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BACKGROUND: Although limited, there is some evidence that certain physical punishments may vary by household religion. OBJECTIVE: This study aimed to determine whether parent disciplinary behavior varies by religious affiliation in two countries which have large, diverse religious groups. PARTICIPANTS AND SETTING: Data from Multiple Indicator Cluster Surveys for Suriname (2018) and Guyana (2019-20), which contain nationally representative household samples, were used. The study was restricted to the three most prevalent religious groups: Christians, Hindus, and Muslims. METHODS: Adult responses to a standardized survey that included questions about use of disciplinary behaviors in the household towards children (aged 1-14 years) were examined in relation to religious affiliation of the head-of-household and multiple covariates. RESULTS: Of the 3518 Suriname households, 62.4 %, 23.3 % and 14.3 % were Christians, Hindus, and Muslims, respectively. Compared to Christians, children in both Hindu and Muslim households had significantly lower odds of being hit with an object in adjusted logistic regression models. However, only Hindus had lower odds of being spanked and Muslims lower odds of exposure to a combined physical and non-physical practice, compared to Christians. Of the 2535 Guyana households, 69.5 %, 23.5 % and 7.0 % were Christians, Hindus, and Muslims, respectively. Children in Hindu, but not Muslim households, had significantly lower odds of being spanked, hit with an object, and exposed to a combine practice in adjusted models compared to Christians. CONCLUSIONS: Partial support was found for a potential influence of religion on some disciplinary behaviors. Further investigation is warranted to identify possible conditions and mechanisms.

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Introduction. Streptococcus pyogenes [group A streptococci (GAS)] is the causative agent of pharyngitis and various other syndromes involving cellulitis, streptococcal toxic shock syndrome (STSS), and necrotising fasciitis. Although the prevalence of GAS infections globally remains high, necessitating the widespread use of ß-lactam antibiotics, GAS have remained largely susceptible to these agents. However, there have been several reports of GAS with reduced susceptibility harbouring mutations in genes for penicillin-binding proteins (PBPs). The objectives of this study were to examine the in vitro ß-lactam susceptibility patterns of group A streptococci, determine the prevalence of drug resistance, and ascertain whether such resistance could be attributed to mutations in specific PBP genes. Methods. In this study, we sought to use Sanger sequencing to identify mutations in PBP genes of Streptococcus pyogenes isolated from patients that required inpatient and outpatient care that could confer reduced PBP affinity for penicillin and/or cephalosporin antibiotics. All isolates were screened for susceptibility to penicillin, amoxicillin, and cefazolin using E-test strips. Results. While there were no documented cases of reduced susceptibility to penicillin or amoxicillin, 13 isolates had reduced susceptibility to cefazolin. Examination of pbp1a by Sanger sequencing revealed several isolates with single amino acid substitutions, which could potentially reduce the affinity of PBP 1A for cefazolin and possibly other first-generation cephalosporins. Conclusion. Penicillin and penicillin-derived antibiotics remain effective treatment options for GAS infections, but active surveillance is needed to monitor for changes to susceptibility patterns against these and other antibiotics and understand the genetic mechanisms contributing to them.

