Science.gov

Sample records for emergent risk factors

  1. Cardiovascular Disease Risk Factors among Emerging Adults in College

    ERIC Educational Resources Information Center

    Abshire, Demetrius Alexander

    2014-01-01

    The purpose of this dissertation was to examine factors associated with cardiovascular disease (CVD) risk among emerging adults in college aged 18-25 years. CVD risks that develop during this period often persist into adulthood making it an ideal time to target CVD prevention. The specific aims of this dissertation were to 1) explore perceptions…

  2. Cardiovascular Disease Risk Factors among Emerging Adults in College

    ERIC Educational Resources Information Center

    Abshire, Demetrius Alexander

    2014-01-01

    The purpose of this dissertation was to examine factors associated with cardiovascular disease (CVD) risk among emerging adults in college aged 18-25 years. CVD risks that develop during this period often persist into adulthood making it an ideal time to target CVD prevention. The specific aims of this dissertation were to 1) explore perceptions…

  3. Emerging risk factors and markers of chronic kidney disease progression.

    PubMed

    Kronenberg, Florian

    2009-12-01

    Chronic kidney disease (CKD) is a common condition with an increasing prevalence. A number of comorbidities are associated with CKD and prognosis is poor, with many patients experiencing disease progression. Recognizing the factors associated with CKD progression enables high-risk patients to be identified and given more intensive treatment if necessary. The identification of new predictive markers might improve our understanding of the pathogenesis and progression of CKD. This Review discusses a number of emerging factors and markers for which epidemiological evidence from prospective studies indicates an association with progression of CKD. The following factors and markers are discussed: asymmetric dimethylarginine, factors involved in calcium-phosphate metabolism, adrenomedullin, A-type natriuretic peptide, N-terminal pro-brain natriuretic peptide, liver-type fatty acid binding protein, kidney injury molecule 1, neutrophil gelatinase-associated lipocalin, apolipoprotein A-IV, adiponectin and some recently identified genetic polymorphisms. Additional epidemiological and experimental data are required before these markers can be broadly used for the prediction of CKD progression and before the risk factors can be considered as potential drug targets in clinical interventional trials.

  4. Emerging Risk Factors and Prevention of Perioperative Pulmonary Complications

    PubMed Central

    2014-01-01

    Modern surgery is faced with the emergence of newer “risk factors” and the challenges associated with identifying and managing these risks in the perioperative period. Obstructive sleep apnea and obesity hypoventilation syndrome pose unique challenges in the perioperative setting. Recent studies have identified some of the specific risks arising from caring for such patients in the surgical setting. While all possible postoperative complications are not yet fully established or understood, the prevention and management of these complications pose even greater challenges. Pulmonary hypertension with its changing epidemiology and novel management strategies is another new disease for the surgeon and the anesthesiologist in the noncardiac surgical setting. Traditionally most such patients were not considered surgical candidates for any required elective surgery. Our review discusses these disease entities which are often undiagnosed before elective noncardiac surgery. PMID:24578647

  5. Risk factors for asthma severity among emergency rooms attendees, Palestine.

    PubMed

    Al Zabadi, Hamzeh; El Sharif, Nuha

    2009-06-01

    Emergency Room of Alia Governmental hospital in Hebron district, south of West Bank, Palestine. To determine the factors associated with chronic asthma severity among asthma patients attending the emergency rooms in Palestine. A cross-sectional study using previously validated questionnaires. Among the 121 patients, 45.5% had moderate/severe asthma. Most days' regular intake of oral theophylline, and using >or=5 courses/year of oral steroids were more likely to be associated with moderate/severe asthmatics (p<0.05). Moderate/severe asthmatics compared with mild asthmatics were more likely to use inhaled short B(2)-agonists more frequently (most days, 50% vs. 17%; p<0.05) and in higher concentrations (>or=1 cannister/month, 78% vs. 29%; p<0.05). They were also more likely to get regular treatment (p<0.05) and to report their inability to afford/obtain asthma medicines (p>0.05). Access to health services doesn't necessarily ensure a good quality of care for asthmatics. The effectiveness of oral theophyline in controlling the more severe asthma symptoms should be reconsidered. We recommend a training program for health professionals and an educational one on self-management for the asthma patients.

  6. Risk Factors of Emergence Agitation in Adults Undergoing General Anesthesia for Nasal Surgery

    PubMed Central

    Kim, Hyo-Jin; Kim, Hyo-Yeol; Kim, Jin-Kyoung; Choi, Seung-Won

    2015-01-01

    Objectives To identify the incidence and the risk factors of emergence agitation in adults undergoing general anesthesia for nasal surgery. Methods We retrospectively examined 792 patients aged ≥18 years who underwent general anesthesia for elective nasal surgery between July 2012 and August 2013. Patients in the postanesthesia care unit with a Richmond Agitation Sedation Scale≥+1 at any time were considered to have emergence agitation. Results The overall incidence of emergence agitation is 22.2%. From multivariate regression analysis, the following six variables were found to be significantly associated with emergence agitation (P<0.05): younger age, recent smoking, sevoflurane anesthesia, postoperative pain on the numerical rating scale (NRS)≥5, presence of a tracheal tube, and presence of a urinary catheter. Presence of a tracheal tube was the greatest risk factor, increasing the risk of developing emergence agitation by approximately fivefold (odds ratio, 5.448; 95% confidence interval, 2.973 to 9.982). Younger age was also a strong risk factor (odds ratio, 0.975 for each 1-year increase; 95% confidence interval, 0.964 to 0.987). Current smoking, sevoflurane anesthesia, postoperative pain of NRS≥5, and the presence of a urinary catheter nearly doubled the risk of emergence agitation. Conclusion Emergence agitation following general anesthesia is a common complication in adult nasal surgery patients. To reduce the occurrence and consequences of agitation episodes, elimination of the associated risk factors is necessary, especially in at-risk patients. PMID:25729495

  7. Retinal vein occlusion: evaluation of "classic" and "emerging" risk factors and treatment.

    PubMed

    Turello, Marina; Pasca, Samantha; Daminato, Roberto; Dello Russo, Patrizia; Giacomello, Roberta; Venturelli, Ugo; Barillari, Giovanni

    2010-05-01

    Retinal vein occlusion (RVO) is the second most common retinal vein disease and an important cause of blindness and visual morbidity. Systemic risk factors are commonly associated with RVO, while unclear it is the role of the thrombophilic and coagulation disorders. To evaluate "classic" and "emerging" risk factors, and to establish a good treatment for RVO. Fifty patients, 31 males and 19 females, with RVO were selected for our study. RVO patients were divided into two groups: those with central retinal vein occlusion (CRVO) and those with branch retinal vein occlusion (BRVO). All patients were subjected to an anamnestic investigation and were tested for thrombophilia, coagulation disorders and hyperlipidemia. Treatment and prophylaxis were evaluated. We have named "classic" the systemic risk factors associated with RVO and "emerging" those risk factors, haemostasis related, not clearly associated with RVO. RVO occurs more commonly in patients aged over 50. "Emerging" risk factors were more frequent in CRVO, "classic" in BRVO. Hyperhomocysteinemia is the most common "emerging" risk factor related to RVO. 71.4% of tested patients had hypercholesterolemia. Treatment with LMWH would appear to be safe and effective, but the small number of patients considered not allow us a definitive evaluation of its efficacy. Although our study has shown the correlation between RVO and the "emerging" risk factors, more studies are necessary to better know the real role of thrombophilic and coagulation disorders in this disease and to determine a specific protocol for the treatment and prophylaxis of RVO.

  8. Opium; an emerging risk factor for gastric adenocarcinoma

    PubMed Central

    Shakeri, Ramin; Malekzadeh, Reza; Etemadi, Arash; Nasrollahzadeh, Dariush; Aghcheli, Karim; Sotoudeh, Masoud; Islami, Farhad; Pourshams, Akram; Pawlita, Michael; Boffetta, Paolo; Dawsey, Sanford M.; Abnet, Christian C.; Kamangar, Farin

    2013-01-01

    Opium use has been associated with higher risk of cancers of the esophagus, bladder, larynx, and lung; however, no previous study has examined its association with gastric cancer. There is also little information on the associations between hookah (water pipe) smoking or the chewing of tobacco products and the risk of gastric cancer. In a case-control study in Golestan Province of Iran, we enrolled 309 cases of gastric adenocarcinoma (118 noncardia, 161 cardia, and 30 mixed-location adenocarcinomas) and 613 matched controls. Detailed information on long-term use of opium, tobacco products, and other covariates were collected using structured and validated lifestyle and food frequency questionnaires. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were obtained using conditional logistic regression models. Opium use was associated with an increased risk of gastric adenocarcinoma, with an adjusted OR (95% CI) of 3.1 (1.9 – 5.1), and this increased risk was apparent for both anatomic subsites (cardia and noncardia). There was a dose-response effect, and individuals with the highest cumulative opium use had the strongest association (OR: 4.5; 95%CI: 2.3-8.5). We did not find a statistically significant association between the use of any of the tobacco products and risk of gastric adenocarcinoma, overall or by anatomic subsite. We showed, for the first time, an association between opium use and gastric adenocarcinoma. Given that opium use is a traditional practice in many parts of the world, these results are of public health significance. PMID:23319416

  9. Opium: an emerging risk factor for gastric adenocarcinoma.

    PubMed

    Shakeri, Ramin; Malekzadeh, Reza; Etemadi, Arash; Nasrollahzadeh, Dariush; Aghcheli, Karim; Sotoudeh, Masoud; Islami, Farhad; Pourshams, Akram; Pawlita, Michael; Boffetta, Paolo; Dawsey, Sanford M; Abnet, Christian C; Kamangar, Farin

    2013-07-15

    Opium use has been associated with higher risk of cancers of the esophagus, bladder, larynx, and lung; however, no previous study has examined its association with gastric cancer. There is also little information on the associations between hookah (water pipe) smoking or the chewing of tobacco products and the risk of gastric cancer. In a case-control study in Golestan Province of Iran, we enrolled 309 cases of gastric adenocarcinoma (118 noncardia, 161 cardia and 30 mixed-location adenocarcinomas) and 613 matched controls. Detailed information on long-term use of opium, tobacco products and other covariates were collected using structured and validated lifestyle and food frequency questionnaires. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were obtained using conditional logistic regression models. Opium use was associated with an increased risk of gastric adenocarcinoma, with an adjusted OR (95% CI) of 3.1 (1.9-5.1), and this increased risk was apparent for both anatomic subsites (cardia and noncardia). There was a dose-response effect, and individuals with the highest cumulative opium use had the strongest association (OR: 4.5; 95% CI: 2.3-8.5). We did not find a statistically significant association between the use of any of the tobacco products and risk of gastric adenocarcinoma, overall or by anatomic subsite. We showed, for the first time, an association between opium use and gastric adenocarcinoma. Given that opium use is a traditional practice in many parts of the world, these results are of public health significance.

  10. Oxidized LDL, lipoprotein (a) and other emergent risk factors in acute myocardial infarction (FORTIAM study).

    PubMed

    Gómez, Miquel; Valle, Vicente; Arós, Fernando; Sanz, Ginés; Sala, Joan; Fiol, Miquel; Bruguera, Jordi; Elosua, Roberto; Molina, Lluís; Martí, Helena; Covas, M Isabel; Rodríguez-Llorián, Andrés; Fitó, Montserrat; Suárez-Pinilla, Miguel A; Amezaga, Rocío; Marrugat, Jaume

    2009-04-01

    To determine the prevalence of acute myocardial infarction (AMI) without classical risk factors, and to ascertain whether affected patients exhibit a higher prevalence of emergent risk factors and whether the presence of specific emergent risk factors influence prognosis at 6 months. The FORTIAM (Factores Ocultos de Riesgo Tras un Infarto Agudo de Miocardio) study is a multicenter cohort study that includes 1371 AMI patients who were admitted within 24 hours of symptom onset. Strict definitions were used for classical risk factors and the concentrations of the following markers were determined: lipoprotein (a) [Lp(a)], oxidized low-density lipoprotein (oxLDL), high-sensitivity C-reactive protein, fibrinogen, homocysteine and antibody to Chlamydia. The end-points observed during the 6-month follow-up were death, angina and re-infarction. The prevalence of AMI without classical risk factors was 8.0%. The absence of classical risk factors did not affect the 6-month prognosis. The only emergent risk factors independently associated with a poorer prognosis were the Lp(a) and oxLDL concentrations. Cut-points were determined using smoothing splines: 60 mg/ dL for Lp(a) and 74 U/L for oxLDL. The associated hazard ratios, adjusted for age, sex and classical risk factors, were 1.40 (95% confidence interval, 1.06-1.84 ) and 1.48 (95% confidence interval, 1.06-2.06), respectively. The proportion of AMI patients without classical risk factors was low and their prognosis was similar to that in other AMI patients. Both oxLDL and Lp(a) concentrations were independently associated with a poorer 6-month prognosis, irrespective of the presence of classical risk factors.

  11. Opium use: an emerging risk factor for cancer?

    PubMed

    Kamangar, Farin; Shakeri, Ramin; Malekzadeh, Reza; Islami, Farhad

    2014-02-01

    An estimated 16·5 million people worldwide illicitly use opiates, of whom 4 million use raw opium. We did a systematic review to investigate the association between opium use and cancer incidence and mortality. Opium use was associated with an increased risk of cancers of the oesophagus, stomach, larynx, lung, and urinary bladder. Although the present evidence suggests that these associations are possibly causal, further epidemiological studies (particularly prospective studies that collect detailed data about lifetime opium use and control for a broad range of potential confounders) are needed.

  12. Worker, workplace, and community/environmental risk factors for workplace violence in emergency departments.

    PubMed

    Gillespie, Gordon Lee; Pekar, Bunnany; Byczkowski, Terri L; Fisher, Bonnie S

    2017-03-04

    Workplace violence committed by patients and visitors has high propensity to occur against emergency department employees. This article reports the association of worker, workplace, and community/environmental factors with violence risks. A cross-sectional research design was used with 280 employees from six emergency departments in the Midwest United States. Respondents completed the Survey of Violence Experienced by Staff and a 10-item demographic questionnaire. Data were analyzed using frequencies, percentages, Chi-square tests, and adjusted relative risks with 95% confidence intervals. Over 80% of respondents experienced at least one type of workplace violence with their current employer and approximately 40% experienced all three types. Risks for workplace violence were significantly higher for registered nurses and hospital-based emergency departments. Workplace violence can impact all employees in the emergency department regardless of worker, workplace, and community/environmental factors.

  13. Patients Visiting Multiple Emergency Departments: Patterns, Costs and Risk Factors.

    PubMed

    Lyons, Todd W; Olson, Karen L; Palmer, Nathan P; Horwitz, Reed; Mandl, Kenneth D; Fine, Andrew M

    2017-09-01

    We sought to characterize the population of patients seeking care at multiple EDs and to quantify the proportion of all ED visits and costs accounted for by these patients. We performed a retrospective, cohort study of de-identified insurance claims for privately insured patients with ≥ 1 ED visit between 2010 and 2016. We measured the number of EDs visited by each patient and determined the overall proportion of all ED visits and ED costs accounted for by patients who visit multiple EDs. We identified factors associated with visiting multiple EDs. 8,651,716 patients made 16,390,676 ED visits over the study period, accounting for $26,102,831,740 in ED costs. A significant minority (20.5%) of patients visited more than one ED over the study period. However, these patients accounted for a disproportionate amount of all ED visits (41.4%) and all ED costs (39.2%). A small proportion (0.4%) of patients visited 5 of more EDs but accounted for 2.8% of ED visits and costs. Among patients with two ED visits within 30-days, 32% were to different EDs. Having at least one ED visit for mental health or substance abuse related diagnosis was associated with increased odds of visiting multiple EDs. A substantial minority of patients visit multiple EDs, but account for a disproportionate burden of overall ED utilization and costs. Future work should evaluate the impact of visiting multiple EDs on care utilization and outcomes and explore systems for improving access to patient records across care centers. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  14. Pediatric Emergency Department Return: A Literature Review of Risk Factors and Interventions.

    PubMed

    Tran, Quincy Khoi; Bayram, Jamil D; Boonyasai, Romsai T; Case, Meredith A; Connor, Christine; Doggett, David; Fawole, Oluwakemi A; Ijagbemi, O Mayowa; Levin, Scott; Wu, Albert W; Pham, Julius Cuong

    2016-08-01

    Children discharged from emergency departments (EDs) are often at risk for ED return. The objective was to identify risk factors and interventions to mitigate or prevent ED return among this patient population. Structured literature review of PubMed and clinicaltrials.gov was conducted to identify relevant studies. Inclusion criteria were studies evaluating ED returns by identifying risk factors and interventions in the pediatric population. Emergency department return was defined as returning to the ED within 1 year after initial visit. Abstract and full text articles were reviewed, and data were abstracted by 2 independent authors. A total of 963 articles were screened and yielded 42 potential relevant articles involving pediatric population. After full text review, a total of 12 articles were included in the final analysis (6 on risk factors and 6 on interventions). Risk factors for pediatric ED return included behavioral/psychiatric problems, younger age, acuity of illness, medical history of asthma, and social factors. Interventions included computer-generated instructions, postdischarge telephone coaching, ED-made appointments, case management, and home environment intervention. Emergency department-made appointments and postdischarge telephone coaching plus monetary incentive improved outpatient follow-up rate but not ED return. Home environment assessment coupled with case management reduced ED returns specifically among asthma patients. Several patient and visit characteristics can help predict children at risk for ED return. Although some interventions are successful at improving postdischarge follow-up, most did not reduce ED returns.

  15. Identifying Factors Associated with Risk Assessment Competencies of Public Health Emergency Responders

    PubMed Central

    Hao, Jiejing; Ren, Jiaojiao; Wu, Qunhong; Hao, Yanhua; Sun, Hong; Ning, Ning; Ding, Ding

    2017-01-01

    This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as “relatively low”, contrasting with 21.4% rated as “relatively high”. Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders. PMID:28587226

  16. Identifying Factors Associated with Risk Assessment Competencies of Public Health Emergency Responders.

    PubMed

    Hao, Jiejing; Ren, Jiaojiao; Wu, Qunhong; Hao, Yanhua; Sun, Hong; Ning, Ning; Ding, Ding

    2017-06-04

    This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as "relatively low", contrasting with 21.4% rated as "relatively high". Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders.

  17. Assessment of risk factors for emergence distress and postoperative behavioural changes in children following general anaesthesia.

    PubMed

    Tripi, Paul A; Palermo, Tonya Mizell; Thomas, Susan; Goldfinger, Mark M; Florentino-Pineda, Ivan

    2004-03-01

    Emergence distress commonly occurs in children recovering from the immediate effects of general anaesthesia. This study was performed to (1) examine whether parental presence in the operating room during emergence from anaesthesia reduces the incidence or severity of emergence distress behaviour, and (2) assess psychosocial risk factors, including child temperament and sleep behaviour, for development of emergence distress. A randomized and controlled trial of parental presence at emergence was conducted in 100 ASA class I and II children having general anaesthesia for inguinal or penile surgery. Children in the study group had a parent present at induction and emergence of anaesthesia, while children in the control group had a parent present only at induction. Emergence and postanaesthesia care unit (PACU) behaviour was monitored using both the Operating Room Behaviour Rating Scale (ORBRS) and a 7-point Likert type cooperation scale. One-way anovas showed no significant differences between the control group and the study group on emergence distress behaviour. The frequency of negative postoperative behavioural changes at 1 and 4 weeks postsurgery was low in both groups. Children described as clingy/dependent (chi2 = 5.57, P < 0.06) and children with frequent temper tantrums (chi2 = 7.44, P < 0.02) were more likely to have emergence distress behaviour. Parental presence during emergence from anesthesia did not decrease the incidence or severity of emergence distress behaviour in children. Young children and children with a history of temper tantrums or separation anxiety may be more likely to develop such behaviour.

  18. Review of risk and protective factors of substance use and problem use in emerging adulthood.

    PubMed

    Stone, Andrea L; Becker, Linda G; Huber, Alice M; Catalano, Richard F

    2012-07-01

    This review examines the evidence for longitudinal predictors of substance use and abuse in emerging adulthood. Nationally representative data from the 2007 National Survey on Drug use and Health suggest that many substance use problems reach their peak prevalence during emerging adulthood (usually defined as the period from age 18 to age 26). This stage of development is characterized by rapid transitions into new social contexts that involve greater freedom and less social control than experienced during adolescence. Concurrent with this newfound independence is an increase in rates of substance use and abuse. Understanding the risk and protective factors associated with emerging adult substance use problems is an important step in developing interventions targeting those problems. While multiple reviews have examined risk and protective factors for substance use during adolescence, and many of these earlier predictors may predict emerging adult substance use, few studies have focused primarily on the emerging adult outcomes examining predictors from both adolescence and emerging adulthood. This review used the databases PubMed and PsycInfo to identify articles pertaining to longitudinal predictors of substance use problems in emerging adulthood, building from the conceptual framework presented in a review on risk and protective factors for adolescent substance abuse by Hawkins and colleagues (Hawkins, Catalano, & Miller, 1992). Predictors identified as predictors of substance use in adolescence, sometimes decreased in strength and in one case reversed direction. Unique predictors in emerging adulthood were also identified. Implications for prevention science during adolescence and emerging adulthood are discussed as well as suggestions for future research.

  19. A Person-Centered Analysis of Risk Factors that Compromise Wellbeing in Emerging Adulthood.

    PubMed

    Newcomb-Anjo, Sarah E; Barker, Erin T; Howard, Andrea L

    2016-11-08

    The transition to adulthood is a major life course transition that can pose risk to wellbeing. Research is needed to identify patterns of risk for compromised wellbeing, in order to best identify supports for individuals during this potentially vulnerable transition. The purpose of this study was to identify profiles of risk in an emerging adulthood sample, and to relate these profiles to mental health and subjective and academic wellbeing. Undergraduate emerging adults (N = 903, 82 % female), aged 18-25 years (M = 21.14, SD = 1.75), completed a series of questionnaires about risk factors, mental health, and academic variables. Results from a latent profile analysis identified four distinct risk profiles: Low Risk (76 %), Low Social Support Risk (4 %), Financial Risk (11 %), and Multiple Risk (8 %). The risk profiles were subsequently related to mental health and subjective and academic wellbeing outcomes, using a pseudo-class draws approach. Analyses indicated that the risk-pattern profiles differed in several ways across outcomes. Implications for targeted interventions are discussed.

  20. The fibroblast growth factor-23 and Vitamin D emerge as nontraditional risk factors and may affect cardiovascular risk.

    PubMed

    Masson, S; Agabiti, N; Vago, T; Miceli, M; Mayer, F; Letizia, T; Wienhues-Thelen, U; Mureddu, G F; Davoli, M; Boccanelli, A; Latini, R

    2015-03-01

    Fibroblast growth factor-23 (FGF-23) and vitamin D are hormones involved in phosphate homoeostasis. They also directly influence cardiomyocyte hypertrophy. We examined whether the relationships between levels of vitamin D or FGF-23, cardiac phenotype and outcome were independent of established cardiac biomarkers in a large cohort of community-dwelling elderly subjects. Plasma levels of FGF-23 and vitamin D were measured in 1851 men and women (65-84 years) resident in the Lazio region of Italy. Participants were referred to eight cardiology centres for clinical examination, electrocardiography, comprehensive Doppler echocardiography and blood sampling. All-cause mortality or hospitalizations were available after a median follow-up of 47 months with record linkage of administrative data. Vitamin D deficiency (<20 ng mL(-1) ) was found in 72.3% of subjects, but FGF-23 levels were normal [74 (58-97) RU per mL]. After adjustment for cardiovascular risk factors and morbidities, low concentrations of vitamin D and high levels of FGF-23 were associated with a higher left ventricular (LV) mass index. Levels of FGF-23 [hazard ratio (HR) (95% confidence interval (CI)) 1.71 (1.28-2.28), P < 0.0001] but not vitamin D [0.76 (0.57-1.01), P = 0.08] were independently associated with mortality after adjustment for clinical risk factors and two cardiac markers together (N-terminal pro-brain natriuretic peptide and high-sensitivity cardiac troponin T), but did not predict hospital admission. People with above median values of FGF-23 and below median values of vitamin D had greater LV hypertrophy and higher mortality. In community-dwelling elderly individuals with highly prevalent vitamin D deficiency, FGF-23 levels were associated with LV hypertrophy and predicted mortality independently of two robust cardiac biomarkers. A causal relationship was not demonstrated, but the hormones involved in mineral metabolism emerged as nontraditional risk factors and may affect cardiovascular risk

  1. Vulnerability and social justice as factors in emergent U.S. nanotechnology risk perceptions.

    PubMed

    Conti, Joseph; Satterfield, Terre; Harthorn, Barbara Herr

    2011-11-01

    As an emerging domain of risk research, nanotechnologies engender novel research questions, including how new technologies are encountered given different framing and contextual detail. Using data from a recent U.S. national survey of perceived risks (N= 1,100), risk versus benefit framings and the specific social positions from which people encounter or perceive new technologies are explored. Results indicate that vulnerability and attitudes toward environmental justice significantly influenced risk perceptions of nanotechnology as a broad class, while controlling for demographic and affective factors. Comparative analyses of different examples of nanotechnology applications demonstrated heightened ambivalence across acceptability when risk versus benefit information was provided with application descriptions (described in short vignettes as compared to the general category "nanotechnology," absent of risk or benefit information). The acceptability of these nano-specific vignettes varied significantly in only some cases given indexes of vulnerability and attitudes toward environmental justice. However, experimental narrative analyses, using longer, more comprehensive descriptive passages, show how assessments of risks and benefits are tied to the systematically manipulated psychometric qualities of the application (its invasiveness and controllability), risk messaging from scientists, and the social implications of the technology with regard to justice. The article concludes with discussion of these findings for risk perception research and public policy related to nanotechnology and possibly other emerging technologies. © 2011 Society for Risk Analysis.

  2. Unemployment and Depression Among Emerging Adults in 12 States, Behavioral Risk Factor Surveillance System, 2010

    PubMed Central

    Thompson, Nancy J.

    2015-01-01

    Introduction The high rate of unemployment among emerging adults (aged 18 to 25 years) is a public health concern. The risk of depression is higher among the unemployed than among the employed, but little is known about the relationship between unemployment and mental health among emerging adults. This secondary data analysis assessed the relationship between unemployment and depression among emerging adults. Methods Data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. Responses to the Patient Health Questionnaire-8 provided data about the prevalence of depression. Bivariate relationships were assessed using χ2 tests, and multivariable adjusted odds ratios were calculated with logistic regressions. Sociodemographic variables were sex, race/ethnicity, marital status, and education. In addition, logistic regression models adjusted for health insurance status, disability, smoking, and body mass index. The analyses were completed using SAS 9.3 survey procedures to account for the complex sampling design. Results Almost 12% of emerging adults were depressed (PHQ-8 ≥10) and about 23% were unemployed. Significantly more unemployed than employed emerging adults were classified with depression. In the final model, the odds of depression were about 3 times higher for unemployed than employed emerging adults. Conclusion The relationship between unemployment and depression is significant among emerging adults. With high rates of unemployment for this age group, this population may benefit from employment- and mental-health–focused interventions. PMID:25789499

  3. Unemployment and depression among emerging adults in 12 states, Behavioral Risk Factor Surveillance System, 2010.

    PubMed

    McGee, Robin E; Thompson, Nancy J

    2015-03-19

    The high rate of unemployment among emerging adults (aged 18 to 25 years) is a public health concern. The risk of depression is higher among the unemployed than among the employed, but little is known about the relationship between unemployment and mental health among emerging adults. This secondary data analysis assessed the relationship between unemployment and depression among emerging adults. Data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. Responses to the Patient Health Questionnaire-8 provided data about the prevalence of depression. Bivariate relationships were assessed using χ(2) tests, and multivariable adjusted odds ratios were calculated with logistic regressions. Sociodemographic variables were sex, race/ethnicity, marital status, and education. In addition, logistic regression models adjusted for health insurance status, disability, smoking, and body mass index. The analyses were completed using SAS 9.3 survey procedures to account for the complex sampling design. Almost 12% of emerging adults were depressed (PHQ-8 ≥10) and about 23% were unemployed. Significantly more unemployed than employed emerging adults were classified with depression. In the final model, the odds of depression were about 3 times higher for unemployed than employed emerging adults. The relationship between unemployment and depression is significant among emerging adults. With high rates of unemployment for this age group, this population may benefit from employment- and mental-health-focused interventions.

  4. Review and Meta-analysis of Emerging Risk Factors for Agricultural Injury.

    PubMed

    Jadhav, Rohan; Achutan, Chandran; Haynatzki, Gleb; Rajaram, Shireen; Rautiainen, Risto

    2016-01-01

    Agricultural injury is a significant public health problem globally. Extensive research has addressed this problem, and a growing number of risk factors have been reported. The authors evaluated the evidence for frequently reported risk factors earlier. The objective in the current study was to identify emerging risk factors for agricultural injury and calculate pooled estimates for factors that were assessed in two or more studies. A total of 441 (PubMed) and 285 (Google Scholar) studies were identified focusing on occupational injuries in agriculture. From these, 39 studies reported point estimates of risk factors for injury; 38 of them passed the Newcastle-Ottawa criteria for quality and were selected for the systematic review and meta-analysis. Several risk factors were significantly associated with injury in the meta-analysis. These included older age (vs. younger), education up to high school or higher (vs. lower), non-Caucasian race (vs. Caucasian), Finnish language (vs. Swedish), residence on-farm (vs. off-farm), sleeping less than 7-7.5 hours (vs. more), high perceived injury risk (vs. low), challenging social conditions (vs. normal), greater farm sales, size, income, and number of employees on the farm (vs. smaller), animal production (vs. other production), unsafe practices conducted (vs. not), computer use (vs. not), dermal exposure to pesticides and/or chemicals (vs. not), high cooperation between farms (vs. not), and machinery condition fair/poor (vs. excellent/good). Eighteen of the 25 risk factors were significant in the meta-analysis. The identified risk factors should be considered when designing interventions and selecting populations at high risk of injury.

  5. The Emerging Epidemic of Cardiovascular Risk Factors and Atherosclerotic Disease in Developing Countries.

    PubMed

    Teo, Koon K; Dokainish, Hisham

    2017-03-01

    Cardiovascular disease (CVD) and its risk factors, which are major health burdens in high-income countries, are a growing problem in developing or lower-income countries, where the vast majority of CVD now occurs. Two case-control studies, INTERHEART and INTERSTROKE, which included a majority of patients from developing countries, were seminal in identifying common risk factors explaining the vast majority of risk for acute myocardial infarction and stroke, respectively. The population-based Prospective Urban and Rural Epidemiological (PURE) study, which included > 150,000 participants, also with a majority from developing countries, found that although high-income countries were at highest cardiovascular (CV) risk, they had the lowest incidence of CVD and associated case-fatality rates, whereas patients in low-income countries had the lowest CV risk and yet the highest CVD and case-fatality rates. The PURE study also demonstrated relatively low rates of CV medicine use in high- and middle-income countries, but even lower rates in low-income countries, where these medicines were often either unavailable or unaffordable. The PURE study also demonstrated that control of CV risk factors and adherence to lifestyle modifications, although suboptimal globally, were poorest in low-income countries. Taken together, these data identify common CV risk factors requiring targeted, systematic, sustained, and effective interventions in developing countries to mitigate the emerging epidemic of CVD in these regions of the world. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  6. Risk Factors of Contrast-induced Acute Kidney Injury in Patients Undergoing Emergency Percutaneous Coronary Intervention

    PubMed Central

    Yuan, Ying; Qiu, Hong; Hu, Xiao-Ying; Luo, Tong; Gao, Xiao-Jin; Zhao, Xue-Yan; Zhang, Jun; Wu, Yuan; Yan, Hong-Bing; Qiao, Shu-Bin; Yang, Yue-Jin; Gao, Run-Lin

    2017-01-01

    Background: Previous studies of contrast-induced acute kidney injury (CI-AKI) were mostly based on selective percutaneous coronary intervention (PCI) cases, and risk factors of CI-AKI after emergency PCI are unclear. The aim of this study was to explore the risk factors of CI-AKI in a Chinese population undergoing emergency PCI. Methods: A total of 1061 consecutive patients undergoing emergency PCI during January 2013 and June 2015 were enrolled and divided into CI-AKI and non-CI-AKI group. Univariable and multivariable analyses were used to identify the risk factors of CI-AKI in emergency PCI patients. CI-AKI was defined as an increase in serum creatinine ≥25% or ≥0.5 mg/dl (44.2 μmol/L) above baseline within 3 days after exposure to contrast medium. Results: The incidence of CI-AKI in patients undergoing emergency PCI was 22.7% (241/1061). Logistic multivariable analysis showed that body surface area (BSA) (odds ratio [OR] 0.213, 95% confidence interval [CI]: 0.075–0.607, P = 0.004), history of myocardial infarction (MI) (OR 1.642, 95% CI: 1.079–2.499, P = 0.021), left ventricular ejection fraction (LVEF) (OR 0.969, 95% CI: 0.944–0.994, P = 0.015), hemoglobin (Hb) (OR 0.988, 95% CI: 0.976–1.000, P = 0.045), estimated glomerular filtration rate (OR 1.027, 95% CI: 1.018–1.037, P < 0.001), left anterior descending (LAD) stented (OR 1.464, 95% CI: 1.000–2.145, P = 0.050), aspirin (OR 0.097, 95%CI: 0.009–0.987, P = 0.049), and diuretics use (OR 1.850, 95% CI: 1.233–2.777, P = 0.003) were independent predictors of CI-AKI in patients undergoing emergency PCI. Conclusion: History of MI, low BSA, LVEF and Hb level, LAD stented, and diuretics use are associated with increased risk of CI-AKI in patients undergoing emergency PCI. PMID:28051022

  7. Organisational failures in urgent and emergency surgery. A potential peri-operative risk factor.

    PubMed

    Pearse, R M; Dana, E C; Lanigan, C J; Pook, J A

    2001-07-01

    Medical error is an important cause of morbidity and mortality. Organisational failure in the pre-operative period has been associated with catastrophic outcome. Little information is available regarding peri-operative organisational problems. The incidence and nature of organisational failure before urgent and emergency surgery in a district general hospital was studied prospectively in 159 cases over a 30-day period. Organisational failure affected more than half of the cases overall, but varied in both its incidence and its complexity between surgical disciplines. Various causative factors were identified, e.g. 8% of cases were subject to delay due to clinical emergencies. The median [range] time required to rectify the problems was 115 [5-750] min. A consultant anaesthetist and surgeon were present in 30 and 20% of cases, respectively. Difficulty with the preparation of patients for emergency surgery is an important but underevaluated cause of medical error that may put patients at risk.

  8. A qualitative study of health problems, risk factors, and prevention among Emergency Medical Service workers.

    PubMed

    Dropkin, Jonathan; Moline, Jacqueline; Power, Paul M; Kim, Hyun

    2015-01-01

    Risk factors among Emergency Medical Service (EMS) workers are difficult to characterize and inconsistencies remain about their main health problems. To identify main work-related health problems among EMS workers in the United States; identify risk factors at the organizational, task, and exposure level; identify prevention strategies; examine these issues between participants (EMS workers and supervisors). Two types of qualitative research methods based on grounded theory were used: in-depth interviews with emergency medical technicians/paramedics (EMS workers) and focus groups (EMS workers and supervisors). Most participants reported similar health problems (musculoskeletal injuries) and the task related to these injuries, patient handling. Participants also reported similar physical exposures (ascending stairs with patients and patient weight). For organization/psychosocial factors, participants agreed that fitness, wages, breaks, and shift scheduling were linked with injuries, but overall, perceptions about these issues differed more than physical exposures. Lack of trust between EMS workers and supervisors were recurrent concerns among workers. However, not all organizational/psychosocial factors differed. EMS workers and supervisors agreed pre-employment screening could reduce injuries. Participants identified micro- and macro-level prevention opportunities. The grounded theory approach identified workers' main health problems, and the organizational factors and exposures linked with them. Perceptions about work organization/psychosocial exposures appeared more diverse than physical exposures. Prevention among all participants focused on mechanized equipment, but EMS workers also wanted more organizational support.

  9. Potential links between the emerging risk factors for food allergy and vitamin D status.

    PubMed

    Vuillermin, P J; Ponsonby, A-L; Kemp, A S; Allen, K J

    2013-06-01

    A variety of hypotheses have been proposed to explain the recently described increase in food allergy among children living in developed countries. In this study, we summarize the emerging risk factors for IgE-mediated food allergy in early life, and then review the evidence for and against an association between low vitamin status (VDS) and food allergy. We consider whether each of the epidemiological variables that have been associated with food allergy may also be associated with VDS; and argue that future studies must adequately account for the potential relationships between risk factors for food allergy and VDS, and must also discriminate between vitamin D derived by sun exposure, diet and oral supplementation. © 2012 John Wiley & Sons Ltd.

  10. Homelessness: patterns of emergency department use and risk factors for re-presentation.

    PubMed

    Moore, G; Gerdtz, M F; Hepworth, G; Manias, E

    2011-05-01

    To describe patterns of service use and to predict risk factors for re-presentation to a metropolitan emergency department (ED) among people who are homeless. A retrospective cohort analysis was undertaken over a 24-month period from a principal referral hospital in Melbourne, Australia. All ED visits relating to people classified as homeless were included. A predictive model for risk of re-presentation was developed using logistic regression with random effects. Rates of re-presentation, defined as the total number of visits to the same ED within 28 days of discharge, were measured. The study period was 1 January 2003 to 31 December 2004. The re-presentation rate for homeless people was 47.8% (3199/6689) of ED visits and 45.5% (725/1595) of the patients. The final predictive model included risk factors, which incorporated both hospital and community service use. Those characteristics that resulted in significantly increased odds of re-presentation were leaving hospital at own risk (OR 1.31; 95% CI 1.10 to 1.56), treatment in another hospital (OR 1.45, 95% CI 1.23 to 1.72) and being in receipt of community-based case management (OR 1.31, 95% CI 1.11 to 1.54) or pension (OR 1.34, 95% CI 1.12 to 1.62). The predictive model identified nine risk factors of re-presentation to the ED for people who are homeless. Early identification of these factors among homeless people may alert clinicians to the complexity of issues influencing an individual ED visit. This information can be used at admission and discharge by ensuring that homeless people have access to services commensurate with their health needs. Improved linkage between community and hospital services must be underscored by the capacity to provide safe and secure housing.

  11. [Hyponatremia on admission to the emergency room as a risk factor for hospital mortality].

    PubMed

    Vega, Jorge; Manríquez, Francisco; Madrid, Eva; Goecke, Helmuth; Carrasco, Alejandra; Martínez, Gonzalo; Joyas, Alejandro; Rojas, Fernando; Salinas, Julio; Borja, Hernán

    2011-08-01

    Patients who develop hyponatremia during their hospitalization have higher hospital mortality. To determine if the presence of hyponatremia on admission to the emergency room is a risk factor for hospital mortality. Two hundred forty five patients consecutively admitted to the emergency room and then transferred to the Medicine Department, where they finally died, were matched for age and gender with 245 control subjects admitted to the emergency room and hospitalized in the Medicine Department at the same time, but survived. The dependent variable was death, and the exposure variable was hyponatremia. Admission diagnosis and Charlson comorbidity index was considered as confounding variables. Hyponatremia at admission occurred in 30 and 17% of patients who died and survived, respectively, rendering an adjusted odds ratio for death of 2.13 (95% confidence intervals = 1.27-3.57). Charlson Comorbidity Index according to age score was higher in subjects with hyponatremia compared to those without hyponatremia (8.1 ± 3.1 and 7.2 ± 2.8; p = 0.01). Multivariate analysis showed that age, gender, length of stay, cause of hospitalization and chronic diseases did not significantly modify the effect of hyponatremia on hospital mortality. Hyponatremia on admission at emergency room had a significant association with hospital mortality. Subjects with hyponatremia had a higher Charlson Comorbidity Index score.

  12. POST Traumatic Stress Disorder in Emergency Workers: Risk Factors and Treatment

    NASA Astrophysics Data System (ADS)

    Argentero, Piergiorgio; Dell'Olivo, Bianca; Setti, Ilaria

    Post traumatic stress disorder (PTSD) are emergent phenomena resulting from exposure to a traumatic event that causes actual or threatened death or injury and produces intense fear, helplessness, or horror. In order to assess the role of different factors contributing to this kind of emergent phenomenon prevalence rates across gender, cultures, and samples exposed to different traumas are examined. Risk factors for PTSD, including pre-existing individual-based factors, features of the traumatic event, and post-trauma interventions are examined as well. Several characteristics of the trauma, related to cognitions, post-trauma social support and therapeutic interventions for PTSD are also considered. Further work is needed in order to analyze the inter-relationships among these factors and underlying mechanisms. The chaotic nature of traumatic processes, the multiple and interactive impacts on traumatic events require a comprehensive perspective aimed at planning effective interventions. Treatment outcome studies recommended the combined use of training and therapies as first-line treatment for PTSD.

  13. Alcohol Use as Risk Factors for Older Adults’ Emergency Department Visits: A Latent Class Analysis

    PubMed Central

    Choi, Namkee G.; Marti, C. Nate Nathan; DiNitto, Diana M.; Choi, Bryan Y.

    2015-01-01

    Introduction Late middle-aged and older adults’ share of emergency department (ED) visits is increasing more than other age groups. ED visits by individuals with substance-related problems are also increasing. This paper was intended to identify subgroups of individuals aged 50+ by their risk for ED visits by examining their health/mental health status and alcohol use patterns. Methods Data came from the 2013 National Health Interview Survey’s Sample Adult file (n=15,713). Following descriptive analysis of sample characteristics by alcohol use patterns, latent class analysis (LCA) modeling was fit using alcohol use pattern (lifetime abstainers, ex-drinkers, current infrequent/light/moderate drinkers, and current heavy drinkers), chronic health and mental health status, and past-year ED visits as indicators. Results LCA identified a four-class model. All members of Class 1 (35% of the sample; lowest-risk group) were infrequent/light/moderate drinkers and exhibited the lowest probabilities of chronic health/mental health problems; Class 2 (21%; low-risk group) consisted entirely of lifetime abstainers and, despite being the oldest group, exhibited low probabilities of health/mental health problems; Class 3 (37%; moderate-risk group) was evenly divided between ex-drinkers and heavy drinkers; and Class 4 (7%; high-risk group) included all four groups of drinkers but more ex-drinkers. In addition, Class 4 had the highest probabilities of chronic health/mental problems, unhealthy behaviors, and repeat ED visits, with the highest proportion of Blacks and the lowest proportions of college graduates and employed persons, indicating significant roles of these risk factors. Conclusion Alcohol nonuse/use (and quantity of use) and chronic health conditions are significant contributors to varying levels of ED visit risk. Clinicians need to help heavy-drinking older adults reduce unhealthy alcohol consumption and help both heavy drinkers and ex-drinkers improve chronic

  14. Alcohol Use as Risk Factors for Older Adults' Emergency Department Visits: A Latent Class Analysis.

    PubMed

    Choi, Namkee G; Marti, C Nate Nathan; DiNitto, Diana M; Choi, Bryan Y

    2015-12-01

    Late middle-aged and older adults' share of emergency department (ED) visits is increasing more than other age groups. ED visits by individuals with substance-related problems are also increasing. This paper was intended to identify subgroups of individuals aged 50+ by their risk for ED visits by examining their health/mental health status and alcohol use patterns. Data came from the 2013 National Health Interview Survey's Sample Adult file (n=15,713). Following descriptive analysis of sample characteristics by alcohol use patterns, latent class analysis (LCA) modeling was fit using alcohol use pattern (lifetime abstainers, ex-drinkers, current infrequent/light/moderate drinkers, and current heavy drinkers), chronic health and mental health status, and past-year ED visits as indicators. LCA identified a four-class model. All members of Class 1 (35% of the sample; lowest-risk group) were infrequent/light/moderate drinkers and exhibited the lowest probabilities of chronic health/mental health problems; Class 2 (21%; low-risk group) consisted entirely of lifetime abstainers and, despite being the oldest group, exhibited low probabilities of health/mental health problems; Class 3 (37%; moderate-risk group) was evenly divided between ex-drinkers and heavy drinkers; and Class 4 (7%; high-risk group) included all four groups of drinkers but more ex-drinkers. In addition, Class 4 had the highest probabilities of chronic health/mental problems, unhealthy behaviors, and repeat ED visits, with the highest proportion of Blacks and the lowest proportions of college graduates and employed persons, indicating significant roles of these risk factors. Alcohol nonuse/use (and quantity of use) and chronic health conditions are significant contributors to varying levels of ED visit risk. Clinicians need to help heavy-drinking older adults reduce unhealthy alcohol consumption and help both heavy drinkers and ex-drinkers improve chronic illnesses self-management.

  15. Postoperative Delirium after elective and emergency surgery: analysis and checking of risk factors. A study protocol

    PubMed Central

    Agnoletti, Vanni; Ansaloni, Luca; Catena, Fausto; Chattat, Rabbih; De Cataldis, Angelo; Di Nino, Gianfranco; Franceschi, Claudio; Gagliardi, Stefano; Melotti, Rita Maria; Potalivo, Antonella; Taffurelli, Mario

    2005-01-01

    Background Delirum is common in hospitalized elderly patients and may be associated with increased morbidity, length of stay and patient care costs. Delirium (acute confusional state) is defined as an acute disorder of attention and cognition. In elderly patients, delirium is often an early indicator of patho-physiological disturbances. Despite landmark studies dating back to the 1940s, the pathogenesis of Delirium remains poorly understood. Early investigators noted that Delirium was characterized by global cortical dysfunction that was associated predominantly with specific electroencephalographic changes. It's important to understand the risk factors and incidence of Delirium. Some of the risk factors are already identified in literature and can be summarized in the word "VINDICATE" which stands for: Vascular, Infections, Nutrition, Drugs, Injury, Cardiac, Autoimmune, Tumors, Endocrine. Aims of this study are: to re-evaluate the above mentioned clinical risk factors, adding some others selected from literature, and to test, as risk factors, a pattern of some genes associated to cognitive dysfunction and inflammation possibly related to postoperative Delirium. Design All patients admitted to our Emergency Unit who are meet our inclusion/exclusion criteria will be recruited. The arising of postoperative Delirium will select incidentally two groups (Delirium/non Delirium) and the forward analysis of correlate risk factors will be performed. As in a typical observational case/control study we will consider all the exposure factors to which our population are submitted towards the outcome (presence of Delirium). Our exposures are the following: ASA, Pain (SVS; VAS), Blood gas analysis (pH; Hb; pO2; pCO2), Residence pharmacological therapy (BDZ; hypnotics; narcotic drugs; alcohol; nitrous derivates), Body temperature, Arterial pressure, Heart frequency, Breath frequency, Na, K, Creatinin, Glicemia, Albumin, Hct, White blood cells, Glasgow Coma Scale (GCS), Cognitive

  16. Risk factors for accident and emergency (A&E) attendance for asthma in inner city children

    PubMed Central

    Forbes, Lindsay; Harvey, Sheila; Newson, Roger; Jarvis, Deborah; Luczynska, Christina; Price, John; Burney, Peter

    2007-01-01

    Background Inner city children make heavy use of accident and emergency (A&E) services for asthma. Developing strategies to reduce this requires a better understanding of the risk factors. Methods A case‐control study was carried out of children with asthma living in south‐east London: 1018 children who attended A&E for asthma over 1 year and 394 children who had not attended A&E for asthma over the previous year. The main risk factors were socioeconomic status, home environment, routine asthma management and parents' psychological responses to and beliefs about the treatment of asthma attacks. Results A&E attendance was more common in children living in poorer households. No associations were found with home environment or with measures of routine asthma care. Children who had attended outpatients were much more likely to attend A&E (odds ratio (OR) 13.17, 95% CI 7.13 to 24.33). Other risk factors included having a parent who reported feeling alone (OR 2.58, 95% CI 1.71 to 3.87) or panic or fear (OR 2.62. 95% CI 1.75 to 3.93) when the child's asthma was worse; and parental belief that the child would be seen more quickly in A&E than at the GP surgery (OR 2.48, 95% CI 1.62 to 3.79). Parental confidence in the GP's ability to treat asthma attacks reduced the risk of attending A&E (OR 0.30, 95% CI 0.17 to 0.54). Conclusions There is no evidence that passive smoking, damp homes or poor routine asthma care explains heavy inner city use of A&E in children with asthma. Reducing A&E use is unlikely to be achieved by improving these, but identifying appropriate settings for treating children with asthma attacks and communicating these effectively may do so. PMID:17456503

  17. Risk Factors for Adverse Events in Emergency Department Procedural Sedation for Children.

    PubMed

    Bhatt, Maala; Johnson, David W; Chan, Jason; Taljaard, Monica; Barrowman, Nick; Farion, Ken J; Ali, Samina; Beno, Suzanne; Dixon, Andrew; McTimoney, C Michelle; Dubrovsky, Alexander Sasha; Sourial, Nadia; Roback, Mark G

    2017-08-21

    Procedural sedation for children undergoing painful procedures is standard practice in emergency departments worldwide. Previous studies of emergency department sedation are limited by their single-center design and are underpowered to identify risk factors for serious adverse events (SAEs), thereby limiting their influence on sedation practice and patient outcomes. To examine the incidence and risk factors associated with sedation-related SAEs. This prospective, multicenter, observational cohort study was conducted in 6 pediatric emergency departments in Canada between July 10, 2010, and February 28, 2015. Children 18 years or younger who received sedation for a painful emergency department procedure were enrolled in the study. Of the 9657 patients eligible for inclusion, 6760 (70.0%) were enrolled and 6295 (65.1%) were included in the final analysis. The primary risk factor was receipt of sedation medication. The secondary risk factors were demographic characteristics, preprocedural medications and fasting status, current or underlying health risks, and procedure type. Four outcomes were examined: SAEs, significant interventions performed in response to an adverse event, oxygen desaturation, and vomiting. Of the 6295 children included in this study, 4190 (66.6%) were male and the mean (SD) age was 8.0 (4.6) years. Adverse events occurred in 736 patients (11.7%; 95% CI, 6.4%-16.9%). Oxygen desaturation (353 patients [5.6%]) and vomiting (328 [5.2%]) were the most common of these adverse events. There were 69 SAEs (1.1%; 95% CI, 0.5%-1.7%), and 86 patients (1.4%; 95% CI, 0.7%-2.1%) had a significant intervention. Use of ketamine hydrochloride alone resulted in the lowest incidence of SAEs (17 [0.4%]) and significant interventions (37 [0.9%]). The incidence of adverse sedation outcomes varied significantly with the type of sedation medication. Compared with ketamine alone, propofol alone (3.7%; odds ratio [OR], 5.6; 95% CI, 2.3-13.1) and the combinations of ketamine

  18. Delirium in older emergency department patients: recognition, risk factors, and psychomotor subtypes.

    PubMed

    Han, Jin H; Zimmerman, Eli E; Cutler, Nathan; Schnelle, John; Morandi, Alessandro; Dittus, Robert S; Storrow, Alan B; Ely, E Wesley

    2009-03-01

    Missing delirium in the emergency department (ED) has been described as a medical error, yet this diagnosis is frequently unrecognized by emergency physicians (EPs). Identifying a subset of patients at high risk for delirium may improve delirium screening compliance by EPs. The authors sought to determine how often delirium is missed in the ED and how often these missed cases are detected by admitting hospital physicians at the time of admission, to identify delirium risk factors in older ED patients, and to characterize delirium by psychomotor subtypes in the ED setting. This cross-sectional study was a convenience sample of patients conducted at a tertiary care, academic ED. English-speaking patients who were 65 years and older and present in the ED for less than 12 hours at the time of enrollment were included. Patients were excluded if they refused consent, were previously enrolled, had severe dementia, were unarousable to verbal stimuli for all delirium assessments, or had incomplete data. Delirium status was determined by using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) administered by trained research assistants (RAs). Recognition of delirium by emergency and hospital physicians was determined from the medical record, blinded to CAM-ICU status. Multivariable logistic regression was used to identify independent delirium risk factors. The Richmond Agitation and Sedation Scale was used to classify delirium by its psychomotor subtypes. Inclusion and exclusion criteria were met in 303 patients, and 25 (8.3%) presented to the ED with delirium. The vast majority (92.0%, 95% confidence interval [CI] = 74.0% to 99.0%) of delirious patients had the hypoactive psychomotor subtype. Of the 25 patients with delirium, 19 (76.0%, 95% CI = 54.9% to 90.6%) were not recognized to be delirious by the EP. Of the 16 admitted delirious patients who were undiagnosed by the EPs, 15 (93.8%, 95% CI = 69.8% to 99.8%) remained unrecognized by the hospital

  19. Risk factors for repeat adverse asthma events in children after visiting an emergency department.

    PubMed

    To, Teresa; Wang, Chengning; Dell, Sharon; Fleming-Carroll, Bonnie; Parkin, Patricia; Scolnik, Dennis; Ungar, Wendy

    2008-01-01

    The aim of this study was to identify risk factors for long-term adverse outcomes in children with asthma after visiting the emergency department (ED). A prospective observational study was conducted at the ED of a pediatric tertiary hospital in Ontario, Canada. Patient outcomes (ie, acute asthma episodes and ED visits) were measured at baseline and at 1- and 6-months post-ED discharge. Time trends in outcomes were assessed using the generalized estimating equations method. Multiple conditional logistic regressions were used to model outcomes at 6 months and examine the impact of drug insurance coverage while adjusting for confounders. Of the 269 children recruited, 81.8% completed both follow-ups. ED use significantly reduced from 39.4% at baseline to 26.8% at 6 months (P < .001), whereas the level of acute asthma episodes remained unchanged. Children with drug insurance coverage were less likely to have acute asthma episodes (adjusted odds ratio [AOR] = 0.36; 95% CI, 0.15-0.85; P < .02) or repeat ED visits (AOR = 0.45; 95% CI, 0.20-0.99; P < .05) at 6 months. Other risk factors for adverse outcomes included previous adverse asthma events and certain asthma triggers (eg, cold/sinus infection). Washing bed linens in hot water weekly was protective against subsequent acute asthma episodes. Our study demonstrated significant improvements in long-term outcomes in children seeking acute care for asthma in the ED. Future efforts remain in targeting the sustainability of improved outcomes beyond 6 months. Risk factors identified can help target vulnerable populations for proper interventions, which may include efforts to maximize insurance coverage for asthma medications and strategies to improve asthma self-management through patient and provider education.

  20. Screening for violence risk factors identifies young adults at risk for return emergency department visit for injury.

    PubMed

    Hankin, Abigail; Wei, Stanley; Foreman, Juron; Houry, Debra

    2014-08-01

    Homicide is the second leading cause of death among youth aged 15-24. Prior cross-sectional studies, in non-healthcare settings, have reported exposure to community violence, peer behavior, and delinquency as risk factors for violent injury. However, longitudinal cohort studies have not been performed to evaluate the temporal or predictive relationship between these risk factors and emergency department (ED) visits for injuries among at-risk youth. The objective was to assess whether self-reported exposure to violence risk factors in young adults can be used to predict future ED visits for injuries over a 1-year period. This prospective cohort study was performed in the ED of a Southeastern US Level I trauma center. Eligible participants were patients aged 18-24, presenting for any chief complaint. We excluded patients if they were critically ill, incarcerated, or could not read English. Initial recruitment occurred over a 6-month period, by a research assistant in the ED for 3-5 days per week, with shifts scheduled such that they included weekends and weekdays, over the hours from 8AM-8PM. At the time of initial contact in the ED, patients were asked to complete a written questionnaire, consisting of previously validated instruments measuring the following risk factors: a) aggression, b) perceived likelihood of violence, c) recent violent behavior, d) peer behavior, e) community exposure to violence, and f) positive future outlook. At 12 months following the initial ED visit, the participants' medical records were reviewed to identify any subsequent ED visits for injury-related complaints. We analyzed data with chi-square and logistic regression analyses. Three hundred thirty-two patients were approached, of whom 300 patients consented. Participants' average age was 21.1 years, with 60.1% female, 86.0% African American. After controlling for participant gender, ethnicity, or injury complaint at time of first visit, return visits for injuries were significantly

  1. Metabolic risk factors in pediatric stone formers: a report from an emerging economy.

    PubMed

    Imran, Kiran; Zafar, Mirza Naqi; Ozair, Uzma; Khan, Sadia; Rizvi, Syed Adibul Hasan

    2016-10-15

    The goal of this study was to investigate metabolic risk factors in pediatric stone formers in an emerging economy. A prospective, data collection enrolled 250 children age <1-15 years at our center. Risk factors were evaluated by gender and in age groups <1-5, 6-10 and 11-15 years. Patients were evaluated for demographics, blood and 24 h urine for calcium, magnesium, phosphate, uric acid, electrolytes and additional protein, citrate, ammonia and oxalate in urine. All reported values were two sided and statistical significance was considered at p value ≤0.05. The mean age at diagnosis was 7.50 ± 3.56 years with a male to female ratio of 1.84:1. A family history of urolithiasis was found in 41 (16.4 %), urinary tract infection in 18 (7 %) and chronic diarrhea in 75 (30 %). Hypercalcemia was seen in 37 (14.8 %), hyperuricemia in 23 (9.2 %) and hyperphosphatemia in 6 (2.4 %). Urinary metabolic abnormalities were identified in 248 (98 %) of the cases. Hypocitraturia was found in 207 (82.8 %), hyperoxaluria in 62 (26.4 %), hyperuricosuria in 82 (32.8 %), hypercalciuria in 51 (20.4 %), hyperphosphaturia in 46 (18.4 %), hyperammonuria in 10 (4 %), hypocalciuria in 82 (32.8 %), and hypovolemia in 73 (29.2 %). Risk factors were similar between genders except higher rates of hyponatriuria, hypophosphaturia, and hypocalciuria in females. Hyperuricosuria, hyponatriuria, and hypovolemia were highest in 1-5 years (52, 49, 49 %) as compared to (18, 21, 12 %) those in 11-15 years (p < 0.001), respectively. This study shows that careful metabolic analysis can identify risk factors in 98 % of the children where appropriate metaphylaxis can be undertaken both for treatment and prevention of recurrence.

  2. Risk Factors Associated With Emergency Department Return Visits Following Trauma System Discharge.

    PubMed

    Ruttan, Timothy; Lawson, Karla A; Piper, Karen; Wilkinson, Matthew

    2017-06-06

    Little evidence exists in the pediatric trauma literature regarding what factors are associated with re-presentation to the hospital for patients discharged from the emergency department (ED). This was a retrospective cohort study of trauma system activations at a pediatric trauma center from June 30, 2007, through June 30, 2013, who were subsequently discharged from the ED or after a brief inpatient stay. Returns within 30 days were reviewed. χ, Student t test, and univariate logistical regression were used to compare predictive factors for those returning and not. One thousand eight hundred sixty-three patient encounters were included in the cohort. Seventy-two patients (3.9%) had at least 1 return visit that was related to the original trauma activation. Age, sex, language, race/ethnicity, ED length of stay, arrival mode, level of trauma activation, and transfer from an outside hospital did not vary significantly between the groups. Patients with public insurance were almost 2 times more likely to return compared with those with private insurance (odds ratio, 1.92; 95% confidence interval, 1.11-3.35). Income by zip code was associated with the risk of a return visit, with patients in neighborhoods at less than the 50th percentile income twice as likely to return to the ED (odds ratio, 2.15; 95% confidence interval, 1.30-3.54). Patients with public insurance and those from low-income neighborhoods were significantly more likely to return to the ED after trauma system activation. These data can be used to target interventions to decrease returns in high-risk trauma patients.

  3. Is polypharmacy an independent risk factor for adverse outcomes after an emergency department visit?

    PubMed

    Salvi, Fabio; Rossi, Lorena; Lattanzio, Fabrizia; Cherubini, Antonio

    2017-03-01

    This study aimed at verifying the role of polypharmacy as an independent risk factor for adverse health outcomes in older emergency department (ED) patients. This was a large (n = 2057) sample of older ED patients (≥65 years) participating in an observational cohort study. Polypharmacy and excessive polypharmacy were defined as having 6-9 drug prescriptions and 10 or more drug prescriptions in the last 3 months, respectively. The total number of medication prescriptions was also available. Outcome measures were in-hospital mortality; 30-day ED return; ED revisit, hospital admission, and mortality at 6 months. Logistic and Cox regression models as well as receiver operating characteristic curves using the Youden index and the area under the curve were calculated. Polypharmacy and excessive polypharmacy were present in 624 (30.3 %) and 367 (17.8 %) subjects, respectively. The mean number of prescriptions in the last 3 months was 5.7 (range 0-25) drugs. Polypharmacy and, particularly, excessive polypharmacy were constantly and independently associated with worse outcomes. A cut-off of 6 had the highest value of the Youden Index in predicting the majority of the adverse outcomes considered. Polypharmacy and excessive polypharmacy are independent risk factors for adverse health outcomes after an ED visit. Further studies are needed to clarify whether drug related issues (such as non-compliance, inappropriate or suboptimal prescribing, adverse drug reactions, and drug-drug or drug-disease interactions) or underlying multimorbidity and disease severity, as well as clinical complexity and frailty, are responsible for the negative outcomes associated with polypharmacy.

  4. Risk factors for maxillofacial injuries in a Brazilian emergency hospital sample

    PubMed Central

    LELES, José Luiz Rodrigues; dos SANTOS, Ênio José; JORGE, Fabrício David; da SILVA, Erica Tatiane; LELES, Cláudio Rodrigues

    2010-01-01

    Background Maxillofacial injuries occur in a significant number of trauma patients. Epidemiological assessments are essential to reaffirm patterns, identify new trends and develop clinical and research priorities for effective treatment and prevention of these injuries. Objective The aim of this study was to identify the epidemiological profile and risk factors associated with maxillofacial trauma treated at a referral emergency hospital for the Public Health System in the State Capital of Goiás, Brazil. Material and Methods A cross-sectional study was designed including 530 patients with maxillofacial trauma, 76% male, with a mean age of 25.5±15.0 years. Data were collected between May 2003 and August 2004 over weekly shift-working periods. Results: The main causes of trauma were traffic accidents (45.7%) and physical assaults (24.3%), and differences in etiological factors were identified according to gender (p<0.001). The distribution of patients according to age and etiology showed significant differences for traffic accidents (p<0.01), physical assaults (p<0.001), falls (p<0.001) and sport injuries (p<0.01). In the multinomial logistic regression analysis (R2 = 0.233; p<0.05), age was associated with injury in traffic accidents and falls (p<0.01), sports-related accidents were associated with males (p<0.05), and alcohol consumption with assaults and traffic accidents (p<0.001). Facial soft tissue lesions were found in 98% of patients and facial fractures in 51%. Conclusions The significant association of maxillofacial trauma with young males and alcohol consumption reinforces the need for educational strategies and the development of policies for the prevention and reduction of associated damage in this specific risk group. PMID:20379678

  5. Risk factors for early return visits to the emergency department in patients with urinary tract infection.

    PubMed

    Jorgensen, Sarah; Zurayk, Mira; Yeung, Samantha; Terry, Jill; Dunn, Maureen; Nieberg, Paul; Wong-Beringer, Annie

    2017-06-21

    Optimal management of urinary tract infections (UTIs) in the emergency department (ED) is challenging due to high patient turnover, decreased continuity of care, and treatment decisions made in the absence of microbiologic data. We sought to identify risk factors for return visits in ED patients treated for UTI. A random sample of 350 adult ED patients with UTI by ICD 9/10 codes was selected for review. Relevant data was extracted from medical charts and compared between patients with and without ED return visits within 30days (ERVs). We identified 51 patients (15%) with 59 ERVs, of whom 6% returned within 72h. Nearly half of ERVs (47%) were UTI-related and 33% of ERV patients required hospitalization. ERVs were significantly more likely (P<0.05) in patients with the following: age≥65years; pregnancy; skilled nursing facility residence; dementia; psychiatric disorder; obstructive uropathy; healthcare exposure; temperature≥38 °C heart rate>100; and bacteremia. Escherichia coli was the most common uropathogen (70%) and susceptibility rates to most oral antibiotics were below 80% in both groups except nitrofurantoin (99% susceptible). Cephalexin was the most frequently prescribed antibiotic (51% vs. 44%; P=0.32). Cephalexin bug-drug mismatches were more common in ERV patients (41% vs. 15%; P=0.02). Culture follow-up occurred less frequently in ERV patients (75% vs. 100%; P<0.05). ERV in UTI patients may be minimized by using ED-source specific antibiogram data to guide empiric treatment decisions and by targeting at-risk patients for post-discharge follow-up. Copyright © 2017. Published by Elsevier Inc.

  6. A Model of Home Learning Environment and Social Risk Factors in Relation to Children's Emergent Literacy and Social Outcomes

    ERIC Educational Resources Information Center

    Foster, M.A.; Lambert, R.; Abbott-Shim, M.; McCarty, F.; Franze, S.

    2005-01-01

    The quality of the home environment is widely recognized as a strong contributor to young children's emergent literacy and social competence and to their subsequent educational success. The present study examined the relationships between family variables (socioeconomic status (SES), social risk factors, and home learning variables) and children's…

  7. Role of India's wildlife in the emergence and re-emergence of zoonotic pathogens, risk factors and public health implications.

    PubMed

    Singh, B B; Gajadhar, A A

    2014-10-01

    Evolving land use practices have led to an increase in interactions at the human/wildlife interface. The presence and poor knowledge of zoonotic pathogens in India's wildlife and the occurrence of enormous human populations interfacing with, and critically linked to, forest ecosystems warrant attention. Factors such as diverse migratory bird populations, climate change, expanding human population and shrinking wildlife habitats play a significant role in the emergence and re-emergence of zoonotic pathogens from India's wildlife. The introduction of a novel Kyasanur forest disease virus (family flaviviridae) into human populations in 1957 and subsequent occurrence of seasonal outbreaks illustrate the key role that India's wild animals play in the emergence and reemergence of zoonotic pathogens. Other high priority zoonotic diseases of wildlife origin which could affect both livestock and humans include influenza, Nipah, Japanese encephalitis, rabies, plague, leptospirosis, anthrax and leishmaniasis. Continuous monitoring of India's extensively diverse and dispersed wildlife is challenging, but their use as indicators should facilitate efficient and rapid disease-outbreak response across the region and occasionally the globe. Defining and prioritizing research on zoonotic pathogens in wildlife are essential, particularly in a multidisciplinary one-world one-health approach which includes human and veterinary medical studies at the wildlife-livestock-human interfaces. This review indicates that wild animals play an important role in the emergence and re-emergence of zoonotic pathogens and provides brief summaries of the zoonotic diseases that have occurred in wild animals in India. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Risk Factors for Emergence of Resistance to Broad-Spectrum Cephalosporins among Enterobacter spp.

    PubMed Central

    Kaye, Keith S.; Cosgrove, Sara; Harris, Anthony; Eliopoulos, George M.; Carmeli, Yehuda

    2001-01-01

    Among 477 patients with susceptible Enterobacter spp., 49 subsequently harbored third-generation cephalosporin-resistant Enterobacter spp. Broad-spectrum cephalosporins were independent risk factors for resistance (relative risk [OR] = 2.3, P = 0.01); quinolone therapy was protective (OR = 0.4, P = 0.03). There were trends toward decreased risk for resistance among patients receiving broad-spectrum cephalosporins and either aminoglycosides or imipenem. Of the patients receiving broad-spectrum cephalosporins, 19% developed resistance. PMID:11502540

  9. Risk Factors for Malnutrition among Older Adults in the Emergency Department: A Multicenter Study.

    PubMed

    Burks, Collin E; Jones, Christopher W; Braz, Valerie A; Swor, Robert A; Richmond, Natalie L; Hwang, Kay S; Hollowell, Allison G; Weaver, Mark A; Platts-Mills, Timothy F

    2017-08-01

    Among older adults, malnutrition is common, often missed by healthcare providers, and influences recovery from illness or injury. To identify modifiable risk factors associated with malnutrition in older patients. Prospective cross-sectional multicenter study. 3 EDs in the South, Northeast, and Midwest. Non-critically ill, English-speaking adults aged ≥65 years. Random time block sampling was used to enroll patients. The ED interview assessed malnutrition using the Mini Nutritional Assessment Short-Form. Food insecurity and poor oral health were assessed using validated measures. Other risk factors examined included depressive symptoms, limited mobility, lack of transportation, loneliness, and medication side effects, qualified by whether the patient reported the risk factor affected their diet. The population attributable risk proportion (PARP) for malnutrition was estimated for each risk factor. In our sample (n = 252), the prevalence of malnutrition was 12%. Patient characteristics associated with malnutrition included not having a college degree, being admitted to the hospital, and residence in an assisted living facility. Of the risk factors examined, the PARPs for malnutrition were highest for poor oral health (54%; 95% CI 16%, 78%), food insecurity (14%; 95% CI 3%, 31%), and lack of transportation affecting diet (12%; 95% CI 3%, 28%). Results of this observational study identify multiple modifiable factors associated with the problem of malnutrition in older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  10. Association of cardiovascular emerging risk factors with acute coronary syndrome and stroke: A case-control study.

