Parental understanding and self-blame following sudden infant death: a mixed-methods study of bereaved parents' and professionals' experiences

PubMed Central

Griffiths, Frances; Sidebotham, Peter

2016-01-01

Objectives Improvements in our understanding of the role of modifiable risk factors for sudden infant death syndrome (SIDS) mean that previous reassurance to parents that these deaths were unpreventable may no longer be appropriate. This study aimed to learn of bereaved parents' and healthcare professionals' experiences of understanding causes of death following detailed sudden unexpected death in infancy (SUDI) investigations. The research questions were: How do bereaved parents understand the cause of death and risk factors identified during detailed investigation following a sudden unexpected infant death? What is the association between bereaved parents' mental health and this understanding? What are healthcare professionals' experiences of sharing such information with families? Design This was a mixed-methods study using a Framework Approach. Setting Specialist paediatric services. Participants Bereaved parents were recruited following detailed multiagency SUDI investigations; 21/113 eligible families and 27 professionals participated giving theoretical saturation of data. Data collection We analysed case records from all agencies, interviewed professionals and invited parents to complete the Hospital Anxiety and Depression Scale (HADS) and questionnaires or in-depth interviews. Results Nearly all bereaved parents were able to understand the cause of death and several SIDS parents had a good understanding of the relevant modifiable risk factors even when these related directly to their actions. Paediatricians worried that discussing risk factors with parents would result in parental self-blame and some deliberately avoided these discussions. Over half the families did not mention blame or blamed no one. The cause of death of the infants of these families varied. 3/21 mothers expressed overwhelming feelings of self-blame and had clinically significant scores on HADS. Conclusions Bereaved parents want detailed information about their child's death. Our study suggests parents want health professionals to explain the role of risk factors in SIDS. We found no evidence that sharing this information is a direct cause of parental self-blame. PMID:27198994

Understanding cardiovascular risk in hemophilia: A step towards prevention and management.

PubMed

Sousos, Nikolaos; Gavriilaki, Eleni; Vakalopoulou, Sofia; Garipidou, Vasileia

2016-04-01

Advances in hemophilia care have led to increased life expectancy and new challenges in the management of the aging hemophilia population, including cardiovascular risk. Despite the deep knowledge into cardiovascular disease in terms of pathophysiology, risk prediction, prevention, early detection and management gained over the last decades, studies in hemophiliacs are scarce and mainly descriptive. As a growing amount of evidence points towards a similar or increased prevalence of traditional cardiovascular risk factors in hemophilia compared to the general population, the role of non-traditional, disease-related and treatment-related cardiovascular risk factors remains under investigation. Better understanding of cardiovascular risk in hemophilia is mandatory for proper cardiovascular risk prevention and management. Therefore, this review aims to summarize current knowledge on cardiovascular risk in hemophilia patients focusing on a) cardiovascular risk factors (traditional, non-traditional, disease-related and treatment-related), b) cardiovascular morbidity and mortality and c) cardiovascular prevention and management. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

Psychological and physical pain as predictors of suicide risk: evidence from clinical and neuroimaging findings.

PubMed

Rizvi, Sakina J; Iskric, Adam; Calati, Raffaella; Courtet, Philippe

2017-03-01

Suicide is a multidimensional clinical phenomenon with complex biological, social and psychological risk factors. Therefore, it is imperative for studies to focus on developing a unified understanding of suicide risk that integrates current clinical and neurobiological findings. A recent line of research has implicated different classifications of pain in understanding suicide risk, including the concepts of psychache and pain tolerance. Although psychache is defined as the experience of unbearable psychological pain, pain tolerance refers to the greatest duration or intensity of painful stimuli that one is able to bear. This review will focus on integrating current clinical and neurobiological findings by which psychache and pain tolerance confer suicide risk. Results indicate that psychache has been identified as a significant risk factor for suicide and that psychache may be associated with the neurocircuitry involved in the modulation of physical pain. Converging evidence has also been found linking pain tolerance to self-injurious behaviours and suicide risk. The experience of psychache and physical pain in relation to other predictors of suicide, including reward processing, hopelessness and depression, are further discussed. Future research examining the pain-suicide connection is required to understand the mechanism behind clinically relevant risk factors for suicide, which can ultimately inform the construction of empirically supported suicide risk assessment and intervention techniques.

Individual-Level Risk Factors of Incarcerated Youth

ERIC Educational Resources Information Center

Pyle, Nicole; Flower, Andrea; Fall, Anna Mari; Williams, Jacob

2016-01-01

This systematic review sought to understand the individual characteristics of incarcerated youth within the major risk factor domains identified by the U.S. Office of Juvenile Justice and Delinquency Prevention (OJJDP). A comprehensive search of the literature from 1979 to 2013 identified 85 articles of individual-level risk characteristics that…

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

Evaluating Determinants of Environmental Risk Perception for Risk Management in Contaminated Sites

PubMed Central

Janmaimool, Piyapong; Watanabe, Tsunemi

2014-01-01

Understanding the differences in the risk judgments of residents of industrial communities potentially provides insights into how to develop appropriate risk communication strategies. This study aimed to explore citizens’ fundamental understanding of risk-related judgments and to identify the factors contributing to perceived risks. An exploratory model was created to investigate the public’s risk judgments. In this model, the relationship between laypeople’s perceived risks and the factors related to the physical nature of risks (such as perceived probability of environmental contamination, probability of receiving impacts, and severity of catastrophic consequences) were examined by means of multiple regression analysis. Psychological factors, such as the ability to control the risks, concerns, experiences, and perceived benefits of industrial development were also included in the analysis. The Maptaphut industrial area in Rayong Province, Thailand was selected as a case study. A survey of 181 residents of communities experiencing different levels of hazardous gas contamination revealed rational risk judgments by inhabitants of high-risk and moderate-risk communities, based on their perceived probability of contamination, probability of receiving impacts, and perceived catastrophic consequences. However, risks assessed by people in low-risk communities could not be rationally explained and were influenced by their collective experiences. PMID:24937530

Acute colonic diverticulitis: modern understanding of pathomechanisms, risk factors, disease burden and severity.

PubMed

Søreide, Kjetil; Boermeester, Marja A; Humes, David J; Velmahos, George C

2016-12-01

Conservative, non-antibiotic and non-surgical management of acute diverticulitis is currently being investigated. To better inform clinical decisions, better understanding of disease mechanisms, disease burden and severity is needed. Literature search of risk factors, pathophysiology, epidemiology and disease burden/severity reported over the last decade. Acute diverticulitis is a common disease and has a high disease burden. Incidence of hospital admissions is reported around 71 per 100,000 population, with reported increase in several subpopulations over the last decades. The incidence is likely to increase further with the aging populations. Risk factors for left-sided acute diverticulitis include dietary, anthropometric and lifestyle factors. Disease mechanisms are still poorly understood, but a distinction between inflammation and infection is emerging. The integrative and complex role of the gut microbiota has become an interesting factor for both understanding the disease as well as a potential target for intervention using probiotics. Mild, self-limiting events are increasingly reported from studies of successful non-antibiotic management in a considerable number of cases. Risk markers of progression to or presence of severe, complicated disease are needed for better disease stratification. Current risk stratification by clinical, imaging or endoscopic means is imperfect and needs validation. Long-term results from minimal-invasive and comparative surgical trials may better help inform clinicians and patients. Over- and under-treatment as well as over- and under-diagnosis of severity is likely to continue in clinical practice due to lack of reliable, robust and universal severity and classification systems. Better understanding of pathophysiology is needed.

A Review of Terminological, Conceptual, and Methodological Issues in the Developmental Risk Factor Literature for Antisocial and Delinquent Behavior

ERIC Educational Resources Information Center

Day, David M.; Wanklyn, Sonya G.; Yessine, Annie K.

2014-01-01

Background: The study of risk factors for antisocial and delinquent behavior has flourished in the past 20 years, as great strides have been made in understanding the developmental pathways that give rise to the onset, course, and desistance of the behavior. However, as a body of literature, risk factor research (RFR) is characterized by…

Animal models of gene-environment interaction in schizophrenia: a dimensional perspective

PubMed Central

Ayhan, Yavuz; McFarland, Ross; Pletnikov, Mikhail V.

2015-01-01

Schizophrenia has long been considered as a disorder with multifactorial origins. Recent discoveries have advanced our understanding of the genetic architecture of the disease. However, even with the increase of identified risk variants, heritability estimates suggest an important contribution of non-genetic factors. Various environmental risk factors have been proposed to play a role in the etiopathogenesis of schizophrenia. These include season of birth, maternal infections, obstetric complications, adverse events at early childhood, and drug abuse. Despite the progress in identification of genetic and environmental risk factors, we still have a limited understanding of the mechanisms whereby gene-environment interactions (GxE) operate in schizophrenia and psychoses at large. In this review we provide a critical analysis of current animal models of GxE relevant to psychotic disorders and propose that dimensional perspective will advance our understanding of the complex mechanisms of these disorders. PMID:26510407

Retinopathy of prematurity: a review of risk factors and their clinical significance.

PubMed

Kim, Sang Jin; Port, Alexander D; Swan, Ryan; Campbell, J Peter; Chan, R V Paul; Chiang, Michael F

2018-04-19

Retinopathy of prematurity (ROP) is a retinal vasoproliferative disease that affects premature infants. Despite improvements in neonatal care and management guidelines, ROP remains a leading cause of childhood blindness worldwide. Current screening guidelines are primarily based on two risk factors: birth weight and gestational age; however, many investigators have suggested other risk factors, including maternal factors, prenatal and perinatal factors, demographics, medical interventions, comorbidities of prematurity, nutrition, and genetic factors. We review the existing literature addressing various possible ROP risk factors. Although there have been contradictory reports, and the risk may vary between different populations, understanding ROP risk factors is essential to develop predictive models, to gain insights into pathophysiology of retinal vascular diseases and diseases of prematurity, and to determine future directions in management of and research in ROP. Copyright © 2018 Elsevier Inc. All rights reserved.

Community Epidemiology of Risk and Adolescent Substance Use: Practical Questions for Enhancing Prevention

PubMed Central

2012-01-01

To promote an effective approach to prevention, the community diagnosis model helps communities systematically assess and prioritize risk factors to guide the selection of preventive interventions. This increasingly widely used model relies primarily on individual-level research that links risk and protective factors to substance use outcomes. I discuss common assumptions in the translation of such research concerning the definition of risk factor elevation; the equivalence, independence, and stability of relations between risk factors and problem behaviors; and community differences in risk factors and risk factor–problem behavior relations. Exploring these assumptions could improve understanding of the relations of risk factors and substance use within and across communities and enhance the efficacy of the community diagnosis model. This approach can also be applied to other areas of public health where individual and community levels of risk and outcomes intersect. PMID:22390508

Limitations in predicting the space radiation health risk for exploration astronauts.

PubMed

Chancellor, Jeffery C; Blue, Rebecca S; Cengel, Keith A; Auñón-Chancellor, Serena M; Rubins, Kathleen H; Katzgraber, Helmut G; Kennedy, Ann R

2018-01-01

Despite years of research, understanding of the space radiation environment and the risk it poses to long-duration astronauts remains limited. There is a disparity between research results and observed empirical effects seen in human astronaut crews, likely due to the numerous factors that limit terrestrial simulation of the complex space environment and extrapolation of human clinical consequences from varied animal models. Given the intended future of human spaceflight, with efforts now to rapidly expand capabilities for human missions to the moon and Mars, there is a pressing need to improve upon the understanding of the space radiation risk, predict likely clinical outcomes of interplanetary radiation exposure, and develop appropriate and effective mitigation strategies for future missions. To achieve this goal, the space radiation and aerospace community must recognize the historical limitations of radiation research and how such limitations could be addressed in future research endeavors. We have sought to highlight the numerous factors that limit understanding of the risk of space radiation for human crews and to identify ways in which these limitations could be addressed for improved understanding and appropriate risk posture regarding future human spaceflight.

Nutrition Interventions for Obesity.

PubMed

Ard, Jamy D; Miller, Gary; Kahan, Scott

2016-11-01

Obesity is a common disorder with complex causes. The epidemic has spurred significant advances in the understanding of nutritional approaches to treating obesity. Although the primary challenge is to introduce a dietary intake that creates an energy deficit, clinicians should also consider targeted risk factor modification with manipulation of the nutrient profile of the weight-reducing diet. These strategies produce significant weight loss and improvements in cardiometabolic risk factors. Future research is needed to better understand how to personalize nutrient prescriptions further to promote optimal risk modification and maintenance of long-term energy balance in the weight-reduced state. Copyright © 2016 Elsevier Inc. All rights reserved.

Risk for psychopathology in the children of depressed mothers: a developmental model for understanding mechanisms of transmission.

PubMed

Goodman, S H; Gotlib, I H

1999-07-01

A large body of literature documents the adverse effects of maternal depression on the functioning and development of offspring. Although investigators have identified factors associated with risk for abnormal development and psychopathology in the children, little attention has been paid to the mechanisms explaining the transmission of risk from the mothers to the children. Moreover, no existing model both guides understanding of the various processes' interrelatedness and considers the role of development in explicating the manifestation of risk in the children. This article proposes a developmentally sensitive, integrative model for understanding children's risk in relation to maternal depression. Four mechanisms through which risk might be transmitted are evaluated: (a) heritability of depression; (b) innate dysfunctional neuroregulatory mechanisms; (c) exposure to negative maternal cognitions, behaviors, and affect; and (d) the stressful context of the children's lives. Three factors that might moderate this risk are considered: (a) the father's health and involvement with the child, (b) the course and timing of the mother's depression, and (c) characteristics of the child. Relevant issues are discussed, and promising directions for future research are suggested.

Cognitive mapping tools: review and risk management needs.

PubMed

Wood, Matthew D; Bostrom, Ann; Bridges, Todd; Linkov, Igor

2012-08-01

Risk managers are increasingly interested in incorporating stakeholder beliefs and other human factors into the planning process. Effective risk assessment and management requires understanding perceptions and beliefs of involved stakeholders, and how these beliefs give rise to actions that influence risk management decisions. Formal analyses of risk manager and stakeholder cognitions represent an important first step. Techniques for diagramming stakeholder mental models provide one tool for risk managers to better understand stakeholder beliefs and perceptions concerning risk, and to leverage this new understanding in developing risk management strategies. This article reviews three methodologies for assessing and diagramming stakeholder mental models--decision-analysis-based mental modeling, concept mapping, and semantic web analysis--and assesses them with regard to their ability to address risk manager needs. © 2012 Society for Risk Analysis.

Reducing hazardous fuels on nonindustrial private forests: factors influencing landowner decisions

Treesearch

A. Paige Fischer

2011-01-01

In mixed-ownership landscapes, fuels conditions on private lands have implications for fire risk on public lands and vice versa. The success of efforts to mitigate fire risk depends on the extent, efficacy, and coordination of treatments on nearby ownerships. Understanding factors in forest owners' decisions to address the risk of wildland fire is therefore...

Ovarian, Fallopian Tube, & Primary Peritoneal Cancer Prevention (PDQ®)—Health Professional Version

Cancer.gov

Ovarian, fallopian tube, and primary peritoneal cancer prevention involves understanding risk and protective factors, and the evidence behind them. Get detailed information about specific risk and protective factors and prevention strategies for these cancer types in this clinician summary.

Relationship Risks in Context: A Cumulative Risk Approach to Understanding Relationship Satisfaction

PubMed Central

Rauer, Amy J.; Karney, Benjamin R.; Garvan, Cynthia W.; Hou, Wei

2009-01-01

Risks associated with less satisfying intimate relationships often co-occur within individuals, raising questions about approaches that consider only their independent impact. Utilizing the cumulative risk model, which acknowledges the natural covariation of risk factors, this study examined individuals in intimate relationships using the Florida Family Formation Survey (n = 2,876) and a replication sample (n = 1,048). Analyses confirmed that not only was relationship satisfaction lower among those with more risks, but the cumulative risk score was predictive above and beyond the individual risk factors. Furthermore, experiencing multiple risks exacerbated the negative associations between individual risks and relationship satisfaction, suggesting that the operation of a risk factor in a relationship is moderated by the presence or absence of other risks. PMID:19587840

Conceptualizing a Dynamic Fall Risk Model Including Intrinsic Risks and Exposures.

PubMed

Klenk, Jochen; Becker, Clemens; Palumbo, Pierpaolo; Schwickert, Lars; Rapp, Kilan; Helbostad, Jorunn L; Todd, Chris; Lord, Stephen R; Kerse, Ngaire

2017-11-01

Falls are a major cause of injury and disability in older people, leading to serious health and social consequences including fractures, poor quality of life, loss of independence, and institutionalization. To design and provide adequate prevention measures, accurate understanding and identification of person's individual fall risk is important. However, to date, the performance of fall risk models is weak compared with models estimating, for example, cardiovascular risk. This deficiency may result from 2 factors. First, current models consider risk factors to be stable for each person and not change over time, an assumption that does not reflect real-life experience. Second, current models do not consider the interplay of individual exposure including type of activity (eg, walking, undertaking transfers) and environmental risks (eg, lighting, floor conditions) in which activity is performed. Therefore, we posit a dynamic fall risk model consisting of intrinsic risk factors that vary over time and exposure (activity in context). eHealth sensor technology (eg, smartphones) begins to enable the continuous measurement of both the above factors. We illustrate our model with examples of real-world falls from the FARSEEING database. This dynamic framework for fall risk adds important aspects that may improve understanding of fall mechanisms, fall risk models, and the development of fall prevention interventions. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Risk factors for asthma and allergy associated with urban migration: background and methodology of a cross-sectional study in Afro-Ecuadorian school children in Northeastern Ecuador (Esmeraldas-SCAALA Study).

PubMed

Cooper, Philip J; Chico, Martha E; Vaca, Maritza G; Rodriguez, Alejandro; Alcântara-Neves, Neuza M; Genser, Bernd; de Carvalho, Lain Pontes; Stein, Renato T; Cruz, Alvaro A; Rodrigues, Laura C; Barreto, Mauricio L

2006-09-13

Asthma and allergic diseases are becoming increasingly frequent in children in urban centres of Latin America although the prevalence of allergic disease is still low in rural areas. Understanding better why the prevalence of asthma is greater in urban migrant populations and the role of risk factors such as life style and environmental exposures, may be key to understand what is behind this trend. The Esmeraldas-SCAALA (Social Changes, Asthma and Allergy in Latin America) study consists of cross-sectional and nested case-control studies of school children in rural and urban areas of Esmeraldas Province in Ecuador. The cross-sectional study will investigate risk factors for atopy and allergic disease in rural and migrant urban Afro-Ecuadorian school children and the nested case-control study will examine environmental, biologic and social risk factors for asthma among asthma cases and non-asthmatic controls from the cross-sectional study. Data will be collected through standardised questionnaires, skin prick testing to relevant aeroallergen extracts, stool examinations for parasites, blood sampling (for measurement of IgE, interleukins and other immunological parameters), anthropometric measurements for assessment of nutritional status, exercise testing for assessment of exercise-induced bronchospasm and dust sampling for measurement of household endotoxin and allergen levels. The information will be used to identify the factors associated with an increased risk of asthma and allergies in migrant and urbanizing populations, to improve the understanding of the causes of the increase in asthma prevalence and to identify potentially modifiable factors to inform the design of prevention programmes to reduce the risk of allergy in urban populations in Latin America.

Risk factors for asthma and allergy associated with urban migration: background and methodology of a cross-sectional study in Afro-Ecuadorian school children in Northeastern Ecuador (Esmeraldas-SCAALA Study)

PubMed Central

Cooper, Philip J; Chico, Martha E; Vaca, Maritza G; Rodriguez, Alejandro; Alcântara-Neves, Neuza M; Genser, Bernd; de Carvalho, Lain Pontes; Stein, Renato T; Cruz, Alvaro A; Rodrigues, Laura C; Barreto, Mauricio L

2006-01-01

Background Asthma and allergic diseases are becoming increasingly frequent in children in urban centres of Latin America although the prevalence of allergic disease is still low in rural areas. Understanding better why the prevalence of asthma is greater in urban migrant populations and the role of risk factors such as life style and environmental exposures, may be key to understand what is behind this trend. Methods/design The Esmeraldas-SCAALA (Social Changes, Asthma and Allergy in Latin America) study consists of cross-sectional and nested case-control studies of school children in rural and urban areas of Esmeraldas Province in Ecuador. The cross-sectional study will investigate risk factors for atopy and allergic disease in rural and migrant urban Afro-Ecuadorian school children and the nested case-control study will examine environmental, biologic and social risk factors for asthma among asthma cases and non-asthmatic controls from the cross-sectional study. Data will be collected through standardised questionnaires, skin prick testing to relevant aeroallergen extracts, stool examinations for parasites, blood sampling (for measurement of IgE, interleukins and other immunological parameters), anthropometric measurements for assessment of nutritional status, exercise testing for assessment of exercise-induced bronchospasm and dust sampling for measurement of household endotoxin and allergen levels. Discussion The information will be used to identify the factors associated with an increased risk of asthma and allergies in migrant and urbanizing populations, to improve the understanding of the causes of the increase in asthma prevalence and to identify potentially modifiable factors to inform the design of prevention programmes to reduce the risk of allergy in urban populations in Latin America. PMID:16970809

Inflammatory and Other Biomarkers: Role in Pathophysiology and Prediction of Gestational Diabetes Mellitus

PubMed Central

Abell, Sally K.; De Courten, Barbora; Boyle, Jacqueline A.; Teede, Helena J.

2015-01-01

Understanding pathophysiology and identifying mothers at risk of major pregnancy complications is vital to effective prevention and optimal management. However, in current antenatal care, understanding of pathophysiology of complications is limited. In gestational diabetes mellitus (GDM), risk prediction is mostly based on maternal history and clinical risk factors and may not optimally identify high risk pregnancies. Hence, universal screening is widely recommended. Here, we will explore the literature on GDM and biomarkers including inflammatory markers, adipokines, endothelial function and lipids to advance understanding of pathophysiology and explore risk prediction, with a goal to guide prevention and treatment of GDM. PMID:26110385

COMPARATIVE EVALUATION OF RISK FACTORS FOR CARDIOVASCULAR DISEASE (CVD) IN GENETICALLY PREDISPOSED RATS

EPA Science Inventory

Rodent CVD models are increasingly used for understanding individual differences in susceptibility to environmental stressors such as air pollution. We characterized pathologies and a number of known human risk factors of CVD in genetically predisposed, male young adult Spontaneo...

Perceptions and attitude effects on nanotechnology acceptance: an exploratory framework

NASA Astrophysics Data System (ADS)

Ganesh Pillai, Rajani; Bezbaruah, Achintya N.

2017-02-01

Existing literature in people's attitude toward nanotechnology and acceptance of nanotechnology applications has generally investigated the impact of factors at the individual or context levels. While this vast body of research is very informative, a comprehensive understanding of how attitude toward nanotechnology are formed and factors influencing the acceptance of nanotechnology are elusive. This paper proposes an exploratory nanotechnology perception-attitude-acceptance framework (Nano-PAAF) to build a systematic understanding of the phenomenon. The framework proposes that perceptions of risks and benefits of nanotechnology are influenced by cognitive, affective, and sociocultural factors. The sociodemographic factors of consumers and contextual factors mitigate the influence of cognitive, affective, and sociocultural factors on the perception of risks and benefits. The perceived risks and benefits in turn influence people's attitude toward nanotechnology, which then influences acceptance of nanotechnology products. This framework will need further development over time to incorporate emerging knowledge and is expected to be useful for researchers, decision and policy makers, industry, and business entities.

Understanding suicide risk within the Research Domain Criteria (RDoC) framework: A meta-analytic review.

PubMed

Glenn, Catherine R; Kleiman, Evan M; Cha, Christine B; Deming, Charlene A; Franklin, Joseph C; Nock, Matthew K

2018-01-01

The field is in need of novel and transdiagnostic risk factors for suicide. The National Institute of Mental Health's Research Domain Criteria (RDoC) provides a framework that may help advance research on suicidal behavior. We conducted a meta-analytic review of existing prospective risk and protective factors for suicidal thoughts and behaviors (ideation, attempts, and deaths) that fall within one of the five RDoC domains or relate to a prominent suicide theory. Predictors were selected from a database of 4,082 prospective risk and protective factors for suicide outcomes. A total of 460 predictors met inclusion criteria for this meta-analytic review and most examined risk (vs. protective) factors for suicidal thoughts and behaviors. The overall effect of risk factors was statistically significant, but relatively small, in predicting suicide ideation (weighted mean odds ratio: wOR = 1.72; 95% CI: 1.59-1.87), suicide attempt (wOR = 1.66 [1.57-1.76), and suicide death (wOR = 1.41 [1.24-1.60]). Across all suicide outcomes, most risk factors related to the Negative Valence Systems domain, although effect sizes were of similar magnitude across RDoC domains. This study demonstrated that the RDoC framework provides a novel and promising approach to suicide research; however, relatively few studies of suicidal behavior fit within this framework. Future studies must go beyond the "usual suspects" of suicide risk factors (e.g., mental disorders, sociodemographics) to understand the processes that combine to lead to this deadly outcome. © 2017 Wiley Periodicals, Inc.

Diabetes mellitus and stroke: A clinical update

PubMed Central

Tun, Nyo Nyo; Arunagirinathan, Ganesan; Munshi, Sunil K; Pappachan, Joseph M

2017-01-01

Cardiovascular disease including stroke is a major complication that tremendously increases the morbidity and mortality in patients with diabetes mellitus (DM). DM poses about four times higher risk for stroke. Cardiometabolic risk factors including obesity, hypertension, and dyslipidaemia often co-exist in patients with DM that add on to stroke risk. Because of the strong association between DM and other stroke risk factors, physicians and diabetologists managing patients should have thorough understanding of these risk factors and management. This review is an evidence-based approach to the epidemiological aspects, pathophysiology, diagnostic work up and management algorithms for patients with diabetes and stroke. PMID:28694925

Children at Risk: The Association between Perceived Weight Status and Suicidal Thoughts and Attempts in Middle School Youth

ERIC Educational Resources Information Center

Whetstone, Lauren M.; Morrissey, Susan L.; Cummings, Doyle M.

2007-01-01

Background: Suicide is one of the most common causes of death among young people. A report from the US Surgeon General called for strategies to prevent suicide, including increasing public awareness of suicide and risks factors, and enhancing research to understand risk and protective factors. Weight perception has been linked to depression and…

Identifying Academic & Social Risk Factors of Baccalaureate Nursing Students Using the College Persistence Questionnaire

ERIC Educational Resources Information Center

Betts, Kelly J.; Shirley, Janet A.; Kennedy, Robert

2017-01-01

Background: Student success in a baccalaureate nursing program is of utmost importance at a southern College of Nursing (CON).CON faculty wanted to understand better what academic/ social risk factors attributed to attrition in the first year of the nursing program. The purpose of this study was to determine academic and social risk factors…

Risk factors of the upper limb disorders among cashiers in grocery retail industries: A review

NASA Astrophysics Data System (ADS)

Zuhaidi, Muhammad Fareez Ahmad; Nasrull Abdol Rahman, Mohd

2017-08-01

Cashiers have been appointed as one of top ten occupations in developing musculoskeletal disorders (MSDs) particularly on the upper limb. Many of the workers are still in high risk injury due to incorrect workstations and lack of employee education in basic biomechanical principles. Normally, cashiers are exposed in several risk factors such as awkward and static postures, repetition motion and forceful exertions. Thus, cashiers in supermarket are considered at risk from developing upper limb disorders (ULDs). This review evaluates selected papers that have studied risk factors of the upper limb disorders among cashiers in grocery retail industries. In addition, other studies from related industry were reviewed as applicable. In order to understand risk factors of the upper limb disorders among cashiers, it is recommended that future studies are needed in evaluating these risk factors among cashiers.

Treatment of juvenile idiopathic arthritis-associated uveitis: challenges and update.

PubMed

Rabinovich, C Egla

2011-09-01

To update the current understanding of the risk factors for poor outcomes in juvenile idiopathic arthritis-related uveitis. In addition, current therapies, both traditional and biological, are reviewed. Male sex, independent of age or antinuclear antibody status, is associated with increased ocular morbidity. Having anterior chamber inflammation on first exam increases the risk of developing vision-threatening eye complications. Presence of one complication increases the risk of developing another. Risk of cataract development associated with topical glucocorticoid use is better defined. Longer duration of remission on therapy has been found to decrease the risk of disease flare after discontinuation of methotrexate. Recent studies of both nonbiological and biological therapies for arthritis-related uveitis are discussed. With a better understanding of risk factors associated with the ocular morbidity of uveitis associated with juvenile idiopathic arthritis, aggressive therapies can be targeted for improved visual outcomes. Alternative treatments to avoid long-term corticosteroid use include the use of antimetabolites and biological therapies. More prospective comparator studies and/or use of multicenter databases are needed to better understand best treatments.

Interaction of Occupational and Personal Risk Factors in Workforce Health and Safety

PubMed Central

Pandalai, Sudha; Wulsin, Victoria; Chun, HeeKyoung

2012-01-01

Most diseases, injuries, and other health conditions experienced by working people are multifactorial, especially as the workforce ages. Evidence supporting the role of work and personal risk factors in the health of working people is frequently underused in developing interventions. Achieving a longer, healthy working life requires a comprehensive preventive approach. To help develop such an approach, we evaluated the influence of both occupational and personal risk factors on workforce health. We present 32 examples illustrating 4 combinatorial models of occupational hazards and personal risk factors (genetics, age, gender, chronic disease, obesity, smoking, alcohol use, prescription drug use). Models that address occupational and personal risk factors and their interactions can improve our understanding of health hazards and guide research and interventions. PMID:22021293

“It is not possible for me to have diabetes”–Community Perceptions on Diabetes and Its Risk Factors in Rural Purworejo District, Central Java, Indonesia

PubMed Central

Pujilestari, Cahya Utamie; Ng, Nawi; Hakimi, Mohammad; Eriksson, Malin

2014-01-01

Accumulating evidence suggests that negative perceptions towards diabetes can limit the management and prevention of the disease. The negative perceptions towards diabetes are prevalent in many different settings, especially among rural communities. Few qualitative studies have been performed to understand how the community views diabetes and its associated risk factors. This study aimed to explore general community perceptions of diabetes and its risk factors in rural Indonesia. A total of 68 participants were recruited to 12 focus group discussions (FGDs) comprised of different age groups and sexes. The FGDs were conducted in six villages in rural Purworejo District, Central Java, Indonesia, from 2011 to 2012. All FGDs were recorded and transcribed. Qualitative content analysis was performed to describe and analyse how the rural community perceived diabetes and its risk factors. Diabetes was perceived as a visible and scary sugar disease, and the affected individuals themselves were blamed for getting the disease. Recognised as ‘sugar’ or ‘sweet-pee’ disease with terrifying effects, diabetes was believed to be a disease with no cure. The participants seemed to have an unrealistic optimism with regards to the diabetes risk factors. They believed that diabetes would not affect them, only others, and that having family members with diabetes was necessary for one to develop diabetes. Our findings demonstrate that rural communities have negative perceptions about diabetes and at the same time individuals have unrealistic optimism about their own risk factors. Understanding how such communities perceive diabetes and its risk factors is important for planning prevention strategies. Health messages need to be tailored to health-related behaviours and the local culture’s concepts of diseases and risk factors. PMID:25168994

"It is not possible for me to have diabetes"-community perceptions on diabetes and its risk factors in Rural Purworejo District, Central Java, Indonesia.

PubMed

Pujilestari, Cahya Utamie; Ng, Nawi; Hakimi, Mohammad; Eriksson, Malin

2014-06-12

Accumulating evidence suggests that negative perceptions towards diabetes can limit the management and prevention of the disease. The negative perceptions towards diabetes are prevalent in many different settings, especially among rural communities. Few qualitative studies have been performed to understand how the community views diabetes and its associated risk factors. This study aimed to explore general community perceptions of diabetes and its risk factors in rural Indonesia. A total of 68 participants were recruited to 12 focus group discussions (FGDs) comprised of different age groups and sexes. The FGDs were conducted in six villages in rural Purworejo District, Central Java, Indonesia, from 2011 to 2012. All FGDs were recorded and transcribed. Qualitative content analysis was performed to describe and analyse how the rural community perceived diabetes and its risk factors. Diabetes was perceived as a visible and scary sugar disease, and the affected individuals themselves were blamed for getting the disease. Recognised as 'sugar' or 'sweet-pee' disease with terrifying effects, diabetes was believed to be a disease with no cure. The participants seemed to have an unrealistic optimism with regards to the diabetes risk factors. They believed that diabetes would not affect them, only others, and that having family members with diabetes was necessary for one to develop diabetes. Our findings demonstrate that rural communities have negative perceptions about diabetes and at the same time individuals have unrealistic optimism about their own risk factors. Understanding how such communities perceive diabetes and its risk factors is important for planning prevention strategies. Health messages need to be tailored to health-related behaviours and the local culture's concepts of diseases and risk factors.

Evaluation of Risk Perception and Risk-Comparison Information Regarding Dietary Radionuclides after the 2011 Fukushima Nuclear Power Plant Accident.

PubMed

Murakami, Michio; Nakatani, Jun; Oki, Taikan

2016-01-01

In the wake of the 2011 Fukushima Daiichi Nuclear Power Station accident, to facilitate evidence-based risk communication we need to understand radiation risk perception and the effectiveness of risk-comparison information. We measured and characterized perceptions of dread risks and unknown risks regarding dietary radionuclides in residents of Fukushima, Tokyo, and Osaka to identify the primary factors among location, evacuation experience, gender, age, employment status, absence/presence of spouse, children and grandchildren, educational background, humanities/science courses, smoking habits, and various types of trustworthy information sources. We then evaluated the effects of these factors and risk-comparison information on multiple outcomes, including subjective and objective understanding, perceived magnitude of risk, perceived accuracy of information, backlash against information, and risk acceptance. We also assessed how risk-comparison information affected these multiple outcomes for people with high risk perception. Online questionnaires were completed by people (n = 9249) aged from 20 to 69 years in the three prefectures approximately 5 years after the accident. We gave each participant one of 15 combinations of numerical risk data and risk-comparison information, including information on standards, smoking-associated risk, and cancer risk, in accordance with Covello's guidelines. Dread-risk perception among Fukushima residents with no experience of evacuation was much lower than that in Osaka residents, whereas evacuees had strikingly higher dread-risk perception, irrespective of whether their evacuation had been compulsory or voluntary. We identified location (distance from the nuclear power station), evacuation experience, and trust of central government as primary factors. Location (including evacuation experience) and trust of central government were significantly associated with the multiple outcomes above. Only information on "cancer risk from radiation and smoking risk" enhanced both subjective and objective understanding without diminishing trust in all participants and in the high dread-risk perception group; use of other risk-comparison information could lead the public to overestimate risk.

Psychosocial and cultural factors affecting the perceived risk of genetically modified food: an overview of the literature.

PubMed

Finucane, Melissa L; Holup, Joan L

2005-04-01

The rapid globalization of the world economy has increased the need for an astute understanding of cultural differences in perceptions, values, and ways of thinking about new food technologies. In this paper, we describe how socio-psychological and cultural factors may affect public perceptions of the risk of genetically modified (GM) food. We present psychological, sociological, and anthropological research on risk perception as a framework for understanding cross-national differences in reactions to GM food. Differences in the cultural values and circumstances of people in the US, European countries, and the developing world are examined. The implications of cultural theory for risk communication and decision making about GM food are discussed and directions for future research highlighted.

Evaluation of Risk Perception and Risk-Comparison Information Regarding Dietary Radionuclides after the 2011 Fukushima Nuclear Power Plant Accident

PubMed Central

Murakami, Michio; Nakatani, Jun; Oki, Taikan

2016-01-01

In the wake of the 2011 Fukushima Daiichi Nuclear Power Station accident, to facilitate evidence-based risk communication we need to understand radiation risk perception and the effectiveness of risk-comparison information. We measured and characterized perceptions of dread risks and unknown risks regarding dietary radionuclides in residents of Fukushima, Tokyo, and Osaka to identify the primary factors among location, evacuation experience, gender, age, employment status, absence/presence of spouse, children and grandchildren, educational background, humanities/science courses, smoking habits, and various types of trustworthy information sources. We then evaluated the effects of these factors and risk-comparison information on multiple outcomes, including subjective and objective understanding, perceived magnitude of risk, perceived accuracy of information, backlash against information, and risk acceptance. We also assessed how risk-comparison information affected these multiple outcomes for people with high risk perception. Online questionnaires were completed by people (n = 9249) aged from 20 to 69 years in the three prefectures approximately 5 years after the accident. We gave each participant one of 15 combinations of numerical risk data and risk-comparison information, including information on standards, smoking-associated risk, and cancer risk, in accordance with Covello’s guidelines. Dread-risk perception among Fukushima residents with no experience of evacuation was much lower than that in Osaka residents, whereas evacuees had strikingly higher dread-risk perception, irrespective of whether their evacuation had been compulsory or voluntary. We identified location (distance from the nuclear power station), evacuation experience, and trust of central government as primary factors. Location (including evacuation experience) and trust of central government were significantly associated with the multiple outcomes above. Only information on “cancer risk from radiation and smoking risk” enhanced both subjective and objective understanding without diminishing trust in all participants and in the high dread-risk perception group; use of other risk-comparison information could lead the public to overestimate risk. PMID:27802304

An application of an ecological framework to understand risk factors of PTSD due to prolonged conflict exposure: Israeli and Palestinian adolescents in the Line of Fire

PubMed Central

Rosshandler, Yasmin; Hall, Brian J.; Canetti, Daphna

2016-01-01

Objective Adolescents living in Israel and the Palestinian authority are exposed to political violence. This review examines psychosocial risk factors for posttraumatic stress disorder (PTSD) organized within an ecological framework. Method Relevant articles were identified through PubMed and PsycINFO. Studies measuring risk and/or protective factors for PTSD in the Palestinian and/or Israeli adolescent populations due to conflict exposure from 1990 to present were included. Results A total of 20 studies met inclusion criteria. Greater violence exposure, poor economic resources, living in rural compared to urban areas, poor family and peer relations and poor coping skills were associated with PTSD symptoms. Conclusions The ecological framework is a useful approach to understanding factors affecting adolescent PTSD. Future research should focus on socio-ecological levels that have received limited attention. PMID:26950012

An application of an ecological framework to understand risk factors of PTSD due to prolonged conflict exposure: Israeli and Palestinian adolescents in the line of fire.

PubMed

Rosshandler, Yasmin; Hall, Brian J; Canetti, Daphna

2016-09-01

Adolescents living in Israel and the Palestinian authority are exposed to political violence. This review examines psychosocial risk factors for posttraumatic stress disorder (PTSD) organized within an ecological framework. Relevant articles were identified through PubMed and PsycINFO. Studies measuring risk and/or protective factors for PTSD in the Palestinian and/or Israeli adolescent populations because of conflict exposure from 1990 to present were included. A total of 20 studies met inclusion criteria. Greater violence exposure, poor economic resources, living in rural compared with urban areas, poor family and peer relations, and poor coping skills were associated with PTSD symptoms. The ecological framework is a useful approach to understanding factors affecting adolescent PTSD. Future research should focus on socioecological levels that have received limited attention. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

A complex web of risks for metabolic syndrome: race/ethnicity, economics, and gender.

PubMed

Salsberry, Pamela J; Corwin, Elizabeth; Reagan, Patricia B

2007-08-01

Metabolic syndrome is a recognizable clinical cluster of risks known to be associated in combination and independently with an increased risk for cardiovascular disease (CVD). Identifying and treating metabolic syndrome is one promising strategy to reduce CVD. The intersection of race/ethnicity, gender, and economic status complicates our understanding of who is at risk for metabolic syndrome, but understanding this social patterning is important for the development of targeted interventions. This study examines the relationship between metabolic syndrome (and the underlying contributing risk factors) and race/ethnicity, economic status, and gender. National Health and Nutrition Examination Survey data collected from 1999 through 2002 were used; analysis was completed in 2006-2007. Metabolic syndrome was defined using the Adult Treatment Panel III definition. Economic status was measured using income as a percentage of the poverty level. Prevalence of metabolic syndrome and each of its contributing risk factors were determined by race/ethnicity and economic group. Logistic regressions were estimated. All analyses were stratified by gender. Economic effects were seen for women, but not men. Women in the lowest economic group were more likely to be at risk in four of the five risk categories when compared with women in the highest economic group. Differences in the contributing risk profiles for metabolic syndrome were seen by race/ethnicity. Strategies to reduce CVD must be built on a clear understanding of the differences in contributing risk factors for metabolic syndrome across subgroups. The findings from this study provide further information to guide the targeting of these strategies.

Genetic and environmental risk factors for rheumatoid arthritis.

PubMed

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

2017-02-01

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

School Adjustment of Pupils with ADHD: Cognitive, Emotional and Temperament Risk Factors

ERIC Educational Resources Information Center

Sanchez-Perez, Noelia; Gonzalez-Salinas, Carmen

2013-01-01

From different research perspectives, the cognitive and emotional characteristics associated with ADHD in children have been identified as risk factors for the development of diverse adjustment problems in the school context. Research in nonclinical population can additionally help in understanding ADHD deficits, since children with specific…

Bridging the gap between preventive and restorative dentistry: identification of caries risk factors and strategies for minimizing risk.