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Background: The human population in Guyana, located on the South American continent, is vulnerable to zoonotic diseases due to an appreciable reliance on Neotropical wildlife as a food source and for trade. An existing suboptimal health surveillance system may affect the effective monitoring of important zoonotic diseases. To effectively address this deficit, a One Health zoonotic disease prioritization workshop was conducted to identify nationally significant zoonoses. Methods: Prioritization of zoonotic diseases was conducted for the first time in Guyana & Caribbean region using literature review, prioritization criteria and a risk prioritization tool in combination with a consultative One Health workshop. This involved multisectoral experts from varied disciplines of social, human, animal, and environmental health to prioritize zoonotic diseases using a modified semi-quantitative One Health Zoonotic Disease Prioritization (OHZDP) tool. The inclusion and exclusion criteria were applied to pathogen hazards in existence among wildlife in Guyana during the hazard identification phase. Results: In total, fifty zoonoses were chosen for prioritization. Based on their weighted score, prioritized diseases were ranked in order of relative importance using a one-to-five selection scale. In Guyana, this zoonotic disease prioritization method is the first significant step toward bringing together specialists from the fields of human, animal, and environmental health. Following discussion of the OHZDP Tool output among disease experts, a final zoonotic disease list, including tuberculosis, leptospirosis, gastroenteritis, rabies, coronavirus, orthopoxvirus, viral hemorrhagic fevers, and hepatitis were identified as the top eight priority zoonoses in Guyana. Conclusions: This represents the first prioritization of nationally significant zoonotic diseases in Guyana and the English-speaking Caribbean. This One Health strategy to prioritize these eight zoonoses of wildlife origin is a step that will support future tracking and monitoring for disease prevalence among humans and wildlife and can be used as a decision-making guide for policymakers and stakeholders in Guyana.

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OBJECTIVES: To collaborate and share medical knowledge between US and Caribbean physicians during the COVID-19 pandemic via a free online continuing medical education (CME) series.  Method: This was a multi-institution collaborative effort between the Southern Regional Area Health Education Center and Cape Fear Valley Medical Center, both located in North Carolina, USA, and its Caribbean partners, the Guyana Medical Council and Ministry of Health, and the University of the West Indies Medical Alumni Association, Jamaica. The lecture series ran from July 2021 to October 2022. The Zoom (Zoom Video Communications Inc., San Jose, CA, USA) meeting platform was used for the monthly lectures on the fourth Thursday between 7 and 8 p.m. Eastern Standard Time (EST).  Results: Analysis of program data from July 2021 through October 2022 (excluding December 2021) found 1,105 unique individuals engaged in the 15 continuing education sessions. The series had a cumulative total of 2,411 participants, with a mean session participation of 161 and a range of 94 to 299 participants per lecture. An outcome survey assessing the reasons for attendance identified that the most significant factors in their participation in the series were: a) the quality of educational content (83.21%), b) the ease of access and Zoom platform (81.76%), and c) the lectures being offered at no cost (61.31%), and 80.84% gained new medical knowledge leading to practice changes.  Conclusion: The Internal Medicine Learning Collaborative (IMLC) model can be easily replicated by following the steps outlined. It overcomes barriers such as travel and quarantine restrictions and is cost-effective to initiate and maintain. It allows physicians with access to resources and specialty training in the United States to share medical knowledge with colleagues in the developing world where such access may be limited, thus promoting health care and continuing education activity in their respective regions using freely available technologies.

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Plasmodium parasites, the causal agents of malaria, are eukaryotic organisms that obligately undergo sexual recombination within mosquitoes. However, in low transmission settings where most mosquitoes become infected with only a single parasite clone, parasites recombine with themselves, and the clonal lineage is propagated rather than broken up by outcrossing. We investigated whether stochastic/neutral factors drive the persistence and abundance of Plasmodium falciparum clonal lineages in Guyana, a country with relatively low malaria transmission, but the only setting in the Americas in which an important artemisinin resistance mutation (pfk13 C580Y) has been observed. To investigate whether this clonality was potentially associated with the persistence and spatial spread of the mutation, we performed whole genome sequencing on 1,727 Plasmodium falciparum samples collected from infected patients across a five-year period (2016-2021). We characterized the relatedness between each pair of monoclonal infections (n=1,409) through estimation of identity by descent (IBD) and also typed each sample for known or candidate drug resistance mutations. A total of 160 clones (mean IBD ≥ 0.90) were circulating in Guyana during the study period, comprising 13 highly related clusters (mean IBD ≥ 0.40). In the five-year study period, we observed a decrease in frequency of a mutation associated with artemisinin partner drug (piperaquine) resistance (pfcrt C350R) and limited co-occurence of pfcrt C350R with duplications of plasmepsin 2/3, an epistatic interaction associated with piperaquine resistance. We additionally report polymorphisms exhibiting evidence of selection for drug resistance or other phenotypes and reported a novel pfk13 mutation (G718S) as well as 61 nonsynonymous substitutions that increased markedly in frequency. However, P. falciparum clonal dynamics in Guyana appear to be largely driven by stochastic factors, in contrast to other geographic regions. The use of multiple artemisinin combination therapies in Guyana may have contributed to the disappearance of the pfk13 C580Y mutation.