    PubMed

    Martínez Linares, José Manuel; Guisado Barrilao, Rafael; Ocaña Peinado, Francisco Manuel; Salgado Parreño, Francisco Javier

    2016-12-01

    In this study, we estimated the risk of acute coronary syndrome and stroke associated with several emerging cardiovascular risk factors. This was a case-control study, where an age - and sex-matched acute coronary syndrome group and stroke group were compared with controls. Demographic and clinical data were collected through patient interviews, and blood samples were taken for analysis. In the bivariate analysis, all cardiovascular risk factors analyzed showed as predictors of acute coronary syndrome and stroke, except total cholesterol and smoking. In the multivariate logistic regression model for acute coronary syndrome, hypertension and body mass index, N-terminal section brain natriuretic peptide and pregnancy-associated plasma protein-A were independent predictors. For stroke, the predictors were hypertension, diabetes mellitus, body mass index, and N-terminal section brain natriuretic peptide. Controlling for age, sex, and classical cardiovascular risk factors, N-terminal section brain natriuretic peptide and pregnancy-associated plasma protein-A were independent emerging cardiovascular risk factors for acute coronary syndrome, but pregnancy-associated plasma protein-A was not for stroke. High levels of cardiovascular risk factors in individuals with no episodes of cardiovascular disease requires the implementation of prevention programs, given that at least half of them are modifiable. © 2016 John Wiley & Sons Australia, Ltd.

  11. [The incidence of emergence delirium and risk factors following sevoflurane use in pediatric patients for day case surgery, Kingston, Jamaica].

    PubMed

    Gooden, Rachel; Tennant, Ingrid; James, Brian; Augier, Richard; Crawford-Sykes, Annette; Ehikhametalor, Kelvin; Gordon-Strachan, Georgiana; Harding-Goldson, Hyacinth

    2014-01-01

    Emergence delirium is a distressing complication of the use of sevoflurane for general anesthesia. This study sought to determine the incidence of emergence delirium and risk factors in patients at a specialist pediatric hospital in Kingston, Jamaica. This was a cross-sectional, observational study including pediatric patients aged 3-10 years, ASA I and II, undergoing general anesthesia with sevoflurane for elective day-case procedures. Data collected included patients' level of anxiety pre-operatively using the modified Yale Preoperative Anxiety Scale, surgery performed, anesthetic duration and analgesics administered. Postoperatively, patients were assessed for emergence delirium, defined as agitation with non-purposeful movement, restlessness or thrashing; inconsolability and unresponsiveness to nursing and/or parental presence. The need for pharmacological treatment and post-operative complications related to emergence delirium episodes were also noted. 145 children were included, with emergence delirium occurring in 28 (19.3%). Emergence delirium episodes had a mean duration of 6.9±7.8min, required pharmacologic intervention in 19 (67.8%) children and were associated with a prolonged recovery time (49.4±11.9 versus 29.7±10.8min for non-agitated children; p<0.001). Factors positively associated with emergence delirium included younger age (p=0.01, OR 3.3, 95% CI 1.2-8.6) and moderate and severe anxiety prior to induction (p<0.001, OR 5.6, 95% CI 2.3-13.0). Complications of emergence delirium included intravenous line removal (n=1), and surgical site bleeding (n=3). Children of younger age with greater preoperative anxiety are at increased risk of developing emergence delirium following general anesthesia with sevoflurane. The overall incidence of emergence delirium was 19%. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  12. Emerging and established global life-style risk factors for cancer of the upper aero-digestive tract.

    PubMed

    Gupta, Bhawna; Johnson, Newell W

    2014-01-01

    Upper aero-digestive tract cancer is a multidimensional problem, international trends showing complex rises and falls in incidence and mortality across the globe, with variation across different cultural and socio-economic groups. This paper seeks some explanations and identifies some research and policy needs. The literature illustrates the multifactorial nature of carcinogenesis. At the cellular level, it is viewed as a multistep process involving multiple mutations and selection for cells with progressively increasing capacity for proliferation, survival, invasion, and metastasis. Established and emerging risk factors, in addition to changes in incidence and prevalence of cancers of the upper aero-digestive tract, were identified. Exposure to tobacco and alcohol, as well as diets inadequate in fresh fruits and vegetables, remain the major risk factors, with persistent infection by particular so-called "high risk" genotypes of human papillomavirus increasingly recognised as also playing an important role in a subset of cases, particularly for the oropharynx. Chronic trauma to oral mucosa from poor restorations and prostheses, in addition to poor oral hygiene with a consequent heavy microbial load in the mouth, are also emerging as significant risk factors. Understanding and quantifying the impact of individual risk factors for these cancers is vital for health decision-making, planning and prevention. National policies and programmes should be designed and implemented to control exposure to environmental risks, by legislation if necessary, and to raise awareness so that people are provided with the information and support they need to adopt healthy lifestyles.

  13. Mortality rates and risk factors for emergent open repair of abdominal aortic aneurysms in the endovascular era.

    PubMed

    Pecoraro, Felice; Gloekler, Steffen; Mader, Caecilia E; Roos, Malgorzata; Chaykovska, Lyubov; Veith, Frank J; Cayne, Neal S; Mangialardi, Nicola; Neff, Thomas; Lachat, Mario

    2017-09-14

    The background of this paper is to report the mortality at 30 and 90 days and at mean follow-up after open abdominal aortic aneurysms (AAA) emergent repair and to identify predictive risk factors for 30- and 90-day mortality. Between 1997 and 2002, 104 patients underwent emergent AAA open surgery. Symptomatic and ruptured AAAs were observed, respectively, in 21 and 79% of cases. Mean patient age was 70 (SD 9.2) years. Mean aneurysm maximal diameter was 7.4 (SD 1.6) cm. Primary endpoints were 30- and 90-day mortality. Significant mortality-related risk factor identification was the secondary endpoint. Open repair trend and its related perioperative mortality with a per-year analysis and a correlation subanalysis to identify predictive mortality factor were performed. Mean follow-up time was 23 (SD 23) months. Overall, 30-day mortality was 30%. Significant mortality-related risk factors were the use of computed tomography (CT) as a preoperative diagnostic tool, AAA rupture, preoperative shock, intraoperative cardiopulmonary resuscitation (CPR), use of aortic balloon occlusion, intraoperative massive blood transfusion (MBT), and development of abdominal compartment syndrome (ACS). Previous abdominal surgery was identified as a protective risk factor. The mortality rate at 90 days was 44%. Significant mortality-related risk factors were AAA rupture, aortocaval fistula, peripheral artery disease (PAD), preoperative shock, CPR, MBT, and ACS. The mortality rate at follow-up was 45%. Correlation analysis showed that MBT, shock, and ACS are the most relevant predictive mortality factor at 30 and 90 days. During the transition period from open to endovascular repair, open repair mortality outcomes remained comparable with other contemporary data despite a selection bias for higher risk patients. MBT, shock, and ACS are the most pronounced predictive mortality risk factors.

  14. Risk factors for septic shock in acute obstructive pyelonephritis requiring emergency drainage of the upper urinary tract.

    PubMed

    Kamei, Jun; Nishimatsu, Hiroaki; Nakagawa, Tohru; Suzuki, Motofumi; Fujimura, Tetsuya; Fukuhara, Hiroshi; Igawa, Yasuhiko; Kume, Haruki; Homma, Yukio

    2014-03-01

    To assess the risk factors for septic shock in patients with acute obstructive pyelonephritis requiring emergency drainage of the upper urinary tract. We retrospectively reviewed the records of 48 patients who underwent emergency drainage of the upper urinary tract for sepsis associated with acute obstructive pyelonephritis at our institute. Univariate and multivariate analyses were performed to identify the risk factors. Among 54 events of sepsis, we identified 20 events of septic shock requiring vasopressor therapy. Cases with shock were more likely than those without shock to have ureteral stone (70 vs 38%, p = 0.024) and positive blood culture results (81 vs 28%, p = 0.006). They received drainage significantly earlier than those without shock (1.0 vs 3.5 days, p < 0.001). Univariate analysis demonstrated that acute obstructive pyelonephritis by ureteral stone, rapid progression (the occurrence of symptoms to drainage ≤ 1 day), positive blood culture, leukocytopenia (<4,000/mm(3)), thrombocytopenia (<120,000/mm(3)), and prothrombin time international normalized ratio ≥ 1.20 were correlated with septic shock. Multivariate logistic regression analysis identified thrombocytopenia (p = 0.005) and positive blood culture (p = 0.040) as independent risk factors for septic shock. Thrombocytopenia and positive blood culture were independent risk factors for septic shock in acute obstructive pyelonephritis requiring emergency drainage. Thrombocytopenia would be practically useful as a predictor of septic shock.

  15. Human Immunodeficiency Virus Risk Factors and Beliefs Reported by Families Presenting to a Pediatric Emergency Department.

    PubMed

    Barbour, Worth L; Rodgers, Joel B; Wang, Henry E; Donnelly, John P; Tapley, Amanda M; Galbraith, James W

    2015-11-06

    Adolescents are at greater risk for acquiring human immunodeficiency virus (HIV) due to increased risk behaviors. Parental influence is known to reduce adolescent risk behaviors. We compared HIV risk behaviors reported by adolescents to parents' perception of adolescent risky behavior engagement. We also examined participants' knowledge of HIV transmission and testing preferences. Participants included English-speaking adolescents and parents presenting to a pediatric emergency department. Participants were interviewed separately in private. Modeled after existing instruments, "adolescent" and "parent" questionnaires included multiple choices items, Likert-type scales, and standard yes/no and true/false options. Data were analyzed using a κ statistic and observed agreement to measure discordance between adolescent and parent responses. Participants included 126 adolescents and 110 parents. Many adolescents reported ever having sex (61%), of which 32% reported always practicing safe sex. Comparative analysis revealed low agreement between adolescents' risk behaviors and parents' perception of risk behavior engagement by youth. Discordance concerning tobacco use was greatest (κ = 0.13), followed by drug use (κ = 0.19) and ever having sex (κ= 0.19), and alcohol use (κ= 0.22). There was also poor agreement regarding HIV transmission knowledge (ie, oral sex; κ = 0.16). Participants shared strong agreement regarding parental support for adolescent interest in HIV testing (95.5%). Parents are mostly unaware of adolescents' broad risk behaviors. Participants' knowledge of HIV transmission is limited. Adolescents and parents shared strong agreement regarding HIV testing preferences. Multidimensional HIV prevention strategies aiming to decrease adolescent risk behaviors, increase parental involvement, and improve adolescent and parental knowledge of HIV transmission are needed.This is an open-access article distributed under the terms of the Creative Commons

  16. Exploring risk factors for the emergence of children's mental health problems.

    PubMed

    Essex, Marilyn J; Kraemer, Helena C; Armstrong, Jeffrey M; Boyce, W Thomas; Goldsmith, H Hill; Klein, Marjorie H; Woodward, Hermi; Kupfer, David J

    2006-11-01

    Exploratory studies that generate testable models of how risk factors for childhood mental health problems work together over time are critical for developing effective prevention and treatment strategies. To build models addressing the following 2 questions: (1) How early can we identify children at risk for mental health problems in third grade? (2) How do the risk factors work together over time? We assessed a Wisconsin community sample 8 times, beginning during pregnancy. Three hundred seventy-nine families completed multi-informant reports (mothers, teachers, and children) of children's mental health symptoms in third grade. Symptom severity and directionality (externalizing vs internalizing). The hypothesis was generated that family socioeconomic status (SES) defined different pathways to symptom severity. In low/middle SES families, children were at risk if their mothers were distressed during the infancy period, which was then associated with more generalized maternal and child distress and dysregulation during the preschool period. In high SES families, the picture was more complex, beginning with parental histories of depression and family psychopathology, which then led to greater family stress in the infancy period and maternal and child distress and dysregulation during the preschool period. For all children, social and academic impairment during the school transition was an important mediator. Two pathways to later symptom directionality consisted of one beginning with child sex and the other with child temperament. Most risk factors predicted symptom severity and not directionality. The risk factors for internalizing and externalizing problems may be much the same, and the same preventive interventions might be effective for both classes of problems. Furthermore, at-risk children from high SES families might be identifiable as early as infancy, whereas those from lower SES families may be identifiable only as preschoolers.

  17. Risk/protective factors associated with substance use among runaway/homeless youth utilizing emergency shelter services nationwide.

    PubMed

    Thompson, Sanna J

    2004-09-01

    Rates of alcohol, tobacco, and marijuana use among runaway/homeless youth are substantially higher than found among American high school students. To understand the risk and protective factors associated with substance use, this study (1) assessed cigarette, alcohol, and marijuana use among a national sample of runaway/homeless youth, (2) identified risk/protective factors associated with lifetime substance use, and (3) examined risk/protective factors associated with six month frequency of substance use. Unduplicated cases (n = 11,841) from the 1997 Runaway/ Homeless Youth Management Information System (RHY MIS) were analyzed. Results showed that substance use levels are greater than previously reported for this population. Predictors of cigarette, alcohol, and marijuana use and frequency were predominately individual youth risk factors and demographics rather than family risk factors. Providers in emergency youth shelters are in a prime position to assess substance use behaviors, as well as the associated risk factors. Provision of appropriate screening and referral to other services is essential to meet the needs of these youth.

  18. Emerging viral disease risk to pollinating insects: ecological, evolutionary and anthropogenic factors.

    PubMed

    Manley, Robyn; Boots, Mike; Wilfert, Lena

    2015-04-01

    The potential for infectious pathogens to spillover and emerge from managed populations to wildlife communities is poorly understood, but ecological, evolutionary and anthropogenic factors are all likely to influence the initial exposure and subsequent infection, spread and impact of disease. Fast-evolving RNA viruses, known to cause severe colony losses in managed honeybee populations, deserve particular attention for their propensity to jump between host species and thus threaten ecologically and economically important wild pollinator communities. We review the literature on pollinator viruses to identify biological and anthropogenic drivers of disease emergence, highlight gaps in the literature, and discuss potential management strategies. We provide evidence that many wild pollinator species are exposed to viruses from commercial species, resulting in multiple spillover events. However, it is not clear whether species become infected as a result of spillover or whether transmission is occurring within these wild populations. Ecological traits of pollinating insects, such as overlapping ranges, niches and behaviours, clearly promote cross-species transmission of RNA viruses. Moreover, we conclude that the social behaviour and phylogenetic relatedness of social pollinators further facilitate within- and between-host transmission, leaving these species particularly vulnerable to emerging diseases. We argue that the commercial use of pollinators is a key driver of disease emergence in these beneficial insects and that this must be addressed by management and policy. Synthesis and applications. There are important knowledge gaps, ranging from disease distribution and prevalence, to pathogen life history and virulence, to the impacts of disease emergence, which need to be addressed as research priorities. It is clear that avoiding anthropogenic pathogen spillover is crucial to preventing and managing disease emergence in pollinators, with far-reaching effects on our

  19. Emerging viral disease risk to pollinating insects: ecological, evolutionary and anthropogenic factors

    PubMed Central

    Manley, Robyn; Boots, Mike; Wilfert, Lena

    2015-01-01

    The potential for infectious pathogens to spillover and emerge from managed populations to wildlife communities is poorly understood, but ecological, evolutionary and anthropogenic factors are all likely to influence the initial exposure and subsequent infection, spread and impact of disease. Fast-evolving RNA viruses, known to cause severe colony losses in managed honeybee populations, deserve particular attention for their propensity to jump between host species and thus threaten ecologically and economically important wild pollinator communities. We review the literature on pollinator viruses to identify biological and anthropogenic drivers of disease emergence, highlight gaps in the literature, and discuss potential management strategies. We provide evidence that many wild pollinator species are exposed to viruses from commercial species, resulting in multiple spillover events. However, it is not clear whether species become infected as a result of spillover or whether transmission is occurring within these wild populations. Ecological traits of pollinating insects, such as overlapping ranges, niches and behaviours, clearly promote cross-species transmission of RNA viruses. Moreover, we conclude that the social behaviour and phylogenetic relatedness of social pollinators further facilitate within- and between-host transmission, leaving these species particularly vulnerable to emerging diseases. We argue that the commercial use of pollinators is a key driver of disease emergence in these beneficial insects and that this must be addressed by management and policy. Synthesis and applications. There are important knowledge gaps, ranging from disease distribution and prevalence, to pathogen life history and virulence, to the impacts of disease emergence, which need to be addressed as research priorities. It is clear that avoiding anthropogenic pathogen spillover is crucial to preventing and managing disease emergence in pollinators, with far-reaching effects on our

  20. Overeating and Binge Eating in Emerging Adulthood: 10-Year Stability and Risk Factors

    ERIC Educational Resources Information Center

    Goldschmidt, Andrea B.; Wall, Melanie M.; Zhang, Jun; Loth, Katie A.; Neumark-Sztainer, Dianne

    2016-01-01

    Overeating (eating an unusually large amount of food) and binge eating (overeating with loss of control [LOC]) predict adverse health consequences in adolescence. We aimed to characterize the stability of and risk factors for these distinct but interrelated constructs during critical developmental transitions. We used a population-based sample (n…

  1. Risk Factors for Alcohol Use among Male Adolescents and Emerging Adults in Haiti

    ERIC Educational Resources Information Center

    Gage, Anastasia J.; Suzuki, Chiho

    2006-01-01

    This study examined risk factors associated with alcohol use in the past 3 months among young men aged 15-24 in Haiti using data from the 2000 Enquete Mortalite, Morbidite et Utilization des Services. Findings indicate that life-time smoking, multiple sexual partnerships, witnessing inter-parental conflict in childhood, disruption of parental…

  2. Overeating and Binge Eating in Emerging Adulthood: 10-Year Stability and Risk Factors

    ERIC Educational Resources Information Center

    Goldschmidt, Andrea B.; Wall, Melanie M.; Zhang, Jun; Loth, Katie A.; Neumark-Sztainer, Dianne

    2016-01-01

    Overeating (eating an unusually large amount of food) and binge eating (overeating with loss of control [LOC]) predict adverse health consequences in adolescence. We aimed to characterize the stability of and risk factors for these distinct but interrelated constructs during critical developmental transitions. We used a population-based sample (n…

  3. Transactional sex involvement: exploring risk and promotive factors among substance-using youth in an urban emergency department.

    PubMed

    Patton, Rikki A; Cunningham, Rebecca M; Blow, Frederic C; Zimmerman, Marc A; Booth, Brenda M; Walton, Maureen A

    2014-07-01

    The current study aims to evaluate individual, relational, and community-level risk and promotive factors for transactional sex involvement among substance-using youth. Youth (ages 14-24 years) presenting for care in an urban emergency department, who reported drug use within the past 6 months, were surveyed as part of a larger study assessing violence. Of the 600 youth enrolled in this study, 350 presented to the emergency department with violent injury. Based on youth presenting with violent injury, a proportionally selected (age and gender) comparison group of youth (n = 250) presenting without violent injury were enrolled. Participants were queried about both risk and promotive factors at the individual, relational, and community levels. Of the sample, 7.3% reported involvement in transactional sex within the past month. Regression analyses indicated that being African American or other race (as compared with White), having more than one sexual partner, depressive symptoms, negative peer influence, and substance use treatment utilization were positively associated with transactional sex involvement. Increased school involvement was negatively related to involvement in transactional sex. Drug-using youth who reported recent transactional sex involvement are more likely to experience increased HIV risk, depressive symptoms, and negative peer influence and are less likely to experience the promotive factors of school involvement. Future research is needed to better understand the bidirectional relationship between transactional sex involvement and both risk and promotive factors at multiple ecological levels.

  4. Pulmonary tuberculosis - An emerging risk factor for venous thromboembolism: A case series and review of literature

    PubMed Central

    Gupta, Amitesh; Mrigpuri, Parul; Faye, Abhishek; Bandyopadhyay, Debdutta; Singla, Rupak

    2017-01-01

    One-third of patients with symptomatic venous thromboembolism (VTE) manifest pulmonary embolism, whereas two-thirds manifest deep vein thrombosis (DVT). Overall, 25%–50% of patients with first-time VTE have an idiopathic condition, without a readily identifiable risk factor, and its association with tuberculosis (TB) is a rare occurrence. Deep venous thrombosis has been associated with 1.5%–3.4% cases of TB. Early initiation of anti-TB treatment along with anticoagulant therapy decreases the overall morbidity and mortality associated with the disease. We report three cases of DVT associated with pulmonary TB who were diagnosed due to high index of suspicion as the risk factors for the development of DVT were present in these cases. PMID:28144063

  5. Risk factors, representations and practices associated with emerging urban human visceral leishmaniasis in Posadas, Argentina.

    PubMed

    López, Karen; Tartaglino, Lilian Catalina; Steinhorst, Ingrid Iris; Santini, María Soledad; Salomon, Oscar Daniel

    2016-02-23

    Visceral leishmaniasis is an often overlooked disease with high lethality rates about which there is need of additional local studies to inform the design of effective control strategies. The urbanization of its transmission has already been verified in America, with domestic dogs being the primary reservoirs and vectors of the disease. Socio-economic conditions, demographics and practices of domestic groups typically present in urban settings may play a specific role in the transmission of the infection, which is still poorly understood.  To analyze the sociodemographic characteristics, risk factors and overall practices concerning prevention and coping strategies of visceral leishmaniasis, in both human beings and canines.  This study utilized a cross-sectional case-control design. Cases were defined as a domestic group where the Public Health Ministry had at least one record of a member with human visceral leishmaniasis. Control cases were defined as a domestic group without a clinical record of the disease. The populations were characterized demographically and socially using primary information sources. Measures of household quality and a ranking of knowledge and attitudes towards visceral leishmaniasis were constructed, and practices associated with the presence, and the risk for canine visceral leishmaniasis were described.  Low household quality (p≤0.001), a member of the domestic group out of the household after 6:00 pm (OR=4.4; 95% CI: 1.69-12.18), the uncontrolled racial breeding of dogs (OR=15.7; 95% CI: 3.91-63.2), and the presence of infected dogs infected in the household (OR=120.3; 95% CI: 18.51-728.3) were variables positively associated with the risk of infection.  We observed certain social risk factors, primarily low household quality and overcrowding, associated with structural poverty that could increase human-vector contact probability. The most important risk factor for human visceral leishmaniasis was the possession of infected dogs

  6. Delayed neuropsychological sequelae after carbon monoxide poisoning: predictive risk factors in the Emergency Department. A retrospective study.

    PubMed

    Pepe, Giuseppe; Castelli, Matteo; Nazerian, Peiman; Vanni, Simone; Del Panta, Massimo; Gambassi, Francesco; Botti, Primo; Missanelli, Andrea; Grifoni, Stefano

    2011-03-17

    Delayed neuropsychological sequelae (DNS) commonly occur after recovery from acute carbon monoxide (CO) poisoning. The preventive role and the indications for hyperbaric oxygen therapy in the acute setting are still controversial. Early identification of patients at risk in the Emergency Department might permit an improvement in quality of care. We conducted a retrospective study to identify predictive risk factors for DNS development in the Emergency Department. We retrospectively considered all CO-poisoned patients admitted to the Emergency Department of Careggi University General Hospital (Florence, Italy) from 1992 to 2007. Patients were invited to participate in three follow-up visits at one, six and twelve months from hospital discharge. Clinical and biohumoral data were collected; univariate and multivariate analysis were performed to identify predictive risk factors for DNS. Three hundred forty seven patients were admitted to the Emergency Department for acute CO poisoning from 1992 to 2007; 141/347 patients participated in the follow-up visit at one month from hospital discharge. Thirty four/141 patients were diagnosed with DNS (24.1%). Five/34 patients previously diagnosed as having DNS presented to the follow-up visit at six months, reporting a complete recovery. The following variables (collected before or upon Emergency Department admission) were associated to DNS development at one month from hospital discharge in the univariate analysis: CO exposure duration >6 hours, a Glasgow Coma Scale (GCS) score <9, seizures, systolic blood pressure <90 mmHg, elevated creatine phosphokinase concentration and leukocytosis. There was no significant correlation with age, sex, voluntary exposure, headache, transient loss of consciousness, GCS between 14 and 9, arterial lactate and carboxyhemoglobin concentration. The multivariate analysis confirmed as independent prognostic factors GCS <9 (OR 7.15; CI 95%: 1.04-48.8) and leukocytosis (OR 3.31; CI 95%: 1

  7. Delayed neuropsychological sequelae after carbon monoxide poisoning: predictive risk factors in the Emergency Department. A retrospective study

    PubMed Central

    2011-01-01

    Background Delayed neuropsychological sequelae (DNS) commonly occur after recovery from acute carbon monoxide (CO) poisoning. The preventive role and the indications for hyperbaric oxygen therapy in the acute setting are still controversial. Early identification of patients at risk in the Emergency Department might permit an improvement in quality of care. We conducted a retrospective study to identify predictive risk factors for DNS development in the Emergency Department. Methods We retrospectively considered all CO-poisoned patients admitted to the Emergency Department of Careggi University General Hospital (Florence, Italy) from 1992 to 2007. Patients were invited to participate in three follow-up visits at one, six and twelve months from hospital discharge. Clinical and biohumoral data were collected; univariate and multivariate analysis were performed to identify predictive risk factors for DNS. Results Three hundred forty seven patients were admitted to the Emergency Department for acute CO poisoning from 1992 to 2007; 141/347 patients participated in the follow-up visit at one month from hospital discharge. Thirty four/141 patients were diagnosed with DNS (24.1%). Five/34 patients previously diagnosed as having DNS presented to the follow-up visit at six months, reporting a complete recovery. The following variables (collected before or upon Emergency Department admission) were associated to DNS development at one month from hospital discharge in the univariate analysis: CO exposure duration >6 hours, a Glasgow Coma Scale (GCS) score <9, seizures, systolic blood pressure <90 mmHg, elevated creatine phosphokinase concentration and leukocytosis. There was no significant correlation with age, sex, voluntary exposure, headache, transient loss of consciousness, GCS between 14 and 9, arterial lactate and carboxyhemoglobin concentration. The multivariate analysis confirmed as independent prognostic factors GCS <9 (OR 7.15; CI 95%: 1.04-48.8) and leukocytosis (OR 3

  8. Transient risk factors of acute occupational injuries: a case-crossover study in two Danish emergency departments.

    PubMed

    Østerlund, Anna H; Lander, Flemming; Nielsen, Kent; Kines, Pete; Möller, Jette; Lauritsen, Jens

    2017-05-01

    Objectives The objectives of this study were to (i) identify transient risk factors of occupational injuries and (ii) determine if the risk varies with age, injury severity, job task, and industry risk level. Method A case-crossover design was used to examine the effect of seven specific transient risk factors (time pressure, disagreement with someone, feeling sick, being distracted by someone, non-routine task, altered surroundings, and broken machinery and materials) for occupational injuries. In the study, 1693 patients with occupational injuries were recruited from a total of 4002 occupational injuries seen in 2013 at two emergency departments in Denmark. Effect estimates were calculated using the matched-pair interval approach. Results Increased risk for an occupational injury was found for time pressure [odds ratio (OR) 1.6, 95% confidence interval (95% CI) 1.3-2.0], feeling sick (OR 2.7, 95% CI 1.9-3.9), being distracted by someone (OR 3.1, 95% CI 2.3-4.1), non-routine task (OR 8.2, 95% CI 5.3-12.5), altered surroundings (OR 20.9, 95% CI 12.2-35.8), and broken machinery or materials (OR 20.6, 95% CI 13.5-31.7). The risk of occupational injury did not vary substantially in relation to sex, age, job task, industry risk level, or injury severity. Conclusion Use of a case-crossover design identified several worker-related transient risk factors (time pressure, feeling sick, being distracted by someone) that led to significantly increased risks for occupational injuries. In particular, equipment (broken machinery or materials) and work-practice-related factors (non-routine task and altered surroundings) increased the risk of an occupational injury. Elaboration of results in relation to hazard period and information bias is warranted.

  9. Epidemiology and Related Risk Factors of Preterm Labor as an obstetrics emergency

    PubMed Central

    Halimi asl, Ali asghar; Safari, Saeed; Parvareshi Hamrah, Mohsen

    2017-01-01

    Introduction: Preterm birth is still a major health problem throughout the world, which results in 75% of neonatal mortality. Preterm labor not only inflicts financial and emotional distress, it may also lead to permanent disability. The present study was conducted to determine the related risk factors and preventive measures of preterm labor. Methods: This retrospective cross-sectional study assessed all preterm labors, as well as an equal number of term labors, during seven years, at an educational hospital. Probable risk factors of preterm labor were collected using medical profiles of participants by the aid of a pre-designed checklist. Significant related factors of preterm labor were used for multivariate logistic regression analysis with SPSS 21.0. Result: 810 cases with the mean age of 28.33 ± 6.1 years were evaluated (48.7% preterm). Multipartite; fetal anomaly; prenatal care; smoking; not consuming folic acid and iron supplements; in vitro fertilization; history of infertility, caesarian section, trauma, systemic disease, and hypertension; amniotic fluid leak; rupture of membranes; cephalic presentation; vaginal bleeding; placenta decolman; oligohydramnios; pre-eclampsia; chorioamnionitis; uterine abnormalities; cervical insufficiency; intercourse during the previous week; short time since last delivery; and mother’s weight significantly correlated with preterm labor. Conclusion: Based on the results of the present study, intercourse during the previous week, multipartite, short time from last delivery, preeclampsia, fetal anomaly, rupture of membranes, hypertension, and amniotic fluid leak, respectively, were risk factors for preterm labor. On the other hand, iron consumption, cephalic presentation, systematic disease, history of caesarian section, prenatal care, and mother’s weight could be considered as protective factors. PMID:28286810

  10. Predicting Factors and Risk Stratification for Return Visits to the Emergency Department Within 72 Hours in Pediatric Patients.

    PubMed

    Sung, Sheng-Feng; Liu, Kang Ernest; Chen, Solomon Chih-Cheng; Lo, Chia-Lun; Lin, Kuei-Chih; Hu, Ya-Han

    2015-12-01

    A return visit (RV) to the emergency department (ED) is usually used as a quality indicator for EDs. A thorough comprehension of factors affecting RVs is beneficial to enhancing the quality of emergency care. We performed this study to identify pediatric patients at high risk of RVs using readily available characteristics during an ED visit. We retrospectively collected data of pediatric patients visiting 6 branches of an urban hospital during 2007. Potential variables were analyzed using a multivariable logistic regression analysis to determine factors associated with RVs and a classification and regression tree technique to identify high-risk groups. Of the 35,435 visits from which patients were discharged home, 2291 (6.47%) visits incurred an RV within 72 hours. On multivariable analysis, younger age, weekday visits, diagnoses belonging to the category of symptoms, signs, and ill-defined conditions, and being seen by a female physician were associated with a higher probability of RVs. Children younger than 6.5 years who visited on weekdays or between midnight and 8:00 AM on weekends or holidays had the highest probability of returning to the ED within 72 hours. Our study reexamined several important factors that could affect RVs of pediatric patients to the ED and identified high-risk groups of RVs. Further intervention studies or qualitative research could be targeted on these at-risk groups.

  11. The incidence and risk factors for hypotension during emergent decompressive craniotomy in children with traumatic brain injury.

    PubMed

    Miller, Patrick; Mack, Christopher D; Sammer, Marla; Rozet, Irene; Lee, Lorri A; Muangman, Saipin; Wang, Marjorie; Hollingworth, Will; Lam, Arthur M; Vavilala, Monica S

    2006-10-01

    We conducted a retrospective cohort study in children <13 yr with traumatic brain injury (TBI) at a Level 1 pediatric trauma center to describe risk factors for intraoperative hypotension (IH) during emergent decompressive craniotomy. Between 1994 and 2004, 108 children underwent emergent decompressive craniotomy for TBI. Overall, 56 (52%) patients had IH. Independent risk factors for IH were each 10 mL estimated blood loss/kg (ARR 1.15 95% CI 1.08-1.22), each mm of computed tomography (CT) midline shift (ARR 1.04 95%CI 1.01-1.07), each 10 mL of CT lesion volume (ARR 1.03 95%CI 1.01-1.05), and emergency department (ED) hypotension (5/5 patients with ED hypotension had IH). CT midline shift > or =4 mm predicted IH (ARR 1.67 95% CI 1.06-2.63), independent of blood loss. IH occurred frequently during emergent decompressive craniotomy in children with TBI. ED hypotension, blood loss, CT lesion volume, and CT midline shift predicted IH. Anesthesiologists can expect children with preoperative CT midline shift > or =4 mm to have IH during this procedure.

  12. Pressure ulcer development in trauma patients with suspected spinal injury; the influence of risk factors present in the Emergency Department.

    PubMed

    Ham, H W Wietske; Schoonhoven, L Lisette; Schuurmans, M Marieke J; Leenen, L Luke P H

    2017-01-01

    To explore the influence of risk factors present at Emergency Department admission on pressure ulcer development in trauma patients with suspected spinal injury, admitted to the hospital for evaluation and treatment of acute traumatic injuries. Prospective cohort study setting level one trauma center in the Netherlands participants adult trauma patients transported to the Emergency Department on a backboard, with extrication collar and headblocks and admitted to the hospital for treatment or evaluation of their injuries. Between January and December 2013, 254 trauma patients were included. The following dependent variables were collected: Age, Skin color and Body Mass Index, and Time in Emergency Department, Injury Severity Score, Mean Arterial Pressure, hemoglobin level, Glasgow Coma Score, and admission ward after Emergency Department. Pressure ulcer development during admission was associated with a higher age (p 0.00, OR 1.05) and a lower Glasgow Coma Scale score (p 0.00, OR 1.21) and higher Injury Severity Scores (p 0.03, OR 1.05). Extra nutrition decreases the probability of PU development during admission (p 0.04, OR 0.20). Pressure ulcer development within the first 48h of admission was positively associated with a higher age (p 0.01, OR 1.03) and a lower Glasgow Coma Scale score (p 0.01, OR 1.16). The proportion of patients admitted to the Intensive Care Unit and Medium Care Unit was higher in patients with pressure ulcers. The pressure ulcer risk during admission is high in patients with an increased age, lower Glasgow Coma Scale and higher Injury Severity Score in the Emergency Department. Pressure ulcer risk should be assessed in the Emergency Department to apply preventive interventions in time. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Overeating and binge eating in emerging adulthood: 10-year stability and risk factors.

    PubMed

    Goldschmidt, Andrea B; Wall, Melanie M; Zhang, Jun; Loth, Katie A; Neumark-Sztainer, Dianne

    2016-03-01

    Overeating (eating an unusually large amount of food) and binge eating (overeating with loss of control [LOC]) predict adverse health consequences in adolescence. We aimed to characterize the stability of and risk factors for these distinct but interrelated constructs during critical developmental transitions. We used a population-based sample (n = 1,902) that completed surveys at 5-year intervals spanning adolescence and young adulthood. The trajectories of no overeating, overeating, binge eating, and binge eating disorder (BED; recurrent binge eating with associated distress) were characterized using cross-tabulations. Body mass index, depressive symptoms, self-esteem, and body satisfaction were examined as risk factors for no overeating, overeating, and binge eating (including BED) 5-years later using multinomial logistic regression. We found that all overeating categories tended to remit to no overeating at 5-year follow-up. Although overeating had the lowest remittance rates at each time-point, binge eating and BED showed higher rates of persistence or worsening of symptoms during the transition from late adolescence/early young adulthood to early/middle young adulthood. Overeating and binge eating had similar risk factors, although for females, depressive symptoms, body satisfaction, and self-esteem in late adolescence/early young adulthood differentially predicted binge eating versus overeating in early/middle young adulthood (ps < .05). While overeating with or without LOC tends to remit over time, problematic eating persists for a subset of individuals. Greater psychosocial problems in late adolescence/early young adulthood predicted greater odds of binge eating relative to overeating in early/middle young adulthood among females, indicating that poorer psychosocial functioning in this developmental stage portends more severe eating-related psychopathology later in life.

  14. Antenatal and intrapartum risk factors for use of emergency and restorative Medicaid dental services for children.

    PubMed

    Yepes, Juan F; Bush, Heather M; Li, Hsin-Fang; Talbert, Jeffrey; Nash, David A

    2014-01-01

    To investigate the relationship between antenatal/intrapartum factors and Medicaid use. Three databases were used: (1) birth records; (2) Medicaid files; and (3) Medicaid dental claims. Children of Caucasian mothers were 34 percent more likely to have more than one restorative claim versus children of African American mothers (odds ratio [OR] equals 1.34, 95 percent confidence interval [95% CI] equals 1.10 to 1.65, P<.005). Children born with low birth weight were 37 percent more likely to have emergency claims (OR equals 1.37, 95% CI equals 1.02 to 1.83, P=.03). The adjusted analysis found that Caucasian mothers had higher odds ratio of having a dental claim than African American mothers (P<.001): 33 percent for a restorative claim and 56 percent for an emergency claim. When race was analyzed, the odds of a restorative claim among African American mothers were 2.5 times higher in children delivered by C-section versus those vaginally delivered (OR equals 2.52, 95% CI equals 1.02-6.2, P<.001). This study found: an association between children of Caucasian mothers and the likelihood of experiencing claims; and a relationship between children born with low birth weight and C-section and the likelihood of use of Medicaid services.

  15. Risk Factors for Emergency Department Short Time Readmission in Stratified Population

    PubMed Central

    Besga, Ariadna; Ayerdi, Borja; Alcalde, Guillermo; Manzano, Alberto; Lopetegui, Pedro; Graña, Manuel; González-Pinto, Ana

    2015-01-01

    Background. Emergency department (ED) readmissions are considered an indicator of healthcare quality that is particularly relevant in older adults. The primary objective of this study was to identify key factors for predicting patients returning to the ED within 30 days of being discharged. Methods. We analysed patients who attended our ED in June 2014, stratified into four groups based on the Kaiser pyramid. We collected data on more than 100 variables per case including demographic and clinical characteristics and drug treatments. We identified the variables with the highest discriminating power to predict ED readmission and constructed classifiers using machine learning methods to provide predictions. Results. Classifier performance distinguishing between patients who were and were not readmitted (within 30 days), in terms of average accuracy (AC). The variables with the greatest discriminating power were age, comorbidity, reasons for consultation, social factors, and drug treatments. Conclusions. It is possible to predict readmissions in stratified groups with high accuracy and to identify the most important factors influencing the event. Therefore, it will be possible to develop interventions to improve the quality of care provided to ED patients. PMID:26682222

  16. Psychosocial risk and protective factors for the health and well-being of professionals working in emergency and non-emergency medical transport services, identified via questionnaires.

    PubMed

    Navarro Moya, P; González Carrasco, M; Villar Hoz, E

    2017-09-06

    Medical transport (MT) professionals are subject to considerable emotional demands due to their involvement in life-or-death situations and their exposure to the serious health problems of their clients. An increase in the demand for MT services has, in turn, increased interest in the study of the psychosocial risk factors affecting the health of workers in this sector. However, research thus far has not distinguished between emergency (EMT) and non-emergency (non-EMT) services, nor between the sexes. Furthermore, little emphasis has been placed on the protective factors involved. The main objective of the present study is to identify any existing differential exposure - for reasons of work setting (EMT and non-EMT) or of gender - to the various psychosocial risk and protective factors affecting the health of MT workers. Descriptive and transversal research with responses from 201 professionals. The scores obtained on the various psychosocial scales in our study - as indicators of future health problems - were more unfavourable for non-EMT workers than they were for EMT workers. Work setting, but not gender, was able to account for these differences. The scores obtained for the different psychosocial factors are generally more favourable for the professionals we surveyed than those obtained in previous samples. The significant differences observed between EMT and non-EMT personnel raise important questions regarding the organization of work in companies that carry out both services at the same time in the same territory. The relationships among the set of risk/protective factors suggests a need for further investigation into working conditions as well as a consideration of the workers' sense of coherence and subjective well-being as protective factors against occupational burnout syndrome.

  17. Emerging risk factors as markers for carotid intima media thickness scores.

    PubMed

    Masley, Steven C; Roetzheim, Richard; Masley, Lucas V; McNamara, Timothy; Schocken, Douglas D

    2015-01-01

    Cardiovascular disease (CVD) remains the number one cause of mortality in the Western world. This study aims to determine which lifestyle factors are associated with mean carotid intima media thickness (IMT), a safe and reliable predictor of future CVD risk. A prospective cross-sectional analysis of 592 subjects. Measures were made of body composition, anthropometric measures, fitness, diet (measured with a 3-day food diary), laboratory results, and mean carotid IMT. Multivariate analyses show that higher mean IMT values are associated with increasing age (p < 0.0001), male gender (p = 0.0002), higher systolic blood pressure (BP; p = 0.0008), higher body mass index (BMI; p = 0.0005), and lower intake of zinc (p = 0.0001). Bivariate analyses controlling for age and gender, with and without statin use, showed that higher mean IMT scores were statistically associated with higher diastolic BP (p = 0.007), higher total cholesterol/high-density lipoprotein (HDL) ratio (p < 0.0001), higher triglyceride/HDL ratio (p = 0.0001), lower aerobic capacity measures (p = 0.0007), higher body fat percentage and waist circumference (p < 0.0001), higher fasting glucose level (p = 0.028), and lower intake of magnesium (p = 0.019), fish (p = 0.007), and fiber (p = 0.02). Other factors that were not associated with mean IMT include total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-sensitivity C-reactive protein (hs-CRP); intake of saturated fat, potassium, calcium, sodium, or vitamin K; percentage of calories from protein, fat, or carbohydrate; measures of strength (assessed with push-up and sit-up testing); and reported exercise. Aerobic fitness and dietary intake of fiber, fish, magnesium, and zinc are inversely associated with carotid IMT scores. Of the traditional CVD risk factors, only systolic BP, fasting glucose, body composition, and total cholesterol/HDL ratio have a direct relationship with mean carotid IMT.

  18. Emergence of Coxiella burnetii in ruminants on Reunion Island? Prevalence and risk factors.

    PubMed

    Cardinale, Eric; Esnault, Olivier; Beral, Marina; Naze, Florence; Michault, Alain

    2014-08-01

    Q fever is a widespread zoonosis that is caused by Coxiella burnetii (C. burnetii), and ruminants are identified as the main sources of human infections. Some human cases have been described, but very limited information was available about Q fever in ruminants on Reunion Island, a tropical island in the Indian Ocean. A cross-sectional study was undertaken from March 2011 to August 2012 to assess the Q fever prevalence and to identify the major risk factors of C. burnetii infection in ruminants. A total of 516 ruminants (245 cattle, 137 sheep and 134 goats) belonging to 71 farms and localized in different ecosystems of the island were randomly selected. Samples of blood, vaginal mucus and milk were concomitantly collected from females, and a questionnaire was submitted to the farmers. Ticks from positively detected farms were also collected. The overall seropositivity was 11.8% in cattle, 1.4% in sheep and 13.4% in goats. C. burnetii DNA was detected by PCR in 0.81%, 4.4% and 20.1% in cow, sheep and goat vaginal swabs, respectively. C. burnetii shedding in milk was observed in 1% of cows, 0% in sheep and 4.7% in goats. None of the ticks were detected to be positive for C. burnetii. C. burnetii infection increased when the farm was exposed to prevailing winds and when there were no specific precautions for a visitor before entering the farm, and they decreased when a proper quarantine was set up for any introduction of a new ruminant and when the animals returned to the farm at night. MLVA genotyping confirmed the role of these risk factors in infection.

  19. Emergence of Coxiella burnetii in Ruminants on Reunion Island? Prevalence and Risk Factors

    PubMed Central

    Cardinale, Eric; Esnault, Olivier; Beral, Marina; Naze, Florence; Michault, Alain

    2014-01-01

    Q fever is a widespread zoonosis that is caused by Coxiella burnetii (C. burnetii), and ruminants are identified as the main sources of human infections. Some human cases have been described, but very limited information was available about Q fever in ruminants on Reunion Island, a tropical island in the Indian Ocean. A cross-sectional study was undertaken from March 2011 to August 2012 to assess the Q fever prevalence and to identify the major risk factors of C. burnetii infection in ruminants. A total of 516 ruminants (245 cattle, 137 sheep and 134 goats) belonging to 71 farms and localized in different ecosystems of the island were randomly selected. Samples of blood, vaginal mucus and milk were concomitantly collected from females, and a questionnaire was submitted to the farmers. Ticks from positively detected farms were also collected. The overall seropositivity was 11.8% in cattle, 1.4% in sheep and 13.4% in goats. C. burnetii DNA was detected by PCR in 0.81%, 4.4% and 20.1% in cow, sheep and goat vaginal swabs, respectively. C. burnetii shedding in milk was observed in 1% of cows, 0% in sheep and 4.7% in goats. None of the ticks were detected to be positive for C. burnetii. C. burnetii infection increased when the farm was exposed to prevailing winds and when there were no specific precautions for a visitor before entering the farm, and they decreased when a proper quarantine was set up for any introduction of a new ruminant and when the animals returned to the farm at night. MLVA genotyping confirmed the role of these risk factors in infection. PMID:25101780

  20. Clinically significant hemodynamic alterations after propacetamol injection in the emergency department: prevalence and risk factors.

    PubMed

    Bae, June-Il; Ahn, Shin; Lee, Yoon-Seon; Kim, Won Young; Lee, Jae Ho; Oh, Bum Jin; Lim, Kyung Soo

    2017-04-01

    Propacetamol, a water-soluble prodrug form of paracetamol, is hydrolyzed by esterase to generate paracetamol in the blood. Each gram of propacetamol is equal to 0.5 g of paracetamol. It has been reported to cause hypotension in critically ill patients with a fever. We aimed to investigate the hemodynamic effects of propacetamol for the control of fever in patients with diverse severities of illness who were managed in the emergency department (ED). We also aimed to identify clinical factors related to significant hemodynamic alterations in ED patients. This was a retrospective study of 1507 ED patients who received propacetamol. Significant hemodynamic alterations were defined as systolic blood pressure (SBP) <90 mmHg or diastolic blood pressure (DBP) <60 mmHg, or a drop in SBP >30 mmHg, which required treatments with a bolus of fluid or vasopressor administration. Postinfusion SBP and DBP were significantly lower than the preinfusion SBP and DBP. A clinically significant drop in BP occurred in 162 (10.7 %) patients, and interventions were necessary. Among the predictors assessed, congestive heart failure (OR 6.21, 95 % CI 2.67-14.45) and chills (OR 3.10, 95 % CI 2.04-4.70) were independent factors for a significant hemodynamic change. Administration of propacetamol can provoke a reduction in BP in ED patients. This reduction was clinically significant for 10 % of infusions. Clinicians should be aware of this potential deleterious effect, especially in patients with congestive heart failure or who experience chills prior to the administration of propacetamol.

  1. Conditions and Household Preparedness for Public Health Emergencies: Behavioral Risk Factor Surveillance System, 2006–2010

    PubMed Central

    Ko, Jean Y.; Strine, Tara W.; Allweiss, Pamela

    2016-01-01

    Introduction Individuals with chronic conditions often experience exacerbation of those conditions and have specialized medical needs after a disaster. Less is known about the level of disaster preparedness of this particular population and the extent to which being prepared might have an impact on the risk of disease exacerbation. The purpose of this study was to examine the association between self-reported asthma, cardiovascular disease, and diabetes and levels of household disaster preparedness. Methods Data were analyzed from 14 US states participating in the 2006–2010 Behavioral Risk Factor Surveillance System (BRFSS), a large state-based telephone survey. Chi-square statistics and adjusted prevalence ratios were calculated. Results After adjusting for sociodemographic characteristics, as compared to those without each condition, persons with cardiovascular disease (aPR =1.09; 95% CI, 1.01–1.17) and diabetes (aPR =1.13; 95% CI, 1.05–1.22) were slightly more likely to have an evacuation plan and individuals with diabetes (aPR =1.04; 95% CI, 1.02–1.05) and asthma (aPR =1.02; 95% CI, 1.01–1.04) were slightly more likely to have a 3-day supply of prescription medication. There were no statistically significant differences in the prevalence for all other preparedness measures (3-day supply of food and water, working radio and flashlight, willingness to leave during a mandatory evacuation) between those with and those without each chronic condition. Conclusion Despite the increased morbidity and mortality associated with chronic conditions, persons with diabetes, cardiovascular disease, and asthma were generally not more prepared for natural or man-made disasters than those without each chronic condition. PMID:24330818

  2. Hypertension, an Emerging Problem in Rural Cameroon: Prevalence, Risk Factors, and Control

    PubMed Central

    Arrey, Walters Tabi; Atashili, Julius; Mbuagbaw, Josephine; Monekosso, Gottlieb Lobe

    2016-01-01

    Background. Despite the increasing trends suggesting that hypertension is a growing public health problem in developing countries, studies on its prevalence, associated risk factors, and extent of blood pressure control have been inequitably done in urban and rural communities in these countries. We therefore aimed to determine the prevalence of hypertension and extent of blood pressure control in rural Cameroon. Methods. This was a community-based cross-sectional study conducted in rural Cameroon (the Moliwe Health Area). Participants aged 21 years and above were recruited by a probability proportional to size multistage sampling method, using systematic sampling for household selection and random sampling for participant selection. Blood pressure, weight, and height were measured by standard methods. Hypertension was defined as BP ≥ 140/90 mmHg. Results. The prevalence of hypertension among the 733 participants recruited was 31.1% (95% CI: 27.8–34.6) and 71% (95% CI: 58.7–81.7) of these hypertensive patients were newly diagnosed. Only 21.2% (95% CI: 12.1–33.3) of known hypertensives had a well controlled BP. Age, obesity, low educational status, and being married were associated with HTN after adjusting for confounders. Conclusions. The high prevalence of hypertension and inadequate BP control among known hypertensives in rural Cameroon warrants greater sensitization and regular screening to reduce hypertension-related morbidity and mortality. PMID:28053779

  3. Emergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factors.

    PubMed

    Dizbay, Murat; Guzel Tunccan, Ozlem; Karasahin, Omer; Aktas, Firdevs

    2014-01-15

    Risk factors for nosocomial carbapenem-resistant Klebsiella spp. (CRK) infections were analyzed in this study. The incidence, clinical characteristics, risk factors, antimicrobial susceptibility, and outcomes of CRK infections during a seven-year period (2004-2010) were retrospectively analyzed. A total of 720 patients were included in the study. Carbapenem resistance among Klebsiella spp. were significantly increased between 2003 and 2007 (p<0.001). CRK strains were mostly isolated from ICUs (p<0.001). Use of imipenem and cefoperazone-sulbactam within prior three months, stay in ICU, receiving immunspressive therapy, receiving H2 receptor antagonists, tracheostomy, mechanical ventilation, hemodialysis, urinary catheter were found to be significant risk factors for carbapenem resistance Klebsiella spp. infections. In a multivariate analysis, prior use of imipenem (OR 3.35; CI 1.675-6.726, p<0.001), stay in ICU (OR 3.36; 95% CI 1.193-9.508; p=0.022), receiving H2 receptor antagonist (OR 4.49; 95% CI 1.011-19.951; p=0.048) were independently associated with carbapenem resistance. Respiratory tract infections were the most seen nosocomial infection. Attack mortality rate was significantly higher in patients infected with CRK strains (p<0.001). CRK strains showed significantly higher resistance rates to other antibiotics. In conclusion, the emergence and rapid spread of CRK strains in our hospital is worrisome. The patients in ICU are most important risk group for the acquisition of CRK strains. High resistant rates to other antibiotics except than colistin and tigecycline limits therapeutic options, and increases mortality rates.

  4. Emerging viral respiratory tract infections--environmental risk factors and transmission.

    PubMed

    Gautret, Philippe; Gray, Gregory C; Charrel, Remi N; Odezulu, Nnanyelugo G; Al-Tawfiq, Jaffar A; Zumla, Alimuddin; Memish, Ziad A

    2014-11-01

    The past decade has seen the emergence of several novel viruses that cause respiratory tract infections in human beings, including Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia, an H7N9 influenza A virus in eastern China, a swine-like influenza H3N2 variant virus in the USA, and a human adenovirus 14p1 also in the USA. MERS-CoV and H7N9 viruses are still a major worldwide public health concern. The pathogenesis and mode of transmission of MERS-CoV and H7N9 influenza A virus are poorly understood, making it more difficult to implement intervention and preventive measures. A united and coordinated global response is needed to tackle emerging viruses that can cause fatal respiratory tract infections and to fill major gaps in the understanding of the epidemiology and transmission dynamics of these viruses.

  5. [Faintness in emergency departments is frequent, benign but expensive: An epidemiologic study of hospitalization's risk factors to reduce overcrowdings of emergency departments].

    PubMed

    Gedda, E; Robbins, A; Hentzien, M; Giltat, A; Pinel-Petit, V; Souille, J; N'Guyen, Y

    2017-01-01

    We assessed (i) the frequency of consultations for faintness in the Emergency department (ED) of a University hospital centre (UHC), (ii) clinical epidemiology and (iii) cost of faintness, taking a particular interest into the determining risk factors for hospitalization. This epidemiological study has been conducted retrospectively, from data obtained for every patient having consulted for faintness in ED of Reims UHC (01/01/12-03/31/12). Every medical record was classified as syncope/lipothymia/brief consciousness loss on one hand and as syncope according to the definition of the French Health High Authority (FHHA). Three hundred and forty-one patients out of 5953 (5.7%) were referred for faintness during the study period. Medical records were analysed for 296 patients. Sixty-two point eight percent were women, with a median age of 43years. Physical examination was normal for 57% of patients. For 48% of cases, there was no complete consciousness loss thus corresponding to lipothymia, which is not taken into account by the FHHA definition. Median length of stay in the ED was 4hours and 67 patients (22.6%) were hospitalized. Minimal estimated cost was 280,000 euros. Risk factors independently associated with hospitalization were age≥60 and complete consciousness loss unlike predisposing circumstances to vagal hypertonia. Age≥60 and complete consciousness loss seemed to be associated with hospitalization. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  6. Pancreatic Cancer Risk Factors

    MedlinePlus

    ... Cancer Causes, Risk Factors, and Prevention Pancreatic Cancer Risk Factors A risk factor is anything that affects ... these are risk factors for exocrine pancreatic cancer . Risk factors that can be changed Tobacco use Smoking ...

  7. Gastric dilation-volvulus in dogs attending UK emergency-care veterinary practices: prevalence, risk factors and survival.

    PubMed

    O'Neill, D G; Case, J; Boag, A K; Church, D B; McGreevy, P D; Thomson, P C; Brodbelt, D C

    2017-08-21

    To report prevalence, risk factors and clinical outcomes for presumptive gastric dilation-volvulus diagnosed among an emergency-care population of UK dogs. The study used a cross-sectional design using emergency-care veterinary clinical records from the VetCompass Programme spanning September 1, 2012 to February 28, 2014 and risk factor analysis using multivariable logistic regression modelling. The study population comprised 77,088 dogs attending 50 Vets Now clinics. Overall, 492 dogs had presumptive gastric dilation-volvulus diagnoses, giving a prevalence of 0·64% (95% Confidence interval: 0·58 to 0·70%). Compared with cross-bred dogs, breeds with the highest odds ratios for the diagnosis of presumptive gastric dilation-volvulus were the great Dane (odds ratio: 114·3, 95% Confidence interval 55·1 to 237·1, P<0·001), akita (odds ratio: 84·4, 95% Confidence interval 33·6 to 211·9, P<0·001) and dogue de Bordeaux (odds ratio: 82·9, 95% Confidence interval 39·0 to 176·3, P<0·001). Odds increased as dogs aged up to 12 years and neutered male dogs had 1·3 (95% Confidence interval 1·0 to 1·8, P=0·041) times the odds compared with entire females. Of the cases that were presented alive, 49·7% survived to discharge overall, but 79·3% of surgical cases survived to discharge. Approximately 80% of surgically managed cases survived to discharge. Certain large breeds were highly predisposed. © 2017 British Small Animal Veterinary Association.

  8. "Honor," collectivity, and agnation: emerging risk factors in "honor"-based violence.

    PubMed

    Payton, Joanne

    2014-11-01

    "Honor"-based violence (HBV) is increasingly recognized as form of violence against women and girls, but is neither fully conceptualized nor integrated into risk management strategies that are increasingly used to address gender-based violence in Europe and Anglophone states. This article will argue that there are grounds for the differentiation of HBV as a sub-category of gender-based violence which may affect risk management. Research was based in an analysis of 40 case files taken from Arabic- and Kurdish-speaking clients of a London nongovernment organization (NGO) providing services to women facing violence. Interrelations were found between "honor," agnation, and collectivity in their experiences of violence, with ramifications for service provision. © The Author(s) 2014.

  9. Substance Use as a Risk Factor for Sleep Problems Among Adolescents Presenting to the Emergency Department.

    PubMed

    Zhabenko, Olena; Austic, Elizabeth; Conroy, Deirdre A; Ehrlich, Peter; Singh, Vijay; Epstein-Ngo, Quyen; Cunningham, Rebecca M; Walton, Maureen A

    2016-01-01

    To determine correlates of sleep problems among adolescents. Specifically, to assess the relative strength of associations between sleep problems and dating victimization, reasons for emergency department (ED) visit, depression, unhealthy alcohol use, and other drug use (marijuana, nonmedical use of prescription opioids, stimulants, and tranquilizers). A total of 1852 adolescents aged 14 to 20 years presenting for care to the University of Michigan Emergency Department, Ann Arbor, Michigan, during 2011-2012, self-administered a computerized health survey. Sleep problems were identified if any of the 4 items on the Sleep Problems Questionnaire were rated by a patient as greater than 3 on a 0 to 5 scale. Adolescents who were too sick to be screened in the ED were eligible to participate in the study during their inpatient stay. Exclusion criteria for baseline included insufficient cognitive orientation precluding informed consent, not having parent/guardian present if younger than 18 years, medical severity precluding participation, active suicidal/homicidal ideation, non-English-speaking, deaf/visually impaired, or already participated in this study on a prior visit. 23.5% of adolescents reported clinically significant sleep problems. Female gender, depression, dating victimization, tobacco use, nonmedical use of prescription medication, and an ED visit for medical reasons were each associated with sleep problems among adolescents, even while controlling for age, other types of drug use, receiving public assistance, and dropping out of school. These exploratory findings indicate that ED-based screening and brief intervention approaches addressing substance use and/or dating victimization may need to account for previously undiagnosed sleep problems.

  10. Animal husbandry practices in rural Bangladesh: potential risk factors for antimicrobial drug resistance and emerging diseases.

    PubMed

    Roess, Amira A; Winch, Peter J; Ali, Nabeel A; Akhter, Afsana; Afroz, Dilara; El Arifeen, Shams; Darmstadt, Gary L; Baqui, Abdullah H

    2013-11-01

    Antimicrobial drug administration to household livestock may put humans and animals at risk for acquisition of antimicrobial drug-resistant pathogens. To describe animal husbandry practices, including animal healthcare-seeking and antimicrobial drug use in rural Bangladesh, we conducted semi-structured in-depth interviews with key informants, including female household members (n = 79), village doctors (n = 10), and pharmaceutical representatives, veterinarians, and government officials (n = 27), and performed observations at animal health clinics (n = 3). Prevalent animal husbandry practices that may put persons at risk for acquisition of pathogens included shared housing and water for animals and humans, antimicrobial drug use for humans and animals, and crowding. Household members reported seeking human and animal healthcare from unlicensed village doctors rather than formal-sector healthcare providers and cited cost and convenience as reasons. Five times more per household was spent on animal than on human healthcare. Strengthening animal and human disease surveillance systems should be continued. Interventions are recommended to provide vulnerable populations with a means of protecting their livelihood and health.

  11. Emergency Department Use and Risk Factors among Deaf American Sign Language Users

    PubMed Central

    McKee, Michael M.; Winters, Paul C.; Sen, Ananda; Zazove, Philip; Fiscella, Kevin

    2015-01-01

    Background Deaf American Sign Language (ASL) users comprise a linguistic minority population with poor health care access due to communication barriers and low health literacy. Potentially, these health care barriers could increase Emergency Department (ED) use. Objective To compare ED use between deaf and non-deaf patients. Method A retrospective cohort from medical records. The sample was derived from 400 randomly selected charts (200 deaf ASL users and 200 hearing English speakers) from an outpatient primary care health center with a high volume of deaf patients. Abstracted data included patient demographics, insurance, health behavior, and ED use in the past 36 months. Results Deaf patients were more likely to be never smokers and be insured through Medicaid. In an adjusted analysis, deaf individuals were significantly more likely to use the ED (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.11–3.51) over the prior 36 months. Conclusion Deaf American Sign Language users appear to be at greater odds for elevated ED utilization when compared to the general hearing population. Efforts to further understand the drivers for increased ED utilization among deaf ASL users are much needed. PMID:26166160

  12. Relationships of work-related psychosocial risks, stress, individual factors and burnout - Questionnaire survey among emergency physicians and nurses.

    PubMed

    Ilić, Ivana M; Arandjelović, Mirjana Ž; Jovanović, Jovica M; Nešić, Milkica M

    2017-03-24

    Psychosocial risks represent a great challenge for safety and health protection at work in Europe. The purpose of this study has been to determine the relationships of psychosocial risks arising from work, stress, personal characteristics and burnout among physicians and nurses in the Emergency Medical Service (EMS). We performed a cross-sectional study based on a questionnaire survey which contained the Copenhagen Psychosocial Questionnaire (COPSOQ) and Copenhagen Burnout Inventory (CBI). A total of 88 physicians and 80 nurses completed the survey. Physicians demonstrated higher emotional (mean (M) ± standard deviation (SD) = 74.57±16.85) and cognitive (M±SD = 75.95±13.74) demands as compared to nurses. Both groups had high sensory demands and responsibilities at work, in spite of the low degree of their autonomy. The meaning of work, commitment to the workplace, and insecurity at work were high for both groups. Among all participants, stressful behavior and reactions were within the limits of low values (< 40) and coping strategies showed high values (> 60). Personal and patient-related burnout was high for both groups, where physicians were significantly affected by work-related burnout. The influence at work, degree of freedom at work, social support, sense of coherence, mental health, and problem-focused coping are negatively related to work-related burnout. Based on personal factors and coping styles, emergency physicians and nurses are representing a self-selective professional group that meets high work demands, great responsibility, strong commitment and insecurity at work. Burnout of physicians and nurses in the EMS tends to be ignored, although it has severe consequences on their mental and general health. Med Pr 2017;68(2):178-178.

  13. Heart disease - risk factors

    MedlinePlus

    Heart disease - prevention; CVD - risk factors; Cardiovascular disease - risk factors; Coronary artery disease - risk factors; CAD - risk ... a certain health condition. Some risk factors for heart disease you cannot change, but some you can. ...

  14. Factors associated with an increased risk of perioperative cardiac arrest in emergent and elective craniotomy and spine surgery.

    PubMed

    Quinn, Timothy D; Brovman, Ethan Y; Aglio, Linda S; Urman, Richard D

    2017-10-01

    Cardiac arrest following neurosurgery is a devastating complication associated with significant postoperative morbidity and mortality. There are no published studies that have used a large and robust multicenter database to specifically examine demographic and surgical risk factors associated with cardiac arrests following craniotomy and spine surgeries, respectively. We retrospectively analyzed data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for the period between January 1, 2007 and December 31, 2013, focusing on cardiac arrest associated with craniotomy and spine surgery from the intraoperative period to 30days after surgery. A total of 73,584 neurosurgical patients were analyzed (59,609 spine surgeries and 13,975 craniotomies). There was an increased risk of cardiac arrest for both craniotomy and spine surgeries in patients with American Society of Anesthesiologists (ASA) Physical Status class 4 or 5, Black and Asian patients compared to White patients and patients totally dependent versus independent based on the ACS-NSQIP risk calculator. The risk of cardiac arrest for craniotomy was 66.5 per 10,000 anesthetics and for spine surgery was 21.3 per 10,000 anesthetics. Cardiac arrest associated with emergent non-traumatic craniotomy was 36.5% and with emergent non-traumatic spine surgery was only 17.3%. We found that 18% of cardiac arrests for craniotomy and 25% of cardiac arrests for spine surgery occurred from the intraoperative period through postoperative day (POD) 0. Both craniotomy and spine surgery patients who had a cardiac arrest were more likely to have acute kidney injury (AKI), failure to wean from the ventilator, postoperative dialysis, myocardial infarction (MI), venous thromboembolism (VTE) and sepsis in the postoperative period. The overall mortality rate for both craniotomy and spine surgeries who had a cardiac arrest from the intraoperative period to 30days postoperative was 61

  15. Risk Factors

    MedlinePlus

    ... has been linked to some cancers: Links between air pollution and cancer risk have been found. These include ... between lung cancer and secondhand tobacco smoke , outdoor air pollution, and asbestos . Drinking water that contains a large ...

  16. Risk factors.

    PubMed

    Robbins, Catherine J; Connors, K C; Sheehan, Timothy J; Vaughan, James S

    2005-06-01

    Minimize surprises on your financial statement by adopting a model for integrated risk management that: Examines interrelationships among operations, investments, and financing. Incorporates concepts of the capital asset pricing model to manage unexpected volatility

  17. Evaluation of prediagnosis emergency department presentations in patients with active tuberculosis: the role of chest radiography, risk factors and symptoms

    PubMed Central

    Appleton, S C; Connell, D W; Singanayagam, A; Bradley, P; Pan, D; Sanderson, F; Cleaver, B; Rahman, A; Kon, O M

    2017-01-01

    Introduction London has a high rate of tuberculosis (TB) with 2572 cases reported in 2014. Cases are more common in non-UK born, alcohol-dependent or homeless patients. The emergency department (ED) presents an opportunity for the diagnosis of TB in these patient groups. This is the first study describing the clinico-radiological characteristics of such attendances in two urban UK hospitals for pulmonary TB (PTB) and extrapulmonary TB (EPTB). Methods We conducted a retrospective cohort study using the London TB Register (LTBR) and hospital records to identify patients who presented to two London ED's in the 6 months prior to their ultimate TB diagnosis 2011–2012. Results 397 TB cases were identified. 39% (154/397) had presented to the ED in the 6 months prior to diagnosis. In the study population, the presence of cough, weight loss, fever and night sweats only had prevalence rates of 40%, 34%, 34% and 21%, respectively. Chest radiography was performed in 76% (117/154) of patients. For cases where a new diagnosis of TB was suspected, 73% (41/56) had an abnormal radiograph, compared with 36% (35/98) of patients where it was not. There was an abnormality on a chest radiograph in 73% (55/75) of PTB cases and also in 40% (21/52) of EPTB cases where a film was requested. Conclusions A large proportion of patients with TB present to ED. A diagnosis was more likely in the presence of an abnormal radiograph, suggesting opportunities for earlier diagnosis if risk factors, symptoms and chest radiograph findings are combined. PMID:28123749

  18. Evaluation of prediagnosis emergency department presentations in patients with active tuberculosis: the role of chest radiography, risk factors and symptoms.

    PubMed

    Appleton, S C; Connell, D W; Singanayagam, A; Bradley, P; Pan, D; Sanderson, F; Cleaver, B; Rahman, A; Kon, O M

    2017-01-01

    London has a high rate of tuberculosis (TB) with 2572 cases reported in 2014. Cases are more common in non-UK born, alcohol-dependent or homeless patients. The emergency department (ED) presents an opportunity for the diagnosis of TB in these patient groups. This is the first study describing the clinico-radiological characteristics of such attendances in two urban UK hospitals for pulmonary TB (PTB) and extrapulmonary TB (EPTB). We conducted a retrospective cohort study using the London TB Register (LTBR) and hospital records to identify patients who presented to two London ED's in the 6 months prior to their ultimate TB diagnosis 2011-2012. 397 TB cases were identified. 39% (154/397) had presented to the ED in the 6 months prior to diagnosis. In the study population, the presence of cough, weight loss, fever and night sweats only had prevalence rates of 40%, 34%, 34% and 21%, respectively. Chest radiography was performed in 76% (117/154) of patients. For cases where a new diagnosis of TB was suspected, 73% (41/56) had an abnormal radiograph, compared with 36% (35/98) of patients where it was not. There was an abnormality on a chest radiograph in 73% (55/75) of PTB cases and also in 40% (21/52) of EPTB cases where a film was requested. A large proportion of patients with TB present to ED. A diagnosis was more likely in the presence of an abnormal radiograph, suggesting opportunities for earlier diagnosis if risk factors, symptoms and chest radiograph findings are combined.

