Knowledge and awareness toward menopause and hormone therapy among premenopausal women in Jordan.

BACKGROUND: Menopause is a natural important transition in women's life. Having adequate knowledge and perception about menopause at a young age is critical for women to cope better with its associated consequences and improve their well-being. OBJECTIVE: This study evaluated the awareness, knowledge, and perception of menopause and menopause hormone therapy (MHT) among premenopausal females from Jordan. METHODS: A cross-sectional study including females aged 20-40 years (n = 450) was conducted from November 2018 to March 2019 in two hospitals in Irbid, Jordan. A structured questionnaire was developed based on previous literature and using the Green Climacteric Scale to assess participants' knowledge and awareness of signs and symptoms of menopause and MHT. Data were collected by face-to-face interview. Factors associated with the degree of menopausal knowledge were identified. RESULTS: The mean ± standard deviation age of participants was 29.1 ± 6.3 years. More than half of participants were knowledgeable about several aspects of menopause. Education to college or more was significantly and positively associated with knowledge about menopause (ß = 0.504, p = 0.005). The majority of participants did not know the roles, benefits, and risks of MHT. There was an almost equal distribution for participants' positive (47.6%) and negative (50%) attitudes toward menopause. CONCLUSIONS: The findings suggest that premenopausal females in Jordan are knowledgeable about various aspects of menopause. Nevertheless, there is still a need to develop educational programs and implement proper counseling to improve young females' awareness about menopause, particularly its health implications and treatment options.

Smoking prevalence, knowledge and attitudes among primary healthcare professionals: a study from Jordan.

This was a questionnaire-based cross-sectional study of 400 healthcare professionals recruited from primary healthcare centres in northern Jordan between April and October 2015. The questionnaire included questions about smoking behaviour, risks, opinions and providing anti-smoking counselling. More than 80% of participants reported that smoking-free policies were not enforced at primary healthcare centres. Compared to hospitals and the general population, smoking was less prevalent among primary healthcare professionals and more prevalent in men. More than 90% of participants believed that smoking was dangerous and associated with cardiovascular and respiratory diseases. Around 92% believed that they should set a good example to patients by not smoking and advise them about smoking cessation. Only 15.3% of participants felt well prepared when counselling patients about smoking and 92.8% believed that they needed training. This study suggests that primary healthcare professionals should act as anti-smoking role models after receiving professional training.

Smoking prevalence, knowledge and attitudes among primary healthcare professionals: a study from Jordan

This was a questionnaire-based cross-sectional study of 400 healthcare professionals recruited from primary healthcare centres in northern Jordan between April and October 2015. The questionnaire included questions about smoking behaviour, risks, opinions and providing anti-smoking counselling. More than 80% of participants reported that smoking-free policies were not enforced at primary healthcare centres. Compared to hospitals and the general population, smoking was less prevalent among primary healthcare professionals and more prevalent in men. More than 90% of participants believed that smoking was dangerous and associated with cardiovascular and respiratory diseases. Around 92% believed that they should set a good example to patients by not smoking and advise them about smoking cessation. Only 15.3% of participants felt well prepared when counselling patients about smoking and 92.8% believed that they needed training. This study suggests that primary healthcare professionals should act as anti-smoking role models after receiving professional training

La présente étude transversale reposait sur un questionnaire rempli par 400 professionnels de santé issus de centres de soins de santé primaires dans le nord de la Jordanie entre avril et octobre 2015. Le questionnaire incluait des questions portant sur les comportements tabagiques, les risques liés au tabac et les opinions à ce sujet, et sur la façon d'apporter des conseils pour prévenir le tabagisme. Plus de 80% des participants ont rapporté que les politiques sans tabac n'étaient pas appliquées dans les centres de soins de santé primaires. Comparé aux hôpitaux et à la population générale, le tabagisme était moins prévalent parmi les professionnels de soins de santé primaires, mais plus prévalent chez les hommes. Plus de 90% des participants étaient d'avis que fumer était dangereux et associé à des maladies cardio-vasculaires et respiratoires. Environ 92% pensaient qu'ils devaient donner l'exemple aux patients en étant non fumeurs et en leur promulguant des conseils pour arrêter de fumer. Seuls 15,3% des participants se sentaient suffisamment préparés pour conseiller les patients sur le tabagisme, et 92,8% étaient d'avis qu'ils avaient besoin d'une formation. L'étude suggère que les professionnels des soins de santé primaires devraient jouer le rôle de modèles non fumeur après avoir reçu une formation professionnelle

Circulating CD36+ microparticles are not altered by docosahexaenoic or eicosapentaenoic acid supplementation.

