Demographic, socioeconomic, and behavioral factors affecting patterns of tooth decay in the permanent dentition: Principal components and factor analyses

PubMed Central

Shaffer, John R.; Polk, Deborah E.; Feingold, Eleanor; Wang, Xiaojing; Cuenco, Karen T.; Weeks, Daniel E.; DeSensi, Rebecca S.; Weyant, Robert J.; Crout, Richard; McNeil, Daniel W.; Marazita, Mary L.

2012-01-01

Objectives Dental caries of the permanent dentition is a multi-factorial disease resulting from the complex interplay of endogenous and environmental risk factors. The disease is not easily quantified due to the innumerable possible combinations of carious lesions across individual tooth surfaces of the permanent dentition. Global measures of decay, such as the DMFS index (which was developed for surveillance applications), may not be optimal for studying the epidemiology of dental caries because they ignore the distinct patterns of decay across the dentition. We hypothesize that specific risk factors may manifest their effects on specific tooth surfaces leading to patterns of decay that can be identified and studied. In this study we utilized two statistical methods of extracting patterns of decay from surface-level caries data in order to create novel phenotypes with which to study the risk factors affecting dental caries. Methods Intra-oral dental examinations were performed on 1,068 participants aged 18 to 75 years to assess dental caries. The 128 tooth surfaces of the permanent dentition were scored as carious or not and used as input for principal components analysis (PCA) and factor analysis (FA), two methods of identifying underlying patterns without a priori knowledge of the patterns. Demographic (age, sex, birth year, race/ethnicity, and educational attainment), anthropometric (height, body mass index, waist circumference), endogenous (saliva flow), and environmental (tooth brushing frequency, home water source, and home water fluoride) risk factors were tested for association with the caries patterns identified by PCA and FA, as well as DMFS, for comparison. The ten strongest patterns (i.e., those that explain the most variation in the data set) extracted by PCA and FA were considered. Results The three strongest patterns identified by PCA reflected (i) global extent of decay (i.e., comparable to DMFS index), (ii) pit and fissure surface caries, and (iii) smooth surface caries, respectively. The two strongest patterns identified by FA corresponded to (i) pit and fissure surface caries and (ii) maxillary incisor caries. Age and birth year were significantly associated with several patterns of decay, including global decay/DMFS index. Sex, race, educational attainment, and tooth brushing were each associated with specific patterns of decay, but not with global decay/DMFS index. Conclusions Taken together, these results support the notion that caries experience is separable into patterns attributable to distinct risk factors. This study demonstrates the utility of such novel caries patterns as new outcomes for exploring the complex, multifactorial nature of dental caries. PMID:23106439

Demographic, socioeconomic, and behavioral factors affecting patterns of tooth decay in the permanent dentition: principal components and factor analyses.

PubMed

Shaffer, John R; Polk, Deborah E; Feingold, Eleanor; Wang, Xiaojing; Cuenco, Karen T; Weeks, Daniel E; DeSensi, Rebecca S; Weyant, Robert J; Crout, Richard; McNeil, Daniel W; Marazita, Mary L

2013-08-01

Dental caries of the permanent dentition is a multifactorial disease resulting from the complex interplay of endogenous and environmental risk factors. The disease is not easily quantitated due to the innumerable possible combinations of carious lesions across individual tooth surfaces of the permanent dentition. Global measures of decay, such as the DMFS index (which was developed for surveillance applications), may not be optimal for studying the epidemiology of dental caries because they ignore the distinct patterns of decay across the dentition. We hypothesize that specific risk factors may manifest their effects on specific tooth surfaces leading to patterns of decay that can be identified and studied. In this study, we utilized two statistical methods of extracting patterns of decay from surface-level caries data to create novel phenotypes with which to study the risk factors affecting dental caries. Intra-oral dental examinations were performed on 1068 participants aged 18-75 years to assess dental caries. The 128 tooth surfaces of the permanent dentition were scored as carious or not and used as input for principal components analysis (PCA) and factor analysis (FA), two methods of identifying underlying patterns without a priori knowledge of the patterns. Demographic (age, sex, birth year, race/ethnicity, and educational attainment), anthropometric (height, body mass index, waist circumference), endogenous (saliva flow), and environmental (tooth brushing frequency, home water source, and home water fluoride) risk factors were tested for association with the caries patterns identified by PCA and FA, as well as DMFS, for comparison. The ten strongest patterns (i.e. those that explain the most variation in the data set) extracted by PCA and FA were considered. The three strongest patterns identified by PCA reflected (i) global extent of decay (i.e. comparable to DMFS index), (ii) pit and fissure surface caries and (iii) smooth surface caries, respectively. The two strongest patterns identified by FA corresponded to (i) pit and fissure surface caries and (ii) maxillary incisor caries. Age and birth year were significantly associated with several patterns of decay, including global decay/DMFS index. Sex, race, educational attainment, and tooth brushing were each associated with specific patterns of decay, but not with global decay/DMFS index. Taken together, these results support the notion that caries experience is separable into patterns attributable to distinct risk factors. This study demonstrates the utility of such novel caries patterns as new outcomes for exploring the complex, multifactorial nature of dental caries. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Major dietary patterns and cardiovascular risk factors from childhood to adulthood. The Cardiovascular Risk in Young Finns Study.

PubMed

Mikkilä, Vera; Räsänen, Leena; Raitakari, Olli T; Marniemi, Jukka; Pietinen, Pirjo; Rönnemaa, Tapani; Viikari, Jorma

2007-07-01

Studies on the impact of single nutrients on the risk of CVD have often given inconclusive results. Recent research on dietary patterns has offered promising information on the effects of diet as a whole on the risk of CVD. The Cardiovascular Risk in Young Finns Study is an ongoing, prospective cohort study with a 21-year follow-up to date. The subjects were children and adolescents at baseline (3-18 years, n 1768) and adults at the latest follow-up study (24-39 years, n 1037). We investigated the associations between two major dietary patterns and several risk factors for CVD. In longitudinal analyses with repeated measurements, using multivariate mixed linear regression models, the traditional dietary pattern (characterised by high consumption of rye, potatoes, butter, sausages, milk and coffee) was independently associated with total and LDL cholesterol concentrations, apolipoprotein B and C-reactive protein concentrations among both genders, and also with systolic blood pressure and insulin levels among women and concentrations of homocysteine among men (P < 0.05 for all). A dietary pattern reflecting more health-conscious food choices (such as high consumption of vegetables, legumes and nuts, tea, rye, cheese and other dairy products, and alcoholic beverages) was inversely, but less strongly associated with cardiovascular risk factors. Our results support earlier findings that dietary patterns have a role in the development of CVD.

Dietary patterns and risk of ductal carcinoma of the breast: a factor analysis in Uruguay.

PubMed

Ronco, Alvaro L; De Stefani, Eduardo; Deneo-Pellegrini, Hugo; Boffetta, Paolo; Aune, Dagfinn; Silva, Cecilia; Landó, Gabriel; Luaces, María E; Acosta, Gisele; Mendilaharsu, María

2010-01-01

Breast cancer (BC) shows very high incidence rates in Uruguayan women. The present factor analysis of ductal carcinoma of the breast, the most frequent histological type of this malignancy both in Uruguay and in the World, was conducted at a prepaid hospital of Montevideo, Uruguay. We identified 111 cases with ductal BC and 222 controls with normal mammograms. A factor analysis was conducted using 39 food groups, allowing retention of six factors analyzed through logistic regression in order to obtain odds ratios (OR) associated with ductal BC. The low fat and non-alcoholic beverage patterns were inversely associated (OR=0.30 and OR=0.45, respectively) with risk. Conversely, the fatty cheese pattern was positively associated (OR=4.17) as well as the fried white meat (OR=2.28) and Western patterns (OR 2.13). Ductal BC shared similar dietary risk patterns as those identified by studies not discriminating between histologic type of breast cancer.

Analysis of work zone rear-end crash risk for different vehicle-following patterns.

PubMed

Weng, Jinxian; Meng, Qiang; Yan, Xuedong

2014-11-01

This study evaluates rear-end crash risk associated with work zone operations for four different vehicle-following patterns: car-car, car-truck, truck-car and truck-truck. The deceleration rate to avoid the crash (DRAC) is adopted to measure work zone rear-end crash risk. Results show that the car-truck following pattern has the largest rear-end crash risk, followed by truck-truck, truck-car and car-car patterns. This implies that it is more likely for a car which is following a truck to be involved in a rear-end crash accident. The statistical test results further confirm that rear-end crash risk is statistically different between any two of the four patterns. We therefore develop a rear-end crash risk model for each vehicle-following pattern in order to examine the relationship between rear-end crash risk and its influencing factors, including lane position, the heavy vehicle percentage, lane traffic flow and work intensity which can be characterized by the number of lane reductions, the number of workers and the amount of equipment at the work zone site. The model results show that, for each pattern, there will be a greater rear-end crash risk in the following situations: (i) heavy work intensity; (ii) the lane adjacent to work zone; (iii) a higher proportion of heavy vehicles and (iv) greater traffic flow. However, the effects of these factors on rear-end crash risk are found to vary according to the vehicle-following patterns. Compared with the car-car pattern, lane position has less effect on rear-end crash risk in the car-truck pattern. The effect of work intensity on rear-end crash risk is also reduced in the truck-car pattern. Copyright © 2014 Elsevier Ltd. All rights reserved.

Comparative Spatial Dynamics of Japanese Encephalitis and Acute Encephalitis Syndrome in Nepal

PubMed Central

Robertson, Colin; Pant, Dhan Kumar; Joshi, Durga Datt; Sharma, Minu; Dahal, Meena; Stephen, Craig

2013-01-01

Japanese Encephalitis (JE) is a vector-borne disease of major importance in Asia. Recent increases in cases have spawned the development of more stringent JE surveillance. Due to the difficulty of making a clinical diagnosis, increased tracking of common symptoms associated with JE—generally classified as the umbrella term, acute encephalitis syndrome (AES) has been developed in many countries. In Nepal, there is some debate as to what AES cases are, and how JE risk factors relate to AES risk. Three parts of this analysis included investigating the temporal pattern of cases, examining the age and vaccination status patterns among AES surveillance data, and then focusing on spatial patterns of risk factors. AES and JE cases from 2007–2011 reported at a district level (n = 75) were examined in relation to landscape risk factors. Landscape pattern indices were used to quantify landscape patterns associated with JE risk. The relative spatial distribution of landscape risk factors were compared using geographically weighted regression. Pattern indices describing the amount of irrigated land edge density and the degree of landscape mixing for irrigated areas were positively associated with JE and AES, while fragmented forest measured by the number of forest patches were negatively associated with AES and JE. For both JE and AES, the local GWR models outperformed global models, indicating spatial heterogeneity in risks. Temporally, the patterns of JE and AES risk were almost identical; suggesting the relative higher caseload of AES compared to JE could provide a valuable early-warning signal for JE surveillance and reduce diagnostic testing costs. Overall, the landscape variables associated with a high degree of landscape mixing and small scale irrigated agriculture were positively linked to JE and AES risk, highlighting the importance of integrating land management policies, disease prevention strategies and promoting healthy sustainable livelihoods in both rural and urban-fringe developing areas. PMID:23894277

The Tromsø Heart Study: coronary risk factors in Seventh-Day Adventists.

PubMed

Fønnebø, V

1985-11-01

Seventh-Day Adventists in Tromsø showed a coronary risk factor pattern similar to Seventh-Day Adventists in other parts of the world. Compared with non-Seventh-Day Adventists, serum cholesterol was 1.35 mmol/liter (1974) and 0.83 mmol/liter (1979-1980) lower in males and 0.64 mmol/liter (1979-1980) lower in females. Blood pressure was lower in Seventh-Day Adventist women. The religiously inactive Seventh-Day Adventists had risk factor patterns more similar to non-Seventh-Day Adventists.

Orbitofrontal sulcogyral patterns are related to temperamental risk for psychopathology.

PubMed

Whittle, Sarah; Bartholomeusz, Cali; Yücel, Murat; Dennison, Meg; Vijayakumar, Nandita; Allen, Nicholas B

2014-02-01

There are marked individual differences in the pattern of cortical (sulcogyral) folding in the orbitofrontal cortex (OFC), and there is a growing literature suggesting that these individual differences are associated with risk for psychotic disorders. To date, however, no study has investigated whether OFC folding patterns are associated with broader risk factors relevant to a range of psychopathology. This study helps address this knowledge gap by examining whether OFC sulcogyral folding patterns are associated with putative risk factors, specifically affective temperament and psychiatric symptoms, in a large community sample (N = 152) of adolescents. Results showed that the most common pattern of folding ('Type I', marked by discontinuity of the medial orbital sulcus and continuity of the lateral orbital sulcus) was associated with low levels of Surgency, high levels of Negative Affectivity (in girls) and higher depressive symptoms. This pattern was also associated with reduced thickness of OFC gray matter. Overall, the findings, combined with previous work, suggest some specificity of neurodevelopmental risk for different types of psychopathology. Thus, these results have the potential to inform the early identification of at-risk individuals.

Using an autologistic regression model to identify spatial risk factors and spatial risk patterns of hand, foot and mouth disease (HFMD) in Mainland China

PubMed Central

2014-01-01

Background There have been large-scale outbreaks of hand, foot and mouth disease (HFMD) in Mainland China over the last decade. These events varied greatly across the country. It is necessary to identify the spatial risk factors and spatial distribution patterns of HFMD for public health control and prevention. Climate risk factors associated with HFMD occurrence have been recognized. However, few studies discussed the socio-economic determinants of HFMD risk at a space scale. Methods HFMD records in Mainland China in May 2008 were collected. Both climate and socio-economic factors were selected as potential risk exposures of HFMD. Odds ratio (OR) was used to identify the spatial risk factors. A spatial autologistic regression model was employed to get OR values of each exposures and model the spatial distribution patterns of HFMD risk. Results Results showed that both climate and socio-economic variables were spatial risk factors for HFMD transmission in Mainland China. The statistically significant risk factors are monthly average precipitation (OR = 1.4354), monthly average temperature (OR = 1.379), monthly average wind speed (OR = 1.186), the number of industrial enterprises above designated size (OR = 17.699), the population density (OR = 1.953), and the proportion of student population (OR = 1.286). The spatial autologistic regression model has a good goodness of fit (ROC = 0.817) and prediction accuracy (Correct ratio = 78.45%) of HFMD occurrence. The autologistic regression model also reduces the contribution of the residual term in the ordinary logistic regression model significantly, from 17.25 to 1.25 for the odds ratio. Based on the prediction results of the spatial model, we obtained a map of the probability of HFMD occurrence that shows the spatial distribution pattern and local epidemic risk over Mainland China. Conclusions The autologistic regression model was used to identify spatial risk factors and model spatial risk patterns of HFMD. HFMD occurrences were found to be spatially heterogeneous over the Mainland China, which is related to both the climate and socio-economic variables. The combination of socio-economic and climate exposures can explain the HFMD occurrences more comprehensively and objectively than those with only climate exposures. The modeled probability of HFMD occurrence at the county level reveals not only the spatial trends, but also the local details of epidemic risk, even in the regions where there were no HFMD case records. PMID:24731248

Dietary patterns and cardiovascular risk markers in the UK Low Income Diet and Nutrition Survey.

PubMed

Hamer, M; Mishra, G D

2010-09-01

Dietary patterns have been associated with various disease risk markers. There is presently little representative data about the dietary patterns of adults on low income. The objective was therefore to identify dietary patterns and how they relate to cardiovascular (CVD) risk markers in this specific population. Exploratory factor analysis was performed to examine dietary patterns in participants from the UK Low Income Diet and Nutrition Survey (n=2931, aged 49.4+/-20.2 years, 65% female). Dietary intake was assessed from three 24h dietary recalls and blood was drawn for the assessment of CVD risk markers (C-reactive protein [CRP], total and high density lipoprotein [HDL] cholesterol, triglycerides, homocysteine). Results of the factor analysis revealed four interpretable principle components accounting for approximately 16.5% of the total variance, with similar patterns across gender. A 'fast food' diet pattern explained the greatest proportion of the variance (5.5%), followed by 'health aware' (4.1%), 'traditional' (3.6%), and 'sweet' (3.3%) factors. Participants consuming more items from the fast food pattern were younger, more likely to be smokers and employed, but not partnered. The 'health aware' diet pattern was inversely associated with concentrations of CRP and homocysteine, and positively with HDL-cholesterol. A fast food dietary pattern, high in saturated fat, explained the greatest proportion of the variance in a representative sample of adults on low income from the UK. There was, however, considerable heterogeneity in dietary intake among this socially deprived group and healthy eating was associated with lower CVD risk markers. Copyright 2009 Elsevier B.V. All rights reserved.

Associations of dietary intake patterns identified using reduced rank regression with markers of arterial stiffness among youth with type 1 diabetes.

PubMed

Lamichhane, A P; Liese, A D; Urbina, E M; Crandell, J L; Jaacks, L M; Dabelea, D; Black, M H; Merchant, A T; Mayer-Davis, E J

2014-12-01

Youth with type 1 diabetes (T1DM) are at substantially increased risk for adverse vascular outcomes, but little is known about the influence of dietary behavior on cardiovascular disease (CVD) risk profile. We aimed to identify dietary intake patterns associated with CVD risk factors and evaluate their impact on arterial stiffness (AS) measures collected thereafter in a cohort of youth with T1DM. Baseline diet data from a food frequency questionnaire and CVD risk factors (triglycerides, low density lipoprotein-cholesterol, systolic blood pressure, hemoglobin A1c, C-reactive protein and waist circumference) were available for 1153 youth aged ⩾10 years with T1DM from the SEARCH for Diabetes in Youth Study. A dietary intake pattern was identified using 33 food groups as predictors and six CVD risk factors as responses in reduced rank regression (RRR) analysis. Associations of this RRR-derived dietary pattern with AS measures (augmentation index (AIx75), n=229; pulse wave velocity, n=237; and brachial distensibility, n=228) were then assessed using linear regression. The RRR-derived pattern was characterized by high intakes of sugar-sweetened beverages (SSB) and diet soda, eggs, potatoes and high-fat meats and low intakes of sweets/desserts and low-fat dairy; major contributors were SSB and diet soda. This pattern captured the largest variability in adverse CVD risk profile and was subsequently associated with AIx75 (β=0.47; P<0.01). The mean difference in AIx75 concentration between the highest and the lowest dietary pattern quartiles was 4.3% in fully adjusted model. Intervention strategies to reduce consumption of unhealthy foods and beverages among youth with T1DM may significantly improve CVD risk profile and ultimately reduce the risk for AS.

T wave abnormalities, high body mass index, current smoking and high lipoprotein (a) levels predict the development of major abnormal Q/QS patterns 20 years later. A population-based study

PubMed Central

Moller, Christina Strom; Byberg, Liisa; Sundstrom, Johan; Lind, Lars

2006-01-01

Background Most studies on risk factors for development of coronary heart disease (CHD) have been based on the clinical outcome of CHD. Our aim was to identify factors that could predict the development of ECG markers of CHD, such as abnormal Q/QS patterns, ST segment depression and T wave abnormalities, in 70-year-old men, irrespective of clinical outcome. Methods Predictors for development of different ECG abnormalities were identified in a population-based study using stepwise logistic regression. Anthropometrical and metabolic factors, ECG abnormalities and vital signs from a health survey of men at age 50 were related to ECG abnormalities identified in the same cohort 20 years later. Results At the age of 70, 9% had developed a major abnormal Q/QS pattern, but 63% of these subjects had not been previously hospitalized due to MI, while 57% with symptomatic MI between age 50 and 70 had no major Q/QS pattern at age 70. T wave abnormalities (Odds ratio 3.11, 95% CI 1.18–8.17), high lipoprotein (a) levels, high body mass index (BMI) and smoking were identified as significant independent predictors for the development of abnormal major Q/QS patterns. T wave abnormalities and high fasting glucose levels were significant independent predictors for the development of ST segment depression without abnormal Q/QS pattern. Conclusion T wave abnormalities on resting ECG should be given special attention and correlated with clinical information. Risk factors for major Q/QS patterns need not be the same as traditional risk factors for clinically recognized CHD. High lipoprotein (a) levels may be a stronger risk factor for silent myocardial infarction (MI) compared to clinically recognized MI. PMID:16519804

Comparison of 3 Methods for Identifying Dietary Patterns Associated With Risk of Disease

PubMed Central

DiBello, Julia R.; Kraft, Peter; McGarvey, Stephen T.; Goldberg, Robert; Campos, Hannia

2008-01-01

Reduced rank regression and partial least-squares regression (PLS) are proposed alternatives to principal component analysis (PCA). Using all 3 methods, the authors derived dietary patterns in Costa Rican data collected on 3,574 cases and controls in 1994–2004 and related the resulting patterns to risk of first incident myocardial infarction. Four dietary patterns associated with myocardial infarction were identified. Factor 1, characterized by high intakes of lean chicken, vegetables, fruit, and polyunsaturated oil, was generated by all 3 dietary pattern methods and was associated with a significantly decreased adjusted risk of myocardial infarction (28%–46%, depending on the method used). PCA and PLS also each yielded a pattern associated with a significantly decreased risk of myocardial infarction (31% and 23%, respectively); this pattern was characterized by moderate intake of alcohol and polyunsaturated oil and low intake of high-fat dairy products. The fourth factor derived from PCA was significantly associated with a 38% increased risk of myocardial infarction and was characterized by high intakes of coffee and palm oil. Contrary to previous studies, the authors found PCA and PLS to produce more patterns associated with cardiovascular disease than reduced rank regression. The most effective method for deriving dietary patterns related to disease may vary depending on the study goals. PMID:18945692

Patterns and Factors of High School Dropout Risks of Racial and Linguistic Groups

ERIC Educational Resources Information Center

Kim, Sunha; Chang, Mido; Singh, Kusum; Allen, Katherine R.

2015-01-01

This study examined the dropout trajectories of racial and linguistic minority students and explored the effects of students' contextual factors on their high school dropout risks. Our motivation was to identify the dropout patterns of Black, Hispanic, and Hispanic English language learner (ELL) students, who have comparatively high dropout rates,…

African-American suicide: a cultural paradox.

PubMed

Gibbs, J T

1997-01-01

African-American suicide rates have traditionally been lower than White rates despite a legacy of racial discrimination, persistent poverty, social isolation, and lack of community resources. This paper focuses on four issues: (1) patterns and trends of Black suicide across the lifespan; (2) risk and protective factors in subgroups of Blacks; (3) the influence of cultural factors on suicide patterns of Blacks; and (4) implications of these patterns for prevention and early intervention of suicidal behavior among African Americans. Risk factors for Black suicide include: male sex, early adulthood, substance abuse, psychiatric disorders, family or interpersonal conflict, antisocial behavior, and homosexuality. Protective factors that mitigate the risks of suicide include religiosity, older age, southern residence, and social support. Implications for preventive policies and programs are discussed to counter the recent trend of rising suicide rates among adolescents and very elderly Blacks.

Relation of type A behavior pattern and job-related psychosocial factors to nonfatal myocardial infarction: a case-control study of Japanese male workers and women.

PubMed

Yoshimasu, K

2001-01-01

To study the relation of type A behavior pattern and job-related psychosocial factors to the risk of myocardial infarction. Study subjects comprised 290 cases (173 male workers and 117 women) of nonfatal acute myocardial infarction (AMI) and 489 controls (303 male workers and 186 women) recruited from among residents of the study area. Participation rates of cases and controls were 86% and 50%, respectively. Type A behavior pattern, job-related psychosocial factors, and other coronary risk factors were ascertained by interview using a questionnaire. Type A behavior pattern was measured by 12 questions, and job strain by the method of Karasek. Logistic regression analysis was used to calculate odds ratio and 95% confidence interval with adjustment for potential confounding variables. The relation to job strain was examined only in men. Type A behavior pattern was significantly associated with an increased risk of AMI in male workers (adjusted OR = 1.9, 95% CI, 1.2-2.9) and in women (adjusted OR = 2.8, 95% CI, 1.6-4.9). Although job control and job demand showed no material association with AMI, job strain, a combination of low job control and high job demand was associated with an increased risk of AMI (adjusted OR = 2.2, 95% CI, 1.1-4.5). Abbreviated type A score and job demand score were higher among nonparticipant control candidates than participant controls in male workers. Type A behavior pattern may be an important risk factor for AMI especially in Japanese women. The present study also revealed persons in stressful psychosocial circumstances were less likely to participate in the study.

Analyzing musculoskeletal neck pain, measured as present pain and periods of pain, with three different regression models: a cohort study.

PubMed

Grimby-Ekman, Anna; Andersson, Eva M; Hagberg, Mats

2009-06-19

In the literature there are discussions on the choice of outcome and the need for more longitudinal studies of musculoskeletal disorders. The general aim of this longitudinal study was to analyze musculoskeletal neck pain, in a group of young adults. Specific aims were to determine whether psychosocial factors, computer use, high work/study demands, and lifestyle are long-term or short-term factors for musculoskeletal neck pain, and whether these factors are important for developing or ongoing musculoskeletal neck pain. Three regression models were used to analyze the different outcomes. Pain at present was analyzed with a marginal logistic model, for number of years with pain a Poisson regression model was used and for developing and ongoing pain a logistic model was used. Presented results are odds ratios and proportion ratios (logistic models) and rate ratios (Poisson model). The material consisted of web-based questionnaires answered by 1204 Swedish university students from a prospective cohort recruited in 2002. Perceived stress was a risk factor for pain at present (PR = 1.6), for developing pain (PR = 1.7) and for number of years with pain (RR = 1.3). High work/study demands was associated with pain at present (PR = 1.6); and with number of years with pain when the demands negatively affect home life (RR = 1.3). Computer use pattern (number of times/week with a computer session > or = 4 h, without break) was a risk factor for developing pain (PR = 1.7), but also associated with pain at present (PR = 1.4) and number of years with pain (RR = 1.2). Among life style factors smoking (PR = 1.8) was found to be associated to pain at present. The difference between men and women in prevalence of musculoskeletal pain was confirmed in this study. It was smallest for the outcome ongoing pain (PR = 1.4) compared to pain at present (PR = 2.4) and developing pain (PR = 2.5). By using different regression models different aspects of neck pain pattern could be addressed and the risk factors impact on pain pattern was identified. Short-term risk factors were perceived stress, high work/study demands and computer use pattern (break pattern). Those were also long-term risk factors. For developing pain perceived stress and computer use pattern were risk factors.

Analyzing musculoskeletal neck pain, measured as present pain and periods of pain, with three different regression models: a cohort study

PubMed Central

Grimby-Ekman, Anna; Andersson, Eva M; Hagberg, Mats

2009-01-01

Background In the literature there are discussions on the choice of outcome and the need for more longitudinal studies of musculoskeletal disorders. The general aim of this longitudinal study was to analyze musculoskeletal neck pain, in a group of young adults. Specific aims were to determine whether psychosocial factors, computer use, high work/study demands, and lifestyle are long-term or short-term factors for musculoskeletal neck pain, and whether these factors are important for developing or ongoing musculoskeletal neck pain. Methods Three regression models were used to analyze the different outcomes. Pain at present was analyzed with a marginal logistic model, for number of years with pain a Poisson regression model was used and for developing and ongoing pain a logistic model was used. Presented results are odds ratios and proportion ratios (logistic models) and rate ratios (Poisson model). The material consisted of web-based questionnaires answered by 1204 Swedish university students from a prospective cohort recruited in 2002. Results Perceived stress was a risk factor for pain at present (PR = 1.6), for developing pain (PR = 1.7) and for number of years with pain (RR = 1.3). High work/study demands was associated with pain at present (PR = 1.6); and with number of years with pain when the demands negatively affect home life (RR = 1.3). Computer use pattern (number of times/week with a computer session ≥ 4 h, without break) was a risk factor for developing pain (PR = 1.7), but also associated with pain at present (PR = 1.4) and number of years with pain (RR = 1.2). Among life style factors smoking (PR = 1.8) was found to be associated to pain at present. The difference between men and women in prevalence of musculoskeletal pain was confirmed in this study. It was smallest for the outcome ongoing pain (PR = 1.4) compared to pain at present (PR = 2.4) and developing pain (PR = 2.5). Conclusion By using different regression models different aspects of neck pain pattern could be addressed and the risk factors impact on pain pattern was identified. Short-term risk factors were perceived stress, high work/study demands and computer use pattern (break pattern). Those were also long-term risk factors. For developing pain perceived stress and computer use pattern were risk factors. PMID:19545386

Factors affecting stability and change in risky driving from late adolescence to the late twenties.

PubMed

Vassallo, Suzanne; Lahausse, Julie; Edwards, Ben

2016-03-01

The risky driving tendencies of young drivers has been extensively researched, but much less is known about across-time patterns of risky driving behavior and the factors which influence these. This study identified factors associated with stable, increasing and decreasing risky driving trajectories among 751 Australian drivers participating in an ongoing longitudinal study. Five groups were formed on the basis of participants' patterns of risky driving from 19-20 to 27-28 years (i.e., stable low-risk, stable speeding, stable high-risk, increasing and decreasing). Very few participants exhibited a stable high-risk pattern. Characteristics that differentiated the different across-time groups were identified using Multinomial Logistic Regression. The most consistent correlates of risky driving patterns were antisocial behavior, binge drinking and relationship status. Sex, school completion, temperament, civic engagement, and antisocial peer friendships were also correlated with different across-time patterns. The implications of these findings for road safety are discussed. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Do ethnic patterns in cryptorchidism reflect those found in testicular cancer?

PubMed

Gurney, Jason; Sarfati, Diana; Stanley, James; Studd, Rodney

2013-11-01

There are established variations in testicular cancer incidence between ethnic groups within countries. It is currently unclear whether the occurrence of cryptorchidism-a known risk factor for testicular cancer-follows similar patterns. In New Zealand Māori have unusually high rates of testicular cancer compared to individuals of European ancestry. We hypothesized that ethnic trends in the incidence of cryptorchidism would reflect those for testicular cancer in this setting. We followed 318,441 eligible male neonates born in New Zealand between 2000 and 2010 for the incidence of orchiopexy confirmed cryptorchidism and the incidence of known risk factors for cryptorchidism (low birth weight, short gestation, small size for gestational age) using routine maternity, hospitalization and mortality records. Logistic regression was used to calculate odds ratios for the presence of known risk factors for cryptorchidism by ethnic group. Poisson regression was used to calculate relative risk of cryptorchidism by ethnicity, adjusted for risk factors. Ethnic patterns of cryptorchidism incidence in New Zealand closely mirrored those previously observed for testicular cancer. Māori had higher rates of cryptorchidism than all other ethnic groups (adjusted RR 1.2 [95% CI 1.11-1.3]), with Pacific (0.89 [0.8-0.99]) and Asian groups (0.68 [0.59-0.79]) having the lowest rates (European/other, referent). Since the principal risk factors for cryptorchidism are present in utero, the results of the current study strengthen the likelihood that the ethnic patterning of testicular cancer is at least partly due to prenatal risk factors. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Personality patterns predict the risk of antisocial behavior in Spanish-speaking adolescents.

PubMed

Alcázar-Córcoles, Miguel A; Verdejo-García, Antonio; Bouso-Sáiz, José C; Revuelta-Menéndez, Javier; Ramírez-Lira, Ezequiel

2017-05-01

There is a renewed interest in incorporating personality variables in criminology theories in order to build models able to integrate personality variables and biological factors with psychosocial and sociocultural factors. The aim of this article is the assessment of personality dimensions that contribute to the prediction of antisocial behavior in adolescents. For this purpose, a sample of adolescents from El Salvador, Mexico, and Spain was obtained. The sample consisted of 1035 participants with a mean age of 16.2. There were 450 adolescents from a forensic population (those who committed a crime) and 585 adolescents from the normal population (no crime committed). All of participants answered personality tests about neuroticism, extraversion, psychoticism, sensation seeking, impulsivity, and violence risk. Principal component analysis of the data identified two independent factors: (i) the disinhibited behavior pattern (PDC), formed by the dimensions of neuroticism, psychoticism, impulsivity and risk of violence; and (ii) the extrovert behavior pattern (PEC), formed by the dimensions of sensation risk and extraversion. Both patterns significantly contributed to the prediction of adolescent antisocial behavior in a logistic regression model which properly classifies a global percentage of 81.9%, 86.8% for non-offense and 72.5% for offense behavior. The classification power of regression equations allows making very satisfactory predictions about adolescent offense commission. Educational level has been classified as a protective factor, while age and gender (male) have been classified as risk factors.

Comparison of Suicide Attempters and Decedents in the U.S. Army: A Latent Class Analysis.

PubMed

Skopp, Nancy A; Smolenski, Derek J; Sheppard, Sean C; Bush, Nigel E; Luxton, David D

2016-08-01

A clearer understanding of risk factors for suicidal behavior among soldiers is of principal importance to military suicide prevention. It is unclear whether soldiers who attempt suicide and those who die by suicide have different patterns of risk factors. As such, preventive efforts aimed toward reducing suicide attempts and suicides, respectively, may require different strategies. We conducted a latent class analysis (LCA) to examine classes of risk factors among suicide attempters (n = 1,433) and decedents (n = 424). Both groups were represented by three classes: (1) External/Antisocial Risk Factors, (2) Mental Health Risk Factors, and (3) No Pattern. These findings support the conceptualization that military suicide attempters and decedents represent a single population. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Geographic variation in risk factors for SFG rickettsial and leptospiral exposure in Colombia.

PubMed

Padmanabha, Harish; Hidalgo, Marylin; Valbuena, Gustavo; Castaneda, Elizabeth; Galeano, Armando; Puerta, Henry; Cantillo, Cesar; Mantilla, Gilma

2009-10-01

In order to characterize the patterns of human exposure to spotted fever group (SFG) rickettsial and leptospiral infection, IgG surveys were conducted on 642 residents of ten different areas of the rural district of Necoclí, Colombia. Areas were selected based on forest cover and human settlement pattern, and individual risk factors were elucidated through multivariate logistic models, controlling for variance clustering within communities. Overall, prevalence of high antibody titers indicating previous exposure to SFG rickettsia and leptospira was 29.2% and 35.6%, respectively, and both were most prevalent in the same peri-urban neighborhood. Forest cover .10% demonstrated the strongest independent association with leptospiral exposure, followed by homes with outdoor storage sheds. Isolated rural housing was the only variable independently associated with SFG rickettsia exposure. Community-level variables significantly modified the effects of individual risk factors. For both pathogens the eldest quartile was less exposed in periurban areas although there was no age effect overall for either. Females living in population settlements were more exposed to SFG rickettsiae but there was no sex association in isolated rural houses. Similarly, in sites with forest cover .10%, individuals working at home had higher leptospira seroprevalence, but place of work was not a risk factor in areas of forest cover ,10%. These data suggest that the patterns of maintenance and/or exposure to leptospira and rickettsia vary across different human created landscapes and settlement patterns. While contrasting risk factors may reflect the unique transmission cycles of each pathogen, the observed patterns of geographic variation suggest that both diseases may respond similarly larger scale human-ecological dynamics.

Internet and Cell Phone Usage Patterns among Young Adults with Intellectual Disabilities

ERIC Educational Resources Information Center

Jenaro, Cristina; Flores, Noelia; Cruz, Maribel; Pérez, Ma Carmen; Vega, Vanessa; Torres, Víctor A.

2018-01-01

Background: The risks and opportunities associated with the use of technologies are of growing research interest. Patterns of technology usage illuminate these opportunities and risks. However, no studies have assessed the usage patterns (frequency, duration, and intensity) and related factors in young people with intellectual disabilities.…

Generalizability of dietary patterns of the inverse association between alcohol consumption and type 2 diabetes risk

USDA-ARS?s Scientific Manuscript database

Epidemiology of dietary components and disease risk limits interpretability due to potential residual confounding by correlated dietary components. Dietary pattern analyses by factor analysis or partial least squares may overcome this limitation. To examine confounding by dietary pattern as well as ...

Confounding by dietary pattern of the inverse association between alcohol consumption and type 2 diabetes risk

USDA-ARS?s Scientific Manuscript database

Epidemiology of dietary components and disease risk limits interpretability due to potential residual confounding by correlated dietary components. Dietary pattern analyses by factor analysis or partial least squares may overcome the limitation. To examine confounding by dietary pattern as well as ...

Confounding by dietary patterns of the inverse association between alcohol consumption and type 2 diabetes risk

USDA-ARS?s Scientific Manuscript database

Epidemiology of dietary components and disease risk limits interpretability due to potential residual confounding by correlated dietary components. Dietary pattern analyses by factor analysis or partial least squares may overcome this limitation. To examine confounding by dietary pattern as well as ...

Dietary Patterns and Obesity among Chinese Adults: Results from a Household-Based Cross-Sectional Study.

PubMed

Zou, Yan; Zhang, Ronghua; Xia, Shichang; Huang, Lichun; Meng, Jia; Fang, Yueqiang; Ding, Gangqiang

2017-05-05

The key dietary pattern other than dietary factors influencing obesity has been reported by several large epidemiological studies. This study was carried out between 2010 and 2012 including 1613 adult residents in Zhejiang Province. Dietary patterns were extracted by factor analysis based on 24-h dietary recall. Associations with dietary patterns and obesity were examined and adjusted for age and gender by logistic regression. Five dietary patterns were identified by factor analysis with their eigenvalues greater than 1: 'cereal, animal, and plant food', 'high protein food', 'plant food', 'poultry', and 'beverage'. After adjustment for age and gender, the 'cereal, animal, and plant food' and 'beverage' pattern was associated with obesity (OR = 2.924, 3.257; 95% CI = 1.147-7.463, 1.372-7.692). In conclusion, 'cereal, animal, and plant food' and 'beverage' dietary patterns may be associated with increased risk of obesity. 'Cereal, animal, and plant food' dietary patterns may be associated with increased risk of obesity resulting from increased total energy intake by increased protein and fat intake; while a 'beverage' dietary pattern may be associated with increased risk of obesity resulting from increased total energy intake by increased carbohydrate intake. The findings are valuable in targeting future nutrition education.

Association between dietary pattern and risk of cardiovascular disease among adults in the Middle East and North Africa region: a systematic review

PubMed Central

Aljefree, Najlaa; Ahmed, Faruk

2015-01-01

Objective This paper reviews the evidence related to the association of dietary pattern with coronary heart disease (CHD), strokes, and the associated risk factors among adults in the Middle East and North Africa (MENA) region. Methods A systematic review of published articles between January 1990 and March 2015 was conducted using Pro-Quest Public Health, MEDLINE, and Google Scholar. The term ‘dietary pattern’ refers to data derived from dietary pattern analyses and individual food component analyses. Results The search identified 15 studies. The available data in the MENA region showed that Western dietary pattern has been predominant among adults with fewer adherences to the traditional diet, such as the Mediterranean diet. The Western dietary pattern was found to be associated with an increased risk of dyslipidaemia, diabetes, metabolic syndrome (MetS), body mass index (BMI), and hypertension. The Mediterranean diet, labelled in two studies as ‘the traditional Lebanese diet’, was negatively associated with BMI, waist circumference (WC), and the risk of diabetes, while one study found no association between the Mediterranean diet and MetS. Two randomised controlled trials conducted in Iran demonstrated the effect of the dietary approach to stop hypertension (DASH) in reducing metabolic risk among patients with diabetes and MetS. Likewise, the consumption of dairy products was associated with decreased blood pressure and WC, while the intake of whole grains was associated with reduced WC. In addition, the high consumption of black tea was found to be associated with decreased serum lipids. The intake of fish, vegetable oils, and tea had a protective effect on CHD, whereas the intake of full-fat yoghurt and hydrogenated fats was associated with an increased risk of CHD. Conclusion There appears to be a significant association of Western dietary pattern with the increased risk of CHD, strokes, and associated risk factors among adults in the MENA region. Conversely, increased adherence to Mediterranean and/or DASH dietary patterns or their individual food components is associated with a decreased risk of CHD and the associated risk factors. Therefore, increasing awareness of the high burden of CHD and the associated risk factors is crucial, as well as the need for nutrition education programs to improve the knowledge among the MENA population regarding healthy diets and diet-related diseases. PMID:26088003

An Evaluation of the Numbers and Locations of Coronary Artery Disease with Some of the Major Atherosclerotic Risk Factors in Patients with Coronary Artery Disease

PubMed Central

Naghshtabrizi, Behshad; Moradi, Abbas; Amiri, Jalaleddin; Aarabi, Sepide

2017-01-01

Introduction Despite definite recognition of major atherosclerotic risk factors, the relationship between the pattern of coronary artery disease and these risk factors is unknown. Aim The aim of this study was to identify the relationship between some of the major atherosclerotic risk factors and the number and pattern of coronary artery disease in patients with coronary artery disease who presented to Farshchian Heart University Hospital, Hamadan, Iran. Materials and Methods In this descriptive cross-sectional study, we investigated some of the major atherosclerotic risk factors and their relationships with the type of coronary artery disease in terms of number and location of disease. A total of 1100 patients were enrolled with coronary artery disease confirmed by selective coronary angiography from 2010-2014. A p-value<0.05 was considered statistically significant. Results A total of 1100 patients enrolled in this study. The patient population consisted of 743 (67.5%) males and 357 (32.5%) females. A meaningful relationship existed between ageing, diabetes mellitus, hypertension and 3-Vessel Disease (3VD, p<0.001) as well as between hyperlipidemia and Single Vessel Disease (SVD, p<0.001). Patients diagnosed with diabetes mellitus, hypertension, and hyperlipidemia showed greater potential to develop coronary artery disease at the proximal section of the coronary arteries. Conclusion Based on the relationship between some of the major risk factors and the pattern of coronary artery disease in the current study, prospective studies should investigate other risk factors. We recommend that a plan should be developed to reduce adjustable risk factors such as diabetes mellitus, hypertension and hyperlipidemia in order to decrease coronary artery disease. PMID:28969179

Patterns, Predictors, and Situational Contexts of HIV Risk Behaviors among Homeless Men and Women.

ERIC Educational Resources Information Center

Somlai, Anton M.; Kelly, Jeffrey A.; Wagstaff, David A.; Whitson, Donna P.

1998-01-01

Investigates psychosocial, relationship, and situational factors associated with HIV risk in a sample of 152 inner-city homeless men and women. Results show gender differences in risk patterns. Concludes that HIV prevention efforts tailored to the different risk circumstances of men and women are needed in social services programs for homeless…

[Analysis of dietary pattern and diabetes mellitus influencing factors identified by classification tree model in adults of Fujian].

PubMed

Yu, F L; Ye, Y; Yan, Y S

2017-05-10

Objective: To find out the dietary patterns and explore the relationship between environmental factors (especially dietary patterns) and diabetes mellitus in the adults of Fujian. Methods: Multi-stage sampling method were used to survey residents aged ≥18 years by questionnaire, physical examination and laboratory detection in 10 disease surveillance points in Fujian. Factor analysis was used to identify the dietary patterns, while logistic regression model was applied to analyze relationship between dietary patterns and diabetes mellitus, and classification tree model was adopted to identify the influencing factors for diabetes mellitus. Results: There were four dietary patterns in the population, including meat, plant, high-quality protein, and fried food and beverages patterns. The result of logistic analysis showed that plant pattern, which has higher factor loading of fresh fruit-vegetables and cereal-tubers, was a protective factor for non-diabetes mellitus. The risk of diabetes mellitus in the population at T2 and T3 levels of factor score were 0.727 (95 %CI: 0.561-0.943) times and 0.736 (95 %CI : 0.573-0.944) times higher, respectively, than those whose factor score was in lowest quartile. Thirteen influencing factors and eleven group at high-risk for diabetes mellitus were identified by classification tree model. The influencing factors were dyslipidemia, age, family history of diabetes, hypertension, physical activity, career, sex, sedentary time, abdominal adiposity, BMI, marital status, sleep time and high-quality protein pattern. Conclusion: There is a close association between dietary patterns and diabetes mellitus. It is necessary to promote healthy and reasonable diet, strengthen the monitoring and control of blood lipids, blood pressure and body weight, and have good lifestyle for the prevention and control of diabetes mellitus.

DNA Methylation: An Epigenetic Risk Factor in Preterm Birth

PubMed Central

Menon, Ramkumar; Conneely, Karen N.; Smith, Alicia K.

2012-01-01

Spontaneous preterm birth (PTB; birth prior to 37 weeks of gestation) is a complex phenotype with multiple risk factors that complicate our understanding of its etiology. A number of recent studies have supported the hypothesis that epigenetic modifications such as DNA methylation induced by pregnancy-related risk factors may influence the risk of PTB or result in changes that predispose a neonate to adult-onset diseases. The critical role of timing of gene expression in the etiology of PTB makes it a highly relevant disorder in which to examine the potential role of epigenetic changes. Because changes in DNA methylation patterns can result in long-term consequences, it is of critical interest to identify the epigenetic patterns associated with adverse pregnancy outcomes. This review examines the potential role of DNA methylation as a risk factor for PTB and discusses several issues and limitations that should be considered when planning DNA methylation studies. PMID:22228737

Urinary incontinence, fecal incontinence and pelvic organ prolapse in a population-based, racially diverse cohort. Prevalence and risk factors

PubMed Central

RORTVEIT, Guri; SUBAK, Leslee L.; THOM, David H.; CREASMAN, Jennifer M.; VITTINGHOFF, Eric; VAN DEN EEDEN, Stephen K.; BROWN, Jeanette S.

2016-01-01

Objectives We investigated the prevalence of and risk factors for combinations of urinary incontinence (UI), fecal incontinence (FI) and pelvic organ prolapse (POP) in racially diverse women over age 40. Methods The Reproductive Risks for Incontinence Study at Kaiser (RRISK) is a population-based study with data from 2106 women > 40 years. Pelvic floor conditions were determined by self-report. Risk factors were assessed by self-report, interview and record review. Independent risk factors were identified by multinomial logistic regression analysis. Results At least one pelvic floor condition was reported by 714 (34%) women. Of these, 494 (69%) had UI only, 60 (8%) POP only, and 46 (6%) had FI only. Both UI and FI were reported by 64 (9%), both UI and POP by 51 (7%). Among women with FI, 60% reported more than one condition. Corresponding figures for POP and UI were 49% and 18%. Estrogen use and constipation were shared risk factors for UI, FI and POP. BMI was a unique risk factor for UI only, diabetes for FI only and parity for POP only. No clear pattern could be found to support the hypothesis that risk factors for single conditions are more strongly associated with combined conditions. Conclusions Patients with FI or POP often have concomitant UI. These diseases both share and have unique risk factors in a complex pattern. PMID:22453506

A single-center experience and review of the literature: 64 cases of phyllodes tumors to better understand risk factors and disease management.

PubMed

Lightner, Amy L; Shurell, Elizabeth; Dawson, Nicole; Omidvar, Yasaman; Foster, Nova

2015-03-01

Phyllodes tumors of the breast are rare fibroepithelial tumors that are characterized as benign, borderline, or malignant based on cellular characteristics such as stromal overgrowth and number of mitoses. Currently, there is a lack of consensus on risk factors and management of patients with phyllodes tumors, which has led to variation in treatment patterns as well as patient outcomes across many institutions. This study seeks to understand the clinicopathologic features, risk factors for local and metastatic recurrence, and clinical outcomes of patients with phyllodes tumors to better define optimal treatment patterns.

Circadian rhythm, sleep pattern, and metabolic consequences: an overview on cardiovascular risk factors.

PubMed

Machado, Roberta Marcondes; Koike, Marcia Kiyomi

2014-04-01

Sleep duration is a risk factor for cardiovascular disease. Alteration in sleep pattern can induce the loss of circadian rhythmicity. Chronically, this desynchronization between endogenous rhythm and behavioral cycles can lead to an adverse metabolic profile, a proinflammatory condition and can increase the risk of cardiovascular disease. The circadian cycle can vary due to environmental cues. The circadian pacemaker is located in the suprachiasmatic nuclei; this central clock coordinates the circadian rhythm in the central nervous system and peripheral tissues. The mechanisms involved in sleep disturbance, circadian misalignment and adverse metabolic effects have yet to be fully elucidated. This review looks over the association among sleep alteration, circadian rhythm and the development of risk factors implicated in cardiovascular disease.

Structural Factors Influencing Patterns of Drug Selling and Use and HIV Risk in the San Salvador Metropolitan Area

PubMed Central

Dickson-Gomez, Julia

2013-01-01

This article explores differences in the social context in which crack sales and use and HIV risk take place in seven low-income communities in San Salvador, and structural factors that may influence these differences. The organization of drug selling varied among the communities on a number of dimensions including: whether drug sales were open or closed systems; the type of drug-selling site; and the participation of drug users in drug-distribution roles. Drug-use sites also varied according to whether crack was used in private, semiprivate, or public spaces, and whether individuals used drugs alone or with other drug users. Three patterns of drug use and selling were identified based on the dimensions outlined above. Structural factors that influenced these patterns included the geographic location of the communities, their physical layout, gang involvement in drug sales, and police surveillance. Implications for HIV risk and prevention are explored for each pattern. PMID:20550091

Dietary patterns are associated with incident stroke and contribute to excess risk of stroke in black Americans.

PubMed

Judd, Suzanne E; Gutiérrez, Orlando M; Newby, P K; Howard, George; Howard, Virginia J; Locher, Julie L; Kissela, Brett M; Shikany, James M

2013-12-01

Black Americans and residents of the Southeastern United States are at increased risk of stroke. Diet is one of many potential factors proposed that might explain these racial and regional disparities. Between 2003 and 2007, the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study enrolled 30 239 black and white Americans aged≥45 years. Dietary patterns were derived using factor analysis and foods from food frequency data. Incident strokes were adjudicated using medical records by a team of physicians. Cox-proportional hazards models were used to examine risk of stroke. During 5.7 years, 490 incident strokes were observed. In a multivariable-adjusted analysis, greater adherence to the plant-based pattern was associated with lower stroke risk (hazard ratio, 0.71; 95% confidence interval, 0.56-0.91; Ptrend=0.005). This association was attenuated after addition of income, education, total energy intake, smoking, and sedentary behavior. Participants with a higher adherence to the Southern pattern experienced a 39% increased risk of stroke (hazard ratio, 1.39; 95% confidence interval, 1.05, 1.84), with a significant (P=0.009) trend across quartiles. Including Southern pattern in the model mediated the black-white risk of stroke by 63%. These data suggest that adherence to a Southern style diet may increase the risk of stroke, whereas adherence to a more plant-based diet may reduce stroke risk. Given the consistency of finding a dietary effect on stroke risk across studies, discussing nutrition patterns during risk screening may be an important step in reducing stroke.

Dietary Patterns and Obesity among Chinese Adults: Results from a Household-Based Cross-Sectional Study

PubMed Central

Zou, Yan; Zhang, Ronghua; Xia, Shichang; Huang, Lichun; Meng, Jia; Fang, Yueqiang; Ding, Gangqiang

2017-01-01

The key dietary pattern other than dietary factors influencing obesity has been reported by several large epidemiological studies. This study was carried out between 2010 and 2012 including 1613 adult residents in Zhejiang Province. Dietary patterns were extracted by factor analysis based on 24-h dietary recall. Associations with dietary patterns and obesity were examined and adjusted for age and gender by logistic regression. Five dietary patterns were identified by factor analysis with their eigenvalues greater than 1: ‘cereal, animal, and plant food’, ‘high protein food’, ‘plant food’, ‘poultry’, and ‘beverage’. After adjustment for age and gender, the ‘cereal, animal, and plant food’ and ‘beverage’ pattern was associated with obesity (OR = 2.924, 3.257; 95% CI = 1.147–7.463, 1.372–7.692). In conclusion, ‘cereal, animal, and plant food’ and ‘beverage’ dietary patterns may be associated with increased risk of obesity. ‘Cereal, animal, and plant food’ dietary patterns may be associated with increased risk of obesity resulting from increased total energy intake by increased protein and fat intake; while a ‘beverage’ dietary pattern may be associated with increased risk of obesity resulting from increased total energy intake by increased carbohydrate intake. The findings are valuable in targeting future nutrition education. PMID:28475157

Specificity of Putative Psychosocial Risk Factors for Psychiatric Disorders in Children and Adolescents

ERIC Educational Resources Information Center

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

2008-01-01

Background: Most psychosocial risk factors appear to have general rather than specific patterns of association with common childhood and adolescence disorders. However, previous research has typically failed to 1) control for comorbidity among disorders, 2) include a wide range of risk factors, and 3) examine sex by developmental stage effects on…

Local Breast Cancer Spatial Patterning: A Tool for Community Health Resource Allocation to Address Local Disparities in Breast Cancer Mortality

PubMed Central

Brantley-Sieders, Dana M.; Fan, Kang-Hsien; Deming-Halverson, Sandra L.; Shyr, Yu; Cook, Rebecca S.

2012-01-01

Despite available demographic data on the factors that contribute to breast cancer mortality in large population datasets, local patterns are often overlooked. Such local information could provide a valuable metric by which regional community health resources can be allocated to reduce breast cancer mortality. We used national and statewide datasets to assess geographical distribution of breast cancer mortality rates and known risk factors influencing breast cancer mortality in middle Tennessee. Each county in middle Tennessee, and each ZIP code within metropolitan Davidson County, was scored for risk factor prevalence and assigned quartile scores that were used as a metric to identify geographic areas of need. While breast cancer mortality often correlated with age and incidence, geographic areas were identified in which breast cancer mortality rates did not correlate with age and incidence, but correlated with additional risk factors, such as mammography screening and socioeconomic status. Geographical variability in specific risk factors was evident, demonstrating the utility of this approach to identify local areas of risk. This method revealed local patterns in breast cancer mortality that might otherwise be overlooked in a more broadly based analysis. Our data suggest that understanding the geographic distribution of breast cancer mortality, and the distribution of risk factors that contribute to breast cancer mortality, will not only identify communities with the greatest need of support, but will identify the types of resources that would provide the most benefit to reduce breast cancer mortality in the community. PMID:23028869

A prospective cohort study of dietary patterns of non-western migrants in the Netherlands in relation to risk factors for cardiovascular diseases: HELIUS-Dietary Patterns

PubMed Central

2011-01-01

Background In Western countries the prevalence of cardiovascular disease (CVD) is often higher in non-Western migrants as compared to the host population. Diet is an important modifiable determinant of CVD. Increasingly, dietary patterns rather than single nutrients are the focus of research in an attempt to account for the complexity of nutrient interactions in foods. Research on dietary patterns in non-Western migrants is limited and may be hampered by a lack of validated instruments that can be used to assess the habitual diet of non-western migrants in large scale epidemiological studies. The ultimate aims of this study are to (1) understand whether differences in dietary patterns explain differences in CVD risk between ethnic groups, by developing and validating ethnic-specific Food Frequency Questionnaires (FFQs), and (2) to investigate the determinants of these dietary patterns. This paper outlines the design and methods used in the HELIUS-Dietary Patterns study and describes a systematic approach to overcome difficulties in the assessment and analysis of dietary intake data in ethnically diverse populations. Methods/Design The HELIUS-Dietary Patterns study is embedded in the HELIUS study, a Dutch multi-ethnic cohort study. After developing ethnic-specific FFQs, we will gather data on the habitual intake of 5000 participants (18-70 years old) of ethnic Dutch, Surinamese of African and of South Asian origin, Turkish or Moroccan origin. Dietary patterns will be derived using factor analysis, but we will also evaluate diet quality using hypothesis-driven approaches. The relation between dietary patterns and CVD risk factors will be analysed using multiple linear regression analysis. Potential underlying determinants of dietary patterns like migration history, acculturation, socio-economic factors and lifestyle, will be considered. Discussion This study will allow us to investigate the contribution of the dietary patterns on CVD risk factors in a multi-ethnic population. Inclusion of five ethnic groups residing in one setting makes this study highly innovative as confounding by local environment characteristics is limited. Heterogeneity in the study population will provide variance in dietary patterns which is a great advantage when studying the link between diet and disease. PMID:21649889

Analysis of sex-specific injury patterns and risk factors in young high-level athletes.

PubMed

Frisch, A; Seil, R; Urhausen, A; Croisier, J L; Lair, M L; Theisen, D

2009-12-01

This study analyzed sex-specific injury patterns and risk factors in young athletes (n=256) from 12 sport disciplines practicing at the national or the international level in the Grand-Duchy of Luxembourg. Injury occurrence as a result of sport practice was analyzed retrospectively over the year 2006 using a standardized self-administered questionnaire. Overall incidence was not different between girls and boys (1.20 and 1.21 injuries/1000 athlete-hours, respectively), but in the context of team sport competition girls tended to be at a greater risk (rate ratio 2.05, P=0.053). Girls had a higher proportion of injuries in the ankle/foot region compared with boys (34.8% vs 16.8%). No sex-related differences were found regarding injury severity. Multivariate logistic regression (controlling for age and practice volume) revealed that girls' team sports were associated with a greater injury risk compared with individual sports [odds ratio (OR) of 4.76], while in boys this was observed for racket sports (OR=3.31). Furthermore, physical or emotional stress tended to be a specific risk factor in girls. There was a tendency for injury outside sports to be coupled to a higher injury risk in girls and boys. Consideration of sex-specific injury patterns and risk factors could be of importance for effective injury prevention.

Early Patterns of Self-Regulation as Risk and Promotive Factors in Development: A Longitudinal Study from Childhood to Adulthood in a High-Risk Sample

ERIC Educational Resources Information Center

Causadias, Jose M.; Salvatore, Jessica E.; Sroufe, L. Alan

2012-01-01

The present study examines two childhood markers of self-regulation, ego control and ego resiliency, as promotive factors for the development of global adjustment and as risk factors for the development of internalizing and externalizing behavior problems in a high-risk sample. Teachers and observers rated ego control and ego resiliency when…

Protective and risk factors in amateur equestrians and description of injury patterns: A retrospective data analysis and a case - control survey

PubMed Central

2011-01-01

Background In Switzerland there are about 150,000 equestrians. Horse related injuries, including head and spinal injuries, are frequently treated at our level I trauma centre. Objectives To analyse injury patterns, protective factors, and risk factors related to horse riding, and to define groups of safer riders and those at greater risk Methods We present a retrospective and a case-control survey at conducted a tertiary trauma centre in Bern, Switzerland. Injured equestrians from July 2000 - June 2006 were retrospectively classified by injury pattern and neurological symptoms. Injured equestrians from July-December 2008 were prospectively collected using a questionnaire with 17 variables. The same questionnaire was applied in non-injured controls. Multiple logistic regression was performed, and combined risk factors were calculated using inference trees. Results Retrospective survey A total of 528 injuries occured in 365 patients. The injury pattern revealed as follows: extremities (32%: upper 17%, lower 15%), head (24%), spine (14%), thorax (9%), face (9%), pelvis (7%) and abdomen (2%). Two injuries were fatal. One case resulted in quadriplegia, one in paraplegia. Case-control survey 61 patients and 102 controls (patients: 72% female, 28% male; controls: 63% female, 37% male) were included. Falls were most frequent (65%), followed by horse kicks (19%) and horse bites (2%). Variables statistically significant for the controls were: Older age (p = 0.015), male gender (p = 0.04) and holding a diploma in horse riding (p = 0.004). Inference trees revealed typical groups less and more likely to suffer injury. Conclusions Experience with riding and having passed a diploma in horse riding seem to be protective factors. Educational levels and injury risk should be graded within an educational level-injury risk index. PMID:21294862

Dietary Pattern and Its Association with the Prevalence of Obesity and Related Cardiometabolic Risk Factors among Chinese Children

PubMed Central

Shang, Xianwen; Li, Yanping; Liu, Ailing; Zhang, Qian; Hu, Xiaoqi; Du, Songming; Ma, Guansheng

2012-01-01

Background The association of dietary pattern with chronic diseases has been investigated widely in western countries. However, information is quite limited among children in China. Our study is aimed to identify the dietary patterns of Chinese children and examine their association with obesity and related cardiometabolic risk factors. Methods A total of 5267 children were selected using multistage random sampling from 30 primary schools of 5 provincial capital cities in China. Dietary intake was derived from 24 hour dietary recall for three consecutive days. Anthropometric measurements, glucose and lipid profiles were obtained. Factor analysis combined with cluster analysis was used for identifying major dietary patterns. The associations of dietary patterns with obesity and related cardiometabolic risk factors were examined by logistic regression analysis. Results Three mutually exclusive dietary patterns were identified, which were labeled as the healthy dietary pattern, the transitive dietary pattern, and the Western dietary pattern. Compared with children of the healthy dietary pattern, the multiple-adjusted odds ratios (95% confidence interval (CI)) of obesity were 1.11 (0.89–1.38) for children with the transitive dietary pattern and 1.80 (1.15–2.81) for children with the Western dietary pattern, which was 1.31 (95%CI 1.09–1.56) and 1.71 (95%CI: 1.13–2.56), respectively, for abdominal obesity. The Western dietary pattern was associated with significantly higher concentrations of low-density lipoprotein cholesterol (P<.001), triglycerides (P<.001), systolic blood pressure (P = 0.0435) and fasting glucose (P = 0.0082) and a lower concentration of high-density lipoprotein cholesterol (P = 0.0023), as compared with the healthy dietary pattern. Conclusions The Western dietary pattern characterized by red meat, eggs, refined grain and products, was positively associated with odds of obesity, the levels of plasma glucose, low-density lipoprotein cholesterol and triglycerides, and was inversely associated with the level of high-density lipoprotein cholesterol. PMID:22905228

Dietary patterns and risk of colorectal cancer in Tehran Province: a case-control study.

PubMed

Safari, Akram; Shariff, Zalilah Mohd; Kandiah, Mirnalini; Rashidkhani, Bahram; Fereidooni, Foroozandeh

2013-03-12

Colorectal cancer is the third and fourth leading cause of cancer incidence and mortality among men and women, respectively in Iran. However, the role of dietary factors that could contribute to this high cancer incidence remains unclear. The aim of this study was to determine major dietary patterns and its relationship with colorectal cancer. This case-control study was conducted in four hospitals in Tehran city of Iran. A total of 71 patients (35 men and 36 women, aged 40-75 years) with incident clinically confirmed colorectal cancer (CRC) and 142 controls (70 men and 72 women, aged 40-75 years) admitted to hospital for acute, non-neoplastic diseases were recruited and interviewed. Dietary data were assessed by 125-item semi-quantitative food frequency questionnaire. Multivariate logistic regression was used to estimate the relationship between dietary patterns and risk of colorectal cancer. Two major dietary patterns (Healthy pattern and Western pattern) were derived using principal component analysis. Each dietary pattern explained 11.9% (Healthy pattern) and 10.3% (Western pattern) of the variation in food intake, respectively. After adjusting for confounding factors, the Healthy dietary pattern was significantly associated with a decreased risk of colorectal cancer (OR= 0.227; 95% CI=0.108-0.478) while an increased risk of colorectal cancer was observed with the Western dietary pattern (OR=2.616; 95% CI= 1.361-5.030). Specific dietary patterns, which include healthy and western patterns, may be associated with the risk of colorectal cancer. This diet-disease relationship can be used for developing interventions that aim to promote healthy eating for the prevention of chronic disease, particularly colorectal cancer in the Iranian population.

Dietary Patterns and Risk of Gallbladder Disease: A Hospital-based Case-Control Study in Adult Women

PubMed Central

Jessri, Mahsa

2015-01-01

ABSTRACT Gallbladder disease is one of the most prevalent gastrointestinal disorders that may result from a complex interaction of genetic and environmental factors. This study examined the association of dietary patterns with gallstone disease among Iranian women. This case-control study was conducted in general teaching hospitals in Tehran, Iran. Participants were 101 female cases and 204 female controls aged 40-65 years who were admitted for problems other than GBD. Dietary patterns were identified using principal components analysis based on food frequency questionnaire. Compared to the control group, cases were less educated, less physically active, and consumed more total energy (p<0.02). Having ≥3 livebirths increased the risk of gallstone by more than 5 times, followed by having rapid weight loss, being single, having familial history of gallstone, and consuming high total energy. Two distinct dietary patterns were identified in women (healthy and unhealthy). After adjustment for several confounding variables, healthy dietary pattern was associated with a decreased risk of gallstone disease (OR=0.14, 95% CI 0.048-0.4) while unhealthy dietary pattern was associated with an increased risk (OR=3.77, 95% CI 1.52-9.36). These findings confirm that dietary pattern approach provides potentially useful and relevant information on the relationship between diet and disease. Identifying risk factors will provide an opportunity for prevention of gallbladder disease in developing countries facing an increased risk of obesity. PMID:25995720

Risk factors for under-diagnosis of gastric intraepithelial neoplasia and early gastric carcinoma in endoscopic forceps biopsy in comparison with endoscopic submucosal dissection in Chinese patients.

PubMed

Xu, Guifang; Zhang, Weijie; Lv, Ying; Zhang, Bin; Sun, Qi; Ling, Tingsheng; Zhang, Xiaoqi; Zhou, Zhihua; Wang, Lei; Huang, Qin; Zou, Xiaoping

2016-07-01

Differences in pathologic diagnosis between endoscopic forceps biopsy (EFB) and endoscopic submucosal dissection (ESD) for gastric intraepithelial neoplasia (GIN) and early gastric carcinoma (EGC) in Chinese patients remain unknown. The aim of the study was to investigate risk factors for under-diagnosed pathology in initial EFB, compared to final ESD. We reviewed endoscopic and histopathologic findings for tumor location, size, macroscopic pattern, nodularity, erythema, erosion, GIN (low and high grade), and EGC diagnosed with the WHO criteria. Differences in those features between EFB and ESD were compared and risk factors for under-diagnosis by EFB were analyzed. Although concordant in most (74.9 %) cases between EFBs and ESDs, pathological diagnoses in 57 (25.1 %) cases were upgraded in ESDs. Compared to the concordant group, the lesion size ≥2 cm, and depressed and excavated patterns were significantly more frequent in the upgraded group. Further multivariate regression analysis demonstrated the depressed pattern and lesion size ≥2 cm as independent risk factors for upgraded pathology with the odds ratio of 5.778 (95 % confidence interval 2.893-11.542) and 2.535 (95 % confidence interval 1.257-5.111), respectively. Lesion size ≥2.0 cm and the depressed pattern at initial EFB were independent risk factors for pathologic upgrade to advanced diseases in ESD. Therefore, these endoscopic characteristics should be considered together with the initial EFB diagnosis to guide the optimal clinical management of patients with GIN and EGC.

Factors Associated with the Risk of Behaviour Problems in Adolescents with Severe Intellectual Disabilities

ERIC Educational Resources Information Center

Chadwick, O.; Kusel, Y.; Cuddy, M.

2008-01-01

Background: Little is known about the factors affecting the risk of behavioural and emotional problems in young people with severe intellectual disability (ID), although such evidence as there is suggests that there may be differences between the pattern of risk factors in this group and those that operate in general population samples of the same…

Clustering of four major lifestyle risk factors among Korean adults with metabolic syndrome.

PubMed

Ha, Shin; Choi, Hui Ran; Lee, Yo Han

2017-01-01

The purpose of this study was to investigate the clustering pattern of four major lifestyle risk factors-smoking, heavy drinking, poor diet, and physical inactivity-among people with metabolic syndrome in South Korea. There were 2,469 adults with metabolic syndrome aged 30 years or older available with the 5th Korean National Health and Nutrition Examination Survey dataset. We calculated the ratio of the observed to expected (O/E) prevalence for the 16 different combinations and the prevalence odds ratios (POR) of four lifestyle risk factors. The four lifestyle risk factors tended to cluster in specific multiple combinations. Smoking and heavy drinking was clustered (POR: 1.86 for male, 4.46 for female), heavy drinking and poor diet were clustered (POR: 1.38 for male, 1.74 for female), and smoking and physical inactivity were also clustered (POR: 1.48 for male). Those who were male, younger, low-educated and living alone were much more likely to have a higher number of lifestyle risk factors. Some helpful implications can be drawn from the knowledge on clustering pattern of lifestyle risk factors for more effective intervention program targeting metabolic syndrome.

The RS4939827 polymorphism in the SMAD7 GENE and its association with Mediterranean diet in colorectal carcinogenesis.

PubMed

Alonso-Molero, Jéssica; González-Donquiles, Carmen; Palazuelos, Camilo; Fernández-Villa, Tania; Ramos, Elena; Pollán, Marina; Aragonés, Nuria; Llorca, Javier; Henar Alonso, M; Tardón, Adonina; Amiano, Pilar; Moleon, José Juan Jiménez; Pérez, Rosana Peiró; Capelo, Rocío; Molina, Antonio J; Acebo, Inés Gómez; Guevara, Marcela; Perez-Gomez, Beatriz; Lope, Virginia; Huerta, José María; Castaño-Vinyals, Gemma; Kogevinas, Manolis; Moreno, Victor; Martín, Vicente

2017-10-30

The objective of our investigation is to study the relationship between the rs4939827 SNP in the SMAD7 gene, Mediterranean diet pattern and the risk of colorectal cancer. We examined 1087 cases of colorectal cancer and 2409 population controls with available DNA samples from the MCC-Spain study, 2008-2012. Descriptive statistical analyses, and multivariate logistic mixed models were performed. The potential synergistic effect of rs4939827 and the Mediterranean diet pattern was evaluated with logistic regression in different strata of of adherence to the Mediterranean diet and the genotype. High adherence to Mediterrenean diet was statistically significantly associated with colorectal cancer risk. A decreased risk for CRC cancer was observed for the CC compared to the TT genotype (OR = 0.65 and 95% CI = 0.51-0.81) of the rs4939827 SNP Also, we could show an association between the Mediterranean diet pattern (protective factor) and rs4939827. Although the decreased risk for the CC genotype was slightly more pronounced in subjects with high adherence to Mediterrenean diet, there was no statistically significant synergistic effect between genotype CC and adherence to the Mediterranean dietary pattern factors. The SMAD7 gene and specifically the allele C could be protective for colorectal cancer. An independent protective association was also observed between high adherence Mediterranean diet pattern and CRC risk. Findings form this study indicate that high adherence to Mediterranean diet pattern has a protective role for CRC cancer probably involving the Tumor Growth Factor- β pathway in this cancer.

Cluster Profiles of Youths Living in Urban Poverty: Factors Affecting Risk and Resilience

ERIC Educational Resources Information Center

Anthony, Elizabeth K.

2008-01-01

This study examined risk and protective factors among a sample of 157 youths between grades and 8 who resided in three urban public housing developments. The relationship between identified patterns of risk and protection and educational and behavioral outcomes was assessed. Indicators of risk and protection were based on an ecological and…

Dietary patterns associated with fall-related fracture in elderly Japanese: a population based prospective study.

PubMed

Monma, Yasutake; Niu, Kaijun; Iwasaki, Koh; Tomita, Naoki; Nakaya, Naoki; Hozawa, Atsushi; Kuriyama, Shinichi; Takayama, Shin; Seki, Takashi; Takeda, Takashi; Yaegashi, Nobuo; Ebihara, Satoru; Arai, Hiroyuki; Nagatomi, Ryoichi; Tsuji, Ichiro

2010-06-01

Diet is considered an important factor for bone health, but is composed of a wide variety of foods containing complex combinations of nutrients. Therefore we investigated the relationship between dietary patterns and fall-related fractures in the elderly. We designed a population-based prospective survey of 1178 elderly people in Japan in 2002. Dietary intake was assessed with a 75-item food frequency questionnaire (FFQ), from which dietary patterns were created by factor analysis from 27 food groups. The frequency of fall-related fracture was investigated based on insurance claim records from 2002 until 2006. The relationship between the incidence of fall-related fracture and modifiable factors, including dietary patterns, were examined. The Cox proportional hazards regression model was used to examine the relationships between dietary patterns and incidence of fall-related fracture with adjustment for age, gender, Body Mass Index (BMI) and energy intake. Among 877 participants who agreed to a 4 year follow-up, 28 suffered from a fall-related fracture. Three dietary patterns were identified: mainly vegetable, mainly meat and mainly traditional Japanese. The moderately confirmed (see statistical methods) groups with a Meat pattern showed a reduced risk of fall-related fracture (Hazard ratio = 0.36, 95% CI = 0.13 - 0.94) after adjustment for age, gender, BMI and energy intake. The Vegetable pattern showed a significant risk increase (Hazard ratio = 2.67, 95% CI = 1.03 - 6.90) after adjustment for age, gender and BMI. The Traditional Japanese pattern had no relationship to the risk of fall-related fracture. The results of this study have the potential to reduce fall-related fracture risk in elderly Japanese. The results should be interpreted in light of the overall low meat intake of the Japanese population.

Which modifiable health risk behaviours are related? A systematic review of the clustering of Smoking, Nutrition, Alcohol and Physical activity ('SNAP') health risk factors.

PubMed

Noble, Natasha; Paul, Christine; Turon, Heidi; Oldmeadow, Christopher

2015-12-01

There is a growing body of literature examining the clustering of health risk behaviours, but little consensus about which risk factors can be expected to cluster for which sub groups of people. This systematic review aimed to examine the international literature on the clustering of smoking, poor nutrition, excess alcohol and physical inactivity (SNAP) health behaviours among adults, including associated socio-demographic variables. A literature search was conducted in May 2014. Studies examining at least two SNAP risk factors, and using a cluster or factor analysis technique, or comparing observed to expected prevalence of risk factor combinations, were included. Fifty-six relevant studies were identified. A majority of studies (81%) reported a 'healthy' cluster characterised by the absence of any SNAP risk factors. More than half of the studies reported a clustering of alcohol with smoking, and half reported clustering of all four SNAP risk factors. The methodological quality of included studies was generally weak to moderate. Males and those with greater social disadvantage showed riskier patterns of behaviours; younger age was less clearly associated with riskier behaviours. Clustering patterns reported here reinforce the need for health promotion interventions to target multiple behaviours, and for such efforts to be specifically designed and accessible for males and those who are socially disadvantaged. Copyright © 2015 Elsevier Inc. All rights reserved.

Early and Late Recurrent Epistaxis Admissions: Patterns of Incidence and Risk Factors.

PubMed

Cohen, Oded; Shoffel-Havakuk, Hagit; Warman, Meir; Tzelnick, Sharon; Haimovich, Yaara; Kohlberg, Gavriel D; Halperin, Doron; Lahav, Yonatan

2017-09-01

Objective Epistaxis is a common complaint, yet few studies have focused on the incidence and risk factors of recurrent epistaxis. Our objective was to determine the patterns of incidence and risk factors for recurrent epistaxis admission (REA). Study Design Case series with chart review. Settings Single academic center. Subjects and Methods The medical records of patients admitted for epistaxis between 1999 and 2015 were reviewed. The follow-up period was defined as 3 years following initial admission. REAs were categorized as early (30 days) and late (31 days to 3 years) following initial admission. Logistic regression was used to identify potential predictors of REAs. Results A total of 653 patients were included. Eighty-six patients (14%) had REAs: 48 (7.5%) early and 38 (6.5%) late. Nonlinear incidence curve was demonstrated for both early and late REAs. Based on logistic regression, prior nasal surgery and anemia were independent risk factors for early REAs. According to multivariate analysis, thrombocytopenia was significantly associated with late REAs. Conclusion Early and late REAs demonstrate different risk predictors. Knowledge of such risk factors may help in risk stratification for this selected group of patients. All patients at risk should be advised on possible preventive measures. Patients at risk for early REA may benefit from a more proactive approach.

Dietary patterns are associated with incident stroke and contribute to excess risk of stroke in Black Americans

PubMed Central

Judd, Suzanne E; Gutiérrez, Orlando M.; Newby, PK; Howard, George; Howard, Virginia J; Locher, Julie L; Kissela, Brett M; Shikany, James M

2014-01-01

Background and Purpose Black Americans and residents of the Southeastern United States, are at increased risk of stroke. Diet is one of many potential factors proposed that might explain these racial and regional disparities. Methods Between 2003–2007, the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study enrolled 30,239 black and white Americans aged 45 years or older. Dietary patterns were derived using factor analysis and foods from food frequency data. Incident strokes were adjudicated using medical records by a team of physicians. Cox proportional hazards models were used to examine risk of stroke. Results Over 5.7 years, 490 incident strokes were observed. In a multivariable-adjusted analysis, greater adherence to the Plant-based pattern was associated with lower stroke risk (HR=0.71; 95% CI=0.56–0.91; ptrend=0.005). This association was attenuated after addition of income, education, total energy intake, smoking, and sedentary behavior. Participants with a higher adherence to the Southern pattern experienced a 39% increased risk of stroke (HR=1.39; 95% CI=1.05, 1.84), with a significant (p = 0.009) trend across quartiles. Including Southern pattern in the model mediated the black-white risk of stroke by 63%. Conclusions These data suggest that adherence to a Southern style diet may increase the risk of stroke while adherence to a more plant-based diet may reduce stroke risk. Given the consistency of finding a dietary impact on stroke risk across studies, discussing nutrition patterns during risk screening may be an important step in reducing stroke. PMID:24159061

Prescription Pattern of NSAIDs and the Prevalence of NSAID-induced Gastrointestinal Risk Factors of Orthopaedic Patients in Clinical Practice in Korea

PubMed Central

Lee, Sung-Hun; Han, Chang-Dong; Yang, Ick-Hwan

2011-01-01

This is a cross-sectional observational study undertaken to explore the current prescription pattern of non-steroidal anti-inflammatory drugs (NSAIDs) and the prevalence of NSAID-induced gastrointestinal (GI) risk factors of orthopaedic patients in real clinical practice in Korea. Study cohort included 3,140 orthopaedic outpatients at 131 hospitals and clinics between January 2008 and August 2008. A self-administered questionnaire was completed by each patient and physician. A simplified risk scoring scale (the Standardized Calculator of Risk for Events; SCORE) was used to measure patients' risk for GI complications. The pattern of NSAIDs prescription was identified from medical recordings. Forty-five percents of the patients belonged to high risk or very high risk groups for GI complications. The cyclooxygenase-2 enzyme (COX-2) selective NSAID showed a propensity to be prescribed more commonly for high/very high GI risk groups, but the rate was still as low as 51%. In conclusion, physician's considerate prescription of NSAIDs with well-understanding of each patient's GI risk factors is strongly encouraged in order to maximize cost effectiveness and to prevent serious GI complications in Korea. Other strategic efforts such as medical association-led education programs and application of Korean electronic SCORE system to hospital order communication system (OCS) should also be accompanied in a way to promote physician's attention. PMID:21468265

77 FR 9665 - Submission for OMB Emergency Review; Comment Request: A Multi-Center International Hospital-Based...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-17

... postulated risk factors for evaluation in this study are chemical exposures (i.e., organochlorines, trichloroethylene, and benzene) and genetic susceptibility. Other factors potentially related to lymphoma, such as... also be studied. Patterns of key risk factors, including range of exposures, prevalence of exposures...

Western Dietary Pattern Increases, and Prudent Dietary Pattern Decreases, Risk of Incident Diverticulitis in a Prospective Cohort Study.

PubMed

Strate, Lisa L; Keeley, Brieze R; Cao, Yin; Wu, Kana; Giovannucci, Edward L; Chan, Andrew T

2017-04-01

Dietary fiber is implicated as a risk factor for diverticulitis. Analyses of dietary patterns may provide information on risk beyond those of individual foods or nutrients. We examined whether major dietary patterns are associated with risk of incident diverticulitis. We performed a prospective cohort study of 46,295 men who were free of diverticulitis and known diverticulosis in 1986 (baseline) using data from the Health Professionals Follow-Up Study. Each study participant completed a detailed medical and dietary questionnaire at baseline. We sent supplemental questionnaires to men reporting incident diverticulitis on biennial follow-up questionnaires. We assessed diet every 4 years using a validated food frequency questionnaire. Western (high in red meat, refined grains, and high-fat dairy) and prudent (high in fruits, vegetables, and whole grains) dietary patterns were identified using principal component analysis. Follow-up time accrued from the date of return of the baseline questionnaire in 1986 until a diagnosis of diverticulitis, diverticulosis or diverticular bleeding; death; or December 31, 2012. The primary end point was incident diverticulitis. During 894,468 person years of follow-up, we identified 1063 incident cases of diverticulitis. After adjustment for other risk factors, men in the highest quintile of Western dietary pattern score had a multivariate hazard ratio of 1.55 (95% CI, 1.20-1.99) for diverticulitis compared to men in the lowest quintile. High vs low prudent scores were associated with decreased risk of diverticulitis (multivariate hazard ratio, 0.74; 95% CI, 0.60-0.91). The association between dietary patterns and diverticulitis was predominantly attributable to intake of fiber and red meat. In a prospective cohort study of 46,295 men, a Western dietary pattern was associated with increased risk of diverticulitis, and a prudent pattern was associated with decreased risk. These data can guide dietary interventions for the prevention of diverticulitis. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Cardiovascular disease risk factor patterns and their implications for intervention strategies in Vietnam.

PubMed

Nguyen, Quang Ngoc; Pham, Son Thai; Do, Loi Doan; Nguyen, Viet Lan; Wall, Stig; Weinehall, Lars; Bonita, Ruth; Byass, Peter

2012-01-01

Background. Data on cardiovascular disease risk factors (CVDRFs) in Vietnam are limited. This study explores the prevalence of each CVDRF and how they cluster to evaluate CVDRF burdens and potential prevention strategies. Methods. A cross-sectional survey in 2009 (2,130 adults) was done to collect data on behavioural CVDRF, anthropometry and blood pressure, lipidaemia profiles, and oral glucose tolerance tests. Four metabolic CVDRFs (hypertension, dyslipidaemia, diabetes, and obesity) and five behavioural CVDRFs (smoking, excessive alcohol intake, unhealthy diet, physical inactivity, and stress) were analysed to identify their prevalence, cluster patterns, and social predictors. Framingham scores were applied to estimate the global 10-year CVD risks and potential benefits of CVD prevention strategies. Results. The age-standardised prevalence of having at least 2/4 metabolic, 2/5 behavioural, or 4/9 major CVDRF was 28%, 27%, 13% in women and 32%, 62%, 34% in men. Within-individual clustering of metabolic factors was more common among older women and in urban areas. High overall CVD risk (≥20% over 10 years) identified 20% of men and 5% of women-especially at higher ages-who had coexisting CVDRF. Conclusion. Multiple CVDRFs were common in Vietnamese adults with different clustering patterns across sex/age groups. Tackling any single risk factor would not be efficient.

Acute changes in foot strike pattern and cadence affect running parameters associated with tibial stress fractures.

PubMed

Yong, Jennifer R; Silder, Amy; Montgomery, Kate L; Fredericson, Michael; Delp, Scott L

2018-05-18

Tibial stress fractures are a common and debilitating injury that occur in distance runners. Runners may be able to decrease tibial stress fracture risk by adopting a running pattern that reduces biomechanical parameters associated with a history of tibial stress fracture. The purpose of this study was to test the hypothesis that converting to a forefoot striking pattern or increasing cadence without focusing on changing foot strike type would reduce injury risk parameters in recreational runners. Running kinematics, ground reaction forces and tibial accelerations were recorded from seventeen healthy, habitual rearfoot striking runners while running in their natural running pattern and after two acute retraining conditions: (1) converting to forefoot striking without focusing on cadence and (2) increasing cadence without focusing on foot strike. We found that converting to forefoot striking decreased two risk factors for tibial stress fracture: average and peak loading rates. Increasing cadence decreased one risk factor: peak hip adduction angle. Our results demonstrate that acute adaptation to forefoot striking reduces different injury risk parameters than acute adaptation to increased cadence and suggest that both modifications may reduce the risk of tibial stress fractures. Copyright © 2018 Elsevier Ltd. All rights reserved.

