement continued to affect transitions from lower to higher risk; parental monitoring did not have a significant effect in later years. Our findings have important implications for developing targeted and developmentally appropriate interventions to prevent and reduce risk behaviors among middle-to-late adolescents.

Identifying opportunities for harmonized microplastics and mesoplastics monitoring for Caribbean Small Island Developing States using a spatiotemporal assessment of beaches in South Eleuthera, The Bahamas.

Increasing quantities of microplastics and mesoplastics in the marine environment underscore the need for marine microplastics to be included in the global Plastics Treaty to end plastic pollution. Caribbean Small Island Developing States (SIDS) lack harmonized microplastics monitoring protocols, leaving them data deficient at the science-policy interface required for treaty negotiations. This baseline study assessed spatial and seasonal abundance and distribution of microplastic (1-5 mm) and mesoplastic (5-25 mm) on 16 beaches with three coastal exposures (Atlantic Ocean, Exuma Sound, Bahama Bank) in South Eleuthera, The Bahamas and its implications for Caribbean SIDS. Microplastics were the dominant debris type sampled (74 %) across all beaches, with significant spatial (p = 0.0005) and seasonal (p = 0.0363) differences in abundance and distribution across study sites. This baseline study identifies opportunities required for developing harmonized microplastics and mesoplastics monitoring by Caribbean SIDS to collect data to help support global plastics treaty negotiations.

Historical DNA from a rediscovered nineteenth-century paratype reveals genetic continuity of a Bahamian hutia (Geocapromys ingrahami) population.

Past and ongoing human activities have shaped the geographical ranges and diversity of species. New genomic techniques applied to degraded samples, such as those from natural history collections, can uncover the complex evolutionary consequences of human pressures and generate baselines for interpreting magnitudes of species loss or persistence relevant to conservation. Here we integrate mitogenomic data with historical records from a recently rediscovered Bahamian hutia (Geocapromys ingrahami; (FMP Z02816)) specimen at the Fairbanks Museum & Planetarium (Vermont, USA) to determine when and where the specimen was collected and to place it in a phylogenetic context with specimens that both predate (palaeontological) and postdate (archaeological) human arrival in The Bahamas. We determined that this specimen was part of the same population as the named holotype specimen in 1891 on East Plana Cay (EPC). Bahamian hutia populations were widely extirpated following European colonization. Today, EPC hosts the last remaining natural Bahamian hutia population. Mitogenomic data places the focal specimen within the southern Bahamian hutia population, which is now largely restricted to EPC. The results reveal previously undocumented genetic continuity among the EPC population for at least the past 500 years, highlighting how 'dark' museum specimens inform new conservation-relevant understandings of diversity.

A new species of the hagfish genus Eptatretus (Myxinidae) from the Bahamas, western North Atlantic.

A new species of the hagfish genus Eptatretus (Myxinidae) is described based on two specimens (407-433 mm total length) collected off the northern Bahamas, between depths of 910 and 1153 m. The new species is distinguished from its congeners by having seven pairs of gill apertures well-spaced and arranged in a near straight line, a 3/2 multicusp pattern of teeth, 10-11 anterior unicusps, 50-51 total cusps, 12-14 prebranchial pores, 48-52 trunk pores, 79-84 total pores, and no nasal-sinus papillae. An identification key for the species of Eptatretus from the western Atlantic Ocean is also provided.

The origin of carbonate mud and implications for global climate.

