Faculty of Medical Sciences Library

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Walkability, Physical Activity and Health: The story of Barbados
(The University of the West Indies Cave Hill Campus, 2022-01-28) Rocke, Kern
Mr. Kern Rocke's PhD builds on the existing ECHORN Cohort structure in Barbados. ECHORN collects a wealth of data on individuals’ characteristics, their health-related behaviors and health status. Kern’s work looks further upstream and examines built environment characteristics supporting physical activity of the communities in which participants reside. Zooming out even further, he will characterize the built environment using walkability as a proxy at a national level. From his work, we’ll be able better understand how the built environment influences physical activity in an Eastern Caribbean population.
Assessing the foodscape of a Small Island Developing State: The Barbados Nutrition Environment Survey (Barbados-NEMS) for Stores
(The University of the West Indies Cave Hill Campus, 2022-01-28) Whiteman, Stephanie; Whiteman, Stephanie
The food environment, also known as the foodscape, has many elements that interact which eventually influence our food choices and consumption. One of these elements is known as the consumer food environment. The consumer food environment is the area of the foodscape in which the individual/consumer interacts with the food environment, with the food retailers. Features of the consumer food environment include availability of food items, accessibility of the food stores and pricing of the food items as well as facilitators and barriers to healthy eating. The aims of this study are to assess the reliability of the Barbados Nutrition Environment Measurement Survey for Stores and to evaluate the consumer food environment of Barbados. A total of 40% of food stores (n=50) across all 11 parishes of Barbados were assessed using the Barbados Nutrition Environment Measurement Survey between September – November 2021. The food stores were categorized into three main types; Wholesale retailers, Supermarket/Grocery Stores and Mini-Mart/Convenience Stores. The retail food outlets were identified, enumerated, classified and mapped using multiple data sources, including the telephone business directory and a list of all registered food outlets obtained from the Corporate Affairs and Intellectual Property Office (CAIPO) of Barbados. Each store was independently audited by pairs of trained raters. Each rater surveyed 19 food categories and assesses the availability, quality and price of these food items and their healthier alternative. To determine inter-rater reliability, Percent agreement and Kappa statistics were used for binary and categorial variables and intra-class correlations coefficients (ICC) were used for continuous variables. Food environment scores were computed for each store using the dimensions of Variety, Availability, Price and Quality. Essentially, two points were awarded for availability and increased variety of healthier alternatives, and additional 2 points will be awarded when a lower price is offered for a healthier alternative and a negative point will be given when the healthier alternative is higher in price. With regards to quality, up to 3 points were awarded for stores having the majority of their fresh/frozen produce having acceptable quality. The total score ranges from -15 to 115.
Barbadian Women, Metformin and Endometrial Cancer: Project Updates
(The University of the West Indies Cave Hill Campus, 2022-01-28) Date, Stephanie
Epidemiological data were collected from Barbadian women diagnosed with Endometrial cancer (EC), with and without exposure to the anti-diabetic agent, Metformin. All recorded primary cases of EC diagnosed between January 1st, 2008, and December 31st, 2017, were analysed. Age-specific incidence, and crude mortality rates were calculated. Descriptive statistics characterized demographics, risk factors, prescription data and histopathology. Log-rank tests assessed simple group differences by EC type. Survival analysis based on tumour type was plotted using Kaplein-Meir curves. Serum and EC tissue samples from eligible women diagnosed with EC in 2020 were collected for future hormonal and biomarker analysis. There were 270 recoded cases of EC, averaging 66 (8.8) years old, with parity of 3.60 (2.3). Cases were postmenopausal with 95% experiencing postmenopausal bleeding. There were 42% were type 1, 58% type 2 tumours. Weak evidence suggests the latter imparted worse survival (log rank test = 0.02). There was no statistically important difference in survival between women with and without a history of metformin use. Estimated crude incidence rate was 18.64 per 100,000 women. Crude mortality rate from EC between January 1st, 2008 and December 31st, 2019 was 27%. ELISA testing was performed on all serum samples collected and analysis is ongoing. Tissue microarrays were created and will be stained and scanned for biomarker analysis.