Technology-based interpersonal victimization: predictors of patterns of victimization over time.

PubMed

Korchmaros, Josephine D; Mitchell, Kimberly J; Ybarra, Michele L

2014-05-01

The objective of this study was to identify factors that could predict youth's future technology-based interpersonal victimization and the pattern of that future victimization over time. Data from Growing up With Media, a national, longitudinal, online study were analyzed. At baseline, participants (N = 1,018) were 10- to 15-year-old English speakers who had used the Internet at least once in the last 6 months. Twenty-nine percent reported repeat technology-based interpersonal victimization over a 2-year period (re-victimized group); 10% were victims during only Year 1 (desisted victimized group); and 17% reported victimization during only Year 2 (later victimized group). Of the individual risk factors examined, prior technology-based interpersonal victimization and current amount of Internet use had the strongest overall associations with pattern of technology-based interpersonal victimization over the subsequent 2-year period. There was substantial overlap among the individual risk factors. Thus, they could be thought of more simply in terms of four latent risk and three individual risk factors. On average, across these seven risk factors, repeat victims had the greatest average risk score (0.21) and the not victimized group had the lowest (-0.16). Repeat victims were more likely to be female and older and had more prior experience with problem behaviors, substance use, and negative parent-child relationships as compared with the other three groups. Being female, prior experience with problem behavior, prior substance use, and prior negative parent-child relationships were also associated with frequency of technology-based interpersonal victimization in the near (Year 1) and more distant (Year 2) future. Many of these risk factors related to technology-based victimization over time are malleable, suggesting opportunities for effective targeting of future prevention efforts.

Ecocultural patterns of family engagement among low-income Latino families of preschool children.

PubMed

McWayne, Christine M; Melzi, Gigliana; Limlingan, Maria Cristina; Schick, Adina

2016-07-01

For the 5 million low-income Latino children in the United States who are disproportionately impacted by the numerous risk factors associated with poverty, it is essential to identify proximal protective factors that mitigate these risks and bolster the academic and social skills that are foundational to a successful transition into formal schooling. Using ecocultural theory as a lens to guide this work, the present study: (a) described patterns of culture-contextualized family engagement among a low-income, Latino sample, and (b) examined relations between these patterns, family demographic factors, and children's language and social skills in preschool. Across Spanish and English language subsamples, we found evidence that there is heterogeneity in patterns of family engagement within and across language groups, such that different forms of family engagement defined the high engagement profiles in particular. We also found that demographic factors (such as child gender, family structure, and parental education and employment) predicted these patterns differentially across language groups, and that these patterns related to children's social and language skills in meaningful ways. Findings provide directions for future research, theory, and practice with this heterogeneous cultural group. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Patterns and Predictors of Language and Literacy Abilities 4-10 Years in the Longitudinal Study of Australian Children.

PubMed

Zubrick, Stephen R; Taylor, Catherine L; Christensen, Daniel

2015-01-01

Oral language is the foundation of literacy. Naturally, policies and practices to promote children's literacy begin in early childhood and have a strong focus on developing children's oral language, especially for children with known risk factors for low language ability. The underlying assumption is that children's progress along the oral to literate continuum is stable and predictable, such that low language ability foretells low literacy ability. This study investigated patterns and predictors of children's oral language and literacy abilities at 4, 6, 8 and 10 years. The study sample comprised 2,316 to 2,792 children from the first nationally representative Longitudinal Study of Australian Children (LSAC). Six developmental patterns were observed, a stable middle-high pattern, a stable low pattern, an improving pattern, a declining pattern, a fluctuating low pattern, and a fluctuating middle-high pattern. Most children (69%) fit a stable middle-high pattern. By contrast, less than 1% of children fit a stable low pattern. These results challenged the view that children's progress along the oral to literate continuum is stable and predictable. Multivariate logistic regression was used to investigate risks for low literacy ability at 10 years and sensitivity-specificity analysis was used to examine the predictive utility of the multivariate model. Predictors were modelled as risk variables with the lowest level of risk as the reference category. In the multivariate model, substantial risks for low literacy ability at 10 years, in order of descending magnitude, were: low school readiness, Aboriginal and/or Torres Strait Islander status and low language ability at 8 years. Moderate risks were high temperamental reactivity, low language ability at 4 years, and low language ability at 6 years. The following risk factors were not statistically significant in the multivariate model: Low maternal consistency, low family income, health care card, child not read to at home, maternal smoking, maternal education, family structure, temperamental persistence, and socio-economic area disadvantage. The results of the sensitivity-specificity analysis showed that a well-fitted multivariate model featuring risks of substantive magnitude did not do particularly well in predicting low literacy ability at 10 years.

Patterns of Gambling Activities and Gambling Problems Among Italian High School Students: Results from a Latent Class Analysis.

PubMed

De Luigi, Nicola; Gibertoni, Dino; Randon, Emanuela; Scorcu, Antonello E

2018-06-01

This study aims to provide an estimate of the prevalence of gambling among Italian adolescents and a description of their patterns of gambling activities (PGAs) using a latent class analysis on 13 different types of games. A nationwide sample of 10,959 Italian high school students was recruited in 2013. We assessed problem gambling using the South Oaks Gambling Screen: Revisited for Adolescent (SOGS-RA) scale. Approximately half (50.6%) of students reported gambling at least once in the previous year; 5.0% of them were problem gamblers and 9.1% were at-risk gamblers according to their SOGS-RA scores. Eight PGAs were identified, among which heavy players (1.7% of students) could be classified as problem gamblers and broad skill players (2.0%) and lotteries & sports players (2.4%) as "at-risk" players. These high-risk classes were consistently associated with risky behaviours in terms of substance use, school performance, money spent on gambling and family environment; the other five classes identified low-risk players associated with safe behaviours. To the best of our knowledge, this is the first study to identify PGAs among Italian adolescents. Problem gamblers are not a homogeneous group in terms of patterns of gambling activities and are associated with different risk factors, among which environmental factors, such as parents' gambling attitude and behaviour, deserve special attention. The acknowledgment of such patterns and risk factors could be useful in developing sensible public policies addressing prevention strategies and regulatory instruments.

Parental and perinatal risk factors for sexual offending in men: a nationwide case-control study.

PubMed

Babchishin, K M; Seto, M C; Sariaslan, A; Lichtenstein, P; Fazel, S; Långström, N

2017-01-01

Prior studies suggest parental and perinatal risk factors are associated with later offending. It remains uncertain, however, if such risk factors are similarly related to sexual offending. We linked socio-demographic, family relations, and perinatal (obtained at birth) data from the nationwide Swedish registers from 1973 to 2009 with information on criminal convictions of cases and control subjects. Male sex offenders (n = 13 773) were matched 1:5 on birth year and county of birth in Sweden to male controls without sexual or non-sexual violent convictions. To examine risk-factor specificity for sexual offending, we also compared male violent, non-sexual offenders (n = 135 953) to controls without sexual or non-sexual violent convictions. Predictors included parental (young maternal or paternal age at son's birth, educational attainment, violent crime, psychiatric disorder, substance misuse, suicide attempt) and perinatal (number of older brothers, low Apgar score, low birth weight, being small for gestational age, congenital malformations, small head size) variables. Conditional logistic regression models found consistent patterns of statistically significant, small to moderate independent associations of parental risk factors with sons' sexual offending and non-sexual violent offending. For perinatal risk factors, patterns varied more; small for gestational age and small head size exhibited similar risk effects for both offence types whereas a higher number of older biological brothers and any congenital malformation were small, independent risk factors only for non-sexual violence. This nationwide study suggests substantial commonalities in parental and perinatal risk factors for the onset of sexual and non-sexual violent offending.

Herd-level risk factors for bovine viral diarrhea infection in cattle of Tamil Nadu.

PubMed

Kumar, Subbiah Krishna; Palanivel, K M; Sukumar, K; Ronald, B Samuel Masilamoni; Selvaraju, G; Ponnudurai, G

2018-04-01

A cross-sectional study was carried out to identify risk factors for bovine viral diarrhea virus (BVDV) infection in 62 randomly selected dairy herds which were tested for BVD serum antibodies by using an indirect ELISA kit (IDEXX). Results from the chi-square test analysis were interpreted by analyzing by chi-square test. A sum of 500 sera samples were screened and 66 animals (13.20%) showed positive for BVDV antibody. Within herd, BVD seroprevalence was 12-65%. This study concluded that epidemiological risk factors like location, herd size, housing patterns like, tail to tail system, roofing pattern, distance between the manure pit and farm, and distance between farms were significantly associated with BVDV serological status (P < 0.05).

[The monophasic pattern in oral glucose tolerance test as a predictive risk factor of type 2 diabetes in obese paediatric patients].

PubMed

Herrera-Martínez, Aura D; Enes, Patricia; Martín-Frías, María; Roldán, Belén; Yelmo, Rosa; Barrio, Raquel

2017-10-01

The onset of obesity at young ages is strongly associated with the early development of type 2diabetes (T2D). The shape of the curves of glucose and insulin curves during an oral glucose tolerance test (OGTT) could predict the risk of developing T2D. To analyse the morphology of the OGTT and determine T2D risk factors in a mainly Caucasian population of children and adolescents. Observational retrospective study including 588 patients (309 males, 279 females) with a mean age of 11.1±2years, and of whom 90.3% were Caucasian. Risk factors for T2D were compared in patients with a monophasic or biphasic pattern during the performance of an OGTT, as well as anthropometric and biochemical variables, insulin resistance, and beta-cell function. The shape of the glucose curve was monophasic in 50.2% of patients (50.8% male), biphasic in 48.5% (47.6% males), and indeterminate in 1.3%. The monophasic pattern showed lower insulin-sensitivity and worse beta-cell function. Patients with a biphasic pattern had a higher BMI, waist circumference, and blood pressure, although the results were not significant. Latin-American patients had significantly lower serum glucose levels with higher insulin levels during the OGTT. The pattern of response to an OGTT reflects different metabolic phenotypes. Paediatric patients with a biphasic pattern have lower risk-profiling for T2D. The performing of an OGTT could be useful to implement early intervention strategies in children and adolescents with obesity, in order to prevent the development of pre-diabetes or T2D. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Breakfast patterns and their likelihood of increased risk of overweight/obesity and risk factors for metabolic syndrome in adults 19+ years: National Health and Nutrition Examination Survey 2001-2008

USDA-ARS?s Scientific Manuscript database

Little is known about the relationship of specific types of breakfast consumed and the risk of overweight/obesity or risk factors for metabolic syndrome. Cluster analysis using National Health and Nutrition Examination Survey 2001-2008 data identified 12 breakfast clusters—including no breakfast, in...

The Association of Socio-Demographic Status, Lifestyle Factors and Dietary Patterns with Total Urinary Phthalates in Australian Men

PubMed Central

Bai, Peter Y.; Wittert, Gary A.; Taylor, Anne W.; Martin, Sean A.; Milne, Robert W.; Shi, Zumin

2015-01-01

Objective To investigate the associations between socio-demographic status, lifestyle factors, dietary patterns and urinary total phthalate concentration in a cohort of South Australian men. Method We randomly selected 1527 males aged 39 to 84 from wave two of the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study. Total phthalate concentration was examined in fasting morning urine samples. Socio-demographic and lifestyle factors were assessed by questionnaire. Food intake was assessed by food frequency questionnaire (FFQ). Dietary patterns were constructed using factor analysis. Results Total phthalates were detected in 99.6% of the urine samples. The overall geometric mean (95% CI) of total phthalate concentration was 112.4 (107.5–117.5) ng/mL. The least square geometric means (LSGMs) of total phthalate concentration were significantly higher among people who were obese (127.8 ng/mL), consuming less than two serves fruit per day (125.7 ng/mL) and drinking more than one can (375mL) of carbonated soft drink per day (131.9 ng/mL). Two dietary patterns were identified: a prudent dietary pattern and a western dietary pattern. Both the western dietary pattern (p = 0.002) and multiple lifestyle risk factors including smoking, obesity, insufficient physical activity and the highest quartile of the western dietary pattern (p<0.001), were positively associated with total phthalate levels. There was no significant relationship between total phthalate concentration and socio-demographic status. Conclusion Phthalate exposure is ubiquitous and positively associated with lifestyle risk factors in urban dwelling Australian men. PMID:25875472

Dietary patterns, goitrogenic food, and thyroid cancer: a case-control study in French Polynesia.

PubMed

Cléro, Énora; Doyon, Françoise; Chungue, Vaïana; Rachédi, Frédérique; Boissin, Jean-Louis; Sebbag, Joseph; Shan, Larrys; Rubino, Carole; de Vathaire, Florent

2012-01-01

French Polynesia has one of the world's highest thyroid cancer incidence rates. A case-control study among native residents of French Polynesia included 229 cases of differentiated thyroid cancer diagnosed between 1979 and 2004, and 371 population controls. Dietary patterns and goitrogenic food consumption (cabbage, cassava) were analyzed. We used a factor analysis to identify dietary patterns and a conditional logistic regression analysis to investigate the association between dietary patterns or food items and thyroid cancer risk. Two distinct dietary patterns were identified: traditional Polynesian and Western. A nonsignificant inverse association was observed between the traditional Polynesian dietary pattern and thyroid cancer risk. The Western pattern was not associated with thyroid cancer risk. Cassava consumption was significantly associated with a decreased risk of thyroid cancer. In conclusion, a traditional Polynesian dietary pattern led to a weak reduced risk of thyroid cancer in French Polynesia. The protective effect of cassava on this cancer does not seem to be substantially different from that of cabbage, which was the main goitrogenic food studied to date.

Unique dietary patterns and chronic disease risk profiles of adult men: the Framingham nutrition studies.

PubMed

Millen, Barbara E; Quatromoni, Paula A; Pencina, Michael; Kimokoti, Ruth; Nam, Byung-H O; Cobain, Sonia; Kozak, Waldemar; Appugliese, Danielle P; Ordovas, Jose; D'Agostino, Ralph B

2005-11-01

To identify the dietary patterns of adult men and examine their relationships with nutrient intake and chronic disease risk over long-term follow-up. Baseline 145-item food frequency questionnaires from 1,666 Framingham Offspring-Spouse cohort men were used to identify comprehensive dietary patterns. Independent 3-day dietary records at baseline and 8 years later provided estimates of subjects' nutrient intake by dietary pattern. Chronic disease risk factor status was compared at baseline and 16-year follow-up across all male dietary patterns. Cluster analysis was applied to food frequency data to identify non-overlapping male dietary patterns. Analysis of covariance and logistic regression were used to compare nutrient intake, summary nutritional risk scores, and chronic disease risk status at baseline and follow-up by male dietary pattern. Five distinct and comprehensive dietary patterns of Framingham Offspring-Spouse men were identified and ordered according to overall nutritional risk: Transition to Heart Healthy, Higher Starch, Average Male, Lower Variety, and Empty Calories. Nutritional risk was high and varied by dietary pattern; key nutrient contrasts were stable over 8-year follow-up. Chronic disease risk also varied by dietary pattern and specific subgroup differences persisted over 16 years, notably rates of overweight/obesity and smoking. Quantitative cluster analysis applied to food frequency questionnaire data identified five distinct, comprehensive, and stable dietary patterns of adult Framingham Offspring-Spouse cohort men. The close associations between the dietary patterns, nutritional risk, and chronic disease profiles of men emphasize the importance of targeted preventive nutrition interventions to promote health in the male population.

A fruit, milk and whole grain dietary pattern is positively associated with bone mineral density in Korean healthy adults.

PubMed

Shin, S; Sung, J; Joung, H

2015-04-01

Osteoporosis is a major health problem that will grow in burden with ageing of the global population. Modifiable risk factors for osteoporosis, including diet, have significant implications for disease prevention. We examined associations between dietary patterns and bone mineral density (BMD) in a Korean adult population. In total, 1828 individuals from the Healthy Twin Cohort were included as subjects. Information on general characteristics, lifestyles and health status was obtained through a health examination, and BMD was assessed using DEXA. Dietary intake was assessed using a 3-day food record, and dietary patterns were examined by factor analysis. Associations between dietary patterns and BMD were examined using mixed linear regression, adjusting for family and twin structure as well as other potential risk factors for bone health. Four dietary patterns were identified (Rice and kimchi; eggs, meat and flour; Fruit, milk and whole grains; and Fast food and soda). The 'Fruit, milk and whole grains' pattern was associated with a reduced risk of having low BMD in men (odds ratio (OR)=0.38; 95% confidence interval (CI)=0.22-0.67) and women (OR=0.45; 95% CI=0.28-0.72) and was positively associated with BMD at multiple sites. The 'rice and kimchi' pattern had a positive association with only whole-arm BMD in men and women. Our results suggest that a dietary pattern with high intake of dairy products, fruits and whole grains may contribute positively to bone health in a Korean adult population, and dietary pattern-based strategies could have potential in promoting bone health.

Risk Factors for Chronic Disease in Viet Nam: A Review of the Literature

PubMed Central

Rao, Chalapati; Nhung, Nguyen Thi Trang; Marks, Geoffrey; Hoa, Nguyen Phuong

2013-01-01

Introduction Chronic diseases account for most of the disease burden in low- and middle-income countries, particularly those in Asia. We reviewed literature on chronic disease risk factors in Viet Nam to identify patterns and data gaps. Methods All population-based studies published from 2000 to 2012 that reported chronic disease risk factors were considered. We used standard chronic disease terminology to search PubMed and assessed titles, abstracts, and articles for eligibility for inclusion. We summarized relevant study information in tables listing available studies, risk factors measured, and the prevalence of these risk factors. Results We identified 23 studies conducted before 2010. The most common age range studied was 25 to 64 years. Sample sizes varied, and sample frames were national in 5 studies. A combination of behavioral, physical, and biological risk factors was studied. Being overweight or obese was the most common risk factor studied (n = 14), followed by high blood pressure (n = 11) and tobacco use (n = 10). Tobacco and alcohol use were high among men, and tobacco use may be increasing among Vietnamese women. High blood pressure is common; however, people’s knowledge that they have high blood pressure may be low. A high proportion of diets do not meet international criteria for fruit and vegetable consumption. Prevalence of overweight and obesity is increasing. None of the studies evaluated measured dietary patterns or total caloric intake, and only 1 study measured dietary salt intake. Conclusion Risk factors for chronic diseases are common in Viet Nam; however, more recent and context-specific information is required for planning and monitoring interventions to reduce risk factors and chronic disease in this country. PMID:23306076

Dietary patterns associated with metabolic syndrome, sociodemographic and lifestyle factors in young adults: the Bogalusa Heart Study

USDA-ARS?s Scientific Manuscript database

Our objective was to examine the association between dietary patterns (DP) and risk for metabolic syndrome (MetS); and to identify differences in DP by socio-economic, demographic and lifestyle factors. Dietary intake (from an FFQ), anthropometric/biochemical parameters and sociodemographic/lifestyl...

Friendship Group Composition and Juvenile Institutional Misconduct.

PubMed

Reid, Shannon E

2017-02-01

The present study examines both the patterns of friendship networks and how these network characteristics relate to the risk factors of institutional misconduct for incarcerated youth. Using friendship networks collected from males incarcerated with California's Division of Juvenile Justice (DJJ), latent profile analysis was utilized to create homogeneous groups of friendship patterns based on alter attributes and network structure. The incarcerated youth provided 144 egocentric networks reporting 558 social network relationships. Latent profile analysis identified three network profiles: expected group (67%), new breed group (20%), and model citizen group (13%). The three network profiles were integrated into a multiple group analysis framework to examine the relative influence of individual-level risk factors on their rate of institutional misconduct. The analysis finds variation in predictors of institutional misconduct across profile types. These findings suggest that the close friendships of incarcerated youth are patterned across the individual characteristics of the youth's friends and that the friendship network can act as a moderator for individual risk factors for institutional misconduct.

Night-waking trajectories and associated factors in French preschoolers from the EDEN birth-cohort.

PubMed

Reynaud, Eve; Forhan, Anne; Heude, Barbara; de Lauzon-Guillain, Blandine; Charles, Marie-Aline; Plancoulaine, Sabine

Night waking in preschoolers has been associated with adverse health outcomes in cross-sectional studies, but has rarely been analyzed in a longitudinal setting. Therefore, little is known about the evolution of night waking in early childhood. The objectives of the present study were: to identify night-waking trajectories in preschoolers, and to examine the risk factors associated with those trajectories. Analyses were based on the French birth-cohort study EDEN, which recruited 2002 pregnant women between 2003 and 2006. Data on a child's night waking at the ages of two, three, and five, six years, and potential confounders, were collected through parental self-reported questionnaires. Night-waking trajectories were computerized using group-based trajectory modeling on 1346 children. Two distinct developmental patterns were identified: the "2-5 rare night-waking" (77% of the children) and the "2-5 common night-waking" pattern. Logistic regressions were performed to identify the factors associated with the trajectories. Risk factors for belonging to the "2-5 common night-waking" trajectory were: exposure to passive smoking at home, daycare in a collective setting, watching television for extended periods, bottle feeding at night, high emotionality, and low shyness. This approach allowed identification of risk factors associated with night waking during a critical age window, and laid the groundwork for identifying children at higher risk of deleterious sleep patterns. Those risk factors were mainly living habits, which indicated that prevention and intervention programs could be highly beneficial in this population. Copyright © 2016 Elsevier B.V. All rights reserved.

Association between dietary pattern and cardiometabolic risk in children and adolescents: a systematic review.

PubMed

Rocha, Naruna Pereira; Milagres, Luana Cupertino; Longo, Giana Zarbato; Ribeiro, Andréia Queiroz; Novaes, Juliana Farias de

To evaluate the association between dietary patterns and cardiometabolic risk factors in children and adolescents. This article followed the recommendations of PRISMA, which aims to guide review publications in the health area. The article search strategy included searches in the electronic databases MEDLINE via PubMed, Scopus, and LILACS. There was no date limitation for publications. The descriptors were used in English according to MeSH and in Portuguese according to DeCS. Only articles on dietary patterns extracted by the a posteriori methodology were included. The question to be answered was: how much can an "unhealthy" dietary pattern influence biochemical and inflammatory markers in this population? The studies showed an association between dietary patterns and cardiometabolic alterations. The patterns were characterized as unhealthy when associated to the consumption of ultraprocessed products, poor in fiber and rich in sodium, fat, and refined carbohydrates. Despite the associations, in several studies, the strength of this association for some risk markers was reduced or lost after adjusting for confounding variables. There was a positive association between "unhealthy" dietary patterns and cardiometabolic alterations in children and adolescents. Some unconfirmed associations may be related to the difficulty of assessing food consumption. Nevertheless, studies involving dietary patterns and their association with risk factors should be performed in children and adolescents, aiming at interventions and early changes in dietary habits considered to be inadequate. Copyright © 2017. Published by Elsevier Editora Ltda.

Dietary Patterns in Asian Indians in the United States: An Analysis of the Metabolic Syndrome and Atherosclerosis in South Asians Living in America Study (MASALA)

PubMed Central

Gadgil, Meghana D.; Anderson, Cheryl A. M.; Kandula, Namratha R.; Kanaya, Alka M.

2013-01-01

Dietary patterns contribute to cardiovascular disease (CVD) risk. Asian Indians have earlier onset, more severe and prevalent CVD than many other racial/ethnic groups. We aimed to characterize dietary patterns in Asian Indians living in the United States and examine associations with cardio-metabolic risk factors. 150 Asian Indians, aged 45–84 years, without known cardiovascular disease, living in the San Francisco Bay area between August 2006 and October 2007 were enrolled into the Metabolic Syndrome and Atherosclerosis in South Asians Living in America (MASALA) study. A food frequency questionnaire validated in Asian Indians, fasting blood samples, and CT scans were obtained on all participants. Principal component analysis with varimax rotation was used to determine prevalent dietary patterns. Linear regression analyses were performed for associations between dietary patterns and metabolic factors, adjusting initially for age and sex, then additionally for BMI, income, education, MET-minutes of exercise, alcohol consumption, and smoking. Two distinct dietary patterns were identified that we termed “Western,” and “Vegetarian.” Compared with the Western diet, the Vegetarian diet was associated with lower HOMA-IR (−1.12; p=0.05) and lower HDL (−4.77, p=0.09). Given that the Western and Vegetarian patterns were each associated with adverse metabolic changes, healthful dietary choices may help Asian Indians improve risk factors for CVD. PMID:24295929

Prevalence study of nevi in children from Barcelona. Dermoscopy, constitutional and environmental factors.

PubMed

Aguilera, Paula; Puig, Susana; Guilabert, Antonio; Julià, Marc; Romero, David; Vicente, Asunción; González-Enseñat, María A; Malvehy, Josep

2009-01-01

Malignant melanoma is becoming an increasingly important problem in public health as incidence rates have been increasing continuously in Caucasian populations. Childhood and adolescence is an important time of life for the formation and evolution of nevi, and the presence of a higher number of nevi in early life could predict a major risk of developing melanoma. (1) To determine the number of nevi and the dermoscopic pattern predominance in children of our population. (2) To relate it to constitutional and environmental factors. Clinical and dermoscopic examinations were performed in 180 children aged 1-15 years. A questionnaire including topics such as past history of sunburns, tanning ability, tendency to sunburn, history of sunlight exposure, use of sunscreens, tendency to freckle and family history of cancer was completed in a face-to-face interview with the parents. On clinical examination, we evaluated hair color, eye color, number of nevi and the presence of nevi in specific locations. All melanocytic lesions were examined dermoscopically, and all patterns were registered as present or absent. We also registered the predominant dermoscopic pattern of the child, defined as being present in more than 40% of all of the individual's nevi. The mean number of moles was 17.5. Male gender, past history of sunburns, facial freckling and family history of breast cancer were independent risk factors for having a higher number of nevi. We found that 61.1% of children had nevi on the face and neck, 17.2% on the buttocks, 11.7% on the scalp, 19.4% had acral nevi and 31.7% had congenital nevi. We found the presence of nevi in some of these locations to be a risk factor for having a higher number of nevi. The most frequent dominant dermoscopic pattern found in our population was the globular type. Interestingly, we found that the homogeneous pattern predominates in the youngest children, the reticular pattern predominates in adolescents and the dominant globular pattern is constant among all ages evaluated. This is the first study clinically and dermoscopically characterizing nevi in children from our population, and evaluating constitutional and environmental risk factors. 2008 S. Karger AG, Basel

Patterns of intimate partner violence and associated risk factors among married enlisted female soldiers.

PubMed

Forgey, Mary Ann; Badger, Lee

2010-01-01

A sample of 248 enlisted active duty females married to civilian spouses completed a self-report survey that asked about their own and their spouse's violence. The survey also asked about their sex-role attitudes, marital satisfaction, alcohol use, childhood trauma, and depression. Results identified patterns of intimate partner violence and their relationship to the psychosocial risk factors. Females experiencing severe bidirectional violence were likely to be the most depressed and to have a history of child sexual abuse. Females experiencing minor bidirectional violence did not share any of the psychosocial risk factors found for severe bidirectional violence. Females perpetrating unilateral violence toward their spouses were found to be as satisfied in their marriages as nonviolent couples and less depressed than the females experiencing bidirectional violence.

Risk of nitrate in groundwaters of the United States - A national perspective

USGS Publications Warehouse

Nolan, B.T.; Ruddy, B.C.; Hitt, K.J.; Helsel, D.R.

1997-01-01

Nitrate contamination of groundwater occurs in predictable patterns, based on findings of the U.S. Geological Survey's (USGS) National Water Quality Assessment (NAWQA) Program. The NAWQA Program was begun in 1991 to describe the quality of the Nation's water resources, using nationally consistent methods. Variables affecting nitrate concentration in groundwater were grouped as 'input' factors (population density end the amount of nitrogen contributed by fertilizer, manure, and atmospheric sources) and 'aquifer vulnerability' factors (soil drainage characteristic and the ratio of woodland acres to cropland acres in agricultural areas) and compiled in a national map that shows patterns of risk for nitrate contamination of groundwater. Areas with high nitrogen input, well-drained soils, and low woodland to cropland ratio have the highest potential for contamination of shallow groundwater by nitrate. Groundwater nitrate data collected through 1992 from wells less than 100 ft deep generally verified the risk patterns shown on the national map. Median nitrate concentration was 0.2 mg/L in wells representing the low-risk group, and the maximum contaminant level (MCL) was exceeded in 3% of the wells. In contrast, median nitrate concentration was 4.8 mg/L in wells representing the high-risk group, and the MCL was exceeded in 25% of the wells.Nitrate contamination of groundwater occurs in predictable patterns, based on findings of the U.S. Geological Survey's (USGS) National Water Quality Assessment (NAWQA) Program. The NAWQA Program was begun in 1991 to describe the quality of the Nation's water resources, using nationally consistent methods. Variables affecting nitrate concentration in groundwater were grouped as `input' factors (population density and the amount of nitrogen contributed by fertilizer, manure, and atmospheric sources) and `aquifer vulnerability' factors (soil drainage characteristic and the ratio of woodland acres to cropland acres in agricultural areas) and compiled in a national map that shows patterns of risk for nitrate contamination of groundwater. Areas with high nitrogen input, well-drained soils, and low woodland to cropland ratio have the highest potential for contamination of shallow groundwater by nitrate. Groundwater nitrate data collected through 1992 from wells less than 100 ft deep generally verified the risk patterns shown on the national map. Median nitrate concentration was 0.2 mg/L in wells representing the low-risk group, and the maximum contaminant level (MCL) was exceeded in 3% of the wells. In contrast, median nitrate concentration was 4.8 mg/L in wells representing the high-risk group, and the MCL was exceeded in 25% of the wells.

Analyzing seasonal patterns of wildfire exposure factors in Sardinia, Italy.

PubMed

Salis, Michele; Ager, Alan A; Alcasena, Fermin J; Arca, Bachisio; Finney, Mark A; Pellizzaro, Grazia; Spano, Donatella

2015-01-01

In this paper, we applied landscape scale wildfire simulation modeling to explore the spatiotemporal patterns of wildfire likelihood and intensity in the island of Sardinia (Italy). We also performed wildfire exposure analysis for selected highly valued resources on the island to identify areas characterized by high risk. We observed substantial variation in burn probability, fire size, and flame length among time periods within the fire season, which starts in early June and ends in late September. Peak burn probability and flame length were observed in late July. We found that patterns of wildfire likelihood and intensity were mainly related to spatiotemporal variation in ignition locations, fuel moisture, and wind vectors. Our modeling approach allowed consideration of historical patterns of winds, ignition locations, and live and dead fuel moisture on fire exposure factors. The methodology proposed can be useful for analyzing potential wildfire risk and effects at landscape scale, evaluating historical changes and future trends in wildfire exposure, as well as for addressing and informing fuel management and risk mitigation issues.

Changes in Coronary Heart Disease Risk Profile of Adults with Intellectual Disabilities following a Physical Activity Intervention

ERIC Educational Resources Information Center

Moss, S. J.

2009-01-01

Background: Regular physical activity is one of the modifiable risk factors for coronary heart disease (CHD). With an increasing age profile and similar patterns of morbidity to the general population, persons with intellectual disabilities (ID) and their caregivers would benefit from data that indicate CHD risk factors. Knowledge of the CHD risk…

Advanced brain aging: relationship with epidemiologic and genetic risk factors, and overlap with Alzheimer disease atrophy patterns.

PubMed

Habes, M; Janowitz, D; Erus, G; Toledo, J B; Resnick, S M; Doshi, J; Van der Auwera, S; Wittfeld, K; Hegenscheid, K; Hosten, N; Biffar, R; Homuth, G; Völzke, H; Grabe, H J; Hoffmann, W; Davatzikos, C

2016-04-05

We systematically compared structural imaging patterns of advanced brain aging (ABA) in the general-population, herein defined as significant deviation from typical BA to those found in Alzheimer disease (AD). The hypothesis that ABA would show different patterns of structural change compared with those found in AD was tested via advanced pattern analysis methods. In particular, magnetic resonance images of 2705 participants from the Study of Health in Pomerania (aged 20-90 years) were analyzed using an index that captures aging atrophy patterns (Spatial Pattern of Atrophy for Recognition of BA (SPARE-BA)), and an index previously shown to capture atrophy patterns found in clinical AD (Spatial Patterns of Abnormality for Recognition of Early Alzheimer's Disease (SPARE-AD)). We studied the association between these indices and risk factors, including an AD polygenic risk score. Finally, we compared the ABA-associated atrophy with typical AD-like patterns. We observed that SPARE-BA had significant association with: smoking (P<0.05), anti-hypertensive (P<0.05), anti-diabetic drug use (men P<0.05, women P=0.06) and waist circumference for the male cohort (P<0.05), after adjusting for age. Subjects with ABA had spatially extensive gray matter loss in the frontal, parietal and temporal lobes (false-discovery-rate-corrected q<0.001). ABA patterns of atrophy were partially overlapping with, but notably deviating from those typically found in AD. Subjects with ABA had higher SPARE-AD values; largely due to the partial spatial overlap of associated patterns in temporal regions. The AD polygenic risk score was significantly associated with SPARE-AD but not with SPARE-BA. Our findings suggest that ABA is likely characterized by pathophysiologic mechanisms that are distinct from, or only partially overlapping with those of AD.

Dietary Patterns Exhibit Sex-Specific Associations with Adiposity and Metabolic Risk in a Cross-Sectional Study in Urban Mexican Adolescents.

PubMed

Perng, Wei; Fernandez, Carmen; Peterson, Karen E; Zhang, ZhenZhen; Cantoral, Alejandra; Sanchez, Brisa N; Solano-González, Maritsa; Téllez-Rojo, Martha Maria; Baylin, Ana

2017-10-01

Background: Studies in Western nations have shown associations of certain dietary patterns with obesity and metabolic risk in youth. Little is known about these relations in newly industrialized countries where obesity prevalence is surpassing those of developed countries. Objective: We sought to characterize dietary patterns in a cross-sectional study in 224 adolescents aged 8-14 y in Mexico and to investigate associations of the dietary patterns with adiposity and metabolic risk. Methods: We used principal components analysis to derive dietary patterns from food-frequency questionnaire data. By using linear regression models that accounted for mother's marital status, education, and smoking habits and child's age and physical activity, we examined associations of the dietary patterns with adiposity [body mass index z score, waist circumference, the sum and ratio of the subscapular and triceps skinfold thicknesses, blood pressure, serum fasting glucose and a C-peptide-based measure of insulin resistance (CP-IR), lipid profile, and a metabolic syndrome risk z score (MetS z score)]. Results: We identified a "prudent" dietary pattern characterized by high intakes of vegetables, fruit, fish, chicken, and legumes and a "transitioning" dietary pattern, which comprises processed meats, Mexican foods, and sweetened beverages. Each unit increase in the prudent pattern factor score corresponded with 0.33 ng/mL (95% CI: 0.09, 0.57 ng/mL) lower C-peptide, 0.08 units (95% CI: 0.02, 0.13 units) lower CP-IR, and a 0.14 unit (0.00, 0.27 unit) lower MetS z score in boys. In girls, the transitioning pattern corresponded with higher subscapular + triceps skinfold thickness (per 1-unit increase in the factor score: 2.46 mm; 95% CI: 0.10, 4.81 mm). These results did not change after accounting for pubertal status. Conclusions: A prudent dietary pattern was protective against metabolic risk in adolescent boys, whereas a transitioning dietary pattern corresponded with higher adiposity among adolescent girls. Given that adolescence is a key developmental period for long-term health, efforts to elucidate dietary determinants of metabolic risk during this life stage may have long-term benefits. © 2017 American Society for Nutrition.

The influence of socioeconomic factors on cardiovascular disease risk factors in the context of economic development in the Samoan archipelago.

PubMed

Ezeamama, Amara E; Viali, Satupaitea; Tuitele, John; McGarvey, Stephen T

2006-11-01

Early in economic development there are positive associations between socioeconomic status (SES) and cardiovascular disease (CVD) risk factors, and in the most developed market economy societies there are negative associations. The purpose of this report is to describe cross-sectional and longitudinal associations between indicators of SES and CVD risk factors in a genetically homogenous population of Samoans at different levels of economic development. At baseline 1289 participants 25-58yrs, and at 4-year follow-up, 963 participants were studied in less economically developed Samoa and in more developed American Samoa. SES was assessed by education, occupation, and material lifestyle at baseline. The CVD risk factors, obesity, type-2 diabetes and hypertension were measured at baseline and 4-year follow-up, and an index of any incident CVD risk factor at follow-up was calculated. Sex and location (Samoa and American Samoa) specific multivariable logistic regression models were used to test for relationships between SES and CVD risk factors at baseline after adjustment for age and the other SES indicators. In addition an ordinal SES index was constructed for each individual based on all three SES indicators, and used in a multivariable model to estimate the predicted probability of CVD risk factors across the SES index for the two locations. In both the models using specific SES measures and CVD risk factor outcomes, and the models using the ordinal SES index and predicted probabilities of CVD risk factors, we detected a pattern of high SES associated with: (1) elevated odds of CVD risk factors in less developed Samoa, and (2) decreased odds of CVD risk factors in more developed American Samoa. We conclude that the pattern of inverse associations between SES and CVD risk factors in Samoa and direct associations in American Samoa is attributable to the heterogeneity across the Samoas in specific exposures to social processes of economic development and the natural history of individual CVD risk factors. The findings suggest that interventions on non-communicable diseases in the Samoas must be devised based on the level of economic development, the socio-economic context of risk factor exposures, and individual characteristics such as age, sex and education level.

Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-Analysis of Controlled Trials.

PubMed

Chiavaroli, Laura; Nishi, Stephanie K; Khan, Tauseef A; Braunstein, Catherine R; Glenn, Andrea J; Mejia, Sonia Blanco; Rahelić, Dario; Kahleová, Hana; Salas-Salvadó, Jordi; Jenkins, David J A; Kendall, Cyril W C; Sievenpiper, John L

2018-05-25

The evidence for the Portfolio dietary pattern, a plant-based dietary pattern that combines recognized cholesterol-lowering foods (nuts, plant protein, viscous fibre, plant sterols), has not been summarized. To update the European Association for the Study of Diabetes clinical practice guidelines for nutrition therapy, we conducted a systematic review and meta-analysis of controlled trials using GRADE of the effect of the Portfolio dietary pattern on the primary therapeutic lipid target for cardiovascular disease prevention, low-density lipoprotein cholesterol (LDL-C), and other established cardiometabolic risk factors. We searched MEDLINE, EMBASE, and The Cochrane Library through April 19, 2018. We included controlled trials ≥ 3-weeks assessing the effect of the Portfolio dietary pattern on cardiometabolic risk factors compared with an energy-matched control diet free of Portfolio dietary pattern components. Two independent reviewers extracted data and assessed risk of bias. The primary outcome was LDL-C. Data were pooled using the generic inverse-variance method and expressed as mean differences (MDs) with 95% confidence intervals (CIs). Heterogeneity was assessed (Cochran Q statistic) and quantified (I 2 -statistic). GRADE assessed the certainty of the evidence. Eligibility criteria were met by 7 trial comparisons in 439 participants with hyperlipidemia, in which the Portfolio dietary pattern was given on a background of a National Cholesterol Education Program (NCEP) Step II diet. The combination of a portfolio dietary pattern and NCEP Step II diet significantly reduced the primary outcome LDL-C by ~17% (MD, -0.73mmol/L, [95% CI, -0.89 to -0.56 mmol/L]) as well as non-high-density lipoprotein cholesterol, apolipoprotein B, total cholesterol, triglycerides, systolic and diastolic blood pressure, C-reactive protein, and estimated 10-year coronary heart disease (CHD) risk, compared with an NCEP Step 2 diet alone (P<0.05). There was no effect on high-density lipoprotein cholesterol or body weight. The certainty of the evidence was high for LDL-cholesterol and most lipid outcomes and moderate for all others outcomes. Current evidence demonstrates that the Portfolio dietary pattern leads to clinically meaningful improvements in LDL-C as well as other established cardiometabolic risk factors and estimated 10-year CHD risk. Copyright © 2018. Published by Elsevier Inc.

Heritable patterns of tooth decay in the permanent dentition: principal components and factor analyses.

PubMed

Shaffer, John R; Feingold, Eleanor; Wang, Xiaojing; Tcuenco, Karen T; Weeks, Daniel E; DeSensi, Rebecca S; Polk, Deborah E; Wendell, Steve; Weyant, Robert J; Crout, Richard; McNeil, Daniel W; Marazita, Mary L

2012-03-09

Dental caries is the result of a complex interplay among environmental, behavioral, and genetic factors, with distinct patterns of decay likely due to specific etiologies. Therefore, global measures of decay, such as the DMFS index, may not be optimal for identifying risk factors that manifest as specific decay patterns, especially if the risk factors such as genetic susceptibility loci have small individual effects. We used two methods to extract patterns of decay from surface-level caries data in order to generate novel phenotypes with which to explore the genetic regulation of caries. The 128 tooth surfaces of the permanent dentition were scored as carious or not by intra-oral examination for 1,068 participants aged 18 to 75 years from 664 biological families. Principal components analysis (PCA) and factor analysis (FA), two methods of identifying underlying patterns without a priori surface classifications, were applied to our data. The three strongest caries patterns identified by PCA recaptured variation represented by DMFS index (correlation, r = 0.97), pit and fissure surface caries (r = 0.95), and smooth surface caries (r = 0.89). However, together, these three patterns explained only 37% of the variability in the data, indicating that a priori caries measures are insufficient for fully quantifying caries variation. In comparison, the first pattern identified by FA was strongly correlated with pit and fissure surface caries (r = 0.81), but other identified patterns, including a second pattern representing caries of the maxillary incisors, were not representative of any previously defined caries indices. Some patterns identified by PCA and FA were heritable (h(2) = 30-65%, p = 0.043-0.006), whereas other patterns were not, indicating both genetic and non-genetic etiologies of individual decay patterns. This study demonstrates the use of decay patterns as novel phenotypes to assist in understanding the multifactorial nature of dental caries.

Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of meta-analyses

PubMed Central

Bellou, Vanesa; Belbasis, Lazaros; Tzoulaki, Ioanna

2018-01-01

Background Type 2 diabetes mellitus (T2DM) is a global epidemic associated with increased health expenditure, and low quality of life. Many non-genetic risk factors have been suggested, but their overall epidemiological credibility has not been assessed. Methods We searched PubMed to capture all meta-analyses and Mendelian randomization studies for risk factors of T2DM. For each association, we estimated the summary effect size, its 95% confidence and prediction interval, and the I2 metric. We examined the presence of small-study effects and excess significance bias. We assessed the epidemiological credibility through a set of predefined criteria. Results We captured 86 eligible papers (142 associations) covering a wide range of biomarkers, medical conditions, and dietary, lifestyle, environmental and psychosocial factors. Adiposity, low hip circumference, serum biomarkers (increased level of alanine aminotransferase, gamma-glutamyl transferase, uric acid and C-reactive protein, and decreased level of adiponectin and vitamin D), an unhealthy dietary pattern (increased consumption of processed meat and sugar-sweetened beverages, decreased intake of whole grains, coffee and heme iron, and low adherence to a healthy dietary pattern), low level of education and conscientiousness, decreased physical activity, high sedentary time and duration of television watching, low alcohol drinking, smoking, air pollution, and some medical conditions (high systolic blood pressure, late menarche age, gestational diabetes, metabolic syndrome, preterm birth) presented robust evidence for increased risk of T2DM. Conclusions A healthy lifestyle pattern could lead to decreased risk for T2DM. Future randomized clinical trials should focus on identifying efficient strategies to modify harmful daily habits and predisposing dietary patterns. PMID:29558518

Patterns and Predictors of Language and Literacy Abilities 4-10 Years in the Longitudinal Study of Australian Children

PubMed Central

Zubrick, Stephen R.; Taylor, Catherine L.; Christensen, Daniel

2015-01-01

Aims Oral language is the foundation of literacy. Naturally, policies and practices to promote children’s literacy begin in early childhood and have a strong focus on developing children’s oral language, especially for children with known risk factors for low language ability. The underlying assumption is that children’s progress along the oral to literate continuum is stable and predictable, such that low language ability foretells low literacy ability. This study investigated patterns and predictors of children’s oral language and literacy abilities at 4, 6, 8 and 10 years. The study sample comprised 2,316 to 2,792 children from the first nationally representative Longitudinal Study of Australian Children (LSAC). Six developmental patterns were observed, a stable middle-high pattern, a stable low pattern, an improving pattern, a declining pattern, a fluctuating low pattern, and a fluctuating middle-high pattern. Most children (69%) fit a stable middle-high pattern. By contrast, less than 1% of children fit a stable low pattern. These results challenged the view that children’s progress along the oral to literate continuum is stable and predictable. Findings Multivariate logistic regression was used to investigate risks for low literacy ability at 10 years and sensitivity-specificity analysis was used to examine the predictive utility of the multivariate model. Predictors were modelled as risk variables with the lowest level of risk as the reference category. In the multivariate model, substantial risks for low literacy ability at 10 years, in order of descending magnitude, were: low school readiness, Aboriginal and/or Torres Strait Islander status and low language ability at 8 years. Moderate risks were high temperamental reactivity, low language ability at 4 years, and low language ability at 6 years. The following risk factors were not statistically significant in the multivariate model: Low maternal consistency, low family income, health care card, child not read to at home, maternal smoking, maternal education, family structure, temperamental persistence, and socio-economic area disadvantage. The results of the sensitivity-specificity analysis showed that a well-fitted multivariate model featuring risks of substantive magnitude did not do particularly well in predicting low literacy ability at 10 years. PMID:26352436

Featured Article: Community Crime Exposure and Risk for Obesity in Preschool Children: Moderation by the Hypothalamic-Pituitary-Adrenal-Axis Response.

PubMed

Gartstein, Maria A; Seamon, Erich; Thompson, Stephanie F; Lengua, Liliana J

2018-05-01

Identification of early risk factors related to obesity is critical to preventative public health efforts. In this study, we investigated links between the Hypothalamic-Pituitary-Adrenal (HPA)-axis activity (diurnal cortisol pattern), geospatially operationalized exposure to neighborhood crime, and body mass index (BMI) for a sample of 5-year-old children. Greater community crime exposure and lower HPA-axis activity were hypothesized to contribute to higher BMI, with child HPA-axis moderating the association between crime exposure and BMI. Families residing within the boundaries of the City of Seattle (N = 114) provided information concerning demographic/psychosocial risk factors, used to calculate a Cumulative Risk Index, indicating the number of contextual adversities present. Child BMI and diurnal cortisol pattern (derived from assays of saliva samples) were examined, along with neighborhood crime indices computed with publically available information, based on participants' locations. Hierarchical multiple regression analyses, adjusted for covariates (cumulative risk, age, and sex), indicated that crime proximity made a unique contribution to child BMI, in the direction signaling an increase in the risk for obesity. Consistent with our hypothesis, a significant interaction was observed, indicative of moderation by diurnal cortisol pattern. Follow-up simple slope analyses demonstrated that crime exposure was significantly related to higher BMI for children with low-flat (blunted) diurnal cortisol patterns, where community crime and BMI were not significantly associated at higher levels of cortisol. Community crime exposure contributes to higher BMI as early as the preschool period, and blunted diurnal cortisol patterns may place children experiencing neighborhood adversity at greater risk for obesity.

Dietary patterns in India and their association with obesity and central obesity.

PubMed

Satija, Ambika; Hu, Frank B; Bowen, Liza; Bharathi, Ankalmadugu V; Vaz, Mario; Prabhakaran, Dorairaj; Reddy, K Srinath; Ben-Shlomo, Yoav; Davey Smith, George; Kinra, Sanjay; Ebrahim, Shah

2015-11-01

Obesity is a growing problem in India, the dietary determinants of which have been studied using an 'individual food/nutrient' approach. Examining dietary patterns may provide more coherent findings, but few studies in developing countries have adopted this approach. The present study aimed to identify dietary patterns in an Indian population and assess their relationship with anthropometric risk factors. FFQ data from the cross-sectional sib-pair Indian Migration Study (IMS; n 7067) were used to identify dietary patterns using principal component analysis. Mixed-effects logistic regression was used to examine associations with obesity and central obesity. The IMS was conducted at four factory locations across India: Lucknow, Nagpur, Hyderabad and Bangalore. The participants were rural-to-urban migrant and urban non-migrant factory workers, their rural and urban resident siblings, and their co-resident spouses. Three dietary patterns were identified: 'cereals-savoury foods' (cooked grains, rice/rice-based dishes, snacks, condiments, soups, nuts), 'fruit-veg-sweets-snacks' (Western cereals, vegetables, fruit, fruit juices, cooked milk products, snacks, sugars, sweets) and 'animal-food' (red meat, poultry, fish/seafood, eggs). In adjusted analysis, positive graded associations were found between the 'animal-food' pattern and both anthropometric risk factors. Moderate intake of the 'cereals-savoury foods' pattern was associated with reduced odds of obesity and central obesity. Distinct dietary patterns were identified in a large Indian sample, which were different from those identified in previous literature. A clear 'plant food-based/animal food-based pattern' dichotomy emerged, with the latter being associated with higher odds of anthropometric risk factors. Longitudinal studies are needed to further clarify this relationship in India.

Dietary patterns and the risk of rhinitis in primary school children: a prospective cohort study

PubMed Central

Liu, Xudong; Wong, Claudie Chiu-Yi; Yu, Ignatius T. S.; Zhang, Zilong; Tan, Lixing; Lau, Arthur P. S.; Lee, Albert; Yeoh, Eng Kiong; Lao, Xiang Qian

2017-01-01

This study was to investigate the association between dietary patterns and rhinitis in primary school children. 1,599 students without rhinitis at baseline survey were selected from a primary school children cohort. Information on food consumption, respiratory symptoms, and confounders was collected using questionnaires. Dietary patterns were defined using principal component analysis. Logistic regression was performed to calculate odds ratio (OR) with 95% confidence intervals (95% CI). The incidence of rhinitis during 12 months follow-up was 21.2%. Three patterns were extracted and labeled as pattern I, II and III. Dietary pattern II which had higher factor loadings of legumes, butter, nuts and potatoes was associated with an increased risk of rhinitis (OR: 1.34, 95% CI: 1.01–1.87) when the highest tertile of pattern score was compared to the lowest tertile, after adjusted for confounders. Besides, every 1-unit increase of score of pattern II was also associated with an increased risk of rhinitis (OR: 1.19, 95% CI: 1.05–1.35). Neither pattern I nor Pattern III was observed to be associated with risk of rhinitis. A diet with higher levels of consumption of legumes, butter, nuts and potatoes may increase the risk of allergic rhinitis in primary school children. PMID:28294150

Admission of term infants to the neonatal intensive care unit in a Saudi tertiary teaching hospital: cumulative incidence and risk factors.

PubMed

Al-Wassia, Heidi; Saber, Mafaza

2017-01-01

An increasing number of term infants of appropriate birthweight receive care in neonatal intensive care units (NICUs). This study assessed the prevalence, patterns, and risk factors for admission of term infants to a NICU to identify areas for quality improvement. Cross-sectional analytical study. An academic and referral center in Jeddah, Saudi Arabia. The cases were all term infants (>=37 weeks gestational age) admitted to the NICU between 1 January and 31 December 2015. The controls were term infants who were not admitted to the NICU. Cases and controls were matched in a 1:1 ratio according to the date of birth (within one day). Prevalence, pattern, and risk factors for admission of term infants to the NICU. The rate of admission of term infants to the NICU during the study period was 4.1% (142 of 3314 live births in that year). Respiratory complications accounted for 36.6% (52/142) of admissions, followed by hypoglycemia (23/142, 16.2%) and jaundice (11/142, 7.7%). Premature membrane rupture and non-Saudi national status were the risk factors that remained significant after adjusting for confounders. A growing number of term infants are admitted unexpectedly to the NICU. The risk factors and pattern of admission of term infants to the NICU should receive more attention in quality improvement and management agendas. This was a single-center study with limited access to information about unbooked mothers and details of the hospital stay of the admitted neonates.

Anthropogenic factors and the risk of highly pathogenic avian influenza H5N1: prospects from a spatial-based model.

PubMed

Paul, Mathilde; Tavornpanich, Saraya; Abrial, David; Gasqui, Patrick; Charras-Garrido, Myriam; Thanapongtharm, Weerapong; Xiao, Xiangming; Gilbert, Marius; Roger, Francois; Ducrot, Christian

2010-01-01

Beginning in 2003, highly pathogenic avian influenza (HPAI) H5N1 virus spread across Southeast Asia, causing unprecedented epidemics. Thailand was massively infected in 2004 and 2005 and continues today to experience sporadic outbreaks. While research findings suggest that the spread of HPAI H5N1 is influenced primarily by trade patterns, identifying the anthropogenic risk factors involved remains a challenge. In this study, we investigated which anthropogenic factors played a role in the risk of HPAI in Thailand using outbreak data from the "second wave" of the epidemic (3 July 2004 to 5 May 2005) in the country. We first performed a spatial analysis of the relative risk of HPAI H5N1 at the subdistrict level based on a hierarchical Bayesian model. We observed a strong spatial heterogeneity of the relative risk. We then tested a set of potential risk factors in a multivariable linear model. The results confirmed the role of free-grazing ducks and rice-cropping intensity but showed a weak association with fighting cock density. The results also revealed a set of anthropogenic factors significantly linked with the risk of HPAI. High risk was associated strongly with densely populated areas, short distances to a highway junction, and short distances to large cities. These findings highlight a new explanatory pattern for the risk of HPAI and indicate that, in addition to agro-environmental factors, anthropogenic factors play an important role in the spread of H5N1. To limit the spread of future outbreaks, efforts to control the movement of poultry products must be sustained. INRA, EDP Sciences, 2010.

Identifying risk factors of highly pathogenic avian influenza (H5N1 subtype) in Indonesia

PubMed Central

Leo, Loth; Marius, Gilbert; Jianmei, Wu; Christina, Czarnecki; Muhammad, Hidayat; Xiangming, Xiao

2016-01-01

Highly pathogenic avian influenza (HPAI), subtype H5N1, was first officially reported in Indonesia in 2004. Since then the disease has spread and is now endemic in large parts of the country. This study investigated the statistical relationship between a set of risk factors and the presence or absence of HPAI in Indonesia during 2006 and 2007. HPAI was evaluated through participatory disease surveillance (PDS) in backyard village chickens (the study population), and risk factors included descriptors of people and poultry distribution (separating chickens, ducks and production sectors), poultry movement patterns and agro-ecological conditions. The study showed that the risk factors “elevation”, “human population density” and “rice cropping” were significant in accounting for the spatial variation of the PDS-defined HPAI cases. These findings were consistent with earlier studies in Thailand and Vietnam. In addition “commercial poultry population”, and two indicators of market locations and transport; “human settlements” and “road length”, were identified as significant risk factors in the models. In contrast to several previous studies carried out in Southeast Asia, domestic backyard ducks were not found to be a significant risk factor in Indonesia. The study used surrogate estimates of market locations and marketing chains and further work should focus on the actual location of the live bird markets, and on the flow of live poultry and poultry products between them, so that patterns of possible transmission, and regions of particular risk could be better inferred. PMID:21813198

Dietary intake patterns of low-income urban African-American adolescents

USDA-ARS?s Scientific Manuscript database

Background: Improper dietary intake pattern is a risk factor for chronic disease. Few studies have examined the multifaceted aspects of dietary intake of low-income, urban African American adolescents. Objective: This study aimed to describe dietary intake patterns including energy, nutrient, food g...

Dietary intake practices associated with cardiovascular risk in urban and rural Ecuadorian adolescents: a cross-sectional study.

PubMed

Ochoa-Avilés, Angélica; Verstraeten, Roosmarijn; Lachat, Carl; Andrade, Susana; Van Camp, John; Donoso, Silvana; Kolsteren, Patrick

2014-09-09

Cardiovascular diseases (CVD) are amongst the leading causes of death worldwide. Risk factors of CVD develop during childhood and adolescence, and dietary quality has been linked to the development of CVD itself. This study examines the association between dietary patterns and cardiovascular risk in a group of urban and rural Ecuadorian adolescents from different socioeconomic backgrounds. A cross-sectional study was conducted from January 2008 to April 2009 among 606 adolescents from the 8th, 9th and 10th grade in an urban area (Cuenca), and 173 adolescents from a rural area (Nabón) in Ecuador. Data collection involved measuring anthropometric data (weight, height and waist circumference), blood pressure, dietary intake (2-day 24 h recall) and socio-demographic characteristics. Fasting blood lipids and glucose were measured in a subsample of 334 adolescents. Factor analysis was used to identify dietary patterns and linear regression models were used to (i) identify differences in food intake practices according to socioeconomic status and place of residence and (ii) establish relationships between dietary patterns and cardiovascular risk factors. Median energy intake was 1851 kcal/day. Overall, fiber, fish and fruit and vegetables were scarcely consumed, while added sugar, refined cereals and processed food were important constituents of the diet. Two dietary patterns emerged, one labelled as "rice-rich non-animal fat pattern" and the other one as "wheat-dense animal-fat pattern". The first pattern was correlated with a moderate increase in glucose in urban participants, while the second pattern was associated with higher LDL and cholesterol blood levels in rural participants. This group of adolescents presented various dietary practices conducive to CVD development. Effective strategies are needed to prevent CVD in the Ecuadorian population by encouraging a balanced diet, which contains less refined cereals, added sugar, and processed food, but has more fruits, vegetables and whole grain cereals.

Dietary patterns and risk of colorectal cancer: a systematic review of cohort studies (2000-2011).

PubMed

Yusof, Afzaninawati Suria; Isa, Zaleha Md; Shah, Shamsul Azhar

2012-01-01

This systematic review of cohort studies aimed to identify any association between specific dietary patterns and risk of colorectal cancer (CRC). Dietary patterns involve complex interactions of food and nutrients summarizing the total diet or key aspects of the diet for a population under study. This review involves 6 cohort studies of dietary patterns and their association with colorectal cancer. An exploratory or a posteriori approach and a hypothesis-oriented or a priori approach were employed to identify dietary patterns. The dietary pattern identified to be protective against CRC was healthy, prudent, fruits and vegetables, fat reduced/diet foods, vegetables/fish/poultry, fruit/wholegrain/dairy, healthy eating index 2005, alternate healthy eating index, Mediterranean score and recommended food score. An elevated risk of CRC was associated with Western diet, pork processed meat, potatoes, traditional meat eating, and refined grain pattern. The Western dietary pattern which mainly consists of red and processed meat and refined grains is associated with an elevated risk of development of CRC. Protective factors against CRC include a healthy or prudent diet, consisting of vegetables, fruits, fish and poultry.

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.

Spatial Variability in ADHD-Related Behaviors Among Children Born to Mothers Residing Near the New Bedford Harbor Superfund Site

PubMed Central

Vieira, Verónica M.; Fabian, M. Patricia; Webster, Thomas F.; Levy, Jonathan I.; Korrick, Susan A.

2017-01-01

Abstract Attention-deficit/hyperactivity disorder (ADHD) has an uncertain etiology, with potential contributions from different risk factors such as prenatal environmental exposure to organochlorines and metals, social risk factors, and genetics. The degree to which geographic variability in ADHD is independent of, or explained by, risk factors may provide etiological insight. We investigated determinants of geographic variation in ADHD-related behaviors among children living near the polychlorinated biphenyl–contaminated New Bedford Harbor (NBH) Superfund site in Massachusetts. Participants were 573 children recruited at birth (1993–1998) who were born to mothers residing near the NBH site. We assessed ADHD-related behaviors at age 8 years using Conners’ Teacher Rating Scale–Revised: Long Version. Adjusted generalized additive models were used to smooth the association of pregnancy residence with ADHD-related behaviors and assess whether prenatal organochlorine or metal exposures, sociodemographic factors, or other factors explained spatial patterns. Models that adjusted for child's age and sex displayed significantly increased ADHD-related behavior among children whose mothers resided west of the NBH site during pregnancy. These spatial patterns persisted after adjusting for prenatal exposure to organochlorines and metals but were no longer significant after controlling for sociodemographic factors. The findings underscore the value of spatial analysis in identifying high-risk subpopulations and evaluating candidate risk factors. PMID:28444119

Assessment of Cardiovascular Disease Risk in South Asian Populations

PubMed Central

Hussain, S. Monira; Oldenburg, Brian; Zoungas, Sophia; Tonkin, Andrew M.

2013-01-01

Although South Asian populations have high cardiovascular disease (CVD) burden in the world, their patterns of individual CVD risk factors have not been fully studied. None of the available algorithms/scores to assess CVD risk have originated from these populations. To explore the relevance of CVD risk scores for these populations, literature search and qualitative synthesis of available evidence were performed. South Asians usually have higher levels of both “classical” and nontraditional CVD risk factors and experience these at a younger age. There are marked variations in risk profiles between South Asian populations. More than 100 risk algorithms are currently available, with varying risk factors. However, no available algorithm has included all important risk factors that underlie CVD in these populations. The future challenge is either to appropriately calibrate current risk algorithms or ideally to develop new risk algorithms that include variables that provide an accurate estimate of CVD risk. PMID:24163770

Do Specific Transitional Patterns of Antisocial Behavior during Adolescence Increase Risk for Problems in Young Adulthood?

PubMed Central

Cook, Emily C.; Pflieger, Jacqueline C.; Connell, Arin M.; Connell, Christian M.

2014-01-01

Latent transition analysis was used to identify patterns and trajectories of antisocial behavior (ASB) and their association with young adult outcomes in a nationally representative sample of adolescents (N = 5,422; 53.9% female). Participants were on average 13.96 years of age (SD= 1.06) at wave 1 of the study. Latent class analysis identified four classes of ASB including a non-ASB class, an aggressive class, a petty theft class, and a serious ASB class. In general, youth who were classified as serious stable ASB were the most at risk for problematic functioning in young adulthood. Youth who escalated to more serious patterns of ASB or reduced involvement also were at greater risk of negative outcomes in young adulthood compared to stable non-ASB youth, although they generally fared better than youth involved in stable patterns of more serious ASB. Gender differences indicated that involvement in ASB was a greater risk factor for alcohol use among boys and a greater risk factor for depression among girls in young adulthood. Results are discussed in terms of the predictive validity of classes of ASB to functioning in young adulthood and the implications of this research for prevention efforts. PMID:24893667

Increasing numbers of nonaneurysmal subarachnoid hemorrhage in the last 15 years: antithrombotic medication as reason and prognostic factor?

PubMed

Konczalla, Juergen; Kashefiolasl, Sepide; Brawanski, Nina; Senft, Christian; Seifert, Volker; Platz, Johannes

2016-06-01

OBJECT Subarachnoid hemorrhage (SAH) is usually caused by a ruptured intracranial aneurysm, but in some patients no source of hemorrhage can be detected. More recent data showed increasing numbers of cases of spontaneous nonaneurysmal SAH (NASAH). The aim of this study was to analyze factors, especially the use of antithrombotic medications such as systemic anticoagulation or antiplatelet agents (aCPs), influencing the increasing numbers of cases of NASAH and the clinical outcome. METHODS Between 1999 and 2013, 214 patients who were admitted to the authors' institution suffered from NASAH, 14% of all patients with SAH. Outcome was assessed according to the modified Rankin Scale (mRS) at 6 months. Risk factors were identified based on the outcome. RESULTS The number of patients with NASAH increased significantly in the last 15 years of the study period. There was a statistically significant increase in the rate of nonperimesencephalic (NPM)-SAH occurrence and aCP use, while the proportion of elderly patients remained stable. Favorable outcome (mRS 0-2) was achieved in 85% of cases, but patients treated with aCPs had a significantly higher risk for an unfavorable outcome. Further analysis showed that elderly patients, and especially the subgroup with a Fisher Grade 3 bleeding pattern, had a high risk for an unfavorable outcome, whereas the subgroup of NPM-SAH without a Fisher Grade 3 bleeding pattern had a favorable outcome, similar to perimesencephalic (PM)-SAH. CONCLUSIONS Over the years, a significant increase in the number of patients with NASAH has been observed. Also, the rate of aCP use has increased significantly. Risk factors for an unfavorable outcome were age > 65 years, Fisher Grade 3 bleeding pattern, and aCP use. Both "PM-SAH" and "NPM-SAH without a Fisher Grade 3 bleeding pattern" had excellent outcomes. Patients with NASAH and a Fisher Grade 3 bleeding pattern had a significantly higher risk for an unfavorable outcome and death. Therefore, for further investigations, NPM-SAH should be stratified into patients with or without a Fisher Grade 3 bleeding pattern. Also, cases of spontaneous SAH should be stratified into NASAH and aneurysmal SAH.

Incidence Patterns and Occupational Risk Factors of Human Brucellosis in Greece, 2004-2015.

PubMed

Lytras, T; Danis, K; Dounias, G

2016-10-01

Brucellosis is the most common bacterial zoonosis worldwide. Greece has the highest reported incidence among EU countries. However, occupational risk factors have not been well described. To determine the incidence patterns and exposure risk factors of brucellosis in Greece. We used national-level surveillance and occupational denominator data to estimate the incidence patterns and exposure risk factors of brucellosis in Greece, with particular emphasis on occupation. Between November 2003 and December 2015 a total of 2159 human brucellosis cases was reported. The mean incidence rate was 1.62 per 100 000 population per year. A large majority of cases (77.1%) reported consumption of unpasteurized milk or contact with livestock animals. Most cases occured in farmers and livestock breeders (1079 [87.7%] of 1231 cases reporting their occupation), corresponding to an annual incidence of 7.1 per 100 000. However, there were other occupations with a similar or higher risk: butchers and abattoir workers (12.7 per 100 000), laboratory personnel (3.1 per 100 000), while the highest risk was for veterinarians (53.2 per 100 000). Brucellosis incidence in specific occupational groups was much higher than in the general population. These results underline the importance of collecting information on occupation, both during the diagnostic process and in the surveillance system. Besides efforts to control brucellosis in animals, organized prevention efforts are needed within an occupational health framework, especially for the most vulnerable workers.

Effects of urbanization expansion on landscape pattern and region ecological risk in Chinese coastal city: a case study of Yantai city.

PubMed

Zhou, Di; Shi, Ping; Wu, Xiaoqing; Ma, Jinwei; Yu, Junbao

2014-01-01

Applied with remote sensing, GIS, and mathematical statistics, the spatial-temporal evolution characteristics of urbanization expansion of Yantai city from 1974 to 2009 was studied. Based on landscape pattern metrics and ecological risk index, the landscape ecological risk from the landscape pattern dynamics was evaluated. The results showed that the area of urban land increased by 189.77 km(2) with average expansion area of 5.42 km(2) y(-1) from 1974 to 2009. The urbanization intensity index during 2004-2009 was 3.92 times of that during 1974-1990. The land use types of urban land and farmland changed greatly. The changes of landscape pattern metrics for land use patterns indicated that the intensity of human activities had strengthened gradually in study period. The landscape ecological risk pattern of Yantai city shaped half-round rings along the coastline. The ecological risk index decreased with increase of the distance to the coastline. The ratio of high ecological risk to subhigh ecological risk zones in 2009 was 2.23 times of that in 1990. The significant linear relationship of urbanization intensity index and regional ecological risk indicated that the anthropological economic activities were decisive factors for sustainable development of costal ecological environment.

Effects of Urbanization Expansion on Landscape Pattern and Region Ecological Risk in Chinese Coastal City: A Case Study of Yantai City

NASA Astrophysics Data System (ADS)

Zhou, D.; Yu, J.; Li, Y.; Zhan, C.

2017-12-01

Applied with remote sensing, GIS, and mathematical statistics, the spatial-temporal evolution characteristics of urbanization expansion of Yantai city from1974 to 2009 was studied. Based on landscape pattern metrics and ecological risk index, the landscape ecological risk from the landscape pattern dynamics was evaluated. The results showed that the area of urban land increased by 189.77 km2 with average expansion area of 5.42 km2 y-1 from1974 to 2009.The urbanization intensity index during 2004-2009 was 3.92 times of that during 1974-1990. The land use types of urban land and farmland changed greatly. The changes of landscape pattern metrics for land use patterns indicated that the intensity of human activities had strengthened gradually in study period. The landscape ecological risk pattern of Yantai city shaped half-round rings along the coastline. The ecological risk index decreased with increase of the distance to the coastline. The ratio of high ecological risk to sub-high ecological risk zones in 2009 was 2.23 times of that in 1990.The significant linear relationship of urbanization intensity index and regional ecological risk indicated that the anthropological economic activities were decisive factors for sustainable development of costal ecological environment.

Effects of Urbanization Expansion on Landscape Pattern and Region Ecological Risk in Chinese Coastal City: A Case Study of Yantai City

PubMed Central

Zhou, Di; Shi, Ping; Wu, Xiaoqing; Ma, Jinwei

2014-01-01

Applied with remote sensing, GIS, and mathematical statistics, the spatial-temporal evolution characteristics of urbanization expansion of Yantai city from 1974 to 2009 was studied. Based on landscape pattern metrics and ecological risk index, the landscape ecological risk from the landscape pattern dynamics was evaluated. The results showed that the area of urban land increased by 189.77 km2 with average expansion area of 5.42 km2 y−1 from 1974 to 2009. The urbanization intensity index during 2004–2009 was 3.92 times of that during 1974–1990. The land use types of urban land and farmland changed greatly. The changes of landscape pattern metrics for land use patterns indicated that the intensity of human activities had strengthened gradually in study period. The landscape ecological risk pattern of Yantai city shaped half-round rings along the coastline. The ecological risk index decreased with increase of the distance to the coastline. The ratio of high ecological risk to subhigh ecological risk zones in 2009 was 2.23 times of that in 1990. The significant linear relationship of urbanization intensity index and regional ecological risk indicated that the anthropological economic activities were decisive factors for sustainable development of costal ecological environment. PMID:24983003

Association between dietary patterns and anaemia in adults from Jiangsu Province in Eastern China.

PubMed

Shi, Zumin; Hu, Xiaoshu; Yuan, Baojun; Pan, Xiaoqun; Dai, Yue; Holmboe-Ottesen, Gerd

2006-11-01

The objective of the present study was to investigate the association between food patterns and anaemia among Chinese adults. It was a cross-sectional household survey undertaken in 2002. The sample contained 2849 men and women aged 20 years and above, and had a response rate of 89.0 %. Factor analysis was used to identify food patterns based on a food-frequency questionnaire. Logistic regression was used to relate food patterns to anaemia. A four-factor solution explained 30.5 % of the total variance. After adjusting for socio-demographic factors and four distinct food patterns, the 'traditional' (rice, vegetable, wheat flour), 'sweet tooth' (drinks, cake) and 'healthy' (whole grains, fruits, vegetables) patterns were independently associated with anaemia. 'Traditional' and 'sweet tooth' patterns were positively associated with anaemia, whereas the association with 'healthy' food pattern was negative. No association was observed between the 'macho' pattern (meat and alcohol) and anaemia. Compared with the lowest quartile (Q1) of the 'traditional' pattern, the highest quartile (Q4) had a higher risk of anaemia (men: odds ratio (OR) 2.60, 95 % CI 1.38, 4.88; women: OR 3.40, 95 % CI 2.14, 5.39). For the 'sweet tooth' pattern, compared with the lowest quartile (Q1), the OR of the highest quartile was 2.34 (95 % CI 1.47, 3.73) for men and 2.02 (95 %CI 1.31, 3.13) for women. The fourth quartile of healthy food was associated with a lower risk of anaemia (men: OR 0.50, 95 % CI 0.31, 0.79; women: OR 0.51, 95 % CI 0.34, 0.75). Women in the north had a higher risk of anaemia (OR 2.49, 95 %CI 1.80, 3.43). Food patterns were associated with anaemia in this area with a high prevalence of anaemia.

Temporal Trends and the Impact of Race, Insurance, and Socioeconomic Status in the Management of Localized Prostate Cancer.

PubMed

Gray, Phillip J; Lin, Chun Chieh; Cooperberg, Matthew R; Jemal, Ahmedin; Efstathiou, Jason A

2017-05-01

Numerous management options exist for patients with prostate cancer; however, recent trends and their influencing factors are not well described. To describe modern patterns of care and factors associated with management choice using the National Cancer Database. Patients with localized prostate cancer diagnosed between 2004 and 2012 were included and grouped according to National Comprehensive Cancer Network guidelines into low, intermediate, or high risk. Trend analyses and multivariate logistic regression was used to identify factors associated with management. There were 598 640 patients who met the study criteria; 36.3% were classified as low risk, 43.8% intermediate risk, and 20.0% high risk. Over the study period, among low-risk patients, observation increased from 9.2% to 21.3%, while radical prostatectomy (RP) increased from 29.5% to 51.1% (p<0.001 for both). In contrast, external beam radiotherapy decreased from 24.3% to 14.5%, while brachytherapy decreased from 31.7% to 11.1%. A similar pattern was seen for patients with intermediate-risk or high-risk disease. Among high-risk patients, RP increased from 25.1% to 43.4% replacing external beam radiotherapy as the dominant therapy. On multivariate analysis, racial minorities, the uninsured, and low-income patients were less likely to receive RP. Low-risk patients in similar subgroups were significantly more likely to be observed. Limitations include potential miscoding or misclassification of variables. Patterns of care in localized prostate cancer are changing rapidly. While use of observation is increasing in low-risk groups, the use of RP is increasing across all risk groups with a concomitant decline in use of radiotherapy. Socioeconomic factors appear to influence management choice. In this report we identify a recent significant increase in the use of radical prostatectomy for prostate cancer patients. Socioeconomic factors such as race, insurance type, and income may affect treatments offered to and received by patients. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Physical activity and cardiorespiratory fitness as major markers of cardiovascular risk: their independent and interwoven importance to health status.

PubMed

Myers, Jonathan; McAuley, Paul; Lavie, Carl J; Despres, Jean-Pierre; Arena, Ross; Kokkinos, Peter

2015-01-01

The evolution from hunting and gathering to agriculture, followed by industrialization, has had a profound effect on human physical activity (PA) patterns. Current PA patterns are undoubtedly the lowest they have been in human history, with particularly marked declines in recent generations, and future projections indicate further declines around the globe. Non-communicable health problems that afflict current societies are fundamentally attributable to the fact that PA patterns are markedly different than those for which humans were genetically adapted. The advent of modern statistics and epidemiological methods has made it possible to quantify the independent effects of cardiorespiratory fitness (CRF) and PA on health outcomes. Based on more than five decades of epidemiological studies, it is now widely accepted that higher PA patterns and levels of CRF are associated with better health outcomes. This review will discuss the evidence supporting the premise that PA and CRF are independent risk factors for cardiovascular disease (CVD) as well as the interplay between both PA and CRF and other CVD risk factors. A particular focus will be given to the interplay between CRF, metabolic risk and obesity. Published by Elsevier Inc.

Meal irregularity and cardiometabolic consequences: results from observational and intervention studies.

PubMed

Pot, Gerda K; Almoosawi, Suzana; Stephen, Alison M

2016-11-01

Studying irregular meal patterns fits in with the latest research focusing not only on what people eat but also when they eat, also called chrono-nutrition. Chrono-nutrition involves studying the impact of nutrition on metabolism via circadian patterns, including three aspects of time: (ir)regularity, frequency and clock time. The present paper aimed to narratively review research on irregular meal patterns and cardiometabolic consequences. Only few cross-sectional studies and prospective cohort studies were identified, and most of these suggested that eating meals irregularly is associated with a higher risk of the metabolic syndrome and cardiometabolic risk factors, including BMI and blood pressure. This was supported by two randomised controlled intervention studies showing that consuming meals regularly for 2 weeks v. an irregular meal pattern, led to beneficial impact on cardiometabolic risk factors as lower peak insulin, lower fasting total and LDL-cholesterol, both in lean and obese women. In conclusion, the limited evidence on meal regularity and cardiometabolic consequences supports the hypothesis that consuming meals irregularly is adversely associated with cardiometabolic risk. However, it also highlights the need for more large-scale studies, including detailed dietary assessment to further advance the understanding of the impact of chrono-nutrition on public health.

Further Trends in Work-Related Musculoskeletal Disorders-A Comparison of Risk factors for Symptoms Using Quality of Work Life Data From the 2002, 2006 and 2010 General Social Survey

PubMed Central

Dick, Robert B.; Lowe, Brian; Ming-Lun, Lu; Krieg, Edward F.

2015-01-01

Objective Report trends for risk of musculoskeletal disorders (MSDs). Methods Three QWL surveys examine the risk factors for MSDs. Results Findings similar for several risk factors, but differences across the reporting years may reflect economic conditions. 2010 respondent numbers were reduced, some risk factors had pattern changes and there were gender and age differences. Trend analysis showed most significant changes were for the “Work Fast” risk factor. New 2010 “Physical Effort” item showed gender differences and items reflective of total worker health showed strong associations with “Back Pain” and “Pain in Arms.” Conclusions Intervention strategies should focus on physical exposures and psychosocial risk factors (work stress, safety climate, job satisfaction, supervisor support, work fast, work freedom, work time) that have been consistently related to reports of MSDs. Economic conditions will influence some psychosocial risk factors. PMID:26247646

Dietary Pattern and Plasma BCAA-Variations in Healthy Men and Women-Results from the KarMeN Study.

PubMed

Merz, Benedikt; Frommherz, Lara; Rist, Manuela J; Kulling, Sabine E; Bub, Achim; Watzl, Bernhard

2018-05-15

Branched-chain amino acids (BCAA) in plasma are discussed as risk factors for the onset of several diseases. Information about the contribution of the overall diet to plasma BCAA concentrations is controversial. Our objective was to investigate which dietary pattern is associated with plasma BCAA concentrations and whether other additional nutrients besides BCAA further characterize this dietary pattern. Based on the cross-sectional KarMeN study, fasting plasma amino acid (AA) concentrations, as well as current and habitual dietary intake were assessed in 298 healthy individuals. Using reduced rank regression, we derived a habitual dietary pattern that explained 32.5% of plasma BCAA variation. This pattern was high in meat, sausages, sauces, eggs, and ice cream but low in nuts, cereals, mushrooms, and pulses. The age, sex, and energy intake adjusted dietary pattern score was associated with an increase in animal-based protein together with a decrease in plant-based protein, dietary fiber, and an unfavorable fatty acid composition. Besides BCAA, alanine, lysine and the aromatic AA were positively associated with the dietary pattern score as well. All of these factors were reported to be associated with risk of type 2 diabetes and cardiovascular diseases before. Our data suggest that rather than the dietary intake of BCAA, the overall dietary pattern that contributes to high BCAA plasma concentrations may modulate chronic diseases risk.

Dietary Pattern and Plasma BCAA-Variations in Healthy Men and Women—Results from the KarMeN Study

PubMed Central

Frommherz, Lara; Kulling, Sabine E.

2018-01-01

Branched-chain amino acids (BCAA) in plasma are discussed as risk factors for the onset of several diseases. Information about the contribution of the overall diet to plasma BCAA concentrations is controversial. Our objective was to investigate which dietary pattern is associated with plasma BCAA concentrations and whether other additional nutrients besides BCAA further characterize this dietary pattern. Based on the cross-sectional KarMeN study, fasting plasma amino acid (AA) concentrations, as well as current and habitual dietary intake were assessed in 298 healthy individuals. Using reduced rank regression, we derived a habitual dietary pattern that explained 32.5% of plasma BCAA variation. This pattern was high in meat, sausages, sauces, eggs, and ice cream but low in nuts, cereals, mushrooms, and pulses. The age, sex, and energy intake adjusted dietary pattern score was associated with an increase in animal-based protein together with a decrease in plant-based protein, dietary fiber, and an unfavorable fatty acid composition. Besides BCAA, alanine, lysine and the aromatic AA were positively associated with the dietary pattern score as well. All of these factors were reported to be associated with risk of type 2 diabetes and cardiovascular diseases before. Our data suggest that rather than the dietary intake of BCAA, the overall dietary pattern that contributes to high BCAA plasma concentrations may modulate chronic diseases risk. PMID:29762522

Motor vehicle-bicycle crashes in Beijing: irregular maneuvers, crash patterns, and injury severity.

PubMed

Yan, Xinping; Ma, Ming; Huang, Helai; Abdel-Aty, Mohamed; Wu, Chaozhong

2011-09-01

This research presents a comprehensive analysis of motor vehicle-bicycle crashes using 4 years of reported crash data (2004-2007) in Beijing. The interrelationship of irregular maneuvers, crash patterns and bicyclist injury severity are investigated by controlling for a variety of risk factors related to bicyclist demographics, roadway geometric design, road environment, etc. Results show that different irregular maneuvers are correlated with a number of risk factors at different roadway locations such as the bicyclist age and gender, weather and traffic condition. Furthermore, angle collisions are the leading pattern of motor vehicle-bicycle crashes, and different irregular maneuvers may lead to some specific crash patterns such as head-on or rear-end crashes. Orthokinetic scrape is more likely to result in running over bicyclists, which may lead to more severe injury. Moreover, bicyclist injury severity level could be elevated by specific crash patterns and risk factors including head-on and angle collisions, occurrence of running over bicyclists, night without streetlight, roads without median/division, higher speed limit, heavy vehicle involvement and older bicyclists. This study suggests installation of median, division between roadway and bikeway, and improvement of illumination on road segments. Reduced speed limit is also recommended at roadway locations with high bicycle traffic volume. Furthermore, it may be necessary to develop safety campaigns aimed at male, teenage and older bicyclists. Copyright © 2011 Elsevier Ltd. All rights reserved.

Diet patterns are associated with demographic factors and nutritional status in South Indian children.

PubMed

Kehoe, Sarah H; Krishnaveni, Ghattu V; Veena, Sargoor R; Guntupalli, Aravinda M; Margetts, Barrie M; Fall, Caroline H D; Robinson, Sian M

2014-01-01

The burden of non-communicable chronic disease (NCD) in India is increasing. Diet and body composition 'track' from childhood into adult life and contribute to the development of risk factors for NCD. Little is known about the diet patterns of Indian children. We aimed to identify diet patterns and study associations with body composition and socio-demographic factors in the Mysore Parthenon Study cohort. We collected anthropometric and demographic data from children aged 9.5 years (n = 538). We also administered a food frequency questionnaire and measured fasting blood concentrations of folate and vitamin B12. Using principal component analysis, we identified two diet patterns. The 'snack and fruit' pattern was characterised by frequent intakes of snacks, fruit, sweetened drinks, rice and meat dishes and leavened breads. The 'lacto-vegetarian' pattern was characterised by frequent intakes of finger millet, vegetarian rice dishes, yoghurt, vegetable dishes and infrequent meat consumption. Adherence to the 'snack and fruit' pattern was associated with season, being Muslim and urban dwelling. Adherence to the lacto-vegetarian pattern was associated with being Hindu, rural dwelling and a lower maternal body mass index. The 'snack and fruit' pattern was negatively associated with the child's adiposity. The lacto-vegetarian pattern was positively associated with blood folate concentration and negatively with vitamin B12 concentration. This study provides new information on correlates of diet patterns in Indian children and how diet relates to nutritional status. Follow-up of these children will be important to determine the role of these differences in diet in the development of risk factors for NCD including body composition. © 2013 The Authors. Maternal and Child Nutrition published by John Wiley & Sons Ltd.

