ABSTRACT
CONTEXT: Studies in mice and humans suggest that melanocortin-4 receptor (MC4R) deficiency affects body weight in a sex-/gender-dependent manner. However, similar evidence for type 2 diabetes (T2D) is scarce. OBJECTIVE AND DESIGN: We investigated whether sex/gender modifies the association between the loss-of-function MC4R p.Ile269Asn mutation and T2D in 6929 Mexican adults (3175 T2D cases and 3754 normal glucose tolerance [NGT] controls). The 2003 American Diabetes Association criteria were used to define NGT and T2D. The MC4R p.Ile269Asn mutation was genotyped in all participants using TaqMan technology. RESULTS: The MC4R p.Ile269Asn mutation was associated with T2D in 6929 Mexican adults (Ncontrols = 3754, Ncases = 3175, odds ratio [OR] = 2.00, 95% confidence interval [CI], 1.35-2.97; P = 5.7 × 10-4). The MC4R p.Ile269Asn mutation had a frequency of 0.86 and 1.05% in women with NGT and T2D, and 0.78 and 1.32% in men with NGT and T2D, respectively. We identified a significant interaction between the MC4R p.Ile269Asn mutation and sex/gender on T2D risk (P = 0.049). Although a strong association between the mutation and T2D was observed in men (Ncontrols = 2418, Ncases = 1807, OR = 2.63, 95% CI, 1.62-4.28, P = 9.3 × 10-5), results were not significant in women (Ncontrols = 1336, Ncases = 1368, OR = 1.16, 95% CI, 0.60-2.26, P = 0.65). Further adjustment for body mass index in the logistic regression model did not alter the sex-/gender-specific pattern of association (men: OR = 2.22, 95% CI, 1.34-3.67, P = 0.0019; women: OR = 1.02, 95% CI, 0.51-2.02, P = 0.95). CONCLUSION: This is the first report of a male-specific association between the MC4R p.Ile269Asn loss-of-function mutation and T2D in the Mexican population.
Subject(s)
Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/genetics , Receptor, Melanocortin, Type 4/genetics , Adult , Aged , Amino Acid Substitution , Asparagine/genetics , Case-Control Studies , Cross-Sectional Studies , Effect Modifier, Epidemiologic , Female , Gene Frequency , Genetic Association Studies , Genetic Predisposition to Disease , Genotype , Humans , Isoleucine/genetics , Male , Mexico/epidemiology , Middle Aged , Polymorphism, Single Nucleotide , Risk Factors , Sex FactorsABSTRACT
PURPOSE: To determine whether group education is as effective as individual education in improving cervical cancer screening uptake along the US-Mexico border. DESIGN: Cluster randomized controlled study. SETTING: El Paso and Hudspeth Counties, Texas. PARTICIPANTS: Three hundred women aged 21 to 65 years, uninsured, due for a Pap test, no prior history of cervical cancer or hysterectomy. INTERVENTION: Theory-based, culturally appropriate program comprised of outreach, educational session, navigation services, and no-cost cervical cancer testing. MEASURES: Baseline, immediate postintervention, and 4-month follow-up surveys measured knowledge and theoretical constructs from the Health Belief Model, Theory of Reasoned Action, and the Social Cognitive Theory. ANALYSIS: Relative risk regression analyses to assess the effects of educational delivery mode on the uptake of screening. Mixed effect models to analyze changes in psychosocial variables. RESULTS: One hundred and fifty women assigned to each educational group; 99% Hispanic. Of all, 85.7% completed the follow-up survey. Differences in screening rate at follow-up were analyzed by education type. Overall screening rate at follow-up was 73.2%, no significant difference by education type (individual: 77.6%, group: 68.9% P = .124). Significant increases among group education at follow-up for knowledge, perceived susceptibility, perceived seriousness, and subjective norms and significant decrease for perceived benefits. CONCLUSION: This study provides evidence to support the effectiveness of group education to promote cervical cancer screening among vulnerable Hispanic women and offers an additional method to address cervical cancer disparities.
