Impact of Delivering a Healthy Lifestyle Intervention: Promotora Findings from Familias Sanas y Activas II.

Background: Community health workers, promotoras, have been identified as effective change agents of their community members' health behaviors and health status. However, few studies have examined the effects of delivering an intervention on the promotoras themselves. Objectives: This study assessed whether promotoras delivering a healthy lifestyle intervention for adults improved their health behaviors and health status from baseline to 6- and 12-months post-baseline. Methods: Volunteer promotoras were trained to promote healthy lifestyles including physical activity through workshops and free group exercise classes throughout their communities. Twenty completed all required trainings and delivered at least one class during the period between baseline and 12-month assessments. The promotoras were measured on the following variables: Systolic and diastolic blood pressure, waist circumference, weight, and height. Additionally, they reported their health behaviors and status including moderate-to-vigorous physical activity, beverage consumption, sleep duration, and depressive symptoms. Results: Repeated measures ANOVAs showed statistically significant decreases from baseline to 6 months for systolic blood pressure (p ≤ 0.05), diastolic blood pressure (p ≤ 0.001) and body mass index (p ≤ 0.05). Changes in self-reported measures were not statistically significant although trends were observed with increases in water consumption. Conclusions: Findings from this study suggest positive effects associated with delivery of a PA intervention. This is one of the first studies to focus on a cohort of promotoras to examine health outcomes from delivering a healthy lifestyle intervention. It is important to further explore these impacts on the community health workers as they have become increasingly essential to the health of some communities.

HIV Knowledge, Risk Behaviors, and Testing Among Chinese-, Korean-, and Vietnamese-American Women.

The relationship between HIV knowledge and testing behavior is poorly understood among young Chinese-, Korean-, and Vietnamese-American women. This study assesses: (1) levels of HIV/AIDS knowledge, (2) lifetime and annual prevalence of HIV testing, and (3) whether higher levels of HIV knowledge were associated with increased likelihood of testing after controlling for HIV risk behaviors. Fifty-one percent reported lifetime HIV testing (n=117); among those tested, 53% were tested within the past year. A significant and positive association between scores on the HIV Knowledge Questionnaire (HIV KQ-45) and HIV testing was identified. This association was no longer statistically significant after controlling for sexual risk behaviors. Participants were most knowledgeable about HIV symptoms (88.6%) and least knowledgeable about treatment options (56.8%). Future studies should further characterize cultural factors affecting these women's sexual practices, as well develop culturally adapted HIV educational interventions to increase HIV knowledge and testing rates.

Attitude and perception of spectacle wearers towards contact lens wear

Aim: To investigate the attitude and perception of spectacle wearers towards contact lens wear. Method: A cross-sectional questionnaire was distributed from the waiting rooms of licensed Optometry Offices to spectacle-wearing participants over 18 years of age with no history of contact lens wear and those who previously wore contact lenses. The data collected on the barriers, attitude, awareness, and willingness of the spectacle wearers towards contact lens wear was statistically analyzed using the Statistical Package for Social Sciences Computer Software with the significance level set to a p-value of 5%. Results: Of the 119 participants, the majority were females (63.0%), had secondary education (47.1%), were of East Indian descent (59.7%) and were over 50 years (29.4%). Only 40 spectacle wearers indicated a history of previously wearing contact lenses. The main barriers for non-CL wearers were reportedly comfort of spectacles (40.5%), the perception that contact lenses are uncomfortable (38.0%) and difficult to use (36.7%) whereas for previous CL wearers it was mainly discomfort (57.5%). The main source of information were from eye-care practitioners (58.0%) and was only significantly associated with age (P=0.023). There was a greater willingness to retry contact lenses among previous CL wearers (62.5%) than non-CL wearers (41.8%). Conclusion: There was a positive attitude and perception among previous contact lens wearers than those who have never worn contact lenses. There is a need for increased health education by eye-care practitioners and other delivery methods to remove misconceptions and perpetuate the awareness of contact lenses and their benefits to allow for an increase in contact lens usage (AU)

Cardiovascular Health in a Single Community in Rural Haiti: A Cross-sectional Study.

INTRODUCTION: There is a growing burden of cardiovascular disease in low- and middle-income countries and assessment of cardiovascular health (CVH) may identify populations at risk for poor CVH. METHODS: Between July 2014 and August 2014, we performed a household survey from a convenience sample among adult community members in rural northern Haiti. We used a modified World Health Organization STEPwise approach to chronic disease questionnaire to capture self-reported data on tobacco, diet, physical activity, and diabetes, and measured blood pressure and body mass index. We used an adapted American Heart Association definition and thresholds for determining ideal, intermediate, and poor cardiovascular health. We used linear and logistic regression to examine associations between socio-demographic characteristics with CVH score and ideal CVH. RESULTS: Among 540 participants (mean [SD] age = 40.3 [17.1] years, 67% women), there was a high prevalence of poor CVH (n=476, 88.1%) compared with intermediate (n=56, 10.4%) and ideal (n=41, 7.6%) CVH. Ideal metrics for blood pressure (47%) and diet (26%) were least often met, while body weight (84%), physical activity (83%), and smoking (90%) were most often met. Men were associated with better CVH score (0.31, [0.04-0.59]; P=0.03), and being a farmer was associated with ideal CVH (P=0.006). CONCLUSION: In this community-based sample of a farming community in rural Haiti, very few adults had ideal CVH. Higher CVH score was associated with male sex, and farming as a primary occupation. Women and non-farmers may represent at-risk subgroups within this population. Blood pressure and diet may represent possible areas for improvement.