BACKGROUND AND AIMS: Circulating microparticles (MP) are the source of a plasma derived form of the scavenger receptor CD36, termed soluble (s)CD36, the levels of which correlate with markers of atherosclerosis and risk of cardiovascular disease. Long chain n-3 polyunsaturated fatty acids have cardioprotective effects that we have previously reported to be gender specific. The aim of this study was to determine if dietary docosahexaenoic acid (DHA) and/or eicosapentaenoic acid (EPA) supplementation affect circulating CD36 + MP levels, and if this occurs differentially in healthy men and women. METHODS AND RESULTS: Participants (43M, 51F) aged 39.6 ± 1.7 years received 4 weeks of daily supplementation with DHA rich (200 mg EPA; 1000 mg DHA), EPA rich (1000 mg EPA; 200 mg DHA), or placebo (sunola) oil in a double-blinded, randomised, placebo controlled trial. Plasma CD36 + MP were enumerated by flow cytometry and differences between genders and treatments were evaluated by Student's or paired t-test and one way ANOVA. Males and females had similar levels of CD36 + MP at baseline (mean = 1018 ± 325 vs 980 ± 318; p = 0.577) and these were not significantly changed after DHA (M, p = 0.571; F, p = 0.444) or EPA (M, p = 0.361; F, p = 0.901) supplementation. Likewise, the overall percent change in these levels were not different between supplemented cohorts compared to placebo when all participants were combined (% change in CD36 + MP: DHA = 5.7 ± 37.5, EPA = -3.4 ± 35.4, placebo = -11.5 ± 32.9; p = 0.158) or stratified by gender (M, DHA = -2.6 ± 30.6, EPA = -15.1 ± 20.1, placebo = -21.4 ± 28.7, p = 0.187; F, DHA = 11.7 ± 41.5, EPA = 6.8 ± 42.9, placebo = -2.8 ± 34.7, p = 0.552). CONCLUSION: The cardioprotective effects of DHA and EPA do not act through a CD36 + MP mechanism.

The origin of circulating CD36 in type 2 diabetes.

OBJECTIVE: Elevated plasma levels of the fatty acid transporter, CD36, have been shown to constitute a novel biomarker for type 2 diabetes mellitus (T2DM). We recently reported such circulating CD36 to be entirely associated with cellular microparticles (MPs) and aim here to determine the absolute levels and cellular origin(s) of these CD36+MPs in persons with T2DM. DESIGN: An ex vivo case-control study was conducted using plasma samples from 33 obese individuals with T2DM (body mass index (BMI)=39.9±6.4 kg m(-2); age=57±9 years; 18 male:15 female) and age- and gender-matched lean and obese non-T2DM controls (BMI=23.6±1.8 kg m(-2) and 33.5±5.9 kg m(-2), respectively). Flow cytometry was used to analyse surface expression of CD36 together with tissue-specific markers: CD41, CD235a, CD14, CD105 and phosphatidyl serine on plasma MPs. An enzyme-linked immunosorbent assay was used to quantify absolute CD36 protein concentrations. RESULTS: CD36+MP levels were significantly higher in obese people with T2DM (P<0.00001) and were primarily derived from erythrocytes (CD235a+=35.8±14.6%); although this did not correlate with haemoglobin A(1c). By contrast, the main source of CD36+MPs in non-T2DM individuals was endothelial cells (CD105+=40.9±8.3% and 33.9±8.3% for lean and obese controls, respectively). Across the entire cohort, plasma CD36 protein concentration varied from undetectable to 22.9 µg ml(-1) and was positively correlated with CD36+MPs measured by flow cytometry (P=0.0006) but only weakly associated with the distribution of controls and T2DM (P=0.021). Multivariate analysis confirmed that plasma CD36+MP levels were a much better biomarker for diabetes than CD36 protein concentration (P=0.009 vs P=0.398, respectively). CONCLUSIONS: Both the levels and cellular profile of CD36+MPs differ in T2DM compared with controls, suggesting that these specific vesicles could represent distinct biological vectors contributing to the pathology of the disease.

The putative diabetic plasma marker, soluble CD36, is non-cleaved, non-soluble and entirely associated with microparticles.

BACKGROUND: CD36 is a widely expressed cell surface receptor that binds lipoproteins, and its function has been implicated in many complications of the metabolic syndrome. A cell-free form of CD36, soluble CD36 (sCD36), has been reported in human plasma, found to be elevated in obesity and diabetes, and claimed as a marker of insulin resistance. OBJECTIVE: To determine the nature of sCD36; in particular, whether sCD36 is truly soluble or, as hypothesized, is found as a component of circulating microparticles (MPs). METHODS: Lipoproteins were fractionated by density gradient centrifugation, and plasma MPs were isolated by ultracentrifugation, size exclusion, and immunoprecipitation with CD36 detected by immunoblotting. MPs from plasma and activated platelets were analyzed by multicolor flow cytometry, with a DyLight-488 anti-CD36 conjugate in combination with antibodies against different cellular markers. RESULTS: Cell-free plasma CD36 was not observed associated with lipoproteins and was not a proteolytic fragment; rather, it was associated with the plasma MP fraction, suggesting that sCD36 in the plasma of normal subjects is a product of circulating MPs. Cytometric and immunoblotting analyses of plasma from normal donors showed that these MPs were derived mainly from platelets. Analysis of in vitro activated platelets also showed that CD36 to be secreted in the form of MPs. CONCLUSIONS: sCD36 is not a proteolytic product, but rather is associated with a specific subset of circulating MPs that can readily be analysed. This finding will enable more specific investigations into the cellular source of the increased levels of plasma CD36 found in subjects with diabetes.