Dietary fatty acids alter mitochondrial phospholipid fatty acyl composition and proton leak in Drosophila melanogaster

Two groups of fruit flies (Drosophila melanogaster) were maintained on different diets. Mitochondria were isolated, proton leak was measured and phospholipid fatty acid composition determined. Mitochondria from flies fed on corn-base meal (containing high amounts of polyunsaturated fatty acids, 18:2(n-6) and 18:3(n-3) and low amounts of monounsaturated fattyacid, 18:1(n-9)) contained more polyunsaturated fatty acids in their membranes than mitochondria from flies fed on yeast-base meal (containing less amount of polyunsaturates and high amount of monounsaturates). The more polyunsaturated mitochondria were leakier toprotons than the more monounsaturated mitochondria

Mitochondria as Pharmacological Targets: The Discovery of Novel Anti-Obesity Mitochondrial Uncouplers from Africa’s Medicinal Plants

Obesity results from prolonged positive imbalance between energy in take and expenditure. When food intake chronically exceeds the body’s energy need, an efficient metabolism results in the storage of the excess energy as fat. Mitochondria are the main centre for energy production in eukaryotic cells. Mitochondrial proton cycling is responsible for a significant proportion of basal or standard metabolic rate, therefore, further uncoupling of mitochondria may be a good way to increase energy expenditure and hence represent a good pharmacological target for the treatment of obesity. This implies that, any chemical agent or photochemical compound that further uncouples the mitochondria in vivo without having any effect on mitochondria activity could be a potential target in finding treatment for obesity. In the past, uncoupling by 2, 4-dinitrophenol has been used this way with notable success. This paper discusses the mitochondria as targets in the discovery of potential plant natural anti-obesity products from Africa’s rich rainforests.Key words: Uncoupling, Mitochondria, Pharmacology, Medicinal Plants, Obesity

The Nexus between Communication and Development Planning. Exploring the Communication Methods Used by Development Planners in Ghana

The nexus between Planning and communication especially in Africa is barely explored despite suggestions by renowned writers such as Habermas, whose communicative action theory has informed several Planning strategies that focus on providing more practical frameworks for understanding and practicing in the field.  Using the case study methodology, this study explored the case of four agencies engaged in development planning activities in the Kumasi Metropolis, Ghana. It was found out the Planners hardly employ the wide range of communication methods available. This study reveals that the situation results from Planners’ preference for keeping to comfort-zones shaped by their limited levels of awareness, knowledge and competence and recommends that Planner employ the broad range of options to achieve greater efficacy in the communicative process of development planning. Keywords: Communicative planning, communication methods, development planning, participation, Ghan

A pilot study on the efficacy of an Antiaris toxicaria subsp. africana (Engl.) C.C. Berg based Ghanaian herbal product in the management of peripheral neuropathy.

Context: Peripheral neuropathy is a common neurologic disease that accounts for a lot of physician visits. Aims: To evaluate the efficacy of a Ghanaian herbal product prepared from the stem bark of Antiaris toxicaria subsp. africana (known as Mist Antiaris) in the management of neurological disorders in patients clinically diagnosed with peripheral neuropathy. Methods: A prospective open label non-comparative study was undertaken involving 24 patients seen at the clinic of the Centre for Plant Medicine Research, Mampong-Akuapem. A modified Neuropathic Symptoms Score (NSS) and a visual analogue scale (VAS) using the standardized Wong-Baker faces rating scale (WBFRS) were used to grade each participant on the first day of visit. The VAS was subsequently used to grade and monitor improvements in the symptom characteristics of peripheral neuropathy at the fourth week and on the eighth week. Results: Mean age of participants involved in the study was 46.08 ± 2.77 years with the most significant comorbidity associated with participants being hypertension and type II diabetes, which accounted for 10 (41.66%) of the cases recorded. Baseline NSS indicated that 20 (83.0%) of the participants had severe symptoms and 4 (17.0%) reporting with moderate symptoms of neuropathy. Treatment resulted in an improvement of symptoms with a decline in mean VAS from a baseline of 6.04 ± 0.41 to 3.79 ± 0.74 on day 28 and 2.13 ± 0.93 by day 56. Conclusions: The results gathered from this pilot study indicates that the product Mist Antiaris has good prospects as an anti-neuropathic medication

Analysis of drug resistance among difficult-to-treat tuberculosis patients in Ghana identifies several pre-XDR TB cases

