Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study.

PubMed

Nematy, Mohsen; Alinezhad-Namaghi, Maryam; Rashed, Masoud Mahdavi; Mozhdehifard, Mostafa; Sajjadi, Seyedeh Sania; Akhlaghi, Saeed; Sabery, Maryam; Mohajeri, Seyed Amir R; Shalaey, Neda; Moohebati, Mohsen; Norouzy, Abdolreza

2012-09-10

Previous research has shown that Ramadan fasting has beneficial effects on cardiovascular risk factors, however there are controversies. In the present study, the effect of Ramadan fasting on cardiovascular risk factors has been investigated. This is a prospective observational study that was carried out in a group of patients with at least one cardiovascular risk factor (including history of documented previous history of either coronary artery disease (CAD), metabolic syndrome or cerebro-vascular disease in past 10 y). Eighty two volunteers including 38 male and 44 female, aged 29-70 y, mean 54.0 ± 10 y, with a previous history of either coronary artery disease, metabolic syndrome or cerebro-vascular disease were recruited. Subjects attended the metabolic unit after at least 10 h fasting, before and after Ramadan who were been fasting for at least 10 days. A fasting blood sample was obtained, blood pressure was measured and body mass index (BMI) was calculated. Lipids profile, fasting blood sugar (FBS) and insulin, homocysteine (hcy), high-sensitivity C-reactive protein (hs-CRP) and complete blood count (CBC) were analyzed on all blood samples. A significant improvement in 10 years coronary heart disease risk (based on Framingham risk score) was found (13.0 ± 8 before Ramadan and 10.8 ±7 after Ramadan, P <0.001, t test).There was a significant higher HDL-c, WBC, RBC and platelet count (PLT), and lower plasma cholesterol, triglycerides, LDL-c, VLDL-c, systolic blood pressure, body mass index and waist circumference after Ramadan (P <0.05, t test). The changes in FBS, insulin, Homeostasis Model Assessment Insulin Resistance (HOMA-IR), hcy, hs-CRP and diastolic blood pressure before and after Ramadan were not significant (P >0.05, t test). This study shows a significant improvement in 10 years coronary heart disease risk score and other cardiovascular risk factors such as lipids profile, systolic blood pressure, weight, BMI and waist circumference

The Age-Specific Quantitative Effects of Metabolic Risk Factors on Cardiovascular Diseases and Diabetes: A Pooled Analysis

PubMed Central

Farzadfar, Farshad; Stevens, Gretchen A.; Woodward, Mark; Wormser, David; Kaptoge, Stephen; Whitlock, Gary; Qiao, Qing; Lewington, Sarah; Di Angelantonio, Emanuele; vander Hoorn, Stephen; Lawes, Carlene M. M.; Ali, Mohammed K.; Mozaffarian, Dariush; Ezzati, Majid

2013-01-01

Background The effects of systolic blood pressure (SBP), serum total cholesterol (TC), fasting plasma glucose (FPG), and body mass index (BMI) on the risk of cardiovascular diseases (CVD) have been established in epidemiological studies, but consistent estimates of effect sizes by age and sex are not available. Methods We reviewed large cohort pooling projects, evaluating effects of baseline or usual exposure to metabolic risks on ischemic heart disease (IHD), hypertensive heart disease (HHD), stroke, diabetes, and, as relevant selected other CVDs, after adjusting for important confounders. We pooled all data to estimate relative risks (RRs) for each risk factor and examined effect modification by age or other factors, using random effects models. Results Across all risk factors, an average of 123 cohorts provided data on 1.4 million individuals and 52,000 CVD events. Each metabolic risk factor was robustly related to CVD. At the baseline age of 55–64 years, the RR for 10 mmHg higher SBP was largest for HHD (2.16; 95% CI 2.09–2.24), followed by effects on both stroke subtypes (1.66; 1.39–1.98 for hemorrhagic stroke and 1.63; 1.57–1.69 for ischemic stroke). In the same age group, RRs for 1 mmol/L higher TC were 1.44 (1.29–1.61) for IHD and 1.20 (1.15–1.25) for ischemic stroke. The RRs for 5 kg/m2 higher BMI for ages 55–64 ranged from 2.32 (2.04–2.63) for diabetes, to 1.44 (1.40–1.48) for IHD. For 1 mmol/L higher FPG, RRs in this age group were 1.18 (1.08–1.29) for IHD and 1.14 (1.01–1.29) for total stroke. For all risk factors, proportional effects declined with age, were generally consistent by sex, and differed by region in only a few age groups for certain risk factor-disease pairs. Conclusion Our results provide robust, comparable and precise estimates of the effects of major metabolic risk factors on CVD and diabetes by age group. PMID:23935815

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. ...

The effect of chronic consumption of red wine on cardiovascular disease risk factors in postmenopausal women.

PubMed

Naissides, Mary; Mamo, John C L; James, Anthony P; Pal, Sebely

2006-04-01

Moderate red wine has been shown to reduce cardiovascular disease (CVD) risk, however the effects on certain CVD risk factors are unclear. In this study we have investigated the effects of dealcoholised red wine (DRW) and full-complement red wine (RW) on several cardiovascular risk factors in mildly hypercholesterolaemic postmenopausal women. To elucidate whether the chronic consumption of red wine polyphenols improves risk factors associated with CVD in hypercholesterolaemic postmenopausal women. Forty-five hypercholesterolaemic postmenopausal women were randomly assigned to consume 400 mL/day of either water, DRW or RW for 6 weeks following a 4-week washout. Fasting measures of lipids, lipoproteins, insulin and glucose were taken at 0 and 6 weeks. DRW consumption had no effect of fasting concentrations of lipids, lipoproteins, insulin and glucose. However, chronic consumption of RW significantly reduced fasting LDL cholesterol concentrations by 8% and increased HDL cholesterol concentrations by 17% in hypercholesterolaemic postmenopausal women. Collectively, regular consumption of full-complement red wine reduces CVD risk by improving fasting lipid levels in hypercholesterolaemic postmenopausal women. This study uniquely demonstrated the LDL cholesterol-lowering effects of red wine in individuals at high CVD risk, which has not previously been shown.

Communication of uncertainty regarding individualized cancer risk estimates: effects and influential factors.

PubMed

Han, Paul K J; Klein, William M P; Lehman, Tom; Killam, Bill; Massett, Holly; Freedman, Andrew N

2011-01-01

To examine the effects of communicating uncertainty regarding individualized colorectal cancer risk estimates and to identify factors that influence these effects. Two Web-based experiments were conducted, in which adults aged 40 years and older were provided with hypothetical individualized colorectal cancer risk estimates differing in the extent and representation of expressed uncertainty. The uncertainty consisted of imprecision (otherwise known as "ambiguity") of the risk estimates and was communicated using different representations of confidence intervals. Experiment 1 (n = 240) tested the effects of ambiguity (confidence interval v. point estimate) and representational format (textual v. visual) on cancer risk perceptions and worry. Potential effect modifiers, including personality type (optimism), numeracy, and the information's perceived credibility, were examined, along with the influence of communicating uncertainty on responses to comparative risk information. Experiment 2 (n = 135) tested enhanced representations of ambiguity that incorporated supplemental textual and visual depictions. Communicating uncertainty led to heightened cancer-related worry in participants, exemplifying the phenomenon of "ambiguity aversion." This effect was moderated by representational format and dispositional optimism; textual (v. visual) format and low (v. high) optimism were associated with greater ambiguity aversion. However, when enhanced representations were used to communicate uncertainty, textual and visual formats showed similar effects. Both the communication of uncertainty and use of the visual format diminished the influence of comparative risk information on risk perceptions. The communication of uncertainty regarding cancer risk estimates has complex effects, which include heightening cancer-related worry-consistent with ambiguity aversion-and diminishing the influence of comparative risk information on risk perceptions. These responses are influenced by

Media Violence and Other Aggression Risk Factors in Seven Nations.

PubMed

Anderson, Craig A; Suzuki, Kanae; Swing, Edward L; Groves, Christopher L; Gentile, Douglas A; Prot, Sara; Lam, Chun Pan; Sakamoto, Akira; Horiuchi, Yukiko; Krahé, Barbara; Jelic, Margareta; Liuqing, Wei; Toma, Roxana; Warburton, Wayne A; Zhang, Xue-Min; Tajima, Sachi; Qing, Feng; Petrescu, Poesis

2017-07-01

Cultural generality versus specificity of media violence effects on aggression was examined in seven countries (Australia, China, Croatia, Germany, Japan, Romania, the United States). Participants reported aggressive behaviors, media use habits, and several other known risk and protective factors for aggression. Across nations, exposure to violent screen media was positively associated with aggression. This effect was partially mediated by aggressive cognitions and empathy. The media violence effect on aggression remained significant even after statistically controlling a number of relevant risk and protective factors (e.g., abusive parenting, peer delinquency), and was similar in magnitude to effects of other risk factors. In support of the cumulative risk model, joint effects of different risk factors on aggressive behavior in each culture were larger than effects of any individual risk factor.

Effects of transdermal estrogen replacement therapy on cardiovascular risk factors.

PubMed

Menon, Dileep V; Vongpatanasin, Wanpen

2006-01-01

The prevalence of hypertension and cardiovascular disease increases dramatically after menopause in women, implicating estrogen as having a protective role in the cardiovascular system. However, recent large clinical trials have failed to show cardiovascular benefit, and have even demonstrated possible harmful effects, of opposed and unopposed estrogen in postmenopausal women. While these findings have led to a revision of guidelines such that they discourage the use of estrogen for primary or secondary prevention of heart disease in postmenopausal women, many investigators have attributed the negative results in clinical trials to several flaws in study design, including the older age of study participants and the initiation of estrogen late after menopause.Because almost all clinical trials use oral estrogen as the primary form of hormone supplementation, another question that has arisen is the importance of the route of estrogen administration with regards to the cardiovascular outcomes. During oral estrogen administration, the concentration of estradiol in the liver sinusoids is four to five times higher than that in the systemic circulation. This supraphysiologic concentration of estrogen in the liver can modulate the expression of many hepatic-derived proteins, which are not observed in premenopausal women. In contrast, transdermal estrogen delivers the hormone directly into the systemic circulation and, thus, avoids the first-pass hepatic effect.Although oral estrogen exerts a more favorable influence than transdermal estrogen on traditional cardiovascular risk factors such as high- and low-density lipoprotein-cholesterol levels, recent studies have indicated that oral estrogen adversely influences many emerging risk factors in ways that are not seen with transdermal estrogen. Oral estrogen significantly increases levels of acute-phase proteins such as C-reactive protein and serum amyloid A; procoagulant factors such as prothrombin fragments 1+2; and several

Elaborations on sexual assault on dates among Israeli students: risk, detrimental effect, and resilience factors.

PubMed

Shechory Bitton, Mally; Ben-David, Sarah

2014-12-01

The current study of 668 Israeli male and female students examines the prevalence of gendered risk factors for sexual assault (SA) on dates, posttraumatic stress disorder (PTSD) as a detrimental effect of SA, and self-efficacy as resiliency to refuse unwanted sex following SA. Two different sets of risk factors that increased the likelihood of SA on dates emerged from the hierarchical regression. Sexual experience, use of drugs, and private location increased the risk of being SA victims among males, whereas sexual experience, perceived provocative behavior, and alcohol use increased the risk among females. In addition, PTSD and self-efficacy to refuse unwanted sex following SA on dates were predicted by the extent of coercive sexual victimization. PTSD was also predicted by subjective perception of sexual behavior and rape myths, whereas efficacy was predicted by private location. The findings contribute to the literature by showing the contribution of various risk factors to experiencing SA, and by showing SA effect on PTSD and self-efficacy. © The Author(s) 2013.

The Effects of Chronic Aerobic Exercise on Cardiovascular Risk Factors in Persons with Diabetes Mellitus.

PubMed

Miele, Emily M; Headley, Samuel A E

2017-09-12

Aerobic exercise training is a component of diabetes mellitus (DM) care guidelines due to its favorable effects on glycemic control and cardiovascular disease (CVD) risk factors. The purpose of this review is to outline the recent evidence regarding the clinical effects of chronic aerobic exercise on CVD risk factors in persons with DM and to compare the effects of varying intensities and types of exercise. Among individuals with DM, all types of aerobic exercise training can impact positively on some traditional and non-traditional risk factors for CVD. Training programs with a higher volume or intensity induce greater improvements in vascular function, cardiorespiratory fitness (CRF), and lipid profiles. The beneficial outcomes of aerobic training include improvements in glycemic control, endothelial function, oxidative stress, dyslipidemia, myocardial function, adiposity, and CRF. Findings regarding markers of inflammation are discrepant and further research should focus on the role of exercise to impact upon the chronic inflammation associated with DM.

Language delay in severely neglected children: a cumulative or specific effect of risk factors?

PubMed

Sylvestre, Audette; Mérette, Chantal

2010-06-01

This research sought to determine if the language delay (LD) of severely neglected children under 3 years old was better explained by a cumulative risk model or by the specificity of risk factors. The objective was also to identify the risk factors with the strongest impact on LD among various biological, psychological, and environmental factors. Sixty-eight severely neglected children and their mothers participated in this cross-sectional study. Children were between 2 and 36 months of age. Data included information about the child's language development and biological, psychological, and environmental risk factors. Prevalence of LD is significantly higher in this subgroup of children than in the population as a whole. Although we observed that the risk of LD significantly increased with an increase in the cumulative count of the presence of the child's biological-psychological risk factors, the one-by-one analysis of the individual factors revealed that the cumulative effect mainly reflected the specific impact of the child's cognitive development. When we considered also the environmental risk factors, multivariate logistic regression established that cognitive development, the mother's own physical and emotional abuse experience as a child, and the mother's low acceptability level towards her child are linked to LD in severely neglected children. Language development is the result of a complex interaction between risk factors. LD in severely neglected children is better explained by the specificity of risk factors than by the cumulative risk model. Most prevention and early intervention programs promote and target an increase in the quantity and quality of language stimulation offered to the child. Our results suggest that particular attention should be given to other environmental factors, specifically the mother's psychological availability and her sensitivity towards the child. It is essential to suggest interventions targeting various ecological dimensions

The relationship between the effect of pravastatin and risk factors for coronary heart disease in Japanese patients with hypercholesterolemia.

PubMed

Ishikawa, Toshitsugu; Mizuno, Kyoichi; Nakaya, Noriaki; Ohashi, Yasuo; Tajima, Naoko; Kushiro, Toshio; Teramoto, Tamio; Uchiyama, Shinichiro; Nakamura, Haruo

2008-10-01

Several epidemiologic studies in Japan have shown the risk factors for coronary heart disease (CHD) in the general population. The present analysis determined the risk factors for CHD in the MEGA Study, a large primary prevention trial with pravastatin in Japanese with hypercholesterolemia. The relationship between each baseline characteristic and the risk of CHD for the 5-year study period were evaluated using the Cox proportional hazard model. The multivariable predictors of CHD were sex, age, high-density lipoprotein-cholesterol (HDL-C), diabetes mellitus (DM), hypertension (HT), and history of smoking. Serum total and low-density lipoprotein-cholesterol were not independent risk factors for CHD in the current analysis. In addition, the effect of pravastatin was evaluated by subgroups in each risk factor using the interaction in a Cox model. Diet plus pravastatin treatment reduced CHD risk by 14-43% compared with diet alone, regardless of the presence or absence of risk factors. The risk factors for CHD were sex, age, DM, HT, smoking, and low HDL-C in the MEGA Study. The pravastatin treatment was effective for reducing the risk of CHD, regardless of the presence of risk factors.

Early life risk factors and their cumulative effects as predictors of overweight in Spanish children.

PubMed

Iguacel, Isabel; Escartín, Laura; Fernández-Alvira, Juan M; Iglesia, Iris; Labayen, Idoia; Moreno, Luis A; Samper, María Pilar; Rodríguez, Gerardo

2018-05-01

To explore early life risk factors of overweight/obesity at age 6 years and their cumulative effects on overweight/obesity at ages 2, 4 and 6 years. Altogether 1031 Spanish children were evaluated at birth and during a 6-year follow-up. Early life risk factors included: parental overweight/obesity, parental origin/ethnicity, maternal smoking during pregnancy, gestational weight gain, gestational age, birth weight, caesarean section, breastfeeding practices and rapid infant weight gain collected via hospital records. Cumulative effects were assessed by adding up those early risk factors that significantly increased the risk of overweight/obesity. We conducted binary logistic regression models. Rapid infant weight gain (OR 2.29, 99% CI 1.54-3.42), maternal overweight/obesity (OR 1.93, 99% CI 1.27-2.92), paternal overweight/obesity (OR 2.17, 99% CI 1.44-3.28), Latin American/Roma origin (OR 3.20, 99% CI 1.60-6.39) and smoking during pregnancy (OR 1.61, 99% CI 1.01-2.59) remained significant after adjusting for confounders. A higher number of early life risk factors accumulated was associated with overweight/obesity at age 6 years but not at age 2 and 4 years. Rapid infant weight gain, parental overweight/obesity, maternal smoking and origin/ethnicity predict childhood overweight/obesity and present cumulative effects. Monitoring children with rapid weight gain and supporting a healthy parental weight are important for childhood obesity prevention.

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

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.

Quantifying cardiometabolic risk using modifiable non-self-reported risk factors.

PubMed

Marino, Miguel; Li, Yi; Pencina, Michael J; D'Agostino, Ralph B; Berkman, Lisa F; Buxton, Orfeu M

2014-08-01

Sensitive general cardiometabolic risk assessment tools of modifiable risk factors would be helpful and practical in a range of primary prevention interventions or for preventive health maintenance. To develop and validate a cumulative general cardiometabolic risk score that focuses on non-self-reported modifiable risk factors such as glycosylated hemoglobin (HbA1c) and BMI so as to be sensitive to small changes across a span of major modifiable risk factors, which may not individually cross clinical cut-off points for risk categories. We prospectively followed 2,359 cardiovascular disease (CVD)-free subjects from the Framingham offspring cohort over a 14-year follow-up. Baseline (fifth offspring examination cycle) included HbA1c and cholesterol measurements. Gender-specific Cox proportional hazards models were considered to evaluate the effects of non-self-reported modifiable risk factors (blood pressure, total cholesterol, high-density lipoprotein cholesterol, smoking, BMI, and HbA1c) on general CVD risk. We constructed 10-year general cardiometabolic risk score functions and evaluated its predictive performance in 2012-2013. HbA1c was significantly related to general CVD risk. The proposed cardiometabolic general CVD risk model showed good predictive performance as determined by cross-validated discrimination (male C-index=0.703, 95% CI=0.668, 0.734; female C-index=0.762, 95% CI=0.726, 0.801) and calibration (lack-of-fit chi-square=9.05 [p=0.338] and 12.54 [p=0.128] for men and women, respectively). This study presents a risk factor algorithm that provides a convenient and informative way to quantify cardiometabolic risk on the basis of modifiable risk factors that can motivate an individual's commitment to prevention and intervention. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Quantifying Cardiometabolic Risk Using Modifiable Non–Self-Reported Risk Factors

PubMed Central

Marino, Miguel; Li, Yi; Pencina, Michael J.; D’Agostino, Ralph B.; Berkman, Lisa F.; Buxton, Orfeu M.

2014-01-01

Background Sensitive general cardiometabolic risk assessment tools of modifiable risk factors would be helpful and practical in a range of primary prevention interventions or for preventive health maintenance. Purpose To develop and validate a cumulative general cardiometabolic risk score that focuses on non–self-reported modifiable risk factors such as glycosylated hemoglobin (HbA1c) and BMI so as to be sensitive to small changes across a span of major modifiable risk factors, which may not individually cross clinical cut off points for risk categories. Methods We prospectively followed 2,359 cardiovascular disease (CVD)-free subjects from the Framingham offspring cohort over a 14–year follow-up. Baseline (fifth offspring examination cycle) included HbA1c and cholesterol measurements. Gender–specific Cox proportional hazards models were considered to evaluate the effects of non–self-reported modifiable risk factors (blood pressure, total cholesterol, high–density lipoprotein cholesterol, smoking, BMI, and HbA1c) on general CVD risk. We constructed 10–year general cardiometabolic risk score functions and evaluated its predictive performance in 2012–2013. Results HbA1c was significantly related to general CVD risk. The proposed cardiometabolic general CVD risk model showed good predictive performance as determined by cross-validated discrimination (male C-index=0.703, 95% CI=0.668, 0.734; female C-index=0.762, 95% CI=0.726, 0.801) and calibration (lack-of-fit χ2=9.05 [p=0.338] and 12.54 [p=0.128] for men and women, respectively). Conclusions This study presents a risk factor algorithm that provides a convenient and informative way to quantify cardiometabolic risk based on modifiable risk factors that can motivate an individual’s commitment to prevention and intervention. PMID:24951039

Risk Factors and Dose-Effect Relationship for Mandibular Osteoradionecrosis in Oral and Oropharyngeal Cancer Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Ik Jae; Koom, Woong Sub; Lee, Chang Geol, E-mail: cglee1023@yuhs.a

2009-11-15

Purpose: To analyze risk factors and the dose-effect relationship for osteoradionecrosis (ORN) of the mandible after radiotherapy of oral and oropharyngeal cancers. Materials and Methods: One-hundred ninety-eight patients with oral (45%) and oropharyngeal cancer (55%) who had received external radiotherapy between 1990 and 2000 were retrospectively reviewed. All patients had a dental evaluation before radiotherapy. The median radiation dose was 60 Gy (range, 16-75 Gy), and the median biologically effective dose for late effects (BED{sub late}) in bone was 114 Gy{sub 2} (range, 30-167 Gy{sub 2}). Results: The frequency of ORN was 13 patients (6.6%). Among patients with mandibular surgery,more » eight had ORN at the surgical site. Among patients without mandibular surgery, five patients had ORN on the molar area of the mandible. The median time to ORN was 22 months (range, 1-69 months). Univariate analysis revealed that mandibular surgery and Co-60 were significant risk factors for ORN (p = 0.01 and 0.04, respectively). In multivariate analysis, mandibular surgery was the most important factor (p = 0.001). High radiation doses over BED 102.6 Gy{sub 2} (conventional dose of 54 Gy at 1.8 Gy/fraction) were also a significant factor for ORN (p = 0.008) and showed a positive dose-effect relationship in logistic regression (p = 0.04) for patients who had undergone mandibular surgery. Conclusions: Mandibular surgery was the most significant risk factor for ORN of mandible in oral and oropharyngeal cancers patients. A BED of 102.6 Gy{sub 2} or higher to the mandible also significantly increases the risk of ORN.« less

The effect of sildenafil citrate (Viagra) on cerebral blood flow in patients with cerebrovascular risk factors.

PubMed

Lorberboym, M; Mena, I; Wainstein, J; Boaz, M; Lampl, Y

2010-06-01

Sildenafil citrate is widely used for erectile dysfunction. The present study examined the short-term effects of sildenafil administration in individuals with cerebrovascular risk factors, including patients with a history of stroke. Twenty-five consecutive male patients with erectile dysfunction and vascular risk factors were included in the study. A perfusion brain SPECT study was performed at baseline and 1 h after the oral administration of sildenafil. Associations between any of the risk factors and the perfusion scores were not detected, with the exception of stroke. Stroke patients showed significantly more areas with diminished perfusion after sildenafil administration compared to baseline. In patients with diabetes or hypertension, a dose of 50 mg sildenafil does not appear to produce detrimental effects on cerebral blood flow. However, patients with a history of stroke may be at increased risk of hemodynamic impairment after the use of sildenafil.

Deconstructing racial differences: the effects of quality of education and cerebrovascular risk factors.

PubMed

Carvalho, Janessa O; Tommet, Doug; Crane, Paul K; Thomas, Michael L; Claxton, Amy; Habeck, Christian; Manly, Jennifer J; Romero, Heather R

2015-07-01

To evaluate the effects of vascular conditions and education quality on cognition over time in White and African American (AA) older adults. We investigated cross-sectional and longitudinal racial differences in executive functioning (EF) and memory composites among Whites (n = 461) and AAs (n = 118) enrolled in a cohort study. We examined whether cerebrovascular risk factors and Shipley Vocabulary scores (a proxy for education quality) accounted for racial differences. On average, AAs had lower quality of education and more cerebrovascular risk factors including hypertension, diabetes, and obesity. AAs had lower mean EF and memory at baseline, but there were no group differences in rates of decline. Cross-sectional racial differences in EF and memory persisted after controlling for vascular disease, but disappeared when controlling for Shipley Vocabulary. Quality of education appears to be more important than cerebrovascular risk factors in explaining cross-sectional differences in memory and EF performance between White and AA older adults. Further investigation is needed regarding the relative contribution of education quality and cerebrovascular risk factors to cognitive decline among ethnically/racially diverse older adults. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Risk Factors for Scleroderma

MedlinePlus

... You are here: Home For Patients Risk Factors Risk Factors for Scleroderma The cause of scleroderma is ... what biological factors contribute to scleroderma pathogenesis. Genetic Risk Scleroderma does not tend to run in families ...

Epidemiology and risk factors of schizophrenia.

PubMed

Janoutová, Jana; Janácková, Petra; Serý, Omar; Zeman, Tomás; Ambroz, Petr; Kovalová, Martina; Varechová, Katerina; Hosák, Ladislav; Jirík, Vitezslav; Janout, Vladimír

2016-01-01

Schizophrenia is a severe mental disorder that affects approximately one percent of the general population. The pathogenesis of schizophrenia is influenced by many risk factors, both environmental and genetic. The environmental factors include the date of birth, place of birth and seasonal effects, infectious diseases, complications during pregnancy and delivery, substance abuse and stress. At the present time, in addition to environmental factors, genetic factors are assumed to play a role in the development of the schizophrenia. The heritability of schizo- phrenia is up to 80%. If one parent suffers from the condition, the probability that it will be passed down to the offspring is 13%. If it is present in both parents, the risk is more than 20%. The opinions are varied as to the risk factors affecting the development of schizophrenia. Knowing these factors may greatly contribute to prevention of the condition.

Effects of Three Depression Prevention Interventions on Risk for Depressive Disorder Onset in the Context of Depression Risk Factors

PubMed Central

Rohde, Paul; Stice, Eric; Gau, Jeff M.

2013-01-01

Study aims were to identify subgroups of adolescents with elevated depressive symptoms who had the highest likelihood of developing future major/minor depressive disorder on the basis of depression risk factors and participation in three depression prevention programs, with the goal of evaluating the preventive effect of indicated prevention interventions in the context of known risk factors. Adolescents (N = 341) with elevated depressive symptoms were randomized to one of four prevention intervention conditions (cognitive-behavioral group, supportive-expressive group, cognitive-behavioral bibliotherapy, educational brochure control). By 2-year follow-up, 14% showed onset of major/minor depressive disorders. Classification tree analysis (CTA) revealed that negative attributional style was the most important risk factor: youth with high scores showed a 4-fold increase in depression onset compared to youth who did not endorse this attributional style. For adolescents with negative attributional style, prevention condition emerged as the most important predictor: those receiving bibliotherapy showed a 5-fold reduction in depression disorder onset relative to adolescents in the three other intervention conditions. For adolescents who reported low negative attributional style scores, elevated levels of depressive symptoms at baseline emerged as the most potent predictor. Results implicate two key pathways to depression involving negative attributional style and elevated depressive symptoms in this population, and suggest that bibliotherapy may offset the risk conveyed by the most important depression risk factor in this sample. PMID:22932745

Effects of three depression prevention interventions on risk for depressive disorder onset in the context of depression risk factors.

PubMed

Rohde, Paul; Stice, Eric; Gau, Jeff M

2012-12-01

Study aims were to identify subgroups of adolescents with elevated depressive symptoms who had the highest likelihood of developing future major/minor depressive disorder on the basis of depression risk factors and participation in three depression prevention programs, with the goal of evaluating the preventive effect of indicated prevention interventions in the context of known risk factors. Adolescents (N = 341) with elevated depressive symptoms were randomized to one of four prevention intervention conditions (cognitive-behavioral group, supportive-expressive group, cognitive-behavioral bibliotherapy, educational brochure control). By 2-year follow-up, 14% showed onset of major/minor depressive disorders. Classification tree analysis (CTA) revealed that negative attributional style was the most important risk factor: Youth with high scores showed a 4-fold increase in depression onset compared to youth who did not endorse this attributional style. For adolescents with negative attributional style, prevention condition emerged as the most important predictor: Those receiving bibliotherapy showed a 5-fold reduction in depression disorder onset relative to adolescents in the three other intervention conditions. For adolescents who reported low negative attributional style scores, elevated levels of depressive symptoms at baseline emerged as the most potent predictor. Results implicate two key pathways to depression involving negative attributional style and elevated depressive symptoms in this population, and suggest that bibliotherapy may offset the risk conveyed by the most important depression risk factor in this sample.

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. Copyright © 2012 Elsevier Inc

Environmental and lifestyle risk factors of gastric cancer.

PubMed

Lee, Yeong Yeh; Derakhshan, Mohammad H

2013-06-01

Effective prevention and early diagnostic strategies are the most important public health interventions in gastric cancer, which remains a common malignancy worldwide. Preventive strategies require identification and understanding of environmental risk factors that lead to carcinogenesis. Helicobacter pylori (H. pylori) is the primary carcinogen as this ancient bacterium has a complex ability to interact with its human host. Smoking and salt are strong independent risk factors for gastric cancer whereas alcohol is only a risk when it is heavily consumed. Red meat and high fat increase the risk of gastric cancer however fresh fruits, vegetables (allium family) and certain micronutrients (selenium, vitamin C) reduce the risk, with evidence lacking for fish, coffee and tea. Foods that inhibit H. pylori viability, colonization and infection may reduce cancer risk. Obesity is increasingly recognized as a contributory factor in gastric cardia carcinogenesis. Therefore, modest daily physical activities can be protective against cancer. Foundry workers are at risk for developing gastric cancer with dust iron being an important cause. Other risk factors include Epstein-Barr virus (EBV), possibly JC virus and radiation but the effects of these are likely to remain small.

Protective Factors for Violence among Released Prisoners--Effects over Time and Interactions with Static Risk

ERIC Educational Resources Information Center

Ullrich, Simone; Coid, Jeremy

2011-01-01

Objective: There is a substantial body of research on risk factors for violent behavior in adulthood but little empirical study of protective factors and desistance. Method: This study aimed to investigate the protective effects of factors hypothesized to reduce violent reoffending among a sample of 800 male prisoners following release into the…

Capsaicinoids Modulating Cardiometabolic Syndrome Risk Factors: Current Perspectives

PubMed Central

2016-01-01

Capsaicinoids are bioactive nutrients present within red hot peppers reported to cut ad libitum food intake, to increase energy expenditure (thermogenesis) and lipolysis, and to result in weight loss over time. In addition it has shown more benefits such as improvement in reducing oxidative stress and inflammation, improving vascular health, improving endothelial function, lowering blood pressure, reducing endothelial cytokines, cholesterol lowering effects, reducing blood glucose, improving insulin sensitivity, and reducing inflammatory risk factors. All these beneficial effects together help to modulate cardiometabolic syndrome risk factors. The early identification of cardiometabolic risk factors can help try to prevent obesity, hypertension, diabetes, and cardiovascular disease. PMID:27313880

Personal and couple level risk factors: Maternal and paternal parent-child aggression risk.

PubMed

Tucker, Meagan C; Rodriguez, Christina M; Baker, Levi R

2017-07-01

Previous literature examining parent-child aggression (PCA) risk has relied heavily upon mothers, limiting our understanding of paternal risk factors. Moreover, the extent to which factors in the couple relationship work in tandem with personal vulnerabilities to impact PCA risk is unclear. The current study examined whether personal stress and distress predicted PCA risk (child abuse potential, over-reactive discipline style, harsh discipline practices) for fathers as well as mothers and whether couple functioning mediated versus moderated the relation between personal stress and PCA risk in a sample of 81 couples. Additionally, the potential for risk factors in one partner to cross over and affect their partner's PCA risk was considered. Findings indicated higher personal stress predicted elevated maternal and paternal PCA risk. Better couple functioning did not moderate this relationship but partially mediated stress and PCA risk for both mothers and fathers. In addition, maternal stress evidenced a cross-over effect, wherein mothers' personal stress linked to fathers' couple functioning. Findings support the role of stress and couple functioning in maternal and paternal PCA risk, including potential cross-over effects that warrant further inquiry. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Effect of Interdisciplinary Interventions on Risk Factors for Lifestyle Disease: A Literature Review

ERIC Educational Resources Information Center

Tapsell, Linda C.; Neale, Elizabeth P.

2016-01-01

Interventions that comprise interdisciplinary collaboration including behavioral elements are effective in addressing lifestyle disease risk factors. However, it is not known how best to conduct this collaboration for sustainable change. The aim of this study was to systematically examine the evidence for the effects of interdisciplinary…

Invited review: Incidence, risk factors, and effects of clinical mastitis recurrence in dairy cows.

PubMed

Jamali, Hossein; Barkema, Herman W; Jacques, Mario; Lavallée-Bourget, Eve-Marie; Malouin, François; Saini, Vineet; Stryhn, Henrik; Dufour, Simon

2018-06-01

Clinical mastitis (CM) is one of the most frequent and costly diseases in dairy cows. A frustrating aspect of CM is its recurrent nature. This review was conducted to synthesize knowledge on risk of repeated cases of CM, effects of recurrent CM cases, and risk factors for CM recurrence. A systematic review methodology was used to identify articles for this narrative review. Searches were performed to identify relevant scientific literature published after 1989 in English or French from 2 databases (PubMed and CAB Abstracts) and 1 search platform (Web of Science). Fifty-seven manuscripts were selected for qualitative synthesis according to the inclusion criteria. Among the 57 manuscripts selected in this review, a description of CM recurrence, its risk factors, and effects were investigated and reported in 33, 37, and 19 selected manuscripts, respectively. Meta-analysis and meta-regression analyses were used to compute risk ratio comparing risk of CM in cows that already had 1 CM event in the current lactation with risk of CM in healthy cows. For these analyses, 9 manuscripts that reported the total number of lactations followed and the number of lactations with ≤1 and ≤2 CM cases were used. When summarizing results from studies requiring ≥5 d between CM events to consider a CM event as a new case, we observed no significant change in CM susceptibility following a first CM case (risk ratio: 0.99; 95% confidence interval: 0.86-1.14). However, for studies using a more liberal CM recurrence definition (i.e., only 24 h between CM events to consider new CM cases), we observed a 1.54 times greater CM risk (95% confidence interval: 1.20-1.97) for cows that already had 1 CM event in the current lactation compared with healthy cows. The most important risk factors for CM recurrence were parity (i.e., higher risk in older cows), a higher milk production, pathogen species involved in the preceding case, and whether a bacteriological cure was observed following the

Risk Factors and Levels of Risk for High School Dropouts

ERIC Educational Resources Information Center

Suh, Suhyun; Suh, Jingyo

2007-01-01

The study in this article identifies three major risk categories of high school dropouts and evaluates the impact of possible prevention strategies. As students accumulate these risks, they became more likely to drop out and prevention programs become less effective. Additionally, it was found that factors influencing the decision to drop out vary…

The effect of Ramadan fasting on cardiometabolic risk factors and anthropometrics parameters: A systematic review.

PubMed

Mazidi, Mohsen; Rezaie, Peyman; Chaudhri, Owais; Karimi, Ehsan; Nematy, Mohsen

2015-01-01

Fasting during the month of Ramadan is a religious rituals of all healthy adult Muslims. However, there is no clear agreement on the effects of Ramadan fasting on cardiovascular disease. Comorbidities and factors such as age, gender, health status, daily duration of fasting, food intake before and after fasting may impact on a fasting individual's cardiometabolic risk. This review was undertaken to assess the effects of Ramadan fasting on: the incidence of cardiovascular disease during the month of Ramadan; the clinical status of patients with stable cardiac disease; and any alterations in cardiometabolic risk profile. A systematic search was undertaken for studies that investigated the impact of Ramadan fasting on cardiovascular outcomes and risk factors. Electronic databases including MEDLINE, Scopus and Web of Knowledge were searched from 1982 up to 2014. The incidence of acute cardiac illness during Ramadan fasting was similar when compared to non-fasting days. Ramadan fasting is associated with elevations in high-density lipoprotein cholesterol (HDL-c), and reductions in low-density lipoprotein cholesterol (LDL-c) and total cholesterol (T-chol). However, the lipid profile of diabetic patients deteriorated significantly during Ramadan fasting. In addition, Ramadan fasting lowers body weight, body fat percentage and BMI (body mass index). However, the relationship between weight reduction and loss of body fat is not studied. The majority of patients with stable cardiac illness can opt for Ramadan fasting safely. However, the long term effects of Ramadan fasting on cardiovascular outcomes and risk factors remains uncertain, and the apparent discordant effects in individuals with and without diabetes mellitus merits further study.

[Perception of health risks: psychological and social factors].

PubMed

Kurzenhäuser, S; Epp, A

2009-12-01

This article reviews central findings and current developments of psychological and sociological research on the perception of health risks. Risk perception is influenced by numerous psychological, social, political, and cultural factors. These factors can be categorized into (a) risk characteristics, (b) characteristics of the risk perceiving person and his/her situation, and (c) characteristics of risk communication. Thus, besides individual cognitive and affective processing of risk information, social processes of risk amplification (e.g., media effects) are also involved in the construction of individual risk perceptions. We discuss the recommendations for health risk communication that follow from these findings with regard to different communication goals.

Vascular risk factors and the effect of white matter lesions on extrapyramidal signs in Alzheimer's disease.

PubMed

Park, Moon Ho; Min, Joo Young; Kwon, Do-Young; Lee, Seung Hwan; Na, Hae Ri; Cho, Sung Tae; Na, Duk L

2011-06-01

Extrapyramidal signs (EPSs), which are important characteristics of Parkinson's disease (PD), occur frequently in Alzheimer's disease (AD). Although AD and PD share common clinical features such as EPSs, these diseases vary with respect to vascular risk factors. The presence of vascular risk factors increases the risk of AD; however, these factors have been known to be inversely associated with PD. We aimed to assess the effect of vascular risk factors and white matter lesions (WMLs) on EPSs in AD. We recruited 1,187 AD patients and 333 controls with neither cognitive impairment nor EPSs. All participants underwent detailed clinical evaluations which included assessments of vascular risk factors, cognitive function, and EPSs, as well as WMLs on brain MRIs. EPS subtypes were classified into tremor-dominant, postural instability gait difficulty, or indeterminate; WMLs subtypes were classified into periventricular WML (pvWML) or deep WML (dWML). EPSs were present in 17.9% of subjects with AD and were significantly associated with vascular risk factors such as age, male gender, diabetes mellitus, and WMLs. Additionally, a multivariate logistic regression analysis showed that EPSs in AD were associated with pvWML (odds ratio (OR), 1.61-2.52), not with dWML. With respect to EPS subtypes, the majority (78.4%) of EPSs in AD were postural instability gait difficulty, which was also associated with WMLs (OR 1.84-2.41), pvWML (OR 2.09-3.14), and dWML (OR 1.83-3.42). EPSs in AD are associated with selected vascular risk factors as well as WMLs.

Global risk factor rankings: the importance of age-based health loss inequities caused by alcohol and other risk factors.

PubMed

Shield, Kevin D; Rehm, Jürgen

2015-06-09

Achieving health equity is a priority of the World Health Organization; however, there is a scant amount of literature on this topic. As the underlying influences that determine health loss caused by risk factors are age-dependent, the aim of this paper is to examine how the risk factor rankings for health loss differ by age. Rankings were based on data obtained from the 2010 Global Burden of Disease study. Health loss (as measured by Disability Adjusted Life Years lost) by risk factor was estimated using Population-Attributable Fractions, years of life lost due to premature mortality, and years lived with disability, which were calculated for 187 countries, 20 age groups and both sexes. Uncertainties of the risk factor rankings were estimated using 1,000 simulations taken from posterior distributions The top risk factors by age were: household air pollution for neonates 0-6 days of age [95% uncertainty interval (UI): 1 to 1]; suboptimal breast feeding for children 7-27 days of age (95% UI: 1-1); childhood underweight for children 28 days to less than 1 year of age and 1-4 years of age (95% UI: 1-2 and 1-1, respectively); iron deficiency for children and youth 5-14 years of age (95% UI: 1-1); alcohol use for people 15-49 years of age (95% UI: 1-2); and dietary risks for people 50 years of age and older (95% UI: 1-1). Rankings of risk factors varied by sex among the older age groups. Alcohol and smoking were the most important risk factors among men 15 years of age and older, and high body mass and intimate partner violence were some of the most important risk factors among women 15 years of age and older. Our analyses confirm that the relative importance of risk factors is age-dependent. Therefore, preventing harms caused by various modifiable risk factors using interventions that target people of different ages should be a priority, especially since easily implemented and cost-effective public health interventions exist.

Modifying pro-drug risk factors in adolescents: results from project ALERT.

PubMed

Ghosh-Dastidar, Bonnie; Longshore, Douglas L; Ellickson, Phyllis L; McCaffrey, Daniel F

2004-06-01

The objective of this study was to evaluate the impact of a revised state-of-the-art drug prevention program, Project ALERT, on risk factors for drug use in mostly rural midwestern schools and communities. Fifty-five middle schools from South Dakota were randomly assigned to treatment or control conditions. Treatment-group students received 11 lessons in Grade 7 and 3 more in Grade 8. Effects for 4276 eighth graders were assessed 18 months after baseline. Results indicate that Project ALERT had statistically significant effects on all the targeted risk factors associated with cigarette and marijuana use and more modest gains with the pro-alcohol risk factors. The program helped adolescents at low, moderate, and high risk for future use, with the effect sizes typically stronger for the low- and moderate-risk groups. Thus, school-based drug prevention programs can lower risk factors that correlate with drug use, help low- to high-risk adolescents, and be effective in diverse school environments.

Risk factors for stress fractures.

PubMed

Bennell, K; Matheson, G; Meeuwisse, W; Brukner, P

1999-08-01

Preventing stress fractures requires knowledge of the risk factors that predispose to this injury. The aetiology of stress fractures is multifactorial, but methodological limitations and expediency often lead to research study designs that evaluate individual risk factors. Intrinsic risk factors include mechanical factors such as bone density, skeletal alignment and body size and composition, physiological factors such as bone turnover rate, flexibility, and muscular strength and endurance, as well as hormonal and nutritional factors. Extrinsic risk factors include mechanical factors such as surface, footwear and external loading as well as physical training parameters. Psychological traits may also play a role in increasing stress fracture risk. Equally important to these types of analyses of individual risk factors is the integration of information to produce a composite picture of risk. The purpose of this paper is to critically appraise the existing literature by evaluating study design and quality, in order to provide a current synopsis of the known scientific information related to stress fracture risk factors. The literature is not fully complete with well conducted studies on this topic, but a great deal of information has accumulated over the past 20 years. Although stress fractures result from repeated loading, the exact contribution of training factors (volume, intensity, surface) has not been clearly established. From what we do know, menstrual disturbances, caloric restriction, lower bone density, muscle weakness and leg length differences are risk factors for stress fracture. Other time-honoured risk factors such as lower extremity alignment have not been shown to be causative even though anecdotal evidence indicates they are likely to play an important role in stress fracture pathogenesis.

Risk factors and effectiveness of preventive measures against influenza in the community

PubMed Central

Castilla, Jesús; Godoy, Pere; Domínguez, Ángela; Martín, Vicente; Delgado‐Rodríguez, Miguel; Martínez‐Baz, Iván; Baricot, Maretva; Soldevila, Nuria; Mayoral, José M.; Astray, Jenaro; Quintana, José M.; Cantón, Rafael; Castro, Ady; González‐Candelas, Fernando; Alonso, Jordi; Saez, Marc; Tamames, Sonia; Pumarola, Tomás

2012-01-01

Please cite this paper as: Castilla et al. (2013) Risk factors and effectiveness of preventive measures against influenza in the community. Influenza and Other Respiratory Viruses 7(2) 177–183. Background  The role of different risk exposures and preventive measures against influenza has not been well established. Objective  The aim of this study was to evaluate risk factors and measures to prevent influenza infection in the community. Methods  We conducted a multicenter case–control study. Cases were 481 outpatients aged 18 years or older with laboratory‐confirmed influenza A(H1N1)09 in the 2009–2010 season in Spain. A control was selected for each case from outpatients from the same area matched by age and date of consultation. Information on risk situations, preventive measures and other variables was obtained by interview and review of the medical record. Results  In the multivariate conditional logistic regression analysis, the risk of a diagnosis of influenza increased with the number of cohabitants (compared with <3 cohabitants, three cohabitants had an OR = 1·80, 95% CI 1·12–2·89, and ≥5 cohabitants had an OR = 2·66, 95% CI 1·31–5·41) and for health care workers (OR = 2·94, 95% CI 1·53–5·66). The use of metropolitan public transport was associated with a lower frequency of a diagnosis of influenza (OR = 0·45, 95% CI 0·30–0·68) but not the use of taxis or long‐distance transport. The influenza A(H1N1)09 vaccine had a protective effect (OR = 0·13, 95% CI 0·04–0·48), unlike hand washing after touching contaminated surfaces or the use of alcohol‐based hand sanitizers. Conclusion  The home environment appears to play an important role in the spread of influenza in adults, but not the use of public transport. Health care workers have a higher risk of contracting influenza. Vaccination was the most effective preventive measure. PMID:22458533

The effect of foot landing position on biomechanical risk factors associated with anterior cruciate ligament injury.

