Nexus between constructs of social cognitive theory model and diabetes self-management among Ghanaian diabetic patients: A mediation modelling approach

The promotion of Diabetes Self-Management (DSM) practices, education, and support is vital to improving the care and wellbeing of diabetic patients. Identifying factors that affect DSM behaviours may be useful to promote healthy living among these patients. The study assessed the determinants of DSM practices among Type 2 diabetes mellitus (T2DM) patients using a model-based social cognitive theory (SCT). This cross-sectional study comprised 420 (T2DM) patients who visited the Diabetic Clinic of the Komfo Anokye Teaching Hospital (KATH), Kumasi-Ghana. Data was collected using self-structured questionnaires to obtain socio-demographic characteristics, T2DM-related knowledge, DSM practices, SCT constructs; beliefs in treatment effectiveness, level of self-efficacy, perceived family support, and healthcare provider-patient communication. Path analysis was used to determine direct and indirect effects of T2DM-related knowledge, perceived family support, and healthcare provider service on DSM practices with level of self-efficacy mediating the relationships, and beliefs in treatment effectiveness as moderators. The mean age of the participants was 53.1(SD = 11.4) years and the average disease duration of T2DM was 10 years. Most of the participants (65.5 %) had high ( \u3e 6.1mmol/L) fasting blood glucose (FBG) with an average of 6.93 (SD = 2.41). The path analysis model revealed that age (p = 0.176), gender (p = 0.901), and duration of T2DM (p = 0.119) did not confound the relationships between the SCT constructs and DSM specified in the model. A significant direct positive effect of family and friends’ support (Critical ratio (CR) = 5.279, p \u3c 0.001) on DSM was observed. Self-efficacy was a significant mediator in this relationship (CR = 4.833, p \u3c 0.001). There were significant conditional indirect effects (CIE) for knowledge of T2DM and family and friends’ support at medium and high levels of belief in treatment effectiveness (p \u3c 0.05) via level of self-efficacy on DSM practices. However, no evidence of moderated-mediation was observed for the exogenous variables on DSM. Diabetes-related knowledge of T2DM, family and friends’ support, level of self-efficacy, and belief in treatment effectiveness are crucial in DSM practices among Ghanaian T2DM patients. It is incumbent to consider these factors when designing interventions to improve DSM adherence

Upregulation of cytokeratins in the extravillous trophoblast in the basal plate of healthy and pre-eclamptic placentae

This research has determined which specific keratin molecular species are upregulated when comparing the chorionic villous trophoblast (CVT) to the extravillous trophoblast (EVT) in the basal plate tissues of placentae from healthy and pre-eclamptic mothers at term. Indirect immunofluorescence Confocal Laser Scanning Microscopy (CLSM) revealed that at least 5 keratin proteins are expressed in villous trophoblast and the same 5 in extravillous trophoblast. A further 15 keratin proteins tested were undetectable in these tissues. All the specific keratins identified (K5, 7, 8, 18 and 19) in trophoblast were upregulated by over 20-fold in the EVT “percentage of pixels with high intensity”, a reflection of increased specific immunofluorescence. The statistically significant difference (P < 0.0001) of K5 for example, showed an increase from a median pixel value of 0.14% in CVT to 2.88% in the EVT whereas in the pre-eclamptic there was an increase from 0.06% in the CVT to 2.97% in the EVT. Similar patterns were obtained for K7, 8, 18, and 19. The reduction in the ratio of 4.8:1 of the percentage median pixel intensity from the healthy to pre-eclamptic CVT keratin related immunofluorescence expression was statistically significant in all 5 keratins (p < 0.0001). There were no significant differences in immunofluorescence pixel intensity for the EVTs at the CLSM level. At the electron microscopy level, immunogold labelling technique using anti-K7 and anti-K18 antibodies which were representatives of the two major keratin families TYPE II and TYPE I respectively, were down regulated in the CVT and EVT in pre-eclamptic compared with the healthy. On the basis of the results of these investigations the villous trophoblast in pre-eclamptic placentae may be cytoskeletally weaker through deficiency of these keratin filaments. This could be a reason why, in pre-eclampsia, trophoblast is deported in greater quantity than in healthy placenta

Upregulation of cytokeratins in the extravillous trophoblast in the basal plate of healthy and pre-eclamptic placentae