PubMed

Maragliano-Muniz, Pamela

2013-10-01

Following the introduction of CAMBRA (Caries Management by Risk Assessment) in 2007, a number of recommendations for office protocols were introduced, and many companies have formulated products and procedures for implementing CAMBRA. As a result, the implementation of a caries management program can be confounding and overwhelming to a dental practitioner. Understanding risk factors as they contribute to the caries process can help mitigate confusion and guide the practitioner when selecting materials for their practice. Ultimately, knowing how the risk factors play a role in the progression of dental caries will lead to appropriate risk management and product recommendations. The purpose of this article is to discuss the contribution of risk factors to the caries process and to introduce strategies that restorative dentists can utilize to minimize caries risk.

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

PubMed

Thompson, Sanna J

2004-09-01

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

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

PubMed Central

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

2016-01-01

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

Environmental and societal influences acting on cardiovascular risk factors and disease at a population level: a review

PubMed Central

Chow, Clara Kayei; Lock, Karen; Teo, Koon; Subramanian, SV; McKee, Martin; Yusuf, Salim

2009-01-01

It has long been known that cardiovascular disease (CVD) rates vary considerably among populations, across space and through time. It is now apparent that most of the attributable risk for myocardial infarction ‘within’ populations from across the world can be ascribed to the varying levels of a limited number of risk factors among individuals in a population. Individual risk factors (e.g. blood pressure) can be modified with resulting health gains. Yet, the persistence of large international variations in cardiovascular risk factors and resulting CVD incidence and mortality indicates that there are additional factors that apply to ‘populations’ that are important to understand as part of a comprehensive approach to CVD control. This article reviews the evidence on why certain populations are more at risk than others. PMID:19261658

Environmental and societal influences acting on cardiovascular risk factors and disease at a population level: a review.

PubMed

Chow, Clara Kayei; Lock, Karen; Teo, Koon; Subramanian, S V; McKee, Martin; Yusuf, Salim

2009-12-01

It has long been known that cardiovascular disease (CVD) rates vary considerably among populations, across space and through time. It is now apparent that most of the attributable risk for myocardial infarction 'within' populations from across the world can be ascribed to the varying levels of a limited number of risk factors among individuals in a population. Individual risk factors (e.g. blood pressure) can be modified with resulting health gains. Yet, the persistence of large international variations in cardiovascular risk factors and resulting CVD incidence and mortality indicates that there are additional factors that apply to 'populations' that are important to understand as part of a comprehensive approach to CVD control. This article reviews the evidence on why certain populations are more at risk than others.

Impact of cardiovascular risk factors on medical expenditure: evidence from epidemiological studies analysing data on health checkups and medical insurance.

PubMed

Nakamura, Koshi

2014-01-01

Concerns have increasingly been raised about the medical economic burden in Japan, of which approximately 20% is attributable to cardiovascular disease, including coronary heart disease and stroke. Because the management of risk factors is essential for the prevention of cardiovascular disease, it is important to understand the relationship between cardiovascular risk factors and medical expenditure in the Japanese population. However, only a few Japanese epidemiological studies analysing data on health checkups and medical insurance have provided evidence on this topic. Patients with cardiovascular risk factors, including obesity, hypertension, and diabetes, may incur medical expenditures through treatment of the risk factors themselves and through procedures for associated diseases that usually require hospitalization and sometimes result in death. Untreated risk factors may cause medical expenditure surges, mainly due to long-term hospitalization, more often than risk factors preventively treated by medication. On an individual patient level, medical expenditures increase with the number of concomitant cardiovascular risk factors. For single risk factors, personal medical expenditure may increase with the severity of that factor. However, on a population level, the medical economic burden attributable to cardiovascular risk factors results largely from a single, particularly prevalent risk factor, especially from mildly-to-moderately abnormal levels of the factor. Therefore, cardiovascular risk factors require management on the basis of both a cost-effective strategy of treating high-risk patients and a population strategy for reducing both the ill health and medical economic burdens that result from cardiovascular disease.

Models of Intergenerational and Transgenerational Transmission of Risk for Psychopathology in Mice

PubMed Central

Klengel, Torsten; Dias, Brian G; Ressler, Kerry J

2016-01-01

Trajectories toward risk or resilience in psychiatric disorders are influenced by acquired and inherited factors. More recently, evidence from rodent studies suggest that acquired risk factors can be transmitted through non-genomic, epigenetic mechanisms to subsequent generations, potentially contributing to a cycle of disease and disease risk. Here, we review examples of transmission of environmental factors across generations and illustrate the difference between behavioral transmission and epigenetic inheritance. We highlight essential definitions of intergenerational and transgenerational transmission of disease risk with corresponding examples. We then explore how these phenomena may influence our understanding of psychiatric disorders leading toward new prevention and therapeutic approaches. PMID:26283147

Using a syndemics theory approach to study HIV risk taking in a population of men who use the internet to find partners for unprotected sex.

PubMed

Klein, Hugh

2011-11-01

This study examines the value of using syndemics theory as a model for understanding HIV risk taking in a population of men who are at great risk for acquiring and/or transmitting HIV. The principal aim is to provide an empirical test of the applicability of the theory to sexual risk behaviors in this particular research population. The study was based on a national random sample of 332 men who have sex with men, or MSM, who use the Internet to seek men with whom they can engage in unprotected sex. Data collection was conducted via telephone interviews between January 2008 and May 2009. As hypothesized in the syndemics theory model, attitudes toward condom use were central to understanding men's involvement in risky sex. As hypothesized, these attitudes depended on various demographic, psychological/psychosocial functioning, and sex-related preference measures. Also as hypothesized, psychological and psychosocial functioning were found to be very important to the overall model, and as expected, these factors were shaped greatly by factors such as demographic characteristics and childhood maltreatment experiences. The structural equation assessing the fit of the overall model indicated solid support for the syndemics theory approach. Overall, syndemics theory seems to apply fairly well to understanding the complexity of the factors that underlie men's risk-taking practices. The complicated interplay among factors such as attitudes toward condom use, childhood maltreatment experiences, psychological and psychosocial functioning, and substance use and abuse-all of which are central to a syndemics theory approach to studying risk-was demonstrated.

A public health framework to translate risk factors related to political violence and war into multi-level preventive interventions.

PubMed

De Jong, Joop T V M

2010-01-01

Political violence, armed conflicts and human rights violations are produced by a variety of political, economic and socio-cultural factors. Conflicts can be analyzed with an interdisciplinary approach to obtain a global understanding of the relative contribution of risk and protective factors. A public health framework was designed to address these risk factors and protective factors. The framework resulted in a matrix that combined primary, secondary and tertiary interventions with their implementation on the levels of the society-at-large, the community, and the family and individual. Subsequently, the risk and protective factors were translated into multi-sectoral, multi-modal and multi-level preventive interventions involving the economy, governance, diplomacy, the military, human rights, agriculture, health, and education. Then the interventions were slotted in their appropriate place in the matrix. The interventions can be applied in an integrative form by international agencies, governments and non-governmental organizations, and molded to meet the requirements of the historic, political-economic and socio-cultural context. The framework maps the complementary fit among the different actors while engaging themselves in preventive, rehabilitative and reconstructive interventions. The framework shows how the economic, diplomatic, political, criminal justice, human rights, military, health and rural development sectors can collaborate to promote peace or prevent the aggravation or continuation of violence. A deeper understanding of the association between risk and protective factors and the developmental pathways of generic, country-specific and culture-specific factors leading to political violence is needed.

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

PubMed

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

2017-12-27

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

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

PubMed Central

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

2017-01-01

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

A Qualitative Comparison of Susceptibility and Behavior in Recreational and Occupational Risk Environments: Implications for Promoting Health and Safety.

PubMed

Haas, Emily Joy; Mattson, Marifran

2016-06-01

Although internal factors that influence risk are frequently studied to understand human behavior, external factors, including social, cultural, and institutional factors, should be better utilized to inform ways to efficiently target, tailor, and promote safety messaging to at-risk populations. Semi-structured interviews obtained data from 37 motorcyclists and 18 mineworkers about their risk perceptions and behaviors within their respective dynamic environments. A comparative thematic analysis revealed information about external factors that influence risk perceptions and behaviors. Results support the importance of qualitative approaches for assessing and targeting individuals' risk perceptions and behaviors. In addition, segmenting at-risk subgroups within target populations and tailoring messages for these at-risk groups is critical for safety behavior modification. Practitioners should utilize strategic, culture-centric risk communication that takes into account external factors when determining when, who, and what to communicate via health promotion activities to more accurately disseminate valid, empathetic, and engaging communication with a higher level of fidelity.

Suicidal Behaviour in Mood Disorders—Who, When, and Why?

PubMed Central

Isometsä, Erkki

2014-01-01

Objective: About one-half to two-thirds of all suicides are by people who suffer from mood disorders; preventing suicides among those who suffer from them is thus central for suicide prevention. Understanding factors underlying suicide risk is necessary for rational preventive decisions. Method: The literature on risk factors for completed and attempted suicide among subjects with depressive and bipolar disorders (BDs) was reviewed. Results: Lifetime risk of completed suicide among psychiatric patients with mood disorders is likely between 5% and 6%, with BDs, and possibly somewhat higher risk than patients with major depressive disorder. Longitudinal and psychological autopsy studies indicate suicidal acts usually take place during major depressive episodes (MDEs) or mixed illness episodes. Incidence of suicide attempts is about 20- to 40-fold, compared with euthymia, during these episodes, and duration of these high-risk states is therefore an important determinant of overall risk. Substance use and cluster B personality disorders also markedly increase risk of suicidal acts during mood episodes. Other major risk factors include hopelessness and presence of impulsive–aggressive traits. Both childhood adversity and recent adverse life events are likely to increase risk of suicide attempts, and suicidal acts are predicted by poor perceived social support. Understanding suicidal thinking and decision making is necessary for advancing treatment and prevention. Conclusion: Among subjects with mood disorders, suicidal acts usually occur during MDEs or mixed episodes concurrent with comorbid disorders. Nevertheless, illness factors can only in part explain suicidal behaviour. Illness factors, difficulty controlling impulsive and aggressive responses, plus predisposing early exposures and life situations result in a process of suicidal thinking, planning, and acts. PMID:24881160

Suicidal behaviour in mood disorders--who, when, and why?

PubMed

Isometsä, Erkki

2014-03-01

About one-half to two-thirds of all suicides are by people who suffer from mood disorders; preventing suicides among those who suffer from them is thus central for suicide prevention. Understanding factors underlying suicide risk is necessary for rational preventive decisions. The literature on risk factors for completed and attempted suicide among subjects with depressive and bipolar disorders (BDs) was reviewed. Lifetime risk of completed suicide among psychiatric patients with mood disorders is likely between 5% and 6%, with BDs, and possibly somewhat higher risk than patients with major depressive disorder. Longitudinal and psychological autopsy studies indicate suicidal acts usually take place during major depressive episodes (MDEs) or mixed illness episodes. Incidence of suicide attempts is about 20- to 40-fold, compared with euthymia, during these episodes, and duration of these high-risk states is therefore an important determinant of overall risk. Substance use and cluster B personality disorders also markedly increase risk of suicidal acts during mood episodes. Other major risk factors include hopelessness and presence of impulsive-aggressive traits. Both childhood adversity and recent adverse life events are likely to increase risk of suicide attempts, and suicidal acts are predicted by poor perceived social support. Understanding suicidal thinking and decision making is necessary for advancing treatment and prevention. Among subjects with mood disorders, suicidal acts usually occur during MDEs or mixed episodes concurrent with comorbid disorders. Nevertheless, illness factors can only in part explain suicidal behaviour. Illness factors, difficulty controlling impulsive and aggressive responses, plus predisposing early exposures and life situations result in a process of suicidal thinking, planning, and acts.

2012 AAPS National Biotech Conference Open Forum: a perspective on the current state of immunogenicity prediction and risk management.

PubMed

Rajadhyaksha, Manoj; Subramanyam, Meena; Rup, Bonnie

2013-10-01

The immunogenicity profile of a biotherapeutic is determined by multiple product-, process- or manufacturing-, patient- and treatment-related factors and the bioanalytical methodology used to monitor for immunogenicity. This creates a complex situation that limits direct correlation of individual factors to observed immunogenicity rates. Therefore, mechanistic understanding of how these factors individually or in concert could influence the overall incidence and clinical risk of immunogenicity is crucial to provide the best benefit/risk profile for a given biotherapeutic in a given indication and to inform risk mitigation strategies. Advances in the field of immunogenicity have included development of best practices for monitoring anti-drug antibody development, categorization of risk factors contributing to immunogenicity, development of predictive tools, and development of effective strategies for risk management and mitigation. Thus, the opportunity to ask "where we are now and where we would like to go from here?" was the main driver for organizing an Open Forum on Improving Immunogenicity Risk Prediction and Management, conducted at the 2012 American Association of Pharmaceutical Scientists' (AAPS) National Biotechnology Conference in San Diego. The main objectives of the Forum include the following: to understand the nature of immunogenicity risk factors, to identify analytical tools used and animal models and management strategies needed to improve their predictive value, and finally to identify collaboration opportunities to improve the reliability of risk prediction, mitigation, and management. This meeting report provides the Forum participant's and author's perspectives on the barriers to advancing this field and recommendations for overcoming these barriers through collaborative efforts.

What Makes Youth Harass Their Immigrant Peers? Understanding the Risk Factors

ERIC Educational Resources Information Center

Bayram Özdemir, Sevgi; Özdemir, Metin; Stattin, Håkan

2016-01-01

Immigrant youth are at risk of experiencing harassment in school; however, we have only limited understanding of what makes youth harass their peers on ground of their ethnic origin. To address this major limitation, we examined (a) whether youth's negative attitudes toward immigrants impact their engagement in ethnic harassment over time and (b)…

Sexual Risk Behavior among African American College Women: Understanding Socio-Cultural Factors in the Context of HIV/AIDS

ERIC Educational Resources Information Center

Gibbons, Maya A.

2010-01-01

African American women are at the center of the discussion on health disparities, specifically disparities regarding HIV/AIDS and Sexually Transmitted Infections (STIs). Though there has been substantial research examining sexual risk behavior among low income African American women, little has been done to understand sexual behavior…

New Genes and New Insights from Old Genes: Update on Alzheimer Disease

PubMed Central

Ringman, John M.; Coppola, Giovanni

2013-01-01

Purpose of Review: This article discusses the current status of knowledge regarding the genetic basis of Alzheimer disease (AD) with a focus on clinically relevant aspects. Recent Findings: The genetic architecture of AD is complex, as it includes multiple susceptibility genes and likely nongenetic factors. Rare but highly penetrant autosomal dominant mutations explain a small minority of the cases but have allowed tremendous advances in understanding disease pathogenesis. The identification of a strong genetic risk factor, APOE, reshaped the field and introduced the notion of genetic risk for AD. More recently, large-scale genome-wide association studies are adding to the picture a number of common variants with very small effect sizes. Large-scale resequencing studies are expected to identify additional risk factors, including rare susceptibility variants and structural variation. Summary: Genetic assessment is currently of limited utility in clinical practice because of the low frequency (Mendelian mutations) or small effect size (common risk factors) of the currently known susceptibility genes. However, genetic studies are identifying with confidence a number of novel risk genes, and this will further our understanding of disease biology and possibly the identification of therapeutic targets. PMID:23558482

Environment and asthma in adults.

PubMed

Le Moual, Nicole; Jacquemin, Bénédicte; Varraso, Raphaëlle; Dumas, Orianne; Kauffmann, Francine; Nadif, Rachel

2013-09-01

The present review addresses recent advances and especially challenging aspects regarding the role of environmental risk factors in adult-onset asthma, for which the causes are poorly established. In the first part of the review, we discuss aspects regarding some environmental risk factors for adult-onset asthma: air pollution, occupational exposures with a focus on an emerging risk represented by exposure to cleaning agents (both at home and in the workplace), and lifestyle and nutrition. The second part is focused on perspectives and challenges, regarding relevant topics on which research is needed to improve the understanding of the role of environmental factors in asthma. Aspects of exposure assessment, the complexity of multiple exposures, the interrelationships of the environment with behavioral characteristics and the importance of studying biological markers and gene-environment interactions to identify the role of the environment in asthma are discussed. We conclude that environmental and lifestyle exposures play an important role in asthma or related phenotypes. The changes in lifestyle and the environment in recent decades have modified the specific risk factors in asthma even for well-recognized risks such as occupational exposures. To better understand the role of the environment in asthma, the use of objective (quantitative measurement of exposures) or modern tools (bar code, GPS) and the development of multidisciplinary collaboration would be very promising. A better understanding of the complex interrelationships between socio-economic, nutritional, lifestyle and environmental conditions might help to study their joint and independent roles in asthma. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

The INHANCE consortium: toward a better understanding of the causes and mechanisms of head and neck cancer.

PubMed

Winn, D M; Lee, Y-C A; Hashibe, M; Boffetta, P

2015-09-01

The International Head and Neck Cancer Epidemiology (INHANCE) consortium is a collaboration of research groups leading large epidemiology studies to improve the understanding of the causes and mechanisms of head and neck cancer. The consortium includes investigators of 35 studies who have pooled their data on 25 500 patients with head and neck cancer (i.e., cancers of the oral cavity, oropharynx, hypopharynx, and larynx) and 37 100 controls. The INHANCE analyses have confirmed that tobacco use and alcohol intake are key risk factors of these diseases and have provided precise estimates of risk and dose response, the benefit of quitting, and the hazard of smoking even a few cigarettes per day. Other risk factors include short height, lean body mass, low education and income, and a family history of head and neck cancer. Risk factors are generally similar for oral cavity, pharynx, and larynx, although the magnitude of risk may vary. Some major strengths of pooling data across studies include more precise estimates of risk and the ability to control for potentially confounding factors and to examine factors that may interact with each other. The INHANCE consortium provides evidence of the scientific productivity and discoveries that can be obtained from data pooling projects. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chaos, Poverty, and Parenting: Predictors of Early Language Development

ERIC Educational Resources Information Center

Vernon-Feagans, Lynne; Garrett-Peters, Patricia; Willoughby, Michael; Mills-Koonce, Roger

2012-01-01

Studies have shown that distal family risk factors like poverty and maternal education are strongly related to children's early language development. Yet, few studies have examined these risk factors in combination with more proximal day-to-day experiences of children that might be critical to understanding variation in early language. Young…

Childhood Conduct Problems and Other Early Risk Factors in Rural Adult Stimulant Users

ERIC Educational Resources Information Center

Kramer, Teresa L.; Han, Xiaotong; Leukefeld, Carl; Booth, Brenda M.; Edlund, Carrie

2009-01-01

Context: Understanding childhood risk factors associated with adult substance use and legal problems is important for treatment and prevention. Purpose: To examine the relationship of early substance use, conduct problems before age 15, and family history of substance abuse on adult outcomes in rural, stimulant users. Methods: Adult cocaine and…

Suicide Among Soldiers: A Review of Psychosocial Risk and Protective Factors

PubMed Central

Nock, Matthew K.; Deming, Charlene A.; Fullerton, Carol S.; Gilman, Stephen E.; Goldenberg, Matthew; Kessler, Ronald C.; McCarroll, James E.; McLaughlin, Katie A.; Peterson, Christopher; Schoenbaum, Michael; Stanley, Barbara; Ursano, Robert J.

2014-01-01

Suicide is difficult to predict and prevent and remains a leading cause of death worldwide. Although soldiers historically have had a suicide rate well below that of the general population, the suicide rate among members of the U.S. Army has increased markedly over the past several years and now exceeds that of the general population. This paper reviews psychosocial factors known to be associated with the increased risk of suicidal behavior in general and describes how some of these factors may be especially important in understanding suicide among soldiers. Moving forward, the prevention of suicide requires additional research aimed at: (a) better describing when, where, and among whom suicidal behavior occurs, (b) using exploratory studies to discover new risk and protective factors, (c) developing new methods of predicting suicidal behavior that synthesize information about modifiable risk and protective factors from multiple domains, and (d) understanding the mechanisms and pathways through which suicidal behavior develops. Although the scope and severity of this problem is daunting, the increasing attention and dedication to this issue by the Armed Forces, scientists, and society provide hope for our ability to better predict and prevent these tragic outcomes in the future. PMID:23631542

Identifying the necessary and sufficient number of risk factors for predicting academic failure.

PubMed

Lucio, Robert; Hunt, Elizabeth; Bornovalova, Marina

2012-03-01

Identifying the point at which individuals become at risk for academic failure (grade point average [GPA] < 2.0) involves an understanding of which and how many factors contribute to poor outcomes. School-related factors appear to be among the many factors that significantly impact academic success or failure. This study focused on 12 school-related factors. Using a thorough 5-step process, we identified which unique risk factors place one at risk for academic failure. Academic engagement, academic expectations, academic self-efficacy, homework completion, school relevance, school safety, teacher relationships (positive relationship), grade retention, school mobility, and school misbehaviors (negative relationship) were uniquely related to GPA even after controlling for all relevant covariates. Next, a receiver operating characteristic curve was used to determine a cutoff point for determining how many risk factors predict academic failure (GPA < 2.0). Results yielded a cutoff point of 2 risk factors for predicting academic failure, which provides a way for early identification of individuals who are at risk. Further implications of these findings are discussed. PsycINFO Database Record (c) 2012 APA, all rights reserved.

A multidomain approach to understanding risk for underage drinking: converging evidence from 5 data sets.

PubMed

Jones, Damon E; Feinberg, Mark E; Cleveland, Michael J; Cooper, Brittany Rhoades

2012-11-01

We examined the independent and combined influence of major risk and protective factors on youths' alcohol use. Five large data sets provided similar measures of alcohol use and risk or protective factors. We carried out analyses within each data set, separately for boys and girls in 8th and 10th grades. We included interaction and curvilinear predictive terms in final models if results were robust across data sets. We combined results using meta-analytic techniques. Individual, family, and peer risk factors and a community protective factor moderately predicted youths' alcohol use. Family and school protective factors did not predict alcohol use when combined with other factors. Youths' antisocial attitudes were more strongly associated with alcohol use for those also reporting higher levels of peer or community risk. For certain risk factors, the association with alcohol use varied across different risk levels. Efforts toward reducing youths' alcohol use should be based on robust estimates of the relative influence of risk and protective factors across adolescent environment domains. Public health advocates should focus on context (e.g., community factors) as a strategy for curbing underage alcohol use.

Quantitative influence of risk factors on blood glucose level.

PubMed

Chen, Songjing; Luo, Senlin; Pan, Limin; Zhang, Tiemei; Han, Longfei; Zhao, Haixiu

2014-01-01

The aim of this study is to quantitatively analyze the influence of risk factors on the blood glucose level, and to provide theory basis for understanding the characteristics of blood glucose change and confirming the intervention index for type 2 diabetes. The quantitative method is proposed to analyze the influence of risk factors on blood glucose using back propagation (BP) neural network. Ten risk factors are screened first. Then the cohort is divided into nine groups by gender and age. According to the minimum error principle, nine BP models are trained respectively. The quantitative values of the influence of different risk factors on the blood glucose change can be obtained by sensitivity calculation. The experiment results indicate that weight is the leading cause of blood glucose change (0.2449). The second factors are cholesterol, age and triglyceride. The total ratio of these four factors reaches to 77% of the nine screened risk factors. And the sensitivity sequences can provide judgment method for individual intervention. This method can be applied to risk factors quantitative analysis of other diseases and potentially used for clinical practitioners to identify high risk populations for type 2 diabetes as well as other disease.

Sepsis in general surgery: a deadly complication.

PubMed

Moore, Laura J; Moore, Frederick A; Jones, Stephen L; Xu, Jiaqiong; Bass, Barbara L

2009-12-01

Sepsis is a deadly and potentially preventable complication. A better understanding of sepsis in general surgery patients is needed to help direct resources to those patients at highest risk for death from sepsis. We identified risk factors for sepsis in general surgery patients by using the National Surgical Quality Improvement Project database. Analysis of the database identified 3 major risk factors for both the development of sepsis and death from sepsis in general surgery patients. These risk factors are age older than 60 years, need for emergency surgery, and the presence of comorbid conditions. Risk factors for death from sepsis or septic shock in general surgery patients include age older than 60 years, need for emergency surgery, and the presence of preexisting comorbidities. These findings emphasize the need for early recognition through aggressive sepsis screening and rapid implementation of evidence-based interventions for sepsis and septic shock in general surgery patients with these risk factors.

Skin cancer: an overview of epidemiology and risk factors.

PubMed

Gordon, Randy

2013-08-01

To provide a general overview of malignant melanoma and non-melanoma skin cancer, with an emphasis on epidemiology, clinical presentation, and the multiple and varied risk factors associated with skin cancer. Peer-reviewed journal articles, government health reports, book chapters, and Web-based resources. Skin cancer is the most common carcinoma, affecting millions worldwide. Incidence is increasing yearly, making it a pre-eminent public health threat. Myriad factors increase the risk of skin cancer and may serve as important prognostic indicators for the disease. To provide nurses with a clearer understanding of the causative mechanisms of skin cancer and an improved awareness of the risk factors associated with the disease. Copyright © 2013 Elsevier Inc. All rights reserved.

Gene-by-Environment Interactions in Pancreatic Cancer: Implications for Prevention

PubMed Central

Jansen, Rick J.; Tan, Xiang-Lin; Petersen, Gloria M.

2015-01-01

Pancreatic cancer (PC) has been estimated to have higher incidence and correspondingly higher mortality rates in more developed regions worldwide. Overall, the age-adjusted incidence rate is 4.9/105 and age-adjusted mortality rate is at 4.8/105. We review here our current knowledge of modifiable risk factors (cigarette smoking, obesity, diet, and alcohol) for PC, genetic variants implicated by genome-wide association studies, possible genetic interactions with risk factors, and prevention strategies to provide future research directions that may further our understanding of this complex disease. Cigarette smoking is consistently associated with a two-fold increased PC risk. PC associations with dietary intake have been largely inconsistent, with the potential exception of certain unsaturated fatty acids decreasing risk and well-done red meat or meat mutagens increasing risk. There is strong evidence to support that obesity (and related measures) increase risk of PC. Only the heaviest alcohol drinkers seem to be at an increased risk of PC. Currently, key prevention strategies include avoiding tobacco and excessive alcohol consumption and adopting a healthy lifestyle. Screening technologies and PC chemoprevention are likely to become more sophisticated, but may only apply to those at high risk. Risk stratification may be improved by taking into account gene environment interactions. Research on these modifiable risk factors is key to reducing the incidence of PC and understanding who in the population can be considered high risk. PMID:26029010

Understanding Suicide Across the Lifespan: A United States Perspective of Suicide Risk Factors, Assessment & Management.

PubMed

Steele, Ian H; Thrower, Natasha; Noroian, Paul; Saleh, Fabian M

2018-01-01

Suicide is a troubling, preventable phenomenon. Prior to attempts, individuals often seek help, prompting practitioners to perform risk assessments that ideally use evidence-based risk management strategies. A literature review was performed using Harvard Countway Library of Medicine, Google Scholar, PubMed. Key words used were "Forensic Science," "Suicide Risk Management," "Pediatric Suicide Risk Factors," "Adult Suicide Risk Factors," "Geriatric Suicide Risk Factors," "Suicide Risk Assessment." Parameters limited articles to studies/reviews completed in the past twenty years in the United States. Results indicated predictors of suicide in juveniles were insomnia, burdensomeness, and recent conflicts with family or a romantic partner. Adults had greater risk if male, substance abusing, with marital/job loss. Elderly individuals with multiple medical comorbidities, hopelessness, and isolation were at higher risk. Everyone evaluated should be screened for access to firearms. Management of suicide risk involves providing the least restrictive form of treatment which maintains an individual's safety. © 2017 American Academy of Forensic Sciences.

Beliefs about weight and breast cancer: an interview study with high risk women following a 12 month weight loss intervention.

PubMed

Wright, Claire E; Harvie, Michelle; Howell, Anthony; Evans, D Gareth; Hulbert-Williams, Nick; Donnelly, Louise S

2015-01-01

Breast cancer is the most common cancer in the UK. Lifestyle factors including excess weight contribute to risk of developing the disease. Whilst the exact links between weight and breast cancer are still emerging, it is imperative to explore how women understand these links and if these beliefs impact on successful behaviour change. Overweight/obese premenopausal women (aged 35-45) with a family history of breast cancer (lifetime risk 17-40%) were invited to a semi-structured interview following their participation in a 12 month weight loss intervention aimed at reducing their risk of breast cancer. Interviews were carried out with 9 women who successfully achieved ≥5% weight loss and 11 who were unsuccessful. Data were transcribed verbatim and analysed using thematic analysis. Three themes were developed from the analysis. The first theme how women construct and understand links between weight and breast cancer risk is composed of two subthemes, the construction of weight and breast cancer risk and making sense of weight and breast cancer risk. This theme explores women's understanding of what contributes to breast cancer risk and whether they believe that weight loss could reduce their breast cancer risk. The second theme motivation and adherence to weight loss interventions explains that breast cancer risk can be a motivating factor for adherence to a weight loss intervention. The final theme, acceptance of personal responsibility for health is composed of two subthemes responsibility for one's own health and responsibility for family health through making sensible lifestyle choices. Beliefs about weight and breast cancer risk were informed by social networks, media reports and personal experiences of significant others diagnosed with breast cancer. Our study has highlighted common doubts, anxieties and questions and the importance of providing a credible rationale for weight control and weight loss which addresses individual concerns. Counselling and health education material should be tailored to facilitate understanding of both genetic and modifiable risk factors and should do more help individuals to visualise the weight and breast cancer link.

Environmental and gene-environment interactions and risk of rheumatoid arthritis

PubMed Central

Karlson, Elizabeth W.; Deane, Kevin

2012-01-01

Multiple environmental factors including hormones, dietary factors, infections and exposure to tobacco smoke as well as gene-environment interactions have been associated with increased risk for rheumatoid arthritis (RA). Importantly, the growing understanding of the prolonged period prior to the first onset of symptoms of RA suggests that these environmental and genetic factors are likely acting to drive the development of RA-related autoimmunity long before the appearance of the first joint symptoms and clinical findings that are characteristic of RA. Herein we will review these factors and interactions, especially those that have been investigated in a prospective fashion prior to the symptomatic onset of RA. We will also discuss how these factors may be explored in future study to further the understanding of the pathogenesis of RA, and ultimately perhaps develop preventive measures for this disease. PMID:22819092

Risk factors for leptospirosis infection in humans and implications for public health intervention in Indonesia and the Asia-Pacific region.

PubMed

Sakundarno, Mateus; Bertolatti, Dean; Maycock, Bruce; Spickett, Jeffery; Dhaliwal, Satvinder

2014-01-01

Prevention and control of leptospirosis require an understanding of risk factors. This review identifies risk factors associated with leptospirosis infection from countries in the Asia-Pacific region, and compares and contrasts these data with those available from Indonesia. MEDLINE, PubMed, and Scopus databases were used to search for relevant articles. Indonesian gray literature was searched for leptospirosis risk factor studies in Indonesia. A total of 34 articles were included in this review. The contrast between peer-reviewed publications and Indonesian gray literature revealed that the variety of risk factors associated with leptospirosis infection is region or area specific. The presence of skin wounds, the existence of rodents, especially rats, and activities related to contact with contaminated surface water are factors frequently reported to have significant association with leptospirosis infection in human in Indonesia and in other Asia-Pacific countries.

Can Rheumatoid Arthritis Be Prevented?

PubMed Central

Deane, Kevin

2013-01-01

The discovery of elevations of rheumatoid arthritis (RA)-related biomarkers prior to the onset of clinically apparent RA raises hopes that individuals who are at risk for future RA can be identified in a preclinical phase of disease that is defined as abnormalities of RA-related immune activity prior to the clinically apparent onset of joint disease. Additionally, there is a growing understanding of the immunologic processes that are occurring in preclinical RA, as well as a growing understanding of risk factors that may be mechanistically related to RA development. Furthermore, there are data supporting that treatment of early RA can lead to drug free remission. Taken as a whole, these findings suggest that it may be possible to use biomarkers and other factors to accurately identify the likelihood and timing of onset of future RA, and intervene with immunomodulatory therapies and/or risk factor modification to prevent the future onset of RA in at-risk individuals. Importantly, several clinical prevention trials for RA have already been tried, and one is underway. However, while our understanding of the growing understanding of the mechanisms and natural history of RA development may be leading us to the implementation of prevention strategies for RA, there are still several challenges to be met. These include developing sufficiently accurate methods of predicting those at high risk for future RA so that clinical trials can be developed based on accurate rates of development of arthritis and subjects can be adequately informed of their risk for disease, identifying the appropriate interventions and biologic targets for optimal prevention, and addressing the psychosocial and economic aspects that are crucial to developing broadly applicable prevention measures for RA. These issues notwithstanding, prevention of RA may be within reach in the near future. PMID:24315049

Overview of critical risk factors in Power-Two-Wheeler safety.

PubMed

Vlahogianni, Eleni I; Yannis, George; Golias, John C

2012-11-01

Power-Two-Wheelers (PTWs) constitute a vulnerable class of road users with increased frequency and severity of accidents. The present paper focuses of the PTW accident risk factors and reviews existing literature with regard to the PTW drivers' interactions with the automobile drivers, as well as interactions with infrastructure elements and weather conditions. Several critical risk factors are revealed with different levels of influence to PTW accident likelihood and severity. A broad classification based on the magnitude and the need for further research for each risk factor is proposed. The paper concludes by discussing the importance of dealing with accident configurations, the data quality and availability, methods implemented to model risk and exposure and risk identification which are critical for a thorough understanding of the determinants of PTW safety. Copyright © 2012 Elsevier Ltd. All rights reserved.

Risk Factors for Progression of Chronic Kidney Disease

PubMed Central

Staples, Amy; Wong, Craig

2010-01-01

Purpose of Review Provides an overview of the identified risk factors for chronic kidney disease (CKD) progression emphasizing the pediatric population. Recent findings Over the past ten years, there have been significant changes to our understanding and study of pre-terminal kidney failure. Recent refinements in the measurement of glomerular filtration rate (GFR) and GFR estimating equations are important tools for identification and association of risk factors for CKD progression in children. In pediatric CKD, lower level of kidney function at presentation, higher levels of proteinuria, and hypertension are known markers for a more rapid decline in GFR. Anemia and other reported risk factors from the pre-genomic era have need for further study and validation. Genome-wide association studies have identified genetic loci which have provided novel genetic risk factors for CKD progression. Summary With cohort studies of children with CKD becoming mature, they have started to yield important refinements to the assessment of CKD progression. While many of the traditional risk factors for renal progression will certainly be assessed, such cohorts will be important for evaluating novel risk factors identified by genome-wide studies. PMID:20090523

Understanding Depression in Adolescents: A Dynamic Psychosocial Web of Risk and Protective Factors

ERIC Educational Resources Information Center

Kassis, Wassilis; Artz, Sibylle; White, Jennifer

2017-01-01

Background: Adolescent depression has been recognized as a complex problem that presents a global public health challenge. Left undetected and untreated, depression can significantly reduce quality of life. Objective: The main purpose of this paper is to re-visit risk and protective factors for depression in adolescents with a specific focus on…

Parent/Student Risk and Protective Factors in Understanding Early Adolescent's Body Mass Index

ERIC Educational Resources Information Center

Fitzpatrick, Kevin M.; Willis, Don

2016-01-01

This article's aim is to examine correlates of middle school students' body mass index (BMI). Little research simultaneously has considered both child and parent correlates in predicting child's BMI; we examine the interrelationships between middle school students and their parent's risks and protective factors and their impact on the child's BMI.…

Polishing the prism: improving wildfire mitigation planning by coupling landscape and social dimensions

Treesearch

Geoffrey Koch; Alan Ager; Jeff Kline; Paige Fischer

2016-01-01

Effectively addressing wildfire risk to communities on large multi-owner landscapes requires an understanding of the biophysical factors that influence risk, such as fuel loads, topography, and weather, and social factors such as the capacity and willingness for communities to engage in fire-mitigation activities. Biophysical and social processes often are disconnected...

Where Lies the Risk? An Ecological Approach to Understanding Child Mental Health Risk and Vulnerabilities in Sub-Saharan Africa

PubMed Central

Atilola, Olayinka

2014-01-01

Efforts at improving child-health and development initiatives in sub-Saharan Africa had focused on the physical health of children due to the neglect of child and adolescent mental health (CAMH) policy initiatives. A thorough and broad-based understanding of the prevalent child mental-health risk and vulnerability factors is needed to successfully articulate CAMH policies. In this discourse, we present a narrative on the child mental-health risk and vulnerability factors in sub-Saharan Africa. Through an ecological point of view, we identified widespread family poverty, poor availability and uptake of childcare resources, inadequate community and institutional childcare systems, and inadequate framework for social protection for vulnerable children as among the risk and vulnerability factors for CAMH in the region. Others are poor workplace policy/practice that does not support work-family life balance, poor legislative framework for child protection, and some harmful traditional practices. We conclude that an ecological approach shows that child mental-health risks are diverse and cut across different layers of the care environment. The approach also provides a broad and holistic template from which appropriate CAMH policy direction in sub-Saharan Africa can be understood. PMID:24834431

Where lies the risk? An ecological approach to understanding child mental health risk and vulnerabilities in sub-saharan Africa.

PubMed

Atilola, Olayinka

2014-01-01

Efforts at improving child-health and development initiatives in sub-Saharan Africa had focused on the physical health of children due to the neglect of child and adolescent mental health (CAMH) policy initiatives. A thorough and broad-based understanding of the prevalent child mental-health risk and vulnerability factors is needed to successfully articulate CAMH policies. In this discourse, we present a narrative on the child mental-health risk and vulnerability factors in sub-Saharan Africa. Through an ecological point of view, we identified widespread family poverty, poor availability and uptake of childcare resources, inadequate community and institutional childcare systems, and inadequate framework for social protection for vulnerable children as among the risk and vulnerability factors for CAMH in the region. Others are poor workplace policy/practice that does not support work-family life balance, poor legislative framework for child protection, and some harmful traditional practices. We conclude that an ecological approach shows that child mental-health risks are diverse and cut across different layers of the care environment. The approach also provides a broad and holistic template from which appropriate CAMH policy direction in sub-Saharan Africa can be understood.

Association of Physical Inactivity, Weight, Smoking, and Prior Injury on Physical Performance in a Military Setting

PubMed Central

Teyhen, Deydre S.; Rhon, Daniel I.; Butler, Robert J.; Shaffer, Scott W.; Goffar, Stephen L.; McMillian, Danny J.; Boyles, Robert E.; Kiesel, Kyle B.; Plisky, Phillip J.

2016-01-01

Context: Although inactivity, being overweight, smoking, and a history of injury are identified as risk factors for poor health and injury, few authors have examined their association on physical performance. Young adults may be more likely to adopt healthier lifestyles if they understand the effect of health behaviors on performance. Objective: To determine the association of being overweight, smoking, inactivity, and a history of injury with physical performance. Design: Cross-sectional study. Setting: Military population. Patients or Other Participants: Active-duty service members (N = 1466; 1380 men, 86 women; age = 24.7 ± 5.0 years; body mass index = 26.7 ± 3.4 kg/m2). Main Outcome Measure(s): Participants performed 8 measures (the triple-crossover hop for distance, the 6-m timed-hop test, the Functional Movement Screen, the Lower Quarter Y-Balance Test, the Upper Quarter Y-Balance Test, and the 3-event Army Physical Fitness Test) for evaluation of endurance, strength, muscular endurance, power, agility, balance, and motor control. Participants were categorized based on the number of health risk factors present. Using an analysis of covariance, we assessed the relationship between risk factors and physical performance with age and sex as covariates. Results: Compared with those who had no risk factors (27.9% of men, 34.9% of women), physical performance was worse in those who had 1, 2, or 3 to 4 risk factors present by 4.3%, 6.7%, and 10.3%, respectively. Decrements in performance for those with 3 to 4 risk factors ranged from 3.3% to 14.4%. Conclusions: An unhealthy lifestyle habit or a history of injury was negatively associated with physical performance. Physical performance decrements were associated with the number of risk factors present. Understanding how risk factors contribute to decreased physical performance may enable clinicians to improve compliance with injury-prevention programs in occupational settings in which a young and relatively healthy workforce may be more concerned about performance than health. PMID:27690529

Association of Physical Inactivity, Weight, Smoking, and Prior Injury on Physical Performance in a Military Setting.

PubMed

Teyhen, Deydre S; Rhon, Daniel I; Butler, Robert J; Shaffer, Scott W; Goffar, Stephen L; McMillian, Danny J; Boyles, Robert E; Kiesel, Kyle B; Plisky, Phillip J

2016-11-01

 Although inactivity, being overweight, smoking, and a history of injury are identified as risk factors for poor health and injury, few authors have examined their association on physical performance. Young adults may be more likely to adopt healthier lifestyles if they understand the effect of health behaviors on performance.  To determine the association of being overweight, smoking, inactivity, and a history of injury with physical performance.  Cross-sectional study.  Military population.  Active-duty service members (N = 1466; 1380 men, 86 women; age = 24.7 ± 5.0 years; body mass index = 26.7 ± 3.4 kg/m 2 ).  Participants performed 8 measures (the triple-crossover hop for distance, the 6-m timed-hop test, the Functional Movement Screen, the Lower Quarter Y-Balance Test, the Upper Quarter Y-Balance Test, and the 3-event Army Physical Fitness Test) for evaluation of endurance, strength, muscular endurance, power, agility, balance, and motor control. Participants were categorized based on the number of health risk factors present. Using an analysis of covariance, we assessed the relationship between risk factors and physical performance with age and sex as covariates.  Compared with those who had no risk factors (27.9% of men, 34.9% of women), physical performance was worse in those who had 1, 2, or 3 to 4 risk factors present by 4.3%, 6.7%, and 10.3%, respectively. Decrements in performance for those with 3 to 4 risk factors ranged from 3.3% to 14.4%.  An unhealthy lifestyle habit or a history of injury was negatively associated with physical performance. Physical performance decrements were associated with the number of risk factors present. Understanding how risk factors contribute to decreased physical performance may enable clinicians to improve compliance with injury-prevention programs in occupational settings in which a young and relatively healthy workforce may be more concerned about performance than health.