PubMed

Tran, Andrew A; Gatewood, Corey; Harris, Alex H S; Thompson, Julie A; Dragoo, Jason L

2016-12-01

Identification of biomechanical risk factors associated with anterior cruciate ligament (ACL) injury can facilitate injury prevention. The purpose of this study is to investigate the effects of three foot landing positions, "toe-in", "toe-out" and "neutral", on biomechanical risk factors for ACL injury in males and females. The authors hypothesize that 1) relative to neutral, the toe-in position increases the biomechanical risk factors for ACL injury, 2) the toe-out position decreases these biomechanical risk factors, and 3) compared to males, females demonstrate greater changes in lower extremity biomechanics with changes in foot landing position. Motion capture data on ten male and ten female volunteers aged 20-30 years (26.4 ± 2.50) were collected during double-leg jump landing activities. Subjects were asked to land on force plates and target one of three pre-templated foot landing positions: 0° ("neutral"), 30° internal rotation ("toe-in"), and 30° external rotation ("toe-out") along the axis of the anatomical sagittal plane. A mixed-effects ANOVA and pairwise Tukey post-hoc comparison were used to detect differences in kinematic and kinetic variables associated with biomechanical risk factors of ACL injury between the three foot landing positions. Relative to neutral, landing in the toe-in position increased peak hip adduction, knee internal rotation angles and moments (p < 0.01), and peak knee abduction angle (p < 0.001). Landing in the toe-in position also decreased peak hip flexion angle (p < 0.001) and knee flexion angle (p = 0.023). Landing in the toe-out position decreased peak hip adduction, knee abduction, and knee internal rotation angles (all p < 0.001). Male sex was associated with a smaller increase in hip adduction moment (p = 0.043) and knee internal rotation moment (p = 0.032) with toe-in landing position compared with female sex. Toe-in landing position exacerbates biomechanical risk factors associated with

External risk factors affecting construction costs

NASA Astrophysics Data System (ADS)

Mubarak, Husin, Saiful; Oktaviati, Mutia

2017-11-01

Some risk factors can have impacts on the cost, time, and performance. Results of previous studies indicated that the external conditions are among the factors which give effect to the contractor in the completion of the project. The analysis in the study carried out by considering the conditions of the project in the last 15 years in Aceh province, divided into military conflict phase (2000-2004), post tsunami disaster rehabilitation and reconstruction phase (2005-2009), and post-rehabilitation and reconstruction phase (2010-present). This study intended to analyze the impact of external risk factors, primarily related to the impact on project costs and to investigate the influence of the risk factors and construction phases impacted the project cost. Data was collected by using a questionnaire distributed in 15 large companies qualification contractors in Aceh province. Factors analyzed consisted of socio-political, government policies, natural disasters, and monetary conditions. Data were analyzed using statistical application of severity index to measure the level of risk impact. The analysis results presented the tendency of impact on cost can generally be classified as low. There is only one variable classified as high-impact, variable `fuel price increases', which appear on the military conflict and post tsunami disaster rehabilitation and reconstruction periods. The risk impact on costs from the factors and variables classified with high intensity needs a serious attention, especially when the high level impact is followed by the high frequency of occurrences.

The Differential Effects of Eicosapentaenoic Acid and Docosahexaenoic Acid on Cardiometabolic Risk Factors: A Systematic Review

PubMed Central

Innes, Jacqueline K.; Calder, Philip C.

2018-01-01

A large body of evidence supports the cardioprotective effects of the long-chain omega-3 polyunsaturated fatty acids (PUFAs), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). There is increasing interest in the independent effects of EPA and DHA in the modulation of cardiometabolic risk factors. This systematic review aims to appraise the latest available evidence of the differential effects of EPA and DHA on such risk factors. A systematic literature review was conducted up to May 2017. Randomised controlled trials were included if they met strict eligibility criteria, including EPA or DHA > 2 g/day and purity ≥ 90%. Eighteen identified articles were included, corresponding to six unique studies involving 527 participants. Both EPA and DHA lowered triglyceride concentration, with DHA having a greater triglyceride-lowering effect. Whilst total cholesterol levels were largely unchanged by EPA and DHA, DHA increased high-density lipoprotein (HDL) cholesterol concentration, particularly HDL2, and increased low-density lipoprotein (LDL) cholesterol concentration and LDL particle size. Both EPA and DHA inhibited platelet activity, whilst DHA improved vascular function and lowered heart rate and blood pressure to a greater extent than EPA. The effects of EPA and DHA on inflammatory markers and glycaemic control were inconclusive; however both lowered oxidative stress. Thus, EPA and DHA appear to have differential effects on cardiometabolic risk factors, but these need to be confirmed by larger clinical studies. PMID:29425187

Risk factors affecting survival in heart transplant patients.

PubMed

Almenar, L; Cardo, M L; Martínez-Dolz, L; García-Palomar, C; Rueda, J; Zorio, E; Arnau, M A; Osa, A; Palencia, M

2005-11-01

Certain cardiovascular risk factors have been linked to morbidity and mortality in heart transplant (HT) patients. The sum of various risk factors may have a large cumulative negative effect, leading to a substantially worse prognosis and the need to consider whether HT is contraindicated. The objective of this study was to determine whether the risk factors usually available prior to HT result in an excess mortality in our setting that contraindicates transplantation. Consecutive patients who underwent heart transplantation from November 1987 to January 2004 were included. Heart-lung transplants, retransplants, and pediatric transplants were excluded. Of the 384 patients, 89% were men. Mean age was 52 years (range, 12 to 67). Underlying disease included ischemic heart disease (52%), idiopathic dilated cardiomyopathy (36%), valvular disease (8%), and other (4%). Variables considered risk factors were obesity (BMI >25), dyslipidemia, hypertension, prior thoracic surgery, diabetes, and history of ischemic heart disease. Survival curves by number of risk factors using Kaplan-Meier and log-rank for comparison of curves. Overall patient survival at 1, 5, 10, and 13 years was 76%, 68%, 54%, and 47%, respectively. Survival at 10 years, if fewer than two risk factors were present, was 69%; 59% if two or three factors were present; and 37% if more than three associated risk factors were present (P = .04). The presence of certain risk factors in patients undergoing HT resulted in lower survival rates. The combination of various risk factors clearly worsened outcomes. However, we do not believe this should be an absolute contraindication for transplantation.

Effects of socioeconomic position and clinical risk factors on spontaneous and iatrogenic preterm birth

PubMed Central

2014-01-01

Background The literature shows a variable and inconsistent relationship between socioeconomic position and preterm birth. We examined risk factors for spontaneous and iatrogenic preterm birth, with a focus on socioeconomic position and clinical risk factors, in order to explain the observed inconsistency. Methods We carried out a retrospective population-based cohort study of all singleton deliveries in Nova Scotia from 1988 to 2003. Data were obtained from the Nova Scotia Atlee Perinatal Database and the federal income tax T1 Family Files. Separate logistic models were used to quantify the association between socioeconomic position, clinical risk factors and spontaneous preterm birth and iatrogenic preterm birth. Results The study population included 132,714 singleton deliveries and the rate of preterm birth was 5.5%. Preterm birth rates were significantly higher among the women in the lowest (versus the highest) family income group for spontaneous (rate ratio 1.14, 95% confidence interval (CI) 1.03, 1.25) but not iatrogenic preterm birth (rate ratio 0.95, 95% CI 0.75, 1.19). Adjustment for maternal characteristics attenuated the family income-spontaneous preterm birth relationship but strengthened the relationship with iatrogenic preterm birth. Clinical risk factors such as hypertension were differentially associated with spontaneous (rate ratio 3.92, 95% CI 3.47, 4.44) and iatrogenic preterm (rate ratio 14.1, 95% CI 11.4, 17.4) but factors such as diabetes mellitus were not (rate ratio 4.38, 95% CI 3.21, 5.99 for spontaneous and 4.02, 95% CI 2.07, 7.80 for iatrogenic preterm birth). Conclusions Socioeconomic position and clinical risk factors have different effects on spontaneous and iatrogenic preterm. Recent temporal increases in iatrogenic preterm birth appear to be responsible for the inconsistent relationship between socioeconomic position and preterm birth. PMID:24670050

Effects of socioeconomic position and clinical risk factors on spontaneous and iatrogenic preterm birth.

PubMed

Joseph, K S; Fahey, John; Shankardass, Ketan; Allen, Victoria M; O'Campo, Patricia; Dodds, Linda; Liston, Robert M; Allen, Alexander C

2014-03-27

The literature shows a variable and inconsistent relationship between socioeconomic position and preterm birth. We examined risk factors for spontaneous and iatrogenic preterm birth, with a focus on socioeconomic position and clinical risk factors, in order to explain the observed inconsistency. We carried out a retrospective population-based cohort study of all singleton deliveries in Nova Scotia from 1988 to 2003. Data were obtained from the Nova Scotia Atlee Perinatal Database and the federal income tax T1 Family Files. Separate logistic models were used to quantify the association between socioeconomic position, clinical risk factors and spontaneous preterm birth and iatrogenic preterm birth. The study population included 132,714 singleton deliveries and the rate of preterm birth was 5.5%. Preterm birth rates were significantly higher among the women in the lowest (versus the highest) family income group for spontaneous (rate ratio 1.14, 95% confidence interval (CI) 1.03, 1.25) but not iatrogenic preterm birth (rate ratio 0.95, 95% CI 0.75, 1.19). Adjustment for maternal characteristics attenuated the family income-spontaneous preterm birth relationship but strengthened the relationship with iatrogenic preterm birth. Clinical risk factors such as hypertension were differentially associated with spontaneous (rate ratio 3.92, 95% CI 3.47, 4.44) and iatrogenic preterm (rate ratio 14.1, 95% CI 11.4, 17.4) but factors such as diabetes mellitus were not (rate ratio 4.38, 95% CI 3.21, 5.99 for spontaneous and 4.02, 95% CI 2.07, 7.80 for iatrogenic preterm birth). Socioeconomic position and clinical risk factors have different effects on spontaneous and iatrogenic preterm. Recent temporal increases in iatrogenic preterm birth appear to be responsible for the inconsistent relationship between socioeconomic position and preterm birth.

Frequently observed risk factors for fall-related injuries and effective preventive interventions: a multihospital survey of nurses' perceptions.

PubMed

Tzeng, Huey-Ming; Yin, Chang-Yi

2013-01-01

There is an urgent need to prioritize the risk factors for injurious falls and effective interventions in nursing practice. Registered nurses perceived that the most frequently observed risk factors were confusion, gait problems, Alzheimer disease, disorientation, and inability to follow safety instructions. The most effective interventions were keeping hospital bed brakes locked, keeping floor surfaces clean/dry, using appropriate footwear for patients, maintaining a call light within reach, and reducing tripping hazards.

Risk Factors of Periodontal Disease: Review of the Literature

PubMed Central

AlJehani, Yousef A.

2014-01-01

Objectives. This paper aims to review the evidence on the potential roles of modifiable and nonmodifiable risk factors associated with periodontal disease. Data. Original articles that reported on the risk factors for periodontal disease were included. Sources. MEDLINE (1980 to Jan 2014), PubMed (using medical subject headings), and Google Scholar were searched using the following terms in different combinations: “periodontal disease,” “periodontitis,” “risk factors,” and “causal.” This was supplemented by hand-searching in peer-reviewed journals and cross-referenced with the articles accessed. Conclusions. It is important to understand the etiological factors and the pathogenesis of periodontal disease to recognize and appreciate the associated risk factors. As periodontal disease is multifactorial, effective disease management requires a clear understanding of all the associated risk factors. PMID:24963294

Population-Attributable Risk Proportion of Clinical Risk Factors for Breast Cancer.

PubMed

Engmann, Natalie J; Golmakani, Marzieh K; Miglioretti, Diana L; Sprague, Brian L; Kerlikowske, Karla

2017-09-01

Many established breast cancer risk factors are used in clinical risk prediction models, although the proportion of breast cancers explained by these factors is unknown. To determine the population-attributable risk proportion (PARP) for breast cancer associated with clinical breast cancer risk factors among premenopausal and postmenopausal women. Case-control study with 1:10 matching on age, year of risk factor assessment, and Breast Cancer Surveillance Consortium (BCSC) registry. Risk factor data were collected prospectively from January 1, 1996, through October 31, 2012, from BCSC community-based breast imaging facilities. A total of 18 437 women with invasive breast cancer or ductal carcinoma in situ were enrolled as cases and matched to 184 309 women without breast cancer, with a total of 58 146 premenopausal and 144 600 postmenopausal women enrolled in the study. Breast Imaging Reporting and Data System (BI-RADS) breast density (heterogeneously or extremely dense vs scattered fibroglandular densities), first-degree family history of breast cancer, body mass index (>25 vs 18.5-25), history of benign breast biopsy, and nulliparity or age at first birth (≥30 years vs <30 years). Population-attributable risk proportion of breast cancer. Of the 18 437 women with breast cancer, the mean (SD) age was 46.3 (3.7) years among premenopausal women and 61.7 (7.2) years among the postmenopausal women. Overall, 4747 (89.8%) premenopausal and 12 502 (95.1%) postmenopausal women with breast cancer had at least 1 breast cancer risk factor. The combined PARP of all risk factors was 52.7% (95% CI, 49.1%-56.3%) among premenopausal women and 54.7% (95% CI, 46.5%-54.7%) among postmenopausal women. Breast density was the most prevalent risk factor for both premenopausal and postmenopausal women and had the largest effect on the PARP; 39.3% (95% CI, 36.6%-42.0%) of premenopausal and 26.2% (95% CI, 24.4%-28.0%) of postmenopausal breast cancers could potentially be

Marriage is a dependent risk factor for mortality of colon adenocarcinoma without a time-varying effect

PubMed Central

Yu, Wei; Chen, Jie; Xiong, Weibin; Chen, Shuang; Yu, Li

2017-01-01

Background It has been well recognized that the effects of many prognostic factors could change during long-term follow-up. Although marriage has been proven to be a significant prognostic factor for the survival of colon cancer, whether the effect of marriage is constant with time remain unknown. This study analyzed the impact of marital status on the mortality of colon cancer patients with an extended Cox model that allowed for time-varying effects. Methods We identified 71,955 patients who underwent colectomy between 2004 and 2009 to treat colon adenocarcinoma from the Surveilance, Epidemiology and End Results Database. The multivariate extended Cox model was used to evaluate the effect of marital status on all-cause mortality, while the Fine-Gray competing risks model was used for colon cancer-specific mortality, with death from other causes as the competing risk. Results The unmarried patients carried a 1.37-fold increased risk of all-cause mortality compared with the married patients (95%CI: 1.33-1.40; p<0.001), and the hazard ratio remained constant over time. Being unmarried was at a higher risk of death from colon adenocarcinoma as well as death from other causes. Four variables including tumor site, tumor grade, sex and TNM stage were proved to have time-varying effects on survival. Conclusions Marriage is a dependent prognosis factor for survival of surgically treated colon adenocarcinoma patients. Psychological interventions are suggested to improve receipt of treatment among unmarried patients, as their poor survival may be due to the inefficient treatment. PMID:28423614

Marriage is a dependent risk factor for mortality of colon adenocarcinoma without a time-varying effect.

PubMed

Liu, Minling; Li, Lixian; Yu, Wei; Chen, Jie; Xiong, Weibin; Chen, Shuang; Yu, Li

2017-03-21

It has been well recognized that the effects of many prognostic factors could change during long-term follow-up. Although marriage has been proven to be a significant prognostic factor for the survival of colon cancer, whether the effect of marriage is constant with time remain unknown. This study analyzed the impact of marital status on the mortality of colon cancer patients with an extended Cox model that allowed for time-varying effects. We identified 71,955 patients who underwent colectomy between 2004 and 2009 to treat colon adenocarcinoma from the Surveilance, Epidemiology and End Results Database. The multivariate extended Cox model was used to evaluate the effect of marital status on all-cause mortality, while the Fine-Gray competing risks model was used for colon cancer-specific mortality, with death from other causes as the competing risk. The unmarried patients carried a 1.37-fold increased risk of all-cause mortality compared with the married patients (95%CI: 1.33-1.40; p<0.001), and the hazard ratio remained constant over time. Being unmarried was at a higher risk of death from colon adenocarcinoma as well as death from other causes. Four variables including tumor site, tumor grade, sex and TNM stage were proved to have time-varying effects on survival. Marriage is a dependent prognosis factor for survival of surgically treated colon adenocarcinoma patients. Psychological interventions are suggested to improve receipt of treatment among unmarried patients, as their poor survival may be due to the inefficient treatment.

Risk factor management: antiatherogenic therapies.

PubMed

Gielen, Stephan; Sandri, Marcus; Schuler, Gerhard; Teupser, Daniel

2009-08-01

Despite the advances in interventional techniques, the management of stable atherosclerosis remains the domain of optimal guideline-oriented therapy. Recent studies on the effects of aggressive lipid lowering on atheroma volume changes using intravascular ultrasound indicate that it is possible to achieve atherosclerosis regression by reaching low-density lipoprotein (LDL) levels less than 75 mg/dl. The pleiotropic anti-inflammatory effects of statins contribute to the reduction of cardiovascular (CV) event observed with aggressive lipid lowering. As a second important strategy to prevent disease progression, lifestyle changes with regular physical exercise are capable of halting the atherosclerotic process and reducing angina symptoms and CV events. Optimal medical therapy, a healthy lifestyle with regular physical exercise, and coronary interventions are not mutually exclusive treatment strategies. Over the last few decades, both have proved to be effective in significantly reducing the CV mortality in the Western world. However, risk factor modification contributed to at least half the effect in the reduction of CV mortality. This figure provides an estimate of what could be achieved if we were to take risk factor modification more seriously - especially in the acute care setting. The knowledge is there: today we have a better understanding on how to stop progression and even induce regression of atherosclerosis. Much research still needs to be done and will be done. In the meantime, however, our primary focus should lie in implementing what is already known. In addition, it is essential not just to treat CV risk factors, but also to treat them to achieve the target values as set by the guidelines of European Society of Cardiology.

Salivary Gland Cancer: Risk Factors

MedlinePlus

... Cancer: Risk Factors Request Permissions Salivary Gland Cancer: Risk Factors Approved by the Cancer.Net Editorial Board , ... To see other pages, use the menu. A risk factor is anything that increases a person’s chance ...

Adverse effects of fructose on cardiometabolic risk factors and hepatic lipid metabolism in subjects with abdominal obesity.

PubMed

Taskinen, M-R; Söderlund, S; Bogl, L H; Hakkarainen, A; Matikainen, N; Pietiläinen, K H; Räsänen, S; Lundbom, N; Björnson, E; Eliasson, B; Mancina, R M; Romeo, S; Alméras, N; Pepa, G D; Vetrani, C; Prinster, A; Annuzzi, G; Rivellese, A; Després, J-P; Borén, J

2017-08-01

Overconsumption of dietary sugars, fructose in particular, is linked to cardiovascular risk factors such as type 2 diabetes, obesity, dyslipidemia and nonalcoholic fatty liver disease. However, clinical studies have to date not clarified whether these adverse cardiometabolic effects are induced directly by dietary sugars, or whether they are secondary to weight gain. To assess the effects of fructose (75 g day -1 ), served with their habitual diet over 12 weeks, on liver fat content and other cardiometabolic risk factors in a large cohort (n = 71) of abdominally obese men. We analysed changes in body composition, dietary intake, an extensive panel of cardiometabolic risk markers, hepatic de novo lipogenesis (DNL), liver fat content and postprandial lipid responses after a standardized oral fat tolerance test (OFTT). Fructose consumption had modest adverse effects on cardiometabolic risk factors. However, fructose consumption significantly increased liver fat content and hepatic DNL and decreased β-hydroxybutyrate (a measure of β-oxidation). The individual changes in liver fat were highly variable in subjects matched for the same level of weight change. The increase in liver fat content was significantly more pronounced than the weight gain. The increase in DNL correlated positively with triglyceride area under the curve responses after an OFTT. Our data demonstrated adverse effects of moderate fructose consumption for 12 weeks on multiple cardiometabolic risk factors in particular on liver fat content despite only relative low increases in weight and waist circumference. Our study also indicates that there are remarkable individual differences in susceptibility to visceral adiposity/liver fat after real-world daily consumption of fructose-sweetened beverages over 12 weeks. © 2017 The Association for the Publication of the Journal of Internal Medicine.

[Chronic renal disease as cardiovascular risk factor].

PubMed

Hermans, M M H; Kooman, J P; Stehouwer, C D A

2008-07-19

A lowering of the glomerular filtration rate (GFR) and/or the presence of albuminuria are signs of chronic renal disease. Both variables are for the most part independently associated with an increased risk of cardiovascular morbidity and mortality. Albuminuria is a marker of endothelial dysfunction. A decrease of the GFR is associated with non-traditional risk factors, e.g. renal anaemia, uraemic toxins due to a decrease of the renal clearance, hyperhomocysteinaemia caused by a diminished homocysteine metabolism, excessive activation of the sympathetic nervous system which is related to sleep apnoea syndrome, oxidative stress and dyslipidaemia associated with the formation of vasotoxic, oxidised LDL cholesterol. These non-traditional risk factors may, alone or in combination with traditional atherogenic risk factors (e.g. age, male gender, smoking, hypercholesterolaemia, hypertension, obesity, positive family history and diabetes mellitus), partially via endothelial dysfunction, result in harmful effects on arterial function, increasing cardiovascular morbidity and mortality. Different stages of chronic kidney disease are associated with specific risk factors, making a specific therapeutic approach essential.

Income inequality and cardiovascular disease risk factors in a highly unequal country: a fixed-effects analysis from South Africa.

PubMed

Adjaye-Gbewonyo, Kafui; Kawachi, Ichiro; Subramanian, S V; Avendano, Mauricio

2018-03-06

Chronic stress associated with high income inequality has been hypothesized to increase CVD risk and other adverse health outcomes. However, most evidence comes from high-income countries, and there is limited evidence on the link between income inequality and biomarkers of chronic stress and risk for CVD. This study examines how changes in income inequality over recent years relate to changes in CVD risk factors in South Africa, home to some of the highest levels of income inequality globally. We linked longitudinal data from 9356 individuals interviewed in the 2008 and 2012 National Income Dynamics Study to district-level Gini coefficients estimated from census and survey data. We investigated whether subnational district income inequality was associated with several modifiable risk factors for cardiovascular disease (CVD) in South Africa, including body mass index (BMI), waist circumference, blood pressure, physical inactivity, smoking, and high alcohol consumption. We ran individual fixed-effects models to examine the association between changes in income inequality and changes in CVD risk factors over time. Linear models were used for continuous metabolic outcomes while conditional Poisson models were used to estimate risk ratios for dichotomous behavioral outcomes. Both income inequality and prevalence of most CVD risk factors increased over the period of study. In longitudinal fixed-effects models, changes in district Gini coefficients were not significantly associated with changes in CVD risk factors. Our findings do not support the hypothesis that subnational district income inequality is associated with CVD risk factors within the high-inequality setting of South Africa.

Selected environmental risk factors and congenital heart defects.

PubMed

Kuciene, Renata; Dulskiene, Virginija

2008-01-01

The aim of the article is to review the published scientific literature and epidemiological studies about the effect of selected environmental risk factors on congenital heart defects in infants. According to recent reports, the prevalence of congenital heart defects is around 1% of live births. Congenital heart malformations are the leading cause of infant mortality. Unfortunately, the majority of the causes of heart defects remain unknown. These malformations are caused by interaction of genetic and environmental factors. The article reviews selected environmental risk factors: maternal illnesses and conditions associated with metabolic disorder (maternal diabetes, obesity, phenylketonuria), maternal lifestyle factors (alcohol use, smoking), which may increase the risk of congenital heart defects.

Effect of peer support interventions on cardiovascular disease risk factors in adults with diabetes: a systematic review and meta-analysis.

PubMed

Patil, Sonal J; Ruppar, Todd; Koopman, Richelle J; Lindbloom, Erik J; Elliott, Susan G; Mehr, David R; Conn, Vicki S

2018-03-23

Peer support by persons affected with diabetes improves peer supporter's diabetes self-management skills. Peer support interventions by individuals who have diabetes or are affected by diabetes have been shown to improve glycemic control; however, its effects on other cardiovascular disease risk factors in adults with diabetes are unknown. We aimed to estimate the effect of peer support interventions on cardiovascular disease risk factors other than glycemic control in adults with diabetes. We conducted a systematic review and meta-analysis of randomized controlled trials comparing peer support interventions to a control condition in adults affected by diabetes that measured any cardiovascular disease risk factors [Body Mass Index, smoking, diet, physical activity, cholesterol level, glucose control and blood pressure]. Quality was assessed by Cochrane's risk of bias tool. We calculated standardized mean difference effect sizes using random effects models. We retrieved 438 citations from multiple databases including OVID MEDLINE, Cochrane database and Scopus, and author searches. Of 233 abstracts reviewed, 16 articles met inclusion criteria. A random effects model in a total of 3243 participants showed a positive effect of peer support interventions on systolic BP with a pooled effect size of 2.07 mmHg (CI 0.35 mmHg to 3.79 mmHg, p = 0.02); baseline pooled systolic blood pressure was 137 mmHg. There was a non-significant effect of peer support interventions on diastolic blood pressure, cholesterol, body mass index, diet and physical activity. Cardiovascular disease risk factors other than glycemic control outcomes were secondary outcomes in most studies and baseline values were normal or mildly elevated. Only one study reported smoking outcomes. We found a small (2 mmHg) positive effect of peer support interventions on systolic blood pressure in adults with diabetes whose baseline blood pressure was on average minimally elevated. Additional studies need to

Improving Fall Risk Factor Identification and Documentation of Risk Reduction Strategies by Rehabilitation Therapists through Continuing Education

ERIC Educational Resources Information Center

Karnes, Michele J.

2011-01-01

This static group comparison study determined that an educational intervention was effective in increasing fall risk factor assessment, documentation of fall risk factors, and strategies devised to reduce fall risk factors by rehabilitation therapists for their older adult outpatients in clinics. Results showed that experimental group identified…

Risk Factors for Birth Canal Lacerations in Primiparous Women

PubMed Central

Mikolajczyk, Rafael T.; Zhang, Jun; Troendle, James; Chan, Linda

2013-01-01

Lacerations of the birth canal are common side effects of vaginal birth. They are potentially preventable. Although serious long-term consequences have been identified for severe perineal lacerations, less attention has been paid to lacerations in other locations and how the risk factors vary for different lacerations. We analyzed a dataset including 1009 primiparous women with singleton pregnancies and vaginal deliveries, and we examined risk factors for third- and fourth-degree perineal lacerations and periurethral, vaginal, and labial lacerations using logistic regression analysis. Large fetal size (≥ 3500 g) substantially increased the risk of perineal (odd ratio [OR], 3.8; 95% confidence interval [CI], 1.8 to 7.9) and periurethral (OR, 2.3; 95% CI, 1.0 to 5.0) lacerations but not other types of lacerations. Episiotomy had no impact on perineal lacerations (OR 0.9) but had very strong protective effects for other lacerations (OR 0.1). Prolonged second stage of labor (>120 minutes) increased the risk of perineal and vaginal lacerations but reduced the risk for periurethral lacerations. Instrumental deliveries were significant risk factors for third- and fourth-degree perineal lacerations, with by far the strongest effect for low forceps (OR 25.0 versus <3 for outlet forceps, outlet vacuum, and low vacuum). We concluded that separating different birth canal lacerations is critical in identifying risk factors and potential preventive strategies. PMID:18509884

Risk factors for birth canal lacerations in primiparous women.

PubMed

Mikolajczyk, Rafael T; Zhang, Jun; Troendle, James; Chan, Linda

2008-05-01

Lacerations of the birth canal are common side effects of vaginal birth. They are potentially preventable. Although serious long-term consequences have been identified for severe perineal lacerations, less attention has been paid to lacerations in other locations and how the risk factors vary for different lacerations. We analyzed a dataset including 1009 primiparous women with singleton pregnancies and vaginal deliveries, and we examined risk factors for third- and fourth-degree perineal lacerations and periurethral, vaginal, and labial lacerations using logistic regression analysis. Large fetal size (> or = 3500 g) substantially increased the risk of perineal (odd ratio [OR], 3.8; 95% confidence interval [CI], 1.8 to 7.9) and periurethral (OR, 2.3; 95% CI, 1.0 to 5.0) lacerations but not other types of lacerations. Episiotomy had no impact on perineal lacerations (OR 0.9) but had very strong protective effects for other lacerations (OR 0.1). Prolonged second stage of labor (> 120 minutes) increased the risk of perineal and vaginal lacerations but reduced the risk for periurethral lacerations. Instrumental deliveries were significant risk factors for third- and fourth-degree perineal lacerations, with by far the strongest effect for low forceps (OR 25.0 versus < 3 for outlet forceps, outlet vacuum, and low vacuum). We concluded that separating different birth canal lacerations is critical in identifying risk factors and potential preventive strategies.

Risk factors for serious injury in Finnish agriculture.

PubMed

Rautiainen, Risto H; Ledolter, Johannes; Donham, Kelley J; Ohsfeldt, Robert L; Zwerling, Craig

2009-05-01

Previous studies indicate 20% of injuries represent 80% of injury costs in agriculture. To help prevent the most costly injuries, we aimed to identify characteristics and risk factors associated with serious injuries. We analyzed insurance records of 93,550 self-employed Finnish farmers. We ranked injury causes by claim cost and used multiple logistic regressions to identify risk factors for (any) injury and serious injury (injuries exceeding claim costs of 2000 euros). A total of 5,507 compensated injuries occurred in 2002 (rate 5.9/100 person-years), and 1,167 or 21% of them (rate 1.25/100 person-years) were serious. The causes/sources resulting in highest average claim costs were motor vehicles; stairs, scaffoldings, and ladders; trailers and wagons; floors, walkways, and steps; other structures and obstacles; augers, mills, and grain handling equipment; horses; combines and harvesting equipment; tractor steps; and uneven and slippery terrain. Older age, male gender, higher income level, greater field size, residing on the farm, Finnish language (vs. Swedish), occupational health service (OHS) membership, and animal production were risk factors for injury. The risk factors for serious injury were similar; however, the effects of age, income level, and the raising of horses were more prominent. Language, residence, ownership status, and OHS membership were not risk factors for serious injury. Cost-effective prevention efforts should address the following risk factors: older age, male gender, larger income and operation size, livestock production (particularly dairy, swine, and horses), motor vehicle incidents, falls from elevation, and slips, trips and falls. Copyright 2009 Wiley-Liss, Inc.

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.

[Modifiable risk factors for primary headache. A systematic review].

PubMed

Albers, L; Ziebarth, S; von Kries, R

2014-08-01

Strategies to prevent primary headaches could be very beneficial, especially given that primary headaches can lead to the development of chronic headache. In order to establish headache prevention strategies, the modifiable risk factors for primary headaches need to be identified. A systematic literature search on the risk factors for primary headaches was conducted independently by two persons using the databases MEDLINE and Embase. Further inclusion criteria were observational studies in adult general populations or case-control studies, where the effect sizes were reported as odds ratios or where the odds ratios could be calculated from the given data. In all, 24 studies were included in the analysis. There was a large amount of heterogeneity among the studies concerning headache acquisition, headache classification, and risk factors for headache development. Independent of headache trigger and definition of headache, the association between headache and the risk factor "stress" was very high: The meta-analysis shows an overall effect of 2.26 (odds ratio; 95 %-CI = [1.79; 2.85]). Studies evaluating neck and shoulder pain also report a strong association with headache; however, these results could not be summarized in a meta-analysis. Equally, the overall effects of smoking and coffee consumption on headaches could not be verified because the effect sizes were rather small and predominantly noticeable only at higher doses. A strong association between headache and the risk factors stress and neck and shoulder pain was confirmed. The effect sizes of smoking and coffee consumption on headaches were rather small.

Effectiveness of a peer-delivered dissonance-based program in reducing eating disorder risk factors in high school girls.

PubMed

Ciao, Anna C; Latner, Janet D; Brown, Krista E; Ebneter, Daria S; Becker, Carolyn B

2015-09-01

This pilot study investigated the feasibility, acceptability, and effectiveness of a peer-led dissonance-based eating disorders (ED) prevention/risk factor reduction program with high school girls. Ninth grade girls (n = 50) received the peer-led program within the school curriculum. A quasi-experimental design was used to assess changes in ED risk factors preintervention and postintervention compared with waitlist control. Participants were followed through 3-month follow-up. Peer-leader adherence to an intervention manual tailored for this age group was high. The intervention was rated as highly acceptable, with a large proportion of participants reporting that they enjoyed the program and learned and applied new information. Intervention participants exhibited significantly greater pre-post reductions in a majority of risk-factor outcomes compared to waitlist controls. When groups were combined to assess program effects over time there were significant pre-post reductions in a majority of outcomes that were sustained through 3-month follow-up. This pilot study provides tentative support for the effectiveness of using peer leaders to implement an empirically supported ED risk factor reduction program in a high school setting. Additional research is needed to replicate results in larger, better-controlled trials with longer follow-up. © 2015 Wiley Periodicals, Inc.

Anesthesia patient risk: a quantitative approach to organizational factors and risk management options.

PubMed

Paté-Cornell, M E; Lakats, L M; Murphy, D M; Gaba, D M

1997-08-01

The risk of death or brain damage to anesthesia patients is relatively low, particularly for healthy patients in modern hospitals. When an accident does occur, its cause is usually an error made by the anesthesiologist, either in triggering the accident sequence, or failing to take timely corrective measures. This paper presents a pilot study which explores the feasibility of extending probabilistic risk analysis (PRA) of anesthesia accidents to assess the effects of human and management components on the patient risk. We develop first a classic PRA model for the patient risk per operation. We then link the probabilities of the different accident types to their root causes using a probabilistic analysis of the performance shaping factors. These factors are described here as the "state of the anesthesiologist" characterized both in terms of alertness and competence. We then analyze the effects of different management factors that affect the state of the anesthesiologist and we compute the risk reduction benefits of several risk management policies. Our data sources include the published version of the Australian Incident Monitoring Study as well as expert opinions. We conclude that patient risk could be reduced substantially by closer supervision of residents, the use of anesthesia simulators both in training and for periodic recertification, and regular medical examinations for all anesthesiologists.

[Risk factors for developing tuberculosis].

PubMed

Skodrić-Trifunović, Vesna

2004-01-01

Application of modern achievements in the field of medicine such as organ transplantation, long-term immunosuppressive therapy in treatment of numerous diseases, dialysis, successful treatment of malignant diseases prolonged duration of life and consequential continuation of long-term immunodeficiency. HIV infection currently represents a major risk factor for reactivation of tuberculosis with its associated relative risk being 30-170 times higher in comparison to the control group, in regard to the number of CD4 T-lymphocytes. Malignant diseases (hematological, lung and breast carcinomas) are important immunocompromising conditions affecting reactivation of tuberculosis, whereas the relative risk is 16. Development of tuberculosis among diabetics is considerably more frequent in comparison to general population (relative risk 2-4). Prominent glycoregulation disorders point to greater liability to development of tuberculosis. Alcoholism is characterized by general reduction of resistance, resulting from alcohol intoxication, malnutrition, irregular life style, etc. In malabsorption, immunosuppression is induced by deficiency of nutritive components and thus, relative risk for reactivation of tuberculosis is 5-12 in gastrectomy and 27-63 in jejunoileal bypass. In patients with chronic renal failur the relative risk ranges from 10 (nephropathies) to 37 (transplantation). Numerous patients use long-term immunosuppressive therapy that contributes to increased risk for developing tuberculosis (relative risk 12) as early as one month after application of a dose above 15 mg/day. There are numerous of risk factors that have frequently combined effects responsible for immunologic imbalance and development of tuberculosis.

The Role of Text Messaging in Cardiovascular Risk Factor Optimization.

PubMed

Klimis, Harry; Khan, Mohammad Ehsan; Kok, Cindy; Chow, Clara K

2017-01-01

Many cases of CVD may be avoidable through lowering behavioural risk factors such as smoking and physical inactivity. Mobile health (mHealth) provides a novel opportunity to deliver cardiovascular prevention programs in a format that is potentially scalable. Here, we provide an overview of text messaging-based mHealth interventions in cardiovascular prevention. Text messaging-based interventions appear effective on a range of behavioural risk factors and can effect change on multiple risk factors-e.g. smoking, weight, blood pressure-simultaneously. For many texting studies, there are challenges in interpretation as many texting interventions are part of larger complex interventions making it difficult to determine the benefits of the separate components. Whilst there is evidence for text messaging improving cardiovascular risk factor levels in the short-term, future studies are needed to examine the durability of these effects and whether they can be translated to improvements in clinical care and outcomes.

Modifiable risk factors associated with bronchiolitis

PubMed Central

Nenna, Raffaella; Cutrera, Renato; Frassanito, Antonella; Alessandroni, Claudia; Nicolai, Ambra; Cangiano, Giulia; Petrarca, Laura; Arima, Serena; Caggiano, Serena; Ullmann, Nicola; Papoff, Paola; Bonci, Enea; Moretti, Corrado; Midulla, Fabio

2017-01-01

Background: We sought to clarify possibly modifiable risk factors related to pollution responsible for acute bronchiolitis in hospitalized infants. Methods: For this observational study, we recruited 213 consecutive infants with bronchiolitis (cases: median age: 2 months; age range: 0.5–12 months; boys: 55.4%) and 213 children aged <3 years (controls: median age: 12 months; age range: 0.5–36 months; boys: 54.5%) with a negative medical history for lower respiratory tract diseases hospitalized at ‘Sapienza’ University Rome and IRCCS Bambino Gesù Hospital. Infants’ parents completed a standardized 53-item questionnaire seeking information on social-demographic and clinical characteristics, indoor pollution, eating habits and outdoor air pollution. Multivariate logistic regression analyses were run to assess the independent effect of risk factors, accounting for confounders and effect modifiers. Results: In the 213 hospitalized infants the questionnaire identified the following risk factors for acute bronchiolitis: breastfeeding ⩾3 months (OR: 2.1, 95% confidence interval [CI]: 1.2–3.6), presence of older siblings (OR: 2.8, 95% CI: 1.7–4.7), ⩾4 cohabitants (OR: 1.5, 95% CI: 1.1–2.1), and using seed oil for cooking (OR: 1.7, 95% CI: 1.2–2.6). Having renovated their home in the past 12 months and concurrently being exposed daily to smoking, involving more than 11 cigarettes and two or more smoking cohabitants, were more frequent factors in cases than in controls (p = 0.021 and 0.05), whereas self-estimated proximity to road and traffic was similar in the two groups. Conclusions: We identified several risk factors for acute bronchiolitis related to indoor and outdoor pollution, including inhaling cooking oil fumes. Having this information would help public health authorities draw up effective preventive measures – for example, teach mothers to avoid handling their child when they have a cold and eliminate exposure to second-hand tobacco smoke

The effects of intimate partner violence duration on individual and partner-related sexual risk factors among women.

PubMed

Fontenot, Holly B; Fantasia, Heidi Collins; Lee-St John, Terrence J; Sutherland, Melissa A

2014-01-01

Intimate partner violence (IPV) is associated with risk of sexually transmitted infections (STIs) and HIV among women, but less is known about mechanisms of this association and if length of relationship violence is a factor. The purpose of this study was to explore the relationship between the duration of IPV and both individual and partner-related sexual risk factors that may increase women's risk for STIs and HIV. This was a secondary analysis of data collected from the medical records of 2000 women. Four distinct categories defined the duration of partner violence: violence in the past year only, past year and during the past 5 years, past year plus extending for greater than 5 years, and no past year violence but a history of partner violence. Logistic regression models were used to examine the associations between the duration of partner violence and individual sexual risk behaviors (eg, number of sexual partners, drug and/or alcohol use, anal sex) and partner-related sexual risk factors (eg, nonmonogamy, STI risk, condom nonuse). Nearly 30% of the women in the study reported a history of partner violence during their lifetime. All of the individual risk factors, as well as partner-related risk factors, were significantly associated (P < .05) with partner violence and duration of violence. The study findings extend the knowledge related to partner violence as a risk factor for STIs/HIV, highlighting the effects of partner violence duration on the health of women. Assessing for lifetime experiences of partner violence may improve outcomes for women and their families. © 2014 by the American College of Nurse-Midwives.

Prediction and Informative Risk Factor Selection of Bone Diseases.

PubMed

Li, Hui; Li, Xiaoyi; Ramanathan, Murali; Zhang, Aidong

2015-01-01

With the booming of healthcare industry and the overwhelming amount of electronic health records (EHRs) shared by healthcare institutions and practitioners, we take advantage of EHR data to develop an effective disease risk management model that not only models the progression of the disease, but also predicts the risk of the disease for early disease control or prevention. Existing models for answering these questions usually fall into two categories: the expert knowledge based model or the handcrafted feature set based model. To fully utilize the whole EHR data, we will build a framework to construct an integrated representation of features from all available risk factors in the EHR data and use these integrated features to effectively predict osteoporosis and bone fractures. We will also develop a framework for informative risk factor selection of bone diseases. A pair of models for two contrast cohorts (e.g., diseased patients versus non-diseased patients) will be established to discriminate their characteristics and find the most informative risk factors. Several empirical results on a real bone disease data set show that the proposed framework can successfully predict bone diseases and select informative risk factors that are beneficial and useful to guide clinical decisions.

Biological risk factors for suicidal behaviors: a meta-analysis

PubMed Central

Chang, B P; Franklin, J C; Ribeiro, J D; Fox, K R; Bentley, K H; Kleiman, E M; Nock, M K

2016-01-01

Prior studies have proposed a wide range of potential biological risk factors for future suicidal behaviors. Although strong evidence exists for biological correlates of suicidal behaviors, it remains unclear if these correlates are also risk factors for suicidal behaviors. We performed a meta-analysis to integrate the existing literature on biological risk factors for suicidal behaviors and to determine their statistical significance. We conducted a systematic search of PubMed, PsycInfo and Google Scholar for studies that used a biological factor to predict either suicide attempt or death by suicide. Inclusion criteria included studies with at least one longitudinal analysis using a biological factor to predict either of these outcomes in any population through 2015. From an initial screen of 2541 studies we identified 94 cases. Random effects models were used for both meta-analyses and meta-regression. The combined effect of biological factors produced statistically significant but relatively weak prediction of suicide attempts (weighted mean odds ratio (wOR)=1.41; CI: 1.09–1.81) and suicide death (wOR=1.28; CI: 1.13–1.45). After accounting for publication bias, prediction was nonsignificant for both suicide attempts and suicide death. Only two factors remained significant after accounting for publication bias—cytokines (wOR=2.87; CI: 1.40–5.93) and low levels of fish oil nutrients (wOR=1.09; CI: 1.01–1.19). Our meta-analysis revealed that currently known biological factors are weak predictors of future suicidal behaviors. This conclusion should be interpreted within the context of the limitations of the existing literature, including long follow-up intervals and a lack of tests of interactions with other risk factors. Future studies addressing these limitations may more effectively test for potential biological risk factors. PMID:27622931

Effectiveness of early identification and electronic interventions for teens with risk factors for the development of heart disease and diabetes.

PubMed

Webber, Pam; Marsh, Wallace; Jung, Lorena; Gardiner, Mary; James, Jasmine; McMullan, Pam

2016-01-01

Serum risk factors for the development of heart disease and diabetes are not routinely evaluated in teens. The intent of this study was to determine the prevalence of these risk factors in teens and evaluate the effectiveness of a two-part electronic education program (recurring electronic lifestyle education program [REEP]) on reducing risks. Teens (n = 170) were recruited from one urban and one rural high school in the mid-Atlantic in 2014. Following baseline data collection in February, REEP was initiated and data collection repeated at 12 weeks. Data were analyzed and students sent a report with results and recommendations. One or more serum and/or physical risk factors were found in the majority of students with low vitamin D and elevated body mass index (BMI) being the most common. Correlations existed between elevated BMI and elevated diastolic blood pressure, low vitamin D, and low high-density lipoprotein. All but one risk factor (BMI) improved at 12 weeks. The majority of teens had one or more physical and/or serum risk factors. Using multiple electronic methods to deliver healthy lifestyle recommendations helps lower these risks. Also, Blackboard, an electronic learning platform, was found to be an effective data management and communication center. ©2015 American Association of Nurse Practitioners.

Critical factors and paths influencing construction workers' safety risk tolerances.

PubMed

Wang, Jiayuan; Zou, Patrick X W; Li, Penny P

2016-08-01

While workers' safety risk tolerances have been regarded as a main reason for their unsafe behaviors, little is known about why different people have different risk tolerances even when confronting the same situation. The aim of this research is to identify the critical factors and paths that influence workers' safety risk tolerance and to explore how they contribute to accident causal model from a system thinking perceptive. A number of methods were carried out to analyze the data collected through interviews and questionnaire surveys. In the first and second steps of the research, factor identification, factor ranking and factor analysis were carried out, and the results show that workers' safety risk tolerance can be influenced by four groups of factors, namely: (1) personal subjective perception; (2) work knowledge and experiences; (3) work characteristics; and (4) safety management. In the third step of the research, hypothetical influencing path model was developed and tested by using structural equation modeling (SEM). It is found that the effects of external factors (safety management and work characteristics) on risk tolerance are larger than that of internal factors (personal subjective perception and work knowledge & experiences). Specifically, safety management contributes the most to workers' safety risk tolerance through its direct effect and indirect effect; while personal subjective perception comes the second and can act as an intermedia for work characteristics. This research provides an in-depth insight of workers' unsafe behaviors by depicting the contributing factors as shown in the accident causal model developed in this research. Copyright © 2015 Elsevier Ltd. All rights reserved.

Genetic Factors Influencing Coagulation Factor XIII B-Subunit Contribute to Risk of Ischemic Stroke.

