University of Belize

To demonstrate the utility of applying demographic and epidemiological models to assess the potential effects of sociopolitical status and childhood stress on survivorship, mortality, and morbidity to shed new light on life during the Maya Classic period. Elite and commoner burials (n = 63) from the Lower Dover polity, Belize dating to the Early (CE 250/300-600) and Late/Terminal Classic (CE 600-900/1000) periods were analyzed for lesions associated with developmental stress. Kaplan-Meier and Cox regression hazards analyses were applied to assess survivorship and mortality trends across ages, sociopolitical statuses, and for individuals displaying macroscopic indicators of cribra orbitalia and linear enamel hypoplasia. Kaplan-Meier and Cox regression showed that there are no significant differences in mortality and morbidity between sociopolitical status groups when nonadults (<15 years) are excluded. However, among commoners, those with cribra orbitalia had higher survival than those without it (p = 0.02). Findings show that despite small sample sizes, paleodemographic models have the potential to elucidate the effects of early life stressors and that despite inferred status differences in Maya archaeology, elites and commoners experienced similar survivorship rates at Classic period Lower Dover. This study exemplifies how integrating paleopathological data with demographic modeling provides insights even when sample sizes are limited, and it clarifies some of the complexities inherent in understanding ancient Maya. Poor preservation impacted the analysis of pathological conditions. Paleopathology-broadly and in Mesoamerica more regionally-needs to engage in more rigorous model approaches and reconsider long-held narratives to make substantial headway in understanding the societal and biological impact of childhood stressors.

The lack of biometric data on chondrichthyan species has impeded the implementation of management strategies essential for the conservation of sharks and rays captured using different fishing gears in coastal ecosystems. This study aims to assess morphometric relationships (length–weight [LW], length–dorsal length [DL], and length–disc width [DW]) and the relative weight condition factor ( K rel ) of 14 elasmobranch species caught by shrimp trawls in the Bahía Magdalena‐Almejas (BMA) lagoon system in Mexico from February to December 2014–2022. The length–weight relationships (LWRs) (pooled sexes, females and males) were calculated using the potential model. The growth (allometric or isometric) was determined by comparing the b values for each elasmobranch species with the isometric value ( b = 3.0) using the t ‐Student test. Length–length (LL) relationships were determined by applying the linear regression model. Given the body condition is commonly used as a biometric tool to indicate the overall health and energetic status of fish in relation to growth, the K rel was calculated. The assessment was conducted on 440 elasmobranch specimens (70 sharks and 370 rays) across 14 species, 9 genera, and 8 families. The genus Urobatis was the most abundant in the total elasmobranch catches obtained ( n = 203). The parameter b of the LW relationships varied from 2.57 ( Heterodontus mexicanus ) to 3.87 ( Mustelus lunulatus ). Most morphometric relationships (LDL and LDW) showed a significant statistical correlation ( r 2 &gt; 0.85; p &lt; 0.05). The condition factor analysis indicated that most (86%) elasmobranch species were in good somatic condition ( K rel ≥ 1). This study represents the first reference data on the LWRs for the Mexican Horn Shark ( H. mexicanus ), as well as the first assessment on LL relationships (DL and DW) and the relative weight condition factor for all elasmobranch species included. Consequently, this research helps bridge the information gap regarding shark and ray species, contributing to the monitoring and population assessment of bycatch elasmobranchs in the BMA lagoon system.

