Integrating Genome-Wide CNVs Into QTLs and High Confidence GWAScore Regions Identified Positional Candidates for Sheep Economic Traits.

Copy number variations (CNVs) are important source of genetic variation, which can affect diverse economic traits through a variety of mechanisms. In addition, genome scan can identify many quantitative trait loci (QTLs) for the economic traits, while genome-wide association studies (GWAS) can localize genetic variants associated with the phenotypic variations. Here, we developed a method called GWAScore which collected GWAS summary data to identify potential candidates, and integrated CNVs into QTLs and high confidence GWAScore regions to detect crucial CNV markers for sheep growth traits. We got 197 candidate genes which were overlapping with the candidate CNVs. Some crucial genes (MYLK3, TTC29, HERC6, ABCG2, RUNX1, etc.) showed significantly elevated GWAScore peaks than other candidate genes. In this study, we developed the GWAScore method to excavate the potential value of candidate genes as markers for the sheep molecular breeding.

Barriers to accessing maternal healthcare among ethnic minority women in Western China: a qualitative evidence synthesis.

Quantitative evidence suggests that ethnic disparities in maternal healthcare use are substantial in Western China, but the reasons for these remain under-researched. We undertook a systematic review of English and Chinese databases between January 1, 1990 and February 23, 2018 to synthesize qualitative evidence on barriers faced by ethnic minority women in accessing maternal healthcare in Western China. Four English and 6 Chinese language studies across 8 provinces of Western China and 13 ethnic minority groups were included. We adapted the 'Three Delays' framework and used thematic synthesis to categorize findings into six themes. Studies reported that ethnic minority women commonly held traditional beliefs and had lower levels of education, which limited their willingness to use maternal health services. Despite the existence of different financial protection schemes for services related to delivery care, hospital birth was still too costly for some rural households, and some women faced difficulties navigating reimbursement procedures. Women who lived remotely were less likely to go to hospital in advance of labour because of difficulties in arranging accommodation; they often only sought care if pregnancies were complicated. Poor quality of care in health facilities, particularly misunderstandings between doctors and patients due to language barriers or differences in socio-economic status, and clinical practices that conflicted with local fears and traditional customs, were reported. The overall evidence is weak however: authors treated different ethnicities as if they belonged to one homogeneous group and half of the studies failed in methodological rigour. The current evidence base is very limited and poor in quality, so much more research elucidating the nature of 'ethnicity' as a set of barriers to maternal healthcare access is needed. Addressing the multiple barriers associated with ethnicity will require multi-faceted solutions that adequately reflect the specific local context.

Ethnicity and maternal and child health outcomes and service coverage in western China: a systematic review and meta-analysis.

BACKGROUND: There is a dearth of accurate information about health outcomes and health service coverage among ethnic minorities in China. We assessed maternal and child health (MCH) outcomes and service coverage among ethnic minorities compared with Han populations in western China. METHODS: We did a systematic review searching English (Embase, MEDLINE, Web of Science) and Chinese (China National Knowledge Infrastructure [CNKI], VIP, Wanfang) databases for population-based studies comparing MCH indicators between ethnic minorities between Jan 1, 1990, and Nov 9, 2016, in any language. For studies making individual comparisons we used the odds ratio (OR) and corresponding 95% CIs as the primary measure to assess the association between MCH indicators and ethnicity. We used a random-effects model to pool odds ratios. FINDINGS: We included 29 Chinese and 16 English language studies, providing 31 individual comparisons and 15 ecological comparisons. Ethnic minority women had lower odds of antenatal care use (pooled crude OR 0·60 [95% CI 0·48-0·75]) and birth in health facilities (0·50 [0·39-0·64]) than did Han women; and their children had higher odds of mortality (2·02 [1·23-3·32]) and lower immunisation (0·34 [0·24-0·47]) than did Han children. After taking account of the potential confounding effects of socioeconomic factors, ethnic minority women were less likely to use antenatal care (pooled adjusted OR 0·54 [0·42-0·71]) or to immunise their children (0·57 [0·44-0·74]) compared with Han women. INTERPRETATION: China has a wealth of primary data that could further our understanding of why ethnic minority populations are lagging behind. As MCH outcomes continue to improve nationally, ethnic minorities will take a greater share of the overall burden of adverse outcomes, requiring strategic investments to address the specific challenges faced by people living in remote areas. FUNDING: China Medical Board.

Area disparity in children's perceptions of access to tobacco and cigarette purchasing experiences in Taiwan.

