Localization of type 1 diabetes susceptibility to the MHC class I genes HLA-B and HLA-A

The major histocompatibility complex (MHC) on chromosome 6 is associated with susceptibility to more common diseases than any other region of the human genome, including almost all disorders classified as autoimmune. In type 1 diabetes the major genetic susceptibility determinants have been mapped to the MHC class II genes HLA-DQB1 and HLA-DRB1 (refs 1-3), but these genes cannot completely explain the association between type 1 diabetes and the MHC region. Owing to the region's extreme gene density, the multiplicity of disease-associated alleles, strong associations between alleles, limited genotyping capability, and inadequate statistical approaches and sample sizes, which, and how many, loci within the MHC determine susceptibility remains unclear. Here, in several large type 1 diabetes data sets, we analyse a combined total of 1,729 polymorphisms, and apply statistical methods - recursive partitioning and regression - to pinpoint disease susceptibility to the MHC class I genes HLA-B and HLA-A (risk ratios >1.5; Pcombined = 2.01 × 10-19 and 2.35 × 10-13, respectively) in addition to the established associations of the MHC class II genes. Other loci with smaller and/or rarer effects might also be involved, but to find these, future searches must take into account both the HLA class II and class I genes and use even larger samples. Taken together with previous studies, we conclude that MHC-class-I-mediated events, principally involving HLA-B*39, contribute to the aetiology of type 1 diabetes. ©2007 Nature Publishing Group

Scent lineups compared across eleven countries: Looking for the future of a controversial forensic technique

International audienceA scent lineup is generally a procedure whereby a dog's alerting behavior is used to establish that the dog detects two scents, one from a crime scene and one from a suspect, as deriving from the same person. The aim of this article is to compare methodologies of using dogs in scent lineups as a means of identifying perpetrators of crimes. It is hoped that this comparative approach, looking at countries where the method is currently or has in the past been used, will help determine what issues should be addressed in order to assure that the scent lineup will have a future as a forensic technique. Participants from eleven countries-Belgium, The Czech Republic, Finland, France, Germany, Hungary, Lithuania, The Netherlands, Poland, Russia, and the U.S.-completed a survey questionnaire regarding key aspects of the scent lineup procedures used by the police in their countries. Although there was broad overlap on certain matters, such as the use of control and zero trials, collection of decoy scents from individuals of similar gender and race as the suspect, materials for holding scent, frequency of cleaning and changing stations, and use and timing of rewards, there were significant differences in the degree of blindness required, who calls an alert (handler or experimenter), and whether handlers can work with more than one dog. The gap between recommendations and results available from the scientific literature and procedures used in police practice was greater for some countries than others, even taking into account that some scientific methodologies might be expensive or impractical given agency resources. The authors make recommendations about how to go forward if scent lineups are to remain a valid forensic technique

'I daresay I might find it embarrassing': general practitioners' perspectives on discussing sexual health issues with lesbian and gay patients

The present paper explores general practitioners’ (GPs’) perspectives on the difficulties which they face when discussing sexual health issues with lesbian and gay patients in primary care consultations. It draws upon data obtained from a qualitative interview study with 22 GPs aged between 34 and 57 years who were practising in Sheffield, UK. Interviews were transcribed verbatim and the data were analysed thematically. The results indicate that (non-hetero)sexual orientation could form a barrier to talking about sexual health matters for almost half of this GP sample. Difficulties related primarily to ignorance of lesbian and gay lifestyles and sexual practices, and also included concerns about the appropriate language to use and assumptions about the nature of gay men’s relationships. Homophobic attitudes were also identified in a minority of the sample. Participants suggested improvements around improving communication about sexual health with lesbian and gay patients. These included training at undergraduate and postgraduate levels, taking a proactive role during consultations, not making assumptions about patients’ sexual orientation and having a non-discriminatory policy for their practice