Some preliminary research suggests higher rates of gastrointestinal disease in individuals with eating disorders (EDs). However, research is limited, and it remains unknown what etiologic factors ...account for observed associations. This was the first study to examine how EDs and dimensional ED symptoms (e.g. body dissatisfaction, binge eating) are phenotypically and etiologically associated with gastrointestinal disease in a large, population-based twin sample.
Adult female (
= 2980) and male (
= 2903) twins from the Michigan State University Twin Registry reported whether they had a lifetime ED (anorexia nervosa, bulimia nervosa, or binge-eating disorder) and completed a measure of dimensional ED symptoms. We coded the presence/absence of lifetime gastrointestinal disease (e.g. inflammatory bowel disease) based on responses to questions regarding chronic illnesses and medications. We first examined whether twins with gastrointestinal disease had higher rates of EDs and ED symptoms, then used correlated factors twin models to investigate genetic and environmental contributions to the overlap between disorders.
Twins with gastrointestinal disease had significantly greater dimensional ED symptoms (
= 0.21,
< 0.001) and odds of a lifetime ED (OR 2.90,
= 0.001), regardless of sex. Shared genetic factors fully accounted for the overlap between disorders, with no significant sex differences in etiologic associations.
Comorbidity between EDs and gastrointestinal disease may be explained by overlap in genetic influences, potentially including inflammatory genes implicated in both types of disorders. Screening for gastrointestinal disease in people with EDs, and EDs in those with gastrointestinal disease, is warranted.
Heterosexual sex, foremost its gender-power dynamics, is embedded in and informed by the socio-historical context in which it occurs. While safer sexual communication skills are well documented as ...key to the success of sexual and reproductive health programming and education, communication skills about the positive aspects of sexuality such as sexual pleasure are often limited if not absent. Using data from in-depth qualitative interviews with men and women aged 26-39 from a diverse set of backgrounds in Cape Town, South Africa, this study examines the ways in which gender-power dynamics manifest in negotiations of HIV and pregnancy prevention and sexual pleasure in the intimate spaces of heterosex. Findings fall under three themes: 1) condom negotiation as a replacement for other aspects of sexual communication; 2) self-efficacy in negotiating prevention and negotiating one's own sexual pleasure; and 3) the integral role men play in heterosexual encounters in the facilitation of women's sexual autonomy and women's sexual pleasure. This study contributes to research not only examining the positive and more nuanced realities of heterosex in the South African context, but also argues for the need to integrate positive aspects of sexuality into sexual and reproductive health programming in general.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Common Variants of the Novel Type 2 Diabetes Genes CDKAL1 and HHEX/IDE Are Associated With Decreased Pancreatic β-Cell Function
Laura Pascoe 1 ,
Andrea Tura 2 ,
Sheila K. Patel 3 ,
Ibrahim M. Ibrahim ...1 ,
Ele Ferrannini 4 ,
Eleftheria Zeggini 5 ,
Michael N. Weedon 6 ,
Andrea Mari 2 ,
Andrew T. Hattersley 6 ,
Mark I. McCarthy 5 ,
Timothy M. Frayling 6 ,
Mark Walker 1 and
for the RISC Consortium and the U.K. Type 2 Diabetes Genetics Consortium
1 Diabetes Research Group, Newcastle University, Newcastle upon Tyne, U.K
2 CNR Institute of Biomedical Engineering, Padova, Italy
3 Cardiovascular Research Group, Department of Medicine, University of Melbourne, Melbourne, Australia
4 University of Pisa, School of Medicine, Pisa, Italy
5 Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, and the Wellcome Trust Centre for Human Genetics,
University of Oxford, Oxford, U.K
6 Diabetes Genetics Group and Genetics of Complex Traits, Peninsula Medical School, Exeter, U.K
Address correspondence and reprint requests to Prof. Mark Walker, School of Clinical Medical Sciences, 4th Floor William Leech
Bldg., The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, U.K. E-mail: mark.walker{at}ncl.ac.uk
Abstract
OBJECTIVE— Type 2 diabetes is characterized by impaired pancreatic β-cell function and decreased insulin sensitivity. Genome-wide association
studies have identified common, novel type 2 diabetes susceptibility loci within the FTO , CDKAL1 , CDKN2A/CDKN2B , IGF2BP2 , HHEX/IDE , and SLC30A8 gene regions. Our objective was to explore the relationships between the diabetes-associated alleles and measures of β-cell
function and whole-body insulin sensitivity.