Risk factors associated with high prevalence rates of hepatitis C infection in Egypt.

PubMed

Reker, Celeste; Islam, K M

2014-08-01

Egypt has the highest reported prevalence of hepatitis C virus (HCV) globally. Until now, no systematic review has been conducted to understand risk factors associated with these high prevalence rates of HCV. This study attempted to identify the various HCV risk factors in Egypt responsible for the high incidence and prevalence rates. Using systematic literature review methods, we searched databases for eligible manuscripts, selecting cohort and case-control studies published in English. Peer-reviewed papers published between 2008 and February 2013 were included. A total of 11 articles met the study selection criteria. The most examined risk factors found during our review analysis were surgery, transfusion, and age (64-82% of total articles; n = 11). Multiple risk factors held significant association with HCV infection in the included research. Based on this review, the main HCV risk factor categories are unsafe medical practices and familial risk factors. Improving medical safety and encouraging familial education on HCV may help reduce the incidence of the disease. Most risk factors for HCV transmission in Egypt are healthcare-associated. Primary prevention of HCV infection remains important to reduce HCV transmission. Further research should also focus on risk factor dynamics of HCV in Egypt to reduce transmission and HCV disease burden. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Understanding the pathogenesis of abdominal aortic aneurysms

PubMed Central

Kuivaniemi, Helena; Ryer, Evan J.; Elmore, James R.; Tromp, Gerard

2016-01-01

Summary An aortic aneurysm is a dilatation in which the aortic diameter is ≥ 3.0 cm. If left untreated, the aortic wall continues to weaken and becomes unable to withstand the forces of the luminal blood pressure resulting in progressive dilatation and rupture, a catastrophic event associated with a mortality of 50 – 80%. Smoking and positive family history are important risk factors for the development of abdominal aortic aneurysms (AAA). Several genetic risk factors have also been identified. On the histological level, visible hallmarks of AAA pathogenesis include inflammation, smooth muscle cell apoptosis, extracellular matrix degradation, and oxidative stress. We expect that large genetic, genomic, epigenetic, proteomic and metabolomic studies will be undertaken by international consortia to identify additional risk factors and biomarkers, and to enhance our understanding of the pathobiology of AAA. Collaboration between different research groups will be important in overcoming the challenges to develop pharmacological treatments for AAA. PMID:26308600

Early development of physical aggression and early risk factors for chronic physical aggression in humans.

PubMed

Tremblay, Richard E

2014-01-01

This chapter describes the state of knowledge on the development of physical aggression from early childhood to adulthood, the long term outcomes of chronic physical aggression during childhood and the risk factors for chronic physical aggression. Unraveling the development of physical aggression is important to understand when and why humans start using physical aggression, to understand why some humans suffer from chronic physical aggression and to understand how to prevent the development of this disorder which causes much distress to the aggressors and their victims. The study of the developmental origins of aggression also sheds light on the reasons why situational prevention of aggression is important at all ages and in all cultures.

Honey bee surveillance: a tool for understanding and improving honey bee health.

PubMed

Lee, Kathleen; Steinhauer, Nathalie; Travis, Dominic A; Meixner, Marina D; Deen, John; vanEngelsdorp, Dennis

2015-08-01

Honey bee surveillance systems are increasingly used to characterize honey bee health and disease burdens of bees in different regions and/or over time. In addition to quantifying disease prevalence, surveillance systems can identify risk factors associated with colony morbidity and mortality. Surveillance systems are often observational, and prove particularly useful when searching for risk factors in real world complex systems. We review recent examples of surveillance systems with particular emphasis on how these efforts have helped increase our understanding of honey bee health. Copyright © 2015 Elsevier Inc. All rights reserved.

Risk behaviours among early adolescents: risk and protective factors.

PubMed

Wang, Ruey-Hsia; Hsu, Hsiu-Yueh; Lin, Shu-Yuan; Cheng, Chung-Ping; Lee, Shu-Li

2010-02-01

This paper is a report of a study conducted to examine the influence of risk/protective factors on risk behaviours of early adolescents and whether protective factors moderate their impact. An understanding of how risk and protective factors operate to influence risk behaviours of early adolescents will better prepare nurses to perform interventions appropriately to reduce risk behaviours of early adolescents. A cross-sectional study was carried out, based on a sample of public junior high schools (from 7th to 9th grades) in one city and one county in Taiwan. An anonymous questionnaire designed to measure five risk factors, six protective factors and risk behaviours was administered from October 2006 to March 2007. Data from 878 students were used for the present analysis. Pearson's correlations, anova with random effect models, and generalized linear models were used to analyse the statistically significant explanatory variables for risk behaviours. Gender, perceived father's risk behaviour, perceived mother's risk behaviour, health self-efficacy, interaction of health self-efficacy and perceived peers' risk behaviour, and interaction of emotional regulation and perceived peers' risk behaviour were statistically significant explanatory variables of risk behaviours. Health self-efficacy and emotional regulation moderated the negative effects of peers' perceived risk behaviour on risk behaviours. All protective factors were negative statistically correlated with risk behaviours, and all risk factors positively statistically correlated with risk behaviours. Male adolescents should be considered an at-risk group for risk behaviour intervention. Nurses could provide early adolescents with training regarding health self-efficacy improvement, self-esteem enhancement, emotional regulation skills to reduce their risk behaviours.

TOXICOPROTEOMICS AND ITS APPLICATION TO HUMAN HEALTH RISK ASSESSMENT

EPA Science Inventory

Humans are exposed to a variety of environmental toxicants, and this together with a large number of interacting factors can contribute to an individual's risk for health. To understand the toxic mechanisms and/or modes of action for human health risk assessment, molecular charac...

Effect of Neurocognition and Concussion on Musculoskeletal Injury Risk

PubMed Central

Herman, Daniel C.; Zaremski, Jason L.; Vincent, Heather K.; Vincent, Kevin R.

2015-01-01

Research regarding musculoskeletal injury risk has focused primarily on anatomical, neuromuscular, hormonal, and environmental risk factors; however, subsequent injury risk screening and intervention programs have been largely limited to neuromuscular factors and have faced challenges in both implementation and efficacy. Recent studies indicate that poor neurocognitive performance, either at baseline or in the aftermath of a concussion, is associated with elevated risk of musculoskeletal injury. Despite the relatively limited current understanding regarding the nature of the relationship between different aspects of neurocognitive performance and musculoskeletal injury risk, this is a promising area of research that may yield significant advances in musculoskeletal injury risk stratification, rehabilitation, and prevention. PMID:25968852

Applicability of the Social Development Model to Urban Ethnic Minority Youth: Examining the Relationship between External Constraints, Family Socialization, and Problem Behaviors

PubMed Central

Choi, Yoonsun; Harachi, Tracy W.; Gillmore, Mary Rogers; Catalano, Richard F.

2011-01-01

The development of preventive interventions targeting adolescent problem behaviors requires a thorough understanding of risk and protective factors for such behaviors. However, few studies examine whether different cultural and ethnic groups share these factors. This study is an attempt to fill a gap in research by examining similarities and differences in risk factors across racial and ethnic groups. The social development model has shown promise in organizing predictors of problem behaviors. This article investigates whether a version of that model can be generalized to youth in different racial and ethnic groups (N = 2,055, age range from 11 to 15), including African American (n = 478), Asian Pacific Islander (API) American (n = 491), multiracial (n = 442), and European American (n = 644) youth. The results demonstrate that common risk factors can be applied to adolescents, regardless of their race and ethnicity. The findings also demonstrate that there are racial and ethnic differences in the magnitudes of relationships among factors that affect problem behaviors. Further study is warranted to develop a better understanding of these differential magnitudes. PMID:21625351

A Scalable Distribution Network Risk Evaluation Framework via Symbolic Dynamics

PubMed Central

Yuan, Kai; Liu, Jian; Liu, Kaipei; Tan, Tianyuan

2015-01-01

Background Evaluations of electric power distribution network risks must address the problems of incomplete information and changing dynamics. A risk evaluation framework should be adaptable to a specific situation and an evolving understanding of risk. Methods This study investigates the use of symbolic dynamics to abstract raw data. After introducing symbolic dynamics operators, Kolmogorov-Sinai entropy and Kullback-Leibler relative entropy are used to quantitatively evaluate relationships between risk sub-factors and main factors. For layered risk indicators, where the factors are categorized into four main factors – device, structure, load and special operation – a merging algorithm using operators to calculate the risk factors is discussed. Finally, an example from the Sanya Power Company is given to demonstrate the feasibility of the proposed method. Conclusion Distribution networks are exposed and can be affected by many things. The topology and the operating mode of a distribution network are dynamic, so the faults and their consequences are probabilistic. PMID:25789859

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…

Describing Older Adults' Awareness of Fall Risk Using Situation Awareness Research Techniques: A Pilot Study.

PubMed

Azzarello, Jo; Hall, Beth

2016-07-01

The purpose of the current study was to evaluate efficacy of techniques adapted from situation awareness research for describing how older adults perceive and understand fall risk factors in the context of daily routine. Eleven older adults watched a video of an older woman performing daily activities. Thirteen intrinsic, extrinsic, and behavioral fall risks were embedded throughout the scenario. The video was periodically frozen/blanked from view while participants answered questions about their understanding of the situation and associated story elements. Participants perceived a variety of fall risk factors but did not necessarily interpret them as indicating fall risk. Many fall risks held non-fall meaning for participants (e.g., newspapers on the floor meant the woman liked to read). Although four participants readily identified a fall risk situation, seven did not until they were explicitly asked to consider safety. Study techniques were effective for describing situation awareness of fall risk and several suggestions for improvement are described. [Res Gerontol Nurs. 2016; 9(4):161-166.]. Copyright 2016, SLACK Incorporated.

Environmental and lifestyle risk factors of gastric cancer.

PubMed

Lee, Yeong Yeh; Derakhshan, Mohammad H

2013-06-01

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

Surgical wound dehiscence: a conceptual framework for patient assessment.

PubMed

Sandy-Hodgetts, Kylie; Carville, Keryln; Leslie, Gavin D

2018-03-02

This paper presents a conceptual framework which outlines the risk factors associated with surgical wound dehiscence (SWD) as identified in the literature. The purpose for the development of the conceptual framework was to derive an evidence-based, informed understanding of factors associated with SWD, in order to inform a programme of research on the aetiology and potential risk factors of SWD. Incorporated within the patient-centric conceptual framework are patient related comorbidities, intraoperative and postoperative risk factors related to SWD. These are categorised as either 'mechanical' or 'physiological mechanisms' posited to influence these relationships. The use of the conceptual model for assessment of patients has particular clinical relevance for identification of risk and the management of patients in the pre-, intra- and postoperative period.

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.

Perception of Mattering and Suicide Ideation in the Australian Working Population: Evidence from a Cross-Sectional Survey.

PubMed

Milner, A; Page, K M; LaMontagne, A D

2016-07-01

Thoughts about suicide are a risk factor for suicide deaths and attempts and are associated with a range of mental health outcomes. While there is considerable knowledge about risk factors for suicide ideation, there is little known about protective factors. The current study sought to understand the role of perceived mattering to others as a protective factor for suicide in a working sample of Australians using a cross-sectional research design. Logistic regression analysis indicated that people with a higher perception that they mattered had lower odds of suicide ideation than those with lower reported mattering, after controlling for psychological distress, demographic and relationship variables. These results indicate the importance of further research and intervention studies on mattering as a lever for reducing suicidality. Understanding more about protective factors for suicide ideation is important as this may prevent future adverse mental health and behavioural outcomes.

What Interrupts Suicide Attempts in Men: A Qualitative Study

PubMed Central

Player, Michael J.; Proudfoot, Judy; Fogarty, Andrea; Whittle, Erin; Spurrier, Michael; Shand, Fiona; Christensen, Helen; Hadzi-Pavlovic, Dusan; Wilhelm, Kay

2015-01-01

Despite higher rates of suicide in men, there is a dearth of research examining the perspectives and experiences of males at risk of suicide, particularly in terms of understanding how interventions can be tailored to men’s specific needs. The current study aimed to examine factors assisting, complicating or inhibiting interventions for men at risk, as well as outlining the roles of family, friends and others in male suicide prevention. Thirty-five male suicide survivors completed one-to-one interviews, and forty-seven family and friends of male suicide survivors participated in eight focus groups. Thematic analysis revealed five major themes: (1) development of suicidal behaviours tends to follow a common path associated with specific types of risk factors (disrupted mood, unhelpful stoic beliefs and values, avoidant coping strategies, stressors), (2) men at risk of suicide tend to systematically misinterpret changes in their behaviour and thinking, (3) understanding mood and behavioural changes in men enables identification of opportunities to interrupt suicide progression, (4) distraction, provision of practical and emotional supports, along with professional intervention may effectively interrupt acute risk of harm, and (5) suicidal ideation may be reduced through provision of practical help to manage crises, and helping men to focus on obligations and their role within families. Findings suggest that interventions for men at risk of suicidal behaviours need to be tailored to specific risk indicators, developmental factors, care needs and individuals’ preferences. To our knowledge this is the first qualitative study to explore the experiences of both suicidal men and their family/friends after a suicide attempt, with the view to improve understanding of the processes which are effective in interrupting suicide and better inform interventions for men at risk. PMID:26090794

Studying work practices: a key factor in understanding accidents on the level triggered by a balance disturbance.

PubMed

Derosier, C; Leclercq, S; Rabardel, P; Langa, P

2008-12-01

Accidents on the level (AOL) rank second amongst the most numerous and serious occupational accidents with days lost in France and are a major health and safety problem in every sector of activity. The case study described in this paper was conducted at a metallurgical company with 300 employees. The aims of this work were dual: 1) to extend the general knowledge required for preventing these accidents; 2) to propose prevention measures to this company. Existing data on company occupational accidents were gathered and analysed to identify a work situation that appeared likely to cause AOL. This work situation was analysed in detail. Several risk factors were identified within this work situation, by way of interviews with 12 operators. These risk factors concerned various dimensions of the work situation, particularly its physical dimension (e.g. templates structure) and organisational dimension (e.g. parts availability). Interviews were conducted, focusing on risk factors perceived by operators and involving allo-confrontations based on accounts of four AOL occurring in this situation. Allo-confrontations were interviews confronting operators with a risk occupational situation that was accidental for one of their colleagues, the latter being absent from the interview. Results highlighted the fact that the work practices implemented are key factors in understanding these accidents. This study underlines the role of work practices in AOL causality and prevention. It also provides explanations associated with various work situation dimensions involving adoption of more or less safe work practices. AOL are serious and frequent in occupational situations. Injury claims analysis and interviews in an industrial company emphasise the specific characteristics of an occupational situation and of prevention actions forming the basis of an intervention. The need for a better understanding of factors affecting work practice is highlighted in relation to research.

Cardiometabolic Risks in Polycystic Ovary Syndrome: Non-Traditional Risk Factors and the Impact of Obesity.

PubMed

Chiu, Wei-Ling; Boyle, Jacqueline; Vincent, Amanda; Teede, Helena; Moran, Lisa J

2017-01-01

Polycystic ovary syndrome (PCOS) is a common and complex endocrinopathy with reproductive, metabolic, and psychological features and significantly increased cardiometabolic risks. PCOS is underpinned by inherent insulin resistance and hyperandrogenism. Obesity, more common in PCOS, plays an important role in the pathophysiology, exacerbating hyperinsulinaemia and hyperandrogenism, leading to recommended first-line lifestyle intervention. Significant traditional and non-traditional risk factors are implicated in PCOS in addition to obesity-exacerbated cardiometabolic risks and are explored in this review to promote the understanding of this common metabolic and reproductive condition. © 2016 S. Karger AG, Basel.

Chronic headache and potentially modifiable risk factors: screening and behavioral management of sleep disorders.

PubMed

Rains, Jeanetta C

2008-01-01

Sleep-related variables have been identified among risk factors for frequent and severe headache conditions. It has been postulated that migraine, chronic daily headache, and perhaps other forms of chronic headache are progressive disorders. Thus, sleep and other modifiable risk factors may be clinical targets for prevention of headache progression or chronification. The present paper is part of the special series of papers entitled "Chronification of Headache" describing the empirical evidence, future research directions, proposed mechanisms, and risk factors implicated in headache chronification as well as several papers addressing individual risk factors (ie, sleep disorders, medication overuse, psychiatric disorders, stress, obesity). Understanding the link between risk factors and headache may yield novel preventative and therapeutic approaches in the management of headache. The present paper in the special series reviews epidemiological research as a means of quantifying the relationship between chronic headache and sleep disorders (sleep-disordered breathing, insomnia, circadian rhythm disorders, parasomnias) discusses screening for early detection and treatment of more severe and prevalent sleep disorders, and discusses fundamental sleep regulation strategies aimed at headache prevention for at-risk individuals.

Applying the Common Sense Model to Understand Representations of Arsenic Contaminated Well Water

PubMed Central

Severtson, Dolores J.; Baumann, Linda C.; Brown, Roger L.

2015-01-01

Theory-based research is needed to understand how people respond to environmental health risk information. The common sense model of self-regulation and the mental models approach propose that information shapes individual’s personal understandings that influence their decisions and actions. We compare these frameworks and explain how the common sense model (CSM) was applied to describe and measure mental representations of arsenic contaminated well water. Educational information, key informant interviews, and environmental risk literature were used to develop survey items to measure dimensions of cognitive representations (identity, cause, timeline, consequences, control) and emotional representations. Surveys mailed to 1067 private well users with moderate and elevated arsenic levels yielded an 84% response rate (n=897). Exploratory and confirmatory factor analyses of data from the elevated arsenic group identified a factor structure that retained the CSM representational structure and was consistent across moderate and elevated arsenic groups. The CSM has utility for describing and measuring representations of environmental health risks thus supporting its application to environmental health risk communication research. PMID:18726811

National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: Consensus Recommendations for Subsequent Neoplasms

PubMed Central

Morton, Lindsay M.; Saber, Wael; Baker, K. Scott; Barrett, A. John; Bhatia, Smita; Engels, Eric A.; Gadalla, Shahinaz M.; Kleiner, David E.; Pavletic, Steven; Burns, Linda J.

2016-01-01

Subsequent neoplasms (SN) following hematopoietic cell transplantation (HCT) cause significant patient morbidity and mortality. Risks for specific SN types vary substantially, with particularly elevated risks for post-transplant lymphoproliferative disorders, myelodysplastic syndrome/acute myeloid leukemia, and squamous cell malignancies. This consensus document provides an overview of the current state of knowledge regarding SN after HCT and recommends priorities and approaches to overcome challenges and gaps in understanding. Numerous factors have been suggested to impact risk, including patient-related (e.g., age), primary disease-related (e.g., disease type, pre-HCT therapies), and HCT-related characteristics (e.g., type and intensity of conditioning regimen, stem cell source, development of graft-versus-host disease). However, gaps in understanding remain for each of these risk factors, particularly for patients receiving HCT in the current era due to substantial advances in clinical transplantation practices. Additionally, the influence of non-transplant-related risk factors (e.g., germline genetic susceptibility, oncogenic viruses, lifestyle factors) is poorly understood. Clarification of the magnitude of SN risks and identification of etiologic factors will require large-scale, long-term, systematic follow-up of HCT survivors with detailed clinical data. Most investigations of the mechanisms of SN pathogenesis after HCT have focused on immune drivers. Expansion of our understanding in this area will require interdisciplinary laboratory collaborations utilizing measures of immune function and availability of archival tissue from SN diagnoses. Consensus-based recommendations for optimal preventative, screening, and therapeutic approaches have been developed for certain SN after HCT, whereas for other SN, general population guidelines are recommended. Further evidence is needed to specifically tailor preventative, screening, and therapeutic guidelines for SN after HCT, particularly for unique patient populations. Accomplishment of this broad research agenda will require increased investment in systematic data collection with engagement from patients, clinicians, and interdisciplinary scientists in order to reduce the burden of SN in the rapidly growing population of HCT survivors. PMID:27634019

'I should have taken that further' - missed opportunities during cardiovascular risk assessment in patients with psoriasis in UK primary care settings: a mixed-methods study.

PubMed

Nelson, Pauline A; Kane, Karen; Chisholm, Anna; Pearce, Christina J; Keyworth, Christopher; Rutter, Martin K; Chew-Graham, Carolyn A; Griffiths, Christopher E M; Cordingley, Lis

2016-10-01

Unhealthy lifestyle is common in psoriasis, contributing to worsening disease and increased cardiovascular disease (CVD) risk. CVD risk communication should improve patients' understanding of risk and risk-reducing behaviours; however, the effectiveness of risk screening is debated and evaluation currently limited. To examine the process of assessing for and communicating about CVD risk in the context of psoriasis. Mixed-methods study in English general practices to (i) determine proportions of CVD risk factors among patients with psoriasis at risk assessment and (ii) examine patient and practitioner experiences of risk communication to identify salient 'process' issues. Audio recordings of consultations informed in-depth interviews with patients and practitioners using tape-assisted recall, analysed with framework analysis. Patients with psoriasis (n = 287) undergoing CVD risk assessment; 29 patients and 12 practitioners interviewed. A high proportion of patients had risk factor levels apparent at risk assessment above NICE recommendations: very high waist circumference (52%), obesity (35%), raised blood pressure (29%), smoking (18%) and excess alcohol consumption (18%). There was little evidence of personalized discussion about CVD risk and behaviour change support in consultations. Professionals reported a lack of training in behaviour change, while patients wanted to discuss CVD risk/risk reduction and believed practitioners to be influential in supporting lifestyle management. Despite high levels of risk factors identified, opportunities may be missed in consultations to support patients with psoriasis to understand CVD risk/risk reduction. Practitioners need training in behaviour change techniques to capitalize on 'teachable moments' and increase the effectiveness of risk screening. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Individual-Level Risk Factors for Gun Victimization in a Sample of Probationers

ERIC Educational Resources Information Center

Wells, William; Chermak, Steven

2011-01-01

Interventions aimed at preventing the important problem of gun injuries could be improved with an understanding of whether there are unique factors that place individuals at an increased risk of gun victimization. Much remains to be known about the victims of gun violence. The purpose of this article is to assess whether there are individual-level…

Heroic DVD Portrayals: What US and Taiwanese Adolescents Admire and Understand

ERIC Educational Resources Information Center

Calvert, S.L.; Murray, K.J.; Conger, E.E.

2004-01-01

Viewing media aggression can be a risk factor for the long-term well being of viewers, and heroes have been targeted as a major risk factor in this relationship because they commit justified acts of aggression. However, little is known about the specific aspects of heroic conduct that viewers find worthy of emulation. We examined US and Taiwanese…

Windstorm damage in Boundary Waters Canoe Area Wilderness (Minnesota, USA): Evaluating landscape-level risk factors

Treesearch

W. Keith Moser; Mark D. Nelson

2009-01-01

Ecosystem management requires an understanding of disturbance processes and their influence on forests. One of these disturbances is damage due to severe wind events. In an ideal model, assessing risk of windstorm damage to a forested ecosystem entails defining tree-, stand-, and landscape-level factors that influence response and recovery. Data are not always...

Significant factors of aviation insurance and risk management strategy: an empirical study of Taiwanese airline carriers.

PubMed

Lin, Yi Hsin; Chang, Yu Hern

2008-04-01

Aviation insurance premiums have become a heavy burden for the airline industry since September 11, 2001. Although the industry must constantly balance its operations between profitability and safety, the reality is that airlines are in the business of making money. Therefore, their ability to reduce cost and manage risk is a key factor for success. Unlike past research, which used subjective judgment methods, this study applied quantitative historical data (1999-2000) and gray relation analysis to identify the primary factors influencing ratemaking for aviation insurance premiums. An empirical study of six airlines in Taiwan was conducted to determine these factors and to analyze the management strategies used to deal with them. Results showed that the loss experience and performance of individual airlines were the key elements associated with aviation insurance premiums paid by each airline. By identifying and understanding the primary factors influencing ratemaking for aviation insurance, airlines will better understand their relative operational strengths and weaknesses, and further help top management identify areas for further improvement. Knowledge of these factors combined with effective risk management strategies, may result in lower premiums and operating costs for airline companies.

Gene-Environment Interactions in Cardiovascular Disease

PubMed Central

Flowers, Elena; Froelicher, Erika Sivarajan; Aouizerat, Bradley E.

2011-01-01

Background Historically, models to describe disease were exclusively nature-based or nurture-based. Current theoretical models for complex conditions such as cardiovascular disease acknowledge the importance of both biologic and non-biologic contributors to disease. A critical feature is the occurrence of interactions between numerous risk factors for disease. The interaction between genetic (i.e. biologic, nature) and environmental (i.e. non-biologic, nurture) causes of disease is an important mechanism for understanding both the etiology and public health impact of cardiovascular disease. Objectives The purpose of this paper is to describe theoretical underpinnings of gene-environment interactions, models of interaction, methods for studying gene-environment interactions, and the related concept of interactions between epigenetic mechanisms and the environment. Discussion Advances in methods for measurement of genetic predictors of disease have enabled an increasingly comprehensive understanding of the causes of disease. In order to fully describe the effects of genetic predictors of disease, it is necessary to place genetic predictors within the context of known environmental risk factors. The additive or multiplicative effect of the interaction between genetic and environmental risk factors is often greater than the contribution of either risk factor alone. PMID:21684212

Traditional risk factors as the underlying cause of racial disparities in stroke: lessons from the half-full (empty?) glass.

PubMed

Howard, George; Cushman, Mary; Kissela, Brett M; Kleindorfer, Dawn O; McClure, Leslie A; Safford, Monika M; Rhodes, J David; Soliman, Elsayed Z; Moy, Claudia S; Judd, Suzanne E; Howard, Virginia J

2011-12-01

Black/white disparities in stroke incidence are well documented, but few studies have assessed the contributions to the disparity. Here we assess the contribution of "traditional" risk factors. A total of 25 714 black and white men and women, aged≥45 years and stroke-free at baseline, were followed for an average of 4.4 years to detect stroke. Mediation analysis using proportional hazards analysis assessed the contribution of traditional risk factors to racial disparities. At age 45 years, incident stroke risk was 2.90 (95% CI: 1.72-4.89) times more likely in blacks than in whites and 1.66 (95% CI: 1.34-2.07) times at age 65 years. Adjustment for risk factors attenuated these excesses by 40% and 45%, respectively, resulting in relative risks of 2.14 (95% CI: 1.25-3.67) and 1.35 (95% CI: 1.08-1.71). Approximately one half of this mediation is attributable to systolic blood pressure. Further adjustment for socioeconomic factors resulted in total mediation of 47% and 53% to relative risks of 2.01 (95% CI: 1.16-3.47) and 1.30 (1.03-1.65), respectively. Between ages 45 to 65 years, approximately half of the racial disparity in stroke risk is attributable to traditional risk factors (primarily systolic blood pressure) and socioeconomic factors, suggesting a critical need to understand the disparity in the development of these traditional risk factors. Because half of the excess stroke risk in blacks is not attributable to traditional risk factors and socioeconomic factors, differential impact of risk factors, residual confounding, or nontraditional risk factors may also play a role.

Traditional risk factors as the underlying cause of racial disparities in stroke: lessons from the half full (empty?) glass

PubMed Central

Howard, George; Cushman, Mary; Kissela, Brett M.; Kleindorfer, Dawn O.; McClure, Leslie A.; Safford, Monika M.; Rhodes, J. David; Soliman, Elsayed Z.; Moy, Claudia S.; Judd, Suzanne E.; Howard, Virginia J.

2011-01-01

Background and Purpose Black/white disparities in stroke incidence are well-documented, but few studies have assessed the contributions to the disparity. Here we assess the contribution of “traditional” risk factors. Methods 25,714 black and white men and women, aged 45+ and stroke-free at baseline were followed for an average of 4.4 years to detect stroke. Mediation analysis employing proportional hazards analysis assessed the contribution of “traditional” risk factors to racial disparities. Results At age 45, incident stroke risk was 2.90 (95% CI: 1.72 – 4.89) times more likely in blacks than whites, and 1.66 (95% CI: 1.34 – 2.07) times at age 65. Adjustment for risk factors attenuated these excesses by 40% and 45%, respectively, resulting in relative risks of 2.14 (95% CI: 1.25 – 3.67) and 1.35 (95% CI: 1.08 – 1.71). Approximately one-half of this mediation is attributable to systolic blood pressure. Further adjustment for socioeconomic factors resulted in total mediation of 47% and 53% to relative risks of 2.01 (95% CI: 1.16 – 3.47) and 1.30 (1.03 – 1.65) respectively. Conclusions Between ages 45 to 65 years, approximately half of the racial disparity in stroke risk is attributable to traditional risk factors (primarily systolic blood pressure) and socioeconomic factors, suggesting a critical need to understand the disparity in the development of these traditional risk factors. Because half of the excess stroke risk in blacks is not attributable to traditional risk factors and socioeconomic factors, differential racial susceptibility to risk factors, residual confounding or non-traditional risk factors may also play a role. PMID:21960581

Environmental Risk Factors and Type 1 Diabetes: Past, Present, and Future.

PubMed

Butalia, Sonia; Kaplan, Gilaad G; Khokhar, Bushra; Rabi, Doreen M

2016-12-01

Type 1 diabetes is an autoimmune condition that results from the destruction of the insulin-producing beta cells of the pancreas. The excess morbidity and mortality resulting from its complications, coupled with its increasing incidence, emphasize the importance of better understanding the causes of this condition. Over the past several decades, a substantive amount of work has been done and, although many advances have occurred in identifying disease-susceptibility genes, there has been a lag in understanding the environmental triggers. Several putative environmental risk factors have been proposed, including infections, dietary factors, air pollution, vaccines, location of residence, family environment and stress. However, most of these factors have been inconclusive, thus supporting the need for further study into the causes of type 1 diabetes. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Risk factors associated with rural water supply failure: A 30-year retrospective study of handpumps on the south coast of Kenya.

PubMed

Foster, Tim; Willetts, Juliet; Lane, Mike; Thomson, Patrick; Katuva, Jacob; Hope, Rob

2018-06-01

An improved understanding of failure risks for water supplies in rural sub-Saharan Africa will be critical to achieving the global goal of safe water for all by 2030. In the absence of longitudinal biophysical and operational data, investigations into water point failure risk factors have to date been limited to cross-sectional research designs. This retrospective cohort study applies survival analysis to identify factors that predict failure risks for handpumps installed on boreholes along the south coast of Kenya from the 1980s. The analysis is based on a unique dataset linking attributes of >300 water points at the time of installation with their operational lifespan over the following decades. Cox proportional hazards and accelerated failure time models suggest water point failure risks are higher and lifespans are shorter when water supplied is more saline, static water level is deeper, and groundwater is pumped from an unconsolidated sand aquifer. The risk of failure also appears to grow as distance to spare part suppliers increases. To bolster the sustainability of rural water services and ensure no community is left behind, post-construction support mechanisms will need to mitigate heterogeneous environmental and geographical challenges. Further studies are needed to better understand the causal pathways that underlie these risk factors in order to inform policies and practices that ensure water services are sustained even where unfavourable conditions prevail. Copyright © 2018 Elsevier B.V. All rights reserved.

Preliminary plan for case-control crash risk study

DOT National Transportation Integrated Search

2002-01-31

The goal of the Federal Motor Carrier Safety Administration (FMCSA) is to reduce commercial vehicle-related fatalities and injuries. This is achieved through a thorough understanding of crash characteristics, precursors, and risk factors. This will h...

Development and Psychometric Assessment of the Measure of Globalization Influence on Health Risk (MGIHR) Among Mexican Women with Breast Cancer.

PubMed

Nodora, Jesse N; Carvajal, Scott C; Robles-Garcia, Rebeca; Agraz, Francisco Páez; Daneri-Navarro, Adrian; Meza-Montenegro, Maria Mercedes; Gutierrez-Millan, Luis Enrique; Martinez, Maria Elena

2015-08-01

Lacking in the literature are data addressing the extent to which changes in reproductive and lifestyle factors predispose women in developing nations to higher breast cancer rates, and the degree to which these are due to globalization influences. This article describes the development and psychometric assessment of an instrument intended to measure global, predominantly U.S., influences on breast cancer risk profile among women residing in Mexico. Using investigator consensus and a focus group methodology, the Measure of Globalization Influence on Health Risk (MGIHR) was developed and completed by 341 women. Psychometric analysis support the use of an 11-item Consumerism and Modernity scale and 7-item Reproductive Control and Gender Role scale. The MGIHR is a valid and reliable instrument for understanding changing lifestyle and reproductive factors for breast cancer risk and may provide a more complete understanding of breast cancer development and needed interventions.

Updates on the risk markers and outcomes of severe juvenile idiopathic arthritis-associated uveitis

PubMed Central

Angeles-Han, Sheila T; Yeh, Steven; Vogler, Larry B

2013-01-01

Uveitis is the most common extra-articular manifestation of juvenile idiopathic arthritis, which is the most common systemic cause of uveitis in children. Known risk factors for uveitis include antinuclear antibody seropositivity, young age of arthritis onset, specific juvenile idiopathic arthritis subtype and short duration of disease. Risk markers for severe ocular disease include gender, age and complications at initial visit. Due to the risk for vision-compromising sequelae such as cataracts, band keratopathy, glaucoma, vision loss and blindness, an understanding of the risk factors for uveitis development and severe ocular disease is crucial to help prevent serious visual disability and complications. This paper reviews the pathogenesis of uveitis, known risk factors for uveitis development and severe visual outcome, and addresses the need for additional biomarkers of uveitis risk, prognosis and remission. PMID:24187594

What does wildfire risk mean to the public?

Treesearch

Sarah McCaffrey

2006-01-01

Public risk perception that managers may see as inappropriately low may not necessarily be a result of poor understanding but instead may be a result of self-selection and of mental balancing of benefits and risk. This study highlights the complexity of factors considered when members of the public assess wildfire risk including environmental preconditions, ignition...

Injury Prevention in Youth Sports.

PubMed

Stracciolini, Andrea; Sugimoto, Dai; Howell, David R

2017-03-01

Children and adolescents are now participating in competitive sports at younger ages and with increasing intensity. As a result, increasing numbers of young athletes are presenting to pediatricians for care of sports-related injuries and advice about prevention. Understanding and identifying modifiable risk factors for injury in the young athletic population is a critical first step in injury prevention. Risk factors vary by sport, age, and sex. This article reviews the most common risk factors for injury and the evidence to support proposed strategies for prevention. [Pediatr Ann. 2017;46(3):e99-e105.]. Copyright 2017, SLACK Incorporated.

Personal Risk and Resilience Factors in the Context of Daily Stress

PubMed Central

Diehl, Manfred; Hay, Elizabeth L.; Chui, Helena

2012-01-01

This chapter focuses on the role that personal risk and resilience factors play as adults of all ages cope with the stressors encountered in everyday life. Theorists have suggested that researchers should focus on the effects of daily stress and coping rather than focusing exclusively on major life events and chronic stress and have proposed that understanding how adults cope with daily stress is a key aspect of understanding long-term well-being and adaptation in adulthood. After presenting a conceptual model outlining the major components of the daily stress process, the chapter reviews the existing empirical literature on personal risk and resilience factors in the context of daily stress. This research clearly suggests that there is no universal generalization that can be made regarding whether chronological age, in and of itself, confers greater vulnerability or resilience onto adults. Instead, we argue that researchers should ask when and under what conditions is age associated with greater vulnerability to daily stress and when and under what conditions is age associated with greater resilience to daily stress. Age differences in reactivity to daily stress are clearly embedded within a complex system of factors—structural, individual, and situational—that influence stress reactivity and stress recovery in several ways. This complexity should not be taken to mean that stress reactivity and recovery cannot be charted or understood. Researchers, however, will need to approach this complexity with a great deal of theoretical, methodological, and statistical rigor to move our understanding of the importance of age in shaping risk and resilience to daily stress forward. The final section of the chapter outlines several directions for future research in the area of aging and resilience. In particular, we argue that a focus on personal risk and resilience factors in the context of daily stress, in combination with the application of sophisticated statistical methods (e.g., dynamic systems modeling), will contribute to a more dynamic and person-centered understanding of processes of resilience. PMID:23049156

Risk factors for obstetric anal sphincter injuries and postpartum anal and urinary incontinence: a case-control trial.

PubMed

Burrell, Madeline; Dilgir, Sapna; Patton, Vicki; Parkin, Katrina; Karantanis, Emmanuel

2015-03-01

Obstetric anal sphincter injuries (OASIS) cause serious maternal morbidity for mothers. A clearer understanding of aetiological factors is needed. We aimed to determine the risk factors for OASIS . Birth details of 222 primiparous women sustaining OASIS were compared with 174 women who did not sustain OASIS (controls) to determine the relevant risk factors. The data underwent univariate analysis and logistic regression analysis. Asian or Indian ethnicity, operative vaginal birth (p = 0.00), persistent occipito-posterior position (p = 0.038) and rapid uncontrolled delivery of the head were identified as risk factors for OASIS. Pushing time, use of epidural, episiotomy and head circumference were not predictors of OASIS. Women with Asian or Indian ethnicity, operative vaginal birth, persistent occipito-posterior position and rapid uncontrolled delivery of the fetal head were likely to sustain OASIS. Awareness of these factors may help to minimise the incidence of OASIS.

Understanding and Effectively Addressing Breast Cancer in African American Women: Unpacking the Social Context

PubMed Central

Williams, David R.; Mohammed, Selina A.; Shields, Alexandra E.

2017-01-01

Black women have higher incidence of breast cancer before the age of 40, more severe disease at all ages, and elevated mortality risk compared to white women. There is limited understanding of the contribution of social factors to these patterns. Elucidating the role of the social determinants of health in breast cancer disparities requires greater attention to how risk factors for breast cancer unfold over the lifecourse, and the complex ways that socioeconomic status and racism shape exposure to psychosocial, physical, chemical and other individual and community-level assaults that increase the risk of breast cancer. Research that takes seriously the social context in which Black women live is also needed to maximize the opportunities to prevent breast cancer among this underserved group. PMID:26930024

Use of mechanistic simulations as a quantitative risk-ranking tool within the quality by design framework.

PubMed

Stocker, Elena; Toschkoff, Gregor; Sacher, Stephan; Khinast, Johannes G

2014-11-20

The purpose of this study is to evaluate the use of computer simulations for generating quantitative knowledge as a basis for risk ranking and mechanistic process understanding, as required by ICH Q9 on quality risk management systems. In this specific publication, the main focus is the demonstration of a risk assessment workflow, including a computer simulation for the generation of mechanistic understanding of active tablet coating in a pan coater. Process parameter screening studies are statistically planned under consideration of impacts on a potentially critical quality attribute, i.e., coating mass uniformity. Based on computer simulation data the process failure mode and effects analysis of the risk factors is performed. This results in a quantitative criticality assessment of process parameters and the risk priority evaluation of failure modes. The factor for a quantitative reassessment of the criticality and risk priority is the coefficient of variation, which represents the coating mass uniformity. The major conclusion drawn from this work is a successful demonstration of the integration of computer simulation in the risk management workflow leading to an objective and quantitative risk assessment. Copyright © 2014. Published by Elsevier B.V.

Cardiovascular risk

PubMed Central

Payne, Rupert A

2012-01-01

Cardiovascular disease is a major, growing, worldwide problem. It is important that individuals at risk of developing cardiovascular disease can be effectively identified and appropriately stratified according to risk. This review examines what we understand by the term risk, traditional and novel risk factors, clinical scoring systems, and the use of risk for informing prescribing decisions. Many different cardiovascular risk factors have been identified. Established, traditional factors such as ageing are powerful predictors of adverse outcome, and in the case of hypertension and dyslipidaemia are the major targets for therapeutic intervention. Numerous novel biomarkers have also been described, such as inflammatory and genetic markers. These have yet to be shown to be of value in improving risk prediction, but may represent potential therapeutic targets and facilitate more targeted use of existing therapies. Risk factors have been incorporated into several cardiovascular disease prediction algorithms, such as the Framingham equation, SCORE and QRISK. These have relatively poor predictive power, and uncertainties remain with regards to aspects such as choice of equation, different risk thresholds and the roles of relative risk, lifetime risk and reversible factors in identifying and treating at-risk individuals. Nonetheless, such scores provide objective and transparent means of quantifying risk and their integration into therapeutic guidelines enables equitable and cost-effective distribution of health service resources and improves the consistency and quality of clinical decision making. PMID:22348281

Potential of Breastmilk Analysis to Inform Early Events in Breast Carcinogenesis: Rationale and Considerations

PubMed Central

Murphy, Jeanne; Sherman, Mark E.; Browne, Eva P.; Caballero, Ana I.; Punska, Elizabeth C.; Pfeiffer, Ruth M.; Yang, Hannah P.; Lee, Maxwell; Yang, Howard; Gierach, Gretchen L.; Arcaro, Kathleen F.

