An evaluation of psychological well-being and secular trends in the occurrence of type 2 diabetes 1993 – 2014 in outpatients in a community

OBJECTIVE: To evaluate psychosocial well-being and secular trends among outpatient diabetics in community-dwelling Trinidadian patients. METHODS AND DESIGN: We used a cross-sectional study design. The population consisted of all adult patients (>18 years) with Type 2 diabetes (T2DM), receiving care at the main primary health care facility serving that community. The communities came from the North Central Regional Health Authority (RHA) and the Eastern RHA. The WHO-5 Well Being Index was used to determine quality of life and psychological wellbeing. Scores ranged from 0 (worst) to 100 (best). RESULTS: The sample comprised 301 participants. The mean age was 60.78 years (SD ñ11.5) with an inter-quartile range of 51-70 years with no significant age difference between males and females (73.8 versus 75.1, p = 0.235). Females outnumbered males, f:m 1.5:1. Sample participants consisted of 42% Africans and 33.2% South East Asians (SEA). Of the participants, 66% were found to be overweight or obese. One half of the participants scored <50 indicating they were not content with their quality of life, with 1.7% likely to be depressed. There was an increase in patients between the period 1990’s to 2004-14 and the occurrence of cases in younger age groups. For the first time in 2004-09 there were patients aged 29-30 years and there were patients aged 19 -28 years in 2010-14. CONCLUSION: We provide evidence that at the community T2DM is increasingly occurring and shifting towards younger age groups and there was significant dissatisfaction in the quality of their lives.

Notch1 regulates the functional contribution of RhoC to cervical carcinoma progression.

BACKGROUND: The role of Notch signalling in human epithelial cancers is of immense interest. In this study, we examine the interplay between Notch signalling and RhoC, a well-established molecular factor in metastasis. By linking the function of Notch and RhoC, we further strengthen the notion that there is a pro-oncogenic role of Notch signalling in human cervical cancers. METHODS: RhoC protein expression in cervical carcinoma cell lines was assessed by western blotting. Using CaSki and SiHa cells (cervical carcinoma cells lines), we show that RhoC contributes to wound healing, invasion and migration, anoikis resistance, colony formation, in vitro tube formation and tumour formation. Immunohistochemical studies were carried out to assess the co-expression of RhoC, pAkt and Notch1 in clinical sections. RESULTS: An assessment of the changes associated with epithelial-to-mesenchymal transition (EMT) shows that both Notch1 and RhoC have similar phenotypic contribution to EMT. Rho activity assessment on Notch1 inhibition with DAPT shows decreased RhoC activity. We further show that constitutively active RhoC rescues the phenotypic effect of Notch1 inactivation, and a comparison of Notch1 with RhoC expression shows an overlap between the two proteins in the same areas of the tissue. CONCLUSION: This study has provided evidence to suggest that RhoC is an effector of Notch1 in cervical carcinoma.