The 9th Annual Faculty of Medical Sciences Graduate Symposium Biographies & Abstracts

THE UNIVERSITY OF THE WEST INDIES CAVE HILL CAMPUS

The 9th Annual Faculty of Medical Sciences Graduate Symposium Biographies & Abstracts

Friday, January 28, 2022

PRESENTERS  Ms. Stephanie Whiteman – PhD Epidemiology  Dr. Stephanie Date – PhD Pharmacology  Ms. Deidre Shepherd – MPhil Pharmacology  Mr. Kern Rocke – PhD Epidemiology  Ms. Kim Archer – PhD Pharmacology  Ms. Eden Augustus – PhD Public Health  Ms. Marriana Shepherd – MPhil Pharmacology  Ms. Desrie-Ann Parris – MPhil Medical Microbiology FEATURE SPEAKER Dr. Afsan Bhadelia – Fulbright US Scholar

Ms. Stephanie Whiteman PhD Epidemiology

Biography

Stephanie Whiteman, native of Trinidad and Tobago, is a 25-year-old upcoming public health researcher. In 2016 she earned her Bachelor’s Degree in Health Science from the Lock Haven University of Pennsylvania then in 2018, she obtained a Master of Public Health with Distinction from the University of the West Indies, Cave Hill, Barbados. Currently she is pursuing a PhD in Epidemiology at the University of the West Indies. Her main research interest surrounds the topic that explores the relationship between the food environment and health. As a research associate at the George Alleyne Chronic Disease Research Centre, Stephanie has been engaged in a number of research projects that embody aspects of this. In addition, Stephanie is also a recipient of the Vital Strategies Healthy Food Policy Fellowship.

Apart from her researcher roles, Stephanie is also a public health advocate.

She takes pride in being a Youth Advocate for the Healthy Caribbean Coalition as well as being a NCD Child Young Leader.

In addition to her work within the health field, Stephanie is a FIH Level 1 Field Hockey Coach. She played NCAA Division 1 field hockey in the United States while she was pursuing her first degree and she has been part of her home country’s senior women’s national team since 2011.

Assessing the foodscape of a Small Island Developing State: The Barbados Nutrition Environment Survey (Barbados-NEMS) for Stores PhD Epidemiology: Stephanie Whiteman

Abstract

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.

Assessing the foodscape of a Small Island Developing State: The Barbados Nutrition Environment Survey (Barbados-NEMS) for Stores PhD Epidemiology: Ms. Stephanie Whiteman

Abstract (Cont’d) 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.

Keywords: Food environment, nutrition, food outlet, measurement, Nutrition Environment Measurement Survey

Dr. Stephanie Date PhD Pharmacology

Biography Dr. Stephanie Date was born and raised in Barbados, where she graduated from the University of The West Indies (UWI), Cave Hill, with a Bachelor of Medicine Bachelor of Surgery (MBBS) degree in 2015. In 2020, Stephanie upgraded from the MPhil to the PhD Pharmacology program at Cave Hill, and her research surrounds health disparities among Afro-Caribbean women. She is currently investigating a common anti-diabetic drug (Metformin) and its possible anti-neoplastic properties among a cohort of Barbadian, postmenopausal women with endometrial cancer. Continuing, she enjoys serving as Senior Fellow of The Yale Transdisciplinary Collaborative Center for Health Disparities Research, working alongside The Eastern Caribbean Health Outcomes Research Network (ECHORN) and is the Acting Medical Coordinator of the Barbados Cancer Society’s Breast Screening Programme Sub-Committee.

Barbadian Women, Metformin and Endometrial Cancer: Project Updates PhD Pharmacology: Dr. Stephanie Date

Abstract 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 recorded 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.

Ms. Deidre Shepherd MPhil Pharmacology

Biography

Ms. Deidre Shepherd comes from a science background where she acquired a Bachelor’s degree in Chemistry with honours at the University of the West Indies. She is pursuing a master’s degree in Pharmacology to explore new treatments for non-communicable diseases. Ms. Shepherd is currently focusing her research in cardiovascular pharmacology where she has a keen interest in using cannabinoids and medicinal plants for therapeutic purposes. Apart from her academics, she is very passionate about volleyball and has dedicated time to representing the UWI with the Blackbirds volleyball team.