2016-01-01

This review summarizes methods related to the study of human breastmilk in etiologic and biomarkers research. Despite the importance of reproductive factors in breast carcinogenesis, factors that act early in life are difficult to study because young women rarely require breast imaging or biopsy, and analysis of critical circulating factors (e.g. hormones) is often complicated by the requirement to accurately account for menstrual cycle date. Accordingly, novel approaches are needed to understand how events such as pregnancy, breastfeeding, weaning, and post-weaning breast remodeling influence breast cancer risk. Analysis of breastmilk offers opportunities to understand mechanisms related to carcinogenesis in the breast, and to identify risk markers that may inform efforts to identify high-risk women early in the carcinogenic process. In addition, analysis of breastmilk could have value in early detection or diagnosis of breast cancer. In this article we describe the potential for using breastmilk to characterize the microenvironment of the lactating breast with the goal of advancing research on risk assessment, prevention, and detection of breast cancer. PMID:27107568

The Construct and Measurement of Perceived Risk of Nonremunerated Blood Donation: Evidence from the Chinese Public

PubMed Central

Chen, Liangyong

2015-01-01

The perceived risk of nonremunerated blood donation (NRBD) is one of the most important factors which hinder the Chinese public from donating blood. To understand deeply and measure scientifically the public's perceived risk of NRBD, in this paper the qualitative and quantitative methods were used to explore the construct of perceived risk of NRBD in Chinese context. Firstly, the preliminary construct of perceived risk of NRBD was developed based on the grounded theory. Then, a measurement scale of perceived risk of NRBD was designed. Finally, the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were adopted for testing and verifying the construct. The results show that the construct of perceived risk of NRBD has three core dimensions, namely, trust risk, psychological risk, and health risk, which provides a clear construct and concise scale to better capture the Chinese public's perceived risk of NRBD. Blood collection agencies can strategically make polices about perceived risk reduction to maximize the public's NRBD behavior. PMID:26526570

The Construct and Measurement of Perceived Risk of Nonremunerated Blood Donation: Evidence from the Chinese Public.

PubMed

Chen, Liangyong; Ma, Zujun

2015-01-01

The perceived risk of nonremunerated blood donation (NRBD) is one of the most important factors which hinder the Chinese public from donating blood. To understand deeply and measure scientifically the public's perceived risk of NRBD, in this paper the qualitative and quantitative methods were used to explore the construct of perceived risk of NRBD in Chinese context. Firstly, the preliminary construct of perceived risk of NRBD was developed based on the grounded theory. Then, a measurement scale of perceived risk of NRBD was designed. Finally, the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were adopted for testing and verifying the construct. The results show that the construct of perceived risk of NRBD has three core dimensions, namely, trust risk, psychological risk, and health risk, which provides a clear construct and concise scale to better capture the Chinese public's perceived risk of NRBD. Blood collection agencies can strategically make polices about perceived risk reduction to maximize the public's NRBD behavior.

The Seoul Metropolitan Lifestyle Intervention Program and Metabolic Syndrome Risk: A Retrospective Database Study

PubMed Central

Choo, Jina; Yoon, Seok-Jun; Ryu, Hosihn; Park, Mi-Suk; Lee, Hyang Sook; Park, Yoo Mi; Lim, Do-Sun

2016-01-01

Since 2011, the Seoul Metabolic Syndrome Management (SMESY) program has been employed as a community-wide, lifestyle modification intervention in Seoul, Korea. We aimed to determine if the SMESY intervention would be significantly associated with improvements in metabolic syndrome (MetS) risk factors. This retrospective database study included data from 25,449 participants aged 30–64 years between 1 January 2013 and 30 June 2013. In the SMESY program, 3 risk-stratified groups by the number of MetS factors were followed for 12 months with different intensity and timeframe of intervention. Among the high-(n = 7116) and moderate-risk groups (n = 14,762), all MetS factors (except triglycerides among the moderate-risk group) as well as MetS z-scores significantly improved over 12 months (all p < 0.05). Among the low-risk group (n = 3571), all factors aggravated significantly over 12 months (all p < 0.05). We observed temporal associations between the implementation of the SMESY program and improvements in MetS risk factors. However, such improvements differed by risk-stratified group, being most robust for the high-risk group, modest for the moderate-risk group, and aggravated for the low-risk group. Thus, more intensive interventions targeting different risk-stratified groups are needed, given a better understanding of the increase in risk factors observed in the low-risk group. PMID:27384576

Co-Occurring Psychosocial Problems and HIV Risk Among Women Attending Drinking Venues in a South African Township: A Syndemic Approach

PubMed Central

Pitpitan, Eileen V.; Kalichman, Seth C.; Eaton, Lisa A.; Cain, Demetria; Sikkema, Kathleen J.; Watt, Melissa H.; Skinner, Donald; Pieterse, Desiree

2012-01-01

Background In South Africa, women comprise the majority of HIV infections. Syndemics, or co-occurring epidemics and risk factors, have been applied to understanding HIV risk among marginalized groups. Purpose To apply the syndemic framework to examine psychosocial problems that co-occur among women attending drinking venues in South Africa, and to test how the co-occurrence of these problems may exacerbate risk for HIV infection. Method 560 women from a Cape Town township provided data on multiple psychosocial problems, including food insufficiency, depression, abuse experiences, problem drinking, and sexual behaviors. Results Bivariate associations among the syndemic factors showed a high degree of co-occurrence and regression analyses showed an additive effect of psychosocial problems on HIV risk behaviors. Conclusions These results demonstrate the utility of a syndemic framework to understand co-occurring psychosocial problems among women in South Africa. HIV prevention interventions should consider the compounding effects of psychosocial problems among women. PMID:23054944

Contextual factors influencing HIV risk behavior in Central Asia

PubMed Central

Smolak, Alex

2010-01-01

Central Asia has experienced a rapid increase in HIV. HIV interventions and prevention programmes are needed that adequately appreciate and account for the ways that ongoing cultural, political, and economic changes in this region affect HIV risk reduction efforts. Drawing on relevant literature, this paper provides a contextual foundation to better understand the impact of context on HIV risk behaviour in the countries of Central Asia and to begin the conversation on the contextual factors of Islam and polygamy. PMID:20301020

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.

Iodinated contrast media and their adverse reactions.

PubMed

Singh, Jagdish; Daftary, Aditya

2008-06-01

Cross-use of technology between nuclear medicine and radiology technologists is expanding. The growth of PET/CT and the increasing use of intravenous contrast agents during these procedures bring the nuclear medicine technologist into direct contact with these agents and their associated complications. A basic understanding of the occurrence, risk factors, clinical features, and management of these procedures is of increasing importance to the nuclear medicine technologist. After reading this article, the technologist will be able to list the factors that increase the risk of contrast reactions; understand ways to minimize the occurrence of contrast reactions; and develop a plan to identify, treat, and manage the reactions effectively.

Understanding Aggressive Behavior Across the Life Span

PubMed Central

Liu, Jianghong; Lewis, Gary; Evans, Lois

2012-01-01

Aggressive behavior is the observable manifestation of aggression and is often associated with developmental transitions and a range of medical and psychiatric diagnoses across the lifespan. As healthcare professionals involved in the medical and psychosocial care of patients from birth through death, nurses frequently encounter—and may serve as—both victims and perpetrators of aggressive behavior in the workplace. While the nursing literature has continually reported research on prevention and treatment approaches, less emphasis has been given to understanding the etiology, including contextual precipitants of aggressive behavior. This paper provides a brief review of the biological, social, and environmental risk factors that purportedly give rise to aggressive behavior. Further, many researchers have focused specifically on aggressive behavior in adolescence and adulthood. Less attention has been given to understanding the etiology of such behavior in young children and older adults. This paper emphasizes the unique risk factors for aggressive behavior across the developmental spectrum, including childhood, adolescence, adulthood, and late life. Appreciation of the risk factors of aggressive behavior, and, in particular, how they relate to age-specific manifestations, can aid nurses in better design and implementation of prevention and treatment programs. PMID:22471771

Understanding the life experiences of Brazilian women after bariatric surgery: a qualitative study.

PubMed

Magdaleno, Ronis; Chaim, Elinton Adami; Turato, Egberto Ribeiro

2010-08-01

The increase in bariatric surgeries has called into question the aspects that contribute to or impair the results. Psychosocial factors directly influence the results of the surgery, but a lot of controversy exists in relation to the degree of influence of these factors. We propose a qualitative investigation to understand the significance of the surgery for women and how these factors influence the outcomes. This study is a clinical-qualitative method, through the semi-directed interview with open-ended questions in an intentional sample, closed by saturation, with seven women operated in a period of 1.5-3 years, following the definition of emergent categories and qualitative content analysis. The experience of acceptance and social reinsertion is a motivating factor to keep up the challenge of weight loss; social discrimination is a risk factor leading to losing the stimulus to continue the process; the recuperation of self-esteem and personal identity is a factor that improves the quality of life and psychopathological symptoms; disillusionment is an important risk factor, linked principally to the experiences of failure. We observe the necessity of qualitative studies that serve the health team in the handling of these patients, aiming for a greater understanding of their psychological dynamics and of the meanings that weight loss has for them.

UNDERSTANDING ECOSYSTEM RESPONSE TO OZONE STRESS

EPA Science Inventory

Ecological risk assessment of ozone impact requires consideration of many factors that, perhaps, are not of concern in human health risk assessment. The episodic nature of ozone exposure, functional complexity of species, and broad spatial and temporal scales characteristic of n...

Understanding Risky Behavior: The Influence of Cognitive, Emotional and Hormonal Factors on Decision-Making under Risk.

PubMed

Kusev, Petko; Purser, Harry; Heilman, Renata; Cooke, Alex J; Van Schaik, Paul; Baranova, Victoria; Martin, Rose; Ayton, Peter

2017-01-01

Financial risky decisions and evaluations pervade many human everyday activities. Scientific research in such decision-making typically explores the influence of socio-economic and cognitive factors on financial behavior. However, very little research has explored the holistic influence of contextual, emotional, and hormonal factors on preferences for risk in insurance and investment behaviors. Accordingly, the goal of this review article is to address the complexity of individual risky behavior and its underlying psychological factors, as well as to critically examine current regulations on financial behavior.

Are shame and self-esteem risk factors in prolonged grief after death of a spouse?

PubMed

Dellmann, Thomas

2018-07-01

Although many single factors of prolonged grief have been identified in the literature, a comprehensive understanding of predictors is still lacking. This article argues that shame and low self-esteem, present risk factors in prolonged grief after spousal loss, based on a review of correlational studies. Using a practitioner-scientist approach, a developmental model of shame as a core factor in prolonged grief is proposed, outlining the progression from childhood relational trauma, to insecure attachment, shame, self-esteem contingent on spousal approval to eventual prolonged grief.

Understanding Risky Behavior: The Influence of Cognitive, Emotional and Hormonal Factors on Decision-Making under Risk

PubMed Central

Kusev, Petko; Purser, Harry; Heilman, Renata; Cooke, Alex J.; Van Schaik, Paul; Baranova, Victoria; Martin, Rose; Ayton, Peter

2017-01-01

Financial risky decisions and evaluations pervade many human everyday activities. Scientific research in such decision-making typically explores the influence of socio-economic and cognitive factors on financial behavior. However, very little research has explored the holistic influence of contextual, emotional, and hormonal factors on preferences for risk in insurance and investment behaviors. Accordingly, the goal of this review article is to address the complexity of individual risky behavior and its underlying psychological factors, as well as to critically examine current regulations on financial behavior. PMID:28203215

Risk evaluations and condom use decisions of homeless youth: a multi-level qualitative investigation.

PubMed

Kennedy, David P; Brown, Ryan A; Morrison, Penelope; Vie, Loryana; Ryan, Gery W; Tucker, Joan S

2015-01-31

Homeless youth are at higher risk for sexually transmitted infections and unwanted pregnancy than non-homeless youth. However, little is known about how they evaluate risk within the context of their sexual relationships. It is important to understand homeless youths' condom use decisions in light of their sexual relationships because condom use decisions are influenced by relationship dynamics in addition to individual attitudes and event circumstances. It is also important to understand how relationship level factors, sexual event circumstances, and individual characteristics compare and intersect. To explore these issues, we conducted semi-structured interviews with 37 homeless youth in Los Angeles County in 2011 concerning their recent sexual relationships and analyzed the data using systematic methods of team-based qualitative data analysis. We identified themes of risk-related evaluations and decisions at the relationship/partner, event, and individual level. We also identified three different risk profiles that emerged from analyzing how different levels of risk intersected across individual respondents. The three profiles included 1) Risk Takers, who consistently engage in risk and have low concern about consequences of risk behavior, 2) Risk Avoiders, who consistently show high concern about protection and consistently avoid risk, and 3) Risk Reactors, those who are inconsistent in their concerns about risk and protection and mainly take risks in reaction to relationship and event circumstances. Interventions targeting homeless youth should reflect multiple levels of risk behavior and evaluation in order to address the diversity of risk profiles. Relationship/partner-, event-, and individual-level factors are all important but have different levels of importance for different homeless youth. Interventions should be tailored to address the most important factor contributing to homeless youth reproductive needs.

Environmental Exposures and the Development of Systemic Lupus Erythematosus

PubMed Central

Barbhaiya, Medha; Costenbader, Karen H.

2016-01-01

Purpose of Review This review examines evidence relating environmental factors to the development of systemic lupus erythematosus (SLE). Recent findings The strongest epidemiologic evidence exists for the associations of silica, cigarette smoking, oral contraceptives, postmenopausal hormone therapy, and endometriosis, with SLE incidence. Recent studies have also provided robust evidence of the association between alcohol consumption and decreased SLE risk. There are preliminary, conflicting or unsubstantiated data that other factors, including air pollution, ultraviolet light, infections, vaccinations, solvents, pesticides, and heavy metals such as mercury, are related to SLE risk. Biologic mechanisms linking environmental exposures and SLE risk include increased oxidative stress, systemic inflammation and inflammatory cytokine upregulation, and hormonal triggers, as well as epigenetic modifications resulting from exposure that could lead to SLE. Summary Identifying the environmental risk factors related to risk of SLE is essential as it will lead to increased understanding of pathogenesis of this complex disease and will also make risk factor modification possible for those at increased risk. PMID:27428889

Eating disorders: Insights from imaging and behavioral approaches to treatment.

PubMed

Stice, Eric; Shaw, Heather

2017-11-01

Understanding factors that contribute to eating disorders, which affect 13% of females, is critical to developing effective prevention and treatment programs. In this paper, we summarize results from prospective studies that identified factors predicting onset and persistence of eating disorders and core symptom dimensions. Next, implications for intervention targets for prevention, and treatment interventions from the risk- and maintenance-factor findings are discussed. Third, given that evidence suggests eating disorders are highly heritable, implying biological risk and maintenance factors for eating disorders, we offer working hypotheses about biological factors that might contribute to eating disorders, based on extant risk factor findings, theory, and cross-sectional studies. Finally, potentially fruitful directions for future research are presented. We suggest that it would be useful for experimental therapeutics trials to evaluate the effects of reducing the risk factors on future onset of eating pathology and on reducing maintenance factors on the risk for persistence of eating pathology, and encourage researchers to utilize prospective high-risk studies so that knowledge regarding potential intervention targets for prevention and treatment interventions for eating disorders can be advanced. Using the most rigorous research designs should help improve the efficacy of prevention and treatment interventions for eating disorders.

Using agent-based modeling to study multiple risk factors and multiple health outcomes at multiple levels.

PubMed

Yang, Yong

2017-11-01

Most health studies focus on one health outcome and examine the influence of one or multiple risk factors. However, in reality, various pathways, interactions, and associations exist not only between risk factors and health outcomes but also among the risk factors and among health outcomes. The advance of system science methods, Big Data, and accumulated knowledge allows us to examine how multiple risk factors influence multiple health outcomes at multiple levels (termed a 3M study). Using the study of neighborhood environment and health as an example, I elaborate on the significance of 3M studies. 3M studies may lead to a significantly deeper understanding of the dynamic interactions among risk factors and outcomes and could help us design better interventions that may be of particular relevance for upstream interventions. Agent-based modeling (ABM) is a promising method in the 3M study, although its potentials are far from being fully explored. Future challenges include the gap of epidemiologic knowledge and evidence, lack of empirical data sources, and the technical challenges of ABM. © 2017 New York Academy of Sciences.

Toxic-Metabolic Risk Factors in Pediatric Pancreatitis: Recommendations for Diagnosis, Management and Future Research

PubMed Central

Husain, Sohail Z.; Morinville, Veronique; Pohl, John; Abu-El-Haija, Maisam; Bellin, Melena D.; Freedman, Steve; Hegyi, Peter; Heyman, Melvin B; Himes, Ryan; Ooi, Chee Y.; Schwarzenberg, Sarah Jane; Usatin, Danielle; Uc, Aliye

2016-01-01

Objectives Pancreatitis in children can result from metabolic and toxic risk factors, but the evidence linking these factors is sparse. We review the evidence for association or causality of these risk factors in pancreatitis, discuss management strategies and their rationale. Methods We conducted a review of the pediatric pancreatitis literature with respect to the following risk factors: (a) hyperlipidemia, (b) hypercalcemia, (c) chronic renal failure, (d) smoking exposure, (e) alcohol, and (f) medications. Areas of additional research were identified. Results Hypertriglyceridemia of 1000 mg/dl or greater poses an absolute risk for pancreatitis; persistent elevations of calcium are predisposing. Further research is necessary to determine whether end stage renal disease leads to increased pancreatitis in children similar to adults. It is unknown whether cigarette smoking exposure, which clearly increases risk in adults, also increases risk in children. The role of alcohol in pediatric pancreatitis, whether direct or modifying, needs to be elucidated. The evidence supporting most cases of medication-induced pancreatitis is poor. Drug structure, improper handling of drug by host, and by-stander status may be implicated. Other pancreatitis risk factors must be sought in all cases. Conclusions The quality of evidence supporting causative role of various toxic and metabolic factors in pediatric pancreatitis is variable. Careful phenotyping is essential, including search for other etiologic risk factors. Directed therapy includes correction/ removal of any agent identified, and general supportive measures. Further research is necessary to improve our understanding of these pancreatitis risk factors in children. PMID:26594832

Toxic-metabolic Risk Factors in Pediatric Pancreatitis: Recommendations for Diagnosis, Management, and Future Research.

PubMed

Husain, Sohail Z; Morinville, Veronique; Pohl, John; Abu-El-Haija, Maisam; Bellin, Melena D; Freedman, Steve; Hegyi, Peter; Heyman, Melvin B; Himes, Ryan; Ooi, Chee Y; Schwarzenberg, Sarah J; Usatin, Danielle; Uc, Aliye

2016-04-01

Pancreatitis in children can result from metabolic and toxic risk factors, but the evidence linking these factors is sparse. We review the evidence for association or causality of these risk factors in pancreatitis, discuss management strategies, and their rationale. We conducted a review of the pediatric pancreatitis literature with respect to the following risk factors: hyperlipidemia, hypercalcemia, chronic renal failure, smoking exposure, alcohol, and medications. Areas of additional research were identified. Hypertriglyceridemia of 1000 mg/dL or greater poses an absolute risk for pancreatitis; persistent elevations of calcium are predisposing. Further research is necessary to determine whether end-stage renal disease leads to increased pancreatitis in children similar to adults. It is unknown whether cigarette smoking exposure, which clearly increases risk in adults, also increases risk in children. The role of alcohol in pediatric pancreatitis, whether direct or modifying, needs to be elucidated. The evidence supporting most cases of medication-induced pancreatitis is poor. Drug structure, improper handling of drug by host, and bystander status may be implicated. Other pancreatitis risk factors must be sought in all cases. The quality of evidence supporting causative role of various toxic and metabolic factors in pediatric pancreatitis is variable. Careful phenotyping is essential, including search for other etiologic risk factors. Directed therapy includes correction/removal of any agent identified, and general supportive measures. Further research is necessary to improve our understanding of these pancreatitis risk factors in children.

Empirical analysis of farmers' drought risk perception: objective factors, personal circumstances, and social influence.

PubMed

Duinen, Rianne van; Filatova, Tatiana; Geurts, Peter; Veen, Anne van der

2015-04-01

Drought-induced water shortage and salinization are a global threat to agricultural production. With climate change, drought risk is expected to increase as drought events are assumed to occur more frequently and to become more severe. The agricultural sector's adaptive capacity largely depends on farmers' drought risk perceptions. Understanding the formation of farmers' drought risk perceptions is a prerequisite to designing effective and efficient public drought risk management strategies. Various strands of literature point at different factors shaping individual risk perceptions. Economic theory points at objective risk variables, whereas psychology and sociology identify subjective risk variables. This study investigates and compares the contribution of objective and subjective factors in explaining farmers' drought risk perception by means of survey data analysis. Data on risk perceptions, farm characteristics, and various other personality traits were collected from farmers located in the southwest Netherlands. From comparing the explanatory power of objective and subjective risk factors in separate models and a full model of risk perception, it can be concluded that farmers' risk perceptions are shaped by both rational and emotional factors. In a full risk perception model, being located in an area with external water supply, owning fields with salinization issues, cultivating drought-/salt-sensitive crops, farm revenue, drought risk experience, and perceived control are significant explanatory variables of farmers' drought risk perceptions. © 2014 Society for Risk Analysis.

Predictors of HIV, HIV Risk Perception, and HIV Worry Among Adolescent Girls and Young Women in Lilongwe, Malawi.

PubMed

Price, Joan T; Rosenberg, Nora E; Vansia, Dhrutika; Phanga, Twambilile; Bhushan, Nivedita L; Maseko, Bertha; Brar, Savvy K; Hosseinipour, Mina C; Tang, Jennifer H; Bekker, Linda-Gail; Pettifor, Audrey

2018-01-01

Adolescent girls and young women (AGYW) in sub-Saharan Africa have high HIV prevalence and incidence. We sought to understand which HIV risk factors individually and in combination contribute to risk, and whether these factors are associated with HIV worry and risk perception. This study is ongoing at 4 public health centers in Lilongwe, Malawi (2016-2017). AGYW of 15-24 years old were recruited to participate in a study assessing 4 models of service delivery. At each health center, participants completed a baseline survey assessing socioeconomic, behavioral, biomedical, and partnership characteristics; self-reported HIV status; and, if HIV-uninfected, HIV risk perception (high versus low or none) and HIV worry (any versus none). We analyzed associations between baseline characteristics and HIV prevalence, risk perception, and worry. Among 1000 AGYW, median age was 19 years (IQR: 17-21). Thirty-three participants reported being HIV-infected. Fifteen characteristics were associated with HIV infection. Having more risk factors was associated with higher HIV prevalence (≤4 factors, 0.5%; 5-8 factors, 6%; >8 factors, 21%). Having more risk factors was also associated with higher risk perception (P < 0.001) and higher worry (P < 0.001). However, among those with ≥8 risk factors, 52% did not consider themselves to be at high risk and 21% did not report any HIV worry. Most AGYW perceive little risk of HIV acquisition, even those at highest risk. As a critical gap in the HIV prevention cascade, accurate risk perception is needed to tailor effective and sustained combination prevention strategies for this vulnerable population.

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…

QUANTITATIVE TOXICOPROTEOMIC ANALYSIS OF CARCINOGEN-TREATED ANIMAL TISSUES AND HUMAN CELLS FOR HUMAN HEALTH RISK ASSESSMENT

EPA Science Inventory

Humans are exposed to a variety of environmental toxicants, and this together with a large number of interacting factors can contribute to an individual's risk for health. To understand the toxic mechanisms and/or modes of action for human health risk assessment, molecular charac...

Understanding risk and protective factors for child maltreatment: the value of integrated, population-based data.

PubMed

Putnam-Hornstein, Emily; Needell, Barbara; Rhodes, Anne E

2013-01-01

In this article, we argue for expanded efforts to integrate administrative data systems as a "practical strategy" for developing a richer understanding of child abuse and neglect. Although the study of child maltreatment is often critiqued for being atheoretical, we believe that a more pressing concern is the absence of population-based and prospective epidemiological data that can be used to better understand the distribution and interacting nature of risk and protective factors for maltreatment. We begin by briefly addressing the relevance of empirical observations to etiological theories of child maltreatment. Although the latter is widely cited as critical to the development of effective prevention and intervention responses, less attention has been paid to the role of population-based data in the development of theories relevant to highly applied research questions such as those pertaining to child abuse and neglect. We then discuss how child protection data, in isolation, translates into a relatively narrow range of questions that can be asked and answered, with an inherently pathology-focused construction of risks and little attention paid to strengths or protective factors. We next turn to examples of recent findings--spanning multiple countries--emerging from information integrated across data systems, concluding by calling for expanded administrative data linkages in an effort to better understand and prevent child maltreatment. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

The physiological determinants of Sudden Infant Death Syndrome☆,☆☆

PubMed Central

Garcia, Alfredo J.; Koschnitzky, Jenna E.; Ramirez, Jan-Marino

2013-01-01

It is well-established that environmental and biological risk factors contribute to Sudden Infant Death Syndrome (SIDS). There is also growing consensus that SIDS requires the intersection of multiple risk factors that result in the failure of an infant to overcome cardio-respiratory challenges. Thus, the critical next steps in understanding SIDS are to unravel the physiological determinants that actually cause the sudden death, to synthesize how these determinants are affected by the known risk factors, and to develop novel ideas for SIDS prevention. In this review, we will examine current and emerging perspectives related to cardio-respiratory dysfunctions in SIDS. Specifically, we will review: (1) the role of the preBötzinger complex (preBötC) as a multi-functional network that is critically involved in the failure to adequately respond to hypoxic and hypercapnic challenges; (2) the potential involvement of the pre-BötC in the gender and age distributions that are characteristic for SIDS; (3) the link between SIDS and prematurity; and (4) the potential relationship between SIDS, auditory function, and central chemosensitivity. Each section underscores the importance of marrying the epidemiological and pathological data to experimental data in order to understand the physiological determinants of this syndrome. We hope that a better understanding will lead to novel ways to reduce the risk to succumb to SIDS. PMID:23735486

Firefighting to Innovation: Using Human Factors and Ergonomics to Tackle Slip, Trip, and Fall Risks in Hospitals.

PubMed

Hignett, Sue; Wolf, Laurie; Taylor, Ellen; Griffiths, Paula

2015-11-01

The aim of this study was to use a theoretical model (bench) for human factors and ergonomics (HFE) and a comparison with occupational slips, trips, and falls (STFs) risk management to discuss patient STF interventions (bedside). Risk factors for patient STFs have been identified and reported since the 1950s and are mostly unchanged in the 2010s. The prevailing clinical view has been that STF events indicate underlying frailty or illness, and so many of the interventions over the past 60 years have focused on assessing and treating physiological factors (dizziness, illness, vision/hearing, medicines) rather than designing interventions to reduce risk factors at the time of the STF. Three case studies are used to discuss how HFE has been, or could be, applied to STF risk management as (a) a design-based (building) approach to embed safety into the built environment, (b) a staff- (and organization-) based approach, and (c) a patient behavior-based approach to explore and understand patient perspectives of STF events. The results from the case studies suggest taking a similar HFE integration approach to other industries, that is, a sustainable design intervention for the person who experiences the STF event-the patient. This paper offers a proactive problem-solving approach to reduce STFs by patients in acute hospitals. Authors of the three case studies use HFE principles (bench/book) to understand the complex systems for facility and equipment design and include the perspective of all stakeholders (bedside). © 2015, Human Factors and Ergonomics Society.

Coronary artery disease risk assessment from unstructured electronic health records using text mining.

PubMed

Jonnagaddala, Jitendra; Liaw, Siaw-Teng; Ray, Pradeep; Kumar, Manish; Chang, Nai-Wen; Dai, Hong-Jie

2015-12-01

Coronary artery disease (CAD) often leads to myocardial infarction, which may be fatal. Risk factors can be used to predict CAD, which may subsequently lead to prevention or early intervention. Patient data such as co-morbidities, medication history, social history and family history are required to determine the risk factors for a disease. However, risk factor data are usually embedded in unstructured clinical narratives if the data is not collected specifically for risk assessment purposes. Clinical text mining can be used to extract data related to risk factors from unstructured clinical notes. This study presents methods to extract Framingham risk factors from unstructured electronic health records using clinical text mining and to calculate 10-year coronary artery disease risk scores in a cohort of diabetic patients. We developed a rule-based system to extract risk factors: age, gender, total cholesterol, HDL-C, blood pressure, diabetes history and smoking history. The results showed that the output from the text mining system was reliable, but there was a significant amount of missing data to calculate the Framingham risk score. A systematic approach for understanding missing data was followed by implementation of imputation strategies. An analysis of the 10-year Framingham risk scores for coronary artery disease in this cohort has shown that the majority of the diabetic patients are at moderate risk of CAD. Copyright © 2015 Elsevier Inc. All rights reserved.

Religion as a risk factor for suicide attempt and suicide ideation among depressed patients

PubMed Central

Lawrence, Ryan E; Brent, David; Mann, J. John; Burke, Ainsley K.; Grunebaum, Michael F.; Galfalvy, Hanga C.; Oquendo, Maria A.

2016-01-01

We aimed to examine the relationship between religion and suicide attempt and ideation. 321 depressed patients were recruited from mood-disorder research studies at the New York State Psychiatric Institute. Participants were interviewed using the SCID, Columbia University Suicide History form, Scale for Suicide Ideation, and Reasons for Living Inventory. Participants were asked about their religious affiliation, importance of religion, and religious service attendance. We found that past suicide attempts were more common among depressed patients with a religious affiliation (OR 2.25, p=.007). Suicide ideation was greater among depressed patients who considered religion more important (Coeff. 1.18, p=.026), and those who attended services more frequently (Coeff. 1.99, p=.001). We conclude that the relationship between religion and suicide risk factors is complex, and can vary among different patient populations. Physicians should seek deeper understanding of the role of religion in an individual patient’s life in order to understand the person’s suicide risk factors more fully. PMID:26894320

COMPLEXITIES IN UNDERSTANDING ECOSYSTEM RESPONSE TO OZONE

EPA Science Inventory

Ecological risk assessment of 03 impact requires consideration of many factors that, perhaps are not of concern in human health risk assessments. The episodic nature of 03 exposure, functional complexity of species assemblages, and the broad spatial and temporal scales character...

Religion and suicide.

PubMed

Gearing, Robin E; Lizardi, Dana

2009-09-01

Religion impacts suicidality. One's degree of religiosity can potentially serve as a protective factor against suicidal behavior. To accurately assess risk of suicide, it is imperative to understand the role of religion in suicidality. PsycINFO and MEDLINE databases were searched for published articles on religion and suicide between 1980 and 2008. Epidemiological data on suicidality across four religions, and the influence of religion on suicidality are presented. Practice guidelines are presented for incorporating religiosity into suicide risk assessment. Suicide rates and risk and protective factors for suicide vary across religions. It is essential to assess for degree of religious commitment and involvement to accurately identify suicide risk.

Unintended pregnancy as a predictor of child maltreatment.

PubMed

Guterman, Kai

2015-10-01

Whereas child maltreatment research has developed considerable evidence on post-natal risk-factors, pre-natal circumstances have been largely overlooked. The circumstances surrounding a pregnancy may considerably impact the environment in which later parenting behaviors occur. This study examines one of the earliest potentially identifiable risk-factors for child maltreatment: the intentions of a pregnancy. Utilizing both mother and father reports, this study focuses on maltreatment risk, as it relates with both parents' perspectives of the pregnancy's intention. Drawing upon data from the Fragile Families and Child Well Being study, a longitudinal, birth cohort study, survey questions were used that asked parents, at the time of the birth, whether they considered abortion for the child. Unintended pregnancy demonstrates predictive value as one of the earliest identifiable risk-factors for child maltreatment. Regardless of whether the mother or father reported the unintended pregnancy, the relationship with maltreating behavior is largely the same, although for different maltreatment types. Mothers' reports of unintended pregnancy are associated with psychological aggression, and neglect. Fathers' reports of unintended pregnancy are associated with physical aggression. Fathers' perspectives regarding pregnancy intentions matter just as much as mothers,' and accounting for their perspectives could be important in understanding the maltreating behaviors of both parents. Identifiable in the earliest stages of caregiving, unintended pregnancy may be an important risk-factor in predicting and understanding child maltreatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Paternal Risk Factors for Oral Clefts in Northern Africans, Southeast Asians, and Central Americans

PubMed Central

Ly, Stephanie; Burg, Madeleine L.; Ihenacho, Ugonna; Brindopke, Frederick; Auslander, Allyn; Magee, Kathleen S.; Sanchez-Lara, Pedro A.; Nguyen, Thi-Hai-Duc; Nguyen, Viet; Tangco, Maria Irene; Hernandez, Angela Rose; Giron, Melissa; Mahmoudi, Fouzia J.; DeClerck, Yves A.; Magee, William P.; Figueiredo, Jane C.

2017-01-01

While several studies have investigated maternal exposures as risk factors for oral clefts, few have examined paternal factors. We conducted an international multi-centered case–control study to better understand paternal risk exposures for oral clefts (cases = 392 and controls = 234). Participants were recruited from local hospitals and oral cleft repair surgical missions in Vietnam, the Philippines, Honduras, and Morocco. Questionnaires were administered to fathers and mothers separately to elicit risk factor and family history data. Associations between paternal exposures and risk of clefts were assessed using logistic regression adjusting for potential confounders. A father’s personal/family history of clefts was associated with significantly increased risk (adjusted OR: 4.77; 95% CI: 2.41–9.45). No other significant associations were identified for other suspected risk factors, including education (none/primary school v. university adjusted OR: 1.29; 95% CI: 0.74–2.24), advanced paternal age (5-year adjusted OR: 0.98; 95% CI: 0.84–1.16), or pre-pregnancy tobacco use (adjusted OR: 0.96; 95% CI: 0.67–1.37). Although sample size was limited, significantly decreased risks were observed for fathers with selected occupations. Further research is needed to investigate paternal environmental exposures as cleft risk factors. PMID:28629204

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

PubMed

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

2017-07-01

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

Current medical research funding and frameworks are insufficient to address the health risks of global environmental change.

PubMed

Ebi, Kristie L; Semenza, Jan C; Rocklöv, Joacim

2016-11-11

Three major international agreements signed in 2015 are key milestones for transitioning to more sustainable and resilient societies: the UN 2030 Agenda for Sustainable Development; the Sendai Framework for Disaster Risk Reduction; and the Paris Agreement under the United Nations Framework Convention on Climate Change. Together, these agreements underscore the critical importance of understanding and managing the health risks of global changes, to ensure continued population health improvements in the face of significant social and environmental change over this century. BODY: Funding priorities of major health institutions and organizations in the U.S. and Europe do not match research investments with needs to inform implementation of these international agreements. In the U.S., the National Institutes of Health commit 0.025 % of their annual research budget to climate change and health. The European Union Seventh Framework Programme committed 0.08 % of the total budget to climate change and health; the amount committed under Horizon 2020 was 0.04 % of the budget. Two issues apparently contributing to this mismatch are viewing climate change primarily as an environmental problem, and therefore the responsibility of other research streams; and narrowly framing research into managing the health risks of climate variability and change from the perspective of medicine and traditional public health. This reductionist, top-down perspective focuses on proximate, individual level risk factors. While highly successful in reducing disease burdens, this framing is insufficient to protect health and well-being over a century that will be characterized by profound social and environmental changes. International commitments in 2015 underscored the significant challenges societies will face this century from climate change and other global changes. However, the low priority placed on understanding and managing the associated health risks by national and international research institutions and organizations leaves populations poorly prepared to cope with changing health burdens. Risk-centered, systems approaches can facilitate understanding of the complex interactions and dependencies across environmental, social, and human systems. This understanding is needed to formulate effective interventions targeting socio-environmental factors that are as important for determining health burdens as are individual risk factors.

Stressors influencing Middle Eastern women's perceptions of the risk of cardiovascular disease: a focus group study.

PubMed

Gholizadeh, Leila; Digiacomo, Michelle; Salamonson, Yenna; Davidson, Patricia M

2011-08-01

To better understand Australia-dwelling Middle Eastern women's lack of service utilization in cardiovascular health, we undertook a study to investigate their understandings and meanings of cardiovascular disease (CVD) and its risk factors. Eight focus groups were conducted in community settings with Turkish, Persian, and Arab women. We found that the women understated their risk of CVD, faced many barriers in reducing their risks, and perceived stress as the most significant contributor to CVD. Women described their stress as primarily emanating from issues surrounding migration and acculturation. Implications for development and delivery of tailored health interventions for Middle Eastern women are discussed.

Convergent synaptic and circuit substrates underlying autism genetic risks.

PubMed

McGee, Aaron; Li, Guohui; Lu, Zhongming; Qiu, Shenfeng

2014-02-01

There has been a surge of diagnosis of autism spectrum disorders (ASD) over the past decade. While large, high powered genome screening studies of children with ASD have identified numerous genetic risk factors, research efforts to understanding how each of these risk factors contributes to the development autism has met with limited success. Revealing the mechanisms by which these genetic risk factors affect brain development and predispose a child to autism requires mechanistic understanding of the neurobiological changes underlying this devastating group of developmental disorders at multifaceted molecular, cellular and system levels. It has been increasingly clear that the normal trajectory of neurodevelopment is compromised in autism, in multiple domains as much as aberrant neuronal production, growth, functional maturation, patterned connectivity, and balanced excitation and inhibition of brain networks. Many autism risk factors identified in humans have been now reconstituted in experimental mouse models to allow mechanistic interrogation of the biological role of the risk gene. Studies utilizing these mouse models have revealed that underlying the enormous heterogeneity of perturbed cellular events, mechanisms directing synaptic and circuit assembly may provide a unifying explanation for the pathophysiological changes and behavioral endophenotypes seen in autism, although synaptic perturbations are far from being the only alterations relevant for ASD. In this review, we discuss synaptic and circuit abnormalities obtained from several prevalent mouse models, particularly those reflecting syndromic forms of ASD that are caused by single gene perturbations. These compiled results reveal that ASD risk genes contribute to proper signaling of the developing gene networks that maintain synaptic and circuit homeostasis, which is fundamental to normal brain development.

[Risk factors for suicide attempt among college students at Central South University].

PubMed

Xu, Hui-lan; Xiao, Shui-yuan; Feng, Shan-shan; Chen, Xi-xi

2004-04-01

To understand the prevalence and risk factors for suicidal ideation among college students and to provide a scientific basis for promoting psychological health and suicide prevention. 623 college students at Central South University were selected using stratified cluster sampling and administered a suicide ideation questionnaire, a Symptom Check List (SCL-90), an Adolescent Self-Rating Life Events Check List (ASLEC), a Social Support Rating Scale (SSRS) and a questionnaire about background information. Multivariate logistic regression analysis was employed to identify risk factors for suicide ideation. One year prior to our investigation, 14.6% of respondents had suicide ideation, 2.5% had made a specific suicide plan, and 1.8% had made a suicide attempt. The main risk factors for suicide ideation were dissatisfaction with the selected major of study, limited social support, recent negative life events and depressive tendency. The prevalence of suicide ideation among these college students was high. Appropriate measures focusing on the risk factors identified in this study should be urgently developed to prevent suicides in college students.

Acinetobacter bacteraemia in Thailand: evidence for infections outside the hospital setting

PubMed Central

PORTER, K. A.; RHODES, J.; DEJSIRILERT, S.; HENCHAICHON, S.; SILUDJAI, D.; THAMTHITIWAT, S.; PRAPASIRI, P.; JORAKATE, P.; KAEWPAN, A.; PERUSKI, L. F.; KERDSIN, A.; PRASERT, K.; YUENPRAKONE, S.; MALONEY, S. A.; BAGGETT, H. C.

2015-01-01

SUMMARY Acinetobacter is a well-recognized nosocomial pathogen. Previous reports of community-associated Acinetobacter infections have lacked clear case definitions and assessment of healthcare-associated (HCA) risk factors. We identified Acinetobacter bacteraemia cases from blood cultures obtained <3 days after hospitalization in rural Thailand and performed medical record reviews to assess HCA risk factors in the previous year and compare clinical and microbiological characteristics between cases with and without HCA risk factors. Of 72 Acinetobacter cases, 32 (44%) had no HCA risk factors. Compared to HCA infections, non-HCA infections were more often caused by Acinetobacter species other than calcoaceticus–baumannii complex species and by antibiotic-susceptible organisms. Despite similar symptoms, the case-fatality proportion was lower in non-HCA than HCA cases (9% vs. 45%, P < 0·01). Clinicians should be aware of Acinetobacter as a potential cause of community-associated infections in Thailand; prospective studies are needed to improve understanding of associated risk factors and disease burden. PMID:24001479

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

PubMed

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

2018-03-20

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

Convergence of External Crohn’s Disease Risk Factors on Intestinal Bacteria

PubMed Central

Oberc, Alexander; Coombes, Brian K.