  19. Risk Factors for Tuberculosis

    PubMed Central

    Narasimhan, Padmanesan; Wood, James; MacIntyre, Chandini Raina; Mathai, Dilip

    2013-01-01

    The risk of progression from exposure to the tuberculosis bacilli to the development of active disease is a two-stage process governed by both exogenous and endogenous risk factors. Exogenous factors play a key role in accentuating the progression from exposure to infection among which the bacillary load in the sputum and the proximity of an individual to an infectious TB case are key factors. Similarly endogenous factors lead in progression from infection to active TB disease. Along with well-established risk factors (such as human immunodeficiency virus (HIV), malnutrition, and young age), emerging variables such as diabetes, indoor air pollution, alcohol, use of immunosuppressive drugs, and tobacco smoke play a significant role at both the individual and population level. Socioeconomic and behavioral factors are also shown to increase the susceptibility to infection. Specific groups such as health care workers and indigenous population are also at an increased risk of TB infection and disease. This paper summarizes these factors along with health system issues such as the effects of delay in diagnosis of TB in the transmission of the bacilli. PMID:23476764

  20. Emerging risk factors and the dose-response relationship between physical activity and lone atrial fibrillation: a prospective case-control study.

    PubMed

    Calvo, Naiara; Ramos, Pablo; Montserrat, Silvia; Guasch, Eduard; Coll-Vinent, Blanca; Domenech, Mònica; Bisbal, Felipe; Hevia, Sara; Vidorreta, Silvia; Borras, Roger; Falces, Carles; Embid, Cristina; Montserrat, Josep Maria; Berruezo, Antonio; Coca, Antonio; Sitges, Marta; Brugada, Josep; Mont, Lluís

    2016-01-01

    The role of high-intensity exercise and other emerging risk factors in lone atrial fibrillation (Ln-AF) epidemiology is still under debate. The aim of this study was to analyse the contribution of each of the emerging risk factors and the impact of physical activity dose in patients with Ln-AF. Patients with Ln-AF and age- and sex-matched healthy controls were included in a 2:1 prospective case-control study. We obtained clinical and anthropometric data transthoracic echocardiography, lifetime physical activity questionnaire, 24-h ambulatory blood pressure monitoring, Berlin questionnaire score, and, in patients at high risk for obstructive sleep apnoea (OSA) syndrome, a polysomnography. A total of 115 cases and 57 controls were enrolled. Conditional logistic regression analysis associated height [odds ratio (OR) 1.06 [1.01-1.11

  1. Emerging risk factors and the dose–response relationship between physical activity and lone atrial fibrillation: a prospective case–control study

    PubMed Central

    Calvo, Naiara; Ramos, Pablo; Montserrat, Silvia; Guasch, Eduard; Coll-Vinent, Blanca; Domenech, Mònica; Bisbal, Felipe; Hevia, Sara; Vidorreta, Silvia; Borras, Roger; Falces, Carles; Embid, Cristina; Montserrat, Josep Maria; Berruezo, Antonio; Coca, Antonio; Sitges, Marta; Brugada, Josep; Mont, Lluís

    2016-01-01

    Aims The role of high-intensity exercise and other emerging risk factors in lone atrial fibrillation (Ln-AF) epidemiology is still under debate. The aim of this study was to analyse the contribution of each of the emerging risk factors and the impact of physical activity dose in patients with Ln-AF. Methods and results Patients with Ln-AF and age- and sex-matched healthy controls were included in a 2:1 prospective case–control study. We obtained clinical and anthropometric data transthoracic echocardiography, lifetime physical activity questionnaire, 24-h ambulatory blood pressure monitoring, Berlin questionnaire score, and, in patients at high risk for obstructive sleep apnoea (OSA) syndrome, a polysomnography. A total of 115 cases and 57 controls were enrolled. Conditional logistic regression analysis associated height [odds ratio (OR) 1.06 [1.01–1.11

  2. Analysis of traditional and emerging risk factors in premenopausal women with coronary artery disease: A pilot-scale study from North India.

    PubMed

    Vijayvergiya, Rajesh; Kapoor, Divya; Aggarwal, Ajay; Sangwan, Sonal; Suri, Vanita; Dhawan, Veena

    2017-03-23

    Premenopausal women are known to have less heart disease than their menopausal counterparts and men. However, there is a rising prevalence of coronary artery disease (CAD) in premenopausal females, which necessitates determination of risk factors that negate the effects of hormonal protection. There are few studies describing the prevalence of traditional and emerging risk factors in premenopausal women with CAD. Thus, our objective was to explore the prevalence of traditional and emerging risk factors and features of coronary lesions in premenopausal women with CAD in an Indian population. Forty premenopausal female patients with angiographically proven CAD and undergoing treatment with conventional therapies and 40 age-matched premenopausal females without any evidence of CAD were enrolled. Premenopausal females with CAD most commonly had the single-vessel CAD and the left anterior descending artery was most commonly involved. The prevalence of hypertension, diabetes, obesity, metabolic syndrome, family history of CAD and 10-year risk score was higher in premenopausal females with CAD than controls. Even after treatment with conventional therapies, premenopausal women with CAD had dyslipidemia and significantly elevated levels of emerging risk factors such as ApoB, ApoB/ApoA1 ratio, hsCRP, lipoprotein (a), uric acid, T4, fibrinogen, and total leukocyte count as compared to controls (p < 0.05). Further, they had significantly lower levels of HDL-C, and Apolipoprotein A1 and T3 which are protective markers for vascular risk. Multivariate regression analysis demonstrated that low levels of Apo A1 and high levels of fibrinogen, hsCRP and TG drive the vascular risk, and therefore these factors should be considered as candidates for better diagnosis, early detection, and intervention of CAD in premenopausal women.

  3. Emerging and reemerging neglected tropical diseases: a review of key characteristics, risk factors, and the policy and innovation environment.

    PubMed

    Mackey, Tim K; Liang, Bryan A; Cuomo, Raphael; Hafen, Ryan; Brouwer, Kimberly C; Lee, Daniel E

    2014-10-01

    In global health, critical challenges have arisen from infectious diseases, including the emergence and reemergence of old and new infectious diseases. Emergence and reemergence are accelerated by rapid human development, including numerous changes in demographics, populations, and the environment. This has also led to zoonoses in the changing human-animal ecosystem, which are impacted by a growing globalized society where pathogens do not recognize geopolitical borders. Within this context, neglected tropical infectious diseases have historically lacked adequate attention in international public health efforts, leading to insufficient prevention and treatment options. This subset of 17 infectious tropical diseases disproportionately impacts the world's poorest, represents a significant and underappreciated global disease burden, and is a major barrier to development efforts to alleviate poverty and improve human health. Neglected tropical diseases that are also categorized as emerging or reemerging infectious diseases are an even more serious threat and have not been adequately examined or discussed in terms of their unique risk characteristics. This review sets out to identify emerging and reemerging neglected tropical diseases and explore the policy and innovation environment that could hamper or enable control efforts. Through this examination, we hope to raise awareness and guide potential approaches to addressing this global health concern. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  4. Emerging and Reemerging Neglected Tropical Diseases: a Review of Key Characteristics, Risk Factors, and the Policy and Innovation Environment

    PubMed Central

    Liang, Bryan A.; Cuomo, Raphael; Hafen, Ryan; Brouwer, Kimberly C.; Lee, Daniel E.

    2014-01-01

    SUMMARY In global health, critical challenges have arisen from infectious diseases, including the emergence and reemergence of old and new infectious diseases. Emergence and reemergence are accelerated by rapid human development, including numerous changes in demographics, populations, and the environment. This has also led to zoonoses in the changing human-animal ecosystem, which are impacted by a growing globalized society where pathogens do not recognize geopolitical borders. Within this context, neglected tropical infectious diseases have historically lacked adequate attention in international public health efforts, leading to insufficient prevention and treatment options. This subset of 17 infectious tropical diseases disproportionately impacts the world's poorest, represents a significant and underappreciated global disease burden, and is a major barrier to development efforts to alleviate poverty and improve human health. Neglected tropical diseases that are also categorized as emerging or reemerging infectious diseases are an even more serious threat and have not been adequately examined or discussed in terms of their unique risk characteristics. This review sets out to identify emerging and reemerging neglected tropical diseases and explore the policy and innovation environment that could hamper or enable control efforts. Through this examination, we hope to raise awareness and guide potential approaches to addressing this global health concern. PMID:25278579

  5. Risk Factors and Prevention

    MedlinePlus

    ... Resources Risk Factors & Prevention Back to Patient Resources Risk Factors & Prevention Even people who look healthy and ... Blood Pressure , high cholesterol, diabetes, and thyroid disease. Risk Factors For Arrhythmias and Heart Disease The following ...

  6. Risk factors and screening instruments to predict adverse outcomes for undifferentiated older emergency department patients: a systematic review and meta-analysis.

    PubMed

    Carpenter, Christopher R; Shelton, Erica; Fowler, Susan; Suffoletto, Brian; Platts-Mills, Timothy F; Rothman, Richard E; Hogan, Teresita M

    2015-01-01

    A significant proportion of geriatric patients experience suboptimal outcomes following episodes of emergency department (ED) care. Risk stratification screening instruments exist to distinguish vulnerable subsets, but their prognostic accuracy varies. This systematic review quantifies the prognostic accuracy of individual risk factors and ED-validated screening instruments to distinguish patients more or less likely to experience short-term adverse outcomes like unanticipated ED returns, hospital readmissions, functional decline, or death. A medical librarian and two emergency physicians conducted a medical literature search of PubMed, EMBASE, SCOPUS, CENTRAL, and ClinicalTrials.gov using numerous combinations of search terms, including emergency medical services, risk stratification, geriatric, and multiple related MeSH terms in hundreds of combinations. Two authors hand-searched relevant specialty society research abstracts. Two physicians independently reviewed all abstracts and used the revised Quality Assessment of Diagnostic Accuracy Studies instrument to assess individual study quality. When two or more qualitatively similar studies were identified, meta-analysis was conducted using Meta-DiSc software. Primary outcomes were sensitivity, specificity, positive likelihood ratio (LR+), and negative likelihood ratio (LR-) for predictors of adverse outcomes at 1 to 12 months after the ED encounters. A hypothetical test-treatment threshold analysis was constructed based on the meta-analytic summary estimate of prognostic accuracy for one outcome. A total of 7,940 unique citations were identified yielding 34 studies for inclusion in this systematic review. Studies were significantly heterogeneous in terms of country, outcomes assessed, and the timing of post-ED outcome assessments. All studies occurred in ED settings and none used published clinical decision rule derivation methodology. Individual risk factors assessed included dementia, delirium, age, dependency

  7. Trends in emerging and high risk activities

    Treesearch

    Robert C. White; Richard Schreyer; Kent Downing

    1980-01-01

    Newly emerging and high risk activities have increased markedly in the last generation, yet little is known about trends in participation. Factors such as technological innovation and creative experimentation with traditional activities appear to play a major role in the development of new activities. Christy's criteria for mass demand in recreation are used to...

  8. Baseline characteristics and treatment-emergent risk factors associated with cerebrovascular event and death with risperidone in dementia patients.

    PubMed

    Howard, Robert; Costafreda, Sergi G; Karcher, Keith; Coppola, Danielle; Berlin, Jesse A; Hough, David

    2016-11-01

    Use of antipsychotics to treat behavioural symptoms of dementia has been associated with increased risks of mortality and stroke. Little is known about individual patient characteristics that might be associated with bad or good outcomes. We examined the risperidone clinical trial data to look for individual patient characteristics associated with these adverse outcomes. Data from all double-blind randomised controlled trials of risperidone in dementia patients (risperidone n = 1009, placebo n = 712) were included. Associations between characteristics and outcome were analysed based on crude incidences and exposure-adjusted incidence rates, and by time-to-event analyses using Cox proportional hazards regression. Interactions between treatment (risperidone or placebo) and characteristic were analysed with a Cox proportional hazards regression model with main effects for treatment and characteristic in addition to the interaction term. Baseline complications of depression (treatment by risk factor interaction on cerebrovascular adverse event (CVAE) hazard ratio (HR): P = 0.025) and delusions (P = 0.043) were associated with a lower relative risk of CVAE in risperidone-treated patients (HR = 1.47 and 0.54, respectively) compared to not having the complication (HR = 5.88 and 4.16). For mortality, the only significant baseline predictor in patients treated with risperidone was depression, which was associated with a lower relative risk (P<0.001). The relative risk of mortality was increased in risperidone patients treated with anti-inflammatory medications (P = 0.021). Only anti-inflammatory medications increased mortality risk with risperidone. The reduced risks of CVAE in patients with comorbid depression and delusions, and of mortality with depression, may have clinical implications when weighing the benefits and risks of treatment with risperidone in patients with dementia. © The Royal College of Psychiatrists 2016.

  9. Estimating the spatial distribution of acute undifferentiated fever (AUF) and associated risk factors using emergency call data in India. A symptom-based approach for public health surveillance.

    PubMed

    Kauhl, Boris; Pilot, Eva; Rao, Ramana; Gruebner, Oliver; Schweikart, Jürgen; Krafft, Thomas

    2015-01-01

    The System for Early-warning based on Emergency Data (SEED) is a pilot project to evaluate the use of emergency call data with the main complaint acute undifferentiated fever (AUF) for syndromic surveillance in India. While spatio-temporal methods provide signals to detect potential disease outbreaks, additional information about socio-ecological exposure factors and the main population at risk is necessary for evidence-based public health interventions and future preparedness strategies. The goal of this study is to investigate whether a spatial epidemiological analysis at the ecological level provides information on urban-rural inequalities, socio-ecological exposure factors and the main population at risk for AUF. Our results displayed higher risks in rural areas with strong local variation. Household industries and proximity to forests were the main socio-ecological exposure factors and scheduled tribes were the main population at risk for AUF. These results provide additional information for syndromic surveillance and could be used for evidence-based public health interventions and future preparedness strategies.

  10. Coping behavior and risk and resilience stress factors in French regional emergency medicine unit workers: a cross-sectional survey

    PubMed Central

    Lala, AI; Sturzu, LM; Picard, JP; Druot, F; Grama, F; Bobirnac, G

    2016-01-01

    The Emergency Department (ED) has the highest workload in a hospital, offering care to patients in their most acute state of illness, as well as comforting their families and tending to stressful situations of the physical and psychological areal. Method. A cross-sectional survey of 366 Emergency Unit staff members including medical doctors, medical residents, medical nurses and ward aids, was undergone. Study participants came from four periphery hospitals in the Moselle Department of Eastern France with similar workforce and daily patient loads statistics. The instruments used were the Perceived Stress Scale PSS-10 and the Brief COPE questionnaire. Conclusions. Perceived work overload and overall stress is strongly related to work hours and tend to have a stronger influence on doctors than on the nursing staff. Substance use is a common coping method for medical interns, consistent with prior research. The regular assessment of the ED staff perception of stress and stress related factors is essential to support organizational decisions in order to promote a better work environment and better patient care. PMID:27928439

  11. Coping behavior and risk and resilience stress factors in French regional emergency medicine unit workers: a cross-sectional survey.

    PubMed

    Lala, A I; Sturzu, L M; Picard, J P; Druot, F; Grama, F; Bobirnac, G

    2016-01-01

    The Emergency Department (ED) has the highest workload in a hospital, offering care to patients in their most acute state of illness, as well as comforting their families and tending to stressful situations of the physical and psychological areal. Method. A cross-sectional survey of 366 Emergency Unit staff members including medical doctors, medical residents, medical nurses and ward aids, was undergone. Study participants came from four periphery hospitals in the Moselle Department of Eastern France with similar workforce and daily patient loads statistics. The instruments used were the Perceived Stress Scale PSS-10 and the Brief COPE questionnaire. Conclusions. Perceived work overload and overall stress is strongly related to work hours and tend to have a stronger influence on doctors than on the nursing staff. Substance use is a common coping method for medical interns, consistent with prior research. The regular assessment of the ED staff perception of stress and stress related factors is essential to support organizational decisions in order to promote a better work environment and better patient care.

  12. Emergence and risk factors of β-lactamase-mediated resistance to oxyimino-β-lactams in Enterobacteriaceae isolates.

    PubMed

    Manageiro, Vera; Ferreira, Eugénia; Jones-Dias, Daniela; Louro, Deolinda; Pinto, Margarida; Diogo, José; Caniça, Manuela

    2012-03-01

    We studied 193 Enterobacteriaceae isolates presenting diminished susceptibility to oxyimino-cephalosporins recovered in a Portuguese hospital (2004-2008). CTX-M-3 producers, firstly detected in Portugal, were associated with a Klebsiella pneumoniae microepidemic clone. Production of CTX-M-type enzymes (CTX-M-1/-3/-9/-14/-15/-32), age ≥65 years, and nosocomial infection were risk factors for higher nonsusceptibility to oxyimino-β-lactams. CMY-2 and DHA-1 β-lactamases were only identified in 1% of isolates. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Phosphate excretion is decreased in older cardiac patients with normal kidney function: an emerging dietary risk factor?

    PubMed

    Jozefacki, Alexis; White, Christine A; Shobeiri, Navid S; Hopman, Wilma M; Johri, Amer M; Adams, Michael A; Holden, Rachel M

    2016-04-01

    Serum phosphate independently predicts cardiovascular events and mortality. Sixteen healthy adults and 9 adults with cardiovascular disease (CVD) ingested 500 mg of sodium phosphate after an over-night fast. In control subjects, the urine phosphate/creatinine ratio was significantly higher at 2 h (3.12 ± 1.02) than at baseline (1.98 ± 0.58, p < 0.001) but no change was observed in CVD patients. Decreased postprandial urinary excretion of phosphate could accelerate vascular calcification and may be an under-recognized risk factor for CVD.

  14. Prevalence of Obesity in Medical students and its correlation with cardiovascular risk factors: Emergency Alarm for Today?

    PubMed

    Purohit, G; Shah, T; Harsoda, J M

    2015-01-01

    Background It is predicted that the prevalence of overweight and obesity will rise significantly by 2015 in young population. Problem of overweight and obesity has been recognized as public health problem worldwide due to the fact that it increases the risk of chronic diseases such as Cardiovascular Diseases (CVD), stroke, diabetes, sleep apnoea, osteoarthritis etc. Objective To assess the body mass index in medical students and its association with various cardiovascular risk factors like blood pressure, dietary habits, and family history of cardiovascular diseases. Method A university based cross-sectional analytical study was conducted in Department of Physiology, Smt. B.K. Shah Medical Institute and Research Center, Vadodara, Gujarat. Data was collected through convenient sampling technique by using selfadministered questionnaire followed by anthropometric measurement. Body Mass Index (BMI) of 138 first year medical students was assessed. Systolic blood pressure, diastolic blood pressure, pulse pressure, mean blood pressure, pulse rate and arterial oxygen saturation were measured. Result Data was compiled in excel sheet, analyzed for percentage and proportion. Chi square and Pearson correlation test were also applied and alpha error was set at 5% level. In comparison to the students with normal BMI, students with BMI >25 kg/m2 (N=49) showed significantly high blood pressure indices. Dietary habits and family history of cardiovascular diseases were also noted. Highly significant association of high BMI was found with elevated blood pressure (X2=7.4042***, p<0.001) and presence of family history of cardiovascular diseases X2=9.8625***, p<0.001). BMI is negatively correlated with SpO2 (r= -0.0504, p<0.05) and pulse rate, while positively correlated with systolic blood pressure (r=0.2736) and diastolic blood pressure (r=0.0275). Conclusion In conclusion, majority (more than 35%) of medical students were overweight, high prevalence of cardiovascular risk factors

  15. Factors Associated with Suicide Outcomes 12-months After Screening Positive for Suicide Risk in the Emergency Department

    PubMed Central

    Arias, Sarah A.; Miller, Ivan; Camargo, Carlos A.; Sullivan, Ashley F.; Goldstein, Amy B.; Allen, Michael H.; Manton, Anne P.; Boudreaux, Edwin D.

    2016-01-01

    Objective The main objective is to identify which patient characteristics have the strongest association with suicide outcomes during the 12-months after the index emergency department (ED) visit. Methods Data were analyzed from the first two phases of the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE). The ED-SAFE study, a quasi-experimental, interrupted time series design, involved participation from eight general medical EDs across the United States. Participants included adults presenting to the ED with active suicidal ideation or an attempt in the last week. Data collection included baseline interview; 6- and 12-month chart reviews; and 6-, 12-, 24-, 36-, and 52-week telephone follow-up assessments. Regression analyses were conducted. Results Among 874 participants, the median age was 37 years (interquartile range 27–47) with 56% female (n=488), 74% white (n=649), and 13% Hispanic (n=113). At baseline, 577 (66%) had suicidal ideation only while 297 (34%) had a suicide attempt in the past week. Data sufficient to determine outcomes were available for 782 (90%). In the 12-months after the index ED visit, 195 (25%) had documentation of at least one suicide attempt or suicide. High school education or less, an ED visit in the preceding 6 months, prior non-suicidal self-injury (NSSI), current alcohol misuse, and intent or plan were predictive of future suicidal behavior. Conclusions and Relevance Continuing to build an understanding of the factors associated with future suicide behaviors for this population will help guide design and implementation of improved suicide screening and interventions in the ED and allocation of scarce resources. PMID:26620285

  16. Short-term return visits of 'general internal medicine' patients to the emergency department: extent and risk factors.

    PubMed

    Vanbrabant, P; Knockaert, D

    2009-01-01

    Although emergency department (ED) return visits are a significant problem universally, it has not been previously studied in our ED. The aim of this study was to determine the extent of the problem in our ED, to identify the relevant clinical predictor variables and to detect diagnostic errors. A retrospective observational study of ED return visits by patients managed by the General Internal Medicine (GIM) service was performed. The study was performed over a one year period at a tertiary hospital ED. Data are reported as relative risk (RR) and 95% confidence interval (CI). There were a total of 51.210 ED visits during the study period. The total number of ED return visits within 72 hours was 1.124 (2,19%; 95% CI 2,07 to 2,32). The total number of ED patients managed by the GIM service was 9.511. The percentage of patients treated by the GIM service who returned to the ED within 72 hours was 1,48% (95% CI 1,25 to 1,74) when calculated for the whole group and 2,9 % (95% CI 2,46-3,41) for those discharged home from the ED (n = 4.860). The majority (82,98%) of ED return visits by patients discharged from the GIM service were unscheduled and related to their index presenting complaint. Abdominal pain was the commonest initial presenting symptom in the patients who returned to the ED after discharge. Patients with diarrhoea as the initial initial presenting symptom had the highest relative risk of an ED return visit (RR = 4.07). The percentage ED return visits by patients discharged from the ED by the GIM service is 1,48%. Patients presenting with diarrhoea as the initial presenting symptom have the highest relative risk of an early ED return visit. Our main practical conclusion is that patients with abdominal pain need to be re-examined carefully and instructed about potential evolution before discharge.

  17. The gender specific risk factors for prolonged hospitalization due to acute pyelonephritis in a Japanese tertiary emergency center.

    PubMed

    Muneishi, Risa; Tanimoto, Ryuta; Wada, Koichiro; Hsiao, Philip; Eguchi, Jun; Araki, Motoo; Watanabe, Toyohiko; Nasu, Yasutomo; Akebi, Naoki

    2016-02-01

    The aim of this study is to characterize the potential differences between male and female patients with acute pyelonephritis (AP) and to predict the severity of AP based on the length of hospital stay. We conducted a retrospective medical chart review of 172 consecutive adult patients who were hospitalized in Tsuyama Central Hospital due to AP from January 2007 through June 2012. We analyzed the length of hospital stay by the proportional hazard model. A total of 172 patients were identified who were admitted to our hospital with a diagnosis of AP. Of them, 62% (106/172) were female. Except for urological malignancy, there was no significant difference between men and women in underlying disease. Out of 26 variables, univariate analysis in male showed that only urolithiasis (OR 1.75, p = 0.0294) was significantly associated with longer hospital stay, while septic shock (OR 3.18, P = 0.003), urological malignancy (OR 2.94, P = 0.002), age over 65 (OR 1.66, p = 0.018) and neurogenic bladder (OR 1.92, p = 0.014) were all associated with longer hospital stay in female patients. This is the first report to identify the risk factors for prolonged hospital stay for the patients who were admitted with AP in the Japanese population. The risk factors causing prolonged hospital stay were totally different between males and females. Reviewing the medical history based on sex gender might enable a clinician to predict the severity of acute pyelonephritis during the initial evaluation. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  18. Risk Factors for Scleroderma

    MedlinePlus

    ... Home For Patients Risk Factors Risk Factors for Scleroderma The cause of scleroderma is still unknown. Scientists ... help find improved therapies and a cure for scleroderma! Your gift today will be matched to have ...

  19. [Entomological factors of arboviruses emergences].

    PubMed

    Jourdain, F; Roiz, D; Perrin, Y; Grucker, K; Simard, F; Paupy, C

    2015-08-01

    Arboviruses - viruses transmitted by haematophagous arthropods - are responsible for febrile syndromes, which sometimes include haemorrhagic or neurological symptoms. Human activities have facilitated the emergence of these originally zoonotic viruses and the domestication and spread throughout the world of their major vectors. The last decade has seen significant changes in the epidemiology of arboviruses transmitted by mosquitoes of the genus Aedes, particularly in relation to the intercontinental spread of Aedes albopictus. Here, we address the epidemiological consequences of the invasion by this species into Central Africa and Europe in a context of viral globalization. The risk of transmission in these areas is influenced by virus-vector adaptation phenomena as well as environmental phenomena including climate. Faced with these new risks, it is essential to develop competences in entomological and virological surveillance, risk assessment and forecasting of epidemic risk in order to develop strategies for the prevention and control of epidemics.

  20. Environmental risk factors for autism

    PubMed Central

    Dietert, Rodney R.; Dietert, Janice M.; Dewitt, Jamie C.

    2010-01-01

    Autism is a devastating childhood condition that has emerged as an increasing social concern just as it has increased in prevalence in recent decades. Autism and the broader category of autism spectrum disorders are among the increasingly seen examples in which there is a fetal basis for later disease or disorder. Environmental, genetic, and epigenetic factors all play a role in determining the risk of autism and some of these effects appear to be transgenerational. Identification of the most critical windows of developmental vulnerability is paramount to understanding when and under what circumstances a child is at elevated risk for autism. No single environmental factor explains the increased prevalence of autism. While a handful of environmental risk factors have been suggested based on data from human studies and animal research, it is clear that many more, and perhaps the most significant risk factors, remain to be identified. The most promising risk factors identified to date fall within the categories of drugs, environmental chemicals, infectious agents, dietary factors, and other physical/psychological stressors. However, the rate at which environmental risk factors for autism have been identified via research and safety testing has not kept pace with the emerging health threat posed by this condition. For the way forward, it seems clear that additional focused research is needed. But more importantly, successful risk reduction strategies for autism will require more extensive and relevant developmental safety testing of drugs and chemicals. PMID:24149029

  1. Predicting older adults who return to the hospital or die within 30 days of emergency department care using the ISAR tool: subjective versus objective risk factors.

    PubMed

    Suffoletto, Brian; Miller, Thomas; Shah, Rahul; Callaway, Clifton; Yealy, Donald M

    2016-01-01

    We sought to evaluate the ability of the Identification of Seniors At Risk (ISAR) tool to differentiate between older adult patients having a poor outcome within 30 days of emergency department (ED) care and those who do not. We compare prognostic accuracy of subjective versus objective risk factors. 202 community-dwelling patients age 65 years and older presenting to two EDs were prospectively enrolled. Participants completed the six-question ISAR and objective testing (cognition, ambulation, vision). We reviewed electronic medical records for current medications, hospitalisations in the past six months, ED disposition, length of hospital stay, subsequent ED visits or inpatient admissions or death at 30 days. Participants were given a point for each risk factor present; subjective and objective risk factors were scored separately. We tested ability of individual risk factors and scores to predict a composite outcome of subsequent ED visit, postdischarge hospitalisation or death by day 30 after the index ED visit. We computed receiver operating curve area under the curves (AUC) to determine tool discrimination. 23% of participants had a poor 30-day outcome. The optimum subjective ISAR cut-off score for screening was ≥2, which was present in 84% of participants, had a sensitivity of 91% and specificity of 19%. Using the subjective ISAR tool, the AUC was 0.66. The optimum objective ISAR-related risk cut-off score for screening was ≥3, which was present in 82% of participants, had a sensitivity of 87% and specificity of 40%. Using the objective ISAR-related tool, the AUC was 0.69. The self-reported ISAR tool did not discriminate well between older adults with or without 30-day hospital revisit or death. An optimum score of ≥2 would identify many older adults at no apparent increased risk of poor outcomes at 30 days. Using objective ISAR-related risk factors did not improve overall discrimination. Published by the BMJ Publishing Group Limited. For

  2. Hot flashes: emerging cardiovascular risk factors in recent and late postmenopause and their association with higher blood pressure.

    PubMed

    Silveira, Juliano S; Clapauch, Ruth; Souza, Maria das Graças C de; Bouskela, Eliete

    2016-08-01

    The aim of the study was to compare the endothelial function of symptomatic (self-reported hot flashes >3 on a scale of 0-10) versus asymptomatic (≤3) women in different postmenopause stages, and to examine if the association between hot flashes and endothelial function was independent of classical cardiovascular risk factors observed during the analysis. Noninvasive venous occlusion plethysmography within two groups: recent (recent postmenopause [RPM], <10 y, n = 63) and late (late postmenopause [LPM], ≥10 y, n = 67) postmenopause. Symptomatic women showed lower forearm blood flow and lower percentage increment of it during the reactive hyperemia response; higher systolic (P < 0.0001 in RPM and P = 0.0008 in LPM) and diastolic (P = 0.0005 in RPM and P = 0.0219 in LPM) blood pressure; highest score for perimenopausal hot flashes (P = 0.0007 in RPM and P < 0.0001 in LPM), longer duration of prior oral contraceptive use (P = 0.009 in RPM and P = 0.0253 in LPM), and higher current sleep disorders (P < 0.0001 in RPM and P = 0.0281 in LPM) compared with asymptomatic ones. In the LPM group, symptomatic women also had higher prevalence of previous hypertension diagnosis (P = 0.0092). During multivariate analysis, blood flow during the reactive hyperemia response was associated with hot flashes after adjusting for age, body mass index, and systolic blood pressure (odds ratio 0.55 [0.36-0.84] in RPM and odds ratio 0.7 [0.5-0.97] in LPM). In both phases, recent and late post menopause, hot flashes were associated with endothelial dysfunction and higher systolic and diastolic blood pressure, but the relationship between hot flashes and endothelial dysfunction was independent of blood pressure.

  3. Household Animal and Human Medicine Use and Animal Husbandry Practices in Rural Bangladesh: Risk Factors for Emerging Zoonotic Disease and Antibiotic Resistance.

    PubMed

    Roess, A A; Winch, P J; Akhter, A; Afroz, D; Ali, N A; Shah, R; Begum, N; Seraji, H R; El Arifeen, S; Darmstadt, G L; Baqui, A H

    2015-11-01

    Animal antimicrobial use and husbandry practices increase risk of emerging zoonotic disease and antibiotic resistance. We surveyed 700 households to elicit information on human and animal medicine use and husbandry practices. Households that owned livestock (n = 265/459, 57.7%) reported using animal treatments 630 times during the previous 6 months; 57.6% obtained medicines, including antibiotics, from drug sellers. Government animal healthcare providers were rarely visited (9.7%), and respondents more often sought animal health care from pharmacies and village doctors (70.6% and 11.9%, respectively), citing the latter two as less costly and more successful based on past performance. Animal husbandry practices that could promote the transmission of microbes from animals to humans included the following: the proximity of chickens to humans (50.1% of households reported that the chickens slept in the bedroom); the shared use of natural bodies of water for human and animal bathing (78.3%); the use of livestock waste as fertilizer (60.9%); and gender roles that dictate that females are the primary caretakers of poultry and children (62.8%). In the absence of an effective animal healthcare system, villagers must depend on informal healthcare providers for treatment of their animals. Suboptimal use of antimicrobials coupled with unhygienic animal husbandry practices is an important risk factor for emerging zoonotic disease and resistant pathogens. © 2015 Blackwell Verlag GmbH.

  4. Factors Associated With Participation in an Emergency Department-Based Take-Home Naloxone Program for At-Risk Opioid Users.

    PubMed

    Kestler, Andrew; Buxton, Jane; Meckling, Gray; Giesler, Amanda; Lee, Michelle; Fuller, Kirsten; Quian, Hong; Marks, Dalya; Scheuermeyer, Frank

    2017-03-01

    Although the World Health Organization recommends take-home naloxone to address the increasing global burden of opioid-related deaths, few emergency departments (EDs) offer a take-home naloxone program. We seek to determine the take-home naloxone acceptance rate among ED patients at high risk of opioid overdose and to examine factors associated with acceptance. At a single urban ED, consecutive eligible patients at risk of opioid overdose were invited to complete a survey about opioid use, overdose experience, and take-home naloxone awareness, and then offered take-home naloxone. The primary outcome was acceptance of take-home naloxone, including the kit and standardized patient training. Univariate and multivariable logistic analyses were used to evaluate factors associated with acceptance. Of 241 eligible patients approached, 201 (83.4%) completed the questionnaire. Three-quarters of respondents used injection drugs, 37% were women, and 26% identified as "Indigenous." Of 201 respondents, 137 (68.2%; 95% confidence interval [CI] 61.7% to 74.7%) accepted take-home naloxone. Multivariable analysis revealed that factors associated with take-home naloxone acceptance included witnessing overdose in others (odds ratio [OR] 4.77; 95% CI 2.25 to 10.09), concern about own overdose death (OR 3.71; 95% CI 1.34 to 10.23), female sex (OR 2.50; 95% CI 1.21 to 5.17), and injection drug use (OR 2.22; 95% CI 1.06 to 4.67). A two-thirds ED take-home naloxone acceptance rate in patients using opioids should encourage all EDs to dispense take-home naloxone. ED-based take-home naloxone programs have the potential to improve access to take-home naloxone and awareness in individuals most vulnerable to overdoses. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  5. System factors to explain 2009 pandemic H1N1 state vaccination rates for children and high-risk adults in US emergency response to pandemic.

    PubMed

    Davila-Payan, Carlo; Swann, Julie; Wortley, Pascale M

    2014-01-03

    During the 2009-2010 H1N1 pandemic, children and high-risk adults had priority for vaccination. Vaccine in short supply was allocated to states pro-rata by population, but vaccination rates as of January 2010 varied among states from 21.3% to 84.7% for children and 10.4% to 47.2% for high-risk adults. States had different campaign processes and decisions. To determine program and system factors associated with higher state pandemic vaccination coverage for children and high-risk adults during an emergency response with short supply of vaccine. Regression analysis of factors predicting state-specific H1N1 vaccination coverage in children and high-risk adults, including state campaign information, demographics, preventive or health-seeking behavior, preparedness funding, providers, state characteristics, and surveillance data. Our modeling explained variation in state-specific vaccination coverage with an adjusted R-squared of 0.82 for children and 0.78 for high-risk adults. We found that coverage of children was positively associated with programs focusing on school clinics and with a larger proportion of doses administered in public sites; negatively with the proportion of children in the population, and the proportion not visiting a doctor because of cost. The coverage for high-risk adults was positively associated with shipments of vaccine to "general access" locations, including pharmacy and retail, with the percentage of women with a Pap smear within the past 3 years and with past seasonal influenza vaccination. It was negatively associated with the expansion of vaccination to the general public by December 4, 2009. For children and high-risk adults, coverage was positively associated with the maximum number of ship-to-sites and negatively associated with the proportion of medically underserved population. Findings suggest that distribution and system decisions such as vaccination venues and providers targeted can positively impact vaccination rates for

  6. Deliberate drug poisonings admitted to an emergency department in Paris area - a descriptive study and assessment of risk factors for intensive care admission.

    PubMed

    Beaune, S; Juvin, P; Beauchet, A; Casalino, E; Megarbane, B

    2016-01-01

    Each year, approximately 165,000 poisonings are managed in the emergency departments (ED) in France. We performed a descriptive analysis of self-poisoned patients admitted to a university hospital ED in the Paris metropolitan area (France) aimed at investigating their outcome and the risk factors for transfer to the intensive care unit (ICU). We retrospectively reviewed patients' records and performed multivariate logistic regression analysis to identify risk factors for ICU admission. During 4 years, 882 self-poisoned patients (median age, 38 years [IQR, 26-47]; sex-ratio, 1M/3F) were admitted to the ED, representing 0.7% of all referred patients. Poisonings mainly resulted from multidrug exposures (53%), including benzodiazepines (78%), serotonin reuptake inhibitors (17%), acetaminophen (13%), antipsychotics (9.5%), imidazopyridines (9.5%), antihypertensive drugs (3%), and polycyclic antidepressants (1.3%). Ethanol was involved in 20% of the exposures. Patients were briefly (<24h) monitored in the ED (55%), transferred to the psychiatric department (30%), medical ward (2%) or ICU (6%), and took an irregular discharge (7%). Among the patients transferred to the ICU, 25% were mechanically ventilated and only one died. Risk factors for ICU admission included antihypertensive (Odds ratio (OR), 40.6; 95%-confidence interval (CI), 7.5-221.9) or antipsychotic drug ingestion (OR, 5.3; CI, 2.0-14.4), male gender (OR, 3.3; CI, 1.30-8.8), and consciousness impairment (OR, 2.1; CI, 1.8-2.5 per point lost in Glasgow coma score). Deliberate drug exposure represents a frequent cause of ED admission. Psychotropic drugs are most commonly involved. Transfer to the ICU is rare and predicted by male gender, drug class, and coma depth.

  7. Risk factors for acute chemical releases with public health consequences: Hazardous Substances Emergency Events Surveillance in the U.S., 1996–2001

    PubMed Central

    Ruckart, Perri Z; Wattigney, Wendy A; Kaye, Wendy E

    2004-01-01

    Background Releases of hazardous materials can cause substantial morbidity and mortality. To reduce and prevent the public health consequences (victims or evacuations) from uncontrolled or illegally released hazardous substances, a more comprehensive analysis is needed to determine risk factors for hazardous materials incidents. Methods Hazardous Substances Emergency Events Surveillance (HSEES) data from 1996 through 2001 were analyzed using bivariate and multiple logistic regression. Fixed-facility and transportation-related events were analyzed separately. Results For fixed-facility events, 2,327 (8%) resulted in at least one victim and 2,844 (10%) involved ordered evacuations. For transportation-related events, 759 (8%) resulted in at least one victim, and 405 (4%) caused evacuation orders. Fire and/or explosion were the strongest risk factors for events involving either victims or evacuations. Stratified analysis of fixed-facility events involving victims showed a strong association for acid releases in the agriculture, forestry, and fisheries industry. Chlorine releases in fixed-facility events resulted in victims and evacuations in more industry categories than any other substance. Conclusions Outreach efforts should focus on preventing and preparing for fires and explosions, acid releases in the agricultural industry, and chlorine releases in fixed facilities. PMID:15496226

  8. Incidence, risk factors and clinical epidemiology of melioidosis: a complex socio-ecological emerging infectious disease in the Alor Setar region of Kedah, Malaysia.

    PubMed

    Hassan, Muhammad R A; Pani, Subhada P; Peng, Ng P; Voralu, Kirtanaa; Vijayalakshmi, Natesan; Mehanderkar, Ranjith; Aziz, Norasmidar A; Michael, Edwin

    2010-10-21

    Melioidosis, a severe and fatal infectious disease caused by Burkholderia pseudomallei, is believed to an emerging global threat. However, data on the natural history, risk factors, and geographic epidemiology of the disease are still limited. We undertook a retrospective analysis of 145 confirmed cases extracted from a hospital-based Melioidosis Registry set up from 2005 in Hospital Sultanah Bahiyah, Alor Setar, Kedah state, Malaysia, in order to provide a first description of the contemporary incidence, risk factors, and clinical epidemiology of the disease in this putatively high risk region of the country. The incidence of melioidosis in Alor Setar is remarkably high at 16.35 per 100,000 population per year. The mean age of patients was 50.40 years, with infection varying nonlinearly with age. Males (75.2%; P < 0.0001) predominated and the majority of cases were Malays (88.9%). The overall, crude mortality rate among the study patients was 33.8%. The proportions of cases and deaths were significantly greater among patients involved in farming, forestry and fishing and the unemployed (χ2 = 30.57, P < 0.0001). A majority of cases (62.75%) were culture positive, with mortality in these patients being 45.05%. A large proportion (83.0%) of culture positives was also bacteremic. Pneumonia accounted for 42.06% of primary diagnoses followed in importance by soft tissue abscess. In patients with pneumonia and who were culture positive, the mortality rate was as high as 65.00%. Diabetes mellitus constituted the major underlying risk factor for developing and dying from melioidosis, occurring in 57% of all diagnosed cases. The age distribution of diabetes paralleled that of melioidosis cases. There were linear associations between cases and deaths with monthly rainfall. Melioidosis represents a complex socio-ecological public health problem in Kedah, being strongly related with age, occupation, rainfall and predisposing chronic diseases, such as diabetes mellitus. Among

  9. Incidence, risk factors and clinical epidemiology of melioidosis: a complex socio-ecological emerging infectious disease in the Alor Setar region of Kedah, Malaysia

    PubMed Central

    2010-01-01

    Background Melioidosis, a severe and fatal infectious disease caused by Burkholderia pseudomallei, is believed to an emerging global threat. However, data on the natural history, risk factors, and geographic epidemiology of the disease are still limited. Methods We undertook a retrospective analysis of 145 confirmed cases extracted from a hospital-based Melioidosis Registry set up from 2005 in Hospital Sultanah Bahiyah, Alor Setar, Kedah state, Malaysia, in order to provide a first description of the contemporary incidence, risk factors, and clinical epidemiology of the disease in this putatively high risk region of the country. Results The incidence of melioidosis in Alor Setar is remarkably high at 16.35 per 100,000 population per year. The mean age of patients was 50.40 years, with infection varying nonlinearly with age. Males (75.2%; P < 0.0001) predominated and the majority of cases were Malays (88.9%). The overall, crude mortality rate among the study patients was 33.8%. The proportions of cases and deaths were significantly greater among patients involved in farming, forestry and fishing and the unemployed (χ2 = 30.57, P < 0.0001). A majority of cases (62.75%) were culture positive, with mortality in these patients being 45.05%. A large proportion (83.0%) of culture positives was also bacteremic. Pneumonia accounted for 42.06% of primary diagnoses followed in importance by soft tissue abscess. In patients with pneumonia and who were culture positive, the mortality rate was as high as 65.00%. Diabetes mellitus constituted the major underlying risk factor for developing and dying from melioidosis, occurring in 57% of all diagnosed cases. The age distribution of diabetes paralleled that of melioidosis cases. There were linear associations between cases and deaths with monthly rainfall. Conclusions Melioidosis represents a complex socio-ecological public health problem in Kedah, being strongly related with age, occupation, rainfall and predisposing chronic

  10. Risk Factors for Development of Chronic Kidney Disease following Renal Infarction: Retrospective Evaluation of Emergency Room Patients from a Single Center

    PubMed Central

    Lin, Wen-Ling; Seak, Chen-June; Wu, Jiunn-Yih; Weng, Yi-Ming; Chen, Hang-Cheng

    2014-01-01

    Background Previous studies have analyzed factors associated with renal infarction so that patients can be provided with earlier diagnosis and treatment. However, the factors associated with development of chronic kidney disease (CKD) following renal infarction are unknown. Methods We retrospectively reviewed the records of patients with a diagnosis of renal infarction based on enhanced computed tomography. All patients were admitted to a single emergency department in Taiwan from 1999 to 2008. Univariate and multivariate analysis were used to assess the effect of different factors on development of CKD based on estimates of the glomerular filtration rate (eGFR) at admission and at 3–12 months after discharge. Results Univariate analysis indicated significantly increased risk of CKD in patients older than 50 years, with symptoms for 24 h or less before admission, lower eGFR at admission, APACHE II score greater than 7, SOFA score greater than 1, ASA score greater than 2, and SAPS II score greater than 15. Multivariate analysis indicated that only SOFA score greater than 1 was significantly and independently associated with CKD at follow-up (p<0.001). Conclusions A total of 32.5% of patients admitted for renal infarction over a ten-year period developed CKD at 3–12 months after discharge. A SOFA score greater than 1 was significantly and independently associated with development of CKD in these patients. PMID:24911965

  11. [Risk factors for arterial disease].

    PubMed

    Madoery, Roberto; Rubin, Graciela; Luquez, Hugo; Luquez, Cecilia; Cravero, Cecilia

    2004-01-01

    The risk factors of arterial disease (FREA) predict a future damage over the vascular system of the human body. Its detection are considered a key for the diagnostic as well as for the preventive and even curative strategies. For a long time, scientist considered those factors originated as a consecuence of large studies during the middle of the last century, with current validity up to our days. A simple classification spoke of them as traditionals. Further investigations described the so called new or emergents.factors that where joint together accordingly to their actions: coagulation factors, psicosocial, inflamatories and infectious. A recent classification, taking into account the type of impact, divided them into; causatives, predisposals and conditionals. Also, it was described a mechanism, the oxidative power, with consecuences over the endothelium, in the last part of the process. Before, another mechanism was described: the insulin resistance and the hiperinsulinism, bases for the Metabolic Syndrome, that includes a number of traditional risk factors.

  12. [Analysis of the risk factors of acute respiratory distress syndrome of Berlin new definition in patients with sepsis in emergency department].

    PubMed

    Qiao, Liang; Liu, Zhi

    2015-07-01

    To discuss the risk factors of acute respiratory distress syndrome (ARDS) in patients with sepsis in emergency department. 312 patients with sepsis admitted to Department of Emergency of China Medical University Affiliated First Hospital were retrospectively analyzed, and they were divided into two groups according to development of ARDS, which was defined according to the Berlin new definition. The age, gender, vital signs, laboratory results, underlying disease, the mortality in emergency department sepsis (MEDS) score and lung injury prediction score (LIPS) were collected. Univariate analysis was done for each parameter. Statistical significance results were evaluated by multivariate logistic regression analysis. Receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of the parameter for ARDS. The incidence of sepsis-related ARDS was 11.2% (35/312). Within 35 cases of ARDS, there were 10 cases of mild ARDS, 18 cases of moderate ARDS, and 7 cases of severe ARDS. Univariate analysis showed that age (t=-2.134, P=0.035), oxygenation index (t=-4.245, P=0.001), arterial lactate (Lac, t=6.245, P<0.001), drugs for vascular diseases (χ2=4.261, P=0.026), shock (χ2=4.386, P=0.021), MEDS (t=4.021, P=0.045), LIPS (t=5.569, P<0.001), lung infections (χ2=4.289, P=0.025), and mechanical ventilation (χ2=6.245, P=0.001) were related to ARDS. The incidence of ARDS was different in different levels of Lac, which was 5.00% (3/16) at low level of Lac (<2.0 mmol/L), 9.46% (14/148) at middle level of Lac (2.0-3.9 mmol/L) and 17.31% (18/104) at high level of Lac (≥4.0 mmol/L). It was shown by multivariate logistic regression analysis that LIPS [ odds ratio (OR)=5.124, 95% confidence interval (95%CI)=3.642-10.153, P=0.002], Lac (OR=18.180, 95%CI=7.677-32.989, P<0.001) were independent risk factors for ARDS. It was shown by area under ROC (AUC) that the predictive value of LIPS and Lac in ARDS occurrence was significant. AUC of LIPS was 0.725, the

  13. Case-control studies reporting on risk factors for emergence of antimicrobial resistance: bias associated with the selection of the control group.

    PubMed

    Rafailidis, Petros I; Bliziotis, Ioannis A; Falagas, Matthew E

    2010-12-01

    The optimal control group for case-control studies examining antibiotics as risk factors for the emergence of antimicrobial resistance is patients selected randomly from the total hospital population, while the selection of patients with a susceptible bacterium is deemed suboptimal. We sought to theoretically elaborate on potential parameters that introduce bias associated with the use of randomly selected control subjects, based on personal experience and data from the literature. In addition, we considered parameters that introduce potential bias associated with the definition of case patients. Parameters that may introduce potential bias associated with the randomly selected control subjects are use of antibiotics in the community (background exposure), availability of an antibiotic in a country, ability to purchase specific antibiotics or health care, the bacterial resistance pattern in the country, in vitro evaluation issues, source of admitting patients (nursing home or community), type of hospital to which patients are admitted (general or disease specific), and ward of hospital to which patients are admitted. Parameters that may introduce potential bias associated with the case definition are multidrug resistance versus resistance to only one antibiotic, resistance phenotype of the microbe, multistep versus one-step development of resistance, appropriateness versus adequacy of antibiotic treatment, antibiotic synergy, details regarding the daily dose and duration of administration of the specific antibiotic, and use of other antibiotics. In conclusion, selection of control subjects from the hospital population is also associated with bias. The most acceptable solutions to evaluate the risk factors for antimicrobial resistance are probably the case-control-control study design and the case-case-control study design.

  14. [Risk factors for stroke].

    PubMed

    Mandić, Milan; Rancić, Natasa

    2011-01-01

    Stroke is the third cause of mortality both in men and in women throughout the world. In Serbia, stroke is the first cause of mortality in women older than 55 years of age and the second cause of death in men of the same age. Both ischemic heart diseases and ischemic stroke correlate with the same predisposing, potentially modifiable risk factors (hypertension, abnormal blood lipids and lipoproteins, cigarette smoking, physical inactivity, obesity, diabetes mellitus). Stroke does not usually occur on its own. Patients with stroke have a high prevalence of associated medical problems. These conditions may predict the stroke ("preexisting conditions"), occur for the first time after stroke ("post-stroke complications"), or present as manifestations of preexisting medical conditions after stroke. Risk factors for stroke are divided into the three groups: risk factors which cannot be influenced on such as: age, gender, positive family history of stroke, race: those which are modifiable such as: hypertension, diabetes mellitus, smoking cigarettes, obesity, physical inactivity and the third group consists of potential risk factors for stroke (consumption of alcohol, hormones, changes in fibrinolysis, changes in blood. Stroke remains a leading cause of long-term disability and premature death of both men and women. Consequently, stroke survivors are often handicapped and doomed to sedentary lifestyle which restrains performance of activities of daily living, increases the risk for falls, and may contribute to a higher risk for recurrent stroke and cardiovascular disease. Prevention of stroke is still a great medical and social problem. Further studies are required to investigate potential risk factors for the occurrence of stroke as well as the measures of primary and secondary prevention.

  15. Nanotechnology risk perceptions and communication: emerging technologies, emerging challenges.

    PubMed

    Pidgeon, Nick; Harthorn, Barbara; Satterfield, Terre

    2011-11-01

    Nanotechnology involves the fabrication, manipulation, and control of materials at the atomic level and may also bring novel uncertainties and risks. Potential parallels with other controversial technologies mean there is a need to develop a comprehensive understanding of processes of public perception of nanotechnology uncertainties, risks, and benefits, alongside related communication issues. Study of perceptions, at so early a stage in the development trajectory of a technology, is probably unique in the risk perception and communication field. As such it also brings new methodological and conceptual challenges. These include: dealing with the inherent diversity of the nanotechnology field itself; the unfamiliar and intangible nature of the concept, with few analogies to anchor mental models or risk perceptions; and the ethical and value questions underlying many nanotechnology debates. Utilizing the lens of social amplification of risk, and drawing upon the various contributions to this special issue of Risk Analysis on Nanotechnology Risk Perceptions and Communication, nanotechnology may at present be an attenuated hazard. The generic idea of "upstream public engagement" for emerging technologies such as nanotechnology is also discussed, alongside its importance for future work with emerging technologies in the risk communication field.

  16. Managing Multiple Risk Factors.

    DTIC Science & Technology

    1998-09-01

    cardiovascular disease among black women can be better controlled through the use of a stress reduction intervention that reduces the sympathetic nervous...All participants will have high normal (130/80) or mild hypertension and at least two additional risk factors for cardiovascular disease (e.g

  17. Emergent Risks In Critical Infrastructures

    NASA Astrophysics Data System (ADS)

    Dynes, Scott

    Firms cannot function successfully without managing a host of internal and external organizational and process interdependencies. Part of this involves business continuity planning, which directly aects how resilient arm and its business sector are in the face of disruptions. This paper presents the results of eld studies related to information risk management practices in the health care and retail sectors. The studies explore information risk management coordinating signals within and across rms in these sectors as well as the potential eects of cyber disruptions on the rms as stand-alone entities and as part of a critical infrastructure. The health care case study investigates the impact of the Zotob worm on the ability to deliver medical care and treatment. The retail study examines the resilience of certain elements of the food supply chain to cyber disruptions.

  18. Risk communication for public health emergencies.

    PubMed

    Glik, Deborah C

    2007-01-01

    This review defines crisis risk communication, traces its origins to a number of applied fields, and then shows how basic principles have become incorporated into emergency preparedness and risk communication for public health. Literature from four different disciplines that inform crisis risk communications are reviewed. These are (a) environmental risk communication, (b) disaster management, (c) health promotion and communication, and (d) media and communication studies. Current curricula and training materials are briefly reviewed. Although this literature review suggests much progress has been made to incorporate and disseminate crisis risk communication principles into public health practice, and case studies suggest that public health workers have gained skills and experience, this emerging field still lacks in-depth evaluation of the effectiveness of event-specific crisis risk communication efforts.

  19. Factors Associated With the Risk of Acute Malnutrition Among Children Aged 6 to 36 Months in Households Targeted by an Emergency Cash Transfer Program.

    PubMed

    Bliss, Jessica; Jensen, Nathan; Thiede, Brian; Shoham, Jeremy; Dolan, Carmel; Sibson, Victoria; Fenn, Bridget

    2016-07-11

    Assessing whether and how the expenditure of emergency cash transfer programs (CTPs) relates to child nutritional status is a necessary step for informed program design and targeting. We hypothesized that greater child food expenditures would have a protective effect against the risk of acute malnutrition in the context of a food crisis in Niger. We investigated the relationship between food and medical expenditures and acute malnutrition in children aged 6 to 36 months through an observational cohort study of 420 households enrolled in an emergency CTP in Niger. A Cox proportional hazards model was used to estimate the risk of acute malnutrition while adjusting for relevant child and household characteristics. Seventy-four (18% of the cohort) children developed acute malnutrition. The risk was 1.79 times higher among ill children than healthy children (hazard ratio [HR]: 1.79; 95% confidence interval [CI]: 1.10-2.92; P < .05), nearly 3 times higher among children in the poorest households than those in wealthier households (HR: 2.98; 95% CI: 1.86-4.78; P < .001), and 2.85 times lower with each unit increase in baseline weight-for-height Z score (HR: 0.35; 95% CI: 0.23-0.53; P < .001). Food expenditures were not associated with risk (HR: 0.97; 95% CI: 0.87-1.07; P > .05). Our findings highlight the importance of the health-related determinants of child undernutrition and suggest that a potential role of emergency CTPs may be to enable and promote health service access where services exist. They also indicate a need for more sustained poverty reduction and undernutrition prevention activities in concert with well-timed and strategic use of emergency interventions. © The Author(s) 2016.

  20. [Pathological gambling: risk factors].

    PubMed

    Bouju, G; Grall-Bronnec, M; Landreat-Guillou, M; Venisse, J-L

    2011-09-01

    In France, consumption of gambling games increased by 148% between 1960 and 2005. In 2004, gamblers lost approximately 0.9% of household income, compared to 0.4% in 1960. This represents approximately 134 Euros per year and per head. In spite of this important increase, the level remains lower than the European average (1%). However, gambling practices may continue to escalate in France in the next few years, particularly with the recent announce of the legalisation of online games and sports betting. With the spread of legalised gambling, pathological gambling rates may increase in France in the next years, in response to more widely available and more attractive gambling opportunities. In this context, there is a need for better understanding of the risk factors that are implicated in the development and maintenance of pathological gambling. This paper briefly describes the major risk factors for pathological gambling by examining the recent published literature available during the first quarter of 2008. This documentary basis was collected by Inserm for the collective expert report procedure on Gambling (contexts and addictions). Seventy-two articles focusing on risk factors for pathological gambling were considered in this review. Only 47 of them were taken into account for analysis. The selection of these 47 publications was based on the guide on literature analysis established by the French National Agency for Accreditation and Assessment in Health (ANAES, 2000). Some publications from more recent literature have also been added, mostly about Internet gambling. We identify three major types of risk factors implicated in gambling problems: some of them are related to the subject (individual factors), others are related to the object of the addiction, here the gambling activity by itself (structural factors), and the last are related to environment (contextual or situational factors). Thus, the development and maintenance of pathological gambling seems to be

  1. Breast cancer risk factors

    PubMed Central

    Ciszewski, Tomasz; Łopacka-Szatan, Karolina; Miotła, Paweł; Starosławska, Elżbieta

    2015-01-01

    Breast cancer is the most frequently diagnosed neoplastic disease in women around menopause often leading to a significant reduction of these women's ability to function normally in everyday life. The increased breast cancer incidence observed in epidemiological studies in a group of women actively participating in social and professional life implicates the necessity of conducting multidirectional studies in order to identify risk factors associated with the occurrence of this type of neoplasm. Taking the possibility of influencing the neoplastic transformation process in individuals as a criterion, all the risk factors initiating the process can be divided into two groups. The first group would include inherent factors such as age, sex, race, genetic makeup promoting familial occurrence of the neoplastic disease or the occurrence of benign proliferative lesions of the mammary gland. They all constitute independent parameters and do not undergo simple modification in the course of an individual's life. The second group would include extrinsic factors conditioned by lifestyle, diet or long-term medical intervention such as using oral hormonal contraceptives or hormonal replacement therapy and their influence on the neoplastic process may be modified to a certain degree. Identification of modifiable factors may contribute to development of prevention strategies decreasing breast cancer incidence. PMID:26528110

  2. Human factors and simulation in emergency medicine.

    PubMed

    Hayden, Emily M; Wong, Ambrose H; Ackerman, Jeremy; Sande, Margaret K; Lei, Charles; Kobayashi, Leo; Cassara, Michael; Cooper, Dylan D; Perry, Kimberly; Lewandowski, William E; Scerbo, Mark W

    2017-09-19

    This consensus group from the 2017 Academic Emergency Medicine Consensus Conference "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes" held in Orlando, Florida on May 16, 2017 focused on the use of human factors and simulation in the field of emergency medicine. The human factors discipline is often underutilized within emergency medicine but has significant potential in improving the interface between technologies and individuals in the field. The discussion explored the domain of human factors, its benefits in medicine, how simulation can be a catalyst for human factors work in emergency medicine, and how emergency medicine can collaborate with human factors professionals to affect change. Implementing human factors in emergency medicine through healthcare simulation will require a demonstration of clinical and safety outcomes, advocacy to stakeholders and administrators, and establishment of structured collaborations between human factors professionals and emergency medicine, such as in this breakout group. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  3. Risk Factors for Eating Disorders

    ERIC Educational Resources Information Center

    Striegel-Moore, Ruth H.; Bulik, Cynthia M.

    2007-01-01

    The authors review research on risk factors for eating disorders, restricting their focus to studies in which clear precedence of the hypothesized risk factor over onset of the disorder is established. They illustrate how studies of sociocultural risk factors and biological factors have progressed on parallel tracks and propose that major advances…

  4. Risk Factors for Cholelithiasis.

    PubMed

    Pak, Mila; Lindseth, Glenda

    2016-01-01

    Gallstone disease is one of the most common public health problems in the United States. Approximately 10%-20% of the national adult populations currently carry gallstones, and gallstone prevalence is rising. In addition, nearly 750,000 cholecystectomies are performed annually in the United States; direct and indirect costs of gallbladder surgery are estimated to be $6.5 billion. Cholelithiasis is also strongly associated with gallbladder, pancreatic, and colorectal cancer occurrence. Moreover, the National Institutes of Health estimates that almost 3,000 deaths (0.12% of all deaths) per year are attributed to complications of cholelithiasis and gallbladder disease. Although extensive research has tried to identify risk factors for cholelithiasis, several studies indicate that definitive findings still remain elusive. In this review, predisposing factors for cholelithiasis are identified, the pathophysiology of gallstone disease is described, and nonsurgical preventive options are discussed. Understanding the risk factors for cholelithiasis may not only be useful in assisting nurses to provide resources and education for patients who are diagnosed with gallstones, but also in developing novel preventive measures for the disease.

  5. Ensemble Risk Model of Emergency Admissions (ERMER).

    PubMed

    Mesgarpour, Mohsen; Chaussalet, Thierry; Chahed, Salma

    2017-07-01

    About half of hospital readmissions can be avoided with preventive interventions. Developing decision support tools for identification of patients' emergency readmission risk is an important area of research. Because, it remains unclear how to design features and develop predictive models that can adjust continuously to a fast-changing healthcare system and population characteristics. The objective of this study was to develop a generic ensemble Bayesian risk model of emergency readmission. We produced a decision support tool that predicts risk of emergency readmission using England's Hospital Episode Statistics inpatient database. Firstly, we used a framework to develop an optimal set of features. Then, a combination of Bayes Point Machine (BPM) models for different cohorts was considered to create an optimised ensemble model, which is stronger than the individual generative and non-linear classifications. The developed Ensemble Risk Model of Emergency Admissions (ERMER) was trained and tested using three time-frames: 1999-2004, 2000-05 and 2004-09, each of which includes about 20% of patients in England during the trigger year. Comparisons are made for different time-frames, sub-populations, risk cut-offs, risk bands and top risk segments. The precision was 71.6-73.9%, the specificity was 88.3-91.7% and the sensitivity was 42.1-49.2% across different time-frames. Moreover, the Area Under the Curve was 75.9-77.1%. The decision support tool performed considerably better than the previous modelling approaches, and it was robust and stable with high precision. Moreover, the framework and the Bayesian model allow the model to continuously adjust it to new significant features, different population characteristics and changes in the system. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Salivary Gland Cancer: Risk Factors

    MedlinePlus

    ... Cancer > Salivary Gland Cancer: Risk Factors Request Permissions Salivary Gland Cancer: Risk Factors Approved by the Cancer.Net ... f t k e P Types of Cancer Salivary Gland Cancer Guide Cancer.Net Guide Salivary Gland Cancer ...

  7. [Cardiovascular risk factors in women].

    PubMed

    Cengel, Atiye

    2010-03-01

    It is estimated that at least 80% of patients with cardiovascular disease (CVD) have conventional risk factors and optimization of these risk factors can reduce morbidity and mortality due to this disease considerably. Contemporary women have increased burden of some of these risk factors such as obesity, metabolic syndrome and smoking. Turkish women have a worse CV risk profile than Turkish men in some aspects. Risk stratification systems such as Framingham have a tendency of underestimating the risk in women. Coronary artery disease remains in vessel wall for a longer period of time in women; therefore obstructive disease appear later in their lifespan necessitating risk stratification systems for estimating their lifetime risk.

  8. Risk Factor Assessment Branch (RFAB)

    Cancer.gov

    The Risk Factor Assessment Branch (RFAB) focuses on the development, evaluation, and dissemination of high-quality risk factor metrics, methods, tools, technologies, and resources for use across the cancer research continuum, and the assessment of cancer-related risk factors in the population.

  9. Pediatric rhinitis risk factors

    PubMed Central

    Ji, Yaofeng; Liu, Yin; Yang, Na

    2016-01-01

    Rhinitis is a common global disorder that impacts on the quality of life of the sufferer and caregivers. Treatment for pediatric rhinitis is empirical and does not include a detailed history of the allergy triggers or allergy testing. Thus, allergen avoidance advice is not tailored to the child's sensitivities, which may result in adenoid hypertrophy. However, infant onset rhinitis, especially its relationship with respiratory viruses, remains to be further clarified. Rhinitis basically involves inflammation of the upper nasal lining, presenting typically with symptoms of runny nose (rhinorrhea), nasal blockage, and/or sneezing. While not typically fatal, it does impose significant health, psychological, and monetary burden to its sufferers, and is thus considered a global health problem. Previous findings showed that immunotherapy had significant clinical efficacy in children with allergic rhinitis. The present review article aims to highlight recent perspectives pertaining to the rhinitis risk factors especially in pediatric patients. PMID:27698737

  10. Well-being and employee health-how employees' well-being scores interact with demographic factors to influence risk of hospitalization or an emergency room visit.

    PubMed

    Gandy, William M; Coberley, Carter; Pope, James E; Rula, Elizabeth Y

    2014-02-01

    The goal of this study was to determine the relationship between individual well-being and risk of a hospital event in the subsequent year. The authors hypothesized an inverse relationship in which low well-being predicts higher likelihood of hospital use. The study specifically sought to understand how well-being segments and demographic variables interact in defining risk of a hospital event (inpatient admission or emergency room visit) in an employed population. A retrospective study design was conducted with data from 8835 employees who completed a Well-Being Assessment questionnaire based on the Gallup-Healthways Well-Being Index. Cox proportional hazards models were used to examine the impact of Individual Well-Being Score (IWBS) segments and member demographics on hazard ratios (HRs) for a hospital event during the 12 months following assessment completion. Significant main effects were found for the influence of IWBS segments, sex, education, and relationship status on HRs of a hospital event, but not for age. However, further analysis revealed significant interactions between age and IWBS segments (P=0.005) and between age and sex (P<0.0001), indicating that the effects for IWBS segments and sex on HRs of a hospital event are mediated through their relationship with age. Overall, the strong relationship between low well-being and higher risk of an event in employees ages 44 years and older is mitigated in younger age groups. These results suggest that youth attenuates the risk engendered in poor well-being; therefore, methods to maintain or improve well-being as individuals age presents a strong opportunity for reducing hospital events.

  11. Risk factors in school shootings.

    PubMed

    Verlinden, S; Hersen, M; Thomas, J

    2000-01-01

    Nine incidents of multiple-victim homicide in American secondary schools are examined and common risk factors are identified. The literature dealing with individual, family, social, societal, and situational risk factors for youth violence and aggression is reviewed along with existing risk assessment methods. Checklists of risk factors for serious youth violence and school violence are used in reviewing each school shooting case. Commonalties among the cases and implications for psychologists practicing in clinical and school settings are discussed.

  12. Human factors and safety in emergency medicine

    NASA Technical Reports Server (NTRS)

    Schaefer, H. G.; Helmreich, R. L.; Scheidegger, D.

    1994-01-01

    A model based on an input process and outcome conceptualisation is suggested to address safety-relevant factors in emergency medicine. As shown in other dynamic and demanding environments, human factors play a decisive role in attaining high quality service. Attitudes held by health-care providers, organisational shells and work-cultural parameters determine communication, conflict resolution and workload distribution within and between teams. These factors should be taken into account to improve outcomes such as operational integrity, job satisfaction and morale.

  13. Human factors and safety in emergency medicine

    NASA Technical Reports Server (NTRS)

    Schaefer, H. G.; Helmreich, R. L.; Scheidegger, D.

    1994-01-01

    A model based on an input process and outcome conceptualisation is suggested to address safety-relevant factors in emergency medicine. As shown in other dynamic and demanding environments, human factors play a decisive role in attaining high quality service. Attitudes held by health-care providers, organisational shells and work-cultural parameters determine communication, conflict resolution and workload distribution within and between teams. These factors should be taken into account to improve outcomes such as operational integrity, job satisfaction and morale.

  14. Human factors and error prevention in emergency medicine.

    PubMed

    Bleetman, Anthony; Sanusi, Seliat; Dale, Trevor; Brace, Samantha

    2012-05-01

    Emergency departments are one of the highest risk areas in health care. Emergency physicians have to assemble and manage unrehearsed multidisciplinary teams with little notice and manage critically ill patients. With greater emphasis on management and leadership skills, there is an increasing awareness of the importance of human factors in making changes to improve patient safety. Non-clinical skills are required to achieve this in an information-poor environment and to minimise the risk of errors. Training in these non-clinical skills is a mandatory component in other high-risk industries, such as aviation and, needs to be part of an emergency physician's skill set. Therefore, there remains an educational gap that we need to fill before an emergency physician is equipped to function as a team leader and manager. This review will examine the lessons from aviation and how these are applicable to emergency medicine. Solutions to averting errors are discussed and the need for formal human factors training in emergency medicine.

  15. Atherosclerosis risk factors in systemic lupus erythematosus.

    PubMed

    Agarwal, Surabhi; Elliott, Jennifer R; Manzi, Susan

    2009-08-01

    Cardiovascular disease (CVD) has emerged as a leading cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Growing evidence suggests that inflammation plays a key role in the pathogenesis of atherosclerosis from initial endothelial dysfunction to rupture of atheromatous plaques. The increased frequency of atherosclerosis in SLE is likely due to a complex interplay among traditional risk factors, disease-related factors such as medications and disease activity, and inflammatory and immunogenic factors. Identification of these novel risk factors will lead to a better understanding of CVD pathogenesis and may also provide targets for potential treatment strategies. When caring for SLE patients, clinicians should be aware of the increased CVD risk and treat the known modifiable risk factors in addition to controlling disease activity and inflammation.

  16. Factors in the emergence of infectious diseases.

    PubMed Central

    Morse, S. S.

