Central America Health Sciences University

Background: High social support is easily assessed and associated with a healthier lifestyle, including vaccination adherence. Similarly, immunization is a widely available public health statistic associated with healthier behaviors. However, the link between the hepatitis immunization status and social support needs to be explored. Methods: We assessed the association between levels of social support and hepatitis immunization status using the National Health and Nutrition Examination Survey (NHANES), a cross-sectional multidisciplinary database publicly available for researchers. With 2005–2006 data, 2997 participants were included. Statistical analyses were conducted using STATA18.5v software, including the odds ratio of both univariable logistic regression and multivariable logistic regression. After adjusting for clinically relevant confounders, two distinct models were designed: 1) full immunization, and 2) incomplete immunization. Results: Multivariable analysis revealed significantly greater odds of high social support for participants fully or partially immunized against both hepatitis A and B: 3.15 (95% CI 1.03–9.66,p=0.04) and 3.35 (95% CI 1.15–9.75,p=0.03), respectively. Conclusion: Our findings show an association between vaccination and social support in both adjusted models. Individuals not vaccinated at all may behave differently from those willing to be, at least partially, immunized. It seems that a similar behavior that may lead to vaccination may also lead to increased social support. Therefore, our study suggests that hepatitis vaccination could perhaps be a surrogate marker for public-health-related outcomes.

IntroductionSeagrass sediments are important ‘blue carbon’ reservoirs which store climatically significant quantities of organic carbon (Corg) at the global scale. Seagrass meadows that overly these sediments also provide a range of critical ecosystem services including shoreline stabilization, storm surge protection, and fisheries nursery grounds. However, the controls over accumulation and the sources of organic C to these sediments beds are highly variable and poorly understood with the relative importance of hydrodynamic setting, species composition and canopy density being unclear.MethodsHere we address these questions using the first observation-based estimates of Corg stocks and provenance on Turneffe Atoll, Belize, made via remotely-sensed habitat extent, local Corg data and isotopic data. Sedimentary Corg was highest in sediments underlying the most sheltered meadows and decreased with increasing exposure to wind and wave energy with the seagrass meadows in the central lagoon containing an extensive deposit of mangrove derived organic carbon, stabilized and protected by the overlying seagrass meadow.ResultsThe influence of species composition appeared weak with the ubiquitous species T. testudinum occurring across a wide range of hydrodynamic regimes ranging from the most sheltered to the most energetic and being associated with a wide range of sedimentary organic C concentrations. Importantly from the perspective of remote sensing, org C concentrations were unrelated to canopy density. We hypothesize that this decoupling of organic C concentration from seagrass canopy cover reflects a much longer timescale for carbon storage in the sediments than the lifespan of the seagrass plants themselves and/or a substantial non seagrass derived organic C burden in seagrass sediments. Overall, we conservatively estimate that the top 30cm of sediments underlying the seagrass meadows overlying carbonate sediments on the atoll exterior store 0.58 x 106 Mg Corg, most of which is seagrass-derived, whilst the sediments underlying the meadows within the central lagoon store an additional 1.28 x 106 Mg Corg. When the maximum possible extent of seagrass is considered, this estimate increases to 3.54 x 106 Mg Corg. Substantial Corg stocks extending >1m depth were observed across all sites, and so these inventories are considered conservative.DiscussionA preliminary ‘cost of loss’ for sedimentary Corg in the top 30 cm of Turneffe Atoll’s seagrass meadows, based on a carbon trading value of €60 tCO2 (eq), is estimated at €42 million for the outer atoll, increasing to €136 million when the mangrove-derived sediments of the central atoll are considered and €260 million when turbid areas are assumed to contain seagrass.