PubMed

Hanscombe, Ken B; Traylor, Matthew; Hysi, Pirro G; Bevan, Stephen; Dichgans, Martin; Rothwell, Peter M; Worrall, Bradford B; Seshadri, Sudha; Sudlow, Cathie; Williams, Frances M K; Markus, Hugh S; Lewis, Cathryn M

2015-08-01

Abnormal coagulation has been implicated in the pathogenesis of ischemic stroke, but how this association is mediated and whether it differs between ischemic stroke subtypes is unknown. We determined the shared genetic risk between 14 coagulation factors and ischemic stroke and its subtypes. Using genome-wide association study results for 14 coagulation factors from the population-based TwinsUK sample (N≈2000 for each factor), meta-analysis results from the METASTROKE consortium ischemic stroke genome-wide association study (12 389 cases, 62 004 controls), and genotype data for 9520 individuals from the WTCCC2 ischemic stroke study (3548 cases, 5972 controls-the largest METASTROKE subsample), we explored shared genetic risk for coagulation and stroke. We performed three analyses: (1) a test for excess concordance (or discordance) in single nucleotide polymorphism effect direction across coagulation and stroke, (2) an estimation of the joint effect of multiple coagulation-associated single nucleotide polymorphisms in stroke, and (3) an evaluation of common genetic risk between coagulation and stroke. One coagulation factor, factor XIII subunit B (FXIIIB), showed consistent effects in the concordance analysis, the estimation of polygenic risk, and the validation with genotype data, with associations specific to the cardioembolic stroke subtype. Effect directions for FXIIIB-associated single nucleotide polymorphisms were significantly discordant with cardioembolic disease (smallest P=5.7×10(-04)); the joint effect of FXIIIB-associated single nucleotide polymorphisms was significantly predictive of ischemic stroke (smallest P=1.8×10(-04)) and the cardioembolic subtype (smallest P=1.7×10(-04)). We found substantial negative genetic covariation between FXIIIB and ischemic stroke (rG=-0.71, P=0.01) and the cardioembolic subtype (rG=-0.80, P=0.03). Genetic markers associated with low FXIIIB levels increase risk of ischemic stroke cardioembolic subtype. © 2015 The

Risk factors for faecal sand excretion in Icelandic horses.

PubMed

Husted, L; Andersen, M S; Borggaard, O K; Houe, H; Olsen, S N

2005-07-01

Sandy soil is often mentioned as a risk factor in the development of sand-related gastrointestinal disease (SGID) in the horse. There are other variables, but few studies confirm any of these. To investigate soil type, pasture quality, feeding practice in the paddock, age, sex and body condition score as risk factors for sand intake in the horse. Faeces were collected from 211 Icelandic horses on 19 different studs in Denmark together with soil samples and other potential risk factors. Sand content in faeces determined by a sand sedimentation test was interpreted as evidence of sand intake. Soil types were identified by soil analysis and significance of the data was tested using logistic analysis. Of horses included in the study, 56.4% showed sand in the faeces and 5.7% had more than 5 mm sand as quantified by the rectal sleeve sedimentation test. Soil type had no significant effect when tested as main effect, but there was interaction between soil type and pasture quality. Significant interactions were also found between paddock feeding practice and pasture quality. To evaluate the risk of sand intake it is important to consider 3 variables: soil type, pasture quality and feeding practice. Pasture quality was identified as a risk factor of both short and long grass in combination with sandy soil, while clay soil had the lowest risk in these combinations. Feeding practice in the paddock revealed feeding directly on the ground to be a risk factor when there was short (1-5 cm) or no grass. Also, no feeding outdoors increased the risk on pastures with short grass, while this had no effect in paddocks with no grass. More than 50% of all horses investigated in this study had sand in the faeces. The identification of risk factors is an important step towards prevention of SGID. Further research is necessary to determine why some horses exhibit more than 5 mm sand in the sedimentation test and whether this is correlated with geophagic behaviour.

Marijuana protective behavioral strategies as a moderator of the effects of risk/protective factors on marijuana-related outcomes.

PubMed

Bravo, Adrian J; Anthenien, Amber M; Prince, Mark A; Pearson, Matthew R

2017-06-01

Given that both marijuana use and cannabis use disorder peak among college students, it is imperative to determine the factors that may reduce risk of problematic marijuana use and/or the development of cannabis use disorder. From a harm reduction perspective, the present study examined whether the use of marijuana protective behavioral strategies (PBS) buffers or amplifies the effects of several distinct risk and protective factors that have been shown to relate to marijuana-related outcomes (i.e., use frequency and consequences). Specifically, we examined marijuana-PBS use as a moderator of the effects of impulsivity-like traits, marijuana use motives, gender, and marijuana use frequency on marijuana-related outcomes in a large sample of college students (n=2093 past month marijuana users across 11 universities). In all models PBS use was robustly related with use frequency and consequences (i.e., strongly negatively associated with marijuana outcomes). Among interactions, we found: 1) unique significant interactions between specific impulsivity-like traits (i.e., premeditation, perseverance, and sensation seeking) and marijuana-PBS use in predicting marijuana consequences, 2) unique significant interactions between each marijuana use motive and marijuana-PBS use in predicting marijuana use frequency and 3) marijuana-PBS use buffered the risk associated with male gender in predicting both marijuana outcomes. Our results suggest that marijuana-PBS use can buffer risk factors and enhance protective factors among marijuana using college students. Future research is needed to understand context-specific factors and individual-level factors that may make marijuana-PBS use more effective. Copyright © 2017 Elsevier Ltd. All rights reserved.

Multiple risk factor interventions for primary prevention of coronary heart disease

PubMed Central

Ebrahim, Shah; Beswick, Andrew; Burke, Margaret; Smith, George Davey

2014-01-01

Background Primary prevention programmes in many countries attempt to reduce mortality and morbidity due to coronary heart disease (CHD) through risk factor modification. It is widely believed that multiple risk factor intervention using counselling and educational methods is efficacious and cost-effective and should be expanded. Recent trials examining risk factor changes have cast considerable doubt on the effectiveness of these multiple risk factor interventions. Objectives To assess the effects of multiple risk factor intervention for reducing cardiovascular risk factors, total mortality, and mortality from CHD among adults without clinical evidence of established cardiovascular disease. Search strategy MEDLINE was searched for the original review to 1995. This was updated by searching the Cochrane Central Register of Controlled Trials on The Cochrane Library Issue 3 2001, MEDLINE(2000 to September 2001) and EMBASE (1998 to September 2001). Selection criteria Intervention studies using counselling or education to modify more than one cardiovascular risk factor in adults from general populations, occupational groups, or high risk groups. Trials of less than 6 months duration were excluded. Data collection and analysis Data were extracted by two reviewers independently. Investigators were contacted to obtain missing information. Main results A total of 39 trials were found of which ten reported clinical event data. In the ten trials with clinical event end-points, the pooled odds ratios for total and CHD mortality were 0.96 (95% confidence intervals (CI) 0.92 to 1.01) and 0.96 (95% CI 0.89 to 1.04) respectively. Net changes in systolic and diastolic blood pressure, and blood cholesterol were (weighted mean differences) −3.6 mmHg (95% CI −3.9 to −3.3 mmHg), −2.8 mmHg (95% CI −2.9 to −2.6 mmHg) and −0.07 mMol/l (95% CI −0.8 to −0.06 mMol/l) respectively. Odds of reduction in smoking prevalence was 20% (95% CI 8% to 31%). Statistical heterogeneity

Probability Distribution of Dose and Dose-Rate Effectiveness Factor for use in Estimating Risks of Solid Cancers From Exposure to Low-Let Radiation.

PubMed

Kocher, David C; Apostoaei, A Iulian; Hoffman, F Owen; Trabalka, John R

2018-06-01

This paper presents an analysis to develop a subjective state-of-knowledge probability distribution of a dose and dose-rate effectiveness factor for use in estimating risks of solid cancers from exposure to low linear energy transfer radiation (photons or electrons) whenever linear dose responses from acute and chronic exposure are assumed. A dose and dose-rate effectiveness factor represents an assumption that the risk of a solid cancer per Gy at low acute doses or low dose rates of low linear energy transfer radiation, RL, differs from the risk per Gy at higher acute doses, RH; RL is estimated as RH divided by a dose and dose-rate effectiveness factor, where RH is estimated from analyses of dose responses in Japanese atomic-bomb survivors. A probability distribution to represent uncertainty in a dose and dose-rate effectiveness factor for solid cancers was developed from analyses of epidemiologic data on risks of incidence or mortality from all solid cancers as a group or all cancers excluding leukemias, including (1) analyses of possible nonlinearities in dose responses in atomic-bomb survivors, which give estimates of a low-dose effectiveness factor, and (2) comparisons of risks in radiation workers or members of the public from chronic exposure to low linear energy transfer radiation at low dose rates with risks in atomic-bomb survivors, which give estimates of a dose-rate effectiveness factor. Probability distributions of uncertain low-dose effectiveness factors and dose-rate effectiveness factors for solid cancer incidence and mortality were combined using assumptions about the relative weight that should be assigned to each estimate to represent its relevance to estimation of a dose and dose-rate effectiveness factor. The probability distribution of a dose and dose-rate effectiveness factor for solid cancers developed in this study has a median (50th percentile) and 90% subjective confidence interval of 1.3 (0.47, 3.6). The harmonic mean is 1.1, which

Cumulative Effects of Mothers' Risk and Promotive Factors on Daughters' Disruptive Behavior

ERIC Educational Resources Information Center

van der Molen, Elsa; Hipwell, Alison E.; Vermeiren, Robert; Loeber, Rolf

2012-01-01

Little is known about the ways in which the accumulation of maternal factors increases or reduces risk for girls' disruptive behavior during preadolescence. In the current study, maternal risk and promotive factors and the severity of girls' disruptive behavior were assessed annually among girls' ages 7-12 in an urban community sample (N = 2043).…

Examination of Substance Use, Risk Factors, and Protective Factors on Student Academic Test Score Performance.

PubMed

Arthur, Michael W; Brown, Eric C; Briney, John S; Hawkins, J David; Abbott, Robert D; Catalano, Richard F; Becker, Linda; Langer, Michael; Mueller, Martin T

2015-08-01

School administrators and teachers face difficult decisions about how best to use school resources to meet academic achievement goals. Many are hesitant to adopt prevention curricula that are not focused directly on academic achievement. Yet, some have hypothesized that prevention curricula can remove barriers to learning and, thus, promote achievement. We examined relationships among school levels of student substance use and risk and protective factors that predict adolescent problem behaviors and achievement test performance. Hierarchical generalized linear models were used to predict associations involving school-averaged levels of substance use and risk and protective factors and students' likelihood of meeting achievement test standards on the Washington Assessment of Student Learning, statistically controlling for demographic and economic factors known to be associated with achievement. Levels of substance use and risk/protective factors predicted the academic test score performance of students. Many of these effects remained significant even after controlling for model covariates. Implementing prevention programs that target empirically identified risk and protective factors has the potential to have a favorable effect on students' academic achievement. © 2015, American School Health Association.

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.

Cardiovascular risk factors among college students: Knowledge, perception, and risk assessment.

PubMed

Tran, Dieu-My T; Zimmerman, Lani M; Kupzyk, Kevin A; Shurmur, Scott W; Pullen, Carol H; Yates, Bernice C

2017-04-01

To assess college students' knowledge and perception of cardiovascular risk factors and to screen for their cardiovascular risks. The final sample that responded to recruitment consisted of 158 college students from a midwestern university. A cross-sectional, descriptive study was performed using convenience sampling. College students were knowledgeable about cardiovascular risk factors but did not perceive themselves at risk for cardiovascular disease (CVD). Knowledge of cardiovascular risk factors was correlated with the lifetime risk estimates (ρ = .17, p = .048), and perception of cardiovascular risk was positively associated with 30-year CVD risk estimates (ρ = .16, p = .048). More than 50% of the participants had 1 or more cardiovascular risk factors. High knowledge level of cardiovascular risk factors was not sufficient to lower cardiovascular risks within this study population, but changing perception of cardiovascular risk factors may play a bigger role in reducing long-term cardiovascular risks.

Side Effects of Radiographic Contrast Media: Pathogenesis, Risk Factors, and Prevention

PubMed Central

Tasanarong, Adis

2014-01-01

Radiocontrast media (RCM) are medical drugs used to improve the visibility of internal organs and structures in X-ray based imaging techniques. They may have side effects ranging from itching to a life-threatening emergency, known as contrast-induced nephropathy (CIN). We define CIN as acute renal failure occurring within 24–72 hrs of exposure to RCM that cannot be attributed to other causes. It usually occurs in patients with preexisting renal impairment and diabetes. The mechanisms underlying CIN include reduction in medullary blood flow leading to hypoxia and direct tubule cell damage and the formation of reactive oxygen species. Identification of patients at high risk for CIN is important. We have reviewed the risk factors and procedures for prevention, providing a long list of references enabling readers a deep evaluation of them both. The first rule to follow in patients at risk of CIN undergoing radiographic procedure is monitoring renal function by measuring serum creatinine and calculating the eGFR before and once daily for 5 days after the procedure. It is advised to discontinue potentially nephrotoxic medications, to choose radiocontrast media at lowest dosage, and to encourage oral or intravenous hydration. In high-risk patients N-acetylcysteine may also be given. PMID:24895606

Lifestyle Risk Factors Predict Disability and Death in Healthy Aging Adults

PubMed Central

Chakravarty, Eliza F.; Hubert, Helen B.; Krishnan, Eswar; Bruce, Bonnie B.; Lingala, Vijaya B.; Fries, James F.

2011-01-01

Background Associations between modifiable health risk factors during middle age with disability and mortality in later life are critical to maximizing longevity while preserving function. Positive health effects of maintaining normal weight, routine exercise, and non-smoking are known for the short and intermediate term. We studied the effects of these risk factors into advanced age. Methods A cohort of 2,327 college alumnae ≥60 years was followed annually (1986–2005) by questionnaires addressing health risk factors, history, and Health Assessment Questionnaire disability (HAQ-DI). Mortality data were ascertained from the National Death Index. Low, medium, and high risk groups were created based upon the number (0, 1, ≥2) of health risk factors (overweight, smoking, inactivity) at baseline. Disability and mortality for each group were estimated from unadjusted data and regression analyses. Multivariable survival analyses estimated time to disability or death. Results Medium and high-risk groups had higher disability than the low risk group throughout the study (p<0.001). Low-risk subjects had onset of moderate disability delayed 8.3 years compared with high-risk. Mortality rates were higher in the high risk group (384 versus 247 per 10,000 person-years). Multivariable survival analyses showed the number of risk factors to be associated with cumulative disability and increased mortality. Conclusions Seniors with fewer behavioral risk factors during middle age have lower disability and improved survival. These data document that the associations of lifestyle risk factors upon health continue into the ninth decade. PMID:22269623

Stroke Risk Factors and Symptoms

MedlinePlus

... » [ pdf, 433 kb ] Order Materials » Stroke Risk Factors and Symptoms Risk Factors for a Stroke Stroke prevention is still ... it. Treatment can delay complications that increase the risk of stroke. Transient ischemic attacks (TIAs). Seek help. ...

Effect of Ramadan fasting on urinary risk factors for calculus formation.

PubMed

Miladipour, Amir Hossein; Shakhssalim, Nasser; Parvin, Mahmoud; Azadvari, Mohaddeseh

2012-01-01

Even though dehydration could aggravate formation of urinary calculi, the effects of fluid and food restriction on calculus formation is not thoroughly defined. The purpose of this study is to evaluate the effects of fluid and food restriction in Ramadan fasting on urinary factors in kidney and urinary calculus formation. Fifty-seven men aged 30 to 55 years old, including 37 recurrent calcium calculus formers and 20 with no history of kidney calculi were evaluated for blood tests, ultrasonography investigations, urinalysis, urine culture, and also 24-hour urine collection test. Metabolites including calcium, oxalate, citrate, uric acid, magnesium, phosphate, potassium, sodium, and creatinine were measured before and during Ramadan fasting. The values of calculus-precipitating solutes as well as inhibitory factors were documented thoroughly. Total excretion of calcium, phosphate, and magnesium in 24-hour urine and also urine volume during fasting were significantly lower than those in the nonfasting period. Urine concentration of calcium during fasting was significantly lower than nonfasting (P < .001). Urine concentrations of uric acid, citrate, phosphate, sodium, and potassium during fasting were significantly higher than nonfasting. Uric acid supersaturation was accentuated, and calcium phosphate supersaturation was decreased significantly during fasting. There was no significant increase in calcium oxalate supersaturation during the fasting period. Fasting during Ramadan has different effects on total excretion and concentrations of urinary precipitate and inhibitory factors contributing to calculus formation. We did not find enough evidence in favor of increased risks of calculus formation during Ramadan fasting.

Adolescent eating disorder behaviours and cognitions: gender-specific effects of child, maternal and family risk factors

PubMed Central

Micali, N.; De Stavola, B.; Ploubidis, G.; Simonoff, E.; Treasure, J.; Field, A. E.

2015-01-01

Background Eating disorder behaviours begin in adolescence. Few longitudinal studies have investigated childhood risk and protective factors. Aims To investigate the prevalence of eating disorder behaviours and cognitions and associated childhood psychological, physical and parental risk factors among a cohort of 14-year-old children. Method Data were collected from 6140 boys and girls aged 14 years. Gender-stratified models were used to estimate prospective associations between childhood body dissatisfaction, body mass index (BMI), self-esteem, maternal eating disorder and family economic disadvantage on adolescent eating disorder behaviours and cognitions. Results Childhood body dissatisfaction strongly predicted eating disorder cognitions in girls, but only in interaction with BMI in boys. Higher self-esteem had a protective effect, particularly in boys. Maternal eating disorder predicted body dissatisfaction and weight/shape concern in adolescent girls and dieting in boys. Conclusions Risk factors for eating disorder behaviours and cognitions vary according to gender. Prevention strategies should be gender-specific and target modifiable predictors in childhood and early adolescence. PMID:26206865

Effects of smoking and aerobic exercise on male college students' metabolic syndrome risk factors.

PubMed

Kim, Jee-Youn; Yang, Yuhao; Sim, Young-Je

2018-04-01

[Purpose] The aim was to investigate the effects of university students' smoking and aerobic exercise on metabolic syndrome risk factors. [Subjects and Methods] Twenty-three male students were randomly assigned to the following groups: exercise smoker (n=6), non-exercise smoker (n=6), exercise non-smoker (n=6), and non-exercise non-smoker (n=5). A basketball exercise program was conducted three times per week (70 minutes per session) for 8 weeks with exercise intensity set at 50-80% of heart rate reserve. After 8 weeks, the variables of risk factors for metabolic syndrome were obtained. [Results] Systolic blood pressure and diastolic blood pressure were significantly decreased in the exercise non-smoker group and significantly increased in the non-exercise smoker group. Waist circumference was significantly reduced in both exercise groups regardless of smoking and significantly increased in the non-exercise smoker group. Triglyceride, high-density lipoprotein-cholesterol, and fasting plasma glucose showed no differences between the groups. [Conclusion] Obesity and smoking management should be conducted together for students as well as for those with metabolic syndrome risk factors. It is recommended that more students participate in such programs, and exercise programs should be further developed and diversified to prevent metabolic syndrome and cardiovascular diseases.

Rules and regulations as potential moderator on the relationship between organizational internal and external factors with effective construction risk management in Nigerian construction companies: A proposed framework

NASA Astrophysics Data System (ADS)

Adeleke, A. Q.; Bahaudin, A. Y.; Kamaruddeen, A. M.

2016-08-01

Certain organizational internal and external factors have been found to influence effective construction risk management within the construction company which has contributed to massive risk occurrence on the projects. Yet, the influence of the organizational factors such as effective communication, team competency with skills, active leadership, political factor, organizational culture, technology factor and economic factor on effective construction risk management among the construction companies operating in Abuja and Lagos state Nigeria have not received considerable attention. More so, a moderating variable is proposed. This paper proposes rules and regulations as the potential moderator on the relationship between organisational internal factors, external factors and effective construction risk management.

Educational differences in cardiovascular mortality: The role of shared family factors and cardiovascular risk factors.

PubMed

Kjøllesdal, M K R; Ariansen, I; Mortensen, L H; Davey Smith, G; Næss, Ø

2016-12-01

To explore the confounding effects of early family factors shared by siblings and cardiovascular risk factors in midlife on the educational differences in mortality from cardiovascular disease (CVD). Data from national and regional health surveys in Norway (1974-2003) were linked with data from the Norwegian Family Based Life Course Study, the National Educational Registry and the Cause of Death Registry. The study population consisted of participants with at least one full sibling among the health survey participants ( n=271,310). Data were available on CVD risk factors, including weight, height, blood pressure, total cholesterol and smoking. The hazards ratio (HR) of CVD mortality was 3.44 (95% confidence interval (CI) 2.98-3.96) in the lowest educational group relative to the highest. The HRs were little altered in the within-sibship analyses. Adjusted for risk factors, the HR for CVD mortality in the cohort analyses was 2.05 (CI 1.77-2.37) in the lowest educational group relative to the highest. The respective HR in the within-sibship analyses was 2.46 (CI 1.48-2.24). Using a sibling design, we did not find that the association between education and CVD mortality was confounded by early life factors shared by siblings, but it was explained to a large extent by CVD risk factors. These results suggest that reducing levels of CVD risk factors could have the greatest effect on mortality in less well-educated people.

Substantial contribution of extrinsic risk factors to cancer development

PubMed Central

Wu, Song; Powers, Scott; Zhu, Wei; Hannun, Yusuf A

2015-01-01

Summary Recent research has highlighted a strong correlation between tissue-specific cancer risk and the lifetime number of tissue-specific stem cell divisions. Whether such correlation implies a high unavoidable intrinsic cancer risk has become a key public health debate with dissemination of the ‘bad luck’ hypothesis. Here we provide evidence that intrinsic risk factors contribute only modestly (<10~30%) to cancer development. First, we demonstrate that the correlation between stem-cell division and cancer risk does not distinguish between the effects of intrinsic and extrinsic factors. Next, we show that intrinsic risk is better estimated by the lower bound risk controlling for total stem cell divisions. Finally, we show that the rates of endogenous mutation accumulation by intrinsic processes are not sufficient to account for the observed cancer risks. Collectively, we conclude that cancer risk is heavily influenced by extrinsic factors. These results carry immense consequences for strategizing cancer prevention, research, and public health. PMID:26675728

Introduction of risk size in the determination of uncertainty factor UFL in risk assessment

NASA Astrophysics Data System (ADS)

Xue, Jinling; Lu, Yun; Velasquez, Natalia; Yu, Ruozhen; Hu, Hongying; Liu, Zhengtao; Meng, Wei

2012-09-01

The methodology for using uncertainty factors in health risk assessment has been developed for several decades. A default value is usually applied for the uncertainty factor UFL, which is used to extrapolate from LOAEL (lowest observed adverse effect level) to NAEL (no adverse effect level). Here, we have developed a new method that establishes a linear relationship between UFL and the additional risk level at LOAEL based on the dose-response information, which represents a very important factor that should be carefully considered. This linear formula makes it possible to select UFL properly in the additional risk range from 5.3% to 16.2%. Also the results remind us that the default value 10 may not be conservative enough when the additional risk level at LOAEL exceeds 16.2%. Furthermore, this novel method not only provides a flexible UFL instead of the traditional default value, but also can ensure a conservative estimation of the UFL with fewer errors, and avoid the benchmark response selection involved in the benchmark dose method. These advantages can improve the estimation of the extrapolation starting point in the risk assessment.

Effects of opium consumption on coronary artery disease risk factors and oral health: Results of Kerman Coronary Artery Disease Risk factors Study a population-based survey on 5900 subjects aged 15-75 years.

PubMed

Najafipour, Hamid; Masoomi, Mohammad; Shahesmaeili, Armita; Haghdoost, Ali Akbar; Afshari, Mahdi; Nasri, Hamid Reza; Kahnooji, Masoomeh; Samadi, Sadra; Mirzazadeh, Ali

2015-01-01

Opium abuse as a relatively common behavior among Iranian population may have an association with the other coronary artery disease (CAD) risk factors. Here, we reported the prevalence of opium abuse and its co-exposures with oral health and other CAD risk factors. We recruited 5900 inhabitant aged 15-75 years using a randomized cluster household survey. All were interviewed for level of physical activity (PA), depression, anxiety and opium use and assessed for hypertension, diabetes, hyperlipidemia, and oral health status. Regarding to opium abuse, participants were grouped into: "Non-," "occasional," and "dependent" users. Using logistic regression model for every CAD risk factor, we assessed whether the co-exposure of opium and CAD risk factor is significant. Overall, 10.6% reported ever opium use including 5.6% dependent and 5% occasional users. The prevalence of opium abuse was increased from 2.1% in 15-25 years to 24.5% in 55-64 years group. Opium abuse, in occasional and dependent forms, was associated with depression (adjusted odds ratio [AOR] 1.81 and 2.49) and low PS (AOR 1.43 and 1.71 respectively). Dependents were less obese than nonusers (P < 0.01). Opium abuse had no significant association with hypertension, diabetes, oral health status and lipid profile. Opium abuse was associated with depression and low PA. No ameliorative effect was observed on hypertension, diabetes, and plasma lipid profile. Therefore, positive association of opium with depression and LPA and the incorrectness of belief on its ameliorative effect on three other important risk factors of CAD should be clearly highlighted in public health messages to the community.

Risk factors for community-acquired bacterial meningitis.

PubMed

Lundbo, Lene Fogt; Benfield, Thomas

2017-06-01

Bacterial meningitis is a significant burden of disease and mortality in all age groups worldwide despite the development of effective conjugated vaccines. The pathogenesis of bacterial meningitis is based on complex and incompletely understood host-pathogen interactions. Some of these are pathogen-specific, while some are shared between different bacteria. We searched the database PubMed to identify host risk factors for bacterial meningitis caused by the pathogens Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b, because they are three most common causative bacteria beyond the neonatal period. We describe a number of risk factors; including socioeconomic factors, age, genetic variation of the host and underlying medical conditions associated with increased susceptibility to invasive bacterial infections in both children and adults. As conjugated vaccines are available for these infections, it is of utmost importance to identify high risk patients to be able to prevent invasive disease.

Influence of exposure to perinatal risk factors and parental mental health related hospital admission on adolescent deliberate self-harm risk.

PubMed

Hu, Nan; Li, Jianghong; Glauert, Rebecca A; Taylor, Catherine L

2017-07-01

Adolescent deliberate self-harm (DSH) has been found to be associated with a range of bio-psycho-social factors. Simultaneous investigations of these factors enable more robust estimation of the independent effect of a specific risk factor by adjusting for a more complete set of covariates. However, few studies have had the ability to examine all of these factors together. This study used the linkage of population-level de-identified data collections from government agencies to investigate a range of biological, psychological, and social risk factors and their effects on adolescent risk of DSH (with or without suicidal intent). The investigation was undertaken by progressively adjusting for plausible covariates, including fetal growth status and birth order, early familial social factors, parental hospital admissions due to psychiatric disorders or DSH, and parental all-cause death. Conditional logistic regression was used for data analysis. Children's psychiatric history was analysed to examine the extent to which it may account for the link between the risk factors and adolescent DSH risk. This study identified significant biological and perinatal social risk factors for adolescent DSH risk, including overdue birth, high birth order (≥2), single or teen/young motherhood, high neighbourhood socioeconomic disadvantage, and parental psychiatric and/or DSH-related hospital admissions. Further, parental psychiatric and/or DSH-related admissions, and children's psychiatric admissions in particular, largely attenuated the effects of the perinatal social risk factors but not the biological factors on adolescent DSH risk. These results highlight the importance of taking joint actions involving both health and social services in the prevention of adolescent DSH.

Strength training in the elderly: effects on risk factors for age-related diseases.

PubMed

Hurley, B F; Roth, S M

2000-10-01

Strength training (ST) is considered a promising intervention for reversing the loss of muscle function and the deterioration of muscle structure that is associated with advanced age. This reversal is thought to result in improvements in functional abilities and health status in the elderly by increasing muscle mass, strength and power and by increasing bone mineral density (BMD). In the past couple of decades, many studies have examined the effects of ST on risk factors for age-related diseases or disabilities. Collectively, these studies indicate that ST in the elderly: (i) is an effective intervention against sarcopenia because it produces substantial increases in the strength, mass, power and quality of skeletal muscle; (ii) can increase endurance performance; (iii) normalises blood pressure in those with high normal values; (iv) reduces insulin resistance; (v) decreases both total and intra-abdominal fat; (vi) increases resting metabolic rate in older men; (vii) prevents the loss of BMD with age; (viii) reduces risk factors for falls; and (ix) may reduce pain and improve function in those with osteoarthritis in the knee region. However, contrary to popular belief, ST does not increase maximal oxygen uptake beyond normal variations, improve lipoprotein or lipid profiles, or improve flexibility in the elderly.

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

PubMed

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

2014-01-01

Cardiovascular disease (CVD) has emerged as a major cause of morbidity and mortality in HIV-infected adults. Research in noninfected 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. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

[Tuberculosis recurrence and its risk factors].

PubMed

de Oliveira, H B; Moreira Filho, D de C

2000-04-01

The persistence of tuberculosis bacilli in patients who are cured, thus causing recurrence, is an important issue. This case-control study investigated individual and institutional risk factors for relapse by analyzing independent variables related to the patient, the use of antituberculosis drugs, and the service delivered at health care institutions; 56 cases and 105 controls were interviewed. Recurrence was defined as a new tuberculosis episode after the patient had been successfully treated. Controls were selected from among patients who were treated and cured of pulmonary tuberculosis and who did not experience a relapse. Regression models were proposed to control confounding factors or effect modifiers. The variables identified as risk factors for relapse were those related to erratic patient behavior (missing medical appointments and therefore not picking up the medication, not taking the medication, taking the wrong dosage), age, and stress from life events; adverse reactions to antituberculosis drugs; and problems in the organization of health care services that resulted in patients receiving insufficient dosages or amounts of antituberculosis drugs. Receiving information regarding treatment duration provided protection against recurrence. The knowledge regarding these risk factors should result in more intensive follow-up and in more use of directly observed treatment of tuberculosis in order to prevent relapse.

17 CFR 229.904 - (Item 904) Risk factors and other considerations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 2 2011-04-01 2011-04-01 false (Item 904) Risk factors and... 904) Risk factors and other considerations. (a) Immediately following the summary required by Item 903 of this subpart (§ 229.903), describe in reasonable detail each material risk and effect of the roll...

Modifiable risk factors for migraine progression.

PubMed

Bigal, Marcelo E; Lipton, Richard B

2006-10-01

Migraine is a chronic-recurrent disorder that progresses in some individuals. Transformed migraine is the result of this progression. Since migraine does not progress in most patients, identifying the risk factors for progression has emerged as a very important public health priority. If risk factors can be identified, that might provide a foundation for more aggressive preventive intervention. Risk factors for progression may be divided into non-remediable (gender, age, race) and remediable categories. In this paper, we focus on several already identified remediable risk factors, including frequency of migraine attacks, obesity, acute medication overuse, caffeine overuse, stressful life events, depression, and sleep disorders. We present the evidence for each risk factor and discuss possible interventions to address them.

The effects of improved metabolic risk factors on bone turnover markers after 12 weeks of simvastatin treatment with or without exercise.

PubMed

Jiang, Jun; Boyle, Leryn J; Mikus, Catherine R; Oberlin, Douglas J; Fletcher, Justin A; Thyfault, John P; Hinton, Pamela S

2014-11-01

Emerging evidence supports an association between metabolic risk factors and bone turnover. Statins and exercise independently improve metabolic risk factors; however whether improvements in metabolic risk factor affects bone turnover is unknown. The purpose of the present study was to: 1) evaluate the relationship between metabolic risk factors and bone turnover; and 2) determine if improvements in metabolic risk factors after 12 weeks of statin treatment, exercise or the combination affect bone turnover. Fifty participants with ≥2 metabolic syndrome defining characteristics were randomly assigned to one of three groups: statin (STAT: simvastatin, 40 mg/day), exercise (EX: brisk walking and/or slow jogging, 45 minutes/day, 5 days/week), or the combination (STAT+EX). Body composition and whole body bone mineral density were measured with dual energy X-ray absorptiometry. Serum markers of bone formation (bone specific alkaline phosphatase, BAP; osteocalcin, OC), resorption (C-terminal peptide of type I collagen, CTX) and metabolic risk factors were determined. Two-factor (time, group) repeated-measures ANCOVA was used to examine changes of metabolic risk factors and bone turnover. General linear models were used to determine the effect of pre-treatment metabolic risk factors on post-treatment bone turnover marker outcomes. Participants with ≥4 metabolic syndrome defining characteristics had lower pre-treatment OC than those with 3 or fewer. OC was negatively correlated with glucose, and CTX was positively correlated with cholesterol. STAT or STAT+EX lowered total and LDL cholesterol. The OC to CTX ratio decreased in all groups with no other significant changes in bone turnover. Higher pre-treatment insulin or body fat predicted a greater CTX reduction and a greater BAP/CTX increase. Metabolic risk factors were negatively associated with bone turnover markers. Short-term statin treatment with or without exercise lowered cholesterol and all treatments had a small

Do insulin-like growth factors mediate the effect of alcohol on breast cancer risk?

PubMed

Yu, H; Berkel, J

1999-06-01

Despite a large number of epidemiologic studies demonstrating an increased risk of breast cancer in association with alcohol consumption, a causal relationship between alcohol intake and breast cancer risk remains to be determined. Several biological mechanisms have been proposed, but none of them explains well the features of the association, i.e. a modest increase in risk, a limited range of dose-response relationship and no further increase in risk among heavy drinkers. A new mechanism underlying a possible biological role of alcohol in breast cancer is proposed in this paper. Moderate consumption of alcohol increases the production of insulin-like growth factors (IGFs) by the liver and elevated IGFs via circulation stimulate or promote the development and/or growth of breast cancer. The effect of alcohol on IGF production declines among heavy drinkers as alcohol-caused liver-function damage results in no further increase in IGF production. Therefore, compared to moderate drinkers, heavy alcohol users do not have a higher risk of breast cancer.

Achilles tendon injury risk factors associated with running.

PubMed

Lorimer, Anna V; Hume, Patria A

2014-10-01

Research into the nature of overuse Achilles tendon injuries is extensive, yet uncertainty remains around how to identify athletes susceptible to Achilles tendon injury. To identify the strength of evidence for biomechanical risk factors associated with Achilles tendon injuries. SPORTDiscus, CINAHL, Web of Science and PubMed were searched for Achilles tendon injury risk factors and biomechanical measures which are altered in runners with Achilles tendon injuries, excluding ruptures. Fifteen articles were included in the analysis. Two variables, high vertical forces and high arch, showed strong evidence for reduced injury risk. High propulsive forces and running on stiffer surfaces may also be protective. Only one biomechanical variable, high braking force, showed clear evidence for increasing Achilles injury risk. Gait retraining to direct the centre of mass further forward to reduce high braking force could be useful in decreasing the risk of Achilles injury. The majority of biomechanical risk factors examined showed unclear results, which is likely due to the multifactorial nature of Achilles overuse injuries. Many risk factors are related to how the athlete's body interacts with the environment during gait, including ground reaction forces, muscle activity both prior to landing and immediately post ground contact, and joint motion throughout stance. Multiple risk factors have been associated with the development of Achilles tendon injuries in running athletes but most effects remain unclear. Advice for athletes recovering from Achilles tendon injuries could include avoiding soft surfaces and reducing the pace of recovery runs. Orthotic intervention could assist athletes with low arches but modification of pronation should be viewed with caution. Strength training and gait retraining could be beneficial for reducing injury risk.

Sociodemographic factors associated with multiple cardiovascular risk factors among Malaysian adults.

PubMed

Ghazali, Sumarni Mohd; Seman, Zamtira; Cheong, Kee Chee; Hock, Lim Kuang; Manickam, Mala; Kuay, Lim Kuang; Yusoff, Ahmad Faudzi; Mustafa, Feisul Idzwan; Mustafa, Amal Nasir

2015-01-31

To determine the prevalence and sociodemographic correlates of multiple risk factors for cardiovascular disease (CVD) among Malaysian adults. We analysed data on 1044 men and 1528 women, aged 24-64 years, participants in the Non Communicable Disease Surveillance 2005/2006, a nationally representative, population-based, cross-sectional study. Prevalence of obesity, high blood pressure, dyslipidaemia, hyperglycemia, physical inactivity, smoking, risky drinking, low vegetable and fruit intake were determined and multivariable logistic regression was used to identify sociodemographic factors associated with having ≥3 of these cardiovascular disease risk factors. The response rate was 84.6% (2572/3040). Overall, 68.4% (95% CI: 63.2, 73.1) had at least three risk factors. Among men, older age and Indian ethnicity were independently associated with having ≥3 CVD risk factors; while among women, older age, low education, and housewives were more likely to have ≥3 CVD risk factors. The prevalence of cardiovascular risk factors clustering among Malaysian adults is high, raising concerns that cardiovascular disease incidence will rise steeply in the near future if no immediate preventive measures are taken. The current national health education and promotion programmes pertaining to modifiable risk factors can be further improved by taking into account the sociodemographic variation in CVD risk factors clustering.

[The Impact of Risk Factors and Effective Factors on Success in Crisis Intervention for Children and Adolescents].

PubMed

Wisiol, Florian; Juen, Barbara; Unterrainer, Christine

2017-05-01

The Impact of Risk Factors and Effective Factors on Success in Crisis Intervention for Children and Adolescents This article focuses on the evaluation of (inpatient) crisis interventions for children and adolescents, who can be admitted into the residential area of the KIZ for up to eight weeks in order to provide acute protection against massive violence, neglect or family conflicts in emergency situations. How successful the crisis intervention is or can be depends on various factors that have been worked out in this study. Various factors have an impact on success in crisis intervention; above all the participation, a good relationship and/or cooperation with the Counselors in the Crisis Intervention Center contribute to a great success. Restoring their own possibilities for action after a massive crisis, the strengthening of self-efficacy in crisis intervention must be considered critically. The young clients see little change here. The crisis intervention must therefore not only focus on its most important function, protection and security, but also on the strengthening of self-esteem and a positive sense of coherence as part of the crisis intervention.

Language Delay in Severely Neglected Children: A Cumulative or Specific Effect of Risk Factors?

ERIC Educational Resources Information Center

Sylvestre, Audette; Merette, Chantal

2010-01-01

Objectives: This research sought to determine if the language delay (LD) of severely neglected children under 3 years old was better explained by a cumulative risk model or by the specificity of risk factors. The objective was also to identify the risk factors with the strongest impact on LD among various biological, psychological, and…

Low bone density risk is higher in exercising women with multiple triad risk factors.

PubMed

Gibbs, Jenna C; Nattiv, Aurelia; Barrack, Michelle T; Williams, Nancy I; Rauh, Mitchell J; Nichols, Jeanne F; De Souza, Mary Jane

2014-01-01

The cumulative effect of the female athlete triad (Triad) risk factors on the likelihood of low bone mineral density (BMD) in exercising women is unclear. This study aimed to determine the risk of low BMD in exercising women with multiple Triad risk factors. We retrospectively examined cross-sectional data from 437 exercising women (mean ± SD age of 18.0 ± 3.5 yr, weighed 57.5 ± 7.1 kg with 24.5% ± 6.1% body fat) obtained at baseline from 4 prospective cohort studies examining Triad risk factors. Questionnaires were completed to obtain information on demographic characteristics, self-reported eating attitudes/behaviors, menstrual function, sport/activity participation, and medication use. Height and body weight were measured. BMD was measured using dual energy x-ray absorptiometry. Low BMD was defined as z-scores of <-1 and ≤-2. Chi-square tests were performed to determine the percentage of women with low BMD who met the criteria for individual (current oligo/amenorrhea, late menarche, low body mass index (BMI), elevated dietary restraint, lean sport/activity participation) or multiple (2, 3, 4, or 5) Triad risk factors. Late menarche and low BMI were associated with the highest percentage of low BMD (z-score < -1), 55% and 54%, respectively, and low BMD (z-score ≤-2), 14% and 16%, respectively. The percentage of participants with low BMD (z-score < -1 and ≤-2) increased from 10% to 62% and from 2% to 18%, respectively, as women met the criteria for an increasing number of Triad risk factors. A cumulative number of Triad risk factors were associated with an increased risk of low BMD, suggesting a dose-response association between the number of Triad risk factors and BMD in exercising women. Further research should be conducted to develop a user-friendly algorithm integrating these indicators of risk for low BMD in exercising women (particularly factors associated with low BMI/body weight, menstrual dysfunction, lean sport/activity participation, and

Cost-effectiveness of a nurse-led internet-based vascular risk factor management programme: economic evaluation alongside a randomised controlled clinical trial.

PubMed

Greving, J P; Kaasjager, H A H; Vernooij, J W P; Hovens, M M C; Wierdsma, J; Grandjean, H M H; van der Graaf, Y; de Wit, G A; Visseren, F L J

2015-05-20

To assess the cost-effectiveness of an internet-based, nurse-led vascular risk factor management programme in addition to usual care compared with usual care alone in patients with a clinical manifestation of a vascular disease. Cost-effectiveness analysis alongside a randomised controlled trial (the Internet-based vascular Risk factor Intervention and Self-management (IRIS) study). Multicentre trial in a secondary and tertiary healthcare setting. 330 patients with a recent clinical manifestation of atherosclerosis in the coronary, cerebral, or peripheral arteries and with ≥2 treatable vascular risk factors not at goal. The intervention consisted of a personalised website with an overview and actual status of patients' vascular risk factors, and mail communication with a nurse practitioner via the website for 12 months. The intervention combined self-management support, monitoring of disease control and pharmacotherapy. Societal costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness. Patients experienced equal health benefits, that is, 0.86 vs 0.85 QALY (intervention vs usual care) at 1 year. Adjusting for baseline differences, the incremental QALY difference was -0.014 (95% CI -0.034 to 0.007). The intervention was associated with lower total costs (€4859 vs €5078, difference €219, 95% CI -€2301 to €1825). The probability that the intervention is cost-effective at a threshold value of €20,000/QALY, is 65%. At mean annual cost of €220 per patient, the intervention is relatively cheap. An internet-based, nurse-led intervention in addition to usual care to improve vascular risk factors in patients with a clinical manifestation of a vascular disease does not result in a QALY gain at 1 year, but has a small effect on vascular risk factors and is associated with lower costs. NCT00785031. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Cost-effectiveness of a nurse-led internet-based vascular risk factor management programme: economic evaluation alongside a randomised controlled clinical trial

PubMed Central

Greving, J P; Kaasjager, H A H; Vernooij, J W P; Hovens, M M C; Wierdsma, J; Grandjean, H M H; van der Graaf, Y; de Wit, G A; Visseren, F L J

2015-01-01

Objective To assess the cost-effectiveness of an internet-based, nurse-led vascular risk factor management programme in addition to usual care compared with usual care alone in patients with a clinical manifestation of a vascular disease. Design Cost-effectiveness analysis alongside a randomised controlled trial (the Internet-based vascular Risk factor Intervention and Self-management (IRIS) study). Setting Multicentre trial in a secondary and tertiary healthcare setting. Participants 330 patients with a recent clinical manifestation of atherosclerosis in the coronary, cerebral, or peripheral arteries and with ≥2 treatable vascular risk factors not at goal. Intervention The intervention consisted of a personalised website with an overview and actual status of patients’ vascular risk factors, and mail communication with a nurse practitioner via the website for 12 months. The intervention combined self-management support, monitoring of disease control and pharmacotherapy. Main outcome measures Societal costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness. Results Patients experienced equal health benefits, that is, 0.86 vs 0.85 QALY (intervention vs usual care) at 1 year. Adjusting for baseline differences, the incremental QALY difference was −0.014 (95% CI −0.034 to 0.007). The intervention was associated with lower total costs (€4859 vs €5078, difference €219, 95% CI −€2301 to €1825). The probability that the intervention is cost-effective at a threshold value of €20 000/QALY, is 65%. At mean annual cost of €220 per patient, the intervention is relatively cheap. Conclusions An internet-based, nurse-led intervention in addition to usual care to improve vascular risk factors in patients with a clinical manifestation of a vascular disease does not result in a QALY gain at 1 year, but has a small effect on vascular risk factors and is associated with lower costs. Trial registration number NCT00785031. PMID

Risk Factors for Peri-Implantitis: Effect of History of Periodontal Disease and Smoking Habits. A Systematic Review and Meta-Analysis

PubMed Central

Berton, Federico; Perinetti, Giuseppe; Frassetto, Andrea; Lombardi, Teresa; Khoury, Aiman; Andolsek, Francesca; Di Lenarda, Roberto

2016-01-01

ABSTRACT Objectives The purpose of this review was to evaluate whether history of periodontitis and smoking habits could represent a risk factor for peri-implantitis and implant loss. Material and Methods This systematic review followed PRISMA guidelines and was registered at the PROSPERO database [registration numbers CRD42016034160 (effect of history of periodontitis) and CRD42016033676 (effect of smoking)]. Broad electronic (MEDLINE) and manual searches were conducted among articles published from January 1st 1990 up to December 31st 2015, resulting in 49332 records for history of periodontitis and 3199 for smoking habits. Selection criteria included prospective studies comparing two cohorts of patients, with and without the investigated risk factor, with a minimum follow-up period of three years, and reporting data on peri-implantitis and implant loss occurrence. Considering that only prospective studies were included, dichotomous data were expressed as risk ratios and 95% confidence intervals. Results Three studies evaluating history of periodontitis (on which quantitative analysis was performed) and one study on smoking effect were included. Both implant and patient-based meta-analyses revealed a significantly higher risk of developing peri-implantitis in patients with a history of periodontitis compared with periodontally healthy subjects, but not a statistically significant increased risk for implant loss. Conclusions The outcomes of this systematic review indicate history of periodontitis as a possible risk factor for peri-implantitis, while insufficient data are present in literature to evaluate the role of smoking. However, available evidence is still weak and immature, and sound epidemiological studies are needed to analyse the specific contribution of these potential risk factors. PMID:27833728

Effect of obesity on cardiovascular disease risk factors in African American women.