Diet patterns are associated with demographic factors and nutritional status in South Indian children

PubMed Central

Kehoe, Sarah H; Krishnaveni, Ghattu V; Veena, Sargoor R; Guntupalli, Aravinda M; Margetts, Barrie M; Fall, Caroline HD; Robinson, Sian M

2014-01-01

The burden of non-communicable chronic disease (NCD) in India is increasing. Diet and body composition ‘track’ from childhood into adult life and contribute to the development of risk factors for NCD. Little is known about the diet patterns of Indian children. We aimed to identify diet patterns and study associations with body composition and socio-demographic factors in the Mysore Parthenon Study cohort. We collected anthropometric and demographic data from children aged 9.5 years (n = 538). We also administered a food frequency questionnaire and measured fasting blood concentrations of folate and vitamin B12. Using principal component analysis, we identified two diet patterns. The ‘snack and fruit’ pattern was characterised by frequent intakes of snacks, fruit, sweetened drinks, rice and meat dishes and leavened breads. The ‘lacto-vegetarian’ pattern was characterised by frequent intakes of finger millet, vegetarian rice dishes, yoghurt, vegetable dishes and infrequent meat consumption. Adherence to the ‘snack and fruit’ pattern was associated with season, being Muslim and urban dwelling. Adherence to the lacto-vegetarian pattern was associated with being Hindu, rural dwelling and a lower maternal body mass index. The ‘snack and fruit’ pattern was negatively associated with the child's adiposity. The lacto-vegetarian pattern was positively associated with blood folate concentration and negatively with vitamin B12 concentration. This study provides new information on correlates of diet patterns in Indian children and how diet relates to nutritional status. Follow-up of these children will be important to determine the role of these differences in diet in the development of risk factors for NCD including body composition. PMID:23819872

Dietary patterns and breast cancer risk in a prospective Japanese study.

PubMed

Kojima, Reiji; Okada, Emiko; Ukawa, Shigekazu; Mori, Mitsuru; Wakai, Kenji; Date, Chigusa; Iso, Hiroyasu; Tamakoshi, Akiko

2017-01-01

The association between dietary patterns and breast cancer has been inconsistent. This study examined associations between dietary patterns and risk of developing breast cancer among 23,172 women from the Japan Collaborative Cohort Study, including 119 incidences of breast cancer diagnosed during a median 16.9-year follow-up period. Factor analysis was conducted to obtain dietary patterns, and Cox proportional models were used to estimate hazard ratios (HR) and 95 % confidence intervals (95 % CI) for breast cancer morbidity. Three dietary patterns were identified: ''vegetable pattern'' (vegetables, potatoes, seaweed, tofu, fruits, fresh fish, eggs, and miso soup); ''animal food pattern'' (meat, deep-fried foods, fried vegetables, fish paste and salt-preserved fish); and "dairy product pattern'' (milk, dairy products, fruits, coffee and tea). After adjusting for potential confounders, the vegetable and dairy product patterns were not significantly associated with risk of breast cancer. However, the animal food pattern was significantly associated with a decreased risk of breast cancer morbidity among premenopausal women by HR 0.47 for the 2nd tertile (95 % CI 0.22-1.00) and HR 0.42 for the 3rd tertile (95 % CI 0.18-0.93), compared with the bottom tertile (p for trend 0.04). We found no significant association between the vegetable and dairy product dietary patterns and breast cancer risk; however, an animal product diet may reduce risk of breast cancer among premenopausal Japanese women.

Cardiovascular diseases and risk factors among Chinese immigrants.

PubMed

Gong, Zhizhong; Zhao, Dong

2016-04-01

The aim of this study is to identify the prevalence of cardiovascular disease (CVD) and major CVD risk factors, including diabetes, hypertension, dyslipidemia, obesity and smoking among Chinese immigrants by a systematic review of studies from various countries. PubMed and the China National Knowledge Infrastructure databases were searched for studies of the prevalence of major CVDs and risk factors, and of CVD mortality among Chinese immigrants. The search identified 386 papers, 16 of which met the inclusion criteria for this review. In mainland China, there is a pattern of high stroke prevalence but low coronary heart disease (CHD) prevalence. Among Chinese immigrants, there is a much lower prevalence and mortality of stroke, but a higher prevalence and mortality of CHD, even though these are lower than the rates in immigrants of other ethnicities in the host country. The prevalence of CVD risk factors is also markedly different in immigrants. Compared with mainland Chinese, Chinese immigrants have a higher prevalence of diabetes and hypertension, higher serum cholesterol, poorer dietary patterns, and higher prevalence of obesity and smoking. Thus, the epidemiological pattern of CVD among Chinese immigrants changes compared with resident mainland Chinese. The less healthy environmental factor after immigration may be a major trigger in the adverse CVD status of Chinese immigrants. It is important for policy-makers to pay more attention to specific minority immigrant groups, and to implement more effective preventive measures to improve the health of immigrant populations.

Knowledge and prevalence of risk factors for arterial hypertension and blood pressure pattern among bankers and traffic wardens in Ilorin, Nigeria.

PubMed

Salaudeen, A G; Musa, O I; Babatunde, O A; Atoyebi, O A; Durowade, K A; Omokanye, L O

2014-09-01

High job strain, mental stress, sedentary lifestyle, increase in BMI are among the factors associated with significantly higher incidence of hypertension. The job of bank employees is both sedentary in nature and accompanies high mental stress. The aim of this study is to assess the level of knowledge of risk factors among respondents and to compare the blood pressure pattern of bankers and traffic wardens. The study design is a descriptive cross-sectional conducted among bankers and traffic wardens in Ilorin to determine the pattern and knowledge of blood pressure. Self-administered questionnaires, weighing scale (Omron Digital scale), stadiometer and sphygmomanometer were used as the research instruments. Simple random sampling was used to select respondents involved in the study. The prevalence of hypertension in this study was 34.4% in bankers and 22.2% in traffic wardens. The risk factors the bankers commonly had knowledge of are alcohol, obesity, high salt intake, certain drugs, stress, emotional problems and family history while the traffic wardens commonly had knowledge of all these in addition to cigarette smoking. Also, more bankers (32.2%) than traffic wardens (13.3%) were smoking cigarette and more of these cigarette smokers that are bankers (17.8%) had elevated blood pressure compared to the traffic wardens (3.3%). Workers in the banking industry as well as traffic wardens should be better educated about the risk factors of hypertension and bankers should be encouraged to create time for exercise.

Medical Surveillance Monthly Report

DTIC Science & Technology

2016-12-01

sure to ultraviolet radiation is the major risk factor for NMSC, personal pro- tective measures such as wearing proper clothing, decreasing time in...tone and light-colored eyes and hair, and envi- ronmental factors, particularly exposure to solar ultraviolet (UV) radiation .4 In the U.S., the... radiation is well accepted as a risk factor as evidenced by observed patterns or the anatomic distributions of NMSCs, higher rates by latitude, higher

Vegetarian diets in the Adventist Health Study 2: a review of initial published findings1234

PubMed Central

Orlich, Michael J; Fraser, Gary E

2014-01-01

The Adventist Health Study 2 is a large cohort that is well suited to the study of the relation of vegetarian dietary patterns to health and disease risk. Here we review initial published findings with regard to vegetarian diets and several health outcomes. Vegetarian dietary patterns were associated with lower body mass index, lower prevalence and incidence of diabetes mellitus, lower prevalence of the metabolic syndrome and its component factors, lower prevalence of hypertension, lower all-cause mortality, and in some instances, lower risk of cancer. Findings with regard to factors related to vegetarian diets and bone health are also reviewed. These initial results show important links between vegetarian dietary patterns and improved health. PMID:24898223

Trajectories of Developmental Functioning among Children of Adolescent Mothers: Factors Associated with Risk for Delay

ERIC Educational Resources Information Center

Jahromi, Laudan B.; Umaña-Taylor, Adriana J.; Updegraff, Kimberly A.; Zeiders, Katharine H.

2016-01-01

Children of adolescent mothers are at risk for developmental delays. Less is known about the heterogeneity in these children's developmental trajectories, and factors associated with different patterns of development. This longitudinal study used latent class growth analysis (LCGA) to identify distinct trajectories in children of Mexican-origin…

Suicide Ideation, Plan, and Attempt in the Mexican Adolescent Mental Health Survey

ERIC Educational Resources Information Center

Borges, Guilherme; Benjet, Corina; Medina-Mora, Maria Elena; Orozco, Ricardo; Nock, Matthew

2008-01-01

The study examines data from the Mexican Adolescent Mental Health Survey to study the prevalence and risk factors for suicide ideation, plan, and attempt among Mexican adolescents. The results reveal patterns of the risk factors and suggest that intervention should focus on adolescents with mental disorders to effectively prevent suicides.

Epidemiology of and Risk Factors for Type 2 Diabetes in Egypt.

PubMed

Hegazi, Refaat; El-Gamal, Mohamed; Abdel-Hady, Nagy; Hamdy, Osama

2015-01-01

Diabetes is a fast-growing health problem in Egypt with a significant impact on morbidity, mortality, and health care resources. Currently, the prevalence of type 2 diabetes (T2D) in Egypt is around 15.6% of all adults aged 20 to 79. To describe the epidemiology, principal causes, associated risk factors, cultural aspects, and challenges that may contribute to the rapid rise in T2D in Egypt. Review of papers in PubMed and relevant gray literature. The International Diabetes Federation (IDF) has identified Egypt as the ninth leading country in the world for the number of patients with T2D. The prevalence of T2D in Egypt was almost tripled over the last 2 decades. This sharp rise could be attributed to either an increased pattern of the traditional risk factors for T2D such as obesity and physical inactivity and change in eating pattern or other risk factors unique to Egypt. These include increased exposure to environmental risk factors like pesticides and increased prevalence of chronic hepatitis C. Prevention, early identification, and effective intervention are integral components of effective T2D care in Egypt. These strategies may reduce the expanding economic burden associated with T2D care. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Prevalence and risk factors of childhood allergic diseases in eight metropolitan cities in China: a multicenter study.

PubMed

Li, Fei; Zhou, Yingchun; Li, Shenghui; Jiang, Fan; Jin, Xingming; Yan, Chonghuai; Tian, Ying; Zhang, Yiwen; Tong, Shilu; Shen, Xiaoming

2011-06-06

Several studies conducted during the past two decades suggested increasing trend of childhood allergic diseases in China. However, few studies have provided detailed description of geographic variation and explored risk factors of these diseases. This study investigated the pattern and risk factors of asthma, allergic rhinitis and eczema in eight metropolitan cities in China. We conducted a cross-sectional survey during November-December 2005 in eight metropolitan cities in China. A total of 23791 children aged 6-13 years participated in this survey. Questions from the standard questionnaire of the International Study of Asthma and Allergies in Children (ISAAC) were used to examine the pattern of current asthma, allergic rhinitis and eczema. Logistic regression analyses were performed to assess the risk factors for childhood allergies. The average prevalence of childhood asthma, allergic rhinitis and eczema across the eight cities was 3.3% (95% Confidence interval (CI): 3.1%, 3.6%), 9.8% (95% CI: 9.4%, 10.2%) and 5.5% (95% CI: 5.2%, 5.8%), respectively. Factors related to lifestyle, mental health and socio-economic status were found to be associated with the prevalence of childhood allergies. These risk factors were unevenly distributed across cities and disproportionately affected the local prevalence. There was apparent geographic variation of childhood allergies in China. Socio-environmental factors had strong impacts on the prevalence of childhood allergies; but these impacts differed across regions. Thus public health policies should specifically target at the local risk factors for each individual area.

Patterns and Risk Factors of Soil-Transmitted Helminthiasis among Orang Asli Subgroups in Peninsular Malaysia

PubMed Central

Ngui, Romano; Aziz, Shafie; Chua, Kek Heng; Aidil, Roslan Muhammad; Lee, Soo Ching; Tan, Tiong Kai; Sani, Mistam Mohd; Arine, Ahmad Fadzlun; Rohela, Mahmud; Lim, Yvonne A. L.

2015-01-01

A cross-sectional study was conducted to provide comprehensive data on the patterns and associated risk factors of soil-transmitted helminth (STH) infections among five Orang Asli subgroups in Peninsular Malaysia. The overall prevalence of STH infections was 59.9% (95% confidence interval [CI] = 56.1–63.7%). Trichuris trichiura (54.3%; 95% CI = 50.4–58.2%) was the predominant species followed by Ascaris lumbricoides (26.7%; 95% CI = 23.3–30.1%) and hookworm (9.1%; 95% CI = 6.9–11.3%). This study showed diversity for STH infections by subgroup with poverty and personal sanitary behavior as important risk factors for infection. Risk profile analyses indicating that Orang Kuala subgroup who has a generally well-developed infrastructure and better quality of life had a low rate of infection. There is a need for poverty reduction and promotion of deworming programs along with mass scale campaigns to create awareness about health and hygiene to reduce STH infections. PMID:26055746

Patterns and Risk Factors of Soil-Transmitted Helminthiasis Among Orang Asli Subgroups in Peninsular Malaysia.

PubMed

Ngui, Romano; Aziz, Shafie; Chua, Kek Heng; Aidil, Roslan Muhammad; Lee, Soo Ching; Tan, Tiong Kai; Sani, Mistam Mohd; Arine, Ahmad Fadzlun; Rohela, Mahmud; Lim, Yvonne A L

2015-08-01

A cross-sectional study was conducted to provide comprehensive data on the patterns and associated risk factors of soil-transmitted helminth (STH) infections among five Orang Asli subgroups in Peninsular Malaysia. The overall prevalence of STH infections was 59.9% (95% confidence interval [CI] = 56.1-63.7%). Trichuris trichiura (54.3%; 95% CI = 50.4-58.2%) was the predominant species followed by Ascaris lumbricoides (26.7%; 95% CI = 23.3-30.1%) and hookworm (9.1%; 95% CI = 6.9-11.3%). This study showed diversity for STH infections by subgroup with poverty and personal sanitary behavior as important risk factors for infection. Risk profile analyses indicating that Orang Kuala subgroup who has a generally well-developed infrastructure and better quality of life had a low rate of infection. There is a need for poverty reduction and promotion of deworming programs along with mass scale campaigns to create awareness about health and hygiene to reduce STH infections. © The American Society of Tropical Medicine and Hygiene.

Birthweight below the tenth percentile: the relative and attributable risks of maternal tobacco consumption and other factors.

PubMed

Morrison, J; Williams, G M; Najman, J M; Andersen, M J; Keeping, J D

1993-10-01

Analysis of 7776 singleton births defined a cohort of babies with birthweight below the 10th percentile after adjusting for gestational age and sex. The relative risk of a baby being small for gestational age in respect to a number of factors, such as parental anthropometry, demographic factors, behavior patterns (tobacco, cannabis, alcohol, and caffeine consumption), maternal pathology, and fetal abnormality, was calculated. The highest relative risks are associated with severe antepartum hemorrhage, severe pre-eclampsia, and severe fetal abnormality. As these are relatively rare events, a more accurate calculation of overall risk to the population as opposed to the individual can be obtained by studying the percent attributable risk of each of the factors. This demonstrates that maternal tobacco consumption is the major environmental risk factor in our population.

Birth-cohort patterns in Crohn's disease and ulcerative colitis.

PubMed

Sonnenberg, Amnon

2014-01-01

To test the long-term time trends of mortality from inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), for the presence of birth-cohort phenomena. We analyzed mortality data from the national statistical offices of Canada, England and Wales, Italy, the Netherlands, Switzerland, and the USA for the past 60-80 years. Age-specific rates of death were plotted against the period of death, as period-age contours, and against the period of birth, as cohort-age contours. In all six countries alike, the general time trends of IBD have been shaped by an underlying birth-cohort pattern. This pattern was also observed in the data of CD and UC analyzed separately. UC mortality increased in all generations born during the 19th century. It peaked among generations born shortly before the turn of the century and then decreased in all subsequent generations born throughout the 20th century. Compared with UC, the birth-cohort pattern of CD was delayed by 30-50 years. In addition to one risk factor responsible for the general occurrence of IBD and possibly UC alone, there exists at least one additional risk factor responsible for CD. Exposure to both separate risk factors must occur during early life.

A multiphase non-linear mixed effects model: An application to spirometry after lung transplantation.

PubMed

Rajeswaran, Jeevanantham; Blackstone, Eugene H

2017-02-01

In medical sciences, we often encounter longitudinal temporal relationships that are non-linear in nature. The influence of risk factors may also change across longitudinal follow-up. A system of multiphase non-linear mixed effects model is presented to model temporal patterns of longitudinal continuous measurements, with temporal decomposition to identify the phases and risk factors within each phase. Application of this model is illustrated using spirometry data after lung transplantation using readily available statistical software. This application illustrates the usefulness of our flexible model when dealing with complex non-linear patterns and time-varying coefficients.

Associations between Patterns of Objectively Measured Physical Activity and Risk Factors for the Metabolic Syndrome

PubMed Central

Metzger, Jesse S.; Catellier, Diane J.; Evenson, Kelly R.; Treuth, Margarita S.; Rosamond, Wayne D.; Siega-Riz, Anna Maria

2017-01-01

Purpose Determine whether certain patterns of objectively measured physical activity (PA) are associated with the risk factors for or the diagnosis of the metabolic syndrome (MS). Design Latent class analysis, including the assessment of the associations between latent PA classes and the risk factors for MS. Setting Random sample from throughout the United States (US) using data from 2003–2004 National Health and Nutrition Examination Survey. Subjects A total of 3,458 adult, civilian, non-institutionalized US citizens. Measures Daily minutes of moderate-to-vigorous PA across a 7-day week, based on accelerometer measurements, as well ashigh blood pressure, blood glucose levels, triglyceride levels, and body mass index, along with low levels of high density lipoproteins, using clinical cut points. Results Membership in the more active PA classes was consistently associated with lower odds of all of the risk factors for the MS. However, when participants were categorized into quartiles of the coefficient of variation of PA across 7 days, few differences were seen in any of the risk factors. Conclusion Accumulating the total recommended amount of PA for a week is consistently associated with positive health profiles, and more PA than the recommended amounts may suggest. However, the manner in which this activity is accumulated, either spread over most days of the week or compressed into just a couple of days, may have similar associations with the risk factors for the MS. PMID:20073381

Identifying risk factors of highly pathogenic avian influenza (H5N1 subtype) in Indonesia.

PubMed

Loth, Leo; Gilbert, Marius; Wu, Jianmei; Czarnecki, Christina; Hidayat, Muhammad; Xiao, Xiangming

2011-10-01

Highly pathogenic avian influenza (HPAI), subtype H5N1, was first officially reported in Indonesia in 2004. Since then the disease has spread and is now endemic in large parts of the country. This study investigated the statistical relationship between a set of risk factors and the presence or absence of HPAI in Indonesia during 2006 and 2007. HPAI was evaluated through participatory disease surveillance (PDS) in backyard village chickens (the study population), and risk factors included descriptors of people and poultry distribution (separating chickens, ducks and production sectors), poultry movement patterns and agro-ecological conditions. The study showed that the risk factors "elevation", "human population density" and "rice cropping" were significant in accounting for the spatial variation of the PDS-defined HPAI cases. These findings were consistent with earlier studies in Thailand and Vietnam. In addition "commercial poultry population", and two indicators of market locations and transport; "human settlements" and "road length", were identified as significant risk factors in the models. In contrast to several previous studies carried out in Southeast Asia, domestic backyard ducks were not found to be a significant risk factor in Indonesia. The study used surrogate estimates of market locations and marketing chains and further work should focus on the actual location of the live bird markets, and on the flow of live poultry and poultry products between them, so that patterns of possible transmission, and regions of particular risk could be better inferred. Copyright © 2011 Elsevier B.V. All rights reserved.

Dietary patterns and risk of death and progression to ESRD in individuals with CKD: a cohort study.

PubMed

Gutiérrez, Orlando M; Muntner, Paul; Rizk, Dana V; McClellan, William M; Warnock, David G; Newby, P K; Judd, Suzanne E

2014-08-01

Nutrition is linked strongly with health outcomes in chronic kidney disease (CKD). However, few studies have examined relationships between dietary patterns and health outcomes in persons with CKD. Observational cohort study. 3,972 participants with CKD (defined as estimated glomerular filtration rate < 60 mL/min/1.73 m2 or albumin-creatinine ratio ≥ 30 mg/g at baseline) from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study, a prospective cohort study of 30,239 black and white adults at least 45 years of age. 5 empirically derived dietary patterns identified by factor analysis: "convenience" (Chinese and Mexican foods, pizza, and other mixed dishes), "plant-based" (fruits and vegetables), "sweets/fats" (sugary foods), "Southern" (fried foods, organ meats, and sweetened beverages), and "alcohol/salads" (alcohol, green-leafy vegetables, and salad dressing). All-cause mortality and end-stage renal disease (ESRD). 816 deaths and 141 ESRD events were observed over approximately 6 years of follow-up. There were no statistically significant associations of convenience, sweets/fats, or alcohol/salads pattern scores with all-cause mortality after multivariable adjustment. In Cox regression models adjusted for sociodemographic factors, energy intake, comorbid conditions, and baseline kidney function, higher plant-based pattern scores (indicating greater consistency with the pattern) were associated with lower risk of mortality (HR comparing fourth to first quartile, 0.77; 95% CI, 0.61-0.97), whereas higher Southern pattern scores were associated with greater risk of mortality (HR comparing fourth to first quartile, 1.51; 95% CI, 1.19-1.92). There were no associations of dietary patterns with incident ESRD in multivariable-adjusted models. Missing dietary pattern data, potential residual confounding from lifestyle factors. A Southern dietary pattern rich in processed and fried foods was associated independently with mortality in persons with CKD. In contrast, a diet rich in fruits and vegetables appeared to be protective. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Fingerprints and cardiovascular risk. The San Valentino fingerprint vascular screening project (SanVal/FP).

PubMed

Belcaro, G; Cesarone, M R; Ledda, A; Cornelli, U; Dugall, M; Di Renzo, A; Hosoi, M; Stuard, S; Vinciguerra, G; Pellegrini, L; Gizzi, G

2008-10-01

Fingerprints (FP), characteristic of humans, are impressions due to skin marks (ridges) on fingertips. Ridges are present on fingers/hands forming curved lines of different sizes/patterns. The point where a line stops or splits is defined typica' (their number/amount constitute identification patterns). FP are permanent and unique. This study compared FP patterns with cardiovascular risk factors: 7 main types of FP were used: 1. Arch: lines form waves from one site to the other side. 2. Tentarch: like arches but with a rising stick in the middle. 3. Loop: lines coming from one site returning in the middle to the same site. 4. Double loop: like loops but with two loops inside: one standing, one hanging. 5. Pocked loop: like the loop but with a small circle in the turning point. 6. Whorl: lines make circles. 7. Mixed figure: composed of different figures. There are two kinds of real typica: A. Ending line; B. Splitting lines (bifurcations). Several combinations may result. Ultrasound evaluation of carotid/femoral arteries in asymptomatic subjects. Arteries were evaluated with high-resolution ultrasound at the bifurcations. Four classes were defined: 1: normal intima-media (IMT) complex; 2: IMT thickening; 3: non-stenosing plaques (<50% stenosis); 4: stenosing plaque (>50%). Subjects in classes 1, 2, 3 were included into the analysis made comparing FP patterns and ultrasound. For each FP pattern: A. the main proportion of subjects with cardiovacular risk factors (91%) had arches (41.2%) and loops (either single, 38.2% or double 11.7% for a total of 49.9%). B. The remaining classes were statistically less important. C. The number of ridges per square mm was comparable in all pattern classes. D. The analysis of typica and other ridges characteristics requires a more elaborated system. Future research must define simple, low cost screening methods for preselection of subjects at higher cardiovascular risk or for exclusion of low risk subjects. The evaluation of fingerprint pattern may be useful to define risk groups.

Identifying Trajectories of Adolescents' Depressive Phenomena: An Examination of Early Risk Factors

ERIC Educational Resources Information Center

Mazza, James J.; Fleming, Charles B.; Abbott, Robert D.; Haggerty, Kevin P.; Catalano, Richard F.

2010-01-01

Few studies have examined risk factors of childhood and early adolescent depressive symptomatology trajectories. This study examined self-report depressive symptomatology across a 6-year time period from 2nd to 8th grade to identify latent groups of individuals with similar patterns of depressive phenomena in a sample of 951 children (440 girls,…

Ecocultural Patterns of Family Engagement among Low-Income Latino Families of Preschool Children

ERIC Educational Resources Information Center

McWayne, Christine M.; Melzi, Gigliana; Limlingan, Maria Cristina; Schick, Adina

2016-01-01

For the 5 million low-income Latino children in the United States who are disproportionately impacted by the numerous risk factors associated with poverty, it is essential to identify proximal protective factors that mitigate these risks and bolster the academic and social skills that are foundational to a successful transition into formal…

An average/deprivation/inequality (ADI) analysis of chronic disease outcomes and risk factors in Argentina

PubMed Central

De Maio, Fernando G; Linetzky, Bruno; Virgolini, Mario

2009-01-01

Background Recognition of the global economic and epidemiological burden of chronic non-communicable diseases has increased in recent years. However, much of the research on this issue remains focused on individual-level risk factors and neglects the underlying social patterning of risk factors and disease outcomes. Methods Secondary analysis of Argentina's 2005 Encuesta Nacional de Factores de Riesgo (National Risk Factor Survey, N = 41,392) using a novel analytical strategy first proposed by the United Nations Development Programme (UNDP), which we here refer to as the Average/Deprivation/Inequality (ADI) framework. The analysis focuses on two risk factors (unhealthy diet and obesity) and one related disease outcome (diabetes), a notable health concern in Latin America. Logistic regression is used to examine the interplay between socioeconomic and demographic factors. The ADI analysis then uses the results from the logistic regression to identify the most deprived, the best-off, and the difference between the two ideal types. Results Overall, 19.9% of the sample reported being in poor/fair health, 35.3% reported not eating any fruits or vegetables in five days of the week preceding the interview, 14.7% had a BMI of 30 or greater, and 8.5% indicated that a health professional had told them that they have diabetes or high blood pressure. However, significant variation is hidden by these summary measures. Educational attainment displayed the strongest explanatory power throughout the models, followed by household income, with both factors highlighting the social patterning of risk factors and disease outcomes. As educational attainment and household income increase, the probability of poor health, unhealthy diet, obesity, and diabetes decrease. The analyses also point toward important provincial effects and reinforce the notion that both compositional factors (i.e., characteristics of individuals) and contextual factors (i.e., characteristics of places) are important in understanding the social patterning of chronic diseases. Conclusion The application of the ADI framework enables identification of the regions or groups worst-off for each outcome measure under study. This can be used to highlight the variation embedded within national averages; as such, it encourages a social perspective on population health indicators that is particularly attuned to issues of inequity. The ADI framework is an important tool in the evaluation of policies aiming to prevent or control chronic non-communicable diseases. PMID:19505309

Spatial Variability in ADHD-Related Behaviors Among Children Born to Mothers Residing Near the New Bedford Harbor Superfund Site.

PubMed

Vieira, Verónica M; Fabian, M Patricia; Webster, Thomas F; Levy, Jonathan I; Korrick, Susan A

2017-05-15

Attention-deficit/hyperactivity disorder (ADHD) has an uncertain etiology, with potential contributions from different risk factors such as prenatal environmental exposure to organochlorines and metals, social risk factors, and genetics. The degree to which geographic variability in ADHD is independent of, or explained by, risk factors may provide etiological insight. We investigated determinants of geographic variation in ADHD-related behaviors among children living near the polychlorinated biphenyl-contaminated New Bedford Harbor (NBH) Superfund site in Massachusetts. Participants were 573 children recruited at birth (1993-1998) who were born to mothers residing near the NBH site. We assessed ADHD-related behaviors at age 8 years using Conners' Teacher Rating Scale-Revised: Long Version. Adjusted generalized additive models were used to smooth the association of pregnancy residence with ADHD-related behaviors and assess whether prenatal organochlorine or metal exposures, sociodemographic factors, or other factors explained spatial patterns. Models that adjusted for child's age and sex displayed significantly increased ADHD-related behavior among children whose mothers resided west of the NBH site during pregnancy. These spatial patterns persisted after adjusting for prenatal exposure to organochlorines and metals but were no longer significant after controlling for sociodemographic factors. The findings underscore the value of spatial analysis in identifying high-risk subpopulations and evaluating candidate risk factors. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

An empirical assessment of driver motivation and emotional states in perceived safety margins under varied driving conditions.

PubMed

Zhang, Yu; Kaber, David B

2013-01-01

Motivation models in driving behaviour postulate that driver motives and emotional states dictate risk tolerance under various traffic conditions. The present study used time and driver performance-based payment systems to manipulate motivation and risk-taking behaviour. Ten participants drove to a predefined location in a simulated driving environment. Traffic patterns (density and velocity) were manipulated to cause driver behaviour adjustments due to the need to conform with the social norms of the roadway. The driving environment complexity was investigated as a mediating factor in risk tolerance. Results revealed the performance-based payment system to closely relate to risk-taking behaviour as compared with the time-based payment system. Drivers conformed with social norms associated with specific traffic patterns. Higher roadway complexity led to a more conservative safety margins and speeds. This research contributes to the further development of motivational models of driver behaviour. This study provides empirical justification for two motivation factors in driver risk-taking decisions, including compliance with social norm and emotions triggered by incentives. Environment complexity was identified as a mediating factor in motivational behaviour model. This study also recommended safety margin measures sensitive to changes in driver risk tolerance.

Association between healthy maternal dietary pattern and risk for gestational diabetes mellitus.

PubMed

Tryggvadottir, E A; Medek, H; Birgisdottir, B E; Geirsson, R T; Gunnarsdottir, I

2016-02-01

Gestational diabetes mellitus (GDM) is associated with negative health effects for mother and child. The aim was to investigate the association between maternal dietary patterns and GDM. Prospective observational study including 168 pregnant women aged 18-40 years, recruited at routine 20-week ultrasound. All participants kept a 4-day weighed food record following recruitment (commencement: gestational weeks 19-24). Principal component analysis was used to extract dietary patterns from 29 food groups. A Healthy Eating Index (HEI) was constructed. All women underwent an oral glucose tolerance test in weeks 23-28. One clear dietary pattern (Eigenvalue 2.4) was extracted with positive factor loadings for seafood; eggs; vegetables; fruits and berries; vegetable oils; nuts and seeds; pasta; breakfast cereals; and coffee, tea and cocoa powder, and negative factor loadings for soft drinks and French fries. This pattern was labeled a prudent dietary pattern. Explained variance was 8.2%. The prevalence of GDM was 2.3% among women of normal weight before pregnancy (n=86) and 18.3% among overweight/obese women (n=82). The prudent dietary pattern was associated with lower risk of GDM (OR: 0.54; 95% CI: 0.30, 0.98). When adjusting for age, parity, prepregnancy weight, energy intake, weekly weight gain and total metabolic equivalent of task the association remained (OR: 0.36; 95% CI: 0.14, 0.94). Similar results were found when only including overweight or obese women (OR: 0.31; 95% CI: 0.13, 0.75). Adhering to a prudent dietary pattern in pregnancy was clearly associated with lower risk of GDM, especially among women already at higher risk because of overweight/obesity before pregnancy.

Restrictive pattern on spirometry: association with cardiovascular risk and level of physical activity in asymptomatic adults

PubMed Central

Sperandio, Evandro Fornias; Arantes, Rodolfo Leite; Matheus, Agatha Caveda; da Silva, Rodrigo Pereira; Lauria, Vinícius Tonon; Romiti, Marcello; Gagliardi, Antônio Ricardo de Toledo; Dourado, Victor Zuniga

2016-01-01

Objective : To determine whether a restrictive pattern on spirometry is associated with the level of physical activity in daily life (PADL), as well as with cardiovascular disease (CVD) risk factors, in asymptomatic adults. Methods : A total of 374 participants (mean age, 41 ± 14 years) underwent spirometry, which included the determination of FVC and FEV1. A restrictive pattern on spirometry was defined as an FEV1/FVC ratio > 0.7 and an FVC < 80% of the predicted value. After conducting demographic, anthropometric, and CVD risk assessments, we evaluated body composition, muscle function, and postural balance, as well as performing cardiopulmonary exercise testing and administering the six-minute walk test. The PADL was quantified with a triaxial accelerometer. Results : A restrictive pattern on spirometry was found in 10% of the subjects. After multivariate logistic regression, adjusted for confounders (PADL and cardiorespiratory fitness), the following variables retained significance (OR; 95% CI) as predictors of a restrictive pattern: systemic arterial hypertension (17.5; 1.65-184.8), smoking (11.6; 1.56-87.5), physical inactivity (8.1; 1.43-46.4), larger center-of-pressure area while standing on a force platform (1.34; 1.05-1.71); and dyslipidemia (1.89; 1.12-1.98). Conclusions : A restrictive pattern on spirometry appears to be common in asymptomatic adults. We found that CVD risk factors, especially systemic arterial hypertension, smoking, and physical inactivity, were directly associated with a restrictive pattern, even when the analysis was adjusted for PADL and cardiorespiratory fitness. Longitudinal studies are needed in order to improve understanding of the etiology of a restrictive pattern as well as to aid in the design of preventive strategies. PMID:26982037

The socio-spatial context as a risk factor for hospitalization due to mental illness in the metropolitan areas of Portugal.

PubMed

Loureiro, Adriana; Costa, Cláudia; Almendra, Ricardo; Freitas, Ângela; Santana, Paula

2015-11-01

This study's aims are: (i) identifying spatial patterns for the risk of hospitalization due to mental illness and for the potential risk resulting from contextual factors with influence on mental health; and (ii) analyzing the spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors in the metropolitan areas of Lisbon and Porto, Portugal. A cross-sectional ecological study was conducted by applying statistical methods for assessing spatial dependency and heterogeneity. Results reveal a spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors with a statistical relevance of moderate intensity. 20% of the population under study lives in areas with a simultaneously high potential risk resulting from contextual factors and risk of hospitalization due to mental illness. Porto Metropolitan Area show the highest percentage of population living in parishes with a significantly high risk of hospitalization due to mental health, which puts forward the need for interventions on territory-adjusted contextual factors influencing mental health.

Fetal Substance Exposure and Cumulative Environmental Risk in an African American Cohort

ERIC Educational Resources Information Center

Yumoto, Chie; Jacobson, Sandra W.; Jacobson, Joseph L.

2008-01-01

Two models of vulnerability to socioenvironmental risk were examined in 337 African American children (M = 7.8 years) recruited to overrepresent prenatal alcohol or cocaine exposure: The cumulative risk model predicted synergistic effects from exposure to multiple risk factors, and the fetal patterning of disease model predicted that prenatal…

The Diverse Risk Profiles of Persistently Absent Primary Students: Implications for Attendance Policies in Australia

ERIC Educational Resources Information Center

Hancock, Kirsten J.; Mitrou, Francis; Taylor, Catherine L.; Zubrick, Stephen R.

2018-01-01

The risk factors associated with absenteeism are well known. However, children's exposure to combinations of risks and how these relate to absence patterns remains unclear. Understanding variations in risk profiles among persistently non-attending children will inform the development of absence interventions. Using a longitudinal sample of…

Work-related behaviour and experience patterns of physicians compared to other professions.

PubMed

Voltmer, Edgar; Kieschke, Ulf; Spahn, Claudia

2007-08-11

To identify health risk factors and resources of physicians in comparison with other professions. Data of cross-sectional mail surveys conducted among German physicians (n = 344), teachers (n = 5169), policemen (n = 851), prison officers (n = 3653), and starting entrepreneurs (n = 632) were analysed regarding eleven health-relevant dimensions and four behaviour patterns examined by the questionnaire "Work-Related Behaviour and Experience Pattern (AVEM)". Only 17% of the physicians showed healthy behaviour and experience patterns. With 43%, they scored highest in terms of reduced working motivation. Together with the teachers, they also had the highest scores for resignation and burnout (27%). Satisfaction with life and work as well as social support showed medium scores. Starting entrepreneurs showed the healthiest patterns (45%), but also the highest risk pattern for overexertion (38%). It was possible to identify clear risk patterns for profession-related psychosocial symptoms and impairments. The high scores for reduced working motivation demonstrate the need for interventions to improve organisation of health care and individual coping strategies.

Infection after primary hip arthroplasty

PubMed Central

2011-01-01

Background and purpose The aim of the present study was to assess incidence of and risk factors for infection after hip arthroplasty in data from 3 national health registries. We investigated differences in risk patterns between surgical site infection (SSI) and revision due to infection after primary total hip arthroplasty (THA) and hemiarthroplasty (HA). Materials and methods This observational study was based on prospective data from 2005–2009 on primary THAs and HAs from the Norwegian Arthroplasty Register (NAR), the Norwegian Hip Fracture Register (NHFR), and the Norwegian Surveillance System for Healthcare–Associated Infections (NOIS). The Norwegian Patient Register (NPR) was used for evaluation of case reporting. Cox regression analyses were performed with revision due to infection as endpoint for data from the NAR and the NHFR, and with SSI as the endpoint for data from the NOIS. Results The 1–year incidence of SSI in the NOIS was 3.0% after THA (167/5,540) and 7.3% after HA (103/1,416). The 1–year incidence of revision due to infection was 0.7% for THAs in the NAR (182/24,512) and 1.5% for HAs in the NHFR (128/8,262). Risk factors for SSI after THA were advanced age, ASA class higher than 2, and short duration of surgery. For THA, the risk factors for revision due to infection were male sex, advanced age, ASA class higher than 1, emergency surgery, uncemented fixation, and a National Nosocomial Infection Surveillance (NNIS) risk index of 2 or more. For HAs inserted after fracture, age less than 60 and short duration of surgery were risk factors of revision due to infection. Interpretation The incidences of SSI and revision due to infection after primary hip replacements in Norway are similar to those in other countries. There may be differences in risk pattern between SSI and revision due to infection after arthroplasty. The risk patterns for revision due to infection appear to be different for HA and THA. PMID:22066562

Cervical node metastasis in T1 squamous cell carcinoma of oral tongue- pattern and the predictive factors.

PubMed

S, Vishak; Rohan, Vinayak

2014-06-01

The squamous cell carcinoma (SCC) of the oral tongue is a common cancer in India. Elective lymphadenectomy is generally performed in all patients with T2-T4 tumors. In this study we have tried to analyze the pattern and risk factors associated with lymph node metastasis in T1 tongue cancers. A retrospective review of the records of 57 patients undergoing surgery for treatment of T1 sqamous cell carcinoma of oral tongue was carried out. The clinicopatological features of the tumor, pattern of nodal metastasis and the risk factors associated with lymph node metastasis were studied. Totally 57 patients with T1 tumor underwent excision of the primary and modified neck dissection (MND). Lymph node metastasis was found in 36.8 % of the patients. Level I to Level II was the commonest site of metastasis. Skip metastasis at level III and IV was found in 8.5 % of the patients and isolated skip metastasis at level IV in 1.5 % of the patients. The risk factors associated with the lymph node metastasis on univariete analysis were; higher grade, tumor size >1 cm and tumor thickness >3 mm. On multivariate analysis only the tumor thickness was found to be a risk factor for the lymph node metastasis (hazard ratio of 21.59). T1 sqamous cell carcinoma of tongue is associated with a high incidence of lymph node metastasis. Elective neck dissection should be considered in all patients with tumors more than 3 mm in thickness.

Asymptomatic Wolff-Parkinson-White Pattern ECG in USAF Aviators.

PubMed

Davenport, Eddie D; Rupp, Karen A N; Palileo, Edwin; Haynes, Jared

2017-01-01

Wolff-Parkinson-White (WPW) pattern is occasionally found in asymptomatic aviators during routine ECGs. Aeromedical concerns regarding WPW pattern include risk of dysrhythmia or sudden cardiac death (SCD), thus affecting the safety of flight. The purpose of this study was to determine the prevalence and outcomes of aviators with asymptomatic WPW pattern and assess for risk factors that contribute to progression to dysrhythmia or symptoms. The U.S. Air Force (USAF) ECG library database containing over 1.2 million ECGs collected over the past 68 yr was used to identify 638 individual aviators with WPW pattern. Demographic, medical history, and outcome data were obtained by medical record review. Aviators who developed high risk features defined as symptoms, arrhythmia, or ablation of a high risk pathway, were compared to those who remained asymptomatic. Prevalence of WPW pattern was 0.30% among all USAF aviators. Of the 638 individuals, 64 (10%) progressed to the combined endpoint of SCD, arrhythmia, and/or ablation of a high risk pathway over 6868 patient years, with average follow-up of 10.5 yr. There were two sudden cardiac deaths (0.3%). Annual risk of possible sudden incapacitation was 0.95% and of SCD 0.03%. Those that progressed to high risk were significantly younger, had lower diastolic blood pressure, lower total cholesterol, and better physical fitness testing scores. WPW pattern on ECG found in asymptomatic aviators confers < 1% annual risk of arrhythmia or incapacitating events with the highest risk in the younger, healthier, and most fit populations.Davenport ED, Rupp KAN, Palileo E, Haynes J. Asymptomatic Wolff-Parkinson-White pattern ECG in USAF aviators. Aerosp Med Hum Perform. 2017; 88(1):56-60.

Meat consumption as a risk factor for type 2 diabetes.

PubMed

Barnard, Neal; Levin, Susan; Trapp, Caroline

2014-02-21

Disease risk factors identified in epidemiological studies serve as important public health tools, helping clinicians identify individuals who may benefit from more aggressive screening or risk-modification procedures, allowing policymakers to prioritize intervention programs, and encouraging at-risk individuals to modify behavior and improve their health. These factors have been based primarily on evidence from cross-sectional and prospective studies, as most do not lend themselves to randomized trials. While some risk factors are not modifiable, eating habits are subject to change through both individual action and broader policy initiatives. Meat consumption has been frequently investigated as a variable associated with diabetes risk, but it has not yet been described as a diabetes risk factor. In this article, we evaluate the evidence supporting the use of meat consumption as a clinically useful risk factor for type 2 diabetes, based on studies evaluating the risks associated with meat consumption as a categorical dietary characteristic (i.e., meat consumption versus no meat consumption), as a scalar variable (i.e., gradations of meat consumption), or as part of a broader dietary pattern.

Meat Consumption as a Risk Factor for Type 2 Diabetes

PubMed Central

Barnard, Neal; Levin, Susan; Trapp, Caroline

2014-01-01

Disease risk factors identified in epidemiological studies serve as important public health tools, helping clinicians identify individuals who may benefit from more aggressive screening or risk-modification procedures, allowing policymakers to prioritize intervention programs, and encouraging at-risk individuals to modify behavior and improve their health. These factors have been based primarily on evidence from cross-sectional and prospective studies, as most do not lend themselves to randomized trials. While some risk factors are not modifiable, eating habits are subject to change through both individual action and broader policy initiatives. Meat consumption has been frequently investigated as a variable associated with diabetes risk, but it has not yet been described as a diabetes risk factor. In this article, we evaluate the evidence supporting the use of meat consumption as a clinically useful risk factor for type 2 diabetes, based on studies evaluating the risks associated with meat consumption as a categorical dietary characteristic (i.e., meat consumption versus no meat consumption), as a scalar variable (i.e., gradations of meat consumption), or as part of a broader dietary pattern. PMID:24566443

Empirically derived dietary patterns and risk of postmenopausal breast cancer in a large prospective cohort study.

PubMed

Velie, Ellen M; Schairer, Catherine; Flood, Andrew; He, Jian-Ping; Khattree, Ravindra; Schatzkin, Arthur

2005-12-01

Inconsistent associations have been reported between diet and breast cancer. We prospectively examined the association between dietary patterns and postmenopausal breast cancer risk in a US-wide cohort study. Data were analyzed from 40 559 women who completed a self-administered 61-item Block food-frequency questionnaire in the Breast Cancer Detection Demonstration Project, 1987-1998; 1868 of those women developed breast cancer. Dietary patterns were defined by using principal components factor analysis. Cox proportional hazard regression was used to assess breast cancer risk. Three major dietary patterns emerged: vegetable-fish/poultry-fruit, beef/pork-starch, and traditional southern. The vegetable-fish/poultry-fruit pattern was associated with higher education than were the other patterns, but was similar in nutrient intake to the traditional southern pattern. After adjustment for confounders, there was no significant association between the vegetable-fish/poultry-fruit and beef/pork-starch patterns and breast cancer. The traditional southern pattern, however, was associated with a nonsignificantly reduced breast cancer risk among all cases (in situ and invasive) that was significant for invasive breast cancer (relative hazard = 0.78; 95% CI = 0.65, 0.95; P for trend = 0.003). This diet was also associated with a reduced risk in women without a family history of breast cancer (P = 0.05), who were underweight or normal weight [body mass index (in kg/m(2)) < 25; P = 0.02], or who had tumors positive for estrogen receptor (P = 0.01) or progesterone receptor (P = 0.003). Foods in the traditional southern pattern associated with reduced breast cancer risk were legumes, low mayonnaise-salad dressing intake, and possibly cabbage. The traditional southern diet or its components are associated with a reduced risk of invasive breast cancer in postmenopausal women.

Risk stratification in cervical cancer screening by complete screening history: Applying bioinformatics to a general screening population.

PubMed

Baltzer, Nicholas; Sundström, Karin; Nygård, Jan F; Dillner, Joakim; Komorowski, Jan

2017-07-01

Women screened for cervical cancer in Sweden are currently treated under a one-size-fits-all programme, which has been successful in reducing the incidence of cervical cancer but does not use all of the participants' available medical information. This study aimed to use women's complete cervical screening histories to identify diagnostic patterns that may indicate an increased risk of developing cervical cancer. A nationwide case-control study was performed where cervical cancer screening data from 125,476 women with a maximum follow-up of 10 years were evaluated for patterns of SNOMED diagnoses. The cancer development risk was estimated for a number of different screening history patterns and expressed as Odds Ratios (OR), with a history of 4 benign cervical tests as reference, using logistic regression. The overall performance of the model was moderate (64% accuracy, 71% area under curve) with 61-62% of the study population showing no specific patterns associated with risk. However, predictions for high-risk groups as defined by screening history patterns were highly discriminatory with ORs ranging from 8 to 36. The model for computing risk performed consistently across different screening history lengths, and several patterns predicted cancer outcomes. The results show the presence of risk-increasing and risk-decreasing factors in the screening history. Thus it is feasible to identify subgroups based on their complete screening histories. Several high-risk subgroups identified might benefit from an increased screening density. Some low-risk subgroups identified could likely have a moderately reduced screening density without additional risk. © 2017 UICC.

Longitudinal trends in HbA1c patterns and association with outcomes: A systematic review.

PubMed

Luo, Miyang; Tan, Kristin Hui Xian; Tan, Chuen Seng; Lim, Wei Yen; Tai, E-Shyong; Venkataraman, Kavita

2018-04-17

This study aimed to review studies that identified patterns of longitudinal HbA 1c trends in patients with diabetes and to summarize factors and outcomes associated with distinct trajectory patterns. PubMed and Web of Science were systematically searched for studies examining HbA 1c trends among patients with diabetes from database inception through September 2017. Articles were included if they met the following inclusion criteria: (a) longitudinal study of subjects with diabetes only, (b) use of serial measurements of HbA 1c , and (c) analysis of the trend of HbA 1c using group-based trajectory approaches. Twenty studies were included, 11 on type 1 diabetes and 9 on type 2 diabetes. These studies identified 2 to 6 HbA 1c trajectory patterns. The most commonly identified patterns included stable HbA 1c around 7.0% and at levels between 8.0% and 9.9%, which usually captured the HbA 1c pattern among the majority of subjects in the study population. Unstable patterns identified included increasing HbA 1c trend, decreasing HbA 1c trend, and non-linear patterns. These patterns were associated with differential risk of disease outcomes, over and beyond single-point HbA 1c measures. Age, gender, ethnicity, diabetes duration, disease management frequency, cardiovascular risk factors, insulin treatment, family environment, and psychosocial factors were the most frequently reported factors associated with membership of specific HbA 1c pattern groups. Common patterns of longitudinal HbA 1c trends were identified despite heterogeneity among the studies. A better understanding of what underlies these different patterns may provide opportunities to tailor therapies and care for these patients to reduce adverse outcomes. © 2018 The Authors. Diabetes/Metabolism Research and Reviews Published by John Wiley & Sons Ltd.

Associations between residence at birth and mental health disorders: a spatial analysis of retrospective cohort data.

PubMed

Hoffman, Kate; Aschengrau, Ann; Webster, Thomas F; Bartell, Scott M; Vieira, Verónica M

2015-07-21

Mental health disorders impact approximately one in four US adults. While their causes are likely multifactorial, prior research has linked the risk of certain mental health disorders to prenatal and early childhood environmental exposures, motivating a spatial analysis to determine whether risk varies by birth location. We investigated the spatial associations between residence at birth and odds of depression, bipolar disorder, and post-traumatic stress disorder (PTSD) in a retrospective cohort (Cape Cod, Massachusetts, 1969-1983) using generalized additive models to simultaneously smooth location and adjust for confounders. Birth location served as a surrogate for prenatal exposure to the combination of social and environmental factors related to the development of mental illness. We predicted crude and adjusted odds ratios (aOR) for each outcome across the study area. The results were mapped to identify areas of increased risk. We observed spatial variation in the crude odds ratios of depression that was still present even after accounting for spatial confounding due to geographic differences in the distribution of known risk factors (aOR range: 0.61-3.07, P = 0.03). Similar geographic patterns were seen for the crude odds of PTSD; however, these patterns were no longer present in the adjusted analysis (aOR range: 0.49-1.36, P = 0.79), with family history of mental illness most notably influencing the geographic patterns. Analyses of the odds of bipolar disorder did not show any meaningful spatial variation (aOR range: 0.58-1.17, P = 0.82). Spatial associations exist between residence at birth and odds of PTSD and depression, but much of this variation can be explained by the geographic distributions of available risk factors. However, these risk factors did not account for all the variation observed with depression, suggesting that other social and environmental factors within our study area need further investigation.

A Multiphase Non-Linear Mixed Effects Model: An Application to Spirometry after Lung Transplantation

PubMed Central

Rajeswaran, Jeevanantham; Blackstone, Eugene H.

2014-01-01

In medical sciences, we often encounter longitudinal temporal relationships that are non-linear in nature. The influence of risk factors may also change across longitudinal follow-up. A system of multiphase non-linear mixed effects model is presented to model temporal patterns of longitudinal continuous measurements, with temporal decomposition to identify the phases and risk factors within each phase. Application of this model is illustrated using spirometry data after lung transplantation using readily available statistical software. This application illustrates the usefulness of our flexible model when dealing with complex non-linear patterns and time varying coefficients. PMID:24919830

Divergent Drinking Patterns of Restaurant Workers: The Influence of Social Networks and Job Position.

PubMed

Duke, Michael R; Ames, Genevieve M; Moore, Roland S; Cunradi, Carol B

2013-01-01

Restaurant workers have higher rates of problem drinking than most occupational groups. However, little is known about the environmental risks and work characteristics that may lead to these behaviors. An exploration of restaurant workers' drinking networks may provide important insights into their alcohol consumption patterns, thus guiding workplace prevention efforts. Drawing from social capital theory, this paper examines the unique characteristics of drinking networks within and between various job categories. Our research suggests that these multiple, complex networks have unique risk characteristics, and that self-selection is based on factors such as job position and college attendance, among other factors.

Divergent Drinking Patterns of Restaurant Workers: The Influence of Social Networks and Job Position

PubMed Central

Ames, Genevieve M.; Moore, Roland S.; Cunradi, Carol B.

2013-01-01

Restaurant workers have higher rates of problem drinking than most occupational groups. However, little is known about the environmental risks and work characteristics that may lead to these behaviors. An exploration of restaurant workers’ drinking networks may provide important insights into their alcohol consumption patterns, thus guiding workplace prevention efforts. Drawing from social capital theory, this paper examines the unique characteristics of drinking networks within and between various job categories. Our research suggests that these multiple, complex networks have unique risk characteristics, and that self-selection is based on factors such as job position and college attendance, among other factors. PMID:23687470

Associations between Dietary Patterns and Impaired Fasting Glucose in Chinese Men: A Cross-Sectional Study

PubMed Central

Zhang, Meilin; Zhu, Yufeng; Li, Ping; Chang, Hong; Wang, Xuan; Liu, Weiqiao; Zhang, Yuwen; Huang, Guowei

2015-01-01

Few studies have examined the association between Asian dietary pattern and prediabetes, in particular, the Chinese diet. We conducted a cross-sectional study to identify dietary patterns associated with impaired fasting glucose (IFG) which considered a state of prediabetes in Chinese men. The study included 1495 Chinese men aged 20 to 75 years. Information about diet was obtained using an 81-item food frequency questionnaire (FFQ), and 21 predefined food groups were considered in a factor analysis. Three dietary patterns were generated by factor analysis: (1) a vegetables-fruits pattern; (2) an animal offal-dessert pattern; and (3) a white rice-red meat pattern. The multivariate-adjusted odds ratio (OR) of IFG for the highest tertile of the animal offal-dessert pattern in comparison with the lowest tertile was 3.15 (95% confidence intervals (CI): 1.87–5.30). The vegetables-fruits dietary pattern was negatively associated with the risk of IFG, but a significant association was observed only in the third tertile. There was no significant association between IFG and the white rice-red meat pattern. Our findings indicated that the vegetables-fruits dietary pattern was inversely associated with IFG, whereas the animal offal-dessert pattern was associated with an increased risk of IFG in Chinese men. Further prospective studies are needed to elucidate the diet-prediabetes relationships. PMID:26402695

Associations between Dietary Patterns and Impaired Fasting Glucose in Chinese Men: A Cross-Sectional Study.

PubMed

Zhang, Meilin; Zhu, Yufeng; Li, Ping; Chang, Hong; Wang, Xuan; Liu, Weiqiao; Zhang, Yuwen; Huang, Guowei

2015-09-21

Few studies have examined the association between Asian dietary pattern and prediabetes, in particular, the Chinese diet. We conducted a cross-sectional study to identify dietary patterns associated with impaired fasting glucose (IFG) which considered a state of prediabetes in Chinese men. The study included 1495 Chinese men aged 20 to 75 years. Information about diet was obtained using an 81-item food frequency questionnaire (FFQ), and 21 predefined food groups were considered in a factor analysis. Three dietary patterns were generated by factor analysis: (1) a vegetables-fruits pattern; (2) an animal offal-dessert pattern; and (3) a white rice-red meat pattern. The multivariate-adjusted odds ratio (OR) of IFG for the highest tertile of the animal offal-dessert pattern in comparison with the lowest tertile was 3.15 (95% confidence intervals (CI): 1.87-5.30). The vegetables-fruits dietary pattern was negatively associated with the risk of IFG, but a significant association was observed only in the third tertile. There was no significant association between IFG and the white rice-red meat pattern. Our findings indicated that the vegetables-fruits dietary pattern was inversely associated with IFG, whereas the animal offal-dessert pattern was associated with an increased risk of IFG in Chinese men. Further prospective studies are needed to elucidate the diet-prediabetes relationships.

Smoking Risk Factors and Gender Differences among Spanish High School Students

ERIC Educational Resources Information Center

Garcia-Rodriguez, Olaya; Suarez-Vazquez, Rosa; Secades-Villa, Roberto; Fernandez-Hermida, Jose R.

2010-01-01

The objectives of the present study were to analyze the pattern of tobacco use among Spanish adolescents, as well as to determine gender differences in specific risk factors of cigarette use. The study sample was made up of 1,483 boys and 1,358 girls, aged 12-16 (M = 14). Participants were asked to answer an "ad-hoc" instrument to…

Patterns of multisite pain and associations with risk factors

PubMed Central

Coggon, David; Ntani, Georgia; Palmer, Keith T.; Felli, Vanda E.; Harari, Raul; Barrero, Lope H.; Felknor, Sarah A.; Gimeno, David; Cattrell, Anna; Vargas-Prada, Sergio; Bonzini, Matteo; Solidaki, Eleni; Merisalu, Eda; Habib, Rima R.; Sadeghian, Farideh; Masood Kadir, M.; Warnakulasuriya, Sudath S.P.; Matsudaira, Ko; Nyantumbu, Busisiwe; Sim, Malcolm R.; Harcombe, Helen; Cox, Ken; Marziale, Maria H.; Sarquis, Leila M.; Harari, Florencia; Freire, Rocio; Harari, Natalia; Monroy, Magda V.; Quintana, Leonardo A.; Rojas, Marianela; Salazar Vega, Eduardo J.; Harris, E. Clare; Serra, Consol; Martinez, J. Miguel; Delclos, George; Benavides, Fernando G.; Carugno, Michele; Ferrario, Marco M.; Pesatori, Angela C.; Chatzi, Leda; Bitsios, Panos; Kogevinas, Manolis; Oha, Kristel; Sirk, Tuuli; Sadeghian, Ali; Peiris-John, Roshini J.; Sathiakumar, Nalini; Wickremasinghe, A. Rajitha; Yoshimura, Noriko; Kelsall, Helen L.; Hoe, Victor C.W; Urquhart, Donna M.; Derrett, Sarah; McBride, David; Herbison, Peter; Gray, Andrew

2013-01-01

To explore definitions for multisite pain, and compare associations with risk factors for different patterns of musculoskeletal pain, we analysed cross-sectional data from the Cultural and Psychosocial Influences on Disability (CUPID) study. The study sample comprised 12,410 adults aged 20–59 years from 47 occupational groups in 18 countries. A standardised questionnaire was used to collect information about pain in the past month at each of 10 anatomical sites, and about potential risk factors. Associations with pain outcomes were assessed by Poisson regression, and characterised by prevalence rate ratios (PRRs). Extensive pain, affecting 6–10 anatomical sites, was reported much more frequently than would be expected if the occurrence of pain at each site were independent (674 participants vs 41.9 expected). In comparison with pain involving only 1–3 sites, it showed much stronger associations (relative to no pain) with risk factors such as female sex (PRR 1.6 vs 1.1), older age (PRR 2.6 vs 1.1), somatising tendency (PRR 4.6 vs 1.3), and exposure to multiple physically stressing occupational activities (PRR 5.0 vs 1.4). After adjustment for number of sites with pain, these risk factors showed no additional association with a distribution of pain that was widespread according to the frequently used American College of Rheumatology criteria. Our analysis supports the classification of pain at multiple anatomical sites simply by the number of sites affected, and suggests that extensive pain differs importantly in its associations with risk factors from pain that is limited to only a small number of anatomical sites. PMID:23727463

A Healthy Beverage Consumption Pattern Is Inversely Associated with the Risk of Obesity and Metabolic Abnormalities in Korean Adults.

PubMed

Lee, Kyung Won; Shin, Dayeon

2018-03-23

As the use of beverages in diets is increasing, several studies have examined the effect of beverage consumption in human health. Thus, we aimed at identifying specific beverage patterns and determining their associations with obesity and metabolic syndrome (MetS) risk factors in Korean adults. Based on the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2012 data, 19,800 Korean adults (≥20 years) with a single 24-h dietary recall and health examination data were investigated. All beverage items consumed by participants were categorized into 15 beverage groups based on the KNHANES coding system. Three major beverage consumption patterns were identified according to factor analysis: (1) the "healthy beverage" (high intake of dairy products, 100% fruit/vegetable juices and low intake of alcoholic beverages); (2) the "sugar-sweetened beverage" (high intake of soda, sweetened coffee/tea, and fruit drink); and (3) the "unsweetened beverage" (high intake of unsweetened coffee) patterns. Multivariable logistic regression analyses were conducted to determine the odds of obesity (body mass index ≥25 kg/m 2 ) and MetS (defined by National Cholesterol Education Program III [NCEP III]) for each beverage pattern after controlling for covariates. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for associations of the "healthy beverage" pattern with risks of obesity, abdominal obesity, and elevated triglycerides, fasting blood glucose (FBG), and blood pressure (BP) were 0.88 (0.79-0.98), 0.83 (0.74-0.92), 0.88 (0.78-0.99), 0.85 (0.79-0.98), and 0.81 (0.72-0.92), respectively. AORs (95% CIs) of associations of the "sugar-sweetened beverage" pattern with risks of abdominal obesity, elevated FBG and BP were 1.15 (1.03-1.30), 1.14 (1.01-1.29), and 1.18 (1.04-1.33), respectively. However, no associations were found between the "unsweetened beverage" pattern and any parameters examined. Intake of healthy beverages should be encouraged to reduce risks of obesity and metabolic abnormalities; however, individuals who consume sugar-sweetened beverages should be advised on the adverse effects of those beverages on the risk of obesity and MetS.

Associations of different phenotypes of wheezing illness in early childhood with environmental variables implicated in the aetiology of asthma.

PubMed

Granell, Raquel; Sterne, Jonathan A C; Henderson, John

2012-01-01

Asthma is a complex heterogeneous disease that has increased in prevalence in many industrialised countries. However, the causes of asthma inception remain elusive. Consideration of sub-phenotypes of wheezing may reveal important clues to aetiological risk factors. Longitudinal phenotypes capturing population heterogeneity in wheezing reports from birth to 7 years were derived using latent class analysis in the Avon Longitudinal Study of Parents and Children (ALSPAC). Probability of class membership was used to examine the association between five wheezing phenotypes (transient early, prolonged early, intermediate-onset, late-onset, persistent) and early life risk factors for asthma. Phenotypes had similar patterns and strengths of associations with early environmental factors. Comparing transient early with prolonged early wheezing showed a similar pattern of association with most exposure variables considered in terms of the direction of the effect estimates but with prolonged early wheezing tending to have stronger associations than transient early wheezing except for parity and day care attendance. Associations with early life risk factors suggested that prolonged early wheeze might be a severe form of transient early wheezing. Although differences were found in the associations of early life risk factors with individual phenotypes, these did not point to novel aetiological pathways. Persistent wheezing phenotype has features suggesting overlap of early and late-onset phenotypes.

The Impact of Ethnicity on Objectively Measured Physical Activity in Children

PubMed Central

Eyre, Emma Lisa Jane; Duncan, Michael J.

2013-01-01

Obesity and obesity-related diseases (cardiovascular disease/metabolic risk factors) are experienced differently in individuals from different ethnic backgrounds, which originate in childhood. Physical activity is a modifiable risk factor for obesity and related diseases. Both physical activity and metabolic risk factors track to adulthood, and thus understanding the physical activity patterns in children from different ethnic backgrounds is important. Given the limitations of self-report measures in children, this study provides a review of studies which have objectively measured physical activity patterns in children from different ethnic backgrounds. From a total of 16 studies, it can be concluded that physical activity does seem to vary amongst the ethnic groups especially South Asian and Black compared to White EU (European Union). The findings are less consistent for Hispanic/Mexican American children. However, there are several methodological limitations which need to be considered in future studies. Firstly, there is a need for consistency in the measurement of physical activity. Secondly, there are a range of complex factors such as socioeconomic status and body composition which affect both physical activity and ethnicity. Studies have failed to account for these differences limiting the ability to generalise that ethnicity is an independent risk factor for physical activity. PMID:24555154

Patterns of Bullying and Sexual Harassment: Connections with Parents and Teachers as Direct Protective Factors.

PubMed

Doty, Jennifer L; Gower, Amy L; Rudi, Jessie H; McMorris, Barbara J; Borowsky, Iris W

2017-11-01

Involvement in bullying and sexual harassment in adolescence is associated with a variety of internalizing, externalizing, and health-risk behaviors. Yet, the two behaviors are often studied independently. The current study examined how bullying and sexual harassment co-occur and whether social connections protected youth from risk patterns. The data for this study come from the 2013 Minnesota Student Survey (N = 121,311; 50% female, 74% White, 26% received free or reduced-price lunch; M age  = 14.9, SD = 1.3). Students reported on bullying and sexual harassment victimization and perpetration. Using latent class analysis, youth were classified into five patterns: High-Risk of All Forms of Victimization and Perpetration (7%), Relational and Cyberbullying Victimization (17%), Sexual Harassment Victimization and Perpetration (8%), Physical Bullying Perpetration (6%), and Low-Risk (62%). Compared to the low-risk class, the four other classes had lower levels of social connections, particularly with teachers and parents. Older youth (9th and 11th grade students) were at greater risk for the sexual harassment pattern, while younger youth (8th grade students) were at greater risk for bullying patterns. The results indicate that efforts to reduce bullying should also address sexual harassment and social connections with adults.

Communicating Hydrocephalus Associated with Intracranial Schwannoma Treated by Gamma Knife Radiosurgery.

PubMed

Park, Chang Kyu; Lee, Sung Ho; Choi, Man Kyu; Choi, Seok Keun; Park, Bong Jin; Lim, Young Jin

2016-05-01

Gamma knife radiosurgery (GKRS) has been established as an effective and safe treatment for intracranial schwannoma. However, serious complications can occur after GKRS, including hydrocephalus. The pathophysiology and risk factors of this disorder are not yet fully understood. The objective of the study was to assess potential risk factors for hydrocephalus after GKRS. We retrospectively reviewed the medical radiosurgical records of 244 patients who underwent GKRS to treat intracranial schwannoma. The following parameters were analyzed as potential risk factors for hydrocephalus after GKRS: age, sex, target volume, irradiation dose, prior tumor resection, treatment technique, and tumor enhancement pattern. The tumor enhancement pattern was divided into 2 groups: group A (homogeneous enhancement) and group B (heterogeneous or rim enhancement). Of the 244 patients, 14 of them (5.7%) developed communicating hydrocephalus. Communicating hydrocephalus occurred within 2 years after GKRS in most patients (92.8%). No significant association was observed between any of the parameters investigated and the development of hydrocephalus, with the exception of tumor enhancement pattern. Group B exhibited a statistically significant difference by univariate analysis (P = 0.002); this difference was also significant by multivariate analysis (P = 0.006). Because hydrocephalus is curable, patients should be closely monitored for the development of this disorder after GKRS. In particular, patients with intracranial schwannomas with irregular enhancement patterns or cysts should be meticulously observed. Copyright © 2015 Elsevier Inc. All rights reserved.

Preference for Geometric Patterns Early in Life as a Risk Factor for Autism

PubMed Central

Pierce, Karen; Conant, David; Hazin, Roxana; Stoner, Richard; Desmond, Jamie

2016-01-01

Context Early identification efforts are essential for the early treatment of the symptoms of autism but can only occur if robust risk factors are found. Children with autism often engage in repetitive behaviors and anecdotally prefer to visually examine geometric repetition, such as the moving blade of a fan or the spinning of a car wheel. The extent to which a preference for looking at geometric repetition is an early risk factor for autism has yet to be examined. Objectives To determine if toddlers with an autism spectrum disorder (ASD) aged 14 to 42 months prefer to visually examine dynamic geometric images more than social images and to determine if visual fixation patterns can correctly classify a toddler as having an ASD. Design Toddlers were presented with a 1-minute movie depicting moving geometric patterns on 1 side of a video monitor and children in high action, such as dancing or doing yoga, on the other. Using this preferential looking paradigm, total fixation duration and the number of saccades within each movie type were examined using eye tracking technology. Setting University of California, San Diego Autism Center of Excellence. Participants One hundred ten toddlers participated in final analyses (37 with an ASD, 22 with developmental delay, and 51 typical developing toddlers). Main Outcome Measure Total fixation time within the geometric patterns or social images and the number of saccades were compared between diagnostic groups. Results Overall, toddlers with an ASD as young as 14 months spent significantly more time fixating on dynamic geometric images than other diagnostic groups. If a toddler spent more than 69% of his or her time fixating on geometric patterns, then the positive predictive value for accurately classifying that toddler as having an ASD was 100%. Conclusion A preference for geometric patterns early in life may be a novel and easily detectable early signature of infants and toddlers at risk for autism. PMID:20819977

Intracoastal shipping drives patterns of regional population expansion by an invasive marine invertebrate.

PubMed

Darling, John A; Herborg, Leif-Matthias; Davidson, Ian C

2012-10-01

Understanding the factors contributing to expansion of nonnative populations is a critical step toward accurate risk assessment and effective management of biological invasions. Nevertheless, few studies have attempted explicitly to test hypotheses regarding factors driving invasive spread by seeking correlations between patterns of vector movement and patterns of genetic connectivity. Herein, we describe such an attempt for the invasive tunicate Styela clava in the northeastern Pacific. We utilized microsatellite data to estimate gene flow between samples collected throughout the known range of S. clava in the region, and assessed correlation of these estimates with patterns of intracoastal commercial vessel traffic. Our results suggest that recent shipping patterns have contributed to the contemporary distribution of genetic variation. However, the analysis also indicates that other factors-including a complex invasion history and the influence of other vectors-have partially obscured genetic patterns associated with intracoastal population expansion.

Patterns of health risk behaviors for chronic disease: a comparison between adolescent and adult American Indians living on or near reservations in Montana.

PubMed

Nelson, D E; Moon, R W; Holtzman, D; Smith, P; Siegel, P Z

1997-07-01

To compare the chronic disease health risk behavior patterns of adolescents and adults among American Indians living on or near reservations in Montana. We analyzed data from the 1993 Youth Risk Behavior Survey of American Indians in Grades 9-12 living on or near Montana reservations. Risk factors included tobacco use, low physical activity, attempted weight loss, and low consumption of fruits, vegetables, and green salad. Similar data were analyzed from a 1994 Behavioral Risk Factor Survey of American Indian adults living on or near reservations in Montana. The prevalence of most adolescent health risk behaviors was high, especially cigarette smoking (45% for males, 57% for females), smokeless tobacco use (44% for males, 30% for females), and infrequent consumption of salad or vegetables (59-76%). With the exception of daily cigarette smoking and inadequate fruit consumption among adolescents of both genders and physical inactivity among adolescent males, the prevalence of chronic disease health risk behaviors among adolescents was similar to or higher than the prevalence of the same risk behaviors among adults. Many health risk behaviors for chronic diseases are common by the time this group of American Indians in Montana has reached adolescence. Possible reasons may include modeling of familial behaviors, peer pressure, advertising, or age cohort effects. If these risk behavior patterns continue into adulthood, morbidity and mortality from chronic diseases are likely to remain high. Substantial efforts are needed to prevent or reduce health risk behaviors among adolescents and adults in this population.

Occupational health hazards in a prosthodontic practice: review of risk factors and management strategies

PubMed Central

Arunachalam, Kuthalingam Subbiah; Solomon, EGR

2012-01-01

The intent of this article was to analyze the potential hazards and risks involved in persons exposed to prosthodontic practice. These risks include exposure to physical and chemical hazards, dental materials, infectious environment, inappropriate working pattern and psychosocial stress. The potential harm of these hazards and its prevention is highlighted. Prosthodontists, students, dental technicians, and others working in the prosthodontic clinics and laboratory should be aware of the specific risk factors and take measures to prevent and overcome these hazards. PMID:23236581

Risk factors of urinary tract infection in pregnancy.

PubMed

Haider, Gulfareen; Zehra, Nishat; Munir, Aftab Afroze; Haider, Ambreen

2010-03-01

To determine the frequency, risk factors and pattern of urinary complaints during pregnancy. A descriptive study was conducted in the Obstetric and Gynaecology Department of Isra University Hospital, Hyderabad from 1st January to 30th August 2008. Total 232 women were selected to ascertain the frequency and pattern of urinary symptoms as well as the risk factors of urinary tract infection (UTI) such as age, parity, education, past history of UTI and haemoglobin among women attending an antenatal clinic. All pregnant women irrespective of age, parity and gestational age were included, while women with known underlying renal pathology, chronic renal disease, renal transplant, diabetes or taking immunosuppressant therapy were excluded. Informed consent was taken and data collected on a self designed proforma. All the women underwent complete examination of urine. Dipstick test was performed on midstream urine and urine was cultured incase of positive dipstick test and women with urinary symptoms. Data was analyzed on SPSS version 11. Odds ratio and 95% confidence interval were calculated among the categorical parameters by applying the Fisher's exact test. Out of 232 women, 108(46.5%) reported urinary symptoms which were due to pregnancy induced changes on urinary system as no growth was obtained on urine culture, while 10 (4.3%) were due to underlying UTI. Most common urinary symptom in these women was abnormal voiding pattern 85 (40.3%) followed by irritative symptoms and voiding difficulties. Illiteracy, history of sexual activity, low socioeconomic (monthly income < Rs. 10,000 / month) group, past history of UTI and multiparity were found to be risk factors for UTI in these women. On complete urine examination, 222 (95.6%) patients either did not reveal any pus cells or had less than 5 WBC/HPF. Out of 108 cultures, only 10 (4.3%) specimens showed growth. E-coli was the most commonly detected organism 7 (3%) followed by S-aureus in 3 (1.3%). The common urinary symptoms encountered in the studied women were abnormal voiding pattern followed by irritative symptoms. Majority of urinary symptoms were due to pregnancy related changes in the urinary system. Past history of UTI, sexual activity, lower socioeconomic group and multi parity were significant risk factors for UTI.

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.

MUSCLE STRENGTH AND QUALITATIVE JUMP-LANDING DIFFERENCES IN MALE AND FEMALE MILITARY CADETS: THE JUMP-ACL STUDY.

PubMed

Beutler, Ai; de la Motte, Sj; Marshall, Sw; Padua, DA; Boden, Bp

2009-01-01

Recent studies have focused on gender differences in movement patterns as risk factors for ACL injury. Understanding intrinsic and extrinsic factors which contribute to movement patterns is critical to ACL injury prevention efforts. Isometric lower-extremity muscular strength, anthropometrics, and jump-landing technique were analyzed for 2,753 cadets (1,046 female, 1,707 male) from the U.S. Air Force, Military and Naval Academies. Jump-landings were evaluated using the Landing Error Scoring System (LESS), a valid qualitative movement screening tool. We hypothesized that distinct anthropometric factors (Q-angle, navicular drop, bodyweight) and muscle strength would predict poor jump-landing technique in males versus females, and that female cadets would have higher scores (more errors) on a qualitative movement screen (LESS) than males. Mean LESS scores were significantly higher in female (5.34 ± 1.51) versus male (4.65 ± 1.69) cadets (P<.001). Qualitative movement scores were analyzed using factor analyses, yielding five factors, or "patterns", contributing to poor landing technique. Females were significantly more likely to have poor technique due to landing with less hip and knee flexion at initial contact (P<.001), more knee valgus with wider landing stance (P<.001), and less flexion displacement over the entire landing (P<.001). Males were more likely to have poor technique due to landing toe-out (P<.001), with heels first, and with an asymmetric foot landing (P<.001). Many of the identified factor patterns have been previously proposed to contribute to ACL injury risk. However, univariate and multivariate analyses of muscular strength and anthropometric factors did not strongly predict LESS scores for either gender, suggesting that changing an athlete's alignment, BMI, or muscle strength may not directly improve his or her movement patterns.

Gossypibomas, a surgeon's nightmare—patient demographics, risk factors, imaging and how we can prevent it

PubMed Central

Thomas, Binston; Basti, Ram S; Suresh, Hadihally B

2017-01-01

Objective: Gossypibomas are a cottonoid matrix left behind following surgery. Owing to the legal issues associated with it, very few literature studies are available online, most of them being case reports. The purpose of our study was to identify the patient demographics, risk factors and imaging features. Methods: Six surgically identified and histopathologically confirmed cases of gossypibomas recorded over a period of 5 years from a single tertiary institution were retrospectively evaluated for patient demographics [sex, age, body mass index (BMI)], type of surgery and duration from time of surgery to onset of symptoms. Ultrasound and CT images obtained from our hospital database were evaluated for their characteristic pattern. Statistics used included percentage and frequency. Results: Females formed the bulk of our patients and the mean BMI of our patients was 24.25. The interval between surgery and symptom presentation ranged from 2 months to 7 years. The most common imaging patterns observed on ultrasound and CT were a thick-walled hypoechoic lesion with a strong posterior acoustic shadowing and a “spongiform pattern”, respectively. Conclusion: A detailed patient history, taking into account radiologist—surgeon interaction, along with familiarization of the various risk factors and imaging patterns can bring about an accurate diagnosis of a gossypiboma. Advances in knowledge: Our study showed that the female sex, especially those undergoing gynaecology-related surgery such as hysterectomy and patients with a high BMI were at risk of gossypibomas. The combination of a hypoechoic lesion with strong posterior shadowing on ultrasound along with a spongiform pattern on CT was highly characteristic for gossypiboma on imaging. PMID:27885854

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.

Assessment and possible control of endemic measles in urban Nigeria.

PubMed

Byass, P; Adedeji, M D; Mongdem, J G; Zwandor, A C; Brew-Graves, S H; Clements, C J

1995-06-01

Measles remains as a serious problem of infancy and childhood in the developing world, despite the availability of a vaccine. Increasing urbanization is changing patterns of endemicity. A survey of measles in an urban area of Nigeria, using a rapid assessment approach, was carried out to characterize measles in this community. An annual incidence rate of 11.8% among under-fives was found, associated with an acute case fatality rate of 3.3%. This level of endemicity was two orders of magnitude greater than that suggested by official case reports. An endemic, rather than epidemic, pattern was found over the six-month period of the study. Vaccine efficacy was estimated at 26%. Risk factor analyses showed the major risks for measles to be clinic attendance in the month preceding disease, households with more than one mother, and having under-five siblings. Measles itself was the principal risk factor for malnutrition and against survival. Improved understanding of measles epidemiology and risk factors are prerequisites for effective control. Possible strategies should include vertical vaccination efforts in addition to routine programmes.

Epidemiology of Lung Cancer

PubMed Central

Brock, Malcolm V.; Ford, Jean G.; Samet, Jonathan M.; Spivack, Simon D.

2013-01-01

Background: Ever since a lung cancer epidemic emerged in the mid-1900s, the epidemiology of lung cancer has been intensively investigated to characterize its causes and patterns of occurrence. This report summarizes the key findings of this research. Methods: A detailed literature search provided the basis for a narrative review, identifying and summarizing key reports on population patterns and factors that affect lung cancer risk. Results: Established environmental risk factors for lung cancer include smoking cigarettes and other tobacco products and exposure to secondhand tobacco smoke, occupational lung carcinogens, radiation, and indoor and outdoor air pollution. Cigarette smoking is the predominant cause of lung cancer and the leading worldwide cause of cancer death. Smoking prevalence in developing nations has increased, starting new lung cancer epidemics in these nations. A positive family history and acquired lung disease are examples of host factors that are clinically useful risk indicators. Risk prediction models based on lung cancer risk factors have been developed, but further refinement is needed to provide clinically useful risk stratification. Promising biomarkers of lung cancer risk and early detection have been identified, but none are ready for broad clinical application. Conclusions: Almost all lung cancer deaths are caused by cigarette smoking, underscoring the need for ongoing efforts at tobacco control throughout the world. Further research is needed into the reasons underlying lung cancer disparities, the causes of lung cancer in never smokers, the potential role of HIV in lung carcinogenesis, and the development of biomarkers. PMID:23649439

Fistulizing pattern in Crohn's disease and pancolitis in ulcerative colitis are independent risk factors for cancer: a single-center cohort study.

PubMed

Biancone, Livia; Zuzzi, Sara; Ranieri, Micaela; Petruzziello, Carmelina; Calabrese, Emma; Onali, Sara; Ascolani, Marta; Zorzi, Francesca; Condino, Giovanna; Iacobelli, Simona; Pallone, Francesco

2012-06-01

The combined role of immunomodulators (IMM) and clinical characteristics of Inflammatory Bowel Disease (IBD) in determining the cancer risk is undefined. The aim was to assess whether clinical characteristics of IBD are independent risk factors for cancer, when considering thiopurines and anti-TNFs use. In a single-center cohort study, clinical characteristics of IBD patients with IBD duration ≥1 year and ≥2 visits from 2000 to 2009 were considered. Tests for crude rates and survival analysis methods were used to assess differences of incidence of cancer between groups. The methods were adjusted for the time interval between diagnosis and immunomodulatory treatments. IBD population included 1222 patients :615 Crohn's disease (CD), 607 ulcerative colitis (UC). Cancer was diagnosed in 51 patients (34 CD,17 UC), with an incidence rate of 4.3/1000 pt/year. The incidence rate of cancer was comparable between CD and UC (4.6/1000 pt/year vs 2.9/1000 pt/year ;p=n.s.). Cancer most frequently involved the breast, the GI tract, the skin. Lymphoma was diagnosed in CD (1HL, 1NHL,0 HSTCL). Risk factors for cancer included older age at diagnosis of IBD (CD: HR 1.25;95%CI 1.08-1.45; UC:HR 1.33;95%CI 1.15-1.55 for an increase by 5 years; p=0.0023; p=0.0002), fistulizing pattern in CD (HR 2.55; 95%CI 1.11-5.86,p=0.0275), pancolitis in UC (HR 2.79;95%CI 1.05-7.40 p=0.0396 vs distal). IMM and anti-TNFs did not increase the cancer risk in CD, neither IMM in UC (anti-TNFs risk in UC not feasible as no cases observed). Fistulizing pattern in CD, pancolitis in UC and older age at diagnosis of IBD are independent risk factors for cancer. Copyright © 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

[Elaboration of an ethogram for the diagnosis of the A Pattern in coronary pathology].

PubMed

Etienne, T; Isingrini, M; Benhamou, M; Tichet, F; Raynaud, P; Brochier, M

1990-09-01

In order to develop a technique which allows the detection of Pattern A (PA) we present in this paper a series of steps for constructing an observation gril (ethogram) which allows for the quantification of behavior in situation of structured interview. The behavioral units making up the final ethogram are derived from inter-item correlations taken from a population of 48 subjects who had suffered heart attacks. The observations on this population permit an inclusion score in the PA. These observations also confirm that the PA present a risk factor which is independent of classical risk factors. A significative positive correlation with work stress has been found showing, in accordance with the view of Friedman and Rosenman that the PA corresponds to a particular behavioral pattern which is dependent on the work environment.

A Systematic Review of Risk Factors for Intimate Partner Violence

PubMed Central

Capaldi, Deborah M.; Knoble, Naomi B.; Shortt, Joann Wu; Kim, Hyoun K.

2012-01-01

A systematic review of risk factors for intimate partner violence was conducted. Inclusion criteria included publication in a peer-reviewed journal, a representative community sample or a clinical sample with a control-group comparison, a response rate of at least 50%, use of a physical or sexual violence outcome measure, and control of confounding factors in the analyses. A total of 228 articles were included (170 articles with adult and 58 with adolescent samples). Organized by levels of a dynamic developmental systems perspective, risk factors included: (a) contextual characteristics of partners (demographic, neighborhood, community and school factors), (b) developmental characteristics and behaviors of the partners (e.g., family, peer, psychological/behavioral, and cognitive factors), and (c) relationship influences and interactional patterns. Comparisons to a prior review highlight developments in the field in the past 10 years. Recommendations for intervention and policy along with future directions for intimate partner violence (IPV) risk factor research are presented. PMID:22754606

Type A behaviour pattern: a concept revisited.

