An exploration of the cultural understanding and help-seeking behaviours of Congolese immigrants in South Africa regarding mental health challenges

The ongoing war in the Democratic Republic of Congo (DRC) has caused sustained trauma on a number of levels and stressors that could easily have debilitating consequences on the mental health of Congolese citizens. The literature further reveals that immigration brings with it a host of additional stressors. The stress related to immigration, an appreciation of diverse cultural understandings of mental health, the burdens and costs of adequate mental health policy and provisioning within developing countries, are concepts that are not well understood nor fully documented. The present study explored the cultural understanding and help-seeking behaviours of Congolese immigrants in South Africa. The purpose of the study was to understand the ways in which Congolese cope with stressors related to immigration. Using SocialIdentity Theory as a partial conceptual framework, the role of acculturation processes in their understanding and help-seeking behaviours regarding mental health challenges, were examined. A platform for participants to suggest suitable ways of responding to improving the management of mental challenges in their community was provided. A qualitative approach, based on Participatory Action Research (PAR) and content analysis to explore the emerging narratives, was used with a Gauteng-based sample to gather the accounts of the lived experiences of Congolese immigrants. A snowball sampling technique enabled twenty-seven respondents to participate in one paired conversation and five focus groups. The emerging findings are critically discussed aligned to the six categories of inquiry structured by the interview schedule, namely, coping strategies since immigration, the understanding of mental health challenges, the possible impact of being immersed in the South African culture, perceptions of mental challenges and persons affected within the Congolese community, the preferred help-seeking behaviours regarding mental health challenges and, finally, their recommendations for improving the management of mental health challenges. The layered meta-analysis of the data consisted of interrogating the thematic categories, then conducting an analytical review aligned to both the pertinent research aim and objectives, as well as related theoretical positions and research findings. v | P a g e The key research question underpinning this study was formulated as follows: “Will immigrating from the DRC to South Africa change the understanding and help-seeking behaviours of Congolese?” The study drew on the processes of acculturation from Social Identity Theory to examine these processes. Participants reported experiencing the effects of acculturation but in different ways. Patterns of assimilation, separation and integration were found. The study therefore served to contribute to our understanding of the effects of acculturation with regard to the cultural understanding and help-seeking behaviours of Congolese immigrants in South Africa regarding mental health. Most significantly, the assumption of high levels of trauma and stress within this vulnerable community were unfounded. Rich and complex survival strategies have emerged requiring refinement of our knowledge about migrant communities. The strengths and relative weaknesses of the study are shared as well as a set of recommendations for future research in this domain.PsychologyM. Sc.(Psychology

Relationships of Basal Level of Serum 17-Hydroxyprogesterone with that of Serum Androstenedione and Their Stimulated Responses to a Low Dose of ACTH in Young Adult Patients with Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency

A single measurement of serum 17α-hydroxyprogesterone (17OHP) level can be unreliable because of its marked diurnal variation. We investigated the relationship of serum level of 17OHP with that of androstenedione (AD), which shows a smaller diurnal variation. And we tested whether the responses of these two hormones to low-dose ACTH stimulation are correlated in patients with 21-hydroxylase deficiency. Baseline serum 17OHP and AD levels were measured in 87 patients and a low-dose ACTH stimulation test was performed in 41 patients. The basal 17OHP level correlated positively with the basal AD level independently of sex, type of 21-hydroxylase deficiency, and the time of day of blood sampling (n = 87, R2 = 0.75, P < 0.001). The area under the curve of 17OHP and AD correlated positively with their respective basal levels. The fold-change increase in 17OHP after ACTH injection correlated negatively with the basal 17OHP level, but that of AD did not correlate with the basal AD level. The random serum 17OHP level, used in the clinic, is a reliable guide and a low-dose ACTH stimulation test provides no extra benefit for assessing the treatment adequacy in patients with 21-hydroxylase deficiency

Increased site 1 affinity improves biopotency of porcine growth hormone - Evidence against diffusion dependent receptor dimerization