PubMed

Henry-Okafor, Queen; Cowan, Patricia A; Wicks, Mona N; Rice, Muriel; Husch, Donna S; Khoo, Michelle S C

2012-04-01

Obesity is a growing health care concern with implications for cardiovascular disease (CVD). Obesity and CVD morbidity and mortality are highly prevalent among African American women. This pilot study examined the association between obesity and the traditional and emerging CVD risk factors in a sample of African American women. Participants comprised 48 women (27 obese, 21 normal weight) aged 18-45. with no known history of CVD. The women completed demographic and 7-day physical activity recall questionnaires. Height and weight were used to determine body mass index (BMI). Hypertension risk was assessed using the average of two resting blood pressure (BP) measurements. Lipid profile, blood glucose, fibrinogen, high-sensitivity C-reactive protein (hs-CRP), plasminogen activator inhibitor-1 (PAI-1), soluble intercellular adhesion molecule-1 (sICAM-1), and E-selectin (eSel) levels were assessed using fasting blood samples. Laboratory findings were interpreted using the American Diabetes Association (ADA) and Adult Treatment Panel (ATP) III reference guidelines as well as manufacturers' reference ranges for the novel CVD risk factors. The most common traditional risk factors were physical inactivity (72.9%), positive family history of CVD (58.3%), and obesity (56.3%). Obese individuals had elevated systolic BP (p = .0002), diastolic BP (p = .0007) and HDL-cholesterol (p = .01), triglyceride (p = .02), hs-CRP (p = .002), and fibrinogen (p = .01), when compared with normal-weight women. The findings suggest an association between obesity and higher prevalence of both traditional and emerging CVD risk factors in young African American women.

Identifying Causal Risk Factors for Violence among Discharged Patients

PubMed Central

Coid, Jeremy W.; Kallis, Constantinos; Doyle, Mike; Shaw, Jenny; Ullrich, Simone

2015-01-01

Background Structured Professional Judgement (SPJ) is routinely administered in mental health and criminal justice settings but cannot identify violence risk above moderate accuracy. There is no current evidence that violence can be prevented using SPJ. This may be explained by routine application of predictive instead of causal statistical models when standardising SPJ instruments. Methods We carried out a prospective cohort study of 409 male and female patients discharged from medium secure services in England and Wales to the community. Measures were taken at baseline (pre-discharge), 6 and 12 months post-discharge using the Historical, Clinical and Risk-20 items version 3 (HCR-20v3) and Structural Assessment of Protective Factors (SAPROF). Information on violence was obtained via the McArthur community violence instrument and the Police National Computer. Results In a lagged model, HCR-20v3 and SAPROF items were poor predictors of violence. Eight items of the HCR-20v3 and 4 SAPROF items did not predict violent behaviour better than chance. In re-analyses considering temporal proximity of risk/ protective factors (exposure) on violence (outcome), risk was elevated due to violent ideation (OR 6.98, 95% CI 13.85–12.65, P<0.001), instability (OR 5.41, 95% CI 3.44–8.50, P<0.001), and poor coping/ stress (OR 8.35, 95% CI 4.21–16.57, P<0.001). All 3 risk factors were explanatory variables which drove the association with violent outcome. Self-control (OR 0.13, 95% CI 0.08–0.24, P<0.001) conveyed protective effects and explained the association of other protective factors with violence. Conclusions Using two standardised SPJ instruments, predictive (lagged) methods could not identify risk and protective factors which must be targeted in interventions for discharged patients with severe mental illness. Predictive methods should be abandoned if the aim is to progress from risk assessment to effective risk management and replaced by methods which identify factors

Effectiveness of a web-based personalized rheumatoid arthritis risk tool with or without a health educator for knowledge of RA risk factors.

PubMed

Prado, Maria G; Iversen, Maura D; Yu, Zhi; Miller Kroouze, Rachel; Triedman, Nellie A; Kalia, Sarah S; Lu, Bing; Green, Robert C; Karlson, Elizabeth W; Sparks, Jeffrey A

2018-01-05

To assess knowledge of rheumatoid arthritis (RA) risk factors among unaffected first-degree relatives (FDRs) and to study whether a personalized RA education tool increases risk factor knowledge. We performed a randomized controlled trial assessing RA educational interventions among 238 FDRs. The web-based Personalized Risk Estimator for RA (PRE-RA) tool displayed personalized RA risk results (genetics, autoantibodies, demographics, and behaviors) and educated about risk factors. Subjects were randomly assigned to: Comparison arm (standard RA education, n=80), PRE-RA arm (PRE-RA alone, n=78), or PRE-RA Plus arm (PRE-RA and a one-on-one session with a trained health educator, n=80). The RA Knowledge Score (RAKS, the number of 8 established RA risk factors identified as related to RA) was calculated at baseline and post-education (immediate/6 weeks/6 months/12 months). We compared RAKS and its components at each post-education point by randomization arm. At baseline before education, few FDRs identified behavioral RA risk factors (15.9% for dental health, 31.9% for smoking, 47.5% for overweight/obesity, and 54.2% for diet). After education, RAKS increased in all arms, higher in PRE-RA and PRE-RA Plus than Comparison at all post-education points (p<0.05). PRE-RA were more likely to identify risk factors than those that received standard education (proportion agreeing smoking is a risk factor at 6 weeks: 83.1% in PRE-RA Plus arm, 71.8% in PRE-RA, and 43.1% in Comparison arms, p<0.05 for PRE-RA vs. Comparison). Despite being both familiar with RA and at increased risk, FDRs had low knowledge about RA risk factors. A web-based personalized RA education tool successfully increased RA risk factor knowledge. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Risk Factors of Typhoid Infection in the Indonesian Archipelago

PubMed Central

Alba, Sandra; Bakker, Mirjam I.; Hatta, Mochammad; Scheelbeek, Pauline F. D.; Dwiyanti, Ressy; Usman, Romi; Sultan, Andi R.; Sabir, Muhammad; Tandirogang, Nataniel; Amir, Masyhudi; Yasir, Yadi; Pastoor, Rob; van Beers, Stella; Smits, Henk L.

2016-01-01

Background Knowledge of risk factors and their relative importance in different settings is essential to develop effective health education material for the prevention of typhoid. In this study, we examine the effect of household level and individual behavioural risk factors on the risk of typhoid in three Indonesian islands (Sulawesi, Kalimantan and Papua) in the Eastern Indonesian archipelago encompassing rural, peri-urban and urban areas. Methods We enrolled 933 patients above 10 years of age in a health facility-based case-control study between June 2010 and June 2011. Individuals suspected of typhoid were tested using the typhoid IgM lateral flow assay for the serodiagnosis of typhoid fever followed by blood culture testing. Cases and controls were defined post-recruitment: cases were individuals with a culture or serology positive result (n = 449); controls were individuals negative to both serology and culture, with or without a diagnosis other than typhoid (n = 484). Logistic regression was used to examine the effect of household level and individual level behavioural risk factors and we calculated the population attributable fraction (PAF) of removing each risk significant independent behavioural risk factor. Results Washing hands at critical moments of the day and washing hands with soap were strong independent protective factors for typhoid (OR = 0.38 95% CI 0.25 to 0.58 for each unit increase in hand washing frequency score with values between 0 = Never and 3 = Always; OR = 3.16 95% CI = 2.09 to 4.79 comparing washing hands with soap sometimes/never vs. often). These effects were independent of levels of access to water and sanitation. Up to two thirds of cases could be prevented by compliance to these practices (hand washing PAF = 66.8 95% CI 61.4 to 71.5; use of soap PAF = 61.9 95%CI 56.7 to 66.5). Eating food out in food stalls or restaurant was an important risk factor (OR = 6.9 95%CI 4.41 to 10.8 for every unit increase in frequency score

Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles.

PubMed

Ndindjock, Roger; Gedeon, Jude; Mendis, Shanthi; Paccaud, Fred; Bovet, Pascal

2011-04-01

To assess the prevalence of cardiovascular (CV) risk factors in Seychelles, a middle-income African country, and compare the cost-effectiveness of single-risk-factor management (treating individuals with arterial blood pressure ≥ 140/90 mmHg and/or total serum cholesterol ≥ 6.2 mmol/l) with that of management based on total CV risk (treating individuals with a total CV risk ≥ 10% or ≥ 20%). CV risk factor prevalence and a CV risk prediction chart for Africa were used to estimate the 10-year risk of suffering a fatal or non-fatal CV event among individuals aged 40-64 years. These figures were used to compare single-risk-factor management with total risk management in terms of the number of people requiring treatment to avert one CV event and the number of events potentially averted over 10 years. Treatment for patients with high total CV risk (≥ 20%) was assumed to consist of a fixed-dose combination of several drugs (polypill). Cost analyses were limited to medication. A total CV risk of ≥ 10% and ≥ 20% was found among 10.8% and 5.1% of individuals, respectively. With single-risk-factor management, 60% of adults would need to be treated and 157 cardiovascular events per 100000 population would be averted per year, as opposed to 5% of adults and 92 events with total CV risk management. Management based on high total CV risk optimizes the balance between the number requiring treatment and the number of CV events averted. Total CV risk management is much more cost-effective than single-risk-factor management. These findings are relevant for all countries, but especially for those economically and demographically similar to Seychelles.

Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles

PubMed Central

Ndindjock, Roger; Gedeon, Jude; Mendis, Shanthi; Paccaud, Fred

2011-01-01

Abstract Objective To assess the prevalence of cardiovascular (CV) risk factors in Seychelles, a middle-income African country, and compare the cost-effectiveness of single-risk-factor management (treating individuals with arterial blood pressure ≥ 140/90 mmHg and/or total serum cholesterol ≥ 6.2 mmol/l) with that of management based on total CV risk (treating individuals with a total CV risk ≥ 10% or ≥ 20%). Methods CV risk factor prevalence and a CV risk prediction chart for Africa were used to estimate the 10-year risk of suffering a fatal or non-fatal CV event among individuals aged 40–64 years. These figures were used to compare single-risk-factor management with total risk management in terms of the number of people requiring treatment to avert one CV event and the number of events potentially averted over 10 years. Treatment for patients with high total CV risk (≥ 20%) was assumed to consist of a fixed-dose combination of several drugs (polypill). Cost analyses were limited to medication. Findings A total CV risk of ≥ 10% and ≥ 20% was found among 10.8% and 5.1% of individuals, respectively. With single-risk-factor management, 60% of adults would need to be treated and 157 cardiovascular events per 100 000 population would be averted per year, as opposed to 5% of adults and 92 events with total CV risk management. Management based on high total CV risk optimizes the balance between the number requiring treatment and the number of CV events averted. Conclusion Total CV risk management is much more cost-effective than single-risk-factor management. These findings are relevant for all countries, but especially for those economically and demographically similar to Seychelles. PMID:21479093

Risk Factors and Causes of Syncope

MedlinePlus

... Risk Factors & Causes of Syncope Risk Factors for Cardiovascular Syncope The risk of cardiovascular syncope increases with ... Long QT syndrome and Brugada Syndrome Signs of Cardiovascular Syncope Cardiovascular syncope usually is sudden. There may ...

Metformin modifies the exercise training effects on risk factors for cardiovascular disease in impaired glucose tolerant adults

PubMed Central

Malin, Steven K.; Nightingale, Joy; Choi, Sung-Eun; Chipkin, Stuart R.; Braun, Barry

2012-01-01

Impaired glucose tolerant (IGT) adults are at elevated risk for cardiovascular disease (CVD). Exercise or metformin reduce CVD risk, but the efficacy of combining treatments is unclear. To determine the effects of exercise training plus metformin, compared to each treatment alone, on CVD risk factors in IGT adults. Subjects were assigned to: placebo (P), metformin (M), exercise plus placebo (EP), or exercise plus metformin (EM) (8/group). In a double-blind design, P or 2000mg/d of M were administered for 12 weeks and half performed aerobic and resistance training 3 days/week for approximately 60 minutes/day at 70% pre-training heart rate peak. Outcomes included: adiposity, blood pressure (BP), lipids and high sensitivity C-reactive protein (hs-CRP). Z-scores were calculated to determine metabolic syndrome severity. M and EM, but not EP, decreased body weight compared to P (p <0.05). M and EP lowered systolic BP by 6% (p < 0.05), diastolic BP by 6% (p < 0.05), and hs-CRP by 20% (M: trend p = 0.06; EP: p < 0.05) compared to P. Treatments raised HDL-cholesterol (p < 0.05; EM: trend p = 0.06) compared to P and lowered triacyglycerol (p < 0.05) and metabolic syndrome Z-score compared to baseline (EP; trend p = 0.07 and EM or M; p < 0.05). Although exercise and/or metformin improve some CVD risk factors, only training or metformin alone lowered hs-CRP and BP. Thus, metformin may attenuate the effects of training on some CVD risk factors and metabolic syndrome severity in IGT adults. PMID:23505172

Cardiac implantable electronic device hematomas: Risk factors and effect of prophylactic pressure bandaging.

PubMed

Koh, Youlin; Bingham, Nicholas E; Law, Natalie; Le, Dustin; Mariani, Justin A

2017-07-01

Cardiac implantable electronic device (CIED) hematomas are associated with many adverse outcomes. We examined the incidence and risk factors associated with hematoma formation post-CIED implantation, and explored the preventative effect of prophylactic pressure bandaging (PPB) in a large tertiary center. 1,091 devices were implanted during October 2011-December 2014. Clinically significant hematomas (CSH) were those that necessitated prolonged admission, including those due to reoperation, and clinically suspicious hematomas were swellings noted by medical/nursing staff. We screened for variables affecting hematoma incidence prior to conducting multivariate logistic regression analyses, one for all hematomas and one for CSH. 61 hematomas were identified (5.6% of patients), with 12 of those clinically significant (1.1% of patients). Factors significantly increasing the odds of developing any hematoma were stage 2 (odds ratio [OR] = 2.93, 95% confidence interval [CI] [1.08-7.94], P = 0.034) and 3 chronic kidney disease (CKD) (OR = 3.39 [1.20-9.56], P = 0.021), unfractionated heparin/therapeutic enoxaparin (OR = 3.15 [1.22-8.14], P = 0.018), and dual antiplatelets-aspirin + clopidogrel (OR = 2.95 [1.14-7.65], P = 0.026) + other combinations. Body Mass index (BMI) 25.0-29.9 (OR 0.52 [0.28-0.98], P = 0.044) and >30 were associated with decreased hematoma risk (OR 0.43 [0.20-0.91], P = 0.028). Factors significant for CSH formation were unfractionated heparin/therapeutic enoxaparin (OR = 9.55 [1.83-49.84], P = 0.007) and aspirin + clopidogrel (OR = 7.19 [1.01-50.91], P = 0.048). PPB nonsignificantly increased the odds of total hematoma development (OR = 1.53 [0.87-2.69], P = 0.135), and reduced CSH (OR = 0.67 [0.18-2.47], P = 0.547). Heparin and dual antiplatelet use remain strong predictors of overall hematoma formation. CKD is a comparatively moderate predictor. BMI > 25 may decrease the risk of hematoma formation. PPB had nonsignificant effects on hematoma development

Cancer risk factors in Korean news media: a content analysis.

PubMed

Kye, Su Yeon; Kwon, Jeong Hyun; Kim, Yong-Chan; Shim, Minsun; Kim, Jee Hyun; Cho, Hyunsoon; Jung, Kyu Won; Park, Keeho

2015-01-01

Little is known about the news coverage of cancer risk factors in Korea. This study aimed to examine how the news media encompasses a wide array of content regarding cancer risk factors and related cancer sites, and investigate whether news coverage of cancer risk factors is congruent with the actual prevalence of the disease. A content analysis was conducted on 1,138 news stories covered during a 5-year period between 2008 and 2012. The news stories were selected from nationally representative media in Korea. Information was collected about cancer risk factors and cancer sites. Of various cancer risk factors, occupational and environmental exposures appeared most frequently in the news. Breast cancer was mentioned the most in relation to cancer sites. Breast, cervical, prostate, and skin cancer were overrepresented in the media in comparison to incidence and mortality cases, whereas lung, thyroid, liver, and stomach cancer were underrepresented. To our knowledge, this research is the first investigation dealing with news coverage about cancer risk factors in Korea. The study findings show occupational and environmental exposures are emphasized more than personal lifestyle factors; further, more prevalent cancers in developed countries have greater media coverage, not reflecting the realities of the disease. The findings may help health journalists and other health storytellers to develop effective ways to communicate cancer risk factors.

Aggregate Exposure and Cumulative Risk Assessment—Integrating Occupational and Non-occupational Risk Factors

PubMed Central

Lentz, T. J.; Dotson, G. S.; Williams, P. R.D.; Maier, A.; Gadagbui, B.; Pandalai, S. P.; Lamba, A.; Hearl, F.; Mumtaz, M.

2015-01-01

Occupational exposure limits have traditionally focused on preventing morbidity and mortality arising from inhalation exposures to individual chemical stressors in the workplace. While central to occupational risk assessment, occupational exposure limits have limited application as a refined disease prevention tool because they do not account for all of the complexities of the work and non-occupational environments and are based on varying health endpoints. To be of greater utility, occupational exposure limits and other risk management tools could integrate broader consideration of risks from multiple exposure pathways and routes (aggregate risk) as well as the combined risk from exposure to both chemical and non-chemical stressors, within and beyond the workplace, including the possibility that such exposures may cause interactions or modify the toxic effects observed (cumulative risk). Although still at a rudimentary stage in many cases, a variety of methods and tools have been developed or are being used in allied risk assessment fields to incorporate such considerations in the risk assessment process. These approaches, which are collectively referred to as cumulative risk assessment, have potential to be adapted or modified for occupational scenarios and provide a tangible path forward for occupational risk assessment. Accounting for complex exposures in the workplace and the broader risks faced by the individual also requires a more complete consideration of the composite effects of occupational and non-occupational risk factors to fully assess and manage worker health problems. Barriers to integrating these different factors remain, but new and ongoing community-based and worker health-related initiatives may provide mechanisms for identifying and integrating risk from aggregate exposures and cumulative risks from all relevant sources, be they occupational or non-occupational. PMID:26583907

Aggregate Exposure and Cumulative Risk Assessment--Integrating Occupational and Non-occupational Risk Factors.

PubMed

Lentz, T J; Dotson, G S; Williams, P R D; Maier, A; Gadagbui, B; Pandalai, S P; Lamba, A; Hearl, F; Mumtaz, M

2015-01-01

Occupational exposure limits have traditionally focused on preventing morbidity and mortality arising from inhalation exposures to individual chemical stressors in the workplace. While central to occupational risk assessment, occupational exposure limits have limited application as a refined disease prevention tool because they do not account for all of the complexities of the work and non-occupational environments and are based on varying health endpoints. To be of greater utility, occupational exposure limits and other risk management tools could integrate broader consideration of risks from multiple exposure pathways and routes (aggregate risk) as well as the combined risk from exposure to both chemical and non-chemical stressors, within and beyond the workplace, including the possibility that such exposures may cause interactions or modify the toxic effects observed (cumulative risk). Although still at a rudimentary stage in many cases, a variety of methods and tools have been developed or are being used in allied risk assessment fields to incorporate such considerations in the risk assessment process. These approaches, which are collectively referred to as cumulative risk assessment, have potential to be adapted or modified for occupational scenarios and provide a tangible path forward for occupational risk assessment. Accounting for complex exposures in the workplace and the broader risks faced by the individual also requires a more complete consideration of the composite effects of occupational and non-occupational risk factors to fully assess and manage worker health problems. Barriers to integrating these different factors remain, but new and ongoing community-based and worker health-related initiatives may provide mechanisms for identifying and integrating risk from aggregate exposures and cumulative risks from all relevant sources, be they occupational or non-occupational.

Risk factors for laryngeal cancer.

PubMed

De Stefani, E; Correa, P; Oreggia, F; Leiva, J; Rivero, S; Fernandez, G; Deneo-Pellegrini, H; Zavala, D; Fontham, E

1987-12-15

One hundred seven patients afflicted with incident laryngeal cancer and 290 controls with diseases considered not related to tobacco and alcohol exposure were interviewed in the University Hospital of Montevideo, Uruguay. The study followed a case-referent design, and epidemiologic analysis was carried out at the Louisiana State University, New Orleans. Dark tobacco smoking was the strongest risk factor, with an RR 2.5 times higher than that showed by light (flue-cured) tobacco smokers and 35 times that of non-smokers. Alcohol exposure displayed lesser effects but its interaction with tobacco smoking resulted in very high risks (more than 100 times higher). Among particular types of alcoholic beverages, red wine showed RR's similar to those displayed by hard liquor consumption. The habit of drinking a local tea called "mate" was associated with a threefold increase in risk, after controlling for the effects of age and tobacco and alcohol consumption. Infrequent consumption of vegetables and fruits showed RR on the order of 2.7, suggesting a role of diet in the causation of laryngeal cancer.

Gender differences in risk factors for cigarette smoking initiation in childhood.

PubMed

Sylvestre, Marie-Pierre; Wellman, Robert J; O'Loughlin, Erin K; Dugas, Erika N; O'Loughlin, Jennifer

2017-09-01

We investigated whether established risk factors for initiating cigarette smoking during adolescence (parents, siblings, friends smoke; home smoking rules, smokers at home, exposure to smoking in cars, academic performance, susceptibility to smoking, depressive symptoms, self-esteem, school connectedness, use of other tobacco products) are associated with initiation in preadolescents, and whether the effects of these factors differ by gender. In spring 2005, baseline data were collected in self-report questionnaires from 1801 5th grade students including 1553 never-smokers (mean age=10.7years), in the longitudinal AdoQuest I Study in Montréal, Canada. Follow-up data were collected in the fall and spring of 6th grade (2005-2006). Poisson regression analyses with robust variance estimated the effects of each risk factor on initiation and additive interactions with gender were computed to assess the excess risk of each risk factor in girls compared to boys. 101 of 1399 participants in the analytic sample (6.7% of boys; 7.7% of girls) initiated smoking during follow-up. After adjustment for age, gender and maternal education, all risk factors except academic performance and school connectedness were statistically significantly associated with initiation. Paternal and sibling smoking were associated with initiation in girls only, and girls with lower self-esteem had a significant excess risk of initiating smoking in 6th grade. Risk factors for smoking initiation in preadolescents mirror those in adolescents; their effects do not differ markedly by gender. Preventive programs targeting children should focus on reducing smoking in the social environment and the dangers of poly-tobacco use. Copyright © 2017 Elsevier Ltd. All rights reserved.

Interactions between inflammation, sex steroids, and Alzheimer’s disease risk factors

PubMed Central

Uchoa, Mariana F.; Moser, V. Alexandra; Pike, Christian J.

2016-01-01

Alzheimer’s disease (AD) is an age-related neurodegenerative disorder for which there are no effective strategies to prevent or slow its progression. Because AD is multifactorial, recent research has focused on understanding interactions among the numerous risk factors and mechanisms underlying the disease. One mechanism through which several risk factors may be acting is inflammation. AD is characterized by chronic inflammation that is observed before clinical onset of dementia. Several genetic and environmental risk factors for AD increase inflammation, including apolipoprotein E4, obesity, and air pollution. Additionally, sex steroid hormones appear to contribute to AD risk, with age-related losses of estrogens in women and androgens in men associated with increased risk. Importantly, sex steroid hormones have anti-inflammatory actions and can interact with several other AD risk factors. This review examines the individual and interactive roles of inflammation and sex steroid hormones in AD, as well as their relationships with the AD risk factors apolipoprotein E4, obesity, and air pollution. PMID:27651175

Cancer-related fatigue--mechanisms, risk factors, and treatments.

PubMed

Bower, Julienne E

2014-10-01

Fatigue is one of the most common adverse effects of cancer that might persist for years after treatment completion in otherwise healthy survivors. Cancer-related fatigue causes disruption in all aspects of quality of life and might be a risk factor of reduced survival. The prevalence and course of fatigue in patients with cancer have been well characterized and there is growing understanding of the underlying biological mechanisms. Inflammation seems to have a key role in fatigue before, during, and after cancer-treatment. However, there is a considerable variability in the presentation of cancer-related fatigue, much of which is not explained by disease-related or treatment-related characteristics, suggesting that host factors might be important in the development and persistence of this symptom. Indeed, longitudinal studies have identified genetic, biological, psychosocial, and behavioural risk factors associated with cancer-related fatigue. Although no current gold-standard treatment for fatigue is available, a variety of intervention approaches have shown beneficial effects in randomized controlled trials, including physical activity, psychosocial, mind-body, and pharmacological treatments. This Review describes the mechanisms, risk factors, and possible interventions for cancer-related fatigue, focusing on recent longitudinal studies and randomized trials that have targeted fatigued patients.

Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment.

PubMed

2014-08-01

High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010. We used data for exposure to risk factors by country, age group, and sex from pooled analyses of population-based health surveys. We obtained relative risks for the effects of risk factors on cause-specific mortality from meta-analyses of large prospective studies. We calculated the population attributable fractions for each risk factor alone, and for the combination of all risk factors, accounting for multicausality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific population attributable fractions by the number of disease-specific deaths. We obtained cause-specific mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the final estimates. In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After accounting for multicausality, 63% (10·8 million deaths, 95% CI 10·1-11·5) of deaths from these diseases in 2010 were attributable to the combined effect of these four metabolic risk factors, compared with 67% (7·1 million deaths, 6·6-7·6) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country level, age-standardised death rates from these diseases attributable to the combined effects of these

Vertigo and dizziness in adolescents: Risk factors and their population attributable risk.

PubMed

Filippopulos, Filipp M; Albers, Lucia; Straube, Andreas; Gerstl, Lucia; Blum, Bernhard; Langhagen, Thyra; Jahn, Klaus; Heinen, Florian; von Kries, Rüdiger; Landgraf, Mirjam N

2017-01-01

To assess potential risk factors for vertigo and dizziness in adolescents and to evaluate their variability by different vertigo types. The role of possible risk factors for vertigo and dizziness in adolescents and their population relevance needs to be addressed in order to design preventive strategies. The study population consisted of 1482 school-children between the age of 12 and 19 years, who were instructed to fill out a questionnaire on different vertigo types and related potential risk factors. The questionnaire specifically asked for any vertigo, spinning vertigo, swaying vertigo, orthostatic dizziness, and unspecified dizziness. Further a wide range of potential risk factors were addressed including gender, stress, muscular pain in the neck and shoulder region, sleep duration, migraine, coffee and alcohol consumption, physical activity and smoking. Gender, stress, muscular pain in the neck and shoulder region, sleep duration and migraine were identified as independent risk factors following mutual adjustment: The relative risk was 1.17 [1.10-1.25] for female sex, 1.07 [1.02-1.13] for stress, 1.24 [1.17-1.32] for muscular pain, and 1.09 [1.03-1.14] for migraine. The population attributable risk explained by these risk factors was 26%, with muscular pain, stress, and migraine accounting for 11%, 4%, and 3% respectively. Several established risk factors in adults were also identified in adolescents. Risk factors amenable to prevention accounted for 17% of the total population risk. Therefore, interventions targeting these risk factors may be warranted.

[Prevalence of cardiovascular risk factors in adolescents].

PubMed

Romanzini, Marcelo; Reichert, Felipe Fossati; Lopes, Adair da Silva; Petroski, Edio Luiz; de Farias Júnior, José Cazuza

2008-11-01

The aim of this study was to determine the prevalence of cardiovascular risk factors in adolescents and to verify its association with age and gender. 644 high school students from public schools in the city of Londrina, Paraná State, Brazil, participated in the study. A two-step sampling process was used. Behavioral risk factors (physical inactivity, inadequate consumption of fruits and vegetables, and smoking) and biological risk factors (overweight and high blood pressure) were investigated. Nearly 90% of adolescents showed at least one risk factor. Inadequate consumption of fruits (56.7%) and vegetables (43.9%) and physical inactivity (39.2%) were the most prevalent risk factors. Prevalence rates for high blood pressure and overweight were 18.6 and 12.7%, respectively. Cardiovascular risk factors were more frequent among boys (PR = 1.20; 95%CI = 1.01-1.42). In conclusion, cardiovascular risk factors are a prevalent health issue among students in the city of Londrina.

Gender differences in risk factors for coronary heart disease.

PubMed

Tan, Yen Y; Gast, Gerrie-Cor M; van der Schouw, Yvonne T

2010-02-01

Coronary heart disease (CHD), traditionally considered a male disease, is also a major threat to women. This review article addresses independent risk factors for CHD that are specific for women as well as non-gender-specific risk factors and how their effects differ between men and women. Although polycystic ovary syndrome (PCOS) in women is associated with an adverse metabolic risk profile, current evidence regarding future risk of CHD is conflicting. Preeclampsia is consistently associated with higher risk of CHD later in life. Menopause is associated with an increased risk of CHD, and the earlier the onset of menopause, the larger the risk. Existing data on postmenopausal hormone therapy (HT) was inconclusive with regard to possible protection when HT is initiated close to menopause in young peri- or postmenopausal women. Evidence on use of low-dose oral contraceptives strongly suggests no increased risk of CHD. Although levels of physical inactivity are similar for men and women, the higher prevalences of hypertension, diabetes, and obesity in older women portends a greater risk in women than in men. Additionally, risk factors like smoking, hypertriglyceridemia and low high-density lipoprotein cholesterol levels have greater impact in women than in men. This review indicates that acknowledgement of non-gender-specific risk factors in addition to those that are unique to women would help optimize diagnosis, treatment and earlier prevention of CHD in women. Further research is needed to ascertain if incorporating these gender-specific risks into a clinically used risk stratification model would change outcome in women. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

The effects of cumulative risks and promotive factors on urban adolescent alcohol and other drug use: a longitudinal study of resiliency.

PubMed

Ostaszewski, Krzysztof; Zimmerman, Marc A

2006-12-01

Resiliency theory provides a conceptual framework for studying why some youth exposed to risk factors do not develop the negative behaviors they predict. The purpose of this study was to test compensatory and protective models of resiliency in a longitudinal sample of urban adolescents (80% African American). The data were from Years 1 (9th grade) and 4 (12th grade). The study examined effects of cumulative risk and promotive factors on adolescent polydrug use including alcohol, tobacco and marijuana. Cumulative measures of risk/promotive factors represented individual characteristics, peer influence, and parental/familial influences. After controlling for demographics, results of multiple regression of polydrug use support the compensatory model of resiliency both cross-sectionally and longitudinally. Promotive factors were also found to have compensatory effects on change in adolescent polydrug use. The protective model of resiliency evidenced cross-sectionally was not supported in longitudinal analysis. The findings support resiliency theory and the use of cumulative risk/promotive measures in resiliency research. Implications focused on utilizing multiple assets and resources in prevention programming are discussed.

The Effects of Exercise Therapy on CVD Risk Factors in Women

PubMed Central

Hur, Sun; Kim, Seon-Rye

2014-01-01

[Purpose] The purpose of this study was to search for the association of Type D personality and CVD risk factors through comparison of the association of exercise participation with CVD risk factors in women. [Subjects] The research subjects were randomly assigned to four groups: Type D+Exercise (n=12), Type D+non-exercise (n=12), non-Type D+Exercise (n=12), and non-Type D+non-exercise (n=10). The study consisted of 46 participants. [Methods] An aerobic exercise program and meditation were conducted in parallel for 10 months. Stretching was performed for 10 min as a warm-up, and then walking and running on a treadmill at 60 to 70% of HRmax were performed for 40 min three times a week. Blood samples were processed according to standard laboratory procedures. The concentrations of TG and HDL cholesterol were determined enzymatically using a clinical chemistry analyzer (Hitachi High-Technologies Corporation, Tokyo, Japan). [Results] The weight, percentage of body fat, waist circumference, triglyceride concentration, HDL cholesterol concentration, systolic blood pressure, and diastolic blood pressure showed a significant difference between measurement times in the exercise groups. [Conclusion] In conclusion, there were significant differences between groups in terms of cardiovascular disease risk factors. PMID:25276017

Ischemic heart disease in women: a focus on risk factors.

PubMed

Mehta, Puja K; Wei, Janet; Wenger, Nanette K

2015-02-01

Heart disease remains a major contributor to morbidity and mortality in women in the United States and worldwide. This review highlights known and emerging risk factors for ischemic heart disease (IHD) in women. Traditional Framingham risk factors such as hypertension, hyperlipidemia, diabetes, smoking, as well as lifestyle habits such as unhealthy diet and sedentary lifestyle are all modifiable. Health care providers should be aware of emerging cardiac risk factors in women such as adverse pregnancy outcomes, systemic autoimmune disorders, obstructive sleep apnea, and radiation-induced heart disease; psychosocial factors such as mental stress, depression, anxiety, low socioeconomic status, and work and marital stress play an important role in IHD in women. Appropriate recognition and management of an array of risk factors is imperative given the growing burden of IHD and need to deliver cost-effective, quality care for women. Copyright © 2015 Elsevier Inc. All rights reserved.

Framing Risk: Audience and Reader Factors.

ERIC Educational Resources Information Center

Hornig, Susanna

1992-01-01

Finds that lay readers respond to the risk implicit in news stories involving science and technology along four factors: (1) the proposition that science and technology are expensive and risky; (2) the idea that science and technology can have negative effects; (3) concerns associated with control and dependency; and (4) fear that science and…

The Joint Effects of Lifestyle Factors and Comorbidities on the Risk of Colorectal Cancer: A Large Chinese Retrospective Case-Control Study

PubMed Central

Hu, Hai; Zhou, Yangyang; Ren, Shujuan; Wu, Jiajin; Zhu, Meiying; Chen, Donghui; Yang, Haiyan; Wang, Liwei

2015-01-01

Background Colorectal cancer (CRC) is a major cause of cancer morbidity and mortality. In previous epidemiologic studies, the respective correlation between lifestyle factors and comorbidity and CRC has been extensively studied. However, little is known about their joint effects on CRC. Methods We conducted a retrospective case-control study of 1,144 diagnosed CRC patients and 60,549 community controls. A structured questionnaire was administered to the participants about their socio-demographic factors, anthropometric measures, comorbidity history and lifestyle factors. Logistic regression model was used to calculate the odds ratio (ORs) and 95% confidence intervals (95%CIs) for each factor. According to the results from logistic regression model, we further developed healthy lifestyle index (HLI) and comorbidity history index (CHI) to investigate their independent and joint effects on CRC risk. Results Four lifestyle factors (including physical activities, sleep, red meat and vegetable consumption) and four types of comorbidity (including diabetes, hyperlipidemia, history of inflammatory bowel disease and polyps) were found to be independently associated with the risk of CRC in multivariant logistic regression model. Intriguingly, their combined pattern- HLI and CHI demonstrated significant correlation with CRC risk independently (ORHLI: 3.91, 95%CI: 3.13–4.88; ORCHI: 2.49, 95%CI: 2.11–2.93) and jointly (OR: 10.33, 95%CI: 6.59–16.18). Conclusions There are synergistic effects of lifestyle factors and comorbidity on the risk of colorectal cancer in the Chinese population. PMID:26710070

Risk Factors for Dystocia in Pigtailed Macaques (Macaca nemestrina)

PubMed Central

Stockinger, Diane E; Torrence, Anne E; Hukkanen, Renee R; Vogel, Keith W; Hotchkiss, Charlotte E; Ha, James C

2011-01-01

Dystocia (difficult labor) is an important component of the management of nonhuman primates and results in significant fetal and maternal morbidity and increased use of veterinary resources. Dystocias can arise from abnormalities of the maternal pelvis or fetus or uncoordinated uterine activity. Although risk factors for stillbirths have been established in nonhuman primates, risk factors for dystocias have not. The objective of this study was to determine maternal and fetal risk factors for dystocia in macaques. Retrospective data were collected from 83 pigtailed macaques (Macaca nemestrina) diagnosed with dystocia. The diagnosis of dystocia was made based on clinical or pathologic evidence. Maternal records of age, reproductive history, experimental history, clinical records, and fetal birth weight and any applicable fetal necropsy reports were reviewed. The gestational age of the fetus, the infant's birth weight, total previous births by the dam, and the proportions of both viable delivery (inverse effect) and surgical pregnancy interventions (direct effect) in the dam's history generated a model that maximized the experimental variance for predicting dystocia in the current pregnancy and explained 24% of the dystocia deliveries. The number of total previous births and proportion of previous cesarean sections accounted for the greatest effect. This model can identify individual dams within a colony that are at risk for dystocias and allow for changes in breeding colony management, more intense monitoring of dams at risk, or allocation of additional resources. PMID:21535929

Vertigo and dizziness in adolescents: Risk factors and their population attributable risk

PubMed Central

Albers, Lucia; Straube, Andreas; Gerstl, Lucia; Blum, Bernhard; Langhagen, Thyra; Jahn, Klaus; Heinen, Florian; von Kries, Rüdiger; Landgraf, Mirjam N.

2017-01-01

Objectives To assess potential risk factors for vertigo and dizziness in adolescents and to evaluate their variability by different vertigo types. The role of possible risk factors for vertigo and dizziness in adolescents and their population relevance needs to be addressed in order to design preventive strategies. Study design The study population consisted of 1482 school-children between the age of 12 and 19 years, who were instructed to fill out a questionnaire on different vertigo types and related potential risk factors. The questionnaire specifically asked for any vertigo, spinning vertigo, swaying vertigo, orthostatic dizziness, and unspecified dizziness. Further a wide range of potential risk factors were addressed including gender, stress, muscular pain in the neck and shoulder region, sleep duration, migraine, coffee and alcohol consumption, physical activity and smoking. Results Gender, stress, muscular pain in the neck and shoulder region, sleep duration and migraine were identified as independent risk factors following mutual adjustment: The relative risk was 1.17 [1.10–1.25] for female sex, 1.07 [1.02–1.13] for stress, 1.24 [1.17–1.32] for muscular pain, and 1.09 [1.03–1.14] for migraine. The population attributable risk explained by these risk factors was 26%, with muscular pain, stress, and migraine accounting for 11%, 4%, and 3% respectively. Conclusion Several established risk factors in adults were also identified in adolescents. Risk factors amenable to prevention accounted for 17% of the total population risk. Therefore, interventions targeting these risk factors may be warranted. PMID:29131843

Effect of rural-to-urban within-country migration on cardiovascular risk factors in low- and middle-income countries: a systematic review.

PubMed

Hernández, Adrián V; Pasupuleti, Vinay; Deshpande, Abhishek; Bernabé-Ortiz, Antonio; Miranda, J Jaime

2012-02-01

Limited information is available of effects of rural-to-urban within-country migration on cardiovascular (CV) risk factors in low- and middle- income countries (LMIC). A systematic review of studies evaluating these effects was performed with rural and/or urban control groups. Two teams of investigators searched observational studies in Medline, Web of Science and Scopus until May 2011. Studies evaluating international migration were excluded. Three investigators extracted the information stratified by gender. Information on 17 known CV risk factors was obtained. Eighteen studies (n=58,536) were included. Studies were highly heterogeneous with respect to study design, migrant sampling frame, migrant urban exposure and reported CV risk factors. In migrants, commonly reported CV risk factors-systolic and diastolic blood pressure, body mass index, obesity, total cholesterol and low-density lipoprotein-were usually higher or more common than in the rural group and usually lower or less common than in the urban group. This gradient was usually present in both genders. Anthropometric (waist-to-hip ratio, hip/waist circumference, triceps skinfolds) and metabolic (fasting glucose/insulin, insulin resistance) risk factors usually followed the same gradient, but conclusions were weak as information was insufficient. Hypertension, high-density lipoprotein, fibrinogen and C-reactive protein did not follow any pattern. In LMIC, most but not all, CV risk factors are higher or more common in migrants than in rural groups but lower or less common than in urban groups. Such gradients may or may not be associated with differential CV events and long-term evaluations are necessary.

Can a trial of motivational lifestyle counseling be effective for controlling childhood obesity and the associated cardiometabolic risk factors?

PubMed

Kelishadi, Roya; Malekahmadi, Mohammad; Hashemipour, Mahin; Soghrati, Mehrnaz; Soghrati, Mojgan; Mirmoghtadaee, Parisa; Ghatrehsamani, Shohreh; Poursafa, Parinaz; Khavarian, Noushin

2012-04-01

This study was conducted to assess the effectiveness of a simple office-based program for encouraging healthy lifestyle on controlling childhood obesity and associated cardiometabolic risk factors. This non-randomized 24-week lifestyle modification trial was conducted among 457 obese children and adolescents, aged 2-18 years, who had at least one cardiometabolic risk factor in addition to obesity. This trial included three components of exercise, diet education and behavior modification, with all recommendations provided by a pediatrician, two general physicians and a nurse. Instead of strict inhibitory recommendations, healthier lifestyle was encouraged. Overall 448 (98.04%) of enrolled children completed the trial with a mean age of 9.6 ± 2.9 years. After the trial, the mean of anthropometric measures and cardiometabolic risk factors decreased significantly, the mean high-density lipoprotein cholesterol (HDL-C) increased significantly, and the prevalence of the metabolic syndrome decreased from 20.8% to 1.8%. Triglycerides, LDL-C, diastolic blood pressure and WC had the highest decrease in all age groups, with the most prominent changes in the 14-18-year age group. By each -1SD decline in BMI and WC, risk factors had significant improvement. Motivational office-based counseling can be effective in treatment of childhood obesity and its associated cardio-metabolic risk factors. Such approach can be implemented in the primary health care system; and can be of special concern in low- and middle-income countries with limited human and financial resources. We suggest that expanding the roles of non-physician clinicians such as nurse practitioners can help to increase the amount of time available for such services. Copyright © 2012. Published by Elsevier B.V.

Level of education and multiple sclerosis risk after adjustment for known risk factors: The EnvIMS study.

PubMed

Bjørnevik, Kjetil; Riise, Trond; Cortese, Marianna; Holmøy, Trygve; Kampman, Margitta T; Magalhaes, Sandra; Myhr, Kjell-Morten; Wolfson, Christina; Pugliatti, Maura

2016-01-01

Several recent studies have found a higher risk of multiple sclerosis (MS) among people with a low level of education. This has been suggested to reflect an effect of smoking and lower vitamin D status in the social class associated with lower levels of education. The objective of this paper is to investigate the association between level of education and MS risk adjusting for the known risk factors smoking, infectious mononucleosis, indicators of vitamin D levels and body size. Within the case-control study on Environmental Factors In MS (EnvIMS), 953 MS patients and 1717 healthy controls from Norway reported educational level and history of exposure to putative environmental risk factors. Higher level of education were associated with decreased MS risk (p trend = 0.001) with an OR of 0.53 (95% CI 0.41-0.68) when comparing those with the highest and lowest level of education. This association was only moderately reduced after adjusting for known risk factors (OR 0.61, 95% CI 0.44-0.83). The estimates remained similar when cases with disease onset before age 28 were excluded. These findings suggest that factors related to lower socioeconomic status other than established risk factors are associated with MS risk. © The Author(s), 2015.

Level of education and multiple sclerosis risk after adjustment for known risk factors: The EnvIMS study

PubMed Central

Bjørnevik, Kjetil; Riise, Trond; Cortese, Marianna; Holmøy, Trygve; Kampman, Margitta T; Magalhaes, Sandra; Myhr, Kjell-Morten; Wolfson, Christina; Pugliatti, Maura

2016-01-01

Background: Several recent studies have found a higher risk of multiple sclerosis (MS) among people with a low level of education. This has been suggested to reflect an effect of smoking and lower vitamin D status in the social class associated with lower levels of education. Objective: The objective of this paper is to investigate the association between level of education and MS risk adjusting for the known risk factors smoking, infectious mononucleosis, indicators of vitamin D levels and body size. Methods: Within the case-control study on Environmental Factors In MS (EnvIMS), 953 MS patients and 1717 healthy controls from Norway reported educational level and history of exposure to putative environmental risk factors. Results: Higher level of education were associated with decreased MS risk (p trend = 0.001) with an OR of 0.53 (95% CI 0.41–0.68) when comparing those with the highest and lowest level of education. This association was only moderately reduced after adjusting for known risk factors (OR 0.61, 95% CI 0.44–0.83). The estimates remained similar when cases with disease onset before age 28 were excluded. Conclusion: These findings suggest that factors related to lower socioeconomic status other than established risk factors are associated with MS risk. PMID:26014605

Risk factors of patients with and without postoperative nausea (PON).

PubMed

Dienemann, Jacqueline; Hudgens, Amanda N; Martin, Dana; Jones, Holly; Hunt, Ronald; Blackwell, Richard; Norton, H James; Divine, George

2012-08-01

This purpose of this analysis was to study risk factors of postoperative nausea (PON) and their strength. Data were obtained during the screening phase of a controlled clinical trial of aromatherapy for PON. In a sample of 1151 postsurgical subjects, 301 (26.2%) reported PON. Significant risk factors identified in the order of odds ratios for nausea were female gender, gastrointestinal surgery, use of volatile anesthesia gases, history of PON, history of motion sickness, and use of opioids after surgery. Although still over 1.0, the risk factors of length of surgery over 1 hour and gynecologic surgery had the lowest odds ratios. Likelihood of nausea increased significantly with the number of significant risk factors (P<.0001). Administration of preventive antiemetic medication also increased with the number of significant risk factors (P<.0001). Among 301 subjects reporting nausea, 49 (16.28%) received preventive medication. Despite prevention efforts, PON remains a substantial side effect for many surgical patients. Copyright © 2012 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Phytate (myo-inositol hexaphosphate) and risk factors for osteoporosis.