PubMed Central

Rose, M I

1987-01-01

It is generally accepted that the type A behaviour pattern is a risk factor in the development of coronary artery disease (CAD). Type A people have been characterized as hard-driving, competitive, aggressive and hurried. A number of investigators have attempted to correlate these facets of type A behaviour with increased risks of CAD. However, there have been conflicting results, primarily owing to differences in methods and CAD outcomes and inconsistencies associated with measuring the type A behaviour pattern. As a result, researchers have begun to focus on subcomponents of the type A behaviour pattern, particularly hostility and anger, that appear to be more reliable predictors of CAD outcome. A reconceptualization of the type A behaviour pattern is required. PMID:3815195

The Relationship between Multiple Substance Use, Perceived Academic Achievements, and Selected Socio-Demographic Factors in a Polish Adolescent Sample

PubMed Central

Mazur, Joanna; Tabak, Izabela; Dzielska, Anna; Wąż, Krzysztof; Oblacińska, Anna

2016-01-01

Predictors of high-risk patterns of substance use are often analysed in relation to demographic and school-related factors. The interaction between these factors and the additional impact of family wealth are still new areas of research. The aim of this study was to find determinants of the most common patterns of psychoactive substance use in mid-adolescence, compared to non-users. A sample of 1202 Polish students (46.1% boys, mean age of 15.6 years) was surveyed in 2013/2014. Four patterns of psychoactive substance use were defined using cluster analysis: non-users—71.9%, mainly tobacco and alcohol users—13.7%, high alcohol and cannabis users—7.2%, poly-users—7.2%. The final model contained the main effects of gender and age, and one three-way (perceived academic achievement × gender × family affluence) interaction. Girls with poor perception of school performance (as compared to girls with better achievements) were at significantly higher risk of being poly-users, in both less and more affluent families (adjusted odds ratio (OR) = 5.55 and OR = 3.60, respectively). The impact of family affluence was revealed only in interaction with other factors. Patterns of substance use in mid-adolescence are strongly related to perceived academic achievements, and these interact with selected socio-demographic factors. PMID:28009806

The Relationship between Multiple Substance Use, Perceived Academic Achievements, and Selected Socio-Demographic Factors in a Polish Adolescent Sample.

PubMed

Mazur, Joanna; Tabak, Izabela; Dzielska, Anna; Wąż, Krzysztof; Oblacińska, Anna

2016-12-21

Predictors of high-risk patterns of substance use are often analysed in relation to demographic and school-related factors. The interaction between these factors and the additional impact of family wealth are still new areas of research. The aim of this study was to find determinants of the most common patterns of psychoactive substance use in mid-adolescence, compared to non-users. A sample of 1202 Polish students (46.1% boys, mean age of 15.6 years) was surveyed in 2013/2014. Four patterns of psychoactive substance use were defined using cluster analysis: non-users-71.9%, mainly tobacco and alcohol users-13.7%, high alcohol and cannabis users-7.2%, poly-users-7.2%. The final model contained the main effects of gender and age, and one three-way (perceived academic achievement × gender × family affluence) interaction. Girls with poor perception of school performance (as compared to girls with better achievements) were at significantly higher risk of being poly-users, in both less and more affluent families (adjusted odds ratio (OR) = 5.55 and OR = 3.60, respectively). The impact of family affluence was revealed only in interaction with other factors. Patterns of substance use in mid-adolescence are strongly related to perceived academic achievements, and these interact with selected socio-demographic factors.

Spatial epidemiological techniques in cholera mapping and analysis towards a local scale predictive modelling

NASA Astrophysics Data System (ADS)

Rasam, A. R. A.; Ghazali, R.; Noor, A. M. M.; Mohd, W. M. N. W.; Hamid, J. R. A.; Bazlan, M. J.; Ahmad, N.

2014-02-01

Cholera spatial epidemiology is the study of the spread and control of the disease spatial pattern and epidemics. Previous studies have shown that multi-factorial causation such as human behaviour, ecology and other infectious risk factors influence the disease outbreaks. Thus, understanding spatial pattern and possible interrelationship factors of the outbreaks are crucial to be explored an in-depth study. This study focuses on the integration of geographical information system (GIS) and epidemiological techniques in exploratory analyzing the cholera spatial pattern and distribution in the selected district of Sabah. Spatial Statistic and Pattern tools in ArcGIS and Microsoft Excel software were utilized to map and analyze the reported cholera cases and other data used. Meanwhile, cohort study in epidemiological technique was applied to investigate multiple outcomes of the disease exposure. The general spatial pattern of cholera was highly clustered showed the disease spread easily at a place or person to others especially 1500 meters from the infected person and locations. Although the cholera outbreaks in the districts are not critical, it could be endemic at the crowded areas, unhygienic environment, and close to contaminated water. It was also strongly believed that the coastal water of the study areas has possible relationship with the cholera transmission and phytoplankton bloom since the areas recorded higher cases. GIS demonstrates a vital spatial epidemiological technique in determining the distribution pattern and elucidating the hypotheses generating of the disease. The next research would be applying some advanced geo-analysis methods and other disease risk factors for producing a significant a local scale predictive risk model of the disease in Malaysia.

Activity characteristics and movement patterns in people with and people without low back pain who participate in rotation-related sports

PubMed Central

Chimenti, Ruth L.; Scholtes, Sara A.

2013-01-01

Many risk factors have been identified as contributing to the development or persistence of low back pain (LBP). However, the juxtaposition of both high and low levels of physical activity being associated with LBP reflects the complexity of the relationship between a risk factor and LBP. Moreover, not everyone with an identified risk factor, such as a movement pattern of increased lumbopelvic rotation, has LBP. Objective The purpose of this study was to examine differences in activity level and movement patterns between people with and people without chronic or recurrent LBP who participate in rotation-related sports. Design Case Case-control study. Setting University laboratory environment. Participants 52 people with chronic or recurrent LBP and 25 people without LBP who all play a rotation-related sport. Main Outcome Measures Participants completed self-report measures including the Baecke Habitual Activity Questionnaire and a questionnaire on rotation-related sports. A 3-dimensional motion-capture system was used to collect movement-pattern variables during 2 lower-limb-movement tests. Results Compared with people without LBP, people with LBP reported a greater difference between the sport subscore and an average work and leisure composite subscore on the Baecke Habitual Activity Questionnaire (F = 6.55, P = .01). There were no differences between groups in either rotation-related-sport participation or movement-pattern variables demonstrated during 2 lower-limb movement tests (P > .05 for all comparisons). Conclusions People with and people without LBP who regularly play a rotation-related sport differed in the amount and nature of activity participation but not in movement pattern variables. An imbalance between level of activity during sport and daily functions may contribute to the development or persistence of LBP in people who play a rotation-related sport. PMID:23295458

Dietary patterns and the incidence of hyperglyacemia in China.

PubMed

Hong, Xin; Xu, Fei; Wang, Zhiyong; Liang, Yaqiong; Li, Jiequan

2016-01-01

Epidemiological studies have examined associations between dietary patterns and the risk of type 2 diabetes. However, information on dietary patterns and the risk of type 2 diabetes in Chinese populations is scarce. The aim of the present study was to identify dietary patterns and examine their association with incident hyperglycaemia in Nanjing, China. A community-based prospective cohort study. Dietary assessment was carried out using a validated eighty-seven-item FFQ. Dietary patterns were identified by exploratory factor analysis. Participants were categorized into tertiles of dietary factor score for each dietary pattern. The relationship between dietary patterns and hyperglycaemia risk was analysed using multivariable linear and Cox regression. Seven communities from two urban districts in Nanjing, China. A total of 2900 of Chinese local residents aged 30 years or above, free of hyperglycaemia and other serious diseases, who participated in the baseline survey from June to September 2007 were followed up 3 years later from June to September 2010 for the development of hyperglycaemia. Fasting blood samples were collected at both baseline and 3-year follow-up surveys. Hyperglycaemia was defined as fasting plasma glucose concentration of ≥6·1 mmol/l or already taking oral hyperglycaemia agents for treatment of type 2 diabetes. Five major dietary patterns were identified: (i) the 'condiments' pattern; (ii) the 'animal and plant protein' pattern; (iii) the 'healthy traditional' pattern; (iv) the 'fruits, eggs and juice' pattern; and (v) the 'alcohol, milk and tea' pattern. A total of 2093 (72·2 %) individuals completed the follow-up survey and the 3-year cumulative incidence of hyperglycaemia was 7·5 % (158/2093). A 1-unit increase in the score for the 'healthy traditional' pattern was associated with a decrease of 0·054 mmol/l in fasting plasma glucose (P=0·017), while a 1-unit increase in the 'fruits, eggs and juice' pattern score was associated with an increase of 0·050 mmol/l in fasting plasma glucose (P=0·023) by multivariable linear regression. For men, tertile 3 of the 'fruits, eggs and juice' pattern was associated with an 88 % greater risk (hazard ratio=1·88; 95 % CI 1·04, 3·54) of hyperglycaemia than tertile 1 of this pattern. Being in tertile 3 of the 'alcohol, milk and tea' pattern was associated with a 35 % greater risk (hazard ratio=1·35; 95 % CI 1·04, 2·16) relative to tertile 1 in women, while for the ''healthy traditional' pattern tertile 3 was associated with a 41 % lower risk (hazard ratio=0·59; 95 % CI 0·35, 0·99) compared with tertile 1. The 'condiments' and the 'animal and plant protein' patterns were not independently associated with hyperglycaemia. Our findings suggest that modifying dietary patterns could reduce hyperglycaemia incidence in the mainland Chinese adult population.

Statewide analysis of bicycle crashes : [project summary].

DOT National Transportation Integrated Search

2017-06-01

An extensive literature review was conducted to locate existing studies in four areas: (1) risk factors that affect the frequency and severity of bicycle crashes; (2) bicycle crash causes, patterns, and contributing factors; (3) network screening met...

Community-Engaged Modeling of Geographic and Demographic Patterns of Multiple Public Health Risk Factors

PubMed Central

Basra, Komal; Fabian, M. Patricia; Holberger, Raymond R.; French, Robert

2017-01-01

Many health risk factors are intervention targets within communities, but information regarding high-risk subpopulations is rarely available at a geographic resolution that is relevant for community-scale interventions. Researchers and community partners in New Bedford, Massachusetts (USA) collaboratively identified high-priority behaviors and health outcomes of interest available in the Behavioral Risk Factor Surveillance System (BRFSS). We developed multivariable regression models from the BRFSS explaining variability in exercise, fruit and vegetable consumption, body mass index, and diabetes prevalence as a function of demographic and behavioral characteristics, and linked these models with population microdata developed using spatial microsimulation to characterize high-risk populations and locations. Individuals with lower income and educational attainment had lower rates of multiple health-promoting behaviors (e.g., fruit and vegetable consumption and exercise) and higher rates of self-reported diabetes. Our models in combination with the simulated population microdata identified census tracts with an elevated percentage of high-risk subpopulations, information community partners can use to prioritize funding and intervention programs. Multi-stressor modeling using data from public databases and microsimulation methods for characterizing high-resolution spatial patterns of population attributes, coupled with strong community partner engagement, can provide significant insight for intervention. Our methodology is transferrable to other communities. PMID:28684710

Assessing environmental factors associated with regional schistosomiasis prevalence in Anhui Province, Peoples' Republic of China using a geographical detector method.

PubMed

Hu, Yi; Xia, Congcong; Li, Shizhu; Ward, Michael P; Luo, Can; Gao, Fenghua; Wang, Qizhi; Zhang, Shiqing; Zhang, Zhijie

2017-04-17

Schistosomiasis is a water-borne disease caused by trematode worms belonging to genus Schistosoma, which is prevalent most of the developing world. Transmission of the disease is usually associated with multiple biological characteristics and social factors but also factors can play a role. Few studies have assessed the exact and interactive influence of each factor promoting schistosomiasis transmission. We used a series of different detectors (i.e., specific detector, risk detector, ecological detector and interaction detector) to evaluate separate and interactive effects of the environmental factors on schistosomiasis prevalence. Specifically, (i) specific detector quantifies the impact of a risk factor on an observed spatial disease pattern, which were ranked statistically by a value of Power of Determinate (PD) calculation; (ii) risk detector detects high risk areas of a disease on the condition that the study area is stratified by a potential risk factor; (iii) ecological detector explores whether a risk factor is more significant than another in controlling the spatial pattern of a disease; (iv) interaction detector probes whether two risk factors when taken together weaken or enhance one another, or whether they are independent in developing a disease. Infection data of schistosomiasis based on conventional surveys were obtained at the county level from the health authorities in Anhui Province, China and used in combination with information from Chinese weather stations and internationally available environmental data. The specific detector identified various factors of potential importance as follows: Proximity to Yangtze River (0.322) > Land cover (0.285) > sunshine hours (0.256) > population density (0.109) > altitude (0.090) > the normalized different vegetation index (NDVI) (0.077) > land surface temperature at daytime (LST day ) (0.007). The risk detector indicated that areas of schistosomiasis high risk were located within a buffer distance of 50 km from Yangtze River. The ecological detector disclosed that the factors investigated have significantly different effects. The interaction detector revealed that interaction between the factors enhanced their main effects in most cases. Proximity to Yangtze River had the strongest effect on schistosomiasis prevalence followed by land cover and sunshine hours, while the remaining factors had only weak influence. Interaction between factors played an even more important role in influencing schistosomiasis prevalence than each factor on its own. High risk regions influenced by strong interactions need to be targeted for disease control intervention.

Patient clusters in acute, work-related back pain based on patterns of disability risk factors.

PubMed

Shaw, William S; Pransky, Glenn; Patterson, William; Linton, Steven J; Winters, Thomas

2007-02-01

To identify subgroups of patients with work-related back pain based on disability risk factors. Patients with work-related back pain (N = 528) completed a 16-item questionnaire of potential disability risk factors before their initial medical evaluation. Outcomes of pain, functional limitation, and work disability were assessed 1 and 3 months later. A K-Means cluster analysis of 5 disability risk factors (pain, depressed mood, fear avoidant beliefs, work inflexibility, and poor expectations for recovery) resulted in 4 sub-groups: low risk (n = 182); emotional distress (n = 103); severe pain/fear avoidant (n = 102); and concerns about job accommodation (n = 141). Pain and disability outcomes at follow-up were superior in the low-risk group and poorest in the severe pain/fear avoidant group. Patients with acute back pain can be discriminated into subgroups depending on whether disability is related to pain beliefs, emotional distress, or workplace concerns.

Factors associated with female pattern hair loss and its prevalence in Taiwanese women: a community-based survey.

PubMed

Su, Lin-Hui; Chen, Li-Sheng; Chen, Hsiu-Hsi

2013-08-01

Although female pattern hair loss (FPHL) has been considered simply the female counterpart of male pattern hair loss in men, the risk factors may differ. We sought to evaluate factors associated with FPHL and to estimate its prevalence in women. In total, 26,226 subjects aged 30 years and older participated in a cross-sectional survey. Ludwig and Norwood classifications were used to assess the degree of hair loss. Information on possible risk factors for FPHL was collected using a questionnaire interview. The prevalence of FPHL (Ludwig grade >I) for all ages was 11.8% (95% CI 11.5%-12.2%), increasing with advancing age. After controlling for age and family history, statistically significant associations were noted between FPHL and high fasting glucose (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.04-1.28), fewer childbirths (OR 1.24, 95% CI 1.12-1.38), breast-feeding (OR 0.88, 95% CI 0.78-0.98), oral contraceptive use (OR 1.21, 95% CI 1.01-1.45), and ultraviolet exposure more than 16 hours per week (OR 1.12, 95% CI 1.02-1.22). The validity and reliability of FPHL classification may be not perfect in this survey and may need to be verified. Information on family history may be still subject to recall bias. Risk factors for FPHL and male androgenic alopecia may differ. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Temporal and nonlinear dispersal patterns of Ludwigia hexapetala in a regulated river

USDA-ARS?s Scientific Manuscript database

Rivers are vulnerable to biological invasion due to hydrologic connectivity, which facilitates post-entry movement of aquatic plant propagules by water currents. Ecological and watershed factors may influence spatial and temporal dispersal patterns. Field-based data on dispersal could improve risk...

Race Differences in Patterns of Risky Behavior and Associated Risk Factors in Adolescence.

PubMed

Childs, Kristina K; Ray, James V

2017-05-01

Using data from the National Longitudinal Study of Adolescent Health (Add Health), this study expands on previous research by (a) examining differences across race in patterns or "subgroups" of adolescents based on nine self-reported behaviors (e.g., delinquency, substance use, risky sexual practices) and (b) comparing the risk factors (e.g., peer association, parenting, neighborhood cohesion), both within and across the race-specific subgroups, related to membership into the identified latent classes. The data used in this study include respondents aged 13 to 17 who participated in Waves 1 and 2 of the Add Health in-home interview. Latent class analysis (LCA) identified key differences in the number and characteristics of the latent classes across the racial subgroups. In addition, both similarities and differences in the risk factors for membership into the latent classes were identified across and within the race-specific subgroups. Implications for understanding risky behavior in adolescence, as well as directions for future research, are discussed.

Comparative epidemiology of cancer between the United States and Japan. A second look.

PubMed

Wynder, E L; Fujita, Y; Harris, R E; Hirayama, T; Hiyama, T

1991-02-01

Vital statistics were examined for the years 1955 through 1985 for Japanese natives and United States whites to elucidate changes in cancer mortality and related antecedent patterns of life-style in these two populations. Results show that lung cancer rates are rapidly accelerating among Japanese males as a consequence of their prior history of heavy cigarette smoking. Oropharyngeal cancer rates are also rising in Japan paralleling increases in alcohol and tobacco utilization. As the Japanese life-style and diet continue to become more "westernized," the rates of malignancies of the breast, ovary, corpus uteri, prostate, pancreas, and colon also continue to rise. Nevertheless, the mortality patterns of certain malignancies, viz., laryngeal, esophageal, and urinary bladder cancer, are discrepant with their established risk factor associations, suggesting the existence of other differences in risk factor exposure between the two countries. Epidemiologists and health educators need to develop innovative international programs of investigation and health promotion with preventive impact on common malignancies associated with risk factors of life-style.

Asymmetry of lumbopelvic movement patterns during active hip abduction is a risk factor for low back pain development during standing.

PubMed

Sorensen, Christopher J; Johnson, Molly B; Norton, Barbara J; Callaghan, Jack P; Van Dillen, Linda R

2016-12-01

An induced-pain paradigm has been used in back-healthy people to understand risk factors for developing low back pain (LBP) during prolonged standing. We examined asymmetry of lumbopelvic movement timing during a clinical test of active hip abduction in back-healthy people who developed LBP symptoms during standing (Pain Developers; PDs) compared to back-healthy people who did not develop LBP symptoms during standing (Non Pain Developers, NPDs). Participants completed the hip abduction test while movement was recorded with a motion capture system. Difference in time between start of hip and lumbopelvic movement was calculated (startdiff). PDs moved the lumbopelvic region earlier during left hip abduction than right hip abduction. There was no difference between sides in NPDs. In PDs, the amount of asymmetry was related to average symptom intensity during standing. Asymmetric lumbopelvic movement patterns may be a risk factor for LBP development during prolonged standing. Copyright © 2016 Elsevier B.V. All rights reserved.

Asymmetry of lumbopelvic movement patterns during active hip abduction is a risk factor for low back pain development during standing

PubMed Central

Sorensen, Christopher J.; Johnson, Molly B.; Norton, Barbara J.; Callaghan, Jack P.; Van Dillen, Linda R.

2016-01-01

An induced-pain paradigm has been used in back-healthy people to understand risk factors for developing low back pain (LBP) during prolonged standing. We examined asymmetry of lumbopelvic movement timing during a clinical test of active hip abduction in back-healthy people who developed LBP symptoms during standing (Pain Developers; PDs) compared to back-healthy people who did not develop LBP symptoms during standing (Non Pain Developers, NPDs). Participants completed the hip abduction test while movement was recorded with a motion capture system. Difference in time between start of hip and lumbopelvic movement was calculated (startdiff). PDs moved the lumbopelvic region earlier during left hip abduction than right hip abduction. There was no difference between sides in NPDs. In PDs, the amount of asymmetry was related to average symptom intensity during standing. Asymmetric lumbopelvic movement patterns may be a risk factor for LBP development during prolonged standing. PMID:27744105

Adequate nutrient intake can reduce cardiovascular disease risk in African Americans.

PubMed

Reusser, Molly E; DiRienzo, Douglas B; Miller, Gregory D; McCarron, David A

2003-03-01

Cardiovascular disease kills nearly as many Americans each year as the next seven leading causes of death combined. The prevalence of cardiovascular disease and most of its associated risk factors is markedly higher and increasing more rapidly among African Americans than in any other racial or ethnic group. Improving these statistics may be simply a matter of improving diet quality. In recent years, a substantial and growing body of evidence has revealed that dietary patterns complete in all food groups, including nutrient-rich dairy products, are essential for preventing and reducing cardiovascular disease and the conditions that contribute to it. Several cardiovascular risk factors, including hypertension, insulin resistance syndrome, and obesity, have been shown to be positively influenced by dietary patterns that include adequate intake of dairy products. The benefits of nutrient-rich dietary patterns have been specifically tested in randomized, controlled trials emphasizing African American populations. These studies demonstrated proportionally greater benefits for African Americans without evidence of adverse effects such as symptoms of lactose intolerance. As currently promoted for the prevention of certain cancers and osteoporosis, regular consumption of diets that meet recommended nutrient intake levels might also be the most effective approach for reducing cardiovascular disease risk in African Americans.

Perceptions of Risk from Substance Use among Adolescents. The NSDUH Report

ERIC Educational Resources Information Center

Substance Abuse and Mental Health Services Administration, 2009

2009-01-01

Although many factors may influence the initiation of drug or alcohol use, the perception of risk associated with these behaviors also varies by gender, age, and type of drug. Understanding the different patterns of risk perceptions that emerge during adolescent development may help to better target health communication messages and increase the…

Patterns of Gender-Based Violence and Associations with Mental Health and HIV Risk Behavior Among Female Sex Workers in Mombasa, Kenya: A Latent Class Analysis.

PubMed

Roberts, Sarah T; Flaherty, Brian P; Deya, Ruth; Masese, Linnet; Ngina, Jacqueline; McClelland, R Scott; Simoni, Jane; Graham, Susan M

2018-03-30

Gender-based violence (GBV) is common among female sex workers (FSWs) and is associated with multiple HIV risk factors, including poor mental health, high-risk sexual behavior, and sexually transmitted infections (STIs). Prior studies have focused on GBV of one type (e.g. physical or sexual) or from one kind of perpetrator (e.g., clients or regular partners), but many FSWs experience overlapping types of violence from multiple perpetrators, with varying frequency and severity. We examined the association between lifetime patterns of GBV and HIV risk factors in 283 FSWs in Mombasa, Kenya. Patterns of GBV were identified with latent class analysis based on physical, sexual, or emotional violence from multiple perpetrators. Cross-sectional outcomes included depressive symptoms, post-traumatic stress disorder (PTSD) symptoms, disordered alcohol and other drug use, number of sex partners, self-reported unprotected sex, prostate-specific antigen (PSA) in vaginal secretions, and a combined unprotected sex indicator based on self-report or PSA detection. We also measured HIV/STI incidence over 12 months following GBV assessment. Associations between GBV patterns and each outcome were modeled separately using linear regression for mental health outcomes and Poisson regression for sexual risk outcomes. Lifetime prevalence of GBV was 87%. We identified 4 GBV patterns, labeled Low (21% prevalence), Sexual (23%), Physical/Moderate Emotional (18%), and Severe (39%). Compared to women with Low GBV, those with Severe GBV had higher scores for depressive symptoms, PTSD symptoms, and disordered alcohol use, and had more sex partners. Women with Sexual GBV had higher scores for disordered alcohol use than women with Low GBV, but similar sexual risk behavior. Women with Physical/Moderate Emotional GBV had more sex partners and a higher prevalence of unprotected sex than women with Low GBV, but no differences in mental health. HIV/STI incidence did not differ significantly by GBV pattern. The prevalence of GBV was extremely high in this sample of Kenyan FSWs, and different GBV patterns were associated with distinct mental health and sexual risk outcomes. Increased understanding of how health consequences vary by GBV type and severity could lead to more effective programs to reduce HIV risk in this vulnerable population.

History of family violence, childhood behavior problems, and adolescent high-risk behaviors as predictors of girls' repeated patterns of dating victimization in two developmental periods.

PubMed

Vézina, Johanne; Hébert, Martine; Poulin, François; Lavoie, Francine; Vitaro, Frank; Tremblay, Richard E

2015-04-01

This study aims to document the prevalence of repeated patterns of dating victimization and to examine, within the frameworks of an ecological model and lifestyle/routine activities theories, associations between such patterns and family, peer, and individual factors. Dating victimization in adolescence (age 15) and early adulthood (age 21) was evaluated in 443 female participants. Multinomial logistic regression analyses revealed that history of family violence, childhood behavior problems, and adolescent high-risk behaviors were associated with an increased risk for girls of being victimized (psychologically and/or physically/sexually) in their dating relationships, either in adolescence or early adulthood, or at both developmental periods. © The Author(s) 2015.

Factors Influencing Running-Related Musculoskeletal Injury Risk Among U.S. Military Recruits.

PubMed

Molloy, Joseph M

2016-06-01

Running-related musculoskeletal injuries among U.S. military recruits negatively impact military readiness. Low aerobic fitness, prior injury, and weekly running distance are known risk factors. Physical fitness screening and remedial physical training (or discharging the most poorly fit recruits) before entry-level military training have tended to reduce injury rates while decreasing attrition, training, and medical costs. Incorporating anaerobic running sessions into training programs can offset decreased weekly running distance and decrease injury risk. Varying lower extremity loading patterns, stride length or cadence manipulation, and hip stability/strengthening programming may further decrease injury risk. No footstrike pattern is ideal for all runners; transitioning to forefoot striking may reduce risk for hip, knee, or tibial injuries, but increase risk for calf, Achilles, foot or ankle injuries. Minimal evidence associates running surfaces with injury risk. Footwear interventions should focus on proper fit and comfort; the evidence does not support running shoe prescription per foot type to reduce injury risk among recruits. Primary injury mitigation efforts should focus on physical fitness screening, remedial physical training (or discharge for unfit recruits), and continued inclusion of anaerobic running sessions to offset decreased weekly running distance. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Sleep patterns and the risk for unipolar depression: a review

PubMed Central

Wiebe, Sabrina T; Cassoff, Jamie; Gruber, Reut

2012-01-01

Psychological disorders, particularly mood disorders, such as unipolar depression, are often accompanied by comorbid sleep disturbances, such as insomnia, restless sleep, and restricted sleep duration. The nature of the relationship between unipolar depression and these sleep disturbances remains unclear, as sleep disturbance may be a risk factor for development, an initial manifestation of the disorder, or a comorbid condition affected by similar mechanisms. Various studies have examined the impact of sleep deprivation on the presence of (or exacerbation of) depressive symptoms, and have examined longitudinal and concurrent associations between different sleep disturbances and unipolar depression. This review examines the evidence for sleep disturbances as a risk factor for the development and presence of depression, as well as examining common underlying mechanisms. Clinical implications pertaining to the comorbid nature of various sleep patterns and depression are considered. PMID:23620679

Clustering of temperamental and cognitive risk factors for anxiety in a college sample of late adolescents.

PubMed

Viana, Andres G; Gratz, Kim L; Bierman, Karen L

2013-01-01

Temperamental vulnerabilities (e.g., behavioral inhibition, anxiety sensitivity) and cognitive biases (e.g., interpretive and judgment biases) may exacerbate feelings of stress and anxiety, particularly among late adolescents during the early years of college. The goal of the present study was to apply person-centered analyses to explore possible heterogeneity in the patterns of these four risk factors in late adolescence, and to examine associations with several anxiety outcomes (i.e., worry, anxiety symptoms, and trait anxiety). Cluster analyses in a college sample of 855 late adolescents revealed a Low-Risk group, along with four reliable clusters with distinct profiles of risk factors and anxiety outcomes (Inhibited, Sensitive, Cognitively-Biased, and Multi-Risk). Of the risk profiles, Multi-Risk youth experienced the highest levels of anxiety outcomes, whereas Inhibited youth experienced the lowest levels of anxiety outcomes. Sensitive and Cognitively-Biased youth experienced comparable levels of anxiety-related outcomes, despite different constellations of risk factors. Implications for interventions and future research are discussed.

Mortality and economic instability: detailed analyses for Britain and comparative analyses for selected industrialized countries.

PubMed

Brenner, M H

1983-01-01

This paper discusses a first-stage analysis of the link of unemployment rates, as well as other economic, social and environmental health risk factors, to mortality rates in postwar Britain. The results presented represent part of an international study of the impact of economic change on mortality patterns in industrialized countries. The mortality patterns examined include total and infant mortality and (by cause) cardiovascular (total), cerebrovascular and heart disease, cirrhosis of the liver, and suicide, homicide and motor vehicle accidents. Among the most prominent factors that beneficially influence postwar mortality patterns in England/Wales and Scotland are economic growth and stability and health service availability. A principal detrimental factor to health is a high rate of unemployment. Additional factors that have an adverse influence on mortality rates are cigarette consumption and heavy alcohol use and unusually cold winter temperatures (especially in Scotland). The model of mortality that includes both economic changes and behavioral and environmental risk factors was successfully applied to infant mortality rates in the interwar period. In addition, the "simple" economic change model of mortality (using only economic indicators) was applied to other industrialized countries. In Canada, the United States, the United Kingdom, and Sweden, the simple version of the economic change model could be successfully applied only if the analysis was begun before World War II; for analysis beginning in the postwar era, the more sophisticated economic change model, including behavioral and environmental risk factors, was required. In France, West Germany, Italy, and Spain, by contrast, some success was achieved using the simple economic change model.

Inflammatory Dietary Pattern, IL-17F Genetic Variant, and the Risk of Colorectal Cancer.

PubMed

Cho, Young Ae; Lee, Jeonghee; Oh, Jae Hwan; Chang, Hee Jin; Sohn, Dae Kyung; Shin, Aesun; Kim, Jeongseon

2018-06-05

A proinflammatory diet may increase the risk of colorectal cancer, but its role may differ according to individuals' genetic variants. We aimed to examine whether a specific dietary pattern reflecting inflammation was associated with a risk of colorectal cancer and whether IL-17F genetic variant altered this association. In a study of 695 colorectal cancer cases and 1846 controls, we derived a reduced rank regression dietary pattern using 32 food groups as predictors and the plasma C-reactive protein (CRP) concentration as the response. High CRP levels were associated with a high risk of colorectal cancer (OR (95% CI) = 3.58 (2.65⁻4.82) for the highest quartile vs. lowest quartile). After adjusting for potential confounding factors, high pattern scores were associated with a high risk of colorectal cancer (OR (95% CI) = 9.98 (6.81⁻14.62) for the highest quartile vs. lowest quartile). When stratified by the IL-17F rs763780 genotype, this association was stronger for individuals carrying the C allele ( p for interaction = 0.034), particularly for individuals with rectal cancer ( p for interaction = 0.011). In conclusion, a dietary pattern reflecting inflammation was significantly associated with colorectal cancer risk. Moreover, this association could be modified according to the IL-17F rs763780 genotype and anatomic site.

Gut microbiota and cardiometabolic outcomes: influence of dietary patterns and their associated components.

PubMed

Wong, Julia M W

2014-07-01

Many dietary patterns have been associated with cardiometabolic risk reduction. A commonality between these dietary patterns is the emphasis on plant-based foods. Studies in individuals who consume vegetarian and vegan diets have shown a reduced risk of cardiovascular events and incidence of diabetes. Plant-based dietary patterns may promote a more favorable gut microbial profile. Such diets are high in dietary fiber and fermentable substrate (ie, nondigestible or undigested carbohydrates), which are sources of metabolic fuel for gut microbial fermentation and, in turn, result in end products that may be used by the host (eg, short-chain fatty acids). These end products may have direct or indirect effects on modulating the health of their host. Modulation of the gut microbiota is an area of growing interest, and it has been suggested to have the potential to reduce risk factors associated with chronic diseases. Examples of dietary components that alter the gut microbial composition include prebiotics and resistant starches. Emerging evidence also suggests a potential link between interindividual differences in the gut microbiota and variations in physiology or predisposition to certain chronic disease risk factors. Alterations in the gut microbiota may also stimulate certain populations and may assist in biotransformation of bioactive components found in plant foods. Strategies to modify microbial communities may therefore provide a novel approach in the treatment and management of chronic diseases. © 2014 American Society for Nutrition.

Dietary patterns and the risk of esophageal squamous cell carcinoma: A population-based case-control study in a rural population.

PubMed

Liu, Xudong; Wang, Xiaorong; Lin, Sihao; Lao, Xiangqian; Zhao, Jin; Song, Qingkun; Su, Xuefen; Tak-Sun Yu, Ignatius

2017-02-01

Few studies were available in exploring the roles of dietary patterns in the development of esophageal cancer, especially in China. This study aimed to investigate the roles of dietary patterns in the risk of esophageal squamous cell carcinoma (ESCC) in a Chinese rural population. A population-based cases-control study was designed and conducted in Yanting County, Sichuan Province of China during two years (between June 2011 and May 2013). A total of 942 pairs of ESCC cases and controls were recruited. A food frequency questionnaire was adopted to collect information of dietary consumption. Dietary patterns were extracted by using principle component and factor analysis based on 24 dietary groups. Odds ratios (ORs) with 95% confidence intervals (95% CI) were calculated by using logistic regression model, with adjustment for possible confounding variables. Four major dietary patterns were identified, which were labeled as "prudent", "vegetable and fruits", "processed food" and "alcohol drinking". In comparison of the highest with the lowest quartiles of pattern scores, the processed food pattern (OR: 2.84, 95% CI: 2.13-3.80) and alcohol drinking pattern (OR: 2.69, 95% CI: 1.95-3.71) were significantly associated with an increased risk of ESCC, while the vegetable and fruit pattern (OR: 0.70, 95% CI: 0.53-0.92) was associated with reduced risk by 30%. The prudent pattern was associated with a reduced risk by 33% (OR: 0.67, 95% CI: 0.50-0.88) in a multivariate logistic regression model, but no statistical significance was reached in a composite model. The results suggest an important role of dietary patterns in ESCC. Diets rich in vegetables and fruits may decrease the risk of ESCC, whereas diets rich in processed food and drinking alcohol may increase the risk. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Risk and contributing factors of ecosystem shifts over naturally vegetated land under climate change in China

PubMed Central

Yin, Yuanyuan; Tang, Qiuhong; Wang, Lixin; Liu, Xingcai

2016-01-01

Identifying the areas at risk of ecosystem transformation and the main contributing factors to the risk is essential to assist ecological adaptation to climate change. We assessed the risk of ecosystem shifts in China using the projections of four global gridded vegetation models (GGVMs) and an aggregate metric. The results show that half of naturally vegetated land surface could be under moderate or severe risk at the end of the 21st century under the middle and high emission scenarios. The areas with high risk are the Tibetan Plateau region and an area extended northeastward from the Tibetan Plateau to northeast China. With the three major factors considered, the change in carbon stocks is the main contributing factor to the high risk of ecosystem shifts. The change in carbon fluxes is another important contributing factor under the high emission scenario. The change in water fluxes is a less dominant factor except for the Tibetan Plateau region under the high emission scenario. Although there is considerable uncertainty in the risk assessment, the geographic patterns of the risk are generally consistent across different scenarios. The results could help develop regional strategies for ecosystem conservation to cope with climate change. PMID:26867481

Risk and contributing factors of ecosystem shifts over naturally vegetated land under climate change in China.

PubMed

Yin, Yuanyuan; Tang, Qiuhong; Wang, Lixin; Liu, Xingcai

2016-02-12

Identifying the areas at risk of ecosystem transformation and the main contributing factors to the risk is essential to assist ecological adaptation to climate change. We assessed the risk of ecosystem shifts in China using the projections of four global gridded vegetation models (GGVMs) and an aggregate metric. The results show that half of naturally vegetated land surface could be under moderate or severe risk at the end of the 21(st) century under the middle and high emission scenarios. The areas with high risk are the Tibetan Plateau region and an area extended northeastward from the Tibetan Plateau to northeast China. With the three major factors considered, the change in carbon stocks is the main contributing factor to the high risk of ecosystem shifts. The change in carbon fluxes is another important contributing factor under the high emission scenario. The change in water fluxes is a less dominant factor except for the Tibetan Plateau region under the high emission scenario. Although there is considerable uncertainty in the risk assessment, the geographic patterns of the risk are generally consistent across different scenarios. The results could help develop regional strategies for ecosystem conservation to cope with climate change.

Local Failure After Episcleral Brachytherapy for Posterior Uveal Melanoma: Patterns, Risk Factors, and Management.

PubMed

Bellerive, Claudine; Aziz, Hassan A; Bena, James; Wilkinson, Allan; Suh, John H; Plesec, Thomas; Singh, Arun D

2017-05-01

To evaluate the patterns, the risk factors, and the management of recurrence following brachytherapy in patients with posterior uveal melanoma, given that an understanding of the recurrence patterns can improve early recognition and management of local treatment failure in such patients. Retrospective cohort study. Setting: Multispecialty tertiary care center. A total of 375 eyes treated with episcleral brachytherapy for posterior uveal melanoma from January 2004 to December 2014. Exclusion criteria included inadequate follow-up (<1 year) and previous radiation therapy. Main Outcomes and Measures: Local control rate and time to recurrence were the primary endpoints. Kaplan-Meier estimation and Cox proportional hazards models were conducted to identify risk factors for recurrence. Twenty-one patients (5.6%) experienced recurrence (follow-up range 12-156 months; median 47 months). The median time to recurrence was 18 months (range 4-156 months). Five-year estimated local recurrence rate was 6.6%. The majority (90.5%) of the recurrences occurred within the first 5 years. The predominant site of recurrence was at the tumor margin (12 patients, 57.1%). Univariate analysis identified 3 statistically significant recurrence risk factors: advanced age, largest basal diameter, and the use of adjuvant transpupillary thermotherapy (TTT). Recurrent tumors were managed by repeat brachytherapy, TTT, or enucleation. Local recurrences following brachytherapy are uncommon 5 years after episcleral brachytherapy. Follow-up intervals can be adjusted to reflect time to recurrence. Most of the eyes with recurrent tumor can be salvaged by conservative methods. Copyright © 2017 Elsevier Inc. All rights reserved.

[Study on the mobile phone dependence syndrome and its distribution among 2213 college students in Guangzhou].

PubMed

Wang, Chang; Wang, Sheng-yong; Li, Wen-hao; Dong, Xiao-mei; Chi, Gui-bo

2013-10-01

To investigate the occurrence, distribution and risk factors of mobile phone dependence syndrome(MPDS)among college students in Guangzhou. A unified questionnaire was adopted, with 2311 college students from 6 universities in Guangzhou investigated by cluster sampling. Distribution and risk factors of MPDS among different groups were analyzed by logistic regression. A total number of 2213 effective questionnaires was retrieved, including 1149 males and 1064 females. The average age was(21.33 ± 1.72). The incidence rate of MPDS among studied college students in Guangzhou was 23.3% (515/2213). Regarding the distribution of personal characteristics, significant differences were found in the following aspects:grades, majors in college, being the only child of the family, monthly cost of living, personal characters and the academic performance at school (P<0.05). Regarding the distribution of characteristics among parents, significant differences were found in the following areas:educational levels of the mother, rearing patterns of both parents, status of feeling on mother's caring(P<0.05)etc. The main risk factors for MPDS were as follows:students major in literature and law, with high monthly living cost, father's autocratic and democratic patterns of rearing, mother's autocratic and doting rearing pattern as well as personal feeling on mother's attitude of unconcern. The incidence of MPDS among those persons with uncertain characters was less than those who were extroverts. MPDS among college students seemed to be severe in Guangzhou. No difference was found in the incidence rates of MPDS between genders. Should take interventions according to its risk factors.

Dietary Patterns and Risk of Death and Progression to ESRD in Individuals With CKD: A Cohort Study

PubMed Central

Gutiérrez, Orlando M.; Muntner, Paul; Rizk, Dana V.; McClellan, William M.; Warnock, David G.; Newby, P.K.; Judd, Suzanne E.

2014-01-01

Background Nutrition is strongly linked with health outcomes in chronic kidney disease (CKD). However, few studies have examined relationships between dietary patterns and health outcomes in persons with CKD. Study Design Observational cohort study. Setting & Participants 3,972 participants with CKD (defined as an estimated glomerular filtration rate < 60 ml/min/1.73 m2 or an albumin-creatinine ratio ≥30 mg/g at baseline) from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a prospective cohort study of 30,239 black and white adults at least 45 years of age. Predictors Five empirically derived dietary patterns identified via factor analysis: “Convenience” (Chinese and Mexican foods, pizza, other mixed dishes), “Plant-Based” (fruits, vegetables), “Sweets/Fats” (sugary foods), “Southern” (fried foods, organ meats, sweetened beverages), and “Alcohol/Salads” (alcohol, green-leafy vegetables, salad dressing). Outcomes All-cause mortality and end-stage renal disease (ESRD). Results A total of 816 deaths and 141 ESRD events were observed over approximately 6 years of follow-up. There were no statistically significant associations of Convenience, Sweets/Fats or Alcohol/Salads pattern scores with all-cause mortality after multivariable adjustment. In Cox regression models adjusted for sociodemographic factors, energy intake, co-morbidities, and baseline kidney function, higher Plant-Based pattern scores (indicating greater consistency with the pattern) were associated with lower risk of mortality (HR comparing fourth to first quartile, 0.77; 95%CI, 0.61–0.97) whereas higher Southern pattern scores were associated with greater risk of mortality (HR comparing fourth to first quartile, 1.51; 95%CI, 1.19–1.92). There were no associations of dietary patterns with incident ESRD in multivariable-adjusted models. Limitations Missing dietary pattern data, potential residual confounding from lifestyle factors. Conclusions A Southern dietary pattern rich in processed and fried foods was independently associated with mortality in persons with CKD. In contrast, a diet rich in fruits and vegetables appeared to be protective. PMID:24679894

Physical Activity, a Critical Exposure Factor of Environmental Pollution in Children and Adolescents Health Risk Assessment.

PubMed

Dong, Jingmei; Zhang, Su; Xia, Li; Yu, Yi; Hu, Shuangshuang; Sun, Jingyu; Zhou, Ping; Chen, Peijie

2018-01-23

It is an extremely urgent problem that physical fitness promotion must face not only the increasing air pollution but also the decline of physical activity level of children and adolescents worldwide at present, which is the major reason that forms an inactive lifestyle and does harm to adolescents' health. Thus, it is necessary to focus on the exposure factor in environmental health risk assessment (EHRA) which conducts supervision of environmental pollution and survey of adolescents' activity patterns according to the harmful characteristics of air pollutant and relationship between dose and response. Some countries, such as USA, Canada and Australia, regard both respiratory rate and physical activity pattern as main exposure factors for adolescents in both air pollution health risk assessment and exercise risk assessment to forecast a safe exposing condition of pollutant for adolescents while they are doing exercise outdoors. In addition, it suggests that the testing indexes and testing methods of these two exposure factors, such as investigating the time of daily physical activity, strength, and characteristic of frequency, help to set up the quantitative relationship between environmental pollution index and the time, strength, frequency of daily activities, and formulate children's and adolescents' activity instructions under different levels of environmental pollutions. As smog becomes increasingly serious at present, it is meaningful to take physical activity as a critical composition of exposure factor and establish physical activity guideline, so as to reduce the risk of air pollution, and promote physical health of children and adolescents effectively.

Possible risk factors associated with burn wound colonization in burn units of Gaza strip hospitals, Palestine

PubMed Central

Al Laham, N.A.; Elmanama, A.A.; Tayh, G.A.

2013-01-01

Summary The epidemiological pattern and risk factors of burns and burn infections varies widely in different parts of the world. This study aims to determine the epidemiologic pattern of burn injuries and possible risk factors associated with burn infections in burn units of Gaza strip hospitals. A total of 118 patients were included in the study. The data collected included: patient age and gender, the causes, site, degree, and TBSA of the burns, as well as surgical operations, length of hospital stay, and microbiological profile of samples collected from patients, the environment, and from health care staff. Pediatric and adult patients accounted for 72% and 28% respectively. 58.5% of all patients were male and 41.5% were female. The most common etiological factors in children were scalding, while in adults these were open fire and flammable liquids. The mean TBSA was 12% with a range from 1–90%. Second and third degree burns accounted for 78% and 22% respectively. The area of the body most often affected was the torso (39%), followed by the lower limb (29.7%), and upper limb (17.8%). The predominant microorganisms isolated from burn wounds were Pseudomonas aeruginosa, Enterobacter spp. and Staphylococcus spp. The study showed the highest risk groups to be children and males, and enabled us to identify possible risk factors that can help in future efforts toward prevention and minimizing nosocomial infections in burn units of Gaza strip hospitals. PMID:24133399

Dietary patterns and colorectal cancer: results from a Canadian population-based study.

PubMed

Chen, Zhi; Wang, Peizhong Peter; Woodrow, Jennifer; Zhu, Yun; Roebothan, Barbara; Mclaughlin, John R; Parfrey, Patrick S

2015-01-15

The relationship between major dietary patterns and colorectal cancer (CRC) in other populations largely remains consistent across studies. The objective of the present study is to assess if dietary patterns are associated with the risk of CRC in the population of Newfoundland and Labrador (NL). Data from a population based case-control study in the province of NL were analyzed, including 506 CRC patients (306 men and 200 women) and 673 controls (400 men and 273 women), aged 20-74 years. Dietary habits were assessed by a 169-item food frequency questionnaire (FFQ). Logistic regression analyses were performed to investigate the association between dietary patterns and the CRC risk. Three major dietary patterns were derived using factor analysis, namely a Meat-diet pattern, a Plant-based diet pattern and a Sugary-diet pattern. In combination the three dietary patterns explained 74% of the total variance in food intake. Results suggest that the Meat-diet and the Sugary-diet increased the risk of CRC with corresponding odds ratios (ORs) of 1.84 (95% CI: 1.19-2.86) and 2.26 (95% CI: 1.39-3.66) for people in the highest intake quintile compared to those in the lowest. Whereas plant-based diet pattern decreases the risk of CRC with a corresponding OR of 0.55 (95% CI: 0.35-0.87). Even though odds ratios (ORs) were not always statistically significant, largely similar associations across three cancer sites were found: the proximal colon, the distal colon, and the rectum. The finding that Meat-diet/Sugary-diet patterns increased and Plant-based diet pattern decreased the risk of CRC would guide the promotion of healthy eating for primary prevention of CRC in this population.

Patterns in Trouble Sleeping among Women at Mid-Life: Results from a British Prospective Cohort Study

PubMed Central

Tom, Sarah E.; Kuh, Diana; Guralnik, Jack M.; Mishra, Gita D

2012-01-01

Background While trouble sleeping is a common problem among women at mid-life, patterns in trouble sleeping relating to social and health-related risk factors are unclear. This analysis describes the dynamics of trouble sleeping among women at mid-life Methods The National Survey of Health and Development is a nationally representative study of births in 1946 in England, Scotland, and Wales followed up through mid-life. Multistate life table analysis utilised 893 women interviewed annually between ages 48 to 54 years. Results Women spent an average of 2.6 years with trouble sleeping, and the average length of a continuous episode of trouble sleeping was 2.4 years. Among women who reported at least one episode, the average number of episodes was 1.5. Health-related risk factors at age 43 of number of physical conditions, anxiety and depression symptoms, use of prescription medication, and current or past trouble sleeping were related to increased total and per episode duration of trouble sleeping over the seven year study interval and increased duration per episode. Differences associated with these risk factors ranged from 1.2 – 1.8 years for duration over the study interval and 0.5-0.8 years per episode. There was no association between average number of episodes per woman reporting at least one episode and these health-related risk factors at age 43. Conclusions This study provides support for association between increased duration of trouble sleeping, in total and per episode, and health risk factors at age 43, suggesting a long-term relationship between risk factors and sleep. PMID:19608560

Drivers: A Biologically Contextualized, Cross-Inferential View of the Epidemiology of Neurodegenerative Disorders

PubMed Central

de Pedro-Cuesta, Jesús; Martínez-Martín, Pablo; Rábano, Alberto; Alcalde-Cabero, Enrique; José García López, Fernando; Almazán-Isla, Javier; Ruiz-Tovar, María; Medrano, Maria-José; Avellanal, Fuencisla; Calero, Olga; Calero, Miguel

2016-01-01

Background: Sutherland et al. (2011) suggested that, instead of risk factors for single neurodegenerative disorders (NDDs), there was a need to identify specific “drivers”, i.e., risk factors with impact on specific deposits, such as amyloid-β, tau, or α-synuclein, acting across entities. Objectives and Methods: Redefining drivers as “neither protein/gene- nor entity-specific features identifiable in the clinical and general epidemiology of conformational NDDs (CNDDs) as potential footprints of templating/spread/transfer mechanisms”, we conducted an analysis of the epidemiology of ten CNDDs, searching for patterns. Results: We identified seven potential drivers, each of which was shared by at least two CNDDs: 1) an age-at-exposure-related susceptibility to Creutzfeldt-Jakob disease (CJD) and several late-life CNDDs; 2) a relationship between age at onset, survival, and incidence; 3) shared genetic risk factors for CJD and late-life CNNDs; 4) partly shared personal (diagnostic, educational, behavioral, and social risk factors) predating clinical onset of late-life CNDDs; 5) two environmental risk factors, namely, surgery for sporadic CJD and amyotrophic lateral sclerosis, and Bordetella pertussis infection for Parkinson’s disease; 6) reticulo-endothelial system stressors or general drivers (andropause or premenopausal estrogen deficiency, APOEɛ4, and vascular risk factors) for late-life CNDDs such as dementia/Alzheimer’s disease, type-2 diabetes mellitus, and some sporadic cardiac and vascular degenerative diseases; and 7) a high, invariant incidence ratio of sporadic to genetic forms of mid- and late-life CNDDs, and type-2 diabetes mellitus. Conclusion: There might be a systematic epidemiologic pattern induced by specific proteins (PrP, TDP-43, SOD1, α-synuclein, amyloid-β, tau, Langerhans islet peptide, and transthyretin) or established combinations of these. PMID:26923014

Blood pressure patterns and cardiovascular risk factors in rural and urban gambian communities.

PubMed

van der Sande, M A; Milligan, P J; Nyan, O A; Rowley, J T; Banya, W A; Ceesay, S M; Dolmans, W M; Thien, T; McAdam, K P; Walraven, G E

2000-08-01

Hypertension is emerging as an important public health problem in sub-Saharan Africa. We studied blood pressure (BP) patterns, hypertension and other cardiovascular risk factors in a rural and an urban area of The Gambia. A total of 5389 adults (> or =15 years) were selected by cluster sampling in the capital Banjul and a rural area around Farafenni. A questionnaire was completed, BP, pulse rate, height and weight were recorded. Glucose was measured 2 h after a 75 g glucose load among participants > or =35 years (n = 2301); total cholesterol, triglycerides, creatinine and uric acid were measured among a stratified subsample (n = 1075). A total of 7.1% of the study participants had a BP > or =160/95 mm Hg; 18.4% of them had a BP > or =140/90 mm Hg. BP was significantly higher in the urban area. BP increased with age in both sexes in both areas. Increasing age was the major independent risk factor for hypertension. Related cardiovascular risk factors (obesity, diabetes and hyperlipidaemia) were significantly more prevalent in the urban area and among hypertensives; 17% of measured hypertensives were aware of this, 73% of people who reported to have been diagnosed as hypertensive before had discontinued treatment; 56% of those who reported being on treatment were normotensive. We conclude that hypertension is no longer rare in either urban or rural Gambians. In the urban site hypertension and related cardiovascular risk factors were more prevalent. Compliance with treatment was low. Interventions aimed at modifying risk factors at the population level, and at improving control of diagnosed hypertension are essential to prevent future increases of cardiovascular morbidity and mortality. In view of limited resources and feasibility of intervention in rural Gambia, these could initially be directed towards urbanised populations.

Dietary patterns and the risk of CVD and all-cause mortality in older British men.

PubMed

Atkins, Janice L; Whincup, Peter H; Morris, Richard W; Lennon, Lucy T; Papacosta, Olia; Wannamethee, S Goya

2016-10-01

Dietary patterns are a major risk factor for cardiovascular morbidity and mortality; however, few studies have examined this relationship in older adults. We examined prospective associations between dietary patterns and the risk of CVD and all-cause mortality in 3226 older British men, aged 60-79 years and free from CVD at baseline, from the British Regional Heart Study. Baseline FFQ data were used to generate thirty-four food groups. Principal component analysis identified dietary patterns that were categorised into quartiles, with higher quartiles representing higher adherence to the dietary pattern. Cox proportional hazards examined associations between dietary patterns and risk of all-cause mortality and cardiovascular outcomes. We identified three interpretable dietary patterns: 'high fat/low fibre' (high in red meat, meat products, white bread, fried potato, eggs), 'prudent' (high in poultry, fish, fruits, vegetables, legumes, pasta, rice, wholemeal bread, eggs, olive oil) and 'high sugar' (high in biscuits, puddings, chocolates, sweets, sweet spreads, breakfast cereals). During 11 years of follow-up, 899 deaths, 316 CVD-related deaths, 569 CVD events and 301 CHD events occurred. The 'high-fat/low-fibre' dietary pattern was associated with an increased risk of all-cause mortality only, after adjustment for confounders (highest v. lowest quartile; hazard ratio 1·44; 95 % CI 1·13, 1·84). Adherence to a 'high-sugar' diet was associated with a borderline significant trend for an increased risk of CVD and CHD events. The 'prudent' diet did not show a significant trend with cardiovascular outcomes or mortality. Avoiding 'high-fat/low-fibre' and 'high-sugar' dietary components may reduce the risk of cardiovascular events and all-cause mortality in older adults.

Vegetable-based dietary pattern and liver cancer risk: results from the Shanghai women's and men's health studies.

PubMed

Zhang, Wei; Xiang, Yong-Bing; Li, Hong-Lan; Yang, Gong; Cai, Hui; Ji, Bu-Tian; Gao, Yu-Tang; Zheng, Wei; Shu, Xiao-Ou

2013-10-01

Although dietary patterns, specific foods, and their constituents have been linked to cancer risk, the role of dietary patterns and specific food groups in liver cancer risk has not been investigated. In the Shanghai Women's Health Study (SWHS) and Shanghai Men's Health Study (SMHS), two cohort studies of 132 837 Chinese women and men, we evaluated the relationship between dietary patterns, food groups, and liver cancer risk. Through in-person interviews, dietary information intake over the preceding year was collected by using a validated food-frequency questionnaire. Cox regression model was used to estimate hazard ratios and 95% confidence intervals with adjustment for potential confounders. During an average follow-up of 10.9 (SWHS) or 5.5 (SMHS) years, 267 incident liver cancer cases were identified after the first 2 years of study enrolment. Three dietary patterns were derived by factor analysis. A vegetable-based dietary pattern was inversely associated with liver cancer; hazard ratios (95% confidence intervals) for the lowest to highest quartiles were: 1.00; 0.98 (0.71-1.35); 0.93 (0.67-1.29); and 0.58 (0.40-0.84); P(trend) = 0.01. The association was stronger among participants with a history of chronic liver disease. Further analyses showed high intakes of celery, mushrooms, allium vegetables, composite vegetables (including asparagus lettuce and garland chrysanthemum), legumes and legume products were associated with reduced liver cancer risk (all P(trend) < 0.05). Fruit- and meat-based dietary patterns were not associated with liver cancer risk. Our study suggests that a vegetable-based dietary pattern is associated with reduced liver cancer risk. © 2013 Japanese Cancer Association.

Characterizing the Intersection of Co-Occurring Risk Factors for Illicit Drug Abuse and Dependence in a U.S. Nationally Representative Sample

PubMed Central

Kurti, Allison N.; Keith, Diana R.; Noble, Alyssa; Priest, Jeff S.; Sprague, Brian; Higgins, Stephen T.

2016-01-01

Few studies have attempted to characterize how co-occurring risk factors for substance use disorders intersect. A recent study examined this question regarding cigarette smoking and demonstrated that co-occurring risk factors generally act independently. The present study examines whether that same pattern of independent intersection of risk factors extends to illicit drug abuse/dependence using a U.S. nationally representative sample (National Survey on Drug Use and Health, 2011–2013). Logistic regression and classification and regression tree (CART) modeling were used to examine risk of past-year drug abuse/dependence associated with a well-established set of risk factors for substance use (age, gender, race/ethnicity, education, poverty, smoking status, alcohol abuse/dependence, mental illness). Each of these risk factors was associated with significant increases in the odds of drug abuse/dependence in univariate logistic regressions. Each remained significant in a multivariate model examining all eight risk factors simultaneously. CART modeling of these 8 risk factors identified subpopulation risk profiles wherein drug abuse/dependence prevalence varied from < 1% to > 80% corresponding to differing combinations of risk factors present. Alcohol abuse/dependence and cigarette smoking had the strongest associations with drug abuse/dependence risk. These results demonstrate that co-occurring risk factors for illicit drug/abuse dependence generally intersect in the same independent manner as risk factors for cigarette smoking, underscoring further fundamental commonalities across these different types of substance use disorders. These results also underscore the fundamental importance of differences in the presence of co-occurring risk factors when considering the often strikingly different prevalence rates of illicit drug abuse/dependence in U.S. population subgroups. PMID:27687534

Predictiveness of Disease Risk in a Global Outreach Tourist Setting in Thailand Using Meteorological Data and Vector-Borne Disease Incidences

PubMed Central

Ninphanomchai, Suwannapa; Chansang, Chitti; Hii, Yien Ling; Rocklöv, Joacim; Kittayapong, Pattamaporn

2014-01-01

Dengue and malaria are vector-borne diseases and major public health problems worldwide. Changes in climatic factors influence incidences of these diseases. The objective of this study was to investigate the relationship between vector-borne disease incidences and meteorological data, and hence to predict disease risk in a global outreach tourist setting. The retrospective data of dengue and malaria incidences together with local meteorological factors (temperature, rainfall, humidity) registered from 2001 to 2011 on Koh Chang, Thailand were used in this study. Seasonal distribution of disease incidences and its correlation with local climatic factors were analyzed. Seasonal patterns in disease transmission differed between dengue and malaria. Monthly meteorological data and reported disease incidences showed good predictive ability of disease transmission patterns. These findings provide a rational basis for identifying the predictive ability of local meteorological factors on disease incidence that may be useful for the implementation of disease prevention and vector control programs on the tourism island, where climatic factors fluctuate. PMID:25325356

Predictiveness of disease risk in a global outreach tourist setting in Thailand using meteorological data and vector-borne disease incidences.

PubMed

Ninphanomchai, Suwannapa; Chansang, Chitti; Hii, Yien Ling; Rocklöv, Joacim; Kittayapong, Pattamaporn

2014-10-16

Dengue and malaria are vector-borne diseases and major public health problems worldwide. Changes in climatic factors influence incidences of these diseases. The objective of this study was to investigate the relationship between vector-borne disease incidences and meteorological data, and hence to predict disease risk in a global outreach tourist setting. The retrospective data of dengue and malaria incidences together with local meteorological factors (temperature, rainfall, humidity) registered from 2001 to 2011 on Koh Chang, Thailand were used in this study. Seasonal distribution of disease incidences and its correlation with local climatic factors were analyzed. Seasonal patterns in disease transmission differed between dengue and malaria. Monthly meteorological data and reported disease incidences showed good predictive ability of disease transmission patterns. These findings provide a rational basis for identifying the predictive ability of local meteorological factors on disease incidence that may be useful for the implementation of disease prevention and vector control programs on the tourism island, where climatic factors fluctuate.

Is physical activity maintenance from adolescence to young adulthood associated with reduced CVD risk factors, improved mental health and satisfaction with life: the HUNT Study, Norway.

PubMed

Rangul, Vegar; Bauman, Adrian; Holmen, Turid Lingaas; Midthjell, Kristian

2012-12-14

Little is known about the effect maintaining physical activity throughout adolescence has on cardiovascular risk factors and health status in early adulthood. This ten-year prospective longitudinal study investigated whether differences in physical activity patterns from adolescence to young-adulthood showed different associations with subsequent cardio-metabolic risk factors and mental health in young-adulthood. Based on the second and third Norwegian Nord-Trøndelag Health Surveys (HUNT2 and 3), we included 1869 individuals (838 males) participating in Young-HUNT (1995-97), aged 13-19 years and followed-up at HUNT3 (2006-08), aged 23-31. Self-reported physical activity (PA), mental health and perceived health were recorded, along with measurements of body mass index (BMI), waist circumference (WC), total cholesterol (TC), HDL cholesterol, glucose, triglycerides, resting heart rate (HR) and blood pressure. We used separate linear regressions models to investigate associations between physical activity and each CVD risk factor, and logistic regression analysis to examine PA patterns and subsequent mental health. Physically active maintainers were compared to inactive maintainers. Adopters (inactive as adolescents and physically active as young adults) were compared to inactive maintainers and to those who discontinued activity (relapsers). Active maintainers had significantly lower HR, compared to all other PA patterns. Active maintaining men had significantly lower WC than relapsers and inactive maintainers. When adjusted for age and gender, WC, BMI, HR, diastolic blood pressure and HDL-C showed significant differences comparing active maintaining to other PA patterns. Comparing inactive maintainers against adopters, only HR was significantly lower. Male adopters did not differ significantly in CVD risk compared to inactive maintainers and relapsers. Among females adopting was associated with lower HR and TC compared to inactive maintainers. Active maintainers showed better mental health than inactive maintainers. Active maintaining males had an increased likelihood of good mental health compared to adopters. Active maintaining females reported greater satisfaction with life compared to adopters. Those who maintained their physical activity from adolescence to young adulthood demonstrated a significantly lower CVD risk and better mental health, compared to inactive maintainers. Compared to inactivity maintainers and relapsers, adopting physical activity was not significantly associated with lowered CVD risk. Adopting physical activity between adolescence and young adulthood may not necessarily protect against mental distress.

Risk and protective factors for recreational and hard drug use among Malaysian adolescents and young adults.

PubMed

Razali, Muzafar Mohd; Kliewer, Wendy

2015-11-01

This study investigated risk and protective factors for recreational and hard drug use in Malaysian adolescents and young adults. Participants (n = 859; M age = 17.24 years, SD = 2.75 years, range = 13-25 years; 59% male) were recruited from secondary schools, technical colleges, a juvenile detention center and a national training center in Malaysia. A version of the Communities That Care survey validated for use in Malaysia (Razali & Kliewer, 2015) was used to assess study constructs. One in 6 adolescents and 1 in 3 young adults reported lifetime recreational and hard drug use, with greater use reported by males across all drug categories. Structural equation modeling was used to determine the strongest risk and protective factors for recreational and hard drug use. The overall pattern of findings was similar for recreational and hard drug use. Shared risk factors for lifetime recreational and hard drug use included early initiation of antisocial behavior, peer antisocial behavior, and peer reinforcement for engaging in antisocial behavior; shared protective factors included religious practices and opportunities for prosocial school involvement. Multiple group analyses comparing adolescents and young adults indicated that patterns of risk and protective factors predicting drug use differed across these age groups. There were fewer significant predictors of either recreational or hard drug use for young adults relative to adolescents. Results suggest that interventions should target multiple microsystems (e.g., peer groups, family systems, school environments) and be tailored to the developmental stage of the individual. Copyright © 2015. Published by Elsevier Ltd.

Dietary patterns and their associations with childhood obesity in China.

PubMed

Zhang, Jiguo; Wang, Huijun; Wang, Youfa; Xue, Hong; Wang, Zhihong; Du, Wenwen; Su, Chang; Zhang, Ji; Jiang, Hongru; Zhai, Fengying; Zhang, Bing

2015-06-28

Dietary patterns represent the combined effects of foods, and illustrate efficaciously the impact of diet on health outcomes. Some findings of previous studies have limited applicability to Chinese children due to cultural factors. The present study was designed to identify dietary patterns and determine their relationships with obesity among Chinese children and adolescents. Data collected from 1282 children and adolescents aged 7-17 years from the 2011 China Health and Nutrition Survey (CHNS) were used. Dietary patterns were identified using factor analysis of data from three consecutive 24-h dietary recalls. Weight and height were measured following standard methods, and BMI was calculated. Three dietary patterns were identified: modern (high intakes of milk, fast foods and eggs), traditional north (high intakes of wheat, tubers and other cereals) and traditional south (high intakes of vegetables, rice and pork). After adjusting for some confounders and total energy intake, subjects in the highest quartiles of the modern and traditional north patterns were found to have significantly greater risk of obesity (OR 3·10, 95 % CI 1·52, 6·32, and OR 2·42, 95 % CI 1·34, 4·39, respectively). In conclusion, the modern dietary pattern and the traditional north dietary pattern were associated with higher risk of obesity. Promoting healthier eating patterns could help prevent obesity in Chinese children.

What lies behind gender inequalities in HIV/AIDS in sub-Saharan African countries: evidence from Kenya, Lesotho and Tanzania

PubMed Central

Sia, Drissa; Onadja, Yentéma; Nandi, Arijit; Foro, Anne; Brewer, Timothy

2014-01-01

Within sub-Saharan Africa, women are disproportionately at risk for acquiring and having human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). It is important to clarify whether gender inequalities in HIV prevalence in this region are explained by differences in the distributions of HIV risk factors, differences in the effects of these risk factors or some combination of both. We used an extension of the Blinder–Oaxaca decomposition approach to explain gender inequalities in HIV/AIDS in Kenya, Lesotho and Tanzania using data from the demographic and health and AIDS indicator surveys. After adjusting for covariates using Poisson regression models, female gender was associated with a higher prevalence of HIV/AIDS in Kenya [prevalence ratio (PR) = 1.73, 95% confidence interval (CI) = 1.33, 2.23 in 2003] and Lesotho (PR = 1.39, 95% CI = 1.20, 1.62 in 2004/05), but not in Tanzania. Decomposition analyses demonstrated two distinct patterns over time. In Tanzania, the gender inequality in HIV/AIDS was explained by differences in the distributions of HIV risk factors between men and women. In contrast, in Kenya and Lesotho, this inequality was partly explained by differences in the effects across men and women of measured HIV/AIDS risk factors, including socio-demographic characteristics (age and marital status) and sexual behaviours (age at first sex); these results imply that gender inequalities in HIV/AIDS would persist in Kenya and Lesotho even if men and women had similar distributions of HIV risk factors. The production of gender inequalities may vary across countries, with inequalities attributable to the unequal distribution of risk factors among men and women in some countries and the differential effect of these factors between groups in others. These different patterns have important implications for policies to reduce gender inequalities in HIV/AIDS. PMID:24345343

Association of major dietary patterns with obesity risk among Mongolian men and women.

PubMed

Dugee, Otgontuya; Khor, Geok Lin; Lye, Munn-Sann; Luvsannyam, Lhagva; Janchiv, Oyunbileg; Jamyan, Batjargal; Esa, Norhaizan

2009-01-01

Mongolia is experiencing changes in its unique nomadic lifestyle and dietary habits in the last two decades with accompanying increase in obesity rate. The dietary pattern approach, which investigates the overall diet in relation to obesity risks, has become appealing in nutrition epidemiology. The aim of this study was to identify major dietary patterns of the Mongolian adults in relation to the risk of having obesity. Dietary intake of a total 418 adults aged ? 25 years was assessed by using a food frequency questionnaire with 68 items. An exploratory factor analysis resulted in three dietary patterns: transitional high in processed meat and potato, traditional rich in whole milk, fats and oils and healthy with greater intake of whole grains, mixed vegetables and fruits. Individuals in the upper quintile of the transitional pattern had significantly greater risk of obesity (BMI > or =25 kg/m2: OR=2.47; 95% CI=1.04-5.86) while subjects in the highest quintile of the healthy dietary pattern were found to have significantly decreased risk of obesity (OR: 0.49; 95% CI=0.25-0.95). Men in the highest quintile of the transitional pattern had greater risk of abdominal obesity WC > or =90 cm: OR= 4.08; 95% CI=1.11-14.97) than those in the lowest quintile. Women in the top quintile of the traditional pattern had a greater odds of having abdominal obesity (WC > or =80 cm: OR=4.59; 95% CI=1.58-13.30) than those in the lowest quintile. The study suggests that public health efforts be targeted at adults in Mongolia to address the undesirable aspects of the transitional and the traditional dietary patterns.

Association between yogurt consumption, dietary patterns, and cardio-metabolic risk factors.

PubMed

Cormier, Hubert; Thifault, Élisabeth; Garneau, Véronique; Tremblay, Angelo; Drapeau, Vicky; Pérusse, Louis; Vohl, Marie-Claude

2016-03-01

To examine whether yogurt consumption is associated with a healthier dietary pattern and with a better cardio-metabolic risk profile among healthy individuals classified on the basis of their body mass index (BMI). A 91-item food frequency questionnaire, including data on yogurt consumption, was administered to 664 subjects from the INFOGENE study. After principal component analysis, two factors were retained, thus classified as the Prudent and Western dietary patterns. Yogurt was a significant contributor to the Prudent dietary pattern. Moreover, yogurt consumption was associated with lower body weight, waist-to-hip ratio, and waist circumference and tended to be associated with a lower BMI. Consumers had lower levels of fasting total cholesterol and insulin. Consumers of yogurt had a positive Prudent dietary pattern mean score, while the opposite trend was observed in non-consumers of yogurt. Overweight/obese individuals who were consumers of yogurts exhibited a more favorable cardio-metabolic profile characterized by lower plasma triglyceride and insulin levels than non-consumers within the same range of BMI. There was no difference in total yogurt consumption between normal-weight individuals and overweight/obese individuals. However, normal-weight subjects had more daily servings of high-fat yogurt and less daily servings of fat-free yogurt compared to overweight/obese individuals. Being a significant contributor to the Prudent dietary pattern, yogurt consumption may be associated with healthy eating. Also, yogurt consumption may be associated with lower anthropometric indicators and a more beneficial cardio-metabolic risk profile in overweight/obese individuals.

Parasympathetic nervous system activity predicts mood repair use and its effectiveness among adolescents with and without histories of major depression

PubMed Central

Yaroslavsky, Ilya; Rottenberg, Jonathan; Bylsma, Lauren M.; Jennings, J. Richard; George, Charles; Baji, Ildikó; Benák, István; Dochnal, Roberta; Halas, Kitti; Kapornai, Krisztina; Kiss, Enikő; Makai, Attila; Varga, Hedvig; Vetró, Ágnes; Kovacs, Maria

2016-01-01

Depressive disorders that onset in the juvenile years have been linked to far reaching adverse consequences, making it imperative to elucidate key mechanisms and contributory factors. Excessive use of regulatory responses that exacerbate sadness (maladaptive mood repair) or insufficient use of regulatory responses that reduce it (adaptive mood repair) may reflect behavioral mechanisms of depression risk. Cardiac vagal control, indexed by patterns of respiratory sinus arrhythmia (RSA), has received attention as a putative physiological risk factor for depression. Although mood repair and RSA are related, the nature of this relationship is not well characterized in the context of depression risk. Therefore, we tested alternative models of the relationships between RSA patterns (at rest and in response to a sad film), trait mood repair, and the effectiveness of a mood repair response in the laboratory (state mood repair) among adolescents with depression histories (n=210) and emotionally healthy peers (n=161). In our data, a mediation model best explained the association between the key constructs: Adolescents with normative RSA patterns exhibited lower levels of depression and trait maladaptive mood repair, and benefited more from instructed (state) mood repair in the laboratory. By contrast, adolescents with atypical RSA patterns exhibited higher levels of depression and dispositional maladaptive mood repair, which, in turn, mediated the relations of RSA patterns and depression symptoms. Atypical RSA patterns also predicted reduced benefits from laboratory mood repair. PMID:26950752

A one-year community study of under-fives in rural Ethiopia: patterns of morbidity and public health risk factors.

PubMed

Muhe, L; Byass, P; Freij, L; Sandström, A; Wall, S

1995-03-01

A prospective weekly home surveillance study was undertaken to determine morbidity patterns within the Butajira Rural Health project in central Ethiopia. Overall prevalence of illness was 5.8% in 1216 person-years observed among rural Ethiopian children aged under 5 years. Acute respiratory infections (ARI) (prevalence 2.8%) and acute diarrhoea (2.4%) were the commonest conditions. Episodes of illness were distributed unequally among children, with a mean of 2.34 episodes per child. These included an average of 1.13 episodes of ARI (of which 0.16 had lower respiratory symptoms [ALRI]) and 1.17 episodes of acute diarrhoea. Sanitation factors were the principal risks for gastroenteritis, while living in rural areas predisposed children to ARI. Parental factors such as illiteracy were also linked to morbidity.

Effect of simple, targeted diet in pregnant women with metabolic risk factors on maternal and fetal outcomes (ESTEEM): study protocol for a pragmatic multicentre randomised trial

PubMed Central

Al Wattar, Bassel H; Dodds, Julie; Placzek, Anna; Spyreli, Eleni; Moore, Amanda; Hooper, Richard; Beresford, Lee; Roseboom, Tessa J; Bes-Rastrollo, Maira; Hitman, Graham; Khan, Khalid S; Thangaratinam, Shakila

2016-01-01

Introduction Women with metabolic risk factors are at higher risk of adverse pregnancy outcomes. Mediterranean-based dietary interventions have the potential to minimise these risks. We aim to evaluate the effectiveness of a simple, targeted intervention modelled on Mediterranean diet in preventing maternal and fetal complications in pregnant women with metabolic risk factors. Methods and analysis Pregnant women with a singleton pregnancy <18 weeks gestation, and without pre-existing diabetes, chronic renal disease and autoimmune diseases will be recruited. Women with metabolic risk factors will be randomised to receive a dietary intervention based on a Mediterranean pattern, supplemented with extra virgin olive oil and mixed nuts until delivery. The intervention will be delivered through a series of one to one and group sessions. The primary outcome is a composite maternal outcome of pre-eclampsia or gestational diabetes and a composite fetal outcome of stillbirth, small for gestational age fetus or admission to the neonatal intensive care unit. Secondary outcomes include maternal, fetal, dietary and laboratory outcomes. We aim to randomise 1230 eligible women with metabolic risk factors. We will also compare the outcomes in women with and without these risk factors. The sample size will provide us with 80% power at 5% significance, assuming a 20% loss to follow-up to detect a 30% reduction in maternal and fetal complications. Ethics and dissemination The ESTEEM trial is designed to provide a definitive estimate of the effects of Mediterranean dietary pattern in pregnancy on maternal and fetal outcomes. The pragmatic nature of ESTEEM ensures the applicability of its findings into clinical practice. The findings of the study will be published in peer-reviewed journals and presented at national and international scientific meetings and congresses. Ethical approval was granted by the NHS Research Ethics Committees (14/EE/1048). Trial registration number NCT02218931; Pre-results. PMID:27798035

Patterns in longitudinal growth of refraction in Southern Chinese children: cluster and principal component analysis.

PubMed

Chen, Yanxian; Chang, Billy Heung Wing; Ding, Xiaohu; He, Mingguang

2016-11-22

In the present study we attempt to use hypothesis-independent analysis in investigating the patterns in refraction growth in Chinese children, and to explore the possible risk factors affecting the different components of progression, as defined by Principal Component Analysis (PCA). A total of 637 first-born twins in Guangzhou Twin Eye Study with 6-year annual visits (baseline age 7-15 years) were available in the analysis. Cluster 1 to 3 were classified after a partitioning clustering, representing stable, slow and fast progressing groups of refraction respectively. Baseline age and refraction, paternal refraction, maternal refraction and proportion of two myopic parents showed significant differences across the three groups. Three major components of progression were extracted using PCA: "Average refraction", "Acceleration" and the combination of "Myopia stabilization" and "Late onset of refraction progress". In regression models, younger children with more severe myopia were associated with larger "Acceleration". The risk factors of "Acceleration" included change of height and weight, near work, and parental myopia, while female gender, change of height and weight were associated with "Stabilization", and increased outdoor time was related to "Late onset of refraction progress". We therefore concluded that genetic and environmental risk factors have different impacts on patterns of refraction progression.

Patterns in longitudinal growth of refraction in Southern Chinese children: cluster and principal component analysis

PubMed Central

Chen, Yanxian; Chang, Billy Heung Wing; Ding, Xiaohu; He, Mingguang

2016-01-01

In the present study we attempt to use hypothesis-independent analysis in investigating the patterns in refraction growth in Chinese children, and to explore the possible risk factors affecting the different components of progression, as defined by Principal Component Analysis (PCA). A total of 637 first-born twins in Guangzhou Twin Eye Study with 6-year annual visits (baseline age 7–15 years) were available in the analysis. Cluster 1 to 3 were classified after a partitioning clustering, representing stable, slow and fast progressing groups of refraction respectively. Baseline age and refraction, paternal refraction, maternal refraction and proportion of two myopic parents showed significant differences across the three groups. Three major components of progression were extracted using PCA: “Average refraction”, “Acceleration” and the combination of “Myopia stabilization” and “Late onset of refraction progress”. In regression models, younger children with more severe myopia were associated with larger “Acceleration”. The risk factors of “Acceleration” included change of height and weight, near work, and parental myopia, while female gender, change of height and weight were associated with “Stabilization”, and increased outdoor time was related to “Late onset of refraction progress”. We therefore concluded that genetic and environmental risk factors have different impacts on patterns of refraction progression. PMID:27874105

Early Risk Factors for Alcohol Use Across High School and Its Covariation With Deviant Friends

PubMed Central

Armstrong, Jeffrey M.; Ruttle, Paula L.; Burk, Linnea R.; Costanzo, Philip R.; Strauman, Timothy J.; Essex, Marilyn J.

2013-01-01

Objective: Past research has associated childhood characteristics and experiences with alcohol use at single time points in adolescence. Other work has focused on drinking trajectories across adolescence but with risk factors typically no earlier than middle or high school. Similarly, although the connection between underage drinking and affiliation with deviant friends is well established, early risk factors for their covariation across adolescence are uncertain. The present study examines the influence of early individual and contextual factors on (a) trajectories across high school of per-occasion alcohol use and (b) the covariation of alcohol use and deviant friends over time. Method: In a longitudinal community sample (n = 374; 51% female), temperamental disinhibition, authoritarian and authoritative parenting, and parental alcohol use were assessed during childhood, and adolescents reported on alcohol use and affiliation with deviant friends in the spring of Grades 9, 10, 11, and 12. Results: Early parental alcohol use predicted the intercept of adolescent drinking. Subsequent patterns of adolescent alcohol use were predicted by sex and interactions of sex and childhood disinhibition with early authoritarian parenting. Additionally, childhood disinhibition interacted with parental alcohol use to moderate the covariation of drinking and deviant friends. Conclusions: These findings highlight early individual and contextual risk factors for alcohol use across high school, extending previous work and underscoring the importance of developmental approaches and longitudinal techniques for understanding patterns of growth in underage drinking. PMID:23948534

Early risk factors for alcohol use across high school and its covariation with deviant friends.

PubMed

Armstrong, Jeffrey M; Ruttle, Paula L; Burk, Linnea R; Costanzo, Philip R; Strauman, Timothy J; Essex, Marilyn J

2013-09-01

Past research has associated childhood characteristics and experiences with alcohol use at single time points in adolescence. Other work has focused on drinking trajectories across adolescence but with risk factors typically no earlier than middle or high school. Similarly, although the connection between underage drinking and affiliation with deviant friends is well established, early risk factors for their covariation across adolescence are uncertain. The present study examines the influence of early individual and contextual factors on (a) trajectories across high school of per-occasion alcohol use and (b) the covariation of alcohol use and deviant friends over time. In a longitudinal community sample (n = 374; 51% female), temperamental disinhibition, authoritarian and authoritative parenting, and parental alcohol use were assessed during childhood, and adolescents reported on alcohol use and affiliation with deviant friends in the spring of Grades 9, 10, 11, and 12. Early parental alcohol use predicted the intercept of adolescent drinking. Subsequent patterns of adolescent alcohol use were predicted by sex and interactions of sex and childhood disinhibition with early authoritarian parenting. Additionally, childhood disinhibition interacted with parental alcohol use to moderate the covariation of drinking and deviant friends. These findings highlight early individual and contextual risk factors for alcohol use across high school, extending previous work and underscoring the importance of developmental approaches and longitudinal techniques for understanding patterns of growth in underage drinking.

Obesity and cardio-metabolic risk factors in urban adults of Benin: Relationship with socio-economic status, urbanisation, and lifestyle patterns

PubMed Central

Sodjinou, Roger; Agueh, Victoire; Fayomi, Benjamin; Delisle, Hélène

2008-01-01

Background There is a dearth of information on diet-related chronic diseases in West Africa. This cross-sectional study assessed the rate of obesity and other cardiovascular disease (CVD) risk factors in a random sample of 200 urban adults in Benin and explored the associations between these factors and socio-economic status (SES), urbanisation as well as lifestyle patterns. Methods Anthropometric parameters (height, weight and waist circumference), blood pressure, fasting plasma glucose, and serum lipids (HDL-cholesterol and triglycerides) were measured. WHO cut-offs were used to define CVD risk factors. Food intake and physical activity were assessed with three non-consecutive 24-hour recalls. Information on tobacco use and alcohol consumption was collected using a questionnaire. An overall lifestyle score (OLS) was created based on diet quality, alcohol consumption, smoking, and physical activity. A SES score was computed based on education, main occupation and household amenities (as proxy for income). Results The most prevalent CVD risk factors were overall obesity (18%), abdominal obesity (32%), hypertension (23%), and low HDL-cholesterol (13%). Diabetes and hypertriglyceridemia were uncommon. The prevalence of overall obesity was roughly four times higher in women than in men (28 vs. 8%). After controlling for age and sex, the odds of obesity increased significantly with SES, while a longer exposure to the urban environment was associated with higher odds of hypertension. Of the single lifestyle factors examined, physical activity was the most strongly associated with several CVD risk factors. Logistic regression analyses revealed that the likelihood of obesity and hypertension decreased significantly as the OLS improved, while controlling for potential confounding factors. Conclusion Our data show that obesity and cardio-metabolic risk factors are highly prevalent among urban adults in Benin, which calls for urgent measures to avert the rise of diet-related chronic diseases. People with higher SES and those with a longer exposure to the urban environment are priority target groups for interventions focusing on environmental risk factors that are amenable to change in this population. Lifestyle interventions would appear appropriate, with particular emphasis on physical activity. PMID:18318907

Spatial interactions between sympatric carnivores: asymmetric avoidance of an intraguild predator.

PubMed

Grassel, Shaun M; Rachlow, Janet L; Williams, Christopher J

2015-07-01

Interactions between intraguild species that act as both competitors and predator-prey can be especially complex. We studied patterns of space use by the black-footed ferret (Mustela nigripes), a prairie dog (Cynomys spp.) specialist, and the American badger (Taxidea taxus), a larger generalist carnivore that competes for prairie dogs and is known to kill ferrets. We expected that ferrets would spatially avoid badgers because of the risk of predation, that these patterns of avoidance might differ between sexes and age classes, and that the availability of food and space might influence these relationships. We used location data from 60 ferrets and 15 badgers to model the influence of extrinsic factors (prairie dog density and colony size) and intrinsic factors (sex, age) on patterns of space use by ferrets in relation to space use by different sex and age categories of badgers. We documented asymmetric patterns of avoidance of badgers by ferrets based on the sex of both species. Female ferrets avoided adult female badgers, but not male badgers, and male ferrets exhibited less avoidance than female ferrets. Additionally, avoidance decreased with increasing densities of prairie dogs. We suggest that intersexual differences in space use by badgers create varying distributions of predation risk that are perceived by the smaller carnivore (ferrets) and that females respond more sensitively than males to that risk. This work advances understanding about how competing species coexist and suggests that including information on both intrinsic and extrinsic factors might improve our understanding of behavioral interactions between sympatric species.

The social patterns of a biological risk factor for disease: race, gender, socioeconomic position, and C-reactive protein.

