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Coastal areas of Grenada in the south-eastern Caribbean are particularly vulnerable to the adverse impacts of climate change. The effects of increasingly powerful hurricanes, sea-level rise, and reef degradation are often compounded by local anthropogenic activities. Many communities reside in low-lying areas, with development and infrastructure concentrated along the coast. Wave/storm surge models based on historic hurricanes Ivan and Lenny, and a hurricane with a predicted 100-year return period, were used to assess coastal inundation under different storm and sea-level rise scenarios. Coupled Tomawac and Telemac models were used in conjunction with high-resolution LiDAR data to provide a full vulnerability assessment across all coastal zones. Results were combined with census data at the Enumeration District level to assess impacts on the built environment. Qualitative and quantitative estimates were derived for the impact on natural features, land use, and infrastructure supporting critical economic activity in Grenada's coastal zones. Estimation of both spatial extent and inundation depth improved the estimation of likely coastal impacts and associated costs at the national level. A general increase in extent and severity of inundation was predicted with projected future sea-level rise, with the potential for disruption to major coastal infrastructure evident in all scenarios, risking serious social and economic consequences for local communities. Coastal communities using poorer-quality building materials were most severely affected. This integrated method of assessment can guide disaster planning and decision-making to reduce risk and aid resilience in hurricane-prone regions. [ABSTRACT FROM AUTHOR]

Maternal infection with Zika virus (ZIKV) is associated with a distinct pattern of birth defects, known as congenital Zika syndrome (CZS). In ZIKV-exposed children without CZS, it is often unclear whether they were protected from in utero infection and neurotropism. Early neurodevelopmental assessment is essential for detecting neurodevelopmental delays (NDDs) and prioritizing at-risk children for early intervention. We compared neurodevelopmental outcomes between ZIKV-exposed and unexposed children at 1, 3 and 4 years to assess exposure-associated NDD risk. A total of 384 mother–child dyads were enrolled during a period of active ZIKV transmission (2016–2017) in Grenada, West Indies. Exposure status was based on laboratory assessment of prenatal and postnatal maternal serum. Neurodevelopment was assessed using the Oxford Neurodevelopment Assessment, the NEPSY® Second Edition and Cardiff Vision Tests, at 12 (n = 66), 36 (n = 58) and 48 (n = 59) months, respectively. There were no differences in NDD rates or vision scores between ZIKV-exposed and unexposed children. Rates of microcephaly at birth (0.88% vs. 0.83%, p = 0.81), and childhood stunting and wasting did not differ between groups. Our results show that Grenadian ZIKV-exposed children, the majority of whom were without microcephaly, had similar neurodevelopmental outcomes to unexposed controls up to at least an age of 4 years. [ABSTRACT FROM AUTHOR]

Objective. To document Grenadian women’s knowledge about cervical cancer and human papillomavirus (HPV) infection, as well as their attitudes towards primary cervical cancer screening methods. Methods. In this qualitative study, we used focus groups in Grenada to gather information concerning women’s knowledge about, attitudes towards and perceptions of screening for cervical cancer and general knowledge about HPV. Ten focus groups comprising 73 participants representing 5 of the 6 parishes in Grenada were conducted with women aged 19–59. Participants were asked about pelvic exams, Pap smears, HPV, reasons for seeking or avoiding cervical cancer screening and how different modalities of testing might affect their decision-making. Responses were then coded and organized into common themes. Results. While many respondents had heard of HPV, far fewer knew about its causative role in cervical cancer, how to prevent HPV infection or testing for the high-risk HPV types that cause almost all cases of cervical cancer. Many participants were aware that cervical cancer screening was beneficial, but numerous barriers to obtaining that screening were noted, including concerns about privacy and stigma, potential discomfort, and the cost and inconvenience involved. Conclusions. Our findings have implications for future cervical cancer screening efforts in Grenada. Central to these efforts should be a focus on educating Grenadians about the role of HPV infection in cervical cancer and the importance of early detection through screening. In addition, addressing issues of stigma and privacy are key to eliminating cervical cancer in Grenada.

Abstract Background Toxoplasma gondii is a widespread zoonotic protozoan parasite capable of infecting all warm‐blooded animals. Although the genotypes of T. gondii in pigs have been reported worldwide, there is no information on the genotypes and diversity of T. gondii in pigs in Grenada, West Indies. Objectives The aims of the present study were to isolate, genotype and determine the diversity of T. gondii genotypes in pigs. Methods We carried out a modified agglutination test (MAT) on blood from 149 pig hearts collected from a local meat market. Myocardial tissue homogenate from pigs that tested positive for T. gondii was homogenized and inoculated into mice for isolation of the parasite. We collected mouse tissues and extracted DNA for genotyping based on 11 polymerase chain reaction‐restriction fragment length polymorphism markers (SAG1, SAG2, alt. SAG2, SAG 3, BTUB, GRA6, L358, PK1, C22‐8, C 29‐2 and Apico). Results Out of the 149 pig hearts, 31 (20.8%) tested positive for T. gondii on MAT. Bioassays in mice yielded 12 isolates designated TgpgGr1 to TgpgGr12. Molecular characterisation of T. gondii revealed four genotypes as follows: ToxoDB #2‐clonal type III (seven isolates); ToxoDB #7 (three isolates); ToxoDB #13 (one isolate); ToxoDB #30 (1 isolate). Overall, ToxoDB #2 was the most common (58%). Toxo database (DB) # 13, which causes interstitial pneumonia in affected mice, has also been reported. Conclusion The genetic diversity of T. gondii in pigs in Grenada is lower than that in other surrounding Caribbean areas.