PubMed

López-González, A A; Grases, F; Roca, P; Mari, B; Vicente-Herrero, M T; Costa-Bauzá, A

2008-12-01

Several risk factors seem to play a role in the development of osteoporosis. Phytate is a naturally occurring compound that is ingested in significant amounts by those with diets rich in whole grains. The aim of this study was to evaluate phytate consumption as a risk factor in osteoporosis. In a first group of 1,473 volunteer subjects, bone mineral density was determined by means of dual radiological absorptiometry in the calcaneus. In a second group of 433 subjects (used for validation of results obtained for the first group), bone mineral density was determined in the lumbar column and the neck of the femur. Subjects were individually interviewed about selected osteoporosis risk factors. Dietary information related to phytate consumption was acquired by questionnaires conducted on two different occasions, the second between 2 and 3 months after performing the first one. One-way analysis of variance or Student's t test was used to determine statistical differences between groups. Bone mineral density increased with increasing phytate consumption. Multivariate linear regression analysis indicated that body weight and low phytate consumption were the risk factors with greatest influence on bone mineral density. Phytate consumption had a protective effect against osteoporosis, suggesting that low phytate consumption should be considered an osteoporosis risk factor.

Quantifying neighbourhood socioeconomic effects in clustering of behaviour-related risk factors: a multilevel analysis.

PubMed

Halonen, Jaana I; Kivimäki, Mika; Pentti, Jaana; Kawachi, Ichiro; Virtanen, Marianna; Martikainen, Pekka; Subramanian, S V; Vahtera, Jussi

2012-01-01

The extent to which neighbourhood characteristics explain accumulation of health behaviours is poorly understood. We examined whether neighbourhood disadvantage was associated with co-occurrence of behaviour-related risk factors, and how much of the neighbourhood differences in the co-occurrence can be explained by individual and neighbourhood level covariates. The study population consisted of 60 694 Finnish Public Sector Study participants in 2004 and 2008. Neighbourhood disadvantage was determined using small-area level information on household income, education attainment, and unemployment rate, and linked with individual data using Global Positioning System-coordinates. Associations between neighbourhood disadvantage and co-occurrence of three behaviour-related risk factors (smoking, heavy alcohol use, and physical inactivity), and the extent to which individual and neighbourhood level covariates explain neighbourhood differences in co-occurrence of risk factors were determined with multilevel cumulative logistic regression. After adjusting for age, sex, marital status, and population density we found a dose-response relationship between neighbourhood disadvantage and co-occurrence of risk factors within each level of individual socioeconomic status. The cumulative odds ratios for the sum of health risks comparing the most to the least disadvantaged neighbourhoods ranged between 1.13 (95% confidence interval (CI): 1.03-1.24) and 1.75 (95% CI, 1.54-1.98). Individual socioeconomic characteristics explained 35%, and neighbourhood disadvantage and population density 17% of the neighbourhood differences in the co-occurrence of risk factors. Co-occurrence of poor health behaviours associated with neighbourhood disadvantage over and above individual's own socioeconomic status. Neighbourhood differences cannot be captured using individual socioeconomic factors alone, but neighbourhood level characteristics should also be considered.

Risk factors for injury accidents among moped and motorcycle riders.

PubMed

Moskal, Aurélie; Martin, Jean-Louis; Laumon, Bernard

2012-11-01

To study and quantify the effect of factors related to the riders of powered two-wheelers on the risk of injury accident involvement. Based on national data held by the police from 1996 to 2005, we conducted a case-control study with responsibility for the accident as the event of interest. We estimated the odds ratios for accident responsibility. Making the hypothesis that the non-responsible riders in the study are representative of all the riders on the road, we thus identified risk factors for being responsible for injury accidents. The studied factors are age, gender, helmet wearing, alcohol consumption, validity of the subject's driving licence and for how long it has been held, the trip purpose and the presence of a passenger on the vehicle. Moped and motorcycle riders are analyzed separately, adjusting for the main characteristics of the accident. For both moped and motorcycle riders, being male, not wearing a helmet, exceeding the legal limit for alcohol and travelling for leisure purposes increased the risk of accident involvement. The youngest and oldest users had a greater risk of accident involvement. The largest risk factor was alcohol, and we identified a dose-effect relationship between alcohol consumption and accident risk, with an estimated odds ratio of over 10 for motorcycle and moped riders with a BAC of 2 g/l or over. Among motorcycle users, riders without a licence had twice the risk of being involved in an accident than those holding a valid licence. However, the number of years the rider had held a licence reduced the risk of accident involvement. One difference between moped and motorcycle riders involved the presence of a passenger on the vehicle: while carrying a passenger increased the risk of being responsible for the accident among moped riders, it protected against this risk among motorcycle riders. This analysis of responsibility has identified the major factors contributing to excess risk of injury accidents, some of which could be

Effectiveness of personalized face-to-face and telephone nursing counseling interventions for cardiovascular risk factors: a controlled clinical trial 1

PubMed Central

Vílchez Barboza, Vivian; Klijn, Tatiana Paravic; Salazar Molina, Alide; Sáez Carrillo, Katia Lorena

2016-01-01

Abstract Objective: to evaluate the effect and gender differences of an innovative intervention involving in-person and telephone nursing counseling to control cardiovascular risk factors (arterial hypertension, dyslipidemia, and overweight), improve health-related quality of life and strengthen self-efficacy and social support in persons using the municipal health centers' cardiovascular health program. Method: a randomized controlled clinical trial involving participants randomized into the intervention group who received traditional consultation plus personalized and telephone nursing counseling for 7 months (n = 53) and the control group (n = 56). The study followed the Consolidated Standards of Reporting Trials Statement. Results: women in the intervention group presented a significant increase in the physical and mental health components compared to the control group, with decreases in weight, abdominal circumference, total cholesterol, low-density lipoprotein cholesterol, and the atherogenic index. The effects attributable to the intervention in the men in the intervention group were increased physical and emotional roles and decreased systolic and diastolic pressure, waist circumference, total cholesterol, low-density lipoprotein cholesterol, atherogenic index, cardiovascular risk factor, and 10-year coronary risk. Conclusion: this intervention is an effective strategy for the control of three cardiovascular risk factors and the improvement of health-related quality of life. PMID:27508917

Risk Factors as Major Determinants of Resilience: A Replication Study.

PubMed

Eshel, Yohanan; Kimhi, Shaul; Lahad, Mooli; Leykin, Dmitry; Goroshit, Marina

2018-03-16

The present study was conducted in the context of current concerns about replication in psychological research. It claims that risk factors should be regarded as an integral part of the definition of individual resilience, which should be defined in terms of the balance between individual strength or protective factors, and individual vulnerability or risk factors (IND-SVR). Five independent samples, including 3457 Israeli participants, were employed to determine the effects of resilience promoting and resilience suppressing variables on the IND-SVR index of resilience, and on its two components: recovery from adversity, and distress symptoms. Five path analyses were employed for determining the role of distress symptoms as a measure of psychological resilience, as compared to other indices of this resilience. Results indicated the major role of risk factors (distress symptoms) as an integral component of resilience. This role was generally replicated in the five investigated samples. Risk factors are legitimate, valid, and useful parts of the definition of psychological resilience. Resilience research has shifted away from studying individual risk factors to investigating the process through which individuals overcome the hardships they experience. The present data seem to suggest that this shift should be reexamined.

Adolescent Risk Factors for Child Maltreatment

PubMed Central

Matsuda, Mauri; Greenman, Sarah J.; Augustyn, Megan Bears; Henry, Kimberly L.; Smith, Carolyn A.; Ireland, Timothy O.

2014-01-01

We investigate adolescent risk factors, measured at both early and late adolescence, for involvement in child maltreatment during adulthood. Comprehensive assessments of risk factors for maltreatment that use representative samples with longitudinal data are scarce and can inform multilevel prevention. We use data from the Rochester Youth Development Study, a longitudinal study begun in 1988 with a sample of 1,000 seventh and eighth graders. Participants have been interviewed 14 times and, at the last assessment (age 31), 80% were retained. Risk factors represent 10 developmental domains: area characteristics, family background/structure, parent stressors, exposure to family violence, parent-child relationships, education, peer relationships, adolescent stressors, antisocial behaviors, and precocious transitions to adulthood. Maltreatment is measured by substantiated reports from Child Protective Services records. Many individual risk factors (20 at early adolescence and 14 at later adolescence) are significantly, albeit moderately, predictive of maltreatment. Several developmental domains stand out, including family background/structure, education, antisocial behaviors, and precocious transitions. In addition, there is a pronounced impact of cumulative risk on the likelihood of maltreatment. For example, only 3% of the youth with no risk domains in their background at early adolescence were involved in later maltreatment, but for those with risk in 9 developmental domains the rate was 45%. Prevention programs targeting youth at high risk for engaging in maltreatment should begin during early adolescence when risk factors are already at play. These programs need to be comprehensive, capable of addressing the multiple and interwoven nature of risk that is associated with maltreatment. PMID:24075569

A Systematic Review and Meta-Analysis on Self-Management for Improving Risk Factor Control in Stroke Patients.

PubMed

Sakakibara, Brodie M; Kim, Amy J; Eng, Janice J

2017-02-01

The aims of this review were to describe the self-management interventions used to improve risk factor control in stroke patients and quantitatively assess their effects on the following: 1) overall risk factor control from lifestyle behaviour (i.e. physical activity, diet and nutrition, stress management, smoking, alcohol, and medication adherence), and medical risk factors (i.e. blood pressure, cholesterol, blood glucose) and (2) individual risk factors. We systematically searched the PubMed, PsycINFO, CINAHL and Cochrane Database of Systematic Reviews databases to September 2015 to identify relevant randomized controlled trials investigating self-management to improve stroke risk factors. The self-management interventions were qualitatively described, and the data included in meta-analyses. Fourteen studies were included for review. The model estimating an effect averaged across all stroke risk factors was not significant, but became significant when four low-quality studies were removed (SMD = 0.10 [95 % CI = 0.02 to 0.17], I 2  = 0 %, p = 0.01). Subgroup analyses revealed a significant effect of self-management interventions on lifestyle behaviour risk factors (SMD = 0.15 [95 % CI = 0.04 to 0.25], I 2  = 0 %, p = 0.007) but not medical risk factors. Medication adherence was the only individual risk factor that self-management interventions significantly improved (SMD = 0.31 [95 % CI = 0.07 to 0.56], I 2  = 0 %, p = 0.01). Self-management interventions appear to be effective at improving overall risk factor control; however, more high-quality research is needed to corroborate this observation. Self-management has a greater effect on lifestyle behaviour risk factors than medical risk factors, with the largest effect at improving medication adherence.

Effect of aerobic exercise training followed by a low-calorie diet on metabolic syndrome risk factors in men.

PubMed

Matsuo, T; So, R; Shimojo, N; Tanaka, K

2015-09-01

Whether low-volume, high-intensity, interval training (HIIT) is an adequate exercise method for improving metabolic risk factors is controversial. Moreover, it is not known if performing a short-term, low-calorie diet intervention (LCDi) after a HIIT program affects risk factors. This study investigated how an 8-week, 3 times/week exercise intervention (EXi) incorporating either HIIT or moderate-intensity continuous training (MICT) followed by a 4-week LCDi affects risk factors. Twenty-six male workers with metabolic risk factors (47.4 ± 7.1 years; cardiorespiratory capacity (VO2peak) of 28.5 ± 3.9 ml/kg/min) were randomly assigned to either the HIIT (3 sets of 3-min cycling with a 2-min active rest between sets, 180 kcal) or MICT (45 min, 360 kcal) group. After the EXi, all subjects participated in a 4-week LCDi (4 counseling sessions). During the EXi, VO2peak improved more (P < 0.05) through HIIT (25.4 ± 14.6%) than through MICT (14.9 ± 12.8%), whereas improvements in body fat and HDL cholesterol were similar. During the LCDi, some risk factors improved further (P < 0.05) without any group differences, while VO2peak in the HIIT group decreased (P < 0.05) to the same level as in the MICT group. VO2peak increased more with HIIT than with MICT during the EXi despite HIIT having a lower exercise volume than MICT, but this advantage of HIIT promptly disappeared through detraining. An intervention strategy consisting of 8 weeks of either HIIT or MICT followed by a 4-week LCDi has a positive effect on metabolic risk factors. UMIN11352. Copyright © 2015 Elsevier B.V. All rights reserved.

Sex disparities in risk and risk factors for ischemic heart disease in the Asia-Pacific region.

PubMed

Peters, Sanne Ae; Woodward, Mark; Lam, Tai H; Fang, Xianghua; Suh, Il; Ueshema, Hirotsugu; Dobson, Annette J; Grobbee, Diederick E; Huxley, Rachel R

2014-05-01

Ischemic heart disease (IHD) is the leading cause of death and disability worldwide, with higher rates among men than women. Relatively few studies on risk factor associations are available from the Asia-Pacific region, especially with regard to sex differences. Our objective was to compare the relationships between modifiable risk factors and IHD in men and women from the Asia-Pacific region. Data from 600,445 individuals from 44 studies from the Asia Pacific Cohort Studies Collaboration, an individual patient data overview, were used. Cox models were used to evaluate the effects of risk factors on fatal and non-fatal IHD separately in men and women from Australia and New Zealand (ANZ) and Asia. Over a median follow-up of 6.7 years, 5695 IHD events were documented. The hazard ratio for IHD, comparing men with women, was 2.14 (95% CI 1.97-2.33) in ANZ and 1.88 (95% CI 1.54-2.29) in Asia. The age-adjusted prevalence of major risk factors was generally higher in men than women, especially in ANZ. Risk factors acted broadly similarly between men and women in both Asia and ANZ, with any indications of differences tending to favor men, rather than women. The excess risk of IHD observed in men compared with women in both Asia and ANZ may be, at least in part, a result of a more hazardous risk profile in men compared with women. The contribution of sex differences in the magnitude of the risk factor-disease associations is unlikely to be a contributing factor.

Risk factors for fractures in the elderly.

PubMed

Jacqmin-Gadda, H; Fourrier, A; Commenges, D; Dartigues, J F

1998-07-01

We report the results of a 5-year prospective cohort study of risk factors for fractures, including drinking fluoridated water, in a cohort of 3,216 men and women aged 65 years and older. We studied risk factors for hip fracture and fractures at other locations separately. We found a higher risk of hip fractures for subjects exposed to fluorine concentrations over 0.11 mg per liter but without a dose-effect relation (odds ratio (OR) = 3.25 for a concentration of 0.11-0.25 mg per liter; OR = 2.43 for > or = 0.25 mg per liter]. For higher thresholds (0.7 and 1 mg per liter), however, the OR was less than 1. We found no association between fluorine and non-hip fractures. Non-hip fractures were associated with polymedication rather than with specific drug use, whereas fracture was associated with polymedication and use of anxiolytic and antidepressive drugs. Subjects drinking spirits every day were more likely to have hip fractures. Tobacco consumption increased the risk for non-hip fractures.

Nurse-led clinics for atrial fibrillation: managing risk factors.

PubMed

Jacob, Liril

2017-12-14

Atrial fibrillation (AF) is the most common and sustained cardiac arrhythmia rated by cardiologists as one of the most difficult conditions to manage. Traditionally, AF management has focused on the three pillars of rate control, rhythm control and anticoagulation. However, more recently, cardiovascular risk-factor management in AF has emerged as a fourth and essential pillar, delivering improved patient outcomes. In the UK, AF is a condition that is often managed poorly, with patients reporting a lack of understanding of their condition and treatment options. Many aspects of assessment and communication in AF management are time consuming. Failure to address those aspects may negatively affect the quality of care. Nurse-led clinics can contribute significantly in the areas of patient education and sustained follow-up care, improving outcomes and addressing current deficiencies in AF risk-factor management due to scarcity of medical resources. This article discusses the major cardiovascular risk factors associated with AF, drawing on evidence from the literature, and considers the effectiveness and implications for practice of introducing community-based nurse-led clinics for risk-factor management in patients with AF.

Effects of controlled whole-body vibration training in improving fall risk factors among individuals with multiple sclerosis: A pilot study.

PubMed

Yang, Feng; Finlayson, Marcia; Bethoux, Francois; Su, Xiaogang; Dillon, Loretta; Maldonado, Hector M

2018-03-01

The purpose of this study was to systematically examine the effect of an 8-week controlled whole-body vibration training on improving fall risk factors and the bone mineral density among people with multiple sclerosis (PwMS). This study adopted a single group pre-test-post-test design. Twenty-five PwMS (50.3 years SD 14.1) received vibration training on a side-alternating vibration platform. Each training session was repeated three times every week for 8 weeks. Prior to and following the 8-week training course, a battery of fall risk factors were evaluated: the body balance, functional mobility, muscle strength, range of motion, and fear of falling. Bone density at both calcanei was also assessed. Twenty-two participants completed the study. Compared with pre-test, almost all fall risk factors and the bone density measurement were significantly improved at post-test, with moderate to large effect sizes varying between 0.571 and 1.007. The 8-week vibration training was well accepted by PwMS and improved their fall risk factors. The important findings of this study were that vibration training may increase the range of motion of ankle joints on the sagittal plane, lower the fear of falling, and improve bone density. IMPLICATIONS FOR REHABILITATION An 8-week vibration training course could be well-accepted by people with multiple sclerosis (MS). Vibration training improves the risk factors of falls in people living with MS. Vibration training could be a promising rehabilitation intervention in individuals with MS.

Risk factors for retained placenta.

PubMed

Coviello, Elizabeth M; Grantz, Katherine L; Huang, Chun-Chih; Kelly, Tara E; Landy, Helain J

2015-12-01

Retained placenta complicates 2-3% of vaginal deliveries and is a known cause of postpartum hemorrhage. Treatment includes manual or operative placental extraction, potentially increasing risks of hemorrhage, infections, and prolonged hospital stays. We sought to evaluate risk factors for retained placenta, defined as more than 30 minutes between the delivery of the fetus and placenta, in a large US obstetrical cohort. We included singleton, vaginal deliveries ≥24 weeks (n = 91,291) from the Consortium of Safe Labor from 12 US institutions (2002-2008). Multivariable logistic regression analyses estimated the adjusted odds ratios (OR) and 95% confidence intervals (CI) for potential risk factors for retained placenta stratified by parity, adjusting for relevant confounding factors. Characteristics such as stillbirth, maternal age, race, and admission body mass index were examined. Retained placenta complicated 1047 vaginal deliveries (1.12%). Regardless of parity, significant predictors of retained placenta included stillbirth (nulliparous adjusted OR, 5.67; 95% CI, 3.10-10.37; multiparous adjusted OR, 4.56; 95% CI, 2.08-9.94), maternal age ≥30 years, delivery at 24 0/7 to 27 6/7 compared with 34 weeks or later and delivery in a teaching hospital. In nulliparous women, additional risk factors were identified: longer first- or second-stage labor duration, whereas non-Hispanic black compared with non-Hispanic white race was found to be protective. Body mass index was not associated with an increased risk. Multiple risk factors for retained placenta were identified, particularly the strong association with stillbirth. It is plausible that there could be something intrinsic about stillbirth that causes a retained placenta, or perhaps there are shared pathways of certain etiologies of stillbirth and a risk of retained placenta. Copyright © 2015 Elsevier Inc. All rights reserved.

Risk Factors for Internet Gaming Disorder: Psychological Factors and Internet Gaming Characteristics.

PubMed

Rho, Mi Jung; Lee, Hyeseon; Lee, Taek-Ho; Cho, Hyun; Jung, Dong Jin; Kim, Dai-Jin; Choi, In Young

2017-12-27

Background : Understanding the risk factors associated with Internet gaming disorder (IGD) is important to predict and diagnose the condition. The purpose of this study is to identify risk factors that predict IGD based on psychological factors and Internet gaming characteristics; Methods : Online surveys were conducted between 26 November and 26 December 2014. There were 3568 Korean Internet game users among a total of 5003 respondents. We identified 481 IGD gamers and 3087 normal Internet gamers, based on Diagnostic and Statistical Manual for Mental Disorders (DSM-5) criteria. Logistic regression analysis was applied to identify significant risk factors for IGD; Results : The following eight risk factors were found to be significantly associated with IGD: functional and dysfunctional impulsivity (odds ratio: 1.138), belief self-control (1.034), anxiety (1.086), pursuit of desired appetitive goals (1.105), money spent on gaming (1.005), weekday game time (1.081), offline community meeting attendance (2.060), and game community membership (1.393; p < 0.05 for all eight risk factors); Conclusions : These risk factors allow for the prediction and diagnosis of IGD. In the future, these risk factors could also be used to inform clinical services for IGD diagnosis and treatment.

Risk factors for Neospora caninum infection in dairy cattle and their possible cause-effect relation for disease.

PubMed

Fávero, Juscivete F; Da Silva, Aleksandro S; Campigotto, Gabriela; Machado, Gustavo; Daniel de Barros, Luiz; Garcia, João Luis; Vogel, Fernanda F; Mendes, Ricardo E; Stefani, Lenita M

2017-09-01

Neospora caninum causes reproductive problems in cattle such as abortion, premature birth, retention of fetal membranes, and metritis. Therefore, this study aimed to verify possible risk factors for N. caninum infection in dairy cattle and their cause-effect relation to neosporosis. Serum samples of 1518 dairy cows from the West of Santa Catarina State, Southern Brazil were analyzed by indirect immunofluorescence assay (IFA) for N. caninum, where 466 were found to be positives (30.69%-CI 95% ; 28.3-33.0). In addition, an epidemiological survey was conducted in order to verify possible risk factors for neosporosis and their relation to the disease. The presence of dogs in the farm was strongly associated with IFA positive results for N. caninum, and lack of history for neosporosis in the farm increased the chances of positivity in 66%. It was found a significant cause-effect relation between the occurrence of reproductive problems and the presence of antibodies against N. caninum (p = 0.05). It is possible to conclude that N. caninum is widely distributed in dairy farms of the Western part of Santa Catarina state, Brazil, and that the occurrence of reproductive problems is directly related to the disease with the presence of dogs as a risk factor for N. caninum infection. Copyright © 2017 Elsevier Ltd. All rights reserved.

Protective Factors, Risk Indicators, and Contraceptive Consistency Among College Women.

PubMed

Morrison, Leslie F; Sieving, Renee E; Pettingell, Sandra L; Hellerstedt, Wendy L; McMorris, Barbara J; Bearinger, Linda H

2016-01-01

To explore risk and protective factors associated with consistent contraceptive use among emerging adult female college students and whether effects of risk indicators were moderated by protective factors. Secondary analysis of National Longitudinal Study of Adolescent to Adult Health Wave III data. Data collected through in-home interviews in 2001 and 2002. National sample of 18- to 25-year-old women (N = 842) attending 4-year colleges. We examined relationships between protective factors, risk indicators, and consistent contraceptive use. Consistent contraceptive use was defined as use all of the time during intercourse in the past 12 months. Protective factors included external supports of parental closeness and relationship with caring nonparental adult and internal assets of self-esteem, confidence, independence, and life satisfaction. Risk indicators included heavy episodic drinking, marijuana use, and depression symptoms. Multivariable logistic regression models were used to evaluate relationships between protective factors and consistent contraceptive use and between risk indicators and contraceptive use. Self-esteem, confidence, independence, and life satisfaction were significantly associated with more consistent contraceptive use. In a final model including all internal assets, life satisfaction was significantly related to consistent contraceptive use. Marijuana use and depression symptoms were significantly associated with less consistent use. With one exception, protective factors did not moderate relationships between risk indicators and consistent use. Based on our findings, we suggest that risk and protective factors may have largely independent influences on consistent contraceptive use among college women. A focus on risk and protective factors may improve contraceptive use rates and thereby reduce unintended pregnancy among college students. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published

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 highest among those with low relationship satisfaction [corrected]. 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.

Risk factors for post-tonsillectomy hemorrhage.

PubMed

Ikoma, Ryo; Sakane, Sayaka; Niwa, Kazutomo; Kanetaka, Sayaka; Kawano, Toshiro; Oridate, Nobuhiko

2014-08-01

The aim of the present study was to investigate the rate of post-tonsillectomy hemorrhage (PTH) in a single institution and to evaluate the clinical risk factors for PTH. We reviewed the records of 692 patients who underwent tonsillectomy (TE) at Yokohama Minami Kyosai Hospital in Japan. PTH grades were grouped into three categories according to the severity of the hemorrhagic episode: (I) minimal hemorrhage that stopped after noninvasive treatment, (II) hemorrhage requiring treatment with local anesthesia, and (III) hemorrhage requiring reoperation under general anesthesia in the operating room. Clinical risk factors such as sex, age (adults vs. children), TE indication, surgeon's skill level, operative time, ligature type, and duration of antibiotic administration for PTH were investigated. Among the 692 patients, 80 (11.6%) showed PTH, with primary and secondary hemorrhage accounting for 1.6% and 10.0%, respectively. A category III PTH was observed in 18 patients; thus, the overall risk of reoperation was 2.6%. The PTH episode most frequently occurred on postoperative days 5 and 6. The frequency of PTH was significantly higher in male patients and in adults (P<0.01, for both factors). Surgeon's skill was also associated with PTH rate. A stepwise multivariate logistic regression revealed that adult age (odds ratio [OR]=18.9) and male gender (OR=3.78) were the clinical risk factors for PTH. It also revealed that male gender (OR=82065335), adult age (OR=10.6), and surgeon's skill level (OR=7.50) were the clinical risk factors for the category III PTH. The risk of PTH was higher in this report compared with previous reports, which may be associated with the definition of PTH. Clinical risk factors for PTH were adult age and male gender. The surgeon's skill level was an additional risk factor for category III PTH. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Lifestyle Risk Factors Increase the Risk of Hospitalization for Sciatica: Findings of Four Prospective Cohort Studies.

PubMed

Shiri, Rahman; Euro, Ulla; Heliövaara, Markku; Hirvensalo, Mirja; Husgafvel-Pursiainen, Kirsti; Karppinen, Jaro; Lahti, Jouni; Rahkonen, Ossi; Raitakari, Olli T; Solovieva, Svetlana; Yang, Xiaolin; Viikari-Juntura, Eira; Lallukka, Tea

2017-12-01

The purpose of this study is to assess the effects of lifestyle risk factors on the risk of hospitalization for sciatica and to determine whether overweight or obesity modifies the effect of leisure-time physical activity on hospitalization for sciatica. We included 4 Finnish prospective cohort studies (Health 2000 Survey, Mobile Clinic Survey, Helsinki Health Study, and Young Finns Study) consisting of 34,589 participants and 1259 hospitalizations for sciatica during 12 to 30 years of follow-up. Sciatica was based on hospital discharge register data. We conducted a random-effects individual participant data meta-analysis. After adjustment for confounding factors, current smoking at baseline increased the risk of subsequent hospitalization for sciatica by 33% (95% confidence interval [CI], 13%-56%), whereas past smokers were no longer at increased risk. Obesity defined by body mass index increased the risk of hospitalization for sciatica by 36% (95% CI 7%-74%), and abdominal obesity defined by waist circumference increased the risk by 41% (95% CI 3%-93%). Walking or cycling to work reduced the risk of hospitalization for sciatica by 33% (95% CI 4%-53%), and the effect was independent of body weight and other leisure activities, while other types of leisure activities did not have a statistically significant effect. Smoking and obesity increase the risk of hospitalization for sciatica, whereas walking or cycling to work protects against hospitalization for sciatica. Walking and cycling can be recommended for the prevention of sciatica in the general population. Copyright © 2017 Elsevier Inc. All rights reserved.

Factors Increasing Vulnerability to Health Effects before, during and after Floods

PubMed Central

Lowe, Dianne; Ebi, Kristie L.; Forsberg, Bertil

2013-01-01

Identifying the risk factors for morbidity and mortality effects pre-, during and post-flood may aid the appropriate targeting of flood-related adverse health prevention strategies. We conducted a systematic PubMed search to identify studies examining risk factors for health effects of precipitation-related floods, among Organisation for Economic Co-Operation and Development (OECD) member countries. Research identifying flood-related morbidity and mortality risk factors is limited and primarily examines demographic characteristics such as age and gender. During floods, females, elderly and children appear to be at greater risk of psychological and physical health effects, while males between 10 to 29 years may be at greater risk of mortality. Post-flood, those over 65 years and males are at increased risk of physical health effects, while females appear at greater risk of psychological health effects. Other risk factors include previous flood experiences, greater flood depth or flood trauma, existing illnesses, medication interruption, and low education or socio-economic status. Tailoring messages to high-risk groups may increase their effectiveness. Target populations differ for morbidity and mortality effects, and differ pre-, during, and post-flood. Additional research is required to identify the risk factors associated with pre- and post-flood mortality and post-flood morbidity, preferably using prospective cohort studies. PMID:24336027

Factors increasing vulnerability to health effects before, during and after floods.

PubMed

Lowe, Dianne; Ebi, Kristie L; Forsberg, Bertil

2013-12-11

Identifying the risk factors for morbidity and mortality effects pre-, during and post-flood may aid the appropriate targeting of flood-related adverse health prevention strategies. We conducted a systematic PubMed search to identify studies examining risk factors for health effects of precipitation-related floods, among Organisation for Economic Co-Operation and Development (OECD) member countries. Research identifying flood-related morbidity and mortality risk factors is limited and primarily examines demographic characteristics such as age and gender. During floods, females, elderly and children appear to be at greater risk of psychological and physical health effects, while males between 10 to 29 years may be at greater risk of mortality. Post-flood, those over 65 years and males are at increased risk of physical health effects, while females appear at greater risk of psychological health effects. Other risk factors include previous flood experiences, greater flood depth or flood trauma, existing illnesses, medication interruption, and low education or socio-economic status. Tailoring messages to high-risk groups may increase their effectiveness. Target populations differ for morbidity and mortality effects, and differ pre-, during, and post-flood. Additional research is required to identify the risk factors associated with pre- and post-flood mortality and post-flood morbidity, preferably using prospective cohort studies.

[Risk factors of necrotizing enterocolitis].

PubMed

Tapia-Rombo, C A; Velasco-Lavín, M R; Nieto-Caldelas, A

1993-09-01

The purpose of the present study is to compare risk factors of necrotizing enterocolitis (NEC) between two group: group A, newborns with the disease and group B, newborns with other diseases different from NEC, in order to know if these risk factors are more frequent or not in the first group. We assessed the clinical records of all the patients hospitalized in the Neonatal Intensive Care Unit and Neonatology Service of the La Raza General Hospital between 1987 and 1991 with the diagnosis of NEC. They were compared with 65 clinical records chosen at random of patients hospitalized in the same Unit with other diagnosis at the same time, and who were discharged by improvement or deceased. In all of them were look for known risk factors for NEC generally accepted such as: prematurity, neonatal asphyxia, poliglobulia, cyanotic congenital heart disease, patent ductus arteriosus, respiratory distress syndrome, catheterization of umbilical vessels, early feeding of elevated formula increases, exchange exchange transfusion, hypoxic ischemic encephalopathy, infection, etc. Just 25 records of the possible 50 with the diagnosis of NEC full filled inclusion criteria. There were no statistically significant difference in weight, sex, mortality and known risk factors of NEC between both groups. Were concluded that NEC is a disease of unknown etiology that should be studied more thoroughly. The known risk factors must be avoided because the patient susceptibility probably play an important role.

Effects of Low-Carbohydrate Diets Versus Low-Fat Diets on Metabolic Risk Factors: A Meta-Analysis of Randomized Controlled Clinical Trials

PubMed Central

Hu, Tian; Mills, Katherine T.; Yao, Lu; Demanelis, Kathryn; Eloustaz, Mohamed; Yancy, William S.; Kelly, Tanika N.; He, Jiang; Bazzano, Lydia A.

2012-01-01

The effects of low-carbohydrate diets (≤45% of energy from carbohydrates) versus low-fat diets (≤30% of energy from fat) on metabolic risk factors were compared in a meta-analysis of randomized controlled trials. Twenty-three trials from multiple countries with a total of 2,788 participants met the predetermined eligibility criteria (from January 1, 1966 to June 20, 2011) and were included in the analyses. Data abstraction was conducted in duplicate by independent investigators. Both low-carbohydrate and low-fat diets lowered weight and improved metabolic risk factors. Compared with participants on low-fat diets, persons on low-carbohydrate diets experienced a slightly but statistically significantly lower reduction in total cholesterol (2.7 mg/dL; 95% confidence interval: 0.8, 4.6), and low density lipoprotein cholesterol (3.7 mg/dL; 95% confidence interval: 1.0, 6.4), but a greater increase in high density lipoprotein cholesterol (3.3 mg/dL; 95% confidence interval: 1.9, 4.7) and a greater decrease in triglycerides (−14.0 mg/dL; 95% confidence interval: −19.4, −8.7). Reductions in body weight, waist circumference and other metabolic risk factors were not significantly different between the 2 diets. These findings suggest that low-carbohydrate diets are at least as effective as low-fat diets at reducing weight and improving metabolic risk factors. Low-carbohydrate diets could be recommended to obese persons with abnormal metabolic risk factors for the purpose of weight loss. Studies demonstrating long-term effects of low-carbohydrate diets on cardiovascular events were warranted. PMID:23035144

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…

Breast Cancer Risk From Modifiable and Nonmodifiable Risk Factors Among White Women in the United States

PubMed Central

Maas, Paige; Barrdahl, Myrto; Joshi, Amit D.; Auer, Paul L.; Gaudet, Mia M.; Milne, Roger L.; Schumacher, Fredrick R.; Anderson, William F.; Check, David; Chattopadhyay, Subham; Baglietto, Laura; Berg, Christine D.; Chanock, Stephen J.; Cox, David G.; Figueroa, Jonine D.; Gail, Mitchell H.; Graubard, Barry I.; Haiman, Christopher A.; Hankinson, Susan E.; Hoover, Robert N.; Isaacs, Claudine; Kolonel, Laurence N.; Le Marchand, Loic; Lee, I-Min; Lindström, Sara; Overvad, Kim; Romieu, Isabelle; Sanchez, Maria-Jose; Southey, Melissa C.; Stram, Daniel O.; Tumino, Rosario; VanderWeele, Tyler J.; Willett, Walter C.; Zhang, Shumin; Buring, Julie E.; Canzian, Federico; Gapstur, Susan M.; Henderson, Brian E.; Hunter, David J.; Giles, Graham G; Prentice, Ross L.; Ziegler, Regina G.; Kraft, Peter; Garcia-Closas, Montse; Chatterjee, Nilanjan

2017-01-01

were at the lowest and highest deciles of nonmodifiable risks, the 5th and 95th percentile range of the risk distribution associated with 4 modifiable factors was 2.9% to 5.0% and 15.5% to 25.0%, respectively. For women in the highest decile of risk owing to nonmodifiable factors, those who had low BMI, did not drink or smoke, and did not use MHT had risks comparable to an average woman in the general population. CONCLUSIONS AND RELEVANCE This model for absolute risk of breast cancer including SNPs can provide stratification for the population of white women in the United States. The model can also identify subsets of the population at an elevated risk that would benefit most from risk-reduction strategies based on altering modifiable factors. The effectiveness of this model for individual risk communication needs further investigation. PMID:27228256

Delineating selection and mediation effects among childhood personality and environmental risk factors in the development of adolescent substance abuse.

PubMed

Hicks, Brian M; Johnson, Wendy; Durbin, C Emily; Blonigen, Daniel M; Iacono, William G; McGue, Matt

2014-01-01

Utilizing the large, longitudinal Minnesota Twin Family Study (N = 2510; 96 % European American ancestry), we examined the influence of several person-environment transactions on adolescent substance abuse. We focused on the two childhood personality traits found to be most predictive of substance abuse in this sample-socialization (willingness to follow rules and endorse conventional values) and boldness (social engagement and assurance, stress resilience, thrill seeking)-and the environmental variables of antisocial and prosocial peers, academic engagement, parent-child relationship quality, and stressful life events. Path analysis revealed that low socialization had a selection effect for each environmental risk factor, that is, socialization at age 11 predicted environmental risk at age 14, after controlling for the stability of the environmental variables from ages 11 to 14. Antisocial peers and academic engagement at age 14 then mediated some of the risk of low socialization on substance abuse at age 17, but the majority of risk for substance abuse was accounted for by the stability of socialization from age 11 to 14. Boldness at age 11 also increased risk for substance abuse, but did so primarily via a direct effect. The findings help to parse the nature of person-environment transactions across multiple personality traits and contextual risk factors that contribute to adolescent substance abuse.

Delineating Selection and Mediation Effects among Childhood Personality and Environmental Risk Factors in the Development of Adolescent Substance Abuse

PubMed Central

Hicks, Brian M.; Johnson, Wendy; Durbin, C. Emily; Blonigen, Daniel M.; Iacono, William G.; McGue, Matt

2014-01-01

Utilizing the large, longitudinal Minnesota Twin Family Study (N = 2510; 96% European American ancestry), we examined the influence of several person-environment transactions on adolescent substance abuse. We focused on the two childhood personality traits found to be most predictive of substance abuse in this sample—socialization (willingness to follow rules and endorse conventional values) and boldness (social engagement and assurance, stress resilience, thrill seeking)—and the environmental variables of antisocial and prosocial peers, academic engagement, parent-child relationship quality, and stressful life events. Path analysis revealed that low socialization had a selection effect for each environmental risk factor, that is, socialization at age 11 predicted environmental risk at age 14, after controlling for the stability of the environmental variables from ages 11 to 14. Antisocial peers and academic engagement at age 14 then mediated some of the risk of low socialization on substance abuse at age 17, but the majority of risk for substance abuse was accounted for by the stability of socialization from age 11 to 14. Boldness at age 11 also increased risk for substance abuse, but did so primarily via a direct effect. The findings help to parse the nature of person-environment transactions across multiple personality traits and contextual risk factors that contribute to adolescent substance abuse. PMID:24337735

Skin Cancer: Biology, Risk Factors & Treatment

MedlinePlus

... turn Javascript on. Feature: Skin Cancer Skin Cancer: Biology, Risk Factors & Treatment Past Issues / Summer 2013 Table ... Articles Skin Cancer Can Strike Anyone / Skin Cancer: Biology, Risk Factors & Treatment / Timely Healthcare Checkup Catches Melanoma ...

Genetic and environmental risk factors for rheumatoid arthritis.

PubMed

Deane, Kevin D; Demoruelle, M Kristen; Kelmenson, Lindsay B; Kuhn, Kristine A; Norris, Jill M; Holers, V Michael

2017-02-01

Multiple genetic and environmental factors have been associated with an increased risk for rheumatoid arthritis (RA). Of these, the strongest associations have been seen with female sex, a family history of RA, the genetic factor the "shared epitope," and exposure to tobacco smoke. There is also renewed interest in mucosal inflammation and microbial factors as contributors to the development of RA. However, the identification of a "preclinical" period of RA that can be defined as local or systemic autoimmunity as measured by autoantibodies and other biomarkers prior to the development of clinically apparent synovitis suggests that the risk factors for RA are acting long prior to first clinical evidence of IA. As such, a major challenge to the field will be to investigate the full spectrum of the development of RA, from initiation and propagation of autoimmunity during preclinical RA and transition to clinically apparent synovitis and classifiable RA, to determine which genetic and environmental factors are important at each stage of disease development. Understanding the exact role and timing of action of risk factors for RA is especially important given the advent of prevention trials in RA, and the hope that a full understanding of genetic and environmental factors in RA could lead to effective preventive interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Can an Internet-based health risk assessment highlight problems of heart disease risk factor awareness? A cross-sectional analysis.

PubMed

Dickerson, Justin B; McNeal, Catherine J; Tsai, Ginger; Rivera, Cathleen M; Smith, Matthew Lee; Ohsfeldt, Robert L; Ory, Marcia G

2014-04-18

Health risk assessments are becoming more popular as a tool to conveniently and effectively reach community-dwelling adults who may be at risk for serious chronic conditions such as coronary heart disease (CHD). The use of such instruments to improve adults' risk factor awareness and concordance with clinically measured risk factor values could be an opportunity to advance public health knowledge and build effective interventions. The objective of this study was to determine if an Internet-based health risk assessment can highlight important aspects of agreement between respondents' self-reported and clinically measured CHD risk factors for community-dwelling adults who may be at risk for CHD. Data from an Internet-based cardiovascular health risk assessment (Heart Aware) administered to community-dwelling adults at 127 clinical sites were analyzed. Respondents were recruited through individual hospital marketing campaigns, such as media advertising and print media, found throughout inpatient and outpatient facilities. CHD risk factors from the Framingham Heart Study were examined. Weighted kappa statistics were calculated to measure interrater agreement between respondents' self-reported and clinically measured CHD risk factors. Weighted kappa statistics were then calculated for each sample by strata of overall 10-year CHD risk. Three samples were drawn based on strategies for treating missing data: a listwise deleted sample, a pairwise deleted sample, and a multiple imputation (MI) sample. The MI sample (n=16,879) was most appropriate for addressing missing data. No CHD risk factor had better than marginal interrater agreement (κ>.60). High-density lipoprotein cholesterol (HDL-C) exhibited suboptimal interrater agreement that deteriorated (eg, κ<.30) as overall CHD risk increased. Conversely, low-density lipoprotein cholesterol (LDL-C) interrater agreement improved (eg, up to κ=.25) as overall CHD risk increased. Overall CHD risk of the sample was lower than

Examination of Substance Use, Risk Factors, and Protective Factors on Student Academic Test Score Performance

PubMed Central

Arthur, Michael W.; Brown, Eric C.; Briney, John S.; Hawkins, J. David; Abbott, Robert D.; Catalano, Richard F.; Becker, Linda; Langer, Michael; Mueller, Martin T.

2016-01-01

BACKGROUND School administrators and teachers face difficult decisions about how best to use school resources in order to meet academic achievement goals. Many are hesitant to adopt prevention curricula that are not focused directly on academic achievement. Yet, some have hypothesized that prevention curricula can remove barriers to learning and, thus, promote achievement. This study examined relationships between school levels of student substance use and risk and protective factors that predict adolescent problem behaviors and achievement test performance in Washington State. METHODS Hierarchical Generalized Linear Models were used to examine predictive associations between school-averaged levels of substance use and risk and protective factors and Washington State students’ likelihood of meeting achievement test standards on the Washington Assessment of Student Learning, statistically controlling for demographic and economic factors known to be associated with achievement. RESULTS Results indicate that levels of substance use and risk/protective factors predicted the academic test score performance of students. Many of these effects remained significant even after controlling for model covariates. CONCLUSIONS The findings suggest that implementing prevention programs that target empirically identified risk and protective factors have the potential to positively affect students’ academic achievement. PMID:26149305

Managing Multiple Risk Factors.

DTIC Science & Technology

1998-09-01

to the racial differences in cardiovascular risk and events among women. High levels of socioeconomic stress, higher dietary fat intake and sedentary ... lifestyle are more prevalent among black than white women. The proposed study will address the issue of whether the cluster of risk factors for

A comparative analysis of risk factors for stroke in blacks and whites: The Atherosclerosis Risk in Communities (ARIC) Study

PubMed Central

Huxley, Rachel; Bell, Elizabeth J.; Lutsey, Pamela L.; Bushnell, Cheryl; Shahar, Eyal; Rosamond, Wayne; Gottesman, Rebecca; Folsom, Aaron

2013-01-01

Objective Previous studies have speculated that the higher stroke incidence rate in blacks compared with whites may be due, in part, to stroke risk factors exerting a more adverse effect among blacks than whites. To determine whether such racial differences exist we compared the prospective associations between novel, traditional and emerging stroke risk factors in blacks and whites. Design Baseline characteristics on risk factor levels were obtained on 15,407 participants from the Atherosclerosis Risk in Communities Study. Stroke incidence was ascertained from 1987–2008. Adjusted Cox proportional hazard models were used to compute hazard ratios (HRs) and their 95% confidence intervals (CIs) for stroke in relation to stroke risk factor levels stratified by race. Results During follow-up 988 stroke events occurred: Blacks had higher stroke incident rates compared with whites with the greatest difference in those aged <60 years: 4.34, 3.24, 1.20 and 0.84 per 1,000 person-years, in black men, black women, white men and white women, respectively. Associations between risk factors with incident stroke were similar in blacks and whites excluding diabetes which was more strongly associated with risk of stroke in blacks than in whites: HR 2.54 (95% CI: 2.03–3.18) vs. 1.74 (1.37–2.21), respectively; p for race interaction=0.02. Conclusions At all ages, blacks are at considerably higher risk of incident stroke compared with whites, although the effect is most marked in younger age groups. This is most likely due to blacks having a greater burden of stroke risk factors rather than there being any substantial race differences in the associations between risk factors and stroke outcomes. PMID:24261746

Non-dietary environmental risk factors in prostate cancer

PubMed Central

Ferrís-i-Tortajada, J; Berbel-Tornero, O; Garcia-i-Castell, J; López-Andreu, J.A.; Sobrino-Najul, E; Ortega-García, J.A.

2016-01-01

Introduction The aim is to update and disclose the main environmental risk factors, excluding dietary factors, involved in the etiopathology of prostate cancer. Materials and methods Bibliographic review of the last 25 years of non-dietary environmental risk factors associated with prostate cancer between 1985 and 2010, obtained from MedLine, CancerLit, Science Citation Index and Embase. The search profiles were Environmental Risk Factors/Tobacco/Infectious-Inflammatory Factors/Pesticides/Vasectomy/Occupational Exposures/ Chemoprevention Agents/Radiation and Prostate Cancer. Results While some non-dietary environmental risk factors increase the risk of acquiring the disease, others decrease it. Of the former, it is worth mentioning exposal to tobacco smoke, chronic infectious-inflammatory prostatic processes and occupational exposure to cadmium, herbicides and pesticides. The first factors that reduce the risk are the use of chemopreventive drugs (Finasterida, Dutasteride) and exposure to ultraviolet solar radiation. With the current data, a vasectomy does not influence the risk of developing the disease. Conclusions The slow process of prostate carcinogenesis is the final result of the interaction of constitutional risk and environmental factors. Non-dietary environmental factors play an important role in the etiopathology of this disease. To appropriately assess the risk factors, extensive case studies that include all the possible variables must be analyzed. PMID:21439685

Prostate cancer: The main risk and protective factors-Epigenetic modifications.