BACKGROUND: Resistance to tuberculosis (TB) drugs has become a major threat to global control efforts. Early case detection and drug susceptibility profiling of the infecting bacteria are essential for appropriate case management. The objective of this study was to determine the drug susceptibility profiles of difficult-to-treat (DTT) TB patients in Ghana. METHODS: Sputum samples obtained from DTT-TB cases from health facilities across Ghana were processed for rapid diagnosis and detection of drug resistance using the Genotype MTBDRplus and Genotype MTBDRsl.v2 from Hain Life science. RESULTS: A total of 298 (90%) out of 331 sputum samples processed gave interpretable bands out of which 175 (58.7%) were resistant to at least one drug (ANY(r)); 16.8% (50/298) were isoniazid-mono-resistant (INH(r)), 16.8% (50/298) were rifampicin-mono-resistant (RIF(r)), and 25.2% (75/298) were MDR. 24 (13.7%) of the ANY(r) were additionally resistant to at least one second line drug: 7.4% (2 RIF(r), 1 INH(r), and 10 MDR samples) resistant to only FQs and 2.3% (2 RIF(r), 1 INH(r), and 1 MDR samples) resistant to AMG drugs kanamycin (KAN), amikacin (AMK), capreomycin (CAP), and viomycin (VIO). Additionally, there were 4.0% (5 RIF(r) and 2 MDR samples) resistant to both FQs and AMGs. 81 (65.6%) out of 125 INH-resistant samples including INH(r) and MDR had katG-mutations (MT) whereas 15 (12%) had inhApro-MT. The remaining 28 (22.4%) had both katG and inhA MT. All the 19 FQ-resistant samples were gyrA mutants whereas the 10 AMGs were rrs (3), eis (3) as well as rrs, and eis co-mutants (4). Except for the seven pre-XDR samples, no sample had eis MT. CONCLUSION: The detection of several pre-XDR TB cases in Ghana calls for intensified drug resistance surveillance and monitoring of TB patients to, respectively, ensure early diagnosis and treatment compliance

The Patient Journey

AbstractThe wide implementation of patient safety improvement efforts continues to face many barriers including insufficient involvement of all stakeholders in healthcare, lack of individual and organizational learning when medical errors occur and scarce investments in patient safety. The promotion of systems-based approaches offers methods and tools to improve the safety of care. A multidisciplinary perspective must include the involvement of patients and citizens as fundamental contributors to the design, implementation, and delivery of health services.The patient journey is a challenging example of using a systems approach. The inclusion of the patient's viewpoint and experience about their health journey throughout the time of care and across all the care settings represents a key factor in improving patient safety. Patient engagement ensures that the design of healthcare services are aligned with the values, the preferences, and needs of the patient community and integrates the real-life experience and the skills of the people to enhance patient safety in the patient journey.The utmost priority to implement patient engagement is the training of patients. Therefore, training for both patients/families/advocates and health professionals is the foundation on which to build active engagement of patients and consequently an effective and efficient patient journey.The chapter offers examples of successful training courses designed to foster strategic alliances among healthcare professionals and researchers with patients and their organizations. Training of patients constitutes the first step to develop shared knowledge, co-produced projects, and the achievement of active multilevel participation of patients for the implementation of patient safety in the patient journey

Patient and public involvement in patient safety research: a workshop to review patient information, minimise psychological risk and inform research

Background Patient safety has attracted increasing attention in recent years. This paper explores patients’ contributions to informing patient safety research at an early stage, within a project on intravenous infusion errors. Currently, there is little or no guidance on how best to involve patients and the wider public in shaping patient safety research, and indeed, whether such efforts are worthwhile. Method We ran a 3-hour workshop involving nine patients with experience of intravenous therapy in the hospital setting. The first part explored patients’ experiences of intravenous therapy. We derived research questions from the resulting discussion through qualitative analysis. In the second part, patients were asked for feedback on patient information sheets considering both content and clarity, and on two potential approaches to framing our patient information: one that focused on research on safety and error, the other on quality improvement. Results The workshop led to a thorough review of how we should engage with patients. Importantly, there was a clear steer away from terms such as ‘error’ and ‘safety’ that could worry patients. The experiences that patients revealed were also richer than we had anticipated, revealing different conceptions of how patients related to their treatment and care, their role in safety and use of medical devices, the different levels of information they preferred, and broader factors impacting perceptions of their care. Conclusion Involving patients at an early stage in patient safety research can be of great value. Our workshop highlighted sensitivities around potentially worrying patients about risks that they might not have considered previously, and how to address these. Patient representatives also emphasised a need to expand the focus of patient safety research beyond clinicians and error, to include factors affecting perceptions of quality and safety for patients more broadly