Subject(s)
Cultural Competency , Early Detection of Cancer , Health Education , Hispanic or Latino , Mass Screening , Medically Underserved Area , Uterine Cervical Neoplasms/ethnology , Uterine Cervical Neoplasms/prevention & control , Adult , Aged , Cluster Analysis , Female , Health Knowledge, Attitudes, Practice , Humans , Mexico/ethnology , Middle Aged , Texas , Young AdultABSTRACT
Centre for Children Committing Offences (CCCO), at Child Development Institute (CDI) in Toronto, Canada, developed Early Assessment Risk Lists (EARL-20B for boys; EARL-21G for girls), for young children at-risk for future criminality. In this first EARL prospective longitudinal study, 573 boys and 294 girls who participated in SNAP®, a gender-specific evidence-based model for at-risk children (6-11 years), 8.2% of boys and 3.1% of girls had registered criminal offences at follow up (mean age 14.9 and 14.6 respectively). EARL Total, Family, Child, and Responsivity domain scores, including two gender-specific risk items and Overall Clinical Judgment predicted early onset of criminal activity. Findings suggest that gender-sensitive clinical risk assessment and management tools are important for effectively identifying and potentially reducing criminal outcomes.
En el Centro para Niños Infractores (CCCO), del Instituto de Desarrollo Infantil (CDI) en Toronto (Canadá), se desarrollaron las Listas de Evaluación de Riesgos Tempranos (EARL-20B para niños; EARL-21G para niñas), para niños en riesgo de desarrollar criminalidad. En este primer estudio longitudinal de las EARL, 573 niños y 294 niñas que participaron en SNAP un modelo basado en evidencia de género específico para riesgo en niños (6-11 años), 8.2 % de niños y 3.1 % de las niñas registraron delitos criminales durante el seguimiento (M = 14.9 y 14.6, respectivamente). Los puntajes de EARL Total, Familia, Niños y Responsividad, incluyendo dos ítems de riesgo específicos de género, y el Juicio Clínico General predicen el inicio temprano de actividad criminal. Los resultados sugieren que la evaluación del riesgo clínico sensible al género y el manejo de herramientas son importantes para la identificación efectiva y potencialmente reducen los resultados criminales.
Subject(s)
Child , Risk Assessment , Antisocial Personality DisorderABSTRACT
OBJECTIVE: The study was done to assess knowledge, attitudes and practices of women within the child bearing age with regard to smoking and exposure to environmental tobacco smoke (ETS) on children's health. SUBJECTS AND METHODS: A cross-sectional study with quantitative and qualitative components was designed to collect data from women in the child-bearing age. The sample comprised of persons from the two largest combined family planning and antenatal clinics in Kingston, Jamaica. RESULTS: The women surveyed had a fair level of knowledge about ETS health risks, negative attitudes to smoking in general, and most supported a ban on smoking in public places. Significant knowledge differences existed between young and older women and between smokers and non-smokers. CONCLUSION: Women with the highest level of knowledge were the non-smokers: of the low knowledge score group (current smokers), 50% were in the 15-24-year age range. There is a need for more public education on smoking and the consequences ofenvironmental tobacco smoke exposure on children s health.
OBJETIVO: El estudio fue realizado para evaluar los conocimientos, actitudes y prácticas de las mujeres en edad de procrear, en relación con el hábito de fumar y la exposición al humo de tabaco ambiental (HTA) sobre la salud de los niños. SUJETOS Y MÉTODOS: Se diseñó un estudio transversal con componentes cuantitativos y cualitativos con el propósito de recopilar datos de las mujeres en edad fértil. La muestra abarcó personas de las dos clínicas más grandes en Kingston, que combinan la atención prenatal con la planificación familiar. RESULTADOS: Las mujeres encuestadas tenían un nivel razonable de conocimientos acerca de los riesgos del HTA para la salud, actitudes negativas hacia el hábito de fumar en general, y la mayoría apoyaban la prohibición de fumar en lugares públicos. Se hallaron diferencias significativas en el conocimiento existente entre las mujeres jóvenes y mayores, así como entre las fumadoras y no fumadoras. CONCLUSIÓN: Las mujeres con el más alto nivel de conocimientos fueron las no fumadoras. Del grupo de bajo puntaje de conocimiento (actuales fumadoras), el 50% estaban en el rango de edad de 15-24 años. Existe una necesidad de mayor educación pública acerca del hábito de fumar y las consecuencias de la exposición al humo de tabaco ambiental sobre la salud de los niños.