PubMed

Adjakly, Mawussi; Ngollo, Marjolaine; Dagdemir, Aslihan; Judes, Gaëlle; Pajon, Amaury; Karsli-Ceppioglu, Seher; Penault-Llorca, Frédérique; Boiteux, Jean-Paul; Bignon, Yves-Jean; Guy, Laurent; Bernard-Gallon, Dominique

2015-02-01

With 13 million new cases worldwide every year, prostate cancer is as a very real public health concern. Prostate cancer is common in over-50s men and the sixth-leading cause of cancer-related death in men worldwide. Like all cancers, prostate cancer is multifactorial - there are non-modifiable risk factors like heredity, ethnicity and geographic location, but also modifiable risk factors such as diet. Diet-cancer linkages have risen to prominence in the last few years, with accruing epidemiological data pointing to between-population incidence differentials in numerous cancers. Indeed, there are correlations between fat-rich diet and risk of hormone-dependent cancers like prostate cancer and breast cancer. Diet is a risk factor for prostate cancer, but certain micronutrients in specific diets are considered protective factors against prostate cancer. Examples include tomato lycopene, green tea epigallocatechin gallate, and soy phytoestrogens. These micronutrients are thought to exert cancer-protective effects via anti-oxidant pathways and inhibition of cell proliferation. Here, we focus in on the effects of phytoestrogens, and chiefly genistein and daidzein, which are the best-researched to date. Soy phytoestrogens are nonsteroid molecules whose structural similarity lends them the ability to mimic the effects of 17ß-estradiol. On top of anti-oxidant effects, there is evidence that soy phytoestrogens can modulate the epigenetic modifications found in prostate cancer. We also studied the impact of phytoestrogens on epigenetic modifications in prostate cancer, with special focus on DNA methylation, miRNA-mediated regulation and histone modifications. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Suicide in developing countries (2): risk factors.

PubMed

Vijayakumar, Lakshmi; John, Sujit; Pirkis, Jane; Whiteford, Harvey

2005-01-01

The majority of studies on risk factors for suicide have been conducted in developed countries, and less work has been done to systematically profile risk factors in developing countries. The current paper presents a selective review of sociodemographic, clinical, and environmental/situational risk factors in developing countries. Taken together, the evidence suggests that the profiles of risk factors in developing countries demonstrate some differences from those in developed countries. In some developing countries, at least, being female, living in a rural area, and holding religious beliefs that sanction suicide may be of more relevance to suicide risk than these factors are in developed countries. Conversely, being single or having a history of mental illness may be of less relevance. Risk factors that appear to be universal include youth or old age, low socioeconomic standing, substance use, and previous suicide attempts. Recent stressful life events play a role in both developing and developed countries, although their nature may differ (e.g., social change may have more of an influence in the former). Likewise, access to means heightens risk in both, but the specific means may vary (e.g., access to pesticides is of more relevance in developing countries). These findings have clear implications for suicide prevention, suggesting that preventive efforts that have shown promise in developed countries may need to be tailored differently to address the risk factor profile of developing countries.

Risk Factors for Internet Gaming Disorder: Psychological Factors and Internet Gaming Characteristics

PubMed Central

Lee, Hyeseon; Lee, Taek-Ho; Cho, Hyun; Kim, Dai-Jin; Choi, In Young

2017-01-01

Background: Understanding the risk factors associated with Internet gaming disorder (IGD) is important to predict and diagnose the condition. The purpose of this study is to identify risk factors that predict IGD based on psychological factors and Internet gaming characteristics; Methods: Online surveys were conducted between 26 November and 26 December 2014. There were 3568 Korean Internet game users among a total of 5003 respondents. We identified 481 IGD gamers and 3087 normal Internet gamers, based on Diagnostic and Statistical Manual for Mental Disorders (DSM-5) criteria. Logistic regression analysis was applied to identify significant risk factors for IGD; Results: The following eight risk factors were found to be significantly associated with IGD: functional and dysfunctional impulsivity (odds ratio: 1.138), belief self-control (1.034), anxiety (1.086), pursuit of desired appetitive goals (1.105), money spent on gaming (1.005), weekday game time (1.081), offline community meeting attendance (2.060), and game community membership (1.393; p < 0.05 for all eight risk factors); Conclusions: These risk factors allow for the prediction and diagnosis of IGD. In the future, these risk factors could also be used to inform clinical services for IGD diagnosis and treatment. PMID:29280953

Assessment of Risk Factors of Intrauterine Adhesions in Patients With Induced Abortion and the Curative Effect of Hysteroscopic Surgery.

PubMed

Mo, Xiaoliang; Qin, Guirong; Zhou, Zhoulin; Jiang, Xiaoli

2017-10-03

To explore the risk factors for intrauterine adhesions in patients with artificial abortion and clinical efficacy of hysteroscopic dissection. 1500 patients undergoing artificial abortion between January 2014 and June 2015 were enrolled into this study. The patients were divided into two groups with or without intrauterine adhesions. Univariate and Multiple logistic regression were conducted to assess the effects of multiple factors on the development of intrauterine adhesions following induced abortion. The incidence rate for intrauterine adhesions following induced abortion is 17.0%. Univariate showed that preoperative inflammation, multiple pregnancies and suction evacuation time are the influence risk factors of intrauterine adhesions. Multiple logistic regression demonstrates that multiple pregnancies, high intrauterine negative pressure, and long suction evacuation time are independent risk factors for the development of intrauterine adhesions following induced abortion. Additionally, intrauterine adhesions were observed in 105 mild, 80 moderate, and 70 severe cases. The cure rates for these three categories of intrauterine adhesions by hysteroscopic surgery were 100.0%, 93.8%, and 85.7%, respectively. Multiple pregnancies, high negative pressure suction evacuation and long suction evacuation time are independent risk factors for the development of intrauterine adhesions following induced abortions. Hysteroscopic surgery substantially improves the clinical outcomes of intrauterine adhesions.

Adult Mortality Attributable to Preventable Risk Factors for Non-Communicable Diseases and Injuries in Japan: A Comparative Risk Assessment

PubMed Central

Ikeda, Nayu; Inoue, Manami; Iso, Hiroyasu; Ikeda, Shunya; Satoh, Toshihiko; Noda, Mitsuhiko; Mizoue, Tetsuya; Imano, Hironori; Saito, Eiko; Katanoda, Kota; Sobue, Tomotaka; Tsugane, Shoichiro; Naghavi, Mohsen; Ezzati, Majid; Shibuya, Kenji

2012-01-01

Background The population of Japan has achieved the longest life expectancy in the world. To further improve population health, consistent and comparative evidence on mortality attributable to preventable risk factors is necessary for setting priorities for health policies and programs. Although several past studies have quantified the impact of individual risk factors in Japan, to our knowledge no study has assessed and compared the effects of multiple modifiable risk factors for non-communicable diseases and injuries using a standard framework. We estimated the effects of 16 risk factors on cause-specific deaths and life expectancy in Japan. Methods and Findings We obtained data on risk factor exposures from the National Health and Nutrition Survey and epidemiological studies, data on the number of cause-specific deaths from vital records adjusted for ill-defined codes, and data on relative risks from epidemiological studies and meta-analyses. We applied a comparative risk assessment framework to estimate effects of excess risks on deaths and life expectancy at age 40 y. In 2007, tobacco smoking and high blood pressure accounted for 129,000 deaths (95% CI: 115,000–154,000) and 104,000 deaths (95% CI: 86,000–119,000), respectively, followed by physical inactivity (52,000 deaths, 95% CI: 47,000–58,000), high blood glucose (34,000 deaths, 95% CI: 26,000–43,000), high dietary salt intake (34,000 deaths, 95% CI: 27,000–39,000), and alcohol use (31,000 deaths, 95% CI: 28,000–35,000). In recent decades, cancer mortality attributable to tobacco smoking has increased in the elderly, while stroke mortality attributable to high blood pressure has declined. Life expectancy at age 40 y in 2007 would have been extended by 1.4 y for both sexes (men, 95% CI: 1.3–1.6; women, 95% CI: 1.2–1.7) if exposures to multiple cardiovascular risk factors had been reduced to their optimal levels as determined by a theoretical-minimum-risk exposure distribution. Conclusions

Mental illness, criminal risk factors and parole release decisions.

PubMed

Matejkowski, Jason; Draine, Jeffrey; Solomon, Phyllis; Salzer, Mark S

2011-01-01

Research has not examined whether higher rates of parole denial among inmates with mental illness (MI) are the result of the increased presence of criminal risk factors among this population. Employing a representative sample of inmates with (n  =  219) and without (n  =  184) MI receiving parole release decisions in 2007, this study tested whether the central eight risk factors for recidivism considered in parole release decisions intervened in the relationship between MI and parole release. MI was associated with possession of a substance use disorder, antisocial personality disorder and violent charges while incarcerated; however, these factors were not related to release decisions. MI was found to have neither a direct nor an indirect effect on release decisions. While results indicate that release decisions appear, to some extent, to be evidence-based, they also suggest considerable discretion is being implemented by parole board members in release decisions above and beyond consideration of criminal risk factors. Copyright © 2011 John Wiley & Sons, Ltd.

Explanatory risk factors in the relations between schizotypy and indicators of suicide risk.

PubMed

Jahn, Danielle R; DeVylder, Jordan E; Hilimire, Matthew R

2016-04-30

Schizotypy has been linked to suicide risk, but it is not known whether established suicide-related risk factors mediate this relation. The aim of this study was to assess the mediating effects of depressive symptoms, social anxiety, self-esteem, and intimate disclosure in peer relationships in the relation between interpersonal schizotypy and suicide ideation or lifetime suicide attempts. This aim was tested in 590 young adults using a nonparametric bootstrapping procedure. After inclusion of the mediators, interpersonal schizotypy was no longer directly associated with either suicide ideation or lifetime suicide attempts. Depression and self-esteem mediated the relation between interpersonal schizotypy and suicide ideation. No variables mediated the relation between interpersonal schizotypy and lifetime suicide attempts, and there were no significant direct relations when mediators were included. Schizotypy appears to be a distal risk factor for suicidal behavior; assessing depressive symptoms and self-esteem may provide more proximal information about suicide risk, and may be targets for mitigating suicide risk in individuals with schizotypy. Published by Elsevier Ireland Ltd.

Risk factors and biomarkers of life-threatening cancers

PubMed Central

Autier, Philippe

2015-01-01

There is growing evidence that risk factors for cancer occurrence and for cancer death are not necessarily the same. Knowledge of cancer aggressiveness risk factors (CARF) may help in identifying subjects at high risk of developing a potentially deadly cancer (and not just any cancer). The availability of CARFs may have positive consequences for health policies, medical practice, and the search for biomarkers. For instance, cancer chemoprevention and cancer screening of subjects with CARFs would probably be more ethical and cost-effective than recommending chemoprevention and screening to entire segments of the population. Also, the harmful consequences of chemoprevention and of screening would be reduced while effectiveness would be optimised. We present examples of CARF already in use (e.g. mutations of the breast cancer (BRCA) gene), of promising avenues for the discovery of biomarkers thanks to the investigation of CARFs (e.g. breast radiological density and systemic inflammation), and of biomarkers commonly used that are not real CARFs (e.g. certain mammography images, prostate-specific antigen (PSA) concentration, nevus number). PMID:26635900

Risk factors for inhibitor development in severe hemophilia a.

PubMed

Garagiola, Isabella; Palla, Roberta; Peyvandi, Flora

2018-05-25

Although significant advances in hemophilia treatment have improved patient outcomes and quality of life, one of the greatest complications in severe hemophilia A is the development of anti-Factor VIII (FVIII) antibodies that inhibit FVIII activity in almost 30% of previously untreated patients (PUPs). Inhibitors make very difficult the management of patients and increase their morbidity and mortality reducing drastically their quality of life. Numerous studies have investigated the mechanisms leading to the development of FVIII inhibitors. However, the etiology of their onset is complex and not yet fully understood. Inhibitors develop from a multicausal immune response involving both genetic (unmodifiable) and environmental (modifiable) factors. F8 gene mutations are the most important genetic risk factor, with null mutations being associated with the highest risk of inhibitor development. Immune response genes (e.g. the human leukocyte antigen complex) and proteins (e.g. cytokines) were studied without any strong confirmation of their role in modulating of inhibitor development. Type of FVIII product is the most important modifiable risk factor. The plasma-derived products containing von Willebrand factor were recently suggested to determine a lower incidence of inhibitor development than recombinant products in PUPs, in the first 50 exposure days (EDs). Other environmental factors including, age at first treatment, treatment intensity and the danger signal effect (surgery, severe bleeds, vaccinations and infections) has also been postulated as an explanation for environment-related inhibitor risk. This review reports the current knowledge on genetic and environmental risk factors on inhibitor development in patients with severe hemophilia A. Copyright © 2018 Elsevier Ltd. All rights reserved.

Lack of effect of drinking water barium on cardiovascular risk factors.

PubMed Central

Wones, R G; Stadler, B L; Frohman, L A

1990-01-01

Higher cardiovascular mortality has been associated in a single epidemiological study with higher levels of barium in drinking water. The purpose of this study was to determine whether drinking water barium at levels found in some U.S. communities alters the known risk factors for cardiovascular disease. Eleven healthy men completed a 10-week dose-response protocol in which diet was controlled (600 mg cholesterol; 40% fat, 40% carbohydrate, 20% protein; sodium and potassium controlled at the subject's pre-protocol estimated intake). Other aspects of the subjects' lifestyles known to affect cardiac risk factors were controlled, and the barium content (as barium chloride) of the drinking water (1.5 L/day) was varied from 0 (first 2 weeks), to 5 ppm (next 4 weeks), to 10 ppm (last 4 weeks). Multiple blood and urine samples, morning and evening blood pressure measurements, and 48-hr electrocardiographic monitoring were performed at each dose of barium. There were no changes in morning or evening systolic or diastolic blood pressures, plasma cholesterol or lipoprotein or apolipoprotein levels, serum potassium or glucose levels, or urine catecholamine levels. There were no arrhythmias related to barium exposure detected on continuous electrocardiographic monitoring. A trend was seen toward increased total serum calcium levels with exposure to barium, which was of borderline statistical significance and of doubtful clinical significance. In summary, drinking water barium at levels of 5 and 10 ppm did not appear to affect any of the known modifiable cardiovascular risk factors. PMID:2384067

Risk factors for pulmonary tuberculosis in Estonia.

PubMed

Tekkel, M; Rahu, M; Loit, H M; Baburin, A

2002-10-01

To determine the risk factors for pulmonary tuberculosis incidence in Estonia. In a case-control study, the cases were 248 adult tuberculosis patients treated in a hospital in Tallinn between January 1999 and June 2000, and the controls were 248 persons sampled from the Population Registry and matched to cases by sex, year of birth and county of residence. A questionnaire was administered to collect information on potential risk factors. Logistic regression was used to calculate odds ratios and 95% confidence intervals. The main risk factors for tuberculosis were marital status other than married, educational level less than higher, low income, having been in prison, not having own place of residence, current unemployment, current smoking, alcohol consumption, shortage of food, and contact with tuberculosis patients. Place of birth was not a risk factor. Risk of tuberculosis decreased for overweight persons whose individual economic situation had improved during the last year. The pattern of risk factors for pulmonary tuberculosis in Estonia was somewhat different from that in Western European countries; a large percentage of the patients were men, but were not elderly, and immigration and drug abuse did not increase the risk. Major risk factors were related to poverty and low socio-economic status.

Hidden Risk Factors for Women

MedlinePlus

... risk factors are present. History of Preeclampsia/Eclampsia: Women with a history of preeclampsia/eclampsia have an increased risk of ... can increase the risk of stroke. Clotting disorders: Women who’ve ... can include previous history of clots in the legs (deep vein thrombosis) ...

Quantifying links between stroke and risk factors: a study on individual health risk appraisal of stroke in a community of Chongqing.

PubMed

Wu, Yazhou; Zhang, Ling; Yuan, Xiaoyan; Wu, Yamin; Yi, Dong

2011-04-01

The objective of this study is to investigate the risk factors of stroke in a community in Chongqing by setting quantitative criteria for determining the risk factors of stroke. Thus, high-risk individuals can be identified and laid a foundation for predicting individual risk of stroke. 1,034 cases with 1:2 matched controls (2,068) were chosen from five communities in Chongqing including Shapingba, Xiaolongkan, Tianxingqiao, Yubei Road and Ciqikou. Participants were interviewed with a uniform questionnaire. The risk factors of stroke and the odds ratios of risk factors were analyzed with a logistic regression model, and risk exposure factors of different levels were converted into risk scores using statistical models. For men, ten risk factors including hypertension (5.728), family history of stroke (4.599), and coronary heart disease (5.404), among others, were entered into the main effect model. For women, 11 risk factors included hypertension (5.270), family history of stroke (4.866), hyperlipidemia (4.346), among others. The related risk scores were added to obtain a combined risk score to predict the individual's risk of stoke in the future. An individual health risk appraisal model of stroke, which was applicable to individuals of different gender, age, health behavior, disease and family history, was established. In conclusion, personal diseases including hypertension, diabetes mellitus, etc., were very important to the prevalence of stoke. The prevalence of stroke can be effectively reduced by changing unhealthy lifestyles and curing the positive individual disease. The study lays a foundation for health education to persuade people to change their unhealthy lifestyles or behaviors, and could be used in community health services.

The effects of insulin sensitizers on the cardiovascular risk factors in women with polycystic ovary syndrome.

PubMed

Kassi, E; Diamanti-Kandarakis, E

2008-12-01

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in pre-menopausal women characterized by menstrual cycle disturbances, chronic anovulation, and clinical and/or biochemical hyperandrogenism. Although, the primary etiology of PCOS remains unknown, insulin resistance/hyperinsulinemia plays a pivotal role in the pathogenesis of the syndrome. A growing body of recent data support that women with PCOS have displayed an increased prevelance of cardiovascular disease (CVD) risk factors putting potentially at a hight risk for heart disease. Most of these CVD risk factors are etiologically correlated with insulin resistance/hyperinsulinemia, highlighting the role of insulin sensitizers in the therapeutic quiver for the chronic treatment of PCOS. In this review, we discuss the current literature on the CVD risk factors in PCOS and the influence of insulin sensitizers upon these risk factors.

Risk factors for burnout among caregivers working in nursing homes.

PubMed

Kandelman, Nadia; Mazars, Thierry; Levy, Antonin

2018-01-01

(i) To assess the level of burnout in nursing home caregivers within a unique healthcare network in France and (ii) to evaluate potential risk factors in this population. Burnout syndrome occurs frequently among nursing home caregivers and has strong detrimental effects on the quality of health care for residents. We used an observational survey to study burnout in nursing home caregivers. The survey was used to quantify burnout level (Maslach Burnout Inventory) and potential risk factors and was implemented from October 2013-April 2014. A logistic regression was used to explore the association between burnout and its risk factors. Three hundred and sixty questionnaires were delivered to caregivers in 14 nursing homes within a unique healthcare network. The response rate was 37% (132/360), and 124/132 (94%) surveys were analysed. Caregiver burnout rate was 40% (49/124). Median age was 41 years (range, 20-70) and most caregivers were female. The most common profession (n = 54; 44%) was nurse caregiver and 90% (n = 112) had an antecedent of bullying by a resident. Risk factors identified were as follows: the presence of institutional protocols (death announcement [OR: 3.7] and pain assessment [OR: 2.8]), working in a profit-making establishment (OR: 2.6) and the antecedent of bullying by a resident (OR: 6.2). Factors most negatively associated with burnout included: practising pastimes (OR: 0.4) and working as a nurse (OR: 0.3). The only significant risk factor in the multivariate analysis was the antecedent of bullying by a resident (OR: 5.3). Several specific risk factors for burnout in nursing home caregivers were identified. In high-risk populations of healthcare professionals, screening and management of risk factors is crucial for preventing burnout. © 2017 John Wiley & Sons Ltd.

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.

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

Urbanisation and its effect on risk factors associated with childhood diarrhoea in Mbour, Senegal: A visualisation.

PubMed

Thiam, Sokhna; Fuhrimann, Samuel; Niang-Diène, Aminata; Sy, Ibrahima; Faye, Ousmane; Utzinger, Jürg; Cissé, Guéladio

2017-11-27

Rapid urbanisation, particularly in secondary cities in Africa, brings along specific challenges for global health, including the prevention and control of infectious diseases such as diarrhoea. Our purpose was to visualise urbanisation trends and its effect on risk factors associated with childhood diarrhoea, e.g. water supply, sanitation, wastewater and solid waste management in Mbour, a secondary city in south-western Senegal. Our visualisation is facilitated by epidemiological and geographical surveys carried out in 2016. A deeper spatial and visual understanding of the urbanisation trends and the disparities of diarrhoea-associated risk factors might lead to the implementation of suitable health interventions and preventive measures. Our visualisation is aimed to serve as a basis for discussion and as a decision support tool for policymakers, municipal officials and local communities to prioritise interventions related to water, sanitation and waste management with a view to reduce the environmental and health risks in the rapidly growing city of Mbour, which is set as an example for other similar secondary cities across low- and middle-income countries in Africa.

Effect of Alzheimer's disease risk and protective factors on cognitive trajectories in subjective memory complainers.

PubMed

Teipel, Stefan J; Cavedo, Enrica; Lista, Simone; Habert, Marie-Odile; Potier, Marie-Claude; Grothe, Michel J; Epelbaum, Stephane; Sambati, Luisa; Gagliardi, Geoffroy; Toschi, Nicola; Greicius, Michael; Dubois, Bruno; Hampel, Harald

2018-05-21

Cognitive change in people at risk of Alzheimer's disease (AD) such as subjective memory complainers is highly variable across individuals. We used latent class growth modeling to identify distinct classes of nonlinear trajectories of cognitive change over 2 years follow-up from 265 subjective memory complainers individuals (age 70 years and older) of the INSIGHT-preAD cohort. We determined the effect of cortical amyloid load, hippocampus and basal forebrain volumes, and education on the cognitive trajectory classes. Latent class growth modeling identified distinct nonlinear cognitive trajectories. Education was associated with higher performing trajectories, whereas global amyloid load and basal forebrain atrophy were associated with lower performing trajectories. Distinct classes of cognitive trajectories were associated with risk and protective factors of AD. These associations support the notion that the identified cognitive trajectories reflect different risk for AD that may be useful for selecting high-risk individuals for intervention trials. Copyright © 2018. Published by Elsevier Inc.

Risk factors for first time incidence sciatica: a systematic review.

PubMed

Cook, Chad E; Taylor, Jeffrey; Wright, Alexis; Milosavljevic, Steven; Goode, Adam; Whitford, Maureen

2014-06-01

Characteristically, sciatica involves radiating leg pain that follows a dermatomal pattern along the distribution of the sciatic nerve. To our knowledge, there are no studies that have investigated risk factors associated with first time incidence sciatica. The purpose of the systematic review was to identify the longitudinal risk factors associated with first time incidence sciatica and to report incidence rates for the condition. For the purposes of this review, first time incidence sciatica was defined as either of the following: 1) no prior history of sciatica or 2) transition from a pain-free state to sciatica. Studies included subjects of any age from longitudinal, observational, cohort designs. The study was a systematic review. Eight of the 239 articles identified by electronic search strategies met the inclusion criteria. Risk factors and their respective effect estimates were reported using descriptive analysis and the preferred reporting items for systematic reviews and meta-analyses guidelines. Modifiable risk factors included smoking, obesity, occupational factors and health status. Non-modifiable factors included age, gender and social class. Incidence rates varied among the included studies, in part reflecting the variability in the operationalized definition of sciatica but ranged from <1% to 37%. A majority of the identified risk factors associated with first time sciatica are modifiable, suggesting the potential benefits of primary prevention. In addition, those risk factors are also associated with unhealthy lifestyles, which may function concomitantly toward the development of sciatica. Sciatica as a diagnosis is inconsistently defined among studies. © 2013 John Wiley & Sons, Ltd.

Strategies for reducing body fat mass: effects of liposuction and exercise on cardiovascular risk factors and adiposity

PubMed Central

Benatti, Fabiana Braga; Lira, Fábio Santos; Oyama, Lila Missae; do Nascimento, Cláudia Maria da Penha Oller; Lancha, Antonio Herbert

2011-01-01

Liposuction is the most popular aesthetic surgery performed in Brazil and worldwide. Evidence showing that adipose tissue is a metabolically active tissue has led to the suggestion that liposuction could be a viable method for improving metabolic profile through the immediate loss of adipose tissue. However, the immediate liposuction-induced increase in the proportion of visceral to subcutaneous adipose tissue could be detrimental to metabolism, because a high proportion of visceral to subcutaneous adipose tissue is associated with risk factors for cardiovascular disease. The results of studies investigating the effects of liposuction on the metabolic profile are inconsistent, however, with most studies reporting either no change or improvements in one or more cardiovascular risk factors. In addition, animal studies have demonstrated a compensatory growth of intact adipose tissue in response to lipectomy, although studies with humans have reported inconsistent results. Exercise training improves insulin sensitivity, inflammatory balance, lipid oxidation, and adipose tissue distribution; increases or preserves the fat-free mass; and increases total energy expenditure. Thus, liposuction and exercise appear to directly affect metabolism in similar ways, which suggests a possible interaction between these two strategies. To our knowledge, no studies have reported the associated effects of liposuction and exercise in humans. Nonetheless, one could suggest that exercise training associated with liposuction could attenuate or even block the possible compensatory fat deposition in intact depots or regrowth of the fat mass and exert an additive or even a synergistic effect to liposuction on improving insulin sensitivity and the inflammatory balance, resulting in an improvement of cardiovascular risk factors. Consequently, one could suggest that liposuction and exercise appear to be safe and effective strategies for either the treatment of metabolic disorders or aesthetic

[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

Epidemiology of type 2 diabetes: risk factors.

PubMed

Haffner, S M

1998-12-01

A number of cross-sectional and prospective studies that compared the insulin sensitivity of various national and ethnic populations within the U.S. to the total U.S. population were analyzed to find possible risk factors for the development of type 2 diabetes. It was found that the risks for diabetes in African-Americans, Hispanics, and Native Americans are approximately 2, 2.5, and 5 times greater, respectively, than in Caucasians. Studies of the prevalence of type 2 diabetes in Mexican Americans and non-Hispanic whites in San Antonio showed that there is an inverse relationship between socioeconomic status and the prevalence of diabetes. It also appears that cultural effects lead to an increased incidence of obesity in these populations, which may lead to insulin resistance. Genetic factors may also be a contributing factor. A 5-year, prospective study of insulin resistance in Pima Indians showed a relationship between impaired glucose tolerance and subsequent development of type 2 diabetes. In a 7-year study in Mexican Americans, those subjects who had both high insulin secretion and impaired insulin sensitivity had a 14-fold increased risk of developing type 2 diabetes. Regardless of cultural and ethnic factors, the San Antonio Heart Study, which compared Mexican Americans and non-Hispanic whites, showed that in both groups, the strongest predictors of developing type 2 diabetes are elevated fasting insulin concentrations and low insulin secretion.

Long-term Effects of Large-volume Liposuction on Metabolic Risk Factors for Coronary Heart Disease

PubMed Central

Mohammed, B. Selma; Cohen, Samuel; Reeds, Dominic; Young, V. Leroy; Klein, Samuel

2009-01-01

Abdominal obesity is associated with metabolic risk factors for coronary heart disease (CHD). Although we previously found that using liposuction surgery to remove abdominal subcutaneous adipose tissue (SAT) did not result in metabolic benefits, it is possible that postoperative inflammation masked the beneficial effects. Therefore, this study provides a long-term evaluation of a cohort of subjects from our original study. Body composition and metabolic risk factors for CHD, including oral glucose tolerance, insulin resistance, plasma lipid profile, and blood pressure were evaluated in seven obese (39 ± 2 kg/m2) women before and at 10, 27, and 84–208 weeks after large-volume liposuction. Liposuction surgery removed 9.4 ± 1.8 kg of body fat (16 ± 2% of total fat mass; 6.1 ± 1.4 kg decrease in body weight), primarily from abdominal SAT; body composition and weight remained the same from 10 through 84–208 weeks. Metabolic endpoints (oral glucose tolerance, homeostasis model assessment of insulin resistance, blood pressure and plasma triglyceride (TG), high-density lipoprotein (HDL)-cholesterol, and low-density lipoprotein (LDL)-cholesterol concentrations) obtained at 10 through 208 weeks were not different from baseline and did not change over time. These data demonstrate that removal of a large amount of abdominal SAT by using liposuction does not improve CHD metabolic risk factors associated with abdominal obesity, despite a long-term reduction in body fat. PMID:18820648

Syndromes, disorders and maternal risk factors associated with neural tube defects (I).

PubMed

Chen, Chih-Ping

2008-03-01

Fetuses with neural tube defects (NTDs) may be associated with syndromes, disorders, and maternal risk factors. This article provides a comprehensive review of syndromes, disorders, and maternal risk factors associated with NTDs, such as acrocallosal syndrome, autosomal dominant brachydactyly-clinodactyly syndrome, Manouvrier syndrome, short rib-polydactyly syndrome, Disorganization ( Ds )-like human malformations, isolated hemihyperplasia, X-linked NTDs, meroanencephaly, schisis association, diprosopus, fetal valproate syndrome, DiGeorge syndrome/velocardiofacial syndrome, Waardenburg syndrome, folic acid antagonists, diabetes mellitus, and obesity. NTDs associated with syndromes, disorders, and maternal risk factors are a rare but important cause of NTDs. The recurrence risk and the preventive effect of maternal folic acid intake in NTDs associated with syndromes, disorders, and maternal risk factors may be different from those of non-syndromic multifactorial NTDs. Perinatal identification of NTDs should alert one to the syndromes, disorders, and maternal risk factors associated with NTDs, and prompt a thorough etiologic investigation and genetic counseling.

Risk Factor Effects and Total Mortality in Older Japanese Men in Japan and Hawaii

PubMed Central

Abbott, Robert D.; Ueshima, Hirotsugu; Hozawa, Atsushi; Okamura, Tomonori; Kadowaki, Takashi; Miura, Katsuyuki; Okuda, Nagako; Nakamura, Yasuyuki; Okayama, Akira; Kita, Yoshikuni; Rodriguez, Beatriz L.; Yano, Katsuhiko; Curb, J. David

2017-01-01

Purpose To identify factors related to total mortality in older Japanese men in Japan and Hawaii. Methods Baseline data were collected from 1980 to 1982 in 1,379 men in Hawaii and 954 men in Japan. Ages ranged from 61 to 81 years with mortality follow-up over a 19 year period. Results Compared to Japan, men in Hawaii had a 2-fold excess of diabetes and a 4-fold excess of prevalent coronary heart disease (p<0.001). Total cholesterol and body mass index were also higher in Hawaii (p<0.001). In contrast, men in Japan had higher systolic blood pressure and were nearly 3-times more likely to smoke cigarettes (p<0.001). Although each cohort had elements of a poor risk factor profile, there was a 1.4-fold excess in the risk of death in Japan (49.4 vs. 36.2/1,000 person-years, p<0.001). While mortality was similar after risk factor adjustment, only blood pressure and cigarette smoking accounted for the higher risk of death in Japan. Conclusions Cigarette smoking and hypertension explain much of the excess mortality in Japan versus Hawaii. In this comparison of genetically similar cohorts, evidence further suggests that Japanese in Japan are equally susceptible to develop the same adverse risk factor conditions that exist in Hawaii. PMID:19041590

Risk factors, health risks, and risk management for aircraft personnel and frequent flyers.

PubMed

Kim, Jeoum Nam; Lee, Byung Mu

2007-01-01

Health risks associated with long periods of time in flight are of concern to astronauts, crew members, and passengers. Many epidemiological studies showed that occupational and frequent flyers may be susceptible to ocular, cardiovascular, neurological, pulmonary, gastrointestinal, sensory, immunological, physiological, and even developmental disorders. In addition, the incidences of cancer and food poisoning are expected to be higher in such individuals. This article reviews health risks and risk factors associated with air travel, and discusses risk management strategies. To reduce adverse health risks, risk factors such as radiation, infection, stress, temperature, pressure, and circadian rhythm need to be avoided or reduced to levels that are as low as technologically achievable to protect flight personnel and passengers.

Quantifying lead-time bias in risk factor studies of cancer through simulation.

PubMed

Jansen, Rick J; Alexander, Bruce H; Anderson, Kristin E; Church, Timothy R

2013-11-01

Lead-time is inherent in early detection and creates bias in observational studies of screening efficacy, but its potential to bias effect estimates in risk factor studies is not always recognized. We describe a form of this bias that conventional analyses cannot address and develop a model to quantify it. Surveillance Epidemiology and End Results (SEER) data form the basis for estimates of age-specific preclinical incidence, and log-normal distributions describe the preclinical duration distribution. Simulations assume a joint null hypothesis of no effect of either the risk factor or screening on the preclinical incidence of cancer, and then quantify the bias as the risk-factor odds ratio (OR) from this null study. This bias can be used as a factor to adjust observed OR in the actual study. For this particular study design, as average preclinical duration increased, the bias in the total-physical activity OR monotonically increased from 1% to 22% above the null, but the smoking OR monotonically decreased from 1% above the null to 5% below the null. The finding of nontrivial bias in fixed risk-factor effect estimates demonstrates the importance of quantitatively evaluating it in susceptible studies. Copyright © 2013 Elsevier Inc. All rights reserved.

Family Risk and Resiliency Factors, Substance Use, and the Drug Resistance Process in Adolescence.

ERIC Educational Resources Information Center

Moon, Dreama G.; Jackson, Kristina M.; Hecht, Michael L.

2000-01-01

Study tests two models to compare the effects of risk and resiliency across gender and ethnicity. Results support the model in which risk and resiliency are discrete sets of factors and demonstrate that overall resiliency factors play a larger role than risk factors in substance use and drug resistance processes. Gender proved to be an important…

Effects of dancing on the risk of falling related factors of healthy older adults: a systematic review.

PubMed

Fernández-Argüelles, Esther López; Rodríguez-Mansilla, Juan; Antunez, Luis Espejo; Garrido-Ardila, Elisa María; Muñoz, Rafael Perez

2015-01-01

Deficits of balance or postural control in persons of advanced age are one of the factors that influence the risk of falling. The most appropriate treatment approaches and their benefits are still unknown. The aim of this article is to systematically review the scientific literature to identify the therapeutic effects of dancing as a physical exercise modality on balance, flexibility, gait, muscle strength and physical performance in older adults. A systematic search of Pubmed, Cochrane Library Plus, PEDro, Science Direct, Dialnet and Academic Search Complete using the search terms "dance", "older", "dance therapy", "elderly", "balance", "gait" and "motor skills". The eligibility criteria were: studies written in English and Spanish, published from January 2000 to January 2013, studies which analyzed the effects of dance (ballroom dance and/or dance based exercise) in older adults over 60 years of age with no disabling disease and included the following variables of study: balance, gait, risk of falls, strength, functionality, flexibility and quality of life. 123 articles were found in the literature. A final selection of seven articles was used for the present manuscript. Although the selected studies showed positive effects on the risk of falling related to factors (balance, gait and dynamic mobility, strength and physical performance), there were some aspects of the studies such as the methodological quality, the small sample size, the lack of homogeneity in relation to the variables and the measurement tools, and the existing diversity regarding the study design and the type of dance, that do not enable us to confirm that dance has significant benefits on these factors based on the scientific evidence. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Risk burdens of modifiable risk factors incorporating lipoprotein (a) and low serum albumin concentrations for first incident acute myocardial infarction

PubMed Central

Yang, Qin; He, Yong-Ming; Cai, Dong-Ping; Yang, Xiang-Jun; Xu, Hai-Feng

2016-01-01

Risk burdens of modifiable risk factors incorporating lipoprotein (a) (Lp(a)) and low serum albumin (LSA) concentrations for first incident acute myocardial infarction (AMI) haven’t been studied previously. Cross-sectional study of 1552 cases and 6125 controls was performed for identifying the association of risk factors with first incident AMI and their corresponding population attributable risks (PARs). Modifiable risk factors incorporating LSA and Lp(a) accounted for up to 92% of PAR for first incident AMI. Effects of these risk factors were different in different sexes across different age categories. Overall, smoking and LSA were the 2 strongest risk factors, together accounting for 64% of PAR for first incident AMI. After multivariable adjustment, Lp(a) and LSA accounted for 19% and 41%, respectively, and together for more than a half (54%) of PAR for first incident AMI. Modifiable risk factors incorporating LSA and Lp(a) have accounted for an overwhelmingly large proportion of the risk of first incident AMI, indicating most first incident AMI is preventable. The knowledge of risk burdens for first incident AMI incorporating Lp (a) and LSA may be beneficial for further reducing first incident AMI from a new angle. PMID:27748452

Stroke - risk factors

MedlinePlus

... is cut off for longer than a few seconds, the brain cannot get nutrients and oxygen. Brain cells can die, causing lasting damage. Risk factors are things that increase your chance of getting a disease or condition. This article ...

Environmental risk factors and Parkinson's disease: An umbrella review of meta-analyses.

PubMed

Bellou, Vanesa; Belbasis, Lazaros; Tzoulaki, Ioanna; Evangelou, Evangelos; Ioannidis, John P A

2016-02-01

Parkinson's disease is a neurological disorder with complex pathogenesis implicating both environmental and genetic factors. We aimed to summarise the environmental risk factors that have been studied for potential association with Parkinson's disease, assess the presence of diverse biases, and identify the risk factors with the strongest support. We searched PubMed from inception to September 18, 2015, to identify systematic reviews and meta-analyses of observational studies that examined associations between environmental factors and Parkinson's disease. For each meta-analysis we estimated the summary effect size by random-effects and fixed-effects models, the 95% confidence interval and the 95% prediction interval. We estimated the between-study heterogeneity expressed by I(2), evidence of small-study effects and evidence of excess significance bias. Overall, 75 unique meta-analyses on different risk factors for Parkinson's disease were examined, covering diverse biomarkers, dietary factors, drugs, medical history or comorbid diseases, exposure to toxic environmental agents and habits. 21 of 75 meta-analyses had results that were significant at p < 0.001 by random-effects. Evidence for an association was convincing (more than 1000 cases, p < 10(-6) by random-effects, not large heterogeneity, 95% prediction interval excluding the null value and absence of hints for small-study effects and excess significance bias) for constipation, and physical activity. Many environmental factors have substantial evidence of association with Parkinson's disease, but several, perhaps most, of them may reflect reverse causation, residual confounding, information bias, sponsor conflicts or other caveats. Copyright © 2016. Published by Elsevier Ltd.

Communication of medical product risk: how effective is effective enough?

PubMed

Goldman, Stephen A

2004-01-01

Ever-increasing attention is being paid worldwide to the safety of medical products, and the risks associated with their use. The integral role of risk communication in overall risk management is demonstrated by several recent market withdrawals of drugs, in which a perceived incapability of healthcare systems to manage well-characterised, avoidable risks was a significant factor. With advances in clinical pharmacology, pharmacogenomics and pharmacoepidemiology expanding our knowledge of medical products, effective delivery of the latest safety-related information to health professionals and consumers becomes even more imperative. In this regard, it is important to evaluate whether current modes of risk communication lead to desired changes in relevant behaviours such as prescribing or drug monitoring, particularly in context with which achieved level of effectiveness is deemed acceptable. This is crucial, as there have been product-specific risk communication efforts that achieved a fair degree of success, yet were not seen as effective enough to prevent market withdrawal of the medical product in question. In the service of improving public health through enhanced risk communication, it is essential to critically assess current methods, both as to results achieved (or not), and whether each method is applicable to the various types of risks associated with medical product use. Furthermore, just as combining methods may well improve overall risk communication, there are societal and psychological factors that must be considered in attempting to maximise effectiveness. However, in assessing risk communication effectiveness, the particular benefit- risk relationship of any individual medical product must also be part of the evaluative process.

Efficacy of Chinese herbal medicine for stroke modifiable risk factors: a systematic review.

PubMed

Peng, Wenbo; Lauche, Romy; Ferguson, Caleb; Frawley, Jane; Adams, Jon; Sibbritt, David

2017-01-01

The vast majority of stroke burden is attributable to its modifiable risk factors. This paper aimed to systematically summarise the evidence of Chinese herbal medicine (CHM) interventions on stroke modifiable risk factors for stroke prevention. A literature search was conducted via the MEDLINE, CINAHL/EBSCO, SCOPUS, and Cochrane Database from 1996 to 2016. Randomised controlled trials or cross-over studies were included. Risk of bias was assessed according to the Cochrane Risk of Bias tool. A total of 46 trials (6895 participants) were identified regarding the use of CHM interventions in the management of stroke risk factors, including 12 trials for hypertension, 10 trials for diabetes, eight trials for hyperlipidemia, seven trials for impaired glucose tolerance, three trials for obesity, and six trials for combined risk factors. Amongst the included trials with diverse study design, an intervention of CHM as a supplement to biomedicine and/or a lifestyle intervention was found to be more effective in lowering blood pressure, decreasing blood glucose level, helping impaired glucose tolerance reverse to normal, and/or reducing body weight compared to CHM monotherapy. While no trial reported deaths amongst the CHM groups, some papers do report moderate adverse effects associated with CHM use. However, the findings of such beneficial effects of CHM should be interpreted with caution due to the heterogeneous set of complex CHM studied, the various control interventions employed, the use of different participants' inclusion criteria, and low methodological quality across the published studies. The risk of bias of trials identified was largely unclear in the domains of selection bias and detection bias across the included studies. This study showed substantial evidence of varied CHM interventions improving the stroke modifiable risk factors. More rigorous research examining the use of CHM products for sole or multiple major stroke risk factors are warranted.

Genetic Predisposition, Nongenetic Risk Factors, and Coronary Infarct

PubMed Central

Trichopoulou, Antonia; Yiannakouris, Nikos; Bamia, Christina; Benetou, Vassiliki; Trichopoulos, Dimitrios; Ordovas, Jose M.

2015-01-01

Background Using a genetic predisposition score (GPS), additively integrating the associations of 11 polymorphisms with coronary heart disease (CHD), we examined the consequences of the joint presence of a high GPS and nongenetic CHD risk factors. Methods Within the European Prospective Investigation Into Cancer and Nutrition, 202 case patients with medically confirmed incident coronary infarct and 197 control subjects were identified in Greece. Each polymorphism contributed 1 unit (high-risk homozygous), one-half unit (heterozygous), or no units (low-risk homozygous) to the GPS. Odds ratios of coronary infarction for those at high risk because of genetic predisposition and simultaneous presence of an established CHD risk factor were estimated, compared with subjects at low risk, for both GPS and each CHD risk factor. Results The joint presence of a high GPS (≥3.5) and each studied CHD risk factor was in all instances associated with a significantly increased risk of coronary infarction. The odds ratio (95% confidence interval) was 2.62 (1.14–6.02) for ever smoking, 2.88 (1.33–6.24) for hypertension, 3.50 (1.67–7.33) for low high-density lipoprotein (HDL) level, 3.05 (1.53–6.08) for high non-HDL level, and 3.66 (1.75–7.65) for poor adherence to the Mediterranean diet. The odds ratios were always lower and nonsignificant when the GPS was low. There was suggestive evidence for interaction of a high GPS with hypertension (P =.05) and non-HDL cholesterol level (P =.13). Conclusions Genetic predisposition may interact with hypertension and, perhaps, also with the level of non-HDL cholesterol, in the causation of CHD. Genetic predisposition and the other studied exposures seem to have converging effects. Thus, the GPS may identify individuals who could realize disproportional benefits by controlling their hypertension and, possibly, their non-HDL cholesterol level. PMID:18443266

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.

Cumulative effect of psychosocial factors in youth on ideal cardiovascular health in adulthood: the Cardiovascular Risk in Young Finns Study.

PubMed

Pulkki-Råback, Laura; Elovainio, Marko; Hakulinen, Christian; Lipsanen, Jari; Hintsanen, Mirka; Jokela, Markus; Kubzansky, Laura D; Hintsa, Taina; Serlachius, Anna; Laitinen, Tomi T; Laitinen, Tomi; Pahkala, Katja; Mikkilä, Vera; Nevalainen, Jaakko; Hutri-Kähönen, Nina; Juonala, Markus; Viikari, Jorma; Raitakari, Olli T; Keltikangas-Järvinen, Liisa

2015-01-20

The American Heart Association has defined a new metric of ideal cardiovascular health as part of its 2020 Impact Goals. We examined whether psychosocial factors in youth predict ideal cardiovascular health in adulthood. Participants were 477 men and 612 women from the nationwide Cardiovascular Risk in Young Finns Study. Psychosocial factors were measured from cohorts 3 to 18 years of age at the baseline of the study, and ideal cardiovascular health was examined 27 years later in adulthood. The summary measure of psychosocial factors in youth comprised socioeconomic factors, emotional factors, parental health behaviors, stressful events, self-regulation of the child, and social adjustment of the child. There was a positive association between a higher number of favorable psychosocial factors in youth and greater ideal cardiovascular health index in adulthood (β=0.16; P<0.001) that persisted after adjustment for age, sex, medication use, and cardiovascular risk factors in childhood (β=0.15; P<0.001). The association was monotonic, suggesting that each increment in favorable psychosocial factors was associated with improvement in cardiovascular health. Of the specific psychosocial factors, a favorable socioeconomic environment (β=0.12; P<0.001) and participants' self-regulatory behavior (β=0.07; P=0.004) were the strongest predictors of ideal cardiovascular health in adulthood. The findings suggest a dose-response association between favorable psychosocial factors in youth and cardiovascular health in adulthood, as defined by the American Heart Association metrics. The effect seems to persist throughout the range of cardiovascular health, potentially shifting the population distribution of cardiovascular health rather than simply having effects in a high-risk population. © 2015 American Heart Association, Inc.

Factors influencing HIV-risk behaviors among HIV-positive urban African Americans.