The Use of Cannabinoids to Modulate Endothelial Dysfunction MPhil Pharmacology: Ms. Deidre Shepherd

Abstract

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.

Mr. Kern Rocke PhD Epidemiology

Biography

Mr. Kern Rocke, is a PhD Epidemiology student of the Faculty of Medical Sciences at the University of the West Indies, Cave Hill Campus.

He currently collaborates on a variety of projects with the George Alleyne Chronic Disease Research Centre, A unit of the Caribbean Institute for Health Research. His 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.

Walkability, Physical Activity and Health: The story of Barbados PhD Epidemiology: Mr. Kern Rocke

Abstract The rising global burden of physical inactivity has led to negative effects on overall population health in particular increasing the risk for adverse cardiovascular (CVD) outcome in older adults. The built environment in particular neighbourhood walkability has been identified as a promising area to increase physical activity (PA) behaviour at the individual and community levels leading to a reduction in CVD risk. There has been limited to no published evidence from Caribbean in characterizing the neighbourhood walking environment and understanding its link with cardiovascular risk in older adults.

Aims: This project sought to firstly identify through a broad examination of the global literature and geospatially map at the national level built environment features (macroscale) which have been associate with physical activity. Secondly, to assess the detailed built environment features (microscale) associated with PA present within neighbourhoods in Barbados.

Thirdly, to examine relationship between macro and microscale walkability with individual active commuting behaviour and cardiovascular risk.

Methods: This project was conducted in three phases. In phase 1 (national data collection) scoping review during the period of 2010-2019 was conducted identifying built environment features associated with physical activity in Small Island Developing States and Latin American settings

Walkability, Physical Activity and Health: The story of Barbados PhD Epidemiology: Mr. Kern Rocke

Abstract (Cont’d) Additionally, using the results from this review a neighborhood walkability index was developed incorporating objectively measured built environment features and implementing a widely used internationally relevant method. In phase 2 (sample data collection) field auditing of the pedestrian environment was conducted in neighbourhoods where national NCD risk factor studies have been conducted. Auditing of predefined routes within these neighbourhoods using the microscale audit of pedestrian streetscapes tool. Lastly. in phase 3 (linkage of neighbourhood features with individual behaviour) baseline data from the adult ECHORN cohort study -Barbados and the Health of the Nation study were used to link built environment features from the macroscale and microscale environment with individual PA behaviour and CVD risk (using the American Heart Association alogirithm) Conclusion: The findings for this project may contribute to gaining a better understanding of the role neighbourhood walkability has in reducing CVD risk in Barbados and the potential for the design of a toolkit for further expansion across the Caribbean region.

Ms. Kim Archer PhD Pharmacology

BIOGRAPHY

Kim Archer was born in Barbados on April 5th, 1983. In 2005, she graduated from the University of the West Indies, Cave Hill Campus with an upper second class honours in a Bachelor of Science degree in both Chemistry and Mathematics. In 2006, she graduated from Newcastle University, United Kingdom, with a Masters of Science degree in Drug Chemistry. She is a chemist by training and a proud mother of a 9 year old son. She is currently enrolled at the University of the West Indies, Cave Hill Campus in the Faculty of Medical Sciences undertaking a Doctor of Philosophy in Pharmacology.

Screening of Potential Anti-Diabetic Properties of Barbadian Folklore from Medicinal Plants Using Nonconventional and Conventional Drug Targets PhD Pharmacology: Ms. Kim Archer

Abstract

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.

Screening of Potential Anti-Diabetic Properties of Barbadian Folklore from Medicinal Plants Using Nonconventional and Conventional Drug Targets PhD Pharmacology: Ms. Kim Archer

Abstract (Cont’d) Phase 3 is the experimental in vivo analysis, which includes inducing Type 2 diabetes in Sprague-Dawley rats, using a high-fat diet and low dose injection of streptozotocin and treating the rats with the test substances. Phase 1 and 2 preliminary data will be used to determine which drug target and plant extract will be used to conduct phase 3.