Carbonate mud represents one of the most important geochemical archives for reconstructing ancient climatic, environmental, and evolutionary change from the rock record. Mud also represents a major sink in the global carbon cycle. Yet, there remains no consensus about how and where carbonate mud is formed. Here, we present stable isotope and trace-element data from carbonate constituents in the Bahamas, including ooids, corals, foraminifera, and algae. We use geochemical fingerprinting to demonstrate that carbonate mud cannot be sourced from the abrasion and mixture of any combination of these macroscopic grains. Instead, an inverse Bayesian mixing model requires the presence of an additional aragonite source. We posit that this source represents a direct seawater precipitate. We use geological and geochemical data to show that "whitings" are unlikely to be the dominant source of this precipitate and, instead, present a model for mud precipitation on the bank margins that can explain the geographical distribution, clumped-isotope thermometry, and stable isotope signature of carbonate mud. Next, we address the enigma of why mud and ooids are so abundant in the Bahamas, yet so rare in the rest of the world: Mediterranean outflow feeds the Bahamas with the most alkaline waters in the modern ocean (>99.7th-percentile). Such high alkalinity appears to be a prerequisite for the nonskeletal carbonate factory because, when Mediterranean outflow was reduced in the Miocene, Bahamian carbonate export ceased for 3-million-years. Finally, we show how shutting off and turning on the shallow carbonate factory can send ripples through the global climate system.

Impact of sustained health policy and population-level interventions on reducing the prevalence of obesity in the Caribbean region: A qualitative study from The Bahamas.

Background: The 2020 Global Nutrition Report highlights that despite improvements in select nutrition indicators, progress is too slow to meet the 2025 Global Nutrition Targets. While the Latin America and the Caribbean (LAC) region has achieved the greatest global reduction in undernutrition (stunting, underweight, and wasting) in the past decade, it also has the highest prevalence of people with overweight worldwide. Since the early 2000s, the region has mounted increasingly comprehensive and multi-sectoral policy interventions to address nutritional health outcomes. The Bahamas is one such LAC country that has used consistent policy responses to address evolving nutritional challenges in its population. After addressing the initial problems of undernutrition in the 1970s and 80s, however, overconsumption of unhealthy foods has led to a rising prevalence of obesity which The Bahamas has grappled with since the early 2000s. Objective: This study develops a timeline of obesity-related health policy responses and explores the macrosocial factors and conditions which facilitated or constrained public health policy responses to obesity in The Bahamas over a 20-year period. Methods: This multi-method case study was conducted between 2019 and 2021. A document review of health policies was combined with secondary analysis of a range of other documents and semi-structured interviews with key actors (policymakers, health workers, scholars, and members of the public). Data sources for secondary data analysis included policy documents, national survey data on obesity, national and regional newspaper websites, and the Digital Library of the Caribbean database. An adapted framework approach was used for the analysis of semi-structured interviews. Results: Between 2000 and 2019, a series of national policies and community-level interventions were enacted to address the prevalence of obesity. Building on previous interventions, obtaining multi-sectoral collaboration, and community buy-in for policy action contributed to reducing obesity prevalence from 49.2 to 43.7% between 2012 and 2019. There are, however, constraining factors, such as political and multi-sectoral challenges and gaps in legislative mandates and financing. Conclusion: Sustained multilevel interventions are effective in addressing the prevalence of obesity. To maintain progress, there is a need to implement gender-specific responses while ensuring accessibility, availability, and affordability of nutritious food for all.

Comparing standard versus enhanced implementation of an evidence-based HIV prevention program among Bahamian sixth grade students: findings from nationwide implementation trials.