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The emerging petroleum production sector has been positively impacting Guyana's economic prospects while contributing to an anticipated increase in the country's greenhouse gas emissions. This article presents a case study that adopts a convergent mixed methods approach. The methods selected for data collection consisted of in-depth interviews, document review and quantitative analysis to examine the implications of the GHG emissions from Guyana's emerging petroleum production sector for the country's net carbon sink status. The article explores measures to enable Guyana to remain a net carbon sink. The study reveals that fugitive emissions were the highest component of greenhouse gas emissions, mostly accounted for by flaring and venting from well testing and flaring from conventional petroleum production. The annual GHG emissions from petroleum production for 2025, 2027 and 2030 were 9034, 13,397 and 20,516 kilotons of CO2e, respectively. Moreover, the combination of the emissions from the oil and gas production and those from three scenarios of growth in Guyana's energy sector, the total annual GHG emissions could vary from 4445 kilotons of CO2e by 2025 to the largest amount of 24,888 kilotons of CO2e by 2030 across various scenarios and conditions. Further, the highest total GHG emissions for 2025 would be 11,015 kilotons CO2e compared to a sequestration rate of 154,060 kilotons CO2 (7%) for 2025. In 2027, the highest total GHG emissions would be 16,234 kilotons CO2e as compared to a sequestration rate of 153,860 kilotons CO2 (11%). No negative implication for Guyana's net carbon sink is projected. However, Guyana should review, update and implement policies to mitigate GHG emissions and offset unavoidable ones. This research highlights the efforts of Guyana to adopt a development path that seeks to fulfil obligations to the UNFCCC and the Paris Accord while improving the social and economic well-being of its citizens.

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Mangrove leaves have unique features that enable them to cope with shifting environmental conditions while preserving their general functionality and efficiency. We examined the morphological characteristics and chlorophyll content (spectroscopically) of 600 mature Avicennia germinans leaves selected from 30 trees located in one degraded, one restored, and one natural mangrove ecosystem along Guyana's coastline. Systematic sampling was carried out using the closest individual sampling method in the wet and dry seasons. We hypothesized that both habitat type and seasonality influence the leaf traits and chlorophyll content of A. germinans. Our findings showed that A. germinans leaves are mesophyllous, and traits such as leaf perimeter, area, length, width, dry mass, wet mass, turgid mass, leaf-specific area, and relative water content showed fluctuations in ecosystems (one-way ANOVA, p < .05) as well as seasonally (paired t-test, p < .05). Substantial, positive correlations (p < .05, R > .75) were also established for over 10 leaf parameters in both seasons while PCA and multiple regression analyses further confirmed the strong relationships between leaf morphological features and their respective locations. Changes in chlorophyll concentration were most noticeable in the degraded ecosystem while variations in leaf traits were more pronounced in the restored mangrove area. This may be due to the various disturbances found in each ecosystem coupled with fluctuations in the seasons. Our results demonstrate that mangroves, to some extent, alter their plant structures to cope with environmental stressors present in the various ecosystems they thrive in to maintain their survival.