PubMed

Herd, Pamela; Karraker, Amelia; Friedman, Elliot

2012-07-01

Understand the links between race and C-reactive protein (CRP), with special attention to gender differences and the role of class and behavioral risk factors as mediators. This study utilizes the National Social Life, Health, and Aging Project data, a nationally representative study of older Americans aged 57-85 to explore two research questions. First, what is the relative strength of socioeconomic versus behavioral risk factors in explaining race differences in CRP levels? Second, what role does gender play in understanding race differences? Does the relative role of socioeconomic and behavioral risk factors in explaining race differences vary when examining men and women separately? When examining men and women separately, socioeconomic and behavioral risk factor mediators vary in their importance. Indeed, racial differences in CRP among men aged 57-74 are little changed after adjusting for both socioeconomic and behavioral risk factors with levels 35% higher for black men as compared to white men. For women aged 57-74, however, behavioral risk factors explain 30% of the relationship between race and CRP. The limited explanatory power of socioeconomic position and, particularly, behavioral risk factors, in elucidating the relationship between race and CRP among men, signals the need for research to examine additional mediators, including more direct measures of stress and discrimination.

Traditional and Emerging Lifestyle Risk Behaviors and All-Cause Mortality in Middle-Aged and Older Adults: Evidence from a Large Population-Based Australian Cohort

PubMed Central

Ding, Ding; Rogers, Kris; van der Ploeg, Hidde; Stamatakis, Emmanuel; Bauman, Adrian E.

2015-01-01

Background Lifestyle risk behaviors are responsible for a large proportion of disease burden worldwide. Behavioral risk factors, such as smoking, poor diet, and physical inactivity, tend to cluster within populations and may have synergistic effects on health. As evidence continues to accumulate on emerging lifestyle risk factors, such as prolonged sitting and unhealthy sleep patterns, incorporating these new risk factors will provide clinically relevant information on combinations of lifestyle risk factors. Methods and Findings Using data from a large Australian cohort of middle-aged and older adults, this is the first study to our knowledge to examine a lifestyle risk index incorporating sedentary behavior and sleep in relation to all-cause mortality. Baseline data (February 2006– April 2009) were linked to mortality registration data until June 15, 2014. Smoking, high alcohol intake, poor diet, physical inactivity, prolonged sitting, and unhealthy (short/long) sleep duration were measured by questionnaires and summed into an index score. Cox proportional hazards analysis was used with the index score and each unique risk combination as exposure variables, adjusted for socio-demographic characteristics. During 6 y of follow-up of 231,048 participants for 1,409,591 person-years, 15,635 deaths were registered. Of all participants, 31.2%, 36.9%, 21.4%, and 10.6% reported 0, 1, 2, and 3+ risk factors, respectively. There was a strong relationship between the lifestyle risk index score and all-cause mortality. The index score had good predictive validity (c index = 0.763), and the partial population attributable risk was 31.3%. Out of all 96 possible risk combinations, the 30 most commonly occurring combinations accounted for more than 90% of the participants. Among those, combinations involving physical inactivity, prolonged sitting, and/or long sleep duration and combinations involving smoking and high alcohol intake had the strongest associations with all-cause mortality. Limitations of the study include self-reported and under-specified measures, dichotomized risk scores, lack of long-term patterns of lifestyle behaviors, and lack of cause-specific mortality data. Conclusions Adherence to healthy lifestyle behaviors could reduce the risk for death from all causes. Specific combinations of lifestyle risk behaviors may be more harmful than others, suggesting synergistic relationships among risk factors. PMID:26645683

Traditional and Emerging Lifestyle Risk Behaviors and All-Cause Mortality in Middle-Aged and Older Adults: Evidence from a Large Population-Based Australian Cohort.

PubMed

Ding, Ding; Rogers, Kris; van der Ploeg, Hidde; Stamatakis, Emmanuel; Bauman, Adrian E

2015-12-01

Lifestyle risk behaviors are responsible for a large proportion of disease burden worldwide. Behavioral risk factors, such as smoking, poor diet, and physical inactivity, tend to cluster within populations and may have synergistic effects on health. As evidence continues to accumulate on emerging lifestyle risk factors, such as prolonged sitting and unhealthy sleep patterns, incorporating these new risk factors will provide clinically relevant information on combinations of lifestyle risk factors. Using data from a large Australian cohort of middle-aged and older adults, this is the first study to our knowledge to examine a lifestyle risk index incorporating sedentary behavior and sleep in relation to all-cause mortality. Baseline data (February 2006- April 2009) were linked to mortality registration data until June 15, 2014. Smoking, high alcohol intake, poor diet, physical inactivity, prolonged sitting, and unhealthy (short/long) sleep duration were measured by questionnaires and summed into an index score. Cox proportional hazards analysis was used with the index score and each unique risk combination as exposure variables, adjusted for socio-demographic characteristics. During 6 y of follow-up of 231,048 participants for 1,409,591 person-years, 15,635 deaths were registered. Of all participants, 31.2%, 36.9%, 21.4%, and 10.6% reported 0, 1, 2, and 3+ risk factors, respectively. There was a strong relationship between the lifestyle risk index score and all-cause mortality. The index score had good predictive validity (c index = 0.763), and the partial population attributable risk was 31.3%. Out of all 96 possible risk combinations, the 30 most commonly occurring combinations accounted for more than 90% of the participants. Among those, combinations involving physical inactivity, prolonged sitting, and/or long sleep duration and combinations involving smoking and high alcohol intake had the strongest associations with all-cause mortality. Limitations of the study include self-reported and under-specified measures, dichotomized risk scores, lack of long-term patterns of lifestyle behaviors, and lack of cause-specific mortality data. Adherence to healthy lifestyle behaviors could reduce the risk for death from all causes. Specific combinations of lifestyle risk behaviors may be more harmful than others, suggesting synergistic relationships among risk factors.

Dietary Patterns and Risk for Metabolic Syndrome in Korean Women

PubMed Central

Choi, Jeong-Hwa; Woo, Hae Dong; Lee, Jeong-Hee; Kim, Jeongseon

2015-01-01

Abstract Dietary patterns are a risk factor for metabolic syndrome (MetS). The prevalence of MetS has increased in Korea, and this condition has become a public health issue. Therefore, the present cross-sectional study aimed to identify the associations between dietary patterns and the risk of MetS among Korean women. The data of 5189 participants were analyzed to determine dietary intake and lifestyle. A principal components analysis was employed to determine participant dietary patterns with regard to 106 food items. MetS was diagnosed using the National Cholesterol Education Program, Adult Treatment Panel III. Logistic regression analyses were applied to evaluate the associations between dietary pattern quintiles and MetS and to generate odds ratios (ORs) and 95% confidence intervals (CIs) after adjusting for potential confounders. Three dietary patterns were identified: “traditional,” “western,” and “prudent.” The “prudent” dietary pattern consisted of a high intake of fruits and fruit products as well as nuts, dairy, and a low consumption of grains; this pattern was negatively associated with the risk of MetS. The highest quintile of the “prudent” dietary pattern was significantly less likely to develop MetS (OR: 0.5, 95% CI: 0.36–0.68, P for trend <0.001) compared with the lowest quintile. This pattern was also negatively associated with all of the MetS diagnostic criteria: abdominal obesity (OR: 0.52, 95% CI: 0.41–0.65), blood pressure (OR: 0.72, 95% CI: 0.59–0.87), triglycerides (OR: 0.67, 95% CI: 0.52–0.85), fasting glucose (OR: 0.64, 95% CI: 0.43–0.95), and high-density lipoprotein cholesterol (OR: 0.53, 95% CI: 0.42–0.68). However, the “traditional” and “western” dietary patterns were not associated with the risk of MetS. The “prudent” dietary pattern was negatively associated with the risk of developing MetS among Korean women. PMID:26313795

The social and economic context and determinants of schistosomiasis japonica.

PubMed

Huang, Yi-Xin; Manderson, Lenore

2005-01-01

A variety of biological and social factors govern schistosomiasis japonica in China. Social factors include those at a national and regional level, such as policies and patterns of development, which impact on local economic activities, and affect community, household and personal risk factors of infection. Drawing on research conducted in China, we illustrate how social structural and related factors influence individual risk and prevalence of infection. At a macro-level, political changes have occurred resulting in the shift from collective to family-based production, leading to clustering of infection in families. Industrialization and urbanization, and associated increased population mobility, have also influenced patterns of transmission and infection. Types of activities and local production patterns determine the exposure of individuals to schistosome-infested water sources. Fishermen have the most frequent water contact, aquatic workers the second and farmers the third; the relative risk of Schistosoma japonicum infection follows the same order. Among farmers, human infection is significantly related to agricultural production in rice fields infested with the intermediate host snail, and to rates of the infection in livestock. Risk of S. japonicum infection is also influenced by the domestic environment, including both the location of the house in relation to snail-colonized water sources, access to safe water, and improved sanitation. Household wealth and income determine family ability to provide and maintain safe water and sanitation, while determining or interacting with other variables. At an individual level, sex, age, educational level and ethnicity are all associated with different patterns of water use and water contact behaviour thereby affecting infection rates. Schistosomiasis impairs the growth and nutrition of children and the physical work capacity of adults, and so affects economic development. Given this, we note the importance of further research and social and contextual aspects of schistosomiasis infection in order to develop and sustain sound control strategies.

Exercise Preference Patterns, Resources, and Environment among Rural Breast Cancer Survivors

ERIC Educational Resources Information Center

Rogers, Laura Q.; Markwell, Stephen J.; Courneya, Kerry S.; McAuley, Edward; Verhulst, Steven

2009-01-01

Context: Rural breast cancer survivors may be at increased risk for inadequate exercise participation. Purpose: To determine for rural breast cancer survivors: (1) exercise preference "patterns," (2) exercise resources and associated factors, and (3) exercise environment. Methods: A mail survey was sent to rural breast cancer survivors identified…

Physical Activity Patterns among U.S. Adults with Disabilities

ERIC Educational Resources Information Center

Chiu, Chung-Yi; An, Ruopeng

2016-01-01

Purpose: To characterize physical activity patterns among people with disabilities using data from a nationally representative health survey. Method: Individual-level data came from the Behavioral Risk Factor Surveillance System 2011 survey. Pearson's chi-squared tests were conducted to assess the difference in the proportion distribution of…

MODULAR APPLICATION OF COMPUTATIONAL MODELS OF INHALED REACTIVE GAS DOSIMETRY FOR RISK ASSESSMENT OF RESPIRATORY TRACT TOXICITY: CHLORINE

EPA Science Inventory

Inhaled reactive gases typically cause respiratory tract toxicity with a prominent proximal to distal lesion pattern. This pattern is largely driven by airflow and interspecies differences between rodents and humans result from factors such as airway architecture, ventilation ra...

Exploring the Life Course Perspective in Maternal and Child Health through Community-Based Participatory Focus Groups: Social Risks Assessment.

PubMed

Salinas-Miranda, Abraham A; King, Lindsey M; Salihu, Hamisu M; Berry, Estrellita; Austin, Deborah; Nash, Susan; Scarborough, Kenneth; Best, Evangeline; Cox, Lillian; King, Georgette; Hepburn, Carrie; Burpee, Conchita; Richardson, Eugene; Ducket, Marlo; Briscoe, Richard; Baldwin, Julie

2017-01-01

Little is known about the patterns of risk factors experienced by communities of color and how diverse community contexts shape the health trajectory of women from the early childhood period to the time of their pregnancies. Thus, we conducted a focus group study to identify social risks over the life course that contribute to maternal and child health from the perspective of community members residing in low income urban areas. Ten community-based participatory focus groups were conducted with residents from selected communities in Tampa, Florida, from September to November 2013. We used the life course perspective to illuminate and explain the experiences reported by the interviewees. A total of 78 residents participated in the focus groups. Children and adolescents' health risks were childhood obesity, lack of physical activity, and low self-esteem. Women's health risks were low self-esteem, low educational level, low health literacy, inadequate parenting skills, and financial problems. Risks during pregnancy included stress, low self-esteem, inadequate eating patterns, lack of physical activity, healthcare issues, lack of social support, and lack of father involvement during pregnancy. Multiple risk factors contribute to maternal and child health in low income communities in Tampa Bay. The intersection of risk factors in different life periods suggest possible pathways, cumulative, and latent effects, which must be considered in future longitudinal studies and when developing effective maternal and child health programs and policies.

Risk of transitional-cell carcinoma of the bladder in first- and second-generation immigrants to Sweden.

PubMed

Mousavi, Seyed Mohsen; Sundquist, Jan; Hemminki, Kari

2010-07-01

Environmental risk factors, particularly tobacco smoking, are important for transitional-cell carcinoma of the bladder. Studies in migrants may provide valuable insight into the environmental and genetic etiology of cancer. The nationwide Swedish Family-Cancer Database was used to calculate standardized incidence ratios (SIRs) for transitional-cell carcinoma among the immigrants compared with native Swedes. SIRs for lung cancer were also calculated as a proxy for smoking prevalence. Significantly decreased risks of bladder cancer were observed for male (SIR=0.89) and female (0.71) Finns and male East Asian (0.39) first-generation immigrants. Male immigrants from many countries showed increased risks, ranging from 1.18 to 2.29. Only female immigrants from Denmark (1.40) and Norway (1.27) had increased risks. The risks for bladder and lung cancers correlated, except for Finnish and Iranian men. The sons of immigrants born in high-risk countries had an increased SIR (1.51) whereas the daughters of immigrants born in low-risk countries had a decreased risk (0.32). The risk in the second-generation immigrants born in Sweden was equal to that of natives. In conclusion, the observed bladder cancer risks in the first-generation immigrants, the changes in risks in the second-generation immigrants, and the covariation of the risk patterns of bladder and lung cancers suggested a main contribution by tobacco smoking. The exceptional patterns among the Finns and Iranians may point to the existence of modifying factors. The changes in incidence in second-generation immigrants, yet based on small case numbers, lend little support to the involvement of genetic factors.

Different Patterns of Risk Reducing Decisions in Affected or Unaffected BRCA Pathogenic Variant Carriers.

PubMed

Lee, Eun-Gyeong; Kang, Hyok Jo; Lim, Myong Cheol; Park, Boyoung; Park, Soo Jin; Jung, So-Youn; Lee, Seeyoun; Kang, Han-Sung; Park, Sang-Yoon; Park, Boram; Joo, Jungnam; Han, Jai Hong; Kong, Sun-Young; Lee, Eun Sook

2018-05-04

The purpose of this study was to investigate decision patterns to reduce the risks of BRCA-related breast and gynecologic cancers in carriers of BRCA pathogenic variants. We found a change in risk-reducing (RR) management patterns after December 2012, when the National Health Insurance System (NHIS) of Korea began to pay for BRCA testing and risk-reducing salpingo-oophorectomy (RRSO) in pathogenic-variant carriers. The study group consisted of 992 patients, including 705 with breast cancer (BC), 23 with ovarian cancer (OC), 10 with both, and 254 relatives of high-risk patients who underwent BRCA testing at the National Cancer Center of Korea from January 2008 to December 2016.We analyzed patterns of and factors in RR management. Of the 992 patients, 220 (22.2%) were carriers of BRCA pathogenic variants. About 92.3% (203/220) had a family history of BC and/or OC, which significantly differed between BRCA1 and BRCA2 carriers (p<0.001). All 41 male carriers chose surveillance. Of the 179 female carriers, 59 (71.1%) of the 83 carriers with BC and the 39 (49.4%) of 79 unaffected carriers underwent RR management. None of the carriers affected with OC underwent RR management. Of the management types, RRSO had the highest rate (42.5%) of patient choice. The rate of risk-reducing surgery was significantly higher after 2013 than before 2013 (46.3% [74/160] vs. 31.6% [6/19], p<0.001). RRSO was the preferred management for carriers of BRCA pathogenic variants. The most important factors in treatment choice were NHIS reimbursement and/or the severity of illness.

Patterns of aeroallergen sensitization predicting risk for asthma in preschool children with atopic dermatitis.

PubMed

Calamelli, Elisabetta; Ricci, Giampaolo; Neri, Iria; Ricci, Lorenza; Rondelli, Roberto; Pession, Andrea; Patrizi, Annalisa

2015-06-01

Atopic dermatitis (AD) is a chronic inflammatory skin disorder mostly affecting young children. Although several studies aimed to identify the risk factors for asthma in AD children, many aspects still need to be clarified. The aim of this study was to investigate the possible risk factors for asthma at school age in 99 children with early-onset and IgE-mediated AD. All children performed clinical evaluation and total and specific IgE assay for a panel of inhalant and food allergens at two different times (t1 and t2) during preschool, and asthma diagnosis was assessed at one follow-up visit (t3) at school age. At t3, 39% of children had developed asthma. Of the variables compared, the sensitization to more than one class of inhalant allergens at t2 (mean age = 30 months) was associated with asthma, with grass (OR = 3.24, p = 0.020) and cat sensitization (OR = 2.74, p = 0.043) as independent risk factors. The sensitization pattern of a child with early-onset AD, also within the first 2-3 years of life, can reflect his risk to develop asthma. Therefore, testing these children for the more common allergens during this time frame should be recommended to predict the evolution of atopic diseases.

The effect of acculturation and discrimination on mental health symptoms and risk behaviors among adolescent migrants in Israel.

PubMed

Nakash, Ora; Nagar, Maayan; Shoshani, Anat; Zubida, Hani; Harper, Robin A

2012-07-01

This study examines the role of acculturation, perceived discrimination, and self-esteem in predicting the mental health symptoms and risk behaviors among 1.5 and second generation non-Jewish adolescents born to migrant families compared with native-born Jewish Israeli adolescents in Israel. Participants included n = 65 1.5 migrant adolescents, n = 60 second generation migrant adolescents, and n = 146 age, gender, and socioeconomic matched sample of native-born Jewish Israelis. Participants completed measures of acculturation pattern, perceived discrimination, and self-esteem as well as measures of mental health symptoms and risk behaviors. Results show that migrant adolescents across generations reported worse mental health symptoms compared with native-born Jewish Israelis. However, only the 1.5 generation migrants reported higher engagement in risk behaviors compared with second generation migrants and native-born Jewish Israelis. Our findings further showed that acculturation plays an important role in predicting the mental health status of migrant youth, with those characterized with integrated acculturative pattern reporting lower mental health symptoms compared with assimilated acculturation pattern. Importantly, contextual factors, such as higher perception of discrimination in the receiving culture as well as individual factors such as lower self-esteem and female gender were strongly associated with worse mental health symptoms. The findings manifest the complex relationship between contextual factors and individual level variables in the acculturative process of migrants as well as the importance of examining the effect of migration generation on mental health outcomes.

Depression Symptom Trajectories and Associated Risk Factors among Adolescents in Chile

PubMed Central

Stapinski, Lexine A.; Montgomery, Alan A.; Heron, Jon; Jerrim, John; Vignoles, Anna; Araya, Ricardo

2013-01-01

Adolescence is a key period for studying the development of depression, with studies in Europe and North America showing a pattern of elevated risk that begins in early adolescence and continues to increase as adolescents age. Few studies have examined the course of adolescent depression and associated risk factors in low and middle-income countries. This longitudinal cohort study examined depression symptom trajectories and risk factors in a sample of socio-economically disadvantaged adolescents in Chile (n = 2,508). Data were collected over an 18-month period as part of a clinical trial for secondary students aged 12 to 18 (median age 14). Clinical levels of depression were prevalent in this sample at baseline (35% for girls and 28% for boys); yet latent growth models of symptom trajectories revealed a pattern of decreasing symptoms over time. There was evidence of an anxiety-depression developmental pathway for girls, with elevated anxiety levels initially predicting poorer depression outcomes later on. Poor problem-solving skills were associated with initial depression levels but did not predict the course of depressive symptoms. Critically, the declining symptom trajectories raise important methodological issues regarding the effects of repeated assessment in longitudinal studies. PMID:24147131

Depression symptom trajectories and associated risk factors among adolescents in Chile.

PubMed

Stapinski, Lexine A; Montgomery, Alan A; Heron, Jon; Jerrim, John; Vignoles, Anna; Araya, Ricardo

2013-01-01

Adolescence is a key period for studying the development of depression, with studies in Europe and North America showing a pattern of elevated risk that begins in early adolescence and continues to increase as adolescents age. Few studies have examined the course of adolescent depression and associated risk factors in low and middle-income countries. This longitudinal cohort study examined depression symptom trajectories and risk factors in a sample of socio-economically disadvantaged adolescents in Chile (n = 2,508). Data were collected over an 18-month period as part of a clinical trial for secondary students aged 12 to 18 (median age 14). Clinical levels of depression were prevalent in this sample at baseline (35% for girls and 28% for boys); yet latent growth models of symptom trajectories revealed a pattern of decreasing symptoms over time. There was evidence of an anxiety-depression developmental pathway for girls, with elevated anxiety levels initially predicting poorer depression outcomes later on. Poor problem-solving skills were associated with initial depression levels but did not predict the course of depressive symptoms. Critically, the declining symptom trajectories raise important methodological issues regarding the effects of repeated assessment in longitudinal studies.

Chronic pain, body mass index and cardiovascular disease risk factors: tests of moderation, unique and shared relationships in the Study of Women's Health Across the Nation (SWAN).

PubMed

Burns, John W; Quartana, Phillip J; Bruehl, Stephen; Janssen, Imke; Dugan, Sheila A; Appelhans, Bradley; Matthews, Karen A; Kravitz, Howard M

2015-04-01

Chronic pain may be related to cardiovascular disease (CVD) risk. The current study examined whether persistent bodily pain was related to cardiovascular disease risk factors, whether these effects were moderated by body mass index (BMI), and, if not, whether chronic pain accounted for unique variance in CVD risk factors. Participants were women (N = 2,135) in the Study of Women's Health Across the Nation. A high pain frequency variable (high pain in 0 through 4 assessments) was coded to reflect the frequency of high levels of bodily pain across the first 3 years of the study. Six CVD risk factors and BMI were measured at follow-up year 3. High pain frequency and BMI were correlated significantly with risk factors, although effects for the former were small. Hierarchical multiple regressions revealed high pain frequency × BMI interactions for 5 of 6 CVD risk factors. Dissecting the interactions revealed a similar pattern across 4 risk factors: for women with normal BMI, there was a "dose-response" in which increasing frequency of high pain revealed increasingly worse CVD risk factor levels, whereas for women with obese BMI, high pain frequency was unrelated to risk factors. For obese women, increasing frequency of high pain was associated with higher blood glucose. Although BMI is a well-established CVD risk factor, evaluation of CVD risk level may be improved by considering the incidence of persistent pain, particularly in normal weight women (BMI < 25 kg/m(2)) lower BMI.

Space-time patterns of Campylobacter spp. colonization in broiler flocks, 2002-2006.

PubMed

Jonsson, M E; Norström, M; Sandberg, M; Ersbøll, A K; Hofshagen, M

2010-09-01

This study was performed to investigate space-time patterns of Campylobacter spp. colonization in broiler flocks in Norway. Data on the Campylobacter spp. status at the time of slaughter of 16 054 broiler flocks from 580 farms between 2002 and 2006 was included in the study. Spatial relative risk maps together with maps of space-time clustering were generated, the latter by using spatial scan statistics. These maps identified the same areas almost every year where there was a higher risk for a broiler flock to test positive for Campylobacter spp. during the summer months. A modified K-function analysis showed significant clustering at distances between 2.5 and 4 km within different years. The identification of geographical areas with higher risk for Campylobacter spp. colonization in broilers indicates that there are risk factors associated with Campylobacter spp. colonization in broiler flocks varying with region and time, e.g. climate, landscape or geography. These need to be further explored. The results also showed clustering at shorter distances indicating that there are risk factors for Campylobacter spp. acting in a more narrow scale as well.

Dietary patterns are associated with obesity in Japanese patients with schizophrenia.

PubMed

Sugawara, Norio; Yasui-Furukori, Norio; Sato, Yasushi; Saito, Manabu; Furukori, Hanako; Nakagami, Taku; Ishioka, Masamichi; Kaneko, Sunao

2014-06-20

Obesity among patients with schizophrenia is a growing concern because being overweight is widely regarded as a major risk factor for cardiovascular disease and premature death. Dietary patterns have been suggested as one modifiable factor that may play a role in development of obesity. The objective of this study was to examine the association between dietary patterns and obesity among patients with schizophrenia in Japan. We recruited patients (n = 338) aged 44.0 ± 13.2 (mean ± SD) years with a DSM-IV diagnosis of schizophrenia who were admitted to four psychiatric hospitals using a cross-sectional design. Diet was assessed with a validated brief-type self-administered diet history questionnaire (BDHQ). Dietary patterns from 52 predefined food groups were extracted by principal component analysis. A total of 61 subjects (18.0%) were classified as obese. Three dietary patterns were identified: the healthy dietary pattern, the processed food dietary pattern, and the alcohol and accompanying dietary patterns. After adjusting for age and gender, patients within the high tertile of each healthy dietary pattern (OR = 0.29, 95% CI = 0.13 to 0.62) and processed food dietary pattern (OR = 0.44, 95% CI = 0.22 to 0.89) had a significantly lower risk for obesity compared with low tertile of dietary pattern. Our findings suggest that dietary patterns, including higher intake of protein, fat, n-3 polyunsaturated fatty acids, n-6 polyunsaturated fatty acids, and vitamins, may be related to a decreased prevalence of obesity within patients with schizophrenia. Future longitudinal research exploring dietary patterns and obesity among patients with schizophrenia is warranted.

Color vision abnormalities in type II diabetes: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study II report no 2

PubMed Central

Gella, Laxmi; Raman, Rajiv; Kulothungan, Vaitheeswaran; Pal, Swakshyar Saumya; Ganesan, Suganeswari; Srinivasan, Sangeetha; Sharma, Tarun

2017-01-01

Purpose: The purpose of this study is to assess color vision abnormalities in a cohort of subjects with type II diabetes and elucidate associated risk factors. Methods: Subjects were recruited from follow-up cohort of Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study I. Six hundred and seventy-three eyes of 343 subjects were included from this population-based study. All subjects underwent detailed ophthalmic evaluation, including the Farnsworth-Munsell 100 hue test. Results: The prevalence of impaired color vision (ICV) was 43% (CI: 39.2–46.7). Risk factors for ICV were higher heart rate (odds ratio [OR]: 1.043, [1.023–1.064]) and a higher intraocular pressure (IOP) (OR: 1.086, [1.012–1.165]). Subjects with clinically significant macular edema (CSME) had three times higher chance of having ICV. C1, C2, and C3 are the commonly found Early Treatment Diabetic Retinopathy Study (ETDRS) patterns. The moment of inertia method showed that the angle did not reveal any specific pattern of color vision defect. Although the major and minor radii were high in those with ICV, we did not observe polarity. Confusion index was high in subjects with ICV, indicating a severe color vision defect. Conclusions: The prevalence of ICV was 43% among subjects with type II diabetes. The most commonly observed patterns were increasing severities of the blue–yellow defect on ETDRS patterns, but no specific pattern was observed at the moment of inertia analysis. The presence of CSME, a higher heart rate, and IOP was significant risk factors for ICV. This functional impairment in color vision could significantly contribute to morbidity among subjects with diabetes. PMID:29044066

Color vision abnormalities in type II diabetes: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study II report no 2.

PubMed

Gella, Laxmi; Raman, Rajiv; Kulothungan, Vaitheeswaran; Pal, Swakshyar Saumya; Ganesan, Suganeswari; Srinivasan, Sangeetha; Sharma, Tarun

2017-10-01

The purpose of this study is to assess color vision abnormalities in a cohort of subjects with type II diabetes and elucidate associated risk factors. Subjects were recruited from follow-up cohort of Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study I. Six hundred and seventy-three eyes of 343 subjects were included from this population-based study. All subjects underwent detailed ophthalmic evaluation, including the Farnsworth-Munsell 100 hue test. The prevalence of impaired color vision (ICV) was 43% (CI: 39.2-46.7). Risk factors for ICV were higher heart rate (odds ratio [OR]: 1.043, [1.023-1.064]) and a higher intraocular pressure (IOP) (OR: 1.086, [1.012-1.165]). Subjects with clinically significant macular edema (CSME) had three times higher chance of having ICV. C1, C2, and C3 are the commonly found Early Treatment Diabetic Retinopathy Study (ETDRS) patterns. The moment of inertia method showed that the angle did not reveal any specific pattern of color vision defect. Although the major and minor radii were high in those with ICV, we did not observe polarity. Confusion index was high in subjects with ICV, indicating a severe color vision defect. The prevalence of ICV was 43% among subjects with type II diabetes. The most commonly observed patterns were increasing severities of the blue-yellow defect on ETDRS patterns, but no specific pattern was observed at the moment of inertia analysis. The presence of CSME, a higher heart rate, and IOP was significant risk factors for ICV. This functional impairment in color vision could significantly contribute to morbidity among subjects with diabetes.

Interaction between VEGF receptor-2 gene polymorphisms and dietary patterns on blood glucose and lipid levels in Chinese Malaysian adults.

PubMed

Yap, Roseline Wai Kuan; Shidoji, Yoshihiro; Hon, Wei Min; Masaki, Motofumi

2011-01-01

The prevalence of lifestyle-related chronic diseases is increasing and gene-diet interaction studies are limited among the Malaysian population. This study was conducted to evaluate the association and interaction effects of vascular endothelial growth factor receptor-2(VEGFR2) gene polymorphisms and dietary patterns on anthropometric and biochemical risk factors of chronic diseases in 179 Chinese Malaysian adults. Genotyping of rs1870377 and rs2071559 was performed by real-time PCR using TaqMan probes. Dietary patterns were constructed from the food frequency questionnaire using factor analysis. Anthropometric measurements: body mass index (BMI), systolic and diastolic blood pressure and biomarkers: blood glucose, glycated hemoglobin A1c (HbA1c) and lipids were obtained. Two dietary patterns: 'Balanced diet' and 'Meat, rice and noodles diet' (MRND) were extracted. MRND was associated with higher BMI, blood pressure, blood glucose and lipids, while T alleles in both rs1870377 and rs2071559 were associated with higher blood lipids (p < 0.05). The interaction of MRND and rs1870377 had a borderline effect on blood HbA1c after adjusting for confounders (p = 0.057). A dietary pattern of MRND and VEGFR2 gene polymorphisms were both associated with increased health risks of lifestyle-related chronic diseases particularly blood glucose and lipid levels in Chinese Malaysian adults. Copyright © 2012 S. Karger AG, Basel.

Musculoskeletal disorders (MSDs) and dental practice Part 2. Risk factors for dentistry, magnitude of the problem, prevention, and dental ergonomics.

PubMed

Yamalik, Nermin

2007-02-01

As a consequence of occupational stresses placed on their bodies, oral health care providers (OHP) are vulnerable to musculoskeletal disorders (MSDs). Muscular imbalance, neuromuscular inhibition, and pain and dysfunction may frequently be observed among OHP. Repeated unnatural, deviated or inadequate working postures, forceful hand movements, inadequate equipment or workplace designs and inappropriate work patterns are likely to be the particular risk factors. However, WMSDs are not an avoidable part of OHPs' professional lives. Paying the necessary attention to occupational and individual risk factors, prevalence, symptoms and consequences of WMSDs, and implementing the recommended health and safety measures can enable a long and healthy career. This review essentially aims to provide background information for OHP regarding the magnitude of the problem, particular risk factors and the available recommendations for prevention.

Coronary heart disease prevention: Nutrients, foods, and dietary patterns

PubMed Central

Bhupathiraju, Shilpa N.; Tucker, Katherine L.

2018-01-01

Diet is a key modifiable risk factor in the prevention and risk reduction of coronary heart disease (CHD). Results from the Seven Countries Study in the early 1970s spurred an interest in the role of single nutrients such as total fat in CHD risk. With accumulating evidence, we have moved away from a focus on total fat to the importance of considering the quality of fat. Recent meta-analyses of intervention studies confirm the beneficial effects of replacing saturated fat with polyunsaturated fatty acids on CHD risk. Scientific evidence for a detrimental role of trans fat intake from industrial sources on CHD risk has led to important policy changes including listing trans fatty acid content on the “Nutrition Facts” panel and banning the use of trans fatty acids in food service establishments in some cities. The effects of such policy changes on changes in CHD incidence are yet to be evaluated. There has been a surging interest in the protective effects of vitamin D in primary prevention. Yet, its associations with secondary events have been mixed and intervention studies are needed to clarify its role in CHD prevention. Epidemiological and clinical trial evidence surrounding the benefit of B vitamins and antioxidants such as carotenoids, vitamin E, and vitamin C, have been contradictory. While pharmacological supplementation of these vitamins in populations with existing CHD has been ineffective and, in some cases, even detrimental, data repeatedly show that consumption of a healthy dietary pattern has considerable cardioprotective effects for primary prevention. Results from these studies and the general ineffectiveness of nutrient-based interventions have shifted interest to the role of foods in CHD risk reduction. The strongest and most consistent protective associations are seen with fruit and vegetables, fish, and whole grains. Epidemiological and clinical trial data also show risk reduction with moderate alcohol consumption. In the past decade, there has been a paradigm shift in nutritional epidemiology to examine associations between dietary patterns and health. Several epidemiological studies show that people following the Mediterranean style diet or the Dietary Approaches to Stop Hypertension (DASH) diet have lower risk of CHD and lower likelihood of developing hypertension. Studies using empirical or data driven dietary patterns have frequently identified two patterns — “Healthy or Prudent” and “Western”. In general, the “Healthy”, compared to the “Western” pattern has been associated with more favorable biological profiles, slower progression of atherosclerosis, and reduced incidence. Evidence on changes in dietary patterns and changes in CHD risk is still emerging. With the emergence of the concept of personalized nutrition, studies are increasingly considering the role of genetic factors in the modulation of the association between nutrients and CHD. More studies of genetic variation and dietary patterns in relation to CHD are needed. PMID:21575619

Type of aphasia: relationship to age, sex, previous risk factors, and outcome of rehabilitation.

PubMed

Steinvil, Y; Ring, H; Luz, Y; Schechter, I; Solzi, P

1985-01-01

Relationship of types of aphasia in hemiplegics to survival, outcome of rehabilitation, activities of daily living (ADL) and pre-existing risk factors, hypertension (HT), ischemic heart disease (IHD), diabetes mellitus (DM) were studied in a group of 257 patients. The control group was a large population of CVA cases previously documented. Four main categories were considered: expressive-receptive (global), predominantly expressive (Broca), predominantly receptive (Wernicke) and predominantly amnestic (anomia) aphasias. 40% of each category were female. No clear pattern emerged concerning relationship with risk factors; however, hypertension, the factor most frequently encountered, was significantly less prevalent among expressive ahphasics, and diabetes mellitus was rare among those with the receptive pattern. For all categories, the most frequent etiology was thrombosis, the second being embolia. The oldest groups were the expressive-receptive and the predominantly receptive aphasia groups: showed the poorest rehabilitation outcome in both ADL and locomotion, and lived less time after stroke (5.8 years). Amnestic and expressive patients were younger and fared better in all other parameters; an etiology of embolia was much more frequent among the former. It can be said that patients with the expressive-receptive kind of aphasia have the worst survival and rehabilitation prognoses.

Pattern of organophosphorous poisoning: a retrospective community based study.

PubMed

Chataut, J; Adhikari, R K; Sinha, N P; Marahatta, S B

2011-01-01

Pesticide poisoning is very common in Nepal. Hospital based studies from various parts of Nepal have shown that poisoning with organophosphorus compounds is the most common type of poisoning. Current study is undertaken to see the pattern of organophosphorus poisoning and to identify the common risk factors among the cases. If the risk factors are modifiable, attempts in addressing the risk factors and decreasing the likelihood of poisoning will certainly be fruitful in reducing the morbidity and mortality associated with organophosphorus poisoning. To assess the risk factors of organophosphorus poisoning which is major public health problem in Nepal. A community based retrospective study of 75 cases of organophosphate poisoning who were brought to the emergency department of Dhulikhel hospital over the period of 3 years. Basic information was collected from hospital records and home visits were made to study the risk factors. Data were collected through interviews of the study population and their family members using a pre-designed questionnaire. In this study 75 cases and their families were interviewed of which there were 59% males and 42% females (M/F ratio of 1:1.4). The majority (40%) of the poisoning cases were in the age group 25-34 years. Lower literacy level showed positive association with the incidence of poisoning. Occupation wise vast majority (80%) of the cases were engaged in agricultural work. Suicidal attempts by ingesting organophosphate compounds were high in farmers and females. In this study, majority of the poisoning were attempts of intentional self harm. Agriculture workers and females are high risk groups and may be associated with the fact that they have easy access to the poison. Interventions directed towards health education, counseling, and enforcement of laws restricting the availability and use of harmful pesticides may help in reducing such events in future.

Boyfriends and booty calls: sexual partnership patterns among Canadian Aboriginal young people.

PubMed

Devries, Karen M; Free, Caroline J

2011-01-01

Sexual partnership patterns, forced sex, and condom non-use can contribute to STI risk, but little is known about these patterns among Aboriginal young people despite elevated STI risk in this group. We describe sexual relationship and condom use patterns among Canadian Aboriginal young people, and how these patterns relate to the socio-structural context as experienced by young people. We use data from in-depth individual interviews conducted in 2004 with 22 young people who reported ever having sex and who self-identified as Aboriginal in British Columbia, Canada. A thematic analysis is presented. Young people described a range of partnership patterns, including 'on-off' relationships which could have high rates of partner turnover but could sometimes be viewed as acceptable contexts for pregnancy, precluding condom use. Contextual elements beyond individual control appeared to contribute to these patterns. Migration between geographic locations was linked with risky partnership patterns, especially if it was linked with family instability or substance use problems. Sexual health interventions for this group must address partnership patterns in addition to promoting condom use. Survey research into 'migration' as a risk factor for STI transmission should consider reasons for migration. Interventions that address both individual level behaviour and the contextual elements that shape behaviour should be developed and tested.

A Comparison of Rule-based Analysis with Regression Methods in Understanding the Risk Factors for Study Withdrawal in a Pediatric Study.

PubMed

Haghighi, Mona; Johnson, Suzanne Bennett; Qian, Xiaoning; Lynch, Kristian F; Vehik, Kendra; Huang, Shuai

2016-08-26

Regression models are extensively used in many epidemiological studies to understand the linkage between specific outcomes of interest and their risk factors. However, regression models in general examine the average effects of the risk factors and ignore subgroups with different risk profiles. As a result, interventions are often geared towards the average member of the population, without consideration of the special health needs of different subgroups within the population. This paper demonstrates the value of using rule-based analysis methods that can identify subgroups with heterogeneous risk profiles in a population without imposing assumptions on the subgroups or method. The rules define the risk pattern of subsets of individuals by not only considering the interactions between the risk factors but also their ranges. We compared the rule-based analysis results with the results from a logistic regression model in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Both methods detected a similar suite of risk factors, but the rule-based analysis was superior at detecting multiple interactions between the risk factors that characterize the subgroups. A further investigation of the particular characteristics of each subgroup may detect the special health needs of the subgroup and lead to tailored interventions.

Severe community-acquired pneumonia. Risk factors and follow-up epidemiology.

PubMed

Ruiz, M; Ewig, S; Torres, A; Arancibia, F; Marco, F; Mensa, J; Sanchez, M; Martinez, J A

1999-09-01

The aim of the study was to determine risk factors for severe community-acquired pneumonia (CAP) as well as to compare microbial patterns of severe CAP to a previous study from our respiratory intensive care unit (ICU) originating from 1984 to 1987. Patients admitted to the ICU according to clinical judgment were defined as having severe CAP. For the study of risk factors, a hospital-based case-control design was used, matching each patient with severe CAP to a patient hospitalized with CAP but not requiring ICU admission. Microbial investigation included noninvasive and invasive techniques. Overall, 89 patients with severe CAP were successfully matched to a control patient. The presence of an alcohol ingestion of >/= 80 g/d (odds ratio [OR] 3.9, 95% confidence interval [CI] 1.4 to 10.6, p = 0.008) was found to be an independent risk factor for severe CAP and prior ambulatory antimicrobial treatment (OR 0.37, 95% CI 0.17 to 0.79, p = 0.009) to be protective. Streptococcus pneumoniae (24%) continued to be the most frequent pathogen; however, 48% of strains were drug-resistant. "Atypical" bacterial pathogens were significantly more common (17% versus 6%, p = 0.006) and Legionella spp. less common (2% versus 14%, p = 0.004) than in our previous study, whereas gram-negative enteric bacilli (GNEB) and Pseudomonas aeruginosa continued to represent important pathogens (6% and 5%, respectively). Our findings provide additional evidence for the importance of the initiation of early empiric antimicrobial treatment for a favorable outcome of CAP. Variations of microbial patterns are only in part due to different epidemiological settings. Therefore, initial empiric antimicrobial treatment will also have to take into account local trends of changing microbial patterns.

Socioeconomic gradients of cardiovascular risk factors in China and India: results from the China health and retirement longitudinal study and longitudinal aging study in India.

PubMed

Hu, Peifeng; Wang, Serena; Lee, Jinkook

2017-09-01

Cardiovascular disease has become a major public health challenge in developing countries. The goal of this study is to compare socioeconomic status (SES) gradients of cardiovascular risk factors (CVRF) both within and between China and India. We used multivariable logistic regression models to examine the associations between SES and CVRF, using data from the China health and retirement longitudinal study and the longitudinal aging study in India. The results showed that, compared to illiteracy, the odds ratios of completing junior high school for high-risk waist circumference were 4.99 (95% confidence interval: 1.77-14.06) among Indian men, 3.42 (95% confidence interval: 1.66-7.05) among Indian women, but 0.74 (95% confidence interval: 0.59-0.92) among Chinese women. Similar patterns were observed between educational attainment and high-risk body mass index, and between education and hypertension, based on self-reported physician diagnosis and direct blood pressure measurements. SES is associated with CVRF in both China and India. However, this relationship showed opposite patterns across two countries, suggesting that this association is not fixed, but is subjective to underlying causal pathways, such as patterns of risky health behaviors and different social and health policies.

Physical Activity, a Critical Exposure Factor of Environmental Pollution in Children and Adolescents Health Risk Assessment

PubMed Central

Zhang, Su; Xia, Li; Yu, Yi; Hu, Shuangshuang; Sun, Jingyu; Zhou, Ping; Chen, Peijie

2018-01-01

It is an extremely urgent problem that physical fitness promotion must face not only the increasing air pollution but also the decline of physical activity level of children and adolescents worldwide at present, which is the major reason that forms an inactive lifestyle and does harm to adolescents’ health. Thus, it is necessary to focus on the exposure factor in environmental health risk assessment (EHRA) which conducts supervision of environmental pollution and survey of adolescents’ activity patterns according to the harmful characteristics of air pollutant and relationship between dose and response. Some countries, such as USA, Canada and Australia, regard both respiratory rate and physical activity pattern as main exposure factors for adolescents in both air pollution health risk assessment and exercise risk assessment to forecast a safe exposing condition of pollutant for adolescents while they are doing exercise outdoors. In addition, it suggests that the testing indexes and testing methods of these two exposure factors, such as investigating the time of daily physical activity, strength, and characteristic of frequency, help to set up the quantitative relationship between environmental pollution index and the time, strength, frequency of daily activities, and formulate children’s and adolescents’ activity instructions under different levels of environmental pollutions. As smog becomes increasingly serious at present, it is meaningful to take physical activity as a critical composition of exposure factor and establish physical activity guideline, so as to reduce the risk of air pollution, and promote physical health of children and adolescents effectively. PMID:29360730

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 in early adolescence. Copyright © 2014. Published by Elsevier Ltd.

Understanding the Diverse Needs of Children whose Parents Abuse Substances

PubMed Central

Solis, Jessica M.; Shadur, Julia M.; Burns, Alison R.; Hussong, Andrea M.

2013-01-01

In this review, we consider the potential service needs of children of substance abusing parents based on what we know about the risk outcomes faced by these children and the parenting deficits often present in these families. Importantly, our review does not address the etiological role of parental substance abuse in children's negative outcomes but instead we discuss the complex inter-related risk factors that often co-occur with and exacerbate risk associated with parental alcohol and drug use. We first review studies showing the elevated risk that children of substance abusing parents face in general for poorer academic functioning; emotional, behavioral, and social problems; and an earlier onset of substance use, faster acceleration in substance use patterns, and higher rates of alcohol and drug use disorders. We then review studies showing contextual risk factors for children of substance abusing parents, including parenting deficits (less warmth, responsiveness, and physical and verbal engagement as well as harsher and more over-involved interaction styles), greater risk for child maltreatment, and less secure attachment patterns. We conclude with a discussion of future directions for research and guidelines for professionals working with children and their families where parental substance abuse is present. PMID:22455509

Associations Between a Dopamine D4 Receptor Gene, Alcohol Use, and Sexual Behaviors among Female Adolescent African Americans

PubMed Central

Sales, Jessica M.; Smearman, Erica; Brown, Jennifer L.; Brody, Gene H.; Philibert, Robert A.; Rose, Eve; DiClemente, Ralph J.

2016-01-01

Adolescent African-American females are disproportionately impacted by HIV, thus there is a clear need to understand factors associated with increased HIV-risk behaviors among this vulnerable population. We sought to explore the association between a dopamine D4 receptor gene (DRD4), a genetic marker associated with natural variations in rewarding behaviors, and self-reported alcohol-use and sexual risk-behaviors, while controlling for other known correlates of risk-taking such as impulsivity, sensation seeking, and peer norms among a group of high-risk African American female adolescents to evaluate whether this biological factor enhances our understanding of patterns of risk in this vulnerable group. PMID:27087792

Culture, risk factors and suicide in rural China: a psychological autopsy case control study.

PubMed

Zhang, J; Conwell, Y; Zhou, L; Jiang, C

2004-12-01

Previous research on sociocultural factors for Chinese suicide have been basically limited to single case studies or qualitative research with ethnographic methodology. The current study examines the major risk factors and some cultural uniqueness related to Chinese rural suicide using a quantitative design. This is a case control study with 66 completed suicides and 66 living controls obtained from psychological autopsy interviews in rural China. Both bivariate analyses and the multiple regression model have found that the Chinese rural suicide patterns are basically similar to those in most other cultures in the world: strong predictors of rural Chinese suicide are the psychopathological, psychological, and physical health variables, followed by social support and negative and stressful life events. Other significant correlates include lower education, poverty, religion, and family disputes. Culture has an important impact on suicide patterns in a society.

Culture, risk factors and suicide in rural China: a psychological autopsy case control study

PubMed Central

Zhang, J.; Conwell, Y.; Zhou, L.; Jiang, C.

2009-01-01

Objective Previous research on sociocultural factors for Chinese suicide have been basically limited to single case studies or qualitative research with ethnographic methodology. The current study examines the major risk factors and some cultural uniqueness related to Chinese rural suicide using a quantitative design. Method This is a case control study with 66 completed suicides and 66 living controls obtained from psychological autopsy interviews in rural China. Results Both bivariate analyses and the multiple regression model have found that the Chinese rural suicide patterns are basically similar to those in most other cultures in the world: strong predictors of rural Chinese suicide are the psychopathological, psychological, and physical health variables, followed by social support and negative and stressful life events. Other significant correlates include lower education, poverty, religion, and family disputes. Conclusion Culture has an important impact on suicide patterns in a society. PMID:15521827

Dietary Pattern and Risk of Hodgkin Lymphoma in a Population-Based Case-Control Study

PubMed Central

Epstein, Mara M.; Chang, Ellen T.; Zhang, Yawei; Fung, Teresa T.; Batista, Julie L.; Ambinder, Richard F.; Zheng, Tongzhang; Mueller, Nancy E.; Birmann, Brenda M.

2015-01-01

Classic Hodgkin lymphoma (cHL) has few known modifiable risk factors, and the relationship between diet and cHL risk is unclear. We performed the first investigation of an association between dietary pattern and cHL risk in 435 cHL cases and 563 population-based controls from Massachusetts and Connecticut (1997–2000) who completed baseline diet questionnaires. We identified 4 major dietary patterns (“vegetable,” “high meat,” “fruit/low-fat dairy,” “desserts/sweets”) using principal components analysis. We computed multivariable odds ratios and 95% confidence intervals for associations of dietary pattern score (quartiles) with younger-adult (age <50 years), older-adult (age ≥50 years), and overall cHL risk. Secondary analyses examined associations by histological subtype and tumor Epstein-Barr virus (EBV) status. A diet high in desserts/sweets was associated with younger-adult (odds ratio(quartile 4 vs. quartile 1) = 1.60, 95% confidence interval: 1.05, 2.45; Ptrend = 0.008) and EBV-negative, younger-adult (odds ratio = 2.11, 95% confidence interval: 1.31, 3.41; Ptrend = 0.007) cHL risk. A high meat diet was associated with older-adult (odds ratio = 3.34, 95% confidence interval: 1.02, 10.91; Ptrend = 0.04) and EBV-negative, older-adult (odds ratio = 4.64, 95% confidence interval: 1.03, 20.86; Ptrend = 0.04) cHL risk. Other dietary patterns were not clearly associated with cHL. We report the first evidence for a role of dietary pattern in cHL etiology. Diets featuring high intake of meat or desserts and sweets may increase cHL risk. PMID:26182945

Dietary pattern and risk of hodgkin lymphoma in a population-based case-control study.

PubMed

Epstein, Mara M; Chang, Ellen T; Zhang, Yawei; Fung, Teresa T; Batista, Julie L; Ambinder, Richard F; Zheng, Tongzhang; Mueller, Nancy E; Birmann, Brenda M

2015-09-01

Classic Hodgkin lymphoma (cHL) has few known modifiable risk factors, and the relationship between diet and cHL risk is unclear. We performed the first investigation of an association between dietary pattern and cHL risk in 435 cHL cases and 563 population-based controls from Massachusetts and Connecticut (1997-2000) who completed baseline diet questionnaires. We identified 4 major dietary patterns ("vegetable," "high meat," "fruit/low-fat dairy," "desserts/sweets") using principal components analysis. We computed multivariable odds ratios and 95% confidence intervals for associations of dietary pattern score (quartiles) with younger-adult (age <50 years), older-adult (age ≥50 years), and overall cHL risk. Secondary analyses examined associations by histological subtype and tumor Epstein-Barr virus (EBV) status. A diet high in desserts/sweets was associated with younger-adult (odds ratio(quartile 4 vs. quartile 1) = 1.60, 95% confidence interval: 1.05, 2.45; Ptrend = 0.008) and EBV-negative, younger-adult (odds ratio = 2.11, 95% confidence interval: 1.31, 3.41; Ptrend = 0.007) cHL risk. A high meat diet was associated with older-adult (odds ratio = 3.34, 95% confidence interval: 1.02, 10.91; Ptrend = 0.04) and EBV-negative, older-adult (odds ratio = 4.64, 95% confidence interval: 1.03, 20.86; Ptrend = 0.04) cHL risk. Other dietary patterns were not clearly associated with cHL. We report the first evidence for a role of dietary pattern in cHL etiology. Diets featuring high intake of meat or desserts and sweets may increase cHL risk. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Dietary patterns and breast cancer risk in the California Teachers Study cohort.

PubMed

Link, Lilli B; Canchola, Alison J; Bernstein, Leslie; Clarke, Christina A; Stram, Daniel O; Ursin, Giske; Horn-Ross, Pamela L

2013-12-01

Evidence that diet is associated with breast cancer risk is inconsistent. Most studies have examined risks associated with specific foods and nutrients, rather than measures of overall diet. This study aimed to evaluate dietary patterns and their relation to breast cancer risk in a large cohort of women. Data from 91,779 women in the California Teachers Study cohort were analyzed, including data from 4140 women with a diagnosis of invasive breast cancer made between 1995 and 2009. Five predominant dietary patterns were identified by using principal components factor analysis: a plant-based diet, high in fruit and vegetables; a high-protein, high-fat diet, high in meats, eggs, fried foods, and high-fat condiments; a high-carbohydrate diet, high in convenience foods, pasta, and bread products; an ethnic diet, high in legumes, soy-based foods, rice, and dark-green leafy vegetables; and a salad and wine diet, high in lettuce, fish, wine, low-fat salad dressing, and coffee and tea. The plant-based pattern was associated with a reduction in breast cancer risk (RR: 0.85; 95% CI: 0.76, 0.95 for the highest compared with the lowest consumption quintile; P-trend = 0.003); risk reduction was greater for estrogen receptor-negative progesterone receptor-negative (ER-PR-) tumors (RR: 0.66; 95% CI: 0.48, 0.91; P-trend = 0.03). The salad and wine pattern was associated with an increased risk of estrogen receptor-positive progesterone receptor-positive tumors (RR: 1.29; 95% CI: 1.12, 1.49); this effect was only slightly attenuated after adjustment for alcohol consumption. The finding that greater consumption of a plant-based dietary pattern is associated with a reduced breast cancer risk, particularly for ER-PR- tumors, offers a potential avenue for prevention.

Analyzing seasonal patterns of wildfire exposure factors in Sardinia, Italy

Treesearch

Michele Salis; Alan A. Ager; Fermin J. Alcasena; Bachisio Arca; Mark A. Finney; Grazia Pellizzaro; Donatella Spano

2015-01-01

In this paper, we applied landscape scale wildfire simulation modeling to explore the spatiotemporal patterns of wildfire likelihood and intensity in the island of Sardinia (Italy). We also performed wildfire exposure analysis for selected highly valued resources on the island to identify areas characterized by high risk. We observed substantial variation in burn...

Risk/Protective Factors for Alcohol Use among Hispanic and White Teenagers.

ERIC Educational Resources Information Center

Felix-Ortiz, Maria; Newcomb, Michael D.

Changing alcohol and drug use patterns among women and ethnic minorities, such as the over-representation of Hispanics in alcohol-related deaths, drunk driving arrests, and treatment facilities, emphasize the importance of understanding substance use patterns in these populations. This study attempted to identify a single cause of substance abuse…

Change in Level of Service Inventory-Ontario Revised (LSI-OR) Risk Scores Over Time: An Examination of Overall Growth Curves and Subscale-Dependent Growth Curves.

PubMed

Day, David M; Wilson, Holly A; Bodwin, Kelly; Monson, Candice M

2017-10-01

The dynamic nature of risk to re-offend is an important issue in the management of offenders and has stimulated extensive research into dynamic risk factors that can alter an individual's overall risk to re-offend if addressed. However, few studies have examined the relative importance of these dynamic risk factors, complicating the task of developing case management and treatment plans that will effect the most change. Using a large, high-risk sample and multi-wave data of a common risk assessment tool, the Level of Service Inventory-Ontario Revised (LSI-OR), the current study investigated the relationship among criminogenic risk factors and their role in influencing the overall risk score. Results indicated a diverse pattern of effects on the eight subscale scores, specifically suggesting that changes on Procriminal Attitude/Orientation, Criminal History, and Leisure/Recreation subscales resulted in a quicker rate of change to the overall risk score over time. These results suggest that some factors may be driving the change in overall risk and could potentially effect the most change if prioritized for intervention. Practical implications and implications for further research are discussed.

Dietary patterns interact with APOA1/APOC3 polymorphisms to alter the risk of the metabolic syndrome: the Tehran Lipid and Glucose Study.

PubMed

Hosseini-Esfahani, Firoozeh; Mirmiran, Parvin; Daneshpour, Maryam S; Mehrabi, Yadollah; Hedayati, Mehdi; Soheilian-Khorzoghi, Mona; Azizi, Fereidoun

2015-02-28

The interaction of genetic and dietary factors, as an area of CVD research, has been explored poorly. The aim of the present study was to examine the interaction of dietary patterns and three genetic variants of APOA1 and APOC3, both independently and in combination, relative to the risk of the metabolic syndrome (MetS) in Tehranian adults. In the present matched, nested case-control study, 414 subjects with the MetS and 414 controls were selected from the participants of the Tehran Lipid and Glucose Study. Dietary patterns were determined by factor analysis. APOC3 (rs5128 3238C>G) and APOA1 (rs670, -75G>A and rs5069,+83C>T) SNP were genotyped by the conventional PCR followed by the restriction fragment length polymorphism technique. Overall, three major dietary patterns were extracted: healthy dietary pattern (HDP); Western dietary pattern (WDP); fat-sweet dietary pattern (FSDP). The A and T allele carriers of the APOA1 SNP had a greater risk of developing the MetS in the highest quartile of WDP scores (OR 3·22, 95 % CI 1·21, 8·58, P(interaction)= 0·03). Compared with other genotype combinations, the combined effect of APOC3/APOA1 (CC/GA+AA/CT+TT) genotypes showed a further increase in the risk of the MetS in the highest quartile of WDP scores (OR 1, 2·49, 8·73, 6·32, P trend< 0·001, P(interaction)= 0·003). A significant interaction was found between the quartiles of FSDP scores and the APOA1 diplotype (GA+AA/CT+TT). OR for these genotype carriers were 1, 0·65, 0·57 and 0·22 (P(trend)= 0·006) in the lowest to the highest quartile of FSDP scores when compared with the other combined genotypes (P(interaction)= 0·03). Our findings suggest that the WDP and FSDP are associated with APOA1 and APOC3 SNP in relation to the risk of the MetS.

The Epidemiology of Chronic Major Depressive Disorder and Dysthymic Disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Blanco, Carlos; Okuda, Mayumi; Markowitz, John C.; Liu, Shang-Min; Grant, Bridget F.; Hasin, Deborah S.

2011-01-01

Objective To examine the prevalence of chronic major depressive disorder (CMDD) and dysthymic disorder (DD), their sociodemographic correlates, patterns of 12-month and lifetime psychiatric comorbidity, lifetime risk factors, psychosocial functioning, and mental health service utilization. Method Face-to-face interviews were conducted in the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (n = 43,093). Results The 12-month and lifetime prevalence were greater for CMDD (1.5% and 3.1%) than for DD (0.5% and 0.9%). Individuals with CMDD and DD shared most sociodemographic correlates and lifetime risk factors for MDD. Individuals with CMDD and DD had almost identically high rates of Axis I and Axis II comorbid disorders. However, individuals with CMDD received higher rates of all treatment modalities than individuals with DD. Conclusion Individuals with CMDD and DD share many sociodemographic correlates, comorbidity patterns, risk factors, and course. Individuals with chronic depressive disorders, especially those with DD, continue to face substantial unmet treatment needs. PMID:21190638

The epidemiology of chronic major depressive disorder and dysthymic disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

PubMed

Blanco, Carlos; Okuda, Mayumi; Markowitz, John C; Liu, Shang-Min; Grant, Bridget F; Hasin, Deborah S

2010-12-01

To examine the prevalence of chronic major depressive disorder (CMDD) and dysthymic disorder, their sociodemographic correlates, patterns of 12-month and lifetime psychiatric comorbidity, lifetime risk factors, psychosocial functioning, and mental health service utilization. Face-to-face interviews were conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (n = 43,093). The 12-month and lifetime prevalences were greater for CMDD (1.5% and 3.1%, respectively) than for dysthymic disorder (0.5% and 0.9%, respectively). Individuals with CMDD and dysthymic disorder shared most sociodemographic correlates and lifetime risk factors for major depressive disorder. Individuals with CMDD and dysthymic disorder had almost identically high rates of Axis I and Axis II comorbid disorders. However, individuals with CMDD received higher rates of all treatment modalities than individuals with dysthymic disorder. Individuals with CMDD and dysthymic disorder share many sociodemographic correlates, comorbidity patterns, risk factors, and course. Individuals with chronic depressive disorders, especially those with dysthymic disorder, continue to face substantial unmet treatment needs. © Copyright 2010 Physicians Postgraduate Press, Inc.

Wellness motivation in cardiac rehabilitation: the role of self-knowledge in cardiovascular risk modification.

PubMed

Fleury, Julie; Sedikides, Constantine

2007-08-01

Understanding the factors that motivate behavioral change is central to health promotion efforts. We used qualitative descriptive methods in an effort to understand the role of self-knowledge in the process of risk factor modification. The sample consisted of 17 men and 7 women with diagnosed coronary heart disease, who were attempting to initiate and sustain programs of cardiovascular risk modification. Participants described self-knowledge in terms of three contextually situated patterns: representational, evaluative, and behavioral action. Results reinforce the motivational role of the self and highlight the importance of understanding dimensions of self-knowledge relevant to cardiovascular risk reduction.

Patterns of Relationships between Cardiovascular Disease Risk Factors and Neurocognitive Function in African Americans

PubMed Central

Sims, Regina; Madhere, Serge; Callender, Clive; Campbell, Alfonso

2013-01-01

Objective The association between cardiovascular disease (CVD) risk and neurocognitive function has gathered a good deal of attention in the health and social science literature; however, the relationship among several CVD risk factors and neurocognitive function has not been fully explored in an African American sample. The purpose of this study was to examine the pattern of relationships among four CVD risk factors and five measures of higher cortical functions. Methods Data were collected from a sample of 106 African American community-dwelling adults in the metropolitan Washington, DC, area. A nurse collected blood pressure, waist circumference, and a blood sample (to assess triglycerides and high-density lipoprotein (HDL) cholesterol) from study participants. Participants completed the Symbol Digit Modalities Test, Trailmaking B, Stroop Colorword Task, California Verbal Learning Test-II, and Wisconsin Card Sorting Test as assessments of neurocognitive function. Canonical analysis and multiple regression analysis were the major statistical methods utilized to assess relationships between CVD risk factors and neurocognitive function. Results The results suggest that 1) attentional processes are associated with diastolic blood pressure levels, 2) verbal learning processes are associated with diastolic blood pressure and triglyceride levels, and 3) the ability to shift cognitive set is associated with HDL cholesterol levels. Conclusion As cardiovascular health worsens in our society, particularly among ethnic minorities, the neurocognitive consequences must be clearly understood. Future studies should focus on identifying and building awareness of cardiovascular and neurocognitive links through longitudinal research designs and brain imaging technology. PMID:19157252

APOL1–Mediated Cell Injury Involves Disruption of Conserved Trafficking Processes

PubMed Central

Kruzel-Davila, Etty; Shemer, Revital; Ofir, Ayala; Bavli-Kertselli, Ira; Darlyuk-Saadon, Ilona; Oren-Giladi, Pazit; Wasser, Walter G.; Magen, Daniella; Zaknoun, Eid; Schuldiner, Maya; Salzberg, Adi; Kornitzer, Daniel; Marelja, Zvonimir; Simons, Matias

2017-01-01

APOL1 harbors C–terminal sequence variants (G1 and G2), which account for much of the increased risk for kidney disease in sub–Saharan African ancestry populations. Expression of the risk variants has also been shown to cause injury to podocytes and other cell types, but the underlying mechanisms are not understood. We used Drosophila melanogaster and Saccharomyces cerevisiae to help clarify these mechanisms. Ubiquitous expression of the human APOL1 G1 and G2 disease risk alleles caused near-complete lethality in D. melanogaster, with no effect of the G0 nonrisk APOL1 allele, corresponding to the pattern of human disease risk. We also observed a congruent pattern of cellular damage with tissue-specific expression of APOL1. In particular, expression of APOL1 risk variants in D. melanogaster nephrocytes caused cell-autonomous accumulation of the endocytic tracer atrial natriuretic factor-red fluorescent protein at early stages and nephrocyte loss at later stages. We also observed differential toxicity of the APOL1 risk variants compared with the APOL1 nonrisk variants in S. cerevisiae, including impairment of vacuole acidification. Yeast strains defective in endosomal trafficking or organelle acidification but not those defective in autophagy displayed augmented APOL1 toxicity with all isoforms. This pattern of differential injury by the APOL1 risk alleles compared with the nonrisk alleles across evolutionarily divergent species is consistent with an impairment of conserved core intracellular endosomal trafficking processes. This finding should facilitate the identification of cell injury pathways and corresponding therapeutic targets of interest in these amenable experimental platforms. PMID:27864431

Environmental Exposure and Risk of Childhood Leukemia: An Overview.

PubMed

Schüz, Joachim; Erdmann, Friederike

2016-11-01

Childhood leukemia is the most common cancer diagnosed in children worldwide. However, only a few causes have been established so far, mainly some genetic syndromes and high doses of ionizing radiation. Major efforts have been undertaken to study the relationship between environmental factors and the risk of childhood leukemia, inspired by geographical variation in incidence rates. Some evidence has emerged for parental occupational exposures to pesticides, whereas there is less evidence for an association with postnatal pesticide exposure. Diagnostic radiation and radon exposure have been suggested but there remains a lack of convincing studies. Extremely low-frequency magnetic fields consistently showed a small increase in risk in numerous studies, but bias and confounding cannot be ruled out as possible explanations. From among factors other than environmental and radiation-related, the most promising candidate is abnormal patterns to common infections, but which children are most at risk and the pathways are not fully understood. In conclusion, although childhood leukemia shows some distinct incidence patterns by sex, age, and geography suggesting a role of the environment in its etiology, no major environmental risk factors including radiation have been established as major contributors to the global childhood leukemia burden. Due to the young age at diagnosis and evidence of chromosomal damage before birth in many of the affected children, parental exposures remain of high interest. Although cure rates of childhood leukemia are high in economically developed countries, because of the adverse late effects of the disease and its treatment, identification of modifiable risk factors for implementing primary prevention remains the ultimate goal. Copyright © 2016 IMSS. Published by Elsevier Inc. All rights reserved.

Spatio-temporal evolution of female lung cancer mortality in a region of Spain, is it worth taking migration into account?

PubMed

Zurriaga, Oscar; Vanaclocha, Hermelinda; Martinez-Beneito, Miguel A; Botella-Rocamora, Paloma

2008-01-31

The Comunitat Valenciana (CV) is a tourist region on the Mediterranean coast of Spain with a high rate of retirement migration. Lung cancer in women is the cancer mortality cause that has increased most in the CV during the period 1991 to 2000. Moreover, the geographical distribution of risk from this cause in the CV has been previously described and a non-homogenous pattern was determined. The present paper studies the spatio-temporal distribution of lung cancer mortality for women in the CV during the period 1987-2004, in order to gain some insight into the factors, such as migration, that have had an influence on these changes. A novel methodology, consisting of a Bayesian hierarchical model, is used in this paper. Such a model allows the handling of data with a very high disaggregation, while at the same time taking advantage of its spatial and temporal structure. The spatio-temporal pattern which was found points to geographical differences in the time trends of risk. In fact, the southern coastal side of the CV has had a higher increase in risk, coinciding with the settlement of a large foreign community in that area, mainly comprised of elderly people from the European Union. Migration has frequently been ignored as a risk factor in the description of the geographical risk of lung cancer and it is suggested that this factor should be considered, especially in tourist regions. The temporal component in disease mapping provides a more accurate depiction of risk factors acting on the population.

Patterns of HIV Risks and Related Factors among People Who Inject Drugs in Kermanshah, Iran: A Latent Class Analysis.

PubMed

Sharifi, Hamid; Mirzazadeh, Ali; Noroozi, Alireza; Marshall, Brandon D L; Farhoudian, Ali; Higgs, Peter; Vameghi, Meroe; Mohhamadi Shahboulaghi, Farahnaz; Qorbani, Mostafa; Massah, Omid; Armoon, Bahram; Noroozi, Mehdi

2017-01-01

The objective of this study was to explore patterns of drug use and sexual risk behaviors among people who inject drugs (PWID) in Iran. We surveyed 500 PWID in Kermanshah concerning demographic characteristics, sexual risk behaviors, and drug-related risk behaviors in the month prior to study. We used latent class analysis (LCA) to establish a baseline model of risk profiles and to identify the optimal number of latent classes, and we used ordinal regression to identify factors associated with class membership. Three classes of multiple HIV risk were identified. The probability of membership in the high-risk class was 0.33, compared to 0.26 and 0.40 for the low- and moderate-risk classes, respectively. Compared to members in the lowest-risk class (reference group), the highest-risk class members had higher odds of being homeless (OR = 4.5, CI: 1.44-8.22; p = 0.001) in the past 12 months. Members of the high-risk class had lower odds of regularly visiting a needle and syringe exchange program as compared to the lowest-risk class members (AOR = 0.42, CI: 0.2-0.81; p = 0.01). Findings show the sexual and drug-related HIV risk clusters among PWID in Iran, and emphasize the importance of developing targeted prevention and harm reduction programs for all domains of risk behaviors, both sexual and drug use related.

Dietary patterns using the Food Guide Pyramid groups are associated with sociodemographic and lifestyle factors: the multiethnic cohort study.

PubMed

Park, Song-Yi; Murphy, Suzanne P; Wilkens, Lynne R; Yamamoto, Jennifer F; Sharma, Sangita; Hankin, Jean H; Henderson, Brian E; Kolonel, Laurence N

2005-04-01

Dietary patterns have been used to identify typical combinations of foods that may be associated with disease risks. We defined dietary patterns among 195,298 participants of the Multiethnic Cohort Study in Hawaii and Los Angeles in 1993-1996. Intakes of Food Guide Pyramid groups were calculated from a quantitative FFQ for subjects of 5 ethnic groups (African Americans, Hawaiians, Japanese Americans, Latinos, and whites). Three distinct dietary patterns, "Fat and Meat," "Vegetables," and "Fruit and Milk," were identified by exploratory factor analysis with a varimax rotation and validated by confirmatory factor analysis. Similar factor loadings were found for each of 10 ethnic-gender groups in stratified analyses. The odds ratios (OR) for being above the median scores for each factor were calculated. Age, gender, and ethnicity had relatively strong associations with dietary patterns whereas education showed only weak associations. BMI > or = 30 was strongly positively associated with the Fat and Meat pattern (OR = 2.14, 95% CI: 2.08-2.20, vs. BMI < 25). Current smokers showed a positive association with the Fat and Meat pattern (OR = 1.67, CI: 1.62-1.72, vs. nonsmokers) and inverse associations with the Vegetables (OR = 0.66, CI: 0.64-0.68) and Fruit and Milk patterns (OR = 0.53, CI: 0.52-0.55). Physical activity was positively associated with the Vegetables and Fruit and Milk patterns but not with the Fat and Meat pattern. These findings support the hypothesis that dietary patterns are influenced by interrelated sociocultural, demographic, and other lifestyle factors and may be useful in investigations of diet-disease relations.

Socioeconomic Status (SES) and Childhood Acute Myeloid Leukemia (AML) Mortality

PubMed Central

Knoble, Naomi B.; Alderfer, Melissa A.; Hossain, Md Jobayer

2016-01-01

Socioeconomic status (SES) is a complex construct of multiple indicators, known to impact cancer outcomes, but has not been adequately examined among pediatric AML patients. This study aimed to identify the patterns of co-occurrence of multiple community-level SES indicators and to explore associations between various patterns of these indicators and pediatric AML mortality risk. A nationally representative US sample of 3,651 pediatric AML patients, aged 0–19 years at diagnosis was drawn from 17 Surveillance, Epidemiology, and End Results (SEER) database registries created between 1973 and 2012. Factor analysis, cluster analysis, stratified univariable and multivariable Cox proportional hazards models were used. Four SES factors accounting for 87% of the variance in SES indicators were identified: F1) economic/educational disadvantage, less immigration; F2) immigration-related features (foreign-born, language-isolation, crowding), less mobility F3) housing instability; and, F4) absence of moving. F1 and F3 showed elevated risk of mortality, adjusted hazards ratios (aHR) (95% CI): 1.07(1.02–1.12) and 1.05(1.00–1.10), respectively. Seven SES-defined cluster groups were identified. Cluster 1: (low economic/educational disadvantage, few immigration-related features, and residential-stability) showed the minimum risk of mortality. Compared to Cluster 1, Cluster 3: (high economic/educational disadvantage, high-mobility) and Cluster 6: (moderately-high economic/educational disadvantages, housing-instability and immigration-related features) exhibited substantially greater risk of mortality, aHR(95% CI) = 1.19(1.0–1.4) and 1.23 (1.1–1.5), respectively. Factors of correlated SES-indicators and their pattern-based groups demonstrated differential risks in the pediatric AML mortality indicating the need of special public-health attention in areas with economic-educational disadvantages, housing-instability and immigration-related features. PMID:27543948

Meal-specific food patterns and the incidence of hyperglycemia in a Chinese adult population.

PubMed

Shi, Zumin; Riley, Malcolm; Taylor, Anne; Noakes, Manny

2017-07-01

This study aimed to examine the association between meal-specific food patterns and incident hyperglycaemia in a Chinese adult population. Adults aged 20 years and older (n 1056) were followed from 2002 to 2007. Dietary data were collected using a 3-d food record and meal-specific (breakfast, lunch and dinner) food patterns were independently described by factor analysis based on the consumption of thirty-five food groups at each eating occasion. Each food pattern score was recoded as quartiles. Hyperglycaemia was defined as fasting plasma glucose >5·6 mmol/l at baseline and follow-up. The associated between food patterns and incident hyperglycaemia was assessed by logistic regression. During the follow-up, 125 new cases of hyperglycaemia were identified. Traditional (wheat) breakfast was inversely associated with incident hyperglycaemia, whereas traditional (rice, vegetable and pork) lunch and dinner were positively associated with the risk of incident hyperglycaemia, even after adjustment for a number of covariates including glycaemic load, carbohydrate intake and BMI. Incident hyperglycaemia occurred in 15·9, 13·6, 11·7, 6·1 % across quartiles of traditional breakfast; and 5·3, 9·1, 15·9, 17·1 % of the quartiles of traditional lunch pattern. The adjusted OR for hyperglycaemia was 0·67 (95 % CI 0·48, 0·92), 1·83 (95 % CI 1·32, 2·53) and 1·39 (95 % CI 1·04, 1·86) for 1 sd increase of traditional breakfast, lunch and dinner pattern factor score, respectively. A traditional wheat-based breakfast is associated with a decreased risk of hyperglycaemia. A rice-based traditional lunch and dinner is associated with an increased risk of hyperglycaemia in Chinese adults.

MYCN controls an alternative RNA splicing program in high-risk metastatic neuroblastoma

PubMed Central

Zhang, Shile; Wei, Jun S.; Li, Samuel Q.; Badgett, Tom C.; Song, Young K.; Agarwal, Saurabh; Coarfa, Cristian; Tolman, Catherine; Hurd, Laura; Liao, Hongling; He, Jianbin; Wen, Xinyu; Liu, Zhihui; Thiele, Carol J.; Westermann, Frank; Asgharzadeh, Shahab; Seeger, Robert C.; Maris, John M.; Auvil, Jamie M Guidry; Smith, Malcolm A; Kolaczyk, Eric D; Shohet, Jason; Khan, Javed

2016-01-01

The molecular mechanisms underlying the aggressive behavior of MYCN driven neuroblastoma (NBL) is under intense investigation; however, little is known about the impact of this family of transcription factors on the splicing program. Here we used high-throughput RNA sequencing to systematically study the expression of RNA isoforms in stage 4 MYCN-amplified NBL, an aggressive subtype of metastatic NBL. We show that MYCN-amplified NBL tumors display a distinct gene splicing pattern affecting multiple cancer hallmark functions. Six splicing factors displayed unique differential expression patterns in MYCN-amplified tumors and cell lines, and the binding motifs for some of these splicing factors are significantly enriched in differentially-spliced genes. Direct binding of MYCN to promoter regions of the splicing factors PTBP1 and HNRNPA1 detected by ChIP-seq demonstrates MYCN controls the splicing pattern by direct regulation of the expression of these key splicing factors. Furthermore, high expression of PTBP1 and HNRNPA1 was significantly associated with poor overall survival of stage4 NBL patients (p≤0.05). Knocking down PTBP1, HNRNPA1 and their downstream target PKM2, an isoform of pro-tumor-growth, result in repressed growth of NBL cells. Therefore, our study reveals a novel role of MYCN in controlling global splicing program through regulation of splicing factors in addition to its well-known role in the transcription program. These findings suggest a therapeutically potential to target the key splicing factors or gene isoforms in high-risk NBL with MYCN-amplification. PMID:26683771

Trajectories of substance use among young American Indian adolescents: patterns and predictors.

PubMed

Whitesell, Nancy Rumbaugh; Asdigian, Nancy L; Kaufman, Carol E; Big Crow, Cecelia; Shangreau, Carly; Keane, Ellen M; Mousseau, Alicia C; Mitchell, Christina M

2014-03-01

Substance use often begins earlier among American Indians compared to the rest of the United States, a troubling reality that puts Native youth at risk for escalating and problematic use. We need to understand more fully patterns of emergent substance use among young American Indian adolescents, risk factors associated with escalating use trajectories, and protective factors that can be parlayed into robust prevention strategies. We used growth mixture modeling with longitudinal data from middle-school students on a Northern Plains reservation (Wave 1 N = 381, M age at baseline = 12.77, 45.6% female) to identify subgroups exhibiting different trajectories of cigarette, alcohol, and marijuana use. We explored how both risk (e.g., exposure to stressful events, deviant peers) and protective (e.g., positive parent-child relationships, cultural identity) factors were related to these trajectories. For all substances, most youth showed trajectories characterized by low rates of substance use (nonuser classes), but many also showed patterns characterized by high and/or escalating use. Across substances, exposure to stress, early puberty, and deviant peer relationships were associated with the more problematic patterns, while strong relationships with parents and prosocial peers were associated with nonuser classes. Our measures of emergent cultural identity were generally unrelated to substance use trajectory classes among these young adolescents. The findings point to the importance of early substance use prevention programs for American Indian youth that attenuate the impact of exposure to stressful events, redirect peer relationships, and foster positive parent influences. They also point to the need to explore more fully how cultural influences can be captured.

Spatial interactions between sympatric carnivores: asymmetric avoidance of an intraguild predator

PubMed Central

Grassel, Shaun M; Rachlow, Janet L; Williams, Christopher J

2015-01-01

Interactions between intraguild species that act as both competitors and predator–prey can be especially complex. We studied patterns of space use by the black-footed ferret (Mustela nigripes), a prairie dog (Cynomys spp.) specialist, and the American badger (Taxidea taxus), a larger generalist carnivore that competes for prairie dogs and is known to kill ferrets. We expected that ferrets would spatially avoid badgers because of the risk of predation, that these patterns of avoidance might differ between sexes and age classes, and that the availability of food and space might influence these relationships. We used location data from 60 ferrets and 15 badgers to model the influence of extrinsic factors (prairie dog density and colony size) and intrinsic factors (sex, age) on patterns of space use by ferrets in relation to space use by different sex and age categories of badgers. We documented asymmetric patterns of avoidance of badgers by ferrets based on the sex of both species. Female ferrets avoided adult female badgers, but not male badgers, and male ferrets exhibited less avoidance than female ferrets. Additionally, avoidance decreased with increasing densities of prairie dogs. We suggest that intersexual differences in space use by badgers create varying distributions of predation risk that are perceived by the smaller carnivore (ferrets) and that females respond more sensitively than males to that risk. This work advances understanding about how competing species coexist and suggests that including information on both intrinsic and extrinsic factors might improve our understanding of behavioral interactions between sympatric species. PMID:26306165

The Influence of Supervisory Neglect on Subtypes of Emerging Adult Substance Use After Controlling for Familial Factors, Relationship Status, and Individual Traits.

PubMed

Snyder, Susan M; Merritt, Darcey H

2015-01-01

This study is the first to explore how child supervisory neglect influences patterns of substance use among young adults. This study investigated patterns of substance use among males and females, 18 to 24 years old, after controlling for adolescent parental drinking, living with parents, relationship status, delinquency, and depression. The study sample (N=10,618) included individuals who participated in Waves I (1994-1995) and III (2001-2002) of the National Longitudinal Study of Adolescent Health (Add Health). The study used latent class analysis to ascertain how patterns of substance use emerged as distinct classes. For both males and females, we identified the following 4 classes of substance use: (1) heavy polysubstance use, (2) moderate polysubstance use, (3) alcohol and marijuana, and (4) low-use substance use patterns. Multinomial logistic regression indicated that, for both males and females 18 to 24 years old, experiencing supervisory neglect, being depressed, being single, and engaging in adolescent delinquency serve as risk factors for heavy polysubstance use class membership. Conversely, being black or Hispanic lowered the likelihood of polysubstance use for males and females. For females only, living with parents served as a protective factor that reduced the risk of membership in heavy polysubstance use, moderate polysubstance use, and alcohol and marijuana classes. For males only, being less educated increased the risk of heavy polysubstance use class membership. Results from this exploratory study underscore the enduring effect of supervisory neglect on substance use among male and female young adults. Future studies should explore whether these relationships hold over time.

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

Sanquist, Thomas F.; Mahy, Heidi A.; Morris, Fred A.

Understanding the issues surrounding public acceptance of homeland security systems is important for balancing security needs and potential civil liberties infringements. A psychometric survey was used to measure attitudes regarding homeland security systems. Psychometric rating data were obtained from 182 respondents on psychological attributes associated with 12 distinct types of homeland security systems. An inverse relationship was observed for the overall rating attributes of acceptability and risk of civil liberties infringement. Principal components analysis yielded a two factor solution, with the rating scale loading pattern suggesting factors of Perceived Effectiveness and Perceived Intrusiveness. These factors also showed an inverse relationship.more » The 12 different homeland security systems showed significantly different scores on the rating scales and PCA factors, which were used to rank the systems in terms of overall acceptability. Difference scores for the rating scales and PCA factors were used to compute a single acceptability value reflecting the relative weight of risks and benefits. Of the 12 systems studied, airport screening, canine detectors and radiation monitoring at borders were found to be relatively acceptable, i.e., the perceived benefits for homeland security outweighed the perceived risks to civil liberties. Students rated several systems as more effective than professionals, but the overall pattern of results for both types of subjects was similar. The data suggest that risk perception research and the psychometric paradigm are useful approaches for quantifying attitudes regarding homeland security systems and policies, and can be used to anticipate potentially significant public acceptance issues.« less

[Cancer and its association with dietary patterns in Córdoba (Argentina)].

PubMed

Pou, Sonia Alejandra; Niclis, Camila; Aballay, Laura Rosana; Tumas, Natalia; Román, María Dolores; Muñoz, Sonia Edith; Coquet, Julia Becaria; Díaz, María del Pilar

2014-03-01

Feeding habits play a prominent role in carcinogenesis. The dietary patterns approach applied to the study of chronic diseases is of increasing interest in nutritional epidemiology. Nevertheless, it has been seldom used in Latin America. To identify dietary patterns in adult population in Córdoba (Argentina) and to estimate their effects on the risk of colon-rectal (CRC), urothelial (UC), breast (BC) and prostate (PC) cancers. Four case control studies were conducted, 2006-2012 for CRC, PC, BC and UC. To identify the dietary patterns, a Principal Components Factor Analysis was conducted. A multilevel logistic regression was adjusted for the risk analyses. Characteristic dietary patterns in the whole population, and in women and men independently, were identified. In the whole population South Cone and Sweet Beverages patterns behaved as promoters for CRC and UC while the Prudent Pattern had a protective effect. Female South Cone, Rural and Starchy patterns were associated to a higher BC risk. Prudent Pattern lowered BC risk. In men, South Cone, Sweet Beverages and Typical Measured patterns promoted PC. It is necessary to promote a regular intake of vegetables, fruits and diary products (although a moderate intake for men), and to reduce red meat (especially fat meat), processed meat, starchy vegetables, wine and sweet beverages intakes, to prevent the occurrence of cancer. In men, it is recommended a moderate intake of egg. In women, it is advised a moderate intake of refined grains, bakery products, oils and mayonnaise intake. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Are adverse drug reaction patterns different between romiplostim and eltrombopag? 2009-2013 French PharmacoVigilance assessment.