2015-01-01

Crohn’s disease (CD) is an immune-mediated intestinal illness that significantly compromises health in many developed countries. Although definitive causes remain elusive, the required contribution of microbes in the progression of disease has become an accepted concept. Known CD risk factors, such as antibiotic use and acute infectious gastroenteritis, may impact the gut. This concept is now being explored with a view toward understanding the beneficial and unfavorable microbes that may be altered in numbers during such external insults. A comprehensive understanding of the microbial component to CD could be useful clinically as future therapies may focus on preventing risk exposures on susceptible individuals, eliminating harmful microbes, or restoring a protective gut microbiome. Here, we examine how acute infectious gastroenteritis and antibiotic exposure may impact the gut microbiota in the context of inflammation in CD. PMID:26579131

Toward an understanding of the context of anal sex behavior in ethnic minority adolescent women.

PubMed

Dimmitt Champion, Jane; Roye, Carol F

2014-07-01

Understanding the context of anal sex behavior among ethnic minority adolescent women has public health implications for behavioral sexual health promotion and risk reduction interventions. African-American (n = 94) and Mexican-American (n = 465) women (14-18 years of age) enrolled in a clinical trial completed semi-structured interviews to assess psychosocial and situational factors and relationships to sexual risk behavior, substance use, sexually transmitted infection/HIV acquisition, and violence. Bivariate analyses with comparisons by anal sex experiences identified differences by ethnicity and higher self-reported histories of sexual risk behaviors, substance use, violence, and stressful psychosocial and situational factors among adolescent women experiencing anal sex. Predictors of anal sex identified through logistic regression included Mexican-American ethnicity, ecstasy use, methamphetamine use, childhood sexual molestation, oral sex, and sex with friends for benefits.

Sex similarities and differences in risk factors for recurrence of major depression.

PubMed

van Loo, Hanna M; Aggen, Steven H; Gardner, Charles O; Kendler, Kenneth S

2017-11-27

Major depression (MD) occurs about twice as often in women as in men, but it is unclear whether sex differences subsist after disease onset. This study aims to elucidate potential sex differences in rates and risk factors for MD recurrence, in order to improve prediction of course of illness and understanding of its underlying mechanisms. We used prospective data from a general population sample (n = 653) that experienced a recent episode of MD. A diverse set of potential risk factors for recurrence of MD was analyzed using Cox models subject to elastic net regularization for males and females separately. Accuracy of the prediction models was tested in same-sex and opposite-sex test data. Additionally, interactions between sex and each of the risk factors were investigated to identify potential sex differences. Recurrence rates and the impact of most risk factors were similar for men and women. For both sexes, prediction models were highly multifactorial including risk factors such as comorbid anxiety, early traumas, and family history. Some subtle sex differences were detected: for men, prediction models included more risk factors concerning characteristics of the depressive episode and family history of MD and generalized anxiety, whereas for women, models included more risk factors concerning early and recent adverse life events and socioeconomic problems. No prominent sex differences in risk factors for recurrence of MD were found, potentially indicating similar disease maintaining mechanisms for both sexes. Course of MD is a multifactorial phenomenon for both males and females.

Risk factors for heat illness among British soldiers in the hot Collective Training Environment

PubMed Central

Moore, Alice C; Stacey, M J; Bailey, K G H; Bunn, R J; Woods, D R; Haworth, K J; Brett, S J; Folkes, S E F

2016-01-01

Background Heat illness is a preventable disorder in military populations. Measures that protect vulnerable individuals and contribute to effective Immediate Treatment may reduce the impact of heat illness, but depend upon adequate understanding and awareness among Commanders and their troops. Objective To assess risk factors for heat illness in British soldiers deployed to the hot Collective Training Environment (CTE) and to explore awareness of Immediate Treatment responses. Methods An anonymous questionnaire was distributed to British soldiers deployed in the hot CTEs of Kenya and Canada. Responses were analysed to determine the prevalence of individual (Intrinsic) and Command-practice (Extrinsic) risk factors for heat illness and the self-reported awareness of key Immediate Treatment priorities (recognition, first aid and casualty evacuation). Results The prevalence of Intrinsic risk factors was relatively low in comparison with Extrinsic risk factors. The majority of respondents were aware of key Immediate Treatment responses. The most frequently reported factors in each domain were increased risk by body composition scoring, inadequate time for heat acclimatisation and insufficient briefing about casualty evacuation. Conclusions Novel data on the distribution and scale of risk factors for heat illness are presented. A collective approach to risk reduction by the accumulation of ‘marginal gains’ is proposed for the UK military. This should focus on limiting Intrinsic risk factors before deployment, reducing Extrinsic factors during training and promoting timely Immediate Treatment responses within the hot CTE. PMID:26036822

The effectiveness of culturally tailored video narratives on medication understanding and use self-efficacy among stroke patients: A randomized controlled trial study protocol.

PubMed

Appalasamy, Jamuna Rani; Tha, Kyi Kyi; Quek, Kia Fatt; Ramaiah, Siva Seeta; Joseph, Joyce Pauline; Md Zain, Anuar Zaini

2018-06-01

A substantial number of the world's population appears to end with moderate to severe long-term disability after stroke. Persistent uncontrolled stroke risk factor leads to unpredicted recurrent stroke event. The increasing prevalence of stroke across ages in Malaysia has led to the adaptation of medication therapy adherence clinic (MTAC) framework. The stroke care unit has limited patient education resources especially for patients with medication understanding and use self-efficacy. Nevertheless, only a handful of studies have probed into the effectiveness of video narrative at stroke care centers. This is a behavioral randomized controlled trial of patient education intervention with video narratives for patients with stroke lacking medication understanding and use self-efficacy. The study will recruit up to 200 eligible stroke patients at the neurology tertiary outpatient clinic, whereby they will be requested to return for follow-up approximately 3 months once for up to 12 months. Consenting patients will be randomized to either standard patient education care or intervention with video narratives. The researchers will ensure control of potential confounding factors, as well as unbiased treatment review with prescribed medications only obtained onsite. The primary analysis outcomes will reflect the variances in medication understanding and use self-efficacy scores, as well as the associated factors, such as retention of knowledge, belief and perception changes, whereas stroke risk factor control, for example, self-monitoring and quality of life, will be the secondary outcomes. The study should be able to determine if video narrative can induce a positive behavioral change towards stroke risk factor control via enhanced medication understanding and use self-efficacy. This intervention is innovative as it combines health belief, motivation, and role model concept to trigger self-efficacy in maintaining healthy behaviors and better disease management. ACTRN (12618000174280).

Longitudinal changes in the antecedent and early manifest course of bipolar disorder-A narrative review of prospective studies.

PubMed

Pfennig, Andrea; Leopold, Karolina; Ritter, Philipp; Böhme, Anne; Severus, Emanuel; Bauer, Michael

2017-05-01

Prospective study designs ideally allow patients to be followed from the first manifestations of the illness or even from an at-risk stage. It can thus provide data on the predictive value of changes in clinical symptomatology, cognition or further biological markers to broaden our understanding of the etiopathology and symptomatic trajectory of bipolar disorders. The scope of this narrative review is to summarize evidence from prospectively collected data on psychopathological and other clinical and biological changes in the early developmental course of bipolar disorders. The narrative review was based on a literature search conducted in February 2016 within the PubMed library for prospective study data of persons in antecedent and early manifest stages of manifest bipolar disorder published within the last 15 years. A total of 19 prospective studies were included. Regarding psychopathological features; personality, temperament and character traits as well as changes in sleep and circadian rhythm, the evidence suggests that risk factors for the development of bipolar disorder can already be described and should be studied further to understand their interaction, mediation with other factors and timing in the developmental process of bipolar disorder. Apart from the positive family history, childhood anxiety, sleep problems, subthreshold (hypo)manic symptoms and certain character traits/emotionality should be identified and monitored already in clinical practice as their presence likely increases risk of bipolar disorder. Up to date no substantiated evidence was found from prospective studies addressing cognitive features, life events, immunological parameters and morphological central nervous system changes as potential risk factors for bipolar disorder. For an improved understanding of episodic disorders, longitudinal data collection is essential. Since the etiology of bipolar disorders is complex, a number of potential risk factors have been proposed. Prospective studies addressing this spectrum and resilience factors are critical and will be best conducted within multi-site research networks or initiatives.

Beliefs and beyond: what can we learn from qualitative studies of lay people’s understandings of cancer risk?

PubMed Central

Lipworth, Wendy L.; Davey, Heather M.; Carter, Stacy M.; Hooker, Claire; Hu, Wendy

2010-01-01

Abstract Background  Clinicians and public health professionals are centrally concerned with mediating risk. However, people often resist the risk‐related information that is communicated to them by experts, or have their own models of risk that conflict with expert views. Quantitative studies have clearly demonstrated the importance of health beliefs and various cognitive and emotional processes in shaping risk perception. More recently, a growing body of qualitative research has emerged, exploring lay conceptualizations, experiences and constructions of cancer risk. To date, this literature has not been synthesized. Objective  We report the findings of a synthesis of qualitative literature regarding the ways in which lay people construct and experience cancer risk. Design  We identified 87 articles and used the method of ‘thematic synthesis’ to identify and interpret key concepts from existing studies. Results  Eight analytic categories were developed: (i) perceptions of risk factors; (ii) process of risk perception; (iii) seeking control and taking responsibility (motivational factors); (iv) experiencing cancer directly; (v) constructing risk temporally; (vi) embodying risk; (vii) identifying with risk; and (viii) constructing risk in a social context. Conclusions  Qualitative enquiry can provide us with a rich and nuanced picture of the ways in which people understand, experience and construct risk and how being ‘at risk’ is managed, and can assist us in our communication with both individual patients and populations. PMID:20536535

Risk models of dating aggression across different adolescent relationships: a developmental psychopathology approach.

PubMed

Williams, Tricia S; Connolly, Jennifer; Pepler, Debra; Craig, Wendy; Laporte, Lise

2008-08-01

The present study examined physical dating aggression in different adolescent relationships and assessed linear, threshold, and moderator risk models for recurrent aggressive relationships. The 621 participants (59% girls, 41% boys) were drawn from a 1-year longitudinal survey of Canadian high school youths ranging from Grade 9 through Grade 12. Approximately 13% of participants reported recurrent dating aggression across 2 different relationships. Using peer and dyadic risk factors from Time 1 of the study, the authors confirmed a linear risk model, such that adolescents in 2 different violent relationships had significantly more contextual risk factors than did adolescents in 1 or no violent relationship. Further, structural equation modeling assessing moderation of contextual risk factors indicated that, for adolescents with high acceptance of dating aggression, peer aggression and delinquency significantly predicted recurrent aggression in a new relationship. In comparison, for adolescents with low acceptance of dating aggression, negative relationship characteristics significantly predicted recurrent aggression. Acceptance did not moderate concurrent associations between risk factors and aggression in 1 relationship. Results support a developmental psychopathological approach to the understanding of recurrent aggression and its associated risk factors. Copyright 2008 APA, all rights reserved.

Risk Factors for Opioid-Use Disorder and Overdose.

PubMed

Webster, Lynn R

2017-11-01

Opioid analgesics are recognized as a legitimate medical therapy for selected patients with severe chronic pain that does not respond to other therapies. However, opioids are associated with risks for patients and society that include misuse, abuse, diversion, addiction, and overdose deaths. Therapeutic success depends on proper candidate selection, assessment before administering opioid therapy, and close monitoring throughout the course of treatment. Risk assessment and prevention include knowledge of patient factors that may contribute to misuse, abuse, addiction, suicide, and respiratory depression. Risk factors for opioid misuse or addiction include past or current substance abuse, untreated psychiatric disorders, younger age, and social or family environments that encourage misuse. Opioid mortality prevalence is higher in people who are middle aged and have substance abuse and psychiatric comorbidities. Suicides are probably undercounted or frequently misclassified in reports of opioid-related poisoning deaths. Greater understanding and better assessment are needed of the risk associated with suicide risk in patients with pain. Clinical tools and an evolving evidence base are available to assist clinicians with identifying patients whose risk factors put them at risk for adverse outcomes with opioids.

Adolescents' sense-making of alcohol-related risks: The role of drinking situations and social settings.

PubMed

Katainen, Anu; Lehto, Anna-Sofia; Maunu, Antti

2015-09-01

The article explores how young people understand the risks of alcohol use and how these understandings are associated with differing drinking situations and social settings. By taking account of situational factors, the aim is to demonstrate how young people have highly nuanced notions of drinking styles that suit different drinking situations and of associated risks. The data for the research were gathered in 18 group interviews with Finnish ninth graders aged 14-15 years. Short film clips portraying young people in different drinking situations were used as stimulus material for the interviews. Data analysis focussed on the risk factors related to the social situations illustrated in the film clips. The results show that young people's risk assessments are not based on alcohol itself, but the magnitude of risk is estimated in relation to the social setting of the drinking situation. What is relevant for young people is whether the social situation allows them to make choices with which they feel comfortable. At the opposite pole of problem drinking was social drinking for the purpose of having fun together with other people in such a way that one remains in control of the drinking situation. From a prevention point of view, a key implication is that awareness of the risks is closely associated with situational and social factors. However, the awareness of those risks does not necessarily prevent young people from drinking because they may be accepted as part of the drinking experience. © The Author(s) 2014.

Mild cool air--a risk factor for asthma exacerbations: results of a retrospective study.

PubMed

Saxena, Tarun; Maheshwari, Sanjiv; Saxen, Manjari

2011-10-01

Worldwide incidence of bronchial asthma is on rise. Infections either viral or bacterial and various environmental factors are considered as major risk factors for exacerbations in various studies. Despite of awareness and preventive strategies to risk factors, exacerbations largely remain uncontrolled, therefore the study was planned to review the existing risk factors and to find out some other risk factor/factors which could help us in understanding the other causes of exacerbations. The study was done in Ajmer, the central part of Rajasthan state, India, at Mittal Hospital & Research Centre and J. L. N. Medical college hospital by collecting data for the period of four years (January 2006 - December 2009). Monthly record of 300 regular cases of bronchial asthma was taken. This record included symptoms, history of exposure to various risk factors, and PEFR. Environmental data was also collected. On the basis of record monthly attack rate was calculated. RESULTS/OBSERVATIONS: Maximum attack rate (> 90%) was found in October, November (early winter) and February and March (spring) during all the four years studied except in October 2009. A common precipitant present during these months was mild cool air (environmental temperature of 23-27 degrees c). Attack rate was very less above and below of this temperature. No clear association was present with any other known precipitants. It is concluded that inhalation of mild coolair (23-27 degrees c) may be an important risk factor besides other risk factors for asthma exacerbation.

Heart Disease in Women: Unappreciated Challenges, GPER as a New Target.

PubMed

Feldman, Ross D

2016-05-18

Heart disease in women remains underappreciated, underdiagnosed and undertreated. Further, although we are starting to understand some of the social and behavioral determinants for this, the biological basis for the increased rate of rise in atherosclerosis risk in women after menopause remains very poorly understand. In this review we will outline the scope of the clinical issues related to heart disease in women, the emerging findings regarding the biological basis underlying the increased prevalence of atherosclerotic risk factors in postmenopausal women (vs. men) and the role of the G protein-coupled estrogen receptor (GPER) and its genetic regulation as a determinant of these sex-specific risks. GPER is a recently appreciated GPCR that mediates the rapid effects of estrogen and aldosterone. Recent studies have identified that GPER activation regulates both blood pressure. We have shown that regulation of GPER function via expression of a hypofunctional GPER genetic variant is an important determinant of blood pressure and risk of hypertension in women. Further, our most recent studies have identified that GPER activation is an important regulator of low density lipoprotein (LDL) receptor metabolism and that expression of the hypofunctional GPER genetic variant is an important contributor to the development of hypercholesterolemia in women. GPER appears to be an important determinant of the two major risk factors for coronary artery disease-blood pressure and LDL cholesterol. Further, the importance of this mechanism appears to be greater in women. Thus, the appreciation of the role of GPER function as a determinant of the progression of atherosclerotic disease may be important both in our understanding of cardiometabolic function but also in opening the way to greater appreciation of the sex-specific regulation of atherosclerotic risk factors.

Retention in a Breast Cancer Risk Information Trial: Motivations of a Population-Based Sample of Women

ERIC Educational Resources Information Center

Ariail, Kiley; Watts, Carolyn; Bowen, Deborah J.

2006-01-01

A better understanding of factors influencing retention in breast cancer risk education and prevention programs can improve the design and effectiveness of such programs. Such information may also be useful to researchers seeking to maximize full retention in research trials involving low risk and low perceived benefit by the participants. These…

Physical activity assessed with three different methods and the Framingham Risk Score on 10-year coronary heart disease risk

USDA-ARS?s Scientific Manuscript database

Physical activity (PA) protects against coronary heart disease (CHD) by favorably altering several CHD risk factors. In order to best understand the true nature of the relationship between PA and CHD, the impact different PA assessment methods have on the relationships must first be clarified. The p...

Understanding consumer health information-seeking behavior from the perspective of the risk perception attitude framework and social support in mobile social media websites.

PubMed

Deng, Zhaohua; Liu, Shan

2017-09-01

This study integrates the risk perception attitude framework and social support to examine factors influencing consumers' intentions to seek health information in mobile social media websites. We develop a research model consisting of four social support dimensions, perceived health risk, health self-efficacy, and health information-seeking intention. A survey is conducted among patients with non-serious conditions. A two-step approach of structural equation modeling is used to test the research model. Among the four dimensions of social support, tangible support and appraisal support significantly influence perceived risk, whereas emotional support and esteem support significantly influence health self-efficacy. Perceived health risk and health self-efficacy significantly influence the health information-seeking behavior intention of consumers. Specifically, health self-efficacy significantly moderates the relationship between perceived risk and behavior intention. This study highlights the integrated effects of social capital and risk perception attitude framework on health information-seeking intention. It examines relationships among perceived health risk, health self-efficacy, and behavior intention in the mobile social media context. The findings help understand effects of social capital factors on perceived health risk and health self-efficacy. Copyright © 2017 Elsevier B.V. All rights reserved.

Do doctors accurately assess coronary risk in their patients? Preliminary results of the coronary health assessment study.

PubMed Central

Grover, S. A.; Lowensteyn, I.; Esrey, K. L.; Steinert, Y.; Joseph, L.; Abrahamowicz, M.

1995-01-01

OBJECTIVE--To evaluate the ability of doctors in primary care to assess risk patients' risk of coronary heart disease. DESIGN--Questionnaire survey. SETTING--Continuing medical education meetings, Ontario and Quebec, Canada. SUBJECTS--Community based doctors who agreed to enroll in the coronary health assessment study. MAIN OUTCOME MEASURE--Ratings of coronary risk factors and estimates by doctors of relative and absolute coronary risk of two hypothetical patients and the "average" 40 year old Canadian man and 70 year old Canadian woman. RESULTS--253 doctors answered the questionnaire. For 30 year olds the doctors rated cigarette smoking as the most important risk factor and raised serum triglyceride concentrations as the least important; for 70 year old patients they rated diabetes as the most important risk factor and raised serum triglyceride concentrations as the least important. They rated each individual risk factor as significantly less important for 70 year olds than for 30 year olds (all risk factors, P < 0.001). They showed a strong understanding of the relative importance of specific risk factors, and most were confident in their ability to estimate coronary risk. While doctors accurately estimated the relative risk of a specific patient (compared with the average adult) they systematically overestimated the absolute baseline risk of developing coronary disease and the risk reductions associated with specific interventions. CONCLUSIONS--Despite guidelines on targeting patients at high risk of coronary disease accurate assessment of coronary risk remains difficult for many doctors. Additional strategies must be developed to help doctors to assess better their patients' coronary risk. PMID:7728035

Breast cancer epidemic in the early twenty-first century: evaluation of risk factors, cumulative questionnaires and recommendations for preventive measures.

PubMed

Golubnitschaja, Olga; Debald, Manuel; Yeghiazaryan, Kristina; Kuhn, Walther; Pešta, Martin; Costigliola, Vincenzo; Grech, Godfrey

2016-10-01

Rapidly increasing incidence of breast cancer is a new social challenge resulting from a spectrum of internal and external risk factors which appear to be well accepted as an attribute of the early twenty-first century, being, however, new for female sub-populations compared to the past. These include altered socio-economical conditions such as occupational exposure, rotating shift work, specific environmental factors (increased pollution and environmental toxicity, altered dietary habits, quality and composition of meal) as well as consequently shifted and/or adapted physiologic factors such as lower age at menarche, late age of first full-term pregnancy, if any, shorter periods of breastfeeding and later menopause. Consolidated expert statements suggest that over 50 % of all breast cancer cases may be potentially prevented by risk reduction strategy such as regulation of modifiable risk factors. Currently available risk assessment models may estimate potential breast cancer predisposition, in general; however, they are not able to predict the disease manifestation individually. Further, current deficits in risk assessment and effective breast cancer prevention have been recently investigated and summarised as follows: gaps in risk estimation, preventive therapy, lifestyle prevention, understanding of the biology of breast cancer risk and implementation of known preventive measures. This paper overviews the most relevant risk factors, provides recommendations for improved risk assessment and proposes an extended questionnaire for effective preventive measures.

Preparation of a flood-risk environmental index: case study of eight townships in Changhua County, Taiwan.

PubMed

Peng, Szu-Hsien

2018-02-26

To evaluate flood-prone areas, correlation analysis of flooding factors for the quantitative evaluation of hazard degree was determined to assist in further disaster prevention management. This study used flood-prone areas in 35 villages over eight townships (Changhua, Huatan, Yuanlin, Xiushui, Puyan, Hemei, Dacun, and Erlin) in Changhua County as research samples. Linear combination was used to evaluate flood-prone environmental indices, and an expert questionnaire was designed by using the analytic hierarchy process and the Delphi method to determine the weights of factors. These factors were then used to calculate the eigenvector of a pairwise comparison matrix to obtain the weights for the risk assessment criteria. Through collection of disaster cases, with particular focus on specifically protected areas where flooding has occurred or is likely to occur, public adaptation and response capabilities were evaluated by using an interview questionnaire that contains the items of perceived disaster risk, resource acquisition capability, adaptation capability, and environment understanding and disaster prevention education. Overlays in a geographic information system were used to analyze the flood-risk degree in villages and to construct a distribution map that contains flood-prone environment indices. The results can assist local governments in understanding the risk degree of various administrative areas to aid them in developing effective mitigation plans.

[Psychosocial risk factors in adolescent tobacco use: negative mood-states, peer group and parenting styles].

PubMed

Julià Cano, Albert; Escapa Solanas, Sandra; Marí-Klose, Marga; Marí-Klose, Pau

2012-01-01

There are multiple factors that can affect the risk of tobacco use in adolescence. By analyzing these factors together we can disentangle the specific relevance of each of them in shaping teenagers' individual behavior. The goal of this research study is to deepen our understanding of the relationship between tobacco use in adolescence and socio-demographic and socio-emotional variables. We worked with a representative sample of 2,289 Catalan teenagers (aged 15-18) who responded to a questionnaire drawn up by the Families and Children Panel. Regression models were developed to assess the statistical associations of different mood states (sadness, nervousness and loneliness), peer-group characteristics and parenting styles, with tobacco use. The results indicate that addictive behavior is more likely when teenagers show negative mood states, controlling for socio-demographic variables and other risk factors. Among these additional factors, authoritative parenting styles reduce the risk of tobacco use, compared to authoritarian, permissive and neglectful parenting. Extensive tobacco use within the peer group is the risk factor most strongly associated with teenagers' individual behavior.

Knee Osteoarthritis: A Primer

PubMed Central

Lespasio, Michelle J; Piuzzi, Nicolas S; Husni, M Elaine; Muschler, George F; Guarino, AJ; Mont, Michael A

2017-01-01

The purpose of this article is to provide a synopsis of the current medical understanding of knee osteoarthritis. We describe the prevalence, causes and associated risk factors, symptoms, diagnosis and classification, and treatment options. A quiz serves to assist readers in their understanding of the presented material. PMID:29035179

Development and Evaluation of an Online Fall-Risk Questionnaire for Nonfrail Community-Dwelling Elderly Persons: A Pilot Study

PubMed Central

Obrist, Seraina; Rogan, Slavko; Hilfiker, Roger

2016-01-01

Introduction. Falls are frequent in older adults and may have serious consequences but awareness of fall-risk is often low. A questionnaire might raise awareness of fall-risk; therefore we set out to construct and test such a questionnaire. Methods. Fall-risk factors and their odds ratios were extracted from meta-analyses and a questionnaire was devised to cover these risk factors. A formula to estimate the probability of future falls was set up using the extracted odds ratios. The understandability of the questionnaire and discrimination and calibration of the prediction formula were tested in a cohort study with a six-month follow-up. Community-dwelling persons over 60 years were recruited by an e-mail snowball-sampling method. Results and Discussion. We included 134 persons. Response rates for the monthly fall-related follow-up varied between the months and ranged from low 38% to high 90%. The proportion of present risk factors was low. Twenty-five participants reported falls. Discrimination was moderate (AUC: 0.67, 95% CI 0.54 to 0.81). The understandability, with the exception of five questions, was good. The wording of the questions needs to be improved and measures to increase the monthly response rates are needed before test-retest reliability and final predictive value can be assessed. PMID:27247571

Association of age-related macular degeneration and reticular macular disease with cardiovascular disease.

PubMed

Rastogi, Neelesh; Smith, R Theodore

2016-01-01

Age-related macular degeneration is the leading cause of adult blindness in the developed world. Thus, major endeavors to understand the risk factors and pathogenesis of this disease have been undertaken. Reticular macular disease is a proposed subtype of age-related macular degeneration correlating histologically with subretinal drusenoid deposits located between the retinal pigment epithelium and the inner segment ellipsoid zone. Reticular lesions are more prevalent in females and in older age groups and are associated with a higher mortality rate. Risk factors for developing age-related macular degeneration include hypertension, smoking, and angina. Several genes related to increased risk for age-related macular degeneration and reticular macular disease are also associated with cardiovascular disease. Better understanding of the clinical and genetic risk factors for age-related macular degeneration and reticular macular disease has led to the hypothesis that these eye diseases are systemic. A systemic origin may help to explain why reticular disease is diagnosed more frequently in females as males suffer cardiovascular mortality at an earlier age, before the age of diagnosis of reticular macular disease and age-related macular degeneration. Copyright © 2015 Elsevier Inc. All rights reserved.

Poor awareness of risk factors for cancer in Irish adults: results of a large survey and review of the literature.

PubMed

Ryan, Aoife M; Cushen, Samantha; Schellekens, Harriët; Bhuachalla, Eadaoin Ni; Burns, Lisa; Kenny, Ursula; Power, Derek G

2015-04-01

Knowledge of cancer risk factors is unknown in Ireland. An understanding of risk factors could help inform cancer prevention programs. A 48-question online survey was designed to gather data to assess levels of public knowledge about cancer risk factors. There were 748 participants (648 women, 100 men). Mean age was 37 years (range: 18-74 years). For the public, 81% were concerned about developing cancer; however, 20% believed that cancer is unavoidable if a family history exists, 27% believed that >50% of cancers are inherited, and 54% believed that 10%-20% of cancers are inherited; 20% were unaware that risk increases with age. The top five risk factors listed by respondents were smoking (87%), diet (76%), genetics (47%), alcohol (42%), and obesity (33%). Only 32% of the public were aware that obesity is a risk factor, and 33% did not think the location of fat was important. Moreover, 29% and 48% believed that risk could be increased by wearing a tight bra and by a blow to the breast, respectively. In addition, 85% and 86% believed that stress and that mobile phones, respectively, "strongly" increase risk; 12% believed that luck is important in avoiding cancer; 35% thought that "detox" diets could reduce risk; and 61% believed that organic food reduces risk. The majority were aware that physical activity of 30 minutes per day can reduce risk. A sizable portion of the population is misinformed about cancer risk. Most participants were aware of classic risk factors (e.g., smoking, diet); however, many overestimated risk attributable to genetics, environment, and stress and underestimated age, obesity, and sunlight. One in seven participants believed that lifetime risk of cancer is not modifiable. ©AlphaMed Press.

Poor Awareness of Risk Factors for Cancer in Irish Adults: Results of a Large Survey and Review of the Literature

PubMed Central

Cushen, Samantha; Schellekens, Harriët; Bhuachalla, Eadaoin Ni; Burns, Lisa; Kenny, Ursula; Power, Derek G.

2015-01-01

Background. Knowledge of cancer risk factors is unknown in Ireland. An understanding of risk factors could help inform cancer prevention programs. Aims and Methods. A 48-question online survey was designed to gather data to assess levels of public knowledge about cancer risk factors. Results. There were 748 participants (648 women, 100 men). Mean age was 37 years (range: 18–74 years). For the public, 81% were concerned about developing cancer; however, 20% believed that cancer is unavoidable if a family history exists, 27% believed that >50% of cancers are inherited, and 54% believed that 10%–20% of cancers are inherited; 20% were unaware that risk increases with age. The top five risk factors listed by respondents were smoking (87%), diet (76%), genetics (47%), alcohol (42%), and obesity (33%). Only 32% of the public were aware that obesity is a risk factor, and 33% did not think the location of fat was important. Moreover, 29% and 48% believed that risk could be increased by wearing a tight bra and by a blow to the breast, respectively. In addition, 85% and 86% believed that stress and that mobile phones, respectively, “strongly” increase risk; 12% believed that luck is important in avoiding cancer; 35% thought that “detox” diets could reduce risk; and 61% believed that organic food reduces risk. The majority were aware that physical activity of 30 minutes per day can reduce risk. Conclusion. A sizable portion of the population is misinformed about cancer risk. Most participants were aware of classic risk factors (e.g., smoking, diet); however, many overestimated risk attributable to genetics, environment, and stress and underestimated age, obesity, and sunlight. One in seven participants believed that lifetime risk of cancer is not modifiable. PMID:25746344

Racial differences in venous thromboembolism.

PubMed

Zakai, N A; McClure, L A

2011-10-01

The incidence of venous thrombosis (VTE) varies by race, with African-Americans having over 5-fold greater incidence than Asian-ancestry populations, and an intermediate risk for European and Hispanic populations. Known racial differences in genetic polymorphisms associated with thrombosis do not account for this gradient of risk, nor do known racial variations in environmental risk factors. Data on the incidence of and risk factors for VTE outside of Europe and North America and in non-European ancestry populations are sparse. Common genetic polymorphisms in European-Ancestry populations, such as factor V Leiden and prothrombin G20210A, and environmental risk factors, such as obesity, may account for some of the increased risk in European populations, and high factor VIII, high von Willebrand factor and low protein C levels and increased prevalence of obesity may explain some of the increased risk in African-Americans. The low rates in Asian populations may be partially explained by low clinical suspicion in a perceived low-risk population and lack of access to healthcare in other populations. As risk factors for thrombosis, such as surgery and treatment for cancer, are applicable to more people, as obesity increases in prevalence in the developing world, and as surveillance systems for VTE improve, VTE may increase in previously low-risk populations. While differences in VTE by race due to genetic predisposition will probably always be present, understanding the reasons for racial differences in VTE will help providers develop strategies to minimize VTE in all populations. © 2011 International Society on Thrombosis and Haemostasis.

Structural equation model of interactions between risk factors and work-related musculoskeletal complaints among Iranian hospital nurses.

PubMed

Mehralizadeh, Semira; Dehdashti, Alireza; Motalebi Kashani, Masoud

2017-01-01

Statistics indicate a high risk of developing work-related musculoskeletal disorders among hospital nurses. The challenge is to understand the associations between musculoskeletal symptoms and various individual and occupational risk factors. This study examined the direct and indirect interactions of various risk factors with musculoskeletal complaints in hospital nurses. In a cross-sectional design, Iranian hospital nurses from Semnan University of Medical Sciences participated in a questionnaire survey reporting their perceived perceptions of various work-related risk factors and musculoskeletal symptoms. We tested our proposed structural equation model to evaluate the relations between latent and observed concepts and the relative importance and strength of exogenous variables in explaining endogenous musculoskeletal complaints. Measurement model fits the data relatively acceptable. Our findings showed direct effects of psychological, role-related and work posture stressors on musculoskeletal complaints. Fatigue mediated the adverse indirect relations of psychological, role-related, work posture and individual factors with musculoskeletal complaints. Structural equation modeling may provide methodological opportunities in occupational health research with a potential to explain the complexity of interactions among risk factors. Prevention of work-related musculoskeletal disorders among nurses must account for physical and psychosocial conditions.

Analysis of risk assessment factors of individuals in volcanic hazards: Review of the last decade

NASA Astrophysics Data System (ADS)

Favereau, Marcel; Robledo, Luis F.; Bull, Maria T.

2018-05-01

During the history of mankind, natural disasters have had severe repercussions on the different ecosystems, with volcanic eruptions being a clear example of this. This review is responsible for gathering the most important volatile hazards assessment research of the last decade with the objective of knowing the state of the art in relation to the studies of people's risk perception and acceptance in communities threatened by the danger of volcanic eruptions. In addition, this study includes the analysis of several cases across different countries. The results that this research offers serve as a frame of reference to determine and understand how resilient a community affected by the volatile hazards can be, since they are able to identify the main incident factors of risk that affect the communities to different degrees according to the context at the time of making the risk judgment. On the other hand, through this review, it is proposed as a future research topic to understand the levels of risk acceptance of individuals, due to the fact that the studies related to this subject are scarce.

The Architecture of Risk for Type 2 Diabetes: Understanding Asia in the Context of Global Findings

PubMed Central

Attia, John; Oldmeadow, Christopher; Scott, Rodney J.; Holliday, Elizabeth G.

2014-01-01

The prevalence of Type 2 diabetes is rising rapidly in both developed and developing countries. Asia is developing as the epicentre of the escalating pandemic, reflecting rapid transitions in demography, migration, diet, and lifestyle patterns. The effective management of Type 2 diabetes in Asia may be complicated by differences in prevalence, risk factor profiles, genetic risk allele frequencies, and gene-environment interactions between different Asian countries, and between Asian and other continental populations. To reduce the worldwide burden of T2D, it will be important to understand the architecture of T2D susceptibility both within and between populations. This review will provide an overview of known genetic and nongenetic risk factors for T2D, placing the results from Asian studies in the context of broader global research. Given recent evidence from large-scale genetic studies of T2D, we place special emphasis on emerging knowledge about the genetic architecture of T2D and the potential contribution of genetic effects to population differences in risk. PMID:24744783

Advancing Our Understanding of the Etiologies and Mutational Landscapes of Basal-Like, Luminal A, and Luminal B Breast Cancers

DTIC Science & Technology

2017-10-01

study to identify how various breast cancer risk factors differ in their relationships to different molecular subtypes of breast cancer and to further...characterize molecular differences between these subtypes. To address the existing research gaps regarding the etiologies of different molecular ... molecular subtypes of breast cancer, basal-like, luminal A, and luminal B tumors, breast cancer risk factors 16. SECURITY CLASSIFICATION OF: 17

Advancing Our Understanding of the Etiologies and Mutational Landscapes of Basal-Like, Luminal A, and Luminal B Breast Cancers

DTIC Science & Technology

2017-10-01

various breast cancer risk factors differ in their relationships to different molecular subtypes of breast cancer and to further characterize... molecular differences between these subtypes. To address the existing research gaps regarding the etiologies of different molecular subtypes of breast... molecular subtypes of breast cancer, basal-like, luminal A, and luminal B tumors, breast cancer risk factors 16. SECURITY CLASSIFICATION OF: 17. LIMITATION

Sex Differences in Common Sports Injuries.

PubMed

Lin, Cindy; Casey, Ellen; Herman, Daniel; Katz, Nicole; Tenforde, Adam

2018-03-14

Common sports injuries include bone stress injuries (BSIs), anterior cruciate ligament (ACL) injuries, and concussions. Less commonly recognized are the specific sex differences in epidemiology, risk factors, and outcomes of these conditions by sex. An understanding of these factors can improve their clinical management, from prescribing appropriate prehabilitation to guiding postinjury rehabilitation and return to play. This narrative review summarizes the sex differences in the diagnosis and management of BSIs, ACL injuries, and concussions. Although BSIs are more common in female athletes, risk factors for both sexes include prior injury and relative energy deficiency in sport (RED-S). Risk factors in female athletes include smaller calf girth, femoral adduction, and higher rates of loading. Female athletes are also at greater risk for developing ACL injuries in high school and college, but their injury rate is similar in professional sports. Increased lateral tibial slope, smaller ACL size, and suboptimal landing mechanics are additional risk factors more often present in female athletes. Male athletes are more likely to have ACL surgery and have a higher rate of return to sport. Concussions occur more commonly in female athletes; however, female athletes are also more likely to report concussions. Male athletes more commonly sustain concussion through contact with another player. Female athletes more commonly sustain injury from contact with playing equipment. Managing post-concussion symptoms is important, and female athletes may have prolonged symptoms. An understanding of the sex-specific differences in these common sports injuries can help optimize their prehabilitation and rehabilitation. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Sociocultural and ecological factors influencing management of edible and non-edible plants: the case of Ixcatlán, Mexico.

PubMed

Rangel-Landa, Selene; Casas, Alejandro; García-Frapolli, Eduardo; Lira, Rafael

2017-10-30

Identifying factors influencing plant management allows understanding how processes of domestication operate. Uncertain availability of resources is a main motivation for managing edible plants, but little is known about management motives of non-edible resources like medicinal and ceremonial plants. We hypothesized that uncertain availability of resources would be a general factor motivating their management, but other motives could operate simultaneously. Uncertainty and risk might be less important motives in medicinal than in edible plants, while for ceremonial plants, symbolic and spiritual values would be more relevant. We inventoried edible, medicinal, and ceremonial plants in Ixcatlán, Oaxaca, Mexico, and conducted in-depth studies with 20 native and naturalized species per use type; we documented their cultural importance and abundance by interviewing 25 households and sampling vegetation in 33 sites. Consumption amounts and preferences were studied through surveys and free listings with 38 interviewees. Management intensity and risk indexes were calculated through PCA and their relation analyzed through regression analyses. Canonical methods allowed identifying the main sociocultural and ecological factors influencing management of plants per use type. Nearly 64, 63, and 55% of all ceremonial, edible, and medicinal wild plants recorded, respectively, are managed in order to maintain or increase their availability, embellishing environments, and because of ethical reasons and curiosity. Management intensity was higher in edible plants under human selection and associated with risk. Management of ceremonial and medicinal plants was not associated with indexes of risk or uncertainty in their availability. Other sociocultural and ecological factors influence management intensity, the most important being reciprocal relations and abundance perception. Plant management through practices and collectively regulated strategies is strongly related to control of risk and uncertainty in edible plants, compared with medicinal and ceremonial plants, in which reciprocal interchanges, curiosity, and spiritual values are more important factors. Understanding how needs, worries, social relations, and ethical values influence management decisions is important to understand processes of constructing management strategies and how domestication could be started in the past and are operated at the present.

The relative importance of wife abuse as a risk factor for violence against children.

PubMed

Tajima, E A

2000-11-01

To investigate the relative importance of wife abuse as a risk factor for physical child abuse, physical punishment, and verbal child abuse. The study explored the importance of wife abuse relative to blocks of parent, child, and family characteristics and also relative to specific risk factors. This study re-analyzed a sub-sample (N = 2,733) of data from the 1985 National Family Violence Survey. Hierarchical logistic regressions were conducted, using five different criterion variables measuring physical child abuse, physical punishment, and verbal abuse separately and in combination. Blocks of parent, child, and family characteristics were more important predictors of violence towards children than was wife abuse, though the presence of wife abuse in the home was a consistently significant specific risk factor for all forms of violence against children. Of specific risk factors, a respondent's history of having been hit as an adolescent was a larger risk factor for physical child abuse than was wife abuse. Wife abuse was an important predictor of physical punishment. Non-violent marital discord was a greater factor in predicting likelihood of verbal child abuse than was wife abuse. Though this study confirms the association between wife abuse and violence towards children, it cautions us not to overlook the contribution of other factors in our attempts to understand the increased risk attributed to wife abuse.

Combining research approaches to advance our understanding of drug addiction.

PubMed

van den Bree, Marianne B M

2005-04-01

Drug addiction is a complex behavior, likely to be influenced by various genes, environmental factors, and gene-gene and gene-environment interactions. Various aspects of addiction are studied by different disciplines. Animal studies are increasing insight into brain regions and genes associated with addiction. Epidemiologic studies are establishing the factors increasing risk for initiation and continuation of substance use. Twin and adoption studies are increasing our understanding of the complex mechanisms involved in substance use, including comorbidity and gene environment interaction. Finally, molecular genetic studies in humans are starting to yield some converging findings. It is argued and illustrated with examples that greater awareness of progress in other disciplines can speed up our understanding of the complex processes involved in addiction. This should help our ability to identify who is at increased risk of becoming addicted and the development of prevention and intervention strategies targeted at an individual's specific needs.

Biodegradation of Petroleum Hydrocarbon in the Vadose Zone

EPA Science Inventory

There are two major impediments to a better understanding of the influence of biodegradation on the risk of intrusion of petroleum vapors. We describe the contribution of biodegradation as an attenuation factor between the source and the receptor. The use of attenuation factors...

Awareness of risk factors and warning signs of stroke in a Nigeria university.