RESEARCH DESIGN AND METHODS— A total of 1,276 healthy subjects of European ancestry were studied at 19 centers. Indexes of β-cell function (including
30-min insulin response and glucose sensitivity) were derived from a 75-g oral glucose tolerance test, and whole-body insulin
sensitivity (M/I) was assessed by hyperinsulinemic-euglycemic clamp. Genotype/phenotype relationships were studied by linear
trend analysis correcting for age, sex, and recruitment center.
RESULTS— CDKAL1 and HHEX/IDE diabetes-associated alleles were both associated with decreased 30-min insulin response (both P = 0.0002) and decreased pancreatic β-cell glucose sensitivity ( P = 9.86 × 10 −5 and 0.009, respectively), and these relationships remained after correction for M/I. The FTO susceptibility allele showed a weak but consistent association with increased adiposity, which in turn was linked to a decrease
in M/I. However, none of the other novel diabetes susceptibility alleles were associated with insulin sensitivity.
CONCLUSIONS— CDKAL1 and HHEX/IDE diabetes-associated alleles are associated with decreased pancreatic β-cell function, including decreased β-cell glucose
sensitivity that relates insulin secretion to plasma glucose concentration. We confirmed the association between the FTO allele and increased adiposity, but none of the other novel susceptibility alleles were associated with whole-body insulin
sensitivity.
GWA, genome-wide association
OGTT, oral glucose tolerance test
RISC, Relationship between Insulin Sensitivity and Cardiovascular Disease
SNP, single nucleotide polymorphism
Footnotes
Published ahead of print at http://diabetes.diabetesjournals.org on 5 September 2007. DOI: 10.2337/db07-0634.
Additional information for this article (including the RISC Consortium and the U.K. Type 2 Diabetes Genetics Consortium membership)
can be found in an online appendix at http://dx.doi.org/10.2337/db07-0634 .
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore
be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
Accepted August 24, 2007.
Received May 9, 2007.
DIABETES
Women may need or seek male partner approval to safely and consistently use oral antiretroviral pre-exposure prophylaxis (PrEP) or vaginal microbicides. We developed CHARISMA, a counseling ...intervention to support women's relationships and their ability to consistently use HIV prevention products.
In a pilot study with 95 female participants in Johannesburg, South Africa, lay counselors implemented CHARISMA, assessing participants' relationship(s) with their male partner(s) and barriers or facilitators to HIV prevention method use, and then providing tailored, interactive counseling. We conducted study participant surveys and clinic staff interviews to evaluate CHARISMA's feasibility and acceptability.
The CHARISMA pilot study indicates that a two-session relationship counseling intervention with 6-month follow-up to support women's ability to safely and effectively use vaginal microbicides was generally acceptable and feasible. Most participants thought CHARISMA was relevant, helpful, and about the right length, and that it had a positive impact on their relationships with their partners and their product use. Staff estimated that the intervention took 1.5-2 h to implement at enrollment and 45 min to an hour for the month 1 visit. They thought that overall CHARISMA was generally feasible to implement.
Findings from this study suggest several lessons learned that may be relevant to others developing interventions supporting women's use of oral PrEP or vaginal microbicides. The use of lay counselors instead of nurses to deliver counseling appeared to be successful, but the counselors experienced significant stress from hearing about participants' traumatic experiences and required emotional support to avoid burnout. Although staff and participants felt that having multiple intervention sessions over time was valuable, a similar level of intensity may not be feasible in other settings. Further research is needed to determine an intervention delivery mode and follow-up period that optimally balances participant needs and clinic resources. Male engagement was a challenge, as it has been in previous studies of vaginal microbicides. Alternative strategies to reach men that do not require them to come to the clinic or rely on their female partners may be more effective.