PubMed

Moulis, Guillaume; Bagheri, Haleh; Sailler, Laurent; Jonville-Bera, Annie-Pierre; Weber, Emmanuelle; Guy, Claire; Petitpain, Nadine; Laroche, Marie-Laure; Favrelière, Sylvie; Béné, Johana; Baldin, Bernadette; Villeval-Federici, Laure; Tebacher-Alt, Martine; Bres, Virginie; Veyrac, Gwenaëlle; Grandvuillemin, Aurélie; Mauprivez, Cédric; Lapeyre-Mestre, Maryse; Montastruc, Jean-Louis

2014-10-01

Romiplostim and eltrombopag, the two marketed thrombopoietin receptor agonists (TPO-RAs), have distinct binding sites and might have distinct pharmacodynamic mechanisms. The aim of this study was to compare their adverse drug reaction (ADR) patterns. We selected in the French PharmacoVigilance Database all ADRs associated with TPO-RAs from TPO-RA marketing until the 31st of December 2013. Medical charts were reviewed. We conducted disproportionality analyses comparing romiplostim exposure in the reports of a given ADR pattern (thrombosis, neurological, cutaneous, gastrointestinal or hematological) to romiplostim exposure in all other TPO-RA-related ADR reports. Reporting Odds Ratios (RORs) were adjusted for age and gender. We also compared the number of reports of a given ADR pattern per million daily defined doses (DDDs) dispensed in France during the study period. We described 45 reports (53 ADRs) with romiplostim and 26 reports (37 ADRs) with eltrombopag. There were 19 venous thromboses. At least one other risk factor was present in 83.3% of the cases. Ten (55.6%) patients had been splenectomized previously. There were eight arterial thromboses. Another risk factor was noticed in all cases. There was no signal for an excess risk of thrombosis with romiplostim versus eltrombopag (ROR: 1.45, 95% CI [0.48-4.45]). There was a signal for a higher risk of gastrointestinal ADRs with eltrombopag (ROR: 30.28, 95% CI [3.23-383.86]) and of hematological ADRs with romiplostim (ROR: 14.36, 95% CI [1.73-119.08]). Dispensing data-adjusted comparisons led to similar results. This study suggests different ADR patterns between romiplostim and eltrombopag. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Previously identified patellar tendinopathy risk factors differ between elite and sub-elite volleyball players.

PubMed

Janssen, I; Steele, J R; Munro, B J; Brown, N A T

2015-06-01

Patellar tendinopathy is the most common knee injury incurred in volleyball, with its prevalence in elite athletes more than three times that of their sub-elite counterparts. The purpose of this study was to determine whether patellar tendinopathy risk factors differed between elite and sub-elite male volleyball players. Nine elite and nine sub-elite male volleyball players performed a lateral stop-jump block movement. Maximum vertical jump, training history, muscle extensibility and strength, three-dimensional landing kinematics (250 Hz), along with lower limb neuromuscular activation patterns (1500 Hz), and patellar tendon loading were collected during each trial. Multivariate analyses of variance (P < 0.05) assessed for between-group differences in risk factors or patellar tendon loading. Significant interaction effects were further evaluated using post-hoc univariate analysis of variance tests. Landing kinematics, neuromuscular activation patterns, patellar tendon loading, and most of the previously identified risk factors did not differ between the elite and sub-elite players. However, elite players participated in a higher training volume and had less quadriceps extensibility than sub-elite players. Therefore, high training volume is likely the primary contributor to the injury discrepancy between elite and sub-elite volleyball players. Interventions designed to reduce landing frequency and improve quadriceps extensibility are recommended to reduce patellar tendinopathy prevalence in volleyball players. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Developmental Trajectories of Aggression from Late Childhood through Adolescence: Similarities and Differences across Gender

PubMed Central

Xie, Hongling; Drabick, Deborah A. G.; Chen, Diane

2015-01-01

Although numerous investigations of overt aggressive and antisocial trajectories have been undertaken, there is a dearth of literature examining gender differences and similarities in trajectory patterns and their correlates. To address these gaps, we investigated gender differences in the prevalence rates, predictive validity during transition to adulthood, childhood risk factors, and adolescent correlates of different trajectories of teacher-reported overt aggression (i.e., fights, argues, gets in trouble) among 220 participants (116 girls and 104 boys) evaluated annually from grade 4 to grade 12. Four patterns of trajectories were identified: low, increasing (i.e., adolescent-onset), decreasing (i.e., childhood-limited), and high (i.e., childhood-onset). majority large proportion of youth, particularly girls, displayed low levels of aggression over time. A small proportion followed the childhood-onset trajectory. Across gender, the childhood-onset trajectory was associated with the highest rates of maladjustment during the transition to adulthood, the highest number of childhood risk factors, and multiple problems during adolescence. The adolescent-onset trajectory was associated with few childhood risk factors, but with high levels of independent status during adolescence. In contrast, the childhood-limited trajectory was associated with several childhood risk factors, but high levels of parental monitoring and school engagement during adolescence. Romantic involvement differentiated the adolescent-onset and childhood-limited trajectories among girls. PMID:21748751

Developmental trajectories of aggression from late childhood through adolescence: similarities and differences across gender.

PubMed

Xie, Hongling; Drabick, Deborah A G; Chen, Diane

2011-01-01

Although numerous investigations of overt aggressive and antisocial trajectories have been undertaken, there is a dearth of literature examining gender differences and similarities in trajectory patterns and their correlates. To address these gaps, we investigated gender differences in the prevalence rates, predictive validity during transition to adulthood, childhood risk factors, and adolescent correlates of different trajectories of teacher-reported overt aggression (i.e., fights, argues, gets in trouble) among 220 participants (116 girls and 104 boys) evaluated annually from grade 4 to grade 12. Four patterns of trajectories were identified: low, increasing (i.e., adolescent-onset), decreasing (i.e., childhood-limited), and high (i.e., childhood-onset). A large proportion of youth, particularly girls, displayed low levels of aggression over time. A small proportion followed the childhood-onset trajectory. Across gender, the childhood-onset trajectory was associated with the highest rates of maladjustment during the transition to adulthood, the highest number of childhood risk factors, and multiple problems during adolescence. The adolescent-onset trajectory was associated with few childhood risk factors, but with high levels of independent status during adolescence. In contrast, the childhood-limited trajectory was associated with several childhood risk factors, but high levels of parental monitoring and school engagement during adolescence. Romantic involvement differentiated the adolescent-onset and childhood-limited trajectories among girls. © 2011 Wiley-Liss, Inc.

Maternal Dietary Patterns and Gestational Diabetes Risk: A Case-Control Study.

PubMed

Sedaghat, Fatemeh; Akhoondan, Mahdieh; Ehteshami, Mehdi; Aghamohammadi, Vahideh; Ghanei, Nila; Mirmiran, Parvin; Rashidkhani, Bahram

2017-01-01

Maternal dietary patterns play an important role in the progress of gestational diabetes mellitus (GDM). The aim of the present study was to explore this association. A total of 388 pregnant women (122 case and 266 control) were included. Dietary intake were collected using a food frequency questionnaire (FFQ). GDM was diagnosed using a 100-gram, 3-hour oral glucose tolerance test. Dietary pattern was identified by factor analysis. To investigate the relation between each of the independent variables with gestational diabetes, the odds ratio (OR) was calculated. Western dietary pattern was high in sweets, jams, mayonnaise, soft drinks, salty snacks, solid fat, high-fat dairy products, potatoes, organ meat, eggs, red meat, processed foods, tea, and coffee. The prudent dietary pattern was characterized by higher intake of liquid oils, legumes, nuts and seeds, fruits and dried fruits, fish and poultry whole, and refined grains. Western dietary pattern was associated with increased risk of gestational diabetes mellitus before and after adjustment for confounders (OR = 1.97, 95% CI: 1.27-3.04, OR = 1.68, 95% CI: 1.04-2.27). However, no significant association was found for a prudent pattern. These findings suggest that the Western dietary pattern was associated with an increased risk of GDM.

Education-based disparities in knowledge of novel health risks: The case of knowledge gaps in HIV risk perceptions.

PubMed

Kiviniemi, Marc T; Orom, Heather; Waters, Erika A; McKillip, Megan; Hay, Jennifer L

2018-05-01

Risk perception is a key determinant of preventive health behaviour, but when asked, some individuals indicate they do not know their health risk. Low education is associated with both lack of knowledge about health risk and with the persistence and exacerbation of gaps in knowledge about health issues. This study uses the context of an emerging infectious disease threat to explore the hypothesis that the education-don't know risk relation results from differences in knowledge about the health issue of interest. Specifically, we examine whether patterns of change over time follow theoretical predictions that disparities in risk knowledge would increase over time in less educated sectors of the population (knowledge gap hypothesis). Secondary analysis of population-representative behavioural surveillance survey. We analysed data from the 1993 to 2000 Behavior Risk Factor Surveillance System surveys, which measured education and perceived HIV/AIDS risk in a population sample collected separately in each survey year; don't know responses were coded. In each year, individuals with higher education were less likely to respond don't know. The absolute prevalence of don't know responding dropped over time; nonetheless, there was an increase over time in the magnitude of the pattern of lower education being associated with greater don't know responding. We found support for the knowledge gap hypothesis. Over time, populations with greater education gained more knowledge about their HIV risk than populations with lower education. Results highlight the need to carefully consider health communication strategies to reach and address those individuals with low education and health knowledge. Statement of contribution What is already known on this subject? A meaningful potion of the population answers 'don't know' when asked to report their risk for health problems, indicating a lack of risk perception in the domain. Previous studies have shown that level of education is associated with don't know responding - those with lower educational attainment are more likely to respond don't know. The education-don't know responding relation suggests that lack of health information and health domain knowledge might be a factor in lacking risk perception, but this mechanism has not been previously tested. What does this study add? Patterns of changes in don't know responding over time as population-level knowledge of a health risk increase are consistent with the health information/health knowledge hypothesis outlined above. As population knowledge of HIV/AIDS risk in the United States increased over time (indicated by declining overall rates of don't know responses), the relation of education level to don't know responding actually became stronger. The pattern of change over time is the classic 'knowledge gap hypothesis' pattern, which has not been previously demonstrated for knowledge of personal health risk. The knowledge gap response pattern supports the health information/health knowledge hypothesis. © 2018 The British Psychological Society.

Long-term dietary patterns and carotid artery intima media thickness: the Cardiovascular Risk in Young Finns Study.

PubMed

Mikkilä, Vera; Räsänen, Leena; Laaksonen, Marika M L; Juonala, Markus; Viikari, Jorma; Pietinen, Pirjo; Raitakari, Olli T

2009-11-01

A whole-diet approach has proven useful for characterising dietary exposure in cardiovascular epidemiology research. In our previous analyses, we found dietary patterns to be significant determinants of CVD risk factor levels among the Cardiovascular Risk in Young Finns cohort. We investigated the associations of major dietary patterns with carotid intima media thickness (IMT), a subclinical predictor of CVD, in healthy adults. The Young Finns Study is an ongoing, prospective cohort study with a 21-year follow-up to date. The subjects were children and adolescents at baseline in 1980 (aged 3-18 years), and all had reached adulthood by the latest follow-up in 2001 (aged 24-39 years). Complete dietary data from the years 1980, 1986 and 2001 and outcome data from the year 2001 were obtained from 785 subjects. The long-term average pattern score for a traditional dietary pattern (characterised by high consumption of rye, potatoes, butter, sausages, milk and coffee) was associated with IMT especially among subjects with a low score for the health-conscious dietary pattern (characterised by high consumption of vegetables, legumes and nuts, rye, tea, cheese and other dairy products). In multivariable regression analyses using long-term pattern scores as predictors, the traditional dietary pattern was independently associated with IMT in men (P < 0.01), but not in women (P = 0.66). Long-term adherence to traditional food choices seems to increase the risk of developing subclinical atherosclerosis among Finnish men.

Temporally varying relative risks for infectious diseases: implications for infectious disease control

PubMed Central

Goldstein, Edward; Pitzer, Virginia E.; O'Hagan, Justin J.; Lipsitch, Marc

2016-01-01

Risks for disease in some population groups relative to others (relative risks) are usually considered to be consistent over time, though they are often modified by other, non-temporal factors. For infectious diseases, in which overall incidence often varies substantially over time, the patterns of temporal changes in relative risks can inform our understanding of basic epidemiologic questions. For example, recent work suggests that temporal changes in relative risks of infection over the course of an epidemic cycle can both be used to identify population groups that drive infectious disease outbreaks, and help elucidate differences in the effect of vaccination against infection (that is relevant to transmission control) compared with its effect against disease episodes (that reflects individual protection). Patterns of change in the in age groups affected over the course of seasonal outbreaks can provide clues to the types of pathogens that could be responsible for diseases for which an infectious cause is suspected. Changing apparent efficacy of vaccines during trials may provide clues to the vaccine's mode of action and/or indicate risk heterogeneity in the trial population. Declining importance of unusual behavioral risk factors may be a signal of increased local transmission of an infection. We review these developments and the related public health implications. PMID:27748685

Temporally Varying Relative Risks for Infectious Diseases: Implications for Infectious Disease Control.

PubMed

Goldstein, Edward; Pitzer, Virginia E; O'Hagan, Justin J; Lipsitch, Marc

2017-01-01

Risks for disease in some population groups relative to others (relative risks) are usually considered to be consistent over time, although they are often modified by other, nontemporal factors. For infectious diseases, in which overall incidence often varies substantially over time, the patterns of temporal changes in relative risks can inform our understanding of basic epidemiologic questions. For example, recent studies suggest that temporal changes in relative risks of infection over the course of an epidemic cycle can both be used to identify population groups that drive infectious disease outbreaks, and help elucidate differences in the effect of vaccination against infection (that is relevant to transmission control) compared with its effect against disease episodes (that reflects individual protection). Patterns of change in the age groups affected over the course of seasonal outbreaks can provide clues to the types of pathogens that could be responsible for diseases for which an infectious cause is suspected. Changing apparent efficacy of vaccines during trials may provide clues to the vaccine's mode of action and/or indicate risk heterogeneity in the trial population. Declining importance of unusual behavioral risk factors may be a signal of increased local transmission of an infection. We review these developments and the related public health implications.

Quantifying risk of death and disability associated with raised blood pressure.

PubMed

Elliott, P; Nichols, R; Chee, D

1999-01-01

Raised blood pressure is one of the most important underlying risk factors for morbidity and mortality in the world today, ranking alongside tobacco in estimates of the worldwide attributable burden of mortality. It is a major risk factor for coronary heart disease and the major risk factor for stroke. Taken together, the cardiovascular diseases are estimated to account for some 28% of all deaths in the world. Already many more of such deaths are occurring in the developing than the developed world, and this burden of disease is set to worsen as a result of demographic changes in the poorer countries, together with adoption of Western lifestyle. The development of unfavourable blood pressure patterns in populations is a key factor underlying this worldwide epidemic. Both primary prevention (for example through improved diet) and secondary prevention (through drug treatment and non-pharmacologic approaches) are needed.

Inherited and Environmental Influences on a Childhood Co-Occurring Symptom Phenotype: Evidence From an Adoption Study

PubMed Central

Roos, Leslie E.; Fisher, Philip A.; Shaw, Daniel S.; Kim, Hyoun K.; Neiderhiser, Jenae M.; Reiss, David; Natsuaki, Misaki N.; Leve, Leslie D.

2015-01-01

Risk factors for the childhood development of co-occurring internalizing and externalizing symptoms are not well understood, despite a high prevalence and poor clinical outcomes associated with this co-occurring phenotype. We examined inherited and environmental risk factors for co-occurring symptoms in a sample of children adopted at birth and their birth mothers and adoptive mothers (N = 293). Inherited risk factors (i.e., birth mothers’ processing speed and internalizing symptoms) and environmental risk factors (i.e., adoptive mothers’ processing speed, internalizing symptoms, and uninvolved parenting) were examined as predictors for the development of internalizing-only, externalizing-only, or co-occurring symptoms using structural equation modeling. Results suggested a unique pattern of predictive factors for the co-occurring phenotype, with risk conferred by adoptive mothers’ uninvolved parenting, birth mothers’ slower processing speed, and the birth mothers’ slower processing speed in tandem with adoptive mothers’ higher internalizing symptoms. Additional analyses indicated that when co-occurring-symptom children were incorporated into internalizing and externalizing symptom groups, differential risk factors for externalizing and internalizing symptoms emerged. The findings suggest that spurious results may be found when children with co-occurring symptoms are not examined as a unique phenotypic group. PMID:25851306

Inherited and environmental influences on a childhood co-occurring symptom phenotype: Evidence from an adoption study.

PubMed

Roos, Leslie E; Fisher, Philip A; Shaw, Daniel S; Kim, Hyoun K; Neiderhiser, Jenae M; Reiss, David; Natsuaki, Misake N; Leve, Leslie D

2016-02-01

Risk factors for the childhood development of co-occurring internalizing and externalizing symptoms are not well understood, despite a high prevalence and poor clinical outcomes associated with this co-occurring phenotype. We examined inherited and environmental risk factors for co-occurring symptoms in a sample of children adopted at birth and their birth mothers and adoptive mothers (N = 293). Inherited risk factors (i.e., birth mothers' processing speed and internalizing symptoms) and environmental risk factors (i.e., adoptive mothers' processing speed, internalizing symptoms, and uninvolved parenting) were examined as predictors for the development of internalizing-only, externalizing-only, or co-occurring symptoms using structural equation modeling. Results suggested a unique pattern of predictive factors for the co-occurring phenotype, with risk conferred by adoptive mothers' uninvolved parenting, birth mothers' slower processing speed, and the birth mothers' slower processing speed in tandem with adoptive mothers' higher internalizing symptoms. Additional analyses indicated that when co-occurring-symptom children were incorporated into internalizing and externalizing symptom groups, differential risk factors for externalizing and internalizing symptoms emerged. The findings suggest that spurious results may be found when children with co-occurring symptoms are not examined as a unique phenotypic group.

Is physical activity maintenance from adolescence to young adulthood associated with reduced CVD risk factors, improved mental health and satisfaction with life: the HUNT Study, Norway

PubMed Central

2012-01-01

Background Little is known about the effect maintaining physical activity throughout adolescence has on cardiovascular risk factors and health status in early adulthood. This ten-year prospective longitudinal study investigated whether differences in physical activity patterns from adolescence to young-adulthood showed different associations with subsequent cardio-metabolic risk factors and mental health in young-adulthood. Methods Based on the second and third Norwegian Nord-Trøndelag Health Surveys (HUNT2 and 3), we included 1869 individuals (838 males) participating in Young-HUNT (1995–97), aged 13–19 years and followed-up at HUNT3 (2006–08), aged 23–31. Self-reported physical activity (PA), mental health and perceived health were recorded, along with measurements of body mass index (BMI), waist circumference (WC), total cholesterol (TC), HDL cholesterol, glucose, triglycerides, resting heart rate (HR) and blood pressure. We used separate linear regressions models to investigate associations between physical activity and each CVD risk factor, and logistic regression analysis to examine PA patterns and subsequent mental health. Physically active maintainers were compared to inactive maintainers. Adopters (inactive as adolescents and physically active as young adults) were compared to inactive maintainers and to those who discontinued activity (relapsers). Results Active maintainers had significantly lower HR, compared to all other PA patterns. Active maintaining men had significantly lower WC than relapsers and inactive maintainers. When adjusted for age and gender, WC, BMI, HR, diastolic blood pressure and HDL-C showed significant differences comparing active maintaining to other PA patterns. Comparing inactive maintainers against adopters, only HR was significantly lower. Male adopters did not differ significantly in CVD risk compared to inactive maintainers and relapsers. Among females adopting was associated with lower HR and TC compared to inactive maintainers. Active maintainers showed better mental health than inactive maintainers. Active maintaining males had an increased likelihood of good mental health compared to adopters. Active maintaining females reported greater satisfaction with life compared to adopters. Conclusions Those who maintained their physical activity from adolescence to young adulthood demonstrated a significantly lower CVD risk and better mental health, compared to inactive maintainers. Compared to inactivity maintainers and relapsers, adopting physical activity was not significantly associated with lowered CVD risk. Adopting physical activity between adolescence and young adulthood may not necessarily protect against mental distress. PMID:23241306

Geographic risk modeling of childhood cancer relative to county-level crops, hazardous air pollutants and population density characteristics in Texas.

PubMed

Thompson, James A; Carozza, Susan E; Zhu, Li

2008-09-25

Childhood cancer has been linked to a variety of environmental factors, including agricultural activities, industrial pollutants and population mixing, but etiologic studies have often been inconclusive or inconsistent when considering specific cancer types. More specific exposure assessments are needed. It would be helpful to optimize future studies to incorporate knowledge of high-risk locations or geographic risk patterns. The objective of this study was to evaluate potential geographic risk patterns in Texas accounting for the possibility that multiple cancers may have similar geographic risks patterns. A spatio-temporal risk modeling approach was used, whereby 19 childhood cancer types were modeled as potentially correlated within county-years. The standard morbidity ratios were modeled as functions of intensive crop production, intensive release of hazardous air pollutants, population density, and rapid population growth. There was supportive evidence for elevated risks for germ cell tumors and "other" gliomas in areas of intense cropping and for hepatic tumors in areas of intense release of hazardous air pollutants. The risk for Hodgkin lymphoma appeared to be reduced in areas of rapidly growing population. Elevated spatial risks included four cancer histotypes, "other" leukemias, Central Nervous System (CNS) embryonal tumors, CNS other gliomas and hepatic tumors with greater than 95% likelihood of elevated risks in at least one county. The Bayesian implementation of the Multivariate Conditional Autoregressive model provided a flexible approach to the spatial modeling of multiple childhood cancer histotypes. The current study identified geographic factors supporting more focused studies of germ cell tumors and "other" gliomas in areas of intense cropping, hepatic cancer near Hazardous Air Pollutant (HAP) release facilities and specific locations with increased risks for CNS embryonal tumors and for "other" leukemias. Further study should be performed to evaluate potentially lower risk for Hodgkin lymphoma and malignant bone tumors in counties with rapidly growing population.

Impact of Real-world Factors Influencing Investment Decisions on the Costs and Distribution of Climate Change Mitigation

NASA Astrophysics Data System (ADS)

Edmonds, J.; Iyer, G.; McJeon, H. C.; Leon, C.; Hultman, N.

2015-12-01

Strategies to mitigate dangerous anthropogenic climate change require a dramatic transformation of the energy system to reduce greenhouse gas emissions, that in turn requires large-scale investments. Investment decisions depend not only on investment capital availability but also on investment risks. A number of factors such as national policy environments, quality of public and private institutions, sector, firm and technology specific characteristics can affect investors' assessments of risks, leading to a wide variation in the business climate for investment. Such heterogeneity in investment risks can have important implications, as investors usually respond to risks by requiring higher returns for riskier projects; delaying or forgoing the investments; or preferring to invest in existing, familiar projects. We study the impact of variation in investment risks on regional patterns of emissions mitigation, the cost of emissions mitigation and patterns of technology deployment. We modify an integrated assessment model, widely used in global climate policy analyses (the Global Change Assessment Model) and incorporate decisions on investments based on risks along two dimensions. Along the first dimension, we vary perceived risks associated with particular technologies. To do so, we assign a higher cost of capital for investment in low-carbon technologies as these involve intrinsically higher levels of regulatory and market risk. The second dimension uses a proxy to vary investment risks across regions, based on an institutional quality metric published by the World Economic Forum. Explicit representation of investment risks has two major effects. First, it raises the cost of emissions mitigation relative to a world with uniform investment risks. Second, it shifts the pattern of emissions mitigation, with industrialized countries mitigating more, and developing countries mitigating less. Our results suggest that institutional reforms aimed at lowering investment risks could be an important element in lowering the cost of climate change mitigation solutions.

The low-carbohydrate diet and cardiovascular risk factors: Evidence from epidemiologic studies

PubMed Central

Hu, T.; Bazzano, L. A.

2015-01-01

Aims Obesity is an important public health issue because of its high prevalence and concomitant increase in risk of cardiovascular diseases. Low carbohydrate diets are popular for weight loss and weight management but are not recommended in leading guidelines due to the perception that increases in dietary fat intake may lead to an adverse cardiovascular risk profile. To clarify the effects of a low-carbohydrate diet for weight loss on cardiovascular disease risk factors as compared to a low fat diet for weight loss, we systematically reviewed data from randomized controlled clinical trials and large observational studies. Data synthesis We searched the MEDLINE database (Jan 1966–Nov 2013) to identify studies that examined a low-carbohydrate diet as compared to a low-fat diet for weight loss or the improvement of cardiovascular disease risk factors. Conclusions Recent randomized controlled trials document that low-carbohydrate diets not only decrease body weight but also improve cardiovascular risk factors. In light of this evidence from randomized controlled trials, dietary guidelines should be re-visited advocating a healthy low carbohydrate dietary pattern as an alternative dietary strategy for the prevention of obesity and cardiovascular disease risk factors. PMID:24613757

Dietary patterns: biomarkers and chronic disease risk.

PubMed

Kant, Ashima K

2010-04-01

With increasing appreciation of the complexity of diets consumed by free-living individuals, there is interest in the assessment of the overall diet or dietary patterns in which multiple related dietary characteristics are considered as a single exposure. The 2 most frequently used methods to derive dietary patterns use (i) scores or indexes based on prevailing hypotheses about the role of dietary factors in disease prevention; and (ii) factors and clusters from exploration of available dietary data. A third method, a hybrid of the hypothesis-driven and data-driven methods, attempts to predict food combinations related to nutrients or biomarkers with hypothesized associations with particular health outcomes. Dietary patterns derived from the first 2 approaches have been examined in relation to nutritional and disease biomarkers and various health outcomes, and generally show the desirable dietary pattern to be consistent with prevalent beliefs about what constitutes a healthful diet. Results from observational studies suggest that the healthful dietary patterns were associated with significant but modest risk reduction (15%-30%) for all-cause mortality and coronary heart disease. Findings for various cancers have been inconsistent. The available randomized controlled intervention trials with a long-term follow-up to examine dietary patterns in relation to health outcome have generally produced null findings. Novel findings with the potential to change existing beliefs about diet and health relationships are yet to emerge from the dietary patterns research. The field requires innovation in methods to derive dietary patterns, validation of prevalent methods, and assessment of the effect of dietary measurement error on dietary patterns.

Clustering of modifiable biobehavioral risk factors for chronic disease in US adults: a latent class analysis.

PubMed

Leventhal, Adam M; Huh, Jimi; Dunton, Genevieve F

2014-11-01

Examining the co-occurrence patterns of modifiable biobehavioral risk factors for deadly chronic diseases (e.g. cancer, cardiovascular disease, diabetes) can elucidate the etiology of risk factors and guide disease-prevention programming. The aims of this study were to (1) identify latent classes based on the clustering of five key biobehavioral risk factors among US adults who reported at least one risk factor and (2) explore the demographic correlates of the identified latent classes. Participants were respondents of the National Epidemiologic Survey of Alcohol and Related Conditions (2004-2005) with at least one of the following disease risk factors in the past year (N = 22,789), which were also the latent class indicators: (1) alcohol abuse/dependence, (2) drug abuse/dependence, (3) nicotine dependence, (4) obesity, and (5) physical inactivity. Housing sample units were selected to match the US National Census in location and demographic characteristics, with young adults oversampled. Participants were administered surveys by trained interviewers. Five latent classes were yielded: 'obese, active non-substance abusers' (23%); 'nicotine-dependent, active, and non-obese' (19%); 'active, non-obese alcohol abusers' (6%); 'inactive, non-substance abusers' (50%); and 'active, polysubstance abusers' (3.7%). Four classes were characterized by a 100% likelihood of having one risk factor coupled with a low or moderate likelihood of having the other four risk factors. The five classes exhibited unique demographic profiles. Risk factors may cluster together in a non-monotonic fashion, with the majority of the at-risk population of US adults expected to have a high likelihood of endorsing only one of these five risk factors. © Royal Society for Public Health 2013.

Environmental factors influencing the risk of autism

PubMed Central

Karimi, Padideh; Kamali, Elahe; Mousavi, Seyyed Mohammad; Karahmadi, Mojgan

2017-01-01

Autism is a developmental disability with age of onset in childhood (under 3 years old), which is characterized by definite impairments in social interactions, abnormalities in speech, and stereotyped pattern of behaviors. Due to the progress of autism in recent decades, a wide range of studies have been done to identify the etiological factors of autism. It has been found that genetic and environmental factors are both involved in autism pathogenesis. Hence, in this review article, a set of environmental factors involved in the occurrence of autism has been collected, and finally, some practical recommendations for reduction of the risk of this devastating disease in children are represented. PMID:28413424

Discounting the value of safety: effects of perceived risk and effort.

PubMed

Sigurdsson, Sigurdur O; Taylor, Matthew A; Wirth, Oliver

2013-09-01

Although falls from heights remain the most prevalent cause of fatalities in the construction industry, factors impacting safety-related choices associated with work at heights are not completely understood. Better tools are needed to identify and study the factors influencing safety-related choices and decision making. Using a computer-based task within a behavioral economics paradigm, college students were presented a choice between two hypothetical scenarios that differed in working height and effort associated with retrieving and donning a safety harness. Participants were instructed to choose the scenario in which they were more likely to wear the safety harness. Based on choice patterns, switch points were identified, indicating when the perceived risk in both scenarios was equivalent. Switch points were a systematic function of working height and effort, and the quantified relation between perceived risk and effort was described well by a hyperbolic equation. Choice patterns revealed that the perceived risk of working at heights decreased as the effort to retrieve and don a safety harness increased. Results contribute to the development of computer-based procedure for assessing risk discounting within a behavioral economics framework. Such a procedure can be used as a research tool to study factors that influence safety-related decision making with a goal of informing more effective prevention and intervention strategies. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

Using a Pattern-Centered Approach to Assess Sexual Risk-Taking in Study Abroad Students

ERIC Educational Resources Information Center

Marcantonio, Tiffany; Angelone, D. J.; Sledjeski, Eve

2016-01-01

Objectives: The purpose of this study was to examine the impact of several potential factors related to sexually risky behaviors in study abroad students. The authors utilized a pattern-centered analysis to identify specific groups that can be targeted for intervention. Participants: The sample consisted of 173 students who studied abroad in a…

Evaluating Preterm Infants with the Bayley-III: Patterns and Correlates of Development

ERIC Educational Resources Information Center

Greene, Michelle M.; Patra, Kousiki; Nelson, Michael N.; Silvestri, Jean M.

2012-01-01

This study investigates the Third Edition of the Bayley Scales of Infant and Toddler Development (Bayley-III) and: (1) early patterns of neurodevelopmental performance among preterm infants 8-12 months of age; and (2) correlations between known risk factors and neurodevelopmental outcome of preterm infants in this cohort. Mean Language Index (LI;…

Aging: Characteristics, Exposure Factors, Epigenetics, and Assessment of Health Risks of Older Adults

EPA Science Inventory

This chapter is organized into three sections. The first part describes the characteristics of the older adult population and the U.S. EPA’s efforts to protect elders form environmental hazards. Section II covers available exposure factor data, activity pattern and the pot...

Socio-economic position and type 2 diabetes risk factors: patterns in UK children of South Asian, black African-Caribbean and white European origin.

PubMed

Thomas, Claudia; Nightingale, Claire M; Donin, Angela S; Rudnicka, Alicja R; Owen, Christopher G; Sattar, Naveed; Cook, Derek G; Whincup, Peter H

2012-01-01

Socio-economic position (SEP) and ethnicity influence type 2 diabetes mellitus (T2DM) risk in adults. However, the influence of SEP on emerging T2DM risks in different ethnic groups and the contribution of SEP to ethnic differences in T2DM risk in young people have been little studied. We examined the relationships between SEP and T2DM risk factors in UK children of South Asian, black African-Caribbean and white European origin, using the official UK National Statistics Socio-economic Classification (NS-SEC) and assessed the extent to which NS-SEC explained ethnic differences in T2DM risk factors. Cross-sectional school-based study of 4,804 UK children aged 9-10 years, including anthropometry and fasting blood analytes (response rates 70%, 68% and 58% for schools, individuals and blood measurements). Assessment of SEP was based on parental occupation defined using NS-SEC and ethnicity on parental self-report. Associations between NS-SEC and adiposity, insulin resistance (IR) and triglyceride differed between ethnic groups. In white Europeans, lower NS-SEC status was related to higher ponderal index (PI), fat mass index, IR and triglyceride (increases per NS-SEC decrement [95%CI] were 1.71% [0.75, 2.68], 4.32% [1.24, 7.48], 5.69% [2.01, 9.51] and 3.17% [0.96, 5.42], respectively). In black African-Caribbeans, lower NS-SEC was associated with lower PI (-1.12%; [-2.01, -0.21]), IR and triglyceride, while in South Asians there were no consistent associations between NS-SEC and T2DM risk factors. Adjustment for NS-SEC did not appear to explain ethnic differences in T2DM risk factors, which were particularly marked in high NS-SEC groups. SEP is associated with T2DM risk factors in children but patterns of association differ by ethnic groups. Consequently, ethnic differences (which tend to be largest in affluent socio-economic groups) are not explained by NS-SEC. This suggests that strategies aimed at reducing social inequalities in T2DM risk are unlikely to reduce emerging ethnic differences in T2DM risk.

Tooth loss patterns in older adults with special needs: a Minnesota cohort

PubMed Central

Chen, Xi; Clark, Jennifer J

2011-01-01

This study was conducted to detail tooth loss patterns in older adults with special needs. A total of 491 elderly subjects with special needs were retrospectively selected and followed during 10/1999-12/2006. Medical, dental, cognitive, and functional assessments were abstracted from dental records and used to predict risk of tooth loss. Tooth loss events were recorded for subjects during follow-up. Chi-squared tests were used to study the association between tooth loss and the selected risk factors. Logistic, poisson, and negative binomial regressions were developed to study tooth loss patterns. Overall, 27% of the subjects lost at least one tooth during follow-up. Fourteen subjects had tooth loss events per 100 person-years. Tooth loss pattern did not differ significantly among different special-needs subgroups (i.e. community-dwelling vs. long-term care, physically disabled vs. functionally independent). Special-needs subjects with three or more active dental conditions at arrival had more than twice the risk of losing teeth than those without any existing conditions. After adjusting other factors, the number of carious teeth or retained roots at arrival was a significant predictor of tooth loss for older adults with special needs (P=0.001). These findings indicate that appropriately managing active caries and associated conditions is important to prevent tooth loss for older adults with special needs. PMID:21449213

Patterns of Chronic Conditions and Their Associations With Behaviors and Quality of Life, 2010

PubMed Central

Mitchell, Sandra A.; Thompson, William W.; Zack, Matthew M.; Reeve, Bryce B.; Cella, David; Smith, Ashley Wilder

2015-01-01

Introduction Co-occurring chronic health conditions elevate the risk of poor health outcomes such as death and disability, are associated with poor quality of life, and magnify the complexities of self-management, care coordination, and treatment planning. This study assessed patterns of both singular and multiple chronic conditions, behavioral risk factors, and quality of life in a population-based sample. Methods In a national survey, adults (n = 4,184) answered questions about the presence of 27 chronic conditions. We used latent class analysis to identify patterns of chronic conditions and to explore associations of latent class membership with sociodemographic characteristics, behavioral risk factors, and health. Results Latent class analyses indicated 4 morbidity profiles: a healthy class (class 1), a class with predominantly physical health conditions (class 2), a class with predominantly mental health conditions (class 3), and a class with both physical and mental health conditions (class 4). Class 4 respondents reported significantly worse physical health and well-being and more days of activity limitation than those in the other latent classes. Class 4 respondents were also more likely to be obese and sedentary, and those with predominantly mental health conditions were most likely to be current smokers. Conclusions Subgroups with distinct patterns of chronic conditions can provide direction for screening and surveillance, guideline development, and the delivery of complex care services. PMID:26679491

Measurement and Associations of Pregnancy Risk Factors with Genetic Influences, Postnatal Environmental Influences, and Toddler Behavior

ERIC Educational Resources Information Center

Marceau, Kristine; Hajal, Nastassia; Leve, Leslie D.; Reiss, David; Shaw, Daniel S.; Ganiban, Jody M.; Mayes, Linda C.; Neiderhiser, Jenae M.

2013-01-01

This study demonstrates the unique contributions of perinatal risk and genetic and environmental influences on child behavior using data from 561 domestic US adoption triads (birth mothers, adopted child, and adoptive parents). Findings show distinct patterns of associations among genetic (birth mother psychopathology), prenatal (six maternal…

Accumulating Brisk Walking for Fitness, Cardiovascular Risk, and Psychological Health.

ERIC Educational Resources Information Center

Murphy, Marie; Nevill, Alan; Neville, Charlotte; Biddle, Stuart; Hardman, Adrianne

2002-01-01

Compared the effects of different patterns of regular brisk walking on fitness, cardiovascular disease risk factors, and psychological well-being in previously sedentary adults. Data on adults who completed either short-bout or long-bout walking programs found that three short bouts of brisk walking accumulated throughout the day were as effective…

A vegetable, fruit, and white rice dietary pattern during pregnancy is associated with a lower risk of preterm birth and larger birth size in a multiethnic Asian cohort: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort study.

PubMed

Chia, Ai-Ru; de Seymour, Jamie V; Colega, Marjorelee; Chen, Ling-Wei; Chan, Yiong-Huak; Aris, Izzuddin M; Tint, Mya-Thway; Quah, Phaik Ling; Godfrey, Keith M; Yap, Fabian; Saw, Seang-Mei; Baker, Philip N; Chong, Yap-Seng; van Dam, Rob M; Lee, Yung Seng; Chong, Mary Foong-Fong

2016-11-01

Maternal dietary patterns during pregnancy have been shown to influence infant birth outcomes. However, to our knowledge, only a few studies have examined the associations in Asian populations. We characterized maternal dietary patterns in Asian pregnant women and examined their associations with the risk of preterm birth and offspring birth size. At 26-28 wk of gestation, 24-h recalls and 3-d food diaries were collected from the women in the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort. Dietary patterns were derived from exploratory factor analysis. Gestational age was determined by a dating ultrasound scan in the first trimester, and infant birth anthropometric measurements were obtained from hospital records. Associations were assessed by logistic and linear regressions with adjustment for confounding factors. Three maternal dietary patterns were identified: vegetable, fruit, and white rice (VFR); seafood and noodle (SfN); and pasta, cheese, and processed meat (PCP). Of 923 infants, 7.6% were born preterm, 13.4% were born small for gestational age, and 14.7% were born large for gestational age. A greater adherence to the VFR pattern (per SD increase in VFR score) was associated with a lower risk of preterm births (OR: 0.67; 95% CI: 0.50, 0.91), higher ponderal index (β: 0.26 kg/m 3 ; 95% CI: 0.06, 0.45 kg/m 3 ), and increased risk of a large-for-gestational-age birth (RR: 1.31; 95% CI: 1.06, 1.62). No associations were observed for the SfN and PCP patterns in relation to birth outcomes. The VFR pattern is associated with a lower incidence of preterm birth and with larger birth size in an Asian population. The findings related to larger birth size warrant further confirmation in independent studies. This trial was registered at clinicaltrials.gov as NCT01174875. © 2016 American Society for Nutrition.

Perceived parenting and risk for major depression in Chinese women

PubMed Central

Gao, J.; Li, Y.; Cai, Y.; Chen, J.; Shen, Y.; Ni, S.; Wei, Y.; Qiu, Y.; Zhu, X.; Liu, Y.; Lu, C.; Chen, C.; Niu, Q.; Tang, C.; Yang, Y.; Wang, Q.; Cui, W.; Xia, J.; Liu, T.; Zhang, J.; Zhao, B.; Guo, Z.; Pan, J.; Chen, H.; Luo, Y.; Sun, L.; Xiao, X.; Chen, Q.; Zhao, X.; He, F.; Lv, L.; Guo, L.; Liu, L.; Li, H.; Shi, S.; Flint, J.; Kendler, K. S.; Tao, M.

2012-01-01

Background In Western countries, a history of major depression (MD) is associated with reports of received parenting that is low in warmth and caring and high in control and authoritarianism. Does a similar pattern exist in women in China? Method Received parenting was assessed by a shortened version of the Parental Bonding Instrument (PBI) in two groups of Han Chinese women: 1970 clinically ascertained cases with recurrent MD and 2597 matched controls. MD was assessed at personal interview. Results Factor analysis of the PBI revealed three factors for both mothers and fathers: warmth, protectiveness, and authoritarianism. Lower warmth and protectiveness and higher authoritarianism from both mother and father were significantly associated with risk for recurrent MD. Parental warmth was positively correlated with parental protectiveness and negatively correlated with parental authoritarianism. When examined together, paternal warmth was more strongly associated with lowered risk for MD than maternal warmth. Furthermore, paternal protectiveness was negatively and maternal protectiveness positively associated with risk for MD. Conclusions Although the structure of received parenting is very similar in China and Western countries, the association with MD is not. High parental protectiveness is generally pathogenic in Western countries but protective in China, especially when received from the father. Our results suggest that cultural factors impact on patterns of parenting and their association with MD. PMID:21943491

Migrants in transit: the importance of monitoring HIV risk among migrant flows at the Mexico-US border.

PubMed

Martinez-Donate, Ana P; Hovell, Melbourne F; Rangel, Maria Gudelia; Zhang, Xiao; Sipan, Carol L; Magis-Rodriguez, Carlos; Gonzalez-Fagoaga, J Eduardo

2015-03-01

We conducted a probability-based survey of migrant flows traveling across the Mexico-US border, and we estimated HIV infection rates, risk behaviors, and contextual factors for migrants representing 5 distinct migration phases. Our results suggest that the influence of migration is not uniform across genders or risk factors. By considering the predeparture, transit, and interception phases of the migration process, our findings complement previous studies on HIV among Mexican migrants conducted at the destination and return phases. Monitoring HIV risk among this vulnerable transnational population is critical for better understanding patterns of risk at different points of the migration process and for informing the development of protection policies and programs.

Migrants in Transit: The Importance of Monitoring HIV Risk Among Migrant Flows at the Mexico–US Border

PubMed Central

Martinez-Donate, Ana P.; Hovell, Melbourne F.; Rangel, Maria Gudelia; Zhang, Xiao; Sipan, Carol L.; Magis-Rodriguez, Carlos; Gonzalez-Fagoaga, J. Eduardo

2015-01-01

We conducted a probability-based survey of migrant flows traveling across the Mexico–US border, and we estimated HIV infection rates, risk behaviors, and contextual factors for migrants representing 5 distinct migration phases. Our results suggest that the influence of migration is not uniform across genders or risk factors. By considering the predeparture, transit, and interception phases of the migration process, our findings complement previous studies on HIV among Mexican migrants conducted at the destination and return phases. Monitoring HIV risk among this vulnerable transnational population is critical for better understanding patterns of risk at different points of the migration process and for informing the development of protection policies and programs. PMID:25602882

Early Patterns of Self-Regulation as Risk and Promotive Factors in Development: A Longitudinal Study from Childhood to Adulthood in a High-Risk Sample

PubMed Central

Causadias, José M.; Salvatore, Jessica E.; Sroufe, L. Alan

2012-01-01

The present study examines two childhood markers of self-regulation, ego-control and ego-resiliency, as promotive factors for the development of global adjustment and as risk factors for the development of internalizing and externalizing behavior problems in a high-risk sample. Teachers and observers rated ego-control and ego-resiliency when participants (n = 136) were in preschool and elementary school. Ratings showed evidence for convergent and discriminant validity and stability over time. Ego-resiliency, but not ego-control, emerged as powerful predictor of adaptive functioning at age 19 and 26, as well as internalizing and externalizing problems at 16, 23, 26, and 32 years. We interpret these findings as evidence that flexibility and adaptability -measured with ego-resiliency- may reduce risk and promote successful adaptation in low-SES environments. PMID:23155299

How effective are strategies for non-communicable disease prevention and control in a high risk population in a developing country? Isfahan Healthy Heart Programme

PubMed Central

Baghaei, Abdolmehdi; Rabiei, Katayoun; Gharipour, Mojgan; Tavasoli, Ali Akbar; Shirani, Shahin; Bahonar, Ahamad; Davarpanah, Amir Hossein; Ramezani, Mohammad Arash; Kelishadi, Roya

2010-01-01

Introduction The Isfahan Healthy Heart Programme (IHHP) is a community-based programme for non-communicable diseases prevention and control using both a population and high risk approach in Iran. This study demonstrated the efficacy of IHHP interventional strategies to improve lifestyle behaviours in a population at risk for developing cardiovascular diseases. Material and methods Healthy Lifestyle for NCDs High Risk Population is one of ten projects of IHHP. High risk individuals were defined as those who have at least one risk factor for developing coronary artery disease (CAD). Changes of behavioural indicators have been compared between two areas with a survey after 5 years of intervention. Results Among high risk individuals in the intervention and reference areas, 77.8% and 82.5% had at least one major risk factor for CAD. The prevalence of major risk factors for CAD (except cigarette smoking) was decreased in both intervention and reference areas during 5 years of intervention and the pattern of diet and physical activity was improved. Conclusions Interventional activities in IHHP targeting the high risk population seem to be effective in improving lifestyle behaviour, increasing awareness and control of risk factors of the high risk population. PMID:22371716

Patterns of NPS Use and Risk Reduction in Slovenia.

PubMed

Sande, Matej; Paš, Mina; Nahtigal, Klara; Šabić, Simona

2018-01-15

The following study presents factors influencing the decision to use/not to use new psychoactive substances (NPS), various patterns of NPS use, the problems experienced by users, and the methods for reducing the risks associated with NPS use. The study seeks to provide an in-depth look into the characteristics of NPS use and support the planning of targeted interventions in the field of NPS. The study involved 19 in-depth interviews carried out with 25 individuals divided into three subsamples in order to gain insight into the various experiences of NPS users. The interviews were conducted in Slovenia between December 2013 and October 2014. The sample was obtained by using the convenience sampling and snowball sampling methods. The main pattern of NPS use determined by the study concerned synthetic cathinones, specifically 3-MMC, with binge use spanning several days being a prominent feature. The main risks involving NPS use were: mixing various drugs, inappropriate dosing, lack of information prior to use, and the use of unknown substances. Several users spoke about effective strategies for reducing risks, such as obtaining information beforehand, using one's own implements and using only small quantities of unknown substances. Conclusions/Importance: The study revealed various factors based on which users decide to use NPS. Furthermore, users reported a number of problems resulting from NPS use, while risk reduction strategies are employed to a much lesser extent. Based on the results obtained, specific intervention efforts concerning NPS use and targeting specific groups of younger users were designed.

Non-communicable disease risk factor patterns among mining industry workers in Papua, Indonesia: longitudinal findings from the Cardiovascular Outcomes in a Papuan Population and Estimation of Risk (COPPER) Study

PubMed Central

Rodriguez-Fernandez, Rodrigo; Rahajeng, Ekowati; Viliani, Francesca; Kushadiwijaya, Haripurnomo; Amiya, Rachel M; Bangs, Michael J

2015-01-01

Objectives Non-communicable diseases (NCDs) constitute an increasing slice of the global burden of disease, with the South-East Asia region projected to see the highest increase in NCD-related deaths over the next decade. Mining industry employees may be exposed to various factors potentially elevating their NCD risk. This study aimed to assess the distribution and 5-year longitudinal trends of key metabolic NCD risk factors in a cohort of copper–gold mining company workers in Papua, Indonesia. Methods Metabolic indicators of NCD risk were assessed among employees (15 580 at baseline, 6496 prospectively) of a large copper–gold mining operation in Papua, Indonesia, using routinely collected 5-year medical surveillance data. The study cohort comprised individuals aged 18–68 years employed for ≥1 year during 2008–2013. Assessed risk factors were based on repeat measures of cholesterol, blood glucose, blood pressure and body weight, using WHO criteria. Results Metabolic risk indicator rates were markedly high and increased significantly from baseline through 5-year follow-up (p<0.001). Adjusting for gender and age, longer duration of employment (≥10 years) predicted raised cholesterol (adjusted OR (AOR)=1.13, p=0.003), raised blood pressure (AOR=1.16, p=0.009) and overweight/obesity (AOR=1.14, p=0.001) at baseline; and persistent raised cholesterol (AOR=1.26, p=0.003), and both incident (AOR=1.33, p=0.014) and persistent raised blood glucose (AOR=1.62, p=0.044) at 3-year follow-up. Conclusions Individuals employed for longer periods in a mining operations setting in Papua, Indonesia, may face elevated NCD risk through various routes. Workplace health promotion interventions and policies targeting modifiable lifestyle patterns and environmental exposures present an important opportunity to reduce such susceptibilities and mitigate associated health risks. PMID:26231573

Risk as Social Context: Immigration Policy and Autism in California*

PubMed Central

Fountain, Christine; Bearman, Peter

2010-01-01

Motivated by the dramatic increase in autism diagnoses in recent years, research into risk factors has uncovered substantial variation in autism prevalence by race/ethnicity, SES, and geography. Less studied is the connection between autism diagnosis rates and the social and political context. In this article, we link the temporal pattern of autism diagnosis for Hispanic children in California to state and federal anti-immigrant policy, particularly ballot initiative Proposition 187, limiting access to public services for undocumented immigrants and their families. Using a population-level dataset of 1992–2003 California births linked to 1992–2006 autism case records, we show that the effects of state and federal policies toward immigrants are visible in the rise and fall of autism risk over time. The common epidemiological practice of estimating risk on pooled samples is thereby shown to obscure patterns and mis-estimate effect sizes. Finally, we illustrate how spatial variation in Hispanic autism rates reflects differential vulnerability to these policies. This study reveals not only the spillover effects of immigration policy on children’s health, but also the hazards of treating individual attributes like ethnicity as risk factors without regard to the social and political environments that give them salience. PMID:21643443

Normalisation theory: Does it accurately describe temporal changes in adolescent drunkenness and smoking?

PubMed

Sznitman, Sharon R; Zlotnick, Cheryl; Harel-Fisch, Yossi

2016-07-01

The multiple risk model postulates that accumulating risk factors increase adolescent drunkenness and smoking. The normalisation theory adds to this by arguing that the relation between accumulative risk and drunkenness and smoking is dependent on the distribution of these behaviours in the larger population. More concretely, normalisation theory predicts that: (i) when population level use increases, low risk adolescents will be more likely to use alcohol and cigarettes; and (ii) adolescents facing multiple risk factors will be equally likely to use alcohol and cigarettes, regardless of trends in population level use. The current study empirically tests these assumptions on five waves of nationally representative samples of Israeli Jewish youth. Five cross-sectional waves of data from the Israeli Health Behaviour in School-aged Children survey for Jewish 10th graders were used. Logistic regression models measured the impact of changes in population level use across waves on drunkenness and smoking, and their association with differing levels of risk factors. Between zero and two risk factors, the risk of drunkenness and smoking increases for each additional risk factor. When reaching two risk factors, added risk does not significantly increase the likelihood of smoking and drunkenness. Changes in population level drunkenness and smoking did not systematically relate to changes in the individual level relationship between risk factors and smoking and drunkenness. The pattern of results in this study provides strong evidence for the multiple risk factor model and inconsistent evidence for the normalisation theory. [Sznitman SR, Zlotnick C, Harel-Fisch Y. Normalisation theory: Does it accurately describe temporal changes in adolescent drunkenness and smoking? Drug Alcohol Rev 2016;35:424-432]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

The striking geographical pattern of gastric cancer mortality in Spain: environmental hypotheses revisited

PubMed Central

2009-01-01

Background Gastric cancer is decreasing in most countries. While socioeconomic development is the main factor to which this decline has been attributed, enormous differences among countries and within regions are still observed, with the main contributing factors remaining elusive. This study describes the geographic distribution of gastric cancer mortality at a municipal level in Spain, from 1994-2003. Methods Smoothed relative risks of stomach cancer mortality were obtained, using the Besag-York-Molliè autoregressive spatial model. Maps depicting relative risk (RR) estimates and posterior probabilities of RR being greater than 1 were plotted. Results From 1994-2003, 62184 gastric cancer deaths were registered in Spain (7 percent of all deaths due to malignant tumors). The geographic pattern was similar for both sexes. RRs displayed a south-north and coast-inland gradient, with lower risks being observed in Andalusia, the Mediterranean coastline, the Balearic and Canary Islands and the Cantabrian seaboard. The highest risk was concentrated along the west coast of Galicia, broad areas of the Castile & Leon Autonomous community, the province of Cáceres in Extremadura, Lleida and other areas of Catalonia. Conclusion In Spain, risk of gastric cancer mortality displays a striking geographic distribution. With some differences, this persistent and unique pattern is similar across the sexes, suggesting the implication of environmental exposures from sources, such as diet or ground water, which could affect both sexes and delimited geographic areas. Also, the higher sex-ratios found in some areas with high risk of smoking-related cancer mortality in males support the role of tobacco in gastric cancer etiology. PMID:19737377

The Age-IPV Curve: Changes in Intimate Partner Violence Perpetration during Adolescence and Young Adulthood

PubMed Central

Johnson, Wendi L.; Giordano, Peggy C.; Manning, Wendy D.; Longmore, Monica A.

2014-01-01

Research on intimate partner violence (IPV) has evolved over the last decade with increasing interest in how IPV develops over adolescence and young adulthood. Studies examining patterns of IPV over time have generally focused on victimization with less attention to temporal shifts in perpetration. While it is generally assumed that IPV peaks during young adulthood, this has not been empirically verified and documented. Additionally, prior longitudinal analyses of IPV have focused on identifying trajectories and their accompanying risk factors, with less attention given to within-individual change in IPV experiences across and within relationships. Drawing on five waves of data from the Toledo Adolescent Relationships Study (TARS), we examined patterns of the perpetration of IPV among a diverse sample of adolescents and young adults (51.1% female, 63.9% non-Hispanic White, 24.6% non-Hispanic Black, 11.5% Hispanic) spanning the ages of 13–28 years (N = 1,164). Analyses demonstrated that IPV patterns deviate from the age-crime curve, with women’s involvement in IPV increasing, while their involvement in other antisocial behaviors is decreasing. Traditional behavioral and psychological risk factors (delinquency, alcohol and drug use, depressive symptoms) accounted for some of the age variation in IPV for men, but these factors did not account for age variation in IPV among women. Relationship risk factors including frequency of disagreements, trust, jealousy, validation and self-disclosure, however, accounted for substantial portions of the age-IPV perpetration relationship for male and female youth. These findings reinforce recent calls for prevention efforts that focus on the development and maintenance of healthy relationships. PMID:25081024

Risk factors for clinical coronary heart disease in systemic lupus erythematosus: the lupus and atherosclerosis evaluation of risk (LASER) study.

PubMed

Haque, Sahena; Gordon, Caroline; Isenberg, David; Rahman, Anisur; Lanyon, Peter; Bell, Aubrey; Emery, Paul; McHugh, Neil; Teh, Lee Suan; Scott, David G I; Akil, Mohamed; Naz, Sophia; Andrews, Jacqueline; Griffiths, Bridget; Harris, Helen; Youssef, Hazem; McLaren, John; Toescu, Veronica; Devakumar, Vinodh; Teir, Jamal; Bruce, Ian N

2010-02-01

Accelerated atherosclerosis and premature coronary heart disease (CHD) are recognized complications of systemic lupus erythematosus (SLE), but the exact etiology remains unclear and is likely to be multifactorial. We hypothesized that SLE patients with CHD have increased exposure to traditional risk factors as well as differing disease phenotype and therapy-related factors compared to SLE patients free of CHD. Our aim was to examine risk factors for development of clinical CHD in SLE in the clinical setting. In a UK-wide multicenter retrospective case-control study we recruited 53 SLE patients with verified clinical CHD (myocardial infarction or angina pectoris) and 96 SLE patients without clinical CHD. Controls were recruited from the same center as the case and matched by disease duration. Charts were reviewed up to time of event for cases, or the same "dummy-date" in controls. SLE patients with clinical CHD were older at the time of event [mean (SD) 53 (10) vs 42 (10) yrs; p < 0.001], more likely to be male [11 (20%) vs 3 (7%); p < 0.001], and had more exposure to all classic CHD risk factors compared to SLE patients without clinical CHD. They were also more likely to have been treated with corticosteroids (OR 2.46; 95% CI 1.03, 5.88) and azathioprine (OR 2.33; 95% CI 1.16, 4.67) and to have evidence of damage on the pre-event SLICC damage index (SDI) (OR 2.20; 95% CI 1.09, 4.44). There was no difference between groups with regard to clinical organ involvement or autoantibody profile. Our study highlights the need for clinical vigilance to identify modifiable risk factors in the clinical setting and in particular with male patients. The pattern of organ involvement did not differ in SLE patients with CHD events. However, the higher pre-event SDI, azathioprine exposure, and pattern of damage items (disease-related rather than therapy-related) in cases suggests that a persistent active lupus phenotype contributes to CHD risk. In this regard, corticosteroids and azathioprine may not control disease well enough to prevent CHD. Clinical trials are needed to determine whether classic risk factor modification will have a role in primary prevention of CHD in SLE patients and whether new therapies that control disease activity can better reduce CHD risk.

National Patterns of Urethral Evaluation and Risk Factors for Urethral Injury in Patients With Penile Fracture.

PubMed

Pariser, Joseph J; Pearce, Shane M; Patel, Sanjay G; Bales, Gregory T

2015-07-01

To examine the epidemiology and timing of penile fracture, patterns of urethral evaluation, and risk factors for concomitant urethral injury. The National Inpatient Sample (2003-2011) was used to identify patients with penile fractures. Clinical data included age, race, comorbidity, insurance, hospital factors, timing, hematuria, and urinary symptoms. Rates of formal urethral evaluation (cystoscopy or urethrogram) and urethral injury were calculated. Multivariate logistic regression was used to identify predictors of urethral evaluation and risk factors for urethral injury. A weighted population of 3883 patients with penile fracture was identified. Presentations during weekends (37%) and summers (30%) were overrepresented (both P <.001). Urethral evaluation was performed in 882 patients (23%). Urethral injury was diagnosed in 813 patients (21%) with penile fracture. There was an increased odds of urethral evaluation with hematuria (odds ratio [OR] = 2.99; 95% confidence interval [CI], 1.03-8.73; P = .045) and a decrease for Hispanics (OR = 0.42; 95% CI, 0.22-0.82; P = .011). Older age (32-41 years: OR = 1.84; 95% CI, 1.07-3.16; P = .027; >41 years: OR = 2.25; 95% CI, 1.25-4.05; P = .007), black race (OR = 1.93; 95% CI, 1.12-3.34; P = .018), and hematuria (OR = 17.03; 95% CI, 3.20-90.54; P = .001) were independent risk factors for urethral injury. Penile fractures, which occur disproportionately during summer and weekends, were associated with a 21% risk of urethral injury. Urethral evaluations were performed in a minority of patients. Even in patients with hematuria, 55% of patients underwent formal urethral evaluation. On multivariate analysis of patients with penile fracture, hematuria as well as older age and black race were independently associated with concomitant urethral injury. Copyright © 2015 Elsevier Inc. All rights reserved.

Family, friend, and media factors are associated with patterns of weight-control behavior among adolescent girls.

PubMed

Balantekin, Katherine N; Birch, Leann L; Savage, Jennifer S

2018-04-01

To examine the relationship of family, friend, and media factors on weight-control group membership at 15 years separately and in a combined model. Subjects included 166 15 year girls. Latent class analysis identified four patterns of weight-control behaviors: non-dieters, lifestyle, dieters, and extreme dieters. Family (family functioning, priority of the family meals, maternal/paternal weight-teasing, and mother's/father's dieting), friend (weight-teasing and dieting), and media variables (media sensitivity and weekly TV time) were included as predictors of weight-control group membership. Family functioning and priority of family meals predicted membership in the Extreme Dieters group, and maternal weight-teasing predicted membership in both dieters and extreme dieters. Friend's dieting and weight-teasing predicted membership in both dieters and extreme dieters. Media sensitivity was significantly associated with membership in lifestyle, dieters, and extreme dieters. In a combined influence model with family, friend, and media factors included, the following remained significantly associated with weight-control group membership: family functioning, friends' dieting, and media sensitivity. Family, friends, and the media are three sources of sociocultural influence, which play a role in adolescent girls' use of patterns of weight-control behaviors; family functioning was a protective factor, whereas friend's dieting and media sensitivity were risk factors. These findings emphasize the need for multidimensional interventions, addressing risk factors for dieting and use of unhealthy weight-control behaviors at the family, peer, and community (e.g., media) levels.

Consistency and Generalizability of Dietary Patterns in a Multiethnic Working Population.

PubMed

Eng, Jui-Yee; Moy, Foong-Ming; Bulgiba, Awang; Rampal, Sanjay

2018-03-31

Dietary pattern analysis is a complementary method to nutrient analysis in evaluating overall diet-disease hypotheses. Although studies have been conducted to derive dietary patterns among Malaysians, their consistency across subgroups has not been examined. The study aimed to derive dietary patterns empirically and to examine the consistency and generalizability of patterns across sex, ethnicity, and urban status in a working population. This was a cross-sectional study using data from the Clustering of Lifestyle Risk Factors and Understanding its Association with Stress on Health and Well-Being among School Teachers in Malaysia study collected between August 2014 and November 2015. Dietary intake was assessed using a food frequency questionnaire, and dietary patterns were derived using factor analysis. Participants were teachers from selected public schools from three states in Peninsular Malaysia (n=4,618). Dietary patterns derived using factor analysis. Separate factor analysis was conducted by sex, ethnicity, and urban status to identify dietary patterns. Eigenvalue >2, scree plot, Velicer's minimum average partial analysis, and Horn's parallel analysis were used to determine the number of factors to retain. The interpretability of each dietary pattern was evaluated. The consistency and generalizability of dietary patterns across subgroups were assessed using the Tucker congruence coefficient. There was no subgroup-specific dietary pattern found. Thus, dietary patterns were derived using the pooled sample in the final model. Two dietary patterns (Western and Prudent) were derived. The Western dietary pattern explained 15.4% of total variance, characterized by high intakes of refined grains, animal-based foods, added fat, and sugar-sweetened beverages as well as fast food. The Prudent dietary pattern explained 11.1% of total variance and was loaded with pulses, legumes, vegetables, and fruits. The derived Western and Prudent dietary patterns were consistent and generalizable across subgroups of sex, ethnicity, and urban status. Further research is needed to explore associations between these dietary patterns and chronic diseases. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Study to Examine Psychological Processes in Suicidal Ideation and Behavior (STEPPS)

DTIC Science & Technology

2015-05-01

diagnoses to better understand suicide; suicide is the result of a complex interplay of psychological, social and biological factors . A more...encounter frequent physiological/psychological stressors, therefore identifying suicide risk and resilience factors in military personnel is vital; so...models have been developed to aid the identification of suicide-specific individual difference factors and patterns of thinking. This program of

MET Receptor Tyrosine Kinase as an Autism Genetic Risk Factor

PubMed Central

Peng, Yun; Huentelman, Matthew; Smith, Christopher; Qiu, Shenfeng

2014-01-01

In this chapter, we will briefly discuss recent literature on the role of MET receptor tyrosine kinase (RTK) in brain development and how perturbation of MET signaling may alter normal neurodevelopmental outcomes. Recent human genetic studies have established MET as a risk factor for autism, and the molecular and cellular underpinnings of this genetic risk are only beginning to emerge from obscurity. Unlike many autism risk genes that encode synaptic proteins, the spatial and temporal expression pattern of MET RTK indicates this signaling system is ideally situated to regulate neuronal growth, functional maturation, and establishment of functional brain circuits, particularly in those brain structures involved in higher levels of cognition, social skills, and executive functions. PMID:24290385

Socioeconomic status (SES) and childhood acute myeloid leukemia (AML) mortality risk: Analysis of SEER data.

PubMed

Knoble, Naomi B; Alderfer, Melissa A; Hossain, Md Jobayer

2016-10-01

Socioeconomic status (SES) is a complex construct of multiple indicators, known to impact cancer outcomes, but has not been adequately examined among pediatric AML patients. This study aimed to identify the patterns of co-occurrence of multiple community-level SES indicators and to explore associations between various patterns of these indicators and pediatric AML mortality risk. A nationally representative US sample of 3651 pediatric AML patients, aged 0-19 years at diagnosis was drawn from 17 Surveillance, Epidemiology, and End Results (SEER) database registries created between 1973 and 2012. Factor analysis, cluster analysis, stratified univariable and multivariable Cox proportional hazards models were used. Four SES factors accounting for 87% of the variance in SES indicators were identified: F1) economic/educational disadvantage, less immigration; F2) immigration-related features (foreign-born, language-isolation, crowding), less mobility; F3) housing instability; and, F4) absence of moving. F1 and F3 showed elevated risk of mortality, adjusted hazards ratios (aHR) (95% CI): 1.07(1.02-1.12) and 1.05(1.00-1.10), respectively. Seven SES-defined cluster groups were identified. Cluster 1 (low economic/educational disadvantage, few immigration-related features, and residential-stability) showed the minimum risk of mortality. Compared to Cluster 1, Cluster 3 (high economic/educational disadvantage, high-mobility) and Cluster 6 (moderately-high economic/educational disadvantages, housing-instability and immigration-related features) exhibited substantially greater risk of mortality, aHR(95% CI)=1.19(1.0-1.4) and 1.23 (1.1-1.5), respectively. Factors of correlated SES-indicators and their pattern-based groups demonstrated differential risks in the pediatric AML mortality indicating the need of special public-health attention in areas with economic-educational disadvantages, housing-instability and immigration-related features. Copyright © 2016 Elsevier Ltd. All rights reserved.

Genome-Wide Association Study of Dietary Pattern Scores

PubMed Central

Bouchard-Mercier, Annie; Rudkowska, Iwona; Lemieux, Simone; Couture, Patrick; Vohl, Marie-Claude

2017-01-01

Dietary patterns, representing global food supplies rather than specific nutrients or food intakes, have been associated with cardiovascular disease (CVD) incidence and mortality. The contribution of genetic factors in the determination of food intakes, preferences and dietary patterns has been previously established. The current study aimed to identify novel genetic factors associated with reported dietary pattern scores. Reported dietary patterns scores were derived from reported dietary intakes for the preceding month and were obtained through a food frequency questionnaire and genome-wide association study (GWAS) conducted in a study sample of 141 individuals. Reported Prudent and Western dietary patterns demonstrated nominal associations (p < 1 × 10−5) with 78 and 27 single nucleotide polymorphisms (SNPs), respectively. Among these, SNPs annotated to genes previously associated with neurological disorders, CVD risk factors and obesity were identified. Further assessment of SNPs demonstrated an impact on gene expression levels in blood for SNPs located within/near BCKDHB (p = 0.02) and the hypothalamic glucosensor PFKFB3 (p = 0.0004) genes, potentially mediated through an impact on the binding of transcription factors (TFs). Overrepresentations of glucose/energy homeostasis and hormone response TFs were also observed from SNP-surrounding sequences. Results from the current GWAS study suggest an interplay of genes involved in the metabolic response to dietary patterns on obesity, glucose metabolism and food-induced response in the brain in the adoption of dietary patterns. PMID:28644415

Ethnic patterns of hypospadias in New Zealand do not resemble those observed for cryptorchidism and testicular cancer: evidence of differential aetiology?

PubMed

Gurney, J K; Stanley, J; Shaw, C; Sarfati, D

2016-01-01

It has been proposed that hypospadias, cryptorchidism, poor semen quality and testicular cancer might share common prenatal causes. We have previously demonstrated similar ethnic patterns for the incidence of testicular cancer and cryptorchidism - a known risk factor for testicular cancer. If the underlying exposure(s) that cause hypospadias, cryptorchidism and testicular cancer are shared, then we would expect the incidence relationship between ethnic groups to follow the same pattern across all three conditions. We followed a birth cohort of 318 345 eligible male neonates born in New Zealand between 2000-2010, and linked routinely collected maternity records with inpatient hospitalization and mortality records through to 2011. We searched hospitalization records for diagnoses of hypospadias, and used mortality records for censoring. We used Poisson regression methods to compare the relative risk of hypospadias between ethnic groups, adjusting for perinatal risk factors and total person time. We observed that European/Other children had the highest risk of hypospadias, with Māori, Pacific and Asian boys having around 40% lower risk of disease compared with this group (adjusted relative risk [RR]: Māori 0.62, 95% CI 0.55-0.70; Pacific 0.62, 95% CI 0.53-0.72; Asian 0.57, 95% CI 0.47-0.69). This contrasts substantially with our previous observations for cryptorchidism and testicular cancer, where Māori males have the greatest risk. Our observations suggest that - at least in New Zealand - the exposures that drive the development of hypospadias may differ to those that that drive the development of cryptorchidism and/or testicular cancer. © 2015 American Society of Andrology and European Academy of Andrology.

An exploratory risk perception study of attitudes toward homeland security systems.

PubMed

Sanquist, Thomas F; Mahy, Heidi; Morris, Frederic

2008-08-01

Understanding the issues surrounding public acceptance of homeland security systems is important for balancing security needs and potential civil liberties infringements. A psychometric survey was used in an exploratory study of attitudes regarding homeland security systems. Psychometric rating data were obtained from 182 respondents on psychological attributes associated with 12 distinct types of homeland security systems. An inverse relationship was observed for the overall rating attributes of acceptability and risk of civil liberties infringement. Principal components analysis (PCA) yielded a two-factor solution with the rating scale loading pattern suggesting factors of perceived effectiveness and perceived intrusiveness. These factors also showed an inverse relationship. The 12 different homeland security systems showed significantly different scores on the rating scales and PCA factors. Of the 12 systems studied, airport screening, canine detectors, and radiation monitoring at borders were found to be the most acceptable, while email monitoring, data mining, and global positioning satellite (GPS) tracking were found to be least acceptable. Students rated several systems as more effective than professionals, but the overall pattern of results for both types of subjects was similar. The data suggest that risk perception research and the psychometric paradigm are useful approaches for quantifying attitudes regarding homeland security systems and policies and can be used to anticipate potentially significant public acceptance issues.

Lifestyle patterns in early pregnancy linked to gestational diabetes mellitus diagnoses when using IADPSG criteria. The St Carlos gestational study.

PubMed

Ruiz-Gracia, Teresa; Duran, Alejandra; Fuentes, Manuel; Rubio, Miguel A; Runkle, Isabelle; Carrera, Evelyn F; Torrejón, María J; Bordiú, Elena; Valle, Laura Del; García de la Torre, Nuria; Bedia, Ana R; Montañez, Carmen; Familiar, Cristina; Calle-Pascual, Alfonso L

2016-06-01

Early-pregnancy lifestyle (EPL) could influence the development of gestational diabetes mellitus(GDM), depending on the diagnostic criteria used. We studied EPL in 1750 pregnant women using Carpenter-Coustan criteria(CCc), and in 1526 with the International Association of Diabetes and Pregnancy Study Groups criteria(IADPSGc). GDM risk factors were assessed in women between 24 and 28 weeks of gestational age during two consecutive years. A semiquantitative frequent-food-consumption questionnaire was used to evaluate lifestyle during pregnancy. Multiple logistic regression analysis was conducted to assess GDM risk with different lifestyle patterns. Using IADPSGc, the GDM ORs (95%CI) for intake/week were: nuts >3 times: 0.59 (0.39-0.91; p < 0.015), refined cereals ≤1 serving: 0.72(0.58-0.89; p < 0.003), juices <4 servings: 0.77 (0.62-0.95; p < 0.017), cookies and pastries <4 servings: 0.71(0.57-0.89; p < 0.003) as compared to opposite habits. No significant nutritional patterns were found to be significant using CCc. The OR (95%CI) for GDM with none of the four risk patterns as compared to having three-four risk factors was 0.21(0.07-0.62; p < 0.005), remaining significant after stratification by BMI, age, obstetric events, parity and family history. The multiple logistic regression model including nutritional categories and pregestational BMI, age, obstetric history, parity, personal/family history, had an area under the curve(AUC) of the receiver operating curve(ROC) for the probability to predict GDM of 0.66 (CI 95%: 0.63-0.69; p < 0.001). Our study is the first to identify four early-pregnancy nutritional patterns associated with the GDM when using IADPSGc. Adherence to a low-risk nutritional pattern from early pregnancy on could be an effective strategy for GDM prevention. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Complex Multi-Block Analysis Identifies New Immunologic and Genetic Disease Progression Patterns Associated with the Residual β-Cell Function 1 Year after Diagnosis of Type 1 Diabetes

PubMed Central

Andersen, Marie Louise Max; Rasmussen, Morten Arendt; Pörksen, Sven; Svensson, Jannet; Vikre-Jørgensen, Jennifer; Thomsen, Jane; Hertel, Niels Thomas; Johannesen, Jesper; Pociot, Flemming; Petersen, Jacob Sten; Hansen, Lars; Mortensen, Henrik Bindesbøl; Nielsen, Lotte Brøndum

2013-01-01

The purpose of the present study is to explore the progression of type 1 diabetes (T1D) in Danish children 12 months after diagnosis using Latent Factor Modelling. We include three data blocks of dynamic paraclinical biomarkers, baseline clinical characteristics and genetic profiles of diabetes related SNPs in the analyses. This method identified a model explaining 21.6% of the total variation in the data set. The model consists of two components: (1) A pattern of declining residual β-cell function positively associated with young age, presence of diabetic ketoacidosis and long duration of disease symptoms (P = 0.0004), and with risk alleles of WFS1, CDKN2A/2B and RNLS (P = 0.006). (2) A second pattern of high ZnT8 autoantibody levels and low postprandial glucagon levels associated with risk alleles of IFIH1, TCF2, TAF5L, IL2RA and PTPN2 and protective alleles of ERBB3 gene (P = 0.0005). These results demonstrate that Latent Factor Modelling can identify associating patterns in clinical prospective data – future functional studies will be needed to clarify the relevance of these patterns. PMID:23755131

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

Impact of obesity on bone metabolism.

PubMed

López-Gómez, Juan J; Pérez Castrillón, José L; de Luis Román, Daniel A

2016-12-01

High weight is a protective factor against osteoporosis and risk of fracture. In obesity, however, where overweight is associated to excess fat, this relationship does not appear to be so clear, excess weight has sometimes been associated to decreased bone mass. Obesity interferes with bone metabolism through mechanical, hormonal, and inflammatory factors. These factors are closely related to weight, body composition, and dietary patterns of these patients. The net beneficial or harmful effect on bone mass or risk of fracture of the different components of this condition is not well known. We need to recognize patients at a greater risk of bone disease related to obesity to start an adequate intervention. Copyright © 2016. Publicado por Elsevier España, S.L.U.

Alcoholic Beverage Consumption and Chronic Diseases

PubMed Central

Zhou, Yue; Zheng, Jie; Li, Sha; Zhou, Tong; Zhang, Pei; Li, Hua-Bin

2016-01-01

Epidemiological and experimental studies have consistently linked alcoholic beverage consumption with the development of several chronic disorders, such as cancer, cardiovascular diseases, diabetes mellitus and obesity. The impact of drinking is usually dose-dependent, and light to moderate drinking tends to lower risks of certain diseases, while heavy drinking tends to increase the risks. Besides, other factors such as drinking frequency, genetic susceptibility, smoking, diet, and hormone status can modify the association. The amount of ethanol in alcoholic beverages is the determining factor in most cases, and beverage types could also make an influence. This review summarizes recent studies on alcoholic beverage consumption and several chronic diseases, trying to assess the effects of different drinking patterns, beverage types, interaction with other risk factors, and provide mechanistic explanations. PMID:27231920

Scale-dependence of desease impacts on quaking aspen (Populus tremuloides) mortality risk in the southwestern U.S.

Treesearch

David M. Bell; John B. Bradford; William K. Lauenroth

2015-01-01

Depending on how disease impacts tree exposure to risk, both the prevalence of disease and disease effects on survival may contribute to patterns of mortality risk across a species’ range. Disease may accelerate tree species’ declines in response to global change factors, such as drought, biotic interactions, such as competition, or functional traits, such as allometry...

Time patterns of recurrences and factors predisposing for a higher risk of recurrence of ocular toxoplasmosis.

PubMed

Reich, Michael; Ruppenstein, Mira; Becker, Matthias D; Mackensen, Friederike

2015-04-01

To ascertain time patterns of recurrences and factors predisposing for a higher risk of recurrence of ocular toxoplasmosis. Retrospective observational case series with follow-up examination. Database of 4,381 patients with uveitis was used. Data of 84 patients with ocular toxoplasmosis (sample group) could be included. Two hundred and eighty active lesions in the first affected eye were detected. The mean number of recurrences per year was 0.29 (standard deviation, 0.24). Median recurrence-free survival time was 2.52 years (95% confidence interval, 2.03-3.02 years). Risk of recurrence was highest in the first year after the most recent episode (26%) implying a decrease with increasing recurrence-free interval. The risk of recurrence decreased with the duration of disease (P < 0.001). Treatment of the first active lesion influenced the risk of recurrence (P = 0.048). Furthermore, the risk of recurrence was influenced by patient age at the time of the first active lesion (P = 0.021) and the most recent episode (P = 0.002). A secondary antibiotic prophylaxis could be discussed 1) during the first year after an active lesion has occurred, especially in case of the first active lesion of ocular toxoplasmosis, and 2) in older patients, especially if primarily infected with Toxoplasma gondii at an older age.

Opposite differential risks for autism and schizophrenia based on maternal age, paternal age, and parental age differences

PubMed Central

Boomsma, Jacobus J.

2016-01-01

Abstract Background and objectives: Effects of maternal and paternal age on offspring autism and schizophrenia risks have been studied for over three decades, but inconsistent risks have often been found, precluding well-informed speculation on why these age-related risks might exist. Methodology: To help clarify this situation we analysed a massive single population sample from Denmark including the full spectrum of autistic and schizophrenic disorders (eliminating between-study confounding), used up to 30 follow-up years, controlled for over 20 potentially confounding factors and interpret the ultimate causation of the observed risk patterns using generally accepted principles of parent-offspring conflict and life-history theory. Results: We evaluated the effects of paternal age, maternal age and parental age difference on offspring mental disorders and found consistently similar risk patterns for related disorders and markedly different patterns between autistic and schizophrenic disorders. Older fathers and mothers both conferred increased risk for autistic but not schizophrenic disorders, but autism risk was reduced in younger parents and offspring of younger mothers had increased risk for many schizophrenic disorders. Risk for most disorders also increased when parents were more dissimilarly aged. Monotonically increasing autism risk is consistent with mutation accumulation as fathers’ age, but this explanation is invalid for schizophrenic disorders, which were not related to paternal age and were negatively correlated with maternal age. Conclusions and implications: We propose that the observed maternally induced risk patterns ultimately reflect a shifting ancestral life-history trade-off between current and future reproduction, mediated by an initially high but subsequently decreasing tendency to constrain foetal provisioning as women proceed from first to final pregnancy. PMID:27637201

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.

Maternal dietary patterns during pregnancy and risk of wheeze and eczema in Japanese infants aged 16-24 months: the Osaka Maternal and Child Health Study.

PubMed

Miyake, Yoshihiro; Okubo, Hitomi; Sasaki, Satoshi; Tanaka, Keiko; Hirota, Yoshio

2011-11-01

Maternal diet during pregnancy might influence the development of childhood allergic disorders.   This prospective study examined the relationship between maternal dietary patterns during pregnancy and the risk of wheeze and eczema in the offspring aged 16-24 months. Subjects were 763 mother-child pairs. Data on maternal intake during pregnancy were assessed with a diet history questionnaire. Dietary patterns were derived from factor analysis of 33 predefined food groups. Symptoms of wheeze and eczema were based on criteria of the International Study of Asthma and Allergies in Childhood. Adjustment was made for maternal age, gestation, residential municipality, family income, maternal and paternal education, maternal and paternal history of allergic disorders, changes in maternal diet in pregnancy, season at baseline, maternal smoking during pregnancy, baby's older siblings, sex, birth weight, age at the third survey, household smoking, and breastfeeding duration. Three dietary patterns were identified: 'healthy', characterized by high intake of green and yellow vegetables, seaweed, mushrooms, white vegetables, pulses, potatoes, fish, sea products, fruit, and shellfish; 'Western', characterized by high intake of vegetable oil, salt-containing seasonings, beef and pork, processed meat, eggs, chicken, and white vegetables; and 'Japanese', characterized by high intake of rice, miso soup, sea products, and fish. There was a tendency for an inverse exposure-response relationship between the maternal Western pattern during pregnancy and the risk of childhood wheeze by crude analysis. After adjustment for the confounding factors under study, the inverse relationship was strengthened: the adjusted OR between extreme quartiles was 0.59 (95% CI: 0.35-0.98, p for trend = 0.02). No such inverse association was observed for childhood eczema. Neither the maternal healthy pattern nor the Japanese pattern during pregnancy was related to childhood wheeze or eczema. The maternal Western pattern during pregnancy may be preventive against wheeze in the offspring. © 2011 John Wiley & Sons A/S.

Trends in nutritional intakes and nutrition-related cardiovascular disease risk factors in Lebanon: the need for immediate action.

PubMed

Nasreddine, Lara; Naja, Farah A; Sibai, Abla-Mehio; Helou, Khalil; Adra, Nada; Hwalla, Nahla

2014-01-01

To examine the burden of cardiovascular disease (CVD) risk factors and their association with dietary variables in the Lebanese population while reviewing secular trends in the population's nutritional intakes and nutrition-related CVD risk factors. Data on CVD risk factors and food consumption patterns in Lebanon were collected from scholarly papers, including individual studies and systematic review articles. Electronic databases were searched using combinations of key terms. The prevalence of obesity in Lebanon followed an alarming increasing trend over time, paralleled by an escalation in the prevalence of hypertension, diabetes and hyperlipidemia. Food consumption surveys illustrate an increasing trend in energy intake and the proportion of energy derived from fat and animal products, with a concomitant decrease in carbohydrates and cereals intakes. The shift towards an atherogenic diet coupled with the alarming increase in nutrition-related cardiovascular risk factors suggest that the Lebanese population is at an increased risk for CVDs. This should alert to the importance of formulating multicomponent intervention strategies at both the individual and population levels to halt the progression of nutrition-related diseases in the country, while highlighting the need for immediate public health efforts to promote the adoption of healthy dietary habits.

Compassion satisfaction, compassion fatigue, anxiety, depression and stress in registered nurses in Australia: study 1 results.

PubMed

Hegney, Desley G; Craigie, Mark; Hemsworth, David; Osseiran-Moisson, Rebecca; Aoun, Samar; Francis, Karen; Drury, Vicki

2014-05-01

To explore compassion fatigue and compassion satisfaction with the potential contributing factors of anxiety, depression and stress. To date, no studies have connected the quality of work-life with other contributing and co-existing factors such as depression, anxiety and stress. A self-report exploratory cross sectional survey of 132 nurses working in a tertiary hospital. The reflective assessment risk profile model provides an excellent framework for examining the relationships between the professional quality of work factors and contributing factors within the established risk profiles. The results show a definite pattern of risk progression for the six factors examined for each risk profile. Additionally, burnout and secondary traumatic stress were significantly related to higher anxiety and depression levels. Higher anxiety levels were correlated with nurses who were younger, worked full-time and without a postgraduate qualification. Twenty percent had elevated levels of compassion fatigue: 7.6% having a very distressed profile. At-risk nurses' stress and depression scores were significantly higher than nurses with higher compassion satisfaction scores. The employed nurse workforce would benefit from a psychosocial capacity building intervention that reduces a nurse's risk profile, thus enhancing retention. © 2013 John Wiley & Sons Ltd.