    1995-01-01

    "Emerging" infectious diseases can be defined as infections that have newly appeared in a population or have existed but are rapidly increasing in incidence or geographic range. Among recent examples are HIV/AIDS, hantavirus pulmonary syndrome, Lyme disease, and hemolytic uremic syndrome (a foodborne infection caused by certain strains of Escherichia coli). Specific factors precipitating disease emergence can be identified in virtually all cases. These include ecological, environmental, or demographic factors that place people at increased contact with a previously unfamiliar microbe or its natural host or promote dissemination. These factors are increasing in prevalence; this increase, together with the ongoing evolution of viral and microbial variants and selection for drug resistance, suggests that infections will continue to emerge and probably increase and emphasizes the urgent need for effective surveillance and control. Dr. David Satcher's article and this overview inaugurate Perspectives, a regular section in this journal intended to present and develop unifying concepts and strategies for considering emerging infections and their underlying factors. The editors welcome, as contributions to the Perspectives section, overviews, syntheses, and case studies that shed light on how and why infections emerge, and how they may be anticipated and prevented. PMID:8903148

  17. Abnormal lipoprotein(a) levels predict coronary artery calcification in Southeast Asians but not in Caucasians: use of noninvasive imaging for evaluation of an emerging risk factor.

    PubMed

    Sharma, Abhinav; Kasim, Manoefris; Joshi, Parag H; Qian, Zhen; Krivitsky, Eric; Akram, Kamran; Rinehart, Sarah; Vazquez, Gustavo; Miller, Joseph; Rohman, Mohammad Saifur; Voros, Szilard

    2011-08-01

    Subclinical atherosclerosis can be quantified by coronary artery calcium (CAC) scoring. Due to its high specificity for atherosclerosis, CAC is an excellent phenotypic tool for the evaluation of emerging risk markers. Lipoprotein(a) [Lp(a)] is atherogenic due to the presence of apoB and may be thrombogenic through its apo(a) component. Lp(a) has been linked to cardiovascular events in Caucasians; however, its link to atherosclerosis in various ethnicities remains unclear. We evaluated the ability of Lp(a) mass to predict subclinical atherosclerosis in Southeast Asians and Caucasians, as measured by CAC. Traditional lipid measurements, Lp(a) measurements, and CAC by 64-slice multidetector computed tomography was performed in 103 consecutive patients in the USA and in 104 consecutive patients in Jakarta, Indonesia. Proportion of positive CAC and median CAC in Southeast Asians and in Caucasians was 61.5% and 63.1%, and 23.5 (interquartile range, 0-270) and 13 (interquartile range, 0-388), respectively. Significantly higher proportion of Southeast Asians had elevated Lp(a) levels, compared to Caucasians (51.0% vs. 29.2%; p = 0.005). In Southeast Asians, Lp(a) remained an independent predictor of CAC with an odds ratio of 4.97 (95% confidence interval, 1.56-15.88; p < 0.0001), but not in Caucasians. Receiver operating characteristic analysis showed an improvement in area under the curve from 0.81 to 0.86 (p = 0.05) when including Lp(a) in the predictive model in Southeast Asians. This translated to 7% of Southeast Asians reclassified to correct CAC status. Lp(a) measurements may have a role in risk stratification of Southeast Asians. Ethnic variation should be taken into account when considering the use of Lp(a) measurements in risk assessment.

  18. Emergency Nurses' Perspectives: Factors Affecting Caring.

    PubMed

    Enns, Carol L; Sawatzky, Jo-Ann V

    2016-05-01

    Caring is a universal phenomenon. However, as a result of higher patient acuity and staff shortages within the chaotic ED environment, caring behaviors may be in peril. The purpose of this study was to gain insight into the meaning of caring from the perspective of emergency nurses. Exploring nurses' perspectives of caring is central to improving staffing and retention issues in this unique work environment. As part of a larger study, a subsample of emergency nurses who work in public hospitals in Manitoba, Canada (n = 17) were interviewed. A qualitative descriptive design was used to gain insight into the caring perspectives of nurses by asking them, "What does caring meaning to you?" and "What affects caring in your practice in the emergency department?" Emerging themes were extracted through analysis of audio tapes and transcripts. Advocacy and holistic care emerged as major themes in the meaning of caring for emergency nurses. Caring was affected by a number of factors, including workload, lack of time, staffing issues, shift work, and lack of self-care. However, lack of management support was the most consistent hindrance to caring identified by study participants. Caring continues to be a unifying concept in nursing; however, influencing factors continue to undermine caring for emergency nurses. Caring is not subsidiary to nursing; it is the central core of nursing. Therefore, fostering a caring working environment is essential for nurses to practice holistic nursing care. It is also imperative to job satisfaction and the retention of emergency nurses. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  19. Emerging Radiation Health-Risk Mitigation Technologies

    SciTech Connect

    Wilson, J.W.; Cucinotta, F.A.; Schimmerling, W.

    2004-02-04

    Past space missions beyond the confines of the Earth's protective magnetic field have been of short duration and protection from the effects of solar particle events was of primary concern. The extension of operational infrastructure beyond low-Earth orbit to enable routine access to more interesting regions of space will require protection from the hazards of the accumulated exposures of Galactic Cosmic Rays (GCR). There are significant challenges in providing protection from the long-duration exposure to GCR: the human risks to the exposures are highly uncertain and safety requirements places unreasonable demands in supplying sufficient shielding materials in the design. A vigorous approach to future radiation health-risk mitigation requires a triage of techniques (using biological and technical factors) and reduction of the uncertainty in radiation risk models. The present paper discusses the triage of factors for risk mitigation with associated materials issues and engineering design methods.

  20. Factors that elevate the internal radionuclide and chemical retention, dose and health risks to infants and children in a radiological-nuclear emergency.

    PubMed

    Richardson, Richard B

    2009-06-01

    The factors that influence the dose and risk to vulnerable population groups from exposure and internal uptake of chemicals are examined and, in particular, the radionuclides released in chemical, biological, radiological, nuclear and explosive events. The paper seeks to identify the areas that would benefit from further research. The intake and body burdens of carbon and calcium were assessed as surrogates for contaminants that either act like or bind to hydrocarbons (e.g. tritium and (14)C) or bone-seeking radionuclides (e.g. (90)Sr and (239)Pu). The shortest turnover times for such materials in the whole body were evaluated for the newborn: 11 d and 0.5 y for carbon and calcium, respectively. However, their biokinetic behaviour is complicated by a particularly high percentage of the gut-absorbed dietary intake of carbon (approximately 16%) and calcium (approximately 100%) that is incorporated into the soft tissue and skeleton of the growing neonate. The International Commission on Radiological Protection dose coefficients (Sv Bq(-1)) were examined for 14 radionuclides, including 9 of concern because of their potential use in radiological dispersal devices. The dose coefficients for a 3-month-old are greater than those for adults (2-56 times more for ingestion and 2-12 times for inhalation). The age-dependent dose and exposure assessment of contaminant intakes would improve by accounting for gender and growth where it is currently neglected. Health risk is evaluated as the product of the exposure and hazard factors, the latter being about 10-fold greater in infants than in adults. The exposure factor is also approximately 10-fold higher for ingestion by infants than by adults, and unity for inhalation varying with the contaminant. Qualitative and quantitative physiological and epidemiological evidence supports infants being more vulnerable to cancer and neurological deficit than older children.

  1. Emergency thoracic ultrasound and clinical risk management

    PubMed Central

    Interrigi, Maria Concetta; Trovato, Francesca M; Catalano, Daniela; Trovato, Guglielmo M

    2017-01-01

    Purpose Thoracic ultrasound (TUS) has been proposed as an easy-option replacement for chest X-ray (CXR) in emergency diagnosis of pneumonia, pleural effusion, and pneumothorax. We investigated CXR unforeseen diagnosis, subsequently investigated by TUS, considering its usefulness in clinical risk assessment and management and also assessing the sustainability of telementoring. Patients and methods This observational report includes a period of 6 months with proactive concurrent adjunctive TUS diagnosis telementoring, which was done using freely available smartphone applications for transfer of images and movies. Results Three hundred and seventy emergency TUS scans (excluding trauma patients) were performed and telementored. In 310 cases, no significant chest pathology was detected either by CXR, TUS, or the subsequent work-up; in 24 patients, there was full concordance between TUS and CXR (ten isolated pleural effusion; eleven pleural effusion with lung consolidations; and three lung consolidation without pleural effusion); in ten patients with lung consolidations, abnormalities identified by CXR were not detected by TUS. In 26 patients, only TUS diagnosis criteria of disease were present: in 19 patients, CXR was not diagnostic, ie, substantially negative, but TUS detected these conditions correctly, and these were later confirmed by computed tomography (CT). In seven patients, even if chest disease was identified by CXR, such diagnoses were significantly modified by ultrasound, and CT confirmed that TUS was more appropriate. The overall respective individual performances of CXR and TUS for the diagnosis of a pleural–pulmonary disease in emergency are good, with accuracy >95%. Conclusion About 20% of pneumonia cases were detectable only by CXR and 20% only by TUS and not by CXR; ie, about 40% of patients may have been misdiagnosed if, by chance, only one of the two tools had been used. The concurrent use of TUS and CXR increases the overall sensitivity and

  2. Absorption of flavonols derived from sea buckthorn (Hippophaë rhamnoides L.) and their effect on emerging risk factors for cardiovascular disease in humans.

    PubMed

    Suomela, Jukka-Pekka; Ahotupa, Markku; Yang, Baoru; Vasankari, Tommi; Kallio, Heikki

    2006-09-20

    Sea buckthorn (Hippophaë rhamnoides L.) is a rich source of flavonols, especially isorhamnetin. Most prospective cohort studies have indicated some degree of inverse association between flavonoid intake and coronary heart disease. Animal and human studies suggest that sea buckthorn flavonoids may scavenge free radicals, lower blood viscosity, and enhance cardiac function. The effects of flavonol aglycones derived from sea buckthorn on the risk factors of cardiovascular disease as well as their absorption were studied in humans. The flavonols, ingested with oatmeal porridge, did not have a significant effect on the levels of oxidized low-density lipoprotein, C-reactive protein, and homocysteine, on the plasma antioxidant potential, or on the paraoxonase activity. Flavonols at two dosages in oatmeal porridge were rapidly absorbed, and a relatively small amount of sea buckthorn oil added to the porridge seemed to have increased the bioavailability of sea buckthorn flavonols consumed at the higher dose.

  3. Risk factors for surgical infections.

    PubMed

    Dominioni, Lorenzo; Imperatori, Andrea; Rotolo, Nicola; Rovera, Francesca

    2006-01-01

    Many risk factors for postoperative infections have been identified that can be used individually or in combination as scoring indices. Infection risk scores can be applied in clinical practice to identify high-risk surgical patients, to indicate the need to implement risk-reduction strategies, and to stratify risk for comparison of outcome among different patient series. In the hierarchy of patient-related risk factors, serum albumin concentration and advanced age rank at the top of the list. Among the treatment-related factors, the quality of the surgical technique is a most important determinant, although most surgical site infections are attributable to patient-related risk factors rather than to flawed surgical care. Scoring systems can identify the patients at highest risk, thus prompting the implementation of therapy to improve modifiable conditions, but most clinicians outside the academic and research setting do not use them. Risk assessment also can be performed by expert clinical judgment. Discussion with the patient and informed consent are essential. Carefully collected scores of patient risk factors may be valuable to document the relations between the risk and the outcome of surgery. Ideally, each institution should select a validated scoring system to audit postoperative infectious morbidity and surgical performance in the various specialties.

  4. Stroke - risk factors

    MedlinePlus

    ... a higher risk. Diseases such as cancer, chronic kidney disease, and some types of arthritis. Weak areas in an artery wall or abnormal arteries and veins . Pregnancy. Both during and in the weeks right after ...

  5. Features of coronary heart disease development in emergency workers of the Chornobyl accident depending on the action of radiation and non radiation risk factors and genotypes of single nucleotide polymorphism rs966221 of phosphodiesterase 4D gene.

    PubMed

    Belyi, D; Pleskach, G; Nastina, O; Sidorenko, G; Kursina, N; Bazyka, O; Kovalev, O; Chumak, A; Abramenko, I

    2016-12-01

    This study devoted to specific features of coronary heart disease (CHD) development in emergency work ers (EW) of the accident at the Chernobyl nuclear power plant (ChNPP) based on analysis the interaction between radiation and non radiation risk factors and single nucleotide polymorphism (SNP) rs966221 of phosphodiesterase (PDE) 4D gene. It was examined 397 men with CHD, including 274 EW of 1986-1987 and 123 non irradiated persons (con trol group) who were 66±10 and 69±11 years old relatively. The program studies included clinical examination, elec trocardiography (ECG), ECG daily monitoring, ECG stress testing, echo doppler cardiography, analysis of serum lipid spectrum, polymerase chain reaction with restriction of reaction products, retrospective analysis of case histories. Diagnosis of CHD or its approval was carried out in accordance with the standards of diagnosis, accepted in Ukraine. All EW before their taking part in cleaning ChNPP territory did not suffered from CHD. According to the analysis of contingency tables, carriers of the TT genotype of rs966221 increased the risk of myocardial infarction (MI) in 2.538 times compared with carriers of genotypes CC and CT. The use of Kaplan Meier method showed that a half of EW with the TT genotype developed MI before 64 years old, while with the other geno types up to 78.7 years old. In the control group statistically significant increase of cumulative proportion of patients with MI, carriers of the TT genotype, began from 60 years old. Compared to the non irradiated patients EW fell ill with CHD on 9.4 years earlier. Using proportional hazards analysis (Cox regression), it was found that EW had 3.9 times higher risk of CHD than in non irradiated individuals. Smoking and overweight brought three times less but significant risk - 1.37 and 1.33 respectively. The TT genotype unlike genotypes CC and CT gene PDE4D increased risk of MI in 1.757 times more both in EW and control group. The risk of CHD development was

  6. Sex Work as an Emerging Risk Factor for Human Immunodeficiency Virus Seroconversion Among People who Inject Drugs in the SurvUDI Network.

    PubMed

    Blouin, Karine; Leclerc, Pascale; Morissette, Carole; Roy, Élise; Blanchette, Caty; Parent, Raymond; Serhir, Bouchra; Alary, Michel

    2016-10-01

    Recent analyses have shown an emerging positive association between sex work and human immunodeficiency virus (HIV) incidence among people who inject drugs (PWIDs) in the SurvUDI network. Participants who had injected in the past 6 months were recruited across the Province of Quebec and in the city of Ottawa, mainly in harm reduction programs. They completed a questionnaire and provided gingival exudate for HIV antibody testing. The associations with HIV seroconversion were tested with a Cox proportional hazard model using time-dependent covariables including the main variable of interest, sexual activity (sex work; no sex work; sexually inactive). The final model included significant variables and confounders of the associations with sexual activity. Seventy-two HIV seroconversions were observed during 5239.2 person-years (py) of follow-up (incidence rates: total = 1.4/100 py; 95% confidence interval [CI], 1.1-1.7; sex work = 2.5/100 py; 95% CI, 1.5-3.6; no sex work = 0.8/100 py; 95% CI, 0.5-1.2; sexually inactive = 1.8/100 py; 95% CI, 1.1-2.5). In the final multivariate model, HIV incidence was significantly associated with sexual activity (sex work: adjusted hazard ratio [AHR], 2.19; 95% CI, 1.13-4.25; sexually inactive: AHR, 1.62; 95% CI, 0.92-2.88), and injection with a needle/syringe used by someone else (AHR, 2.84; 95% CI, 1.73-4.66). Sex work is independently associated with HIV incidence among PWIDs. At the other end of the spectrum of sexual activity, sexually inactive PWIDs have a higher HIV incidence rate, likely due to more profound dependence leading to increased vulnerabilities, which may include mental illness, poverty, and social exclusion. Further studies are needed to understand whether the association between sex work and HIV is related to sexual transmission or other vulnerability factors.

  7. Risk Factors Associated with Overdose among Bahraini Youth.

    ERIC Educational Resources Information Center

    Al Ansari, Ahmed M.; Hamadeh, Randah R.; Matar, Ali M.; Marhoon, Huda; Buzaboon, Bana Y.; Raees, Ahmed G.

    2001-01-01

    Study aimed to identify risk factors, such as family pathology and psychosocial stress, of overdose suicide attempts among Bahraini youth. Stresses from living in a non-intact family; interpersonal relationships mainly with the opposite sex; unemployment; and school performance emerged as main risk factors. Previously identified factors, such as…

  8. Risk factors for periodontal disease.

    PubMed

    Genco, Robert J; Borgnakke, Wenche S

    2013-06-01

    Risk factors play an important role in an individual's response to periodontal infection. Identification of these risk factors helps to target patients for prevention and treatment, with modification of risk factors critical to the control of periodontal disease. Shifts in our understanding of periodontal disease prevalence, and advances in scientific methodology and statistical analysis in the last few decades, have allowed identification of several major systemic risk factors for periodontal disease. The first change in our thinking was the understanding that periodontal disease is not universal, but that severe forms are found only in a portion of the adult population who show abnormal susceptibility. Analysis of risk factors and the ability to statistically adjust and stratify populations to eliminate the effects of confounding factors have allowed identification of independent risk factors. These independent but modifiable, risk factors for periodontal disease include lifestyle factors, such as smoking and alcohol consumption. They also include diseases and unhealthy conditions such as diabetes mellitus, obesity, metabolic syndrome, osteoporosis, and low dietary calcium and vitamin D. These risk factors are modifiable and their management is a major component of the contemporary care of many periodontal patients. Genetic factors also play a role in periodontal disease and allow one to target individuals for prevention and early detection. The role of genetic factors in aggressive periodontitis is clear. However, although genetic factors (i.e., specific genes) are strongly suspected to have an association with chronic adult periodontitis, there is as yet no clear evidence for this in the general population. It is important to pursue efforts to identify genetic factors associated with chronic periodontitis because such factors have potential in identifying patients who have a high susceptibility for development of this disease. Many of the systemic risk factors

  9. The risk factors for labor onset hypertension.

    PubMed

    Ohno, Yasumasa; Terauchi, Mikio; Tamakoshi, Koji; Shiozaki, Arihiro; Saito, Shigeru

    2016-04-01

    Our aim was to clarify the perinatal outcomes of and risk factors for hypertension that is first detected after labor onset (labor onset hypertension, LOH), which may be a risk factor for eclampsia and stroke during labor. A total of 1349 parturient women who did not exhibit preeclampsia or gestational hypertension prior to labor were examined. The patients were classified into four groups: the normotensive (n=1023) (whose systolic blood pressure (SBP) remained below 140 mm Hg throughout labor), mild LOH (n=241) (whose maximum SBP during labor ranged from 140 to 159 mm Hg), severe LOH (n=66) (whose maximum SBP during labor ranged from 160 to 179 mm Hg) and emergent LOH groups (n=19) (whose maximum SBP during labor was greater than 180 mm Hg). The perinatal outcomes and patient characteristics of the four groups were compared. Twenty-four percent of the pregnant women who remained normotensive throughout pregnancy developed hypertension during labor. One of the patients in the emergent LOH group developed eclampsia. The blood pressure at delivery and frequencies of hypotensor use, interventional delivery and low Apgar scores differed significantly among the four groups. The following risk factors for severe/emergent LOH were extracted: being over 35 years old, a body mass index at delivery of >30, an SBP at 36 weeks' gestation of 130-134 mm Hg, an SBP at admission of 130-139 mm Hg, proteinuria (a score of 2+ on the dipstick test) and severe edema. The risk factors for severe/emergent LOH were identified in this study. In high risk cases, repeatedly measuring maternal blood pressure during delivery might help detect critical hypertension early.

  10. [Preeclampsia as cardiovascular risk factor].

    PubMed

    Heida, Karst Y; Franx, Arie; Bots, Michiel L

    2013-01-01

    Cardiovascular diseases (CVD) are the primary cause of death in women. Guidelines for identifying high-risk individuals have been developed, e.g. the Dutch Guideline on Cardiovascular Risk Management. In the most recent version of this guideline, diabetes mellitus (DM) and rheumatoid arthritis (RA) are cited as cardiovascular risk factors; therefore, individuals with these conditions are identified as being at high risk. As with DM and RA, there is strong evidence that the experience of having a hypertensive disorder during pregnancy is a cardiovascular risk factor. This is particularly the case for early preeclampsia, which constitutes a 7-fold increased risk of ischemic heart disease. However, in the Netherlands, there are no guidelines and there is no consensus on how to screen or treat these women. Trial evidence is therefore urgently needed to substantiate the value of cardiovascular risk management for those women with a history of hypertension during pregnancy.

  11. Emerging Risk Biomarkers in Cardiovascular Diseases and Disorders

    PubMed Central

    Upadhyay, Ravi Kant

    2015-01-01

    Present review article highlights various cardiovascular risk prediction biomarkers by incorporating both traditional risk factors to be used as diagnostic markers and recent technologically generated diagnostic and therapeutic markers. This paper explains traditional biomarkers such as lipid profile, glucose, and hormone level and physiological biomarkers based on measurement of levels of important biomolecules such as serum ferritin, triglyceride to HDLp (high density lipoproteins) ratio, lipophorin-cholesterol ratio, lipid-lipophorin ratio, LDL cholesterol level, HDLp and apolipoprotein levels, lipophorins and LTPs ratio, sphingolipids, Omega-3 Index, and ST2 level. In addition, immunohistochemical, oxidative stress, inflammatory, anatomical, imaging, genetic, and therapeutic biomarkers have been explained in detail with their investigational specifications. Many of these biomarkers, alone or in combination, can play important role in prediction of risks, its types, and status of morbidity. As emerging risks are found to be affiliated with minor and microlevel factors and its diagnosis at an earlier stage could find CVD, hence, there is an urgent need of new more authentic, appropriate, and reliable diagnostic and therapeutic markers to confirm disease well in time to start the clinical aid to the patients. Present review aims to discuss new emerging biomarkers that could facilitate more authentic and fast diagnosis of CVDs, HF (heart failures), and various lipid abnormalities and disorders in the future. PMID:25949827

  12. Hidden Risk Factors for Women

    MedlinePlus

    ... previous history of clots in the legs (deep vein thrombosis) and livedo reticularis, a mottled purplish discoloration of the skin. “Risk factors are cumulative,” Dr. Kittner adds. “Reducing even one ...

  13. What Are the Risk Factors?

    MedlinePlus

    ... Cancer Home What Are the Risk Factors for Lung Cancer? Language: English (US) Español (Spanish) Recommend on ... those who smoke. Personal or Family History of Lung Cancer If you are a lung cancer survivor, there ...

  14. Cardiac risk factors: environmental, sociodemographic, and behavioral cardiovascular risk factors.

    PubMed

    Anthony, David; George, Paul; Eaton, Charles B

    2014-06-01

    Several environmental exposures are associated with increased risk of coronary heart disease (CHD). Exposure to secondhand smoke may increase the risk by as much as 25% to 30%. Exposure to third hand smoke, residual components of tobacco smoke that remain in the environment after a cigarette is extinguished, also appears to increase risk. These residual components can remain in rooms and automobiles for up to 30 years and enter the body through the skin or via inhalation or ingestion. Exposure to particulate matter air pollution from automobile emissions, power plants, and other sources is yet another environmental risk factor for CHD, resulting in tens of thousands of deaths annually in the United States. Exposure to other environmental toxins, particularly bisphenol A and phthalates, also has been linked to CHD. There are sociodemographic risks for CHD, with numerous studies showing that lower socioeconomic status is associated with higher risk. Behavioral risk factors include poor diet, such as frequent consumption of fast food and processed meals; sleep disturbance; and psychological stress, particularly related to marital or work issues. Finally, although high alcohol consumption is associated with increased CHD risk, moderate alcohol consumption (ie, less than 1 to 2 drinks/day), particularly of wine and possibly beer, appears to reduce the risk.

  15. [Perception of reproductive risk factors].

    PubMed

    Salinas-Martinez, A M; Martínez-Sanchez, C; Pérez-Segura, J

    1993-01-01

    The objective of this study was to identify risk perception on several factors related to reproductive health, with the goal of implementing an educational intervention based on detected needs. 405 women between 12 and 44 years were interviewed at home. 62.2% perceived the risk of pregnancy at 17 years and younger; 78.8% the risk of pregnancy at 35 years and older; 76.6% the risk of parity of 5 and higher; and 55.1% the risk of birth interval of 2 years and less. 60.5% recognized family history of birth defects, 80.2% age 35 years and older, and 84.4% rubella during pregnancy, as risk factors for newborns with congenital malformations. 27.7% identified history of a low birth weight and 61.0% birth interval of 1 year and less, as risk factors for low birth weight. The majority perceived the risk of tobacco, alcohol and drugs consumption during pregnancy, diseases with no treatment and deficient nutrition. There was an inconsistent influence of social and obstetric variables on risk perception. No linear correlation was detected. Health educators should recognize differences on knowledge and behavior of future receptors before an educational intervention starts.

  16. [Risk factors for Alzheimer's disease].

    PubMed

    Ikeda, Tokuhei; Yamada, Masahito

    2010-07-01

    Alzheimer disease (AD) is the most common cause of dementia in elderly patients. Identification of risk factors for AD would contribute to the understanding of AD pathogenesis and thus, help in the development of preventive methods. Early-onset familial AD is associated with mutations of the genes encoding amyloid precursor protein (APP), presenilin 1 (PS-1), or PS-2, resulting in the overproduction of amyloid beta-protein. Epidemiological and case-control studies have led to the identification of several risk factors for sporadic AD. The most concrete genetic risk factor for AD is the epsilon4 allele of apolipoprotein E gene (APOE). In addition, several genes such as CTNNA3, GAB2, PVRL2, TOMM40, and APOC1 are known to be the risk factors that contribute to AD pathogenesis. On the other hand, nongenetic risk factors, such as age, sex, alcohol consumption, smoking, depression, head injury, and nutrition have also been reported. Although aging is the strongest risk factor for AD, the mechanisms underlying the development of AD as a result of ageing remain to be elucidated.

  17. Quantitative risk assessment: an emerging tool for emerging foodborne pathogens.

    PubMed Central

    Lammerding, A. M.; Paoli, G. M.

    1997-01-01

    New challenges to the safety of the food supply require new strategies for evaluating and managing food safety risks. Changes in pathogens, food preparation, distribution, and consumption, and population immunity have the potential to adversely affect human health. Risk assessment offers a framework for predicting the impact of changes and trends on the provision of safe food. Risk assessment models facilitate the evaluation of active or passive changes in how foods are produced, processed, distributed, and consumed. PMID:9366601

  18. Is High Serum LDL/HDL Cholesterol Ratio an Emerging Risk Factor for Sudden Cardiac Death? Findings from the KIHD Study.

    PubMed

    Kunutsor, Setor K; Zaccardi, Francesco; Karppi, Jouni; Kurl, Sudhir; Laukkanen, Jari A

    2017-06-01

    Low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c), which are components of total cholesterol, have each been suggested to be linked to the risk of sudden cardiac death (SCD). However, the relationship between LDL-c/HDL-c ratio and the risk of SCD has not been previously investigated. We aimed to assess the associations of LDL-c, HDL-c, and the ratio of LDL-c/HDL-c with the risk of SCD. Serum lipoprotein concentrations were assessed at baseline in the Finnish Kuopio Ischemic Heart Disease prospective cohort study of 2,616 men aged 42-61 years at recruitment. Hazard ratios (HRs) (95% confidence intervals [CI]) were assessed. During a median follow-up of 23.0 years, a total of 228 SCDs occurred. There was no significant evidence of an association of LDL-c or HDL-c with the risk of SCD. In analyses adjusted for age, examination year, body mass index, systolic blood pressure, smoking, alcohol consumption, physical activity, years of education, diabetes, previous myocardial infarction, family history of coronary heart disease, and serum high sensitivity C-reactive protein, there was approximately a two-fold increase in the risk of SCD (HR 1.94, 95% CI 1.21-3.11; p=0.006), comparing the top (>4.22) versus bottom (≤2.30) quintile of serum LDL-c/HDL-c ratio. In this middle-aged male population, LDL-c or HDL-c was not associated with the risk of SCD. However, a high serum LDL-c/HDL-c ratio was found to be independently associated with an increased risk of SCD. Further research is warranted to understand the mechanistic pathways underlying this association.

  19. Emerging Comorbidities in Adult Asthma: Risks, Clinical Associations, and Mechanisms

    PubMed Central

    Kankaanranta, Hannu; Kauppi, Paula; Tuomisto, Leena E.; Ilmarinen, Pinja

    2016-01-01

    Asthma is a heterogeneous disease with many phenotypes, and age at disease onset is an important factor in separating the phenotypes. Most studies with asthma have been performed in patients being otherwise healthy. However, in real life, comorbid diseases are very common in adult patients. We review here the emerging comorbid conditions to asthma such as obesity, metabolic syndrome, diabetes mellitus type 2 (DM2), and cardiac and psychiatric diseases. Their role as risk factors for incident asthma and whether they affect clinical asthma are evaluated. Obesity, independently or as a part of metabolic syndrome, DM2, and depression are risk factors for incident asthma. In contrast, the effects of comorbidities on clinical asthma are less well-known and mostly studies are lacking. Cross-sectional studies in obese asthmatics suggest that they may have less well controlled asthma and worse lung function. However, no long-term clinical follow-up studies with these comorbidities and asthma were identified. These emerging comorbidities often occur in the same multimorbid adult patient and may have in common metabolic pathways and inflammatory or other alterations such as early life exposures, systemic inflammation, inflammasome, adipokines, hyperglycemia, hyperinsulinemia, lung mechanics, mitochondrial dysfunction, disturbed nitric oxide metabolism, and leukotrienes. PMID:27212806

  20. Variables Affecting Emerging Adults' Self-Reported Risk and Reckless Behaviors

    ERIC Educational Resources Information Center

    Duangpatra, Krisna N. K.; Bradley, Graham L.; Glendon, A. Ian

    2009-01-01

    Young adults' behaviors are frequently characterized by risk-taking and recklessness. Few studies have examined the correlates of risk and reckless behaviors in emerging adults. Drawing on theories emphasising multifactorial effects of personality, social, and cognitive variables, this study explores psychosocial factors contributing to risk and…

  1. Variables Affecting Emerging Adults' Self-Reported Risk and Reckless Behaviors

    ERIC Educational Resources Information Center

    Duangpatra, Krisna N. K.; Bradley, Graham L.; Glendon, A. Ian

    2009-01-01

    Young adults' behaviors are frequently characterized by risk-taking and recklessness. Few studies have examined the correlates of risk and reckless behaviors in emerging adults. Drawing on theories emphasising multifactorial effects of personality, social, and cognitive variables, this study explores psychosocial factors contributing to risk and…

  2. Environmental risk factors for osteoporosis

    SciTech Connect

    Goyer, R.A.; Korach, K.S. ); Epstein, S. ); Bhattacharyya, M. ); Pounds, J. )

    1994-04-01

    Environmental risk factors for osteoporosis were reviewed at a conference held at the National Institute for Environmental Health Sciences 8-9 November 1993. The conference was co-sponsored by the National Institute of Arthritis and Musculoskeletal and Skin Disease and the NIH Office of Research in Women's Health. The objective of the conference was to review what is known about risk factors for osteoporosis and to identify gaps in the present state of knowledge that might be addressed by future research. The conference was divided into two broad themes. The first session focused on current knowledge regarding etiology, risk factors, and approaches to clinical and laboratory diagnosis. This was followed by three sessions in which various environmental pollutants were discussed. Topics selected for review included environmental agents that interfere with bone and calcium metabolism, such as the toxic metals lead, cadmium, aluminum, and fluoride, natural and antiestrogens, calcium, and vitamin D.

  3. Hurricane risk mitigation - Emergency Operations Center

    NASA Image and Video Library

    2008-07-29

    Construction work on a new Emergency Operations Center at Stennis Space Center is nearing completion. Construction is expected to be complete by February 2009, with actual occupancy of the building planned for later that year. The new building will house fire, medical and security teams and will provide a top-grade facility to support storm emergency responder teams and emergency management operations for the south Mississippi facility.

  4. Risk factors for eosinophilic esophagitis.

    PubMed

    Philpott, H; Nandurkar, S; Royce, S G; Thien, F; Gibson, P R

    2014-08-01

    Eosinophilic esophagitis (EoE) is a chronic antigen driven disease, whereby food and/or aeroallergens result in inflammation and luminal narrowing, and the clinical symptoms of dysphagia and food bolus obstruction events (FBOE). Established risk factors are male gender, Caucasian race and atopy. Increased risk amongst family members, and a single nucleotide polymorphism (SNP) in a gene coding thymic stromal lymphopoietin (TSLP) on the pseudoautosomal region of the X and Y chromosomes supports a genetic predisposition. Environmental factors including the timing and nature of food and aeroallergen exposure to the developing immune system may be important, whilst esophageal barrier function integrity and the influence of microbiota are worthy of future research.

  5. Psychological Factors Linked to Risk Perception

    NASA Astrophysics Data System (ADS)

    Armaş, I.; Creãu, R. Z.; Stǎnciugelu, I.

    2012-04-01

    Risks are mental models, which allow people to cope with dangerous phenomena (Renn, 2008; Jasanoff, 1998). The term "risk" refers to the likelihood of an adverse effect resulting from an event. The aim of the present study is to identify the psychological factors that are most predictive of risk perception in relation with age, gender, educational level and socio-economical status. Earthquake hazard was considered, because it is an emerging danger for Bucharest. 80% of the laypeople sample are waiting for this event to happen in the next three years. By integrating all the research data, it was attempted to build a risk profile of the investigated population, which could be used by institutions responsible for earthquake risk mitigation situations in Bucharest. This research appealed to the social learning Rotter (1966), auto-effectiveness Bandura (1977; 1983), and anxiety and stress theories. We used psychological variables that measured stress, personal effectiveness and the belief in personal control. The multi-modal risk perception questionnaire was structured on a 49 items sequence. The sample was composed of 1.376 participants recruited on a voluntary basis. The characteristics of risk (like probability and magnitude, time scales) are perceived differently according to psychological factors that play a role also in biases in people's ability to draw inferences from probabilistic information (like cognitive dissonance). Since the 1970's, it has been argued that those who perceive life's events as being beyond their locus of control (external locus of control) are significantly more anxious and less adapted. In this research, strongest associations and significant differences were obtained between sex, age and income categories with Stress vulnerability factor and the External Locus of Control factor. The profile of the low risk perceiver is that of a young, more educated, male individual with a higher self- efficacy level and an internal locus of control.

  6. MS ANTWERPEN: Emergency Management Training for Low-Risk Environments

    ERIC Educational Resources Information Center

    Strohschneider, Stefan; Gerdes, Jurgen

    2004-01-01

    Emergency management training programs have been developed mostly for trainees from high-risk environments such as aviation or the chemical industry. This article describes a training program for staff members from low-risk environments such as hospitals or hotels, where the awareness of potential dangers is usually low and emergency plans are…

  7. MS ANTWERPEN: Emergency Management Training for Low-Risk Environments

    ERIC Educational Resources Information Center

    Strohschneider, Stefan; Gerdes, Jurgen

    2004-01-01

    Emergency management training programs have been developed mostly for trainees from high-risk environments such as aviation or the chemical industry. This article describes a training program for staff members from low-risk environments such as hospitals or hotels, where the awareness of potential dangers is usually low and emergency plans are…

  8. Evaluating emergency risk communications: a dialogue with the experts.

    PubMed

    Thomas, Craig W; Vanderford, Marsha L; Crouse Quinn, Sandra

    2008-10-01

    Evaluating emergency risk communications is fraught with challenges since communication can be approached from both a systemic and programmatic level. Therefore, one must consider stakeholders' perspectives, effectiveness issues, standards of evidence and utility, and channels of influence (e.g., mass media and law enforcement). Evaluation issues related to timing, evaluation questions, methods, measures, and accountability are raised in this dialogue with emergency risk communication specialists. Besides the usual evaluation competencies, evaluators in this area need to understand and work collaboratively with stakeholders and be attuned to the dynamic contextual nature of emergency risk communications. Sample resources and measures are provided here to aid in this emerging and exciting field of evaluation.

  9. Risk management of international trade: emergency preparedness.

    PubMed

    Torres, A; David, M J; Bowman, Q P

    2002-12-01

    Emergency preparedness and management are among the most important and critical issues facing animal health in the world today. The goals of a country for an animal health emergency management (AHEM) system should include the following: --being prepared to detect and manage an outbreak of a foreign animal disease --preventing the introduction of foreign and emerging animal pathogens --having an appropriate response system for control and eradication of the disease --having a system for recovery from animal health emergencies, including natural disasters. An AHEM system can no longer be limited to a single organisation within a country. In the event of a serious threat to the animal agriculture of a country, broader and more comprehensive participation is required. If not properly planned for, animal health emergencies can rapidly become national disasters. Therefore, it is essential that the central government of a country work towards these goals through partnerships with other Federal and State/Provincial/District organisations, academic institutions and national animal industries.

  10. Sexual harassment: identifying risk factors.

    PubMed

    O'Hare, E A; O'Donohue, W

    1998-12-01

    A new model of the etiology of sexual harassment, the four-factor model, is presented and compared with several models of sexual harassment including the biological model, the organizational model, the sociocultural model, and the sex role spillover model. A number of risk factors associated with sexually harassing behavior are examined within the framework of the four-factor model of sexual harassment. These include characteristics of the work environment (e.g., sexist attitudes among co-workers, unprofessional work environment, skewed sex ratios in the workplace, knowledge of grievance procedures for sexual harassment incidents) as well as personal characteristics of the subject (e.g., physical attractiveness, job status, sex-role). Subjects were 266 university female faculty, staff, and students who completed the Sexual Experience Questionnaire to assess the experience of sexual harassment and a questionnaire designed to assess the risk factors stated above. Results indicated that the four-factor model is a better predictor of sexual harassment than the alternative models. The risk factors most strongly associated with sexual harassment were an unprofessional environment in the workplace, sexist atmosphere, and lack of knowledge about the organization's formal grievance procedures.

  11. Risk factors for Down syndrome.

    PubMed

    Coppedè, Fabio

    2016-12-01

    Down syndrome (DS) originates, in most of the cases (95 %), from a full trisomy of chromosome 21. The remaining cases are due to either mosaicism for chromosome 21 or the inheritance of a structural rearrangement leading to partial trisomy of the majority of its content. Full trisomy 21 and mosaicism are not inherited, but originate from errors in cell divisions during the development of the egg, sperm or embryo. In addition, full trisomy for chromosome 21 should be further divided into cases of maternal origin, the majority, and cases of paternal origin, less than 10 %. Among cases of maternal origin, a further stratification should be performed into errors that have occurred or originated during the first meiotic division in the maternal grandmother's body and errors that occurred later in life during the second maternal meiotic division. This complex scenario suggests that our understanding of the risk factors for trisomy 21 should take into account the above stratification as it reflects different individuals and generations in which the first error has occurred. Unfortunately, most of the available literature is focused on maternal risk factors, and the only certain risk factors for the birth of a child with DS are advanced maternal age at conception and recombination errors, even though the molecular mechanisms leading to chromosome 21 nondisjunction are still a matter of debate. This article critically reviews the hypotheses and the risk factors which have been suggested to contribute to the birth of a child with DS, including folate metabolism, dietary, lifestyle, environmental, occupational, genetic and epigenetic factors, with focus on maternal and paternal risk factors, and taking into account the possible contribution of the maternal grandmother and that of the developing trisomic embryo, in a complex scenario depicting the birth of a child with DS as the result of complex gene-environment interactions and selection processes involving different

  12. A Risk Management Architecture for Emergency Integrated Aircraft Control

    NASA Technical Reports Server (NTRS)

    McGlynn, Gregory E.; Litt, Jonathan S.; Lemon, Kimberly A.; Csank, Jeffrey T.

    2011-01-01

    Enhanced engine operation--operation that is beyond normal limits--has the potential to improve the adaptability and safety of aircraft in emergency situations. Intelligent use of enhanced engine operation to improve the handling qualities of the aircraft requires sophisticated risk estimation techniques and a risk management system that spans the flight and propulsion controllers. In this paper, an architecture that weighs the risks of the emergency and of possible engine performance enhancements to reduce overall risk to the aircraft is described. Two examples of emergency situations are presented to demonstrate the interaction between the flight and propulsion controllers to facilitate the enhanced operation.

  13. The research of emergency managers’ risk attitude based on genetic neural network

    NASA Astrophysics Data System (ADS)

    Pan, Chen; Jia, Chuanliang; Su, Jie; Chen, Junlin

    2017-08-01

    Since the 21st century, the sudden emergencies occurred around the world. The decision which emergency managers made in the emergency environment is actually a risk decision-making. And decision-makers will be affected by its risk attitude in the risk decision-making. The paper puts forward a kind of forecasting method of risk attitudes of emergency managers, which are influenced by various factors such as their own gender, age, training experiences, treatment experiences, actual average accuracy and self-confidence and so on. Based on the questionnaire results from Kunming and Wuhan, the above six factors were chosen as the input variables of the BP neural network model and the risk attitude values as the output variable. Genetic algorithm was used to optimize the weights and thresholds of the neural network and establish BP Neural network prediction model of emergency managers. The results of risk attitude value prediction show that the GA-BP is a more effective and accurate method to predict emergency managers’ risk attitude, which can provide the reference for the risk managers’ risk attitude prediction and more efficient management.

  14. Prediction of fracture risk. II: Other risk factors.

    PubMed

    Ross, P D

    1996-12-01

    Many osteoporotic fractures are probably preventable-by definition, prevention requires identification of those at risk prior to fracture. There is a continuum in fracture risk and a very wide range in risk among individuals. Bone density, previous fractures, and the frequency and types of falls are important risk factors for fractures. There are also many other risk factors for bone loss, falls, and fractures. People with multiple risk factors are at greater risk than those with either a single risk factor or none. Identification of risk factors can help when planning interventions. For example, dietary deficiencies are amenable to dietary modification or supplementation; however, the effects of many risk factors have not been quantified separately, making it difficult to determine the importance. In addition, it is not possible to accurately predict current bone density and fracture risk from risk factors for bone loss; bone density should always be measured directly.

  15. Physicians' and nurses' perceptions of patient safety risks in the emergency department.

    PubMed

    Källberg, Ann-Sofie; Ehrenberg, Anna; Florin, Jan; Östergren, Jan; Göransson, Katarina E

    2017-02-28

    The emergency department has been described as a high-risk area for errors. It is also known that working conditions such as a high workload and shortage off staff in the healthcare field are common factors that negatively affect patient safety. A limited amount of research has been conducted with regard to patient safety in Swedish emergency departments. Additionally, there is a lack of knowledge about clinicians' perceptions of patient safety risks. Therefore, the purpose of this study was to describe emergency department clinicians' experiences with regard to patient safety risks.

  16. [Risk factors associated to preclampsia].

    PubMed

    López-Carbajal, Mario Joaquín; Manríquez-Moreno, María Esther; Gálvez-Camargo, Daniela; Ramírez-Jiménez, Evelia

    2012-01-01

    preeclampsia constitutes one of the main causes of maternal and perinatal morbidity and mortality. The aim was to identify the risk factors associated to the developmental of preeclampsia mild-moderate and severe, as well as the force of association of these factors in a hospital of second-level medical care. study of cases and controls, a relation 1:1, in women withdrawn of the Service of Gynecology and Obstetrics during 2004 to 2007. Pregnant women with more than 20 weeks gestation were included. In the cases group we included patients with diagnosis of preeclampsia mild-moderate or severe (corroborated clinical and laboratory). In the controls group that had a normal childbirth without pathology during the pregnancy. 42 cases and 42 controls. The average age was of 27 years. The associated risk factors were overweight, obesity, irregular prenatal control, short or long intergenesic period, history of caesarean or preeclampsia in previous pregnancies. the knowledge of the risk factors will allow the accomplishment of preventive measures and decrease the fetal and maternal morbidity and mortality due to preeclampsia.

  17. Risk factor paradox in wasting diseases.

    PubMed

    Kalantar-Zadeh, Kamyar; Horwich, Tamara B; Oreopoulos, Antigone; Kovesdy, Csaba P; Younessi, Houman; Anker, Stefan D; Morley, John E

    2007-07-01

    Emerging data indicate that conventional cardiovascular risk factors (e.g. hypercholesterolemia and obesity) are paradoxically associated with better survival in distinct populations with wasting. We identify these populations and review survival paradoxes and common pathophysiologic mechanisms. A 'reverse epidemiology' of cardiovascular risk is observed in chronic kidney disease, chronic heart failure, chronic obstructive lung disease, cancer, AIDS and rheumatoid arthritis, and in the elderly. These populations apparently have slowly progressive to full-blown wasting and significantly greater short-term mortality than the general population. The survival paradoxes may result from the time differential between the two competing risk factors [i.e. over-nutrition (long-term killer but short-term protective) versus undernutrition (short-term killer)]. Hemodynamic stability of obesity, protective adipokine profile, endotoxin-lipoprotein interaction, toxin sequestration of fat, antioxidation of muscle, reverse causation, and survival selection may also contribute. The seemingly counterintuitive risk factor paradox is the hallmark of chronic disease states or conditions associated with wasting disease at the population level. Studying similarities among these populations may help reveal common pathophysiologic mechanisms of wasting disease, leading to a major shift in clinical medicine and public health beyond the conventional Framingham paradigm and to novel therapeutic approaches related to wasting and short-term mortality.

  18. Risk Factors for Age-Related Maculopathy

    PubMed Central

    Connell, Paul P.; Keane, Pearse A.; O'Neill, Evelyn C.; Altaie, Rasha W.; Loane, Edward; Neelam, Kumari; Nolan, John M.; Beatty, Stephen

    2009-01-01

    Age-related maculopathy (ARM) is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age-related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715/HTRA1, demonstrating that environmental and genetic factors are important for the development of ARM suggesting that gene-environment interaction plays an important role in the pathogenesis of this condition. PMID:20339564

  19. Chronic disease risk factors among hotel workers

    PubMed Central

    Gawde, Nilesh Chandrakant; Kurlikar, Prashika R.

    2016-01-01

    Context: Non-communicable diseases have emerged as a global health issue. Role of occupation in pathogenesis of non-communicable diseases has not been explored much especially in the hospitality industry. Aims: Objectives of this study include finding risk factor prevalence among hotel workers and studying relationship between occupational group and chronic disease risk factors chiefly high body mass index. Settings and Design: A cross-sectional study was conducted among non-managerial employees from classified hotels in India. Materials and Methods: The study participants self-administered pre-designed pilot-tested questionnaires. Statistical analysis used: The risk factor prevalence rates were expressed as percentages. Chi-square test was used for bi-variate analysis. Overweight was chosen as ‘outcome’ variable of interest and binary multi-logistic regression analysis was used to identify determinants. Results: The prevalence rates of tobacco use, alcohol use, inadequate physical activity and inadequate intake of fruits and vegetables were 32%, 49%, 24% and 92% respectively among hotel employees. Tobacco use was significantly common among those in food preparation and service, alcohol use among those in food service and security and leisure time physical activity among front office workers. More than two-fifths (42.7%) were overweight. Among the hotel workers, those employed in food preparation and security had higher odds of 1.650 (CI: 1.025 – 2.655) and 3.245 (CI: 1.296 – 8.129) respectively of being overweight. Conclusions: Prevalence of chronic disease risk factors is high among hotel workers. Risk of overweight is significantly high in food preparation and security departments and workplace interventions are necessary to address these risks PMID:27390474

  20. Chronic disease risk factors among hotel workers.

    PubMed

    Gawde, Nilesh Chandrakant; Kurlikar, Prashika R

    2016-01-01

    Non-communicable diseases have emerged as a global health issue. Role of occupation in pathogenesis of non-communicable diseases has not been explored much especially in the hospitality industry. Objectives of this study include finding risk factor prevalence among hotel workers and studying relationship between occupational group and chronic disease risk factors chiefly high body mass index. A cross-sectional study was conducted among non-managerial employees from classified hotels in India. The study participants self-administered pre-designed pilot-tested questionnaires. The risk factor prevalence rates were expressed as percentages. Chi-square test was used for bi-variate analysis. Overweight was chosen as 'outcome' variable of interest and binary multi-logistic regression analysis was used to identify determinants. The prevalence rates of tobacco use, alcohol use, inadequate physical activity and inadequate intake of fruits and vegetables were 32%, 49%, 24% and 92% respectively among hotel employees. Tobacco use was significantly common among those in food preparation and service, alcohol use among those in food service and security and leisure time physical activity among front office workers. More than two-fifths (42.7%) were overweight. Among the hotel workers, those employed in food preparation and security had higher odds of 1.650 (CI: 1.025 - 2.655) and 3.245 (CI: 1.296 - 8.129) respectively of being overweight. Prevalence of chronic disease risk factors is high among hotel workers. Risk of overweight is significantly high in food preparation and security departments and workplace interventions are necessary to address these risks.

  1. Risk communications and the Chemical Stockpile Emergency-Planning Program

    SciTech Connect

    Vogt, B.M.; Sorensen, J.H.

    1994-09-01

    The CSEPP (Chemical Stockpile Emergency Preparedness Program) was created to improve emergency planning and response capabilities at the eight sites around the country that store chemical weapons. These weapons are scheduled to be destroyed in the near future. In preparation of the Draft Programmatic Environmental Impact Statement (DPEIS) for the Chemical Stockpile Disposal Program (CSDP), it was proposed that the Army mitigate accidents through an enhanced community emergency preparedness program at the eight storage sites. In 1986, the Army initiated the development of an Emergency Response Concept Plan (ERCP) for the CSDP, one of 12 technical support studies conducted during preparation of the Final Programmatic Environmental Impact Statement (FPEIS). The purpose of this document is to provide a fairly comprehensive source book on risk, risk management, risk communication research and recommended risk communication practices. It does not merely summarize each publication in the risk communication literature, but attempts to synthesize them along the lines of a set of organizing principles. Furthermore, it is not intended to duplicate other guidance manuals (such as Covello et al.`s manual on risk comparison). The source book was developed for the CSEPP in support of the training module on risk communications. Although the examples provided are specific to CSEPP, its use goes beyond that of CSEPP as the findings apply to a broad spectrum of risk communication topics. While the emphasis is on communication in emergency preparedness and response specific to the CSEPP, the materials cover other non-emergency communication settings. 329 refs.

  2. The Emerging Risk Factors Collaboration: analysis of individual data on lipid, inflammatory and other markers in over 1.1 million participants in 104 prospective studies of cardiovascular diseases.

    PubMed

    Danesh, J; Erqou, S; Walker, M; Thompson, S G; Tipping, R; Ford, C; Pressel, S; Walldius, G; Jungner, I; Folsom, A R; Chambless, L E; Knuiman, M; Whincup, P H; Wannamethee, S G; Morris, R W; Willeit, J; Kiechl, S; Santer, P; Mayr, A; Wald, N; Ebrahim, S; Lawlor, D A; Yarnell, J W G; Gallacher, J; Casiglia, E; Tikhonoff, V; Nietert, P J; Sutherland, S E; Bachman, D L; Keil, J E; Cushman, M; Psaty, B M; Tracy, R P; Tybjaerg-Hansen, A; Nordestgaard, B G; Frikke-Schmidt, R; Giampaoli, S; Palmieri, L; Panico, S; Vanuzzo, D; Pilotto, L; Simons, L; McCallum, J; Friedlander, Y; Fowkes, F G R; Lee, A J; Smith, F B; Taylor, J; Guralnik, J; Phillips, C; Wallace, R; Blazer, D; Khaw, K T; Jansson, J H; Donfrancesco, C; Salomaa, V; Harald, K; Jousilahti, P; Vartiainen, E; Woodward, M; D'Agostino, R B; Wolf, P A; Vasan, R S; Pencina, M J; Bladbjerg, E M; Jorgensen, T; Moller, L; Jespersen, J; Dankner, R; Chetrit, A; Lubin, F; Rosengren, A; Wilhelmsen, L; Lappas, G; Eriksson, H; Bjorkelund, C; Cremer, P; Nagel, D; Tilvis, R; Strandberg, T; Rodriguez, B; Bouter, L M; Heine, R J; Dekker, J M; Nijpels, G; Stehouwer, C D A; Rimm, E; Pai, J; Sato, S; Iso, H; Kitamura, A; Noda, H; Goldbourt, U; Salomaa, V; Salonen, J T; Nyyssönen, K; Tuomainen, T-P; Deeg, D; Poppelaars, J L; Meade, T; Cooper, J; Hedblad, B; Berglund, G; Engstrom, G; Döring, A; Koenig, W; Meisinger, C; Mraz, W; Kuller, L; Selmer, R; Tverdal, A; Nystad, W; Gillum, R; Mussolino, M; Hankinson, S; Manson, J; De Stavola, B; Knottenbelt, C; Cooper, J A; Bauer, K A; Rosenberg, R D; Sato, S; Naito, Y; Holme, I; Nakagawa, H; Miura, H; Ducimetiere, P; Jouven, X; Crespo, C; Garcia-Palmieri, M; Amouyel, P; Arveiler, D; Evans, A; Ferrieres, J; Schulte, H; Assmann, G; Shepherd, J; Packard, C; Sattar, N; Cantin, B; Lamarche, B; Després, J-P; Dagenais, G R; Barrett-Connor, E; Wingard, D; Bettencourt, R; Gudnason, V; Aspelund, T; Sigurdsson, G; Thorsson, B; Trevisan, M; Witteman, J; Kardys, I; Breteler, M; Hofman, A; Tunstall-Pedoe, H; Tavendale, R; Lowe, G D O; Ben-Shlomo, Y; Howard, B V; Zhang, Y; Best, L; Umans, J; Onat, A; Meade, T W; Njolstad, I; Mathiesen, E; Lochen, M L; Wilsgaard, T; Gaziano, J M; Stampfer, M; Ridker, P; Ulmer, H; Diem, G; Concin, H; Rodeghiero, F; Tosetto, A; Brunner, E; Shipley, M; Buring, J; Cobbe, S M; Ford, I; Robertson, M; He, Y; Ibanez, A M; Feskens, E J M; Kromhout, D; Collins, R; Di Angelantonio, E; Kaptoge, S; Lewington, S; Orfei, L; Pennells, L; Perry, P; Ray, K; Sarwar, N; Scherman, M; Thompson, A; Watson, S; Wensley, F; White, I R; Wood, A M

    2007-01-01

    Many long-term prospective studies have reported on associations of cardiovascular diseases with circulating lipid markers and/or inflammatory markers. Studies have not, however, generally been designed to provide reliable estimates under different circumstances and to correct for within-person variability. The Emerging Risk Factors Collaboration has established a central database on over 1.1 million participants from 104 prospective population-based studies, in which subsets have information on lipid and inflammatory markers, other characteristics, as well as major cardiovascular morbidity and cause-specific mortality. Information on repeat measurements on relevant characteristics has been collected in approximately 340,000 participants to enable estimation of and correction for within-person variability. Re-analysis of individual data will yield up to approximately 69,000 incident fatal or nonfatal first ever major cardiovascular outcomes recorded during about 11.7 million person years at risk. The primary analyses will involve age-specific regression models in people without known baseline cardiovascular disease in relation to fatal or nonfatal first ever coronary heart disease outcomes. This initiative will characterize more precisely and in greater detail than has previously been possible the shape and strength of the age- and sex-specific associations of several lipid and inflammatory markers with incident coronary heart disease outcomes (and, secondarily, with other incident cardiovascular outcomes) under a wide range of circumstances. It will, therefore, help to determine to what extent such associations are independent from possible confounding factors and to what extent such markers (separately and in combination) provide incremental predictive value.

  3. Neighborhood risk factors for obesity.

    PubMed

    Lopez, Russ P

    2007-08-01

    The goal of this study was to explore neighborhood environmental factors associated with obesity in a sample of adults living in a major U.S. metropolitan area. This was a multi-level study combining data from the U.S. Behavioral Risk Factor Surveillance System with data from the U.S. Census. A total of 15,358 subjects living in 327 zip code tabulation areas were surveyed between 1998 and 2002. The outcome was obesity (BMI >30), and independent variables assessed included individual level variables (age, education, income, smoking status, sex, black race, and Hispanic ethnicity), and zip code level variables (percentage black, percentage Hispanic, percentage with more than a high school education, retail density, establishment density, employment density, population density, the presence of a supermarket, intersection density, median household income, and density of fast food outlets). After controlling for individual level factors, median household income [relative risk (RR) = 0.992; 95% confidence interval (CI) = 0.990, 0.994], population density (RR = 0.98; 95% CI = 0.972, 0.990), employment density (RR = 1.004; 95% CI = 1.001, 1.009), establishment density (RR = 0.981 95% CI = 0.964, 0.999), and the presence of a supermarket (RR = 0.893; 95% CI = 0.815, 0.978) were associated with obesity risk. Fast food establishment density was poorly associated with obesity risk. Where one lives may affect obesity status. Given the influence of the presence of a supermarket on obesity risk, efforts to address food access might be a priority for reducing obesity.

  4. Risk factors of striae gravidarum.

    PubMed

    Kasielska-Trojan, A; Sobczak, M; Antoszewski, B

    2015-04-01

    Stretch marks are a common skin disorder. Pregnancy-related lesions are defined as striae gravidarum. The root cause of striae formation remains unknown. The aim of this paper was to identify the risk factors associated with striae gravidarum (SG) development. The study was conducted at Plastic, Reconstructive and Aesthetic Surgery Clinic and Obstetrics Outpatient Department among 299 Caucasian women maximum 6 months after the delivery, regardless of whether they were primiparas or multiparas. Among the women participating in the study, 71.2% (213 of 299) developed striae gravidarum at least in one site. Logistic regression analysis showed that four of the analysed factors were independent predictors of striae gravidarum occurrence: family history of SG, BMI before pregnancy, the lack of chronic diseases and birthweight (P < 0.0001). It has been found that the presence of striae distensae on the breasts increases the risk of SG development (71.4% vs. 28.6%, P = 0.0008), whereas the presence of these lesions on the thighs decreases the risk (23% vs. 77%, P = 0.0076). In this study, we presented a model that can help to predict the risk of SG formation, including family history of SG, BMI before pregnancy, birthweight and chronic diseases. Moreover, women with stretch marks on their breasts should know that the risk of SG development is significantly higher, whereas lesions on the thighs do not increase such a risk. © 2014 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

  5. Psychosocial risk factors for coronary heart disease.

    PubMed

    Glozier, Nick; Tofler, Geoffrey H; Colquhoun, David M; Bunker, Stephen J; Clarke, David M; Hare, David L; Hickie, Ian B; Tatoulis, James; Thompson, David R; Wilson, Alison; Branagan, Maree G

    2013-08-05

    In 2003, the National Heart Foundation of Australia published a position statement on psychosocial risk factors and coronary heart disease (CHD). This consensus statement provides an updated review of the literature on psychosocial stressors, including chronic stressors (in particular, work stress), acute individual stressors and acute population stressors, to guide health professionals based on current evidence. It complements a separate updated statement on depression and CHD. Perceived chronic job strain and shift work are associated with a small absolute increased risk of developing CHD, but there is limited evidence regarding their effect on the prognosis of CHD. Evidence regarding a relationship between CHD and job (in)security, job satisfaction, working hours, effort-reward imbalance and job loss is inconclusive. Expert consensus is that workplace programs aimed at weight loss, exercise and other standard cardiovascular risk factors may have positive outcomes for these risk factors, but no evidence is available regarding the effect of such programs on the development of CHD. Social isolation after myocardial infarction (MI) is associated with an adverse prognosis. Expert consensus is that although measures to reduce social isolation are likely to produce positive psychosocial effects, it is unclear whether this would also improve CHD outcomes. Acute emotional stress may trigger MI or takotsubo ("stress") cardiomyopathy, but the absolute increase in transient risk from an individual stressor is low. Psychosocial stressors have an impact on CHD, but clinical significance and prevention require further study. Awareness of the potential for increased cardiovascular risk among populations exposed to natural disasters and other conditions of extreme stress may be useful for emergency services response planning. Wider public access to defibrillators should be available where large populations gather, such as sporting venues and airports, and as part of the response

  6. Risk factors for persistent diarrhoea.

    PubMed

    Shahid, N S; Sack, D A; Rahman, M; Alam, A N; Rahman, N

    1988-10-22

    With a systematically sampled population of children aged under 5 attending this centre for diarrhoeal disease research during 1983-5 a retrospective analysis of persistent diarrhoea (defined as greater than 14 days' duration) was performed to identify the possible risk factors for this syndrome. Of the 4155 children included in the analysis, 410 (10%) gave a history of persistent diarrhoea. A comparison with children with acute diarrhoea matched for age showed that 11 factors were correlated with persistent diarrhoea, and strongly associated factors were stools with blood or mucus, or both, lower respiratory tract infection, malnutrition, vitamin A deficiency, and antibiotic use before presentation. The peak age was 2 years, and there was no sex difference. Deaths occurred more often in the group with persistent diarrhoea. Although Shigella spp, Campylobacter jejuni, and Giardia lamblia were frequently identified, their rates of isolation were not significantly higher among patients with persistent diarrhoea. No seasonal variation was observed in the rates of persistent diarrhoea. Although the introduction of family food to the diet was associated with higher rates, this factor was difficult to separate from the age dependent risks.

  7. Obesity and related risk factors.

    PubMed

    Mozaffari, H; Nabaei, B

    2007-03-01

    To study the prevalence of overweight and obesity among Iranian schoolgirls and to identify risk factors which lead to obesity. This cross-sectional study was conducted in 2002 and a sample of 1800 female students between 7-12 years old was obtained using a multistage cluster sampling method from Tehran. Height and weight were measured and related socio-economic information was collected. The overall percent of overweight and obesity was 13.3% and 7.7% respectively. BMI (Body Mass Index) was directly and significantly(r=+0.28, P< 0.001) correlated with increasing age. Physical activity was significantly different between obese and non-obese children. (P=0.03) Also, economical factors such as the type of school (private&public) were different in these children. (P=0.03) The statistical analysis of the data revealed a significant and inverse correlation(r=-0.03, P=0.04) between maternal education and occurrence of overweight and obesity in children. The prevalence of overweight and obesity in young Iranian girls was high. Advanced age, lack of physical inactivity, low economical factors and maternal educational status could be risk factors for obesity in children.

  8. Risk factors for persistent diarrhoea.

    PubMed Central

    Shahid, N. S.; Sack, D. A.; Rahman, M.; Alam, A. N.; Rahman, N.

    1988-01-01

    With a systematically sampled population of children aged under 5 attending this centre for diarrhoeal disease research during 1983-5 a retrospective analysis of persistent diarrhoea (defined as greater than 14 days' duration) was performed to identify the possible risk factors for this syndrome. Of the 4155 children included in the analysis, 410 (10%) gave a history of persistent diarrhoea. A comparison with children with acute diarrhoea matched for age showed that 11 factors were correlated with persistent diarrhoea, and strongly associated factors were stools with blood or mucus, or both, lower respiratory tract infection, malnutrition, vitamin A deficiency, and antibiotic use before presentation. The peak age was 2 years, and there was no sex difference. Deaths occurred more often in the group with persistent diarrhoea. Although Shigella spp, Campylobacter jejuni, and Giardia lamblia were frequently identified, their rates of isolation were not significantly higher among patients with persistent diarrhoea. No seasonal variation was observed in the rates of persistent diarrhoea. Although the introduction of family food to the diet was associated with higher rates, this factor was difficult to separate from the age dependent risks. PMID:3142603

  9. What Are the Risk Factors for Eye Cancer?

    MedlinePlus

    ... Causes, Risk Factors, and Prevention What Are the Risk Factors for Eye Cancer? A risk factor is ... may have few or no known risk factors. Risk factors for eye melanoma Race/ethnicity The risk ...

  10. [Risk factors for birth injuries].

    PubMed

    García, Heladia; Rubio-Espíritu, Jorge; Islas-Rodríguez, Maria Teresa

    2006-01-01

    To identify risk factors associated with birth trauma. Servicio de Neonatología, Hospital General "Dr. Manuel Gea González", Secretaría de Salud. Case-control, prolective study. There were 129 cases and 134 controls. We recorded the following variables: a) maternal and delivery: age, weight, height, prenatal care, pre-existing disease or gestational disease, mode of delivery, anesthetic management during labor, use of external maneuvers or forceps; b) newborn: birth weight, gestational age, academic degree of attendant physician at delivery, and type of birth injury. The independent risk factors associated to birth injury were: for ecchymoses; general anesthesia (OR 13.7, 95% CI = 3 - 62.6), breech presentation (OR 6.4, 95% IC 95% = 1.4 - 27.9) and gestational age < or = 32 weeks (OR 6.4, 95% CI = 1.3 - 31.1); for lacerations, vaginal dystocic delivery or cesarean section (OR 19, 95% CI = 4.4 - 81.1) and use of external maneuvers (OR 5.6, 95% CI = 1.5 - 21.6); for cephalhematoma maternal height < or = 1.54 m (OR 7.4, 95% CI = 2.3 - 23.7) and external maneuvers (OR 7.2, 95% CI = 2.3 - 23.7); for caput succedaneum, external maneuvers (OR 3.4, 95% CI = 1.5-7.7) and maternal age < or = 19 or > or = 36 years (OR 3.0, 95% CI = 1.4 - 6.4). Risk factors associated with birth injuries identified in this study involved maternal conditions, neonatal conditions and mechanism of delivery.

  11. Modifications of Coronary Risk Factors

    PubMed Central

    Albu, Jeanine; Gottlieb, Sheldon H.; August, Phyllis; Nesto, Richard W.; Orchard, Trevor J.

    2009-01-01

    In addition to the revascularization and glycemic management interventions assigned at random, the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) design includes the uniform control of major coronary artery disease risk factors, including dyslipidemia, hypertension, smoking, central obesity, and sedentary lifestyle. Target levels for risk factors were adjusted throughout the trial to comply with changes in recommended clinical practice guidelines. At present, the goals are low-density lipoprotein cholesterol <2.59 mmol/L (<100 mg/dL) with an optional goal of <1.81 mmol/L (<70 mg/dL); plasma triglyceride level <1.70 mmol/L (<150 mg/dL); blood pressure level <130 mm Hg systolic and <80 mm Hg diastolic; and smoking cessation treatment for all active smokers. Algorithms were developed for the pharmacologic management of dyslipidemia and hypertension. Dietary prescriptions for the management of glycemia, plasma lipid profiles, and blood pressure levels were adapted from existing clinical practice guidelines. Patients with a body mass index >25 were prescribed moderate caloric restriction; after the trial was under way, a lifestyle weight-management program was instituted. All patients were formally prescribed both endurance and resistance/flexibility exercises, individually adapted to their level of disability and fitness. Pedometers were distributed as a biofeedback strategy. Strategies to achieve the goals for risk factors were designed by BARI 2D working groups (lipid, cardiovascular and hypertension, and nonpharmacologic intervention) and the ongoing implementation of the strategies is monitored by lipid, hypertension, and lifestyle intervention management centers. PMID:16813737

  12. Suicide risk assessment in Australian emergency departments: assessing clinicians' disposition decisions.

    PubMed

    Weiland, T J; Cotter, A; Jelinek, G A; Phillips, G

    2014-01-01

    Objective. To determine (1) the uniformity of disposition decisions made by clinicians working in Australian emergency departments (EDs) using vignettes describing patients presenting with deliberate self-harm or suicide risk; (2) factors associated with these decisions; (3) factors associated with confidence in these decisions. Methodology. We validated and distributed by email an online survey tool to Australian emergency clinicians via their colleges. Participants were presented with five vignettes and asked to rate the level of risk and protective factors for suicide, the patient's disposition (admit/discharge/review), factors influencing this decision, their confidence in the decision, and factors that would have improved their confidence. Results. Percentages of participants choosing the modal disposition decision for each scenario ranged from 58.6% (136/232) to 92.4% (220/238), demonstrating uniformity in clinicians' disposition decisions. Predictors of disposition were consistently level of risk factors perceived and, infrequently, clinician factors including age and years experience. Confidence in disposition decisions was high across scenarios. Clinicians reported patient, clinician, contextual and decision support factors relevant to an Australian emergency context affected their disposition decisions and confidence in decisions. Conclusion. Emergency clinicians are uniform and confident in their disposition decisions for patient vignettes where there is risk of suicide or self harm.

  13. Suicide Risk Assessment in Australian Emergency Departments: Assessing Clinicians' Disposition Decisions

    PubMed Central

    Weiland, T. J.; Cotter, A.; Jelinek, G. A.; Phillips, G.