Based on phage display optimization studies with human growth hormone (GH), it is thought that the biopotency of GH cannot be increased. This is proposed to be a result of the affinity of the first receptor for hormone far exceeding that which is required to trap the hormone long enough to allow diffusion of the second receptor to form the ternary complex, which initiates signaling. We report here that despite similar site 1 kinetics to the hGH/hGH receptor interaction, the potency of porcine GH for its receptor can be increased up to 5-fold by substituting hGH residues involved in site 1 binding into pGH. Based on extensive mutations and BIAcore studies, we show that the higher potency and site 1 affinity of hGH for the pGHR is primarily a result of a decreased off-rate associated with residues in the extended loop between helices 1 and 2 that interact with the two key tryptophans Trp(104) and Trp(169) in the receptor binding hot spot. Our mutagenic analysis has also identified a second determinant (Lys(165)), which in addition to His(169), restricts the ability of non-primate hormones to activate hGH receptor. The increased biopotency of GH that we observe can be explained by a model for GH receptor activation where subunit alignment is critical for effective signaling

Comparison of the Effects of Hypertonic Sucrose and Intracellular Potassium-depletion On Growth-hormone Receptor-binding Kinetics and Down-regulation in Im-9 Cells - Evidence for a Sequential Block of Receptor-mediated Endocytosis

To better understand the complex kinetics of human GH (hGH) binding to its receptors, we have further investigated, in IM-9 cultured human lymphocytes, the cellular locus corresponding to the slowly dissociating component of hormone binding, and to the homologous down-regulation of hGH receptors. First, we have detailed the biphasic kinetics of dissociation of bound hormone in control cells at 30 C. When the association at 30 C was extended from 0.5 to 3 h, the time required for half-dissociation of the fast component was slightly decreased (from 30 to 15 min) but that of the slow component increased considerably (from 6 h to 30 h). Concomitantly, the size of the slowly dissociating component increased from 50 to 80% of total. This indicates a maturation of bound hormone, from a rapidly to a slowly dissociating pool and, in the latter, an increase in the apparent affinity that may reflect a molecular rearrangement. Next, we have compared the effect of two procedures reported to inhibit receptor-mediated endocytosis at the level of coated pits. As previously reported, depletion of intracellular K+ abolished the slowly dissociating component and the down-regulation of hGH receptors. In contrast, upon incubation with 0.4 M sucrose, which like K+ depletion virtually abrogated hGH internalization, the dissociation kinetics remained non-first order, and the down-regulation of hGH-receptor was only slighly reduced. Thus, these procedures appear to block receptor-mediated endocytosis at two successive compartments of the cell surface. In conclusion, we propose that some conformational change of hGH-receptor at the cell surface (possibly associated with clustering) may considerably slow down their dissociation and may be sufficient for down-regulation

Growth hormone receptor C-terminal domains required for growth hormone-induced intracellular free Ca2+ oscillations and gene transcription.

The biological effects of growth hormone (GH) are initiated by its binding to the GH receptor (GHR) followed by association and activation of the tyrosine kinase JAK2. Here we report that GH can stimulate an increase in intracellular free Ca2+ concentration ([Ca2+]i) in cells expressing wild-type GHRs and receptor mutants lacking up to 132 amino acids of the C terminus, whereas GHRs lacking a further 52 amino acids in the C terminus are unable to induce Ca2+ signaling. The GH-induced rise in [Ca2+]i was dependent upon extracellular Ca2+ and the response consisted of GH-induced Ca2+ oscillations of varying frequency and amplitude. GH-induced transcription of the serine protease inhibitor 2.1 gene required the same C-terminal 52-amino acid domain of the receptor as for Ca2+ signaling. Mutation of the four proline residues in the conserved box 1 region of the GHR, which is responsible for binding and activation of JAK2 kinase, completely abolished GH-induced gene transcription but did not affect the GH-induced rise in [Ca2+]i. The Ca2+ channel blocker verapamil prevented GH-induced Ca2+ signaling as well as GH-induced gene transcription in cells expressing endogenous GHRs. These findings indicate that the GHR can initiate two independent signaling pathways, one requiring the box 1 region and the other requiring the region between amino acids 454 and 506, and suggest that both of these pathways are required for GH-induced gene transcription