MYCN controls an alternative RNA splicing program in high-risk metastatic neuroblastoma.

PubMed

Zhang, Shile; Wei, Jun S; Li, Samuel Q; Badgett, Tom C; Song, Young K; Agarwal, Saurabh; Coarfa, Cristian; Tolman, Catherine; Hurd, Laura; Liao, Hongling; He, Jianbin; Wen, Xinyu; Liu, Zhihui; Thiele, Carol J; Westermann, Frank; Asgharzadeh, Shahab; Seeger, Robert C; Maris, John M; Guidry Auvil, Jamie M; Smith, Malcolm A; Kolaczyk, Eric D; Shohet, Jason; Khan, Javed

2016-02-28

The molecular mechanisms underlying the aggressive behavior of MYCN driven neuroblastoma (NBL) is under intense investigation; however, little is known about the impact of this family of transcription factors on the splicing program. Here we used high-throughput RNA sequencing to systematically study the expression of RNA isoforms in stage 4 MYCN-amplified NBL, an aggressive subtype of metastatic NBL. We show that MYCN-amplified NBL tumors display a distinct gene splicing pattern affecting multiple cancer hallmark functions. Six splicing factors displayed unique differential expression patterns in MYCN-amplified tumors and cell lines, and the binding motifs for some of these splicing factors are significantly enriched in differentially-spliced genes. Direct binding of MYCN to promoter regions of the splicing factors PTBP1 and HNRNPA1 detected by ChIP-seq demonstrates that MYCN controls the splicing pattern by direct regulation of the expression of these key splicing factors. Furthermore, high expression of PTBP1 and HNRNPA1 was significantly associated with poor overall survival of stage4 NBL patients (p ≤ 0.05). Knocking down PTBP1, HNRNPA1 and their downstream target PKM2, an isoform of pro-tumor-growth, result in repressed growth of NBL cells. Therefore, our study reveals a novel role of MYCN in controlling global splicing program through regulation of splicing factors in addition to its well-known role in the transcription program. These findings suggest a therapeutically potential to target the key splicing factors or gene isoforms in high-risk NBL with MYCN-amplification. Published by Elsevier Ireland Ltd.

An exploratory factor analysis of nutritional biomarkers associated with major depression in pregnancy

PubMed Central

Bodnar, Lisa M.; Wisner, Katherine L.; Luther, James F.; Powers, Robert W.; Evans, Rhobert W.; Gallaher, Marcia J.; Newby, P.K.

2011-01-01

Objective Major depressive disorder (MDD) during pregnancy increases the risk of adverse maternal and infant outcomes. Maternal nutritional status may be a modifiable risk factor for antenatal depression. We evaluated the association between patterns in mid-pregnancy nutritional biomarkers and MDD. Design Prospective cohort study Setting Pittsburgh, Pennsylvania, USA Subjects Women who enrolled at ≤20 weeks gestation had a diagnosis of MDD made with the Structured Clinical Interview for DSM-IV at 20-, 30-, and 36-week study visits. A total of 135 women contributed 345 person-visits. Non-fasting blood drawn at enrollment was assayed for red cell essential fatty acids, plasma folate, homocysteine, and ascorbic acid; serum 25-hydroxyvitamin D, retinol, vitamin E, carotenoids, ferritin, and soluble transferrin receptors. Nutritional biomarkers were entered into principal components analysis. Results Three factors emerged: Factor 1, Essential Fatty Acids; Factor 2, Micronutrients; and Factor 3, Carotenoids. MDD was prevalent in 21.5% of women. In longitudinal multivariable logistic models, there was no association between the Essential Fatty Acid or Micronutrient patterns and MDD either before or after adjustment for employment, education, or prepregnancy BMI. In unadjusted analysis, women with Carotenoid factor scores in the middle and upper tertiles were 60% less likely than women in the bottom tertile to have MDD during pregnancy, but after adjustment for confounders, the associations were no longer statistically significant. Conclusions While meaningful patterns were derived using nutritional biomarkers, significant associations with MDD were not observed in multivariable adjusted analyses. Larger, more diverse samples are needed to understand nutrition-depression relationships during pregnancy. PMID:22152590

An exploratory factor analysis of nutritional biomarkers associated with major depression in pregnancy.

PubMed

Bodnar, Lisa M; Wisner, Katherine L; Luther, James F; Powers, Robert W; Evans, Rhobert W; Gallaher, Marcia J; Newby, P K

2012-06-01

Major depressive disorder (MDD) during pregnancy increases the risk of adverse maternal and infant outcomes. Maternal nutritional status may be a modifiable risk factor for antenatal depression. We evaluated the association between patterns in mid-pregnancy nutritional biomarkers and MDD. Prospective cohort study. Pittsburgh, Pennsylvania, USA. Women who enrolled at ≤20 weeks' gestation and had a diagnosis of MDD made with the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) at 20-, 30- and 36-week study visits. A total of 135 women contributed 345 person-visits. Non-fasting blood drawn at enrolment was assayed for red cell essential fatty acids, plasma folate, homocysteine and ascorbic acid; serum 25-hydroxyvitamin D, retinol, vitamin E, carotenoids, ferritin and soluble transferrin receptors. Nutritional biomarkers were entered into principal components analysis. Three factors emerged: Factor 1, Essential Fatty Acids; Factor 2, Micronutrients; and Factor 3, Carotenoids. MDD was prevalent in 21·5 % of women. In longitudinal multivariable logistic models, there was no association between the Essential Fatty Acids or Micronutrients pattern and MDD either before or after adjustment for employment, education or pre-pregnancy BMI. In unadjusted analysis, women with factor scores for Carotenoids in the middle and upper tertiles were 60 % less likely than women in the bottom tertile to have MDD during pregnancy, but after adjustment for confounders the associations were no longer statistically significant. While meaningful patterns were derived using nutritional biomarkers, significant associations with MDD were not observed in multivariable adjusted analyses. Larger, more diverse samples are needed to understand nutrition-depression relationships during pregnancy.

HIV-risk characteristics in community corrections.

PubMed

Clark, C Brendan; McCullumsmith, Cheryl B; Waesche, Matthew C; Islam, M Aminul; Francis, Reginald; Cropsey, Karen L

2013-01-01

Individuals in the criminal justice system engage in behaviors that put them at high risk for HIV. This study sought to identify characteristics of individuals who are under community corrections supervision (eg, probation) and at risk for HIV. Approximately 25,000 individuals under community corrections supervision were assessed for HIV risk, and 5059 participants were deemed high-risk or no-risk. Of those, 1519 exhibited high sexual-risk (SR) behaviors, 203 exhibited injection drug risk (IVR), 957 exhibited both types of risk (SIVR), and 2380 exhibited no risk. Sociodemographic characteristics and drug of choice were then examined using univariate and binary logistic regression. Having a history of sexual abuse, not having insurance, and selecting any drug of choice were associated with all forms of HIV risk. However, the effect sizes associated with the various drugs of choice varied significantly by group. Aside from those common risk factors, very different patterns emerged. Female gender was a risk factor for the SR group but was less likely to be associated with IVR. Younger age was associated with SR, whereas older age was associated with IVR. Black race was a risk factor for SR but had a negative association with IVR and SIVR. Living in a shelter, living with relatives/friends, and being unemployed were all risk factors for IVR but were protective factors for SR. Distinct sociodemographic and substance use characteristics were associated with sexual versus injection drug use risk for individuals under community corrections supervision who were at risk for HIV. Information from this study could help identify high-risk individuals and allow tailoring of interventions.

Perception and Sense of Control Over Eating Behaviors Among a Diverse Sample of Adults at Risk for Type 2 Diabetes

PubMed Central

Fukuoka, Yoshimi; Lindgren, Teri G.; Bonnet, Kemberlee; Kamitani, Emiko

2014-01-01

Purpose The purpose of the study was to explore and understand knowledge and attitudes about food, diet, and weight control, focusing on barriers and motivators to reduce risk of developing type 2 diabetes. Methods Six focus groups were conducted in May and June 2010. The groups were stratified by sex. A total of 35 ethnically diverse samples with a high risk for type 2 diabetes participated. The average age was 51 ± 10.6 years, and 57% of the sample represented women. Results Four themes emerged from the focus groups: (1) demonstrated knowledge and source of knowledge, including participants’ basic understanding of “good” and “bad” food and what constitutes a “healthy diet” and trusted sources of information; (2) perceptions of food and diet, encompassing how participants expressed their perception of and interaction with food and diet; (3) sense of control over dietary intake, reflecting participants’ discussion of their perceived ability to control their eating patterns and food choices; and (4) eating behaviors, describing participants’ patterns of eating and perceived barriers to eating a healthy diet. Conclusions Study findings demonstrate that eating healthy requires a complex interaction between individual perceptions of food and sense of control over eating patterns and socio-political and economic structural factors that restrict healthy eating options while promoting unhealthy ones. Programs for long-term eating behavioral change necessary to reduce type 2 diabetes and obesity need to incorporate strategies that address individual-level factors of perception of food and sense of control over eating patterns, as well as structural level factors such as poverty and food insecurity. PMID:24525569

The Influence of Supervisory Neglect on Subtypes of Emerging Adult Substance Use After Controlling for Familial Factors, Relationship Status, and Individual Traits

PubMed Central

Snyder, Susan M.; Merritt, Darcey H.

2016-01-01

Background This study is the first to explore how child supervisory neglect influences patterns of substance use among young adults. This study investigated patterns of substance use among males and females, 18 to 24 years old, after controlling for adolescent parental drinking, living with parents, relationship status, delinquency, and depression. Methods The study sample (N = 10,618) included individuals who participated in Waves I (1994–1995) and III (2001–2002) of the National Longitudinal Study of Adolescent Health (Add Health). The study used latent class analysis to ascertain how patterns of substance use emerged as distinct classes. Results For both males and females, we identified the following 4 classes of substance use: (1) heavy polysubstance use, (2) moderate polysubstance use, (3) alcohol and marijuana, and (4) low-use substance use patterns. Multinomial logistic regression indicated that, for both males and females 18 to 24 years old, experiencing supervisory neglect, being depressed, being single, and engaging in adolescent delinquency serve as risk factors for heavy polysubstance use class membership. Conversely, being black or Hispanic lowered the likelihood of polysubstance use for males and females. For females only, living with parents served as a protective factor that reduced the risk of membership in heavy polysubstance use, moderate polysubstance use, and alcohol and marijuana classes. For males only, being less educated increased the risk of heavy polysubstance use class membership. Conclusions Results from this exploratory study underscore the enduring effect of supervisory neglect on substance use among male and female young adults. Future studies should explore whether these relationships hold over time. PMID:25775372

Meth mouth severity in response to drug-use patterns and dental access in methamphetamine users.

PubMed

Brown, Ronni E; Morisky, Donald E; Silverstein, Steven J

2013-06-01

Meth mouth is the rapid development of tooth decay in methamphetamine users. Our study questioned whether drug-use patterns and dental care access are risk factors affecting the severity of meth mouth. Participants received dental examinations, and the number of decayed, missing and filled teeth (DMFT) were counted and used to measure meth mouth severity.

Psychological Language on Twitter Predicts County-Level Heart Disease Mortality

PubMed Central

Eichstaedt, Johannes C.; Schwartz, Hansen Andrew; Kern, Margaret L.; Park, Gregory; Labarthe, Darwin R.; Merchant, Raina M.; Jha, Sneha; Agrawal, Megha; Dziurzynski, Lukasz A.; Sap, Maarten; Weeg, Christopher; Larson, Emily E.; Ungar, Lyle H.; Seligman, Martin E. P.

2015-01-01

Hostility and chronic stress are known risk factors for heart disease, but they are costly to assess on a large scale. We used language expressed on Twitter to characterize community-level psychological correlates of age-adjusted mortality from atherosclerotic heart disease (AHD). Language patterns reflecting negative social relationships, disengagement, and negative emotions—especially anger—emerged as risk factors; positive emotions and psychological engagement emerged as protective factors. Most correlations remained significant after controlling for income and education. A cross-sectional regression model based only on Twitter language predicted AHD mortality significantly better than did a model that combined 10 common demographic, socioeconomic, and health risk factors, including smoking, diabetes, hypertension, and obesity. Capturing community psychological characteristics through social media is feasible, and these characteristics are strong markers of cardiovascular mortality at the community level. PMID:25605707

Psychological language on Twitter predicts county-level heart disease mortality.

PubMed

Eichstaedt, Johannes C; Schwartz, Hansen Andrew; Kern, Margaret L; Park, Gregory; Labarthe, Darwin R; Merchant, Raina M; Jha, Sneha; Agrawal, Megha; Dziurzynski, Lukasz A; Sap, Maarten; Weeg, Christopher; Larson, Emily E; Ungar, Lyle H; Seligman, Martin E P

2015-02-01

Hostility and chronic stress are known risk factors for heart disease, but they are costly to assess on a large scale. We used language expressed on Twitter to characterize community-level psychological correlates of age-adjusted mortality from atherosclerotic heart disease (AHD). Language patterns reflecting negative social relationships, disengagement, and negative emotions-especially anger-emerged as risk factors; positive emotions and psychological engagement emerged as protective factors. Most correlations remained significant after controlling for income and education. A cross-sectional regression model based only on Twitter language predicted AHD mortality significantly better than did a model that combined 10 common demographic, socioeconomic, and health risk factors, including smoking, diabetes, hypertension, and obesity. Capturing community psychological characteristics through social media is feasible, and these characteristics are strong markers of cardiovascular mortality at the community level. © The Author(s) 2014.

Pattern of socio-economic and health aspects among TB patients and controls.

PubMed

Kapoor, A K; Deepani, Vijit; Dhall, Meenal; Kapoor, Satwanti

2016-10-01

Socio-economic and health-related factors have a significant impact on tuberculosis (TB) incidence among population residing in resource-scare settings. To evaluate the pattern of socio-economic and health-related factors among TB patients and control in Delhi, India. The present cross-sectional study was performed among 893 TB patients (or cases) and 333 healthy disease-free controls. The data for the present study was obtained from several district TB centres in north, west and south Delhi. The collected data was edited, coded and statistical analysed with the help of SPSS 20.0 version. Illiteracy and primary education were significant risk factors being associated with a TB. Rented housing condition had an odds ratio (OR) of 1.4 (95% confidence interval [CI]: 1.09-1.89) compared to owned housing condition. 3-5 individuals per room were 3 times more likely to be associated with a case of TB (95% CI: 2.49-4.41). Migrant individuals were 13 times more likely to be associated with a case of TB (95% CI: 8.77-19.78) in comparison to settled population. Daily consumption of non-vegetarian food also significantly contributed to case of TB with an OR of 3.4 (95% CI: 2.51-4.72). Loss of appetite and family TB served as significant health-related factors associated with TB risk. Lower educational status, rented household, individuals per room (as a measure of overcrowding) and migratory status served as prominent risk factors for TB disease. Preference and frequency of non-vegetarian food being consumed, night sweating, weight loss, loss of appetite, earlier TB and family TB were principle health-related risk factors associated with TB disease. Copyright © 2016 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

Callous-Unemotional Features, Behavioral Inhibition, and Parenting: Independent Predictors of Aggression in a High-Risk Preschool Sample

ERIC Educational Resources Information Center

Kimonis, Eva R.; Frick, Paul J.; Boris, Neil W.; Smyke, Anna T.; Cornell, Amy H.; Farrell, Jamie M.; Zeanah, Charles H.

2006-01-01

A behaviorally-uninhibited temperament, callous-unemotional (CU) features, and harsh parenting have been associated with specific patterns of aggressive behavior in older children and adolescents. We tested the additive and interactive effects of these factors in predicting different types of aggressive behavior in a high-risk preschool sample.…

Irregular vascular pattern by contrast-enhanced ultrasonography and high serum Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein level predict poor outcome after successful radiofrequency ablation in patients with early-stage hepatocellular carcinoma.

PubMed

Takada, Hitomi; Tsuchiya, Kaoru; Yasui, Yutaka; Nakakuki, Natsuko; Tamaki, Nobuharu; Suzuki, Shoko; Nakanishi, Hiroyuki; Itakura, Jun; Takahashi, Yuka; Kurosaki, Masayuki; Asahina, Yasuhiro; Enomoto, Nobuyuki; Izumi, Namiki

2016-11-01

Radiofrequency ablation (RFA) is considered the most effective treatment for early-stage hepatocellular carcinoma (HCC) patients unsuitable for resection. However, poor outcome after RFA has occasionally been reported worldwide. To predict such an outcome, we investigated imaging findings using contrast-enhanced ultrasonography (CEUS) with Sonazoid and serum tumor markers before RFA. This study included 176 early-stage HCC patients who had initially achieved successful RFA. Patients were examined using CEUS; their levels of alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and des-gamma-carboxy prothrombin before RFA were measured. Sonazoid provided parenchyma-specific contrast imaging and facilitated tumor vascular architecture imaging through maximum intensity projection (MIP). Kaplan-Meier analysis examined cumulative rates of local tumor progression, intrasubsegmental recurrence, and survival; factors associated with these were determined with Cox proportional hazards analysis. Local tumor progression (n = 15), intrasubsegmental recurrence (n = 46), and death (n = 18) were observed. Irregular pattern in MIP classification and serum AFP-L3 level (>10%) before RFA were identified as independent risk factors for local tumor progression and intrasubsegmental recurrence. These two factors were independently associated with poor survival after RFA (irregular pattern in MIP: hazard ratio, (HR) = 8.26; 95% confidence interval, (CI) = 2.24-30.3; P = 0.002 and AFP-L3 > 10%: HR = 2.94; 95% CI = 1.09-7.94; P = 0.033). Irregular MIP pattern by CEUS and high level of serum AFP-L3 were independent risk factors for poor outcome after successful RFA. The Patients with these findings should be considered as special high-risk group in early-stage HCC. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Geographic patterns and environmental factors associated with human yellow fever presence in the Americas

PubMed Central

Aldighieri, Sylvain; Machado, Gustavo; Leonel, Deise Galan; Vilca, Luz Maria; Uriona, Sonia; Schneider, Maria Cristina

2017-01-01

Background In the Americas, yellow fever virus transmission is a latent threat due to the proximity between urban and wild environments. Although yellow fever has nearly vanished from North and Central America, there are still 13 countries in the Americas considered endemic by the World Health Organization. Human cases usually occur as a result of the exposure to sylvatic yellow fever in tropical forested environments; but urban outbreaks reported during the last decade demonstrate that the risk in this environment still exists. The objective of this study was to identify spatial patterns and the relationship between key geographic and environmental factors with the distribution of yellow fever human cases in the Americas. Methodology/Principal findings An ecological study was carried out to analyze yellow fever human cases reported to the Pan American Health Organization from 2000 to 2014, aggregated by second administrative level subdivisions (counties). Presence of yellow fever by county was used as the outcome variable and eight geo-environmental factors were used as independent variables. Spatial analysis was performed to identify and examine natural settings per county. Subsequently, a multivariable logistic regression model was built. During the study period, 1,164 cases were reported in eight out of the 13 endemic countries. Nearly 83.8% of these cases were concentrated in three countries: Peru (37.4%), Brazil (28.1%) and Colombia (18.4%); and distributed in 57 states/provinces, specifically in 286 counties (3.4% of total counties). Yellow fever presence was significantly associated with altitude, rain, diversity of non-human primate hosts and temperature. A positive spatial autocorrelation revealed a clustered geographic pattern in 138/286 yellow fever positive counties (48.3%). Conclusions/Significance A clustered geographic pattern of yellow fever was identified mostly along the Andes eastern foothills. This risk map could support health policies in endemic countries. Geo-environmental factors associated with presence of yellow fever could help predict and adjust the limits of other risk areas of epidemiological concern. PMID:28886023

Geographic patterns and environmental factors associated with human yellow fever presence in the Americas.

PubMed

Hamrick, Patricia Najera; Aldighieri, Sylvain; Machado, Gustavo; Leonel, Deise Galan; Vilca, Luz Maria; Uriona, Sonia; Schneider, Maria Cristina

2017-09-01

In the Americas, yellow fever virus transmission is a latent threat due to the proximity between urban and wild environments. Although yellow fever has nearly vanished from North and Central America, there are still 13 countries in the Americas considered endemic by the World Health Organization. Human cases usually occur as a result of the exposure to sylvatic yellow fever in tropical forested environments; but urban outbreaks reported during the last decade demonstrate that the risk in this environment still exists. The objective of this study was to identify spatial patterns and the relationship between key geographic and environmental factors with the distribution of yellow fever human cases in the Americas. An ecological study was carried out to analyze yellow fever human cases reported to the Pan American Health Organization from 2000 to 2014, aggregated by second administrative level subdivisions (counties). Presence of yellow fever by county was used as the outcome variable and eight geo-environmental factors were used as independent variables. Spatial analysis was performed to identify and examine natural settings per county. Subsequently, a multivariable logistic regression model was built. During the study period, 1,164 cases were reported in eight out of the 13 endemic countries. Nearly 83.8% of these cases were concentrated in three countries: Peru (37.4%), Brazil (28.1%) and Colombia (18.4%); and distributed in 57 states/provinces, specifically in 286 counties (3.4% of total counties). Yellow fever presence was significantly associated with altitude, rain, diversity of non-human primate hosts and temperature. A positive spatial autocorrelation revealed a clustered geographic pattern in 138/286 yellow fever positive counties (48.3%). A clustered geographic pattern of yellow fever was identified mostly along the Andes eastern foothills. This risk map could support health policies in endemic countries. Geo-environmental factors associated with presence of yellow fever could help predict and adjust the limits of other risk areas of epidemiological concern.

Selection bias and patterns of confounding in cohort studies: the case of the NINFEA web-based birth cohort.

PubMed

Pizzi, Costanza; De Stavola, Bianca L; Pearce, Neil; Lazzarato, Fulvio; Ghiotti, Paola; Merletti, Franco; Richiardi, Lorenzo

2012-11-01

Several studies have examined the effects of sample selection on the exposure-outcome association estimates in cohort studies, but the reasons why this selection may induce bias have not been fully explored. To investigate how sample selection of the web-based NINFEA birth cohort may change the confounding patterns present in the source population. The characteristics of the NINFEA participants (n=1105) were compared with those of the wider source population-the Piedmont Birth Registry (PBR)-(n=36 092), and the association of two exposures (parity and educational level) with two outcomes (low birth weight and birth by caesarean section), while controlling for other risk factors, was studied. Specifically the associations among measured risk factors within each dataset were examined and the exposure-outcome estimates compared in terms of relative ORs. The associations of educational level with the other risk factors (alcohol consumption, folic acid intake, maternal age, pregnancy weight gain, previous miscarriages) partly differed between PBR and NINFEA. This was not observed for parity. Overall, the exposure-outcome estimates derived from NINFEA only differed moderately from those obtained in PBR, with relative ORs ranging between 0.74 and 1.03. Sample selection in cohort studies may alter the confounding patterns originally present in the general population. However, this does not necessarily introduce selection bias in the exposure-outcome estimates, as sample selection may reduce some of the residual confounding present in the general population.

Observational study of adherence to a traditional Mediterranean diet, sociocultural characteristics and cardiovascular disease risk factors of older Greek Australians from MEDiterranean ISlands (MEDIS-Australia Study): Protocol and rationale.

PubMed

Thodis, Antonia; Itsiopoulos, Catherine; Kouris-Blazos, Antigone; Brazionis, Laima; Tyrovolas, Stefanos; Polychronopoulos, Evangelos; Panagiotakos, Demosthenes B

2018-02-01

To describe the study protocol of the MEDiterranean ISlands-Australia (MEDIS-Australia) Study modelled on the MEDIS Study conducted in Greece. The present study aims to explore adherence to the traditional Mediterranean diet pattern, determine enablers and barriers to adherence, explore the definition of Greek cuisine, and associations between adherence to the diet pattern and risk factors for cardiovascular disease (CVD) and metabolic syndrome in older Greek Australians originally from Greek islands and Cyprus. Now long-term immigrants, with at least 50 years in Australia, characteristics and risk factor profiles of older Greek islander-born Australians will be compared and contrasted to their counterparts living on Greek islands to evaluate the influence of migration on adherence. The present study is an observational study of cross-sectional design using a modified lifestyle and semi-quantitative food frequency questionnaire to capture sociodemographic, health, psychosocial and dietary characteristics, including cuisine, of 150 older Greek islander-born Australians. Anthropometric measures and medical history will be collected. Participants will be aged over 65 years, live independently, are originally from a Greek island and are free from CVD. Data collection is underway. Characteristics and behaviours associated with adherence, if identified, could be evaluated in future studies. For example, exploration of enablers or barriers to adherence to a Mediterranean dietary pattern in an Australian population. © 2017 Dietitians Association of Australia.

Epidemiological studies of migration and environmental risk factors in the inflammatory bowel diseases.

PubMed

Ko, Yanna; Butcher, Rhys; Leong, Rupert W

2014-02-07

Inflammatory bowel diseases (IBD) are idiopathic chronic diseases of the gastrointestinal tract well known to be associated with both genetic and environmental risk factors. Permissive genotypes may manifest into clinical phenotypes under certain environmental influences and these may be best studied from migratory studies. Exploring differences between first and second generation migrants may further highlight the contribution of environmental factors towards the development of IBD. There are few opportunities that have been offered so far. We aim to review the available migration studies on IBD, evaluate the known environmental factors associated with IBD, and explore modern migration patterns to identify new opportunities and candidate migrant groups in IBD migration research.

Dietary patterns and breast cancer risk in the California Teachers Study cohort12345

PubMed Central

Link, Lilli B; Canchola, Alison J; Bernstein, Leslie; Clarke, Christina A; Stram, Daniel O; Ursin, Giske

2013-01-01

Background: Evidence that diet is associated with breast cancer risk is inconsistent. Most studies have examined risks associated with specific foods and nutrients, rather than measures of overall diet. Objective: This study aimed to evaluate dietary patterns and their relation to breast cancer risk in a large cohort of women. Design: Data from 91,779 women in the California Teachers Study cohort were analyzed, including data from 4140 women with a diagnosis of invasive breast cancer made between 1995 and 2009. Five predominant dietary patterns were identified by using principal components factor analysis: a plant-based diet, high in fruit and vegetables; a high-protein, high-fat diet, high in meats, eggs, fried foods, and high-fat condiments; a high-carbohydrate diet, high in convenience foods, pasta, and bread products; an ethnic diet, high in legumes, soy-based foods, rice, and dark-green leafy vegetables; and a salad and wine diet, high in lettuce, fish, wine, low-fat salad dressing, and coffee and tea. Results: The plant-based pattern was associated with a reduction in breast cancer risk (RR: 0.85; 95% CI: 0.76, 0.95 for the highest compared with the lowest consumption quintile; P-trend = 0.003); risk reduction was greater for estrogen receptor–negative progesterone receptor–negative (ER–PR–) tumors (RR: 0.66; 95% CI: 0.48, 0.91; P-trend = 0.03). The salad and wine pattern was associated with an increased risk of estrogen receptor–positive progesterone receptor–positive tumors (RR: 1.29; 95% CI: 1.12, 1.49); this effect was only slightly attenuated after adjustment for alcohol consumption. Conclusion: The finding that greater consumption of a plant-based dietary pattern is associated with a reduced breast cancer risk, particularly for ER−PR− tumors, offers a potential avenue for prevention. PMID:24108781

Association of cardiovascular risk factors between Hispanic/Latino parents and youth: the Hispanic Community Health Study/Study of Latino Youth.

PubMed

Carnethon, Mercedes R; Ayala, Guadalupe X; Bangdiwala, Shrikant I; Bishop, Virginia; Daviglus, Martha L; Delamater, Alan M; Gallo, Linda C; Perreira, Krista; Pulgaron, Elizabeth; Reina, Samantha; Talavera, Gregory A; Van Horn, Linda H; Isasi, Carmen R

2017-04-01

Hispanic/Latinos have a high burden of cardiovascular disease (CVD) risk factors which may begin at young ages. We tested the association of CVD risk factors between Hispanic/Latino parents and their children. We conducted a cross-sectional study in the Hispanic Community Health Study/Study of Latinos Youth study. Girls (n = 674) and boys (n = 667) aged 8 to 16 years (mean age 12.1 years) and their parents (n = 942) had their CVD risk factors measured. CVD risk factors in parents were significantly positively associated with those same risk factors among youth. After adjustment for demographic characteristics, diet and physical activity, obese parents were significantly more likely to have youth who were overweight (odds ratios [ORs], 2.39; 95% confidence interval [CI], 1.20-4.76) or obese (OR, 6.16; 95% CI, 3.23-11.77) versus normal weight. Dyslipidemia among parents was associated with 1.98 higher odds of dyslipidemia among youth (95% CI, 1.37-2.87). Neither hypertension nor diabetes was associated with higher odds of high blood pressure or hyperglycemia (prediabetes or diabetes) in youth. Findings were consistent by sex and in younger (age <12 years) versus older (≥12 years) youth. Hispanic/Latino youth share patterns of obesity and CVD risk factors with their parents, which portends high risk for adult CVD. Copyright © 2017 Elsevier Inc. All rights reserved.

Saturday night's alright for fighting: antisocial traits, fighting, and weapons carrying in a large sample of youth.

PubMed

Ferguson, Christopher J; Cricket Meehan, D

2010-12-01

The current study examines risk and protective factors for youth antisocial personality and behavior from a multivariate format. It is hoped that this research will elucidate those risk and protective factors most important for focus of future prevention and intervention efforts. The current study examines multiple factors associated with youth antisocial traits and behavior in a sample of 8,256 youth (mean age 14), with the goal of identifying the strongest and most consistent risk or protective factors. Data was collected from the Ohio version of the Youth Risk Behavior Surveillance System's (YRBSS) school-based Youth Risk Behavior Survey (YRBS) developed by the Centers for Disease Control (CDC). Hierarchical multiple regression analyses identified peer delinquency, drug use and negative community influences as predictive of antisocial traits. Schools and families functioned as protective factors. Youth who fought frequently tended to be male, antisocial, dug using, depressed, and associated with delinquent peers. Weapons carrying was most common among drug using, antisocial males. Television and video game use were not predictive of antisocial, fighting or weapons carrying outcomes. Developmental patterns across age ranges regarding the relative importance of specific risk factors were also examined. Strategies for intervention and prevention of youth violence that focus on peers, neighborhoods, depression, and families may be particularly likely to bear fruit.

Burden of Chemotherapy-Induced Febrile Neutropenia Hospitalizations in US Clinical Practice, by Use and Patterns of Prophylaxis with Colony-Stimulating Factor.

PubMed

Weycker, Derek; Li, Xiaoyan; Tzivelekis, Spiros; Atwood, Mark; Garcia, Jacob; Li, Yanli; Reiner, Maureen; Lyman, Gary H

2017-02-01

Evidence suggests that many cancer chemotherapy patients who are candidates for colony-stimulating factor (CSF) prophylaxis do not receive it or receive it inconsistent with guidelines, and that such patients have a higher risk of febrile neutropenia hospitalization (FNH). Little is known about the number and consequences of FNH by use/patterns of CSF prophylaxis in US clinical practice. A retrospective cohort design and private healthcare claims data were employed. Study population comprised adults who received a chemotherapy course with a high-risk regimen, or an intermediate-risk regimen (if ≥1 FN risk factor present), for non-metastatic breast cancer or non-Hodgkin's lymphoma (NHL); each chemotherapy cycle within the course and each FNH episode within the cycles were identified. Consequences included mortality, inpatient days, and costs (US$2013) during FNH. Use (yes/no) and patterns (agent, administration day/duration) of CSF prophylaxis were evaluated within cycles in which FNH episodes occurred. Among all FNH episodes (n=6,355; 109 episodes per 1,000 patients), 41.3% (95% CI: 40.1-42.5) occurred among patients who did not receive CSF prophylaxis in that cycle, and 8.8% (8.1-9.5) occurred among those who received CSF prophylaxis on the same day as chemotherapy. Among FNH episodes occurring in patients who received daily CSF agents (2% of CSF use), 56.1% (44.1-68.0) received prophylaxis <7 days during the cycle. Results for FNH consequences were comparable. In this retrospective evaluation, one-half of FNH episodes, outcomes, and costs among cancer chemotherapy patients who were candidates for CSF prophylaxis occurred in those who either did not receive it or received it inconsistent with guidelines.

Altered amygdalar resting-state connectivity in depression is explained by both genes and environment.

PubMed

Córdova-Palomera, Aldo; Tornador, Cristian; Falcón, Carles; Bargalló, Nuria; Nenadic, Igor; Deco, Gustavo; Fañanás, Lourdes

2015-10-01

Recent findings indicate that alterations of the amygdalar resting-state fMRI connectivity play an important role in the etiology of depression. While both depression and resting-state brain activity are shaped by genes and environment, the relative contribution of genetic and environmental factors mediating the relationship between amygdalar resting-state connectivity and depression remain largely unexplored. Likewise, novel neuroimaging research indicates that different mathematical representations of resting-state fMRI activity patterns are able to embed distinct information relevant to brain health and disease. The present study analyzed the influence of genes and environment on amygdalar resting-state fMRI connectivity, in relation to depression risk. High-resolution resting-state fMRI scans were analyzed to estimate functional connectivity patterns in a sample of 48 twins (24 monozygotic pairs) informative for depressive psychopathology (6 concordant, 8 discordant and 10 healthy control pairs). A graph-theoretical framework was employed to construct brain networks using two methods: (i) the conventional approach of filtered BOLD fMRI time-series and (ii) analytic components of this fMRI activity. Results using both methods indicate that depression risk is increased by environmental factors altering amygdalar connectivity. When analyzing the analytic components of the BOLD fMRI time-series, genetic factors altering the amygdala neural activity at rest show an important contribution to depression risk. Overall, these findings show that both genes and environment modify different patterns the amygdala resting-state connectivity to increase depression risk. The genetic relationship between amygdalar connectivity and depression may be better elicited by examining analytic components of the brain resting-state BOLD fMRI signals. © 2015 Wiley Periodicals, Inc.

The association of dietary patterns and the incidence of insulin resistance after a 3-year follow-up: Tehran Lipid and Glucose Study.

PubMed

Doostvandi, Tayebeh; Bahadoran, Zahra; Mozaffari-Khosravi, Hassan; Tahmasebinejad, Zhaleh; Mirmiran, Parvin; Azizi, Fereidoun

2017-05-01

The aim of this study was to investigate the relationship between major dietary patterns and the risk of insulin resistance (IR) among an urban Iranian population. In this longitudinal study, 802 adult men and women were studied within the framework of Tehran Lipid and Glucose Study. Fasting serum insulin and glucose were measured at baseline and again after a 3-year of followup. The usual dietary intakes were assessed using a validated 168 item semi-quantitative food frequency questionnaire and major dietary patterns were obtained using principal component analysis. Logistic regression models were used to estimate the occurrence of IR across tertiles of dietary patterns with adjustment for potential confounding variables. Mean age of participants was 39.0±11.2 years and 45.5% were men. Three major dietary patterns including the Western, traditional and healthy were extracted, which explained 25.3% of total variance in food intake. The healthy dietary pattern, loaded heavily on intake of vegetable oils, fresh and dried fruits, low-fat dairy, nuts and seeds, was accompanied with a reduced risk of insulin resistance by 51% (OR=0.49, 95% CI=0.30-0.81), and 81% (OR=0.19, 95% CI=0.10-0.36), in the second and third tertile, respectively (p trend=0.001). In the presence of all dietary pattern scores in the logistic regression model, a 45% reduced risk of IR was observed per 1 unit increase in healthy dietary pattern score. These findings confirmed the protective effect of a plant-based, low-fat dietary pattern against the development of insulin resistance as a main risk factor of type 2 diabetes and metabolic disorders.

Syndemic Risk Classes and Substance Use Problems among Adults in High-Risk Urban Areas: A Latent Class Analysis.

PubMed

Cleland, Charles M; Lanza, Stephanie T; Vasilenko, Sara A; Gwadz, Marya

2017-01-01

Substance use problems tend to co-occur with risk factors that are especially prevalent in urban communities with high rates of poverty. The present study draws on Syndemics Theory to understand profiles of risk and resilience and their associations with substance use problems in a population at risk for adverse outcomes. African-American/Black and Hispanic heterosexual adults ( N  = 2,853) were recruited by respondent-driven sampling from an urban area with elevated poverty rates, and completed a structured assessment battery covering sociodemographics, syndemic factors (that is, multiple, co-occurring risk factors), and substance use. More than one-third of participants (36%) met criteria for either an alcohol or a drug problem in the past year. Latent class analysis identified profiles of risk and resilience, separately for women and men, which were associated with the probability of a substance use problem. Almost a third of women (27%) and 38% of men had lower risk profiles-patterns of resilience not apparent in other types of analyses. Profiles with more risk and fewer resilience factors were associated with an increased probability of substance use problems, but profiles with fewer risk and more resilience factors had rates of substance use problems that were very similar to the general adult population. Relative to the lowest risk profile, profiles with the most risk and fewest resilience factors were associated with increased odds of a substance use problem for both women [adjusted odds ratio (aOR) = 8.50; 95% CI: 3.85-18.74] and men (aOR = 11.68; 95% CI: 6.91-19.74). Addressing syndemic factors in substance use treatment and prevention may yield improved outcomes.

Western dietary pattern interaction with APOC3 polymorphism in the risk of metabolic syndrome: Tehran Lipid and Glucose Study.

PubMed

Hosseini-Esfahani, Firoozeh; Mirmiran, Parvin; Daneshpour, Maryam S; Mehrabi, Yadollah; Hedayati, Mehdi; Zarkesh, Maryam; Azizi, Fereidoun

2014-01-01

Gene-dietary pattern interactions may contribute to the determination of a susceptibility to metabolic syndrome (MetS). The aim of this study was to evaluate the potential interactions of dietary patterns with the common genetic variant of APOC3 in relation to MetS in adults. In this individual matched nested case-control study, 755 MetS subjects and 755 controls were selected from among participants in the Tehran Lipid and Glucose Study. Dietary patterns were determined by factor analysis. APOC3 3238C>G rs5128 was genotyped by polymerase chain reaction and restriction fragment length polymorphism. Fat-sweet, healthy and Western dietary patterns (WDP) were extracted from the data. In the joint analysis, the associations of the WDP and APOC3 rs5128 with MetS risk tended to be dependent on APOC3 3238C>G gene variants (p for interaction = 0.009) in women. The MetS risk was increased in women with the CC genotype with increasing tertiles of WDP scores compared with women with the CG + GG genotype, whose MetS risk was decreased with increasing tertiles of WDP scores. In addition, we found that intakes of fast food, salty snacks and soft drinks showed significant interactions with the rs5128 genotypes in relation to MetS risk (p for interactions <0.05). The results obtained demonstrate a diet-gene interaction between APOC3 rs5128 polymorphism and the WDP in relation to MetS risk. © 2014 S. Karger AG, Basel.

Health Behaviors and Health Status of At-Risk Latino Students for Diabetes

PubMed Central

Hurtado-Ortiz, Maria T.; Santos, Silvia; Reynosa, Astrid

2012-01-01

This research study examined the behavioral lifestyle patterns and health status of at-risk Latino college students for future diabetes onset in relation to their age, gender, and acculturation status. Participants were 156 Latino (34% male and 66% female) university students who had a first and/or second degree relative afflicted with diabetes. Findings indicated that Latino students exhibit similar lifestyle patterns in terms of dietary intake, physical activity, and drinking and smoking behaviors observed in the general and college population that have been linked to obesity—a particularly problematic risk factor among those who already have a genetic predisposition for diabetes. The reported findings are of importance for the development of culturally-relevant treatment interventions targeting young Latinos in college. PMID:26566366

Health Behaviors and Health Status of At-Risk Latino Students for Diabetes.

PubMed

Hurtado-Ortiz, Maria T; Santos, Silvia; Reynosa, Astrid

This research study examined the behavioral lifestyle patterns and health status of at-risk Latino college students for future diabetes onset in relation to their age, gender, and acculturation status. Participants were 156 Latino (34% male and 66% female) university students who had a first and/or second degree relative afflicted with diabetes. Findings indicated that Latino students exhibit similar lifestyle patterns in terms of dietary intake, physical activity, and drinking and smoking behaviors observed in the general and college population that have been linked to obesity-a particularly problematic risk factor among those who already have a genetic predisposition for diabetes. The reported findings are of importance for the development of culturally-relevant treatment interventions targeting young Latinos in college.

Risk factors for psychosis: impaired social and role functioning.

PubMed

Cornblatt, Barbara A; Carrión, Ricardo E; Addington, Jean; Seidman, Larry; Walker, Elaine F; Cannon, Tyronne D; Cadenhead, Kristin S; McGlashan, Thomas H; Perkins, Diana O; Tsuang, Ming T; Woods, Scott W; Heinssen, Robert; Lencz, Todd

2012-11-01

Risk for psychosis is currently defined primarily on the basis of attenuated positive symptoms (APS), with no inclusion of the functional deficits characteristic of schizophrenia. Impaired social and role functioning have been of interest for reflecting poor outcome but far less is known about the developmental impact of these deficits as vulnerability or risk factors. Age-appropriate social and role functioning were prospectively assessed in 100 individuals at clinical high risk (CHR) for psychosis included in the 8-site North American Prodromal Longitudinal Study database. A nested case-control design was used to compare changes in social and role functioning in 26 individuals converting to psychosis shortly after baseline assessment and 24 converting over a year later. Individuals in each converter subgroup were directly matched to a non-converter at the same site, controlling for time to conversion, age, gender, and severity of baseline symptoms. At baseline, CHR subjects who later became psychotic were significantly more likely to be impaired socially than matched non-converters. Onset of psychosis did not further disrupt social difficulties. Role functioning showed some of the same trends, but the overall pattern was not as consistent as for the social domain. Controlling for neurocognition did not change the pattern of group differences. Early impaired social functioning appears to be a risk factor for psychosis and, added to APS, could potentially contribute to accurate identification of CHR individuals and provide a new direction for early intervention to reduce long-term disability.

Patterns of Migration and Risks Associated with Leprosy among Migrants in Maranhão, Brazil

PubMed Central

Murto, Christine; Chammartin, Frédérique; Schwarz, Karolin; da Costa, Lea Marcia Melo; Kaplan, Charles; Heukelbach, Jorg

2013-01-01

Leprosy remains a public health problem in Brazil with new case incidence exceeding World Health Organization (WHO) goals in endemic clusters throughout the country. Migration can facilitate movement of disease between endemic and non-endemic areas, and has been considered a possible factor in continued leprosy incidence in Brazil. A study was conducted to investigate migration as a risk factor for leprosy. The study had three aims: (1) examine past five year migration as a risk factor for leprosy, (2) describe and compare geographic and temporal patterns of migration among past 5-year migrants with leprosy and a control group, and (3) examine social determinants of health associated with leprosy among past 5-year migrants. The study implemented a matched case-control design and analysis comparing individuals newly diagnosed with leprosy (n = 340) and a clinically unapparent control group (n = 340) without clinical signs of leprosy, matched for age, sex and location in four endemic municipalities in the state of Maranhão, northeastern Brazil. Fishers exact test was used to conduct bivariate analyses. A multivariate logistic regression analysis was employed to control for possible confounding variables. Eighty cases (23.5%) migrated 5-years prior to diagnosis, and 55 controls (16.2%) migrated 5-years prior to the corresponding case diagnosis. Past 5 year migration was found to be associated with leprosy (OR: 1.59; 95% CI 1.07–2.38; p = 0.02), and remained significantly associated with leprosy after controlling for leprosy contact in the family, household, and family/household contact. Poverty, as well as leprosy contact in the family, household and other leprosy contact, was associated with leprosy among past 5-year migrants in the bivariate analysis. Alcohol consumption was also associated with leprosy, a relevant risk factor in susceptibility to infection that should be explored in future research. Our findings provide insight into patterns of migration to localize focused control efforts in endemic areas with high population mobility. PMID:24040433

Type A Behavior Pattern, Impulsiveness, Risk Propensity, and Empathy as Predictors of Dyspnea and Number of Infections in Men with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study.

PubMed

Witusik, Andrzej; Mokros, Łukasz; Kuna, Piotr; Nowakowska-Domagała, Katarzyna; Antczak, Adam; Pietras, Tadeusz

2018-06-06

BACKGROUND Stress and psychological factors can induce dyspnea in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to assess selected elements of the clinical presentation of COPD in the context of the severity of type A pattern of behavior, impulsiveness, and tendency for empathy. MATERIAL AND METHODS This was a cross-sectional study. The study group consisted of 179 men with COPD and the control group consisted of 31 healthy male smokers. In all patients, the number of infectious exacerbations over the past year, the result on the dyspnea scale (MRC), and the FEV1-to- predicted FEV1 ratio was assessed. The A pattern of behavior was measured using the Type A scale. To measure impulsivity, risk propensity, and empathy, the IVE impulsivity questionnaire was used. RESULTS An increase in the number of infectious exacerbations was associated with an increased score on the Type A scale, an increase in risk propensity, and a decrease in impulsivity score. Increased severity of dyspnea was associated with an increase in Type A behavior pattern score and an increase in the risk propensity score. CONCLUSIONS Type A behavior pattern and risk propensity are independent predictors of the number of infections in the last year and of the subjective severity of dyspnea among men with COPD and healthy male smokers.

Exploring the relationships among food insecurity, alcohol use, and sexual risk taking among men and women living in South African townships

PubMed Central

Eaton, Lisa A.; Cain, Demetria N.; Pitpitan, Eileen V.; Carey, Kate B.; Carey, Michael P.; Mehlomakulu, Vuyelwa; Simbayi, Leickness C.; Mwaba, Kelvin; Kalichman, Seth C.

2014-01-01

South African townships have among the highest rates of HIV infection in the world. Considerable research on understanding the high rates of HIV transmission in this country has identified alcohol use as a critical factor in driving the HIV epidemic. Although the relationship between alcohol use and sexual risk-taking is well documented, less is known about how other factors, such as food insecurity, might be important in understanding alcohol’s role in sexual risk-taking. Furthermore, prior research has highlighted how patterns of alcohol use and sexual risk-taking tend to vary by gender. We examined how food insecurity is related to both alcohol use and sexual risk-taking. We administered anonymous community surveys to men (n=1137) and women (n=458) residing within four contiguous Black African townships outside of Cape Town, South Africa. In multivariate linear regression, we found that food insecurity was related to having higher numbers of male sex partners and condom-protected sex acts among women only. These relationships, however, were fully mediated by women’s alcohol use. Among men, we found that food insecurity was negatively related to unprotected sex; that is, men with greater food security reported more unprotected sex acts. Unlike the results found among women, this relationship was not mediated by alcohol use. Food insecurity appears to be an important factor in understanding patterns of sexual risk-taking in regards to gender and alcohol use, and may serve as an important point of intervention for reducing HIV transmission rates. PMID:24806889

Exploring the relationships among food insecurity, alcohol use, and sexual risk taking among men and women living in South African townships.

PubMed

Eaton, Lisa A; Cain, Demetria N; Pitpitan, Eileen V; Carey, Kate B; Carey, Michael P; Mehlomakulu, Vuyelwa; Simbayi, Leickness C; Mwaba, Kelvin; Kalichman, Seth C

2014-08-01

South African townships have among the highest rates of HIV infection in the world. Considerable research on understanding the high rates of HIV transmission in this country has identified alcohol use as a critical factor in driving the HIV epidemic. Although the relationship between alcohol use and sexual risk-taking is well documented, less is known about how other factors, such as food insecurity, might be important in understanding alcohol's role in sexual risk-taking. Furthermore, prior research has highlighted how patterns of alcohol use and sexual risk-taking tend to vary by gender. We examined how food insecurity is related to both alcohol use and sexual risk-taking. We administered anonymous community surveys to men (n = 1,137) and women (n = 458) residing within four contiguous Black African townships outside of Cape Town, South Africa. In multivariate linear regression, we found that food insecurity was related to having higher numbers of male sex partners and condom-protected sex acts among women only. These relationships, however, were fully mediated by women's alcohol use. Among men, we found that food insecurity was negatively related to unprotected sex; that is, men with greater food security reported more unprotected sex acts. Unlike the results found among women, this relationship was not mediated by alcohol use. Food insecurity appears to be an important factor in understanding patterns of sexual risk-taking in regards to gender and alcohol use, and may serve as an important point of intervention for reducing HIV transmission rates.

MET receptor tyrosine kinase as an autism genetic risk factor.

PubMed

Peng, Yun; Huentelman, Matthew; Smith, Christopher; Qiu, Shenfeng

2013-01-01

In this chapter, we will briefly discuss recent literature on the role of MET receptor tyrosine kinase (RTK) in brain development and how perturbation of MET signaling may alter normal neurodevelopmental outcomes. Recent human genetic studies have established MET as a risk factor for autism, and the molecular and cellular underpinnings of this genetic risk are only beginning to emerge from obscurity. Unlike many autism risk genes that encode synaptic proteins, the spatial and temporal expression pattern of MET RTK indicates this signaling system is ideally situated to regulate neuronal growth, functional maturation, and establishment of functional brain circuits, particularly in those brain structures involved in higher levels of cognition, social skills, and executive functions. © 2013 Elsevier Inc. All rights reserved.

Ergonomic risk factors associated with clinical dentistry.

PubMed

Rucker, Lance M; Sunell, Susanne

2002-02-01

Ergonomics has formed an integral aspect of dental education at the University of British Columbia since the early 1980s. However, studies continued to indicate that dentists are at risk for developing musculoskeletal problems. This provided the impetus for a study of the risk factors associated with these problems. The data analyzed from 421 survey respondents in British Columbia indicate that indeed dentists are experiencing musculoskeletal pain and discomfort. However, the data also suggest that dentists can recognize and identify their own postures, practicing positions, and the equipment usage patterns that are associated with increased risks of experiencing musculoskeletal pain and discomfort. Such recognition is the first critical step to avoiding or neutralizing ergonomic habits and work environment layouts that might otherwise unnecessarily shorten professional clinical careers.

Meticillin-resistant Staphylococcus aureus among US prisoners and military personnel: review and recommendations for future studies.

PubMed

Aiello, Allison E; Lowy, Franklin D; Wright, Lester N; Larson, Elaine L

2006-06-01

We reviewed published work examining the prevalence and risk factors for meticillin-resistant Staphylococcus aureus (MRSA) infection in two high-risk groups: prisoners and military enlistees. Significant risk factors for infection included prison occupation, gender, comorbidities, prior skin infection, and previous antibiotic use. Although characteristics such as hygiene, physical contact, and crowding were postulated as risk factors for MRSA infection, there were few epidemiological studies supporting these factors. Most studies identified were retrospective in design and only one study used prospective surveillance for MRSA colonisation among all individuals residing within a single military setting. Our results suggest that there is a high incidence of MRSA infection among individuals in prisons and military settings, but surveys that quantify the prevalence of MRSA colonisation among individuals living within these specialised settings are needed. A thorough examination of MRSA acquisition and transmission patterns in prisons and military settings could help elucidate preventive strategies in other crowded and closed settings.

Eating behaviour and its association with social living conditions and weight status among adolescent girls: results of the cross-sectional Berlin School Children's Cohort study.

PubMed

Bau, Anne-Madeleine; Krull, Sarah; Ernert, Andrea; Babitsch, Birgit

2011-10-01

To capture a more holistic picture of eating behaviour by investigating the impact of the social living conditions and weight status of parents and daughters on food consumption frequency, the context of meals and daily portion sizes. Cross-sectional Berlin School Children's Cohort study. A total of sixty-nine schools in Berlin (3 400 000 inhabitants, eastern Germany) participated in the present study. A total of 1519 girls aged 11-14 years were selected. Bi- and multivariate analyses were performed to examine the impact of age, migration background, socio-economic status (SES), parental education, family situation and the weight status of parents and daughters on three different eating behaviour scores according to nutritional recommendations. For the three dependent eating behaviour variables, different patterns of influencing factors emerged. Multivariate regression (model 1) revealed that low and middle SES, two-parent migration background and older age were significant risk factors. Meal context was also significantly influenced by living with a single parent. Similar results were obtained for the daily portion size scores and maternal overweight status was the most influential. Model 2 succeeded in showing that, within the composite variable of family SES, mothers' level of education was the dominant component. SES as a whole, and especially the component of mothers' level of education and two-parent migration background, was the strongest risk factor for an unfavourable eating pattern among adolescent girls. The results clearly indicated preventive potential. Using three different measures of eating behaviour simultaneously provided an in-depth understanding of general patterns and potential risk factors.

Metabolic syndrome in South Asians

PubMed Central

Pandit, Kaushik; Goswami, Soumik; Ghosh, Sujoy; Mukhopadhyay, Pradip; Chowdhury, Subhankar

2012-01-01

South Asia is home to one of the largest population of people with metabolic syndrome (MetS). The prevalence of MetS in South Asians varies according to region, extent of urbanization, lifestyle patterns, and socioeconomic/cultural factors. Recent data show that about one-third of the urban population in large cities in India has the MetS. All classical risk factors comprising the MetS are prevalent in Asian Indians residing in India. The higher risk in this ethnic population necessitated a lowering of the cut-off values of the risk factors to identify and intervene for the MetS to prevent diabetes and cardiovascular disease. Some pharmacological and nonpharmacological interventions are underway in MetS to assess the efficacy in preventing the diabetes and cardiovascular disease in this ethnic population. PMID:22276252

[Risk groups as related to gastric cancer].

PubMed

Vartan'ian, M G; Zhandarova, L F; Korzhenskiĭ, F P

1979-01-01

Under examination were the features of life, labour, habits, inheritance pattern, a type of diet, the course of the disease in 440 gastric cancer patients. The most typical and frequently observed factors were singled out. The material obtained was processed by an electronic computer. The informative value of the risk factors was checked by selection, using questionnaires of patients irrespective of the reason of their referring to the clinic. The age of patients over 40 and the character of work should become the basic indication for limiting the number of persons subject to a gastrological examination.

Nonesterified Fatty Acids and Spontaneous Preterm Birth: A Factor Analysis for Identification of Risk Patterns

PubMed Central

Catov, Janet M.; Bertolet, Marnie; Chen, Yi-Fan; Evans, Rhobert W.; Hubel, Carl A.

2014-01-01

We considered that accumulation of nonesterified (free) fatty acids (NEFAs) in the first trimester of pregnancy would mark women at excess risk of spontaneous preterm birth (sPTB) and examined the interplay between NEFAs, lipids, and other markers to explore pathways to sPTB. In a case-control study nested in the Pregnancy Exposures and Preeclampsia Prevention Study (Pittsburgh, Pennsylvania, 1997–2001), we assayed NEFA levels in nonfasting serum collected at a mean gestational week of 9.4 (range, 4–20 weeks) in 115 women with sPTB (<37 weeks) and 222 women with births occurring at ≥37 weeks. C-reactive protein, total cholesterol, low-density lipoprotein and high-density lipoprotein (HDL) cholesterol, triglycerides, and uric acid were also measured. Polytomous logistic regression models were used to evaluate tertiles of NEFA levels and sPTB at <34 weeks and 34–36 weeks; factor analysis was used to characterize patterns of biomarkers. Women with NEFA levels in the highest tertile versus the lowest were 2.02 (95% confidence interval: 1.13, 3.48) times more likely to have sPTB, after adjustment for covariates. Risk of sPTB before 34 weeks was particularly high among women with high NEFA levels (odds ratio = 3.73, 95% confidence interval: 1.33, 10.44). Six biomarker patterns were identified, and 2 were associated with sPTB: 1) increasing NEFA and HDL cholesterol levels and 2) family history of gestational hypertension. NEFA levels early in pregnancy were independently associated with sPTB, particularly before 34 weeks. We also detected a novel risk pattern suggesting that NEFAs together with HDL cholesterol may be related to sPTB. PMID:24714724

Nonesterified fatty acids and spontaneous preterm birth: a factor analysis for identification of risk patterns.

PubMed

Catov, Janet M; Bertolet, Marnie; Chen, Yi-Fan; Evans, Rhobert W; Hubel, Carl A

2014-05-15

We considered that accumulation of nonesterified (free) fatty acids (NEFAs) in the first trimester of pregnancy would mark women at excess risk of spontaneous preterm birth (sPTB) and examined the interplay between NEFAs, lipids, and other markers to explore pathways to sPTB. In a case-control study nested in the Pregnancy Exposures and Preeclampsia Prevention Study (Pittsburgh, Pennsylvania, 1997-2001), we assayed NEFA levels in nonfasting serum collected at a mean gestational week of 9.4 (range, 4-20 weeks) in 115 women with sPTB (<37 weeks) and 222 women with births occurring at ≥37 weeks. C-reactive protein, total cholesterol, low-density lipoprotein and high-density lipoprotein (HDL) cholesterol, triglycerides, and uric acid were also measured. Polytomous logistic regression models were used to evaluate tertiles of NEFA levels and sPTB at <34 weeks and 34-36 weeks; factor analysis was used to characterize patterns of biomarkers. Women with NEFA levels in the highest tertile versus the lowest were 2.02 (95% confidence interval: 1.13, 3.48) times more likely to have sPTB, after adjustment for covariates. Risk of sPTB before 34 weeks was particularly high among women with high NEFA levels (odds ratio = 3.73, 95% confidence interval: 1.33, 10.44). Six biomarker patterns were identified, and 2 were associated with sPTB: 1) increasing NEFA and HDL cholesterol levels and 2) family history of gestational hypertension. NEFA levels early in pregnancy were independently associated with sPTB, particularly before 34 weeks. We also detected a novel risk pattern suggesting that NEFAs together with HDL cholesterol may be related to sPTB.

Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder.

PubMed

Beesdo, Katja; Pine, Daniel S; Lieb, Roselind; Wittchen, Hans-Ulrich

2010-01-01

Controversy surrounds the diagnostic categorization of generalized anxiety disorder (GAD). To examine the incidence, comorbidity, and risk patterns for anxiety and depressive disorders and to test whether developmental features of GAD more strongly support a view of this condition as a depressive as opposed to an anxiety disorder. Face-to-face, 10-year prospective longitudinal and family study with as many as 4 assessment waves. The DSM-IV Munich Composite International Diagnostic Interview was administered by clinically trained interviewers. Munich, Germany. A community sample of 3021 individuals aged 14 to 24 years at baseline and 21 to 34 years at last follow-up. Cumulative incidence of GAD, other anxiety disorders (specific phobias, social phobia, agoraphobia, and panic disorder), and depressive disorders (major depressive disorder, and dysthymia). Longitudinal associations between GAD and depressive disorders are not stronger than those between GAD and anxiety disorders or between other anxiety and depressive disorders. Survival analyses reveal that the factors associated with GAD overlap more strongly with those specific to anxiety disorders than those specific to depressive disorders. In addition, GAD differs from anxiety and depressive disorders with regard to family climate and personality profiles. Anxiety and depressive disorders appear to differ with regard to risk constellations and temporal longitudinal patterns, and GAD is a heterogeneous disorder that is, overall, more closely related to other anxiety disorders than to depressive disorders. More work is needed to elucidate the potentially unique aspects of pathways and mechanisms involved in the etiopathogenesis of GAD. Grouping GAD with depressive disorders, as suggested by cross-sectional features and diagnostic comorbidity patterns, minimizes the importance of longitudinal data on risk factors and symptom trajectories.

Circadian Role in Daily Pattern of Cardiovascular Risk

NASA Astrophysics Data System (ADS)

Ivanov, Plamen Ch.; Hu, Kun; Chen, Zhi; Hilton, Michael F.; Stanley, H. Eugene; Shea, Steven A.

2004-03-01

Numerous epidemiological studies demonstrate that sudden cardiac death, pulmonary embolism, myocardial infarction, and stroke have a 24-hour daily pattern with a broad peak between 9-11am. Such a daily pattern in cardiovascular risk could be attributable to external factors, such as the daily behavior patterns, including sleep-wake cycles and activity levels, or internal factors, such as the endogenous circadian pacemaker. Findings of significant alternations in the temporal organization and nonlinear properties of heartbeat fluctuations with disease and with sleep-wake transitions raise the intriguing possibility that changes in the mechanism of control associated with behavioral sleep-wake transition may be responsible for the increased cardiac instability observed in particular circadian phases. Alternatively, we hypothesize that there is a circadian clock, independent of the sleep-wake cycle, which affects the cardiac dynamics leading to increased cardiovascular risk. We analyzed continuous recordings from healthy subjects during 7 cycles of forced desynchrony routine wherein subjects' sleep-wake cycles are adjusted to 28 hours so that their behaviors occur across all circadian phases. Heartbeat data were divided into one-hour segments. For each segment, we estimated the correlations and the nonlinear properties of the heartbeat fluctuations at the corresponding circadian phase. Since the sleep and wake contributions are equally weighted in our experiment, a change of the properties of the heartbeat dynamics with circadian phase suggest a circadian rhythm. We show significant circadian-mediated alterations in the correlation and nonlinear properties of the heartbeat resembling those observed in patients with heart failure. Remarkably, these dynamical alterations are centered at 60 degrees circadian phase, coinciding with the 9-11am window of cardiac risk.

Longitudinal patterns and predictors of multiple health risk behaviors among adolescents: The TRAILS study.

PubMed

de Winter, Andrea F; Visser, Leenke; Verhulst, Frank C; Vollebergh, Wilma A M; Reijneveld, Sijmen A

2016-03-01

Most studies on multiple health risk behaviors among adolescents have cross-sectionally studied a limited number of health behaviors or determinants. To examine the prevalence, longitudinal patterns and predictors of individual and multiple health risk behaviors among adolescents. Eight health risk behaviors (no regular consumption of fruit, vegetables or breakfast, overweight or obesity, physical inactivity, smoking, alcohol use and cannabis use) were assessed in a prospective population study (second and third wave). Participants were assessed in three waves between ages 10 and 17 (2001-2008; n=2230). Multiple linear regression was used to assess the influence of gender, self-control, parental health risk behaviors, parental monitoring and socioeconomic factors on the number of health risk behaviors adjusted for preceding multiple health risk behaviors (analysis: 2013-2014). Rates of >5 health risk behaviors were high: 3.6% at age 13.5 and 10.2% at age 16. Smoking at age 13.5 was frequently associated with health risk behaviors at age 16. No regular consumption of fruit, vegetables and breakfast, overweight or obesity, physical inactivity and smoking predicted the co-occurrence of health risk behaviors at follow-up. Significant predictors of the development of multiple health risk behaviors were adolescents' levels of self-control, socioeconomic status and maternal smoking. Multiple health risk behaviors are common among adolescents. Individual and social factors predict changes in multiple health risk behaviors, showing that prevention targeting multiple risk behaviors is needed. Special attention should be paid to adolescents with low self-control and families with low socioeconomic status or a mother who smokes. Copyright © 2015 Elsevier Inc. All rights reserved.

Aboriginal Street-involved Youth Experience Elevated Risk of Incarceration

PubMed Central

Barker, Brittany; Alfred, Gerald Taiaiake; Fleming, Kim; Nguyen, Paul; Wood, Evan; Kerr, Thomas; DeBeck, Kora

2015-01-01

Objectives Past research has identified risk factors associated with incarceration among adult Aboriginal populations; however, less is known about incarceration among street-involved Aboriginal youth. Therefore, we undertook this study to longitudinally investigate recent reports of incarceration among a prospective cohort of street-involved youth in Vancouver, Canada. Study Design Prospective cohort study. Methods Data were collected from a cohort of street-involved, drug-using youth from September 2005 to May 2013. Multivariate generalized estimating equation analyses were employed to examine the potential relationship between Aboriginal ancestry and recent incarceration. Results Among our sample of 1050 youth, 248 (24%) reported being of aboriginal ancestry, and 378 (36%) reported being incarcerated in the previous six months at some point during the study period. In multivariate analysis controlling for a range of potential confounders including drug use patterns and other risk factors, Aboriginal ancestry remained significantly associated with recent incarceration (adjusted odds ratio [AOR]=1.44; 95% confidence interval [CI]: 1.12–1.86). Conclusions Even after adjusting for drug use patterns and other risk factors associated with incarceration, this study found that Aboriginal street-involved youth were still significantly more likely to be incarcerated than their non-Aboriginal peers. Given the established harms associated with incarceration these findings underscore the pressing need for systematic reform including culturally appropriate interventions to prevent Aboriginal youth from becoming involved with the criminal justice system. PMID:26390949

Evaluation of ergonomic physical risk factors in a truck manufacturing plant: case study in SCANIA Production Angers

PubMed Central

ZARE, Mohsen; MALINGE-OUDENOT, Agnes; HÖGLUND, Robert; BIAU, Sophie; ROQUELAURE, Yves

2015-01-01

The aims of this study were 1) to assess the ergonomic physical risk factors from practitioner’s viewpoint in a truck assembly plant with an in-house observational method and the NIOSH lifting equation, and 2) to compare the results of both methods and their differences. The in-house ergonomic observational method for truck assembly i.e. the SCANIA Ergonomics Standard (SES) and the NIOSH lifting equation were applied to evaluate physical risk factors and lifting of loads by operators. Both risk assessment approaches revealed various levels of risk, ranging from low to high. Two workstations were identified by the SES method as high risk. The NIOSH lifting index (LI) was greater than two for four lifting tasks. The results of the SES method disagreed with the NIOSH lifting equation for lifting tasks. Moreover, meaningful variations in ergonomic risk patterns were found for various truck models at each workstation. These results provide a better understanding of the physical ergonomic exposure from practitioner’s point of view in the automotive assembly plant. PMID:26423331

Evaluation of ergonomic physical risk factors in a truck manufacturing plant: case study in SCANIA Production Angers.

PubMed

Zare, Mohsen; Malinge-Oudenot, Agnes; Höglund, Robert; Biau, Sophie; Roquelaure, Yves

2016-01-01

The aims of this study were 1) to assess the ergonomic physical risk factors from practitioner's viewpoint in a truck assembly plant with an in-house observational method and the NIOSH lifting equation, and 2) to compare the results of both methods and their differences. The in-house ergonomic observational method for truck assembly i.e. the SCANIA Ergonomics Standard (SES) and the NIOSH lifting equation were applied to evaluate physical risk factors and lifting of loads by operators. Both risk assessment approaches revealed various levels of risk, ranging from low to high. Two workstations were identified by the SES method as high risk. The NIOSH lifting index (LI) was greater than two for four lifting tasks. The results of the SES method disagreed with the NIOSH lifting equation for lifting tasks. Moreover, meaningful variations in ergonomic risk patterns were found for various truck models at each workstation. These results provide a better understanding of the physical ergonomic exposure from practitioner's point of view in the automotive assembly plant.

Sleep patterns as predictors for disability pension due to low back diagnoses: a 23-year longitudinal study of Finnish twins.

PubMed

Ropponen, Annina; Silventoinen, Karri; Hublin, Christer; Svedberg, Pia; Koskenvuo, Markku; Kaprio, Jaakko

2013-06-01

Impaired sleep patterns are known to be associated with many chronic conditions and ultimately they may lead to permanent work incapacity. Less is known about the associations between sleep patterns and cause-specific disability pensions, such as low back diagnoses, or whether familial factors (genetics and family environment) can affect the associations. The objective of this study was to investigate sleep patterns as predictors of disability pension due to low back diagnoses with a 23-year follow-up. A prospective cohort study with comprehensive mailed questionnaires about sleep patterns, e.g., quality and length of sleep in 1975 and 1981. Follow-up from the national disability pension register data until 2004. Not applicable. There were 18,979 individuals (7,722 complete twin pairs) born before 1958. Cox proportional hazards regression was used to calculate hazard ratios (HR) with 95% confidence intervals (95% CI). Disability pension due to low back diagnoses had been granted to 467 individuals during the follow-up. Sleeping moderately well (HR 1.25; 95% CI 1.02, 1.53), or fairly poorly/poorly (HR 2.05; 95% CI 1.53, 2.73) at baseline predicted a significantly higher risk for disability pension. Stable patterns of sleeping either fairly well (HR 1.29; 95% CI 1.01, 1.64), or stably fairly poorly/poorly (HR 2.29; 95% CI 1.49, 3.52) between 1975 and 1981 were associated with a higher risk as compared to a stable pattern of sleeping well. Furthermore, a decrease in quality of sleep from 1975 to 1981 was associated (HR 1.34; 95% CI 1.03, 1.76) with an increased risk of disability pension. Sleep quality and changes in sleep quality appear to be early predictors for disability pension due to low back diagnoses independently from other confounding factors.

Disparities in drinking patterns and risks among ethnic majority and minority groups in China: The roles of acculturation, religion, family and friends.

PubMed

He, Jianhui; Assanangkornchai, Sawitri; Cai, Le; McNeil, Edward

2016-02-01

Studies investigating alcohol consumption related factors have rarely focused on the relationship between acculturation, religion and drinking patterns. The objective of this study is to explore the predictors of drinking patterns and their mutual relationships, especially acculturation, ethnicity and religion. A cross-sectional household survey using a multistage systematic sampling technique was conducted in Yunnan Province of China. A revised Vancouver Index of Acculturation (VIA) and Alcohol Use Disorder Identification Test (AUDIT) Chinese version were used to measure acculturation and drinking patterns. Structural equation modeling (SEM) was used to explore the structures of how predictors affect drinking patterns. A total of 977 subjects aged 12-35 years were surveyed. A higher percentage of binge drinking was found among Lisu people. However, the proportion of drinking until intoxication was highest among Han. Gender and enculturation had both direct (standardized β=-0.193, -0.079) and indirect effects (standardized β=-0.126, 0.033) on risky drinking pattern; perceived risk of alcohol consumption (-0.065), family drinking environment (0.061), and friend drinking environment (0.352) affected risky drinking pattern directly, while education level (0.066), ethnicity (-0.038), acculturation (0.012), religious belief (-0.038), and age group (0.088) had indirect effects. Risky drinking pattern was associated with gender and aboriginal culture enculturation both directly and indirectly, and related to mainstream culture acculturation and religious belief indirectly. Other demographic (such as education level) and social family factors (friend drinking environment for example) also had effects on risky drinking pattern. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Methodology of a nationwide cross-sectional survey of prevalence and epidemiological patterns of hepatitis A, B and C infection in Brazil.

PubMed

Ximenes, Ricardo Arraes de Alencar; Pereira, Leila Maria Beltrão; Martelli, Celina Maria Turchi; Merchán-Hamann, Edgar; Stein, Airton Tetelbom; Figueiredo, Gerusa Maria; Braga, Maria Cynthia; Montarroyos, Ulisses Ramos; Brasil, Leila Melo; Turchi, Marília Dalva; Fonseca, José Carlos Ferraz da; Lima, Maria Luiza Carvalho de; Alencar, Luis Cláudio Arraes de; Costa, Marcelo; Coral, Gabriela; Moreira, Regina Celia; Cardoso, Maria Regina Alves

2010-09-01

A population-based survey to provide information on the prevalence of hepatitis viral infection and the pattern of risk factors was carried out in the urban population of all Brazilian state capitals and the Federal District, between 2005 and 2009. This paper describes the design and methodology of the study which involved a population aged 5 to 19 for hepatitis A and 10 to 69 for hepatitis B and C. Interviews and blood samples were obtained through household visits. The sample was selected using stratified multi-stage cluster sampling and was drawn with equal probability from each domain of study (region and age-group). Nationwide, 19,280 households and ~31,000 residents were selected. The study is large enough to detect prevalence of viral infection around 0.1% and risk factor assessments within each region. The methodology seems to be a viable way of differentiating between distinct epidemiological patterns of hepatitis A, B and C. These data will be of value for the evaluation of vaccination policies and for the design of control program strategies.

Migration, Acculturation and Environment: Determinants of Obesity among Iranian Migrants in Australia

PubMed Central

Delavari, Maryam; Sønderlund, Anders Larrabee; Mellor, David; Mohebbi, Mohammadreza; Swinburn, Boyd

2015-01-01

While migration from low- to high-income countries is typically associated with weight gain, the obesity risks of migration from middle-income countries are less certain. In addition to changes in behaviours and cultural orientation upon migration, analyses of changes in environments are needed to explain post-migration risks for obesity. The present study examines the interaction between obesity-related environmental factors and the pattern of migrant acculturation in a sample of 152 Iranian immigrants in Victoria, Australia. Weight measurements, demographics, physical activity levels and diet habits were also surveyed. The pattern of acculturation (relative integration, assimilation, separation or marginalization) was not related to body mass index, diet, or physical activity behaviours. Three relevant aspects of participants’ perception of the Australian environment (physically active environments, social pressure to be fit, unhealthy food environments) varied considerably by demographic characteristics, but only one (physically active environments) was related to a pattern of acculturation (assimilation). Overall, this research highlighted a number of key relationships between acculturation and obesity-related environments and behaviours for our study sample. Theoretical models on migration, culture and obesity need to include environmental factors. PMID:25648171

Microbial etiology of febrile neutropenia.

PubMed

Swati, Mudshingkar; Gita, Nataraj; Sujata, Baveja; Farah, Jijina; Preeti, Mehta

2010-06-01

Bacterial and fungal infections are a major cause of morbidity and mortality among neutropenic patients. The choice of empiric antimicrobial regimen is based on susceptibility pattern of locally prevalent pathogens. From 64 febrile neutropenic patients with clinical sepsis, blood and other appropriate clinical specimens were processed to determine bacterial and fungal spectrum and their antimicrobial susceptibility pattern. Risk factors for developing sepsis were determined by case-control study. 68 organisms were recovered. Fifteen (22.05%) were Gram-positive cocci with predominance of methicillin Sensitive S. aureus (10.29%), 47 (69.11%) were Gram-negative rods with predominance of Klebsiella pneumoniae (30.88%) and four were Non albicans Candida. 81% and 60% of Klebsiella and E. coli were ESBL producers. All species of Candida were sensitive to amphoterecin B and voriconazole. Duration and extent of neutropenia, chemotherapy, immunosuppressive therapy, altered mucosal barriers and presence of central venous lines were statistically significant risk factors for developing sepsis. Gram-negative bacteria were the predominant isolates. The choice of therapy in neutropenic patients should be formulated based on local spectrum of microbes and local and regional resistance patterns.

Microbial Etiology of Febrile Neutropenia

PubMed Central

Gita, Nataraj; Sujata, Baveja; Farah, Jijina; Preeti, Mehta

2010-01-01

Bacterial and fungal infections are a major cause of morbidity and mortality among neutropenic patients. The choice of empiric antimicrobial regimen is based on susceptibility pattern of locally prevalent pathogens. From 64 febrile neutropenic patients with clinical sepsis, blood and other appropriate clinical specimens were processed to determine bacterial and fungal spectrum and their antimicrobial susceptibility pattern. Risk factors for developing sepsis were determined by case–control study. 68 organisms were recovered. Fifteen (22.05%) were Gram-positive cocci with predominance of methicillin Sensitive S. aureus (10.29%), 47 (69.11%) were Gram-negative rods with predominance of Klebsiella pneumoniae (30.88%) and four were Non albicans Candida. 81% and 60% of Klebsiella and E. coli were ESBL producers. All species of Candida were sensitive to amphoterecin B and voriconazole. Duration and extent of neutropenia, chemotherapy, immunosuppressive therapy, altered mucosal barriers and presence of central venous lines were statistically significant risk factors for developing sepsis. Gram-negative bacteria were the predominant isolates. The choice of therapy in neutropenic patients should be formulated based on local spectrum of microbes and local and regional resistance patterns. PMID:21629636

Cumulative Socioeconomic Status Risk, Allostatic Load, and Adjustment: A Prospective Latent Profile Analysis with Contextual and Genetic Protective Factors

ERIC Educational Resources Information Center

Brody, Gene H.; Yu, Tianyi; Chen, Yi-Fu; Kogan, Steven M.; Evans, Gary W.; Beach, Steven R. H.; Windle, Michael; Simons, Ronald L.; Gerrard, Meg; Gibbons, Frederick X.; Philibert, Robert A.

2013-01-01

The health disparities literature has identified a common pattern among middle-aged African Americans that includes high rates of chronic disease along with low rates of psychiatric disorders despite exposure to high levels of cumulative socioeconomic status (SES) risk. The current study was designed to test hypotheses about the developmental…

Interventions with Young Female Offenders and Teenage Girls at Risk: Alternative Educational Services in a Singapore Girls' Home

ERIC Educational Resources Information Center

Zhang, Kaili Chen; Choo, Andrew; Lim, Liping

2009-01-01

This article presents factors that place girls at risk of delinquency and offending as well as the patterns in juvenile delinquency trends for females in Singapore. The authors also describe Singapore's overall structure of services for young offenders and the current status of alternative education programmes for young women engaged in delinquent…

Patterns of HIV/AIDS, STI, Substance Abuse and Hepatitis Risk among Selected Samples of Latino and African-American Youth in Washington, DC

ERIC Educational Resources Information Center

Edberg, Mark C.; Collins, Elizabeth; Harris, Meredith; McLendon, Hedda; Santucci, Patricia

2009-01-01

In order to address evolving risk factors among youth in Washington, DC (District of Columbia), with respect to HIV/AIDS, sexually transmitted infections (STIs), substance abuse, and hepatitis, a targeted, community-needs assessment was conducted through a partnership between the Department of Prevention and Community Health at George Washington…

Health Information–Seeking Behaviors, Health Indicators, and Health Risks

PubMed Central

Mays, Darren; Weaver, Stephanie Sargent; Hopkins, Gary L.; Eroğlu, Doğan; Bernhardt, Jay M.

2010-01-01

Objectives. We examined how different types of health information–seeking behaviors (HISBs)—no use, illness information only, wellness information only, and illness and wellness information combined—are associated with health risk factors and health indicators to determine possible motives for health information seeking. Methods. A sample of 559 Seattle–Tacoma area adults completed an Internet-based survey in summer 2006. The survey assessed types of HISB, physical and mental health indicators, health risks, and several covariates. Covariate-adjusted linear and logistic regression models were computed. Results. Almost half (49.4%) of the sample reported HISBs. Most HISBs (40.6%) involved seeking a combination of illness and wellness information, but both illness-only (28.6%) and wellness-only (30.8%) HISBs were also widespread. Wellness-only information seekers reported the most positive health assessments and the lowest occurrence of health risk factors. An opposite pattern emerged for illness-only information seekers. Conclusions. Our findings reveal a unique pattern of linkages between the type of health information sought (wellness, illness, and so on) and health self-assessment among adult Internet users in western Washington State. These associations suggest that distinct health motives may underlie HISB, a phenomenon frequently overlooked in previous research. PMID:20558794

Abdominal obesity, an independent cardiovascular risk factor in Indian subcontinent: A clinico epidemiological evidence summary.

PubMed

Prasad, D S; Kabir, Zubair; Dash, A K; Das, B C

2011-10-01

Evidence is emerging that obesity-associated cardiovascular disorders (CVD) show variations across regions and ethnicities. However, it is unclear if there are distinctive patterns of abdominal obesity contributing to an increased CVD risk in South Asians. Also, potential underlying mechanistic pathways of such unique patterns are not comprehensively reported in South Asians. This review sets out to examine both. A comprehensive database search strategy was undertaken, namely, PubMed, Embase and Cochrane Library, applying specific search terms for potentially relevant published literature in English language. Grey literature, including scientific meeting abstracts, expert consultations, text books and government/non-government publications were also retrieved. South Asians have 3-5% higher body fat than whites, at any given body mass index. Additional distinctive features, such as South Asian phenotype, low adipokine production, lower lean body mass, ethno-specific socio-cultural and economic factors, were considered as potential contributors to an early age-onset of obesity-linked CVD risk in South Asians. Proven cost-effective anti-obesity strategies, including the development of ethno-specific clinical risk assessment tools, should be adopted early in the life-course to prevent premature CVD deaths and morbidity in South Asians.

A Preliminary Study of Potential Dietary Risk Factors for Coronary Heart Disease among Chinese American Adolescents.

ERIC Educational Resources Information Center

Sun, Wei Yue; Chen, W. William

1994-01-01

This study compared dietary knowledge, attitudes, behaviors, and patterns between Chinese American middle school students and their Chinese equivalents. Chinese students had less knowledge and less favorable attitudes but more positive behavioral factors affecting diet. They consumed less meat, dairy products, fat, sweets, and snacks and ate more…

Pattern of Ipsilateral Breast Tumor Recurrence After Breast-Conserving Therapy

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

Jobsen, Jan, E-mail: j.jobsen@mst.nl; Palen, Job van der; Department of Research Methodology, Measurement, and Data Analysis, Faculty of Behavioral Science, University of Twente, Enschede

Purpose: To analyze the incidence and prognostic factors of ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT) in a large, population-based, single-center study with long-term follow-up. Methods and Materials: We analyzed 3595 cases in which BCT was performed in 3824 women with stage I or II breast cancer. The incidence of IBTR was analyzed over time and was based on IBTR as first event. Results: The 15-year local relapse-free survival was 90.9%. The hazard estimates for IBTR showed a time course with 2 peaks, the first at approximately 5 years and the second, twice as high, at 12 years. Stratifying subjectsmore » by age and margin status showed that, for women ≤40 years old with negative margins, adjuvant systemic therapy led to a 5-fold reduced risk of recurrence compared to none, and the presence of lymph vascular space invasion (LVSI) had a 3-fold increased risk compared to its absence. For women >40 years old, the presence of LVSI (hazard ratio [HR] 2.5) and the presence of lobular carcinoma in situ in the lumpectomy specimen (HR 2.3) were the only 2 risk factors. Conclusions: We demonstrated a pattern in risk of IBTR over time, with 2 peaks, first at approximately 5 years and a second, much higher peak at approximately 12 years, especially for women ≤40 years old. For women ≤40 years old with tumor-free resection margins, we noted that the absence of adjuvant systemic therapy and the presence of LVSI were independent prognostic factors of IBTR. For women >40 years old, the presence of LVSI and the presence of lobular carcinoma in situ were independent risk factors.« less

Patterns of Signs That Telephone Crisis Support Workers Associate with Suicide Risk in Telephone Crisis Line Callers.

PubMed

Hunt, Tara; Wilson, Coralie; Caputi, Peter; Wilson, Ian; Woodward, Alan

2018-01-30

Signs of suicide are commonly used in suicide intervention training to assist the identification of those at imminent risk for suicide. Signs of suicide may be particularly important to telephone crisis-line workers (TCWs), who have little background information to identify the presence of suicidality if the caller is unable or unwilling to express suicidal intent. Although signs of suicide are argued to be only meaningful as a pattern, there is a paucity of research that has examined whether TCWs use patterns of signs to decide whether a caller might be suicidal, and whether these are influenced by caller characteristics such as gender. The current study explored both possibilities. Data were collected using an online self-report survey in a Australian sample of 137 TCWs. Exploratory factor analysis uncovered three patterns of suicide signs that TCWs may use to identify if a caller might be at risk for suicide (mood, hopelessness, and anger), which were qualitatively different for male and female callers. These findings suggest that TCWs may recognise specific patterns of signs to identify suicide risk, which appear to be influenced to some extent by the callers' inferred gender. Implications for the training of telephone crisis workers and others including mental-health and medical professionals, as well as and future research in suicide prevention are discussed.

