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Delivery of electrophysiology (EP) care in developing nations and underserviced populations faces many hurdles, including the lack of local expertise and knowledge creation. The West Indies has experienced a paucity of local EP expertise. The University of Toronto has undertaken a unique collaborative educational effort with the University of the West Indies.We describe the effects of equity, diversity, and inclusion (EDI) in EP training at Toronto General Hospital in Canada by quantifying the impact of training the first female electrophysiologists to practice in Jamaica and Saint Lucia.Data from the ministries of health in Jamaica and Saint Lucia were reviewed. The number of arrhythmia clinic patients seen, EP studies and ablations performed, pacemaker clinic patients seen, and implantable devices, permanent pacemakers (PPMs), and implantable cardioverter-defibrillators (ICDs) implanted were assessed.One hundred one arrhythmia consults were seen by the new electrophysiologist in Jamaica after her return from training in 2020. She has since performed 19 EP studies/catheter ablations at a newly established ablation laboratory. Three cases of left ventricular (LV) dysfunction due to tachy-cardiomyopathy were treated successfully with catheter ablation with immense improvement in LV ejection fraction. Thirteen PPMs, 1 ICD, and 3 LV leads were implanted, after which no early complications were identified. In Saint Lucia, where there is no dedicated electrophysiology laboratory, 2 patients who required catheter ablation for tachycardia-mediated LV dysfunction were identified by the electrophysiologist since her return to the island in 2018. The patients were appropriately referred, resulting in restoration of normal LV function. Six PPMs also were implanted in Saint Lucia. Knowledge translation has been limited by the lack of accessibility to the required devices, catheters, and specialized equipment and accessories, mainly because of their costs.Training the first female electrophysiologists from Jamaica and Saint Lucia led to a quantifiable impact on EP care in both of these Caribbean countries. EDI strategies in EP training programs provide much needed benefits to developing nations, but more support is needed to allow new electrophysiologists to fully utilize their EP training to care for underserviced populations.

Resurgent nationalism has become an important driver of China’s foreign policy, and many countries are concerned about its evident new assertiveness. This article argues that closer attention to the vigorous internal debate among its international relations (IR) experts about their country’s future external strategies will add perspective to those concerns. It contends that the views of these experts provide probably the best available window into China’s thinking about its international options. China’s IR experts have been conspicuously divided about the appropriate balance of strategies for its transition from a previously cautious and inward-looking foreign policy to a more ambitious and proactive agenda. In particular, they differ about the relative emphasis that should be placed on the pursuit of national interests versus the advancement of international interests. This debate reflects contradictory elements in China’s foreign policy under Xi Jinping, some of which may potentially lead to co...

1. Introduction 2. Pessimists and Optimists 3. Acknowledging Uncertainty 4. Political Uncertainties 5. Economic Uncertainties 6. Environmental Uncertainties 7. International Uncertainties 8. Embracing Uncertainty

Thoracic endometriosis syndrome (TES) is a rare presentation of systemic endometriosis. An unusual cluster of patients from the Caribbean who were treated at a single hospital during the year 2001 is presented. All patients were managed surgically in the acute phase, with satisfactory results. The etiology and management of TES has been controversial. A therapeutic approach that includes aggressive surgery to obliterate the pleural space combined with a course of hormonal suppression offers the best chance of cure for these patients.

In early August 1967 the Foreign Ministers of Indonesia, the Philippines, Singapore and Thailand, and the Deputy Prime Minister of Malaysia, met in Thailand to discuss the formation of a new Southeast Asian regional organisation. After three days of talks at the seaside resort of Bangsaen and in Bangkok they signed on 8 August 1967 a Declaration establishing ‘the Association of Southeast Asian Nations’ (ASEAN).