Who wants to be involved in health care decisions? Comparing preferences for individual and collective involvement in England and Sweden

Background: Patient and public involvement (PPI) is framed as positive for individuals, the health system, public health, as well as for communities and society as a whole. We investigated whether preferences for PPI differed between two countries with Beveridge type health systems-Sweden and England. We measured willingness to be involved in individual treatment decisions and in decisions about the organization and provision of local health and social care services. Methods: This was a comparative cross-sectional study of the general population's preferences. Together, the two samples included 3125 respondents; 1625 in England and 1500 in Sweden. Country differences were analysed in a multinomial regression model controlling for gender, age and educational attainment. Results: Overall, 68% of respondents wanted a passive patient role and 44% wanted to be involved in local decisions about organization and provision of services. In comparison with in Sweden, they were in England less likely to want a health professional such as a GP or consultant to make decisions about their treatment and also more likely to want to make their own decisions. They were also less likely to want to be involved in local service development decisions. An increased likelihood of wanting to be involved in organizational decision-making was associated with individuals wanting to make their own treatment decisions. Women were less likely to want health professionals to make decisions and more likely to want to be involved in organizational decisions. Conclusions: An effective health system that ensures public health must integrate an effective approach to PPI both in individual treatment decisions and shaping local health and social care priorities. To be effective, involvement activities must take in to account the variation in the desire for involvement and the implications that this has for equity. More work is needed to understand the relationship between the desire to be involved and actually being involved, but both appear related to judgements of the impact of involvement on health care decisions

Surveillance Technology in Dementia Care: Implicit Assumptions and Unresolved Tensions

This paper examines the concept of “Surveillance Technology [ST]” as it is used in ageing and dementia research but which suffers from poor definition. We attempt to clarify this imprecision by contextualizing a brief history of the development of ST and provide a summary of the research in this area. We contrast this with the responses provided by a public and patient involvement group of people living with a dementia diagnosis, or experience of supporting people with dementia. ST operates in multiple interacting ways, all of which need to be taken into account in research, public and policy debate. As a technology it is often seen as a way of assisting individuals and therefore classified as an Assistive Technology [AT]. However, the meaning of ST used in dementia care has pragmatic implications beyond the meeting of the needs for “safety and independence”; ideas which is often used to justify its use. We argue that there is need to interrogate the terms “Surveillance” and “Technology” more carefully if ST is to be considered as empowering for people with dementia. This tension is brought out in the accounts present in a group discussion on ST and its use. This paper argues that there needs to be an acknowledgement that the purposes of such technologies need to be regularly reviewed in order for society to keep up with the rapidly changing pace of technology and the changing needs of users

Uncoupling protein-1 (UCP1) contributes to the basal proton conductance of brown adipose tissue mitochondria

Proton leak pathways uncouple substrate oxidation from ATP synthesis in mitochondria. These pathways are classified as basal (not regulated) or inducible (activated and inhibited). Previously it was found that over half of the basal proton conductance of muscle mitochondria was catalyzed by the adenine nucleotide translocase (ANT), an abundant mitochondrial anion carrier protein. To determine whether ANT is the unique protein catalyst, or one of many proteins that catalyze basal proton conductance, we measured proton leak kinetics in mitochondria isolated from brown adipose tissue (BAT). BAT can express another mitochondrial anion carrier, UCP1, at concentrations similar to ANT. Basal proton conductance was measured under conditions where UCP1 and ANT were catalytically inactive and was found to be lower in mitochondria from UCP1 knockout mice compared to wild-type. Ablation of another abundant inner membrane protein, nicotinamide nucleotide transhydrogenase, had no effect on proton leak kinetics in mitochondria from liver, kidney or muscle, showing that basal proton conductance is not catalyzed by all membrane proteins. We identify UCP1 as a second protein propagating basal proton leak, lending support to the hypothesis that basal leak pathways are perpetrated by members of the mitochondrial anion carrier family but not by other mitochondrial inner membrane proteins