The Use of Cannabinoids to Modulate Endothelial Dysfunction
(The University of the West Indies Cave Hill Campus, 2022-01-28) Shepherd, Deidre
Endothelial dysfunction can be characterized by a reduced production and bioavailability of nitric oxide and an imbalance of endothelial derived relaxing and contracting factors. This leads to impaired functionality of blood vessels within the vascular system. The endothelium is responsible for many of the mechanisms involved in the regulation and maintenance of vascular tone and homeostasis. Changes in endothelial function can lead to the development of hypertension and atherosclerosis. This study will focus on the impact of synthetic cannabinoids on endothelial dysfunction to investigate their ability to modulate the condition. It will consist of in vitro studies using human aortic endothelial cells to examine biochemical marker activity and cell signaling pathways which would be followed by animal studies. Male Sprague-Dawley rats will be fed with a high fat diet to induce endothelial dysfunction and will be treated with the cannabinoids to determine the effect it would have on the integrity of the blood vessels through vascular reactivity studies at the end of the treatment period.
Identification of Microbiological Pathogens and Inflammatory Markers associated with periodontitis in Diabetes and with the development of Cardiovascular Disease
(The University of the West Indies Cave Hill Campus, 2022-01-28) Parris, Desrie-Ann
Type 2 Diabetes characterized by impaired insulin production and periodontal disease a microbially initiated disease are two diseases identified worldwide with an established bidirectional relationship. This indicates that the prevalence of both diseases is proportional to each other and share similar risks factors. Even though these factors provide enough linkage not every individual develops periodontal disease. In addition, there has also been research surrounding the link between periodontal disease and atherosclerosis. In this study we seek to establish the prevalence and link between periodontal disease and diabetes in Barbadian patients through, the identification and comparison of microbial patterns in diabetic and non-diabetic patients, the linkage between diabetic status and the progression of periodontal disease as well as further development of cardiovascular disease in those diabetic patients. In this study, we will compare the prevalence of periodontal disease in patients with Type 1 Diabetes (n=163), Type 2 (n=163) and a control group (n= 326). A total of 652 samples from individuals ages 13 years of age and older will be included in this study. To determine the presence of PD, an oral exam will be performed on each individual and a subgingival plaque sample taken to assess the microbial levels of bacterial strains associated with periodontal disease. In addition, a full blood count will be done to identify the presence of those inflammatory markers commonly associated with periodontitis such as TNF-α, Creatine Reactive Protein, Interleukin 1, Interleukin 6 and Interleukin 8. With the use of a questionnaire, we will also be able to link the presence or development of PD to other underlying factors through the analysis of their social, medical and dental history. Lastly, to determine the link between cardiovascular disease and PD an ultrasound of the carotid arteries will be performed and the results of those patients with PD and healthy controls will be compared. Overall, with high rates of obesity, diabetes and CVD this study allows us to determine if the progression of diabetes and PD in Barbados are the same as the developing world.
The Impact of Cannabinoid-type 2 Receptor Activation on Glucagon-like Peptide 1 Receptor-mediated Insulin Secretion
(The University of the West Indies Cave Hill Campus, 2022-01-28) Allsopp, Sherry-Ann
Medicinal cannabis and cannabinoid-based products are becoming more accessible as policies continue to globally change towards the status of Cannabis sativa. It is likely that patients with type-2 diabetes (T2D) might opt to use these products as a means of controlling this debilitating disease. Moreover, others might use them in an attempt to relieve neuropathic pain associated with complications of T2D while still actively taking their medication. Incretin mimetics or glucagon-like peptide 1 receptor (GLP-1R) agonists represent a class of medication prescribed for the control of glucose in T2D. By activating the GLP-1R, a G-protein coupled receptor located on the pancreatic beta cell, these molecules augment glucose-stimulated insulin secretion, and improve whole-body glucose homeostasis. Cannabinoids exert their activity via two classical cannabinoid receptors, cannabinoid-1 and 2 (CB1R and CB2R, respectively), which are also G-protein coupled receptors located in several parts of the body including the pancreatic beta cell. Recently, it has been shown that CB1R blockade resulted in an increase in GLP-1R-mediated insulin secretion. However, global blockade of CB1R results in unfavourable psychological effects. To date, no investigations have been conducted on the impact of CB2R on the GLP-1R mediated insulin secretion. By using a Chinese hamster ovary cell line stably and transiently transfected with both GLP-1R and CB2R respectively, as well as utilizing agonists and antagonists of these receptors, I will investigate whether modulation of the CB2R has an impact on GLP-1R-mediated insulin secretion by assessing cyclic adenosine monophosphate (cAMP) accumulation and the underlying signalling pathway.
