Factors affecting sex education in the school system.

STUDY OBJECTIVE: To describe the current status of school based sex education and to determine predictors of providing a comprehensive sex education curriculum. DESIGN: Cross-sectional mailed survey SETTING: Hawaii PARTICIPANTS: Seventh and eighth grade health teachers INTERVENTIONS: Participants were surveyed regarding the content, quality, and influences on sex education for the 2007 to 2008 academic year. MAIN OUTCOME MEASURES: Measures of association (chi-square, ANOVA) and multiple logistic regression were used to determine predictors for teaching comprehensive sex education topics including sexually transmitted infections and pregnancy prevention. RESULTS: Approximately 80% of teachers incorporated some form of sex education into their curriculum and 54.4% of teachers incorporated a comprehensive education. Teachers indicated that personal values and the availability of curriculum had the greatest influence on the content of the curriculum. Specific factors which were associated with an increased likelihood of providing a comprehensive curriculum included teaching in a public school (public 66.7% versus private 34.6%, P = 0.01), receiving formal training in sex education (received training 77.8% versus did not receive training 50.0%, P = 0.03) and having contact with a student who became pregnant (contact 72.7% versus no contact 46.7%, P = 0.04). CONCLUSION: Although most teachers incorporate some form of sex education, only half incorporate a comprehensive curriculum. Personal values as well as teacher resources play an important role in the content of the curriculum.

Rheumatoid arthritis (RA)-associated HLA-DR alleles form less stable complexes with class II-associated invariant chain peptide than non-RA-associated HLA-DR alleles.

Certain HLA-DR alleles confer strong susceptibility to the autoimmune disease rheumatoid arthritis (RA). We compared RA-associated alleles, HLA-DR*0401, HLA-DR*0404, and HLA-DR*0405, with closely related, non-RA-associated alleles, HLA-DR*0402 and HLA-DR*0403, to determine whether they differ in their interactions with the class II chaperone, invariant chain (Ii). Ii binds to class II molecules in the endoplasmic reticulum, inhibits binding of other ligands, and directs class II-Ii complexes to endosomes, where Ii is degraded to class II-associated Ii peptide (CLIP). To evaluate the interaction of Ii and CLIP with these DR4 alleles, we introduced HLA-DR*0401, *0402, and *0404 alleles into a human B cell line that lacked endogenous HLA-DR or HLA-DM molecules. In a similar experiment, we introduced HLA-DR*0403 and *0405 into an HLA-DM-expressing B cell line, 8.1.6, and its DM-negative derivative, 9.5.3. Surface abundance of DR4-CLIP peptide complexes and their susceptibility to SDS-induced denaturation suggested that the different DR4-CLIP complexes had different stabilities. Pulse-chase experiments showed CLIP dissociated more rapidly from RA-associated DR molecules in B cell lines. In vitro assays using soluble rDR4 molecules showed that DR-CLIP complexes of DR*0401 and DR*0404 were less stable than complexes of DR*0402. Using CLIP peptide variants, we mapped the reduced CLIP interaction of RA-associated alleles to the shared epitope region. The reduced interaction of RA-associated HLA-DR4 molecules with CLIP may contribute to the pathophysiology of autoimmunity in RA.