The polymorphism, KLF6‐IVS1‐27A, in the Krüppel‐like factor 6 (KLF6) transcription factor gene enhances its splicing into antagonistic isoforms and is associated with delayed histological progression ...of nonalcoholic fatty liver disease (NAFLD). To explore a potential role for KLF6 in the development of insulin resistance, central to NAFLD pathogenesis, we genotyped KLF6‐IVS1‐27 in healthy subjects and assayed fasting plasma glucose (FPG) and insulin sensitivities. Furthermore, we quantified messenger RNA (mRNA) expression of KLF6 and glucokinase (GCK), as an important mediator of insulin sensitivity, in human livers and in liver tissues derived from a murine Klf6 knockdown model (DeltaKlf6). Klf6 overexpression studies in a mouse hepatocyte line were utilized to mechanistically link KLF6 with Gck promoter activity. KLF6‐IVS1‐27Gwt (i.e., less KLF6 splicing) was associated with stepwise increases in FPG and insulin and reduced hepatic insulin sensitivity. KLF6 binds to the liver‐specific Gck promoter and activates a GCK promoter‐reporter, identifying GCK as a KLF6 direct transcriptional target. Accordingly, in DeltaKlf6 hepatocytes Gck expression was reduced and stable transfection of Klf6 led to up‐regulation of Gck. GCK and KLF6 mRNAs correlate directly in human NAFLD tissues and immunohistochemistry studies confirm falling levels of both KLF6 and GCK in fat‐laden hepatocytes. In contrast to full‐length KLF6, splice variant KLF6‐SV1 increases in NAFLD hepatocytes and inversely correlates with glucokinase regulatory protein, which negatively regulates GCK activity. Conclusion: KLF6 regulation of GCK contributes to the development of hepatic insulin resistance. The KLF6‐IVS1‐27A polymorphism, which generates more KLF6‐SV1, combats this, lowering hepatic insulin resistance and blood glucose. (HEPATOLOGY 2011)
This article presents findings from a national qualitative research study of 33 diverse and profeminist leaders who identify as men and are engaged in gender equality work with men and boys across ...Canada. Key findings include the need to meet men where they are at, moving away from the ineffective “all men are perpetrators” frame, and to evolve to new and more relatable narratives and approaches that get men committed to this work for their own liberation. Taking an intersectional approach and working in partnership with feminist and intersectional organizations are essential to advancing gender equality in the Canadian context.
Evidence shows that a significant proportion of ever-partnered women suffer some form of intimate partner violence (IPV) perpetuated by male partners. The prevalence of IPV in sub-Saharan African ...countries is considerably higher than global estimates. Although existing studies show the effect of women’s and intimate male partner’s characteristics on IPV, knowledge on how these factors increase or reduce women’s risk to specific types of IPV is limited. Using the 2016 Ugandan Demographic and Health Survey (UDHS), we examine regional variations in women’s and intimate male partner’s characteristics and their effect on emotional, sexual, and physical violence perpetuated by men and experienced by women in Uganda. The result shows that women’s educational status is a significant predictor of all forms of IPV, whereas other characteristics, such as employment and housing ownership, have differential effects on specific types of IPV. Less educated women were more likely to experience emotional, sexual, and physical violence. Alcohol abuse was a significant determinant of men perpetuating all types of IPV; other male characteristics had differential effects on specific types of IPV. Male partners who abuse alcohol “often” and “sometimes” were more likely to commit acts of emotional, sexual, and physical violence against their female intimate partners. The findings also show that ~5%, ~8%, and ~2% of the variance in emotional, sexual, and physical violence (respectively; in the final models) are attributable to regional differences. The findings suggest the need for interventions aimed at increasing women’s access to higher education, working with men and boys to reduce the occurrence of alcohol abuse and address harmful constructions of masculinity, and promoting gender equality among men as well as women.
This study examined the impact of a three-year intervention project conducted in the Hoima district of Uganda, which sought to engage men in sexual and reproductive health as clients, equal partners ...and advocates of change. Structured surveys with 164 self-reported heterosexual men aged 18-54 years were used to assess knowledge and attitudes towards sexual and reproductive health. Data from these were analysed using Stata and SPSS. Additionally, five focus groups were conducted with the female partners and male beneficiaries of the project and with project peer educators. Four interviews were conducted with project staff and male beneficiaries. Data from these and the focus groups were analysed using a thematic approach. Following the intervention, a significantly greater number of men accessed, and supported their partners in accessing sexual health services services, had gained sexual and reproductive health awareness, reported sharing domestic duties and contraceptive decision-making, and displayed a decreased tolerance for domestic violence. It was more difficult to assess men's involvement and behaviours as advocates of change, which sheds light on the complexities of a gender transformative project and the importance of evaluating such projects from both men's and their partners' perspectives and at different levels of the male involvement model in sexual and reproductive health.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Globally, men are less likely than women to access human immunodeficiency virus (HIV) testing, treatment, and care, and consequently experience disproportionate HIV-related mortality. To address ...men’s underutilization of HIV services, efforts are needed on two fronts: challenging the regressive gender norms that discourage men from seeking health services, and developing improved health system policies, programs, and service delivery strategies to ensure better provision of HIV services to men. It has long been understood that harmful gender norms make women vulnerable to HIV, and this understanding should expand to include the way these norms also put men at risk. This paper presents the data concerning men and HIV, explores the impact of gender norms, examines national and international policy developments, and chronicles the evolution of men’s place in the HIV response. It does so in part by tracing the efforts of Sonke Gender Justice, a South African nongovernmental organization working across Africa, that it promotes the engagement of men in the fight against the dual epidemics of gender inequality and HIV.
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