This research has determined which specific keratin molecular species are upregulated when comparing the chorionic villous trophoblast (CVT) to the extravillous trophoblast (EVT) in the basal plate tissues of placentae from healthy and pre-eclamptic mothers at term. Indirect immunofluorescence Confocal Laser Scanning Microscopy (CLSM) revealed that at least 5 keratin proteins are expressed in villous trophoblast and the same 5 in extravillous trophoblast. A further 15 keratin proteins tested were undetectable in these tissues. All the specific keratins identified (K5, 7, 8, 18 and 19) in trophoblast were upregulated by over 20-fold in the EVT “percentage of pixels with high intensity”, a reflection of increased specific immunofluorescence. The statistically significant difference (P < 0.0001) of K5 for example, showed an increase from a median pixel value of 0.14% in CVT to 2.88% in the EVT whereas in the pre-eclamptic there was an increase from 0.06% in the CVT to 2.97% in the EVT. Similar patterns were obtained for K7, 8, 18, and 19. The reduction in the ratio of 4.8:1 of the percentage median pixel intensity from the healthy to pre-eclamptic CVT keratin related immunofluorescence expression was statistically significant in all 5 keratins (p < 0.0001). There were no significant differences in immunofluorescence pixel intensity for the EVTs at the CLSM level. At the electron microscopy level, immunogold labelling technique using anti-K7 and anti-K18 antibodies which were representatives of the two major keratin families TYPE II and TYPE I respectively, were down regulated in the CVT and EVT in pre-eclamptic compared with the healthy. On the basis of the results of these investigations the villous trophoblast in pre-eclamptic placentae may be cytoskeletally weaker through deficiency of these keratin filaments. This could be a reason why, in pre-eclampsia, trophoblast is deported in greater quantity than in healthy placenta.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Immuno-electron microscopic localisation of caveolin 1 in human placenta

We have localised the placental endothelial marker caveolin-1 at the ultrastructural level using indirect immunogold labelling. The particulate label has been quantified to assess the distribution of the target protein within term placental chorionic villi. The mesodermal compartment of the tissue was more heavily labelled than the ectodermally derived trophoblast. Basal plate lining endothelium, and villous endothelium had similar immunoreactivity with anti-caveolin-1 antibody. A polarised distribution of the caveolin within chorionic villous capillary endothelial cells was observed. As evidenced by immuno-reactivity, the protein was statistically significantly more concentrated in the region associated with the basal membrane than the apical membrane. The latter region contained in turn significantly more anticaveolin-1 immunoreactivity than the central region. These differences are discussed in the light of possible transport and signalling platform roles for villous and basal plate endothelium. (c) 2006 Elsevier GmbH. All rights reserved

Immunofluorescence confocal laser scanning microscopy and immuno-electron microscopic identification of keratins in human maternofetal interaction zone.

We show here that at least 5 keratin proteins are present in villous trophoblast and the same 5 in extravillous trophoblast. A further 14 tested were undetectable in these tissues. In contrast 10 of the 19 keratins tested were present in amniotic epithelium. The potential for marking amniotic epithelium on the one hand, as distinct from villous and extravillous trophoblast on the other can be achieved using 5 keratins (K4, 6, 13, 14 and 17) with a mixture of positive and negative discrimination that is expected, in combination, to be highly sensitive. All the specific keratins identified in trophoblast were apparently upregulated on the pathway to extravillous trophoblast. Co-ordinated differentiation at the molecular expression level is indicated by this finding. The relevant keratins are K5, 7, 8, 18 and19. Specific keratins have been identified that are down regulated in villous trophoblast in pre-eclamptic pregnancy. This difference between healthy and pre-eclamptic chorionic villous trophoblast keratin expression was statistically significant in 4 out of the 5 keratins. This was not the case for the extravillous trophoblast at the immunofluorescence confocal level but clear significant differences were obtained using immunogold electron microscopy. We suggest that the villous trophoblast in pre-eclamptic placentae is cytoskeletally weaker with respect to the filaments made from these specific proteins and that this is one reason why, in pre-eclampsia, trophoblast is deported in greater quantity than in healthy placentae

Differential expression of cytokeratins 7 and 18 in villous and extravillous trophoblast cells: a confocal laser scanning microscopy study

Differential expression of cytokeratins 7 and 18 in villous and extravillous trophoblast cells: a confocal laser scanning microscopy stud

Correlation Between Soluble Endothelial Adhesion Molecules and Nitric Oxide Metabolites in Sickle Cell Disease.