Through a case study of three educational youth exchanges from London to the Caribbean island of Grenada in the early 1980s, this paper situates decolonisation as a site for youthful agency. Assessing official and ephemeral exchange material held in archives in London and the Caribbean alongside original oral history interviews with key actors, the paper argues that an analysis of youth exchanges as informal education spaces helps bring into focus young people's agency in decolonisation both as a historical process and conceptual undoing. While the paper asserts that exchanging produced transformative moments of becoming in which young people's global educational encounters transcended local perceptions of race, it also reveals youth exchanging to a revolutionary nation was no holiday, and that "youth exchange geographies" were governed, predetermined and impeded by the organisational labour of youth workers, fundraising initiatives, and unfolding international politics. [ABSTRACT FROM AUTHOR]

Measuring health-care acceptability presents conceptual and contextual challenges, particularly in data-poor Multi-Island Micro States (MIMSs). Thus, there has been limited evidence on the acceptability of health care in MIMS and scarce use of acceptability metrics in policy design and health system evaluation. In the present study, we developed and empirically validated a theoretical framework for measuring users' acceptability of health care in a MIMS in the Caribbean. Using a minimum-data approach, we used a synoptic review of health-care literature and consultations with experts and health system stakeholders to define, scope and select constructs for the theoretical framework of health-care acceptability. Empirical validation of the modelled framework was performed using data collected from household expenditure and health-care utilization surveys in Carriacou and Petite Martinique (n  = 226), island dependents of Grenada in the Caribbean. Data were used to create health utilization profiles and analyse measurement scales of the health-care acceptability framework using non-linear partial least square structural equation modelling. The modelled framework included 17 items integrating economic and psychosocial concepts, with 1 dependent construct (utilization) and 3 independent constructs (users' perception, experience and knowledge of health facility). Model analysis and validation indicated that the framework was significant, explaining 19% of the variation in health-care acceptability. Users' experience construct was influenced by perception and knowledge of health facility and was the only construct with a significant negative relationship with acceptability. Health-care acceptability declined with increased waiting and travel times and unsuitable opening hours. We conclude that acceptability comprises a complex multidimensional concept, which is highly dependent on various interacting variables and contextual characteristics of the health system. Therefore, policies and actions to improve acceptability should be context specific and focused on evaluating factors infringing health-care acceptability. Routine acceptability and/or satisfaction studies represent baseline evidence towards understanding and integrating acceptability in health-care assessment. [ABSTRACT FROM AUTHOR]

Varieties of English in the Caribbean have been claimed to have characteristic pitch patterns. However, there is little empirical research on prosodic aspects of English in the region. This paper provides a comparative phonetic analysis of several pitch parameters (pitch level, range, dynamism, rate of change, variability in rate of change, and tone rate) in English language data from Dominica, Grenada, and Trinidad that comprises read and spontaneous speech from 243 speakers. The results show that a wide pitch range and a high degree of variability in pitch, as mentioned in previous works, are not necessarily characteristic of English in the Caribbean overall, but that there are considerable cross‐territorial prosodic differences, with English in Trinidad showing more variability than in Dominica and Grenada, particularly among female speakers. Socioprosodic variation, largely specific to Trinidad, was also identified. [ABSTRACT FROM AUTHOR]

Civil society is seen as a key actor within and for global development. However, spatial representations of civil society within the global development landscape are dominated by scale, place, and verticality, neglecting more relational understandings of civic participation. Engaging with archipelagic thinking, drawn from the work of Édouard Glissant, Derek Walcott, and others, this paper makes a case for thinking about civil society through archipelagic relational ontologies. By employing an archipelagic lens to empirical material from research with civil society groups in Barbados and Grenada, the paper explores the relational creativity and metamorphic transformations that are part of civil society action. Utilising an archipelagic lens to think about civil society organising emphasises how civil society activity is produced, performed, and operationalised through creative relational arrangements that span (and contest) dominant spatial categories. For civil society actors this 'metamorphic creativity' – the crafting of these relations, the bringing together of 'bits and pieces', and the transforming and reworking of these relations to produce new forms and spaces of civic activity – is key to sustaining civil society and their own civic identities. This illustrates the creative, yet fragile nature of civil society, concluding that through these metamorphic relations civil society actors foster new civic spaces and identities, yet civil society simultaneously may also be constituted through, and potentially (re)produce (new) hierarchies of power. Civil society is seen as a key actor within and for global development. However, spatial representations of civil society within the global development landscape tend to neglect relational understandings of civic participation. This paper engages with archipelagic thinking to explore the importance of creative relationalities for civil society organising. [ABSTRACT FROM AUTHOR]