    2014-01-01

    Objective. To determine (1) the uniformity of disposition decisions made by clinicians working in Australian emergency departments (EDs) using vignettes describing patients presenting with deliberate self-harm or suicide risk; (2) factors associated with these decisions; (3) factors associated with confidence in these decisions. Methodology. We validated and distributed by email an online survey tool to Australian emergency clinicians via their colleges. Participants were presented with five vignettes and asked to rate the level of risk and protective factors for suicide, the patient's disposition (admit/discharge/review), factors influencing this decision, their confidence in the decision, and factors that would have improved their confidence. Results. Percentages of participants choosing the modal disposition decision for each scenario ranged from 58.6% (136/232) to 92.4% (220/238), demonstrating uniformity in clinicians' disposition decisions. Predictors of disposition were consistently level of risk factors perceived and, infrequently, clinician factors including age and years experience. Confidence in disposition decisions was high across scenarios. Clinicians reported patient, clinician, contextual and decision support factors relevant to an Australian emergency context affected their disposition decisions and confidence in decisions. Conclusion. Emergency clinicians are uniform and confident in their disposition decisions for patient vignettes where there is risk of suicide or self harm. PMID:24804190

  14. Environmental Risk Factors for ARDS

    PubMed Central

    Moazed, Farzad; Calfee, Carolyn S.

    2014-01-01

    The acute respiratory distress syndrome (ARDS) remains a major cause of morbidity and mortality in critically ill patients. Over the past several decades, alcohol abuse and cigarette smoke exposure have been identified as risk factors for the development of ARDS. The mechanisms underlying these relationships are complex and remain under investigation but are thought to involve pulmonary immune impairment as well as alveolar epithelial and endothelial dysfunction. This review summarizes the epidemiologic data supporting links between these exposures and ARDS susceptibility and outcomes and highlights key mechanistic investigations that provide insight into the pathways by which each exposure is linked to ARDS. PMID:25453414

  15. Managing Emerging Contaminant Risks: Plans & Progress

    DTIC Science & Technology

    2010-06-01

    Nanomaterials Perfluorooctyl sulfonate (PFOS) Di-nitrotoluenes (DNT)*  Nickel  Phase I Impact Assessment completed * To be re-assessed Cadmium...actions underway on all ECs including research on toxicity , substitutes, & treatment.  Phase II Impact Assessment completed. All others initiated...therefore. minimize the use of materials containing cr. • Document the system-specific C .... risks and efforts to qualifY less toxic alternatives in

  16. Psychosocial Predictors of Emerging Adults' Risk and Reckless Behaviors.

    ERIC Educational Resources Information Center

    Bradley, Graham; Wildman, Karen

    2002-01-01

    Studied risk and reckless behavior in 375 emerging adults using self-report measures and a cross-sectional design. Risk behaviors were found to be reliably predicted by sensation seeking, but not by antisocial peer pressure, while the reverse pattern was more true in relation to "reckless" behaviors. (SLD)

  17. Psychosocial Predictors of Emerging Adults' Risk and Reckless Behaviors.

    ERIC Educational Resources Information Center

    Bradley, Graham; Wildman, Karen

    2002-01-01

    Studied risk and reckless behavior in 375 emerging adults using self-report measures and a cross-sectional design. Risk behaviors were found to be reliably predicted by sensation seeking, but not by antisocial peer pressure, while the reverse pattern was more true in relation to "reckless" behaviors. (SLD)

  18. Cardiovascular risk factors for acute stroke: Risk profiles in the different subtypes of ischemic stroke

    PubMed Central

    Arboix, Adrià

    2015-01-01

    Timely diagnosis and control of cardiovascular risk factors is a priority objective for adequate primary and secondary prevention of acute stroke. Hypertension, atrial fibrillation and diabetes mellitus are the most common risk factors for acute cerebrovascular events, although novel risk factors, such as sleep-disordered breathing, inflammatory markers or carotid intima-media thickness have been identified. However, the cardiovascular risk factors profile differs according to the different subtypes of ischemic stroke. Atrial fibrillation and ischemic heart disease are more frequent in patients with cardioembolic infarction, hypertension and diabetes in patients with lacunar stroke, and vascular peripheral disease, hypertension, diabetes, previous transient ischemic attack and chronic obstructive pulmonary disease in patients with atherothrombotic infarction. This review aims to present updated data on risk factors for acute ischemic stroke as well as to describe the usefulness of new and emerging vascular risk factors in stroke patients. PMID:25984516

  19. Women's Heart Disease: Heart Disease Risk Factors

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Disease Risk Factors Past Issues / Winter 2014 Table ... or habits may raise your risk for coronary heart disease (CHD). These conditions are known as risk ...

  20. Shoulder dystocia: risk factors, predictability, and preventability.

    PubMed

    Mehta, Shobha H; Sokol, Robert J

    2014-06-01

    Shoulder dystocia remains an unpredictable obstetric emergency, striking fear in the hearts of obstetricians both novice and experienced. While outcomes that lead to permanent injury are rare, almost all obstetricians with enough years of practice have participated in a birth with a severe shoulder dystocia and are at least aware of cases that have resulted in significant neurologic injury or even neonatal death. This is despite many years of research trying to understand the risk factors associated with it, all in an attempt primarily to characterize when the risk is high enough to avoid vaginal delivery altogether and prevent a shoulder dystocia, whose attendant morbidities are estimated to be at a rate as high as 16-48%. The study of shoulder dystocia remains challenging due to its generally retrospective nature, as well as dependence on proper identification and documentation. As a result, the prediction of shoulder dystocia remains elusive, and the cost of trying to prevent one by performing a cesarean delivery remains high. While ultimately it is the injury that is the key concern, rather than the shoulder dystocia itself, it is in the presence of an identified shoulder dystocia that occurrence of injury is most common. The majority of shoulder dystocia cases occur without major risk factors. Moreover, even the best antenatal predictors have a low positive predictive value. Shoulder dystocia therefore cannot be reliably predicted, and the only preventative measure is cesarean delivery. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Risk factors identified for certain lymphoma subtypes

    Cancer.gov

    In a large international collaborative analysis of risk factors for non-Hodgkin lymphoma (NHL), scientists were able to quantify risk associated with medical history, lifestyle factors, family history of blood or lymph-borne cancers, and occupation for 11

  2. Heart Disease Risk Factors You Can Control

    MedlinePlus

    ... and Stroke Heart disease risk factors you can control Did you know? In women, high triglycerides combined ... information on Heart disease risk factors you can control Read more from womenshealth.gov Heart Disease Fact ...

  3. Risk Factors and Causes of Syncope

    MedlinePlus

    ... Causes of Sy... Back to Fainting Risk Factors & Causes of Syncope Risk Factors for Cardiovascular Syncope The ... heart. LQTS is believed to be a common cause of sudden and unexplained death in children and ...

  4. Preventing delirium in dementia: Managing risk factors.

    PubMed

    Ford, Andrew H

    2016-10-01

    Delirium is a common, disabling medical condition that is associated with numerous adverse outcomes. A number of inter-related factors, including pre-existing cognitive impairment, usually contribute to the development of delirium in a particular susceptible individual. Non-pharmacological approaches to prevention typically target multiple risk factors in a systematic manner (multicomponent interventions). There is generally good evidence that multicomponent interventions reduce the incidence of delirium in hospital populations but there are limited data in people with dementia and those living in the community. It is likely that there is a differential effect of specific interventions in those with cognitive impairment (e.g. people with dementia may respond better to simpler, more pragmatic interventions rather than complex procedures) but this cannot be determined from the existing data. Targeted interventions focussed on hydration, medication rationalization and sleep promotion may also be effective in reducing the incidence of delirium, as well as the active involvement of family members in the care of the elderly hospitalized patient. Hospitalization itself is a potential risk factor for delirium and promising data are emerging of the benefits of home-based care as an alternative to hospitalization but this is restricted to specific sub-populations of patients and is reliant on these services being available. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

  5. Configurations of Common Childhood Psychosocial Risk Factors

    ERIC Educational Resources Information Center

    Copeland, William; Shanahan, Lilly; Costello, E. Jane; Angold, Adrian

    2009-01-01

    Background: Co-occurrence of psychosocial risk factors is commonplace, but little is known about psychiatrically-predictive configurations of psychosocial risk factors. Methods: Latent class analysis (LCA) was applied to 17 putative psychosocial risk factors in a representative population sample of 920 children ages 9 to 17. The resultant class…

  6. Configurations of Common Childhood Psychosocial Risk Factors

    ERIC Educational Resources Information Center

    Copeland, William; Shanahan, Lilly; Costello, E. Jane; Angold, Adrian

    2009-01-01

    Background: Co-occurrence of psychosocial risk factors is commonplace, but little is known about psychiatrically-predictive configurations of psychosocial risk factors. Methods: Latent class analysis (LCA) was applied to 17 putative psychosocial risk factors in a representative population sample of 920 children ages 9 to 17. The resultant class…

  7. Comparable risk of childhood asthma after vaginal delivery and emergency caesarean section.

    PubMed

    Brix, Nis; Stokholm, Lonny; Jonsdottir, Fjola; Kristensen, Kim; Secher, Niels Jørgen

    2017-01-01

    Caesarean section is thought to be a risk factor for childhood asthma, but this association may be caused by confounding from, for instance, familial factors. To address this problem, we used twin pairs to assess the risk of childhood asthma after emergency caesarean section. The study was a register-based nation-wide matched cohort study using twin pairs to minimise residual confounding. Included were twin pairs in which the first twin was delivered vaginally and the second by emergency caesarean section during the study period from January 1997 through December 2012. In total, 464 twin pairs (928 twins) were included. In 30 pairs, the first twin (vaginal delivery) was diagnosed with asthma, but the second twin (emergency caesarean section) was not. In 20 pairs, the second twin (emergency caesarean section) was diagnosed with asthma, but the first twin (vaginal delivery) was not. In 11 pairs, both twins developed asthma. In the unadjusted analysis, emergency caesarean section did not affect the risk of asthma (odds ratio = 0.67 (95% confidence interval: 0.38-1.17); p = 0.16). After adjusting for birth weight, gender, umbilical cord pH, Apgar score at 5 min. and neonatal respiratory morbidity, the risk of childhood asthma following emergency caesarean section remained unchanged. Emergency caesarean section was not associated with childhood asthma. none. not relevant.

  8. Regulatory uncertainty and the associated business risk for emerging technologies

    NASA Astrophysics Data System (ADS)

    Hoerr, Robert A.

    2011-04-01

    An oversight system specifically concerned with nanomaterials should be flexible enough to take into account the unique aspects of individual novel materials and the settings in which they might be used, while recognizing that heretofore unrecognized safety issues may require future modifications. This article considers a question not explicitly considered by the project team: what is the risk that uncertainty over how regulatory oversight will be applied to nanomaterials will delay or block the development of this emerging technology, thereby depriving human health of potential and substantial benefits? An ambiguous regulatory environment could delay the availability of valuable new technology and therapeutics for human health by reducing access to investment capital. Venture capitalists list regulatory uncertainty as a major reason not to invest at all in certain areas. Uncertainty is far more difficult to evaluate than risk, which lends itself to quantitative models and can be factored into projections of return on possible investments. Loss of time has a large impact on investment return. An examination of regulatory case histories suggests that an increase in regulatory resting requirement, where the path is well-defined, is far less costly than a delay of a year or more in achieving product approval and market launch.

  9. Stroke Risk Factors, Genetics, and Prevention.

    PubMed

    Boehme, Amelia K; Esenwa, Charles; Elkind, Mitchell S V

    2017-02-03

    Stroke is a heterogeneous syndrome, and determining risk factors and treatment depends on the specific pathogenesis of stroke. Risk factors for stroke can be categorized as modifiable and nonmodifiable. Age, sex, and race/ethnicity are nonmodifiable risk factors for both ischemic and hemorrhagic stroke, while hypertension, smoking, diet, and physical inactivity are among some of the more commonly reported modifiable risk factors. More recently described risk factors and triggers of stroke include inflammatory disorders, infection, pollution, and cardiac atrial disorders independent of atrial fibrillation. Single-gene disorders may cause rare, hereditary disorders for which stroke is a primary manifestation. Recent research also suggests that common and rare genetic polymorphisms can influence risk of more common causes of stroke, due to both other risk factors and specific stroke mechanisms, such as atrial fibrillation. Genetic factors, particularly those with environmental interactions, may be more modifiable than previously recognized. Stroke prevention has generally focused on modifiable risk factors. Lifestyle and behavioral modification, such as dietary changes or smoking cessation, not only reduces stroke risk, but also reduces the risk of other cardiovascular diseases. Other prevention strategies include identifying and treating medical conditions, such as hypertension and diabetes, that increase stroke risk. Recent research into risk factors and genetics of stroke has not only identified those at risk for stroke but also identified ways to target at-risk populations for stroke prevention. © 2017 American Heart Association, Inc.

  10. Family history and environmental risk factors for colon cancer.

    PubMed

    Fernandez, Esteve; Gallus, Silvano; La Vecchia, Carlo; Talamini, Renato; Negri, Eva; Franceschi, Silvia

    2004-04-01

    We analyzed the joint effect of environmental risk factors and family history of colorectal cancer on colon cancer. We used data from a case-control study conducted in northern Italy between 1992 and 1996 including 1225 cases with colon cancer and 4154 controls. We created a weighed risk factor score for the main environmental risk factors in this population (positive family history, high education, low occupational physical activity, high daily meal frequency, low intake of fiber, low intake of calcium, and low intake of beta-carotene). Compared with the reference category (subjects with no family history of colorectal cancer and in the lowest tertile of the risk factor score), the odds ratios of colon cancer were 2.27 [95% confidence interval (CI) = 1.89-2.73] for subjects without family history and in the highest environmental risk factor score, 3.20 (95% CI = 2.05-5.01) for those with family history and low risk factor score, and 7.08 (95% CI = 4.68-10.71) for those with family history and high risk factor score. The pattern of risk was similar for men and women and no meaningful differences emerged according to subsite within the colon. Family history of colorectal cancer interacts with environmental risk factors of colon cancer.

  11. Cardiovascular risk factor knowledge and risk perception among HIV-infected adults

    PubMed Central

    Cioe, Patricia A.; Crawford, Sybil L.; Stein, Michael D.

    2013-01-01

    Cardiovascular disease (CVD) has emerged as a major cause of morbidity and mortality in HIV-infected adults. Research in non-infected populations has suggested that knowledge of CVD risk factors significantly influences perceptions of risk. This cross-sectional study describes CVD risk factor knowledge and risk perception in HIV-infected adults. We recruited 130 HIV-infected adults (mean age = 48 years, 62% male, 56% current smokers, mean years since HIV diagnosis, 14.7). The mean CVD risk factor knowledge score was fairly high. However, controlling for age, CVD risk factor knowledge was not predictive of perceived risk (F[1,117] = 0.13, p > .05). Estimated risk and perceived risk were weakly, but significantly, correlated, r(126) = .24, p = .01. HIV-infected adults are at increased risk for CVD. Despite having adequate risk factor knowledge, CVD risk perception was inaccurate. Improving risk perception and developing CVD risk reduction interventions for this population are imperative. PMID:24070645

  12. [The colorectal carcinoma risk factors].

    PubMed

    Sobczak, Andrzej; Wawrzyn-Sobczak, Katarzyna; Sobaniec-Lotowska, Maria

    2005-12-01

    Colorectal carcinoma constitutes the second, as for the rate, death cause due to a malignant disease both in the western countries and in Poland. Despite deep knowledge concerning morphogenesis and spread of colorectal carcinoma as well as vast achievements in surgery, chemo- and radiotherapy, the percentage of 5-year-survivals still reaches 40%. According to most authors there are 4 risk factor categories: epidemiological, intestinal, dietetic, and mixed. It is well-known that colorectal carcinoma, like neoplasms localized in other organs and systems, is a disease, in which genetic mutations of somatic cells are the molecular base/source of the disease. The inner innervation of the colon seems to play an important role in carcinoma pathogenesis and spread. At present, 80% of colorectal carcinomas are diagnosed in the advanced stage, with infiltration exceeding the intestinal wall or spreading to neighboring organs, which gives full clinical symptoms. The prognosis as to survival and disease progression is usually poor. Therefore, the ways of early diagnosis, monitoring, and the knowledge of etiological factors are so important in medical practice.

  13. Nanotechnology, risk, and oversight: learning lessons from related emerging technologies.

    PubMed

    Kuzma, Jennifer; Priest, Susanna

    2010-11-01

    Emerging technologies are defined by their novelty and thus are accompanied by significant uncertainty in determining appropriate ways to manage risks associated with them. Yet, there is a body of prior knowledge about risk management and oversight policy for other technologies that have already permeated society. Here, we describe two ways in which prospective oversight policy analysis for emerging technologies can draw upon these past experiences. One involves comparing specific products that have already been marketed to similar products of the emerging technology (cognate-product approach). The other treats the emerging technology as a body of products and methods and relates it to another technological field that has already emerged and penetrated markets (whole-technology approach). In this article, we describe our work using these approaches to inform risk and oversight policy for nanotechnology and its products. We draw parallels between biotechnology and nanotechnology as whole fields of development and also between genetically engineered organisms in the food supply and agricultural products of nanotechnology. Through these comparisons, we find that both approaches to historical learning have value and present lessons that could be applied to nanotechnology. © 2010 Society for Risk Analysis.

  14. An Emerging New Risk Analysis Science: Foundations and Implications.

    PubMed

    Aven, Terje

    2017-09-07

    To solve real-life problems-such as those related to technology, health, security, or climate change-and make suitable decisions, risk is nearly always a main issue. Different types of sciences are often supporting the work, for example, statistics, natural sciences, and social sciences. Risk analysis approaches and methods are also commonly used, but risk analysis is not broadly accepted as a science in itself. A key problem is the lack of explanatory power and large uncertainties when assessing risk. This article presents an emerging new risk analysis science based on novel ideas and theories on risk analysis developed in recent years by the risk analysis community. It builds on a fundamental change in thinking, from the search for accurate predictions and risk estimates, to knowledge generation related to concepts, theories, frameworks, approaches, principles, methods, and models to understand, assess, characterize, communicate, and (in a broad sense) manage risk. Examples are used to illustrate the importance of this distinct/separate risk analysis science for solving risk problems, supporting science in general and other disciplines in particular. © 2016 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  15. Risk Factors Associated With Hookah Use

    PubMed Central

    Krauss, Melissa J.; Kim, Yoonsang; Emery, Sherry L.

    2015-01-01

    Background: Potential harms associated with hookah smoking are largely unrecognized and it is emerging as a trendy behavior. To help inform policy and preventive interventions, we used responses from a population survey of US adults to examine risk factors associated with hookah involvement. Method: An online survey of 17 522 US adults was conducted in 2013. The nationally representative sample was drawn from GfK Group’s KnowledgePanel plus off-panel recruitment. Multinomial logistic regression was used to examine the relationships between tobacco use patterns across multiple products (cigarettes, cigars, and dissolvables), perceived harms towards regular pipe/hookah use, and demographic characteristics with hookah involvement (never used, ever used with/without reusing intent). Result: Nearly one in five (16%) of the respondents had smoked hookah at least once in their life (“ever users”). Ever users of hookah were at higher risk of having used cigarettes, cigars, and dissolvable tobacco products (all P < .01). Odds for hookah use were greater for those who perceived regular pipe/hookah use as less dangerous (P < .05). Odds for hookah involvement were higher among young adults (P < .001), individuals with higher educational attainment (P < .01), and Hispanics/Latinos (P < .05). Conclusions: Information about the public health harms associated with hookah smoking should be delivered to individuals at-risk for hookah smoking. It is likely that misconceptions about the safety of hookah smoking could be driving, at least in-part, its increase in popularity. PMID:25646349

  16. Cardiovascular risk factors and atherosclerosis in young women: atherosclerosis risk factors in female youngsters (ARFY study).

    PubMed

    Knoflach, Michael; Kiechl, Stefan; Penz, Daniela; Zangerle, Alexandra; Schmidauer, Christoph; Rossmann, Andrea; Shingh, Mahavir; Spallek, Ralf; Griesmacher, Andrea; Bernhard, David; Robatscher, Peter; Buchberger, Waltraud; Draxl, Walter; Willeit, Johann; Wick, Georg

    2009-04-01

    Little research has been conducted into risk factors of atherosclerosis development in young women. This cross-sectional study enrolled 205 18- to 22-year-old female students from the Educational Centre for Allied Health Professions. A broad array of risk conditions and lifestyle behaviors was carefully assessed. Intima media thickness (IMT) was used as a well-established surrogate for atherosclerosis and a predictor of vascular risk. High IMT was defined as levels exceeding the 90th percentile in the common and/or internal carotid arteries. In multivariable logistic regression analysis, systolic blood pressure, family history for hypertension, lipoprotein(a), homocysteine, T-cell immune reaction against human heat shock protein 60, and exposure to environmental tobacco smoke and exhaust gases emerged as independent predictors of high IMT. Obesity, metabolic syndrome, and classical risk factors other than high blood pressure were rare and unrelated to IMT. Findings were similar once focusing on IMT as a continuous variable. In female youngsters displaying initiating stages of vascular pathology, blood pressure level and numerous nontraditional risk conditions showed a significant relation to high IMT. Our study indicates that (auto)immune processes, high lipoprotein(a), and environmental exposure to tobacco smoke and traffic exhaust may play a role in early atherogenesis.

  17. Management of acute paracetamol (acetaminophen) toxicity: a standardised proforma improves risk assessment and overall risk stratification by emergency medicine doctors.

    PubMed

    McQuade, David J; Aknuri, Srikanth; Dargan, Paul I; Wood, David M

    2012-12-01

    Paracetamol (acetaminophen) poisoning is the most common toxicological presentation in the UK. Doctors managing patients with paracetamol poisoning need to assess the risk of their patient developing hepatotoxicity before determining appropriate treatment. Patients deemed to be at 'high risk' of hepatotoxicity have lower treatment thresholds than those deemed to be at 'normal risk'. Errors in this process can lead to harmful or potentially fatal under or over treatment. To determine how well treating doctors assess risk factor status and whether a standardised proforma is useful in the risk stratification process. Retrospective 12-month case note review of all patients presenting with paracetamol poisoning to our large inner-city emergency department. Data were collected on the documentation of risk factors, the presence of a local hospital proforma and treatment outcomes. 249 presentations were analysed and only 59 (23.7%) had full documentation of all the risk factors required to make a complete risk assessment. 56 of the 59 (94.9%) had the local hospital proforma included in the notes; the remaining 3 (5.1%) had full documentation of risk factors despite the absence of a proforma. A local hospital proforma was more likely to be included in the emergency department notes in those with 'adequate documentation' (78 out of 120 (65%)) than for those with 'inadequate documentation' (16 out of 129 (12.4%)); X(2), p<0.001. Despite a low overall uptake of the proforma, use of a standardised proforma significantly increased the likelihood of documentation of the risk factors which increase risk for hepatotoxicity following paracetamol poisoning.

  18. Risk management: application of early warning systems to emergency plans

    NASA Astrophysics Data System (ADS)

    Garcia, C.; Sterlacchini, S.; Pasuto, A.; de Amicis, M.

    2009-04-01

    Warning System and emergency plans are two fundamental elements of risk management and governance, but unfortunately, most of the times, they are developed independently one from the other, as sequential steps not necessary linked. The main goal of this research is to develop a methodology for applying Early Warning Systems - Community Based to the emergency plan using the results of social surveys and quantitative risk assessment, taking into account the administrative structure and the planning system of the study area, as well as the legislative obligations of each entity involved in the risk governance and emergency management. Using a integrative scientific and social approach to natural hazards the research aim to contribute to fill the gap between scientists, policy makers, stakeholders and community. Initially applied in Comunità Montana Valtellina di Tirano, Italy, the methodology involves the application of two comprehensive surveys. The first is addressed to stakeholders (including policy makers, emergency managers, emergency volunteers, consultants and scientists) in order to determine their needs, points of view, concerns and constraints. The second survey is addressed specifically to local community to assess risk perception, awareness, needs, capacity and level of trust towards stakeholders, besides asking for their willingness to participate in future risk communication activities. The Early Warning System developed includes all the stages of the early warning process (hazard evaluation and forecasting; warning and dissemination and public response) and would be based on a multidisciplinary partnership that takes into account the different actors involved in the risk management in order to accomplish a more reliable and credible result, including an emergency plan specifically designed for each study area. After evaluating the results of the surveys, information and education campaigns will be developed with the objective of reducing vulnerability

  19. Risk communication, radiation, and radiological emergencies: strategies, tools, and techniques.

    PubMed

    Covello, Vincent T

    2011-11-01

    Risk communication is the two-way exchange of information about risks, including risks associated with radiation and radiological events. The risk communication literature contains a broad range of strategies for overcoming the psychological, sociological, and cultural factors that create public misperceptions and misunderstandings about risks. These strategies help radiation risk communicators overcome the challenges posed by three basic observations about people under stress: (1) people under stress typically want to know that you care before they care about what you know; (2) people under stress typically have difficulty hearing, understanding, and remembering information; (3) people under stress typically focus more on negative information than positive information.

  20. Risk analysis of emergent water pollution accidents based on a Bayesian Network.

    PubMed

    Tang, Caihong; Yi, Yujun; Yang, Zhifeng; Sun, Jie

    2016-01-01

    To guarantee the security of water quality in water transfer channels, especially in open channels, analysis of potential emergent pollution sources in the water transfer process is critical. It is also indispensable for forewarnings and protection from emergent pollution accidents. Bridges above open channels with large amounts of truck traffic are the main locations where emergent accidents could occur. A Bayesian Network model, which consists of six root nodes and three middle layer nodes, was developed in this paper, and was employed to identify the possibility of potential pollution risk. Dianbei Bridge is reviewed as a typical bridge on an open channel of the Middle Route of the South to North Water Transfer Project where emergent traffic accidents could occur. Risk of water pollutions caused by leakage of pollutants into water is focused in this study. The risk for potential traffic accidents at the Dianbei Bridge implies a risk for water pollution in the canal. Based on survey data, statistical analysis, and domain specialist knowledge, a Bayesian Network model was established. The human factor of emergent accidents has been considered in this model. Additionally, this model has been employed to describe the probability of accidents and the risk level. The sensitive reasons for pollution accidents have been deduced. The case has also been simulated that sensitive factors are in a state of most likely to lead to accidents.

  1. Family Factors Predicting Categories of Suicide Risk

    ERIC Educational Resources Information Center

    Randell, Brooke P.; Wang, Wen-Ling; Herting, Jerald R.; Eggert, Leona L.

    2006-01-01

    We compared family risk and protective factors among potential high school dropouts with and without suicide-risk behaviors (SRB) and examined the extent to which these factors predict categories of SRB. Subjects were randomly selected from among potential dropouts in 14 high schools. Based upon suicide-risk status, 1,083 potential high school…

  2. Suicide Risk Factors in Alcohol Abuse.

    ERIC Educational Resources Information Center

    Motto, Jerome A.

    1980-01-01

    A current focus in evaluating suicide risk is the "clinical model" approach, which determines those factors associated with high risk for suicide. The sociological factors identified as estimators of suicide risk included impaired health, job instability, multiple unit residence, no change in living setting, and modest financial resources. (JAC)

  3. [Suicide risk factors among the elderly].

    PubMed

    Pérez Barrero, Sergio Andrés

    2012-08-01

    The author offers a brief overview of suicide risk factors among the elderly such as depression, all manner of abuse of the elderly, as well as medical, psychological and social risk factors, etc. By way of conclusion, a practical guide to evaluate suicide risk among the elderly is provided.

  4. Risk perception of different emergencies in a sample of European firefighters.

    PubMed

    Prati, Gabriele; Pietrantoni, Luca; Saccinto, Elisa; Kehl, Doris; Knuth, Daniela; Schmidt, Silke

    2013-01-01

    Firefighters frequently incur injuries while providing emergency services. Risk perception has been found to be associated with injury and safety behavior. This study examined risk perception of different emergency situations among firefighters. Along with risk perceptions, we investigated the role of practical experience, perceived training, tenure, and acute stress related to different emergency situations. Participants were a sample of 1324 firefighters from Germany and Italy. A questionnaire was administered to participants on risk perceptions, practical experience, perceived training, tenure, and acute stress. The results showed that different levels of risk perception are related to different practical experience, acute stress reactions, and training. Higher risk perception was associated with higher perceived training, practical experience, and acute stress reactions. A significant difference was found between the German and the Italian sample in risk perceptions. More specifically the Italian sample perceived disasters (e.g., earthquakes) as more risky. Moreover, there were some differences in perceived training and practical experience about the different emergency situations, in the two samples. The results underline the importance of considering organizational factors in the prediction of risk perception among firefighters.

  5. [Genetic risk factors in schizophrenia].

    PubMed

    Fabisch, H; Kroisel, P M; Fabisch, Karin

    2005-11-01

    The high pathogenetic relevance of genetic factors in schizophrenia is beyond doubt based on the findings of epidemiological studies. By means of a complex mode of transmission, it is likely that several genes with weak to moderate effect jointly constitute a genetic basis for a vulnerability to schizophrenia that may well vary for different individuals. Other organic and psychosocial factors also play an individually different -- in some cases significant -- role in terms of pathogenesis, as a result of which an oligogenic/polygenic multifactor model is assumed from the standpoint of aetiopathogenetics. Molecular genetic methods consist in linkage analyses and association analyses. Positive linkage findings accumulate particularly for the chromosomes 1q, 6p, 8p, 13q and 22q. By themselves, individual mutations contribute little to the range of schizophrenic feature characteristics, it was not possible -- irrespective of some subtypes -- to replicate genes of major effect. From the large number of possible candidate genes, although studies on DRD3, DRD2 and HTR2A produced positive results, the magnitudes of effect were low. The findings for alleles of dysbindin, neuregulin 1, DAO, COMT, PRODH, ZDHHC and DISC are less clear. The search for schizophrenia-relevant mutations is hampered by the possibility of a heterogeneous phenotype of schizophrenia in case of a homogeneous genotype as much as by the possibility of inter-individually homogeneous phenotypical characteristics in case of schizophrenia-relevant heterotype in the genome. With the aid of the concept of endo-phenotypes, based on neurobiological phenomena, it might be possible to take a more direct approach that leads from relevant mutations to the risk of schizophrenias. However, replacing schizophrenic alienation with neurobiological aspects leads to difficulties in explaining these complex disorder profiles. Schizophrenic diseases require an explanatory approach that also incorporates personality and

  6. Global health risks and cosmopolitisation: from emergence to interference.

    PubMed

    Figuié, Muriel

    2013-02-01

    According to Beck's 'World at Risk' theory, global risks push nations towards a cosmopolitisation of their health policy and open opportunities for a democratic turn. This article provides an empirical analysis of Beck's theory, based on the experience of Vietnamese authorities from 2003 to 2007 in managing the emerging avian flu virus. It shows how Vietnam's framing of avian flu has shifted, under the pressure from international organisations and the US administration, from an epizootic and zoonotic risk (or a classic risk) to a pandemic threat (or a late modern risk). Vietnam's response was part of its overall strategy to join the World Trade Organization and it was limited by Vietnam's defence of its sovereignty. This strategy has been successful for Vietnam but has limited the possibility of cosmopolitan and democratic transformations. The case study highlights the constructed dimension of risks of late modernity and their possible instrumentalisation: it minimises the role of a community of fear relative to a community of trade.

  7. Safety Risk Management for the Emerging Commercial Suborbital Space Industry

    NASA Astrophysics Data System (ADS)

    Verstraeten, Joram; Roelen, Alfred

    2013-09-01

    Commercial suborbital spaceflights will soon be a reality. Since fatal accidents will be disastrous for this emerging market, safety risk management must be adequate from the start. Safety risk management is aimed at the identification of hazards and the assessment of resulting safety risks. A proper hazard identification process assures all information available is used, as much data as possible is collected and no possible hazard is dismissed before analysis. A realistic risk assessment should take into account a peak in failure rates at the beginning of operation. Each unacceptable risk must be reduced to an acceptable level using mitigating measures. The results of the risk assessment should be completely and clearly shared with each potential suborbital space flight participant.

  8. [Vascular risk factors and Alzheimer disease risk: epidemiological studies review].

    PubMed

    Cowppli-Bony, Pascale; Dartigues, Jean-François; Orgogozo, Jean-Marc

    2006-03-01

    Etiology of Alzheimer's disease (AD) is still undefined in its most frequent sporadic type, but a role of vascular risk factor is more and more evocated in its pathophysiology. This role enables to hope that preventive or curative care of vascular risk factors could decrease AD incidence. Among these factors, high blood pressure, diabetes, hypercholesterolemia and tobacco consumption were the most studied. We review the risk for AD, which had been associated with each of these factors in epidemiological studies. High blood pressure is associated with an increased risk of AD in most studies while the results are more controversial for the others factors. All these four vascular risk factors have variable interaction with the presence of cerebrovascular diseases and of the epsilon 4 allele of the apolipoprotein E gene which is a predisposition factor for sporadic AD.

  9. Risk Factors For Diabetic Polyneuropathy

    PubMed Central

    KAPLAN, Yüksel; KURT, Semiha; KARAER ÜNALDI, Hatice; ERKORKMAZ, Ünal

    2014-01-01

    Introduction The aim of this study was to investigate the risk factors for distal symmetric sensory-motor polyneuropathy (DSP) in patients with type 2 diabetes mellitus (DM). Method Sixty seven patients with type 2 DM (33 males and 34 females) were included in the study. In addition to a detailed neurological examination, the Michigan Neuropathy Screening Instrument was administered to all patients and their total neuropathy scores were calculated. Nerve conduction examinations were performed for all patients. Results The mean age of the patients was 52.83±.87 years. The mean glycosylated hemoglobin (HbA1C) value was 8.56±2.07% (normal: 3–6.5%). The total neuropathy score significantly correlated with diabetes duration, hypertension, retinopathy, and HbA1C. Conclusion This study confirms the previous reports regarding the association of neuropathy with poor glycaemic control and duration of the disease. The association of neuropathy with retinopathy and hypertension is important.

  10. Seven Risks Emerging from Life Patents and Corporate Science

    ERIC Educational Resources Information Center

    Ekberg, Merryn

    2005-01-01

    This article examines some of the controversial issues emerging from the privatization of biomedical research and commercialization of biotechnology. The aim is to identify the dominant social, political, and ethical risks associated with the recent shift from academic to corporate science and from the increasing emphasis on investing in research…

  11. Seven Risks Emerging from Life Patents and Corporate Science

    ERIC Educational Resources Information Center

    Ekberg, Merryn

    2005-01-01

    This article examines some of the controversial issues emerging from the privatization of biomedical research and commercialization of biotechnology. The aim is to identify the dominant social, political, and ethical risks associated with the recent shift from academic to corporate science and from the increasing emphasis on investing in research…

  12. Cardiovascular risk factors in primary hyperparathyroidism.

    PubMed

    Luboshitzky, R; Chertok-Schaham, Y; Lavi, I; Ishay, A

    2009-04-01

    Severe primary hyperparathyroidism (PHP) has been associated with increased cardiovascular morbidity. Such an association in mild PHP is not known. We conducted a cross-sectional study to assess the correlation between mild and traditional PHP and emergent cardiovascular risk factors. A total of 139 patients with PHP (72 with severe PHP and indications for parathyroidectomy, 67 with mild PHP and no indications for surgery) and 111 control subjects, of similar age and body weight, were enrolled in this study. Participants had measurement of fasting blood levels of calcium, PTH, insulin, glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, interleukin-6, and C-reactive protein. Body mass index (BMI), waist and hip circumferences, blood pressure, homeostasis model assessment 2-insulin resistance index (IR) and the presence of metabolic syndrome (MS) were evaluated. Severe PHP patients had significantly higher rates of MS (37.5%), IR (38.9 %) vs mild PHP (34.3 and 23.9%, respectively) and controls (14.4 and 14.4%, respectively). Multivariate logistic-regression model, adjusted for age and BMI, and for age and waist size, revealed that severe PHP had significantly higher likelihood of cardiovascular risks [odds ratio (OR) 3.5, 95% confidence interval (CI) 1.5-8.125, p=0.004 for MS, and OR 3.7, 95% CI 1.64-8.29, p=0.002 for IR]. Serum calcium significantly predicted the presence of MS (OR 1.875, 95% CI 1.259-2.793, p=0.002) and IR (OR 2.043, 95% CI 1.365-3.057, p=0.002). Greater probability of MS and insulin resistance was observed in patients with severe PHP. Serum calcium is a predictor of these cardiovascular risk factors.

  13. Hydrocomplexity: Addressing water security and emergent environmental risks

    NASA Astrophysics Data System (ADS)

    Kumar, Praveen

    2015-07-01

    Water security and emergent environmental risks are among the most significant societal concerns. They are highly interlinked to other global risks such as those related to climate, human health, food, human migration, biodiversity loss, urban sustainability, etc. Emergent risks result from the confluence of unanticipated interactions from evolving interdependencies between complex systems, such as those embedded in the water cycle. They are associated with the novelty of dynamical possibilities that have significant potential consequences to human and ecological systems, and not with probabilities based on historical precedence. To ensure water security we need to be able to anticipate the likelihood of risk possibilities as they present the prospect of the most impact through cascade of vulnerabilities. They arise due to a confluence of nonstationary drivers that include growing population, climate change, demographic shifts, urban growth, and economic expansion, among others, which create novel interdependencies leading to a potential of cascading network effects. Hydrocomplexity aims to address water security and emergent risks through the development of science, methods, and practices with the potential to foster a "Blue Revolution" akin to the Green revolution for food security. It blends both hard infrastructure based solution with soft knowledge driven solutions to increase the range of planning and design, management, mitigation and adaptation strategies. It provides a conceptual and synthetic framework to enable us to integrate discovery science and engineering, observational and information science, computational and communication systems, and social and institutional approaches to address consequential water and environmental challenges.

  14. New and Emerging Risks Associated With "Green" Workplaces.

    PubMed

    Wandzich, Dorota Elżbieta; Płaza, Grażyna Anna

    2017-10-01

    Work environments are continuously changing with the introduction of new technologies, substances and work processes, changes in the structure of the workforce and labor market, and new forms of employment and work organization. New work situations bring both risks and challenges for workers and employers, which, in turn, may require political, administrative, technical, and regulatory approaches to ensure worker safety and health. This article is based on a European Agency for Safety and Health at Work (EU-OSHA) report, Green Jobs and Occupational Safety and Health, that detailed new and emerging risks to occupational safety and health associated with new technologies in green jobs. Highlights from this report include key technologies in the bioindustry and new emerging risks associated with green jobs.

  15. Risk Factors for Anterior Cruciate Ligament Injury

    PubMed Central

    Smith, Helen C.; Vacek, Pamela; Johnson, Robert J.; Slauterbeck, James R.; Hashemi, Javad; Shultz, Sandra; Beynnon, Bruce D.

    2012-01-01

    Context: Injuries to the anterior cruciate ligament (ACL) are immediately disabling and are associated with long-term consequences, such as posttraumatic osteoarthritis. It is important to have a comprehensive understanding of all possible risk factors for ACL injury to identify individuals who are at risk for future injuries and to provide an appropriate level of counseling and programs for prevention. Objective: This review, part 2 of a 2-part series, highlights what is known and still unknown regarding hormonal, genetic, cognitive function, previous injury, and extrinsic risk factors for ACL injury. Data Sources: Studies were identified from MEDLINE (1951–March 2011) using the MeSH terms anterior cruciate ligament, knee injury, and risk factors. The bibliographies of relevant articles and reviews were cross-referenced to complete the search. Study Selection: Prognostic case-control and prospective cohort study designs to evaluate risk factors for ACL injury were included in this review. Results: A total of 50 case-control and prospective cohort articles were included in parts 1 and 2. Twenty-one focused on hormonal, genetic, cognitive function, previous injury, and extrinsic risk factors. Conclusions: Several risk factors are associated with increased risk of suffering ACL injury—such as female sex, prior reconstruction of the ACL, and familial predisposition. These risk factors most likely act in combination with the anatomic factors reviewed in part 1 of this series to influence the risk of suffering ACL injury. PMID:23016083

  16. Risk factors for retained surgical items: a meta-analysis and proposed risk stratification system.

    PubMed

    Moffatt-Bruce, Susan D; Cook, Charles H; Steinberg, Steven M; Stawicki, Stanislaw P

    2014-08-01

    Retained surgical items (RSI) are designated as completely preventable "never events". Despite numerous case reports, clinical series, and expert opinions few studies provide quantitative insight into RSI risk factors and their relative contributions to the overall RSI risk profile. Existing case-control studies lack the ability to reliably detect clinically important differences within the long list of proposed risks. This meta-analysis examines the best available data for RSI risk factors, seeking to provide a clinically relevant risk stratification system. Nineteen candidate studies were considered for this meta-analysis. Three retrospective, case-control studies of RSI-related risk factors contained suitable group comparisons between patients with and without RSI, thus qualifying for further analysis. Comprehensive Meta-Analysis 2.0 (BioStat, Inc, Englewood, NJ) software was used to analyze the following "common factor" variables compiled from the above studies: body-mass index, emergency procedure, estimated operative blood loss >500 mL, incorrect surgical count, lack of surgical count, >1 subprocedure, >1 surgical team, nursing staff shift change, operation "afterhours" (i.e., between 5 PM and 7 AM), operative time, trainee presence, and unexpected intraoperative factors. We further stratified resulting RSI risk factors into low, intermediate, and high risk. Despite the fact that only between three and six risk factors were associated with increased RSI risk across the three studies, our analysis of pooled data demonstrates that seven risk factors are significantly associated with increased RSI risk. Variables found to elevate the RSI risk include intraoperative blood loss >500 mL (odds ratio [OR] 1.6); duration of operation (OR 1.7); >1 subprocedure (OR 2.1); lack of surgical counts (OR 2.5); >1 surgical team (OR 3.0); unexpected intraoperative factors (OR 3.4); and incorrect surgical count (OR 6.1). Changes in nursing staff, emergency surgery, body

  17. [Assessment of dynamic violent behavior risk factors].

    PubMed

    Folino, Jorge Oscar; Cáceres, María Soledad; Campos, María Laura; Silveri, Marina; Ucín, Silvana; Ascazibar, Mariel

    2005-01-01

    Dynamic violent behavior risk factors have special significance since they constitute the main target for preventive intervention. Different dynamic factors as well as violent recidivism were assessed with, among other instruments, the environmental risk (Risk Management) section of the Argentinean version of the HCR-20 in 25 parolees from the Province of Buenos Aires Penitentiary System. Among other findings, the prevalence of the risk factors linked to substance abuse and socioeconomic deprivation, and the heterogeneous perception of the official institutions are very significant. Exposure to destabilizers was the factor most associated with violent recidivism.

  18. Investigating the Role of Free-Ranging Wild Boar (Sus scrofa) in the Re-Emergence of Enzootic Pneumonia in Domestic Pig Herds: A Pathological, Prevalence and Risk-Factor Study

    PubMed Central

    Batista Linhares, Mainity; Belloy, Luc; Origgi, Francesco C.; Lechner, Isabel; Segner, Helmut; Ryser-Degiorgis, Marie-Pierre

    2015-01-01

    Enzootic pneumonia (EP) caused by Mycoplasma hyopneumoniae has a significant economic impact on domestic pig production. A control program carried out from 1999 to 2003 successfully reduced disease occurrence in domestic pigs in Switzerland, but recurrent outbreaks suggested a potential role of free-ranging wild boar (Sus scrofa) as a source of re-infection. Since little is known on the epidemiology of EP in wild boar populations, our aims were: (1) to estimate the prevalence of M. hyopneumoniae infections in wild boar in Switzerland; (2) to identify risk factors for infection in wild boar; and (3) to assess whether infection in wild boar is associated with the same gross and microscopic lesions typical of EP in domestic pigs. Nasal swabs, bronchial swabs and lung samples were collected from 978 wild boar from five study areas in Switzerland between October 2011 and May 2013. Swabs were analyzed by qualitative real time PCR and a histopathological study was conducted on lung tissues. Risk factor analysis was performed using multivariable logistic regression modeling. Overall prevalence in nasal swabs was 26.2% (95% CI 23.3–29.3%) but significant geographical differences were observed. Wild boar density, occurrence of EP outbreaks in domestic pigs and young age were identified as risk factors for infection. There was a significant association between infection and lesions consistent with EP in domestic pigs. We have concluded that M. hyopneumoniae is widespread in the Swiss wild boar population, that the same risk factors for infection of domestic pigs also act as risk factors for infection of wild boar, and that infected wild boar develop lesions similar to those found in domestic pigs. However, based on our data and the outbreak pattern in domestic pigs, we propose that spillover from domestic pigs to wild boar is more likely than transmission from wild boar to pigs. PMID:25747151

  19. Investigating the role of free-ranging wild boar (Sus scrofa) in the re-emergence of enzootic pneumonia in domestic pig herds: a pathological, prevalence and risk-factor study.

    PubMed

    Batista Linhares, Mainity; Belloy, Luc; Origgi, Francesco C; Lechner, Isabel; Segner, Helmut; Ryser-Degiorgis, Marie-Pierre

    2015-01-01

    Enzootic pneumonia (EP) caused by Mycoplasma hyopneumoniae has a significant economic impact on domestic pig production. A control program carried out from 1999 to 2003 successfully reduced disease occurrence in domestic pigs in Switzerland, but recurrent outbreaks suggested a potential role of free-ranging wild boar (Sus scrofa) as a source of re-infection. Since little is known on the epidemiology of EP in wild boar populations, our aims were: (1) to estimate the prevalence of M. hyopneumoniae infections in wild boar in Switzerland; (2) to identify risk factors for infection in wild boar; and (3) to assess whether infection in wild boar is associated with the same gross and microscopic lesions typical of EP in domestic pigs. Nasal swabs, bronchial swabs and lung samples were collected from 978 wild boar from five study areas in Switzerland between October 2011 and May 2013. Swabs were analyzed by qualitative real time PCR and a histopathological study was conducted on lung tissues. Risk factor analysis was performed using multivariable logistic regression modeling. Overall prevalence in nasal swabs was 26.2% (95% CI 23.3-29.3%) but significant geographical differences were observed. Wild boar density, occurrence of EP outbreaks in domestic pigs and young age were identified as risk factors for infection. There was a significant association between infection and lesions consistent with EP in domestic pigs. We have concluded that M. hyopneumoniae is widespread in the Swiss wild boar population, that the same risk factors for infection of domestic pigs also act as risk factors for infection of wild boar, and that infected wild boar develop lesions similar to those found in domestic pigs. However, based on our data and the outbreak pattern in domestic pigs, we propose that spillover from domestic pigs to wild boar is more likely than transmission from wild boar to pigs.

  20. Risk Factor Modification and Projections of Absolute Breast Cancer Risk

    PubMed Central

    Decarli, Adriano; Schairer, Catherine; Pfeiffer, Ruth M.; Pee, David; Masala, Giovanna; Palli, Domenico

    2011-01-01

    Background Although modifiable risk factors have been included in previous models that estimate or project breast cancer risk, there remains a need to estimate the effects of changes in modifiable risk factors on the absolute risk of breast cancer. Methods Using data from a case–control study of women in Italy (2569 case patients and 2588 control subjects studied from June 1, 1991, to April 1, 1994) and incidence and mortality data from the Florence Registries, we developed a model to predict the absolute risk of breast cancer that included five non-modifiable risk factors (reproductive characteristics, education, occupational activity, family history, and biopsy history) and three modifiable risk factors (alcohol consumption, leisure physical activity, and body mass index). The model was validated using independent data, and the percent risk reduction was calculated in high-risk subgroups identified by use of the Lorenz curve. Results The model was reasonably well calibrated (ratio of expected to observed cancers = 1.10, 95% confidence interval [CI] = 0.96 to 1.26), but the discriminatory accuracy was modest. The absolute risk reduction from exposure modifications was nearly proportional to the risk before modifying the risk factors and increased with age and risk projection time span. Mean 20-year reductions in absolute risk among women aged 65 years were 1.6% (95% CI = 0.9% to 2.3%) in the entire population, 3.2% (95% CI = 1.8% to 4.8%) among women with a positive family history of breast cancer, and 4.1% (95% CI = 2.5% to 6.8%) among women who accounted for the highest 10% of the total population risk, as determined from the Lorenz curve. Conclusions These data give perspective on the potential reductions in absolute breast cancer risk from preventative strategies based on lifestyle changes. Our methods are also useful for calculating sample sizes required for trials to test lifestyle interventions. PMID:21705679

  1. Risk factor modification and projections of absolute breast cancer risk.

    PubMed

    Petracci, Elisabetta; Decarli, Adriano; Schairer, Catherine; Pfeiffer, Ruth M; Pee, David; Masala, Giovanna; Palli, Domenico; Gail, Mitchell H

    2011-07-06

    Although modifiable risk factors have been included in previous models that estimate or project breast cancer risk, there remains a need to estimate the effects of changes in modifiable risk factors on the absolute risk of breast cancer. Using data from a case-control study of women in Italy (2569 case patients and 2588 control subjects studied from June 1, 1991, to April 1, 1994) and incidence and mortality data from the Florence Registries, we developed a model to predict the absolute risk of breast cancer that included five non-modifiable risk factors (reproductive characteristics, education, occupational activity, family history, and biopsy history) and three modifiable risk factors (alcohol consumption, leisure physical activity, and body mass index). The model was validated using independent data, and the percent risk reduction was calculated in high-risk subgroups identified by use of the Lorenz curve. The model was reasonably well calibrated (ratio of expected to observed cancers = 1.10, 95% confidence interval [CI] = 0.96 to 1.26), but the discriminatory accuracy was modest. The absolute risk reduction from exposure modifications was nearly proportional to the risk before modifying the risk factors and increased with age and risk projection time span. Mean 20-year reductions in absolute risk among women aged 65 years were 1.6% (95% CI = 0.9% to 2.3%) in the entire population, 3.2% (95% CI = 1.8% to 4.8%) among women with a positive family history of breast cancer, and 4.1% (95% CI = 2.5% to 6.8%) among women who accounted for the highest 10% of the total population risk, as determined from the Lorenz curve. These data give perspective on the potential reductions in absolute breast cancer risk from preventative strategies based on lifestyle changes. Our methods are also useful for calculating sample sizes required for trials to test lifestyle interventions.

  2. Cesarean delivery in Finland: maternal complications and obstetric risk factors.

    PubMed

    Pallasmaa, Nanneli; Ekblad, Ulla; Aitokallio-Tallberg, Ansa; Uotila, Jukka; Raudaskoski, Tytti; Ulander, Veli-Matti; Hurme, Saija

    2010-07-01

    To assess the rate of maternal complications related to cesarean section (CS) and to compare morbidity between elective, emergency and crash-emergency CS. To establish risk factors associated with maternal CS morbidity. A prospective multicenter cohort study. Twelve delivery units in Finland. Women delivering by CS (n = 2,496) during a 6 months period in the study hospitals. Data on pregnant women, CS, and maternal recovery during the hospital stay was collected prospectively on report forms. The complication rates by different CSs were calculated, and factors associated with morbidity were analyzed by odds ratios (OR). Maternal complication rates in different types of CS. The association of risk factors with morbidity. About 27% of women delivering by CS had complications; 10% had severe complications. The complication rate was higher in emergency CS than in elective CS, and highest in crash-emergency CS. Significant independent risk factors for maternal morbidity were emergency CS and crash-emergency CS compared to elective CS (OR 1.8; 95% confidence interval (CI) 1.5-2.2), pre-eclampsia (OR 1.5; CI 1.1-2.0), maternal obesity (OR 1.4; CI 1.1-1.8) and maternal increasing age (OR 1.1; CI 1.03-1.2 per each 5 years). Maternal complications are frequent in CS, and although performing CS electively reduces the occurrence of complications, the frequency is still high. The complication rate depends on the degree of emergency, and increases with maternal obesity, older age and pre-eclampsia.

  3. Postpartum depression risk factors: A narrative review.

    PubMed

    Ghaedrahmati, Maryam; Kazemi, Ashraf; Kheirabadi, Gholamreza; Ebrahimi, Amrollah; Bahrami, Masood

    2017-01-01

    Postpartum depression is a debilitating mental disorder with a high prevalence. The aim of this study was review of the related studies. In this narrative review, we report studies that investigated risk factors of postpartum depression by searching the database, Scopus, PubMed, ScienceDirect, Uptodate, Proquest in the period 2000-2015 published articles about the factors associated with postpartum depression were assessed in Farsi and English. The search strategy included a combination of keywords include postpartum depression and risk factors or obstetrical history, social factors, or biological factors. Literature review showed that risk factors for postpartum depression in the area of economic and social factors, obstetrical history, and biological factors, lifestyle and history of mental illness detected. Data from this study can use for designing a screening tools for high-risk pregnant women and for designing a prevention programs.

  4. Screening for abdominal aortic aneurysm in asymptomatic at-risk patients using emergency ultrasound.

    PubMed

    Moore, Chris L; Holliday, R Scott; Hwang, James Q; Osborne, Michael R

    2008-10-01

    Abdominal aortic aneurysm (AAA) is a deadly but often clinically silent disease. Patients at increased risk are elderly men with risk factors for vascular disease who may not have adequate screening through primary care. We sought to examine the prevalence and feasibility of screening for AAA in at-risk patients presenting for unrelated complaints using emergency physician-performed bedside ultrasound. At-risk patients presenting with unrelated complaints were screened for AAA by emergency physician-performed ultrasound. Scan was rated as complete, limited, or inadequate, and time to complete scan noted. Patients with identified AAA were provided with appropriate follow-up and were followed to look at confirmatory imaging and clinical course. A total of 179 patients were screened, with 12 AAAs discovered (6.7%; 95% confidence interval, 3.9%-11.4%). Average time to perform the screening ultrasound was 141 +/- 135 seconds. Average discrepancy between emergency ultrasound and formal imaging was 3.9 mm. Of 12 (92%) patients, 11 were followed up, with repair recommended in 3 patients. The emergency department represents a potential opportunity for screening at-risk patients for AAA. Emergency ultrasound is a fast and accurate method for identifying patients with AAA who may benefit from follow-up or intervention.

  5. Factors Influencing Emergence of Juveniles from Cysts of Heterodera zeae

    PubMed Central

    Hashmi, Sarwar; Krusberg, Lorin R.

    1995-01-01

    Several factors were studied to determine their effects on hatch and emergence of second-stage juveniles (J2) from cysts of Heterodera zeae. The optimum temperature for emergence of J2 from cysts of H. zeae was 30 C. No juveniles emerged from cysts at 10 or 40 C. Immersion of cysts in 4 mM zinc chloride solution stimulated 10% greater emergence of J2 than occurred in tap water controls during 28 days. Fresh corn rhizosphere leachates from 25-day and older plants growing in sand or sandy field soil stimulated 22-24% greater emergence of J2 from cysts than occurred in tap water after 28 days. Rhizosphere leachates stored for 30 days at 4 C and leachates of sand, sandy field soil, and silty field soil inhibited emergence of J2 from cysts by 7-12% compared to tap water. Rhizosphere leachates from corn plants aged 20, 30, 40, 50, or 60 days growing in sandy field soil stimulated emergence of J2 from cysts. Similar numbers of J2 emerged from cysts regardless of whether the source of cysts was field microplot cultures, greenhouse cultures, or growth chamber cultures. Fertilizing growth chamber cultures of H. zeae on corn plants resulted in a doubling of the numbers of cysts produced in the cultures, and those cysts yielded 2-3 times as many emerged J2 in hatching tests compared to cysts from similar unfertilized cultures. PMID:19277300

  6. Risk Factors Associated With Hookah Use.

    PubMed

    Cavazos-Rehg, Patricia A; Krauss, Melissa J; Kim, Yoonsang; Emery, Sherry L

    2015-12-01

    Potential harms associated with hookah smoking are largely unrecognized and it is emerging as a trendy behavior. To help inform policy and preventive interventions, we used responses from a population survey of US adults to examine risk factors associated with hookah involvement. An online survey of 17 522 US adults was conducted in 2013. The nationally representative sample was drawn from GfK Group's KnowledgePanel plus off-panel recruitment. Multinomial logistic regression was used to examine the relationships between tobacco use patterns across multiple products (cigarettes, cigars, and dissolvables), perceived harms towards regular pipe/hookah use, and demographic characteristics with hookah involvement (never used, ever used with/without reusing intent). Nearly one in five (16%) of the respondents had smoked hookah at least once in their life ("ever users"). Ever users of hookah were at higher risk of having used cigarettes, cigars, and dissolvable tobacco products (all P < .01). Odds for hookah use were greater for those who perceived regular pipe/hookah use as less dangerous (P < .05). Odds for hookah involvement were higher among young adults (P < .001), individuals with higher educational attainment (P < .01), and Hispanics/Latinos (P < .05). Information about the public health harms associated with hookah smoking should be delivered to individuals at-risk for hookah smoking. It is likely that misconceptions about the safety of hookah smoking could be driving, at least in-part, its increase in popularity. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Improving Suicide Risk Screening and Detection in the Emergency Department.

    PubMed

    Boudreaux, Edwin D; Camargo, Carlos A; Arias, Sarah A; Sullivan, Ashley F; Allen, Michael H; Goldstein, Amy B; Manton, Anne P; Espinola, Janice A; Miller, Ivan W

    2016-04-01

    The Emergency Department Safety Assessment and Follow-up Evaluation Screening Outcome Evaluation examined whether universal suicide risk screening is feasible and effective at improving suicide risk detection in the emergency department (ED). A three-phase interrupted time series design was used: Treatment as Usual (Phase 1), Universal Screening (Phase 2), and Universal Screening + Intervention (Phase 3). Eight EDs from seven states participated from 2009 through 2014. Data collection spanned peak hours and 7 days of the week. Chart reviews established if screening for intentional self-harm ideation/behavior (screening) was documented in the medical record and whether the individual endorsed intentional self-harm ideation/behavior (detection). Patient interviews determined if the documented intentional self-harm was suicidal. In Phase 2, universal suicide risk screening was implemented during routine care. In Phase 3, improvements were made to increase screening rates and fidelity. Chi-square tests and generalized estimating equations were calculated. Data were analyzed in 2014. Across the three phases (N=236,791 ED visit records), documented screenings rose from 26% (Phase 1) to 84% (Phase 3) (χ(2) [2, n=236,789]=71,000, p<0.001). Detection rose from 2.9% to 5.7% (χ(2) [2, n=236,789]=902, p<0.001). The majority of detected intentional self-harm was confirmed as recent suicidal ideation or behavior by patient interview. Universal suicide risk screening in the ED was feasible and led to a nearly twofold increase in risk detection. If these findings remain true when scaled, the public health impact could be tremendous, because identification of risk is the first and necessary step for preventing suicide. Emergency Department Safety Assessmentand Follow-up Evaluation (ED-SAFE) ClinicalTrials.gov: (NCT01150994). https://clinicaltrials.gov/ct2/show/NCT01150994?term=ED-SAFE&rank=1. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc

  8. Bullying and Suicide Risk among Pediatric Emergency Department Patients

    PubMed Central

    Stanley, Ian H.; Horowitz, Lisa M.; Bridge, Jeffrey A.; Wharff, Elizabeth A.; Pao, Maryland; Teach, Stephen J.

    2015-01-01

    Objectives To describe the association between recent bullying victimization and risk of suicide among pediatric emergency department (ED) patients. Methods Patients presenting to one of three different urban pediatric EDs with either medical/surgical or psychiatric chief complaints completed structured interviews as part of a study to develop a suicide risk screening instrument, the Ask Suicide-Screening Questions (ASQ). Seventeen candidate items and the criterion reference Suicidal Ideation Questionnaire (SIQ) were administered to patients ages 10 to 21 years. Bullying victimization was assessed by a single candidate item (“In the past few weeks, have you been bullied or picked on so much that you felt like you couldn't stand it anymore?”). Results A total of 524 patients completed the interview (34.4% psychiatric chief complaints; 56.9% female; 50.4% white, non-Hispanic; mean age 15.2±2.6 years). Sixty patients (11.5%) reported recent bullying victimization, and of these, 33 (55.0%) screened positive for suicide risk on the ASQ or the previously validated SIQ. After controlling for demographic and clinical variables, including a history of depression and drug use, the odds of screening positive for suicide risk were significantly greater in patients who reported recent bullying victimization (adjusted odds ratio=3.19, 95% CI=1.66-6.11). After stratification by chief complaint, this association persisted for medical/surgical patients but not for psychiatric patients. Conclusions Recent bullying victimization was associated with increased odds of screening positive for elevated suicide risk among pediatric emergency department patients presenting with medical/surgical complaints. Understanding this important correlate of suicide risk in pediatric emergency department patients may help inform ED-based suicide prevention interventions. PMID:26417959

  9. Shared Risk Factors in Cardiovascular Disease and Cancer

    PubMed Central

    Koene, Ryan J.; Prizment, Anna E.; Blaes, Anne; Konety, Suma H.

    2016-01-01

    Cardiovascular disease (CVD) and cancer are the two leading causes of death worldwide. Although commonly thought of as two separate disease entities, CVD and cancer possess various similarities and possible interactions, including a number of similar risk factors (e.g. obesity, diabetes), suggesting a shared biology for which there is emerging evidence. While chronic inflammation is an indispensible feature of the pathogenesis and progression of both CVD and cancer, additional mechanisms can be found at their intersection. Therapeutic advances, despite improving longevity, have increased the overlap between these diseases, but there are now millions of cancer survivors at risk of developing CVD. Cardiac risk factors have a major impact on subsequent treatment-related cardiotoxicity. In this review, we explore the risk factors common to both CVD and cancer, highlighting the major epidemiologic studies and potential biological mechanisms that account for them. PMID:26976915

  10. [Protective and family risk factors related to adolescent drug use].

    PubMed

    Cid-Monckton, Patricia; Pedrão, Luiz Jorge

    2011-06-01

    This cross-sectional and quantitative study aimed to verify the family's protective and risk factors related to drugs use in adolescents, considering the interaction patterns developed in the family, their degree of adaptability and vulnerability. Participants in this study were 80 female adolescents, from the 1st to 4th grade of high school, who answered a questionnaire. The most relevant risk and protective factors that would influence the situation were established, such as patterns of interaction, degree of adaptability, way of coping with problems, family resources and values. The major risk factors that emerged were the way people confront problems and, within these, lack of religious support and professional support, besides communication difficulties within families. The lowest risks were values, such as personal effort. The results highlight that nurses should assume psychosocial interventions as part of their role, especially among school-age children as, thus, they would be acting as agents in the prevention of drugs use.

  11. Risk Factor Intervention for Health Maintenance

    ERIC Educational Resources Information Center

    Breslow, Lester

    1978-01-01

    Risk factors for disease consist of personal habits such as cigarette smoking and excessive alcohol consumption, and bodily characteristics such as hypertension and high serum cholesterol. Progress in identifying, quantifying, and controlling risk factors is opening the way to the prevention of disease. (BB)

  12. Developmental Risk Factors for Sexual Offending.

    ERIC Educational Resources Information Center

    Lee, Joseph K. P.; Jackson, Henry J.; Pattison, Pip; Ward, Tony

    2002-01-01

    A study involving 64 Australian sex offenders and 33 non-sex offenders found childhood emotional abuse and family dysfunction, childhood behavior problems, and childhood sexual abuse were developmental risk factors for paraphilia. Emotional abuse and family dysfunction was found to be a risk factor for pedophilia, exhibitionism, rape, or multiple…

  13. Developmental Risk Factors for Sexual Offending.

    ERIC Educational Resources Information Center

    Lee, Joseph K. P.; Jackson, Henry J.; Pattison, Pip; Ward, Tony

    2002-01-01

    A study involving 64 Australian sex offenders and 33 non-sex offenders found childhood emotional abuse and family dysfunction, childhood behavior problems, and childhood sexual abuse were developmental risk factors for paraphilia. Emotional abuse and family dysfunction was found to be a risk factor for pedophilia, exhibitionism, rape, or multiple…

  14. Risk factors across the eating disorders

    PubMed Central

    Hilbert, Anja; Pike, Kathleen; Goldschmidt, Andrea; Wilfley, Denise; Fairburn, Christopher; Dohm, Faith-Anne; Walsh, Timothy; Weissman, Ruth Striegel

    2016-01-01

    This study sought to examine risk and onset patterns in anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Women with AN (n=71), BN (n=66), BED (n=160) and non-psychiatric controls (n=323) were compared retrospectively on risk factors, symptom onset, and diagnostic migration. Eating disorder groups reported greater risk exposure than non-psychiatric controls. AN and BED differed on premorbid personality/behavioral problems, childhood obesity, and family overeating. Risk factors for BN were shared with AN and BED. Dieting was the most common onset symptom in AN, whereas binge eating was most common in BN and BED. Migration between AN and BED was rare, but more frequent between AN and BN and between BN and BED. AN and BED have distinct risk factors and onset patterns, while BN shares similar risk factors and onset patterns with both AN and BED. Results should inform future classification schemes and prevention programs. PMID:25103674

  15. Surgical treatment of left colon malignant emergencies. A new tool for operative risk evaluation.

    PubMed

    Ceriati, Franco; Tebala, Giovanni D; Ceriati, Emanuela; Coco, Claudio; Tebala, Domenico; Verbo, Alessandro; D'Andrilli, Antonio; Picciocchi, Aurelio

    2002-01-01

    The surgical treatment of left colon and rectal cancer emergencies is still controversial. In our opinion the choice is to be based on the general health status of each patient. We retrospectively analyzed our series of 57 patients who underwent immediate resection and anastomosis. Factors significantly related to short-term results were chronic renal failure, heart disease, low albumin serum levels and colonic perforation. The presence of a diverting colostomy did not result in being a protective factor toward anastomotic dehiscence. We constructed a Colorectal Tumors Emergencies Score made of the identified four factors in which the score of each factor is the approximated odds ratio (chronic renal failure 7 points, low albumin serum levels 6 points, heart disease 5 points, colon perforation 4 points). Each patient was classified as Low Risk (CTES < 4), Moderate Risk (CTES 4-12) and High Risk (CTES > 12), mortality and morbidity being 4.3% and 21.7%, 24.0% and 60.0%, 88.9% and 88.9%, respectively. High-risk patients may undergo a staged procedure. Moderate risk patient may be treated by immediate resection of the tumor, without anastomosis. Immediate resection and anastomosis may be reserved to low-risk patients.

  16. Crisis and emergency risk communication as an integrative model.

    PubMed

    Reynolds, Barbara; W Seeger, Matthew

    2005-01-01

    This article describes a model of communication known as crisis and emergency risk communication (CERC). The model is outlined as a merger of many traditional notions of health and risk communication with work in crisis and disaster communication. The specific kinds of communication activities that should be called for at various stages of disaster or crisis development are outlined. Although crises are by definition uncertain, equivocal, and often chaotic situations, the CERC model is presented as a tool health communicators can use to help manage these complex events.

  17. Risk factors in young patients of acute myocardial infarction.

    PubMed

    Faisal, Abdul Wajid Khan; Ayub, Mohammad; Waseem, Tariq; Khan, Rao Shahzad Abdul Tawwab; Hasnain, Syed Sibitul

    2011-01-01

    Ischemic heart disease is a leading cause of death throughout the world. CAD has been recognized among younger age group more frequently in recent years. Very limited data is available regarding the prevalence of various risk factors in our younger patients that is why this study was planed. Objectives of the study were to look for the risk factors most prevalent in our young patient of 1st Acute Myocardial Infarction. And to also look for the number of Risk Factors present in each patient. We studied 100 consecutive patients from 16-45 years of age presenting with first acute MI. Twelve risk factors were studied namely, gender, family history of premature CAD, smoking hypertension, diabetes, dyslipidemia, obesity, mental stress (type A personality), alcohol, oral contraceptive pills (OCPs), physical activity, and diet. We divided the patients into two groups. Group A with patients 35 years of age or less and group B with patients 36-45 years of age. All risk factors were compared in both the groups. Smoking, diabetes mellitus, dyslipidemia and hypertension were statistically different between the two groups. Frequency wise risk factors were lined up as male sex (91%) Diet (66%), Dyslipidemia (62%), smoking (46%), Type A personality(46%), family history (32%), diabetes mellitus (28%), sedentary lifestyle (26%), hypertension (22%), obesity (17%), alcohol (3%), and OCPs (0%) Most of the patients that is 94% had 3 or more risk factors. Smoking, hypertension, diabetes and dyslipidemia are the major modifiable risk factors in our young adults. If a young male who is smoker or a young female who is diabetic, presents in emergency room with chest pain, always suspect coronary artery disease. Other conventional risk factors are also prevalent but alcohol and OCPs are not a major health problem for us.