Signalling pathways associated with the effect of the extract on the blood glucose levels and the toxicological effects of the extracts will also be analysed. All phases of the study will be carried out in the Faculty of Medical Sciences’ research laboratory at the University of the West Indies, Cave Hill Campus. However, identification of compounds in the active fraction(s) will be outsourced. It is anticipated that findings from this study will be used to validate the folklore use of the plants in the management of diabetes. It will also potentially provide better therapeutic options to manage the multifactorial disease.

Ms. Eden Augustus PhD Public Health

Biography Ms. Eden Augustus is a national of Trinidad and Tobago. She is currently a doctoral candidate within the Faculty of Medical Sciences, at the University of the West Indies (U.W.I), Cave Hill Campus. She is the project coordinator of the Caribbean section of the Intervention Cocreation to Improve Community-based Food Production and Household Nutrition in Small Island Developing States (ICOFAN) project (a project that focuses on promoting the consumption of local nutritious foods in SVG, Fiji and Haiti, which her PhD is independently embedded in). Ms. Augustus has a diverse food and nutrition background, having obtained a Master in Public Health (Distinction) in 2019, a BSc. in Human Nutrition and Dietetics (First Class Honours) in 2018, and associate degrees in both Culinary Science and Culinary Arts. Ms. Augustus is a Healthy Caribbean Coalition Youth Advocate as well as a Queen Elizabeth II Diamond Jubilee Scholar. Her research interests include nutritional and infectious disease epidemiology.

Examining factors impacting local food production and food security in St Vincent and the Grenadines (SVG) – a Small Island Developing State (SIDS) PhD Public Health: Ms. Eden Augustus Abstract 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.

Keywords: COVID-19; La Soufrière volcanic eruption; Food Security; Backyard Gardening

Ms. Marriana Shepherd MPhil Pharmacology

Biography

Background/ Previous Education – Bachelors (with honors) in Chemistry and Biochemistry From The University of The West Indies, Barbados and Masters in Business, from Edinburgh Napier University, Scotland.

I aspire to pursue a career in Academia and Research with a focus in Reproductive Health.

My vision in life is to be successful in whatever I am assigned to do, whether small or large and to share my success with others. Teaching the importance of science, and good quality of work while providing knowledge for the enhancement of persons and their environment.

Science is not just a subject taken in school or a body of knowledge; it is a way of life.

The Effects of Herbal Cocktails on KNDy Neuropeptides and Reproductive Hormones in PCOS Induced Female Sprague Dawley Rats MPhil Pharmacology: Ms. Marriana Shepherd Abstract

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 base 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.

The Effects of Herbal Cocktails on KNDy Neuropeptides and Reproductive Hormones in PCOS Induced Female Sprague Dawley Rats MPhil Pharmacology: Ms. Marriana Shepherd

Abstract (Cont’d)

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.

Ms. Desrie-Ann Parris MPhil Medical Microbiology

Biography Desrie-Ann Parris is a first-year graduate student at The University of the West Indies Cave Hill Campus. She received a bachelor’s degree in Biology with Biochemistry from the aforementioned University. Her field of study is Medical Microbiology where she focuses on identifying the relationship between Periodontitis and the development of Diabetes and Cardiovascular Disease in the Barbados population. Identification of this relationship may assist with early detection of the diseases later easing the burden they place on the healthcare system.

Identification of Microbiological Pathogens and Inflammatory Markers associated with periodontitis in Diabetes and with the development of Cardiovascular Disease MPhil Medical Microbiology: Ms. Desrie-Ann Parris Abstract 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 TNFα, Creatine Reactive Protein, Interleukin 1, Interleukin 6 and Interleukin 8.

Identification of Microbiological Pathogens and Inflammatory Markers associated with periodontitis in Diabetes and with the development of Cardiovascular Disease MPhil Medical Microbiology: Ms. Desrie-Ann Parris

Abstract (Cont’d)

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.

Ms. Afsan Bhadelia Fulbright US Scholar

FEATURE SPEAKER

Presentation Title "Reconfiguring priority-setting and planning to advance justiceoriented health systems"