Assessing E-Health adoption readiness using diffusion of innovation theory and the role mediated by each adopter's category in a Mauritian context.

BACKGROUND: The preparedness of healthcare institutes for the foreseen changes expected to arise through the implementation of E-Health is a significant turning point in determining its success. This should be evaluated through the awareness and readiness of healthcare workers to adopt E-Health technology to reduce health information technology failures. METHODS: This study investigated the relationship between the perceived attributes of innovation and E-Health adoption decisions of healthcare workers as part of a preimplementation process. Using a cross-sectional quantitative approach, the dimensions of the diffusion of innovation (DOI) theory were used to assess the E-Health readiness of 110 healthcare workers in a Mauritian specialized hospital. RESULTS: A strong inclination towards E-Health adoption was observed, where the prime stimulators were perceived as modernization of healthcare management (84.1%, x=4.19), increased work efficiency through reduction of duplication (77.6%, x=4.10) and faster generation of results (71.1%, x=4.07). The findings of this study also validated the use of five DOI dimensions (i.e. relative advantage, compatibility, complexity, trialability and observability) in a predictability model (F(5, 101)=17.067, p<0.001) towards E-Health adoption. A significant association between 'adopter category' and 'willingness to recommend E-Health adoption' (χ2(8)=74.89, p<0.001) endorsed the fact that physicians and nursing managers have central roles within a social ecosystem to facilitate the diffusion of technology and influence the adoption of innovation. CONCLUSION: This is the first study of its kind in Mauritius to successfully characterize each adopter's profile and demonstrate the applicability of the DOI framework to predict the diffusion rate of E-Health platforms, while also highlighting the importance of identifying key opinion leaders who can be primed by innovators regarding the benefits of E-Health platforms, thus ensuring non-disruptive evolutionary innovation in the Mauritian healthcare sector.

Exploring substance use disorders and relapse in Mauritian male addicts.

BACKGROUND: Substance Use Disorder (SUD) places a heavy burden on societal and health systems given its association with high mortality and morbidity rates worldwide, including Mauritius. Illicit substances act as a positive reinforcement and stimulate addiction through its pleasure-seeking attributes. AIM: This study focused on identifying the risk factors leading to SUD among Mauritian male addicts as well as examining the potency of those factors in SUD development. The study also aimed at determining the prevalence of relapse and its causation. RESEARCH SETTING: A cross-sectional study was conducted over a period of six months using a sample of 180 male addicts registered in a public hospital. A questionnaire investigating dimensions such as risk factors, self-esteem and peer pressure was administered. FINDINGS: A high percentage of relapse was noted amongst users within the first year of abstinence. Majority of respondents originated from nuclear or single parents' family and were deprived of adequate social supports given their marital status. 57.5% of participants had a positive family history of SUD. Cannabis was the most commonly abused substance and 76.2% of the addicts were introduced to drugs through curiosity. Transposing the results against the Gateway Drug Theory showed a constant progression from soft to hard drugs for male addicts, a trend which was consistent with literature. Lastly, a theoretical model was developed based on the strong statistical association found between impulsivity and reduced thought processes prior to relapse; data revealing increased impulsivity which is a common trait in antisocial personality disorder and borderline personality disorder as being largely responsible for relapse. CONCLUSION: The study was successful in bringing out the most common risk factors of SUDs which are linked to low socioeconomic status. The inability of addicts to progress with their rehabilitation given the alarming 92% of relapse was related to social pressure as prime deterrent to successful remission. Programmes involving relapse prevention must implemented in the first year of abstinence to facilitate rehabilitation.

Extracts of Mauritian Carica papaya (var. solo) protect SW872 and HepG2 cells against hydrogen peroxide induced oxidative stress.

In line with literature documenting the pluripotent activities of tropical fruits, this study evaluated the antioxidant effects of Carica papaya fruit extracts at cellular level. Investigations using cellular models of oxidative stress provided complementary evidence of the antioxidant activities of papaya fruit. At 2 mg dry weight ml-1, extracts of seed from ripe and unripe fruit significantly reduced oxidative stress levels within human pre-adipocytes (SW872) and hepatocellular carcinoma cells (HepG2) exposed to hydrogen peroxide (H2O2). Maintenance of mitochondrial viability, reduction of intracellular reactive oxygen species levels and mediation of pro-inflammatory cytokine secretory levels (tumour necrosis factor-α, interleukin-6, monocyte chemoattractant protein-1) were all indicative of its cytoprotective effects against oxidative-inflammation. This work demonstrates that the Mauritian Solo papaya is an important source of natural antioxidants that could be used for the dietary modulation of oxidative stress and inflammation.