  18. Factors enhancing career satisfaction among female emergency physicians.

    PubMed

    Clem, Kathleen J; Promes, Susan B; Glickman, Seth W; Shah, Anand; Finkel, Michelle A; Pietrobon, Ricardo; Cairns, Charles B

    2008-06-01

    Attrition rates in emergency medicine have been reported as high as 25% in 10 years. The number of women entering emergency medicine has been increasing, as has the number of female medical school graduates. No studies have identified factors that increase female emergency physician career satisfaction. We assess career satisfaction in women emergency physicians in the American College of Emergency Physicians (ACEP) and identify factors associated with career satisfaction. The survey questionnaire was developed by querying 3 groups: (1) ACEP women in the American Association of Women Emergency Physicians, the (2) Society for Academic Emergency Medicine Mentoring Women Interest Group, and (3) nonaffiliated female emergency physicians. Their responses were categorized into 6 main areas: schedule, relationships with colleagues, administrative support and mentoring, patient/work-related issues, career advancement opportunities, and financial. The study cohort for the survey included all female members of ACEP with a known e-mail address. All contact with survey recipients was exclusively through the e-mail that contained a uniform resource locator link to the survey itself. Two thousand five hundred two ACEP female members were sent the uniform resource locator link. The Web survey was accessed a total of 1,851 times, with a total of 1,380 surveys completed, an overall response rate of 56%. Most women were satisfied with their career as an emergency physician, 492 (35.5%) very satisfied, 610 (44.0%) satisfied, 154 (11.1%) neutral, 99 (7.1%) not satisfied, and 31 (2.3%) very unsatisfied. Significant factors for career satisfaction included amount of recognition at work, career advancement, schedule flexibility, and the fairness of financial compensation. Workplace factors associated with high satisfaction included academic practice setting and sex-equal opportunity for advancement and sex-equal financial compensation. Most of the ACEP female physicians surveyed were

  19. Persistent diarrhea: risk factors and outcome.

    PubMed

    Umamaheswari, B; Biswal, Niranjan; Adhisivam, B; Parija, S C; Srinivasan, S

    2010-08-01

    To identify risk factors associated with Persistent diarrhea (PD) and deaths due to PD. This prospective case control study included 60 children with PD (cases) and 60 children (controls) with acute diarrhoea (AD). Detailed history, examination and appropriate investigations were done for all children. Crude Odds ratio was calculated for each risk factor by univariate analysis and adjusted odds ratio was calculated by multivariate logistic regression. Prior antibiotic use, steroid use, anemia, vitamin A deficiency, malnutrition, LRI, UTI, oral candidiasis, and hyponatremia, were statistically significant risk factors by univariate analysis. Prior antibiotic use, vitamin A deficiency, malnutrition and LRI were independently associated with PD by multivariate logistic regression analysis. The risk factors for mortality were stool frequency more than 10 times per day, severe malnutrition, oral candidiasis, hypoalbuminemia and HIV positivity. The presence of these risk factors should alert the clinician to take appropriate measures, to decrease the mortality.

  20. Risk Factors for Anterior Cruciate Ligament Injury

    PubMed Central

    Smith, Helen C.; Vacek, Pamela; Johnson, Robert J.; Slauterbeck, James R.; Hashemi, Javad; Shultz, Sandra

    2012-01-01

    Context: Injuries to the anterior cruciate ligament (ACL) of the knee are immediately debilitating and can cause long-term consequences, including the early onset of osteoarthritis. It is important to have a comprehensive understanding of all possible risk factors for ACL injury to identify individuals who are at risk for future injuries and to provide an appropriate level of counseling and programs for prevention. Objective: This review, part 1 of a 2-part series, highlights what is known and still unknown regarding anatomic and neuromuscular risk factors for injury to the ACL from the current peer-reviewed literature. Data Sources: Studies were identified from MEDLINE (1951–March 2011) using the MeSH terms anterior cruciate ligament, knee injury, and risk factors. The bibliographies of relevant articles and reviews were cross-referenced to complete the search. Study Selection: Prognostic studies that utilized the case-control and prospective cohort study designs to evaluate risk factors for ACL injury were included in this review. Results: A total of 50 case-control and prospective cohort articles were included in the review, and 30 of these studies focused on neuromuscular and anatomic risk factors. Conclusions: Several anatomic and neuromuscular risk factors are associated with increased risk of suffering ACL injury—such as female sex and specific measures of bony geometry of the knee joint, including decreased intercondylar femoral notch size, decreased depth of concavity of the medial tibial plateau, increased slope of the tibial plateaus, and increased anterior-posterior knee laxity. These risk factors most likely act in combination to influence the risk of ACL injury; however, multivariate risk models that consider all the aforementioned risk factors in combination have not been established to explore this interaction. PMID:23016072

  1. Molecular characterization and risk factors for carbapenem-resistant Gram-negative bacilli colonization in children: emergence of NDM-producing Acinetobacter baumannii in a newborn intensive care unit in Turkey.

    PubMed

    Karaaslan, A; Soysal, A; Altinkanat Gelmez, G; Kepenekli Kadayifci, E; Söyletir, G; Bakir, M

    2016-01-01

    Multidrug-resistant Gram-negative bacilli are responsible for more than 50% of healthcare-associated infections. Colonization dynamics, characteristics, and risk factor data for CR-GNB are scarce in children. To examine the molecular characteristics of, and risk factors for nosocomial colonization with, carbapenem-resistant Gram-negative bacilli (CR-GNB) in hospitalized paediatric patients in a tertiary university hospital's paediatric units in Turkey. A prospective case-control study was performed at a university hospital in Istanbul, Turkey. A total of 1840 rectal swab specimens were collected from all 762 hospitalized children between March 2013 and October 2013. Among them, 176 (23%) patients were colonized with CR-GNB. Of these, 72 (9%) patients were colonized with carbapenem-resistant Enterobacteriaceae, 138 (18%) with CR-non-fermenter Gram-negative bacilli (CR-NF) and 34 (4%) with both. The median CR-GNB colonization time was 10 days (range: 1-116). The median duration of rectal colonization with CR-GNB was 8 days (range: 1-160). NDM (31%) was the second most frequent carbapenemase identified in Acinetobacter baumannii isolates, and has not previously been detected in Turkey. All of the 17 patients colonized with NDM-producing A. baumannii were newborns in the neonatal intensive care unit. Independent risk factors for CR-GNB colonization were: age <1 year, nasogastric tube placement, presence of underlying chronic diseases, ampicillin usage, surgical intervention, and carbapenem use. This is the first description of NDM in A. baumannii in newborn units in Turkey. Carbapenem usage is a common independent risk factor for both CRE and CR-NF colonization, which underscores the importance of antibiotic stewardship programmes. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  2. [Risk factors of main cancer sites].

    PubMed

    Uleckiene, Saule; Didziapetriene, Janina; Griciūte, Liudvika Laima; Urbeliene, Janina; Kasiulevicius, Vytautas; Sapoka, Virginijus

    2008-01-01

    Cancer prevention is a system of various measures devoted to avoid this disease. Primary cancer prevention means the identification, avoidance, or destruction of known risk factors. The main risk factors are smoking, diet, alcohol consumption, occupational factors, environmental pollution, electromagnetic radiation, infection, medicines, reproductive hormones, and lack of physical activity. Approximately one-third of cancers can be avoided by implementing various preventive measures. The aim of this article was to acquaint medical students, family doctors with risk factors of main cancer sites (lung, breast, colorectal, and prostate).

  3. Applying artificial neural networks to predict communication risks in the emergency department.

    PubMed

    Bagnasco, Annamaria; Siri, Anna; Aleo, Giuseppe; Rocco, Gennaro; Sasso, Loredana

    2015-10-01

    To describe the utility of artificial neural networks in predicting communication risks. In health care, effective communication reduces the risk of error. Therefore, it is important to identify the predictive factors of effective communication. Non-technical skills are needed to achieve effective communication. This study explores how artificial neural networks can be applied to predict the risk of communication failures in emergency departments. A multicentre observational study. Data were collected between March-May 2011 by observing the communication interactions of 840 nurses with their patients during their routine activities in emergency departments. The tools used for our observation were a questionnaire to collect personal and descriptive data, level of training and experience and Guilbert's observation grid, applying the Situation-Background-Assessment-Recommendation technique to communication in emergency departments. A total of 840 observations were made on the nurses working in the emergency departments. Based on Guilbert's observation grid, the output variables is likely to influence the risk of communication failure were 'terminology'; 'listening'; 'attention' and 'clarity', whereas nurses' personal characteristics were used as input variables in the artificial neural network model. A model based on the multilayer perceptron topology was developed and trained. The receiver operator characteristic analysis confirmed that the artificial neural network model correctly predicted the performance of more than 80% of the communication failures. The application of the artificial neural network model could offer a valid tool to forecast and prevent harmful communication errors in the emergency department. © 2015 John Wiley & Sons Ltd.

  4. Two-Year Trajectories of Sexual Risk Behaviors Among Drug-Using Adolescents and Emerging Adults in an Urban Community.

    PubMed

    Bonar, Erin E; Walton, Maureen A; Epstein-Ngo, Quyen M; Zimmerman, Marc A; Blow, Frederic C; Cunningham, Rebecca M

    2016-10-06

    Among 14-24 year-olds who used drugs and were recruited from an emergency department, we examined 2-year trajectories of sexual risk behaviors. We hypothesized that those in higher risk trajectories would have more severe substance use, mental health concerns, and dating violence involvement at baseline. Analyses identified three behavioral trajectories. Individuals in the highest risk trajectory had a more severe profile of baseline alcohol use, marijuana use, dating violence involvement, and mental health problems. Future research will examine longitudinal differences in risk factors across trajectories. Understanding risk factors for sexual risk behavior trajectories can inform the delivery and tailoring of prevention interventions.

  5. Seismic Risk Perception compared with seismic Risk Factors

    NASA Astrophysics Data System (ADS)

    Crescimbene, Massimo; La Longa, Federica; Pessina, Vera; Pino, Nicola Alessandro; Peruzza, Laura

    2016-04-01

    The communication of natural hazards and their consequences is one of the more relevant ethical issues faced by scientists. In the last years, social studies have provided evidence that risk communication is strongly influenced by the risk perception of people. In order to develop effective information and risk communication strategies, the perception of risks and the influencing factors should be known. A theory that offers an integrative approach to understanding and explaining risk perception is still missing. To explain risk perception, it is necessary to consider several perspectives: social, psychological and cultural perspectives and their interactions. This paper presents the results of the CATI survey on seismic risk perception in Italy, conducted by INGV researchers on funding by the DPC. We built a questionnaire to assess seismic risk perception, with a particular attention to compare hazard, vulnerability and exposure perception with the real data of the same factors. The Seismic Risk Perception Questionnaire (SRP-Q) is designed by semantic differential method, using opposite terms on a Likert scale to seven points. The questionnaire allows to obtain the scores of five risk indicators: Hazard, Exposure, Vulnerability, People and Community, Earthquake Phenomenon. The questionnaire was administered by telephone interview (C.A.T.I.) on a statistical sample at national level of over 4,000 people, in the period January -February 2015. Results show that risk perception seems be underestimated for all indicators considered. In particular scores of seismic Vulnerability factor are extremely low compared with house information data of the respondents. Other data collected by the questionnaire regard Earthquake information level, Sources of information, Earthquake occurrence with respect to other natural hazards, participation at risk reduction activities and level of involvement. Research on risk perception aims to aid risk analysis and policy-making by

  6. Probabilistic risk assessment of emerging materials: case study of titanium dioxide nanoparticles.

    PubMed

    Tsang, Michael P; Hristozov, Danail; Zabeo, Alex; Koivisto, Antti Joonas; Jensen, Alexander Christian Østerskov; Jensen, Keld Alstrup; Pang, Chengfang; Marcomini, Antonio; Sonnemann, Guido

    2017-05-01

    The development and use of emerging technologies such as nanomaterials can provide both benefits and risks to society. Emerging materials may promise to bring many technological advantages but may not be well characterized in terms of their production volumes, magnitude of emissions, behaviour in the environment and effects on living organisms. This uncertainty can present challenges to scientists developing these materials and persons responsible for defining and measuring their adverse impacts. Human health risk assessment is a method of identifying the intrinsic hazard of and quantifying the dose-response relationship and exposure to a chemical, to finally determine the estimation of risk. Commonly applied deterministic approaches may not sufficiently estimate and communicate the likelihood of risks from emerging technologies whose uncertainty is large. Probabilistic approaches allow for parameters in the risk assessment process to be defined by distributions instead of single deterministic values whose uncertainty could undermine the value of the assessment. A probabilistic approach was applied to the dose-response and exposure assessment of a case study involving the production of nanoparticles of titanium dioxide in seven different exposure scenarios. Only one exposure scenario showed a statistically significant level of risk. In the latter case, this involved dumping high volumes of nano-TiO2 powders into an open vessel with no personal protection equipment. The probabilistic approach not only provided the likelihood of but also the major contributing factors to the estimated risk (e.g. emission potential).

  7. Prospective Evaluation of Risk Factors for Male Breast Cancer

    PubMed Central

    Richesson, Douglas A.; Gierach, Gretchen L.; Lacey, James V.; Park, Yikyung; Hollenbeck, Albert R.; Schatzkin, Arthur

    2008-01-01

    Most risk factors for male breast cancer have been derived from retrospective studies that may reflect selective recall. In the prospective National Institutes of Health–AARP Diet and Health Study, we studied 324 920 men, among whom 121 developed breast cancer. Men who reported a first-degree relative with breast cancer had an increased risk of breast cancer (relative risk [RR] = 1.92, 95% confidence interval [CI] = 1.19 to 3.09). Among the medical conditions examined, a new finding emerged regarding increased male breast cancer risk associated with a history of a bone fracture (RR = 2.20, 95% CI = 1.24 to 3.91). Obesity was positively related to risk (RR = 1.79, 95% CI = 1.10 to 2.91, for body mass indices of ≥30 vs <25 kg/m2) and physical activity inversely related, even after adjustment for body mass index. Smokers were at somewhat elevated risk, although trends with smoking characteristics were inconsistent. Alcohol consumption was not related to risk. The identified risk factors show some commonalities with female breast cancer and indicate the importance of hormonal mechanisms. Differences in risk factors may reflect unique mechanisms associated with androgens and their ratio to bioavailable estrogens. PMID:18840816

  8. Vehicle emission unit risk factors for transportation risk assessments

    SciTech Connect

    Biwer, B.M.; Butler, J.P.

    1999-12-01

    When the transportation risk posed by shipments of hazardous chemical and radioactive materials is being assessed, it is necessary to evaluate the risks associated with both vehicle emissions and cargo-related risks. Diesel exhaust and fugitive dust emissions from vehicles transporting hazardous shipments lead to increased air pollution, which increases the risk of latent fatalities in the affected population along the transport route. The estimated risk from these vehicle-related sources can often by as large or larger than the estimated risk associated with the material being transported. In this paper, data from the US Environmental Protection Agency's Motor Vehicle-Related Air Toxics Study are first used to develop latent cancer fatality estimates per kilometer of travel in rural and urban areas for all diesel truck classes. These unit risk factors are based on studies investigating the carcinogenic nature of diesel exhaust. With the same methodology, the current per=kilometer latent fatality risk factor used in transportation risk assessment for heavy diesel trucks in urban areas is revised and the analysis expanded to provide risk factors for rural areas and all diesel truck classes. These latter fatality estimates may include, but are not limited to, cancer fatalities and are based primarily on the most recent epidemiological data available on mortality rates associated with ambient air PM-10 concentrations.

  9. Vehicle emission unit risk factors for transportation risk assessments.

    PubMed

    Biwer, B M; Butler, J P

    1999-12-01

    When the transportation risk posed by shipments of hazardous chemical and radioactive materials is being assessed, it is necessary to evaluate the risks associated with both vehicle emissions and cargo-related risks. Diesel exhaust and fugitive dust emissions from vehicles transporting hazardous shipments lead to increased air pollution, which increases the risk of latent fatalities in the affected population along the transport route. The estimated risk from these vehicle-related sources can often be as large or larger than the estimated risk associated with the material being transported. In this paper, data from the U.S. Environmental Protection Agency's Motor Vehicle-Related Air Toxics Study are first used to develop latent cancer fatality estimates per kilometer of travel in rural and urban areas for all diesel truck classes. These unit risk factors are based on studies investigating the carcinogenic nature of diesel exhaust. With the same methodology, the current per-kilometer latent fatality risk factor used in transportation risk assessments for heavy diesel trucks in urban areas is revised and the analysis expanded to provide risk factors for rural areas and all diesel truck classes. These latter fatality estimates may include, but are not limited to, cancer fatalities and are based primarily on the most recent epidemiological data available on mortality rates associated with ambient air PM-10 concentrations.

  10. Risk perception, experience, and objective risk: a cross-national study with European emergency survivors.

    PubMed

    Knuth, Daniela; Kehl, Doris; Hulse, Lynn; Schmidt, Silke

    2014-07-01

    Understanding public risk perceptions and their underlying processes is important in order to learn more about the way people interpret and respond to hazardous emergency events. Direct experience with an involuntary hazard has been found to heighten the perceived risk of experiencing the same hazard and its consequences in the future, but it remains unclear if cross-over effects are possible (i.e., experience with one hazard influencing perceived risk for other hazards also). Furthermore, the impact of objective risk and country of residence on perceived risk is not well understood. As part of the BeSeCu (Behavior, Security, and Culture) Project, a sample of 1,045 survivors of emergencies from seven European countries (i.e., Germany, the Czech Republic, Poland, Sweden, Spain, Turkey, and Italy) was drawn. Results revealed heightened perceived risk for emergency events (i.e., domestic and public fires, earthquakes, floods, and terrorist attacks) when the event had been experienced previously plus some evidence of cross-over effects, although these effects were not so strong. The largest country differences in perceived risk were observed for earthquakes, but this effect was significantly reduced by taking into account the objective earthquake risk. For fires, floods, terrorist attacks, and traffic accidents, only small country differences in perceived risk were found. Further studies including a larger number of countries are welcomed.

  11. [Cardiovascular risk factors in young people].

    PubMed

    Sánchez-Contreras, Mónica; Moreno-Gómez, Germán A; Marín-Grisales, Marta E; García-Ortiz, Luis H

    2009-01-01

    Cardiovascular disease (CVD) involves several disorders related to the formation and development of atherosclerotic processes. Several risk factors are involved in CVD aetiology; some of them (i.e. age, hypertension, obesity, dislipidemia and diabetes) have been clearly associated, whereas others have a variable level of association. An increase in cardiovascular risk factors has been recently reported in the young population; studies of cardiovascular risk factors in this population have shown that its cardiovascular risk profile could be different from that presented by older populations. This review presents a summary of reported cardiovascular risk factors in the young population and their causes which have been released and indexed in different databases. Most factors discussed are life-habit risk factors and represent direct targets for clinical intervention. We propose that primary CVD prevention should include a more detailed knowledge of the nature of the risk factors concerning the young population and could have a positive impact on CVD prevalence during the next few years.

  12. Relationship Satisfaction and Risk Factors for Suicide.

    PubMed

    Till, Benedikt; Tran, Ulrich S; Niederkrotenthaler, Thomas

    2017-01-01

    Previous studies suggest that troubled romantic relationships are associated with higher risk factors for mental health. However, studies examining the role of relationship satisfaction in suicide risk factors are scarce. We investigated differences in risk factors for suicide between individuals with high relationship satisfaction, individuals with low relationship satisfaction, and singles. Furthermore, we explored patterns of experiencing, and dealing with, conflicts in the relationship and examined associations with suicide risk factors. In this cross-sectional study, we assessed relationship status, relationship satisfaction, specific types of relationship conflicts, and suicide risk factors (i.e., suicidal ideation, hopelessness, depression) with questionnaires among 382 individuals in Austria. Risk factors for suicide were higher among singles than among individuals in happy relationships, but lower among those with low relationship satisfaction. Participants reporting a high number of unsolved conflicts in their relationship had higher levels of suicidal ideation, hopelessness, and depression than individuals who tend to solve issues with their partner amicably or report no conflicts. Relationship satisfaction and relationship conflicts reflect risk factors for suicide, with higher levels of suicidal ideation, hopelessness, and depression reported by individuals who mentioned unsolved conflicts with their partner and experienced low satisfaction with their relationship.

  13. Concussion risk factors and strategies for prevention.

    PubMed

    Kerr, Hamish A

    2014-12-01

    Concussion in children is frequently related to participation in sports. It requires a traumatic event to occur that transmits acceleration to the brain. Some children may have intrinsic risk factors that place them at greater risk for this type of injury. Comorbidities such as attention-deficit/hyperactivity disorder, migraine headaches, and mood disorders may place athletes at increased risk of more severe injury. A previous concussion is probably the most important influence on risk for future injury. Extrinsic risk factors include coaching techniques, officiating, and choice of sport. Helmet choice does not diminish concussion risk, nor does the use of mouth guards. Education of athletes, coaches, parents, and physicians is very important in improving recognition of potential concussive injury and helping child athletes and their parents understand the risks involved in sport participation.

  14. Cardiovascular disease and modifiable cardiometabolic risk factors.

    PubMed

    Cannon, Christopher P

    2007-01-01

    Cardiovascular disease (CVD) is the leading cause of death in the United States and many parts of the world. Potentially modifiable risk factors for CVD include tobacco use, physical inactivity, hypertension, elevated low-density lipoprotein cholesterol, and a cluster of interrelated metabolic risk factors. Over the last several decades, efforts to prevent or treat CVD risk factors have resulted in significantly lower rates of CVD-related mortality. However, many patients never achieve adequate control of CVD risk factors even when these factors have been identified. In addition, the growing prevalence of obesity and type 2 diabetes mellitus (DM) threatens to undermine the improvements in CVD that have been achieved. In the United States, approximately two thirds of adults are overweight or obese, and even modest excess body weight is associated with a significantly increased risk of CVD-related mortality. Lifestyle interventions to promote weight loss reduce the risk of CVD-related illness but are difficult for patients to sustain over long periods of time. The increased incidence of obesity has also contributed to significant increases in the prevalence of other important CVD risk factors, including hypertension, dyslipidemia, insulin resistance, and type 2 DM. Pharmacologic therapies are currently available to address individual CVD risk factors, and others are being evaluated, including endocannabinoid receptor antagonists, inhibitors of peroxisome proliferator-activated receptor subtypes alpha and gamma, and several agents that modulate the activity of glucagon-like peptide-1. The new agents have the potential to significantly improve several CVD risk factors with a single medication and may provide clinicians with several new strategies to reduce the long-term risk of CVD.

  15. Sudden cardiac death: epidemiology and risk factors

    PubMed Central

    Adabag, A. Selcuk; Luepker, Russell V.; Roger, Véronique L.; Gersh, Bernard J.

    2016-01-01

    Sudden cardiac death (SCD) is an important public-health problem with multiple etiologies, risk factors, and changing temporal trends. Substantial progress has been made over the past few decades in identifying markers that confer increased SCD risk at the population level. However, the quest for predicting the high-risk individual who could be a candidate for an implantable cardioverter-defibrillator, or other therapy, continues. In this article, we review the incidence, temporal trends, and triggers of SCD, and its demographic, clinical, and genetic risk factors. We also discuss the available evidence supporting the use of public-access defibrillators. PMID:20142817

  16. [Outcome predictive factors at six months for patients over 75 years admitted for emergency care].

    PubMed

    Kariger, E; Blanchard, F; Ennuyer, B; Lecoyer, I; Albert, H; Jolly, D; Bocquet, P; Pire, J C

    1996-01-01

    A sample of 199 elderly patients (over 75) admitted to emergency care sections of the Marne's (French department) public hospitals were monitored over six months. The purpose of this study was to assess the factors predicting death or institutionization of elderly patients, in order to improve patient care. Surveys were carried out to collect information on health, standards of living, family surrounding and background, social support and level of dependence. After 6 months, 63 (32%) have died and 19 (12.5%) have been directed to institutions. Risk of death factors are primarily connected with the environment. The risk was multiplied by three for patients placed in institutions and absence of children's visit increased the risk by seven. Dependence was also a risk factor. On the other hand, age and clinical diagnosis had little effect. Risk factors for institutionalization were: admission over the week end (OR = 29), non-accompanied (OR = 31), altered mental abilities (OR = 14), absence of children's visit (OR = 22). These predictors will render possible the rapid identification of high risk patients in every day practice. The improvement of gerontological competences in emergency care sections should enable quicker, more inclusive and adapted care. Measures to stimule or substitute for the failing natural relational network of elderly patients are also needed.

  17. [Risk factors for preterm encephalopathy].

    PubMed

    Kornacka, Maria K; Bokiniec, Renata; Bargiel, Agata

    2009-08-01

    Encephalopathy in a common neonatological sense is a term referring to a complex of clinical symptoms occurring in term infants in the first days of their life as a result of hypoxic-ischemic lesions. However, if we accept the encyclopedic definition of encephalopathy as a vast or multifocal brain lesions caused by a variety of factors, we may use the term to describe all patients with traumatic, hypoxic or toxic brain lesions, and therefore also newborns at different levels of maturity. Contrary to term newborns, in which case the hypoxic-ischemic encephalopathy are mostly intrauterine, for preterm infants there is a number of factors which destroy neural tissue postnatally The occurrence of those factors is often influenced by elements of essential intensive care. The article describes the most common biochemical disturbances and clinical causes.

  18. Risk Factors in Adolescent Hypertension

    PubMed Central

    Ewald, D. Rose; Haldeman, Lauren A.

    2016-01-01

    Hypertension is a complex and multifaceted disease, with many contributing factors. While diet and nutrition are important influences, the confounding effects of overweight and obesity, metabolic and genetic factors, racial and ethnic predispositions, socioeconomic status, cultural influences, growth rate, and pubertal stage have even more influence and make diagnosis quite challenging. The prevalence of hypertension in adolescents far exceeds the numbers who have been diagnosed; studies have found that 75% or more go undiagnosed. This literature review summarizes the challenges of blood pressure classification in adolescents, discusses the impact of these confounding influences, and identifies actions that will improve diagnosis and treatment outcomes. PMID:27335997

  19. [Epidemiology, Risk Factors and Risk Stratification of Venous Thromboembolism in Pregnancy and the Puerperium].

    PubMed

    Tsikouras, Panagiotis; von Tempelhoff, Georg-Friedrich; Rath, Werner

    2017-08-01

    Venous thromboembolism (VTE) remains a leading cause of direct maternal deaths in the developed countries. The incidence of VTE has increased significantly during the past two decades. The absolute risk of VTE is estimated 0.6-2.2 per 1000 deliveries. Compared with age-matched non-pregnant women, the daily risk of VTE is increased 7- to 10-fold for antepartum VTE, but it is 15- to 35-fold for postpartum VTE. The incidence of pulmonary embolism (PE) during the first 6 weeks postpartum is nearly 15-fold higher compared to the incidence in pregnancy, and remains significantly increased up to 12 weeks postpartum. The case fatality rate of PE ranges from 2.2 to 6.6%.The basis of VTE prevention is careful assessment of individual risk factors of VTE and proper risk stratification.It is necessary to differentiate preexisting maternal from transient pregnancy-specific risk factors. Women with previous VTE or hereditary high-risk thrombophilias or with the antiphospholipid syndrome have the highest risk for VTE in pregnancy and the puerperium.Other most important pregnancy-specific risk factors in the antenatal period are severe ovarian hyperstimulation syndrome, hyperemesis, major surgery, severe comorbidities (e.g., systemic lupus erythematodes), hospitalization in women with a body mass index > 25 kg/m(2), and inflammatory bowel diseases.Heart diseases, stillbirth, systemic infections, severe postpartum hemorrhage in combination with blood product replacement and/or surgery and emergency caesarean section are predominant risk factors in the postpartum period.Recommendations for risk stratification vary among current international guidelines. According to the SOGC (Society of Obstetricians and Gynaecologists of Canada) 2014, pharmacologic VTE prophylaxis is recommended if the estimated absolute risk of one or multiple risk factors is greater than 1%.The ACCP (American College of Chest Physicians) Guideline 2012 presents specific recommendations only for post

  20. Factors Associated with Emergency Department Use among the Rural Elderly

    ERIC Educational Resources Information Center

    Fan, Lin; Shah, Manish N.; Veazie, Peter J.; Friedman, Bruce

    2011-01-01

    Context: Emergency Department (ED) use among the rural elderly may present a different pattern from the urban elderly, thus requiring different policy initiatives. However, ED use among the rural elderly has seldom been studied and is little understood. Purpose: To characterize factors associated with having any versus no ED use among the rural…

  1. Factors Associated with Emergency Department Use among the Rural Elderly

    ERIC Educational Resources Information Center

    Fan, Lin; Shah, Manish N.; Veazie, Peter J.; Friedman, Bruce

    2011-01-01

    Context: Emergency Department (ED) use among the rural elderly may present a different pattern from the urban elderly, thus requiring different policy initiatives. However, ED use among the rural elderly has seldom been studied and is little understood. Purpose: To characterize factors associated with having any versus no ED use among the rural…

  2. Developmental risk factors for sexual offending.

    PubMed

    Lee, Joseph K P; Jackson, Henry J; Pattison, Pip; Ward, Tony

    2002-01-01

    The aim of the study was to identify the general, common, and specific developmental risk factors for pedophilia, exhibitionism, rape, and multiple paraphilia, and to address five methodological issues observed in this area of research. This study involved 64 sex offenders and 33 nonsex, nondrug-related, and nonviolent property offenders. The group of 64 sex offenders was further divided into eight subgroups, some of which overlapped in memberships because of multiple diagnoses. To overcome the methodological problem associated with overlapping group memberships, a special approach involving comparisons of sets of logistic regression analyses was adopted. Offenders were clinically assessed for evidence of paraphilias, and their adverse childhood experiences were measured by a battery of tests. Childhood Emotional Abuse and Family Dysfunction, Childhood Behavior Problems, and Childhood Sexual Abuse were found to be general developmental risk factors for paraphilias. Furthermore, Childhood Emotional Abuse and Family Dysfunction was found to be a common developmental risk factor for pedophilia, exhibitionism, rape, or multiple paraphilia. Additional analyses revealed that childhood emotional abuse contributed significantly as a common developmental risk factor compared to family dysfunction. Besides, Childhood Sexual Abuse was found to be a specific developmental risk factor for pedophilia. The study has supported the value of conceptualizing certain childhood adversities as developmental risk factors for paraphilic behaviors. The role of childhood emotional abuse as an important developmental risk contributor, and the relationship between childhood sexual abuse and pedophilia are of theoretical significance. Furthermore, the results have significant implications for the prevention of childhood abuse and treatment of sex offenders.

  3. Glaucoma history and risk factors.

    PubMed

    McMonnies, Charles W

    Apart from the risk of developing glaucoma there is also the risk that it is not detected and irreversible loss of vision ensues. Some studies of methods of glaucoma diagnosis have examined the results of instrument-based examinations with great if not complete reliance on objective findings in arriving at a diagnosis. The very valuable advances in glaucoma detection instrument technologies, and apparent increasing dependence on them, may have led to reduced consideration of information available from a patient history in those studies. Dependence on objective evidence of glaucomatous pathology may reduce the possibility of detecting glaucoma suspects or patients at risk for becoming glaucoma suspects. A valid positive family history of glaucoma is very valuable information. However, negative family histories can often be unreliable due to large numbers of glaucoma cases being undiagnosed. No evidence of family history is appropriate rather than no family history. In addition the unreliability of a negative family history is increased when patients with glaucoma fail to inform their family members. A finding of no family history can only be stated as no known family history. In examining the potential diagnostic contribution from a patient history, this review considers, age, frailty, race, type and degree of refractive error, systemic hyper- and hypotension, vasospasm, migraine, pigmentary dispersion syndrome, pseudoexfoliation syndrome, obstructive sleep apnea syndrome, diabetes, medication interactions and side effects, the degree of exposure to intraocular and intracranial pressure elevations and fluctuations, smoking, and symptoms in addition to genetics and family history of the disease. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  4. HUMAN PROSTATE CANCER RISK FACTORS

    EPA Science Inventory

    Prostate cancer has the highest prevalence of any non-skin cancer in the human body, with similar likelihood of neoplastic foci found within the prostates of men around the world regardless of diet, occupation, lifestyle, or other factors. Essentially all men with circulating an...

  5. HUMAN PROSTATE CANCER RISK FACTORS

    EPA Science Inventory

    Prostate cancer has the highest prevalence of any non-skin cancer in the human body, with similar likelihood of neoplastic foci found within the prostates of men around the world regardless of diet, occupation, lifestyle, or other factors. Essentially all men with circulating an...

  6. Psychological Risk Factors in Headache

    PubMed Central

    Nicholson, Robert A.; Houle, Timothy T.; Rhudy, Jamie L.; Norton, Peter J.

    2008-01-01

    Headache is a chronic disease that occurs with varying frequency and results in varying levels of disability. To date, the majority of research and clinical focus has been on the role of biological factors in headache and headache-related disability. However, reliance on a purely biomedical model of headache does not account for all aspects of headache and associated disability. Using a biopsychosocial framework, the current manuscript expands the view of what factors influence headache by considering the role psychological (i.e., cognitive and affective) factors have in the development, course, and consequences of headache. The manuscript initially reviews evidence showing that neural circuits responsible for cognitive–affective phenomena are highly interconnected with the circuitry responsible for headache pain. The manuscript then reviews the influence cognitions (locus of control and self-efficacy) and negative affect (depression, anxiety, and anger) have on the development of headache attacks, perception of headache pain, adherence to prescribed treatment, headache treatment outcome, and headache-related disability. The manuscript concludes with a discussion of the clinical implications of considering psychological factors when treating headache. PMID:17371358

  7. Risk-communication capability for public health emergencies varies by community diversity

    PubMed Central

    Savoia, Elena; Stoto, Michael A; Biddinger, Paul D; Campbell, Paul; Viswanath, Kasisomayajula; Koh, Howard

    2008-01-01

    Background Public health emergencies heighten several challenges in risk-communication: providing trustworthy sources of information, reaching marginalized populations, and minimizing fear and public confusion. In emergencies, however, information may not diffuse equally among all social groups, and gaps in knowledge may increase. Such knowledge gaps vary by social structure and the size, socioeconomic status, and diversity of the population. This study explores the relationship between risk-communication capabilities, as perceived by public officials participating in emergency tabletop exercises, and community size and diversity. Findings For each of the three communication functions tested, risk-communication capabilities are perceived to be greater in communities with fewer then 10% of the population speaking a language other than English at home, decreasing as the percentage grows to 20% (ANOVA P ≤ 0.02). With respect to community size, however, we found an N-shaped relationship between perceived risk communication capabilities and population size. Capabilities are perceived highest in the largest communities and lowest in the smallest, but lower in communities with 20,000–49,999 inhabitants compared to those with 2,500–19,999. Conclusion The results of this study suggest the need to factor population diversity into risk communication plans and the need for improved state or regional risk-communication capabilities, especially for communities with limited local capacity. PMID:18710541

  8. Cardiovascular risk factor investigation: a pediatric issue

    PubMed Central

    Rodrigues, Anabel N; Abreu, Glaucia R; Resende, Rogério S; Goncalves, Washington LS; Gouvea, Sonia Alves

    2013-01-01

    Objectives To correlate cardiovascular risk factors (e.g., hypertension, obesity, hypercholesterolemia, hypertriglyceridemia, hyperglycemia, sedentariness) in childhood and adolescence with the occurrence of cardiovascular disease. Sources A systematic review of books and selected articles from PubMed, SciELO and Cochrane from 1992 to 2012. Summary of findings Risk factors for atherosclerosis are present in childhood, although cardiovascular disease arises during adulthood. This article presents the main studies that describe the importance of investigating the risk factors for cardiovascular diseases in childhood and their associations. Significant rates of hypertension, obesity, dyslipidemia, and sedentariness occur in children and adolescents. Blood pressure needs to be measured in childhood. An increase in arterial blood pressure in young people predicts hypertension in adulthood. The death rate from cardiovascular disease is lowest in children with lower cholesterol levels and in individuals who exercise regularly. In addition, there is a high prevalence of sedentariness in children and adolescents. Conclusions Studies involving the analysis of cardiovascular risk factors should always report the prevalence of these factors and their correlations during childhood because these factors are indispensable for identifying an at-risk population. The identification of risk factors in asymptomatic children could contribute to a decrease in cardiovascular disease, preventing such diseases as hypertension, obesity, and dyslipidemia from becoming the epidemics of this century. PMID:23515212

  9. Emerging technologies in healthcare: navigating risks, evaluating rewards.

    PubMed

    McGrady, Elizabeth; Conger, Sue; Blanke, Sandra; Landry, Brett J L

    2010-01-01

    The purpose of this prescriptive research is to help decision makers become better informed about three technologies emerging in the healthcare arena by providing a basic description of the technology and describing their current applications, future healthcare deployment, potential risks, and related managerial issues. Two of the technologies, radio frequency identification (RFID) and global positioning systems (GPS), are currently available to healthcare organizations and appear capable of decreasing cost but may require significant initial investment and have disruptive potential. The third technology, nanotechnology, has limited current use but may revolutionize both the delivery of medicine and hospital infrastructure management. With cautious attention to managerial issues and meticulous attention to implementation details, healthcare organizations that can successfully navigate the coming technologically driven paradigm shifts will emerge more resilient organizations.

  10. Hospital Factors Associated With Care Discontinuity Following Emergency General Surgery.

    PubMed

    Havens, Joaquim M; Olufajo, Olubode A; Tsai, Thomas C; Jiang, Wei; Columbus, Alexandra B; Nitzschke, Stephanie L; Cooper, Zara; Salim, Ali

    2017-03-01

    Although there is evidence that changes in clinicians during the continuum of care (care discontinuity) are associated with higher mortality and complications among surgical patients, little is known regarding the drivers of care discontinuity among emergency general surgery (EGS) patients. To identify hospital factors associated with care discontinuity among EGS patients. We performed a retrospective analysis of the 100% Medicare inpatient claims file, from January 1, 2008, to November 30, 2011, and matched patient details to hospital information in the 2011 American Hospital Association Annual Survey database. We selected patients aged 65 years and older who had the most common procedures associated with the previously defined American Association for the Surgery of Trauma EGS diagnosis categories and survived to hospital discharge across the United States. The current analysis was conducted from February 1, 2016, to March 24, 2016. Care discontinuity defined as readmission within 30 days to nonindex hospitals. There were 109 443 EGS patients readmitted within 30 days of discharge and 20 396 (18.6%) were readmitted to nonindex hospitals. Of the readmitted patients, 61 340 (56%) were female. Care discontinuity was higher among patients who were male (19.5% vs 18.0%), those younger than 85 years old (19.0% vs 16.6%), and those who lived 12.8 km (8 miles) or more away from the index hospitals (23.7% vs 14.8%) (all P < .001). Care discontinuity was independently associated with mortality (adjusted odds ratio [aOR], 1.16; 95% CI, 1.08-1.25). Hospital factors associated with care discontinuity included bed size of 200 or more (aOR, 1.45; 95% CI, 1.36-1.54), safety-net status (aOR, 1.35; 95% CI, 1.27-1.43), and teaching status (aOR, 1.18; 95% CI, 1.09-1.28). Care discontinuity was significantly lower among designated trauma centers (aOR, 0.89; 95% CI, 0.83-0.94) and highest among hospitals in the Midwest (aOR, 1.15; 95% CI, 1.05-1.26). Nearly 1 in 5 older EGS

  11. [Midwives' perception of reproductive risk factors].

    PubMed

    García-Barrios, C; Castañeda-Camey, X; Romero-Guerrero, X; González-Hernández, D; Langer-Glas, A

    1993-01-01

    Midwives in rural areas of the State of Morelos are one of the most important resources used by rural women for health care of pregnancy, delivery and the puerperium. This work was aimed at identifying midwives perceptions of pregnant women's risk factors, in order to include this knowledge in reproductive health programs which articulate institutional and traditional health systems. We applied a questionnaire to all midwives in the Municipalities of Ocuituco, yecapixtla and Zacualpan, Morelos (n = 35). Four key informants were selected and interviewed. These instruments enabled us to measure variability in perception of risk factors. Knowledge of risk factors is defective among midwives. Previous training made a big difference. Sixty three per cent of midwives who attended training courses are better qualified from an academic medicine point of view. Only 28.7 per cent of non-trained midwives (43% for both groups), indicating that sociocultural aspects prevail over technical training in midwives perceptions of reproductive risk factors.

  12. Shoulder Dystocia: Incidence and Risk Factors.

    PubMed

    Ouzounian, Joseph G

    2016-12-01

    Shoulder dystocia complicates ∼1% of vaginal births. Although fetal macrosomia and maternal diabetes are risk factors for shoulder dystocia, for the most part its occurrence remains largely unpredictable and unpreventable.

  13. Risk Factors for Hypotension in Urgently Intubated Burn Patients

    DTIC Science & Technology

    2012-01-01

    fold increase in the odds of death. The use of propofol for the induction of anesthesia for endotracheal intubation in critically ill burned patients...did not increase the odds of hypotension or death. In burn patients requiring emergent endotracheal intubation in the BICU, the care team should...01 DEC 2012 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Risk factors for hypotension in urgently intubated burn patients 5a

  14. Concurrent risk factors for adolescent violence.

    PubMed

    Saner, H; Ellickson, P

    1996-08-01

    To examine the risk and protective factors for different types of violent behavior in a sample of high school age adolescents drawn from the general population, illuminate the multiple and cumulative nature of the different risk factors, and characterize gender differences in explanatory variables that foster involvement in violent activities. Using data from a 6-year longitudinal self-report survey of over 4,500 high school seniors and high school dropouts from California and Oregon, we developed weighted estimates of the proportions of youth exhibiting different risk factors who are also involved in violent activities. We use risk scales to show the cumulative effects of multiple factors within substantive domains, and logistic regression techniques to pinpoint the effects of each risk factor relative to others included in the models. Major risk factors for violence include gender and deviant behaviors, such as using and selling drugs, committing nonviolent felonies, and engaging in other forms of nonviolent delinquency. Low academic orientation, lack of parental affection and support, and perceptions of parents' substance use also show strong links with violent behavior. As the number of risk factors increases, so does the likelihood of engaging in violent behavior. Boys and girls show somewhat different paths to violence, with girls being comparatively more susceptible to the effects of family problems or disruption and impaired relationships with parents. For boys, engaging in other deviant behaviors provides the most information about their propensity to commit violent acts. Weak bonds with school and family also have an impact on serious violence for boys. Risk factors from multiple domains--demographic, environmental, and behavioral--contribute to involvement in various types of violent behavior. The strong links between violence, drug use, and delinquency argue for prevention/intervention programs that take into account the clustering of these behaviors

  15. Osteoporosis Risk Factors in Eighth Grade Students.

    ERIC Educational Resources Information Center

    Lysen, Victoria C.; Walker, Robert

    1997-01-01

    Presents findings from food frequency questionnaires and surveys of 138 Midwestern eighth-grade student-parent pairs. The study examined the incidence of modifiable and nonmodifiable osteoporosis risk factors and compared gender differences. Data analysis indicated that many adolescents possessed several modifiable and nonmodifiable risk factors…

  16. Osteoporosis Risk Factors in Eighth Grade Students.

    ERIC Educational Resources Information Center

    Lysen, Victoria C.; Walker, Robert

    1997-01-01

    Presents findings from food frequency questionnaires and surveys of 138 Midwestern eighth-grade student-parent pairs. The study examined the incidence of modifiable and nonmodifiable osteoporosis risk factors and compared gender differences. Data analysis indicated that many adolescents possessed several modifiable and nonmodifiable risk factors…

  17. Behavioral Risk Factors for AIDS among Adolescents.

    ERIC Educational Resources Information Center

    Millstein, Susan G.

    This document examines the incidence of Acquired Immune Deficiency Syndrome (AIDS) among adolescents in the United States and identifies several risk factors for AIDS among this population. It classifies adolescents' risk for contracting human immunodeficiency virus (HIV) infection by the degree to which adolescents engage in behaviors that are…

  18. Cancer associated thrombosis: risk factors and outcomes.

    PubMed

    Eichinger, Sabine

    2016-04-01

    Deep vein thrombosis of the leg and pulmonary embolism are frequent diseases and cancer is one of their most important risk factors. Patients with cancer also have a higher prevalence of venous thrombosis located in other parts than in the legs and/or in unusual sites including upper extremity, splanchnic or cerebral veins. Cancer also affects the risk of arterial thrombotic events particularly in patients with myeloproliferative neoplasms and in vascular endothelial growth factor receptor inhibitor recipients. Several risk factors need to interact to trigger thrombosis. In addition to common risk factors such as surgery, hospitalisation, infection and genetic coagulation disorders, the thrombotic risk is also driven and modified by cancer-specific factors including type, histology, and stage of the malignancy, cancer treatment and certain biomarkers. A venous thrombotic event in a cancer patient has serious consequences as the risk of recurrent thrombosis, the risk of bleeding during anticoagulation and hospitalisation rates are all increased. Survival of cancer patients with thrombosis is worse compared to that of cancer patients without thrombosis, and thrombosis is a leading direct cause of death in cancer patients.

  19. Optimal network solution for proactive risk assessment and emergency response

    NASA Astrophysics Data System (ADS)

    Cai, Tianxing

    Coupled with the continuous development in the field industrial operation management, the requirement for operation optimization in large scale manufacturing network has provoked more interest in the research field of engineering. Compared with the traditional way to take the remedial measure after the occurrence of the emergency event or abnormal situation, the current operation control calls for more proactive risk assessment to set up early warning system and comprehensive emergency response planning. Among all the industries, chemical industry and energy industry have higher opportunity to face with the abnormal and emergency situations due to their own industry characterization. Therefore the purpose of the study is to develop methodologies to give aid in emergency response planning and proactive risk assessment in the above two industries. The efficacy of the developed methodologies is demonstrated via two industrial real problems. The first case is to handle energy network dispatch optimization under emergency of local energy shortage under extreme conditions such as earthquake, tsunami, and hurricane, which may cause local areas to suffer from delayed rescues, widespread power outages, tremendous economic losses, and even public safety threats. In such urgent events of local energy shortage, agile energy dispatching through an effective energy transportation network, targeting the minimum energy recovery time, should be a top priority. The second case is a scheduling methodology to coordinate multiple chemical plants' start-ups in order to minimize regional air quality impacts under extreme meteorological conditions. The objective is to reschedule multi-plant start-up sequence to achieve the minimum sum of delay time compared to the expected start-up time of each plant. All these approaches can provide quantitative decision support for multiple stake holders, including government and environment agencies, chemical industry, energy industry and local

  20. Risk Assessment for Emergency Planning Related to Nuclear Weapons Accidents

    DTIC Science & Technology

    1985-09-25

    Nuclea, Weapons Fixed Facilities," SAI/PL-83-3, Science Applications, Inc. (March 1983). 3) NUREG -0654/FEMA-REP-1 (Rev. 1), "Criteria for Preparation and...Evaluation of Emergency Response Plans and Preparedness in Support of Nuclear Power Plants." November 1980. 4) NUREG -0396, EPA 520/1-78-016...8217 December 1978. 5) "Reactor Safety Study: An Assessment of Accident Risks in U.S. Commercial Nuclear Power Plants," NUREG -75/014, WASH-1400, USNRC, October

  1. Drug use as a driver of HIV Risks: Re-emerging and emerging issues

    PubMed Central

    El-Bassel, Nabila; Shaw, Stacey A.; Dasgupta, Anindita; Strathdee, Steffanie A.

    2014-01-01

    Purpose of Review We reviewed papers published in 2012–2013 that focused on re-emerging and emerging injection and non-injection drug use trends driving HIV risk behaviors and transmission in some parts of the world. Recent Findings While HIV incidence has declined in many countries, HIV epidemics remain at troubling levels among key drug using populations including females who inject drugs (FWID), FWID who trade sex, sex partners of people who inject drugs (SP-PWID), young PWID, and people who use non-injection drugs in a number of low- and middle- income countries such as in Central Asia, Eastern Europe, Southeast Asia, and parts of Africa. Summary HIV epidemics occur within contexts of global economic and political forces, including poverty, human rights violations, discrimination, drug policies, trafficking, and other multi-level risk environments. Trends of injection and non-injection drug use and risk environments driving HIV epidemics in Central Asia, Eastern Europe, Southeast Asia, and parts of Africa call for political will to improve HIV and substance use service delivery, access to combination HIV prevention, and harm reduction programs. PMID:24406532

  2. Risk factors for atherosclerotic vascular disease.

    PubMed

    von Eckardstein, A

    2005-01-01

    Several controlled interventional trials have shown the benefit of anti-hypertensive and hypolipidaemic drugs for the prevention of coronary heart disease (CHD). International guidelines for the prevention of CHD agree in their recommendations for tertiary prevention and recommend lowering the blood pressure to below 140 mm/90 mm Hg and low density lipoprotein (LDL)-cholesterol to below 2.6 mmol/l in patients with manifest CHD. Novel recommendations for secondary prevention are focused on the treatment of the pre-symptomatic high-risk patient with an estimated CHD morbidity risk of higher than 20% per 10 years or an estimated CHD mortality risk of higher than 5% per 10 years. For the calculation of this risk, the physician must record the following risk factors: sex, age, family history of premature myocardial infarction, smoking, diabetes, blood pressure, total cholesterol, LDL-cholesterol, high-density lipoprotein (HDL)-cholesterol, and triglyceride. This information allows the absolute risk of myocardial infarction to be computed by using scores or algorithms which have been deduced from results of epidemiological studies. To improve risk prediction and to identify new targets for intervention, novel risk factors are sought. High plasma levels of C-reactive protein has been shown to improve the prognostic value of global risk estimates obtained by the combination of conventional risk factors and may influence treatment decisions in patients with intermediate global cardiovascular risk (CHD morbidity risk of 10%-20% per 10 years or CHD mortality risk of 2%-5% per 10 years).

  3. Vascular Risk Factors: Imaging and Neuropathologic Correlates

    PubMed Central

    Knopman, David S.; Roberts, Rosebud

    2010-01-01

    Cerebrovascular disease plays an important role in cognitive disorders in the elderly. Cerebrovascular disease and Alzheimer’s disease interact on several levels, one important level being the overlap in risk factors. The major vascular risk factors such as diabetes and impaired glycemic control, hypertension, obesity and hyper- or dyslipidemia have been associated both with Alzheimer’s disease and vascular dementia. The purpose of this review is to consider the context in which vascular dementia is diagnosed, place the pathophysiological consequences of cerebrovascular disease on cognition in the context of clinical and pathological Alzheimer’s disease, and then to consider the evidence for the role of major vascular risk factors in late-life cognitive impairment, changes in brain imaging and neuropathological changes. Midlife diabetes mellitus, hypertension and obesity are established risk factors for clinically defined Alzheimer’s disease as well as vascular dementia. The basis for these relationships could either be that the risk factors lead to microvascular brain disease, promote Alzheimer pathology or both. The associations of late-life onset diabetes mellitus, hypertension and obesity with cognitive impairment are either attenuated or reversed. The role of vascular risk factors in midlife should be the focus of public health efforts to reduce the burden of late-life cognitive impairment. PMID:20182020

  4. Risk Factors for Homelessness Among US Veterans

    PubMed Central

    Tsai, Jack; Rosenheck, Robert A.

    2015-01-01

    Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. PMID:25595171

  5. Risk factors for homelessness among US veterans.

    PubMed

    Tsai, Jack; Rosenheck, Robert A

    2015-01-01

    Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  6. Risk Factors for Cerebral Venous Thrombosis.

    PubMed

    Silvis, Suzanne M; Middeldorp, Saskia; Zuurbier, Susanna M; Cannegieter, Suzanne C; Coutinho, Jonathan M

    2016-09-01

    Cerebral venous thrombosis (CVT) is a rare thrombotic disorder involving the cerebral veins and dural sinuses. In contrast to more common sites of venous thromboembolism (VTE), such as the legs and lungs, CVT mainly affects young adults and children, and women are affected three times more often than men. Although presenting symptoms are variable, headache is usually the first symptom, often in combination with focal neurologic deficits and epileptic seizures. The primary therapy for CVT consists of heparin followed by oral anticoagulation for at least 3 to 6 months. The mortality in the acute phase is 5 to 10% and a substantial proportion of survivors suffer from long-term disabilities. A large number of risk factors have been linked to CVT, although the scientific evidence for an association varies considerably between risk factors. Some risk factors, such as hereditary thrombophilia, correspond with risk factors for more common sites of VTE, whereas others, such as head trauma, are specific to CVT. In most patients, at least one risk factor can be identified. In this review, we provide an overview of the risk factors for CVT.

  7. Modifiable risk factors for schizophrenia and autism--shared risk factors impacting on brain development.

    PubMed

    Hamlyn, Jess; Duhig, Michael; McGrath, John; Scott, James

    2013-05-01

    Schizophrenia and autism are two poorly understood clinical syndromes that differ in age of onset and clinical profile. However, recent genetic and epidemiological research suggests that these two neurodevelopmental disorders share certain risk factors. The aims of this review are to describe modifiable risk factors that have been identified in both disorders, and, where available, collate salient systematic reviews and meta-analyses that have examined shared risk factors. Based on searches of Medline, Embase and PsycINFO, inspection of review articles and expert opinion, we first compiled a set of candidate modifiable risk factors associated with autism. Where available, we next collated systematic-reviews (with or without meta-analyses) related to modifiable risk factors associated with both autism and schizophrenia. We identified three modifiable risk factors that have been examined in systematic reviews for both autism and schizophrenia. Advanced paternal age was reported as a risk factor for schizophrenia in a single meta-analysis and as a risk factor in two meta-analyses for autism. With respect to pregnancy and birth complications, for autism one meta-analysis identified maternal diabetes and bleeding during pregnancy as risks factors for autism whilst a meta-analysis of eight studies identified obstetric complications as a risk factor for schizophrenia. Migrant status was identified as a risk factor for both autism and schizophrenia. Two separate meta-analyses were identified for each disorder. Despite distinct clinical phenotypes, the evidence suggests that at least some non-genetic risk factors are shared between these two syndromes. In particular, exposure to drugs, nutritional excesses or deficiencies and infectious agents lend themselves to public health interventions. Studies are now needed to quantify any increase in risk of either autism or schizophrenia that is associated with these modifiable environmental factors.

  8. The waterpipe: an emerging global risk for cancer.

    PubMed

    Maziak, Wasim

    2013-02-01

    Tobacco smoking continues to be the leading preventable cause of morbidity and mortality worldwide. Each year more than 5 million smokers die prematurely because of their habit wreaking havoc on the welfare of families and communities worldwide. While cigarettes remain the main tobacco killer worldwide, for many youth tobacco use and addiction is maintained by means other than cigarettes. In particular, over the past decade, waterpipe smoking (a.k.a. hookah, shisha, narghile) has become increasingly popular among youth in the Middle East, and is rapidly spreading globally. Available evidence suggests that waterpipe smoking is associated with many of the known risks of tobacco smoking, particularly cancer. Despite these worrisome signs, policies and interventions to address this emerging public health problem have been lagging behind. In this short review I discuss briefly the evidence generated mostly in the past decade about the global spread of waterpipe smoking and its cancer risk potential. Copyright © 2012. Published by Elsevier Ltd.

  9. The waterpipe: An emerging global risk for cancer

    PubMed Central

    Maziak, Wasim

    2014-01-01

    Tobacco smoking continues to be the leading preventable cause of morbidity and mortality worldwide. Each year more than 5 million smokers die prematurely because of their habit wreaking havoc on the welfare of families and communities worldwide. While cigarettes remain the main tobacco killer worldwide, for many youth tobacco use and addiction is maintained by means other than cigarettes. In particular, over the past decade, waterpipe smoking (a.k.a. hookah, shisha, narghile) has become increasingly popular among youth in the Middle East, and is rapidly spreading globally. Available evidence suggests that waterpipe smoking is associated with many of the known risks of tobacco smoking, particularly cancer. Despite these worrisome signs, policies and interventions to address this emerging public health problem have been lagging behind. In this short review I discuss briefly the evidence generated mostly in the past decade about the global spread of waterpipe smoking and its cancer risk potential. PMID:23196170

  10. Vascular risk factors and cognitive disorders.

    PubMed

    Debette, S

    2013-10-01

    Delaying the onset of dementia by just a few years could have a major impact on the prevalence of the disease at the population level. Vascular risk factors are modifiable and may offer an important opportunity for preventive approaches. Several studies have shown that diabetes, hypertension, obesity, and smoking are associated with an increased risk of cognitive decline and dementia, but other groups have not observed such a relation. Positive associations were observed mainly in studies where risk factors were assessed in midlife, suggesting that age is an important modulator in the relation between vascular risk factors and cognition. The population attributable risk of dementia is particularly high for hypertension. Associations of vascular risk factors with cognitive decline and dementia are probably mediated largely by cerebrovascular disease, including both stroke and covert vascular brain injury, which can have additive or synergistic effects with coexisting neurodegenerative lesions. To date, randomized trials have not convincingly demonstrated that treating vascular risk factors is associated with a reduction in cognitive decline or dementia risk. Of eight randomized trials testing the effect of antihypertensive agents on dementia risk, only one was positive, and another in a subgroup of individuals with recurrent stroke. In most trials, cognition and dementia were secondary outcomes, follow-up was short and treatment was initiated at an older age. No effect on cognitive decline or dementia could be demonstrated for statins and intensive glycemic control. Future areas of investigation could include differential class effects of antihypertensive drugs on cognitive outcomes and identification of high risk individuals as target population for clinical trials initiated in midlife. Copyright © 2013. Published by Elsevier Masson SAS.

  11. [Aflatoxins--health risk factors].

    PubMed

    Miliţă, Nicoleta Manuela; Mihăescu, Gr; Chifiriuc, Carmen

    2010-01-01

    Aflatoxins are secondary metabolites produced by a group of strains, mainly Aspergillus and Penicillium species. These mycotoxins are bifurano-coumarin derivatives group with four major products B1, B2, G1 and G2 according to blue or green fluorescence emitted in ultraviolet light and according to chromatographic separation. After metabolism of aflatoxin B1 and B2 in the mammalian body, result two metabolites M1 and M2 as hydroxylated derivatives of the parent compound. Aflatoxins have high carcinogenic potential, the most powerful carcinogens in different species of animals and humans. International Agency for Research on Cancer has classified aflatoxin B1 in Group I carcinogens. The target organ for aflatoxins is the liver. In chronic poisoning, aflatoxin is a risk to health, for a long term causing cancer (hepatocellular carcinoma), and in acute intoxications aflatoxin is lethal. This work purpose to discuss aflatoxins issue: the synthesis, absorption and elimination of aflatoxins, the toxicity mechanisms, and measures to limit the content of aflatoxins in food

  12. Ectasia risk factors in refractive surgery

    PubMed Central

    Santhiago, Marcony R; Giacomin, Natalia T; Smadja, David; Bechara, Samir J

    2016-01-01

    This review outlines risk factors of post-laser in situ keratomileusis (LASIK) ectasia that can be detected preoperatively and presents a new metric to be considered in the detection of ectasia risk. Relevant factors in refractive surgery screening include the analysis of intrinsic biomechanical properties (information obtained from corneal topography/tomography and patient’s age), as well as the analysis of alterable biomechanical properties (information obtained from the amount of tissue altered by surgery and the remaining load-bearing tissue). Corneal topography patterns of placido disk seem to play a pivotal role as a surrogate of corneal strength, and abnormal corneal topography remains to be the most important identifiable risk factor for ectasia. Information derived from tomography, such as pachymetric and epithelial maps as well as computational strategies, to help in the detection of keratoconus is additional and relevant. High percentage of tissue altered (PTA) is the most robust risk factor for ectasia after LASIK in patients with normal preoperative corneal topography. Compared to specific residual stromal bed (RSB) or central corneal thickness values, percentage of tissue altered likely provides a more individualized measure of biomechanical alteration because it considers the relationship between thickness, tissue altered through ablation and flap creation, and ultimate RSB thickness. Other recognized risk factors include low RSB, thin cornea, and high myopia. Age is also a very important risk factor and still remains as one of the most overlooked ones. A comprehensive screening approach with the Ectasia Risk Score System, which evaluates multiple risk factors simultaneously, is also a helpful tool in the screening strategy. PMID:27143849

  13. Failed subacromial decompression. Risk factors.

    PubMed

    Bouchard, A; Garret, J; Favard, L; Charles, H; Ollat, D

    2014-12-01

    Arthroscopic subacromial decompression (acromioplasty) is widely held to be effective, although pain may persist after the procedure. The objective of this study was to evaluate the proportion of patients with residual pain (i.e., the failure rate) after isolated subacromial decompression and to look for predictors of failure. We conducted a retrospective multicentre study of 108 patients managed with isolated arthroscopic subacromial decompression between 2007 and 2011, for any reason. We excluded patients in whom surgical procedures on the rotator cuff tendons were performed concomitantly. Data were collected from the medical records, a telephone questionnaire, and radiographs obtained before surgery and at last follow-up. Failure was defined as persistent pain (visual analogue scale score>3) more than 6 months after surgery and at last follow-up. The failure rate was 29% (31/108). Two factors significantly predicted failure, namely, receiving workers' compensation benefits for the shoulder condition and co-planing. Heterogeneous calcific tendinopathy and deep partial-thickness rotator cuff tears were also associated with poorer outcomes, but the effect was not statistically significant. Co-planing may predict failure of subacromial decompression, although whether this effect is due to an insufficient degree of co-planing or to the technique itself is unclear. Nevertheless, in patients with symptoms from the acromio-clavicular joint, acromio-clavicular resection is probably the best option. Receiving workers' compensation benefits was also associated with treatment failure, as a result of well-known parameters related to the social welfare system. Isolated arthroscopic subacromial decompression is effective in 70% of cases. We recommend the utmost caution if co-planing is considered and/or the patient receives workers' compensation benefits for the shoulder condition, as these two factors are associated with a significant increase in the failure rate. IV

  14. Environmental factors and risk for hepatocellular carcinoma.

    PubMed

    Yu, Mimi C; Yuan, Jian-Min

    2004-11-01

    Chronic infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most important risk factors for the development of hepatocellular carcinoma (HCC) in humans. HBV is the primary cause of HCC in high-risk areas including China and Africa, whereas in developed countries such as the United States, HCV plays a more prominent role and is at least partially responsible for the increase in HCC incidence in this country. Humans are exposed to hepatocarcinogenic aflatoxins through ingestion of moldy foods, a consequence of poor storage of susceptible grains. Highly exposed populations are primarily in sub-Sahara Africa and Asia, where dietary aflatoxins significantly enhance the carcinogenic effects of viral hepatitis. Heavy, long-term alcohol use is a risk factor for HCC, whereas moderate use (1-3 drinks/day) is not. Constituents of cigarette smoke are hepatic carcinogens in animals, and there is mounting evidence that the liver is an organ susceptible to tobacco carcinogenicity. Diabetic patients are at risk for HCC probably as a result of the hepatic injury, fibrosis, and eventual cirrhosis resulting from fatty liver disease. Given the current epidemic of obesity and diabetes in the United States, this risk factor will be increasingly important. Increased risk for HCC is evident in young noncirrhotic users of oral contraceptives in the United States and Europe. In summary, risk factors for HCC are identifiable in most patients and primarily are associated with chronic hepatic injury.

  15. Identification of the high risk emergency surgical patient: Which risk prediction model should be used?

    PubMed Central

    Stonelake, Stephen; Thomson, Peter; Suggett, Nigel

    2015-01-01

    Introduction National guidance states that all patients having emergency surgery should have a mortality risk assessment calculated on admission so that the ‘high risk’ patient can receive the appropriate seniority and level of care. We aimed to assess if peri-operative risk scoring tools could accurately calculate mortality and morbidity risk. Methods Mortality risk scores for 86 consecutive emergency laparotomies, were calculated using pre-operative (ASA, Lee index) and post-operative (POSSUM, P-POSSUM and CR-POSSUM) risk calculation tools. Morbidity risk scores were calculated using the POSSUM predicted morbidity and compared against actual morbidity according to the Clavien–Dindo classification. Results The actual mortality was 10.5%. The average predicted risk scores for all laparotomies were: ASA 26.5%, Lee Index 2.5%, POSSUM 29.5%, P-POSSUM 18.5%, CR-POSSUM 10.5%. Complications occurred following 67 laparotomies (78%). The majority (51%) of complications were classified as Clavien–Dindo grade 2–3 (non-life-threatening). Patients having a POSSUM morbidity risk of greater than 50% developed significantly more life-threatening complications (CD 4–5) compared with those who predicted less than or equal to 50% morbidity risk (P = 0.01). Discussion Pre-operative risk stratification remains a challenge because the Lee Index under-predicts and ASA over-predicts mortality risk. Post-operative risk scoring using the CR-POSSUM is more accurate and we suggest can be used to identify patients who require intensive care post-operatively. Conclusions In the absence of accurate risk scoring tools that can be used on admission to hospital it is not possible to reliably audit the achievement of national standards of care for the ‘high-risk’ patient. PMID:26468369

  16. Clinical trials in "emerging markets": regulatory considerations and other factors.

    PubMed

    Singh, Romi; Wang, Ouhong

    2013-11-01

    Clinical studies are being placed in emerging markets as part of global drug development programs to access large pool of eligible patients and to benefit from a cost effective structure. However, over the last few years, the definition of "emerging markets" is being revisited, especially from a regulatory perspective. For purposes of this article, countries outside US, EU and the traditional "western countries" are discussed. Multiple factors are considered for placement of clinical studies such as adherence to Good Clinical Practice (GCP), medical infrastructure & standard of care, number of eligible patients, etc. This article also discusses other quantitative factors such as country's GDP, patent applications, healthcare expenditure, healthcare infrastructure, corruption, innovation, etc. These different factors and indexes are correlated to the number of clinical studies ongoing in the "emerging markets". R&D, healthcare expenditure, technology infrastructure, transparency, and level of innovation, show a significant correlation with the number of clinical trials being conducted in these countries. This is the first analysis of its kind to evaluate and correlate the various other factors to the number of clinical studies in a country.

  17. Savannah River Reactor Operation: Indices of risk for emergency planning

    SciTech Connect

    O'Kula, K.R.; East, J.M.

    1990-10-01

    Periodically it is necessary to re-examine the implications of new source terms for neighboring offsite populations as Probabilistic Risk Assessment (PRA) and Severe Accident studies mature, and lead to a better understanding of the progression of hypothetical core melt accidents in the Savannah River Site (SRS) reactors. In this application multiple-system failure, low-frequency events, and consequently higher radiological source terms than from normal operation or design basis accidents (DBAs) are considered. Measures of consequence such as constant dose vs distance, boundary doses, and health effects to close-in populations are usually examined in this context. A set of source terms developed for the Safety Information Document (SID) for support of the Reactor Operation Environmental Impact Statement (EIS) forms the basis for the revised risk evaluation discussed herein. The intent of this review is not to completely substantiate the sufficiency of the current Emergency Planning Zone (EPZ). However, the two principal measures (200-rem red-bone marrow dose vs distance and 300-rem thyroid dose vs distance) for setting an EPZ are considered. Additional dose-at-distance calculations and consideration of DBA doses would be needed to complete a re-evaluation of the current EPZ. These subject areas are not addressed in the current document. Also, this report evaluates the sensitivity of individual risk estimates to the extent of offsite evacuation assumed from a K reactor severe accident and compares these risks to the Draft DOE Safety Guidelines. 14 refs., 8 figs., 4 tabs.

  18. Bone metastasis risk factors in breast cancer

    PubMed Central

    Pulido, Catarina; Vendrell, Inês; Ferreira, Arlindo R; Casimiro, Sandra; Mansinho, André; Alho, Irina; Costa, Luís

    2017-01-01

    Bone is the single most frequent site for bone metastasis in breast cancer patients. Patients with bone-only metastasis have a fairly good prognosis when compared with patients with visceral disease. Nevertheless, cancer-induced bone disease carries an important risk of developing skeletal related events that impact quality of life (QoL). It is therefore particularly important to stratify patients according to their risk of developing bone metastasis. In this context, several risk factors have been studied, including demographic, clinicopathological, genetic, and metabolic factors. Most of them show conflicting or non-definitive associations and are not validated for clinical use. Nonetheless, tumour intrinsic subtype is widely accepted as a major risk factor for bone metastasis development and luminal breast cancer carries an increased risk for bone disease. Other factors such as gene signatures, expression of specific cytokines (such as bone sialoprotein and bone morphogenetic protein 7) or components of the extracellular matrix (like bone crosslinked C-telopeptide) might also influence the development of bone metastasis. Knowledge of risk factors related with bone disease is of paramount importance as it might be a prediction tool for triggering the use of targeted agents and allow for better patient selection for future clinical trials. PMID:28194227

  19. Prenatal and perinatal risk factors for autism.

    PubMed

    Burd, L; Severud, R; Kerbeshian, J; Klug, M G

    1999-01-01

    To identify pre- and perinatal risk factors for autism. Case control study. We matched names of patients from North Dakota who met DSM criteria for autism, a pervasive developmental disorder, and autistic disorder with their birth certificates. Five matched controls were selected for each case. Univariate analysis of the 78 cases and 390 controls identified seven risk factors. Logistic modeling to control for confounding produced a five variable model. The model parameters were chi 2 = 36.6 and p < 0.001. The five variables in the model were decreased birth weight, low maternal education, later start of prenatal care, and having a previous termination of pregnancy. Increasing father's age was associated with increased risk of autism. This methodology may provide an inexpensive method for clinics and public health providers to identify risk factors and to identify maternal characteristics of patients with mental illness and developmental disorders.