PubMed

Plowden, Keith O; Fletcher, Audwin; Miller, J Lawrence

2005-01-01

Urban African Americans are disproportionately affected by HIV, the virus associated with AIDS. Although incidence and mortality appear to be decreasing in some populations, they continue to remain steady among inner-city African Americans. A major concern is the number of HIV-positive individuals who continue to practice high-risk behaviors. Understanding factors that increase risks is essential for the development and implementation of effective prevention initiatives. Following a constructionist epistemology, this study used ethnography to explore social and cultural factors that influence high-risk behaviors among inner-city HIV-positive African Americans. Leininger's culture care diversity and universality theory guided the study. Individual qualitative interviews were conducted with HIV-positive African Americans in the community to explore social and cultural factors that increase HIV-risky behaviors. For this study, family/kinship, economic, and education factors played a significant role in risky behaviors. Reducing HIV disparity among African Americans is dependent on designing appropriate interventions that enhance protective factors. Clinicians providing care to HIV-positive individuals can play a key role in reducing transmission by recognizing and incorporating these factors when designing effective prevention interventions.

Effect of diet, life style, and other environmental/chemopreventive factors on colorectal cancer development, and assessment of the risks.

PubMed

Ahmed, Farid E

2004-01-01

This review presents a comprehensive, evenhanded evaluation of the evidence from experimental, in vitro and human studies associating environmental and therapeutic factors with risk of colorectal cancer. Life styles correlated with the greatest increase in colorectal cancer risk are the ones that typify a diet rich in fat and calories, alcohol drinking and tobacco smoking, and low intake of vegetable, fruits and fibers, referred to as a "western diet," as well as sedentary style (i.e., no- or low-exercise). This kind of life style has also been associated with other chronic diseases (other cancers, obesity, dyslipedemia, diabetes, hypertension cardiovascular, and hypertension). The evidence does not implicated red meat as a risk factor, and fiber has been shown to protect against colorectal adenomas and carcinomas. Calcium, vitamin D, folate, and some antioxidant vitamins and minerals (gamma-tocopherol and selenium) have protective effects, and daily exercise for > or =30 min results in a significant decrease in risk. Estrogen use (hormone replacement therapy) substantially reduces colorectal cancer risk in postmenopausal women. Nonsteroidal anti-inflammatory drugs (e.g., aspirin) in excessive doses is protective, especially in high risk populations, but the side effects of its use and cost incurred due to its continued intake over long periods must be carefully scrutinized before any recommendations are made for the general public.

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)

Risk and protective factors for suicidal ideation among Taiwanese adolescents.

PubMed

Wang, Ruey-Hsia; Lai, Hsiao-Jung; Hsu, Hsiu-Yueh; Hsu, Min-Tao

2011-01-01

: Suicide is the ninth leading cause of death in adolescents aged 15-19 years in Taiwan. Suicidal ideation is an important predictor of committing suicide among adolescents. : The aim of this study was to examine the important risk factors, the protective factors, and the role of protective factors on the relationship of risk factors to suicidal ideation among Taiwanese adolescents aged 15-19 years. : By adopting a cross-sectional study, senior high school students (n = 577) aged 15-19 years in southern Taiwan were recruited for this study. An anonymous self-reported questionnaire was used to collect demographic characteristics, risk factors, protective factors, and suicidal ideation of the sample. Hierarchical logistic regression was used to identify the important risk and protective factors and the interaction between risk and protective factors on suicidal ideation. : Nearly 18% (n = 101) of the participants reported having suicidal ideation during the past 12 months. Gender (female; odds ratio [OR] = 4.23), life stress (OR = 1.03), depression (OR = 3.44), peer suicidal ideation (OR = 4.15), and bullying victimization (OR = 1.81) were important risk factors of suicidal ideation among the targeted sample. In addition, self-esteem (OR = 0.92) and emotional adaptation (OR = 0.88) were important protective factors of suicidal ideation. Self-esteem and emotional adaptation were not used to moderate the negative effects of life stress, depression, perceived peer suicidal ideation, and bullying victimization on suicidal ideation. The final model explained 40.6% of the total variance in suicidal ideation and correctly predicted 86.1% of participants with suicidal ideation. : Suicidal ideation prevention programs should be targeted to female adolescents. School-based efforts that provide adolescents with self-esteem enhancement, emotional regulation skills training, positive peer norms for life, coping skills for managing stress and depression, and antibullying programs

[Clinical features of suicide occurring in schizophrenia (I). Risk-factors identification].

PubMed

Besnier, N; Gavaudan, G; Navez, A; Adida, M; Jollant, F; Courtet, P; Lançon, C

2009-04-01

Suicide is the leading cause of premature death in schizophrenia. Approximately 10 to 13% of deaths in schizophrenia are explained by suicide, despite widespread availability of generally effective antipsychotic treatments and suicide attempts have been reported among 20 to 50% of patients. This relatively low ratio of attempts/suicide is consistent with greater lethality of means - more violent - and intents - less ambivalence - in this population. Many studies have focused on risk factors and clinical characteristics for completed and/or attempted suicide. Commonly, sociodemographic risk factors for suicide are male sex, younger age and, among women, being unmarried, divorced or widowed. Previous suicidal behaviour is a strong risk factor for suicide and contrary to the common view, schizophrenic patients often communicate their suicidal intents shortly before death. Moreover, family history of suicide is associated with a heightened risk of suicide and is independent of the diagnosis, according to the growing literature that shows that vulnerability to suicidal behaviour is independent of psychiatric diagnosis. Suicide can occur throughout the entire course of schizophrenia. This is particularly true in those high-risk periods: early phase of the disease, active illness phase, period of relapse or during a depressive episode. The role of insight and positive symptoms remains unclear and probably needs further studies. Although not specifically for people with schizophrenia, hopelessness is a major risk factor and tragic loss is often presented as a trigger for suicide. It has been suggested that treatment side-effects, such as akathisia are associated with suicidal behaviour. A better knowledge of risk and protective factors is necessary to prevent suicide and suicidality.

The quality of risk factor screening during antenatal consultations in Niger.

PubMed

Prual, A; Toure, A; Huguet, D; Laurent, Y

2000-03-01

A decade after the first International Conference on Safe Motherhood, maternal mortality remains very high in most West African countries, even in capital cities. The detection of high risk pregnancies, known as the risk approach, during antenatal consultations has been the basis of most maternal and child health programmes over the last decade. The effectiveness of antenatal care as a tool to prevent or predict obstetric complications is being questioned more and more. In addition to the scarcity of reliable data about the predictivity of most risk factors, the quality of the screening must be questioned. The goal of this study was to assess the frequency of risk factors among a sample of pregnant women attending antenatal care in Niger and to assess the quality of the screening of those risk factors. Overall, 330 pregnant women were enrolled in the study. Each woman was examined twice: the first time by a midwife, the second time by one of the authors but without knowledge of the results of the first consultation. Fifty-five percent of pregnant women had at least one risk factor, 31% had more than one. Ninety-one percent of the risk factors were detected at interview. The following risk factors were not systematically searched for by midwives: height (48.5%), blood pressure (43.6%), glycosuria (40.6%), vaginal bleeding (38.2%), oedema (37.3%), parity (17%), age (16%), previous caesarean section (15.2%), previous stillbirth (15.2%) and previous miscarriages (14.8%). This study has shown that, in Niger, the quality of screening for risk factors during antenatal consultation is poor. In the urban settings where this study took place, lack of personnel, lack of equipment, lack of time and poor compliance by women cannot be made responsible for this situation. While screening of these risk factors continues as policy, the quality of screening must be dramatically improved.

[Risk factors for preterm labor].

PubMed

Rodrigues, T; Barros, H

1998-10-01

Most studies investigating preterm risk factors include medically induced preterm labor due to fetal or maternal complications and do not distinguish preterm labor from preterm premature rupture of membranes. Thus, the objective of this study was to determine the proportion of the three types of preterm birth and identify risk factors for spontaneous preterm labor in a sample of pregnant women who delivered at two level III units. From January to October 1996, we interviewed 385 women with live preterm newborns and, as controls, 357 mothers of term newborns. Preterm births were classified as preterm labor, preterm premature rupture of membranes and iathrogenic preterm. Independent associations between maternal sociodemographic, constitutional, nutritional and obstetric characteristics and preterm labor were identified using logistic regression analysis. In this sample of preterm births, 29% corresponded to preterm labor, 49% to preterm premature rupture of the membranes and 22% were iathrogenic preterm. The identified risk factors for preterm labor were multiple gestation, no paid work during pregnancy, less than six prenatal care visits, arm circumference less than 26 cm and previous preterm or low birth-weight. Gestational bleeding during the first or third trimester was significantly associated with preterm labor. As previously recognized, multiple gestation, prior preterm or low birthweight and gestational bleeding are established risk factors for preterm labor. However, prenatal care, maternal work and nutritional status have also been revealed as important issues in preterm risk, deserving special interest since they are susceptible to preventive intervention.

Stroke Epidemiology and Risk Factor Management.

PubMed

Guzik, Amy; Bushnell, Cheryl

2017-02-01

Death from stroke has decreased over the past decade, with stroke now the fifth leading cause of death in the United States. In addition, the incidence of new and recurrent stroke is declining, likely because of the increased use of specific prevention medications, such as statins and antihypertensives. Despite these positive trends in incidence and mortality, many strokes remain preventable. The major modifiable risk factors are hypertension, diabetes mellitus, tobacco smoking, and hyperlipidemia, as well as lifestyle factors, such as obesity, poor diet/nutrition, and physical inactivity. This article reviews the current recommendations for the management of each of these modifiable risk factors. It has been documented that some blood pressure medications may increase variability of blood pressure and ultimately increase the risk for stroke. Stroke prevention typically includes antiplatelet therapy (unless an indication for anticoagulation exists), so the most recent evidence supporting use of these drugs is reviewed. In addition, emerging risk factors, such as obstructive sleep apnea, electronic cigarettes, and elevated lipoprotein (a), are discussed. Overall, secondary stroke prevention includes a multifactorial approach. This article incorporates evidence from guidelines and published studies and uses an illustrative case study throughout the article to provide examples of secondary prevention management of stroke risk factors.

Risk factors for epistaxis in jump racing in Great Britain (2001-2009).

PubMed

Reardon, Richard J M; Boden, Lisa A; Mellor, Dominic J; Love, Sandy; Newton, Richard J; Stirk, Anthony J; Parkin, Timothy D

2015-07-01

The aim of this study was to evaluate risk factors associated with developing epistaxis in jump racing in Great Britain (GB). A retrospective analysis of records from horses running in all hurdle and steeplechase races in GB between 2001 and 2009 identified diagnoses of epistaxis whilst still at the racecourse. Data were used from 603 starts resulting in epistaxis (event) and 169,065 starts resulting in no epistaxis (non-event) in hurdle racing, and from 550 event starts and 102,344 non-event starts in steeplechase racing. Two multivariable logistic regression models to evaluate risk factors associated with epistaxis were produced. The potential effect of clustering of data (within horse, horse dam, horse sire, trainer, jockey, course, race and race meet) on the associations between risk factors and epistaxis was examined using mixed-effects models. Multiple factors associated with increased risk of epistaxis were identified. Those identified in both types of jump racing included running on firmer ground; horses with >75% of career starts in flat racing and a previous episode of epistaxis recorded during racing. Risk factors identified only in hurdle racing included racing in the spring and increased age at first race; and those identified only in steeplechase racing included running in a claiming race and more starts in the previous 3-6 months. The risk factors identified provide important information about the risk of developing epistaxis. Multiple avenues for further investigation are highlighted, including unmeasured variables at the level of the racecourse. The results of this study can be used to guide the development of interventions to minimise the risk of epistaxis in jump racing. Copyright © 2015. Published by Elsevier Ltd.

Health in police officers: Role of risk factor clusters and police divisions.

PubMed

Habersaat, Stephanie A; Geiger, Ashley M; Abdellaoui, Sid; Wolf, Jutta M

2015-10-01

Law enforcement is a stressful occupation associated with significant health problems. To date, most studies have focused on one specific factor or one domain of risk factors (e.g., organizational, personal). However, it is more likely that specific combinations of risk factors are differentially health relevant and further, depend on the area of police work. A self-selected group of officers from the criminal, community, and emergency division (N = 84) of a Swiss state police department answered questionnaires assessing personal and organizational risk factors as well as mental and physical health indicators. In general, few differences were observed across divisions in terms of risk factors or health indicators. Cluster analysis of all risk factors established a high-risk and a low-risk cluster with significant links to all mental health outcomes. Risk cluster-by-division interactions revealed that, in the high-risk cluster, Emergency officers reported fewer physical symptoms, while community officers reported more posttraumatic stress symptoms. Criminal officers in the high-risk cluster tended to perceived more stress. Finally, perceived stress did not mediate the relationship between risk clusters and posttraumatic stress symptoms. In summary, our results support the notion that police officers are a heterogeneous population in terms of processes linking risk factors and health indicators. This heterogeneity thereby appeared to be more dependent on personal factors and individuals' perception of their own work conditions than division-specific work environments. Our findings further suggest that stress-reduction interventions that do not target job-relevant sources of stress may only show limited effectiveness in reducing health risks associated with police work. Copyright © 2015 Elsevier Ltd. All rights reserved.

Health in police officers: Role of risk factor clusters and police divisions

PubMed Central

Habersaat, Stephanie A.; Geiger, Ashley M.; Abdellaoui, Sid; Wolf, Jutta M.

2015-01-01

Objective Law enforcement is a stressful occupation associated with significant health problems. To date, most studies have focused on one specific factor or one domain of risk factors (e.g., organizational, personal). However, it is more likely that specific combinations of risk factors are differentially health relevant and further, depend on the area of police work. Methods A self-selected group of officers from the criminal, community, and emergency division (N = 84) of a Swiss state police department answered questionnaires assessing personal and organizational risk factors as well as mental and physical health indicators. Results In general, few differences were observed across divisions in terms of risk factors or health indicators. Cluster analysis of all risk factors established a high-risk and a low-risk cluster with significant links to all mental health outcomes. Risk cluster-by-division interactions revealed that, in the high-risk cluster, Emergency officers reported fewer physical symptoms, while community officers reported more posttraumatic stress symptoms. Criminal officers in the high-risk cluster tended to perceived more stress. Finally, perceived stress did not mediate the relationship between risk clusters and posttraumatic stress symptoms. Conclusion In summary, our results support the notion that police officers are a heterogeneous population in terms of processes linking risk factors and health indicators. This heterogeneity thereby appeared to be more dependent on personal factors and individuals' perception of their own work conditions than division-specific work environments. Our findings further suggest that stress-reduction interventions that do not target job-relevant sources of stress may only show limited effectiveness in reducing health risks associated with police work. PMID:26364008

Plasma methionine and risk of acute myocardial infarction: Effect modification by established risk factors.

PubMed

Dhar, Indu; Lysne, Vegard; Seifert, Reinhard; Svingen, Gard F T; Ueland, Per M; Nygård, Ottar K

2018-05-01

Methionine (Met) is an essential amino acid involved in methylation reactions and lipid metabolism. A Met-deficient diet may cause hepatic lipid accumulation, which is considered an independent risk factor for atherosclerosis. However, the prospective relationship between circulating Met and incident acute myocardial infarction (AMI) is unknown. We studied the associations of plasma Met and incident AMI in 4156 patients (77% men; median age 62 years) with stable angina pectoris, among whom the majority received lipid lowering therapy with statins. Risk associations were estimated using Cox-regression analyses. Plasma Met was negatively related to age, serum levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C) and apolipoprotein (apo) B at baseline (all p≤0.05). During a median follow-up of 7.5 years, 534 (12.8%) patients experienced an AMI. There was no overall association between plasma Met and incident AMI; however, plasma Met was inversely associated with risk among patients with high as compared to low levels of serum LDL-C or apo B 100 (multivariate adjusted HRs per SD [95% CI] 0.84 [0.73-0.96] and 0.83[0.73-0.95], respectively; p-interaction ≤0.02). Trends towards an inverse risk relationship were also observed among those younger than 62 years and patients without diabetes or hypertension. Low plasma Met was associated with increased risk of AMI in patients with high circulating levels of atherogenic lipids, but also in subgroups with presumably lower cardiovascular risk. The determinants of Met status and their relation with residual cardiovascular risk in patients with coronary heart disease should be further investigated. Copyright © 2018 Elsevier B.V. All rights reserved.

Risk factor management in a contemporary Australian population at increased cardiovascular disease risk.

PubMed

Campbell, D J; Coller, J M; Gong, F F; McGrady, M; Prior, D L; Boffa, U; Shiel, L; Liew, D; Wolfe, R; Owen, A J; Krum, H; Reid, C M

2017-11-14

Effective management of cardiovascular and chronic kidney disease risk factors offers longer, healthier lives and savings in health care. We examined risk factor management in participants of the SCReening Evaluation of the Evolution of New Heart Failure (SCREEN-HF) study, a self-selected population at increased cardiovascular disease risk recruited from members of a health insurance fund in Melbourne and Shepparton, Australia. Inclusion criteria were age ≥60 years with one or more of self-reported ischaemic or other heart disease, irregular or rapid heart rhythm, cerebrovascular disease, renal impairment, or treatment for hypertension or diabetes for ≥2 years. Exclusion criteria were known heart failure or cardiac abnormality on echocardiography or other imaging. Medical history, clinical examination, full blood examination and biochemistry (without lipids and HbA1c) were performed for 3847 participants on enrolment, and blood pressure, lipids and HbA1c were measured 1-2 years after enrolment for 3202 participants. Despite 99% of 3294 participants with hypertension receiving antihypertensive medication, half had blood pressures >140/90 mmHg. Approximately 77% of participants were overweight or obese, with one third obese. Additionally, 74% of participants at high cardiovascular disease risk had low density lipoprotein cholesterol levels ≥2 mmol/l, one third of diabetic participants had HbA1c >7%, 22% had estimated glomerular filtration rate <60 ml/min/1.73m 2 , and substantial proportions had under-utilisation of antiplatelet therapy, anticoagulation for atrial fibrillation, and were physically inactive. This population demonstrated substantial potential to reduce cardiovascular and renal morbidity and mortality and health care costs through more effective management of modifiable risk factors. This article is protected by copyright. All rights reserved.

A risk-factor analysis of medical litigation judgments related to fall injuries in Korea.

PubMed

Kim, Insook; Won, Seonae; Lee, Mijin; Lee, Won

2018-01-01

The aim of this study was to find out the risk factors through analysis of seven medical malpractice judgments related to fall injuries. The risk factors were analysed by using the framework that approaches falls from a systems perspective and comprised people, organisational or environmental factors, with each factor being comprised of subfactors. The risk factors found in each of the seven judgments were aggregated into one framework. The risk factors related to patients (i.e. the people factor) were age, pain, related disease, activities and functional status, urination state, cognitive function impairment, past history of fall, blood transfusion, sleep endoscopy state and uncooperative attitude. The risk factors related to the medical staff and caregivers (i.e. people factor) were observation negligence, no fall prevention activities and negligence in managing high-risk group for fall. Organisational risk factors were a lack of workforce, a lack of training, neglecting the management of the high-risk group, neglecting the management of caregivers and the absence of a fall prevention procedure. Regarding the environment, the risk factors were found to be the emergency room, chairs without a backrest and the examination table. Identifying risk factors is essential for preventing fall accidents, since falls are preventable patient-safety incidents. Falls do not happen as a result of a single risk factor. Therefore, a systems approach is effective to identify risk factors, especially organisational and environmental factors.

Representing and Retrieving Patients' Falls Risk Factors and Risk for Falls among Adults in Acute Care through the Electronic Health Record

ERIC Educational Resources Information Center

Pfaff, Jann

2013-01-01

Defining fall risk factors and predicting fall risk status among patients in acute care has been a topic of research for decades. With increasing pressure on hospitals to provide quality care and prevent hospital-acquired conditions, the search for effective fall prevention interventions continues. Hundreds of risk factors for falls in acute care…

[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.

Environmental risk factors for dementia: a systematic review.

PubMed

Killin, Lewis O J; Starr, John M; Shiue, Ivy J; Russ, Tom C

2016-10-12

Dementia risk reduction is a major and growing public health priority. While certain modifiable risk factors for dementia have been identified, there remains a substantial proportion of unexplained risk. There is evidence that environmental risk factors may explain some of this risk. Thus, we present the first comprehensive systematic review of environmental risk factors for dementia. We searched the PubMed and Web of Science databases from their inception to January 2016, bibliographies of review articles, and articles related to publically available environmental data. Articles were included if they examined the association between an environmental risk factor and dementia. Studies with another outcome (for example, cognition), a physiological measure of the exposure, case studies, animal studies, and studies of nutrition were excluded. Data were extracted from individual studies which were, in turn, appraised for methodological quality. The strength and consistency of the overall evidence for each risk factor identified was assessed. We screened 4784 studies and included 60 in the review. Risk factors were considered in six categories: air quality, toxic heavy metals, other metals, other trace elements, occupational-related exposures, and miscellaneous environmental factors. Few studies took a life course approach. There is at least moderate evidence implicating the following risk factors: air pollution; aluminium; silicon; selenium; pesticides; vitamin D deficiency; and electric and magnetic fields. Studies varied widely in size and quality and therefore we must be circumspect in our conclusions. Nevertheless, this extensive review suggests that future research could focus on a short list of environmental risk factors for dementia. Furthermore, further robust, longitudinal studies with repeated measures of environmental exposures are required to confirm these associations.

[Periodontal treatment for cardiovascular risk factors: a systematic review].

PubMed

Deng, Linkai; Li, Chunjie; Li, Qian; Zhang, Yukui; Zhao, Hongwei

2013-10-01

To evaluate the efficacy of periodontal treatment for the management of cardiovascular risk factors. Eligible studies in Cochrane Controlled Trials Register/CENTRAL, PubMed, EMBASE, and China Biology Medicine disc (CBMdisc) were searched until October 13, 2011. References of the included studies were hand searched. Two reviewers assessed the risk of bias and extracted the data of the included studies in duplicate. Meta-analysis was conducted with Revman 5.1. Six randomized controlled trials involving 682 participants were included. One case had low risk of bias, another one had moderate risk of bias, and the remaining four had high risk of bias. Meta-analysis showed that periodontal treatment has no significant effect on C-reactive protein, total cholesterol, low-density lipoprotein cholesterol, and triglycerides (P > 0.05). However, the treatment had a significant effect on high-density lipoprotein cholesterol [MD = 0.05, 95% CI (0.00, 0.09), P = 0.04]. Periodontal treatment has good effects on controlling high-density lipoprotein cholesterol although more randomized controlled trials must be conducted to verify its effectiveness.

Critical Success Factors for an Effective Security Risk Management Program in an Organization: An Exploratory Case Study

ERIC Educational Resources Information Center

Zafar, Humayun

2010-01-01

This study investigates differences in perception between layers of management (executive, middle, and lower) and staff with regard to the influence of critical success factors (CSFs) on security risk management (SRM) effectiveness. This is an in-depth case study conducted at a Fortune 500 company. Rockart's (1979) CSF method is modified through…

Community-Level Effects of Individual and Peer Risk and Protective Factors on Adolescent Substance Use

ERIC Educational Resources Information Center

Monahan, Kathryn; Egan, Elizabeth A.; Van Horn, M. Lee; Arthur, Michael; Hawkins, David

2011-01-01

The association between community-aggregated levels of individual and peer risk and protective factors and prevalence of adolescent substance use was examined in repeated cross-sectional data among youth in 41 communities ranging in population from 1,578 to 106,221. The association between community levels of these risk and protective factors in…

[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.

Co-occurring risk factors for current cigarette smoking in a U.S. nationally representative sample

PubMed Central

Higgins, Stephen T.; Kurti, Allison N.; Redner, Ryan; White, Thomas J.; Keith, Diana R.; Gaalema, Diann E.; Sprague, Brian L.; Stanton, Cassandra A.; Roberts, Megan E.; Doogan, Nathan J.; Priest, Jeff S.

2016-01-01

Introduction Relatively little has been reported characterizing cumulative risk associated with co-occurring risk factors for cigarette smoking. The purpose of the present study was to address that knowledge gap in a U.S. nationally representative sample. Methods Data were obtained from 114,426 adults (≥ 18 years) in the U.S. National Survey on Drug Use and Health (years 2011–13). Multiple logistic regression and classification and regression tree (CART) modeling were used to examine risk of current smoking associated with eight co-occurring risk factors (age, gender, race/ethnicity, educational attainment, poverty, drug abuse/dependence, alcohol abuse/dependence, mental illness). Results Each of these eight risk factors was independently associated with significant increases in the odds of smoking when concurrently present in a multiple logistic regression model. Effects of risk-factor combinations were typically summative. Exceptions to that pattern were in the direction of less-than-summative effects when one of the combined risk factors was associated with generally high or low rates of smoking (e.g., drug abuse/dependence, age ≥65). CART modeling identified subpopulation risk profiles wherein smoking prevalence varied from a low of 11% to a high of 74% depending on particular risk factor combinations. Being a college graduate was the strongest independent predictor of smoking status, classifying 30% of the adult population. Conclusions These results offer strong evidence that the effects associated with common risk factors for cigarette smoking are independent, cumulative, and generally summative. The results also offer potentially useful insights into national population risk profiles around which U.S. tobacco policies can be developed or refined. PMID:26902875

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

Nutrient-dense, Plant-rich Dietary Intervention Effective at Reducing Cardiovascular Disease Risk Factors for Worksites: A Pilot Study.

PubMed

Sutliffe, Jay Thomas; Fuhrman, Joel Harvey; Carnot, Mary Jo; Beetham, Raena Marie; Peddy, Madison Sarah

2016-09-01

conduct interventions for health promotion and disease prevention to ameliorate chronic risk factors for disease, such as for cardiovascular disease (CVD). Likewise, nutrient-dense, plant-rich (NDPR) dietary patterns have been shown to be effective at preventing and improving chronic-disease conditions, including CVD. Objective • The study's aim was to determine the feasibility and effectiveness of an NDPR dietary intervention for worksites to lower CVD risk factors. Design • The study was a 6-wk pilot intervention using a pretest and posttest design. The intervention was conducted at the Northern Arizona University (Flagstaff, AZ, USA) and sponsored by its Employee Assistance and Wellness Department. Participants • Participants were 35 employees with body mass indexes (BMIs) >25 kg/m2 who were ready and willing to make a lifestyle change, who were not currently participating in a weight loss program, and who were not taking any medications that could increase medical risk or had weight loss as a primary side effect. The average age of participants was 42.57 y; 91.4% were female, and 80% were Caucasian. Intervention • The intervention used a dietary protocol consisting of the daily consumption of greens, beans, legumes, and a variety of other vegetables, as well as fresh or frozen whole fruits, nuts, seeds, and whole grains. Participants were encouraged to minimize the consumption of refined grains, vegetable oils, processed foods, and animal products. Outcome Measures • The study measured serum lipids, height, weight, waist and hip circumference, waist-to-hip ratio, and blood pressure. Results • Based on paired-sample t tests and Wilcoxon signed-ranks test with a maximum level of P = .05, the intervention resulted in significant changes in weight, BMI, waist and hip measurements, high-density lipoproteins, low-density lipoproteins, and estimated average glucose. Conclusions • The findings favorably revealed that an NDPR dietary intervention that was

Fatty acids linked to cardiovascular mortality are associated with risk factors

PubMed Central

Ebbesson, Sven O. E.; Voruganti, Venkata S.; Higgins, Paul B.; Fabsitz, Richard R.; Ebbesson, Lars O.; Laston, Sandra; Harris, William S.; Kennish, John; Umans, Benjamin D.; Wang, Hong; Devereux, Richard B.; Okin, Peter M.; Weissman, Neil J.; MacCluer, Jean W.; Umans, Jason G.; Howard, Barbara V.

2015-01-01

Background Although saturated fatty acids (FAs) have been linked to cardiovascular mortality, it is not clear whether this outcome is attributable solely to their effects on low-density lipoprotein cholesterol (LDL-C) or whether other risk factors are also associated with FAs. The Western Alaskan Native population, with its rapidly changing lifestyles, shift in diet from unsaturated to saturated fatty acids and dramatic increase in cardiovascular disease (CVD), presents an opportunity to elucidate any associations between specific FAs and known CVD risk factors. Objective We tested the hypothesis that the specific FAs previously identified as related to CVD mortality are also associated with individual CVD risk factors. Methods In this community-based, cross-sectional study, relative proportions of FAs in plasma and red blood cell membranes were compared with CVD risk factors in a sample of 758 men and women aged ≥35 years. Linear regression analyses were used to analyze relations between specific FAs and CVD risk factors (LDL-C, high-density lipoprotein cholesterol, triglycerides, C-reactive protein, systolic blood pressure, diastolic blood pressure, heart rate, body mass index, fasting glucose and fasting insulin, 2-hour glucose and 2-hour insulin). Results The specific saturated FAs previously identified as related to CVD mortality, the palmitic and myristic acids, were adversely associated with most CVD risk factors, whereas unsaturated linoleic acid (18:2n-6) and the marine n-3 FAs were not associated or were beneficially associated with CVD risk factors. Conclusions The results suggest that CVD risk factors are more extensively affected by individual FAs than hitherto recognized, and that risk for CVD, MI and stroke can be reduced by reducing the intake of palmitate, myristic acid and simple carbohydrates and improved by greater intake of linoleic acid and marine n-3 FAs. PMID:26274054

EFFECT OF CHIA SEED (SALVIA HISPANICA L.) CONSUMPTION ON CARDIOVASCULAR RISK FACTORS IN HUMANS: A SYSTEMATIC REVIEW.

PubMed

de Souza Ferreira, Cynthia; dd Sousa Fomes, Lucilia de Fátima; da Silva, Gilze Espirito Santo; Rosa, Glorimar

2015-11-01

chia is a seed rich in such nutrients as proteins, n-3 fatty acids and especially alpha-linolenic acid (ALA), minerals, fibers and antioxidants. Efforts have been made to assess whether human consumption of chia can reduce cardiovascular risk factors; however, it has not been established as effective and the findings of the few studies to have looked into the matter are inconsistent. to systematize the findings of studies assessing the effect the consumption of chia seed, either milled or whole, has in the prevention/control of cardiovascular risk factors in humans. this is a systematic literature review (SLR) with no meta-analysis. The articles scrutinizedwere identified in the electronic databases Lilacs, Medline (Pub- Med version), Cochrane, Scielo, Scopus, and Web of Science under the keywords"dyslipidemia" or "dislipidemia", "hyperlipidemia" or "hiperlipidemia", "obesity" or "obesidade", "salvia"or"salviahispanica", "Lamiaceae" or "chia", "hypertension" or "hipertensão", "hypertrygliceridemia" or "hipertrigliceridemia", and "riscocardiovascular" or "cardiovascularrisk." We chose for our selection English-, Portuguese- or Spanish-language articles about clinical trials on humans and published within the last ten years. The biases of risk analysis were carried out considering 6 of the 8 criteria of the Cochrane Handbook for Systematic Reviews of Interventions Version 5.1. seven studies (n = 200) fit our inclusion criteria. Of the chosen clinical trials, only one was not randomized. Five of the studies were blind experiments. Two of the studies were acute trials, both of them randomized. Of the chia seed interventions, one study showed a significant drop in systolic blood pressure (SBP) and inflammatory markers, yet there was no change in body mass, lipid profile or blood sugar. In four of the studies reviewed there was a significant spike in ALA and eicosapentaenoic acid (EPA), with no significant change to other parameters. In the acute trials, post

Personality Correlates of Midlife Cardiometabolic Risk: The Explanatory Role of Higher-Order Factors of the Five Factor Model

PubMed Central

Dermody, Sarah S.; Wright, Aidan G.C.; Cheong, JeeWon; Miller, Karissa G.; Muldoon, Matthew F.; Flory, Janine D.; Gianaros, Peter J.; Marsland, Anna L.; Manuck, Stephen B.

2015-01-01

Objective Varying associations are reported between Five Factor Model (FFM) personality traits and cardiovascular diseaabolic risk within a hierarchical model of personality that posits higherse risk. Here, we further examine dispositional correlates of cardiomet -order traits of Stability (shared variance of Agreeableness, Conscientiousness, inverse Neuroticism) and Plasticity (Extraversion, Openness), and test hypothesized mediation via biological and behavioral factors. Method In an observational study of 856 community volunteers aged 30–54 years (46% male, 86% Caucasian), latent variable FFM traits (using multiple-informant reports) and aggregated cardiometabolic risk (indicators: insulin resistance, dyslipidemia, blood pressure, adiposity) were estimated using confirmatory factor analysis (CFA). The cardiometabolic factor was regressed on each personality factor or higher-order trait. Cross-sectional indirect effects via systemic inflammation, cardiac autonomic control, and physical activity were tested. Results CFA models confirmed the Stability “meta-trait,” but not Plasticity. Lower Stability was associated with heightened cardiometabolic risk. This association was accounted for by inflammation, autonomic function, and physical activity. Among FFM traits, only Openness was associated with risk over and above Stability and, unlike Stablity, this relationship was unexplained by the intervening variables. Conclusions A Stability meta-trait covaries with midlife cardiometabolic risk, and this association is accounted for by three candidate biological and behavioral factors. PMID:26249259

Risk factors for interpersonal conflicts at work.

PubMed

De Raeve, Lore; Jansen, Nicole Wh; van den Brandt, Piet A; Vasse, Rineke M; Kant, Ijmert

2008-04-01

The main goal of this study was to identify work-related risk factors for the onset of interpersonal conflicts at work. Longitudinal data from the Maastricht Cohort Study on "fatigue at work" (N=9241) were used. After the respondents who reported an interpersonal conflict at baseline were excluded, logistic regression analyses were used to determine the role of several work-related risk factors at baseline in the onset of a conflict with coworkers or supervisors after 1 year of follow-up. Higher psychological job demands, higher levels of role ambiguity, the presence of physical demands, higher musculoskeletal demands, a poorer physical work environment, shift work, overtime, and higher levels of job insecurity significantly predicted the onset of both a coworker conflict and a supervisor conflict. Higher levels of coworker and supervisor social support, more autonomy concerning the terms of employment, good overall job satisfaction, monetary gratification, and esteem reward significantly protected against the onset of both a coworker conflict and a supervisor conflict. Higher levels of decision latitude and more career opportunities also significantly protected against the onset of a supervisor conflict. Several factors in the work environment were related to the onset of interpersonal conflicts at work. Given the rather serious consequences of interpersonal conflicts at work with respect to health and well-being, the observed risk factors can serve as a starting point for effective prevention and intervention strategies in the workplace.

Dispelling urban myths about default uncertainty factors in chemical risk assessment--sufficient protection against mixture effects?

PubMed

Martin, Olwenn V; Martin, Scholze; Kortenkamp, Andreas

2013-07-01

Assessing the detrimental health effects of chemicals requires the extrapolation of experimental data in animals to human populations. This is achieved by applying a default uncertainty factor of 100 to doses not found to be associated with observable effects in laboratory animals. It is commonly assumed that the toxicokinetic and toxicodynamic sub-components of this default uncertainty factor represent worst-case scenarios and that the multiplication of those components yields conservative estimates of safe levels for humans. It is sometimes claimed that this conservatism also offers adequate protection from mixture effects. By analysing the evolution of uncertainty factors from a historical perspective, we expose that the default factor and its sub-components are intended to represent adequate rather than worst-case scenarios. The intention of using assessment factors for mixture effects was abandoned thirty years ago. It is also often ignored that the conservatism (or otherwise) of uncertainty factors can only be considered in relation to a defined level of protection. A protection equivalent to an effect magnitude of 0.001-0.0001% over background incidence is generally considered acceptable. However, it is impossible to say whether this level of protection is in fact realised with the tolerable doses that are derived by employing uncertainty factors. Accordingly, it is difficult to assess whether uncertainty factors overestimate or underestimate the sensitivity differences in human populations. It is also often not appreciated that the outcome of probabilistic approaches to the multiplication of sub-factors is dependent on the choice of probability distributions. Therefore, the idea that default uncertainty factors are overly conservative worst-case scenarios which can account both for the lack of statistical power in animal experiments and protect against potential mixture effects is ill-founded. We contend that precautionary regulation should provide an

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

Effects of endurance, circuit, and relaxing training on cardiovascular risk factors in hypertensive elderly patients.

PubMed

Venturelli, Massimo; Cè, Emiliano; Limonta, Eloisa; Schena, Federico; Caimi, Barbara; Carugo, Stefano; Veicsteinas, Arsenio; Esposito, Fabio

2015-10-01

Recommendations for prevention of cardiovascular diseases (CVDs) risk factors among older adults highlighted the importance of exercise-based interventions, including endurance training (ET). However, the evidence of efficacy of other interventions based on short-bouts of exercise (circuit training, CT), and the practice of breath-control and meditation (relaxing training, RT) is growing. The aim of this study was to elucidate if CT or RT are equally effective in CVD risk factors reduction compared to ET. To this purpose, in 40 elderly participants, with clinically diagnosed grade 1 hypertension, resting blood pressure, blood glucose, and cholesterol levels, peak oxygen uptake ([Formula: see text]), mechanical efficiency and quality of life were evaluated before and after 12 weeks of ET, CT, and RT treatments. Resting blood pressure reduced significantly in all groups by ∼11 %. In ET, blood cholesterol levels (-18 %), [Formula: see text] (+8 %), mechanical efficiency (+9 %), and quality of life scores (+36 %) ameliorated. In CT blood glucose levels (-11 %), [Formula: see text] (+7 %) and quality of life scores (+35 %) were bettered. Conversely, in RT, the lower blood pressure went along only with an improvement in the mental component of quality of life (+42 %). ET and CT were both appropriate interventions to reduce CVDs risk factors, because blood pressure reduction was accompanied by decreases in blood glucose and cholesterol levels, increases in [Formula: see text], mechanical efficiency, and quality of life. Although RT influenced only blood pressure and quality of life, this approach would be an attractive alternative for old individuals unable or reluctant to carry out ET or CT.

Managing Lunar and Mars Mission Radiation Risks. Part 1; Cancer Risks, Uncertainties, and Shielding Effectiveness

NASA Technical Reports Server (NTRS)

Cucinotta, Francis A.; Kim, Myung-Hee Y.; Ren, Lei

2005-01-01

This document addresses calculations of probability distribution functions (PDFs) representing uncertainties in projecting fatal cancer risk from galactic cosmic rays (GCR) and solar particle events (SPEs). PDFs are used to test the effectiveness of potential radiation shielding approaches. Monte-Carlo techniques are used to propagate uncertainties in risk coefficients determined from epidemiology data, dose and dose-rate reduction factors, quality factors, and physics models of radiation environments. Competing mortality risks and functional correlations in radiation quality factor uncertainties are treated in the calculations. The cancer risk uncertainty is about four-fold for lunar and Mars mission risk projections. For short-stay lunar missins (<180 d), SPEs present the most significant risk, but one effectively mitigated by shielding. For long-duration (>180 d) lunar or Mars missions, GCR risks may exceed radiation risk limits. While shielding materials are marginally effective in reducing GCR cancer risks because of the penetrating nature of GCR and secondary radiation produced in tissue by relativisitc particles, polyethylene or carbon composite shielding cannot be shown to significantly reduce risk compared to aluminum shielding. Therefore, improving our knowledge of space radiobiology to narrow uncertainties that lead to wide PDFs is the best approach to ensure radiation protection goals are met for space exploration.

Common risk factors for postoperative pain following the extraction of wisdom teeth

PubMed Central

2015-01-01

The extraction of third molars is a common task carried out at dental/surgery clinics. Postoperative pain is one of the two most common complications of this surgery, along with dry socket. Knowledge of the frequent risk factors of this complication is useful in determining high-risk patients, planning treatment, and preparing the patients mentally. Since the risk factors for postoperative pain have never been summarized before while the risk factors for dry socket have been highly debated, this report summarizes the literature regarding the common predictors of postextraction pain. Except for surgical difficulty and the surgeon's experience, the influences of other risk factors (age, gender and oral contraceptive use) were rather inconclusive. The case of a female gender or oral contraceptive effect might mainly be associated with estrogen levels (when it comes to dry socket), which can differ considerably from case to case. Improvement in and unification of statistical and diagnostic methods seem necessary. In addition, each risk factor was actually a combination of various independent variables, which should instead be targeted in more comprehensive studies. PMID:25922816

Syndromes, disorders and maternal risk factors associated with neural tube defects (VII).

PubMed

Chen, Chih-Ping

2008-09-01

Neural tube defects (NTDs) may be associated with syndromes, disorders and maternal risk factors. This article provides a comprehensive review of the syndromes, disorders and maternal risk factors associated with NTDs, including DK phocomelia syndrome (von Voss-Cherstvoy syndrome), Siegel-Bartlet syndrome, fetal warfarin syndrome, craniotelencephalic dysplasia, Czeizel-Losonci syndrome, maternal cocaine abuse, Weissenbacher- Zweymller syndrome, parietal foramina (cranium bifidum), Apert syndrome, craniomicromelic syndrome, XXagonadism with multiple dysraphic lesions including omphalocele and NTDs, Fryns microphthalmia syndrome, Gershoni-Baruch syndrome, PHAVER syndrome, periconceptional vitamin B6 deficiency, and autosomal dominant Dandy-Walker malformation with occipital cephalocele. NTDs associated with these syndromes, disorders and maternal risk factors are a rare but important cause of NTDs. The recurrence risk and the preventive effect of maternal folic acid intake in NTDs associated with syndromes, disorders and maternal risk factors may be different from those of nonsyndromic multifactorial NTDs. Perinatal diagnosis of NTDs should alert doctors to the syndromes, disorders and maternal risk factors associated with NTDs, and prompt thorough etiologic investigation and genetic counseling.

Occupational and genetic risk factors associated with intervertebral disc disease.

PubMed

Virtanen, Iita M; Karppinen, Jaro; Taimela, Simo; Ott, Jürg; Barral, Sandra; Kaikkonen, Kaisu; Heikkilä, Olli; Mutanen, Pertti; Noponen, Noora; Männikkö, Minna; Tervonen, Osmo; Natri, Antero; Ala-Kokko, Leena

2007-05-01

Cross-sectional epidemiologic study. To evaluate the interaction between known genetic risk factors and whole-body vibration for symptomatic intervertebral disc disease (IDD) in an occupational sample. Risk factors of IDD include, among others, whole-body vibration and heredity. In this study, the importance of a set of known genetic risk factors and whole-body vibration was evaluated in an occupational sample of train engineers and sedentary controls. Eleven variations in 8 genes (COL9A2, COL9A3, COL11A2, IL1A, IL1B, IL6, MMP-3, and VDR) were genotyped in 150 male train engineers with an average of 21-year exposure to whole-body vibration and 61 male paper mill workers with no exposure to vibration. Subjects were classified into IDD-phenotype and asymptomatic groups, based on the latent class analysis. The number of individuals belonging to the IDD-phenotype was significantly higher among train engineers (42% of train engineers vs. 17.5% of sedentary workers; P = 0.005). IL1A -889T allele represented a significant risk factor for the IDD-phenotype both in the single marker allelic association test (P = 0.043) and in the logistic regression analysis (P = 0.01). None of the other allele markers was significantly associated with symptoms when analyzed independently. However, for all the SNP markers considered, whole-body vibration represents a nominally significant risk factor. The results suggest that whole-body vibration is a risk factor for symptomatic IDD. Moreover, whole-body vibration had an additive effect with genetic risk factors increasing the likelihood of belonging to the IDD-phenotype group. Of the independent genetic markers, IL1A -889T allele had strongest association with IDD-phenotype.

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…

Environmental risk factors and male fertility and reproduction.

PubMed

Petrelli, Grazia; Mantovani, Alberto

2002-04-01

Several environmental substances and pesticides exert a direct, cytotoxic effect on male germ cells. However, an increasing concern has been raised by compounds that may act through more subtle mechanisms, for example, specific pesticides that are potentially capable of modulating or disrupting the endocrine system. Overall, exposure to pesticides with endocrine-disrupting potential raise a particular concern for male fertility because of the possible occurrence of both effects at low concentrations and additive interactions with other environmental risk factors. Delayed reproductive problems deserve special attention, since experimental data consistently indicate a high vulnerability in the developing male reproductive system. Epidemiologic studies have confirmed an increased risk of conception delay associated with occupational exposure to pesticides. Moreover, an increased risk of spontaneous abortion has been noted among wives of exposed workers.

Risk Factors for Drug-Resistant Cap in Immunocompetent Patients.

PubMed

Arancibia, Francisco; Ruiz, Mauricio

2017-03-01

The increase in drug-resistant community-acquired pneumonia (CAP) is an important problem all over the world. This article explores the current state of antimicrobial resistance of different bacteria that cause CAP and also assesses risk factors to identify those pathogens. In the last two decades, it has been documented that there is a significant increase in drug-resistant Streptococcus pneumoniae and other bacteria causing CAP. The most important risk factors are overuse of antibiotics, prior hospitalization, and lung comorbidities. The direct consequences can be severe, including prolonged stays in hospital, increased costs, and morbi-mortality. However, drug-resistant CAP declined after the introduction of the pneumococcal conjugate vaccine. This review found an increase in resistance to the antibiotics used in CAP, and the risk factor can be used for identifying patients with drug-resistant CAP and initiate appropriate treatment. Judicious use of antibiotics and the development of effective new vaccines are needed.

Newborn hearing screening programme in Belgium: a consensus recommendation on risk factors.