Background: The study assessed the perception of parents on barriers and facilitators treatment outcomes among children and adolescents attending psychotherapy services in a primary health care centre. Methods: A cross sectional descriptive study using both quantitative and qualitative methods. The quantitative method used retrospective review of records of 65 children and adolescent clients who accessed psychotherapy services between January 2022 and December 2023 at Port Loyola Health Centre in Belize city. The qualitative method used in-depth interviews of twenty parents of the patients randomly selected from the clinic registers. Univariate and bivariate analyses was used for the quantitative data while thematic analysis was used for the qualitative data. Results: 25 (38.5%) of the patients completed their treatment and 34 (52.3%) dropped out, with half dropped out after the first visit. The identified parental perceived barriers and facilitators are organized into four main themes. The first theme was related to knowledge and understanding of mental health problems by the parents which showed that respondents had good knowledge about mental health problems. The second theme identified attitudes towards treatment as a major factor to completion of treatment. The third theme was related to structural factors like transportation cost and parents’ work schedule identified as key barriers. The fourth theme was related to inconvenient appointment time and lack of flexibility in the scheduling of appointment at the clinic. Conclusions: The study highlights key areas of interventions to minimize barriers to completion of treatment among children accessing mental health services.

BackgroundThe relation of diabetes mellitus with cardiovascular diseases is well-known, even acute coronary syndrome (ACS). High levels of glycated haemoglobin (HbA1c) are used is a sign of long-term glycemic control and may be associated with severity in coronary artery disease (CAD). In this particular setting, the aim of this investigation was to examine the relationship between the HbA1c values and the angiographic patterns of patients who were admitted with an ACS diagnosis.MethodologyA cross-sectional study included 120 patients diagnosed with ACS. The criteria for eligibility included patients with ST-elevation myocardial infarction, unstable angina, and non-ST elevation myocardial infarction with history of documented diabetes mellitus. Every patient had a suitable clinical examination, had their HbA1c checked, and had coronary angiography to determine the severity of their CAD. Descriptive statistics and ANOVA were performed for statistical analyses to determine the connection between angiographic patterns and HbA1c.ResultsPatients with elevated HbA1c levels demonstrated a strong association with severe coronary artery disease. Notably, those with HbA1c exceeding 10.5% exhibited significant triple vessel disease and Type C lesions, indicative of advanced coronary artery disease. Statistical analyses revealed a marked difference in angiographic patterns across various HbA1c categories (p < 0.05).ConclusionThe findings of this study suggest that maintaining optimal HbA1c levels is essential for mitigating the severity of coronary artery disease in patients with ACS. Moreover, effective glycemic control may be protective against advanced coronary atherosclerosis and subsequent cardiovascular complications in both diabetic and non-diabetic individuals.

Abstract In recent years, there have been calls for policy makers to do more to fight climate change. Indeed, there are growing concerns that climate could exert a serious detrimental impact on financial stability, and thus the wider economy. Empirically, a limited number of studies have highlighted the inflationary effects of climate‐related variables. This study is an attempt to contribute to this literature. More specifically, the article investigates the dynamic inflationary effect of climate in a case study of Belize. Results derived from quarterly data, over the period 1994–2019, and local linear projections suggest that inflation responds positively and significantly to temperature and rainfall shocks. Further disaggregation of inflation into its subindices reveals that this increase in inflation is mainly driven by the effect of climate on food, alcohol and tobacco, household, hospitality, and other goods and services inflation. The findings remain robust even when accounting for temperature and rainfall deviations from historical means. The results suggest that, while inflation control might not be a core element of monetary policy in Belize, policy makers should be aware that these climate‐related effects may have ramifications for the Belize economy.

The link between the Epstein-Barr virus (EBV) and the development of certain types of lymphomas in patients with human immunodeficiency virus (HIV) is of noteworthy clinical importance. Their immunocompromised state increases the risk of cancers such as lymphomas. Gastrointestinal (GI) lymphomas, though, can occur due to the immunosuppression caused by HIV, with diffuse large B-cell lymphoma (DLBCL) being common in this group. This case report describes a case of a patient with a newly diagnosed HIV who initially presented with symptoms associated with EBV-associated DLBCL and with esophageal candidiasis. This case report highlights the need for increased awareness of HIV-related complications and the importance of close follow-up. In addition, despite advancements in highly active antiretroviral therapy (HAART), acquired immunodeficiency syndrome (AIDS)-related lymphomas continue to be a concern requiring treatment approaches.