BACKGROUND: Adolescents who perceive easy access to tobacco are more likely to acquire cigarettes and experience smoking. This study assesses area disparities in perceptions of access to tobacco and cigarette purchasing experiences among schoolchildren. METHODS: Data on children's tobacco-related variables were obtained from the Control of School-Aged Children Smoking Study Survey in Taiwan. A stratified random sample of 65 primary schools was included. Polytomous logistic regression analyzed factors associated with tobacco accessibility and purchasing experiences. RESULTS: More than half of the children reported that tobacco retailers often or always sold cigarettes to them. Rural and mountainous children were more likely to have access to cigarettes (adjusted odds ratio [AOR] = 2.01 and 3.01, respectively) and have cigarette purchasing experiences (AOR = 3.06 and 13.76, respectively). Cigarette purchasing from retailers (AOR = 1.84) was significantly associated with children's perceptions of access to tobacco. The factors associated with cigarette purchasing experiences were families smoking (AOR = 8.90), peers smoking (AOR = 2.22), frequent exposure to entertainer smoking on TV and in films (AOR = 2.15), and perceived access to tobacco (AOR = 1.51). CONCLUSIONS: The health department should strictly enforce laws regarding retailers selling tobacco to underage, particularly in remote areas. Schools can reinforce tobacco-use prevention messages.

Analysis of influential factors associated with the smoking behavior of aboriginal schoolchildren in remote Taiwanese mountainous areas.

BACKGROUND: A disparity in smoking behavior exists between the general and minority populations residing in Taiwan's mountainous areas. This study analyzed individual and environmental factors associated with children's smoking behavior in these areas of Taiwan. METHODS: In this school-based study, data on smoking behavior and related factors for mountain-dwelling students were obtained from the 2008 and 2009 Control of School-aged Children Smoking Study surveys. A representative sample (N = 1239) from 26 primary schools was included. The association among 3 groups (never-, former-, and current-smokers) and the potential variables were simultaneously examined using unordered polytomous logistic regression analysis. RESULTS: Between 13% and 34% of ever-smokers reported that their first smoking experience was in third grade. More than 70% were found to have bought cigarettes and 87% reported that the tobacco retailers had sold them cigarettes. The significant factors for current-smokers were predisposing factors, ie, attitude toward smoking (adjusted odds ratio [AOR] = 1.21); reinforcing factors, ie, family smoked in front of me (AOR = 2.44), friends smoked in front of me (AOR = 16.24), and school staff smoked in front of me (AOR = 2.98); and enabling factors, ie, cigarette availability and accessibility (AOR = 2.16 and 2.42, respectively). A student's perceived punishment for smoking at school had a positive significant effect on the risk of being former-smokers (AOR = 1.57). CONCLUSION: The findings provide a basis for school and community to design and implement effective anti-smoking programs for remote mountain-based students to further reduce youth smoking.

Factors related to tobacco use among adolescents in southern Taiwan.

Identifying the factors related to the initiation and continuance of smoking among youth has been regarded as a crucial step for school nurses and public health nurses to develop effective smoking prevention and cessation programs in schools and communities. The purpose of this study was to investigate the factors related to adolescent tobacco use in southern Taiwan. A total of 4,500 study samples were selected at random from the students of all high schools located in Pingdong County. This process yielded 3,307 valid samples (a 73.5% response rate). Study results found 62.4% (n = 2,063) reported never having smoked before. Thirty-eight percent (n = 1,244) of participants had experience using tobacco, 59.3% (n = 738) reported being ex-smokers, and 40.7% (n = 506) were current smokers. This study found that having friends who offered cigarettes, academic achievement, father's educational level, perceived peer smoking behavior to be primary influences on smoking, attitude, and self-efficacy and significant predicators of adolescents' current smoking behaviors. Parents' marital status and having classmate who offered cigarettes were significant predictors of adolescent smoking behavior. Study findings can provide a basis for school and public health nurses to design effective smoking prevention and cessation programs in schools and community settings. This study suggests further experimental studies are necessary to test the effectiveness of tobacco control programs designed in reference to the findings of this study.

Effectiveness of case management for community elderly with hypertension, diabetes mellitus, and hypercholesterolemia in Taiwan: a record review.

OBJECTIVE: To identify the effectiveness of case management for community elderly with hypertension (HT), diabetes mellitus, and hypercholesterolemia (HC) (the so-called three highs). DESIGN AND SETTING: Secondary data of the first and 3-month-after visiting records were extracted from 33 Public Health Centers in Taiwan. PARTICIPANTS: Seven hundred and sixty-six clients were selected who were at least 65 years old and had been diagnosed twice on the Case Management Record with at least one of the three highs. RESULTS: This sample had a mean age of 72.6 years, 59.7% were female. Approximately 74% of the clients had HT, 55% had diabetes, and 15% had HC. Each elderly revealed 1.4 highs of the three highs. The elderly with HT, and diabetes, their blood pressures (BP) and blood sugars significantly decreased after being managed by public health nurses. Males and the elderly living in urban areas had more decrease in systolic BP. Females had more decrease in fasting blood sugar. CONCLUSIONS: The study found that the case management of the three highs presented effectiveness on reducing the values of the three highs of the elderly in community.