BACKGROUND: Effective implementation strategies are needed to address the challenges encountered by teachers in implementation of evidence-based HV prevention programs in schools. The current study: 1) compares implementation fidelity of Focus on Youth in the Caribbean (FOYC) plus Caribbean Informed Parents and Children Together (CImPACT) intervention using enhanced implementation strategies (including biweekly monitoring/feedback and site-based mentoring) to those using more traditional approach (teacher training only); and 2) evaluates the impact of school coordinators' and mentors' performance on teachers' implementation fidelity and student outcomes. METHODS: Data from an enhanced implementation trial in 2019-2020, involving 24 government primary schools, 79 teachers, and 2252 students, were compared to data from a standard implementation trial in 2011-2012, involving 35 government primary schools, 110 teachers and 2811 students using mixed-effects modeling and structural equation modeling. FINDINGS: Teachers in the 2019-2020 trial taught more core activities (28.3 vs. 16.3, t = 10.80, P < 0.001) and sessions (7.2 vs. 4.4, t = 9.14, P < 0.001) than those participating in the 2011-2012 trial. Teachers taught > 80% of the intervention curriculum in 2019-2020 compared to 50% curriculum delivery in 2011-2012. Teachers who had a "very good" or "excellent" school coordinator in their schools taught more core activities than those who had a "satisfactory" school coordinator (30.4 vs. 29.6 vs. 22.3, F = 18.54, P < 0.001). Teachers who worked in a school which had a "very good" mentor, taught more core activities than those teachers who did not have a mentor or had only a "satisfactory" mentor (30.4 vs. 27.6; t = 2.96; p = 0.004). Teachers' confidence in implementing core activities, comfort level with the curriculum, attitudes towards sex education in schools, and perceived principal support were significantly related to increased self-efficacy, which in turn was related to teachers' implementation fidelity. The degree of implementation was significantly associated with improved student outcomes. IMPLICATIONS/CONCLUSION: An evidence-based HIV prevention intervention can achieve a high degree of implementation when delivered with enhanced implementation strategies and implementation monitoring. Future program implementers should consider the purposeful selection and training of school coordinators and mentors to support low-implementing teachers as a potentially important strategy when attempting to achieve high-quality implementation of school-based interventions.

Swimming kinematics of the Caribbean reef shark, Carcharhinus perezi.

The Caribbean reef shark, Carcharhinus perezi, is known to rest on the substrate, a behaviour not documented in any of its congeners. We quantified the swimming kinematics of C. perezi in the wild and found that the head yawed at a frequency 15% greater than the tail beat, but that the amplitude of the tail exceeded the head yaw by approximately 80% across the range of velocities measured. We found that C. perezi velocity, head yaw frequency, and tailbeat frequency were all less than its obligate ram ventilating congener C. limbatus.

The Effectiveness of Two Implementation Strategies for Improving Teachers' Delivery of an Evidenced-based HIV Prevention Program.

BACKGROUND: Effective implementation strategies are needed to enhance the success of evidence-based prevention programs. The current study evaluates the effects of two implementation strategies on teachers' implementation of an evidenced-based HIV intervention. METHODS: Using our 7-item pre-implementation school screening tool, we identified teachers who were at-risk for not implementing the Focus on Youth HIV-risk reduction intervention curriculum which targets grade six through grade 8 students. After completing a two-day curriculum workshop, 81 low- and moderate-performing teachers were randomly assigned to one of four experimental conditions and were asked to teach the two-month intervention curriculum. This optimization trial examines the impact of two implementation strategies: biweekly monitoring/feedbacks (BMF) and site-based assistance/mentorship (SAM). The primary outcome is implementation fidelity defined as number of core activities taught. Linear mixed-effects model was used to examine the association of the implementation strategies with implementation fidelity. RESULTS: BMF and SAM were significantly associated with teachers' implementation fidelity. Teachers who received both BFM and SAM taught the greatest numbers of core activities (15 core activities on average), followed by teachers who received either BMF (6.9 activities) or SAM (7.9 activities). Teachers who did not receive BMF or SAM taught the lowest numbers (4.1 activities). Teachers' sustained implementation of FOYC in the prior school year was related to increased implementation fidelity during the optimization trial. Teachers' confidence in implementing five core activities, attitudes toward sex education in schools, and perceived principal support were significantly related to increased self-efficacy, which in turn was related to teachers' fidelity of implementation before the optimization trial. CONCLUSION: BMF and SAM are effective in promoting teachers' implementation of youth evidence-based interventions. Researchers and future program implementers should consider teacher training, teachers' attitudes toward sex education, perceived principal support, and self-efficacy when attempting to maintain the effects of teacher-delivered interventions in schools.