Abstract Background UNICEF advocates for children's rights, aiming to meet their basic needs and expand their opportunities to reach their full potential. Reducing child mortality rates and enhancing health are crucial to this mission. This can be achieved through measures like breastfeeding and complementary feeding practices. This study aims to analyse these practices in Belize using data from three past Multi Indicator Cluster Studies (MICS) and conducted a research study that seeks to identify barriers and other factors influencing breastfeeding, including the impact of the Baby-Friendly Hospital Initiative (BFHI), with a specific focus on the role of maternal mental health. The study specifically examines breastfeeding within the first hour after birth, exclusive breastfeeding for the first six months of life (EBF), and continued breastfeeding for up to two years and more (BF). Methods A mixed-methods design was employed, integrating both quantitative and qualitative approaches, to assess the context and psychosocial factors underlying breastfeeding and complementary feeding practices among caregivers in Belize. This included analysis of secondary MICS data from 2006, 2011 and 2015-16, supplemented by a desk review, and primary data collection in Belize in August/September 2022 using face-to-face interviews with 45 caretakers (mainly women) of children under two years of age, Key Informant Interviews (KII’s), and Focus Group Discussions (FDG’s) with mothers, healthcare staff and other caretakers. Maternal mental health was assessed using Self-Reporting Questionnaire (SRQ-20). Results The findings indicate that two out of three children were not exclusively breastfed for the first six months. Among the 45 interviewed caretakers, 93% reported overall breastfeeding (this includes exclusive, non-exclusive, and complementary breastfeeding), 82% practiced EBF during the first six months, and 78% breastfed their baby within one hour after birth. This suggests that while is the tendency for EBF to increase, general BF practices were more common than EBF and both were more prevalent than breastfeeding immediately after birth. Every second interviewed woman was at risk to develop common mental health disorders. However, there was no direct significant association between mental health and breastfeeding. Correlation analysis revealed that mothers with poorer mental health have more children, are less educated, are from lower socioeconomic backgrounds, are more aware of barriers related to breastfeeding compared to mothers with good mental health. Conclusions Despite significant improvements in EBF over the years in Belize, behaviour change interventions should particularly focus on vulnerable groups: mothers who are poorer, less educated, and living in rural areas. Further investigation is needed into contextual and psychosocial factors influencing these outcomes, with a specific emphasis on maternal mental health to comprehensively address the challenges associated with breastfeeding and complementary feeding practices.

Persons living with HIV should receive tuberculosis preventive therapy at least once in their lifetimes. Current practice at the Matron Roberts Polyclinic II (Belize City, Belize) is of a six-month course of isoniazid in combination with pyridoxine. A medical records audit was conducted for April 2021 with the objective of analyzing the initiation and completion of tuberculosis preventive therapy for people living with HIV seen in the polyclinic. This study was inconclusive due to a lack of standardization of the tuberculosis screening methods used, varied duration of tuberculosis preventive therapy and inconsistencies found in the documentation of the progress and completion of tuberculosis preventive therapy. In order to address these areas, a quality improvement project was conducted utilizing the Plan, Do, Study, Act methodology. The objectives were standardizing the tuberculosis screening methodology, the duration of therapy and the documentation. The following measures were taken: 1) four-question screening was standardized as the method of choice for tuberculosis screening; 2) tuberculosis preventive therapy was established as a six-month duration of isoniazid and pyridoxine; and 3) a documentation insert was added to the clinical notes to document tuberculosis screening and the progress of tuberculosis preventive therapy, among other parameters. Of the targets measured during the three months of the project, the outcomes were: 1) an average usage rate of 74.4% of the documentation insert; and 2) an average rate of initiation or continuation of tuberculosis preventive therapy of 64.3% for persons living with HIV seen over the duration of the project.