Impact of COVID-19 on the intimate relationships of young adults between the ages of 18-30 years in Trinidad and Tobago

The COVID-19 pandemic caused a sudden halt in normal day-today movements & interactions across the world. Restrictive measures were implemented to lessen the spread of the virus, however, it altered social interactions. In times of stress, persons usually turn to social support for comfort. However, this pandemic has forced individuals to be isolated. Although the physical health of individuals has been addressed somewhat, their mental health has not been prioritized. Young adults in relationships were either isolated with or away from their partner, while single young adults were generally without a stable companion. With the impacts discovered from this research, new measures can be adopted in society & health facilities to mediate the harmful effects this pandemic caused & will cause on the mental health of young adults with respect to dating and relationships.

Knowledge and Perception of Physicians regarding Telemedicine Technology in Trinidad and Tobago

Telemedicine is an unexplored practice that has received advocacy due to technological advancement and social distancing regulations imposed due to Covid-19. According to the W.H.O1 50% of its member states have implemented a national telemedicine policy, stimulating the question "Why hasn't Trinidad and Tobago introduced a structured and stable telemedical service?" To investigate this, we target experienced physicians to understand the benefits and limitations of adapting telemedical technology into the current medical model. Utilization of Telemedicine in developing countries, like Trinidad and Tobago, is very promising as it can improve healthcare accessibility and elevate the quality of care for potential patients in rural areas

Choice of Speciality among Medical Students at the Faculty of Medical Sciences, St. Augustine, UWI, Trinidad and Tobago, West Indies

The School of Medicine at the Faculty of Medical Sciences, University of the West Indies (FMS, UWI) graduates over 200 physicians yearly. Shortage of specialists exists; attributed by some, to the lack of opportunities. Challenges faced regarding medical specialization in Trinidad and Tobago (TT) are difficulties meeting the requirements of the available specialty programmes, lack of residency post and training in certain fields (1). Medical school is an opportune time to select a field as experience as a student and progression through the various years of medical school can influence choice (2,3). METHODOLOGY: A cross-sectional study was conducted by convenience sampling on 1278 medical students at the FMS, UWI using an online questionnaire. The distribution of specialist practitioners was abstracted from the online register of The Medical Board of Trinidad and Tobago.

Assessment of the knowledge, attitudes and practices toward respiratory tract infections among the Trinidadian population

Respiratory Tract Infections (RTIs) are currently at the forefront of discussions as the world battles the COVID-19 pandemic. It is important that more awareness is raised on RTIs, their causes, the different types, how they are contracted and spread and complications of and risk factors for RTIs. Prevention measures towards RTIs should also be assessed and encouraged, such as proper hand washing, mask wearing, sneezing and coughing etiquette as well as vaccination. Therefore, this investigation was undertaken to assess the knowledge, attitudes, and practices towards Respiratory Tract Infections (RTIs) among Trinidadian population.

A Study on the Knowledge, Awareness, Perceptions and Behaviour (KAPB) of Students of the University of the West Indies, St. Augustine (UWI-STA) Towards Climate Change and its Impact on Human Health

Climate change (CC) is defined as long-term weather changes in the Earth's climate. CC has been linked to increased global temperatures. This affects human health both directly and indirectly: Directly, via increased risk of cardiovascular, respiratory, and vector-borne diseases. Indirectly, via reduced agricultural crop yields and accessibility to healthcare due to extreme weather events. Studies show that spreading awareness on the health impacts of CC encourages motivation towards mitigation (1). Early awareness of climate change and its health impacts is necessary for future generations to mitigate its effects.

The Ability of Family Physicians in the Caribbean to Promote Planetary Health Concepts and the Challenges of Implementing Changes in Practice

The global environment is rapidly changing and the subsequent effects on human health are devastating. Planetary Health is a field focused on characterizing the human health impacts of human-caused disruptions of Earth's natural systems. It has been determined that Family Physicians (FPs) are the best suited to advocate and raise awareness of Planetary Health. The purpose of this research is to assess FPs in the Caribbean, their knowledge of planetary health, their ability to implement planetary health concepts in their practice, and the challenges that may impede implementation.

The Prevalence of Negative Coping Mechanisms and Its Association with The HealthRelated Quality of Life of University Students: Impact of the COVID-19 Pandemic

Mental health of young adults has become a relevant matter amidst the COVID-19 pandemic. Individuals employ various coping mechanisms to deal with their stresses and mental health challenges. The type of coping strategy determines the outcomes of their Health-related Quality of Life (HRQo). This study investigated the stressors of students at the University of the West Indies, St Augustine Campus (UWI-STA) and how their coping mechanisms influenced their HRQoL during the COVID-19 pandemic

CBCT analysis of root canal Morphology ofthe Mesial roots of Maxillary and Mandibular first and second permanent molars in the Trinidadian population (Pilot study)

Root canal system morphology of maxillary and mandibular molars varies amongst populations, especially the mesial roots. Knowledge of these variations is essential to the outcomes of root canal treatment. CBCT analysis allows a "3-D visualization" of the anatomy.