Our study contributes to a more gender-sensitive approach to marine spatial planning, aiming for balanced, sustainable growth in the blue economy. It examined gendered ocean use patterns and their implications for equitable marine spatial planning. To document the distinct ways men and women interact with and value ocean spaces, we analyzed participatory mapping results from Ocean Use Surveys (OUS) conducted in three regions: the Maldives, the Azores, and Belize. The findings show that, globally, men dominate offshore activities like commercial fishing, whereas women’s activities are concentrated nearshore, often involving informal economic roles such as subsistence fishing, tourism, and cultural uses. Our analysis generated gender-specific heat maps highlighting areas of ocean use by sector and gender. This gender-disaggregated data revealed spatial and sectoral differences: in the Azores, women are more active in research and recreational fishing; in Belize, they engage in mariculture; and in the Maldives, they participate in more informal, small-scale, self-employed economies. We also addressed the gender gap in ocean data, a result of historic biases in data collection, which has led to undervaluing women’s contributions to the maritime economy and to gender-blind policies. The findings stress the need for gender-disaggregated data in marine planning to avoid exacerbating gender inequities and to ensure inclusive, effective policies. We recommend enhanced data practices that capture women’s oceanic contributions, advocating for mixed-gender survey teams and targeted outreach to reduce bias. Policymakers are encouraged to integrate these insights to support equitable marine governance, fostering inclusivity in ocean resource management. • In three regions studied, men and women use and value ocean space differently. • Ocean use surveys show men dominate offshore activities while women focus nearshore. • Gender-disaggregated data is vital for equitable, inclusive marine spatial planning. • Formalizing and valuing women’s nearshore roles can strengthen coastal economies.

BackgroundUNICEF advocates for children’s rights by ensuring their basic needs are met and their potential maximized. Reducing child mortality and improving health are central to this mission, particularly through breastfeeding and complementary feeding. 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 explores barriers and factors influencing breastfeeding, including the Baby-Friendly Hospital Initiative, with a focus on maternal mental health. The study examines breastfeeding within the first hour after birth, exclusive breastfeeding for the first six months (EBF), and continued breastfeeding for up to two years and beyond.MethodsA mixed-methods design was used, combining quantitative MICS data (2006, 2011, 2015-16), desk reviews, and qualitative data collected in Belize in August-September 2022, to assess the context and psychosocial factors, including maternal mental health, that influence breastfeeding and complementary feeding practices among caregivers. Data collection involved 45 face-to-face interviews mainly with female caretakers of children under two, Key Informant Interviews, and Focus Group Discussions with caretakers and healthcare staff. Maternal mental health was assessed using the Self-Reporting Questionnaire (SRQ-20).ResultsThe 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 (exclusive, non-exclusive, or complementary), 82% practiced EBF during the first six months, and 78% breastfed within one hour after birth. While general breastfeeding was common, EBF showed increasing trends, and early initiation was less frequent. Half of the woman interviewed were at risk of common mental health disorders. There was no significant direct association between mental health and breastfeeding. Correlation analysis showed that mothers with poorer mental health had more children, less education, lower socioeconomic status, and greater awareness of breastfeeding barriers.ConclusionsWhile breastfeeding rates in Belize are improving, psychosocial vulnerabilities persist. Indirect links between maternal mental health and structural disadvantage, as well as the identified barriers to breastfeeding highlight the need for integrated, equity-focused public health interventions to enhance breastfeeding outcomes and address broader child nutrition challenges.

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 &amp;gt;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.

BackgroundIncreasing vaccination coverage was key to curbing the COVID-19 pandemic globally. However, lack of trust in the vaccine and fear of side effects in regions like the Caribbean resulted in a low uptake despite enough vaccine supply.MethodsWe conducted two correlational analyses and one experiment between five sequential behaviorally informed Facebook campaigns, social media performance outcomes, and district-level vaccination data. First, we ran multivariate linear regression models to estimate the mean differences between the campaigns in (i) social media performance (“Clicks” and “Engagement”) and (ii) COVID-19 vaccination uptake at the district level. “Clicks” were measured by the number of people who clicked on the respective Facebook advert and visited the official vaccination site. “Engagements” were the number of people interacting with the advert through likes and emojis. Second, we took advantage of the experimental design during one of the campaigns to analyze the differential effect of messages conveying information about the number of people reporting vaccination side effects using words (“Few”/ “Majority) and numbers (“3 out of 100 “) on social media performance.ResultsThe correlational analysis showed that the number of “Clicks” and “Engagement” was similar among campaigns, except for the campaign focusing on vaccines’ effectiveness, which had 14.65 less clicks and 19.52 less engagements per advert (including controls and district-fixed effects) compared to the base “It’s safe” campaign. Vaccination rates were highest at times coinciding with campaigns focusing on vaccination safety and effectiveness. Our experimental results showed that informational messages related to side effects that were framed using words (“Majority did not report discomfort”/ “Few persons reported discomfort”) were better at generating “Clicks” compared to those using numbers (“3 out of 100 reported discomforts”).ConclusionsFacebook adverts highlighting vaccine safety had a similar level of social media performance as other campaigns, except for adverts focusing on vaccine efficacy, which performed worse. Communicating side-effect information with words instead of numbers can expand social media interest in low-uptake regions like the Caribbean. Our results serve as preliminary evidence for public health officials to encourage vaccine uptake in high-hesitancy contexts.

