Racial differences in HbA1c: a cross-sectional analysis of a Brazilian public primary care population.

BACKGROUND: Blacks show higher levels of HbA1c in studies with different populations and are disproportionately affected by most diabetes-related complications. AIMS: The study aims to investigate if the prevalence of altered glycated hemoglobin (HbA1c) varies with skin color and if there is a familial aggregation of either skin color and HbA1c. METHODS: The study used the CAMELIA study (Cardio-Metabolic-Renal familiar) population, conducted between June 2006 and December 2007 (cross sectional). Families were recruited from 13 Family Doctor Program Unities of Niteroi, Brazil, a highly miscegenated population. The visits included questionnaire, medical consultation, anthropometric and nutritional assessment. Blood pressure, blood/urine samples were collected. The dosage of HbA1c was performed by immunoturbidimetry in Labmax 240 equipment. RESULTS: We compare data of 241 (25.5%) Blacks, versus 422 (44.7%) Mulattos or 272 (28.8%) Whites. The groups did not differ significantly with regard to most measures. Blacks had the lowest levels of income/education, higher frequency of diabetes and hypertension (p<0.20) as higher levels of HbA1c (p<0.05) that persisted after adjusting for possible confounders. Among blacks, the correlations between siblings of HbA1c were higher than among white/mulatto, reaching 86% versus 50%, respectively. CONCLUSION: Those results indicate that Brazilian Blacks patients must have more attention, focusing on diabetes preventive care. Longitudinal studies are needed to address the question if the altered level of HbA1c has a real clinical impact.

Risk factors for asthma in a helminth endemic area in bahia, Brazil.

Protective factors associated with atopy or asthma in rural areas include socioeconomic level, overcrowding, and helminth infection. However, little epidemiological information was originated from schistosomiasis areas. This study aimed to investigate factors associated with asthma in a schistosomiasis endemic area. A questionnaire was used to obtain information on demographics, socioeconomic, and environmental features. The ISAAC questionnaire was used to identify individuals with asthma. Parasitological exam was done in all participants and skin prick test to aeroallergens in all asthmatics. Prevalence of Schistosoma mansoni infection was 57.4% and Ascaris lumbricoides, 30.8%. Asthma was found in 13.1% of the population, and 35.1% of them had a positive SPT. Active and passive smoking was positively associated with asthma, whereas A. lumbricoides was negatively associated. In a schistosomiasis hyperendemic region, current infection with A. lumbricoides is protective against asthma. However, we cannot rule out the involvement of S. mansoni infection in this process.

Preliminary report on the Accountability Scale: a change and outcome measure for intimate partner violence research.

The current study investigated the reliability of a new self-report questionnaire assessing accountability for the perpetration of intimate partner violence. The Accountability Scale (AS) is a brief, Likert-type measure designed to assess the degree to which perpetrators acknowledge and accept responsibility for their violent actions. In Study #1, an exploratory factor analysis on a clinical sample revealed two factors: Acknowledging Harm and Internalizing Responsibility. In Study #2, the factor structure was replicated on a community sample using confirmatory factor analysis, revealing an 11-item solution. Factor 1 was related to readiness to change but negatively related to social desirability, suggesting convergent and discriminant validity of that subscale. Factor 2 was negatively related to Factor 1 in the community sample, calling into question the construct of accountability. Preliminary evidence suggests that the AS shows promise as a brief and reliable tool to assess forms of accountability. Future research will examine if the two factors of accountability function as mechanisms of change and outcome measures in intimate partner violence intervention research.

What situations induce intimate partner violence? A reliability and validity study of the Proximal Antecedents to Violent Episodes (PAVE) scale.

The current study investigated the reliability of a new self-report questionnaire assessing stimuli that would likely elicit intimate partner violence. The Proximal Antecedents to Violent Episodes (PAVE) scale is a 30-item, Likert-type measure designed to assess situations that would reportedly precede the use of violence. In Study 1, an exploratory factor analysis on a clinical sample revealed 3 factors: Violence to Control, Violence Out of Jealousy, and Violence Following Verbal Abuse. In Study 2, the factor structure was replicated on a community sample using confirmatory factor analysis. In both studies, different types of batterers, on the basis of A. Holtzworth-Munroe and G. L. Stuart's (1994) typology, scored differently on the 3 factors in ways consistent with theory. Therefore, the PAVE shows promise as a reliable and valid tool to help to understand the context and function of intimate partner violence.