PubMed

Vos, Bénédicte; Senterre, Christelle; Lagasse, Raphaël; Levêque, Alain

2015-10-16

Understanding the risk factors for hearing loss is essential for designing the Belgian newborn hearing screening programme. Accordingly, they needed to be updated in accordance with current scientific knowledge. This study aimed to update the recommendations for the clinical management and follow-up of newborns with neonatal risk factors of hearing loss for the newborn screening programme in Belgium. A literature review was performed, and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system assessment method was used to determine the level of evidence quality and strength of the recommendation for each risk factor. The state of scientific knowledge, levels of evidence quality, and graded recommendations were subsequently assessed using a three-round Delphi consensus process (two online questionnaires and one face-to-face meeting). Congenital infections (i.e., cytomegalovirus, toxoplasmosis, and syphilis), a family history of hearing loss, consanguinity in (grand)parents, malformation syndromes, and foetal alcohol syndrome presented a 'high' level of evidence quality as neonatal risk factors for hearing loss. Because of the sensitivity of auditory function to bilirubin toxicity, hyperbilirubinaemia was assessed at a 'moderate' level of evidence quality. In contrast, a very low birth weight, low Apgar score, and hospitalisation in the neonatal intensive care unit ranged from 'very low' to 'low' levels, and ototoxic drugs were evidenced as 'very low'. Possible explanations for these 'very low' and 'low' levels include the improved management of these health conditions or treatments, and methodological weaknesses such as confounding effects, which make it difficult to conclude on individual risk factors. In the recommendation statements, the experts emphasised avoiding unidentified neonatal hearing loss and opted to include risk factors for hearing loss even in cases with weak evidence. The panel also highlighted the cumulative effect

Social factors matter in cancer risk and survivorship.

PubMed

Dean, Lorraine T; Gehlert, Sarah; Neuhouser, Marian L; Oh, April; Zanetti, Krista; Goodman, Melody; Thompson, Beti; Visvanathan, Kala; Schmitz, Kathryn H

2018-07-01

Greater attention to social factors, such as race/ethnicity, socioeconomic position, and others, are needed across the cancer continuum, including breast cancer, given differences in tumor biology and genetic variants have not completely explained the persistent Black/White breast cancer mortality disparity. In this commentary, we use examples in breast cancer risk assessment and survivorship to demonstrate how the failure to appropriately incorporate social factors into the design, recruitment, and analysis of research studies has resulted in missed opportunities to reduce persistent cancer disparities. The conclusion offers recommendations for how to better document and use information on social factors in cancer research and care by (1) increasing education and awareness about the importance of inclusion of social factors in clinical research; (2) improving testing and documentation of social factors by incorporating them into journal guidelines and reporting stratified results; and (3) including social factors to refine extant tools that assess cancer risk and assign cancer care. Implementing the recommended changes would enable more effective design and implementation of interventions and work toward eliminating cancer disparities by accounting for the social and environmental contexts in which cancer patients live and are treated.

Risk factors for osteoarthritis and contributing factors to current arthritic pain in South Korean older adults.

PubMed

Lee, Kyoung Min; Chung, Chin Youb; Sung, Ki Hyuk; Lee, Seung Yeol; Won, Sung Hun; Kim, Tae Gyun; Choi, Young; Kwon, Soon Sun; Kim, Yeon Ho; Park, Moon Seok

2015-01-01

Although previous studies have focused on risk factors for osteoarthritis, there is some debate on this issue. Furthermore, associated factors with arthritic symptom (arthralgia) have not been sufficiently investigated, despite its clinical importance in the management of osteoarthritis. This study was performed to examine the risk factors for osteoarthritis and the contributing factors to current arthritic pain in older adults. The Fourth Korean National Health and Nutrition Examination Surveys was conducted in 2009. Therein, 720 males and 1008 females aged 65 years and older were included. Comprehensive data on habitual, socioeconomic, medical, nutritional, and psychological factors were collected along with the presence of osteoarthritis and arthritic pain. After univariate analysis, binary logistic regression analysis was performed to identify risk factors for osteoarthritis and contributing factors to current arthritic pain. Age (p=0.005), female gender (p<0.001), higher body mass index (BMI) (p<0.001), and osteoporosis (p<0.001) were significant risk factors for osteoarthritis, while higher education level (p=0.025) was a protective factor for osteoarthritis. Higher BMI (p=0.047), lack of weekly moderate intensity activity (p<0.001), and unfavorable subjective health status (p<0.001) were significant factors contributing to current arthritic pain among subjects with osteoarthritis. Both osteoarthritis and current arthritic pain adversely affected health related quality of life. Higher BMI, lack of weekly moderate intensity activity, and unfavorable subjective health status were significant factors contributing to current arthritic pain. More attention needs to be paid to psychiatric effects on osteoarthritis and joint related pain.

Gambling Risk Groups are Not All the Same: Risk Factors Amongst Sports Bettors.

PubMed

Russell, Alex M T; Hing, Nerilee; Li, En; Vitartas, Peter

2018-03-20

Sports betting is increasing worldwide, with an associated increase in sports betting-related problems. Previous studies have examined risk factors for problem gambling amongst sports bettors and have identified demographic, behavioural, marketing, normative and impulsiveness factors. These studies have generally compared those in problem gambling, or a combination of moderate risk and problem gambling, groups to non-problem gamblers, often due to statistical power issues. However, recent evidence suggests that, at a population level, the bulk of gambling-related harm stems from low risk and moderate risk gamblers, rather than problem gamblers. Thus it is essential to understand the risk factors for each level of gambling-related problems (low risk, moderate risk, problem) separately. The present study used a large sample (N = 1813) to compare each gambling risk group to non-problem gamblers, first using bivariate and then multivariate statistical techniques. A range of demographic, behavioural, marketing, normative and impulsiveness variables were included as possible risk factors. The results indicated that some variables, such as gambling expenditure, number of accounts with different operators, number of different types of promotions used and impulsiveness were significantly higher for all risk groups, while others such as some normative factors, age, gender and particular sports betting variables only applied to those with the highest level of gambling-related problems. The results generally supported findings from previous literature for problem gamblers, and extended these findings to low risk and moderate risk groups. In the future, where statistical power allows, risk factors should be assessed separately for all levels of gambling problems.

[Environmental risk factors for schizophrenia: a review].

PubMed

Vilain, J; Galliot, A-M; Durand-Roger, J; Leboyer, M; Llorca, P-M; Schürhoff, F; Szöke, A

2013-02-01

Evidence of variations in schizophrenia incidence rates has been found in genetically homogenous populations, depending on changes within time or space of certain environmental characteristics. The consideration of the impact of environmental risk factors in etiopathogenic studies has put the environment in the forefront of research regarding psychotic illnesses. Various environmental factors such as urbanicity, migration, cannabis, childhood traumas, infectious agents, obstetrical complications and psychosocial factors have been associated with the risk of developing schizophrenia. These risk factors can be biological, physical, psychological as well as social and may operate at different times in an individual's life (fetal period, childhood, adolescence and early adulthood). Whilst some of these factors act on an individual level, others act on a populational level, modulating the individual risk. These factors can have a direct action on the development of schizophrenia, or on the other hand act as markers for directly implicated factors that have not yet been identified. This article summarizes the current knowledge on this subject. An extensive literature search was conducted via the search engine Pubmed. Eight risk factors were selected and developed in the following paper: urbanicity (or living in an urban area), cannabis, migration (and ethnic density), obstetrical complications, seasonality of birth, infectious agents (and inflammatory responses), socio-demographic factors and childhood traumas. For each of these factors, we provide information on the importance of the risk, the vulnerability period, hypotheses made on the possible mechanisms behind the factors and the level of proof the current research offers (good, medium, or insufficient) according to the amount, type, quality and concordance of the studies at hand. Some factors, such as cannabis, are "unique" in their influence on the development of schizophrenia since it labels only one risk factor

Coronary Risk Factor Scoring as a Guide for Counseling

NASA Technical Reports Server (NTRS)

Fleck, R. L.

1971-01-01

A risk factor scoring system for early detection, possible prediction, and counseling to coronary heart disease patients is discussed. Scoring data include dynamic EKG, cholesterol levels, triglycerine content, total lipid level, total phospolipid levels, and electrophoretic patterns. Results indicate such a system is effective in identifying high risk subjects, but that the ability to predict exceeds the ability to prevent heart disease or its complications.

Risk factors of Internet addiction and the health effect of internet addiction on adolescents: a systematic review of longitudinal and prospective studies.

PubMed

Lam, Lawrence T

2014-11-01

Internet gaming addiction was included in the latest version of the DSM-V as a possible disorder recently, while debate is still on-going as to whether the condition called "Internet Addiction" (IA) could be fully recognised as an established disorder. The major contention is how well IA could fulfil the validation criteria as a psychiatric disorder as in other well-established behavioural addictions. In addition to various proposed validation criteria, evidence of risk and protective factors as well as development of outcomes from longitudinal and prospective studies are suggested as important. A systematic review of available longitudinal and prospective studies was conducted to gather epidemiological evidence on risk and protective factors of IA and the health effect of IA on adolescents. Nine articles were identified after an extensive search of the literature in accordance to the PRISMA guidelines. Of these, eight provided data on risk or protective factors of IA and one focused solely on the effects of IA on mental health. Information was extracted and analysed systematically from each study and tabulated. Many exposure variables were studied and could be broadly classified into three main categories: psychopathologies of the participants, family and parenting factors, and others such as Internet usage, motivation, and academic performance. Some were found to be potential risk or protective factors of IA. It was also found that exposure to IA had a detrimental effect on the mental health of young people. These results were discussed in light of their implications to the fulfilment of the validation criteria.

Risk factors for cryptorchidism

PubMed Central

Gurney, Jason K.; McGlynn, Katherine A.; Stanley, James; Merriman, Tony; Signal, Virginia; Shaw, Caroline; Edwards, Richard; Richiardi, Lorenzo; Hutson, John; Sarfati, Diana

2018-01-01

The condition known as cryptorchidism – undescended testis – is one of the most common congenital abnormalities found among males, and is one of the few known risk factors for testicular cancer (TC). Like testicular cancer, the key exposures in the occurrence of cryptorchidism remain elusive. Testicular descent is thought to occur during two hormonally-controlled phases – between 8–15 weeks and 25–35 weeks gestation – and while it is clear that a failure of testes to descend permanently is likely due to disruptions to one or both of these phases, the cause(s) and mechanism(s) of such disruption are still unclear. In this manuscript, we review the broad range of putative risk factors that have been evaluated in relation to the development of cryptorchidism to date, discuss their plausibility, and make suggestions regarding further approaches to understand aetiology. There are few exposures for which there is consistent evidence of an association with cryptorchidism; and in those cases where evidence appears unequivocal – for example, the relationship between cryptorchidism and gestational measures such as low birth weight – the measured exposure is likely to be a surrogate for the true causal exposure. The relative importance of each risk factor may vary considerably between mother/son pairs depending on an array of genetic, maternal, placental and foetal factors – all of which could vary between regions. PMID:28654092

Bladder cancer, a review of the environmental risk factors

PubMed Central

2012-01-01

Background Many epidemiological studies and reviews have been performed to identify the causes of bladder cancer. The aim of this review is to investigate the links between various environmental risk factors and cancer of the bladder. Methods A systematic literature search was performed using PubMed, Science Direct, Scopus, Scholar Google and Russian Google databases to identify reviews and epidemiological studies on bladder cancer risk factors associated with the environment published between 1998 and 2010. Only literature discussing human studies was considered. Results Smoking, mainly cigarette smoking, is a well known risk factor for various diseases, including bladder cancer. Another factor strongly associated with bladder cancer is exposure to arsenic in drinking water at concentrations higher than 300 µg/l. The most notable risk factor for development of bladder cancer is occupational exposure to aromatic amines (2-naphthylamine, 4-aminobiphenyl and benzidine) and 4,4'-methylenebis(2-chloroaniline), which can be found in the products of the chemical, dye and rubber industries as well as in hair dyes, paints, fungicides, cigarette smoke, plastics, metals and motor vehicle exhaust. There are also data suggesting an effect from of other types of smoking besides cigarettes (cigar, pipe, Egyptian waterpipe, smokeless tobacco and environmental tobacco smoking), and other sources of arsenic exposure such as air, food, occupational hazards, and tobacco. Other studies show that hairdressers and barbers with occupational exposure to hair dyes experience enhanced risk of bladder cancer. For example, a study related to personal use of hair dyes demonstrates an elevated bladder cancer risk for people who used permanent hair dyes at least once a month, for one year or longer. Conclusion Smoking, in particular from cigarettes, exposure to arsenic in drinking water, and occupational exposure to aromatic amines and 4,4'-methylenebis(2-chloroaniline) are well known risk

Bladder cancer, a review of the environmental risk factors.

PubMed

Letašiová, Silvia; Medve'ová, Alžbeta; Šovčíková, Andrea; Dušinská, Mária; Volkovová, Katarína; Mosoiu, Claudia; Bartonová, Alena

2012-06-28

Many epidemiological studies and reviews have been performed to identify the causes of bladder cancer. The aim of this review is to investigate the links between various environmental risk factors and cancer of the bladder. A systematic literature search was performed using PubMed, Science Direct, Scopus, Scholar Google and Russian Google databases to identify reviews and epidemiological studies on bladder cancer risk factors associated with the environment published between 1998 and 2010. Only literature discussing human studies was considered. Smoking, mainly cigarette smoking, is a well known risk factor for various diseases, including bladder cancer. Another factor strongly associated with bladder cancer is exposure to arsenic in drinking water at concentrations higher than 300 µg/l. The most notable risk factor for development of bladder cancer is occupational exposure to aromatic amines (2-naphthylamine, 4-aminobiphenyl and benzidine) and 4,4'-methylenebis(2-chloroaniline), which can be found in the products of the chemical, dye and rubber industries as well as in hair dyes, paints, fungicides, cigarette smoke, plastics, metals and motor vehicle exhaust. There are also data suggesting an effect from of other types of smoking besides cigarettes (cigar, pipe, Egyptian waterpipe, smokeless tobacco and environmental tobacco smoking), and other sources of arsenic exposure such as air, food, occupational hazards, and tobacco. Other studies show that hairdressers and barbers with occupational exposure to hair dyes experience enhanced risk of bladder cancer. For example, a study related to personal use of hair dyes demonstrates an elevated bladder cancer risk for people who used permanent hair dyes at least once a month, for one year or longer. Smoking, in particular from cigarettes, exposure to arsenic in drinking water, and occupational exposure to aromatic amines and 4,4'-methylenebis(2-chloroaniline) are well known risk factors for various diseases including

Gene-environment correlation in the development of adolescent substance abuse: selection effects of child personality and mediation via contextual risk factors.

PubMed

Hicks, Brian M; Johnson, Wendy; Durbin, C Emily; Blonigen, Daniel M; Iacono, William G; McGue, Matt

2013-02-01

We used a longitudinal twin design to examine selection effects of personality traits at age 11 on high-risk environmental contexts at age 14 and the extent to which these contexts mediated risk for substance abuse at age 17. Socialization at age 11 (willingness to follow rules and endorse conventional values) predicted exposure to contextual risk at age 14. Contextual risk partially mediated the effect of socialization on substance abuse, though socialization also had a direct effect. In contrast, boldness at age 11 (social engagement and assurance, thrill seeking, and stress resilience) also predicted substance abuse directly but was unrelated to contextual risk. There was substantial overlap in the genetic and shared environmental influences on socialization and contextual risk, and genetic risk in socialization contributed to substance abuse indirectly via increased exposure to contextual risk. This suggests that active gene-environment correlations related to individual differences in socialization contributed to an early, high-risk developmental trajectory for adolescent substance abuse. In contrast, boldness appeared to index an independent and direct genetic risk factor for adolescent substance abuse.

Gene-Environment Correlation in the Development of Adolescent Substance Abuse: Selection Effects of Child Personality and Mediation via Contextual Risk Factors

PubMed Central

Hicks, Brian M.; Johnson, Wendy; Durbin, C. Emily; Blonigen, Daniel M.; Iacono, William G.; McGue, Matt

2012-01-01

We used a longitudinal twin design to examine selection effects of personality traits at age 11 on high-risk environmental contexts at age 14, and the extent to which these contexts mediated risk for substance abuse at age 17. Socialization at age 11—willingness to follow rules and endorse conventional values—predicted exposure to contextual risk at age 14. Contextual risk partially mediated the effect of socialization on substance abuse, though socialization also had a direct effect. In contrast, boldness at age 11—social engagement and assurance, thrill-seeking, and stress resilience— also predicted substance abuse directly, but was unrelated to contextual risk. There was substantial overlap in the genetic and shared environmental influences on socialization and contextual risk, and genetic risk in socialization contributed to substance abuse indirectly via increased exposure to contextual risk. This suggests that active gene-environment correlations related to individual differences in socialization contributed to an early, high-risk developmental trajectory for adolescent substance abuse. In contrast, boldness appeared to index an independent and direct genetic risk factor for adolescent substance abuse. PMID:23398757

Cost-effectiveness of coronary artery disease screening in asymptomatic patients with type 2 diabetes and other atherogenic risk factors in Japan: factors influencing on international application of evidence-based guidelines.

PubMed

Hayashino, Yasuaki; Shimbo, Takuro; Tsujii, Satoru; Ishii, Hitoshi; Kondo, Hirokazu; Nakamura, Tsukasa; Nagata-Kobayashi, Shizuko; Fukui, Tsuguya

2007-05-16

Screening for coronary artery disease (CAD) in asymptomatic diabetic patients with atherogenic risk factors is recommended by the American College of Cardiology/American Diabetes Association. It is not clear whether these guidelines apply to the Japanese population with a different epidemiology of CAD. This study evaluates the applicability of the U.S. guidelines to Japan, taking account of cost-effectiveness. A cost-effectiveness analysis using a Markov model was performed to measure the clinical benefit and cost of CAD screening in asymptomatic patients with diabetes and additional atherogenic risk factors. We evaluated cohorts of patients stratified by age, gender, and atherogenic risks. The incremental cost-effectiveness of not screening, exercise electrocardiography, exercise echocardiography, and exercise single-photon emission-tomography (SPECT) was calculated. The data used were obtained from the literature. Outcomes are expressed as US dollars per quality-adjusted life year (QALY). Compared with not screening, the incremental cost-effectiveness ratio (ICER) of exercise electrocardiography was $31,400/QALY for 60-year-old asymptomatic diabetic men, and 46,600 for 65-year-old women with hypertension and smoking. The ICER of exercise echocardiography was $31,500/QALY and of SPECT was $326,000/QALY, compared with the next dominant strategy. Sensitivity analyses found that these results varied according to age, gender, the combination of additional atherogenic risk factors, and the frequency of screening. From a societal perspective the U.S. guidelines on screening for CAD in high risk diabetic patients are applicable to the Japanese population. However, the population subjected to screening should be carefully selected to obtain greatest benefit from screening.

Impact of comprehensive cardiovascular risk reduction programme on risk factor clustering associated with elevated blood pressure in an Indian industrial population.

PubMed

Jeemon, Panniyammakal; Prabhakaran, Dorairaj; Goenka, Shifalika; Ramakrishnan, Lakshmy; Padmanabhan, Sandosh; Huffman, Mark; Joshi, Prashant; Sivasankaran, Sivasubramonian; Mohan, B V M; Ahmed, F; Ramanathan, Meera; Ahuja, R; Sinha, Nakul; Thankappan, K R; Reddy, K S

2012-04-01

Cardiovascular risk factors clustering associated with blood pressure (BP) has not been studied in the Indian population. This study was aimed at assessing the clustering effect of cardiovascular risk factors with suboptimal BP in Indian population as also the impact of risk reduction interventions. Data from 10543 individuals collected in a nation-wide surveillance programme in India were analysed. The burden of risk factors clustering with blood pressure and coronary heart disease (CHD) was assessed. The impact of a risk reduction programmme on risk factors clustering was prospectively studied in a sub-group. Mean age of participants was 40.9 ± 11.0 yr. A significant linear increase in number of risk factors with increasing blood pressure, irrespective of stratifying using different risk factor thresholds was observed. While hypertension occurred in isolation in 2.6 per cent of the total population, co-existence of hypertension and >3 risk factors was observed in 12.3 per cent population. A comprehensive risk reduction programme significantly reduced the mean number of additional risk factors in the intervention population across the blood pressure groups, while it continued to be high in the control arm without interventions (both within group and between group P<0.001). The proportion of 'low risk phenotype' increased from 13.4 to 19.9 per cent in the intervention population and it was decreased from 27.8 to 10.6 per cent in the control population (P<0.001). The proportion of individuals with hypertension and three more risk factors decreased from 10.6 to 4.7 per cent in the intervention arm while it was increased from 13.3 to 17.8 per cent in the control arm (P<0.001). Our findings showed that cardiovascular risk factors clustered together with elevated blood pressure and a risk reduction programme significantly reduced the risk factors burden.

Effects of Lactobacillus salivarius-containing tablets on caries risk factors: a randomized open-label clinical trial

PubMed Central

2014-01-01

Background To evaluate the effects of the lactic acid bacterium Lactobacillus salivarius on caries risk factors. Methods The study was performed in 64 healthy volunteers to evaluate the effects of L. salivarius-containing tablets on caries risk factors. The participants were divided randomly into four groups, and took tablets containing L. salivarius WB21, L. salivarius TI 2711, Ovalgen® DC (antibody against glucosyltransferase from Streptococcus mutans), or xylitol. Levels of mutans streptococci and lactobacilli, amount of salivary flow, salivary pH, and salivary buffering capacity were assessed before and after taking the tablets. Subsequently, a short-term administration trial using L. salivarius WB21-containing tablets was performed in eight healthy volunteers. The participants took L. salivarius WB21-containing tablets (2.0 × 109 colony forming units/day) for 2 weeks, and the numbers of mutans streptococci in saliva were counted. Results The levels of mutans streptococci seemed to decrease in the L. salivarius WB21, TI 2711, and Ovalgen® DC groups compared to the xylitol group, with no significant differences between the groups. Lactobacilli levels significantly increased in the L. salivarius WB21 and TI 2711 groups compared to the other groups. Concerning salivary flow and salivary pH, no significant differences were observed between the groups. The salivary buffering capacity significantly increased in the L. salivarius TI 2711 group (P = 0.003) and Ovalgen® DC group (P = 0.002) compared to the xylitol group. The short-term administration trial showed that the L. salivarius WB21-containing tablets significantly decreased the number of mutans streptococci (P = 0.039). Conclusion L. salivarius-containing tablets were suggested to increase resistance to caries risk factors. Trial registration UMIN000013160 (registration date: February 14, 2014). PMID:25178882

Effects of Lactobacillus salivarius-containing tablets on caries risk factors: a randomized open-label clinical trial.

PubMed

Nishihara, Tetsuyo; Suzuki, Nao; Yoneda, Masahiro; Hirofuji, Takao

2014-09-02

To evaluate the effects of the lactic acid bacterium Lactobacillus salivarius on caries risk factors. The study was performed in 64 healthy volunteers to evaluate the effects of L. salivarius-containing tablets on caries risk factors. The participants were divided randomly into four groups, and took tablets containing L. salivarius WB21, L. salivarius TI 2711, Ovalgen® DC (antibody against glucosyltransferase from Streptococcus mutans), or xylitol. Levels of mutans streptococci and lactobacilli, amount of salivary flow, salivary pH, and salivary buffering capacity were assessed before and after taking the tablets. Subsequently, a short-term administration trial using L. salivarius WB21-containing tablets was performed in eight healthy volunteers. The participants took L. salivarius WB21-containing tablets (2.0 × 10(9) colony forming units/day) for 2 weeks, and the numbers of mutans streptococci in saliva were counted. The levels of mutans streptococci seemed to decrease in the L. salivarius WB21, TI 2711, and Ovalgen® DC groups compared to the xylitol group, with no significant differences between the groups. Lactobacilli levels significantly increased in the L. salivarius WB21 and TI 2711 groups compared to the other groups. Concerning salivary flow and salivary pH, no significant differences were observed between the groups. The salivary buffering capacity significantly increased in the L. salivarius TI 2711 group (P = 0.003) and Ovalgen® DC group (P = 0.002) compared to the xylitol group. The short-term administration trial showed that the L. salivarius WB21-containing tablets significantly decreased the number of mutans streptococci (P = 0.039). L. salivarius-containing tablets were suggested to increase resistance to caries risk factors. UMIN000013160 (registration date: February 14, 2014).

Effect of Previous Abdominal Surgery on Laparoscopic Liver Resection: Analysis of Feasibility and Risk Factors for Conversion.

PubMed

Cipriani, Federica; Ratti, Francesca; Fiorentini, Guido; Catena, Marco; Paganelli, Michele; Aldrighetti, Luca

2018-03-28

Previous abdominal surgery has traditionally been considered an additional element of difficulty to later laparoscopic procedures. The aim of the study is to analyze the effect of previous surgery on the feasibility and safety of laparoscopic liver resection (LLR), and its role as a risk factor for conversion. After matching, 349 LLR in patients known for previous abdominal surgery (PS group) were compared with 349 LLR on patients with a virgin abdomen (NPS group). Subgroup analysis included 161 patients with previous upper abdominal surgery (UPS subgroup). Feasibility and safety were evaluated in terms of conversion rate, reasons for conversion and outcomes, and risk factors for conversion assessed via uni/multivariable analysis. Conversion rate was 9.4%, and higher for PS patients compared with NPS patients (13.7% versus 5.1%, P = .021). Difficult adhesiolysis resulted the commonest reason for conversion in PS group (5.7%). However, operative time (P = .840), blood loss (P = .270), transfusion (P = .650), morbidity rate (P = .578), hospital stay (P = .780), and R1 rate (P = .130) were comparable between PS and NPS group. Subgroup analysis confirmed higher conversion rates for UPS patients (23%) compared with both NPS (P = .015) and PS patients (P = .041). Previous surgery emerged as independent risk factor for conversion (P = .033), alongside the postero-superior location and major hepatectomy. LLR are feasible in case of previous surgery and proved to be safe and maintain the benefits of LLR carried out in standard settings. However, a history of surgery should be considered a risk factor for conversion.

Effects of high-intensity training on cardiovascular risk factors in premenopausal and postmenopausal women.

PubMed

Mandrup, Camilla M; Egelund, Jon; Nyberg, Michael; Lundberg Slingsby, Martina H; Andersen, Caroline B; Løgstrup, Sofie; Bangsbo, Jens; Suetta, Charlotte; Stallknecht, Bente; Hellsten, Ylva

2017-04-01

Menopause is associated with increased risk of cardiovascular disease and the causal factors have been proposed to be the loss of estrogen and the subsequent alterations of the hormonal milieu. However, which factors contribute to the deterioration of cardiometabolic health in postmenopausal women is debated as the menopausal transition is also associated with increased age and fat mass. Furthermore, indications of reduced cardiometabolic adaptations to exercise in postmenopausal women add to the adverse health profile. We sought to evaluate risk factors for type 2 diabetes and cardiovascular disease in late premenopausal and early postmenopausal women, matched by age and body composition, and investigate the effect of high-intensity training. A 3-month high-intensity aerobic training intervention, involving healthy, nonobese, late premenopausal (n = 40) and early postmenopausal (n = 39) women was conducted and anthropometrics, body composition, blood pressure, lipid profile, glucose tolerance, and maximal oxygen consumption were determined at baseline and after the intervention. At baseline, the groups matched in anthropometrics and body composition, and only differed by 4.2 years in age (mean [95% confidence limits] 49.2 [48.5-49.9] vs 53.4 [52.4-54.4] years). Time since last menstrual period for the postmenopausal women was (mean [95% confidence limits] 3.1 [2.6-3.7] years). Hormonal levels (estrogen, follicle stimulation hormone, luteinizing hormone) confirmed menopausal status. At baseline the postmenopausal women had higher total cholesterol (P < .001), low-density lipoprotein-cholesterol (P < .05), and high-density lipoprotein-cholesterol (P < .001) than the premenopausal women. The training intervention reduced body weight (P < .01), waist circumference (P < .01), and improved body composition by increasing lean body mass (P < .001) and decreasing fat mass (P < .001) similarly in both groups. Moreover, training resulted in lower diastolic blood pressure

The impact of youth, family, peer and neighborhood risk factors on developmental trajectories of risk involvement from early through middle adolescence.

PubMed

Wang, Bo; Deveaux, Lynette; Li, Xiaoming; Marshall, Sharon; Chen, Xinguang; Stanton, Bonita

2014-04-01

Few studies have analyzed the development course beginning in pre-/early adolescence of overall engagement in health-risk behaviors and associated social risk factors that place individuals in different health-risk trajectories through mid-adolescence. The current longitudinal study identified 1276 adolescents in grade six and followed them for three years to investigate their developmental trajectories of risk behaviors and to examine the association of personal and social risk factors with each trajectory. Group-based trajectory modeling was applied to identify distinctive trajectory patterns of risk behaviors. Multivariate multinomial logistic regression analyses were performed to examine the effects of the personal and social risk factors on adolescents' trajectories. Three gender-specific behavioral trajectories were identified for males (55.3% low-risk, 37.6% moderate-risk, increasing, and 7.1% high-risk, increasing) and females (41.4% no-risk, 53.4% low-risk, increasing and 5.2% moderate to high-risk, increasing). Sensation-seeking, family, peer, and neighborhood factors at baseline predicted following the moderate-risk, increasing trajectory and the high-risk, increasing trajectory in males; these risk factors predicted following the moderate to high-risk, increasing trajectory in females. The presence of all three social risk factors (high-risk neighborhood, high-risk peers and low parental monitoring) had a dramatic impact on increased probability of being in a high-risk trajectory group. These findings highlight the developmental significance of early personal and social risk factors on subsequent risk behaviors in early to middle adolescence. Future adolescent health behavior promotion interventions might consider offering additional prevention resources to pre- and early adolescent youth who are exposed to multiple contextual risk factors (even in the absence of risk behaviors) or youth who are early-starters of delinquency and substance use behaviors

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…

Circadian misalignment increases cardiovascular disease risk factors in humans

PubMed Central

Morris, Christopher J.; Purvis, Taylor E.; Hu, Kun; Scheer, Frank A. J. L.

2016-01-01

Shift work is a risk factor for hypertension, inflammation, and cardiovascular disease. This increased risk cannot be fully explained by classic risk factors. One of the key features of shift workers is that their behavioral and environmental cycles are typically misaligned relative to their endogenous circadian system. However, there is little information on the impact of acute circadian misalignment on cardiovascular disease risk in humans. Here we show—by using two 8-d laboratory protocols—that short-term circadian misalignment (12-h inverted behavioral and environmental cycles for three days) adversely affects cardiovascular risk factors in healthy adults. Circadian misalignment increased 24-h systolic blood pressure (SBP) and diastolic blood pressure (DBP) by 3.0 mmHg and 1.5 mmHg, respectively. These results were primarily explained by an increase in blood pressure during sleep opportunities (SBP, +5.6 mmHg; DBP, +1.9 mmHg) and, to a lesser extent, by raised blood pressure during wake periods (SBP, +1.6 mmHg; DBP, +1.4 mmHg). Circadian misalignment decreased wake cardiac vagal modulation by 8–15%, as determined by heart rate variability analysis, and decreased 24-h urinary epinephrine excretion rate by 7%, without a significant effect on 24-h urinary norepinephrine excretion rate. Circadian misalignment increased 24-h serum interleukin-6, C-reactive protein, resistin, and tumor necrosis factor-α levels by 3–29%. We demonstrate that circadian misalignment per se increases blood pressure and inflammatory markers. Our findings may help explain why shift work increases hypertension, inflammation, and cardiovascular disease risk. PMID:26858430

Sex-specific effects of cardiovascular risk factors on endothelium-dependent dilation and endothelin activity in middle-aged women and men.

PubMed

Brar, Vijaywant; Gill, Sartaj; Cardillo, Carmine; Tesauro, Manfredi; Panza, Julio A; Campia, Umberto

2015-01-01

Healthy middle-aged postmenopausal women have higher endothelium-dependent dilation and lower vasoconstrictor activity of endothelin-1 than men. Whether these sex-specific differences extend to patients with cardiovascular risk factors has not been investigated. The current study aimed to determine whether, in patients with cardiovascular risk factors, sex-specific differences exist in endothelium-dependent dilation and endothelin-1 activity. Forearm blood flow responses were measured by strain-gauge plethysmography during the intra-arterial infusion of acetylcholine, sodium nitroprusside, and the selective endothelin type A receptor blocker BQ-123 in 50 women and 64 men with cardiovascular risk factors. Acetylcholine and sodium nitroprusside induced a significant vasodilation in women and men alike (p < 0.01 for both). Also BQ-123 caused a significant vasodilation (p < 0.001) in both groups. The vasodilator response to acetylcholine was greater in women compared to men; however there were no differences in the response to sodium nitroprusside and BQ-123 (p = NS for both) between the two sex groups. Middle-aged women with cardiovascular risk factors have significantly higher endothelium-dependent dilation than middle-aged men; however, vascular endothelin 1 activity is similar in the two groups. These findings suggest that the presence of cardiovascular risk factors is associated with sex-specific effects on endothelium-dependent dilation but not on endothelin 1 activity. Further study is needed to confirm our findings and to characterize the mechanisms underlying this sex-specific regulation of endothelial function.

Environmental risk factors for osteoporosis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goyer, R.A.; Korach, K.S.; Epstein, S.

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 approachesmore » 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.« less

Risk factors for mortality before age 18 years in cystic fibrosis.

PubMed

McColley, Susanna A; Schechter, Michael S; Morgan, Wayne J; Pasta, David J; Craib, Marcia L; Konstan, Michael W

2017-07-01

Understanding early-life risk factors for childhood death in cystic fibrosis (CF) is important for clinical care, including the identification of effective interventions. Data from the Epidemiologic Study of Cystic Fibrosis (ESCF) collected 1994-2005 were linked with the Cystic Fibrosis Foundation Patient Registry (CFFPR) demographic and mortality data from 2013. Inclusion criteria were ≥1 visit annually at age 3-5 years and ≥1 FEV 1 measurement at age 6-8 years. Demographic data, nutritional parameters, pulmonary signs and symptoms, microbiology, and FEV 1 were evaluated as risk factors for death before age 18 years. Multivariable Cox proportional hazards regression was used to model the simultaneous effects of risk factors associated with death before age 18 years. Among 5365 patients enrolled in ESCF who met inclusion criteria, 3880 (72%) were linked to the CFFPR. Among these, 191 (5.7%) died before age 18 years; median age at death was 13.4 ± 3.1 years. Multivariable regression showed clubbing, crackles, female sex, unknown CFTR genotype, minority race or ethnicity, Medicaid insurance (a proxy of low socioeconomic status), Pseudomonas aeruginosa on 2 or more cultures, and weight-for-age <50th percentile were significant risk factors for death regardless of inclusion of FEV 1 at age 6-8 years in the model. We identified multiple risk factors for childhood death of patients with CF, all of which remained important after incorporating FEV 1 at age 6-8 years. Among the factors identified were the presence of clubbing or crackles at age 3-5 years, signs which are not routinely collected in registries. © 2017 Wiley Periodicals, Inc.

The global distribution of risk factors by poverty level.

PubMed Central

Blakely, Tony; Hales, Simon; Kieft, Charlotte; Wilson, Nick; Woodward, Alistair

2005-01-01

OBJECTIVE: To estimate the individual-level association of income poverty with being underweight, using tobacco, drinking alcohol, having access only to unsafe water and sanitation, being exposed to indoor air pollution and being obese. METHODS: Using survey data for as many countries as possible, we estimated the relative risk association between income or assets and risk factors at the individual level within 11 medium- and low-income subregions of WHO. WHO and The World Bank data on the prevalence of risk factors and income poverty (defined as living on < US$ 1.00 per day, US$ 1-2.00 per day and > US$ 2.00 per day) were analysed to impute the association between poverty and risk factors for each subregion. The possible effect of poverty reduction on the prevalence of risk factors was estimated using population-attributable risk percentages. FINDINGS: There were strong associations between poverty and malnutrition among children, having access only to unsafe water and sanitation, and being exposed to indoor air pollution within each subregion (relative risks were twofold to threefold greater for those living on < US$ 1.00 per day compared with those living on > US$ 2.00 per day). Associations between poverty and obesity, tobacco use and alcohol use varied across subregions. If everyone living on < US$ 2.00 per day had the risk factor profile of those living on > US$ 2.00 per day, 51% of exposures to unimproved water and sanitation could be avoided as could 37% of malnutrition among children and 38% of exposure to indoor air pollution. The more realistic, but still challenging, Millennium Development Goal of halving the number of people living on < US$ 1.00 per day would achieve much smaller reductions. CONCLUSION: To achieve large gains in global health requires both poverty eradication and public health action. The methods used in this study may be useful for monitoring pro-equity progress towards Millennium Development Goals. PMID:15744404

Epidemiology and risk factors of peri-implantitis: A systematic review.

PubMed

Dreyer, H; Grischke, J; Tiede, C; Eberhard, J; Schweitzer, A; Toikkanen, S E; Glöckner, S; Krause, G; Stiesch, M

2018-06-07

The purpose of this systematic review and meta-analysis was to assess the prevalence, incidence and risk factors of peri-implantitis in the current literature. An electronic search was performed to identify publications from January 1980 until March 2016 on 9 databases. The prevalence and incidence of peri-implantitis were assessed in different subgroups of patients and the prevalences were adjusted for sample size (SSA) of studies. For 12 of 111 identified putative risk factors and risk indicators, forest plots were created. Heterogeneity analysis and random effect meta-analysis were performed for selected potential risk factors of peri-implantitis. The search retrieved 8357 potentially relevant studies. Fifty-seven studies were included in the systematic review. Overall, the prevalence of peri-implantitis on implant level ranged from 1.1% to 85.0% and the incidence from 0.4% within 3 years, to 43.9% within 5 years, respectively. The median prevalence of peri-implantitis was 9.0% (SSA 10.9%) for regular participants of a prophylaxis program, 18.8% (SSA 8.8%) for patients without regular preventive maintenance, 11.0% (SSA 7.4%) for non-smokers, 7.0% (SSA 7.0%) among patients representing the general population, 9.6% (SSA 9.6%) for patients provided with fixed partial dentures, 14.3% (SSA 9.8%) for subjects with a history of periodontitis, 26.0% (SSA 28.8%) for patients with implant function time ≥5 years and 21.2% (SSA 38.4%) for ≥10 years. On a medium and medium-high level of evidence, smoking (effect summary OR 1.7, 95% CI 1.25-2.3), diabetes mellitus (effect summary OR 2.5; 95% CI 1.4-4.5), lack of prophylaxis and history or presence of periodontitis were identified as risk factors of peri-implantitis. There is medium-high evidence that patient's age (effect summary OR 1.0, 95% CI 0.87-1.16), gender and maxillary implants are not related to peri-implantitis. Currently, there is no convincing or low evidence available that identifies osteoporosis, absence

Cost-effectiveness analysis of risk-factor guided and birth-cohort screening for chronic hepatitis C infection in the United States.

PubMed

Liu, Shan; Cipriano, Lauren E; Holodniy, Mark; Goldhaber-Fiebert, Jeremy D

2013-01-01

No consensus exists on screening to detect the estimated 2 million Americans unaware of their chronic hepatitis C infections. Advisory groups differ, recommending birth-cohort screening for baby boomers, screening only high-risk individuals, or no screening. We assessed one-time risk assessment and screening to identify previously undiagnosed 40-74 year-olds given newly available hepatitis C treatments. A Markov model evaluated alternative risk-factor guided and birth-cohort screening and treatment strategies. Risk factors included drug use history, blood transfusion before 1992, and multiple sexual partners. Analyses of the National Health and Nutrition Examination Survey provided sex-, race-, age-, and risk-factor-specific hepatitis C prevalence and mortality rates. Nine strategies combined screening (no screening, risk-factor guided screening, or birth-cohort screening) and treatment (standard therapy-peginterferon alfa and ribavirin, Interleukin-28B-guided (IL28B) triple-therapy-standard therapy plus a protease inhibitor, or universal triple therapy). Response-guided treatment depended on HCV genotype. Outcomes include discounted lifetime costs (2010 dollars) and quality adjusted life-years (QALYs). Compared to no screening, risk-factor guided and birth-cohort screening for 50 year-olds gained 0.7 to 3.5 quality adjusted life-days and cost $168 to $568 per person. Birth-cohort screening provided more benefit per dollar than risk-factor guided screening and cost $65,749 per QALY if followed by universal triple therapy compared to screening followed by IL28B-guided triple therapy. If only 10% of screen-detected, eligible patients initiate treatment at each opportunity, birth-cohort screening with universal triple therapy costs $241,100 per QALY. Assuming treatment with triple therapy, screening all individuals aged 40-64 years costs less than $100,000 per QALY. The cost-effectiveness of one-time birth-cohort hepatitis C screening for 40-64 year olds is comparable

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.

Risk factors for fatigue among airline pilots.

PubMed

van Drongelen, Alwin; Boot, Cécile R L; Hlobil, Hynek; Smid, Tjabe; van der Beek, Allard J

2017-01-01

The objective of this study is to determine risk factors for fatigue among airline pilots, taking into account person-, work-, health-, sleep-, and lifestyle-related characteristics. The study population consisted of 502 pilots who participated in the MORE Energy study. Included risk factors were either measured through an online questionnaire or provided by the company. The outcome of this study, fatigue, was assessed using the Checklist Individual Strength (CIS), and was defined as scoring more than 76 points on this questionnaire. The association of the risk factors with fatigue was determined using univariate and multivariate logistic regression analyses. Of the participating pilots, 29.5 % scored more than 76 points on the CIS and were classified as being fatigued. The fully adjusted regression model showed that person-, work-, health-, and lifestyle-related characteristics were associated with fatigue. Pilots who were aged 31 to 40 (OR 3.36, 95 % CI 1.32-8.53) or 41 to 50 (OR 4.19, 95 % CI 1.40-12.47), an evening type (OR 2.40, 95 % CI 1.38-4.16), scored higher on work-life balance disturbance (OR 1.22, 95 % CI 1.10-1.36), scored higher on need for recovery (OR 1.02, 95 % CI 1.01-1.04), scored lower on general health perception (OR 0.31, 95 % CI 0.20-0.47), were less physically active (OR 0.77, 95 % CI 0.66-0.89), and had a moderate alcohol consumption (OR 3.88, 95 % CI 1.21-12.43), were at higher risk for fatigue. Higher age, being an evening type, disturbance of the work-life balance, more need for recovery, a lower perceived health, less physical activity, and moderate alcohol consumption were shown to be risk factors for fatigue. Further longitudinal research is needed to elucidate the direction of the associations found and to evaluate the effects of possible countermeasures in airline pilots.

Effect of Current Dietary Recommendations on Weight Loss and Cardiovascular Risk Factors.

PubMed

Jenkins, David J A; Boucher, Beatrice A; Ashbury, Fredrick D; Sloan, Margaret; Brown, Patrick; El-Sohemy, Ahmed; Hanley, Anthony J; Willett, Walter; Paquette, Melanie; de Souza, Russell J; Ireland, Christopher; Kwan, Natalie; Jenkins, Amy; Pichika, Sathish C; Kreiger, Nancy

2017-03-07

Dietary recommendations emphasize increased consumption of fruit, vegetables, and whole grain cereals for prevention of chronic disease. This study assessed the effect of dietary advice and/or food provision on body weight and cardiovascular disease risk factors. Healthy overweight men (n = 209) and women (n = 710), mean age 44.7 years, body mass index [BMI] 32.4 kg/m 2 , were randomized between November 2005 and August 2009 to receive Health Canada's food guide (control, n = 486) or 1 of 3 interventions: dietary advice consistent with both Dietary Approaches to Stop Hypertension (DASH) and dietary portfolio principles (n = 145); weekly food provision reflecting this advice (n = 148); or food delivery plus advice (n = 140). Interventions lasted 6 months with 12-month follow-up. Semiquantitative food frequency questionnaires and fasting blood, anthropometric and blood pressure measurements were obtained at baseline, 6 months, and 18 months. Participant retention at 6 and 18 months was 91% and 81%, respectively, after food provision compared to 67% and 57% when no food was provided (p < 0.0001). Test and control treatments showed small reductions in body weight (-0.8 to -1.2 kg), waist circumference (-1.1 to -1.9 cm), and mean arterial pressure (0.0 to -1.1 mm Hg) at 6 months and Framingham coronary heart disease risk score at 18 months (-0.19 to -0.42%), which were significant overall. Outcomes did not differ among test and control groups. Provision of foods increased retention but only modestly increased intake of recommended foods. Current dietary recommendations showed small overall benefits in coronary heart disease risk factors. Additional dietary strategies to maximize these benefits are required. (Fruits, Vegetables, and Whole Grains: A Community-based Intervention; NCT00516620). Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

[Atmospheric air pollution: a risk factor for COPD?].

PubMed

Allain, Y-M; Roche, N; Huchon, G

2010-04-01

Tobacco smoking is the leading cause of COPD worldwide but other risk factors have been recognized. Air pollution is one of them, but its exact role in the development of COPD is hard to demonstrate. Its physiological effects on lung function have only been studied since the nineties by long and tedious cohort studies. Difficulties arise from the heterogeneity of air pollution (gas and particles); thus, its respiratory effects have to be examined for every component separately, and in different populations. It is also necessary to analyse the effects of atmospheric pollution in the short and the long term, considering both its physiological, clinical and toxicological effects, from childhood to adulthood. These factors make it difficult to obtain statistically significant results. Nevertheless, most studies seem to point to a role of air pollution in the development of COPD via oxydative stress but further studies are needed to confirm the exact effect of each component of air pollution on the respiratory tract. These studies could lead to improved public health policies and results are awaited that would identify at-risk populations, decide appropriate preventive measures and propose documented thresholds in pollution exposure... thereby limiting the spread of COPD. Copyright 2010 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Effects of Cumulative Family Risk Factors on American Students' Academic Performance

ERIC Educational Resources Information Center

Dunst, Carl J.; Hamby, Deborah W.

2016-01-01

The relationships between cumulative family risk factors and American students' academic performance were examined in all 50 States and the District of Columbia. Data from the 2007 "American Community Survey" were used to ascertain the percent of birth to 18 year old children in the United States who experienced three or more risk…