Validity of the Food Insecurity Experience Scale and prevalence of food insecurity in The Bahamas.

INTRODUCTION: Despite UN recommendations to monitor food insecurity using the Food Insecurity Experience Scale (FIES), to date there are no published reports of its validity for The Bahamas, nor have prevalence rates of moderate or severe food insecurity been reported for the remote island nation. At the same time, food security is a deep concern, with increasing incidence of natural disasters and health concerns related to diet-related disease and dietary quality plaguing the nation and its food system. This article aims to examine the validity of the FIES for use in The Bahamas, the prevalence of moderate and severe food insecurity, and the sociodemographic factors that contribute to increased food insecurity. METHODS: The FIES survey was administered by randomized and weighted landline telephone survey in Nassau in The Bahamas to 1000 participants in June and July 2017. The Rasch modelling procedure was applied to examine tool validity and prevalence of food insecurity. Equating procedures calibrated this study's results to the global FIES reference scale and computed internationally comparable prevalence rates of both moderate and severe food insecurity. A regression analysis assessed the relationship between household variables and food security. RESULTS: The FIES met benchmarks for fit statistics for all eight items and the overall Rasch reliability is 0.7. As of 2017, Bahamians' prevalence of moderate and severe food insecurity was 21%, and the prevalence of severe food insecurity was 10%. Statistically significant variables that contribute to food insecurity included education, age, gender, and presence of diabetes, high blood pressure, or heart disease. Results also indicated that Bahamians experience food insecurity differently than populations across the globe, likely due in large part to the workings of an isolated food system heavily dependent on foreign imports. Responses showed that by the time a Bahamian worries they will not have enough food to eat, they have already restricted their meals to a few kinds of foods and begun to limit their intake of vegetables and fruits. CONCLUSION: This study, which is among the first to comprehensively measure food security in The Bahamas, provides a baseline for further research and evaluation of practices aimed at mitigating food insecurity in small island developing states. Further, this study provides a benchmark for future research, which may seek to understand the impacts of Hurricane Dorian and COVID-19, disasters further isolating the remote island nation. Post-disaster food security data are needed to further understand the extent to which food security is impacted by natural disasters and identify which sectors and stakeholders are most vital in restructuring the agricultural sector and improving food availability following catastrophic events.

Complete mitochondrial genome of the Caribbean reef shark, Carcharhinus perezi (Carcharhinformes: Carcharhinidae).

The Caribbean reef shark (Carcharhinus perezi; Poey, 1876) is a medium to large-bodied coastal and reef-associated predator found throughout the subtropical and tropical waters of the Atlantic Ocean and Caribbean Sea, although its populations are increasingly threatened by overfishing. We describe the first mitochondrial genome sequence for this species, using Illumina MiSeq sequencing of an individual from The Bahamas. We report the mitogenome sequence of the Caribbean reef shark to be 16,709 bp and composed two rRNA genes, 22 tRNA genes, 13 protein-coding genes, 2 non-coding regions; the D-loop control region and the origin of light-strand replication. We discuss the implications of this new information on future monitoring efforts and conservation measures such as marine protected areas, and urge for greater application of mitochondrial studies of sharks in the Atlantic Ocean.

Sea-level trends across The Bahamas constrain peak last interglacial ice melt.

During the last interglacial (LIG) period, global mean sea level (GMSL) was higher than at present, likely driven by greater high-latitude insolation. Past sea-level estimates require elevation measurements and age determination of marine sediments that formed at or near sea level, and those elevations must be corrected for glacial isostatic adjustment (GIA). However, this GIA correction is subject to uncertainties in the GIA model inputs, namely, Earth's rheology and past ice history, which reduces precision and accuracy in estimates of past GMSL. To better constrain the GIA process, we compare our data and existing LIG sea-level data across the Bahamian archipelago with a suite of 576 GIA model predictions. We calculated weights for each GIA model based on how well the model fits spatial trends in the regional sea-level data and then used the weighted GIA corrections to revise estimates of GMSL during the LIG. During the LIG, we find a 95% probability that global sea level peaked at least 1.2 m higher than today, and it is very unlikely (5% probability) to have exceeded 5.3 m. Estimates increase by up to 30% (decrease by up to 20%) for portions of melt that originate from the Greenland ice sheet (West Antarctic ice sheet). Altogether, this work suggests that LIG GMSL may be lower than previously assumed.