  20. Linking GIS and storm water modeling for emergency risk assessment

    SciTech Connect

    Newkirk, R.T.

    1995-12-31

    Many emergencies involve the deposition of chemical contaminants on land either as a direct event or as a secondary byproduct. GIS can be useful in estimating the initial deposition area. Chemical product attribute data bases can be accessed to determine the degree that the contaminants might be transportable in a water medium. An important issue is to estimate the potential impact of the deposition on surface and subsurface water flows. This particularly important since millions of people rely on subsurface ground water as their main source of potable water. Thus, a modeling system is needed by planners and emergency managers to assess the potential for short and long term risks to communities due to storm water transport of deposited contaminants. GIS itself cannot provide the complete analysis. A prototype system to assist in estimating the flows of contaminants related to an emergency has been developed by linking an Arc/Info database, Digital Terrain Model, and SWMM the storm water management modeling system. This system also has important planning applications in assessing alternative land development plans for their impact on ground water recharge and management of storm water.

  1. Bullying and Suicide Risk Among Pediatric Emergency Department Patients.

    PubMed

    Stanley, Ian H; Horowitz, Lisa M; Bridge, Jeffrey A; Wharff, Elizabeth A; Pao, Maryland; Teach, Stephen J

    2016-06-01

    This study aimed to describe the association between recent bullying victimization and risk of suicide among pediatric emergency department (ED) patients. Patients presenting to 1 of 3 different urban pediatric EDs with either medical/surgical or psychiatric chief complaints completed structured interviews as part of a study to develop a suicide risk screening instrument, the Ask Suicide-Screening Questions. Seventeen candidate items and the criterion reference Suicidal Ideation Questionnaire were administered to patients ages 10 to 21 years. Bullying victimization was assessed by a single candidate item ("In the past few weeks, have you been bullied or picked on so much that you felt like you couldn't stand it anymore?"). A total of 524 patients completed the interview (34.4% psychiatric chief complaints; 56.9% female; 50.4% white, non-Hispanic; mean [SD] age, 15.2 [2.6] years). Sixty patients (11.5%) reported recent bullying victimization, and of these, 33 (55.0%) screened positive for suicide risk on the Ask Suicide-Screening Questions or the previously validated Suicidal Ideation Questionnaire. After controlling for demographic and clinical variables, including a history of depression and drug use, the odds of screening positive for suicide risk were significantly greater in patients who reported recent bullying victimization (adjusted odds ratio, 3.19; 95% confidence interval, 1.66-6.11). After stratification by chief complaint, this association persisted for medical/surgical patients but not for psychiatric patients. Recent bullying victimization was associated with increased odds of screening positive for elevated suicide risk among pediatric ED patients presenting with medical/surgical complaints. Understanding this important correlate of suicide risk in pediatric ED patients may help inform ED-based suicide prevention interventions.

  2. Vascular risk factors in sudden hearing loss.

    PubMed

    Rudack, Claudia; Langer, Claus; Stoll, Wolfgang; Rust, Stephan; Walter, Michael

    2006-03-01

    Low density lipoprotein (LDL) and fibrinogen apheresis was recently reported to be an effective therapy in sudden hearing loss (SHL). In this study, we investigated whether lipoprotein and/or fibrinogen plasma concentrations, related gene polymorphisms and other cardiovascular risk factors are also risk factors for SHL. Total cholesterol, HDL and LDL cholesterol plasma concentrations, fibrinogen levels, and two functionally relevant fibrinogen polymorphisms were determined in 142 consecutive patients and in 84 age- and sex-matched control subjects of the same ethnic background, using routine laboratory methods and PCR analysis. In addition, we determined the platelet glycoprotein Ia (GPIa) C807T polymorphism, which was recently proposed to be a genetic risk factor for SHL, and we compared the patients' and controls' clinical characteristics. Total and LDL cholesterol concentrations were not different between patients and controls. Fibrinogen plasma levels were significantly increased in SHL patients (260+/-57 vs. 239+/-110 mg/dl, p=0.002). However, fibrinogen was not related to SHL in multivariate analysis, and none of the investigated fibrinogen polymorphisms was associated with SHL. By contrast, T allele carriers of the GPIa 807 polymorphic site had an increased risk to develop SHL (OR 1.81) and were more likely not to recover from SHL, compared to C allele carriers (OR 3.0). Moreover, significantly more SHL patients were current smokers (56.3% vs. 19.3% in the control group, p<0.0001). In conclusion, there is a partial overlap between classical coronary risk factors and risk factors for SHL. Hypercholesterolemia and hypoalphalipoproteinemia (low HDL cholesterol levels) are apparently no major risk factors for SHL, whereas the GPIa C807T polymorphism, elevated fibrinogen levels, and smoking are associated with an increased risk for SHL. Altogether these findings suggest a vascular involvement in the pathogenesis of SHL and may have important implications for the

  3. Cannabis use motives and personality risk factors.

    PubMed

    Hecimovic, Karen; Barrett, Sean P; Darredeau, Christine; Stewart, Sherry H

    2014-03-01

    According to the model of substance abuse of Conrod, Pihl, Stewart, and Dongier (2000), four personality factors (i.e., anxiety sensitivity [AS], introversion/hopelessness [I/H], sensation seeking [SS], and impulsivity [IMP]) are associated with elevated risk for substance use/misuse, with each personality factor being related to preference for particular drugs of abuse (e.g., AS with anxiolytics). However, cannabis use has not been consistently linked to any one of these personality factors. This may be due to the heterogeneity in cannabis use motives. The present study explored the association between these four personality risk factors and different cannabis use motives. Cannabis users completed an interview about their motives for cannabis use as well as the self-report Substance Use Risk Profile Scale (SURPS; Woicik, Conrod, Stewart, & Pihl, 2009), which measures the four personality risk factors. Results showed that AS was associated with conformity motives and I/H was associated with coping motives for cannabis use. SS was positively associated with expansion motives and IMP was associated with drug availability motives. Thus, personality risk factors in the model of Conrod et al. (2000) are associated with distinct cannabis use motives in a pattern consistent with theory.

  4. [Risk factors associated to female infertility].

    PubMed

    Romero Ramos, Ricardo; Romero Gutiérrez, Gustavo; Abortes Monroy, Ignacio; Medina Sánchez, Héctor Gerardo

    2008-12-01

    Incidence of female infertility is growing worldwide and the its rate varies from 10 to 20%. It has been reported diverse risk factors associated with this medical complication. To identify the risk factors with significant association with female infertility. A case-control study was carried out. There were included 440 patients, divided into 220 women with primary or secondary female infertility (cases) and 220 women without infertility recruited at mediate postpartum (controls). Twenty sociodemographic and clinical risk factors for female infertility were analyzed. Statistical analysis was performed with percentages, arithmetic media, standard error, Student t test and chi squared. An alpha value was set at 0.05. There were 6 factors with statistical significance: advanced age (p < 0.001), elevated body mass index (p < 0.001), age of onset of sexual activity (p < 0.001), prior pelvic surgeries (p < 0.001), and presence of stress (p < 0.001). Other risk factors such as smoking, chemical and radiological treatments, pelvic inflammatory disease, exercise, contraceptive use, alcohol intake, drugs, coffee, solvents, glue and insecticides, were not significant. There are clinical and demographic risk factors associated with female infertility. Them identification in women at reproductive age could diminish the frequency of female infertility and, thus, avoid them consequences.

  5. Sunburn risk factors at Galveston beaches.

    PubMed

    Shoss-Glaich, Adrienne B; Uchida, Tatsuo; Wagner, Richard F

    2004-07-01

    Although the beach is a well-recognized environment for sunburn injury, specific risk factors for sunburn and their interactions are poorly understood. In this epidemiologic study, variables related to sunburn injury at the beach were analyzed. Beachgoers exposed to more than 4 hours of sun at the beach were significantly more likely to sunburn compared with those with less exposure. Other significant sunburn risk factors were lack of sunscreen use or use of sunscreen with a Sun Protection Factor of 15 or less and Fitzpatrick Skin Types I and II. Reasonable sunburn avoidance strategies should include limiting duration of sun exposure to fewer than 4 hours per day.

  6. Tuberculosis: distribution, risk factors, mortality.

    PubMed

    Kochi, A

    1994-10-01

    About a century after Koch's discovery of the TB bacilli the tuberculosis epidemic which had appeared to be under control was again recognized as a major global health threat. The decline in the epidemic in this century had been largely through the improved living standards and, eventually, the availability and use of effective antibiotics. While tuberculosis gradually disappeared from the health agenda in the western world it remained a big killer throughout the century and in 1992 an estimated 2.7 million TB deaths occurred; 30 million will die from TB during the 1990s if current trends are not reversed. The annual number of new cases will increase from 7.5 million estimated in 1990 to more than 10 million in the year 2000. The main factors for this increase are demographic forces, population movements, the HIV epidemic and increasing drug resistance. The impact of the HIV epidemic is already felt in many sub-Saharan African countries and now threatens Asia where almost two-thirds of the world's TB infected population live and where HIV is spreading. Tuberculosis has also reemerged as a major public health problem in industrialized countries due to international migration, the breakdown of health services, including TB services etc. The control of the epidemic can only be through a concerted action to reinstate TB as priority among health concerns, reflected in national and international resources. A coalition of public and private supporters must be mobilized to support the effort to fight the disease. Governments, non-governmental organizations, the business community, refugee organizations, medical institutions, and other UN agencies are invited to join with WHO in this effort.

  7. Risk factors for stillbirths in Tete, Mozambique.

    PubMed

    Geelhoed, Diederike; Stokx, Jocelijn; Mariano, Xavier; Mosse Lázaro, Carla; Roelens, Kristien

    2015-08-01

    To evaluate known risk factors for stillbirth and identify local priorities for stillbirth prevention among institutional deliveries in Tete, Mozambique. A case-control study was conducted among 150 women who experienced stillbirths and 300 women who experienced live deliveries at three health facilities between December 1, 2009, and April 30, 2011. Case and control individuals were matched for health facility, age, and parity. Sociodemographic, pregnancy, and delivery characteristics (including HIV and syphilis serology) were assessed. Bivariate associations and a conditional logistic regression model identified variables contributing to fetal outcome. No between-group differences were recorded in the frequency of infection with HIV (25 [16.7%] cases vs 55 [18.3%] controls; P=0.663) or syphilis (6 [4.0%] vs 16 [5.3%]; P=0.536) at delivery. Multivariate analysis revealed that stillbirth was associated with direct obstetric complications (mutually adjusted odds ratio [OR] 6.7; 95% confidence interval [CI] 3.6-12.1), low socioeconomic status (mutually adjusted OR 1.8; 95% CI 1.1-3.1), and referral during childbirth (mutually adjusted OR 3.2; 95% CI 1.7-6.1). Stillbirths in Tete, Mozambique, were predominantly caused by direct obstetric complications requiring referral among women of low socioeconomic status. Prenatal management of HIV and syphilis limited effects on fetal outcome. Emergency obstetric care and referral systems should be the focus of interventions aimed at stillbirth prevention. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  8. Risk factors for and assessment of constipation.

    PubMed

    Chapman, Sherree; Hungerford, Catherine

    2015-04-01

    Constipation commonly occurs in older people, particularly in hospital or residential care settings, and leads to decreased quality of life and increased healthcare costs. Despite its frequency, however, nurses often overlook the condition. One possible reason for this may be the lack of appropriate tools or scales for nurses to assess risk factors for developing constipation. This article identifies, from the academic literature, 14 risk factors for developing constipation in older people. These factors are then considered in light of four common constipation assessment charts. The article concludes by arguing the need for more comprehensive assessment tools to, firstly, identify risk factors; and, secondly, support the implementation of appropriate preventative strategies that will enable better health outcomes for older people.

  9. [The risk factors of endometrial cancer].

    PubMed

    Gerber, J; Sozański, L; Suchocki, S

    2001-12-01

    Authors presents the risk factors in endometrial cancer underlying such problems like hyperestrogenism, both external and internal caused by hormonally active ovarian masses, polycystic ovarian syndrome, adrenocortical hyperfunction and role of obesity in this pathological state. Other factors have been also described diabetes mellitus and hypertension, oral contraception, genetics factors, patient's obstetric history and other diseases where the increase of aromatization activity of androstendion to estron has been noted.

  10. Factors Influencing Dating Experiences Among African American Emerging Adults

    PubMed Central

    Hall, Naomi M.; Lee, Anna K.; Witherspoon, Daphne D.

    2014-01-01

    This study examined sociocultural factors that impact dating and sexual experiences of heterosexual African American undergraduate college students attending a historically Black institution in the Southeastern United States. Specifically, mate availability and relationship involvement were analyzed to document students’ experiences, and how these influences may be associated with sexual decision making and behavior. Data from nine focus groups (N = 57) were aggregated and four subthemes were identified: competition among women, acceptability of mates, high prevalence of casual relationships, and lowered expectations for commitment. Power dynamics emerged as a contributing factor to the types of relationship involvement, sexual decision-making, and behavior among participants. The importance of prevention programs focusing on situational and cultural variables is highlighted. Additionally, implications for professionals working with emerging adults to consider the impact of the gender ratio imbalance, and perceived power distributions on perceptions of dating relationships, and sexual decision making and behavior are addressed. PMID:25530924

  11. Vulvovaginal candidiasis: Epidemiology, microbiology and risk factors.

    PubMed

    Gonçalves, Bruna; Ferreira, Carina; Alves, Carlos Tiago; Henriques, Mariana; Azeredo, Joana; Silva, Sónia

    2016-11-01

    Vulvovaginal candidiasis (VVC) is an infection caused by Candida species that affects millions of women every year. Although Candida albicans is the main cause of VVC, the identification of non-Candida albicans Candida (NCAC) species, especially Candida glabrata, as the cause of this infection, appears to be increasing. The development of VVC is usually attributed to the disturbance of the balance between Candida vaginal colonization and host environment by physiological or nonphysiological changes. Several host-related and behavioral risk factors have been proposed as predisposing factors for VVC. Host-related factors include pregnancy, hormone replacement, uncontrolled diabetes, immunosuppression, antibiotics, glucocorticoids use and genetic predispositions. Behavioral risk factors include use of oral contraceptives, intrauterine device, spermicides and condoms and some habits of hygiene, clothing and sexual practices. Despite a growing list of recognized risk factors, much remains to be elucidated as the role of host versus microorganisms, in inducing VVC and its recurrence. Thus, this review provides information about the current state of knowledge on the risk factors that predispose to VVC, also including a revision of the epidemiology and microbiology of VVC, as well as of Candida virulence factors associated with vaginal pathogenicity.

  12. Is ambient ethene a cancer risk factor?

    PubMed Central

    Törnqvist, M

    1994-01-01

    Ethene is, on a molar basis, a major urban air pollutant. It has been shown beyond doubt that a fraction of inhaled ethene is metabolized in mammals (including humans) via ethylene oxide, an electrophilic reagent that has been shown to be mutagenic and carcinogenic. To the extent that the linearity hypothesis for dose-response relationships at low levels is accepted, exposure to ethene is therefore expected to lead to a risk increment. In order to judge whether ethene as a single compound should be considered a risk factor, it has to be evaluated whether this risk increment is negligibly small or of concern to individuals or societies. The magnitude of the cancer risk from ethene cannot be inferred from animal experiments. Because of saturation of the metabolism of ethene, sufficient statistical power cannot be attained in long-term animal tests with about 100 animals per dose. By application of the radiation-dose equivalent of the unit of target dose of ethylene oxide and using the best (although still uncertain) value for the conversion factor (about 5%), exposure to 10 ppb ethene--a level occurring in urban areas--is expected to lead to a lifetime risk of cancer death amounting to approximately 70 per 100,000. According to a recent estimate the average exposure in Sweden to ethene is some six times lower. These figures are uncertain by a factor of at least three. They indicate ethene to be a risk factor of concern. PMID:7821290

  13. [Cardiovascular risk factor prevalence in university students].

    PubMed

    García-Gulfo, María H; García-Zea, Jerson A

    2012-10-01

    Determining cardiovascular risk factor prevalence in university students from Medellin. A descriptive study of 112 students determined their lipid profile and a survey was conducted to assess their life-style and family history. There results were analyzed by gender using Chi² test and simple binary logistic regression. 82.1 % of the sample was female. A modifiable risk factor was found for at least 99.1 % of the study population: sedentary life-style (79.5 %), smoking (17 %), alcohol consumption (75.0 %), atherogenic diet (78.6 %), hypertension (1.8 %), some form of dyslipidemia (48.3 % BMI >25 (4.5 %)) and stress (86.7 %). At least one non-modifiable risk factor was identified in 77.7 % of the students. New intervention strategies are needed given the significant percentage of the target population ± 19 mean age having cardiovascular disease risk factors and young people must be encouraged to develop healthy life-styles to reduce cardiovascular risk factor prevalence.

  14. Risk Factors for Recurrent Lumbar Disc Herniation

    PubMed Central

    Huang, Weimin; Han, Zhiwei; Liu, Jiang; Yu, Lili; Yu, Xiuchun

    2016-01-01

    Abstract Recurrent lumbar disc herniation (rLDH) is a common complication following primary discectomy. This systematic review aimed to investigate the current evidence on risk factors for rLDH. Cohort or case-control studies addressing risk factors for rLDH were identified by search in Pubmed (Medline), Embase, Web of Science, and Cochrane library from inception to June 2015. Relevant results were pooled to give overall estimates if possible. Heterogeneity among studies was examined and publication bias was also assessed. A total of 17 studies were included in this systematic review. Risk factors that had significant relation with rLDH were smoking (OR 1.99, 95% CI 1.53–2.58), disc protrusion (OR 1.79, 95% CI 1.15–2.79), and diabetes (OR 1.19, 95% CI 1.06–1.32). Gender, BMI, occupational work, level, and side of herniation did not correlate with rLDH significantly. Based on current evidence, smoking, disc protrusion, and diabetes were predictors for rLDH. Patients with these risk factors should be paid more attention for prevention of recurrence after primary surgery. More evidence provided by high-quality observational studies is still needed to further investigate risk factors for rLDH. PMID:26765413

  15. Risk screening, emergency care, and lay concepts of complications during pregnancy in Chiapas, Mexico.

    PubMed

    Tinoco-Ojanguren, Rolando; Glantz, Namino M; Martinez-Hernandez, Imelda; Ovando-Meza, Ismael

    2008-03-01

    Maternal morbidity and mortality are widespread in Chiapas, Mexico's southernmost state, as in many developing regions. Globally, the utility of three approaches to addressing such problems has been debated: (a) obstetric risk screening (i.e. screening women for risk during pregnancy and channeling those at risk to preventive care); (b) emergency obstetric care (i.e. identifying complications during pregnancy or birth and providing prompt effective treatment); and (c) combined risk screening and emergency care. Unaddressed to date in peer-reviewed journals are the lay perceptions of complications and risk that precede and incite the quest for obstetric care in Mexico. High incidence of maternal mortality in Chiapas, exacerbated by the predominantly rural, highly indigenous, geographically dispersed, and economically marginalized nature of the state's southern Border Region, prompted us to conduct 45 open-ended interviews with a convenience sample of women and their close relative/s, including indigenous and non-indigenous informants in urban and rural areas of four municipalities in this region. Interviews suggest that none of the three approaches is effective in this context, and we detail reasons why each approach has fallen short. Specific obstacles identified include that (1) many women do not access adequate prenatal screening care on a regular basis; (2) emergency obstetric care in this region is severely circumscribed; and (3) lay notions of pregnancy-related risk and complications contrast with official clinical criteria, such that neither clinical nor extra-clinical prenatal monitoring encompasses the entire range of physical and social risk factors and danger signs. Findings reported here center on a rich description of the latter: lay versus clinical criteria for risk of antepartum complication.

  16. Industrial Accidents Triggered by Natural Hazards: an Emerging Risk Issue

    NASA Astrophysics Data System (ADS)

    Renni, Elisabetta; Krausmann, Elisabeth; Basco, Anna; Salzano, Ernesto; Cozzani, Valerio

    2010-05-01

    Natural disasters such as earthquakes, tsunamis, flooding or hurricanes have recently and dramatically hit several countries worldwide. Both direct and indirect consequences involved the population, causing on the one hand a high number of fatalities and on the other hand so relevant economical losses that the national gross product may be affected for many years. Loss of critical industrial infrastructures (electricity generation and distribution, gas pipelines, oil refineries, etc.) also occurred, causing further indirect damage to the population. In several cases, accident scenarios with large releases of hazardous materials were triggered by these natural events, causing so-called "Natech events", in which the overall damage resulted from the simultaneous consequences of the natural event and of the release of hazardous substances. Toxic releases, large fires and explosions, as well as possible long-term environmental pollution, economical losses, and overloading of emergency systems were recognised by post-event studies as the main issues of these Natech scenarios. In recent years the increasing frequency and severity of some natural hazards due to climate change has slowly increased the awareness of Natech risk as an emerging risk among the stakeholders. Indeed, the iNTeg-Risk project, co-funded by the European Commission within the 7th Framework Program specifically addresses these scenarios among new technological issues on public safety. The present study, in part carried out within the iNTeg-Risk project, was aimed at the analysis and further development of methods and tools for the assessment and mitigation of Natech accidents. Available tools and knowledge gaps in the assessment of Natech scenarios were highlighted. The analysis mainly addressed the potential impact of flood, lightning and earthquake events on industrial installations where hazardous substances are present. Preliminary screening methodologies and more detailed methods based on

  17. Prevalence of risk factors for cardiovascular disease in paramedics.

    PubMed

    Hegg-Deloye, S; Brassard, P; Prairie, J; Larouche, D; Jauvin, N; Poirier, P; Tremblay, A; Corbeil, P

    2015-10-01

    Occupational stress and obesity are very prevalent in emergency workers. Some studies have also associated high tobacco consumption rates with occupational stress. Each of these factors is known to increase cardiovascular risk. The aim of this study was to evaluate the prevalence of occupational stress, overweight and tobacco consumption in paramedics. This cross-sectional study of paramedics consisted in a self-report survey of 44 questions divided into two sections. The first section collected demographic information and the second evaluated occupational stressors. The questions were designed to determine the prevalence of work-related psychosocial factors, overweight (body mass index ≥ 25 kg/m(2)) and tobacco consumption (cig/day ≥ 1). The demand-control-social support model and the effort-reward model were used to estimate job strain, iso-strain and imbalance in effort and reward. More than 88 % of paramedics reported at least one cardiovascular risk factor, with males reporting more risk factors than females. Ninety percent of male paramedics reported occupational stress, 12 % reported smoking, and 79 % were overweight or obese by self-report. The prevalence of occupational stress and smoking was similar for female paramedics, but with a lower prevalence of overweight (37 %). By self-report, nine out of ten paramedics are at risk of developing cardiovascular disease. Both individual and organizational efforts should be made to educate and support paramedics and their organizations in reducing these workers' cardiovascular risk.

  18. The epidemiology and risk factors of inflammatory bowel disease

    PubMed Central

    Ye, Yulan; Pang, Zhi; Chen, Weichang; Ju, Songwen; Zhou, Chunli

    2015-01-01

    This review aimed to summarize the epidemiology (incidence, prevalence and morality) and risk factors of inflammatory bowel disease (IBD). IBD is a chronic, relapsing, inflammatory disorder of the gastrointestinal tract and includes Crohn’s Disease (CD) and ulcerative colitis (UC). IBD has increasing incidence and prevalence in most of countries and becomes a global emerging disease. A westernized lifestyle or habits and some environmental factors have been found to contribute to the pathogenesis of IBD. The relevant risk factors include Smoking, hygiene hypothesis, microorganisms, appendectomy, medication, nutrition, and stress have all been found to be associated with the modality of IBD, but results are inconsistent on this issue in available studies. Therefore, more studies are required to identify and understand the environmental determinants of IBD. PMID:26885239

  19. The epidemiology and risk factors of inflammatory bowel disease.

    PubMed

    Ye, Yulan; Pang, Zhi; Chen, Weichang; Ju, Songwen; Zhou, Chunli

    2015-01-01

    This review aimed to summarize the epidemiology (incidence, prevalence and morality) and risk factors of inflammatory bowel disease (IBD). IBD is a chronic, relapsing, inflammatory disorder of the gastrointestinal tract and includes Crohn's Disease (CD) and ulcerative colitis (UC). IBD has increasing incidence and prevalence in most of countries and becomes a global emerging disease. A westernized lifestyle or habits and some environmental factors have been found to contribute to the pathogenesis of IBD. The relevant risk factors include Smoking, hygiene hypothesis, microorganisms, appendectomy, medication, nutrition, and stress have all been found to be associated with the modality of IBD, but results are inconsistent on this issue in available studies. Therefore, more studies are required to identify and understand the environmental determinants of IBD.

  20. Environmental Risk Factors for Inflammatory Bowel Disease

    PubMed Central

    Molodecky, Natalie A.

    2010-01-01

    Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the gastrointestinal tract and is associated with significant morbidity. The etiology of IBD has been extensively studied during the last several decades; however, causative factors in disease pathology are not yet fully understood. IBD is thought to result from the interaction between genetic and environmental factors that influence the normal intestinal commensal flora to trigger an inappropriate mucosal immune response. Although many IBD susceptibility genes have been discovered, similar advances in defining environmental risk factors have lagged. A number of environmental risk factors have been explored, including smoking, appendectomy, oral contraceptives, diet, breastfeeding, infections/ vaccinations, antibiotics, and childhood hygiene. However, most of these factors have demonstrated inconsistent findings, thus making additional studies necessary to better understand the etiology of IBD. PMID:20567592

  1. Perfluorinated Alkyl Substances: Emerging Insights Into Health Risks.

    PubMed

    Grandjean, Philippe; Clapp, Richard

    2015-08-01

    Perfluorinated alkyl substances have been in use for over sixty years. These highly stable substances were at first thought to be virtually inert and of low toxicity. Toxicity information slowly emerged on perfluorooctanoic acid and perfluorooctane sulfonate. More than thirty years ago, early studies reported immunotoxicity and carcinogenicity effects. The substances were discovered in blood samples from exposed workers, then in the general population and in community water supplies near U.S. manufacturing plants. Only recently has research publication on perfluorooctanoic acid and perfluorooctane sulfonate intensified. While the toxicology database is still far from complete, carcinogenicity and immunotoxicity now appear to be relevant risks at prevalent exposure levels. Existing drinking water limits are based on less complete evidence that was available before 2008 and may be more than 100-fold too high. As risk evaluations assume that untested effects do not require regulatory attention, the greatly underestimated health risks from perfluorooctanoic acid and perfluorooctane sulfonate illustrate the public health implications of assuming the safety of incompletely tested industrial chemicals. © The Author(s) 2015.

  2. Visual Impairment and Intracranial Hypertension: An Emerging Spaceflight Risk

    NASA Technical Reports Server (NTRS)

    Fogarty, Jennifer A.; Polk, J. D.; Tarver, W.; Gibson, C. R.; Sargsyan, A.; Taddeo, T.; Alexander, D.; Otto, C.

    2010-01-01

    What is the risk? Given that astronauts exposed to microgravity experience a cephalad fluid shift, and that both symptomatic and asymptomatic astronauts have exhibited optic nerve sheath edema on MRI, there is a high probability that all astronauts have some degree of increased intracranial pressure (ICP; intracranial hypertension), and that those susceptible (via eye architecture, anatomy, narrow optic disc) have a high likelihood of developing papilledema (optic disc edema, globe flattening), choroidal folds, and/or hyperopic shifts and that the degree of edema may determine long-term or permanent vision impairment or loss. Back to back panels on this topic have been developed to address this emerging risk. The first panel will focus on the 6 clinical cases with emphasis on ophthalmic findings and imaging techniques used pre-, in-, and post-flight. The second panel will discuss the operational mitigation and medical requirements, the potential role of CO2 on ISS, and the research approach being developed. In total these back to back panels will explore what is known about this risk, what has been done immediately to address it, and how an integrated research model is being developed.

  3. High risk factors of pancreatic carcinoma.

    PubMed

    Camara, Soriba Naby; Yin, Tao; Yang, Ming; Li, Xiang; Gong, Qiong; Zhou, Jing; Zhao, Gang; Yang, Zhi-Yong; Aroun, Tajoo; Kuete, Martin; Ramdany, Sonam; Camara, Alpha Kabinet; Diallo, Aissatou Taran; Feng, Zhen; Ning, Xin; Xiong, Jiong-Xin; Tao, Jing; Qin, Qi; Zhou, Wei; Cui, Jing; Huang, Min; Guo, Yao; Gou, Shan-Miao; Wang, Bo; Liu, Tao; Olivier, Ohoya Etsaka Terence; Conde, Tenin; Cisse, Mohamed; Magassouba, Aboubacar Sidiki; Ballah, Sneha; Keita, Naby Laye Moussa; Souare, Ibrahima Sory; Toure, Aboubacar; Traore, Sadamoudou; Balde, Abdoulaye Korse; Keita, Namory; Camara, Naby Daouda; Emmanuel, Dusabe; Wu, He-Shui; Wang, Chun-You

    2016-06-01

    Over the past decades, cancer has become one of the toughest challenges for health professionals. The epidemiologists are increasingly directing their research efforts on various malignant tumor worldwide. Of note, incidence of cancers is on the rise more quickly in developed countries. Indeed, great endeavors have to be made in the control of the life-threatening disease. As we know it, pancreatic cancer (PC) is a malignant disease with the worst prognosis. While little is known about the etiology of the PC and measures to prevent the condition, so far, a number of risk factors have been identified. Genetic factors, pre-malignant lesions, predisposing diseases and exogenous factors have been found to be linked to PC. Genetic susceptibility was observed in 10% of PC cases, including inherited PC syndromes and familial PC. However, in the remaining 90%, their PC might be caused by genetic factors in combination with environmental factors. Nonetheless, the exact mechanism of the two kinds of factors, endogenous and exogenous, working together to cause PC remains poorly understood. The fact that most pancreatic neoplasms are diagnosed at an incurable stage of the disease highlights the need to identify risk factors and to understand their contribution to carcinogenesis. This article reviews the high risk factors contributing to the development of PC, to provide information for clinicians and epidemiologists.

  4. What Are the Risk Factors for Chronic Myeloid Leukemia?

    MedlinePlus

    ... What Are the Risk Factors for Chronic Myeloid Leukemia? A risk factor is something that affects a ... Myeloid Leukemia Be Prevented? More In Chronic Myeloid Leukemia About Chronic Myeloid Leukemia Causes, Risk Factors, and ...

  5. What Are the Risk Factors for Thymus Cancer?

    MedlinePlus

    ... and Prevention What Are the Risk Factors for Thymus Cancer? A risk factor is anything that affects ... Cancer? Can Thymus Cancer Be Prevented? More In Thymus Cancer About Thymus Cancer Causes, Risk Factors, and ...

  6. What Are the Risk Factors for Kidney Cancer?

    MedlinePlus

    ... and Prevention What Are the Risk Factors for Kidney Cancer? A risk factor is anything that affects ... not cancer). Other risk factors Family history of kidney cancer People with a strong family history of ...

  7. What Are the Risk Factors for Small Intestine Adenocarcinoma?

    MedlinePlus

    ... Prevention What Are the Risk Factors for Small Intestine Adenocarcinoma? A risk factor is anything that changes ... Small Intestine Adenocarcinoma Be Prevented? More In Small Intestine Cancer About Small Intestine Cancer Causes, Risk Factors, ...

  8. The role of romantic relationship status in pathways of risk for emerging adult alcohol use

    PubMed Central

    Salvatore, Jessica E.; Thomas, Nathaniel S.; Cho, Seung Bin; Adkins, Amy; Kendler, Kenneth S.; Dick, Danielle M.

    2015-01-01

    Dating several people in emerging adulthood has been associated with higher alcohol use compared to being single or being in an exclusive relationship. As a follow-up to that report, we examined whether romantic relationship status is part of a pathway of risk between antecedent alcohol use risk factors and subsequent alcohol outcomes. Participants were 4,410 emerging adults assessed at two time-points during their first year of college. We found that a parental history of alcohol problems was indirectly related to dating several people via two modestly correlated pathways. The first pathway was through conduct problems. The second pathway was through positive urgency (i.e., a positive emotion-based predisposition to rash action). In turn, dating several people was associated with higher alcohol use. Our results suggest that these familial and individual-level alcohol risk factors are related to emerging adults' selection into subsequent romantic relationship experiences that are associated with higher alcohol use. These findings have implications for how romantic relationship experiences may fit into developmental models of the etiology of alcohol use. PMID:27214170

  9. The role of romantic relationship status in pathways of risk for emerging adult alcohol use.

    PubMed

    Salvatore, Jessica E; Thomas, Nathaniel S; Cho, Seung Bin; Adkins, Amy; Kendler, Kenneth S; Dick, Danielle M

    2016-05-01

    Dating several people in emerging adulthood has been associated with higher alcohol use compared with being single or being in an exclusive relationship. As a follow-up to that report, we examined whether romantic relationship status is part of a pathway of risk between antecedent alcohol use risk factors and subsequent alcohol outcomes. Participants were 4,410 emerging adults assessed at 2 time-points during their first year of college. We found that a parental history of alcohol problems was indirectly related to dating several people via 2 modestly correlated pathways. The first pathway was through conduct problems. The second pathway was through positive urgency (i.e., a positive emotion-based predisposition to rash action). In turn, dating several people was associated with higher alcohol use. Our results suggest that these familial and individual-level alcohol risk factors are related to emerging adults' selection into subsequent romantic relationship experiences that are associated with higher alcohol use. These findings have implications for how romantic relationship experiences may fit into developmental models of the etiology of alcohol use. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  10. Gene polymorphisms in association with emerging cardiovascular risk markers in adult women.

    PubMed

    Fan, Amy Z; Yesupriya, Ajay; Chang, Man-huei; House, Meaghan; Fang, Jing; Ned, Renée; Hayes, Donald; Dowling, Nicole F; Mokdad, Ali H

    2010-01-15

    Evidence on the associations of emerging cardiovascular disease risk factors/markers with genes may help identify intermediate pathways of disease susceptibility in the general population. This population-based study is aimed to determine the presence of associations between a wide array of genetic variants and emerging cardiovascular risk markers among adult US women. The current analysis was performed among the National Health and Nutrition Examination Survey (NHANES) III phase 2 samples of adult women aged 17 years and older (sample size n = 3409). Fourteen candidate genes within ADRB2, ADRB3, CAT, CRP, F2, F5, FGB, ITGB3, MTHFR, NOS3, PON1, PPARG, TLR4, and TNF were examined for associations with emerging cardiovascular risk markers such as serum C-reactive protein, homocysteine, uric acid, and plasma fibrinogen. Linear regression models were performed using SAS-callable SUDAAN 9.0. The covariates included age, race/ethnicity, education, menopausal status, female hormone use, aspirin use, and lifestyle factors. In covariate-adjusted models, serum C-reactive protein concentrations were significantly (P value controlling for false-discovery rate < or = 0.05) associated with polymorphisms in CRP (rs3093058, rs1205), MTHFR (rs1801131), and ADRB3 (rs4994). Serum homocysteine levels were significantly associated with MTHFR (rs1801133). The significant associations between certain gene variants with concentration variations in serum C-reactive protein and homocysteine among adult women need to be confirmed in further genetic association studies.

  11. Perinatal risk factors and infantile autism.

    PubMed

    Maimburg, R D; Vaeth, M

    2006-10-01

    Suboptimal conditions during pregnancy and birth have been suggested as a cause of infantile autism. We have studied the association between obstetric factors and infantile autism. A population-based, matched case-control study of infantile autism. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). The risk of infantile autism was increased for mothers aged >35 years, with foreign citizenship, and mothers who used medicine during pregnancy. A higher risk of infantile autism was seen among children with low birth weight and with congenital malformations. Birth interventions, pathological cardiotocography, green amnion fluid and acidosis during delivery were not associated with increased risk for infantile autism. Our findings suggest that suboptimal birth conditions are not an independent risk factor for infantile autism. A high prevalence of low birth weight and birth defects among autism cases seems to explain the suboptimal birth outcome.

  12. Stroke in Women: Risk Factors and Clinical Biomarkers.

    PubMed

    Mirzaei, Hamed

    2017-05-12

    Stroke has been emerged as one of major health problems for women worldwide. Increasing of knowledge in this field has provided new data in this area which contribute to finding of new risk factors and could improve stroke treatment. A large number studies indicated a variety of risk factors including sex, age, race, smoking, diabetes, and physical inactivity could be involved in stroke in women. The understanding of various aspects involved in women stroke including risk factors, outcomes, stroke recovery, and prevention could provide new therapeutic platforms which could likely lead to better treatment in women stroke. Diagnosis is one of important steps in stroke therapy. It has been showed that a variety of biomarkers such as microRNAs (miRNAs), tPA, and von willebrand factor could be used as therapeutic and diagnostic biomarkers in stroke therapy. Here, we summarized various aspects of stroke in women which could help to recognition risk factors, outcomes, care, treatment, and novel biomarkers involve in treatment of stroke. J. Cell. Biochem. 9999: 1-12, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  13. Risk factors for Clostridium difficile infection.

    PubMed

    Bignardi, G E

    1998-09-01

    A systematic review of the literature to identify risk factors associated with Clostridium difficile infection was conducted. Two main outcomes were considered: C. difficile diarrhoea and C. difficile carriage. A qualitative assessment, based on a set of defined and consistently applied criteria, appeared to be the best approach for risk factors other than antibiotic use, as an approach based on meta-analysis would have utilized only the information provided by a minority of the studies. Risk factors for which there was evidence suggestive or consistent with an association with C. difficile diarrhoea were: increasing age (excluding infancy), severity of underlying diseases, non-surgical gastrointestinal procedures, presence of a nasogastric tube, anti-ulcer medications, stay on ITU, duration of hospital stay, duration of antibiotic course, administration of multiple antibiotics. For malignant haematological disorders there was evidence of an association only with C. difficile carriage, but there were no suitable studies to explore a possible association of this risk factor with symptomatic infection. Antibiotic use lent itself to quantitative assessment with meta-analysis using logistic regression. Exposure to an antibiotic was shown to be statistically significantly associated with both C. difficile diarrhoea and C. difficile carriage. The meta-analysis approach enabled the ranking of individual antibiotics in relation to the risk of C. difficile infection, though the 95% confidence intervals were often wide and overlapping. Antibiotics associated with a lower risk of C. difficile diarrhoea should be considered, especially when attempting to control a C. difficile outbreak or when prescribing for a patient with other C. difficile risk factors. This systematic review of the literature enabled the identification of features it would be desirable to consider in future epidemiological studies.

  14. Risk and Protective Factors and Achievement of Children At Risk.

    ERIC Educational Resources Information Center

    Krasner, Diane

    A study was done to identify social, economic, and childhood characteristics of high and low achieving children living in adverse environmental conditions, and to test the association between achievement and specific risk and protective factors. In addition, the study identified the most powerful model for predicting achievement by comparing…

  15. Enhanced risk management by an emerging multi-agent architecture

    NASA Astrophysics Data System (ADS)

    Lin, Sin-Jin; Hsu, Ming-Fu

    2014-07-01

    Classification in imbalanced datasets has attracted much attention from researchers in the field of machine learning. Most existing techniques tend not to perform well on minority class instances when the dataset is highly skewed because they focus on minimising the forecasting error without considering the relative distribution of each class. This investigation proposes an emerging multi-agent architecture, grounded on cooperative learning, to solve the class-imbalanced classification problem. Additionally, this study deals further with the obscure nature of the multi-agent architecture and expresses comprehensive rules for auditors. The results from this study indicate that the presented model performs satisfactorily in risk management and is able to tackle a highly class-imbalanced dataset comparatively well. Furthermore, the knowledge visualised process, supported by real examples, can assist both internal and external auditors who must allocate limited detecting resources; they can take the rules as roadmaps to modify the auditing programme.

  16. Risk Factors for Recurrent Lumbar Disc Herniations

    PubMed Central

    2014-01-01

    The most common complication after lumbar discectomy is reherniation. As the first step in reducing the rate of recurrence, many studies have been conducted to find out the factors that may increase the reherniation risk. Some reported factors are age, sex, the type of lumbar disc herniation, the amount of fragments removed, smoking, alcohol consumption and the length of restricted activities. In this review, the factors studied thus far are summarized, excepting factors which cannot be chosen or changed, such as age or sex. Apart from the factors shown here, many other risk factors such as diabetes, family history, history of external injury, duration of illness and body mass index are considered. Few are agreed upon by all. The reason for the diverse opinions may be that many clinical and biomechanical variables are involved in the prognosis following operation. For the investigation of risk factors in recurrent lumbar disc herniation, large-scale multicenter prospective studies will be required in the future. PMID:24761206

  17. Pattern of Investigation Reflects Risk Profile in Emergency Medical Admissions

    PubMed Central

    Cournane, Seán; Byrne, Declan; O’Riordan, Deirdre; Sheehy, Niall; Silke, Bernard

    2015-01-01

    Demand for hospital resources may increase over time; we have examined all emergency admissions (51,136 episodes) from 2005 to 2013 for underlying trends and whether resource utilization and clinical risk are correlated. We used logistic regression of the resource indicator against 30-day in-hospital mortality and adjusted this risk estimate for other outcome predictors. Generally, resource indicators predicted an increased risk of a 30-day in-hospital death. For CT Brain the Odds Ratio (OR) was 1.37 (95% CI: 1.27, 1.50), CT Abdomen 3.48 (95% CI: 3.02, 4.02) and CT Chest, Thorax, Abdomen and Pelvis 2.50 (95% CI: 2.10, 2.97). Services allied to medicine including Physiotherapy 2.57 (95% CI: 2.35, 2.81), Dietetics 2.53 (95% CI: 2.27, 2.82), Speech and Language 5.29 (95% CI: 4.57, 6.05), Occupational Therapy 2.65 (95% CI: 2.38, 2.94) and Social Work 1.65 (95% CI: 1.48, 1.83) all predicted an increased risk. The in-hospital 30-day mortality increased with resource utilization, from 4.7% (none) to 27.0% (five resources). In acute medical illness, the use of radiological investigations and allied professionals increased over time. Resource utilization was calibrated from case complexity/30-day in-hospital mortality suggesting that complexity determined the need for and validated the use of these resources. PMID:26239468

  18. Step Complexity Measure for Emergency Operating Procedures - Determining Weighting Factors

    SciTech Connect

    Park, Jinkyun; Jung, Wondea; Kim, Jaewhan; Ha, Jaejoo

    2003-09-15

    In complex systems, such as nuclear power plants (NPPs) or airplane control systems, human error has been regarded as the primary cause of many events. Therefore, to ensure system safety, extensive effort has been made to identify the significant factors that can cause human error. According to related studies, written manuals or operating procedures are revealed as one of the important factors, and the understandability is pointed out as one of the major reasons for procedure-related human errors.Many qualitative checklists have been suggested to evaluate emergency operating procedures (EOPs) of NPPs so as to minimize procedure-related human errors. However, since qualitative evaluations using checklists have some drawbacks, a quantitative measure that can quantify the complexity of EOPs is indispensable.From this necessity, Park et al. suggested the step complexity (SC) measure to quantify the complexity of procedural steps included in EOPs. To verify the appropriateness of the SC measure, averaged step performance time data obtained from emergency training records of the loss-of-coolant accident (LOCA) and the excess steam demand event were compared with estimated SC scores. However, although averaged step performance time data and estimated SC scores show meaningful correlation, some important issues such as determining proper weighting factors have to be clarified to ensure the appropriateness of the SC measure. These were not properly dealt with due to a lack of backup data.In this paper, to resolve one of the important issues, emergency training records are additionally collected and analyzed in order to determine proper weighting factors. The total number of collected records is 66, and the training scenarios cover five emergency conditions including the LOCA, the steam generator tube rupture, the loss of all feedwater, the loss of off-site power, and the station blackout. From these records, average step performance time data are retrieved, and new

  19. A Conceptual Framework for the Evaluation of Emergency Risk Communications.

    PubMed

    Savoia, Elena; Lin, Leesa; Gamhewage, Gaya M

    2017-09-01

    To articulate a conceptual framework in support of evaluation activities in emergency risk communications (ERC). The framework proposed is based on a systematic review of the scientific literature (2001-2016) combined with data derived from a series of semistructured interviews with experts and practitioners in ERC, and it is designed to support local, national, and international public health organizations in implementing evaluation studies in ERC. We identified a list of ERC outcomes from the full-text review of 152 articles and categorized these into 3 groups, depending upon the level at which the outcome was measured: (1) information environment, (2) population, and (3) public health system. We analyzed interviewees' data from 18 interviews to identify practices and processes related to the effectiveness of ERC and included these as key structural components and processes in the developed evaluation framework. Researchers and public health practitioners interested in the evaluation of ERC can use the conceptual framework described in this article to guide the development of evaluation studies and methods for assessing communication outcomes related to public health emergencies.

  20. Indicators of emerging hazards and risks to food safety.

    PubMed

    Kleter, Gijs A; Marvin, Hans J P

    2009-05-01

    There is a widely felt need to develop methods for the early identification of emerging hazards to food safety with the aim of preventing these hazards from becoming real risks and causing incidents. This paper reviews various activities and previous reports that describe methods to select indicators that can be used for the purpose of early identification of hazards. These indicators have been divided over three different environments, including (i) the environment surrounding food production, (ii) the food production chain from farm to fork, and (iii) consumers. Changes in these indicators are signals that may require follow-up action. Besides indicators that are linked to specific kinds of hazards, the indicators used for vulnerability assessment can help identifying weak spots in the food production system that are sensitive to a broader range of hazards. Based on the various indicators for emerging hazards that have thus been identified in literature, a set of generic indicators is provided that can be useful for the early identification of hazards.

  1. A Conceptual Framework for the Evaluation of Emergency Risk Communications

    PubMed Central

    Lin, Leesa; Gamhewage, Gaya M.

    2017-01-01

    Objectives. To articulate a conceptual framework in support of evaluation activities in emergency risk communications (ERC). Methods. The framework proposed is based on a systematic review of the scientific literature (2001–2016) combined with data derived from a series of semistructured interviews with experts and practitioners in ERC, and it is designed to support local, national, and international public health organizations in implementing evaluation studies in ERC. Results. We identified a list of ERC outcomes from the full-text review of 152 articles and categorized these into 3 groups, depending upon the level at which the outcome was measured: (1) information environment, (2) population, and (3) public health system. We analyzed interviewees’ data from 18 interviews to identify practices and processes related to the effectiveness of ERC and included these as key structural components and processes in the developed evaluation framework. Conclusions. Researchers and public health practitioners interested in the evaluation of ERC can use the conceptual framework described in this article to guide the development of evaluation studies and methods for assessing communication outcomes related to public health emergencies. PMID:28892436

  2. [Multidrug-resistant tuberculosis: epidemiology and risk factors].

    PubMed

    Smaoui Fourati, S; Mzid, H; Marouane, C; Kammoun, S; Messadi-Akrout, F

    2015-08-01

    Despite the availability of potent drugs and the availability of vaccine, tuberculosis remains until today one of the most worrying infectious diseases because of both its morbidity and mortality. This serious health problem is further complicated by the emergence of multidrug-resistant (MDR) or extensively drug-resistant strains (XDR). The number of MDR and XDR strains has continued to increase in recent years. Therefore, it is necessary to determine the risk factors leading to the emergence of MDR-TB strains to improve its overall management. Most studies indicate that the irregular previous treatment of tuberculosis with poor adherence is the main risk factor found. Other risk factors such as digestive issues, age, sex, and immunosuppression have been reported by several studies. In Tunisia, MDR-TB prevalence remains low with 0.8% among new cases and 12% among the restatements but control of this disease is necessary and remains essentially preventive. It is based on real preventive strategies planned according to local and updated regional data.

  3. Risk factors for osteoporosis: A review.

    PubMed

    Guthrie, J R; Dennerstein, L; Wark, J D

    2000-01-01

    Skeletal fragility and falls are the 2 most potent factors leading to osteoporotic fractures. The aim of this article is to review factors associated with women's risk of developing skeletal fragility and subsequent osteoporosis. Many factors have been implicated, but the evidence for some is unsubstantial. Low premenopausal bone mineral density (BMD), a decrease in BMD, and an increase in bone fragility -- which occur as a result of both aging and the menopause -- are major determinants of subsequent risk for osteoporotic fracture. In addition, low body mass index (BMI), low calcium intake, low physical activity, and smoking can affect BMD. The relative importance of the effects these physical and lifestyle factors have on BMD in midlife women is not fully established. The impact of gynecologic history (parity, lactation, oral contraceptive use, age of menarche) on BMD is uncertain.

  4. Risk factors analysis of consecutive exotropia

    PubMed Central

    Gong, Qianwen; Wei, Hong; Zhou, Xu; Li, Ziyuan; Liu, Longqian

    2016-01-01

    Abstract To evaluate clinical factors associated with the onset of consecutive exotropia (XT) following esotropia surgery. By a retrospective nested case-control design, we reviewed the medical records of 193 patients who had undergone initial esotropia surgery between 2008 and 2015, and had follow-up longer than 6 months. The probable risk factors were evaluated between groups 1 (consecutive XT) and 2 (non-consecutive exotropia). Pearson chi-square test and Mann–Whitney U test were used for univariate analysis, and conditional logistic regression model was applied for exploring the potential risk factors of consecutive XT. Consecutive exotropia occurred in 23 (11.9%) of 193 patients. Patients who had undergone large bilateral medial rectus recession (BMR) (P = 0.017) had a high risk of developing consecutive XT. Oblique dysfunction (P = 0.001), adduction limitation (P = 0.000) were associated with a high risk of consecutive XT, which was confirmed in the conditional logistic regression analysis. In addition, large amount of BMR (6 mm or more) was associated with higher incidence of adduction limitation (P = 0.045). The surgical methods and preoperative factors did not appear to influence the risk of developing consecutive XT (P > 0.05). The amount of surgery could be optimized to reduce the risk of consecutive XT. The presence of oblique overaction and postoperative adduction limitation may be associated with a high risk of consecutive XT, which may require close supervision, and/or even earlier operation intervention. PMID:27977611

  5. Risk factors for mortality in Down syndrome.

    PubMed

    Uppal, H; Chandran, S; Potluri, R

    2015-09-01

    Down syndrome is a genetic condition that contributes to a significantly shorter life expectancy compared with the general population. We investigated the most common comorbidities in a population of acute hospital patients with Down syndrome and further explored what the most common risk factors for mortality are within this population. From our database of one million patients admitted to National Health Service (NHS) Trusts in northern England, we identified 558 people who had Down syndrome. We compared this group with an age- and gender-matched control group of 5580 people. The most prevalent comorbid diseases within the Down's population were hypothyroidism (22.9%) and epilepsy (20.3%). However, the conditions that had the highest relative risks (RRs) in the Down's population were septal defects and dementia. Respiratory failure, dementia and pneumonia were the most significantly related comorbidities to mortality in the Down syndrome population. In the control population, respiratory failure, dementia and renal failure were the most significant disease contributors. When these contributors were analysed using multivariate analysis, heart failure, respiratory failure, pneumonia and epilepsy were the identified risk factors for in-hospital mortality in the Down syndrome population. Respiratory failure was the sole risk factor for mortality in the Down syndrome population [RR = 9.791 (1.6-59.9) P ≤ 0.05], when compared with the risk factors for mortality in the control population. There is significant medical morbidity in Down syndrome. This morbidity contributes to the lower life expectancy. Respiratory failure is a risk factor for mortality in Down syndrome. We need to thoroughly investigate people with Down syndrome to ensure any treatable illnesses are well managed. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  6. Coronary artery disease in South Asians: an emerging risk group.

    PubMed

    Bedi, Updesh Singh; Singh, Sarabjeet; Syed, Asmir; Aryafar, Hamed; Arora, Rohit

    2006-01-01

    Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide and was responsible for 7.2 million deaths in 2003. Various studies have pointed out that South Asians have a higher prevalence of CAD as compared with other ethnicities. South Asians may have a genetic predisposition to CAD; however, environmental, nutritional, and lifestyle factors may also be responsible. South Asians have a much higher prevalence of metabolic syndrome, diabetes, insulin resistance (and resultant hyperinsulinemia), central obesity, dyslipidemias (lower high-density lipoprotein, increased lipoprotein[a], higher triglyceride levels), increased thrombotic tendency (increased plasminogen activator inhibitor-1 and decreased tissue plasminogen activator levels), decreased levels of physical activity, and low birth weights ("fetal origins hypothesis"). In addition, the dietary indiscretions and sedentary lifestyle practiced by most South Asians puts them at a higher risk. A multidisciplinary approach involving the population at risk, healthcare personnel, and the government is required to diminish the incidence. Educational programs regarding the genetic predisposition as well as risk factors for CAD, physical activity, and dietary modifications need to be encouraged. There is a need for implementation of newer guidelines as well as a lower threshold for initiating therapeutic interventions in this population. Mass media should be involved to bring about behavioral changes, and these changes should be reinforced at the physician's level.

  7. Risk factors associated with provoked pulmonary embolism

    PubMed Central

    Gjonbrataj, Endri; Kim, Ji Na; Gjonbrataj, Juarda; Jung, Hye In; Kim, Hyun Jung; Choi, Won-Il

    2017-01-01

    Background/Aims This study aimed to investigate the risk factors associated with provoked pulmonary embolism (PE). Methods This retrospective cohort study included 237 patients with PE. Patients that had transient risk factors at diagnosis were classified as having provoked PE, with the remaining patients being classified as having unprovoked PE. The baseline clinical characteristics and factors associated with coagulation were compared. We evaluated the risk factors associated with provoked PE. Results Of the 237 PE patients, 73 (30.8%) had provoked PE. The rate of respiratory failure and infection, as well as the disseminated intravascular coagulation score and ratio of right ventricular diameter to left ventricular diameter were significantly higher in patients with provoked PE than in those with unprovoked PE. The protein and activity levels associated with coagulation, including protein C antigen, protein S antigen, protein S activity, anti-thrombin III antigen, and factor VIII, were significantly lower in patients with provoked PE than in those with unprovoked PE. Multivariate analysis showed that infection (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.4 to 7.4) and protein S activity (OR, 0.97; 95% CI, 0.95 to 0.99) were significantly associated with provoked PE. Conclusions Protein S activity and presence of infection were important factors associated with provoked PE. We should pay attention to the presence of infection in patients with provoked PE. PMID:27097772

  8. Cardiovascular Risk Factors in Severely Obese Adolescents

    PubMed Central

    Michalsky, Marc P.; Inge, Thomas H.; Simmons, Mark; Jenkins, Todd M.; Buncher, Ralph; Helmrath, Michael; Brandt, Mary L.; Harmon, Carroll M.; Courcoulas, Anita; Chen, Michael; Horlick, Mary; Daniels, Stephen R.; Urbina, Elaine M.

    2015-01-01

    IMPORTANCE Severe obesity is increasingly common in the adolescent population but, as of yet, very little information exists regarding cardiovascular disease (CVD) risks in this group. OBJECTIVE To assess the baseline prevalence and predictors of CVD risks among severely obese adolescents undergoing weight-loss surgery. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study was conducted from February 28, 2007, to December 30, 2011, at the following 5 adolescent weight-loss surgery centers in the United States: Nationwide Children’s Hospital in Columbus, Ohio; Cincinnati Children’s Hospital Medical Center in Cincinnati, Ohio; Texas Children’s Hospital in Houston; University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania; and Children’s Hospital of Alabama in Birmingham. Consecutive patients aged 19 years or younger were offered enrollment in a long-term outcome study; the final analysis cohort consisted of 242 participants. MAIN OUTCOMES AND MEASURES This report examined the preoperative prevalence of CVD risk factors (ie, fasting hyperinsulinemia, elevated high-sensitivity C-reactive protein levels, impaired fasting glucose levels, dyslipidemia, elevated blood pressure, and diabetes mellitus) and associations between risk factors and body mass index (calculated as weight in kilograms divided by height in meters squared), age, sex, and race/ethnicity. Preoperative data were collected within 30 days preceding bariatric surgery. RESULTS The mean (SD) age was 17 (1.6) years and median body mass index was 50.5. Cardiovascular disease risk factor prevalence was fasting hyperinsulinemia (74%), elevated high-sensitivity C-reactive protein levels (75%), dyslipidemia (50%), elevated blood pressure (49%), impaired fasting glucose levels (26%), and diabetes mellitus (14%). The risk of impaired fasting glucose levels, elevated blood pressure, and elevated high-sensitivity C-reactive protein levels increased by 15%, 10%, and 6%, respectively, per 5-unit

  9. Review of risk from potential emerging contaminants in UK groundwater.

    PubMed

    Stuart, Marianne; Lapworth, Dan; Crane, Emily; Hart, Alwyn

    2012-02-01

    This paper provides a review of the types of emerging organic groundwater contaminants (EGCs) which are beginning to be found in the UK. EGCs are compounds being found in groundwater that were previously not detectable or known to be significant and can come from agricultural, urban and rural point sources. EGCs include nanomaterials, pesticides, pharmaceuticals, industrial compounds, personal care products, fragrances, water treatment by-products, flame retardants and surfactants, as well as caffeine and nicotine. Many are relatively small polar molecules which may not be effectively removed by drinking water treatment. Data from the UK Environment Agency's groundwater screening programme for organic pollutants found within the 30 most frequently detected compounds a number of EGCs such as pesticide metabolites, caffeine and DEET. Specific determinands frequently detected include pesticides metabolites, pharmaceuticals including carbamazepine and triclosan, nicotine, food additives and alkyl phosphates. This paper discusses the routes by which these compounds enter groundwater, their toxicity and potential risks to drinking water and the environment. It identifies challenges that need to be met to minimise risk to drinking water and ecosystems. Copyright © 2012. Published by Elsevier B.V.

  10. Exploring Risk Factors for Follicular Lymphoma

    PubMed Central

    Ambinder, Alexander J.; Shenoy, Pareen J.; Malik, Neha; Maggioncalda, Alison; Nastoupil, Loretta J.; Flowers, Christopher R.

    2012-01-01

    Follicular lymphoma (FL) is an indolent malignancy of germinal center B cells with varied incidence across racial groups and geographic regions. Improvements in the classification of non-Hodgkin lymphoma subtypes provide an opportunity to explore associations between environmental exposures and FL incidence. Our paper found that aspects of Western lifestyle including sedentary lifestyle, obesity, and diets high in meat and milk are associated with an increased risk of FL. Diets rich in fruits and vegetables, polyunsaturated fatty acids, vitamin D, and certain antioxidants are inversely associated with FL risk. A medical history of Sjogren's syndrome, influenza vaccination, and heart disease may be associated with FL incidence. Associations between FL and exposure to pesticides, industrial solvents, hair dyes, and alcohol/tobacco were inconsistent. Genetic risk factors include variants at the 6p21.32 region of the MHC II locus, polymorphisms of the DNA repair gene XRCC3, and UV exposure in individuals with certain polymorphisms of the vitamin D receptor. Increasing our understanding of risk factors for FL must involve integrating epidemiological studies of genetics and exposures to allow for the examination of risk factors and interactions between genes and environment. PMID:23028387

  11. [Cardiovascular risk factors in Chilean university students].

    PubMed

    Chiang-Salgado, M T; Casanueva-Escobar, V; Cid-Cea, X; González-Rubilar, U; Olate-Mellado, P; Nickel-Paredes, F; Revello-Chiang, L

    1999-01-01

    To study the prevalence of cardiovascular risk factors in asymptomatic university students of both sexes, aged 18 to 25 years. Serum lipid levels were measured in a subsample of 293 subjects, using a Hitachi 717 chemical analyzer. Obesity was classified using body mass index (BMI) measurements. A self-applied questionnaire was used to collect data on sedentary life style, family history of cardiovascular disease and cigarette smoking. Statistical associations of lipid levels with lipidic and non-lipidic risk factors were assessed using Pearson's chi-square test and multiple regression. We found lipid risk levels in 29.2% for total cholesterol (CT), 16.2% for low-density lipoproteins (C-LDL) and 5% for high-density lipoproteins (C-HDL). The main non-lipidic factors were smoking (46.1%) and sedentarism (60.8%). Obesity, hypertension and parental history of myocardial infarction were present in 1.9%, 4.6% and 11%, respectively. We observed an association of a lipid risk profile with obesity, cigarette smoking and family history. The results show that sedentarism and smoking are associated with a lipid risk profile. These results call for the need to develop appropriate behavior strategies for the successful prevention of cardiovascular disease.

  12. Identifying classes of veterans with multiple risk factors.

    PubMed

    Funderburk, Jennifer S; Kenneson, Aileen; Maisto, Stephen A

    2014-10-01

    As researchers examine the efficacy of interventions that simultaneously target more than 1 symptom, it is important to identify ways to help guide research and program development. This study used electronic medical record data to examine the covariation of multiple risk factors regularly assessed among primary care patients. It also examined the health care utilization of those patients identifying where the health care system came in contact with them to help identify the ideal locations these interventions may be most often used. We obtained data for six risk factors, as well as the number of primary care, mental health, and emergency department visits, from Veteran patients with a primary care visit. There were three main groups of primary care patients, identified using latent class analysis and regression. Although the smallest group, the "High Treatment Need" group, had an increased probability of screening positive for all four risk factors, the post-traumatic stress disorder screen was a significant discriminator of this group from the others. Results show that this group had the greatest number of encounters in all health care locations suggesting significant opportunities for intervention. However, future research is needed to examine the current interventions offered and potential avenues where risk factors may be addressed simultaneously. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  13. Mental Health Problems and Cancer Risk Factors Among Young Adults.

    PubMed

    Massetti, Greta M; Thomas, Cheryll C; King, Jessica; Ragan, Kathleen; Buchanan Lunsford, Natasha

    2017-09-01

    Chronic mental health problems often emerge in young adulthood, when adults begin to develop lifelong health behaviors and access preventive health services. The associations between mental health problems and modifiable cancer risk factors in young adulthood are not well understood. In 2016, the authors analyzed 2014 Behavioral Risk Factor Surveillance System data on demographic characteristics, health service access and use, health status, and cancer risk factors (tobacco use, alcohol use, overweight or obesity, physical activity, and sleep) for 90,821 young adults aged 18-39 years with mental health problems (depressive disorder or frequent mental distress) compared to other young adults. Mental health problems were associated with white race; less than a high school education; lower income; being out of work or unable to work; being uninsured (for men only); poor health; previous diagnosis of asthma, skin cancer, or diabetes; and not having a recent checkup. After controlling for demographic characteristics, health service use, and health status, mental health problems among young adults were associated with smoking, binge drinking, inadequate sleep, having no leisure time physical activity, and being overweight or obese (among women only). Cervical cancer screening was not associated with mental health problems after controlling for demographic characteristics, health service use, and health status. Mental health problems in young adulthood were associated with potentially modifiable factors and behaviors that increase risk for cancer. Efforts to prevent cancer and promote health must attend to mental health disparities to meet the needs of young adults. Published by Elsevier Inc.

  14. [Factors associated with emergency department revisits for acute bacterial prostatitis].

    PubMed

    Ferré Losa, Carles; Llopis Roca, Ferran; Jacob Rodríguez, Javier; Cabello Zamora, Irene; Martínez Muñoz, Concepción; Bardés Robles, Ignasi

    2017-01-01

    To analyze factors associated with revisits by patients with acute bacterial prostatitis treated in a hospital emergency department. Descriptive analysis and prospective follow-up of a cohort of patients with acute bacterial prostatitis treated in an emergency department. We included 241 episodes of acute bacterial prostatitis. The mean (SD) age was 63 (16) years. Seventy-three percent reported dysuria, 64% had fever, and between 15.4% and 22.4% had medical histories of cancer, urethral/bladder catheterization, or prostate adenoma. Positive urine cultures were obtained for 48.1% and positive blood cultures for 17.6%. Escherichia coli was the bacterium isolated most often, and 27.7% of the cultures showed resistance to ciprofloxacin and amoxicillin-clavulanic acid. Twenty-nine patients (12%) revisited within 30 days. The only factors associated with revisiting were performance of a rectal examination (odds ratio [OR], 9.23; 95% CI, 1.12-75.82) and bacteremia (OR, 3.81; 95% CI, 1.31-11.04) (P<.05). Factors associated with revisiting for acute bacterial prostatitis were bacteremia and performance of a rectal examination.

  15. Risk Factors for Domestic Violence in Curacao

    ERIC Educational Resources Information Center

    van Wijk, N. Ph. L.; de Bruijn, J. G. M.

    2012-01-01

    One out of three people (25% of men, 38% of women) in Curacao have experienced some form of domestic violence at some point in their adult lives. The most significant risk factors for domestic violence in Curacao are the female gender, a young age, low education, and experiencing domestic violence victimization in childhood. Divorce, single…

  16. Oral cancer risk factors in New Zealand.

    PubMed

    Yakin, Muhammed; Gavidi, Ratu Osea; Cox, Brian; Rich, Alison

    2017-03-03

    Oral cancer constitutes the majority of head and neck cancers, which are the fifth most common malignancy worldwide, accounting for an estimated 984,430 cases in 2012. Between 2000 and 2010, there were 1,916 cases of OSCC in New Zealand with a male to female ratio of 1.85:1, and an age-standardised incidence rate of 42 persons per 1,000,000 population. This article presents an overview of the main risk factors for oral and oropharyngeal cancers and their prevalence in New Zealand. Alcohol consumption is the most prevalent risk factor in New Zealand, followed by tobacco. Given the high prevalence of these two risk factors and their synergistic effect, it is important for doctors and dentists to encourage smoking cessation in smokers and to recommend judicious alcohol intake. Research is needed to determine the prevalence of use of oral preparations of tobacco and water-pipe smoking in New Zealand, especially due to changing demography and increases in migrant populations. UV radiation is also an important risk factor. Further investigations are also needed to determine the prevalence of oral and oropharyngeal cancers attributable to oncogenic HPV infection.

  17. Risk Factors for Domestic Violence in Curacao

    ERIC Educational Resources Information Center

    van Wijk, N. Ph. L.; de Bruijn, J. G. M.

    2012-01-01

    One out of three people (25% of men, 38% of women) in Curacao have experienced some form of domestic violence at some point in their adult lives. The most significant risk factors for domestic violence in Curacao are the female gender, a young age, low education, and experiencing domestic violence victimization in childhood. Divorce, single…

  18. Risk Factors for Smoking Behaviors among Adolescents

    ERIC Educational Resources Information Center

    Chung, Sung Suk; Joung, Kyoung Hwa

    2014-01-01

    Many students in Korea begin to use tobacco and develop a regular smoking habit before they reach adulthood. Yet, little is known about various signs contributing to the transition of the student smoking behaviors. This study used a national sample to explore and compare risk factors for smoking behaviors. Three types of smoking behaviors were…

  19. Risk Factors for Paternal Physical Child Abuse

    ERIC Educational Resources Information Center

    Lee, Shawna J.; Guterman, Neil B.; Lee, Yookyong

    2008-01-01

    Objective: This study uses the developmental-ecological framework to examine a comprehensive set of paternal factors hypothesized to be linked to risk for paternal child abuse (PCA) among a diverse sample of fathers. Attention was given to fathers' marital status and their race/ethnicity (White, African American, and Hispanic). Methods: Interviews…

  20. Infants at Risk: Perinatal and Neonatal Factors.

    ERIC Educational Resources Information Center

    Lipsitt, Lewis P.