PubMed

Obembe, Adebimpe O; Olaogun, Matthew O; Bamikole, Adesola A; Komolafe, Morenikeji A; Odetunde, Marufat O

2014-04-01

Rapid access to medical services which is an important predictor of treatment and rehabilitation outcome requires that there is an understanding of stroke risk factors and early warning signs. This study assessed awareness of stroke risk factors and warning signs among students and staff of Obafemi Awolowo University, Nigeria. This was a cross sectional survey involving 994 (500 students and 494 staff) respondents. Information on the awareness of stroke risk factors and warning signs was collected with the aid of a structured questionnaire. Descriptive and inferential statistics were used for data analysis. Weakness (66.2%) was the most commonly identified warning sign of stroke with more staff (69.8%) identifying correctly than students (62.6%). Hypertension (83.4%) was the most commonly identified stroke risk factor, with more staff (91.7%) identifying correctly than students (83.2%). There were significant differences (p < 0.05) in the awareness of some risk factors (age, hypertension, stress and obesity), and warning signs (dizziness, numbness, weakness, headache and vision problems) between students and staff. Predictors for adequate awareness of both stroke risk factors and warning signs were younger age, smoking history and higher educational level. Majority of the respondents recognized individual important stroke risk factors and warning signs, but few recognized multiple stroke risk factors and warning signs. Awareness programs on stroke should be organized, even in communities with educated people to increase public awareness on the prevention of stroke and on the reduction of morbidity in the survivors. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Risk factors for child pneumonia - focus on the Western Pacific Region.

PubMed

Nguyen, T K P; Tran, T H; Roberts, C L; Fox, G J; Graham, S M; Marais, B J

2017-01-01

Pneumonia is a major cause of disease and death in infants and young children (aged <5 years) globally, as it is in the World Health Organization Western Pacific region. A better understanding of the underlying risk factors associated with child pneumonia is important, since pragmatic primary prevention strategies are likely to achieve major reductions in pneumonia-associated morbidity and mortality in children. This review focuses on risk factors with high relevance to the Western Pacific region, including a lack of exclusive breastfeeding, cigarette smoke and air pollution exposure, malnutrition and conditions of poverty, as well as common co-morbidities. Case management and vaccination coverage have been considered elsewhere. Copyright © 2016 Elsevier Ltd. All rights reserved.

Antibiotic consumption and Enterobacteriaceae skin colonization in hospitalized adults.

PubMed

Kirby, A; Berry, C; West, R

2017-01-01

Enterobacteriaceae are increasingly antibiotic resistant, and skin colonization may contribute to their spread in hospitals. This study screened 100 hospitalized adults for Enterobacteriaceae skin colonization, and assessed potential risk factors, including antibiotic consumption. Multi-variable analysis found that antibiotic consumption whilst an inpatient [odds ratio (OR) 3.16, 95% confidence interval (CI) 1.19-8.4] and male sex (OR 2.92, 95% CI 1.06-8.4) were risk factors for Enterobacteriaceae skin colonization. If these risk factors are confirmed, work to understand the biological mechanism involved may lead to the development of interventions to prevent Enterobacteriaceae skin colonization. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Mild traumatic brain injury: a risk factor for neurodegeneration

PubMed Central

2010-01-01

Recently, it has become clear that head trauma can lead to a progressive neurodegeneration known as chronic traumatic encephalopathy. Although the medical literature also implicates head trauma as a risk factor for Alzheimer's disease, these findings are predominantly based on clinical diagnostic criteria that lack specificity. The dementia that follows head injuries or repetitive mild trauma may be caused by chronic traumatic encephalopathy, alone or in conjunction with other neurodegenerations (for example, Alzheimer's disease). Prospective longitudinal studies of head-injured individuals, with neuropathological verification, will not only improve understanding of head trauma as a risk factor for dementia but will also enhance treatment and prevention of a variety of neurodegenerative diseases. PMID:20587081

[Eco-epidemiology: towards epidemiology of complexity].

PubMed

Bizouarn, Philippe

2016-05-01

In order to solve public health problems posed by the epidemiology of risk factors centered on the individual and neglecting the causal processes linking the risk factors with the health outcomes, Mervyn Susser proposed a multilevel epidemiology called eco-epidemiology, addressing the interdependence of individuals and their connection with molecular, individual, societal, environmental levels of organization participating in the causal disease processes. The aim of this epidemiology is to integrate more than a level of organization in design, analysis and interpretation of health problems. After presenting the main criticisms of risk-factor epidemiology focused on the individual, we will try to show how eco-epidemiology and its development could help to understand the need for a broader and integrative epidemiology, in which studies designed to identify risk factors would be balanced by studies designed to answer other questions equally vital to public health. © 2016 médecine/sciences – Inserm.

Gender differences in predicting high-risk drinking among undergraduate students.

PubMed

Wilke, Dina J; Siebert, Darcy Clay; Delva, Jorge; Smith, Michael P; Howell, Richard L

2005-01-01

The purpose of this study was to examine gender differences in college students' high-risk drinking as measured by an estimated blood alcohol concentration (eBAC) based on gender, height, weight, self-reported number of drinks, and hours spent drinking. Using a developmental/contextual framework, high-risk drinking is conceptualized as a function of relevant individual characteristics, interpersonal factors, and contextual factors regularly mentioned in the college drinking literature. Individual characteristics include race, gender, and age; interpersonal characteristics include number of sexual partners and having experienced forced sexual contact. Finally, contextual factors include Greek membership, living off-campus, and perception of peer drinking behavior. This study is a secondary data analysis of 1,422 students at a large university in the Southeast. Data were gathered from a probability sample of students through a mail survey. A three-step hierarchical logistic regression analysis showed gender differences in the pathway for high-risk drinking. For men, high-risk drinking was predicted by a combination of individual characteristics and contextual factors. For women, interpersonal factors, along with individual characteristics and contextual factors, predicted high-risk drinking, highlighting the importance of understanding female sexual relationships and raising questions about women's risk-taking behavior. Implications for prevention and assessment are discussed.

Suicide and sleep: Is it a bad thing to be awake when reason sleeps?

PubMed

Perlis, Michael L; Grandner, Michael A; Chakravorty, Subhajit; Bernert, Rebecca A; Brown, Gregory K; Thase, Michael E

2016-10-01

Suicide is the second leading cause of death, worldwide, for those between the ages of 24 and 44 y old. In 2013, more than 41,000 suicides occurred in the United States. These statistics underscore the need to 1) understand why people die by suicide and 2) identify risk factors that are potentially modifiable. While it has been posited that sleep disturbance may represent one such factor, systematic research in this arena did not begin until the 2000s. Since that time, sleep disturbance has been reliably identified as a risk factor for suicidal ideation, suicide attempts, and suicide. While insomnia, nightmares, and other sleep disorders have each been found to contribute to the risk for suicidal ideation and behavior, it is also possible that these factors share some common variance. One possibility is that sleep disturbance results in being awake at night, and being awake at night also confers risk. The hypothesis proffered here is that being awake when one is not biologically prepared to be so results in "hypofrontality" and diminished executive function, and that this represents a common pathway to suicidal ideation and behavior. Such a proposition is highly testable under a variety of possible protocols. The current review summarizes the extant literature on suicide rates by time-of-day, and discusses circadian, psychosocial, and neurocognitive explanations of risk. Such a focus promises to enhance our understanding of how sleep disturbance may confer risk, allows for the identification of future lines of research, and further justifies the need for interventions that promote good sleep continuity among at-risk individuals. Copyright © 2015 Elsevier Ltd. All rights reserved.

Qualitative evaluation of selected social factors that impact sexual risk-taking behaviour among African students in Kwazulu-Natal, South Africa.

PubMed

Ngidi, Ndumiso Daluxolo; Moyo, Sibusiso; Zulu, Thobile; Adam, Jamila Khatoon; Krishna, Suresh Babu Naidu

2016-12-01

The incidence of HIV and AIDS continues to be a source of great concern within universities in South Africa. Furthermore, university students constitute an important community in the intervention against the HIV/AIDS epidemic. Students in the age group of 15-24 years are at a greater risk of HIV infection than any other group in the country; yet, little is known about why they continue to engage in risky sexual practices. This study was designed to explore the sexual behaviour of students in a metropolitan Durban University of Technology in KwaZulu-Natal to understand the social factors underlying their risk of HIV infection. This is a qualitative study that used cluster sampling where the population was stratified by campus and faculty. The study population was selected using a standard randomization technique. This was a part of a multi-phased research project aimed at providing a sero-prevalence baseline and an analysis of risk-taking behaviour at a Durban University of Technology in the eThekwini Metropolitan Municipality area. The study highlights peer pressure among students as an influence in promoting high-risk sexual behaviour. Within this context, the findings revealed that university students lack the ability to negotiate risk-aware decisions especially regarding sexual relationships. This study draws attention to the perspectives of African university students regarding their risk-taking sexual practices and selected factors which influence such behaviour. The findings are not exhaustive in exploring contextual antecedents that shape students' sexual practices. However, they provide an important basis in understanding key factors which expose students to HIV infections. The study provides insights into opportunities for further studies as well as preventative implications.

Qualitative evaluation of selected social factors that impact sexual risk-taking behaviour among African students in Kwazulu-Natal, South Africa

PubMed Central

Ngidi, Ndumiso Daluxolo; Moyo, Sibusiso; Zulu, Thobile; Adam, Jamila Khatoon; Krishna, Suresh Babu Naidu

2016-01-01

Abstract Background: The incidence of HIV and AIDS continues to be a source of great concern within universities in South Africa. Furthermore, university students constitute an important community in the intervention against the HIV/AIDS epidemic. Students in the age group of 15–24 years are at a greater risk of HIV infection than any other group in the country; yet, little is known about why they continue to engage in risky sexual practices. Objectives: This study was designed to explore the sexual behaviour of students in a metropolitan Durban University of Technology in KwaZulu-Natal to understand the social factors underlying their risk of HIV infection. Methods: This is a qualitative study that used cluster sampling where the population was stratified by campus and faculty. The study population was selected using a standard randomization technique. This was a part of a multi-phased research project aimed at providing a sero-prevalence baseline and an analysis of risk-taking behaviour at a Durban University of Technology in the eThekwini Metropolitan Municipality area. Results: The study highlights peer pressure among students as an influence in promoting high-risk sexual behaviour. Within this context, the findings revealed that university students lack the ability to negotiate risk-aware decisions especially regarding sexual relationships. Conclusion: This study draws attention to the perspectives of African university students regarding their risk-taking sexual practices and selected factors which influence such behaviour. The findings are not exhaustive in exploring contextual antecedents that shape students’ sexual practices. However, they provide an important basis in understanding key factors which expose students to HIV infections. The study provides insights into opportunities for further studies as well as preventative implications. PMID:27687152

Suicide and sleep: Is it a bad thing to be awake when reason sleeps?

PubMed Central

Perlis, Michael L.; Grandner, Michael A.; Chakravorty, Subhajit; Bernert, Rebecca A.; Brown, Gregory K.; Thase, Michael E.

2016-01-01

Suicide is the second leading cause of death, worldwide, for those between the ages of 24 and 44 y old. In 2013, more than 41,000 suicides occurred in the United States. These statistics underscore the need to 1) understand why people die by suicide and 2) identify risk factors that are potentially modifiable. While it has been posited that sleep disturbance may represent one such factor, systematic research in this arena did not begin until the 2000s. Since that time, sleep disturbance has been reliably identified as a risk factor for suicidal ideation, suicide attempts, and suicide. While insomnia, nightmares, and other sleep disorders have each been found to contribute to the risk for suicidal ideation and behavior, it is also possible that these factors share some common variance. One possibility is that sleep disturbance results in being awake at night, and being awake at night also confers risk. The hypothesis proffered here is that being awake when one is not biologically prepared to be so results in “hypofrontality” and diminished executive function, and that this represents a common pathway to suicidal ideation and behavior. Such a proposition is highly testable under a variety of possible protocols. The current review summarizes the extant literature on suicide rates by time-of-day, and discusses circadian, psychosocial, and neuro-cognitive explanations of risk. Such a focus promises to enhance our understanding of how sleep disturbance may confer risk, allows for the identification of future lines of research, and further justifies the need for interventions that promote good sleep continuity among at-risk individuals. PMID:26706755

Can Technology Decrease Sexual Risk Behaviors among Young People? Results of a Pilot Study Examining the Effectiveness of a Mobile Application Intervention

ERIC Educational Resources Information Center

Jackson, Dawnyéa D.; Ingram, Lucy Annang; Boyer, Cherrie B.; Robillard, Alyssa; Huhns, Michael N.

2016-01-01

College students represent an important population for studying and understanding factors that influence sexual risk given the populations' high risk of sexually transmitted infections and unintended pregnancies. Using a quasi-experimental design, the efficacy of a brief and theory-driven mobile application intervention designed to decrease sexual…

Biopsychosocial risk factors of persistent fatigue after acute infection: A systematic review to inform interventions.

PubMed

Hulme, Katrin; Hudson, Joanna L; Rojczyk, Philine; Little, Paul; Moss-Morris, Rona

2017-08-01

Fatigue is a prevalent and debilitating symptom, preceded by an acute infectious episode in some patients. This systematic review aimed to identify risk factors for the development of persistent fatigue after an acute infection, to develop an evidence-based working model of post-infectious fatigue. Electronic databases (Medline, PsycINFO and EMBASE) were searched, from inception to March 2016, for studies which investigated biopsychosocial risk factors of on-going fatigue after an acute infection. Inclusion criteria were: prospective design; biological, psychological or social risk factors; standardised measure of post-infectious fatigue (self-report scales or clinical diagnosis). Studies were excluded if the sample had a pre-existing medical condition, infection was conceptualised as 'vaccination' or they were intervention trials. A narrative synthesis was performed. Eighty-one full texts were screened, of which seventeen were included in the review. Over half included glandular fever populations. Other infections included dengue fever, 'general'/'viral' and Q-fever. Risk factors were summarised under biological, social, behavioural, cognitive and emotional subthemes. Patients' cognitive and behavioural responses to the acute illness, and pre-infection or baseline distress and fatigue were the most consistent risk factors for post-infectious fatigue. An empirical summary model is provided, highlighting the risk factors most consistently associated with persistent fatigue. The components of the model, the possible interaction of risk factors and implications for understanding the fatigue trajectory and informing preventative treatments are discussed. Copyright © 2017. Published by Elsevier Inc.

Prevalence of Risk Factors for Coronary Artery Disease in Pennsylvania (USA) Firefighters.

PubMed

Risavi, Brian L; Staszko, Jason

2016-02-01

Firefighting is a physically demanding profession. Heart disease remains the number one killer of firefighters. Many firefighters have multiple risk factors, putting them at risk for sudden cardiac events. The purpose of this study was to describe the prevalence of risk factors for heart disease in a convenience sample of Pennsylvania (USA) firefighters. A convenience sample of 160 firefighters in western Pennsylvania had height, weight, waist circumference, blood pressure, and body mass index (BMI) assessed, and then were surveyed to measure their knowledge of cardiovascular risk factors. Data analysis included subgroup comparisons of age, BMI, waist circumference, and exercise for their impact on health risks in the study cohort. In particular, the researchers were interested in understanding whether the knowledge of risk was associated with lower measures of risk. Eighteen firefighters (4%) reported a history of coronary artery disease (including stents/interventions). In this group, 69% to 82% correctly identified age, hypertension (HTN), high cholesterol, smoking, obesity, sedentary lifestyle, and family history as risk factors for coronary artery disease. Fourteen percent were smokers, 41% had HTN, 38% had pre-HTN with only 12% receiving treatment, and 13.5% were treated for high cholesterol. Fifty-eight percent exercised regularly. While a majority of firefighters were able to identify risk factors for coronary artery disease, many could not. Eighteen (4%) had a history of coronary artery disease, including interventions. Many had several of the risk factors indicated, which highlights the need for an organized national approach to address the medical screening/evaluation, nutrition, and exercise components of firefighter fitness.

A multidimensional approach to understanding the potential risk factors and covariates of adult picky eating.

PubMed

Ellis, Jordan M; Schenk, Rebecca R; Galloway, Amy T; Zickgraf, Hana F; Webb, Rose Mary; Martz, Denise M

2018-06-01

Adult picky eating (PE) has received increased attention in the eating behavior literature due to its important association with adult avoidant-restrictive food intake disorder (ARFID). The current study tested a model of potential risk factors of adult PE behavior, including perceived early parental feeding practices. An exploratory model was also utilized to understand associations with different aspects of adult PE behaviors. A sample of 1339 US adults recruited through Amazon's MTurk completed an online survey that included the recently developed Adult Picky Eating Questionnaire (APEQ), retrospective reports of parental feeding practices, and other measures of eating behavior and demographic variables. A structural equation modeling procedure tested a series of regression models that included BMI and disordered eating behaviors as covariates. SEM modeling indicated that retrospective reports of greater parental pressure to eat, higher disgust sensitivity, lower PE age of onset, and experiencing an aversive food event were associated with general adult PE behavior. Results also indicated parental encouragement of healthy eating may be a protective factor, and that men endorsed higher levels of adult PE. Exploratory analyses indicated that cross-sectional predictors and covariates were differentially related to specific aspects of PE as measured by the APEQ subscales. Early experiences, including parental approaches to feeding, appear to be potential risk factors of PE behavior in adults. A nuanced understanding of adult PE is important for the prevention and treatment of severe PE behaviors, related psychosocial impairment, and ARFID. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

PubMed

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

2005-01-01

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

Network information analysis reveals risk perception transmission in a behaviour-influenza dynamics system.

PubMed

Liao, C-M; You, S-H; Cheng, Y-H

2015-01-01

Influenza poses a significant public health burden worldwide. Understanding how and to what extent people would change their behaviour in response to influenza outbreaks is critical for formulating public health policies. We incorporated the information-theoretic framework into a behaviour-influenza (BI) transmission dynamics system in order to understand the effects of individual behavioural change on influenza epidemics. We showed that information transmission of risk perception played a crucial role in the spread of health-seeking behaviour throughout influenza epidemics. Here a network BI model provides a new approach for understanding the risk perception spread and human behavioural change during disease outbreaks. Our study allows simultaneous consideration of epidemiological, psychological, and social factors as predictors of individual perception rates in behaviour-disease transmission systems. We suggest that a monitoring system with precise information on risk perception should be constructed to effectively promote health behaviours in preparation for emerging disease outbreaks.

Current directions in behavioral medicine research on genetic testing for disease susceptibility: introduction to the special section.

PubMed

Sherman, Kerry A; Cameron, Linda D

2015-10-01

The aim of this special section is to showcase research contributing to our understanding of factors influencing decisions to undergo genetic testing and the impact of the genetic testing process on health-related behaviors of tested individuals. The first two articles report studies investigating factors associated with interest in genetic testing and acceptance of test results (Sherman et al. in J Behav Med doi: 10.1007/s10865-015-9630-9 , 2015; Taber et al. in J Behav Med doi: 10.1007/s10865-015-9642-5 , 2015b). The next two papers address the unique contribution of genetic risk information to understanding risk beyond genetic counseling alone (Heiniger et al. in J Behav Med doi 10.1007/s10865-015-9632-7 , 2015; Taber et al. in J Behav Med doi: 10.1007/s10865-015-9648-z , 2015a). The final three articles investigate the effects of genetic risk information on beliefs about disease control and prevention (Aspinwall et al. in J Behav Med doi: 10.1007/s10865-015-9631-8 , 2015; Kelly et al. in J Behav Med doi 10.1007/s10865-014-9613-2 , 2014; Myers et al. in J Behav Med doi: 10.1007/s10865-015-9626-5 , 2015). Collectively, the special section of papers highlights the diverse ways in which behavioural medicine contributes to our understanding of genetic testing for disease risk, and points to the value of further research to better understand ways in which individuals perceive, interpret and respond to genetic risk information.

Genetic determinants in head and neck squamous cell carcinoma and their influence on global personalized medicine

PubMed Central

Michmerhuizen, Nicole L.; Birkeland, Andrew C.; Bradford, Carol R.; Brenner, J. Chad

2016-01-01

While sequencing studies have provided an improved understanding of the genetic landscape of head and neck squamous cell carcinomas (HNSCC), there remains a significant lack of genetic data derived from non-Caucasian cohorts. Additionally, there is wide variation in HNSCC incidence and mortality worldwide both between and within various geographic regions. These epidemiologic differences are in part accounted for by varying exposure to environmental risk factors such as tobacco, alcohol, high risk human papilloma viruses and betel quid. However, inherent genetic factors may also play an important role in this variability. As limited sequencing data is available for many populations, the involvement of unique genetic factors in HNSCC pathogenesis from epidemiologically diverse groups is unknown. Here, we review current knowledge about the epidemiologic, environmental, and genetic variation in HNSCC cohorts globally and discuss future studies necessary to further our understanding of these differences. Long-term, a more complete understanding of the genetic drivers found in diverse HNSCC cohorts may help the development of personalized medicine protocols for patients with rare or complex genetic events. PMID:27551333

Modeling the Interplay of Multilevel Risk Factors for Future Academic and Behavior Problems: A Person-Centered Approach

PubMed Central

Lanza, Stephanie T.; Rhoades, Brittany L.; Nix, Robert L.; Greenberg, Mark T.

2010-01-01

This study identified profiles of 13 risk factors across child, family, school, and neighborhood domains in a diverse sample of children in kindergarten from 4 US locations (n = 750; 45% minority). It then examined the relation of those early risk profiles to externalizing problems, school failure, and low academic achievement in Grade 5. A person-centered approach, latent class analysis, revealed four unique risk profiles, which varied considerably across urban African American, urban white, and rural white children. Profiles characterized by several risks that cut across multiple domains conferred the highest risk for negative outcomes. Compared to a variable-centered approach, such as a cumulative risk index, these findings provide a more nuanced understanding of the early precursors to negative outcomes. For example, results suggested that urban children in single-parent homes that have few other risk factors (i.e., show at least average parenting warmth and consistency and report relatively low stress and high social support) are at quite low risk for externalizing problems, but at relatively high risk for poor grades and low academic achievement. These findings provide important information for refining and targeting preventive interventions to groups of children who share particular constellations of risk factors. PMID:20423544

Modeling the interplay of multilevel risk factors for future academic and behavior problems: a person-centered approach.

PubMed

Lanza, Stephanie T; Rhoades, Brittany L; Nix, Robert L; Greenberg, Mark T

2010-05-01

This study identified profiles of 13 risk factors across child, family, school, and neighborhood domains in a diverse sample of children in kindergarten from four US locations (n = 750; 45% minority). It then examined the relation of those early risk profiles to externalizing problems, school failure, and low academic achievement in Grade 5. A person-centered approach, latent class analysis, revealed four unique risk profiles, which varied considerably across urban African American, urban White, and rural White children. Profiles characterized by several risks that cut across multiple domains conferred the highest risk for negative outcomes. Compared to a variable-centered approach, such as a cumulative risk index, these findings provide a more nuanced understanding of the early precursors to negative outcomes. For example, results suggested that urban children in single-parent homes that have few other risk factors (i.e., show at least average parenting warmth and consistency and report relatively low stress and high social support) are at quite low risk for externalizing problems, but at relatively high risk for poor grades and low academic achievement. These findings provide important information for refining and targeting preventive interventions to groups of children who share particular constellations of risk factors.

Religion as a Risk Factor for Suicide Attempt and Suicide Ideation Among Depressed Patients.

PubMed

Lawrence, Ryan E; Brent, David; Mann, J John; Burke, Ainsley K; Grunebaum, Michael F; Galfalvy, Hanga C; Oquendo, Maria A

2016-11-01

We aimed to examine the relationship between religion and suicide attempt and ideation. Three hundred twenty-one depressed patients were recruited from mood-disorder research studies at the New York State Psychiatric Institute. Participants were interviewed using the Structured Clinical Interview for DSM Disorders, Columbia University Suicide History form, Scale for Suicide Ideation, and Reasons for Living Inventory. Participants were asked about their religious affiliation, importance of religion, and religious service attendance. We found that past suicide attempts were more common among depressed patients with a religious affiliation (odds ratio, 2.25; p = 0.007). Suicide ideation was greater among depressed patients who considered religion more important (coefficient, 1.18; p = 0.026) and those who attended services more frequently (coefficient, 1.99; p = 0.001). We conclude that the relationship between religion and suicide risk factors is complex and can vary among different patient populations. Physicians should seek deeper understanding of the role of religion in an individual patient's life in order to understand the person's suicide risk factors more fully.

Borderline personality and attention-deficit hyperactivity traits in childhood are associated with hypomanic features in early adulthood.

PubMed

Mistry, Sumit; Zammit, Stanley; Price, Valentina-Escott; Jones, Hannah J; Smith, Daniel J

2017-10-15

There is limited understanding of the symptomatic development of bipolar disorder from childhood to early adulthood. We assessed whether borderline personality disorder traits, ADHD, and emotional, behavioural and social difficulties during childhood were associated with hypomania assessed in young adulthood. We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), to examine associations between measures of childhood psychopathology and lifetime hypomanic features assessed at age 22-23 years using the Hypomania Checklist-32 (HCL-32; n = 3372). We also conducted a factor analysis of the HCL to identify latent constructs underlying hypomania, and the extent to which childhood psychopathology was associated with these. We identified two factors of the HCL corresponding to energy/mood and risk-taking/irritability. There was evidence of association between childhood borderline personality disorder traits and both hypomania factors, with evidence that the association was stronger with the risk-taking/irritability factor. All individual borderline traits, with the exception of fear of abandonment, were associated with hypomania. There was also evidence of association between most other measures of childhood psychopathology (ADHD, hyperactivity, conduct problems, peer relationship problems and reduced prosocial behaviour) and the risk-taking/irritability factor, but much less consistent evidence of association with the energy/mood factor. The HCL cannot diagnose bipolar disorder and may be subject to reporting bias. A broad range of childhood psychopathologies may represent early markers of risk for hypomania. Further studies are required to understand the mechanisms underlying these associations, and to inform earlier detection of bipolar disorder. Copyright © 2017 Elsevier B.V. All rights reserved.

Studying Biology to Understand Risk: Dosimetry Models and Quantitative Adverse Outcome Pathways

EPA Science Inventory

Confidence in the quantitative prediction of risk is increased when the prediction is based to as great an extent as possible on the relevant biological factors that constitute the pathway from exposure to adverse outcome. With the first examples now over 40 years old, physiologi...

UV Influence on the Re-Growth of Pathogens in Cow Fecal Extract

EPA Science Inventory

The health risks pathogens pose to water and food resources are highly dependent on their fate and transport in agricultural settings. In order to assess these risks, and understanding of the factors that influence pathogen fate in agricultural settings is needed and is critical ...

Addiction as a Systems Failure: Focus on Adolescence and Smoking

PubMed Central

Baler, Ruben D.; Volkow, Nora D.

2011-01-01

Objective Scientific advances in the field of addiction have forever debunked the notion that addiction reflects a character flaw under voluntary control, demonstrating instead that it is a bona fide disease of the brain. The aim of this review is to go beyond this consensus understanding and explore the most current evidence regarding the vast number of genetic, developmental, and environmental factors whose complex interactions modulate addiction risk and trajectory. Method Focusing on childhood and adolescent smoking as a paradigm, we review the important risk factors for the development of addictions, starting at the level of genetics and closing with a focus on sociocultural and policy factors. Results A critical review of the pertinent literature provides a detailed view of the cumulative power of risk and protection factors across different phenomenological levels to modulate the risk of undesirable outcomes, particularly for young people. The result represents a compelling argument for the need to engage in comprehensive, multilevel approaches to promoting health. Conclusions Today, the field of medicine understands more about disease than about health; however it need not be that way. The view of drug addiction as a systems failure should help refocus our general approach to developing dynamic models and early comprehensive interventions that optimize the ways in which we prevent and treat a complex, developmental disorder such as drug addiction. PMID:21421173

Clinical and Psychosocial Profiles of Asian Immigrants Who Repeatedly Attempt Suicide: A Mixed-Method Study of Risk and Protective Factors.

PubMed

Chung, Irene W; Caine, Eric D; Barron, Charles T; Badaracco, Mary A

2015-01-01

Persons who repeatedly attempt suicide comprise a highly distressed population that warrants the understanding of risk and protective factors in assessment and treatment. There is a dearth of literature on Asian immigrants' suicidal behavior. The study aimed to capture the clinical and psychosocial profiles of Asian immigrants who made repeated suicide attempts. We utilized retrospective chart reviews (n = 44) and in-person interviews (n = 12) in two urban public hospitals. The study samples shared major suicide risk factors identified in studies of other populations. Participants of the interview sample suffered from a pervasive sense of hopelessness stemming from social isolation, self-stigma, feelings of failure in their life roles, and perceptions of rejection by their families. Conversely, psychological well-being--feeling cared for and able to reciprocate care for others--appeared to be a protective factor for participants who improved in their functioning and recovery. The study lays the groundwork for further research on suicide risk and protective factors.

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

PubMed

Jacob, Liril

2017-12-14

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

[Risk factors found in suicide attempters].

PubMed

Villa-Manzano, Alberto Iram; Robles-Romero, Miguel Angel; Gutiérrez-Román, Elsa Armida; Martínez-Arriaga, María Guadalupe; Valadez-Toscano, Francisco Javier; Cabrera-Pivaral, Carlos E

2009-01-01

A better understanding of risk factors for suicide in general population is crucial for the design of suicide prevention programs. Our objective was to identify personal and family risk factors in suicide attempters. Case-control design. We searched in patients with an acute intoxication, those subjects with and intoxication attributable to suicide attempt. These patients were matched with controls by gender and the date of intoxication. We use a structured questionnaire to identify personal characteristics, family features and network support. Odds ratio (OR) and 95 % confidence interval were obtained. 25 cases and 25 controls were evaluated. The risk factors associated with suicide attempt adjusted by age, were being a student and smoking habits. Family violence background showed OR = 3.8 (IC 95 % = 1.1-13), family disintegration a OR = 8.5 (IC 95 % = 2.1-35), critical events background OR = 8.8 (IC 95 % = 2.1-36), poor self-esteem OR = 8.2 (IC 95 % 2-35), depression OR = 22 (IC 95 % = 3-190), anxiety OR = 9 (IC 95 % = 2-47), family dysfunction OR = 25 (IC 95 % = 4-151). The principal risk factor for suicide attempt was family dysfunction and psychological traits.

Mammographic density and breast cancer risk: current understanding and future prospects

PubMed Central

2011-01-01

Variations in percent mammographic density (PMD) reflect variations in the amounts of collagen and number of epithelial and non-epithelial cells in the breast. Extensive PMD is associated with a markedly increased risk of invasive breast cancer. The PMD phenotype is important in the context of breast cancer prevention because extensive PMD is common in the population, is strongly associated with risk of the disease, and, unlike most breast cancer risk factors, can be changed. Work now in progress makes it likely that measurement of PMD will be improved in the near future and that understanding of the genetics and biological basis of the association of PMD with breast cancer risk will also improve. Future prospects for the application of PMD include mammographic screening, risk prediction in individuals, breast cancer prevention research, and clinical decision making. PMID:22114898

Young people's and stakeholders' perspectives of adolescent sexual risk behavior in Kilifi County, Kenya: A qualitative study.

PubMed

Ssewanyana, Derrick; Mwangala, Patrick N; Marsh, Vicki; Jao, Irene; van Baar, Anneloes; Newton, Charles R; Abubakar, Amina

2018-02-01

A lack of research exists around the most common forms of sexual risk behaviors among adolescents, including their underlying factors, in Sub-Saharan Africa. Using an Ecological Model of Adolescent Behavior, we explore the perceptions of 85 young people and 10 stakeholders on sexual risk behavior of adolescents in Kilifi County on the coast of Kenya. Our findings show that transactional sex, early sexual debut, coerced sex, and multiple sexual partnerships are prevalent. An urgent need exists to develop measures to counter sexual risk behaviors. The results contribute to understanding the range of risks and protective factors in differing contexts, tackling underlying issues at individual, family, local institutional, wider socio-economic, and political levels.

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

Young people’s and stakeholders’ perspectives of adolescent sexual risk behavior in Kilifi County, Kenya: A qualitative study

PubMed Central

Ssewanyana, Derrick; Mwangala, Patrick N; Marsh, Vicki; Jao, Irene; van Baar, Anneloes; Newton, Charles R; Abubakar, Amina

2017-01-01

A lack of research exists around the most common forms of sexual risk behaviors among adolescents, including their underlying factors, in Sub-Saharan Africa. Using an Ecological Model of Adolescent Behavior, we explore the perceptions of 85 young people and 10 stakeholders on sexual risk behavior of adolescents in Kilifi County on the coast of Kenya. Our findings show that transactional sex, early sexual debut, coerced sex, and multiple sexual partnerships are prevalent. An urgent need exists to develop measures to counter sexual risk behaviors. The results contribute to understanding the range of risks and protective factors in differing contexts, tackling underlying issues at individual, family, local institutional, wider socio-economic, and political levels. PMID:29076401

When "The Cure" Is the Risk: Understanding How Substance Use Affects HIV and HCV in a Layered Risk Environment in San Juan, Puerto Rico

ERIC Educational Resources Information Center

Hernández, Diana; Castellón, Pedro C.; Fernández, Yohansa; Torres-Cardona, Francisco A.; Parish, Carrigan; Gorshein, Danielle; Vargas Vidot, Jose; Miranda de Leon, Sandra; Rodriguez, Allan; Santana Bagur, Jorge; Feaster, Daniel J.; Schackman, Bruce R.; Metsch, Lisa R.

2017-01-01

Background: Substance use, particularly injection drug use, continues to fuel the HIV/HCV (hepatitis C virus) epidemics in San Juan, Puerto Rico (PR). Aim: This article examines individual and sociostructural factors that affect HIV/HCV risk among people who use drugs (PWUD) living with or at risk for HIV/HCV in San Juan, PR. Findings were used to…

Exploring Risk Factors for Follicular Lymphoma

PubMed Central

Ambinder, Alexander J.; Shenoy, Pareen J.; Malik, Neha; Maggioncalda, Alison; Nastoupil, Loretta J.; Flowers, Christopher R.

2012-01-01

Follicular lymphoma (FL) is an indolent malignancy of germinal center B cells with varied incidence across racial groups and geographic regions. Improvements in the classification of non-Hodgkin lymphoma subtypes provide an opportunity to explore associations between environmental exposures and FL incidence. Our paper found that aspects of Western lifestyle including sedentary lifestyle, obesity, and diets high in meat and milk are associated with an increased risk of FL. Diets rich in fruits and vegetables, polyunsaturated fatty acids, vitamin D, and certain antioxidants are inversely associated with FL risk. A medical history of Sjogren's syndrome, influenza vaccination, and heart disease may be associated with FL incidence. Associations between FL and exposure to pesticides, industrial solvents, hair dyes, and alcohol/tobacco were inconsistent. Genetic risk factors include variants at the 6p21.32 region of the MHC II locus, polymorphisms of the DNA repair gene XRCC3, and UV exposure in individuals with certain polymorphisms of the vitamin D receptor. Increasing our understanding of risk factors for FL must involve integrating epidemiological studies of genetics and exposures to allow for the examination of risk factors and interactions between genes and environment. PMID:23028387

Which factors in raw cow's milk contribute to protection against allergies?

PubMed

van Neerven, R J Joost; Knol, Edward F; Heck, Jeroen M L; Savelkoul, Huub F J

2012-10-01

Several epidemiologic studies have shown that growing up in a farming environment is associated with a decreased risk of allergies. A factor that correlates strongly with this effect is the early ingestion of unheated cow's milk. Although, to date, no controlled studies on raw milk consumption have been performed to formally demonstrate this effect, several factors in bovine milk have been described that might explain how raw cow's milk consumption can decrease the risk of allergies. In addition, increasing knowledge on the immunologically active factors in breast milk have also contributed to our understanding of the effects of bovine milk in infants because many of the factors in bovine milk are expected to have functional effects in human subjects as well. Here we review these factors and their mechanisms of action and compare their presence in bovine milk and breast milk. A better understanding of these factors, as well as how to retain them, might ultimately lead to the development of mildly processed milk and infant nutrition products that could become a part of preventive strategies to reduce the incidence of allergic disease. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Community perceptions of risk factors for interpersonal violence in townships in Cape Town, South Africa: A focus group study.

PubMed

Makanga, Prestige Tatenda; Schuurman, Nadine; Randall, Ellen

2017-10-01

Interpersonal violence is a major contributor to the burden of disease globally, and in South Africa, it is the leading cause of injury. There is an emerging consensus that the development of actionable policy and effective prevention strategies for interpersonal violence requires an understanding of the contextual matters that elevate risk for interpersonal violence. The objective of this study was to explore community perceptions of risks for interpersonal violence in five townships in Cape Town, South Africa, with high rates of violence. Focus group discussions were conducted with community members to identify key factors in that contributed to being either a perpetrator or victim of interpersonal violence. The ecological framework was used to classify the risk factors as occurring at individual, relationship, community or society levels. Some of the risk factors identified included alcohol abuse, poverty, informality of settlements and cultural norms. Differences in how each of these risk factors are expressed and experienced in the five communities are also elucidated. This approach enabled the collection of contextual community-based data that can complement conventional surveillance data in the development of relevant community-level strategies for interpersonal violence prevention.

Perinatal and sociodemographic factors at birth predicting conduct problems and violence to age 18 years: comparison of Brazilian and British birth cohorts.

PubMed

Murray, Joseph; Maughan, Barbara; Menezes, Ana M B; Hickman, Matthew; MacLeod, John; Matijasevich, Alicia; Gonçalves, Helen; Anselmi, Luciana; Gallo, Erika A G; Barros, Fernando C

2015-08-01

Many low- and middle-income countries have high levels of violence. Research in high-income countries shows that risk factors in the perinatal period are significant precursors of conduct problems which can develop into violence. It is not known whether the same early influences are important in lower income settings with higher rates of violence. This study compared perinatal and sociodemographic risk factors between Brazil and Britain, and their role in explaining higher rates of conduct problems and violence in Brazil. Prospective population-based birth cohort studies were conducted in Pelotas, Brazil (N = 3,618) and Avon, Britain (N = 4,103). Eleven perinatal and sociodemographic risk factors were measured in questionnaires completed by mothers during the perinatal period. Conduct problems were measured in questionnaires completed by mothers at age 11, and violence in self-report questionnaires completed by adolescents at age 18. Conduct problems were predicted by similar risk factors in Brazil and Britain. Female violence was predicted by several of the same risk factors in both countries. However, male violence in Brazil was associated with only one risk factor, and several risk factor associations were weaker in Brazil than in Britain for both females and males. Almost 20% of the higher risk for conduct problems in Brazil compared to Britain was explained by differential exposure to risk factors. The percentage of the cross-national difference in violence explained by early risk factors was 15% for females and 8% for males. A nontrivial proportion of cross-national differences in antisocial behaviour are related to perinatal and sociodemographic conditions at the start of life. However, risk factor associations are weaker in Brazil than in Britain, and influences in other developmental periods are probably of particular importance for understanding male youth violence in Brazil. © 2014 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

Risk factors for the prognosis of pediatric medulloblastoma: a retrospective analysis of 40 cases.

PubMed

Yu, Jianzhong; Zhao, Rui; Shi, Wei; Li, Hao

2017-05-01

In this study, we evaluated the association of molecular subtypes, clinical characteristics and pathological types with the prognosis of patients with medulloblastoma. We analyzed forty patients with medulloblastoma who underwent surgical resection at our center between January 2004 and June 2014. Risk factors associated with survival, disease progression and recurrence were analyzed with a univariate Cox regression analysis, and the identified significant risk factors were further analyzed by Kaplan-Meier survival curves. Factors associated with overall survival included M stage (p=0.014), calcification (p=0.012), postoperative treatment, postoperative Karnofsky Performance Scale (KPS) score (p=0.015), and molecular subtype (p=0.005 for WNT and p=0.008 for SHH). Number of symptoms (p=0.029), M stage (p<0.001), and postoperative radiotherapy (p=0.033) were associated with disease progression. Patients with the WNT or SHH subtype had better survival outcomes than patients with non-WNT/SHH subtypes. Risk factors for disease progression-free survival were symptoms >2 and ≥M1 stage without postoperative radiotherapy. The risk of recurrence increased with advanced M stage. Protective factors for recurrence included M0 stage and a combination of chemotherapy and radiotherapy. We identified the risk factors associated with survival, disease progression and recurrence of medulloblastoma patients. This information is helpful for understanding the prognostic factors related to medulloblastoma.

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.

Integrating Professional and Folk Models of HIV Risk: YMSM’s Perceptions of High-Risk Sex

PubMed Central

Kubicek, Katrina; Carpineto, Julie; McDavitt, Bryce; Weiss, George; Iverson, Ellen F.; Au, Chi-Wai; Kerrone, Dustin; Martinez, Miguel; Kipke, Michele D.

2009-01-01

Risks associated with HIV are well documented in research literature. While a great deal has been written about high-risk sex, little research has been conducted to examine how young men who have sex with men (YMSM) perceive and define high-risk sexual behavior. In this study, we compare the “professional’ and “folk” models of HIV-risk based on YMSM’s understanding of high-risk sex and where and how they gathered their understanding of HIV-risk behaviors. The findings reported here emerged from the quantitative and qualitative interviews from the Healthy Young Men’s Study (HYM), a longitudinal study examining risk and protective factors for substance use and sexual risk among an ethnically diverse sample of YMSM. Findings are discussed in relation to framing how service providers and others can increase YMSM’s knowledge of sexual behavior and help them build solid foundations of sexual health education to protect them from STI and HIV infection. PMID:18558819

Demand and supply factors affecting the rising overmedicalization of birth in India.