Screening of Potential Anti-Diabetic Properties of Barbadian Folklore from Medicinal Plants Using Non-conventional and Conventional Drug Targets
(The University of the West Indies Cave Hill Campus, 2022-01-28) Archer, Kim
Type 2 diabetes can be described as the body’s ineffective use of insulin and it accounts for at least 90% of all diabetic cases. This condition is a multifactorial disease and requires multiple therapeutic approaches, which can lead to prominent irreversible side effects. There are many known classes of drugs for the management of Type 2 diabetes. However, Metformin is used as the oral hypoglycaemic drug of choice for managing the condition. Finding alternative treatments from the plant kingdom is a very viable option. Mormordica charantia (cerasee), Phyllanthus niruri (seed under leaf) and Catharanthus roseus (periwinkle) are all locally grown plants that have been reported anecdotally to exhibit anti-diabetic properties. Their effects on enzymatic drug targets (dipeptidyl peptidase 4 and protein tyrosine phosphatase) to produce better efficacy and safety profiles are being explored. This study incorporates a three-phase drug discovery and preclinical development process to explore potential herbs for the treatment of Type 2 diabetes. Phase 1 includes the collection and extraction of bioactive compounds from the plants. Phase 2 is the in vitro analysis of the extracts on the respective drug targets and it also includes activity guided purification of the bioactive compounds from the extracts.
Examining factors impacting local food production and food security in St Vincent and the Grenadines (SVG) – a Small Island Developing State (SIDS)
(The University of the West Indies Cave Hill Campus, 2022-01-28) Ausgustus, Eden
Consistent access to safe and nutritious food among Small Island Developing States (SIDS) has been distorted by unemployment and poverty, leading to food insecurity. This is further compounded by developmental trajectories such as urbanisation and modernity which impact on previously vibrant agricultural systems towards decreasing agricultural production. In addition to economic challenges, geographic isolation and environmental issues such as natural disasters brought on by climate change as well as limited natural resources have led to an increased reliance on food imports. Recently, SIDS have been faced with another major challenge threatening food security - the COVID-19 pandemic and its sequelae impact or health and the economy. To control transmission rates, non-pharmaceutical interventions (NPIs) including curfews, closure of borders and institutions have been employed, deepening the vulnerability of small-scale food producers. To address the overall local food production and food security issues, an ecologic community back yard gardening initiative using organic practices has been identified as a point of intervention by evidence review and group model building sessions. Here we examine potential barriers to the intervention including the impact of the COVID-19 pandemic and the recent La Soufrière volcanic eruption on food production and food security in a community project in St. Vincent and the Grenadines. Data has been collected using a mixed method design through case studies and a quantitative cross-sectional survey. The case studies will be analysed within a thematic framework and associations will be tested through linear and logistic regressions.
The Effects of Herbal Cocktails on KNDy Neuropeptides and Reproductive Hormones in PCOS Induced Female Sprague Dawley Rats
(The University of the West Indies Cave Hill Campus, 2022-01-28) Shepherd, Marianna
Infertility is an emotional and physical roller coaster that many couples face. Although no official numbers have been released, from discussions with various health personnel, infertility in the Caribbean has become more prominent. PCOS is one of the leading causes of infertility in women, and although many studies have been completed on this disorder, it remains elusive. Due to this, PCOS is treated based on symptoms, and as such, each case may vary. This study seeks to find a herbal treatment, not only for one particular symptom but to promote an overall rebalance of endocrine hormones in the female reproductive system. The focus will be made on the KNDy neuropeptides, (kisspeptin, neurokinin B and dynorphin) which are now known to control the regulation of GnRH. The study will also observe the overall changes in most of the reproductive hormones such as GnRH, LH, FSH, Prolactin, Insulin, Estrogen, Progesterone, and Testosterone as it also seeks to identify any new pathways to the formation of the syndrome. Two herbal cocktails will be prepared using Vitex Agnus Castus (Chasteberry), Angelica Sinensis (Dong Quai), Rubus Idaeus (Red Raspberry Leaf) and Lepidium meyenii (Maca Root); which are popular herbs proven to aid with reproductive health. Rat Hypothalamic Cell lines will be first used to access the mechanism and cytotoxicity of these cocktails in phase one of the study. Due to ethical restrictions, Sprague Dawley rats will be used for phase two of the experiment. The Letrozole PCOS induced rats will be used to observe and measure the effects of the herbal cocktail on KNDy neuropeptides' levels, their receptor expression, and reproductive hormones levels. Metformin, a drug well-known for its success in fertility treatment, will be used as a comparison to validate the potency of the herbal cocktail. Data from this study will also aid in the eventual development of a cure for the syndrome.

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