    1979-01-01

    Reviews studies of infant behavior and development. Delineates a behavioral hypothesis relating prenatal and neonatal risk factors in infancy to crib death. The mutual dependence of experience and neurostructural development suggests that infancy is a period of critical learning experiences. (Author/RH)

  1. Risk factors for osteoporosis and associated fractures.

    PubMed Central

    Kelsey, J L

    1989-01-01

    Established risk factors for osteoporosis and associated fractures are increasing age, female sex, white race, removal of the ovaries at an early age, prolonged immobility, and prolonged use of corticosteroids. Obesity and use of estrogen replacement therapy are protective. Factors that probably or possibly increase risk in postmenopausal white women include a low calcium intake, cigarette smoking, and, at least for hip fractures, use of long half-life psychotrophic drugs and heavy alcohol consumption. Factors probably or possibly associated with a decreased risk include ingestion of vitamin D and its metabolites, fluoride levels of 2 ppm or more in drinking water, moderate physical activity, pregnancies and breast feeding, use of thiazide diuretics, and progestogens. Some evidence suggests that calcium intake and physical activity at young ages may be important determinants of peak bone mass. Few studies have been undertaken in males and blacks, although at least some risk factors in males may be similar to those in females. Preventive efforts may be aimed at increasing peak bone mass at young ages, preventing bone loss in postmenopausal women, and preventing fractures and their adverse consequences in older people with osteoporosis. PMID:2517695

  2. Risk Factors and Prodromal Eating Pathology

    ERIC Educational Resources Information Center

    Stice, Eric; Ng, Janet; Shaw, Heather

    2010-01-01

    Prospective studies have identified factors that increase risk for eating pathology onset, including perceived pressure for thinness, thin-ideal internalization, body dissatisfaction, dietary restraint, and negative affect. Research also suggests that body dissatisfaction and dietary restraint may constitute prodromal stages of the development of…

  3. Risk Factors for Rural Residential Fires

    ERIC Educational Resources Information Center

    Allareddy, Veerasathpurush; Peek-Asa, Corinne; Yang, Jingzhen; Zwerling, Craig

    2007-01-01

    Context and Purpose: Rural households report high fire-related mortality and injury rates, but few studies have examined the risk factors for fires. This study aims to identify occupant and household characteristics that are associated with residential fires in a rural cohort. Methods: Of 1,005 households contacted in a single rural county, 691…

  4. Child sexual assault: risk factors for girls.

    PubMed

    Butler, Amy C

    2013-09-01

    To identify prospectively measured risk factors of sexual assault (SA) among girls age 17 and younger. The data come from the Panel Study of Income Dynamics and are derived from interviews with 1,087 girls, their primary caregivers, and household heads. The data were collected from the girls' first year of life through their early twenties. Factors measured during childhood were used to predict whether the girls experienced a subsequent first sexual assault before the age of 18. Prospectively measured risk factors associated with subsequent child SA included the absence of one or both parents, maternal education less than college, family income below 400% of the federal poverty threshold, low caregiver warmth, child internalizing and externalizing behaviors, impulsivity, low achievement scores, and having been classified by their school as needing special education. Girls with behavioral health problems and learning challenges are at heightened risk for sexual assault. Research on behavioral health consequences of SA should control for preexisting SA risk factors to more accurately estimate the impact of child SA on subsequent behavioral health.

  5. Environmental Risk Factors in Hospital Suicide

    ERIC Educational Resources Information Center

    Lieberman, Daniel Z.; Resnik, Harvey L.P.; Holder-Perkins, Vicenzio

    2004-01-01

    Suicide of hospitalized patients is the most common sentinel event reviewed by The Joint Commission on Accreditation of Healthcare Organizations. Shorter lengths of stay, sicker patients, and higher patient to staff ratios challenge the ability of the hospital to maintain safety. Risk factors associated with the physical environment of the…

  6. Risk Factors for Rural Residential Fires

    ERIC Educational Resources Information Center

    Allareddy, Veerasathpurush; Peek-Asa, Corinne; Yang, Jingzhen; Zwerling, Craig

    2007-01-01

    Context and Purpose: Rural households report high fire-related mortality and injury rates, but few studies have examined the risk factors for fires. This study aims to identify occupant and household characteristics that are associated with residential fires in a rural cohort. Methods: Of 1,005 households contacted in a single rural county, 691…

  7. Risk Factors for Depression in Early Adolescence

    ERIC Educational Resources Information Center

    MacPhee, Angela R.; Andrews, Jac J. W.

    2006-01-01

    The purpose of this study was to identify salient risk factors for depression in early adolescence from a group of common predictors. The following nine predictors were examined: (1) perceived quality of peer relationships, (2) perceived parental nurturance, (3) perceived parental rejection, (4) self-esteem, (5) body image, (6) pubertal status,…

  8. Infants at Risk: Perinatal and Neonatal Factors.

    ERIC Educational Resources Information Center

    Lipsitt, Lewis P.

    1979-01-01

    Reviews studies of infant behavior and development. Delineates a behavioral hypothesis relating prenatal and neonatal risk factors in infancy to crib death. The mutual dependence of experience and neurostructural development suggests that infancy is a period of critical learning experiences. (Author/RH)

  9. Risk Factors and Prodromal Eating Pathology

    ERIC Educational Resources Information Center

    Stice, Eric; Ng, Janet; Shaw, Heather

    2010-01-01

    Prospective studies have identified factors that increase risk for eating pathology onset, including perceived pressure for thinness, thin-ideal internalization, body dissatisfaction, dietary restraint, and negative affect. Research also suggests that body dissatisfaction and dietary restraint may constitute prodromal stages of the development of…

  10. Risk Factors for Depression in Early Adolescence

    ERIC Educational Resources Information Center

    MacPhee, Angela R.; Andrews, Jac J. W.

    2006-01-01

    The purpose of this study was to identify salient risk factors for depression in early adolescence from a group of common predictors. The following nine predictors were examined: (1) perceived quality of peer relationships, (2) perceived parental nurturance, (3) perceived parental rejection, (4) self-esteem, (5) body image, (6) pubertal status,…

  11. Risk Factors for Smoking Behaviors among Adolescents

    ERIC Educational Resources Information Center

    Chung, Sung Suk; Joung, Kyoung Hwa

    2014-01-01

    Many students in Korea begin to use tobacco and develop a regular smoking habit before they reach adulthood. Yet, little is known about various signs contributing to the transition of the student smoking behaviors. This study used a national sample to explore and compare risk factors for smoking behaviors. Three types of smoking behaviors were…

  12. Environmental Risk Factors in Hospital Suicide

    ERIC Educational Resources Information Center

    Lieberman, Daniel Z.; Resnik, Harvey L.P.; Holder-Perkins, Vicenzio

    2004-01-01

    Suicide of hospitalized patients is the most common sentinel event reviewed by The Joint Commission on Accreditation of Healthcare Organizations. Shorter lengths of stay, sicker patients, and higher patient to staff ratios challenge the ability of the hospital to maintain safety. Risk factors associated with the physical environment of the…

  13. The risk factors of CVA in Jordan.

    PubMed

    Auais, Mohammad A; Alzyoud, Jehad M; Sbieh, Ziad; Abdulla, Fuad A

    2012-11-01

    This study aimed to identify the main risk factors of cerebrovascular accident (CVA) in Jordan. Identification of risk factors may help to reduce the incidence of CVA. A form was prepared for data collection which consisted of two parts to gather biodata and the incidence of risk factors. A sample of 200 patients with CVA (60% men) were randomly selected from various areas of Jordan. An age, region distribution, and gender-matched sample were selected to serve as control. Hypertension in the experimental group (66%) was significantly higher than the control group (32%) p  <  0.001. Half of the subjects with stroke had diabetes compared to 22% of the control group (p  <  0.001). Cardiovascular diseases were found in 29% of subjects with CVA compared to 14% in the control group (p  <  0.001). About 27% of the CVA group had hyperlipidemia in comparison to 13% in the controls (p <  0.002). Smokers represented 54% of the experimental group compared to 30% of the control group (p <  0.05). An important finding in the present study was that about half of the selected subjects with strokes were under the age of 60 years. In conclusion, hypertension, diabetes, cardiovascular diseases, hyperlipidemia, and smoking are risk factors for CVA in Jordan.

  14. Biological risk factors for deep vein trombosis.

    PubMed

    Vayá, Amparo; Mira, Yolanda; Martínez, Marcial; Villa, Piedad; Ferrando, Fernando; Estellés, Amparo; Corella, Dolores; Aznar, Justo

    2002-01-01

    Hypercoagulable states due either to inherited or acquired thrombotic risk factors are only present in approximately half of cases of DVT, but the causes in the other half, remain unknown. The importance of biological risk factors such as hyperlipidemia, hypofibrinolysis and hemorheological alterations in the pathogenesis of DVT has not been well established. In order to ascertain whether the above mentioned biological factors are associated with DVT and could constitute independent risk factors, we carried out a case-control study in 109 first DVT patients in whom inherited or acquired thrombophilic risk factors had been ruled out and 121 healthy controls age (42+/-15 years) and sex matched. From all the biological variables analyzed (cholesterol, triglycerides, glucose, fibrinogen, erythrocyte aggregation, hematocrit, plasma viscosity and PAI-1) only fibrinogen concentration reached a statistically significant difference on the comparison of means (290+/-73 mg/dl in cases vs 268+/-58 mg/dl in controls, p<0.05). After this continuous variables were dichotomized according to our reference values, the percentage of cases with cholesterolemia >220 mg/dl, hematocrit >45% and fibrinogen >300 mg/dl was higher in cases than in controls: 38% vs 22%; p<0.01; 43% vs 27%; p<0.05; 36% vs 23%; p<0.05, respectively. The percentage of cases with PAI-1 values >30 ng/ml, 37% vs 25% was borderline significant; p=0.055. Multivariate logistic regression analysis showed that cholesterolemia >220 mg/dl and fibrinogen >300 mg/dl constitute independent predictors of venous thrombotic risk. The adjusted OR's were 2.03 (95% CI; 1.12-3.70) for cholesterolemia and 1.94 (95% CI; 1.07-3.55) for fibrinogen. When these two variables combined DVT risk rose about fourfold (3.96; p<0.05). Our results suggest that hypercholesterolemia and hyperfibrinogenemia should be added to the list of known DVT risk factors and we recommend adopting measures to decrease these variables in the population with a

  15. [Sexual risk factors among European young people].

    PubMed

    Calatrava, María; López-Del Burgo, Cristina; de Irala, Jokin

    2012-05-05

    The sexual transmission of the human immunodeficiency virus (HIV) and other sexually transmitted infections (STI) in Europe are still rising. In order to prioritize STI prevention strategies in Europe, it is important to describe the prevalence of different sexual risk factors for STIs among European young people. We carried out a systematic review of published articles and studies performed by European institutions. A total of 21 articles and 10 studies were identified. The data shows an increase in early sexual initiation and the number of sexual partners. Young people who use condoms inconsistently ranged from 15 to 20%. The observed risk factors are: unawareness about other STIs different from HIV, being in favour of casual sex, wrongly believing that some measures are effective in avoiding HIV, not being aware of the risks from having multiple sexual partners and unawareness about the sexual transmission of HIV. The data suggests the need to improve the information addressed to youth.

  16. CLARIPED: a new tool for risk classification in pediatric emergencies

    PubMed Central

    de Magalhães-Barbosa, Maria Clara; Prata-Barbosa, Arnaldo; da Cunha, Antonio José Ledo Alves; Lopes, Cláudia de Souza

    2016-01-01

    Abstract Objective: To present a new pediatric risk classification tool, CLARIPED, and describe its development steps. Methods: Development steps: (i) first round of discussion among experts, first prototype; (ii) pre-test of reliability, 36 hypothetical cases; (iii) second round of discussion to perform adjustments; (iv) team training; (v) pre-test with patients in real time; (vi) third round of discussion to perform new adjustments; (vii) final pre-test of validity (20% of medical treatments in five days). Results: CLARIPED features five urgency categories: Red (Emergency), Orange (very urgent), Yellow (urgent), Green (little urgent) and Blue (not urgent). The first classification step includes the measurement of four vital signs (VIPE score); the second step consists in the urgency discrimination assessment. Each step results in assigning a color, selecting the most urgent one for the final classification. Each color corresponds to a maximum waiting time for medical care and referral to the most appropriate physical area for the patient's clinical condition. The interobserver agreement was substantial (kappa=0.79) and the final pre-test, with 82 medical treatments, showed good correlation between the proportion of patients in each urgency category and the number of used resources (p<0.001). Conclusions: CLARIPED is an objective and easy-to-use tool for simple risk classification, of which pre-tests suggest good reliability and validity. Larger-scale studies on its validity and reliability in different health contexts are ongoing and can contribute to the implementation of a nationwide pediatric risk classification system. PMID:27083070

  17. CLARIPED: a new tool for risk classification in pediatric emergencies.

    PubMed

    Magalhães-Barbosa, Maria Clara de; Prata-Barbosa, Arnaldo; Alves da Cunha, Antonio José Ledo; Lopes, Cláudia de Souza

    2016-09-01

    To present a new pediatric risk classification tool, CLARIPED, and describe its development steps. Development steps: (i) first round of discussion among experts, first prototype; (ii) pre-test of reliability, 36 hypothetical cases; (iii) second round of discussion to perform adjustments; (iv) team training; (v) pre-test with patients in real time; (vi) third round of discussion to perform new adjustments; (vii) final pre-test of validity (20% of medical treatments in five days). CLARIPED features five urgency categories: Red (Emergency), Orange (very urgent), Yellow (urgent), Green (little urgent) and Blue (not urgent). The first classification step includes the measurement of four vital signs (Vipe score); the second step consists in the urgency discrimination assessment. Each step results in assigning a color, selecting the most urgent one for the final classification. Each color corresponds to a maximum waiting time for medical care and referral to the most appropriate physical area for the patient's clinical condition. The interobserver agreement was substantial (kappa=0.79) and the final pre-test, with 82 medical treatments, showed good correlation between the proportion of patients in each urgency category and the number of used resources (p<0.001). CLARIPED is an objective and easy-to-use tool for simple risk classification, of which pre-tests suggest good reliability and validity. Larger-scale studies on its validity and reliability in different health contexts are ongoing and can contribute to the implementation of a nationwide pediatric risk classification system. Copyright © 2016 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  18. Risk factors associated with lambing traits.

    PubMed

    McHugh, N; Berry, D P; Pabiou, T

    2016-01-01

    The objective of this study was to establish the risk factors associated with both lambing difficulty and lamb mortality in the Irish sheep multibreed population. A total of 135 470 lambing events from 42 675 ewes in 839 Irish crossbred and purebred flocks were available. Risk factors associated with producer-scored ewe lambing difficulty score (scale of one (no difficulty) to four (severe difficulty)) were determined using linear mixed models. Risk factors associated with the logit of the probability of lamb mortality at birth (i.e. binary trait) were determined using generalised estimating equations. For each dependent variable, a series of simple regression models were developed as well as a multiple regression model. In the simple regression models, greater lambing difficulty was associated with quadruplet bearing, younger ewes, of terminal breed origin, lambing in February; for example, first parity ewes experienced greater (P7.0 kg) birth weights, quadruplet born lambs and lambs that experienced a more difficult lambing (predicted probability of death for lambs that required severe and veterinary assistance of 0.15 and 0.32, respectively); lambs from dual-purpose breeds and born to younger ewes were also at greater risk of mortality. In the multiple regression model, the association between ewe parity, age at first lambing, year of lambing and lamb mortality no longer persisted. The trend in solutions of the levels of each fixed effect that remained associated with lamb mortality in the multiple regression model, did not differ from the trends observed in the simple regression models although the differential in relative risk between the different lambing difficulty scores was greater in the multiple regression model. Results from this study show that many common flock- and animal-level factors are associated with both lambing difficulty and lamb mortality and management of different risk category groups (e.g. scanned litter sizes, ewe age groups) can be used

  19. Cardiovascular Risk Factors of Taxi Drivers.

    PubMed

    Elshatarat, Rami Azmi; Burgel, Barbara J

    2016-06-01

    In the United States (U.S.), cardiovascular disease (CVD) is a major leading cause of death. Despite the high mortality rate related to CVD, little is known about CVD risk factors among urban taxi drivers in the U.S. A cross-sectional design was used to identify the predictors of high cardiovascular risk factors among taxi drivers. Convenience sampling method was used to recruit 130 taxi drivers. A structured questionnaire was used to obtain the data. The sample was male (94 %), age mean (45 ± 10.75) years, married (54 %), born outside of the USA (55 %), had some college or below (61.5 %), night drivers (50.8 %), and driving on average 9.7 years and 41 h/week. About 79 % of them were eligible for CVD prevention, and 35.4 % had high CVD risk factors (4-9 risk factors). A CVD high-risk profile had a significant relationship with the subjects who were ≥55 years old; had hypertension, diabetes, or hyperlipidemia; were drinking alcohol ≥2 times/week; and had insufficient physical activity. Subjects who worked as a taxi driver for more than 10 years (OR 4.37; 95 % CI 1.82, 10.50) and had mental exertion from cab driving >5 out of 10 (OR 2.63; 95 % CI 1.05, 6.57) were more likely to have a CVD high-risk profile. As a conclusion, system-level or worksite interventions include offering healthy food at taxi dispatching locations, creating a work culture of frequent walking breaks, and interventions focusing on smoking, physical activity, and weight management. Improving health insurance coverage for this group of workers is recommended.

  20. Environmental factors influencing the risk of autism

    PubMed Central

    Karimi, Padideh; Kamali, Elahe; Mousavi, Seyyed Mohammad; Karahmadi, Mojgan

    2017-01-01

    Autism is a developmental disability with age of onset in childhood (under 3 years old), which is characterized by definite impairments in social interactions, abnormalities in speech, and stereotyped pattern of behaviors. Due to the progress of autism in recent decades, a wide range of studies have been done to identify the etiological factors of autism. It has been found that genetic and environmental factors are both involved in autism pathogenesis. Hence, in this review article, a set of environmental factors involved in the occurrence of autism has been collected, and finally, some practical recommendations for reduction of the risk of this devastating disease in children are represented. PMID:28413424

  1. Prenatal and perinatal risk factors of schizophrenia.

    PubMed

    Meli, Giampiero; Ottl, Birgit; Paladini, Angela; Cataldi, Luigi

    2012-12-01

    Schizophrenia could be considered the most severe of all psychiatric disorders. It shows a heterogeneous clinical picture and presents an etiopathogenesis that is not cleared sufficiently. Even if the etiopathogenesis remains a puzzle, there is a scientific consensus that it is an expression of interaction between genotype and environmental factors. In the present article, following a study of literature and the accumulated evidence, the role of prenatal and perinatal factors in the development of schizophrenia will be revised and synthesized. We think that better knowledge of the risk factors could be helpful not only for better comprehension of the pathogenesis but especially to optimize interventions for prevention of the disorder.

  2. Is consanguinity a risk factor for keratoconus?

    PubMed

    Gordon-Shaag, Ariela; Millodot, Michel; Essa, Maron; Garth, Jeanne; Ghara, Mohammed; Shneor, Einat

    2013-05-01

    To determine whether consanguinity is a risk factor for keratoconus (KC). A questionnaire was distributed to all patients presenting to St. John Eye Hospital, Jerusalem, Israel. Questionnaire included data on demographic characteristics and potential risk factors. Patients were divided into two groups: cases with KC, in at least one eye, who were diagnosed by the attending ophthalmologist on the basis of abnormal corneal topography and at least one of the common signs of the disease; and controls presenting for problems other than KC and free of systemic and ocular conditions associated with KC. Multivariate logistic analyses were performed to identify risk factors for KC. Seventy cases and 140 controls participated in the study. Groups were similar with respect to sex and age. Univariate analyses found a significant association between KC and parental first-cousin consanguinity, eye rubbing, allergy, positive family history, education (>12 years), and sunglass wear, whereas asthma, eczema, smoking, and second-cousin consanguinity were not. Multivariate analyses showed that total consanguinity (first-cousin and second-cousin) (adjusted odds ratio, 3.96; p = 0.001), eye rubbing and absence of sunglass wear were significant risk factors. Education was also associated with KC, but family history was not so in the multivariate analysis. This study supports the hypothesis that consanguinity is a significant risk factor for KC and provides strong support for a genetic contribution to the disease. Wearing sunglasses in this environment is beneficial, and the study confirmed that eye rubbing, allergy, and education are also significantly associated with KC after adjusting for other predictors.

  3. [Injuries in France: trends and risk factors].

    PubMed

    Richard, J-B; Thélot, B; Beck, F

    2013-06-01

    Whatever the type of injury considered, prevention requires an improvement in health services' awareness of risk factors. The Health Barometer is a general population survey conducted in France since 1992 to contribute to surveillance in this field. The survey's statistical power and the numerous health topics included in the questionnaire provide accurate information for healthcare professionals and decision-makers. The Health Barometer 2010 was a nationwide telephone survey of 9110 persons representative of the 15-85-year-old population. One part of the questionnaire detailed injuries which had occurred during the past year. The numerous variables recorded enabled application of logistic regression models to explore risk factors related to different types of injury by age group. The findings were compared with the Health Barometer 2005 data to search for temporal trends of injury prevalence. The data analysis showed that 10.3% of the 15-85-year-olds reported an injury during the past year. This rate was higher than recorded in 2005; the increase was mainly due to domestic accidents and injuries occurring during recreational activities. Both type of injury and risk factors exhibited age-related variability. Domestic accidents and injuries occurring during recreational activities predominated in the older population and were associated with physical or mental health problems (chronic disease, diability, sleep disorders). For younger people, injuries were related to cannabis use, drunkedness, and insufficient sleep. Risk factors were also depended on type of injury: occupational accident-related injuries were linked with social disadvantage (manual worker population) whereas sports injuries were more common in the socially advantaged population. This survey confirms established knowledge and highlights, at different stages of life, new risk factors that contribute to injuries in France. These findings should be helpful for the development of adapted injury

  4. Prenatal risk factors for childhood CKD.

    PubMed

    Hsu, Christine W; Yamamoto, Kalani T; Henry, Rohan K; De Roos, Anneclaire J; Flynn, Joseph T

    2014-09-01

    Development of CKD may be programmed prenatally. We sought to determine the association of childhood CKD with prenatal risk factors, including birth weight, maternal diabetes mellitus (DM), and maternal overweight/obesity. We conducted a population-based, case-control study with 1994 patients with childhood CKD (<21 years of age at diagnosis) and 20,032 controls in Washington state. We linked maternal and infant characteristics in birth records from 1987 to 2008 to hospital discharge data and used logistic regression analysis to assess the association of prenatal risk factors with childhood CKD. The prevalence of CKD was 126.7 cases per 100,000 births. High birth weight and maternal pregestational DM associated nominally with CKD, with respective crude odds ratios (ORs) of 1.17 (95% confidence interval [95% CI], 1.03 to 1.34) and 1.97 (95% CI, 1.15 to 3.37); however, adjustment for maternal confounders attenuated these associations to 0.97 (95% CI, 0.79 to 1.21) and 1.19 (95% CI, 0.51 to 2.81), respectively. The adjusted ORs for CKD associated with other prenatal factors were 2.88 (95% CI, 2.28 to 3.63) for low birth weight, 1.54 (95% CI, 1.13 to 2.09) for maternal gestational DM, 1.24 (95% CI, 1.05 to 1.48) for maternal overweight, and 1.26 (95% CI, 1.05 to 1.52) for maternal obesity. In subgroup analysis by CKD subtype, low birth weight and maternal pregestational DM associated significantly with increased risk of renal dysplasia/aplasia. Low birth weight, maternal gestational DM, and maternal overweight/obesity associated significantly with obstructive uropathy. These data suggest that prenatal factors may impact the risk of CKD. Future studies should aim to determine if modification of these factors could reduce the risk of childhood CKD.

  5. Susceptibility and risk factors in periodontal disease.

    PubMed

    Kinane, D F

    2000-10-01

    Epidemiological studies demonstrate a high prevalence of advanced destruction but also that relatively few individuals in each age group account for most of the advanced periodontal disease. The available data suggest that three quarters of advanced periodontal disease could be prevented by targeting an effective preventive strategy on the 28% of individuals especially at risk. Questions remain regarding: 1) whether an acceptable cost-effective preventive strategy can be devised; and 2) whether it is possible to establish a simple method of identifying the 'at risk' group. The various risk factors are numerous and include systemic diseases, smoking, drug therapy, hormonal disturbances and genetic factors as well as the more mundane factors such as plaque control and socio-economic and education and attitude factors. Aside from these factors, many patients present with periodontal disease and have no discernible predisposition other than possibly genetic, for which we can not currently test, and for the vast majority of patients there would appear to be no other alternative to periodic thorough examination for all patients, early treatment of all periodontal lesions and appropriate dental health education.

  6. [Risk factors associated with dystocic delivery].

    PubMed

    Romero Gutiérrez, Gustavo; Ríos López, Juan Carlos; Cortés Salim, Patricia; Ponce Ponce de León, Ana Lilia

    2007-09-01

    the dystocic delivery is a frequent complication and its perinatal repercussions vary from minor lesions to severe brain damage. It has been reported diverse factors associated with this medical complication. to identify the risk factors with significant association with dystocic delivery. a case-control study was carried out. There were included 750 patients, divided into 250 women with dystocic deliveries (cases) and 500 women with eutocic deliveries (controls). Demographic and clinical variables were registered. The statistical analysis was performed with percentages, arithmetic media, standard deviation, Student t test, chi2 and logistic regression analysis. An alpha value was set at 0.05. the factors with statistical significance were: advanced age (p < 0.001), major patient's height (p < 0.001), major new born's weight (p = 0.009), lower parity (p < 0.001), and prolonged duration of labor (p = 0.04). Other variables such as number of pregnancies, previous cesarean sections, spontaneous abortions, weight of the patient, weight earned during pregnancy, number of medical appointments during antenatal care, previous dystocic delivery, and premature rupture of the membranes, were not significant. there are clinical and demographic risk factors associated with dystocic delivery. To identify this risk factors during the antenatal care could diminish the frequency of dystocic deliveries and therefore to avoid the associated maternal-fetal complications.

  7. Environmental risk factors for autism spectrum disorders.

    PubMed

    Liu, L; Zhang, D; Rodzinka-Pasko, J K; Li, Y-M

    2016-12-01

    Autism spectrum disorders (ASD) are syndromes that are predominantly defined by behavioral features such as impaired social interactions, restricted verbal and nonverbal communication, and repetitive or stereotyped behavior. In the past few decades, the reported prevalence of ASD has increased dramatically. This growth can be partially explained by an increased level of awareness of the problem among professionals and better diagnostic methods. Nevertheless, underpinning causes of ASD have not yet been detailed and explained. It is suggested that rather than having a single causative factor, ASD pathogenesis is influenced by environmental or genetic factors, or a combination of both. The aims of this review are to describe the environmental risk factors associated with ASD so as to provide a reference basis for current and future clinical and experimental work. On the basis of a PubMed search, we review the existing knowledge on environmental factors associated with ASD. A series of environmental factors have been repeatedly reported as risk factors for ASD in existing studies. Air pollution, organic toxicants, seasonal factors, psychological stress, migration, birth order, and nutrition may have a close relationship with the incidence of ASD.

  8. Environmental risk factors for heart disease.

    PubMed

    O'Toole, Timothy E; Conklin, Daniel J; Bhatnagar, Aruni

    2008-01-01

    In this review, we discuss current evidence linking environmental pollutants to cardiovascular disease (CVD). Extensive evidence indicates that environmental factors contribute to CVD risk, incidence, and severity. Migrant studies show that changes in the environment could substantially alter CVD risk in a genetically stable population. Additionally, CVD risk is affected by changes in nutritional and lifestyle choices. Recent studies in the field of environmental cardiology suggest that environmental toxins also influence CVD. Exposure to tobacco smoke is paradigmatic of such environmental risk and is strongly and positively associated with increased cardiovascular morbidity and mortality. In animal models of exposure, tobacco smoke induces endothelial dysfunction and prothrombotic responses and exacerbates atherogenesis and myocardial ischemic injury. Similar mechanism may be engaged by other pollutants or food constituents. Several large population-based studies indicate that exposure to fine or ultrafine particulate air pollution increases CVD morbidity and mortality, and the plausibility of this association is supported by data from animal studies. Exposure to other chemicals such as polyaromatic hydrocarbons, aldehydes, and metals has also been reported to elevate CVD risk by affecting atherogenesis, thrombosis, or blood pressure regulation. Maternal exposure to drugs, toxins, and infection has been linked with cardiac birth defects and premature CVD in later life. Collectively, the data support the notion that chronic environmental stress is an important determinant of CVD risk. Further work is required to assess the magnitude of this risk fully and to delineate specific mechanisms by which environmental toxins affect CVD.

  9. Longitudinal Risk and Protective Factors Associated with Internalizing and Externalizing Symptoms Among Male and Female Adolescents.

    PubMed

    Cotter, Katie L; Wu, Qi; Smokowski, Paul R

    2016-06-01

    Using ecological theory and the peer socialization model, the current study identified risk and protective factors associated with internalizing and externalizing symptoms across ecological domains. It was hypothesized that the constellation of risk and protective factors within the peer microsystem would vary by gender: future optimism and negative peer influence were expected to be significant risk/protective factors for males, whereas peer victimization was expected to be significant risk factors among females. Using four waves of data, three-level hierarchical linear models were estimated for males and females. Results revealed that negative peer influence was a particularly salient risk factor for both internalizing and externalizing behaviors among males, although future optimism did not emerge as a significant protective factor. In addition, as hypothesized, peer victimization indicators were significant risk factors for females. Parent-child conflict was also significantly and positively associated with both internalizing and externalizing symptoms for males and females. Implications are discussed.

  10. Infant siblings and the investigation of autism risk factors

    PubMed Central

    2012-01-01

    Infant sibling studies have been at the vanguard of autism spectrum disorders (ASD) research over the past decade, providing important new knowledge about the earliest emerging signs of ASD and expanding our understanding of the developmental course of this complex disorder. Studies focused on siblings of children with ASD also have unrealized potential for contributing to ASD etiologic research. Moving targeted time of enrollment back from infancy toward conception creates tremendous opportunities for optimally studying risk factors and risk biomarkers during the pre-, peri- and neonatal periods. By doing so, a traditional sibling study, which already incorporates close developmental follow-up of at-risk infants through the third year of life, is essentially reconfigured as an enriched-risk pregnancy cohort study. This review considers the enriched-risk pregnancy cohort approach of studying infant siblings in the context of current thinking on ASD etiologic mechanisms. It then discusses the key features of this approach and provides a description of the design and implementation strategy of one major ASD enriched-risk pregnancy cohort study: the Early Autism Risk Longitudinal Investigation (EARLI). PMID:22958474

  11. Risk factors and their identification second part: study designs for identification of risk factors.

    PubMed

    Balkau, B; Eschwege, E

    1995-06-01

    This is the second a series of three articles which reviews the identification of risk factors of a disease, here: diabetes or complications of diabetes. In the first of the series [1], we gave the definition of a risk factor, along with measures of its force-relative risk and odds ratio, followed by the epidemiological definitions of the diseases: diabetes, coronary heart disease and hypertension. Risk factors were further discussed and we completed the discussion by some observations on the bias which can arise from a study or from its analysis, which can lead the researcher to the wrong conclusion. In this second article we define the three types of epidemiological studies which are used to determine whether factors are associated with a disease: observational or cross-sectional studies, cohort studies and casecohort studies. Examples are provided of each of these study types; their advantages and disadvantages are discussed. The final paper will provide some examples of the identification of risk factors from the literature. The first example involves diabetes and pancreatic cancer, the second birth weight and non-insulin dependent diabetes. Having found an association between a risk factor and diabetes, we will discuss whether it can be considered to be a risk factor, and if so whether it is likely to be a cause of the disease.

  12. [Risk factors for nosocomial pneumonia in patients with abdominal surgery].

    PubMed

    Evaristo-Méndez, Gerardo; Rocha-Calderón, César Haydn

    2016-01-01

    The risk of post-operative pneumonia is a latent complication. A study was conducted to determine its risk factors in abdominal surgery. A cross-sectional study was performed that included analysing the variables of age and gender, chronic obstructive pulmonary disease and smoking, serum albumin, type of surgery and anaesthesia, emergency or elective surgery, incision site, duration of surgery, length of hospital stay, length of stay in the intensive care unit, and time on mechanical ventilation. The adjusted odds ratio for risk factors was obtained using multivariate logistic regression. The study included 91 (9.6%) patients with pneumonia and 851 (90.4%) without pneumonia. Age 60 years or over (OR=2.34), smoking (OR=9.48), chronic obstructive pulmonary disease (OR=3.52), emergency surgery (OR=2.48), general anaesthesia (OR=3.18), surgical time 120 minutes or over (OR=5.79), time in intensive care unit 7 days or over (OR=1.23), time on mechanical ventilation greater than or equal to 4 days (OR=5.93) and length of post-operative hospital stay of 15 days or over (OR=1.20), were observed as independent predictors for the development of postoperative pneumonia. Identifying risk factors for post-operative pneumonia may prevent their occurrence. The length in the intensive care unit of greater than or equal to 7 days (OR=1.23; 95% CI 1.07 - 1.42) and a length postoperative hospital stay of 15 days or more (OR=1.20; 95% CI 1.07 - 1.34) were the predictive factors most strongly associated with lung infection in this study. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  13. Risk Factors Of Heart Disease in Nurses.

    PubMed

    Jahromi, Mahdi K; Hojat, Mohsen; Koshkaki, Saiede R; Nazari, Faride; Ragibnejad, Maryam

    2017-01-01

    Identifying and correcting the modifiable risk factors reduces the prevalence of coronary artery disorders (CAD). Nurses, with regards to their employment conditions, can be prone to cardiovascular disease (CVD). This study aimed to determine the prevalence of cardiovascular risk factors among nurses. In this cross-sectional study, census sampling was conducted among nurses of Jahrom, Iran, in 2014. Data were collected through interviews, blood pressure measurement, anthropometric parameters, and blood sample collection. To analyze the data, descriptive statistical analysis, and comparative (independent t-test) and correlation (Pearson) tests were used; the significance level was considered to be P < 0.05. In this study, 263 (89.76%) nurses participated, 79.8% of whom were women. The mean age of the participants was 31.04 (6.97). In terms of body mass index, 41.7% was the waist-to-hip ratio, 16.7% was the waist-to-height ratio, and 63.1% were in the range of obesity. In addition, 5.7% had abnormal triglyceride, 4.9% had high cholesterol, and 15.1% had high blood pressure. The mean percentage of the Framingham risk score of the participants was 1.07 (1.84). In this study, the total mean percentage of the Framingham risk score of the nurses was 1.07, which showed a low risk of CAD in the study population over the next decade.

  14. Risk Factors Of Heart Disease in Nurses

    PubMed Central

    Jahromi, Mahdi K.; Hojat, Mohsen; Koshkaki, Saiede R.; Nazari, Faride; Ragibnejad, Maryam

    2017-01-01

    Background: Identifying and correcting the modifiable risk factors reduces the prevalence of coronary artery disorders (CAD). Nurses, with regards to their employment conditions, can be prone to cardiovascular disease (CVD). This study aimed to determine the prevalence of cardiovascular risk factors among nurses. Materials and Methods: In this cross-sectional study, census sampling was conducted among nurses of Jahrom, Iran, in 2014. Data were collected through interviews, blood pressure measurement, anthropometric parameters, and blood sample collection. To analyze the data, descriptive statistical analysis, and comparative (independent t-test) and correlation (Pearson) tests were used; the significance level was considered to be P < 0.05. Results: In this study, 263 (89.76%) nurses participated, 79.8% of whom were women. The mean age of the participants was 31.04 (6.97). In terms of body mass index, 41.7% was the waist-to-hip ratio, 16.7% was the waist-to-height ratio, and 63.1% were in the range of obesity. In addition, 5.7% had abnormal triglyceride, 4.9% had high cholesterol, and 15.1% had high blood pressure. The mean percentage of the Framingham risk score of the participants was 1.07 (1.84). Conclusions: In this study, the total mean percentage of the Framingham risk score of the nurses was 1.07, which showed a low risk of CAD in the study population over the next decade. PMID:28904549

  15. Factors Associated with the Occurrence of Cardiac Arrest after Emergency Tracheal Intubation in the Emergency Department

    PubMed Central

    Kim, Won Young; Kwak, Myoung Kwan; Ko, Byuk Sung; Yoon, Jae Chol; Sohn, Chang Hwan; Lim, Kyoung Soo; Andersen, Lars W.; Donnino, Michael W.

    2014-01-01

    Objectives Emergency tracheal intubation has achieved high success and low complication rates in the emergency department (ED). The objective of this study was to evaluate the incidence of post-intubation CA and determine the clinical factors associated with this complication. Methods A matched case-control study with a case to control ratio of 1∶3 was conducted at an urban tertiary care center between January 2007 and December 2011. Critically ill adult patients requiring emergency airway management in the ED were included. The primary endpoint was post-intubation CA, defined as CA within 10 minutes after tracheal intubation. Clinical variables were compared between patients with post-intubation CA and patients without CA who were individually matched based on age, sex, and pre-existing comorbidities. Results Of 2,403 patients who underwent emergency tracheal intubation, 41 patients (1.7%) had a post-intubation CA within 10 minutes of the procedure. The most common initial rhythm was pulseless electrical activity (78.1%). Patients experiencing CA had higher in-hospital mortality than patients without CA (61.0% vs. 30.1%; p<0.001). Systolic hypotension prior to intubation, defined as a systolic blood pressure ≤90 mmHg, was independently associated with post-intubation CA (OR, 3.67 [95% CI, 1.58–8.55], p = 0.01). Conclusion Early post-intubation CA occurred with an approximate 2% frequency in the ED. Systolic hypotension before intubation is associated with this complication, which has potentially significant implications for clinicians at the time of intubation. PMID:25402500

  16. Factors affecting ejection risk in rollover crashes.

    PubMed

    Funk, James R; Cormier, Joseph M; Bain, Charles E; Wirth, Jeffrey L; Bonugli, Enrique B; Watson, Richard A

    2012-01-01

    Ejection greatly increases the risk of injury and fatality in a rollover crash. The purpose of this study was to determine the crash, vehicle, and occupant characteristics that affect the risk of ejection in rollovers. Information from real world rollover crashes occurring from 2000 - 2010 was obtained from the National Automotive Sampling System (NASS) in order to analyze the effect of the following parameters on ejection risk: seatbelt use, rollover severity, vehicle type, seating position, roof crush, side curtain airbag deployment, glazing type, and occupant age, gender, and size. Seatbelt use was found to reduce the risk of partial ejection and virtually eliminate the risk of complete ejection. For belted occupants, the risk of partial ejection risk was significantly increased in rollover crashes involving more roof inversions, light trucks and vans (LTVs), and larger occupants. For unbelted occupants, the risk of complete ejection was significantly increased in rollover crashes involving more roof inversions, LTVs, far side occupants, and higher levels of roof crush. Roof crush was not a significant predictor of ejection after normalizing for rollover severity. Curtain airbag deployment was associated with reduced rates of partial and complete ejection, but the effect was not statistically significant, perhaps due to the small sample size (n = 89 raw cases with curtain deployments). A much greater proportion of occupants who were ejected in spite of curtain airbag deployment passed through the sunroof and other portals as opposed to the adjacent side window compared to occupants who were ejected in rollovers without a curtain airbag deployment. The primary factors that reduce ejection risk in rollover crashes are, in generally decreasing order of importance: seatbelt use, fewer roof inversions, passenger car body type, curtain airbag deployment, near side seating position, and small occupant size.

  17. Factors Affecting Ejection Risk in Rollover Crashes

    PubMed Central

    Funk, James R.; Cormier, Joseph M.; Bain, Charles E.; Wirth, Jeffrey L.; Bonugli, Enrique B.; Watson, Richard A.

    2012-01-01

    Ejection greatly increases the risk of injury and fatality in a rollover crash. The purpose of this study was to determine the crash, vehicle, and occupant characteristics that affect the risk of ejection in rollovers. Information from real world rollover crashes occurring from 2000 – 2010 was obtained from the National Automotive Sampling System (NASS) in order to analyze the effect of the following parameters on ejection risk: seatbelt use, rollover severity, vehicle type, seating position, roof crush, side curtain airbag deployment, glazing type, and occupant age, gender, and size. Seatbelt use was found to reduce the risk of partial ejection and virtually eliminate the risk of complete ejection. For belted occupants, the risk of partial ejection risk was significantly increased in rollover crashes involving more roof inversions, light trucks and vans (LTVs), and larger occupants. For unbelted occupants, the risk of complete ejection was significantly increased in rollover crashes involving more roof inversions, LTVs, far side occupants, and higher levels of roof crush. Roof crush was not a significant predictor of ejection after normalizing for rollover severity. Curtain airbag deployment was associated with reduced rates of partial and complete ejection, but the effect was not statistically significant, perhaps due to the small sample size (n = 89 raw cases with curtain deployments). A much greater proportion of occupants who were ejected in spite of curtain airbag deployment passed through the sunroof and other portals as opposed to the adjacent side window compared to occupants who were ejected in rollovers without a curtain airbag deployment. The primary factors that reduce ejection risk in rollover crashes are, in generally decreasing order of importance: seatbelt use, fewer roof inversions, passenger car body type, curtain airbag deployment, near side seating position, and small occupant size. PMID:23169130

  18. Personality pathology factors predict recurrent major depressive disorder in emerging adults.

    PubMed

    Sheets, Erin S; Duncan, Laramie E; Bjornsson, Andri S; Craighead, Linda W; Craighead, W Edward

    2014-06-01

    Prior investigations consistently indicate that personality pathology is a risk factor for recurrence of major depressive disorder (MDD). Lack of emipircal support, however, for the Diagnostic and Statistical Manual of Mental Disorders (DSM) Fourth Edition organization of Axis II disorders supports the investigation of empirically derived factors of personality pathology as predictors of recurrence. A sample of 130 previously depressed emerging adults (80% female; aged 18 to 21 years) were assessed for personality disorder symptoms at baseline. Participants were then followed for 18 months to identify MDD recurrence during the first 2 years of college. Based on a previous factor analysis of DSM personality disorder criteria, eight personality pathology factors were examined as predictors of MDD recurrence. Survival analysis indicated that factors of interpersonal hypersensitivity, antisocial conduct, and social anxiety were associated with increased risk of MDD recurrence. These findings suggest that an empirically based approach to personality pathology organization may yield useful predictors of MDD recurrence during emerging adulthood. © 2013 Wiley Periodicals, Inc.

  19. What Are the Risk Factors for Breast Cancer in Men?

    MedlinePlus

    ... and Prevention What Are the Risk Factors for Breast Cancer in Men? A risk factor is anything that ... old when they are diagnosed. Family history of breast cancer Breast cancer risk is increased if other members ...

  20. What Are the Risk Factors for Lung Carcinoid Tumors?

    MedlinePlus

    ... and Prevention What Are the Risk Factors for Lung Carcinoid Tumors? A risk factor is anything that ... Can Lung Carcinoid Tumors Be Prevented? More In Lung Carcinoid Tumors About Lung Carcinoid Tumors Causes, Risk ...

  1. Risk factors for suicidal behavior in adolescents.

    PubMed

    Kirkcaldy, B D; Siefen, G R; Urkin, J; Merrick, J

    2006-10-01

    Adolescent suicide is today a public health problem among the leading cause of mortality among adolescents and young adults. There seems to be many reasons for this increase (which has different trends in different populations), but associations have been found with increased substance abuse, television and video violence, socio-economic status and easy access to firearms. Gender differences have also been observed with crime, suicide and substance abuse higher among males, while eating disorder, depression and suicidal behavior more prevalent among females. This paper will review prevalence and incidence of adolescent suicidal behavior, socio-demographic and psychological risk factors, associated cognitive factors and socio-economic factors. Risk factors include previous suicide attempts, a history of others in the family who have been suicidal, mental illness, alcohol and drug use, and other self-destructive behaviors as well as consideration being given to hopelessness, hostility, negative self-concept and isolation. At the individual difference level, factors such as trait depression, anger and hostility, perfectionism and social sensitivity would seem critical variables, as would age, gender and intellectual functioning. Sociological and family-related factors may also be implicated including dysfunctional family organizations, a history of physical or psychological abuse (sexual abuse) and limited extent of social support networks. A frequently reported precipitating event of suicidal behavior is family adversity including rejection, separation and interpersonal conflict. At a socio-economic level it would seem essential to provide comprehensive document about the social and economic conditions from which the adolescent comes.

  2. Recurrent Shoulder Dystocia: Risk Factors and Counseling.

    PubMed

    Gurewitsch Allen, Edith D

    2016-12-01

    A prior history of delivery complicated by shoulder dystocia confers a 6-fold to nearly 30-fold increased risk of shoulder dystocia recurrence in a subsequent vaginal delivery, with most reported rates between 12% and 17%. Whereas prevention of shoulder dystocia in the general population is neither feasible nor cost-effective, directing intervention efforts at the particular subgroup of women with a prior history of shoulder dystocia has merit. Potentially modifiable risk factors and individualized management strategies that may reduce shoulder dystocia recurrence and its associated significant morbidities are reviewed.

  3. Socioeconomic factors and the risk for sarcoma.

    PubMed

    Hampras, Shalaka S; Moysich, Kirsten B; Marimuthu, Sathiya P; Ravi, Vinod; Jayaprakash, Vijayvel

    2014-11-01

    Sarcomas are a heterogeneous group of rare malignancies arising from mesenchymal tissue. Although several occupational exposures have been evaluated in association with sarcoma, little is known about the role of socioeconomic indicators such as education. Socioeconomic status has been found to be associated with risk of development of several types of cancers, primarily lung, gastric, and cervical cancers. We conducted a hospital-based case-control study to evaluate the association of socioeconomic level with the risk for sarcoma. A total of 371 incident cases of sarcoma were matched in terms of age, sex, and year of enrollment in the study with 742 cancer-free controls. Education and income levels were evaluated as the indicators of socioeconomic status. Higher education (college level) was associated with a significantly lower risk for sarcoma [odds ratio (OR)=0.48, 95% confidence interval (CI)=0.29-0.80], even after adjusting for important confounders. After stratifying by sex, significantly lower risk for sarcoma was observed among men who had college level education compared with men with a level of education of eighth grade or lower (OR=0.38, 95% CI=0.19-0.74). A significant association between education and the risk for sarcoma remained after stratifying by income (OR=0.49, 95% CI=0.28-0.86, among the low income group). When analyzed as a composite exposure, individuals with high education and high income status had significantly lower risk for sarcoma compared with those with low income and low education status (OR=0.41, 95% CI=0.23-0.71). Thus, socioeconomic factors may play a significant role in determining the risk for sarcoma and should be explored further to elucidate the underlying factors that may explain these sociodemographic inequalities related to sarcoma.

  4. Clinical Risk Factors for Portopulmonary Hypertension

    PubMed Central

    Kawut, Steven M.; Krowka, Michael J.; Trotter, James F.; Roberts, Kari E.; Benza, Raymond L.; Badesch, David B.; Taichman, Darren B.; Horn, Evelyn M.; Zacks, Steven; Kaplowitz, Neil; Brown, Robert S.; Fallon, Michael B.

    2010-01-01

    Portopulmonary hypertension affects up to 6% of patients with advanced liver disease, but the predictors and biologic mechanism for the development of this complication are unknown. We sought to determine the clinical risk factors for portopulmonary hypertension in patients with advanced liver disease. We performed a multicenter case-control study nested within a prospective cohort of patients with portal hypertension recruited from tertiary care centers. Cases had a mean pulmonary artery pressure >25 mm Hg, pulmonary vascular resistance >240 dynes · second · cm−5, and pulmonary capillary wedge pressure ≤ 15 mm Hg. Controls had a right ventricular systolic pressure < 40 mm Hg (if estimable) and normal right-sided cardiac morphology by transthoracic echocardiography. The study sample included 34 cases and 141 controls. Female sex was associated with a higher risk of portopulmonary hypertension than male sex (adjusted odds ratio =2.90, 95% confidence interval 1.20-7.01, P = 0.018). Autoimmune hepatitis was associated with an increased risk (adjusted odds ratio = 4.02, 95% confidence interval 1.14-14.23, P = 0.031), and hepatitis C infection was associated with a decreased risk (adjusted odds ratio =0.24, 95% confidence interval 0.09-0.65, P =0.005) of portopulmonary hypertension. The severity of liver disease was not related to the risk of portopulmonary hypertension. Conclusion Female sex and autoimmune hepatitis were associated with an increased risk of portopulmonary hypertension, whereas hepatitis C infection was associated with a decreased risk in patients with advanced liver disease. Hormonal and immunologic factors may therefore be integral to the development of portopulmonary hypertension. PMID:18537192

  5. [Risk factors for Alzheimer: towards prevention?].

    PubMed

    Vogel, Thomas; Benetos, Athanase; Verreault, René; Kaltenbach, Georges; Kiesmann, Michèle; Berthel, Marc

    2006-09-01

    Recent longitudinal studies have highlighted associations between Alzheimer's disease (AD) and several factors, especially some cardiovascular risk factors, including hypertension, diabetes, diet, obesity, and elevated levels of homocysteine and lipids in the blood. The strongest associations are with hypertension and diabetes. Moderate alcohol consumption also appears to be associated with a decreased risk of incident AD. Studies of the effect of interventions to control these risk factors on the onset and course of dementia report encouraging results about antihypertensive agents and statins. Benefits from other drug therapies such as nonsteroidal antiinflammatory drugs and antioxidants remain uncertain, and initial hopes for hormonal replacement therapy for postmenopausal women have not been confirmed. Physical, cognitive and leisure activities seem to provide protection against incident AD. Cautious interpretation is necessary in view of the possible biases in these studies (confounding factors as well as survival, regression dilution, and indication biases). These epidemiologic data raise questions about the diagnostic boundaries between AD and vascular dementia. Additional studies are needed to validate these concepts and to confirm the possible benefits of preventive measures.

  6. [Risk factors for anorexia in children].

    PubMed

    Liu, Wei-Xiao; Lang, Jun-Feng; Zhang, Qin-Feng

    2016-11-01

    To investigate the risk factors for anorexia in children, and to reduce the prevalence of anorexia in children. A questionnaire survey and a case-control study were used to collect the general information of 150 children with anorexia (case group) and 150 normal children (control group). Univariate analysis and multivariate logistic stepwise regression analysis were performed to identify the risk factors for anorexia in children. The results of the univariate analysis showed significant differences between the case and control groups in the age in months when supplementary food were added, feeding pattern, whether they liked meat, vegetables and salty food, whether they often took snacks and beverages, whether they liked to play while eating, and whether their parents asked them to eat food on time (P<0.05). The results of the multivariate logistic regression analysis showed that late addition of supplementary food (OR=5.408), high frequency of taking snacks and/or drinks (OR=11.813), and eating while playing (OR=6.654) were major risk factors for anorexia in children. Liking of meat (OR=0.093) and vegetables (OR=0.272) and eating on time required by parents (OR=0.079) were protective factors against anorexia in children. Timely addition of supplementary food, a proper diet, and development of children's proper eating and living habits can reduce the incidence of anorexia in children.

  7. Epidemiology and risk factors for delirium across hospital settings

    PubMed Central

    Vasilevskis, Eduard E.; Han, Jin H.; Hughes, Christopher G.; Ely, E. Wesley

    2013-01-01

    Delirium is one of the most common causes of acute end-organ dysfunction across hospital settings, occurring in as high as 80% of critically ill patients that require intensive care unit (ICU) care. The implications of this acute form of brain injury are profound. Across many hospital settings (emergency department, general medical ward, postoperative and ICU), a patient who experiences delirium is more likely to experience increased short- and long-term mortality, decreases in long-term cognitive function, increases in hospital length of stay and increased complications of hospital care. With the development of reliable setting-specific delirium-screening instruments, researchers have been able to highlight the predisposing and potentially modifiable risk factors that place patients at highest risk. Among the large number of risk factors discovered, administration of potent sedative medications, most notably benzodiazepines, is most consistently and strongly associated with an increased burden of delirium. Alternatively, in both the hospital and ICU, delirium can be prevented with the application of protocols that include early mobility/exercise. Future studies must work to understand the epidemiology across settings and focus upon modifiable risk factors that can be integrated into existing delirium prevention and treatment protocols. PMID:23040281

  8. Emergency Physician Attitudes, Preferences, and Risk Tolerance for Stroke as a Potential Cause of Dizziness Symptoms

    PubMed Central

    Kene, Mamata V.; Ballard, Dustin W.; Vinson, David R.; Rauchwerger, Adina S.; Iskin, Hilary R.; Kim, Anthony S.

    2015-01-01

    Introduction We evaluated emergency physicians’ (EP) current perceptions, practice, and attitudes towards evaluating stroke as a cause of dizziness among emergency department patients. Methods We administered a survey to all EPs in a large integrated healthcare delivery system. The survey included clinical vignettes, perceived utility of historical and exam elements, attitudes about the value of and requisite post-test probability of a clinical prediction rule for dizziness. We calculated descriptive statistics and post-test probabilities for such a clinical prediction rule. Results The response rate was 68% (366/535). Respondents’ median practice tenure was eight years (37% female, 92% emergency medicine board certified). Symptom quality and typical vascular risk factors increased suspicion for stroke as a cause of dizziness. Most respondents reported obtaining head computed tomography (CT) (74%). Nearly all respondents used and felt confident using cranial nerve and limb strength testing. A substantial minority of EPs used the Epley maneuver (49%) and HINTS (head-thrust test, gaze-evoked nystagmus, and skew deviation) testing (30%); however, few EPs reported confidence in these tests’ bedside application (35% and 16%, respectively). Respondents favorably viewed applying a properly validated clinical prediction rule for assessment of immediate and 30-day stroke risk, but indicated it would have to reduce stroke risk to <0.5% to be clinically useful. Conclusion EPs report relying on symptom quality, vascular risk factors, simple physical exam elements, and head CT to diagnose stroke as the cause of dizziness, but would find a validated clinical prediction rule for dizziness helpful. A clinical prediction rule would have to achieve a 0.5% post-test stroke probability for acceptability. PMID:26587108

  9. Juvenile respiratory papillomatosis: risk factors for severity.

    PubMed

    Rodier, Caroline; Lapointe, Annie; Coutlée, François; Mayrand, Marie-Hélène; Dal Soglio, Dorothée; Roger, Michel; Trottier, Helen

    2013-08-01

    Juvenile recurrent respiratory papillomatosis is caused mainly by human papillomavirus genotypes 6 or 11, acquired at birth or during pregnancy from an infected mother. Recurrent respiratory papillomatosis is characterized by recurring warts growing most commonly in the larynx. Multiple surgical procedures and the risk of airway obstruction contribute to the devastating impact of this disease. Some children will go into remission after a few surgeries whereas others will require repeated interventions over several years. Further understanding of the risk factors associated with severity may contribute to tailored treatments. A retrospective study of cases diagnosed between January 1995 and December 2008 was conducted to study determinants of severe forms of juvenile recurrent respiratory papillomatosis. Demographic and clinical variables were abstracted from children's medical charts and mothers' delivery charts. Viral factors (HPV genotyping and viral load) were studied from archived biopsies. Specific HLA class II alleles and killer-cell immunoglobulin-like receptors genes were tested from saliva samples. Logistic regression was performed to identify risk factors for severity. Overall, 31 pediatric cases of recurrent respiratory papillomatosis were identified. The only significant factor associated with severe forms of recurrent respiratory papillomatosis was the maternal history of condylomas during pregnancy (OR: 12.05 [P=0.05]). The analysis failed to identify risk factors that could be used clinically to identify recurrent respiratory papillomatosis cases likely to take a severe course. Although too early to determine, vaccination against the HPV types involved most commonly in recurrent respiratory papillomatosis may provide the best hope to prevent severe forms of this disease.

  10. Risk factors for complete uterine rupture.

    PubMed

    Al-Zirqi, Iqbal; Daltveit, Anne Kjersti; Forsén, Lisa; Stray-Pedersen, Babill; Vangen, Siri

    2017-02-01

    Complete uterine rupture is a rare peripartum complication associated with a catastrophic outcome. Because of its rarity, knowledge about its risk factors is not very accurate. Most previous studies were small and over a limited time interval. Moreover, international diagnostic coding was used in most studies. These codes are not able to differentiate between the catastrophic complete type and less catastrophic partial type. Complete uterine rupture is expected to increase as the rate of cesarean delivery increases. Thus, we need more accurate knowledge about the risk factors for this complication. The objective of the study was to estimate the incidence and risk factors for complete uterine rupture during childbirth in Norway. This population-based study included women that gave birth after starting labor in 1967-2008. Data were from the Medical Birth Registry of Norway and Patient Administration System, complemented with information from medical records. We included 1,317,967 women without previous cesarean delivery and 57,859 with previous cesarean delivery. The outcome was complete uterine rupture (tearing of all uterine wall layers, including serosa and membranes). Risk factors were parameters related to demographics, pregnancy, and labor. Odds ratios for complete uterine rupture were computed with crude logistic regressions for each risk factor. Separate multivariable logistic regressions were performed to calculate the adjusted odds ratios and 95% confidence intervals. Complete uterine rupture occurred in 51 cases without previous cesarean delivery (0.38 per 10,000) and 122 with previous cesarean delivery (21.1 per 10,000). The strongest risk factor was sequential labor induction with prostaglandins and oxytocin, compared with spontaneous labor, in those without previous cesarean delivery (adjusted odds ratio, 48.0, 95% confidence interval, 20.5-112.3) and those with previous cesarean delivery (adjusted odds ratio, 16.1, 95% confidence interval, 8

  11. A case-crossover study of risk factors for occupational eye injuries.

    PubMed

    Blackburn, Justin; Levitan, Emily B; MacLennan, Paul A; Owsley, Cynthia; McGwin, Gerald

    2012-01-01

    To study transient risk factors for occupational eye injuries. A case-crossover study was conducted among patients treated for occupational eye injuries in the emergency department at an eye hospital in Alabama. A questionnaire was administered to collect information regarding risk factors at the time of and prior to eye treatment. Incidence rate ratios were used to measure the relationship between each risk factor and injury occurrence. Protective eyewear reduced the risk of occupational eye injury, while increased risk was observed for the following: being distracted, use of tools, tool malfunction, performing an unfamiliar task, being rushed, working overtime, and feeling fatigued. Although use of protective eyewear can significantly reduce the risk of an eye injury, other factors are important contributors. Identification of potentially modifiable transient risk factors can be used to prevent occupational eye injuries.

  12. A Risk Radar driven by Internet of intelligences serving for emergency management in community.

    PubMed

    Huang, Chongfu; Wu, Tong; Renn, Ortwin

    2016-07-01

    Today, most of the commercial risk radars only have the function to show risks, as same as a set of risk matrixes. In this paper, we develop the Internet of intelligences (IOI) to drive a risk radar monitoring dynamic risks for emergency management in community. An IOI scans risks in a community by 4 stages: collecting information and experience about risks; evaluating risk incidents; verifying; and showing risks. Employing the information diffusion method, we optimized to deal with the effective information for calculating risk value. Also, a specific case demonstrates the reliability and practicability of risk radar. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Nanopesticides and Nanofertilizers: Emerging Contaminants or Opportunities for Risk Mitigation?

    PubMed

    Kah, Melanie

    2015-01-01

    Research into nanotechnology applications for use in agriculture has become increasingly popular over the past decade, with a particular interest in developing novel nanoagrochemicals in the form of so-called "nanopesticides" and "nanofertilizers." In view of the extensive body of scientific literature available on the topic, many authors have foreseen a revolution in current agricultural practices. This perspective integrates scientific, regulatory, public and commercial viewpoints, and aims at critically evaluating progress made over the last decade. A number of key (and sometimes controversial) questions are addressed with the aim of identifying the products that will soon emerge on the market and analyzing how they can fit into current regulatory and commercial frameworks. Issues related to the differences in definitions and perceptions within different sectors are discussed, as well as our current ability to assess new risks and benefits relative to conventional products. Many nanoagrochemicals resemble products used currently, which raises the question whether the effect of formulation has been sufficiently taken into account when evaluating agrochemicals. This analysis identifies directions for future research and regulatory needs in order to encourage intelligent design and promote the development of more sustainable agrochemicals.

  14. Risk Factors for Urosepsis in Older Adults

    PubMed Central

    Peach, Brian C.; Garvan, Gerard J.; Garvan, Cynthia S.; Cimiotti, Jeannie P.

    2016-01-01

    Objective: To identify factors that predispose older adults to urosepsis and urosepsis-related mortality. Method: A systematic search using PubMed and CINAHL databases. Articles that met inclusion criteria were assessed using the Strengthening the Reporting of OBservational studies in Epidemiology (STROBE) criteria and were scored on a 4-point Likert-type scale. Results: A total of 180 articles were identified, and six met inclusion criteria. The presence of an internal urinary catheter was associated with the development of urosepsis and septic shock. Although a number of factors were examined, functional dependency, number of comorbidities, and low serum albumin were associated with mortality across multiple studies included in this review. Discussion: Little scientific evidence is available on urosepsis, its associated risk factors, and those factors associated with urosepsis-related mortality in older adults. More research is warranted to better understand urosepsis in this vulnerable population in an effort to improve the quality of patient care. PMID:28138493

  15. Parkinson's disease: evidence for environmental risk factors.

    PubMed

    Kieburtz, Karl; Wunderle, Kathryn B

    2013-01-01

    Parkinson's disease (PD) has no known cause. Although recent research has focused particularly on genetic causes of PD, environmental causes also play a role in developing the disease. This article reviews environmental factors that may increase the risk of PD, as well as the evidence behind those factors. Enough evidence exists to suggest that age has a causal relationship to PD. Significant evidence exists that gender, tobacco use, and caffeine consumption are also associated with the development of PD. Other environmental factors (pesticide exposure, occupation, blood urate levels, NSAID use, brain injury, and exercise) have limited or conflicting evidence of a relationship to PD. Future research must not neglect the impact of these environmental factors on the development of PD, especially with respect to potential gene-environment interactions.

  16. Cancer-related fatigue: Mechanisms, risk factors, and treatments

    PubMed Central

    Bower, Julienne E.

    2015-01-01

    Fatigue is one of the most common and distressing side effects of cancer and its treatment, and may persist for years after treatment completion in otherwise healthy survivors. Cancer-related fatigue causes disruption in all aspects of quality of life and may be a risk factor for reduced survival. The prevalence and course of fatigue in cancer patients has been well characterized, and there is growing understanding of underlying biological mechanisms. Inflammation has emerged as a key biological pathway for cancer-related fatigue, with studies documenting links between markers of inflammation and fatigue before, during, and particularly after treatment. There is considerable variability in the experience of cancer-related fatigue that is not explained by disease- or treatment-related characteristics, suggesting that host factors may play an important role in the development and persistence of this symptom. Indeed, longitudinal studies have begun to identify genetic, biological, psychosocial, and behavioral risk factors for cancer-related fatigue. Given the multi-factorial nature of cancer-related fatigue, a variety of intervention approaches have been examined in randomized controlled trials, including physical activity, psychosocial, mind-body, and pharmacological treatments. Although there is currently no gold standard for treating fatigue, several of these approaches have shown beneficial effects and can be recommended to patients. This report provides a state of the science review of mechanisms, risk factors, and interventions for cancer-related fatigue, with a focus on recent longitudinal studies and randomized trials that have targeted fatigued patients. PMID:25113839

  17. [Elevated blood pressure as cardiovascular risk factor].

    PubMed

    Kowalewski, Wiesław; Hebel, Kazimiera

    2013-01-01

    Cardiovascular diseases for decades have been and still are the main and current health problem of the Polish society and there are many reasons for these diseases. Hypertension is one of the major risk factors for developing cardiovascular disease. The factors significantly increasing risk the of cardiovascular disease are in addition to high blood pressure, smoking (also passive), high blood fats (cholesterol and its HDL, LDL fractions as well as triglyceride levels, obesity, lack of exercise, diabetes and hereditary features. Other important factors which play an important role are external factors such as e.g. environmental pollution, lifestyle, stress. Prediction of cardiovascular disease should start from the evaluation of the fetal period because low birth weight may be a risk of coronary heart disease, hypertension, obesity or diabetes in adulthood. The authors of the referred tests showed that the level of blood pressure observed during childhood is closely associated with the level of blood pressure in adults and is also dependent on the body weight. Since the issue of the effects of high pressure on the cardiovascular system is inherent in the issue of the metabolic syndrome, it should be mentioned also that another causative factor may be an irregularity in the removal of urine from the body and the amount of insulin. The control of hypertension is a complex problem, at least in view of the wide range of adverse factors affecting the human body: hypertension is often either a constituent of other lesions. Therefore, it is difficult to treat high blood pressure in the strict sense; more often it is a combination therapy based on pharmacology caused for other reasons.

  18. Familial risk factors favoring drug addiction onset.

    PubMed

    Zimić, Jadranka Ivandić; Jukić, Vlado

    2012-01-01

    This study, primarily aimed at identification of familial risk factors favoring drug addiction onset, was carried out throughout 2008 and 2009. The study comprised a total of 146 addicts and 134 control subjects. Based on the study outcome, it can be concluded that in the families the addicts were born into, familial risk factors capable of influencing their psychosocial development and favoring drug addiction onset had been statistically more frequently encountered during childhood and adolescence as compared to the controls. The results also indicated the need for further research into familial interrelations and the structure of the families addicts were born into, as well as the need for the implementation of family-based approaches to both drug addiction prevention and therapy.

  19. [Risk factors for hysterectomy among Brazilian women].

    PubMed

    de Araújo, Thália V Barreto; Aquino, Estela M L

    2003-01-01

    A case-control study was conducted to investigate risk factors for hysterectomy among women using the public health system in Northeast Brazil. The cases were 373 women aged 30-54 years that had undergone elective hysterectomy for benign pelvic conditions. Controls were 742 women with preserved uterus selected from public health clinics. Data were collected through a review of medical records and a personal interview using a structured, pre-tested questionnaire. Unconditional multiple logistic regression was applied in the analysis. Women at greater risk for hysterectomy were those with a higher per capita family income, zero to three children, a history of medical consultation for menstrual problems, hospitalization for gynecological problems, or tubal ligation before age 30 years. Menopause and a history of stillbirth appeared as protective factors in the statistical analysis.

  20. Dynamic risk factors: the Kia Marama evaluation.

    PubMed

    Hudson, Stephen M; Wales, David S; Bakker, Leon; Ward, Tony

    2002-04-01

    Risk assessment is an essential part of clinical practice. Each of the three aspects of risk (static, stable, and acute dynamic) are important at various points of contact between the man and the systems that are responsible for providing service. Dynamic factors, the typical treatment and supervision targets, have received less research attention than static factors. This paper examined the extent to which pretreatment, posttreatment and change scores were associated with reoffending among men incarcerated for sexually molesting. The results were generally supportive of change in prooffending attitudes as the key to not reoffending and suggested that the perspective-taking component of empathy and the use of fantasy may be important mechanisms. Affect scales generally failed to show any relationship with reoffending, outside decreases in trait and suppressed anger. Moreover, these data suggest that we could improve our assessments and treatment through increased sensitivity to offense pathways.

  1. Risk factors for amyotrophic lateral sclerosis

    PubMed Central

    Ingre, Caroline; Roos, Per M; Piehl, Fredrik; Kamel, Freya; Fang, Fang

    2015-01-01

    Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease. It is typically fatal within 2–5 years of symptom onset. The incidence of ALS is largely uniform across most parts of the world, but an increasing ALS incidence during the last decades has been suggested. Although recent genetic studies have substantially improved our understanding of the causes of ALS, especially familial ALS, an important role of non-genetic factors in ALS is recognized and needs further study. In this review, we briefly discuss several major genetic contributors to ALS identified to date, followed by a more focused discussion on the most commonly examined non-genetic risk factors for ALS. We first review factors related to lifestyle choices, including smoking, intake of antioxidants, physical fitness, body mass index, and physical exercise, followed by factors related to occupational and environmental exposures, including electromagnetic fields, metals, pesticides, β-methylamino-L-alanine, and viral infection. Potential links between ALS and other medical conditions, including head trauma, metabolic diseases, cancer, and inflammatory diseases, are also discussed. Finally, we outline several future directions aiming to more efficiently examine the role of non-genetic risk factors in ALS. PMID:25709501

  2. Risk factors for atherosclerosis in young individuals.

    PubMed

    Misra, A

    2000-06-01

    Atherosclerosis starts in childhood, and is accelerated in some individuals. A cluster of clinical and biochemical factors constitute the risk profile for many of them, perhaps most important being metabolic insulin resistance syndrome. Insulin resistance and its components for children and adolescents, especially obesity and dyslipidemia, are generators of hypertension, glucose intolerance and complications of atherosclerosis in adulthood. Some individuals are genetically predisposed, particularly those with the family history of such disorders. For many subjects, there is 'tracking' of metabolic and lifestyle factors from early age to adulthood. Several new risk factors of atherosclerosis (e.g. level of lipoprotein (a), procoagulant state, hyperhomocysteinemia, low birth weight and adverse in-utero environment, and possibly inflammatory markers) are current and potentially future areas of research concerning children and young individuals. Definition of and research on new and hitherto not investigated factors and formulation of strategies to neutralize the known factors are of paramount importance for primary prevention of atherosclerosis. Simple and effective measures for prevention include increasing awareness of the diseases, maintenance of ideal body weight, regular physical exercise, avoidance of smoking and chewing of tobacco, eating a balanced diet, and early periodic monitoring of blood pressure and metabolic status. These measures, starting from childhood, should be applied to all and in particular to the susceptible offspring, predisposed individuals, and populations.

  3. [Risk factors of fatal outcome in pancreatonecrosis].

    PubMed

    Romanov, É I; Zubeev, P S; Ryzhov, M K; Bodrov, A A

    2014-01-01

    The article analyzed risk factors after operations for pancreatonecrosis in order to predict a course of the disease and carefully plan the treatment. It was revealed that the lethality level depended on different factors: the sex, age, a period of admission to the hospital, prevalence of necrotic suppurative process and severity of operative trauma. The authors made a conclusion of radical change to treatment approach. The open operations should be reduced at the expense of introduction of low-invasive methods of treatment in the case of pancreatonecrosis.

  4. Gastric cancer: epidemiology and risk factors.

    PubMed

    de Martel, Catherine; Forman, David; Plummer, Martyn