PubMed

Leone, Tiziana

2014-11-01

To understand the interaction between health systems and individual factors in determining the probability of a cesarean delivery in India. In a retrospective study, data from the 2007-2008 District Level Household and Facility Survey was used to determine the risk of cesarean delivery in six states (Punjab, Delhi, Maharashtra, Andhra Pradesh, Kerala, and Tamil Nadu). Multilevel modeling was used to account for district and community effects. After controlling for key risk factors, the analysis showed that cesareans were more likely at private than public institutions (P<0.001). In terms of demand, higher education levels rather than wealth seemed to increase the likelihood of a cesarean delivery. District-level effects were significant in almost all states (P<0.001), demonstrating the need to control for health system factors. Supply factors might contribute more to the rise in cesarean delivery than does demand. Further research is needed to understand whether the quest for increased institutional deliveries in a country with high maternal mortality might be compromised by pressures for overmedicalization. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Risk and protective factors in early child development: Results from the All Our Babies (AOB) pregnancy cohort.

PubMed

McDonald, Sheila; Kehler, Heather; Bayrampour, Hamideh; Fraser-Lee, Nonie; Tough, Suzanne

2016-11-01

Understanding factors that protect against early developmental delay among children who are experiencing adversity can inform prevention and early intervention strategies. To identify risk factors for development delay at one year and protective factors for developmental delay in 'at risk' environments (poor maternal mental health and socio-demographic risk). Data was analyzed from 3360 mother-child dyads who participated in the All Our Babies (AOB) pregnancy cohort. Participants completed four questionnaires spanning pregnancy to one year postpartum and provided access to medical records. Risk factors for developmental delay at age one were identified using bivariate methods and multivariable modeling. Protective factors for child development in 'at risk' family environments were identified using bivariate analyses. At one year, 17% of children were developmentally delayed, defined as scoring in the monitoring zone on at least 2 of the 5 developmental domains of the Ages and Stages Questionnaire. Prenatal depression, preterm birth, low community engagement, and non-daily parent-child interaction increased the risk of delay. Protective factors for children in 'at risk' environments included relationship happiness, parenting self-efficacy, community engagement, higher social support, and daily parent-child interaction. The study results suggest that maternal and infant outcomes would be improved, even for vulnerable women, through identification and intervention to address poor mental health and through normalizing engagement with low cost, accessible community resources that can also support parent-child interaction. Copyright © 2016 Elsevier Ltd. All rights reserved.

Factors that Influence Women's Technical Skill Development in Outdoor Adventure

ERIC Educational Resources Information Center

Warren, Karen; Loeffler, TA

2006-01-01

This article provides a theoretical foundation for understanding women's technical skill development (TSD) in outdoor adventure. An examination of societal and biological factors influencing women's TSD focuses on gender role socialization, sense of competence, technical conditioning, sexism, spatial ability, and risk-taking. The article suggests…

Risk Factors and Consequent Outcomes of Placenta Previa: Report From a Referral Center.

PubMed

Saleh Gargari, Soraya; Seify, Zahra; Haghighi, Ladan; Khoshnood Shariati, Maryam; Mirzamoradi, Masoumeh

2016-11-01

 Because of an unknown factor, the frequency of complicated pregnancy with placenta previa has been raised during past decade. This study was designed to deepen our understanding of risk factors and outcomes of placenta previa in our country. This study investigated 694 cases of placenta previa comparing with 600 healthy pregnant women with not overlie placenta in two referral and tertiary Obstetrics and Gynecological Hospital in Iran on the basis of the clinical and para-clinical analysis, in order to find the probable risk factors for occurrence of placenta previa and its effect on maternal and neonatal complications. The most important risk factor for the occurrence of placenta previa was advanced maternal age (P<0.001) and history of stillbirth (OR=117.2, CI=58.3-236.0). In the other hand, the most substantial outcome of this disorder was a reduction of gestational age (P<0.001) and low birth weight neonatally (P<0.001). The conservative follow-up should be programmed for women with placenta previa based on the type of risk factors which can provide the best possible management to decrease the morbidity and mortality of their related complications.

The Association between Non-Alcoholic Fatty Liver Disease and Cardiovascular Risk in Children.

PubMed

Di Sessa, Anna; Umano, Giuseppina Rosaria; Miraglia Del Giudice, Emanuele

2017-07-07

The rising prevalence of childhood obesity in the past decades has made Non-Alcoholic Fatty Liver Disease (NAFLD) the most common cause of pediatric chronic liver disease worldwide. Currently, a growing body of evidence links NAFLD with cardiovascular disease (CVD) even at an early age. Data on the pediatric population have shown that NAFLD could represent an independent risk factor not only for cardiovascular events but also for early subclinical abnormalities in myocardial structure and function. Briefly, we review the current knowledge regarding the relationship between pediatric NAFLD and cardiovascular risk in an attempt to clarify our understanding of NAFLD as a possible cardiovascular risk factor in childhood.

Trends in selected chronic conditions and behavioral risk factors among women of reproductive age, behavioral risk factor surveillance system, 2001-2009.

PubMed

Hayes, Donald K; Fan, Amy Z; Smith, Ruben A; Bombard, Jennifer M

2011-11-01

Some potentially modifiable risk factors and chronic conditions cause significant disease and death during pregnancy and promote the development of chronic disease. This study describes recent trends of modifiable risk factors and controllable chronic conditions among reproductive-aged women. Data from the 2001 to 2009 Behavioral Risk Factor Surveillance System, a representative state-based telephone survey of health behavior in US adults, was analyzed for 327,917 women of reproductive age, 18 to 44 years. We calculated prevalence ratios over time to assess trends for 4 selected risk factors and 4 chronic conditions, accounting for age, race/ethnicity, education, health care coverage, and individual states. From 2001 to 2009, estimates of 2 risk factors improved: smoking declined from 25.9% to 18.8%, and physical inactivity declined from 25.0% to 23.0%. One risk factor, heavy drinking, did not change. From 2003 to 2009, the estimates for 1 risk factor and 4 chronic conditions worsened: obesity increased from 18.3% to 24.7%, diabetes increased from 2.1% to 2.9%, high cholesterol increased from 10.3% to 13.6%, asthma increased from 13.5% to 16.2%, and high blood pressure increased from 9.0% to 10.1%. All trends were significant after adjustment, except that for heavy drinking. Among women of reproductive age, prevalence of smoking and physical inactivity improved, but prevalence of obesity and all 4 chronic conditions worsened. Understanding reasons for the improvements in smoking and physical activity may support the development of targeted interventions to reverse the trends and help prevent chronic disease and adverse reproductive outcomes among women in this age group.

The capacity-load model of non-communicable disease risk: understanding the effects of child malnutrition, ethnicity and the social determinants of health.

PubMed

Wells, Jonathan C K

2018-05-01

The capacity-load model is a conceptual model developed to improve understanding of the life-course aetiology of non-communicable diseases (NCDs) and their ecological and societal risk factors. The model addresses continuous associations of both (a) nutrition and growth patterns in early life and (b) lifestyle factors at older ages with NCD risk. Metabolic capacity refers to physiological traits strongly contingent on early nutrition and growth during the first 1000 days, which promote the long-term capacity for homeostasis in the context of fuel metabolism and cardiovascular health. Metabolic load refers to components of nutritional status and lifestyle that challenge homeostasis. The higher the load, and the lower the capacity, the greater the NCD risk. The model therefore helps understand dose-response associations of both early development and later phenotype with NCD risk. Infancy represents a critical developmental period, during which slow growth can constrain metabolic capacity, whereas rapid weight gain may elevate metabolic load. Severe acute malnutrition in early childhood (stunting, wasting) may continue to deplete metabolic capacity, and confer elevated susceptibility to NCDs in the long term. The model can be applied to associations of NCD risk with socio-economic position (SEP): lower SEP is generally associated with lower capacity but often also with elevated load. The model can also help explain ethnic differences in NCD risk, as both early growth patterns and later body composition differ systematically between ethnic groups. Recent work has begun to clarify the role of organ development in metabolic capacity, which may further contribute to ethnic differences in NCD risk.

Risk and Protective Factors for Family Violence among Low-Income Fathers: Implications for Violence Prevention and Fatherhood Programs.

PubMed

Hayward, R Anna; Honegger, Laura; Hammock, Amy Cristina

2018-01-01

Over the last decade there has been an increased focus on improving father engagement to improve child and family outcomes. Recent research suggests that child and family outcomes improve with increased fatherhood engagement. This exploratory study examined risk and protective factors associated with approval of family violence among a sample of low-income fathers (N = 686) enrolled in a responsible fatherhood program. The program goals include increasing father involvement and economic stability and encouraging healthy relationships-with a focus on preventing intimate partner violence. Toward these aims, this study explored factors associated with fathers' self-reported approval of family violence. Understanding the prevalence of risk and protective factors in this population and factors associated with fathers' potential for family violence is important in developing programs to address responsible fatherhood and healthy relationships. © 2017 National Association of Social Workers.

Genetics of schizophrenia in the context of integrative psychiatry.

PubMed

Sagud, Marina; Mihaljević-Peles, Alma; Pivac, Nela; Muck-Seler, Dorotea; Simunović, Ivona; Jakovljević, Miro

2008-09-01

Epidemiological studies suggest a strong heritability in schizophrenia. Positive family history is the greatest risk factor for developing schizophrenia. However, regarding the genetic factors in schizophrenia, there is a lot of the inconsistency (i.e. non-replication) in the literature of the associations of different genes with schizophrenia. The presence of a single gene is neither sufficient, nor necessary to cause schizophrenia. The understanding of the genetic basis of schizophrenia is complex. Besides different gene polymorphisms, numerous environmental factors, interacting with genes, contribute to susceptibility to schizophrenia. Such factors include the use of street drugs, childhood head injury, maternal infection during pregnancy, paternal age at conception, stressful life events and urban upbringing. While knowing genetic risks, integrative psychiatry may have a role in reducing other modifiable risk factors, including reduction of stress level, stress management strategies, family consultation/education, education against street drugs use, treatment of prodromal symptoms and development of social skills.

Suicide on railroad rights-of-way: a psychological autopsy study.

PubMed

Berman, Alan L; Sundararaman, Ramya; Price, Andrea; Au, Josephine S

2014-12-01

Findings from 55 psychological autopsies of decedents who perished on U.S. railroad rights-of-way between October 1, 2007, and September 30, 2010 are reported. Described are distal, proximal, and contextual factors of risk; understandings of why these suicides occurred on railroad rights-of-way; and opportunities for prevention of similar suicides. International comparisons of suicides on railroad rights-of-way are made to highlight distinct findings regarding U.S. cases. Decedents studied exhibited considerable predisposing risk for suicide, with a high prevalence of severe mental disorders and substance abuse. In addition, a number of acute risk factors were commonly observed, notably suicide ideation, hopelessness, anxiety, and anger. In the context of that acute risk, associated situational variables and a relative absence of protective factors are described. © 2014 The American Association of Suicidology.

Applying the Heuristic to the Risk Assessment within the Automotive Industry Supply Chain

NASA Astrophysics Data System (ADS)

Marasova, Daniela; Andrejiova, Miriam; Grincova, Anna

2017-03-01

Risk management facilitates risk identification, evaluation, control, and by means of appropriate set of measures, risk reduction or complete elimination. Therefore, the risk management becomes a strategic factor for a company's success. Properly implemented risk management system does not represent a tool to avoid the risk; it is used to understand the risk and provide the bases for strategic decision-making. Risk management represents a key factor for the supply chain operations. Managing the risks is crucial for achieving the customer satisfaction and thus also a company's success. The subject-matter of the article is the assessment of the supply chain in the automobile industry, in terms of risks. The topicality of this problem is even higher, as after the economic crisis it is necessary to revaluate the readiness of the supply chain for prospective risk conditions. One advantage of this article is the use of the Saaty method as a tool for the risk management within the supply chain.

Awareness of lifestyle risk factors for cancer and heart disease among adults in the UK.

PubMed

Sanderson, Saskia C; Waller, Jo; Jarvis, Martin J; Humphries, Steve E; Wardle, Jane

2009-02-01

To examine and compare awareness of lifestyle risk factors for cancer and heart disease in a single UK representative sample. Two open-ended questions about cancer and heart disease risk factors were included in a population-based survey of 1747 adults. Responses were coded for four lifestyles with established links to both diseases: smoking, eating an unhealthy diet, drinking excessive alcohol and physical inactivity. Awareness of lifestyle risk factors was low for both diseases, although higher for heart disease than cancer. The average number identified by respondents was 2.1 (heart disease) and 1.4 (cancer). The strongest predictor was education (both p<0.001). Awareness that physical inactivity is a cancer risk factor was particularly low at 7%. These findings suggest that public awareness of the impact of lifestyle on commonly feared diseases, especially cancer, is low. Unhealthy lifestyles make a significant contribution to ill health and mortality. Increased public awareness of the links between lifestyles and commonly feared diseases might help people understand the potential health consequences of their actions and encourage them to make much-needed lifestyle changes. Efforts are needed to improve public health messages about how lifestyle risk factors impact on the chances of developing these important diseases.

Geographical Environment Factors and Risk Assessment of Tick-Borne Encephalitis in Hulunbuir, Northeastern China.

PubMed

Li, Yifan; Wang, Juanle; Gao, Mengxu; Fang, Liqun; Liu, Changhua; Lyu, Xin; Bai, Yongqing; Zhao, Qiang; Li, Hairong; Yu, Hongjie; Cao, Wuchun; Feng, Liqiang; Wang, Yanjun; Zhang, Bin

2017-05-26

Tick-borne encephalitis (TBE) is one of natural foci diseases transmitted by ticks. Its distribution and transmission are closely related to geographic and environmental factors. Identification of environmental determinates of TBE is of great importance to understanding the general distribution of existing and potential TBE natural foci. Hulunbuir, one of the most severe endemic areas of the disease, is selected as the study area. Statistical analysis, global and local spatial autocorrelation analysis, and regression methods were applied to detect the spatiotemporal characteristics, compare the impact degree of associated factors, and model the risk distribution using the heterogeneity. The statistical analysis of gridded geographic and environmental factors and TBE incidence show that the TBE patients mainly occurred during spring and summer and that there is a significant positive spatial autocorrelation between the distribution of TBE cases and environmental characteristics. The impact degree of these factors on TBE risks has the following descending order: temperature, relative humidity, vegetation coverage, precipitation and topography. A high-risk area with a triangle shape was determined in the central part of Hulunbuir; the low-risk area is located in the two belts next to the outside edge of the central triangle. The TBE risk distribution revealed that the impact of the geographic factors changed depending on the heterogeneity.

Disruptive behaviour disorders: a systematic review of environmental antenatal and early years risk factors.

PubMed

Latimer, K; Wilson, P; Kemp, J; Thompson, L; Sim, F; Gillberg, C; Puckering, C; Minnis, H

2012-09-01

Disruptive behaviour disorders (DBDs), including attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) are chronic disorders with significant overlap in aetiology and presentation. An integrative examination of environmental risk factors is lacking. Six literature searches of web-based bibliographic databases were completed to identify literature on DBDs in general and five disorders in particular: CD, ODD, ADHD, deficits of attention, motor control and perception, and reactive attachment disorder. Searches were filtered to focus on studies including diagnostic assessment, focussing on environmental risk and protective factors in the first 4 years of life. The database searches generated 9806 papers of which 47 were reviewed after filters had been applied. The evidence suggests links between a number of early life risk factors and DBDs, including prenatal cigarette smoking and alcohol use, prenatal viral illness, maternal stress and anxiety, low birthweight, peri-partum and early neonatal complications, parental stress and parenting styles in infancy, early deprivation, adoption and separation. Despite the understanding that there is sharing of risk factors between the DBDs, there has been a disproportionate focus on the role of certain risk factors at the expense of others and the field is weakened by difficulties in controlling for all potential confounding variables. © 2012 Blackwell Publishing Ltd.

Anterior cruciate ligament injury: Identifying information sources and risk factor awareness among the general population.

PubMed

Nagano, Yasuharu; Yako-Suketomo, Hiroko; Natsui, Hiroaki

2018-01-01

Raising awareness on a disorder is important for its prevention and for promoting public health. However, for sports injuries like the anterior cruciate ligament (ACL) injury no studies have investigated the awareness on risk factors for injury and possible preventative measures in the general population. The sources of information among the population are also unclear. The purpose of the present study was to identify these aspects of public awareness about the ACL injury. A questionnaire was randomly distributed among the general population registered with a web based questionnaire supplier, to recruit 900 participants who were aware about the ACL injury. The questionnaire consisted of two parts: Question 1 asked them about their sources of information regarding the ACL injury; Question 2 asked them about the risk factors for ACL injury. Multivariate logistic regression was used to determine the information sources that provide a good understanding of the risk factors. The leading source of information for ACL injury was television (57.0%). However, the results of logistic regression analysis revealed that television was not an effective medium to create awareness about the risk factors, among the general population. Instead "Lecture by a coach", "Classroom session on Health", and "Newspaper" were significantly more effective in creating a good awareness of the risk factors (p < 0.001).

Development of risk assessment tool for foundry workers.

PubMed

Mohan, G Madhan; Prasad, P S S; Mokkapati, Anil Kumar; Venkataraman, G

2008-01-01

Occupational ill-health and work-related disorders are predominant in manufacturing industries due to the inevitable presence of manual work even after several waves of industrial automation and technological advancements. Ergonomic risk factors and musculoskeletal disorders like low-back symptoms have been noted amongst foundry workers. The purpose of this study was to formulate and develop a Physical Effort Index to assess risk factor. The questionnaire tool applicable to foundry environment has been designed and validated. The data recorded through survey across the foundries has been subjected to regression analysis to correlate between proposed physical effort index and the standard Borg's Ratings of Perceived Exertion (RPE) scale. The physical efforts of sixty seven workers in various foundry shop floors were assessed subjectively. The 'Job factors' and 'Work environment' were the two major parameters considered in assessing the worker discomfort level at workplace. A relation between Borg's RPE scale and the above two parameters were arrived at, through regression analysis. The study demonstrates the prevalence of risk factors amongst foundry workers and the effectiveness of the proposed index in estimating the risk factor levels. RELEVANCE TO THE INDUSTRY: The proposed tool will assist foundry supervisors and managers to assess the risk factors and helps in better understanding of the workplace to avoid work-related disorders, ensuring better output.

Ranking malaria risk factors to guide malaria control efforts in African highlands.

PubMed

Protopopoff, Natacha; Van Bortel, Wim; Speybroeck, Niko; Van Geertruyden, Jean-Pierre; Baza, Dismas; D'Alessandro, Umberto; Coosemans, Marc

2009-11-25

Malaria is re-emerging in most of the African highlands exposing the non immune population to deadly epidemics. A better understanding of the factors impacting transmission in the highlands is crucial to improve well targeted malaria control strategies. A conceptual model of potential malaria risk factors in the highlands was built based on the available literature. Furthermore, the relative importance of these factors on malaria can be estimated through "classification and regression trees", an unexploited statistical method in the malaria field. This CART method was used to analyse the malaria risk factors in the Burundi highlands. The results showed that Anopheles density was the best predictor for high malaria prevalence. Then lower rainfall, no vector control, higher minimum temperature and houses near breeding sites were associated by order of importance to higher Anopheles density. In Burundi highlands monitoring Anopheles densities when rainfall is low may be able to predict epidemics. The conceptual model combined with the CART analysis is a decision support tool that could provide an important contribution toward the prevention and control of malaria by identifying major risk factors.

Does Your Heart Forecast help practitioner understanding and confidence with cardiovascular disease risk communication?

PubMed

Wells, Sue; Kerr, Andrew; Broadbent, Elizabeth; MacKenzie, Craig; Cole, Karl; McLachlan, Andy

2011-03-01

Explaining what cardiovascular disease (CVD) risk means and engaging in shared decision-making regarding risk factor modification is challenging. An electronic CVD risk visualisation tool containing multiple risk communication strategies (Your Heart Forecast) was designed in 2009. To assess whether this tool facilitated explaining CVD risk to primary care patients. Health professionals who accessed a Primary Health Organisation website or who attended educational peer groups over a three-month period were invited to complete questionnaires before and after viewing a four-minute video about the tool. Respondents were asked to make an informed guess of the CVD risk of a 35-year-old patient (actual CVD risk 5%) and rate the following sentence as being true or false: 'If there were 100 people like Mr Andrews, five would go on to have a cardiac event in the next five years.' They also were asked to rank their understanding of CVD risk and confidence in explaining the concept to patients. Fifty health professionals (37 GPs, 12 practice nurses, one other) completed before and after questionnaires. Respondents' CVD risk estimates pre-video ranged from <5% to 25% and nine rated the sentence as being false. After the video, all respondents answered these questions correctly. Personal rankings from zero to 10 about understanding CVD risk and confidence in explaining risk reduced in range and shifted towards greater efficacy. Whether this tool facilitates discussions of CVD risk with patients and improves patient understanding and lifestyle behaviour needs to be evaluated in a randomised trial.

Do arterial stiffness and wave reflection underlie cardiovascular risk in ethnic minorities?

PubMed

Faconti, Luca; Nanino, Elisa; Mills, Charlotte E; Cruickshank, Kennedy J

2016-01-01

Increasing evidence indicates that remarkable differences in cardiovascular risk between ethnic groups cannot be fully explained by traditional risk factors such as hypertension, diabetes or dislipidemia measured in midlife. Therefore, the underlying pathophysiology leading to this "excess risk" in ethnic minority groups is still poorly understood, and one way to address this issue is to shift the focus from "risk" to examine target organs, particularly blood vessels and their arterial properties more directly. In fact, structural and functional changes of the vascular system may be identifiable at very early stages of life when traditional factors are not yet developed. Arterial stiffening, measured as aortic pulse wave velocity, and wave reflection parameters, especially augmentation index, seem to be an important pathophysiological mechanism for the development of cardiovascular disease and predict mortality independent of other risk factors. However, data regarding these arterial indices in ethnic minorities are relatively rare and the heterogeneity between populations, techniques and statistical methods make it difficult to fully understand their role.

Attitude to health risk in the Canadian population: a cross-sectional survey

PubMed Central

Bansback, Nick; Harrison, Mark; Sadatsafavi, Mohsen; Stiggelbout, Anne; Whitehurst, David G.T.

2016-01-01

Background: Risk is a ubiquitous part of health care. Understanding how people respond to risks is important for predicting how populations make health decisions. Our objective was to seek preliminary descriptive insights into the attitude to health risk in the Canadian population and factors associated with heterogeneity in risk attitude. Methods: We used a large market-research panel to survey (in English and French) a representative sample of the Canadian general population that reflected the age, sex and geography of the population. The survey included the Health-Risk Attitude Scale, which predicts how a person resolves risky health decisions related to treatment, prevention of disease and health-related behaviour. In addition, we assessed participants' numeracy and risk understanding, as well as income band and level of education. We summarized the responses, and we explored the independent associations between demographics, numeracy, risk understanding and risk attitude in multivariable models. Results: Of 6780 respondents, 4949 (73.0%) were averse to health risks; however, but there was considerable heterogeneity in the magnitude of risk aversion. We found significant gradients of risk averse attitudes with increasing age and being female (p < 0.001) using the multivariable model. French-speaking participants appeared to be more risk averse than those who were English-speaking (p < 0.001), as were individuals scoring higher on the Subjective Numeracy Scale (p < 0.001). Interpreation: In general, Canadians were averse to health risks, but we found that a sizeable, identifiable group of risk takers exists. Heterogeneity in preferences for risk can explain variations in health care utilization in the context of patient-centred care. Understanding risk preference heterogeneity can help guide policy and assist in patient-physician decisions. PMID:27398375

Menopause and Stroke: An Epidemiologic Review

PubMed Central

Lisabeth, Lynda; Bushnell, Cheryl

2012-01-01

Although women have a lower risk of stroke during middle age, the menopausal transition is a time when many women develop cardiovascular risk factors. In addition, during the 10 years after menopause, the risk of stroke roughly doubles in women. Endogenous estrogen levels decline by 60% during the menopausal transition, leading to a relative androgen excess, which could contribute to the increased cardiovascular risk factors in women. Earlier onset of menopause may influence the risk of stroke, but the data are not clear. Because of the stroke risk associated with hormone therapy, this is only indicated for treatment of vasomotor symptoms, but some formulations may be safe than others. More research is needed to understand which women are at greatest stroke risk during midlife and to determine the safest formulation, dose, and duration of hormone therapy that will treat vasomotor symptoms without increasing the risk for stroke. PMID:22172623

Heart disease versus cancer: understanding perceptions of population prevalence and personal risk.

PubMed

Scheideler, Jennifer K; Taber, Jennifer M; Ferrer, Rebecca A; Grenen, Emily G; Klein, William M P

2017-10-01

Although the gap is narrowing, Americans are more likely to be diagnosed with and die from heart disease than cancer, and yet many believe cancer is more common and their personal risk of cancer is higher than their heart disease risk. Using nationally representative 2013 Health Information National Trends Survey data, we assessed such beliefs and examined sociodemographic and psychological factors and health behaviors associated with these beliefs. 42.8% of participants rated cancer as more common and 78.5% rated their own cancer risk as equal to or exceeding their heart disease risk. These misperceptions were only modestly correlated. Beliefs about relative population risk were associated with various psychological factors, whereas beliefs about relative personal risk were not. Both beliefs were inconsistently associated with health behaviors. Accuracy in beliefs about cancer and heart disease relative risk and prevalence is low and future research should explore antecedents and consequences of these beliefs.

Understanding shaken baby syndrome.

PubMed

Carbaugh, Suzanne Franklin

2004-04-01

Health care professionals involved in the care of infants are in an ideal position to identify and to educate families, the public, and other health care professionals about the risk factors, dangers, and consequences of infant shaking. The purpose of this article is to review the incidence, biomechanics, risk factors, clinical presentation, diagnosis, and prognosis of shaken baby syndrome (SBS), as well as to encourage involvement in SBS prevention through the use of a family teaching tool. Education is essential to decrease the incidence, morbidity, and mortality of SBS.

Diabetes, cardiac disorders and asthma as risk factors for severe organ involvement among adult dengue patients: A matched case-control study.

PubMed

Pang, Junxiong; Hsu, Jung Pu; Yeo, Tsin Wen; Leo, Yee Sin; Lye, David C

2017-01-03

Progression to severe organ involvement due to dengue infection has been associated with severe dengue disease, intensive care treatment, and mortality. However, there is a lack of understanding of the impact of pre-existing comorbidities and other risk factors of severe organ involvement among dengue adults. The aim of this retrospective case-control study is to characterize and identify risk factors that predispose dengue adults at risk of progression with severe organ involvement. This study involved 174 dengue patients who had progressed with severe organ involvement and 865 dengue patients without severe organ involvement, matched by the year of presentation of the cases, who were admitted to Tan Tock Seng Hospital between year 2005 and 2008. Age group of 60 years or older, diabetes, cardiac disorders, asthma, and having two or more pre-existing comorbidities were independent risk factors of severe organ involvement. Abdominal pain, clinical fluid accumulation, and hematocrit rise and rapid platelet count drop at presentation were significantly associated with severe organ involvement. These risk factors, when validated in a larger study, will be useful for triage by clinicians for prompt monitoring and clinical management at first presentation, to minimize the risk of severe organ involvement and hence, disease severity.

Risk factors for Clostridium difficile infections - an overview of the evidence base and challenges in data synthesis.

PubMed

Eze, Paul; Balsells, Evelyn; Kyaw, Moe H; Nair, Harish

2017-06-01

Recognition of a broad spectrum of disease and development of Clostridium difficile infection (CDI) and recurrent CDI (rCDI) in populations previously considered to be at low risk has renewed attention on differences in the risk profile of patients. In the absence of primary prevention for CDI and limited treatment options, it is important to achieve a deep understanding of the multiple factors that influence the risk of developing CDI and rCDI. We conducted a review of systematic reviews and meta-analyses on risk factors for CDI and rCDI published between 1990 and October 2016. 22 systematic reviews assessing risk factors for CDI (n = 19) and rCDI (n = 6) were included. Meta-analyses were conducted in 17 of the systematic reviews. Over 40 risk factors have been associated with CDI and rCDI and can be classified into three categories: pharmacological risk factors, host-related risk factors, and clinical characteristics or interventions. Most systematic reviews and meta-analyses have focused on antibiotic use (n = 8 for CDI, 3 for rCDI), proton pump inhibitors (n = 8 for CDI, 4 for rCDI), and histamine 2 receptor antagonists (n = 4 for CDI) and chronic kidney disease (n = 4 for rCDI). However, other risk factors have been assessed. We discuss the state of the evidence, methods, and challenges for data synthesis. Several studies, synthesized in different systematic review, provide valuable insights into the role of different risk factors for CDI. Meta-analytic evidence of association has been reported for factors such as antibiotics, gastric acid suppressants, non-selective NSAID, and some co-morbidities. However, despite statistical significance, issues of high heterogeneity, bias and confounding remain to be addressed effectively to improve overall risk estimates. Large, prospective primary studies on risk factors for CDI with standardised case definitions and stratified analyses are required to develop more accurate and robust estimates of risk effects that can inform targeted-CDI clinical management procedures, prevention, and research.

Understanding the Molecular Mechanisms Underpinning Gene by Environment Interactions in Psychiatric Disorders: The FKBP5 Model.

PubMed

Matosin, Natalie; Halldorsdottir, Thorhildur; Binder, Elisabeth B

2018-05-15

Epidemiologic and genetic studies suggest common environmental and genetic risk factors for a number of psychiatric disorders, including depression, bipolar disorder, and schizophrenia. Genetic and environmental factors, especially adverse life events, not only have main effects on disease development but also may interact to shape risk and resilience. Such gene by adversity interactions have been described for FKBP5, an endogenous regulator of the stress-neuroendocrine system, conferring risk for a number of psychiatric disorders. In this review, we present a molecular and cellular model of the consequences of FKBP5 by early adversity interactions. We illustrate how altered genetic and epigenetic regulation of FKBP5 may contribute to disease risk by covering evidence from clinical and preclinical studies of FKBP5 dysregulation, known cell-type and tissue-type expression patterns of FKBP5 in humans and animals, and the role of FKBP5 as a stress-responsive molecular hub modulating many cellular pathways. FKBP5 presents the possibility to better understand the molecular and cellular factors contributing to a disease-relevant gene by environment interaction, with implications for the development of biomarkers and interventions for psychiatric disorders. Copyright © 2018 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Understanding clusters of risk factors across different environmental and social contexts for the prediction of injuries among Canadian youth.

PubMed

Russell, K; Davison, C; King, N; Pike, I; Pickett, W

2016-05-01

Among Canadian youth, injury is the most common reason for presentation to the emergency department. Youth who commonly engage in multiple risk-taking behaviours are at greater risk for injury, but is it unknown if this phenomenon is more pronounced in different contexts. We aimed to study relationships between risk-taking behaviours and injury, and variations in such relationships between different environmental and social contexts, among youth in Canada. Risk-taking behaviour and injury outcome data were collected from grade 9 to 10 students using the 2009-2010 (Cycle 6) of the Health Behaviour in School-Aged Children Survey (n=10,429). Principal components analysis was used to identify clusters of risk-taking behaviours. Within each identified cluster, the degree of risk-taking was categorized into quartiles from lowest to highest engagement in the behaviours. Risk ratios with 95% confidence intervals were calculated to determine the association between the risk of any injury and the degree of risk-taking behaviour specific to the cluster. Clusters were then examined across home, school, neighbourhood and sport contexts. Four clusters of risk-taking behaviour were identified which were labelled as "gateway substance use", "hard drugs and weapons", "overt risk-taking", and "physical activity". Each cluster was related to injury occurrence in a graded fashion. Clusters of risk behaviour were most strongly associated with injuries sustained in neighbourhood settings, and expectedly, increasing physical activity behaviours were associated with increased risk of sport injuries and injuries occurring at school. This study furthers understanding of clustered risk-taking phenomena that put youth at increasing levels of injury risk. Higher risks for injury and associated gradients were observed in less structured contexts such as neighbourhoods. In contrast, clustered physical activity behaviours were most related to school injury or sport injury and were more likely to be sustained in a supervised context. Understanding the clustered and cumulative nature of risk-behaviours, and how these vary by environmental and social context, helps to explain potential mechanisms of injury as well as modifiable factors that may be important avenues for intervention. Copyright © 2015 Elsevier Ltd. All rights reserved.

Adolescent Suicidal Behavior and Substance Use: Developmental Mechanisms

PubMed Central

Dawes, Michael A; Mathias, Charles W; Richard, Dawn M; Hill-Kapturczak, Nathalie; Dougherty, Donald M

2008-01-01

Adolescent suicidal behaviors and substance use are disturbingly common. Research suggests overlap of some of the etiological mechanisms for both adolescent suicidal behavior and substance use, yet clear understanding of the complex relations between these behaviors and their causal underpinnings is lacking. A growing body of evidence and a diathesis model (Mann et al. 1999; Mann, 2003) highlight the importance of impulse control as a proximal risk factor for adolescent suicidal and substance use behaviors. This literature review extends current theory on the relationships between adolescent suicidal behavior and substance use by: (1) examining how, when, and to what extent adolescent development is affected by poor impulse control, stressful life events, substance use behavior, and biological factors; (2) presenting proposed causal mechanisms by which these risk factors interact to increase risk for suicidal behaviors and substance use; and (3) proposing specific new hypotheses to extend the diathesis model to adolescents at risk for suicide and substance use. More specifically, new hypotheses are presented that predict bidirectional relationships between stressful life events and genetic markers of 5-HT dysregulation; substance use behavior and impulsivity; and substance use behavior and suicide attempts. The importance of distinguishing between different developmental trajectories of suicidal and substance use behaviors, and the effects of specific risk and protective mechanisms are discussed. Use of new statistical approaches that provide for the comparison of latent growth curves and latent class models is recommended to identify differences in developmental trajectories of suicidal behavior and substance use. Knowledge gained from these prospective longitudinal methods should lead to greater understanding on the timing, duration, and extent to which specific risk and protective factors influence the outcomes of suicidal behavior and substance use. In turn, findings from these studies should inform researchers who conduct future treatment and prevention studies. PMID:20651946

Sex Differences in Sources of Resilience and Vulnerability to Risk for Delinquency.

PubMed

Newsome, Jamie; Vaske, Jamie C; Gehring, Krista S; Boisvert, Danielle L

2016-04-01

Research on adolescent risk factors for delinquency has suggested that, due to genetic differences, youth may respond differently to risk factors, with some youth displaying resilience and others a heightened vulnerability. Using a behavioral genetic design and data from the National Longitudinal Study of Adolescent to Adult Health, this study examines whether there are sex differences in the genetic and environmental factors that influence the ways in which adolescents respond to cumulative risk for violent, nonviolent, and overall delinquency in a sample of twins (152 MZ male, 155 MZ female, 140 DZ male, 130 DZ female, and 204 DZ opposite-sex twin pairs). The results revealed that males tended to show greater vulnerability to risk for all types of delinquency, and females exhibited greater resilience. Among males, additive genetic factors accounted for 41, 29, and 43 % of the variance in responses to risk for violent, nonviolent, and overall delinquency, respectively. The remaining proportion of variance in each model was attributed to unique environmental influences, with the exception of 11 % of the variance in nonviolent responses to risk being attributed to common environmental factors. Among females, no significant genetic influences were observed; however, common environmental contributions to differences in the ways females respond to risk for violent, nonviolent, and overall delinquency were 44, 42, and 45 %, respectively. The remaining variance was attributed to unique environmental influences. Overall, genetic factors moderately influenced males' responses to risk while environmental factors fully explain variation in females' responses to risk. The implications of these findings are discussed in the context of improving the understanding of relationships between risks and outcomes, as well as informing policy and practice with adolescent offenders.

Awareness of ovarian cancer risk factors among women in Malaysia: a preliminary study.

PubMed

Keng, Soon Lean; Abdul Wahab, Syakirah Bainun; Chiu, Lim Bee; Yusuf, Azlina

2015-01-01

Ovarian cancer is recognized as the fourth leading cancer in Malaysia. However, women do not always seek help in a timely manner and gaps in awareness may influence screening uptake and presentation. The purpose of this study was to determine levels of awareness of ovarian cancer risk factors in female population in Penang, Malaysia. A cross-sectional study was conducted in Penang, Malaysia from January until February 2014. Eighty-seven women were selected by convenient sampling. Awareness of risk factors of ovarian cancer was assessed using a self-administered questionnaire. Data were analyzed using statistical package for the social sciences (SPSS) version 20.0 for descriptive statistics and Pearson chi-square test for the association between socio-demographic data and awareness. A p value ≤0.05 was considered statistically significant. In all, 74.7% of participants answered correctly for the risk factor of increasing age, although 94.3% were unaware of increased risk of tall women. A majority, 71.3%, had a low level of awareness of ovarian cancer risk factors. There was a significant association between age and knowledge (p=0.047). Additionally, there was a significant association between higher education level and level of awareness of ovarian cancer risk factors (p=0.039). This study revealed that awareness of ovarian cancer risk factors among Malaysian women is low. The results show a need for improved public understanding about ovarian cancer risks and provision of important information for health professionals about initiatives needed for future awareness, prevention and screening programs.

Factors associated with emergency room visits within 30 days of outpatient foot and ankle surgeries

PubMed Central

Shibuya, Naohiro; Patel, Himani; Graney, Colin; Jupiter, Daniel C.

2018-01-01

ABSTRACT The number of emergency department (ED) visits within 30 days after elective surgery has been utilized as a quality measure by many institutions. The significance of the measure as a postoperative complication in foot and ankle surgery, and risk factors for it, are unknown. We conducted a retrospective cohort study involving 386 patients to determine risk factors associated with ED visits after outpatient foot and ankle surgeries. After adjusting for clinically relevant covariates, we found that previous ED visits within 6 months of surgery, and nonelective surgeries were associated with the postoperative ED visit. Having private insurance was protective against postoperative ED visits. Though these risk factors may not be easily modifiable by surgeons, understanding them may improve patient education and transitional care to prevent overcrowding of the ED. PMID:29706806

Factors associated with emergency room visits within 30 days of outpatient foot and ankle surgeries.

PubMed

Shibuya, Naohiro; Patel, Himani; Graney, Colin; Jupiter, Daniel C

2018-04-01

The number of emergency department (ED) visits within 30 days after elective surgery has been utilized as a quality measure by many institutions. The significance of the measure as a postoperative complication in foot and ankle surgery, and risk factors for it, are unknown. We conducted a retrospective cohort study involving 386 patients to determine risk factors associated with ED visits after outpatient foot and ankle surgeries. After adjusting for clinically relevant covariates, we found that previous ED visits within 6 months of surgery, and nonelective surgeries were associated with the postoperative ED visit. Having private insurance was protective against postoperative ED visits. Though these risk factors may not be easily modifiable by surgeons, understanding them may improve patient education and transitional care to prevent overcrowding of the ED.

Understanding Child Sexual Abuse by Catholic Priests from a Situational Perspective

ERIC Educational Resources Information Center

Terry, Karen J.; Freilich, Joshua D.

2012-01-01

Most sexual offense research focuses on offender motivation and individual risk factors rather than the criminal events themselves. This article provides an analysis of data from two studies on child sexual abuse by Catholic priests to help understand the opportunities clergy had or created to abuse youth. Findings show that situational factors…

Understanding a Successful Implementation of Organizational Social Media: A Multi-Site Case Study

ERIC Educational Resources Information Center

Lahman, Caroline D.

2017-01-01

The purpose of this dissertation was to examine the successful implementation of social media strategies in multiple organizations. Examining the factors an organization used to implement social media can provide the understanding of the benefits and risks associated with this technology. Some businesses are considered successful using social…

An Ecological Understanding of Youth Suicide in South Korea

ERIC Educational Resources Information Center

Lee, Seung-yeon; Hong, Jun Sung; Espelage, Dorothy L.

2010-01-01

This article reviews risk factors for youth suicide in South Korea (hereafter referred to as Korea), based on the ecological systems theory. Although youth suicide is a major concern for Korean society, understanding of this phenomenon has been limited since most of the empirical studies address personal characteristics without much consideration…

Understanding Suicide among Sexual Minority Youth in America: An Ecological Systems Analysis

ERIC Educational Resources Information Center

Hong, Jun Sung; Espelage, Dorothy L.; Kral, Michael J.

2011-01-01

This article examines major risk factors for suicide among sexual minority youth using Bronfenbrenner's ecological systems theory. Although suicidal behavior among sexual minority youth is a major public concern in the United States, understanding of this phenomenon has been limited since the majority of empirical research studies have addressed…

An Ecological-Transactional Understanding of Community Violence: Theoretical Perspectives.

ERIC Educational Resources Information Center

Overstreet, Stacy; Mazza, James

2003-01-01

Community violence has emerged as a major risk factor for the development of mental health problems in children and adolescents. The goal of this article is to present an ecological-transactional model of community violence as a conceptual framework for understanding the existing literature and for guiding future research on community violence…

Understanding Gender Differences in Anxiety: The Mediating Effects of Instrumentality and Mastery

ERIC Educational Resources Information Center

Zalta, Alyson K.; Chambless, Dianne L.

2012-01-01

Developing a better understanding of modifiable psychological factors that account for gender differences in anxiety may provide insight into interventions that can be used to target these risk processes. The authors developed a mediational model to examine the degree to which gender differences in anxiety are explained by instrumentality and…

Developing an aviation exposure index to inform risk-based fire management decisions

Treesearch

Crystal S. Stonesifer; David E. Calkin; Matthew P. Thompson; Jeffrey D. Kaiden

2014-01-01

Wildland firefighting is an inherently dangerous activity, and aviation-related accidents in particular comprise a large share of firefighter fatalities. Due to limited understanding of operational factors that lead to aviation accidents, it is unclear how local decisionmakers, responsible for requesting aviation support, can mitigate the risk of an aviation accident...

