Ethnicity questions and antenatal screening for sickle cell/thalassaemia (EQUANS) in England : Observation and interview study.

Objectives To describe understandings that mothers and midwives have of ethnicity. To explore barriers to the successful implementation of ethnicity screening questions for sickle cell/thalassaemia. Design Observation of 121 first antenatal interviews between midwife and mother in four contrasting areas of sickle cell prevalence in England. Taped interviews with 111 mothers and 115 taped interviews with 61 different midwives. Fieldwork data from 76 preparatory workshops and liaison meetings. Results 'Ethnicity' and 'family' are terms liable to variable interpretation. Both midwives and mothers implied belief in distinct 'racial' groups, disrupting scientifically accurate understandings of the relation between risk of sickle cell/thalassaemia and ethnic/family origins. Bookings were characterised by time pressures and a lack of explanation of sickle cell/thalassaemia. The mother was not permitted to self-assign ethnicity in 13 of 115 observed encounters. Conclusions Antenatal screening for sickle cell/thalassaemia based on an ethnicity screening question is weakened by a range of factors. Some midwives use intuition to select/exclude clients from the screening questions rather than implement formal policy. The screening term 'ethnic/family origins' is vulnerable to varied interpretations by clients. The persistence of erroneous beliefs in 'racial' groups displaces correct understandings of the relation between ethnicity and risk of carrying genes associated with sickle cell/thalassaemia. Midwives require support in both in ethnicity awareness and knowledge of sickle cell and thalassaemia, and more time at antenatal bookings to administer the ethnicity screening question. A challenge to the continued prevalence of scientific racism in popular discourse is required.The NHS Sickle Cell and Thalassaemia Screening Programme, Department of Health and the Unit for the Social Study of Thalassaemia and Sickle Cel

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Ethnic question and screening for sickle cell, RCT

A policy summary of these and related papers has been reproduced in: • The Sickle Cell Disease Information Center, Georgia, USA. • The Sickle Cell Disease Association of America, Baltimore, MD, USA • Athens Institute for Education and Research • London IDEAS Genetics Knowledge Park • Making Research Count: University of WarwickAbstract Concepts allied to ethnicity are increasingly coming under question as legitimate variables for use in health research. A randomised controlled trial of two ethnicity screening questions for ascertaining risk of carrying genes associated with sickle cell and thalassaemia illustrates the challenges and limitations of assessing an association of social constructs and genetic statuses. Objectives To evaluate two candidate ethnicity screening questions in ante-natal screening programmes in low, mixed and high sickle cell prevalence areas, and to identify time taken in administration of the questions by use of the following measures: (1) Proportions of respondents with missing ethnicity data and/or significant changes in ethnic/family origins upon re-interview. (2) Numbers of carriers of clinically significant haemoglobin disorders missed by ethnicity screening questions, (3) Time taken to explain screening question for SCD/thalassaemia and obtain ethnic/family origins. (4) Proportion of clients providing usable ethnic/family origins data (5) Reported ethnic/family origins in pregnant women at first booking with midwife. Design Ten month (Sept 2002-June 2003) questionnaire study with random allocation to two self-administered ethnicity questions, comparison with laboratory results and results from re-interview. The settings were ante-natal booking clinics in four geographical areas of England of varying expected foetal prevalence of sickle cell disease (SCD): very high (29.75 per 10,000 pregnancies); high (8.2); mixed high and low (1.29) and low (0.18). The subjects were 4,559 pregnant women at first booking with midwife. Results Proportion of respondents with missing ethnicity data and/or significant changes in ethnic/family origins upon re-interview were 4.33% (CI 2.63%-6.68%) for a category-based question and 9.45% (CI 6.86%-12.61%) for a binary plus open-ended question. Proportions of carriers missed were 5.74% (CI 2.34%-11.46%) and 9.71% (CI 4.75%-17.13%) by category-based and binary plus open-ended questions respectively. Average time taken averaged to ascertain ethnic/family origins for screening was between 2.17 and 5.12 minutes in different areas, and up to 15 minutes at the 95th Centile. Usable ethnicity screening data was missing in 2.94% of instances. Errors in interpretation or missing data were 3.2% for a category-based question, and 4.71% for a binary plus open-ended ethnicity question. Ethnicity Question A produces fewer cases of missing or misinterpreted data (p<0.001). Conclusions A category-based ethnicity screening question was more effective than a binary plus open-ended question. Using the more effective question, 5.74% (CI 2.34%-11.46%) of significant haemoglobinopathies will be missed in a selective screening programme, and 4.33% (CI 2.63-6.68%) of replies to an ethnicity screening question will be unreliable when compared to information given upon re-interview. In specific carefully circumscribed situations, namely, in ante-natal screening for sickle cell and thalassaemia, it is possible to measure the degree of association between social constructs of ethnicity and health status in a manner that may help in effecting policy decisions.The NHS Sickle Cell and Thalassaemia Screening Programme, Department of Health and the Unit for the Social Study of Thalassaemia and Sickle Cel

Orchesis, 1982

This video is a recording of Orchesis Dance at Central Washington University from 1982. It is the second part of a two-part series whose first part appears to be missing. Performances include: Aura (choreographed and danced by Cris Coffing, Jo Ann Dukes, and Julie Mo Murray), Procrastination City, 1981 (choreographed by Beverly Shotts Ormbrek and Julie Prather; danced by Kal Arnold, Ronald Ellis, and Cindy Kenoyer), In the Stone (choreographed by Dana Cagle and Theresa Greco; danced by Patsy Boorman, Dana Cagle, Theresa Greco, and Charisse Sheridan), and Road to Armageddon (choreographed by Rondi Marsh; danced by Cris Coffing, Sue Crawford, Jo Ann Dukes, Daniel Herron, Julie Kastien, Julie Mo Murray, Cathy Morris, Nomi Nylander, Margo Schmidt, Linda Stephens, Tim Tyree).https://digitalcommons.cwu.edu/kcwutv_kittitas/1008/thumbnail.jp