Fermented papaya preparation modulates the progression of N-methyl-N-nitrosourea induced hepatocellular carcinoma in Balb/c mice.

AIM AND MAIN METHOD: The medicinal properties of fermented papaya preparation (FPP) derived from Carica papaya fruit was investigated in order to determine its ability to modulate the progression of N-methyl-N-nitrosourea induced hepatocellular carcinoma in Balb/c mice. KEY FINDINGS: As well as reducing the physical symptoms associated with N-methyl-N-nitrosourea (MNU)-induced hepatocellular carcinoma, supplementation of Balb/c mice with 500mg FPP/kg BW for 92days normalized the blood cell count, led to an increased activity of several key antioxidant enzymes (SOD: +20%, CAT: +81%, GPx: +66.1%, GR: +54.4%; P<0.001 vs. MNU control), increased the ferrous reducing antioxidant potential (+36.7%, P<0.001 vs. MNU control) and reduced the extent of lipid peroxidation in the liver by 44.3% (P<0.001 vs. MNU control). SIGNIFICANCE: Results demonstrated the ability of FPP to preserve the integrity of liver against oxidative damage and protect hepatocytes against irreversible DNA structural modifications induced by MNU, highlighting its potential role as an immune-defense modulator during hepatocarcinoma.

Diabetes as a risk factor to cancer: functional role of fermented papaya preparation as phytonutraceutical adjunct in the treatment of diabetes and cancer.

Oncologists and diabetologists quote scientific data from epidemiological and in vitro studies to show that high levels of insulin and glucose, in combination with oxidative stress and chronic inflammation, can heighten the risk of developing cancer amongst patients with diabetes. Although the cancers that have been consistently associated with type 2 diabetes include pancreatic, colorectal, breast and liver cancer, the preponderance of the disease risk factors such as obesity, inflammation, hyperglycemia, hyperinsulinaemia (as a result of insulin resistance and oxidative ß-cell damage) and the indirect influence of anti-diabetic medications are increasingly being defined. Fermented papaya preparation (FPP) has defined antioxidant and immune-modulating potentials. The ability of FPP influence signaling cascades associated with cell growth and survival presents a rational for chemopreventive adjunct that can be used in combination with traditional redox based therapies that target oxidative stress in the cancer micro environment. It is further suggested that the demonstrated efficacy FPP to control blood glucose, excessive inflammation and modulate free radical-induced oxidative damage which are triggers of liver, bladder, breast and prostate cancers in type 2 diabetics, may favorably mitigate the side effects of ensuing diabetes and cancer therapy. What remains paramount is early cancer detection and early determination of propensity risks for diabetes. The education of patients, proper dietary management and compliance with therapeutic regime directed at cancer and diabetes encapsulate challenges of global magnitude.

Relationship between fermented papaya preparation supplementation, erythrocyte integrity and antioxidant status in pre-diabetics.

Erythrocytes and their membranes are favorable models to study the relationship between diabetes and susceptibility of erythrocytes to oxidative stress damage. The recommendation for the use of fermented papaya preparation (FPP) as a functional food for dietary management of type 2 diabetes was evaluated by assessing its effect on the human antioxidant status and erythrocyte integrity on a multi-ethnical pre-diabetic population. The in vivo effect of FPP was compared with its in vitro free radical scavenging potentials. FPP exhibited potent in vitro free radical scavenging activities thought to be attributed to residual phenolic or flavonoid compounds. Low doses of FPP significantly reduced the susceptibility of human erythrocytes to undergo free radical-induced hemolysis. The intake of 6g FPP/day for a period of 14weeks was observed to significantly reduce the rate of hemolysis and accumulation of protein carbonyls in the blood plasma of pre-diabetics. That FPP consumption on a daily basis can strengthen the antioxidant defense system in vivo was clearly demonstrated by the marked increase of total antioxidant status in the FPP-supplemented pre-diabetics. That FPP maintains the integrity of erythrocytes could benefit the strategies to improve the quality of future blood products.