The Aetiology of Non-Carious Cervical Lesions - A Mini Review

Non carious cervical lesions are characterized by the loss of tooth structure at the cementoenamel junction caused by wear processes and not by bacterial activity. They have clearly defined edges that are deeper rather than wider, and their internal angle can be either more rounded or sharp. They appear in a variety of shapes and sizes, and are categorized as wedge­shaped, grooved, concave, irregular and shallow NCCLs. Studies show that their aetiology is multifactorial, amongst which are: erosive agents, acidic diets, oral hygiene habits (technique, frequency, force, duration), occlusal stress forces and some medical conditions(GERD).

The impact of COVID-19 related restrictions on orthodontic patients in Trinidad and Tobago

The Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a highly contagious disease that emerged as a global pandemic in early 2020. The mode of transmission of COVID-19 and consequently its high transmission power has led to the closure of most dental clinics and orthodontic practices. The ramifications of the COVID-19 pandemic have greatly influenced the approach to dentistry and the availability of prompt dental care.

A Systematic review of the Primary Therapeutic interventions used in COVID-19 patients who were reinfected

On March 11th, 2020, COVID-19 was declared a global pandemic. Since then, data has been recorded, correlated and reviewed in an effort to better understand how to combat the spread and lower the morbidity of the disease. In this pursuit, many studies have linked the presence of comorbidities, diabetes among those, with a higher mortality rate. To further this line of thought, this review was meant to investigate the factors affecting this poorer prognosis and the risk of reinfection among this population.

A Study of the knowledge, attitudes and practices of community pharmacists to antibiotic resistance in Trinidad

•Antibiotic misuse accelerates the natural process of development of antibiotic resistance •The increasing antibiotic ineffectiveness is a threat to the practice of medicine, leading to an increase in morbidity and mortality as there are an estimated 750,000 deaths annually due to bacteria resistant sepsis •The presence of multi-dug resistant bacteria in North American and Europe has implications for the Caribbean •Education plays an important role in tackling antibiotic resistance •Although Caribbean physicians are aware of antibiotic resistance, this knowledge does not affect prescribing habits •Previous research among pharmacy students in Trinidad identified good knowledge, but the attitude towards use of antibiotics was poor •Research among pharmacists in Brazil identified causes of antibiotic resistance but the role of the law was not explored

Are Natural Remedies Perceived To Be An Effective Treatment for Sinusitis in Trinidad and Tobago? A Cross Sectional Survey

●Sinusitis is inflammation of the mucosal lining of the nose and paranasal sinuses (air-filled cavities in the ethmoid, maxillary, sphenoid and frontal bones within the skull). ● 12% of people worldwide experience sinusitis symptoms. ● Trinidad and Tobago is plagued by Saharan dust, exacerbating symptoms. ● The symptoms of sinusitis are nasal congestion, discharge, reduction/loss of smell, facial pain/pressure, fever and tooth pain. ● Currently, there is little research on effective sinusitis treatment locally.

Natural Bioactive Polypeptides: A Study towards the Clinical Application in The Bahamas and Trinidad & Tobago

Synthetic medication is being overprescribed, resulting in adverse complications linked to major public health issues such as antimicrobial resistance, drug dependency, and the current opioid crisis. According to the United Nations Office on Drugs and Crime, this global burden of overuse of synthetic accounts for the heaviest burden of disease attributable to drug use disorders. In 2015, with almost 12 million disability-adjusted life year (DALYs), or 70% of the global burden of disease attributable to opioid addiction. With suitable alternatives available, peptide-based drugs will help to reduce the global burden, appease the patient preference of naturally derived medication and ensure safer patient usage.

Effects of PCOS on the quality of life of women ages 18-45: A Systematic Review

Polycystic ovary syndrome (PCOS) is a common hormonal disorder with an unknown aetiology that manifests in women of reproductive age. ➢ Excessive insulin levels, genetic predisposition, inflammation, and excessive androgen levels are involved in its development. ➢ PCOS can affect the quality of life (QoL) of women through characteristics like amenorrhea, excess androgens, polycystic ovaries, infertility, hirsutism, acne, and drastic weight gain. ➢ Associated complications like endometrial cancer, abnormal uterine bleeding, miscarriages, gestational diabetes, type 2 diabetes, hypertension, eating disorders, and depression may also arise, which can further lower QoL.

Health-related quality of life (HRQoL) during the COVID-19 pandemic on undergraduate students at the University of the West Indies, St. Augustine

▪ During the COVID-19 pandemic, the shift to online education led to behavioural/lifestyle changes, whichcan affect health-related quality of life (HRQoL). ▪ HRQoL is an individual's perceived physical and mental health over time, and highlights how these changes can impact health.