Stigma affects adversely the HIV prevention continuum and care cascade. Our population-based, mixed-methods study aimed to assess women's perceived HIV stigma and discriminatory attitudes, and their relation with HIV testing in a high-prevalence area in Belize. This population-representing household survey in the mixed urban-rural setting of Stann Creek District, Belize, collected data from 236 women age 15 to 49 years. We analyzed HIV testing rates, HIV prevention and transmission knowledge, perceived stigma manifestations, and participant attitudes. Concurrently, a nested qualitative component of study cognitive interviews with a purposive sample of 23 women explored HIV stigma in their community. A vast majority of women (96%) perceived HIV stigma manifestations in their communities as pervasive and a deterrent to people from testing. Discriminatory attitudes (16% believe children with HIV should not attend school) and HIV misconceptions (53% fear acquiring HIV through saliva) tended to be more common in nonurban areas and among women with less formal education. Stigma persisted even with high HIV testing rates among women. Qualitative findings triangulated survey results and, taken together, suggest that prejudices held against people with HIV led to avoidance of HIV preventive measures such as testing and status disclosure, fueled by a strong distrust of the medical care system regarding confidentiality of HIV test results. Misconceptions about HIV and stigmatizing attitudes remain pervasive among women in Stann Creek, Belize. Health literacy, stigma interventions, and expansion of routine confidential testing to include men are needed to address the HIV and stigma syndemic in Belize.

ABSTRACTObjective.To estimate the national and regional population attributable fraction (PAF) and potential number of preventable anemia cases for three nutritional risk factors (iron, red blood cell folate [RBCF], and vitamin B12 deficiencies) among women of childbearing age in Belize.Methods.A national probability-based household and micronutrient survey capturing sociodemographic and health information was conducted among 937 nonpregnant Belizean women aged 15–49 years. Blood samples were collected to determine hemoglobin, ferritin, alpha-1-glycoprotein (AGP), RBCF, and vitamin B12 status. All analyses used sample weights and design variables to reflect a complex sample survey. Logistic regression was used to determine adjusted prevalence risk (aPR) ratios, which were then used to estimate national and regional PAF for anemia.Results.The overall prevalence of anemia (hemoglobin <12 g/dL) was 21.2% (95% CI [18.7, 25.3]). The prevalence of anemia was significantly greater among women with iron deficiency (59.5%, 95% CI [48.7, 69.5]) compared to women without iron deficiency (15.2%, 95% CI [12.2, 18.3]; aPR 3.9, 95% CI [2.9, 5.1]). The three nutritional deficiencies examined contributed to 34.6% (95% CI [22.1, 47.1]) of the anemia cases. If all these nutritional deficiencies could be eliminated, then an estimated 5 953 (95% CI [3 807, 8 114]) anemia cases could be prevented.Conclusions.This study suggests that among women of child-bearing age in Belize, anemia cases might be reduced by a third if three modifiable nutritional risk factors (iron, RBCF, and vitamin B12 deficiencies) could be eliminated. Fortification is one potential strategy to improve nutritional status and reduce the burden of anemia in this population.