Bioactivity of Nonedible Parts of Punica granatum L.: A Potential Source of Functional Ingredients.

Punica granatum L. has a long standing culinary and medicinal traditional use in Mauritius. This prompted a comparative study to determine the bioefficacy of the flower, peel, leaf, stem, and seed extracts of the Mauritian P. granatum. The flower and peel extracts resulting from organic solvent extraction exhibited strong antioxidant activities which correlated with the high levels of total phenolics, flavonoids, and proanthocyanidins. The peel extract had the most potent scavenging capacity reflected by high Trolox equivalent antioxidant capacity value (5206.01 ± 578.48 µmol/g air dry weight), very low IC50 values for hypochlorous acid (0.004 ± 0.001 mg air dry weight/mL), and hydroxyl radicals scavenging (0.111 ± 0.001 mg air dry weight/mL). Peel extracts also significantly inhibited S. mutans (P < 0.001), S. mitis (P < 0.001), and L. acidophilus (P < 0.05) growth compared to ciprofloxacin. The flower extract exhibited high ferric reducing, nitric oxide scavenging, and iron (II) ions chelation and significantly inhibited microsomal lipid peroxidation. Furthermore, it showed a dose-dependent inhibition of xanthine oxidase with an IC50 value of 0.058 ± 0.011 mg air dry weight/mL. This study showed that nonedible parts of cultivated pomegranates, that are generally discarded, are bioactive in multiassay systems thereby suggesting their potential use as natural prophylactics and in food applications.

The inhibitory effect of a fermented papaya preparation on growth, hydrophobicity, and acid production of Streptococcus mutans, Streptococcus mitis, and Lactobacillus acidophilus: its implications in oral health improvement of diabetics.

Fermented papaya preparation (FPP) is a "natural health product." The high incidence of dental caries, gingivitis, periodontitis, and oral microbial infection cases among patients with diabetes mellitus continues to prevail. The potential role of FPP against common oral microbiota (Streptococcus mutans, Streptococcus mitis, and Lactobacillus acidophilus) isolated from the human oral cavity was investigated using in vitro simulation models of dental plaque and caries. FPP showed an inhibitory effect against the growth (at 0.05 mg/mL: S. mutans: -6.9%; S. mitis: -4.47%, P < 0.05), acid production (at 0.05 mg/mL: S. mutans: +6.38%; L. acidophilus: +2.25%), and hydrophobicity (at 50 mg/mL: S. mutans: 1.01%, P < 0.01; S. mitis: 7.66%, P < 0.05) of tested microbiota. The results of this study suggest that low doses of FPP may be a suitable complement to good oral hygiene practice for the effective prevention of dental caries, plaque, and gingivitis. The functional application of FPP as a constituent of a balanced diet and active lifestyle can make a positive contribution to the oral health status and well-being of patients with diabetes.

Effects of a short term supplementation of a fermented papaya preparation on biomarkers of diabetes mellitus in a randomized Mauritian population.

OBJECTIVE: Clinical evidence and cellular models have shown an inverse relationship between the intakes of plant and fruit based diets and oxidative stress, suggesting the suitability of natural antioxidants in the management of diabetes mellitus and its complications. METHOD: A randomized controlled clinical trial was conducted at the Cardiac Centre, SSRN Hospital, Pamplemousses, (Mauritius) to determine the effect of a short term supplementation of a fermented papaya preparation (FPP®) on biomarkers of diabetes and antioxidant status in a multi-ethnical neo-diabetic population from November 2010 to March 2011. RESULT: Supplementation of 6g FPP®/day for a period of 14 weeks could improve the general health status of several organs targeted by oxidative stress during diabetes. When comparing experimental to control groups with independent samples t-test, C-reactive protein levels significantly decreased (P=0.018), LDL/HDL ratio was considerably changed (P=0.042), and uric acid levels were significantly improved (P=0.001). ANOVA results also validated the same findings with significant differences in C-reactive protein, LDL/HDL ratio, uric acid and in serum ferritin levels. CONCLUSION: FPP® may present a novel, economically feasible nutraceutical supplement for the management of diabetes and for those at risk for cardiovascular disease, neurological disease and other conditions worsened by overt inflammation and oxidative stress.