Patterns of Signs That Telephone Crisis Support Workers Associate with Suicide Risk in Telephone Crisis Line Callers

PubMed Central

Hunt, Tara; Caputi, Peter; Wilson, Ian; Woodward, Alan

2018-01-01

Signs of suicide are commonly used in suicide intervention training to assist the identification of those at imminent risk for suicide. Signs of suicide may be particularly important to telephone crisis-line workers (TCWs), who have little background information to identify the presence of suicidality if the caller is unable or unwilling to express suicidal intent. Although signs of suicide are argued to be only meaningful as a pattern, there is a paucity of research that has examined whether TCWs use patterns of signs to decide whether a caller might be suicidal, and whether these are influenced by caller characteristics such as gender. The current study explored both possibilities. Data were collected using an online self-report survey in a Australian sample of 137 TCWs. Exploratory factor analysis uncovered three patterns of suicide signs that TCWs may use to identify if a caller might be at risk for suicide (mood, hopelessness, and anger), which were qualitatively different for male and female callers. These findings suggest that TCWs may recognise specific patterns of signs to identify suicide risk, which appear to be influenced to some extent by the callers’ inferred gender. Implications for the training of telephone crisis workers and others including mental-health and medical professionals, as well as and future research in suicide prevention are discussed. PMID:29385780

Community context and sub-neighborhood scale detail to explain dengue, chikungunya and Zika patterns in Cali, Colombia.

PubMed

Krystosik, Amy R; Curtis, Andrew; Buritica, Paola; Ajayakumar, Jayakrishnan; Squires, Robert; Dávalos, Diana; Pacheco, Robinson; Bhatta, Madhav P; James, Mark A

2017-01-01

Cali, Colombia has experienced chikungunya and Zika outbreaks and hypoendemic dengue. Studies have explained Cali's dengue patterns but lack the sub-neighborhood-scale detail investigated here. Spatial-video geonarratives (SVG) with Ministry of Health officials and Community Health Workers were collected in hotspots, providing perspective on perceptions of why dengue, chikungunya and Zika hotspots exist, impediments to control, and social outcomes. Using spatial video and Google Street View, sub-neighborhood features possibly contributing to incidence were mapped to create risk surfaces, later compared with dengue, chikungunya and Zika case data. SVG captured insights in 24 neighborhoods. Trash and water risks in Calipso were mapped using SVG results. Perceived risk factors included proximity to standing water, canals, poverty, invasions, localized violence and military migration. These risks overlapped case density maps and identified areas that are suitable for transmission but are possibly underreporting to the surveillance system. Resulting risk maps with local context could be leveraged to increase vector-control efficiency- targeting key areas of environmental risk.

Mapping spatial patterns of people's risk perception of landslides

NASA Astrophysics Data System (ADS)

Kofler, Christian; Pedoth, Lydia; Elzbieta Stawinoga, Agnieszka; Schneiderbauer, Stefan

2016-04-01

The resilience of communities against natural hazards is largely influenced by how the individuals perceive risk. A good understanding of people's risk perception, awareness and hazard knowledge is crucial for developing and improving risk management and communication strategies between authorities and the affected population. A lot of research has been done in investigating the social aspects of risks to natural hazards by means of interviews or questionnaires. However, there is still a lack of research in the investigation of the influence of the spatial distance to a hazard event on peoples risk perception. While the spatial dimension of a natural hazard event is always assessed in works with a natural science approach, it is often neglected in works on social aspects of natural hazards. In the present study, we aimed to overcome these gaps by combining methods from different disciplines and assessing and mapping the spatial pattern of risk perception through multivariate statistical approaches based on empirical data from questionnaires. We will present results from a case study carried out in Badia, located in the Province of South Tyrol- Italy, where in December 2012 a landslide destroyed four residential buildings and led to the evacuation of 36 people. By means of questionnaires distributed to all adults living in the case study area we assessed people's risk perception and asked respondents to allocate their place of residence on a map of the case study area subdivided in 7 zones. Based on the data of the questionnaire results we developed a risk perception factor in order to express various assessed aspects linked to risk perception with one metric. We analyzed and mapped this factor according to the different zones reflecting the spatial distance to the event. Furthermore, a cluster analysis identified various risk behavior profiles within the population. We also investigated the spatial patterns of these risk profiles. We revealed that the residential zone in the immediate proximity to the landslide event showed significantly different results than all other zones. Though we have been able to observe spatial patterns of our developed metrics that changed significantly with geographic distance, our results led to the assumption that risk perception cannot be expressed in units of length. The appropriate spatial unit rather seems to be "immediate proximity" to the event. The results of our study can support response forces and authorities in planning and adopting different communication and management strategies tailored to different groups of affected persons.

Risk Factors for Acute Unintentional Poisoning among Children Aged 1–5 Years in the Rural Community of Sri Lanka

PubMed Central

Jayamanne, Shaluka F.; Jayasinghe, Chamilka Y.

2017-01-01

Background Acute poisoning in children is a major preventable cause of morbidity and mortality in both developed and developing countries. However, there is a wide variation in patterns of poisoning and related risk factors across different geographic regions globally. This hospital based case-control study identifies the risk factors of acute unintentional poisoning among children aged 1−5 years of the rural community in a developing Asian country. Methods This hospital based case-control study included 600 children. Each group comprised three hundred children and all children were recruited at Anuradhapura Teaching Hospital, Sri Lanka, over two years (from February 2012 to January 2014). The two groups were compared to identify the effect of 23 proposed risk factors for unintentional poisoning using multivariate analysis in a binary logistic regression model. Results Multivariate analysis identified eight risk factors which were significantly associated with unintentional poisoning. The strongest risk factors were inadequate supervision (95% CI: 15.4–52.6), employed mother (95% CI: 2.9–17.5), parental concern of lack of family support (95% CI: 3.65–83.3), and unsafe storage of household poisons (95% CI: 1.5–4.9). Conclusions Since inadequate supervision, unsafe storage, and unsafe environment are the strongest risk factors for childhood unintentional poisoning, the effect of community education to enhance vigilance, safe storage, and assurance of safe environment should be evaluated. PMID:28932247

Colorimetric Topography of Atherosclerotic Lesions by Television Image Processing

DTIC Science & Technology

1979-06-15

image. Indeed, the system is capable of detecting such fine dynamics that epidemiologic factors effecting those changes can not be measured...different occurance patterns and development of clinical atherosclerosis (30). Numerous risk factors have been determined by group comparison and some...techniques and scanners today are much more uniform, and these errors are no longer limiting factors . Since the films were "black and white," and scanned as

The contribution of an animal model toward uncovering biological risk factors for PTSD.

PubMed

Cohen, Hagit; Matar, Michael A; Richter-Levin, Gal; Zohar, Joseph

2006-07-01

Clinical studies of posttraumatic stress disorder (PTSD) have elicited proposed risk factors for developing PTSD in the aftermath of stress exposure. Generally, these risk factors have arisen from retrospective analysis of premorbid characteristics of study populations. A valid animal model of PTSD can complement clinical studies and help to elucidate issues, such as the contribution of proposed risk factors, in ways which are not practicable in the clinical arena. Important qualities of animal models include the possibility to conduct controlled prospective studies, easy access to postmortem brains, and the availability of genetically manipulated subjects, which can be tailored to specific needs. When these qualities are further complemented by an approach which defines phenomenologic criteria to address the variance in individual response pattern and magnitude, enabling the animal subjects to be classified into definable groups for focused study, the model acquires added validity. This article presents an overview of a series of studies in such an animal model which examine the contribution of two proposed risk factors and the value of two early postexposure pharmacological manipulations on the prevalence rates of subjects displaying an extreme magnitude of behavioral response to a predator stress paradigm.

Injury perceptions of bombing survivors--interviews from the Oklahoma City bombing.

PubMed

Glenshaw, Mary T; Vernick, Jon S; Frattaroli, Shannon; Brown, Sheryll; Mallonee, Sue

2008-01-01

Bombings, including the 1995 Oklahoma City bombing, remain an important public health threat. However, there has been little investigation into the impressions of injury risk or protective factors of bombing survivors. This study analyzes Oklahoma City bombing survivors' impressions of factors that influenced their risk of injury, and validates a hazard timeline outlining phases of injury risk in a building bombing. In-depth, semi-structured interviews were conducted within a sample of Oklahoma City bombing survivors. Participants included 15 injured and uninjured survivors, who were located in three buildings surrounding the detonation site during the attack. Risk factor themes included environmental glass, debris, and entrapment. Protective factors included knowledge of egress routes, shielding behaviors to deflect debris, and survival training. Building design and health status were reported as risk and protective factors. The hazard timeline was a useful tool, but should be modified to include a lay rescue phase. The combination of a narrative approach and direct questioning is an effective method of gathering the perceptions of survivors. Investigating survivors' impressions of building bombing hazards is critical to capture injury exposures, behavior patterns, and decision-making processes during actual events, and to identify interventions that will be supported by survivors.

Better knowledge improves adherence to lifestyle changes and medication in patients with coronary heart disease.

PubMed

Alm-Roijer, Carin; Stagmo, Martin; Udén, Giggi; Erhardt, Leif

2004-12-01

Many patients with coronary heart disease (CHD) are not managed adequately, and we often fail to reach treatment targets. To investigate if knowledge of risk factors for CHD, measured by a questionnaire, would show any relation to advice to compliance to lifestyle changes to attain treatment goals and adherence to drug therapy. Men and women <71 years who had had a cardiac event were screened consecutively (509) from the medical records. Responders (392) were interviewed, examined and received a questionnaire. Three hundred and forty-seven patients answered the questionnaire regarding their general knowledge of risk factors for CHD, compliance to lifestyle changes to attain treatment goals and adherence to drug therapy. There were statistically significant correlations between general knowledge about risk factors for CHD and compliance to certain lifestyle changes: weight, physical activity, stress management, diet, attainment of lipid level goals and the likelihood of taking prescribed blood pressure-lowering drugs. General knowledge of risk factors had no correlation to blood glucose or blood pressure levels nor on smoking habits or treatment patterns for prescribed lipid- and blood glucose-lowering drugs. Knowledge correlates to patient behaviour with respect to some risk factors, which should be recognised in preventive programs.

Aorto-iliac occlusive disease in the different population groups--clinical pattern, risk profile and results of reconstruction.

PubMed

Madiba, T E; Mars, M; Robbs, J V

1999-12-01

It has previously been accepted that atherosclerotic disease is uncommon among blacks worldwide; however, recent studies have increasingly reported atherosclerotic disease in this group. Prospective study of hospital patients with aorto-iliac occlusive disease presenting to the vascular service of the Durban metropolitan hospitals. The study was designed to assess clinical pattern, risk profile and results of reconstruction in these patients. This is a study of 688 patients with aorto-iliac occlusive disease managed over 9 years in Durban, with clinical pattern and risk factors compared in the different population groups. A subgroup of 492 patients underwent aortobifemoral bypass, providing material for comparison of the results of reconstruction in the different population groups. More black patients presented with gangrene and threatened limb, whereas whites tended to present early with claudication. All groups had hypertension and diabetes as risk factors. In addition, whites and Indians had ischaemic heart disease, which was not found among blacks. Mortality was 5% (blacks 1.8%, whites 8.5%, Indians 5%). Medium-term occlusion rates were 19% in blacks, 13% in Indians and 5% among whites. Five-year cumulative patency rates were 92% for whites, 77% for Indians and 74% for blacks. Whites do significantly better than blacks, who tend to present at an advanced stage of the disease. The presence of ischaemic heart disease among whites and Indians contributes to the higher mortality in these groups.

Heterogeneity in Trajectories of Child Maltreatment Severity: A Two-Part Growth Mixture Model

PubMed Central

Yampolskaya, Svetlana; Greenbaum, Paul E.; Brown, C. Hendricks; Armstrong, Mary I.

2016-01-01

This study examined the trajectories of maltreatment severity and substantiation over a 24-month period among children (N = 82,396) with repeated maltreatment reports. Findings revealed two different longitudinal patterns. The first pattern, Elevated Severity, showed a higher level of maltreatment during the initial incident and increased maltreatment severity during subsequent incidents but the substantiation rates for this class decreased over time. The second pattern, Lowered Severity, showed a much lower level of severity, but the likelihood of substantiation increased over time. The Elevated Severity class was comprised of children with an elevated risk profile due to both individual and contextual risk factors including older age, female gender, caregivers’ substance use problems, and a higher number of previous maltreatment reports. Implications of the findings are discussed. PMID:26300381

Etiological overlap between obsessive-compulsive disorder and anorexia nervosa: a longitudinal cohort, multigenerational family and twin study

PubMed Central

Cederlöf, Martin; Thornton, Laura M; Baker, Jessica; Lichtenstein, Paul; Larsson, Henrik; Rück, Christian; Bulik, Cynthia M; Mataix-Cols, David

2015-01-01

Obsessive-compulsive disorder (OCD) often co-occurs with anorexia nervosa (AN), a comorbid profile that complicates the clinical management of both conditions. This population-based study aimed to examine patterns of comorbidity, longitudinal risks, shared familial risks and shared genetic factors between OCD and AN at the population level. Participants were individuals with a diagnosis of OCD (N=19,814) or AN (N=8,462) in the Swedish National Patient Register between January 1992 and December 2009; their first-, second- and third-degree relatives; and population-matched (1:10 ratio) unaffected comparison individuals and their relatives. Female twins from the population-based Swedish Twin Register (N=8,550) were also included. Females with OCD had a 16-fold increased risk of having a comorbid diagnosis of AN, whereas males with OCD had a 37-fold increased risk. Longitudinal analyses showed that individuals first diagnosed with OCD had an increased risk for a later diagnosis of AN (risk ratio, RR=3.6), whereas individuals first diagnosed with AN had an even greater risk for a later diagnosis of OCD (RR=9.6). These longitudinal risks were about twice as high for males than for females. First- and second-degree relatives of probands with OCD had an increased risk for AN, and the magnitude of this risk tended to increase with the degree of genetic relatedness. Bivariate twin models revealed a moderate but significant degree of genetic overlap between self-reported OCD and AN diagnoses (ra=0.52, 95% CI: 0.26-0.81), but most of the genetic variance was disorder-specific. The moderately high genetic correlation supports the idea that this frequently observed comorbid pattern is at least in part due to shared genetic factors, though disorder-specific factors are more important. These results have implications for current gene-searching efforts and for clinical practice. PMID:26407789

Conserved and species-specific transcription factor co-binding patterns drive divergent gene regulation in human and mouse

PubMed Central

Diehl, Adam G

2018-01-01

Abstract The mouse is widely used as system to study human genetic mechanisms. However, extensive rewiring of transcriptional regulatory networks often confounds translation of findings between human and mouse. Site-specific gain and loss of individual transcription factor binding sites (TFBS) has caused functional divergence of orthologous regulatory loci, and so we must look beyond this positional conservation to understand common themes of regulatory control. Fortunately, transcription factor co-binding patterns shared across species often perform conserved regulatory functions. These can be compared to ‘regulatory sentences’ that retain the same meanings regardless of sequence and species context. By analyzing TFBS co-occupancy patterns observed in four human and mouse cell types, we learned a regulatory grammar: the rules by which TFBS are combined into meaningful regulatory sentences. Different parts of this grammar associate with specific sets of functional annotations regardless of sequence conservation and predict functional signatures more accurately than positional conservation. We further show that both species-specific and conserved portions of this grammar are involved in gene expression divergence and human disease risk. These findings expand our understanding of transcriptional regulatory mechanisms, suggesting that phenotypic divergence and disease risk are driven by a complex interplay between deeply conserved and species-specific transcriptional regulatory pathways. PMID:29361190

Improved representation of investment decisions in assessments of CO2 mitigation

NASA Astrophysics Data System (ADS)

Iyer, Gokul C.; Clarke, Leon E.; Edmonds, James A.; Flannery, Brian P.; Hultman, Nathan E.; McJeon, Haewon C.; Victor, David G.

2015-05-01

Assessments of emissions mitigation patterns have largely ignored the huge variation in real-world factors--in particular, institutions--that affect where, how and at what costs firms deploy capital. We investigate one such factor--how national institutions affect investment risks and thus the cost of financing. We use an integrated assessment model (IAM; ref. ) to represent the variation in investment risks across technologies and regions in the electricity generation sector--a pivotally important sector in most assessments of climate change mitigation--and compute the impact on the magnitude and distribution of mitigation costs. This modified representation of investment risks has two major effects. First, achieving an emissions mitigation goal is more expensive than it would be in a world with uniform investment risks. Second, industrialized countries mitigate more, and developing countries mitigate less. Here, we introduce a new front in the research on how real-world factors influence climate mitigation. We also suggest that institutional reforms aimed at lowering investment risks could be an important element of cost-effective climate mitigation strategies.

Underage drinking on saturday nights, sociodemographic and environmental risk factors: a cross-sectional study

PubMed Central

2011-01-01

Background Excessive alcohol consumption in underage people is a rising phenomenon. A major proportion of the disease burden and deaths of young people in developed nations is attributable to alcohol abuse. The aim of this study was to investigate social, demographic and environmental factors that may raise the risk of Saturday night drinking and binge drinking among Italian school students. Methods The study was conducted on a sample of 845 Italian underage school students, by means of an anonymous, self-test questionnaire. Multivariate logistic regression was applied to identify independent risk factors for alcohol drinking and binge drinking. Ordered logistic regression was used to identify independent risk factors for harmful drinking patterns. Results The independent variables that confer a higher risk of drinking in underage students are older age classes, male sex, returning home after midnight, belonging to a group with little respect for the rules, or to a group where young people are not seen as leaders. The higher the perception of alcohol consumption by the group, the higher the risk. Spending time in bars or discos coincides with a two-fold or four-fold increase, respectively, in the risk of alcohol consumption. Conclusion Our findings show that certain environmental and social risk factors are associated with underage drinking. The most important role for preventing young people's exposure to these factors lies with the family, because only parents can exert the necessary control and provide a barrier against potentially harmful situations. PMID:21729273

Underage drinking on saturday nights, sociodemographic and environmental risk factors: a cross-sectional study.

PubMed

Gallimberti, Luigi; Chindamo, Sonia; Buja, Alessandra; Forza, Giovanni; Tognazzo, Federica; Galasso, Laura; Vinelli, Angela; Baldo, Vincenzo

2011-07-05

Excessive alcohol consumption in underage people is a rising phenomenon. A major proportion of the disease burden and deaths of young people in developed nations is attributable to alcohol abuse. The aim of this study was to investigate social, demographic and environmental factors that may raise the risk of Saturday night drinking and binge drinking among Italian school students. The study was conducted on a sample of 845 Italian underage school students, by means of an anonymous, self-test questionnaire. Multivariate logistic regression was applied to identify independent risk factors for alcohol drinking and binge drinking. Ordered logistic regression was used to identify independent risk factors for harmful drinking patterns. The independent variables that confer a higher risk of drinking in underage students are older age classes, male sex, returning home after midnight, belonging to a group with little respect for the rules, or to a group where young people are not seen as leaders. The higher the perception of alcohol consumption by the group, the higher the risk. Spending time in bars or discos coincides with a two-fold or four-fold increase, respectively, in the risk of alcohol consumption. Our findings show that certain environmental and social risk factors are associated with underage drinking. The most important role for preventing young people's exposure to these factors lies with the family, because only parents can exert the necessary control and provide a barrier against potentially harmful situations.

Using Structured Additive Regression Models to Estimate Risk Factors of Malaria: Analysis of 2010 Malawi Malaria Indicator Survey Data

PubMed Central

Chirombo, James; Lowe, Rachel; Kazembe, Lawrence

2014-01-01

Background After years of implementing Roll Back Malaria (RBM) interventions, the changing landscape of malaria in terms of risk factors and spatial pattern has not been fully investigated. This paper uses the 2010 malaria indicator survey data to investigate if known malaria risk factors remain relevant after many years of interventions. Methods We adopted a structured additive logistic regression model that allowed for spatial correlation, to more realistically estimate malaria risk factors. Our model included child and household level covariates, as well as climatic and environmental factors. Continuous variables were modelled by assuming second order random walk priors, while spatial correlation was specified as a Markov random field prior, with fixed effects assigned diffuse priors. Inference was fully Bayesian resulting in an under five malaria risk map for Malawi. Results Malaria risk increased with increasing age of the child. With respect to socio-economic factors, the greater the household wealth, the lower the malaria prevalence. A general decline in malaria risk was observed as altitude increased. Minimum temperatures and average total rainfall in the three months preceding the survey did not show a strong association with disease risk. Conclusions The structured additive regression model offered a flexible extension to standard regression models by enabling simultaneous modelling of possible nonlinear effects of continuous covariates, spatial correlation and heterogeneity, while estimating usual fixed effects of categorical and continuous observed variables. Our results confirmed that malaria epidemiology is a complex interaction of biotic and abiotic factors, both at the individual, household and community level and that risk factors are still relevant many years after extensive implementation of RBM activities. PMID:24991915

Using structured additive regression models to estimate risk factors of malaria: analysis of 2010 Malawi malaria indicator survey data.

PubMed

Chirombo, James; Lowe, Rachel; Kazembe, Lawrence

2014-01-01

After years of implementing Roll Back Malaria (RBM) interventions, the changing landscape of malaria in terms of risk factors and spatial pattern has not been fully investigated. This paper uses the 2010 malaria indicator survey data to investigate if known malaria risk factors remain relevant after many years of interventions. We adopted a structured additive logistic regression model that allowed for spatial correlation, to more realistically estimate malaria risk factors. Our model included child and household level covariates, as well as climatic and environmental factors. Continuous variables were modelled by assuming second order random walk priors, while spatial correlation was specified as a Markov random field prior, with fixed effects assigned diffuse priors. Inference was fully Bayesian resulting in an under five malaria risk map for Malawi. Malaria risk increased with increasing age of the child. With respect to socio-economic factors, the greater the household wealth, the lower the malaria prevalence. A general decline in malaria risk was observed as altitude increased. Minimum temperatures and average total rainfall in the three months preceding the survey did not show a strong association with disease risk. The structured additive regression model offered a flexible extension to standard regression models by enabling simultaneous modelling of possible nonlinear effects of continuous covariates, spatial correlation and heterogeneity, while estimating usual fixed effects of categorical and continuous observed variables. Our results confirmed that malaria epidemiology is a complex interaction of biotic and abiotic factors, both at the individual, household and community level and that risk factors are still relevant many years after extensive implementation of RBM activities.

A long-recommended but seldom-used method of analysis for fall injuries found a unique pattern of risk factors in the youngest-old.

PubMed

Legrand, Helen; Pihlsgård, Mats; Nordell, Eva; Elmståhl, Sölve

2015-08-01

Few studies on fall risk factors use long-recommended methods for analysis of recurrent events. Previous falls are the biggest risk factor for future falls, but few fall studies focus on the youngest-old. This study's objective was to apply Cox regression for recurrent events to identify factors associated with injurious falls in the youngest-old. Participants were community-dwelling residents of southern Sweden (n = 1,133), aged 59-67 at baseline (median 61.2), from the youngest cohorts of the larger Good Aging in Skåne (GÅS) study. Exposure variable data were collected from baseline study visits and medical records. Injurious falls, defined as emergency, inpatient, or specialist visits associated with ICD-10 fall codes during the follow-up period (2001-2011), were gathered from national and regional registries. Analysis was conducted using time to event Cox Regression for recurrent events. A majority (77.1 %) of injurious falls caused serious injuries such as fractures and open wounds. Exposure to nervous system medications [hazard ratio (HR) 1.40, 95 % confidence interval (CI) 1.03-1.89], central nervous system disease (HR 1.79, CI 1.18-2.70), and previous injurious fall(s) (HR 2.00, CI 1.50-2.68) were associated with increased hazard of injurious fall. Regression for recurrent events is feasible with typical falls' study data. The association of certain exposures with increased hazard of injurious falls begins earlier than previously studied. Different patterns of risk factors by age can provide insight into the progression of frailty. Tailored fall prevention screening and intervention may be of value in populations younger than those traditionally screened.

Comparative Epidemiology of Highly Pathogenic Avian Influenza Virus H5N1 and H5N6 in Vietnamese Live Bird Markets: Spatiotemporal Patterns of Distribution and Risk Factors.

PubMed

Mellor, Kate C; Meyer, Anne; Elkholly, Doaa A; Fournié, Guillaume; Long, Pham T; Inui, Ken; Padungtod, Pawin; Gilbert, Marius; Newman, Scott H; Vergne, Timothée; Pfeiffer, Dirk U; Stevens, Kim B

2018-01-01

Highly pathogenic avian influenza (HPAI) H5N1 virus has been circulating in Vietnam since 2003, whilst outbreaks of HPAI H5N6 virus are more recent, having only been reported since 2014. Although the spatial distribution of H5N1 outbreaks and risk factors for virus occurrence has been extensively studied, there have been no comparative studies for H5N6. Data collected through active surveillance of Vietnamese live bird markets (LBMs) between 2011 and 2015 were used to explore and compare the spatiotemporal distributions of H5N1- and H5N6-positive LBMs. Conditional autoregressive models were developed to quantify spatiotemporal associations between agroecological factors and the two HPAI strains using the same set of predictor variables. Unlike H5N1, which exhibited a strong north-south divide, with repeated occurrence in the extreme south of a cluster of high-risk provinces, H5N6 was homogeneously distributed throughout Vietnam. Similarly, different agroecological factors were associated with each strain. Sample collection in the months of January and February and higher average maximum temperature were associated with higher likelihood of H5N1-positive market-day status. The likelihood of market days being positive for H5N6 increased with decreased river density, and with successive Rounds of data collection. This study highlights marked differences in spatial patterns and risk factors for H5N1 and H5N6 in Vietnam, suggesting the need for tailored surveillance and control approaches.

Comparative Epidemiology of Highly Pathogenic Avian Influenza Virus H5N1 and H5N6 in Vietnamese Live Bird Markets: Spatiotemporal Patterns of Distribution and Risk Factors

PubMed Central

Mellor, Kate C.; Meyer, Anne; Elkholly, Doaa A.; Fournié, Guillaume; Long, Pham T.; Inui, Ken; Padungtod, Pawin; Gilbert, Marius; Newman, Scott H.; Vergne, Timothée; Pfeiffer, Dirk U.; Stevens, Kim B.

2018-01-01

Highly pathogenic avian influenza (HPAI) H5N1 virus has been circulating in Vietnam since 2003, whilst outbreaks of HPAI H5N6 virus are more recent, having only been reported since 2014. Although the spatial distribution of H5N1 outbreaks and risk factors for virus occurrence has been extensively studied, there have been no comparative studies for H5N6. Data collected through active surveillance of Vietnamese live bird markets (LBMs) between 2011 and 2015 were used to explore and compare the spatiotemporal distributions of H5N1- and H5N6-positive LBMs. Conditional autoregressive models were developed to quantify spatiotemporal associations between agroecological factors and the two HPAI strains using the same set of predictor variables. Unlike H5N1, which exhibited a strong north–south divide, with repeated occurrence in the extreme south of a cluster of high-risk provinces, H5N6 was homogeneously distributed throughout Vietnam. Similarly, different agroecological factors were associated with each strain. Sample collection in the months of January and February and higher average maximum temperature were associated with higher likelihood of H5N1-positive market-day status. The likelihood of market days being positive for H5N6 increased with decreased river density, and with successive Rounds of data collection. This study highlights marked differences in spatial patterns and risk factors for H5N1 and H5N6 in Vietnam, suggesting the need for tailored surveillance and control approaches. PMID:29675418

Helicobacter pylori serological biomarkers of gastric cancer risk in the MCC-Spain case-control Study.

PubMed

Fernández de Larrea-Baz, Nerea; Pérez-Gómez, Beatriz; Michel, Angelika; Romero, Beatriz; Lope, Virginia; Pawlita, Michael; Fernández-Villa, Tania; Moreno, Victor; Martín, Vicente; Willhauck-Fleckenstein, Martina; López-Abente, Gonzalo; Castilla, Jesús; Fernández-Tardón, Guillermo; Dierssen-Sotos, Trinidad; Santibáñez, Miguel; Peiró, Rosana; Jiménez-Moleón, José Juan; Navarro, Carmen; Castaño-Vinyals, Gemma; Kogevinas, Manolis; Pollán, Marina; de Sanjosé, Silvia; Del Campo, Rosa; Waterboer, Tim; Aragonés, Nuria

2017-10-01

Helicobacter pylori infection is one of the main risk factors for non-cardia gastric cancer. However, only a minority of infected persons develop the disease. This study aims at identifying H. pylori related serological biomarkers of risk for gastric cancer. Incident gastric cancer cases and population controls (age, sex and region frequency-matched) from the MCC-Spain multicase-control Study were included. Seroreactivities against 16H. pylori proteins were determined using multiplex serology. Infection was defined as seropositivity against≥4 proteins. Relation of serological results to non-cardia and cardia gastric cancer was assessed using multivariable mixed logistic regression and principal components analysis. Seroprevalence was 88% among 2071 controls, 95% among 202 non-cardia gastric cancer cases (OR=1.9 (95% CI: 1.0-3.6)) and 85% among 62 cardia cancer cases (OR=0.5 (95% CI: 0.3-1.1)). In infected subjects, seropositivity for UreA, HP231, NapA and Cagδ was associated with lower non-cardia gastric cancer risk, while seropositivity for CagA and VacA was associated with higher risk. Seropositivity for CagA and seronegativity for Cagδ maintained the association after additional adjustment by serostatus of significant proteins. We identified two antibody reactivity patterns: the "virulent-pattern", related to a threefold higher risk of non-cardia gastric cancer and the "non-virulent pattern", related to a 60% decreased risk (4th vs. first quartile). In our population, people seropositive for H. pylori were characterized by two patterns of antibody reactivity against H. pylori proteins: 1) Combined high seroreactivity against several proteins, associated with a lower non-cardia gastric cancer risk, and 2) High seroreactivity against CagA and VacA, associated with an increased risk. Copyright © 2017 Elsevier Ltd. All rights reserved.

Lifestyle risk factors for cardiovascular disease and diabetic risk in a sedentary occupational group: the Galway taxi driver study.

PubMed

Martin, W P; Sharif, F; Flaherty, G

2016-05-01

Taxi drivers are at increased risk of cardiovascular disease (CVD), something which persists after correcting for the overrepresentation of traditional risk factors for CVD in this cohort. The contribution of lifestyle risk factors to this residually elevated CVD risk remains under-evaluated. We aimed to determine the prevalence of lifestyle risk factors for CVD, self-reported medical risk factors for CVD, and future risk of type 2 diabetes amongst Irish taxi drivers. Male taxi drivers with no history of CVD and type 2 diabetes and working in Galway city in the west of Ireland were invited to participate. Physical activity levels, dietary patterns, anthropometry, smoking, hypertension, hypercholesterolaemia, and Finnish Diabetes Risk Score (FINDRISC) values were recorded in a cross-sectional manner. 41 taxi drivers (mean age 56.7 ± 9.8 years) participated. 37 % were insufficiently active based on self-report, although only 8 % objectively achieved 10, 000 steps per day. Mean modified Mediterranean diet score (mMDS) was 4.6 ± 2.2, and only 13 % of participants had a normal body mass index (BMI) or waist circumference (WC). Those who worked for taxi companies tended to have a higher BMI (p = .07) and WC (p = .04) by multivariable regression. 22 % were current smokers, although a quit rate of 72 % was observed amongst the 78 % of taxi drivers who had ever smoked. 25 % were at high or very high risk of future type 2 diabetes. Lifestyle risk factors for CVD and dysglycaemia are prevalent amongst Irish taxi drivers.

Risk factors associated with sensitization to hydroxyisohexyl 3-cyclohexene carboxaldehyde.

PubMed

Uter, Wolfgang; Geier, Johannes; Schnuch, Axel; Gefeller, Olaf

2013-08-01

Hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) is a synthetic fragrance chemical and an important contact allergen, at least in Europe. Despite this importance, little is known about risk factors associated with this allergen. To examine factors from the history and clinical presentation of patch tested patients associated with HICC sensitization. Contact allergy surveillance data of 95 637 patients collected by the Information Network of Departments of Dermatology (IVDK, www.ivkd.org) in 2002-2011 were analysed. Point and interval estimates of the relative risk were derived from multifactorial logistic regression modelling. The overall prevalence of HICC sensitization was 2.24%. The strongest risk factors were polysensitization and dermatitis of the axillae, followed by dermatitis at other sites. No consistent and significant time trend was observed in this analysis. As compared with the youngest patients, the odds of HICC sensitization increased approximately three-fold in the 52-67-year age group, and strongly declined with further increasing age. The risk pattern with regard to age and affected anatomical site differed from that observed with other fragrance screening allergens. Cosmetic exposure, as broadly defined here, was a stronger and more prevalent individual risk factor than occupational exposure. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Genetic susceptibility to lung cancer—light at the end of the tunnel?

PubMed Central

Christiani, David C.

2013-01-01

Lung cancer is one of the most common and deadliest cancers in the world. The major socio-environmental risk factor involved in the development of lung cancer is cigarette smoking. Additionally, there are multiple genetic factors, which may also play a role in lung cancer risk. Early work focused on the presence of relatively prevalent but low-penetrance alterations in candidate genes leading to increased risk of lung cancer. Development of new technologies such as genomic profiling and genome-wide association studies has been helpful in the detection of new genetic variants likely involved in lung cancer risk. In this review, we discuss the role of multiple genetic variants and review their putative role in the risk of lung cancer. Identifying genetic biomarkers and patterns of genetic risk may be useful in the earlier detection and treatment of lung cancer patients. PMID:23349013

Patterns of risk for anxiety-depression amongst Vietnamese-immigrants: a comparison with source and host populations

PubMed Central

2013-01-01

Background Studies suggest that immigrants have higher rates of anxiety-depression than compatriots in low-middle income countries and lower rates than populations in host high income countries. Elucidating the factors that underlie these stepwise variations in prevalence may throw new light on the pathogenesis of anxiety-depressive disorders globally. This study aimed to examine whether quantitative differences in exposure to, or the interaction between, risk factors account for these anxiety-depression prevalence differences amongst immigrant relative to source and host country populations. Methods Multistage population mental health surveys were conducted in three groups: 1) a Vietnamese-immigrant sample settled in Australia (n = 1161); 2) a Vietnamese source country sample residing in the Mekong Delta region (n = 3039); 3) an Australian-born host country sample (n = 7964). Multivariable logistic regression analyses compared risk factors between the Vietnamese-immigrant group and: 1) the Mekong Delta Vietnamese; and 2) the Australian-born group. Twelve month anxiety-depression diagnoses were the main outcome measures, derived from the Composite International Diagnostic Interview (CIDI), supplemented by an indigenously derived measure - the Phan Vietnamese Psychiatric Scale (PVPS) in both Vietnamese groups. Results The 12-month prevalence of anxiety-depression showed a stepwise increase across groups: Mekong Delta Vietnamese 4.8%; Vietnamese-immigrants 7.0%; Australian-born 10.2%. The two Vietnamese populations showed a similar risk profile with older age, exposure to potentially traumatic events (PTEs), multiple physical illnesses and substance use disorder (SUD) being associated with anxiety-depression, with the older Vietnamese-immigrants reporting greater exposure to these factors. The interaction between key risk factors differed fundamentally when comparing Vietnamese-immigrant and Australian-born samples. Age emerged as the major discriminator, with young Vietnamese-immigrants exhibiting particularly low rates of anxiety-depression. Conclusions The findings reported here suggest that core risk factors for anxiety-depression may be universal, but their patterning and interaction may differ according to country-of-origin. The study also highlights the importance of including both standard international and culturally-specific measures to index cross-cultural manifestations of common mental disorders. PMID:24294940

Correlates and geographic patterns of knowledge that physical activity decreases cancer risk.

PubMed

Ramírez, A Susana; Finney Rutten, Lila J; Vanderpool, Robin C; Moser, Richard P; Hesse, Bradford W

2013-04-01

While many lifestyle-related cancer risk factors including tobacco use, poor diet, and sun exposure are well recognized by the general public, the role of physical activity in decreasing cancer risk is less recognized. Studies have demonstrated gender-, race/ethnicity-, and age-based disparities in cancer risk factor knowledge; however, beliefs and geographic factors that may be related to knowledge are under-examined. In this study, we analyzed data from the 2008 Health Information National Trends Survey to determine correlates of knowledge of the relationship between physical activity and reduced cancer risk in the adult US population. We generated geographic information system maps to examine the geographic distribution of this knowledge. Results revealed that there is confusion among US adults about the relationship between physical activity and cancer risk: Respondents who believed that cancer is not preventable had significantly lower odds of knowing that physical activity reduces cancer risk (p < .001) whereas respondents who believed that cancer is caused by one's behavior had almost two times the odds of knowing that physical activity reduces cancer risk (p < .001). Those who were aware of current physical activity guidelines were also significantly more likely to know that physical activity reduces cancer risk (p < .01). Observed geographic variability in knowledge was consistent with geographic trends in obesity and physical inactivity. Correlates of cancer risk factor knowledge point to opportunities for targeted interventions.

Thinking beyond Opisthorchis viverrini for risk of cholangiocarcinoma in the lower Mekong region: a systematic review and meta-analysis.

PubMed

Steele, Jennifer A; Richter, Carsten H; Echaubard, Pierre; Saenna, Parichat; Stout, Virginia; Sithithaworn, Paiboon; Wilcox, Bruce A

2018-05-17

Cholangiocarcinoma (CCA) is a fatal bile duct cancer associated with infection by the liver fluke, Opisthorchis viverrini, in the lower Mekong region. Numerous public health interventions have focused on reducing exposure to O. viverrini, but incidence of CCA in the region remains high. While this may indicate the inefficacy of public health interventions due to complex social and cultural factors, it may further indicate other risk factors or interactions with the parasite are important in pathogenesis of CCA. This systematic review aims to provide a comprehensive analysis of described risk factors for CCA in addition to O. viverrini to guide future integrative interventions. We searched five international and seven Thai research databases to identify studies relevant to risk factors for CCA in the lower Mekong region. Selected studies were assessed for risk of bias and quality in terms of study design, population, CCA diagnostic methods, and statistical methods. The final 18 included studies reported numerous risk factors which were grouped into behaviors, socioeconomics, diet, genetics, gender, immune response, other infections, and treatment for O. viverrini. Seventeen risk factors were reported by two or more studies and were assessed with random effects models during meta-analysis. This meta-analysis indicates that the combination of alcohol and smoking (OR = 11.1, 95% CI: 5.63-21.92, P <  0.0001) is most significantly associated with increased risk for CCA and is an even greater risk factor than O. viverrini exposure. This analysis also suggests that family history of cancer, consumption of raw cyprinoid fish, consumption of high nitrate foods, and praziquantel treatment are associated with significantly increased risk. These risk factors may have complex relationships with the host, parasite, or pathogenesis of CCA, and many of these risk factors were found to interact with each other in one or more studies. Our findings suggest that a complex variety of risk factors in addition to O. viverrini infection should be addressed in future public health interventions to reduce CCA in affected regions. In particular, smoking and alcohol use, dietary patterns, and socioeconomic factors should be considered when developing intervention programs to reduce CCA.

Dietary Patterns in Relation to General and Central Obesity among Adults in Southwest China.

PubMed

Zhang, Qiang; Chen, Xinguang; Liu, Zhitao; Varma, Deepthi S; Wan, Rong; Wan, Qingqing; Zhao, Shiwen

2016-11-03

Dietary patterns represent a broader picture of food consumption, and are better correlated with a variety of health outcomes. However, few studies have been conducted to explore the associations between dietary patterns and obesity in Southwest China. Data from the 2010-2012 National Nutrition Survey in the province of Yunnan, Southwest China, were analyzed ( n = 1604, aged 18-80 years). Dietary data were collected using the 24 h dietary recall over three consecutive days. Height, weight, and waist circumference were measured following standard methods. Exploratory factor analysis was used to identify dietary patterns. Logistic regression was used to explore the association between dietary patterns and obesity. Three distinct dietary patterns were identified, which were labeled as traditional, modern, and tuber according to their key components. With potential confounders adjusted, adults in the highest quartile of the modern pattern were at higher risk of general and central obesity (odds ratio (OR) 1.95, 95% confidence interval (CI) 1.15-3.48; OR 2.01, 95% CI 1.37-2.93). In contrast, adults in the highest quartile of the tuber pattern were at lower risk of general and central obesity (OR 0.34, 95% CI 0.15-0.61; OR 0.64, 95% CI 0.43-0.95) but at higher risk of underweight (OR 2.57, 95% CI 1.20-6.45). No significant association was found between the traditional pattern and obesity. Moreover, dietary pattern differences occurred due to the differences in socio-demographic characteristics. In conclusion, the modern dietary pattern was positively, and the tuber pattern negatively, associated with general and central obesity among adults in Southwest China.

Processed red meat contribution to dietary patterns and the associated cardio-metabolic outcomes.

PubMed

Lenighan, Yvonne M; Nugent, Anne P; Li, Kaifeng F; Brennan, Lorraine; Walton, Janette; Flynn, Albert; Roche, Helen M; McNulty, Breige A

2017-08-01

Evidence suggests that processed red meat consumption is a risk factor for CVD and type 2 diabetes (T2D). This analysis investigates the association between dietary patterns, their processed red meat contributions, and association with blood biomarkers of CVD and T2D, in 786 Irish adults (18-90 years) using cross-sectional data from a 2011 national food consumption survey. All meat-containing foods consumed were assigned to four food groups (n 502) on the basis of whether they contained red or white meat and whether they were processed or unprocessed. The remaining foods (n 2050) were assigned to twenty-nine food groups. Two-step and k-means cluster analyses were applied to derive dietary patterns. Nutrient intakes, plasma fatty acids and biomarkers of CVD and T2D were assessed. A total of four dietary patterns were derived. In comparison with the pattern with lower contributions from processed red meat, the dietary pattern with greater processed red meat intakes presented a poorer Alternate Healthy Eating Index (21·2 (sd 7·7)), a greater proportion of smokers (29 %) and lower plasma EPA (1·34 (sd 0·72) %) and DHA (2·21 (sd 0·84) %) levels (P<0·001). There were no differences in classical biomarkers of CVD and T2D, including serum cholesterol and insulin, across dietary patterns. This suggests that the consideration of processed red meat consumption as a risk factor for CVD and T2D may need to be re-assessed.

Dietary Patterns and Overweight/Obesity: A Review Article

PubMed Central

MU, Min; XU, Li-Fa; HU, Dong; WU, Jing; BAI, Ming-Jie

2017-01-01

Background: Dietary patterns analysis may provide insights into the influence of overall diet on overweight/obesity. In the past two decades, the relation between dietary patterns and overweight/obesity has been a research focus and a number of results were reported in the research field. Methods: An electronic literature search was conducted in PubMed and Web of Science, to identify human studies published by Mar 2015 and written in English. The following keywords or phrases were involved: dietary patterns, dietary pattern, factor analysis, principal component analysis, diet, obesity, adiposity, overweight and BMI. All the studies were retrieved and prudent/healthy (n=17) and western/unhealthy (n=18) dietary patterns were identified. Results: When compared with the lowest categories of a prudent/healthy dietary pattern, a reduced overweight/obesity risk was shown in the highest (OR=0.64; 95% CI: 0.52, 0.78; P<0.0001). While there was an increased overweight/obesity risk in the highest when compared with the lowest categories of a western/unhealthy dietary pattern (OR=1.65; 95% CI: 1.45, 1.87; P<0.0001). Conclusion: A prudent/healthy dietary pattern and limit intake of western/unhealthy dietary pattern should be followed, which helps to keep a healthy body mass. PMID:28845396

Awareness of risk factors for cancer: a comparative study of Sweden and Denmark.

PubMed

Lagerlund, Magdalena; Hvidberg, Line; Hajdarevic, Senada; Fischer Pedersen, Anette; Runesdotter, Sara; Vedsted, Peter; Tishelman, Carol

2015-11-23

Sweden and Denmark are neighbouring countries with similarities in culture, healthcare, and economics, yet notable differences in cancer statistics. A crucial component of primary prevention is high awareness of risk factors in the general public. We aimed to determine and compare awareness of risk factors for cancer between a Danish and a Swedish population sample, and to examine whether there are differences in awareness across age groups. Data derive from Module 2 of the International Cancer Benchmarking Partnership. Telephone interviews were conducted with 3000 adults in Denmark and 3070 in Sweden using the Awareness and Beliefs about Cancer measure. Data reported here relate to awareness of 13 prompted risk factors for cancer. Prevalence ratios with 95 % confidence intervals were calculated to examine associations between country, age, and awareness of risk factors. Over 90 % of respondents in both countries recognized smoking, use of sunbeds and ionizing radiation as risk factors for cancer. Lowest awareness (<50 %) was found for HPV-infection, low fruit and vegetable intake and alcohol intake. Swedish respondents reported higher awareness than Danish respondents for ten of the 13 risk factors studied. Respondents from Denmark reported higher awareness only regarding low fruit and vegetable intake and use of sunbeds. Low physical activity was the only risk factor for which there was no difference in awareness between the countries. A decline in awareness was generally seen with increasing age in both countries, but deviating patterns were seen for alcohol intake, red/processed meat, obesity and age 70+. This study supports findings from other European studies that generally demonstrate modest public awareness of many established cancer risk factors. Efforts should be made to improve awareness of the cancer risk factors HPV-infection, low fruit and vegetable intake and alcohol intake, which showed particularly low awareness in both countries. Previous studies indicate that repeated, broad campaigns are successful, and suggest that a multimedia approach is used.

Adult medulloblastoma: clinical characters, prognostic factors, outcomes and patterns of relapse.

PubMed

Zhang, Na; Ouyang, Taohui; Kang, Huicong; Long, Wang; Thomas, Benjamin; Zhu, Suiqiang

2015-09-01

To analyze the clinical characters, prognostic factors, patterns of relapse and treatment outcomes for medulloblastoma in adults. The clinical materials of 73 consecutive adult patients (age, ≥16 years) with medulloblastoma were analyzed retrospectively. Follow-up data were available in 62 patients, ranging from 10 to 142 months (median, 78.4 months). Outcome in survival was assessed by the progression-free survival (PFS) and overall survival (OS). Univariate and multivariate analysis were performed to determine the prognostic factors. Total or near-total tumor resection was achieved in 37 cases (59.7 %), subtotal in 19 cases (30.6 %), and partial resection in 6 cases (9.7 %).Twenty-two patients experienced recurrences, and 45 % percent of all recurrences occurred more than 4 years after initial surgery. The PFS rates at 5 and 8 years were 60.1 and 37.0 %, respectively. The OS rates at 5 and 8 years were 82.6 and 57.3 %, respectively. In univariate analysis, less tumor resection, non-desmoplastic pathology, and brainstem involvement were risk factors for worse PFS and OS (P < 0.05). High-risk category was associated with just lower PFS, but not OS. In multivariate analysis, complete resection and desmoplastic pathology were independently predictive factors of improved PFS and OS. In adult medulloblastoma, late relapse is common and therefore long-term follow-up is important for evaluating the real impact of treatments. Risk category had prognostic value just for PFS, but not for OS. Complete resection and desmoplastic histology are independently predictive factors for favorable outcomes.

Smoking cessation and the risk of cardiovascular disease outcomes predicted from established risk scores: results of the Cardiovascular Risk Assessment among Smokers in Primary Care in Europe (CV-ASPIRE) study.

PubMed

Mallaina, Pablo; Lionis, Christos; Rol, Hugo; Imperiali, Renzo; Burgess, Andrew; Nixon, Mark; Malvestiti, Franco Mondello

2013-04-18

Smoking is a major risk factor for cardiovascular disease (CVD). This multicenter, cross-sectional survey was designed to estimate the cardiovascular (CV) risk attributable to smoking using risk assessment tools, to better understand patient behaviors and characteristics related to smoking, and characterize physician practice patterns. 1,439 smokers were recruited from Europe during 2011. Smokers were ≥40 years old, smoked > 10 cigarettes/day and had recent measurements on blood pressure and lipids. CV risk was calculated using the SCORE system, Framingham risk equations, and Progetto CUORE model. The CV risk attributable to smoking was evaluated using a simulated control (hypothetical non-smoker) with identical characteristics as the enrolled smoker. Risks assessed included CV mortality, coronary heart disease (CHD), CVD and hard CHD. Demographics, comorbidities, primary reasons for consultation, behavior towards previous attempts to quit, and interest in smoking cessation was assessed. Dependence on nicotine was evaluated using the Fagerström Test for Nicotine Dependence. GP practice patterns were assessed through a questionnaire. The prediction models consistently demonstrated a high CV risk attributable to smoking. For instance, the SCORE model demonstrated that this study population of smokers have a 100% increased probability of death due to cardiovascular disease in the next 10-years compared to non-smokers. A considerable amount of patients would like to hear from their GP about the different alternatives available to support their quitting attempt. The findings of this study reinforce the importance of smoking as a significant predictor of long-term cardiovascular events. One of the best gains in health could be obtained by tackling the most important modifiable risk factors; these results suggest smoking is among the most important.

Left Ventricular Mass and Geometry and the Risk of Ischemic Stroke

PubMed Central

Di Tullio, Marco R.; Zwas, Donna R.; Sacco, Ralph L.; Sciacca, Robert R.; Homma, Shunichi

2009-01-01

Background and Purpose Left ventricular hypertrophy (LVH) is a risk factor for cardiovascular events, but its effect on ischemic stroke risk is established mainly in whites. The effect of LV geometry on stroke risk has not been defined. The aim of the present study was to evaluate whether LVH and LV geometry are independently associated with increased ischemic stroke risk in a multiethnic population. Methods A population-based case-control study was conducted on 394 patients with first ischemic stroke and 413 age-, sex-, and race-ethnicity–matched community control subjects. LV mass was measured by transthoracic echocardiography. LV geometric patterns (normal, concentric remodeling, concentric or eccentric hypertrophy) were identified. Stroke risk associated with LVH and different LV geometric patterns was assessed by conditional logistic regression analysis in the overall group and age, sex, and race-ethnic strata, with adjustment for established stroke risk factors. Results Concentric hypertrophy carried the greatest stroke risk (adjusted odds ratio [OR], 3.5; 95% confidence interval [CI], 2.0 to 6.2), followed by eccentric hypertrophy (adjusted OR, 2.4; 95% CI, 2.0 to 4.3). Concentric remodeling carried slightly increased stroke risk (adjusted OR, 1.7; 95% CI, 1.0 to 2.9). Increased LV relative wall thickness was independently associated with stroke after adjustment for LV mass (OR, 1.6; 95% CI, 1.1 to 2.3). Conclusions LVH and abnormal LV geometry are independently associated with increased stroke risk. LVH is strongly associated with ischemic stroke in all age, sex, and race-ethnic subgroups. Increased LV relative wall thickness imparts an increased stroke risk after adjustment for LV mass and is of additional value in stroke risk prediction. PMID:12958319

Relationship between dietary intake and the development of type 2 diabetes in a Chinese population: the Hong Kong Dietary Survey.

PubMed

Yu, Ruby; Woo, Jean; Chan, Ruth; Sham, Aprille; Ho, Suzanne; Tso, Annette; Cheung, Bernard; Lam, Tai Hing; Lam, Karen

2011-07-01

To study the relationship between dietary intake and the development of type 2 diabetes among Chinese adults. A prospective cohort study. Dietary assessment was carried out using a validated FFQ. Principal component analysis was used to identify dietary patterns. Dietary glycaemic load and variety of snacks were also calculated. A hospital-based centre at the Queen Mary Hospital in Hong Kong SAR, China. A total of 1010 Chinese adults aged 25-74 years who participated in a territory-wide dietary and cardiovascular risk factor prevalence survey in 1995-1996 were followed up for 9-14 years for the development of diabetes. A total of 690 (68·3 %) individuals completed follow-up during 2005-2008 and seventy-four cases of diabetes were identified over the follow-up period. Four dietary patterns were identified ('more snacks and drinks', 'more vegetables, fruits and fish', 'more meat and milk products' and 'more refined grains'). After adjustment for age, sex, BMI, waist-to-hip ratio, smoking, alcohol intake, participation in exercise/sports and family history of diabetes, the more vegetables, fruits and fish pattern was associated with a 14 % lower risk (OR per 1 sd increase in score = 0·76; 95 % CI 0·58, 0·99), whereas the more meat and milk products pattern was associated with a 39 % greater risk of diabetes (OR per 1 sd increase in score = 1·39; 95 % CI 1·04, 1·84). Dietary glycaemic load, rice intake, snack intake and variety of snacks were not independently associated with diabetes. The more vegetables, fruits and fish pattern was associated with reduced risk and the more meat and milk products pattern was associated with an increased risk of diabetes.

Multimorbidity and Its Patterns according to Immigrant Origin. A Nationwide Register-Based Study in Norway

PubMed Central

Diaz, Esperanza; Poblador-Pou, Beatriz; Gimeno-Feliu, Luis-Andrés; Calderón-Larrañaga, Amaia; Kumar, Bernadette N.; Prados-Torres, Alexandra

2015-01-01

Introduction As the flows of immigrant populations increase worldwide, their heterogeneity becomes apparent with respect to the differences in the prevalence of chronic physical and mental disease. Multimorbidity provides a new framework in understanding chronic diseases holistically as the consequence of environmental, social, and personal risks that contribute to increased vulnerability to a wide variety of illnesses. There is a lack of studies on multimorbidity among immigrants compared to native-born populations. Methodology This nationwide multi-register study in Norway enabled us i) to study the associations between multimorbidity and immigrant origin, accounting for other known risk factors for multimorbidity such as gender, age and socioeconomic levels using logistic regression analyses, and ii) to identify patterns of multimorbidity in Norway for immigrants and Norwegian-born by means of exploratory factor analysis technique. Results Multimorbidity rates were lower for immigrants compared to Norwegian-born individuals, with unadjusted odds ratios (OR) and 95% confidence intervals 0.38 (0.37–0.39) for Eastern Europe, 0.58 (0.57–0.59) for Asia, Africa and Latin America, and 0.67 (0.66–0.68) for Western Europe and North America. Results remained significant after adjusting for socioeconomic factors. Similar multimorbidity disease patterns were observed among Norwegian-born and immigrants, in particular between Norwegian-born and those from Western European and North American countries. However, the complexity of patterns that emerged for the other immigrant groups was greater. Despite differences observed in the development of patterns with age, such as ischemic heart disease among immigrant women, we were unable to detect the systematic development of the multimorbidity patterns among immigrants at younger ages. Conclusions Our study confirms that migrants have lower multimorbidity levels compared to Norwegian-born. The greater complexity of multimorbidity patterns for some immigrant groups requires further investigation. Health care policies and practice will require a holistic approach for specific population groups in order to meet their health needs and to curb and prevent diseases. PMID:26684188

Non-communicable disease risk factor patterns among mining industry workers in Papua, Indonesia: longitudinal findings from the Cardiovascular Outcomes in a Papuan Population and Estimation of Risk (COPPER) Study.

PubMed

Rodriguez-Fernandez, Rodrigo; Rahajeng, Ekowati; Viliani, Francesca; Kushadiwijaya, Haripurnomo; Amiya, Rachel M; Bangs, Michael J

2015-10-01

Non-communicable diseases (NCDs) constitute an increasing slice of the global burden of disease, with the South-East Asia region projected to see the highest increase in NCD-related deaths over the next decade. Mining industry employees may be exposed to various factors potentially elevating their NCD risk. This study aimed to assess the distribution and 5-year longitudinal trends of key metabolic NCD risk factors in a cohort of copper-gold mining company workers in Papua, Indonesia. Metabolic indicators of NCD risk were assessed among employees (15 580 at baseline, 6496 prospectively) of a large copper-gold mining operation in Papua, Indonesia, using routinely collected 5-year medical surveillance data. The study cohort comprised individuals aged 18-68 years employed for ≥1 year during 2008-2013. Assessed risk factors were based on repeat measures of cholesterol, blood glucose, blood pressure and body weight, using WHO criteria. Metabolic risk indicator rates were markedly high and increased significantly from baseline through 5-year follow-up (p<0.001). Adjusting for gender and age, longer duration of employment (≥10 years) predicted raised cholesterol (adjusted OR (AOR)=1.13, p=0.003), raised blood pressure (AOR=1.16, p=0.009) and overweight/obesity (AOR=1.14, p=0.001) at baseline; and persistent raised cholesterol (AOR=1.26, p=0.003), and both incident (AOR=1.33, p=0.014) and persistent raised blood glucose (AOR=1.62, p=0.044) at 3-year follow-up. Individuals employed for longer periods in a mining operations setting in Papua, Indonesia, may face elevated NCD risk through various routes. Workplace health promotion interventions and policies targeting modifiable lifestyle patterns and environmental exposures present an important opportunity to reduce such susceptibilities and mitigate associated health risks. 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.

Snacking patterns, diet quality, and cardiovascular risk factors in adults.

PubMed

Nicklas, Theresa A; O'Neil, Carol E; Fulgoni, Victor L

2014-04-23

The relationship of snacking patterns on nutrient intake and cardiovascular risk factors (CVRF) in adults is unknown. The aim of this study was to examine the associations of snacking patterns with nutrient intake, diet quality, and a selection of CVRF in adults participating in the 2001-2008 National Health and Nutrition Examination Survey. 24-hour dietary recalls were used to determine intake and cluster analysis was used to identify the snacking patterns. Height and weight were obtained and the health indices that were evaluated included diastolic and systolic blood pressure, high density lipoprotein-cholesterol, low density lipoprotein cholesterol, triacylglycerides, blood glucose, and insulin. The sample was participants (n = 18,988) 19+ years (50% males; 11% African-Americans; 72% white, 12% Hispanic-Americans, and 5% other). Cluster analyses generated 12 distinct snacking patterns, explaining 61% of the variance in snacking. Comparisons of snacking patterns were made to the no snack pattern. It was found that miscellaneous snacks constituted the most common snacking pattern (17%) followed by cakes/cookies/pastries (12%) and sweets (9%). Most snacking patterns were associated with higher energy intakes. Snacking patterns cakes/cookies/pastries, vegetables/legumes, crackers/salty snacks, other grains and whole fruit were associated with lower intakes of saturated fatty acids. Added sugars intakes were higher in the cakes/cookies/pastries, sweets, milk desserts, and soft drinks patterns. Five snack patterns (cakes/cookies/pastries, sweets, vegetable/legumes, milk desserts, soft drinks) were associated with lower sodium intakes. Several snack patterns were associated with higher intakes of potassium, calcium, fiber, vitamin A, and magnesium. Five snacking patterns (miscellaneous snacks; vegetables/legumes; crackers/salty snacks; other grains; and whole fruit) were associated with better diet quality scores. Alcohol was associated with a lower body mass index and milk desserts were associated with a lower waist circumference. No snack patterns were associated with other CVRF studied. Overall, several snacking patterns were associated with better diet quality than those consuming no snacks. Yet, the majority of the snacking patterns were not associated with CVRF. Education is needed to improve snacking patterns in terms of nutrients to limit in the diet along with more nutrient-dense foods to be included in snacks.

Developmental trajectories of cigarette use and associations with multilayered risk factors among Chinese adolescents.

PubMed

Xie, Bin; Palmer, Paula; Li, Yan; Lin, Cindy; Johnson, C Anderson

2013-10-01

We aimed to identify developmental trajectories of cigarette use and risk factors associated with the distinct developmental courses of smoking in Chinese early adolescents from age 12 to 16 years. Analysis was conducted with secondary data from a longitudinal, prospective cohort of 3,521 Chinese adolescents randomly selected from 4 rural and 7 urban middle schools in Wuhan, China. A group-based growth mixture modeling approach was adopted to identify developmental trajectories of cigarette use. Multilayered intrapersonal (e.g., attitudes toward smoking) and interpersonal (e.g., parental smoking and perceived parental disapproval of smoking) risk factors selected from an ecological perspective were prospectively linked to the identified patterns of smoking trajectory. Three trajectory patterns were identified from the whole cohort: nonsmokers (48.7%), stable light/occasional smokers (48.6%), and accelerating smokers (2.7%). After adjustments for gender, urban residence, and family socioeconomic status, adolescents with higher levels of problems in parent-child relationships and family disharmony, higher perceived norms of peer smoking, higher proportion of good friend smoking, having more troubles with teachers, poorer academic performance, and reporting more frequent depressive symptoms were significantly more likely to be in the trajectory group of either stable light/occasional smokers or accelerating smokers than in the group of nonsmokers. The probability of being in the accelerating smoking trajectory group was positively and significantly related to parental smoking and lack of school bonding. Study findings help to advance knowledge of the distinct developmental courses of smoking behavior and their associations with multilayered risk factors among Chinese early adolescents.

The role of physicians in a community-wide program for prevention of cardiovascular disease: the Minnesota Heart Health Program.

PubMed Central

Mittelmark, M B; Leupker, R V; Grimm, R; Kottke, T E; Blackburn, H

1988-01-01

The Minnesota Heart Health Program (MHHP) aims to reduce cardiovascular disease (CVD) morbidity and mortality by reducing risk factors among the mass of residents in three midwestern communities. A major aspect of the program is the involvement of community physicians because they have high credibility as citizen leaders, especially on health issues. In the MHHP, physicians contributed in a number of ways. The initial contacts with physicians resulted in their providing support and introductions to other community leaders, whose active support was also gained. Physicians sit as members of the central Community Advisory Borads of MHHP and serve on the executive committees of these boards. All MHHP issues related to medical practice are brought before Physicians' Advisory Groups in each community for resolution. Primary care physicians attend MHHP continuing education programs. In a survey of 109 physicians in one of the MHHP communities, 95 percent of respondents believed cigarette smoking to be an important risk factor for CVD, but only 15 percent judged themselves to be effective in dealing with patients who smoked. Forty-one percent of respondents said that elevated blood cholesterol is an important risk factor, but only 20 percent felt effective in treating the condition. Only 18 percent of the physicians in the sample believed that a poor eating pattern plays a substantial role in CVD, and 9 percent felt effective in counseling patients about eating habits. This pattern of results indicates the need not only for continuing education about risk factors for CVD, but also for training to improve patient counseling skills. PMID:3136495

Mediterranean Diet and Cardiodiabesity: A Review

PubMed Central

García-Fernández, Elena; Rico-Cabanas, Laura; Rosgaard, Nanna; Estruch, Ramón; Bach-Faig, Anna

2014-01-01

Cardiodiabesity has been used to define and describe the well-known relationship between type 2 Diabetes Mellitus (T2DM), obesity, the metabolic syndrome (MetS) and cardiovascular disease (CVD). The objective of this study was to perform a scientific literature review with a systematic search to examine all the cardiovascular risk factors combined and their relationship with adherence to the Mediterranean Diet (MedDiet) pattern as primary prevention against cardiodiabesity in a holistic approach. Research was conducted using the PubMed database including clinical trials, cross-sectional and prospective cohort studies. Thirty-seven studies were reviewed: fourteen related to obesity, ten to CVD, nine to MetS, and four to T2DM. Indeed 33 provided strong evidence on the association between adherence to a MedDiet and a reduced incidence of collective cardiodiabesity risk in epidemiological studies. This scientific evidence makes the MedDiet pattern very useful for preventive strategies directed at the general population and also highlights the need to consider all these diet-related risk factors and health outcomes together in daily primary care. PMID:25192027

Early male partnership patterns, social support, and sexual risk behavior among young men who have sex with men.

PubMed

Glick, Sara Nelson; Golden, Matthew R

2014-08-01

Few data exist on the early sexual behavior patterns of contemporary young men who have sex with men (YMSM), the social context of these patterns, and which of these factors influence risk for HIV and other sexually transmitted infections (STI). We enrolled 94 YMSM (age 16-30) into a 1-year cohort study with serial online retrospective surveys and HIV/STI testing. The first three partnerships of YMSM were characterized by relatively high rates of unprotected anal sex and a rapidly expanding sexual repertoire, but also increasing rates of HIV status disclosure. During follow-up, 17 % of YMSM reported any nonconcordant unprotected anal intercourse (NCUAI) and 15 % were newly diagnosed with HIV/STI. Sex education in high school and current maternal support were protective against HIV/STI, while isolation from family and friends was associated with recent NCUAI. Social support-including from parents, peers, and school-based sex education-may help mitigate HIV/STI risk in this population.

The Costs and Risks of Medical Care

PubMed Central

McPhee, Stephen J.; Myers, Lois P.; Schroeder, Steven A.

1982-01-01

Understanding the costs and risks of medical care, as well as the benefits, is essential to good medical practice. The literature on this topic transcends disciplines, making it a challenge for clinicians and medical educators to compile information on costs and risks for use in patient care. This annotated bibliography presents summaries of pertinent references on (1) financial costs of care, (2) excessive use of medical services, (3) clinical risks of care, (4) decision analysis, (5) cost-benefit analyses, (6) factors affecting physician use of services and (7) strategies to improve physician ordering patterns. PMID:6814071

The Impact of Dietary and Metabolic Risk Factors on Cardiovascular Diseases and Type 2 Diabetes Mortality in Brazil.

PubMed

Otto, Marcia C de Oliveira; Afshin, Ashkan; Micha, Renata; Khatibzadeh, Shahab; Fahimi, Saman; Singh, Gitanjali; Danaei, Goodarz; Sichieri, Rosely; Monteiro, Carlos A; Louzada, Maria L C; Ezzati, Majid; Mozaffarian, Dariush

2016-01-01

Trends in food availability and metabolic risk factors in Brazil suggest a shift toward unhealthy dietary patterns and increased cardiometabolic disease risk, yet little is known about the impact of dietary and metabolic risk factors on cardiometabolic mortality in Brazil. Based on data from Global Burden of Disease (GBD) Study, we used comparative risk assessment to estimate the burden of 11 dietary and 4 metabolic risk factors on mortality due to cardiovascular diseases and diabetes in Brazil in 2010. Information on national diets and metabolic risks were obtained from the Brazilian Household Budget Survey, the Food and Agriculture Organization database, and large observational studies including Brazilian adults. Relative risks for each risk factor were obtained from meta-analyses of randomized trials or prospective cohort studies; and disease-specific mortality from the GBD 2010 database. We quantified uncertainty using probabilistic simulation analyses, incorporating uncertainty in dietary and metabolic data and relative risks by age and sex. Robustness of findings was evaluated by sensitivity to varying feasible optimal levels of each risk factor. In 2010, high systolic blood pressure (SBP) and suboptimal diet were the largest contributors to cardiometabolic deaths in Brazil, responsible for 214,263 deaths (95% uncertainty interval [UI]: 195,073 to 233,936) and 202,949 deaths (95% UI: 194,322 to 211,747), respectively. Among individual dietary factors, low intakes of fruits and whole grains and high intakes of sodium were the largest contributors to cardiometabolic deaths. For premature cardiometabolic deaths (before age 70 years, representing 40% of cardiometabolic deaths), the leading risk factors were suboptimal diet (104,169 deaths; 95% UI: 99,964 to 108,002), high SBP (98,923 deaths; 95%UI: 92,912 to 104,609) and high body-mass index (BMI) (42,643 deaths; 95%UI: 40,161 to 45,111). suboptimal diet, high SBP, and high BMI are major causes of cardiometabolic death in Brazil, informing priorities for policy initiatives.

The Impact of Dietary and Metabolic Risk Factors on Cardiovascular Diseases and Type 2 Diabetes Mortality in Brazil

PubMed Central

de Oliveira Otto, Marcia C.; Afshin, Ashkan; Micha, Renata; Khatibzadeh, Shahab; Fahimi, Saman; Singh, Gitanjali; Danaei, Goodarz; Sichieri, Rosely; Monteiro, Carlos A; Louzada, Maria L. C.; Ezzati, Majid; Mozaffarian, Dariush

2016-01-01

Background Trends in food availability and metabolic risk factors in Brazil suggest a shift toward unhealthy dietary patterns and increased cardiometabolic disease risk, yet little is known about the impact of dietary and metabolic risk factors on cardiometabolic mortality in Brazil. Methods Based on data from Global Burden of Disease (GBD) Study, we used comparative risk assessment to estimate the burden of 11 dietary and 4 metabolic risk factors on mortality due to cardiovascular diseases and diabetes in Brazil in 2010. Information on national diets and metabolic risks were obtained from the Brazilian Household Budget Survey, the Food and Agriculture Organization database, and large observational studies including Brazilian adults. Relative risks for each risk factor were obtained from meta-analyses of randomized trials or prospective cohort studies; and disease-specific mortality from the GBD 2010 database. We quantified uncertainty using probabilistic simulation analyses, incorporating uncertainty in dietary and metabolic data and relative risks by age and sex. Robustness of findings was evaluated by sensitivity to varying feasible optimal levels of each risk factor. Results In 2010, high systolic blood pressure (SBP) and suboptimal diet were the largest contributors to cardiometabolic deaths in Brazil, responsible for 214,263 deaths (95% uncertainty interval [UI]: 195,073 to 233,936) and 202,949 deaths (95% UI: 194,322 to 211,747), respectively. Among individual dietary factors, low intakes of fruits and whole grains and high intakes of sodium were the largest contributors to cardiometabolic deaths. For premature cardiometabolic deaths (before age 70 years, representing 40% of cardiometabolic deaths), the leading risk factors were suboptimal diet (104,169 deaths; 95% UI: 99,964 to 108,002), high SBP (98,923 deaths; 95%UI: 92,912 to 104,609) and high body-mass index (BMI) (42,643 deaths; 95%UI: 40,161 to 45,111). Conclusion suboptimal diet, high SBP, and high BMI are major causes of cardiometabolic death in Brazil, informing priorities for policy initiatives. PMID:26990765

[Risk factors associated to diffuse gastric cancer and intestinal histological patterns in an adult population from Western Mexico].

PubMed

Delgado-Figueroa, Netzahualpilli; Casas-Junco, Paloma; Torres-Jasso, Juan Heriberto; Bustos-Carpinteyro, Andrea Rebeca; Santiago-Luna, Ernesto; Marín-Contreras, María Eugenia; Sánchez-López, Josefina Yoaly

Gastric cancer (GC) is the third leading cause of cancer death worldwide, and is divided histologically in diffuse gastric cancer (DGC) and intestinal gastric cancer (IGC). Multiple risk factors have been associated with GC in different populations. The objective was to analyze the risk factors associated to DGC and IGC in a population from the western region of Mexico. The DGC (n = 27) and IGC (n = 26) cases, each matched by age and sex with a control group, were analyzed. Diet and lifestyle data were obtained by a questionnaire. Statistical analysis was performed with the software SPSSv18. The association of risk was calculated in odds ratio (OR); a value of p < 0.05 was considered significant. In the DGC group, the factors with significant OR values were: consumption of pork OR: 3.4 (1.11-10.4; p =0.032), smoking OR: 4.7 (1.5-15.0; p =0.007), green vegetables OR: 0.16 (0.03-0.83; p =0.029) and fruit OR: 0.28 (0.08-0.88; p =0.029). In the IGC group, the consumption of canned sardines was a significant risk factor OR: 4.07 (1.25-13.24; p =0.019). This work is the first to analyze the risk factors associated with GC in a population from western Mexico.

Gambling for Gatorade: risk-sensitive decision making for fluid rewards in humans

PubMed Central

Platt, Michael L.

2009-01-01

Determining how both humans and animals make decisions in risky situations is a central problem in economics, experimental psychology, behavioral economics, and neurobiology. Typically, humans are risk seeking for gains and risk averse for losses, while animals may display a variety of preferences under risk depending on, amongst other factors, internal state. Such differences in behavior may reflect major cognitive and cultural differences or they may reflect differences in the way risk sensitivity is probed in humans and animals. Notably, in most studies humans make one or a few choices amongst hypothetical or real monetary options, while animals make dozens of repeated choices amongst options offering primary rewards like food or drink. To address this issue, we probed risk-sensitive decision making in human participants using a paradigm modeled on animal studies, in which rewards were either small squirts of Gatorade or small amounts of real money. Possible outcomes and their probabilities were not made explicit in either case. We found that individual patterns of decision making were strikingly similar for both juice and for money, both in overall risk preferences and in trial-to-trial effects of reward outcome on choice. Comparison with decisions made by monkeys for juice in a similar task revealed highly similar gambling styles. These results unite known patterns of risk-sensitive decision making in human and nonhuman primates and suggest that factors such as the way a decision is framed or internal state may underlie observed variation in risk preferences between and within species. PMID:18719953

Multi-Level Risk Factors for Suicidal Ideation Among at-Risk Adolescent Females: The Role of Hypothalamic-Pituitary-Adrenal Axis Responses to Stress

PubMed Central

Calhoun, Casey D.; Hastings, Paul D.; Rudolph, Karen D.; Nock, Matthew K.; Prinstein, Mitchell J.

2014-01-01

Adopting a multi-level approach, this study examined risk factors for adolescent suicidal ideation, with specific attention to (a) hypothalamic-pituitary-adrenal (HPA) axis stress responses and (b) the interplay between HPA-axis and other risk factors from multiple domains (i.e., psychological, interpersonal and biological). Participants were 138 adolescent females (Mage=14.13 years, SD=1.40) at risk for suicidal behaviors. At baseline, lifetime suicidal ideation and a number of risk factors were assessed (i.e., depressive symptoms, impulsiveness, pubertal status and peer stress). Participants were exposed to a psychosocial stress task and HPA-axis responses were assessed by measuring cortisol levels pre- and post-stressor. At 3 months post-baseline, suicidal ideation again was assessed. Using group-based trajectory modeling, three groups of cortisol stress-response patterns were identified (i.e., hyporesponsive, normative, and hyperresponsive). As compared to females in the normative and hyporesponsive group, females in the hyperresponsive group were more likely to report a lifetime history of suicidal ideation at baseline, above and beyond the effects of the other predictors. Moreover, as compared to females in the normative group, females in the hyperresponsive group were at increased risk for reporting suicidal ideation 3 months later, after controlling for prior ideation. No interactions between cortisol group and the other risk factors were significant, with the exception of a non-significant trend between impulsiveness and cortisol group on lifetime suicidal ideation. Findings highlight the importance of HPA-axis responses to acute stressors as a risk factor for suicidal ideation among adolescents. PMID:24958308

Prevalence and patterns of alcohol use in the Australian workforce: findings from the 2001 National Drug Strategy Household Survey.

PubMed

Berry, Jesia G; Pidd, Ken; Roche, Ann M; Harrison, James E

2007-09-01

To describe Australian workers' prevalence and patterns of alcohol use. A secondary analysis of the 2001 National Drug Strategy Household Survey. A total of 13 582 workers > or = 14 years old. Alcohol consumption levels associated with National Health and Medical Research Council (NHMRC) guidelines for short- and long-term harm were stratified by occupation and industry. Approximately 8% of the workforce drank at least weekly at short-term risky or high risk levels, 17% drank at least monthly, 18% drank at least yearly and 11% drank at long-term risky or high risk levels. The prevalence of risky or high risk drinking was higher for younger than for older workers. Controlling for socio-demographic factors, the risk of workers frequently drinking at levels associated with short-term harm was lowest in the education industry and significantly higher in the hospitality, agriculture, manufacturing and construction industries. Drinking patterns associated with long-term harm were more prevalent in the agriculture, retail and manufacturing industries, compared to the education industry. Drinking patterns associated with both short- and long-term harm were more prevalent for blue-collar workers than professionals. Risky and high risk drinking occurred at least occasionally in 44% of Australian workers. Workers in the hospitality, agriculture, manufacturing, construction and retail industries, workers in blue-collar occupations and young workers were identified as at-risk subgroups. These data provide evidence that patterns of consumption differ between occupational and industry groups, and highlight the pressing need to develop policies, prevention and intervention strategies to reduce harmful alcohol use in Australia, particularly among young adults.

Posttraumatic Stress Symptom Trajectories Among Children After Disaster Exposure: A Review

PubMed Central

Lai, Betty S.; Lewis, Rayleen; Livings, Michelle S.; La Greca, Annetate M.; Esnard, Ann-Margaret

2018-01-01

Natural disasters, such as hurricanes and floods, are increasing in frequency and scope. Youth exposed to disasters are at risk for developing posttraumatic stress symptoms (PTSS). However, not all youth who report initially elevated PTSS report persistent PTSS that last beyond the first three to six months postdisaster. Thus, it is crucial to understand how and why youth differ in their patterns of PTSS. This study reviewed the literature on children’s postdisaster PTSS, evaluating the typical number and types of patterns for children’s PTSS trajectories, as well as risk and protective factors predicting trajectory membership. This review identified eight empirical studies on youth PTSS trajectories following natural disasters; these studies included 8,306 children aged 3 to 18 years. All studies identified resilience, recovery, and chronic trajectories. Evidence for a delayed trajectory was mixed. Proportions of children falling into each trajectory varied widely across studies, but overall, resilience was the most prevalent trajectory. These findings were consistent across study factors (i.e., analytic strategy, assessment timing, and study selection criteria). Female gender, disaster exposure, negative coping, and lack of social support were significant risk factors for chronic trajectories across several studies. Future research should combine individual level participant data across studies of children’s responses to disasters to better understand PTSS trajectories. PMID:29193316

Clinical characteristics, treatment patterns, and socio-economic burden of COPD in Bulgaria.

PubMed

Kamusheva, Maria; Dimitrova, Maria; van Boven, Job F M; Postma, Maarten J; van der Molen, Thys; Kocks, Janwillem W H; Mitov, Konstantin; Doneva, Miglena; Petrova, Daniela; Georgiev, Ognyan; Petkova, Valentina; Petrova, Guenka

2017-05-01

While the impact of COPD in Western-Europe is known, data from Eastern-Europe is scarce. This study aimed to evaluate clinical characteristics, treatment patterns, and the socio-economic burden of COPD in Eastern-Europe, taking Bulgaria as a reference case. A representative sample of Bulgarian patients with COPD was randomly chosen by pulmonologists, based on the following inclusion criteria: COPD diagnosis with at least 1 year of living with COPD, ≥40 years of age, and use of COPD medication. Patient characteristics, treatment, quality-of-life, healthcare resource use, and costs were systematically assessed. A total of 426 COPD patients were enrolled. Approximately 69% were male, 40% had occupational risk factors, 45% had severe and 11% had very severe COPD. Mean CAT scores were 13.80 (GOLD A), 21.80 (GOLD B), 17.35 (GOLD C), and 26.70 (GOLD D). Annual per-patient costs of healthcare utilization were €579. Yearly pharmacotherapy costs were €693. Indirect costs (reduced and lost work productivity) outnumbered direct costs three times. Bulgaria has relatively high percentages of (very) severe COPD patients, resulting in considerable socio-economic burden. High smoking rates, occupational risk factors, air pollution, and a differential health system may be related to this finding. Eastern-European COPD strategies should focus on prevention, risk-factor awareness, and early detection.

Coconut oil consumption and cardiovascular risk factors in humans

PubMed Central

Eyres, Michael F.; Chisholm, Alexandra; Brown, Rachel C.

2016-01-01

Coconut oil is being heavily promoted as a healthy oil, with benefits that include support of heart health. To assess the merits of this claim, the literature on the effect of coconut consumption on cardiovascular risk factors and outcomes in humans was reviewed. Twenty-one research papers were identified for inclusion in the review: 8 clinical trials and 13 observational studies. The majority examined the effect of coconut oil or coconut products on serum lipid profiles. Coconut oil generally raised total and low-density lipoprotein cholesterol to a greater extent than cis unsaturated plant oils, but to a lesser extent than butter. The effect of coconut consumption on the ratio of total cholesterol to high-density lipoprotein cholesterol was often not examined. Observational evidence suggests that consumption of coconut flesh or squeezed coconut in the context of traditional dietary patterns does not lead to adverse cardiovascular outcomes. However, due to large differences in dietary and lifestyle patterns, these findings cannot be applied to a typical Western diet. Overall, the weight of the evidence from intervention studies to date suggests that replacing coconut oil with cis unsaturated fats would alter blood lipid profiles in a manner consistent with a reduction in risk factors for cardiovascular disease. PMID:26946252

Gender differences in the association between socioeconomic status and subclinical atherosclerosis.

PubMed

Grimaud, Olivier; Lapostolle, Annabelle; Berr, Claudine; Helmer, Catherine; Dufouil, Carole; Kihal, Wahida; Alpérovitch, Annick; Chauvin, Pierre

2013-01-01

This study explored the pattern of associations between socioeconomic status (SES) and atherosclerosis progression (as indicated by carotid intima media thickness, CIMT) across gender. Cross-sectional analysis of a sample of 5474 older persons (mean age 73 years) recruited between 1999 and 2001 in the 3C study (France). We fitted linear regression models including neighborhood SES, individual SES and cardiovascular risk factors. CIMT was on average 24 µm higher in men (95% CI: 17 to 31). Neighborhood SES was inversely associated with CIMT in women only (highest versus lowest tertiles: -12.2 µm, 95%CI -22 to -2.4). This association persisted when individual SES and risk factors were accounted for. High individual education was associated with lower CIMT in men (-21.4 µm 95%CI -37.5 to -5.3) whereas high professional status was linked to lower CIMT among women (-15.7 µm 95%CI: -29.2 to -2.2). Adjustment for cardiovascular risk factors resulted in a slightly more pronounced reduction of the individual SES-CIMT association observed in men than in women. In this sample, neighborhood and individual SES displayed different patterns of associations with subclinical atherosclerosis across gender. This suggests that the causal pathways leading to SES variations in atherosclerosis may differ among men and women.

Sleep characteristics, body mass index, and risk for hypertension in young adolescents.

PubMed

Peach, Hannah; Gaultney, Jane F; Reeve, Charlie L

2015-02-01

Inadequate sleep has been identified as a risk factor for a variety of health consequences. For example, short sleep durations and daytime sleepiness, an indicator of insufficient sleep and/or poor sleep quality, have been identified as risk factors for hypertension in the adult population. However, less evidence exists regarding whether these relationships hold within child and early adolescent samples and what factors mediate the relationship between sleep and risk for hypertension. Using data from the Study of Early Child Care and Youth Development, the present study examined body mass index (BMI) as a possible mediator for the effects of school-night sleep duration, weekend night sleep duration, and daytime sleepiness on risk for hypertension in a sample of sixth graders. The results demonstrated gender-specific patterns. Among boys, all three sleep characteristics predicted BMI and yielded significant indirect effects on risk for hypertension. Oppositely, only daytime sleepiness predicted BMI among girls and yielded a significant indirect effect on risk for hypertension. The findings provide clarification for the influence of sleep on the risk for hypertension during early adolescence and suggest a potential need for gender-specific designs in future research and application endeavors.

Taxonomy of Older Driver Behaviors and Crash Risk : Appendix C

DOT National Transportation Integrated Search

2012-02-01

This projects objectives were to identify risky behaviors, driving habits, and exposure patterns that have been shown to increase the likelihood of crash involvement among older drivers; and to classify these crash-contributing factors according t...

INTEGRATED ASSESSMENTS OF ANTHROPOGENIC AND NATURAL CHANGES IN CHESAPEAKE BAY WATERSHEDS

EPA Science Inventory

Both natural and anthropogenic factors affect spatial and temporal patterns in ecosystem conditions. To manage environmental change and risks, distinguishing between natural variations in ecosystem conditions and anthropogenic changes becomes important. This concept is illustrate...

Taxonomy of Older Driver Behaviors and Crash Risk : Appendix D

DOT National Transportation Integrated Search

2012-02-01

This projects objectives were to identify risky behaviors, driving habits, and exposure patterns that have been shown to increase the likelihood of crash involvement among older drivers; and to classify these crash-contributing factors according t...