Nitric Oxide (NO) and soluble adhesion molecules are promising biomarkers, which predict endothelial dysfunction in sickle cell disease (SCD). Several studies have investigated the relationship between NO (as well as its metabolites) and endothelial adhesion molecules in SCD. However, these studies were done mainly in the developed world, and it is difficult to extrapolate the findings to SCD populations in other geographical regions such as Africa due to significant disparities in the results. The aim of the current study was to determine the correlation between levels of nitric oxide metabolites (NOx) and adhesion molecules in SCD patients in a tertiary hospital in Ghana. A case control cross-sectional study involving 100 SCD (made up of HbSS and HbSC patients) and 60 healthy controls was conducted. Concentrations of NOx and soluble endothelial adhesion molecules (ICAM-1, VCAM-1 and E-selectin) were measured in all the study participants (n = 160) by the Griess reagent system and enzyme-linked immunosorbent assay (ELISA). Correlation analysis was performed to determine a possible link between the variables. Levels of soluble adhesion molecules were higher in the HbSS patients. Correlation of NOx with ICAM-1 almost approached significance (r = 0.565, p = 0.058) in the HbSS patients. There were no correlations between NOx and E-selectin in both HbSS and HbSC patients. There were no significant correlations between NOx and VCAM-1 in all the study participants (p &gt; 0.05). Of the soluble adhesion molecules, ICAM-1 showed a significant positive correlation with VCAM-1 in the HbSC patients. There were no significant differences between the adhesion molecules and the age of participants in the various study groups. Whether or not a significant correlation exists between NOx and soluble adhesion molecules may not depend on the sickle cell genotype. The expression of adhesion molecules may not depend on age

Ability of Vital and Fluorescent Staining in the Differentiation of <i>Schistosoma haematobium</i> Live and Dead Eggs

This study reports (for the first time) the staining ability of vital (0.4% trypan blue and 1% neutral red) and fluorescent (Hoechst 33258) dyes to differentiate between live and dead Schistosoma haematobium (S. haematobium) eggs in human urine samples. Since S. haematobium egg is important in disease pathology, diagnosis, transmission, and drug development research, it is essential to be able to easily distinguish live eggs from dead ones. Staining is considered a way of enhancing the identification of live and dead eggs. Urine samples from school children were examined for the presence of S. haematobium eggs. Vital and fluorescent dyes were used to stain the samples that contained S. haematobium eggs, after which they were observed using light and fluorescent microscopes, respectively. The Hoechst 33258 provided a good staining outcome for differentiation between live and dead eggs, followed by 0.4% Trypan blue. Regarding the 1% neutral red stain, even though it provided some evidence of which egg was alive or dead, the distinction was not very clear; therefore, it could be useful when used in combination with other stains for egg viability determination. The benefits of this study will include assessing the effect of drugs on S. haematobium eggs in Schistosomiasis research

Nasopharyngeal Carriage and Antimicrobial Susceptibility Profile of <i>Staphylococcus aureus</i> among Children under Five Years in Accra

This cross-sectional study investigated the Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA) nasopharyngeal carriage epidemiology in Accra approximately five years post-pneumococcal conjugate vaccines introduction in the country. Archived nasopharyngeal swabs collected from 410 children aged under five years old were bacteriologically cultured. The resultant S. aureus isolates were subjected to antimicrobial susceptibility testing and screening for carriage of the mecA and LukF-PV (pvl) genes, following standard procedures. The data obtained were analyzed with Statistical Products and Services Solutions (SPSS) using descriptive statistics and Chi square tests of associations. The isolated bacteria decreased across coagulase-negative Staphylococci (47.3%, n = 194), S. aureus (23.2%, n = 95), Diphtheroids (5.4%, n = 22), Micrococcus species (3.7%, n = 15), Klebsiella pneumoniae (3.2%, n = 13), Moraxella species and Citrobacter species (1.5% each, n = 6), Escherichia coli, Enterobacter species, and Pseudomonas species (0.9% each, n = 2). The MRSA carriage prevalence was 0.49% (n = 2). Individuals aged 37–48 months recorded the highest proportion of S. aureus carriage (32.6%, 31/95). Resistance of S. aureus to the antibiotics tested were penicillin G (97.9%, n = 93), amoxiclav (20%, n = 19), tetracycline (18.9%, n = 18), erythromycin (5.3%, n = 5), ciprofloxacin (2.1%, n = 2), gentamicin (1.1%, n = 1), cotrimoxazole, clindamycin, linezolid, and teicoplanin (0% each). No inducible clindamycin resistance was observed for the erythromycin-resistant isolates. Three (3.2%) of the isolates were multidrug resistant, of which 66.7% (2/3) were MRSA. The pvl gene was associated with 59.14% (55/93) of the methicillin-sensitive S. aureus (MSSA) isolates, but was not detected among any of the MRSA isolates