The transport sector has been identified as one of the highest contributors to greenhouse gas emissions in Trinidad and Tobago owing to the increase in the number of vehicles and the inherent traffic congestion. The vehicles are mainly fuelled by conventional fuels with relatively few being alternative fuel vehicles (AFVs), primarily in the form of compressed natural gas (CNG) vehicles. This research explores the current situation with the development and adoption of AFV technology in Trinidad & Tobago. In Trinidad, the natural gas supply is already well-established, refuelling stations are in operation and up to 18 original equipment manufacturer CNG vehicles are available on the market, supplemented by the option of vehicle conversion. The opposite is true for electric vehicles, with only one recognized dealer offering electric vehicles and public charging stations, and only one related market incentive in effect. Despite the number of initiatives geared toward CNG development, the 2018 vehicle conversion targets have not been realized and it would require a very aggressive approach to achieve those figures by 2020. The authors have identified the key impediments to successful attainment of the targets. They note that few of the ongoing fiscal incentives, measures or pilot projects by the government ministries that are associated with renewable energies are directly linked to the transportation sector. Additionally, since measures of effectiveness for sustainability are not being monitored, the country cannot adequately determine its progress towards sustainability. The authors propose measures towards achieving sustainable development in transportation and to overcome the constraints of data availability, perceived barriers to AFV adoption and the notion of affordability over sustainability.

The objective of this research was to develop a mode choice model in a small island developing states (SIDS), specifically the island of Trinidad. The public transportation system of Trinidad is dominated by paratransit modes, which have developed out of necessity due to the inadequacy of the state-owned bus service. Most modal choice models, calibrated from data in developed countries, do not consider the impacts of such para-transit modes in the choice behaviour of commuters. This research develops a discrete mode choice model based on the revealed preferences of commuters and their subjective assessment of the characteristics of the modes. The results from a nested logit model showed that invehicle travel time was a significant factor for the sample, while travel cost, was unimportant in the travellers' mode choice. Large mode-specific constants were estimated in the utility equation when compared to the other variables. This indicated a bias by individuals toward specific modes. This can be due to the current status of the public transportation system. Results highlighted that travellers, consider the illegal "PH" Taxis share more similarities to the private vehicle than to other public transportation modes. This is a significant result that can dictate the development of future policies. This research has shown the importance of incorporating paratransit modes in the mode choice models of SIDS. Future work should consider integrating latent class variables in the model analysis.

Previous research highlighted that the necessary indicators of effectiveness for sustainability are not being measured by the respective stakeholders in Trinidad and Tobago. As with other small island developing states, the country cannot effectively determine its progress towards or away from sustainability. The authors have developed an impact-based hierarchal framework comprising the triple bottom lineeconomy, environment, and societyand applied it to the local transportation system. Bearing in mind the confines of limited resources and data availability for the Trinidad and Tobago case, the selected indicators were aligned with those used by national, regional and international bodies to monitor sustainability progress, making the framework more useful to stakeholders. Three requirements, nine criteria and 22 indicators were incorporated into the transportation sustainability framework. The authors propose that integrating the necessary data collection and monitoring processes with established tasks already under the purview of the various line ministries can reduce the overall costs of evaluating sustainability progress. Local transportation engineering professionals were surveyed to establish a relative weighting for the key sustainability requirements. They were of the view that the social, environmental and economic sustainability requirements should be weighted at 50%, 33.3% and 16.7% respectively. The professionals also saw potential applications like determining the overall status of and setting targets for improvement to the transportation system, assessing the suitability of proposed alternatives and making decisions about investments in the transport sector. The analytical hierarchy process structure employed in the development of the framework also permits the user to apply their preferred multi-criteria decision making technique based on the alternatives arising and the tolerable degree of compromise.

Background: Efficient monitoring of devices to ensure timely removal is an ongoing challenge. There is a need for data visualization products that can aggregate disparate data streams to support device reviews, increase consistency across changes in caregiver teams, and synergize with people and operational processes within and across regional acute-care facilities. Methods: A data display application was developed to provide data from nearly any source in a consistent visual representation that could be used in real time. The infection prevention (IP) overlay combined data related to urinary catheters, central vascular catheters, and femoral vascular catheters from the electronic health record system. Clinical and data experts collaborated to develop data definitions, inclusion criteria, and report components. The application display indicated the current catheter or device status of each patient facility-wide, organized by service unit (Fig. 1). Additional patient information could be accessed from within the application, and a comment feature allowed caregivers to communicate directly through the tool (Fig. 2). Results: Pilot implementation began February 2021, and the NATE IP application was live for all users (unit and facility leaders, providers, infection preventionists, etc) as of July 2021. The tool is currently available for use at 171 acute-care hospitals within the HCA healthcare system, and it accommodated 3 different electronic medical record systems. Usage peaked in August 2021, with an average of 1,700 views per day. Daily utilization maximum ranges from 1,100 to 1,500 views per day, with an average of ~1,300 views per day. The tool is used during daily patient safety rounds, including weekends and holidays. User feedback was overwhelmingly positive, with users reporting an increase in communication, streamlined documentation, improved tracking of reasons to retain, and increased accountability for daily updates. During the proof-of-concept implementation, zero bugs were identified and several feature enhancements were implemented, including addition of port status and device-day reporting counts. Planned enhancements include mupirocin and chlorhexidine bathing use, isolation precaution use, and blood cultures ordered >3 days after admission. Conclusions: The NATE IP tool brings together data related devices into a single view for use by direct caregivers and all levels of leadership. Development of this or similar tools to consolidate various data streams into a central tool facilitates improved communication and consistency between caregiver teams. It also drives operational efficiencies and improves safety. Expansion to incorporate notifications related to potential issue will expand the proactive utility of this tool.Funding: NoneDisclosures: None

The Government of the Republic of Trinidad and Tobago has set itself some lofty targets in terms of reducing CO2 emissions from public transportation by 2030. Several initiatives have been launched since 2015 in order to fulfill these targets. One key strategy is the adoption of a higher percentage of alternative fuel vehicles (AFVs) into the overall fleet of vehicles. This article reviews the history and implementation of the various AFV oriented policies and examines the effectiveness of these initiatives. The authors describe the current state of the motorised vehicle fleet in terms of fuel type and highlight where adoption levels have fallen short of the target. The percentage of AVFs per public transit mode ranges from about 2 to 20 percent, where the higher percent represents the CNG buses belonging to the Public Transport Service Corporation (PTSC). In Trinidad, the natural gas supply is already well-established, refuelling stations are in operation and up to 20 original equipment manufacturer CNG vehicles are available on the market, supplemented by the option of vehicle conversion. The opposite is true for electric vehicles. The article further identifies the four key issues affecting the improved adoption of AFVs namely: (i) Fuel Prices (ii) Availability of Alternative Fuels, (iii) Consumer Perception and Resistance, and (iv) Lack of Institutional Support. In addition to presenting the proposals by others for improvements to the local transportation system, the authors recommend six key actions that should be taken to achieve the targets set for 2021 and beyond.