Predation risk and the evolution of a vertebrate stress response: Parallel evolution of stress reactivity and sexual dimorphism.

Predation risk is often invoked to explain variation in stress responses. Yet, the answers to several key questions remain elusive, including the following: (1) how predation risk influences the evolution of stress phenotypes, (2) the relative importance of environmental versus genetic factors in stress reactivity and (3) sexual dimorphism in stress physiology. To address these questions, we explored variation in stress reactivity (ventilation frequency) in a post-Pleistocene radiation of live-bearing fish, where Bahamas mosquitofish (Gambusia hubbsi) inhabit isolated blue holes that differ in predation risk. Individuals of populations coexisting with predators exhibited similar, relatively low stress reactivity as compared to low-predation populations. We suggest that this dampened stress reactivity has evolved to reduce energy expenditure in environments with frequent and intense stressors, such as piscivorous fish. Importantly, the magnitude of stress responses exhibited by fish from high-predation sites in the wild changed very little after two generations of laboratory rearing in the absence of predators. By comparison, low-predation populations exhibited greater among-population variation and larger changes subsequent to laboratory rearing. These low-predation populations appear to have evolved more dampened stress responses in blue holes with lower food availability. Moreover, females showed a lower ventilation frequency, and this sexual dimorphism was stronger in high-predation populations. This may reflect a greater premium placed on energy efficiency in live-bearing females, especially under high-predation risk where females show higher fecundities. Altogether, by demonstrating parallel adaptive divergence in stress reactivity, we highlight how energetic trade-offs may mould the evolution of the vertebrate stress response under varying predation risk and resource availability.

Perceived Confidence to Interpret Diagnostic Imaging: The Bahamian Physiotherapists' Perspective

ABSTRACT Objective: This study explored Bahamian physiotherapists' perception of the usefulness of radiologic imaging in physiotherapy practice and evaluated their self-reported level of confidence in viewing and interpreting these images. The associations among their academic qualifications, sector of practice and confidence were also examined. Methods: Ethical approval was granted by the University Hospital of the West Indies (UWI/FMS) Ethics Committee and the local hospitals in Nassau, Bahamas. Practicing physiotherapists were invited to participate. Physiotherapy interns, retired physiotherapists and workers designated as physiotherapy assistants/aids were excluded. Only the physiotherapists who gave their consent participated in the study. Results: There was a 75% response rate. Most of the respondents held the Bachelor of Science degree in physiotherapy as their highest academic qualification. The respondents agreed that it is essential for physiotherapists to know how to view and interpret medical imaging. The majority of them reported confidence in interpreting plain X-rays (97%, n = 29). Those with postgraduate qualifications were likely to report greater confidence. Those in private practice were more likely to report confidence with computed tomography (CT) scans, magnetic resonance imaging (MRI), ultrasound (US), and bone scans while those in public practice were most likely to be more confident with X-rays. Most of the respondents expressed a need for more training in the viewing and interpretations of neurological imaging (86.7%, n = 26), US (50%, n = 15), MRI (63.3%, n = 19), and CT scans (43.3%, n = 13). Conclusion: Overall, the results demonstrated that physiotherapists in the Bahamas perceived it essential for physiotherapists to know how to view and interpret medical imaging and that their confidence in interpreting such imaging varied. The 30 physiotherapists expressed the need for further training of physiotherapists.