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Background: The suicide rate in Guyana has consistently ranked in the top ten globally, yet there is only limited literature related to the context in which these suicides occur. This study aims to better understand the psychosocial circumstances and characteristics of suicides in Guyana. Methods: This case series study utilised a qualitative psychological autopsy method. One to three informants per deceased person (N = 31) were interviewed regarding the lives of 20 Guyanese who died by suicide (14 M, 6 F, aged 10-74 years). Interpretative Phenomenological Analysis was utilised for the data. Findings: Four superordinate themes were identified: Interpersonal Conflict, Trauma, Health, and Unknown Reasons. Interpersonal conflict included subordinate themes of Domestic Abuse, Marital Separation, and Financial Disputes. Health included subordinate themes of Physical Health and Mental Health. Pesticide poisoning was the method used by Guyanese people whose suicide was triggered primarily by interpersonal conflict. Interpretation: The findings illustrate the complexities of suicide in Guyana and the importance of adopting a biopsychosocial perspective to suicide prevention. Suicide prevention should include mental health and suicide literacy training of medical professionals. It is recommended that the importation of highly toxic pesticides be restricted, and that less toxic substitutes be promoted. Convenience sampling, recall bias, and limited informants are limitations of this study. Future research should focus on suicidal behaviour using larger sample sizes. Funding: This research was supported by an Australian Government Research Training Program Scholarship through Griffith University Australia.

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Guyana's colonial past has left a trail of economic instability, racial polarization, and physical and mental trauma. Despite the progress made since Guyana's independence in 1966, the remnants of this colonial past continue to shape present-day Guyana. As a result, violence and trauma continue to impact the mental health of the population. This is manifest in endemic problems of domestic violence and racialized social divisions which have created the conditions for rates of suicide which are amongst the highest in the world. The formal mental health provision which exists in Guyana is based primarily on an individualized and largely biomedical model of care. Despite valuable attempts to develop this provision, the difficulty of physically accessing this for some people and the stigma which surround this means that the capacity of this system to address the serious problems which exist is limited. It is also the case that in times of emotional and psychic distress, and in the context of Guyana being a very religious country, many people turn to traditional supernatural healers and remedies for support. In this paper, we discuss what is known as "Obeah", noting that while this is widely practiced, it remains something of a taboo subject in Guyana. We consider the reasons why these practices and beliefs continue to be influential. However, what neither these biomedical or supernatural perceptions of mental health are able to address is the sociogenic nature of Guyana's mental health issues, which we argue emerges out of the historic trauma of Guyana's experience of colonialism and the violence which it engendered. We argue that profound forms of mental distress which exist in Guyana call for an integrative and holistic practice model that contextualizes these problems through a sociogenic lens. Social workers, working collaboratively with other health-related professions, can occupy a critical role in integrating these different conceptions through developing a rights-based model of mental health where the causes of mental ill-health are understood as socially determined.

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Seed dispersal is widely considered an important mechanism for the conservation of plant diversity. In tropical regions, over 80% of woody plant species are dispersed by vertebrates, often through the consumption of fruits. Our understanding of what drives interactions between vertebrates and fruits is limited. Through a systematic literature search, we compiled a database of fruit and seed traits and vertebrate-fruit interactions for tree and vertebrate species occurring in the Guianas, with the aim of facilitating research into seed dispersal and seed predation of tree species in the Guianas. The database was compiled by extracting data from 264 published sources. It consists of 21,082 records, of which 19,039 records contain information about 19 different fruit and seed traits belonging to 1622 different tree species. The other 2043 records contain information on vertebrate-fruit interactions between 161 vertebrate species and 464 tree species. Our analyses showed a taxonomic bias, particularly in the interaction data, toward large-bodied vertebrates, with most interactions recorded for the bearded saki (Chiropotes chiropotes), followed by the lowland tapir (Tapirus terrestris). For plants we found an overrepresentation of the Sapotaceae and Moraceae families and an underrepresentation of the Rubiaceae, Myrtaceae, and Lauraceae families in the interactions. There are no copyright restrictions on the data set; please cite this publication when using these data.

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