Re-growth of fecal indicator bacteria and Escherichia coli 0157:H7 B6914 in cow fecal extract

EPA Science Inventory

The health risks that pathogens pose to water and food resources are highly dependent on their fate and transport in agricultural settings. In order to assess these risks, an understanding of the factors that influence pathogen fate in agricultural settings is needed and is criti...

Resilient Parenting of Preschool Children at Developmental Risk

ERIC Educational Resources Information Center

Ellingsen, R.; Baker, B. L.; Blacher, J.; Crnic, K.

2014-01-01

Background: Given the great benefits of effective parenting to child development under normal circumstances, and the even greater benefits in the face of risk, it is important to understand why some parents manage to be effective in their interactions with their child despite facing formidable challenges. This study examined factors that promoted…

Marital Conflict and Children's Emotional Security in the Context of Parental Depression

ERIC Educational Resources Information Center

Kouros, Chrystyna D.; Merrilees, Christine E.; Cummings, E. Mark

2008-01-01

Evidence has emerged for emotional security as an explanatory variable linking marital conflict to children's adjustment. Further evidence suggests parental psychopathology is a key factor in child development. To advance understanding of the pathways by which these family risk factors impact children's development, the mediational role of…

42 CFR 418.54 - Condition of participation: Initial and comprehensive assessment of the patient.

Code of Federal Regulations, 2011 CFR

2011-10-01

... take into consideration the following factors: (1) The nature and condition causing admission (including the presence or lack of objective data and subjective complaints). (2) Complications and risk factors that affect care planning. (3) Functional status, including the patient's ability to understand...

From Broken Windows to Busy Streets: A Community Empowerment Perspective

ERIC Educational Resources Information Center

Aiyer, Sophie M.; Zimmerman, Marc A.; Morrel-Samuels, Susan; Reischl, Thomas M.

2015-01-01

In the present article, we introduce a community empowerment perspective to understanding neighborhoods. A preponderance of literature exists on neighborhood risk factors for crime. Yet less is known about positive factors that make neighborhoods safe and desirable. We propose community empowerment as a conceptual foundation for understanding…

Risk and protective factors for heavy binge alcohol use among American Indian adolescents utilizing emergency health services.

PubMed

Tingey, Lauren; Cwik, Mary F; Rosenstock, Summer; Goklish, Novalene; Larzelere-Hinton, Francene; Lee, Angelita; Suttle, Rosemarie; Alchesay, Melanie; Massey, Kirk; Barlow, Allison

2016-11-01

American Indian (AI) adolescents are disproportionately burdened by alcohol abuse and heavy binge use, often leading to problematic drinking in adulthood. However, many AI communities also have large proportions of adults who abstain from alcohol. To understand these concurrent and divergent patterns, we explored the relationship between risk and protective factors for heavy binge alcohol use among a reservation-based sample of AI adolescents. Factors at individual, peer, family, and cultural/community levels were examined using a cross-sectional case-control study design. Cases were adolescents with recent heavy binge alcohol use that resulted in necessary medical care. Controls had no lifetime history of heavy binge alcohol use. 68 cases and 55 controls were recruited from emergency health services visits. Participants were 50% male; average age 15.4 years old, range 10 to 19. Independent variables were explored using logistic regression; those statistically significant were combined into a larger multivariate model. Exploratory analyses showed adolescents who were aggressive, impulsive, had deviant peers, poor family functioning or more people living at home were at greater risk for heavy binge alcohol use. Protective factors included attending school, family closeness, residential stability, social problem-solving skills, having traditional AI values and practices, and strong ethnic identity. Confirmatory analysis concluded that school attendance and residential stability reduce the probability of heavy binge alcohol use, even among those already at low risk. Findings deepen the understanding of AI adolescent heavy binge alcohol use and inform adolescent intervention development fostering trajectories to low-risk drinking and abstinence.

Disease Risk in a Dynamic Environment: The Spread of Tick-Borne Pathogens in Minnesota, USA

PubMed Central

Robinson, Stacie J.; Neitzel, David F.; Moen, Ronald A.; Craft, Meggan E.; Hamilton, Karin E.; Johnson, Lucinda B.; Mulla, David J.; Munderloh, Ulrike G.; Redig, Patrick T.; Smith, Kirk E.; Turner, Clarence L.; Umber, Jamie K.; Pelican, Katharine M.

2015-01-01

As humans and climate change alter the landscape, novel disease risk scenarios emerge. Understanding the complexities of pathogen emergence and subsequent spread as shaped by landscape heterogeneity is crucial to understanding disease emergence, pinpointing high-risk areas, and mitigating emerging disease threats in a dynamic environment. Tick-borne diseases present an important public health concern and incidence of many of these diseases are increasing in the United States. The complex epidemiology of tick-borne diseases includes strong ties with environmental factors that influence host availability, vector abundance, and pathogen transmission. Here, we used 16 years of case data from the Minnesota Department of Health to report spatial and temporal trends in Lyme disease (LD), human anaplasmosis, and babesiosis. We then used a spatial regression framework to evaluate the impact of landscape and climate factors on the spread of LD. Finally, we use the fitted model, and landscape and climate datasets projected under varying climate change scenarios, to predict future changes in tick-borne pathogen risk. Both forested habitat and temperature were important drivers of LD spread in Minnesota. Dramatic changes in future temperature regimes and forest communities predict rising risk of tick-borne disease. PMID:25281302

Marriage as a risk factor for HIV: learning from the experiences of HIV-infected women in Malawi.

PubMed

Mkandawire-Valhmu, Lucy; Wendland, Claire; Stevens, Patricia E; Kako, Peninnah M; Dressel, Anne; Kibicho, Jennifer

2013-01-01

The gender inequalities that characterise intimate partner relationships in Malawi, a country with one of the highest HIV prevalence rates in the world, arguably place marriage as an important risk factor for HIV infection among women, yet few studies detail the complex interactions of marriage and risk. In order to develop HIV-prevention interventions that have lasting impacts in such communities, we need a deeper understanding of the intricacies of women's lives, how and why they are involved in marital relationships, and the implications of these relationships for HIV transmission or prevention. This article describes how women understand marriage's effects on their lives and their HIV risks. Drawing from focus group discussions with 72 women attending antiretroviral clinics in Malawi, we explore why women enter marriage, what women's experiences are within marriage and how they leave spouses for other relationships. Based on their narratives, we describe women's lives after separation, abandonment or widowhood, and report their reflections on marriage after being married two or three times. We then review women's narratives in light of published work on HIV, and provide recommendations that would minimise the risks of HIV attendant on marriage.

Disease risk in a dynamic environment: the spread of tick-borne pathogens in Minnesota, USA.

PubMed

Robinson, Stacie J; Neitzel, David F; Moen, Ronald A; Craft, Meggan E; Hamilton, Karin E; Johnson, Lucinda B; Mulla, David J; Munderloh, Ulrike G; Redig, Patrick T; Smith, Kirk E; Turner, Clarence L; Umber, Jamie K; Pelican, Katharine M

2015-03-01

As humans and climate change alter the landscape, novel disease risk scenarios emerge. Understanding the complexities of pathogen emergence and subsequent spread as shaped by landscape heterogeneity is crucial to understanding disease emergence, pinpointing high-risk areas, and mitigating emerging disease threats in a dynamic environment. Tick-borne diseases present an important public health concern and incidence of many of these diseases are increasing in the United States. The complex epidemiology of tick-borne diseases includes strong ties with environmental factors that influence host availability, vector abundance, and pathogen transmission. Here, we used 16 years of case data from the Minnesota Department of Health to report spatial and temporal trends in Lyme disease (LD), human anaplasmosis, and babesiosis. We then used a spatial regression framework to evaluate the impact of landscape and climate factors on the spread of LD. Finally, we use the fitted model, and landscape and climate datasets projected under varying climate change scenarios, to predict future changes in tick-borne pathogen risk. Both forested habitat and temperature were important drivers of LD spread in Minnesota. Dramatic changes in future temperature regimes and forest communities predict rising risk of tick-borne disease.

Risk factors associated with leptospirosis during an outbreak in Middle Andaman, India.

PubMed

Sugunan, A P; Vijayachari, P; Sharma, S; Roy, Subarna; Manickam, P; Natarajaseenivasan, K; Gupte, M D; Sehgal, S C

2009-07-01

Leptospirosis outbreaks occur frequently in North and South Andaman Islands but not in Middle Andaman. In 2002, an outbreak appeared in Middle Andaman for the first time. Although a study on risk factors was conducted in North Andaman, it used seropositivity to define leptospirosis. Since seropositivity might not indicate current leptospiral infection and as no study on risk factors was conducted in Middle Andaman, we carried out this study to identify the risk factors during the outbreak. A suspected outbreak of leptospirosis occurred in Rangat of Middle Andaman during October - November 2002. Suspected cases were screened for leptospirosis using microscopic agglutination test (MAT). Fifty two patients confirmed to have leptospirosis based on rising titres in MAT on paired sera, and 104 age, sex and neighbourhood seronegative matched controls, were included in the study. A conditional multiple regression by backward elimination process was carried out with acute leptospirosis as the dependent factor and various environmental, occupational and behavioural factors as independent factors. A stratified analysis was also carried out. The presence of cattle in the house, drinking stream water, contact with garbage, walking barefoot and standing in water while working were identified as significant factors associated with leptospirosis. Stratified analysis showed a dose response relationship between number of cattle in the house and the risk of leptospiral infection suugesting that cattle could be a source of infection. Identification of the potential risk factors would help understand the transmission dynamics of the disease and formulate public health interventions.

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

A review of risk factors for bovine tuberculosis infection in cattle in the UK and Ireland.

PubMed

Broughan, J M; Judge, J; Ely, E; Delahay, R J; Wilson, G; Clifton-Hadley, R S; Goodchild, A V; Bishop, H; Parry, J E; Downs, S H

2016-10-01

Bovine tuberculosis (bTB) is an important disease of cattle caused by infection with Mycobacterium bovis, a pathogen that may be extremely difficult to eradicate in the presence of a true wildlife reservoir. Our objective was to identify and review relevant literature and provide a succinct summary of current knowledge of risk factors for transmission of infection of cattle. Search strings were developed to identify publications from electronic databases to February 2015. Abstracts of 4255 papers identified were reviewed by three reviewers to determine whether the entire article was likely to contain relevant information. Risk factors could be broadly grouped as follows: animal (including nutrition and genetics), herd (including bTB and testing history), environment, wildlife and social factors. Many risk factors are inter-related and study designs often do not enable differentiation between cause and consequence of infection. Despite differences in study design and location, some risk factors are consistently identified, e.g. herd size, bTB history, presence of infected wildlife, whereas the evidence for others is less consistent and coherent, e.g. nutrition, local cattle movements. We have identified knowledge gaps where further research may result in an improved understanding of bTB transmission dynamics. The application of targeted, multifactorial disease control regimens that address a range of risk factors simultaneously is likely to be a key to effective, evidence-informed control strategies.

Atrial Fibrillation Burden: Moving Beyond Atrial Fibrillation as a Binary Entity: A Scientific Statement From the American Heart Association.

PubMed

Chen, Lin Y; Chung, Mina K; Allen, Larry A; Ezekowitz, Michael; Furie, Karen L; McCabe, Pamela; Noseworthy, Peter A; Perez, Marco V; Turakhia, Mintu P

2018-05-15

Our understanding of the risk factors and complications of atrial fibrillation (AF) is based mostly on studies that have evaluated AF in a binary fashion (present or absent) and have not investigated AF burden. This scientific statement discusses the published literature and knowledge gaps related to methods of defining and measuring AF burden, the relationship of AF burden to cardiovascular and neurological outcomes, and the effect of lifestyle and risk factor modification on AF burden. Many studies examine outcomes by AF burden classified by AF type (paroxysmal versus nonparoxysmal); however, quantitatively, AF burden can be defined by longest duration, number of AF episodes during a monitoring period, and the proportion of time an individual is in AF during a monitoring period (expressed as a percentage). Current guidelines make identical recommendations for anticoagulation regardless of AF pattern or burden; however, a review of recent evidence suggests that higher AF burden is associated with higher risk of stroke. It is unclear whether the risk increases continuously or whether a threshold exists; if a threshold exists, it has not been defined. Higher burden of AF is also associated with higher prevalence and incidence of heart failure and higher risk of mortality, but not necessarily lower quality of life. A structured and comprehensive risk factor management program targeting risk factors, weight loss, and maintenance of a healthy weight appears to be effective in reducing AF burden. Despite this growing understanding of AF burden, research is needed into validation of definitions and measures of AF burden, determination of the threshold of AF burden that results in an increased risk of stroke that warrants anticoagulation, and discovery of the mechanisms underlying the weak temporal correlations of AF and stroke. Moreover, developments in monitoring technologies will likely change the landscape of long-term AF monitoring and could allow better definition of the significance of changes in AF burden over time. © 2018 American Heart Association, Inc.

Childhood Brain Tumor Epidemiology: A Brain Tumor Epidemiology Consortium Review

PubMed Central

Johnson, Kimberly J.; Cullen, Jennifer; Barnholtz-Sloan, Jill S.; Ostrom, Quinn T.; Langer, Chelsea E.; Turner, Michelle C.; McKean-Cowdin, Roberta; Fisher, James L.; Lupo, Philip J.; Partap, Sonia; Schwartzbaum, Judith A.; Scheurer, Michael E.

2014-01-01

Childhood brain tumors are the most common pediatric solid tumor and include several histological subtypes. Although progress has been made in improving survival rates for some subtypes, understanding of risk factors for childhood brain tumors remains limited to a few genetic syndromes and ionizing radiation to the head and neck. In this report, we review descriptive and analytical epidemiology childhood brain tumor studies from the past decade and highlight priority areas for future epidemiology investigations and methodological work that is needed to advance our understanding of childhood brain tumor causes. Specifically, we summarize the results of a review of studies published since 2004 that have analyzed incidence and survival in different international regions and that have examined potential genetic, immune system, developmental and birth characteristics, and environmental risk factors. PMID:25192704

Seeking systemic change: risk and protective factors affecting low-income urban youth.

PubMed

Meyerson, David A; Grant, Kathryn E

2014-01-01

This themed issue presents five articles tackling the topic of risk and protective processes affecting children and adolescents living in urban poverty. Through their research, the authors seek understanding of the particular challenges that low-income urban youth face, with the ultimate goal of understanding how best to intervene at various levels of the ecological system. Within this broad theme, studies examine specific stressors, mediators, and moderators that impact the mental health of youth living in urban poverty. The final article presents a data-driven, community-based intervention for this population.

Discursive junctions in flood risk governance - A comparative understanding in six European countries.

PubMed

Kaufmann, Maria; Wiering, Mark

2017-07-01

Flood risks are managed differently across Europe. While a number of research studies aim to understand these differences, they tend to pay little attention to the social constructionist aspects of flood risk governance, i.e. the meaning that societies give to flood risk and governance. This paper aims to address this gap by understanding differences in flood risk management approaches (FRMA) from a discursive-institutional perspective. Based on this perspective, an analytical framework was developed to systematically analyse and compare discourses pertaining to flood risk and its governance in six European member states (England (the United Kingdom), Flanders (Belgium), France, the Netherlands, Poland and Sweden). Correspondingly, this paper demonstrates how the hegemonic discursive-institutional patterns of flood risk governance differ between the six European countries. These differences may influence the capability of countries to learn from each other, adopt new FRMAs or cooperate with each other. Moreover, the paper argues that differences in discourses partially account for the differences in FRMAs between countries, combined with other factors. Additionally, broader implications are discussed. For example, the research findings imply that some discourses tend to favour or disfavour other discourses, and that they additionally also tend to favour particular FRMAs; e.g. the flood risk discourse pertaining to high manageability of risks seems to favour a governance discourse of collectivity and central governance. The different insights imply that further research is necessary to understand the complex interaction of discourses and institutional arrangements. Copyright © 2017 Elsevier Ltd. All rights reserved.

Research Areas: Causes of Cancer

Cancer.gov

Understanding the exposures and risk factors that cause cancer, as well as the genetic abnormalities associated with the disease, has helped us to reduce certain exposures and to ameliorate their harmful effects.

The fear factor of risk - clinical governance and midwifery talk and practice in the UK.

PubMed

Scamell, Mandie

2016-07-01

Through the critical application of social theory, this paper will scrutinise how the operations of risk management help to constitute midwives׳ understandings of childbirth in a particular way. Drawing from rich ethnographic data, collected in the southeast of England, the paper presents empirical evidence to critically explore how institutional concerns around risk and risk management impact upon the way midwives can legitimately imagine and manage labour and childbirth. Observational field notes, transcribed interviews with various midwives, along with material culture in the form of documentary evidence will be used to explore the unintended consequences of clinical governance and its risk management technologies. Through this analysis the fear factor of risk in midwifery talk and practice will be introduced to provide an insight into how risk management impacts midwifery practice in the UK. Copyright © 2016. Published by Elsevier Ltd.

Whole-body vibration and postural stress among operators of construction equipment: a literature review.

PubMed

Kittusamy, N Kumar; Buchholz, Bryan

2004-01-01

Operators of construction equipment perform various duties at work that expose them to a variety of risk factors that may lead to health problems. A few of the health hazards among operators of construction equipment are: (a) whole-body vibration, (b) awkward postural requirements (including static sitting), (c) dust, (d) noise, (e) temperature extremes, and (f) shift work. It has been suggested that operating engineers (OEs) are exposed to two important risk factors for the development of musculoskeletal disorders: whole-body vibration and non-neutral body postures. This review evaluates selected papers that have studied exposure to whole-body vibration and awkward posture among operators of mobile equipment. There have been only few studies that have specifically examined exposure of these risk factors among operators of construction equipment. Thus other studies from related industry and equipment were reviewed as applicable. In order to better understand whole-body vibration and postural stress among OEs, it is recommended that future studies are needed in evaluating these risk factors among OEs.

Risk Factors and Biomarkers of Age-Related Macular Degeneration

PubMed Central

Lambert, Nathan G.; Singh, Malkit K.; ElShelmani, Hanan; Mansergh, Fiona C.; Wride, Michael A.; Padilla, Maximilian; Keegan, David; Hogg, Ruth E.; Ambati, Balamurali K.

2016-01-01

A biomarker can be a substance or structure measured in body parts, fluids or products that can affect or predict disease incidence. As age-related macular degeneration (AMD) is the leading cause of blindness in the developed world, much research and effort has been invested in the identification of different biomarkers to predict disease incidence, identify at risk individuals, elucidate causative pathophysiological etiologies, guide screening, monitoring and treatment parameters, and predict disease outcomes. To date, a host of genetic, environmental, proteomic, and cellular targets have been identified as both risk factors and potential biomarkers for AMD. Despite this, their use has been confined to research settings and has not yet crossed into the clinical arena. A greater understanding of these factors and their use as potential biomarkers for AMD can guide future research and clinical practice. This article will discuss known risk factors and novel, potential biomarkers of AMD in addition to their application in both academic and clinical settings. PMID:27156982

Differences among Job Positions Related to Communication Errors at Construction Sites

NASA Astrophysics Data System (ADS)

Takahashi, Akiko; Ishida, Toshiro

In a previous study, we classified the communicatio n errors at construction sites as faulty intention and message pattern, inadequate channel pattern, and faulty comprehension pattern. This study seeks to evaluate the degree of risk of communication errors and to investigate differences among people in various job positions in perception of communication error risk . Questionnaires based on the previous study were a dministered to construction workers (n=811; 149 adminis trators, 208 foremen and 454 workers). Administrators evaluated all patterns of communication error risk equally. However, foremen and workers evaluated communication error risk differently in each pattern. The common contributing factors to all patterns wer e inadequate arrangements before work and inadequate confirmation. Some factors were common among patterns but other factors were particular to a specific pattern. To help prevent future accidents at construction sites, administrators should understand how people in various job positions perceive communication errors and propose human factors measures to prevent such errors.

Current Understanding of Lifestyle and Environmental Factors and Risk of Non-Hodgkin Lymphoma: An Epidemiological Update

PubMed Central

Bassig, Bryan A.; Lan, Qing; Rothman, Nathaniel; Zhang, Yawei; Zheng, Tongzhang

2012-01-01

The incidence rates of non-Hodgkin lymphoma (NHL) have steadily increased over the last several decades in the United States, and the temporal trends in incidence can only be partially explained by the HIV epidemic. In 1992, an international workshop sponsored by the United States National Cancer Institute concluded that there was an “emerging epidemic” of NHL and emphasized the need to investigate the factors responsible for the increasing incidence of this disease. Over the past two decades, numerous epidemiological studies have examined the risk factors for NHL, particularly for putative environmental and lifestyle risk factors, and international consortia have been established in order to investigate rare exposures and NHL subtype-specific associations. While few consistent risk factors for NHL aside from immunosuppression and certain infectious agents have emerged, suggestive associations with several lifestyle and environmental factors have been reported in epidemiologic studies. Further, increasing evidence has suggested that the effects of these and other exposures may be limited to or stronger for particular NHL subtypes. This paper examines the progress that has been made over the last twenty years in elucidating the etiology of NHL, with a primary emphasis on lifestyle factors and environmental exposures. PMID:23008714

Cardiovascular Involvement in Autoimmune Diseases

PubMed Central

Amaya-Amaya, Jenny

2014-01-01

Autoimmune diseases (AD) represent a broad spectrum of chronic conditions that may afflict specific target organs or multiple systems with a significant burden on quality of life. These conditions have common mechanisms including genetic and epigenetics factors, gender disparity, environmental triggers, pathophysiological abnormalities, and certain subphenotypes. Atherosclerosis (AT) was once considered to be a degenerative disease that was an inevitable consequence of aging. However, research in the last three decades has shown that AT is not degenerative or inevitable. It is an autoimmune-inflammatory disease associated with infectious and inflammatory factors characterized by lipoprotein metabolism alteration that leads to immune system activation with the consequent proliferation of smooth muscle cells, narrowing arteries, and atheroma formation. Both humoral and cellular immune mechanisms have been proposed to participate in the onset and progression of AT. Several risk factors, known as classic risk factors, have been described. Interestingly, the excessive cardiovascular events observed in patients with ADs are not fully explained by these factors. Several novel risk factors contribute to the development of premature vascular damage. In this review, we discuss our current understanding of how traditional and nontraditional risk factors contribute to pathogenesis of CVD in AD. PMID:25177690

Risk factors for age-related maculopathy.

PubMed

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

2009-01-01

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

A Moderator Model of Alcohol Use and Dating Aggression among Young Adults.

PubMed

Collibee, Charlene; Furman, Wyndol

2018-03-01

Dating aggression has been identified as a priority public health concern. Although alcohol use is a known robust risk factor for dating aggression involvement, such usage is neither necessary nor sufficient for dating aggression involvement. As such, a growing topic of interest is a better understanding of when, and for whom, alcohol use increases risk. A theoretical moderator model posits that associations between alcohol use and dating aggression involvement vary depending on both background (e.g., psychopathology) and situational (e.g., relationship characteristics) risk factors. Alcohol use is thought to be more strongly associated with dating aggression in the context of these other risk factors. Using an intensive longitudinal design, we collected six waves of data spanning 6 months from 120 participants (60 females; M age W1 = 22.44). Alcohol use and relationship risk were both associated with increases in dating aggression involvement. Consistent with a moderator model, interactions emerged between alcohol use and relationship risk for subsequent dating aggression involvement. The findings underscore the importance of alcohol use and relationship risk for the development of intervention and prevention programs.

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.

The Relationship of Financial Pressures and Community Characteristics to Closure of Private Safety Net Clinics.

PubMed

Li, Suhui; Dor, Avi; Pines, Jesse M; Zocchi, Mark S; Hsia, Renee Y

2016-10-01

In order to better understand what threatens vulnerable populations' access to primary care, it is important to understand the factors associated with closing safety net clinics. This article examines how a clinic's financial position, productivity, and community characteristics are associated with its risk of closure. We examine patterns of closures among private-run primary care clinics (PCCs) in California between 2006 and 2012. We use a discrete-time proportional hazard model to assess relative hazard ratios of covariates, and a random-effect hazard model to adjust for unobserved heterogeneity among PCCs. We find that lower net income from patient care, smaller amount of government grants, and lower productivity were associated with significantly higher risk of PCC closure. We also find that federally qualified health centers and nonfederally qualified health centers generally faced the same risk factors of closure. These results underscore the critical role of financial incentives in the long-term viability of safety net clinics. © The Author(s) 2015.

Intracranial aneurysms: Review of current science and management.

PubMed

Toth, Gabor; Cerejo, Russell

2018-06-01

Unruptured intracranial aneurysms often have a relatively benign clinical course. Frequently, they are found incidentally during workup for an underlying, possibly related or unrelated, symptom or condition. Overall, brain aneurysms are considered to have a relatively low annual risk of rupture. However, should it occur, aneurysmal subarachnoid hemorrhage can lead to significant morbidity and mortality. Our understanding of the natural history and treatment outcomes of cerebral aneurysms has significantly increased over the last few decades, but choosing the optimal management for each patient requires the careful consideration of numerous medical, clinical and anatomic factors. The purpose of this review is to help physicians and caregivers, who may participate in the diagnosis, counseling and triage of patients with brain aneurysms, understand the basic elements of decision making. We discuss natural history, risk factors, screening, presentation, diagnosis, and their implications on aneurysm management and long-term follow-up. We also provide an overview of the risks and benefits of currently available treatment options.

Financial and Psychological Risk Attitudes Associated with Two Single Nucleotide Polymorphisms in the Nicotine Receptor (CHRNA4) Gene

PubMed Central

Roe, Brian E.; Tilley, Michael R.; Gu, Howard H.; Beversdorf, David Q.; Sadee, Wolfgang; Haab, Timothy C.; Papp, Audrey C.

2009-01-01

With recent advances in understanding of the neuroscience of risk taking, attention is now turning to genetic factors that may contribute to individual heterogeneity in risk attitudes. In this paper we test for genetic associations with risk attitude measures derived from both the psychology and economics literature. To develop a long-term prospective study, we first evaluate both types of risk attitudes and find that the economic and psychological measures are poorly correlated, suggesting that different genetic factors may underlie human response to risk faced in different behavioral domains. We then examine polymorphisms in a spectrum of candidate genes that affect neurotransmitter systems influencing dopamine regulation or are thought to be associated with risk attitudes or impulsive disorders. Analysis of the genotyping data identified two single nucleotide polymorphisms (SNPs) in the gene encoding the alpha 4 nicotine receptor (CHRNA4, rs4603829 and rs4522666) that are significantly associated with harm avoidance, a risk attitude measurement drawn from the psychology literature. Novelty seeking, another risk attitude measure from the psychology literature, is associated with several COMT (catechol-O-methyl transferase) SNPs while economic risk attitude measures are associated with several VMAT2 (vesicular monoamine transporter) SNPs, but the significance of these associations did not withstand statistical adjustment for multiple testing and requires larger cohorts. These exploratory results provide a starting point for understanding the genetic basis of risk attitudes by considering the range of methods available for measuring risk attitudes and by searching beyond the traditional direct focus on dopamine and serotonin receptor and transporter genes. PMID:19693267

Vocation in theology-based nursing theories.

PubMed

Lundmark, Mikael

2007-11-01

By using the concepts of intrinsicality/extrinsicality as analytic tools, the theology-based nursing theories of Ann Bradshaw and Katie Eriksson are analyzed regarding their explicit and/or implicit understanding of vocation as a motivational factor for nursing. The results show that both theories view intrinsic values as guarantees against reducing nursing practice to mechanistic applications of techniques and as being a way of reinforcing a high ethical standard. The theories explicitly (Bradshaw) or implicitly (Eriksson) advocate a vocational understanding of nursing as being essential for nursing theories. Eriksson's theory has a potential for conceptualizing an understanding of extrinsic and intrinsic motivational factors for nursing but one weakness in the theory could be the risk of slipping over to moral judgments where intrinsic factors are valued as being superior to extrinsic. Bradshaw's theory is more complex and explicit in understanding the concept of vocation and is theologically more plausible, although also more confessional.

Considering sex and gender in Alzheimer disease and other dementias.

PubMed

Podcasy, Jessica L; Epperson, C Neill

2016-12-01

Suffering related to dementia is multifaceted because cognitive and physical functioning slowly deteriorates. Advanced age and sex, two of the most prominent risk factors for dementia, are not modifiable. Lifestyle factors such as smoking, excessive alcohol use, and poor diet modulate susceptibility to dementia in both males and females. The degree to which the resulting health conditions (eg, obesity, type 2 diabetes, and cardiovascular disease) impact dementia risk varies by sex. Depending on the subtype of dementia, the ratio of male to female prevalence differs. For example, females are at greater risk of developing Alzheimer disease dementia, whereas males are at greater risk of developing vascular dementia. This review examines sex and gender differences in the development of dementia with the goal of highlighting factors that require further investigation. Considering sex as a biological variable in dementia research promises to advance our understanding of the pathophysiology and treatment of these conditions.

Identity Formation, Outness and Sexual Risk among Gay and Bisexual Men

PubMed Central

White, Darcy; Stephenson, Rob

2014-01-01

Research on HIV among men who have sex with men (MSM) has focused on individual behavioral and biomedical factors driving transmission risks, but these cannot be fully understood without also understanding the social context within which sexual minorities live. Using data from 703 gay and bisexual men in Atlanta, this study explores the factors associated with homosexual identity formation and disclosure (“outness”) and examines how these constructs are associated with sexual risk taking. In multivariable regression models, sexual identity and outness were associated with age, race, education, employment, and experience of discrimination. Independent of these factors, having a more established and open homosexual identity was associated with lower sexual risk behaviors. These results highlight the need to address discriminatory policies and values in society and call for programs to provide support and promote healthy identity development among vulnerable groups. PMID:23690365

Considering sex and gender in Alzheimer disease and other dementias

PubMed Central

Podcasy, Jessica L.; Epperson, C. Neill

2016-01-01

Suffering related to dementia is multifaceted because cognitive and physical functioning slowly deteriorates. Advanced age and sex, two of the most prominent risk factors for dementia, are not modifiable. Lifestyle factors such as smoking, excessive alcohol use, and poor diet modulate susceptibility to dementia in both males and females. The degree to which the resulting health conditions (eg, obesity, type 2 diabetes, and cardiovascular disease) impact dementia risk varies by sex. Depending on the subtype of dementia, the ratio of male to female prevalence differs. For example, females are at greater risk of developing Alzheimer disease dementia, whereas males are at greater risk of developing vascular dementia. This review examines sex and gender differences in the development of dementia with the goal of highlighting factors that require further investigation. Considering sex as a biological variable in dementia research promises to advance our understanding of the pathophysiology and treatment of these conditions. PMID:28179815

Feelings of loneliness, but not social isolation, predict dementia onset: results from the Amsterdam Study of the Elderly (AMSTEL).

PubMed

Holwerda, Tjalling Jan; Deeg, Dorly J H; Beekman, Aartjan T F; van Tilburg, Theo G; Stek, Max L; Jonker, Cees; Schoevers, Robert A

2014-02-01

Known risk factors for Alzheimer's disease and other dementias include medical conditions, genetic vulnerability, depression, demographic factors and mild cognitive impairment. The role of feelings of loneliness and social isolation in dementia is less well understood, and prospective studies including these risk factors are scarce. We tested the association between social isolation (living alone, unmarried, without social support), feelings of loneliness and incident dementia in a cohort study among 2173 non-demented community-living older persons. Participants were followed for 3 years when a diagnosis of dementia was assessed (Geriatric Mental State (GMS) Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT)). Logistic regression analysis was used to examine the association between social isolation and feelings of loneliness and the risk of dementia, controlling for sociodemographic factors, medical conditions, depression, cognitive functioning and functional status. After adjustment for other risk factors, older persons with feelings of loneliness were more likely to develop dementia (OR 1.64, 95% CI 1.05 to 2.56) than people without such feelings. Social isolation was not associated with a higher dementia risk in multivariate analysis. Feeling lonely rather than being alone is associated with an increased risk of clinical dementia in later life and can be considered a major risk factor that, independently of vascular disease, depression and other confounding factors, deserves clinical attention. Feelings of loneliness may signal a prodromal stage of dementia. A better understanding of the background of feeling lonely may help us to identify vulnerable persons and develop interventions to improve outcome in older persons at risk of dementia.

Overweight individuals are at increased risk for thrombotic thrombocytopenic purpura.

PubMed

Nicol, Kathleen K; Shelton, Brent J; Knovich, Mary Ann; Owen, John

2003-11-01

Our understanding of the pathophysiology of thrombotic thrombocytopenic purpura, TTP, has increased dramatically in the past few years with the identification of the role of ADAMTS13. Nonetheless, risk factors for the development of acute TTP are few. Informally, obesity was felt to be common in patients with TTP and so a formal study was undertaken to further define this association. We report our data in 105 patients with classical TTP as defined by thrombocytopenia and microangiopathic hemolytic anemia. We found that marked obesity is a previously unrecognized risk factor with an associated odds ratio of 7.6. Interestingly, despite this increased risk, obesity might well be associated with lower mortality, although this did not reach statistical significance. Copyright 2003 Wiley-Liss, Inc.

Psychosocial risk factors in home and community settings and their associations with population health and health inequalities: A systematic meta-review

PubMed Central

Egan, Matt; Tannahill, Carol; Petticrew, Mark; Thomas, Sian

2008-01-01

Background The effects of psychosocial risk factors on population health and health inequalities has featured prominently in epidemiological research literature as well as public health policy strategies. We have conducted a meta-review (a review of reviews) exploring how psychosocial factors may relate to population health in home and community settings. Methods Systematic review (QUORUM) of literature reviews (published in any language or country) on the health associations of psychosocial risk factors in community settings. The literature search included electronic and manual searches. Two reviewers appraised included reviews using criteria for assessing systematic reviews. Data from the more robust reviews were extracted, tabulated and synthesised. Results Thirty-one reviews met our inclusion criteria. These explored a variety of psychosocial factors including social support and networks, social capital, social cohesion, collective efficacy, participation in local organisations – and less favourable psychosocial risk factors such as demands, exposure to community violence or anti-social behaviour, exposure to discrimination, and stress related to acculturation to western society. Most of the reviews focused on associations between social networks/support and physical or mental health. We identified some evidence of favourable psychosocial environments associated with better health. Reviews also found evidence of unfavourable psychosocial risk factors linked to poorer health, particularly among socially disadvantaged groups. However, the more robust reviews each identified studies with inconclusive findings, as well as studies finding evidence of associations. We also identified some evidence of apparently favourable psychosocial risk factors associated with poorer health. Conclusion From the review literature we have synthesised, where associations have been identified, they generally support the view that favourable psychosocial environments go hand in hand with better health. Poor psychosocial environments may be health damaging and contribute to health inequalities. The evidence that underpins our understanding of these associations is of variable quality and consistency. Future research should seek to improve this evidence base, with more longitudinal analysis (and intervention evaluations) of the effects of apparently under-researched psychosocial factors such as control and participation within communities. Future policy interventions relevant to this field should be developed in partnership with researchers to enable a better understanding of psychosocial mechanisms and the effects of psychosocial interventions. PMID:18631374

Comparison of Health Risks and Changes in Risks over Time Among a Sample of Lesbian, Gay, Bisexual, and Heterosexual Employees at a Large Firm.

PubMed

Mitchell, Rebecca J; Ozminkowski, Ronald J

2017-04-01

The objective of this study was to estimate the prevalence of health risk factors by sexual orientation over a 4-year period within a sample of employees from a large firm. Propensity score-weighted generalized linear regression models were used to estimate the proportion of employees at high risk for health problems in each year and over time, controlling for many factors. Analyses were conducted with 6 study samples based on sex and sexual orientation. Rates of smoking, stress, and certain other health risk factors were higher for lesbian, gay, and bisexual (LGB) employees compared with rates of these risks among straight employees. Lesbian, gay, and straight employees successfully reduced risk levels in many areas. Significant reductions were realized for the proportion at risk for high stress and low life satisfaction among gay and lesbian employees, and for the proportion of smokers among gay males. Comparing changes over time for sexual orientation groups versus other employee groups showed that improvements and reductions in risk levels for most health risk factors examined occurred at similar rates among individuals employed by this firm, regardless of sexual orientation. These results can help improve understanding of LGB health and provide information on where to focus workplace health promotion efforts to meet the health needs of LGB employees.

Comparative hazard analysis of processes leading to remarkable flash floods (France, 1930-1999)

NASA Astrophysics Data System (ADS)

Boudou, M.; Lang, M.; Vinet, F.; Cœur, D.

2016-10-01

Flash flood events are responsible for large economic losses and lead to fatalities every year in France. This is especially the case in the Mediterranean and oversea territories/departments of France, characterized by extreme hydro-climatological features and with a large part of the population exposed to flood risks. The recurrence of remarkable flash flood events, associated with high hazard intensity, significant damage and socio-political consequences, therefore raises several issues for authorities and risk management policies. This study aims to improve our understanding of the hazard analysis process in the case of four remarkable flood events: March 1930, October 1940, January 1980 and November 1999. Firstly, we present the methodology used to define the remarkability score of a flood event. Then, to identify the factors leading to a remarkable flood event, we explore the main parameters of the hazard analysis process, such as the meteorological triggering conditions, the return period of the rainfall and peak discharge, as well as some additional factors (initial catchment state, flood chronology, cascade effects, etc.). The results contribute to understanding the complexity of the processes leading to flood hazard and highlight the importance for risk managers of taking additional factors into account.

Reducing the risk of heart disease among Indian Australians: knowledge, attitudes, and beliefs regarding food practices - a focus group study.

PubMed

Fernandez, Ritin; Rolley, John X; Rajaratnam, Rohan; Everett, Bronwyn; Davidson, Patricia M

2015-01-01

Australia has a growing number of Asian Indian immigrants. Unfortunately, this population has an increased risk for coronary heart disease (CHD). Dietary adherence is an important strategy in reducing risk for CHD. This study aimed to gain greater understanding of the knowledge, attitudes and beliefs relating to food practices in Asian Indian Australians. Two focus groups with six participants in each were recruited using a convenience sampling technique. Verbatim transcriptions were made and thematic content analysis undertaken. Four main themes that emerged from the data included: migration as a pervasive factor for diet and health; importance of food in maintaining the social fabric; knowledge and understanding of health and diet; and elements of effective interventions. Diet is a complex constructed factor in how people express themselves individually, in families and communities. There are many interconnected factors influencing diet choice that goes beyond culture and religion to include migration and acculturation. Food and associated behaviors are an important aspect of the social fabric. Entrenched and inherent knowledge, attitudes, beliefs and traditions frame individuals' point of reference around food and recommendations for an optimal diet.

Risk and protective factors of posttraumatic stress disorder among African American women living with HIV.

PubMed

Andu, Eaden; Wagenaar, Brad H; Kemp, Chris G; Nevin, Paul E; Simoni, Jane M; Andrasik, Michele; Cohn, Susan E; French, Audrey L; Rao, Deepa

2018-04-26

We sought to examine risk and protective factors for Posttraumatic Stress Disorder (PTSD) among African American women living with HIV. This is a cross-sectional analysis of baseline data from a randomized trial of an HIV stigma reduction intervention. We examined data from two-hundred and thirty-nine African American women living with HIV. We examined whether age, marital status, level of education, internalized HIV-related stigma, and social support as potential protective and risk factors for PTSD symptoms using logistic regression. We analyzed bi-variate associations between each variable and PTSD symptoms, and constructed a multivariate logistic regression model adjusting for all variables. We found 67% reported clinically significant PTSD symptoms at baseline. Our results suggest that age, education, and internalized stigma were found to be associated with PTSD symptoms (p < 0.001), with older age and more education as protective factors and stigma as a risk factor for PTSD. Therefore, understanding this relationship may help improve assessment and treatment through evidence- based and trauma-informed strategies.

Personal, social and environmental risk factors of problematic gambling among high school adolescents in Addis Ababa, Ethiopia.

PubMed

Abdi, Tariku A; Ruiter, Robert A C; Adal, Tamirie A

2015-03-01

Understanding risk factors of problematic gambling is prerequisite to effective intervention design to alleviate the negative consequences of gambling. This study explored the personal, social and environmental risk factors of problematic gambling in four high schools in Addis Ababa, Ethiopia, among students (N = 422) ranging from 12 to 21 years of age. Results from the cross-sectional survey showed that personal feelings (e.g., self-esteem, false perceptions about winning, drug abuse), social factors (e.g., peer influence, parental gambling), and environmental factors (e.g., accessibility of gambling venues, advertisements) were significant correlates of problematic gambling. The study also revealed that men were more at risk for severe problematic gambling than females. Among the identified types of gambling activities, the most prevalent ones were playing cards followed by flipping coin and pool gambling while internet gambling was among the least reported gambling activities. By identifying personal, social and environmental correlates of risky gambling activities this study provides evidence-based information for the systematic design and evaluation of educational interventions to prevent problematic gambling in young people.

Personal, Social and Environmental Risk Factors of Problematic Gambling Among High School Adolescents in Addis Ababa, Ethiopia.

PubMed

Abdi, Tariku A; Ruiter, Robert A C; Adal, Tamirie A

2013-09-29

Understanding risk factors of problematic gambling is prerequisite to effective intervention design to alleviate the negative consequences of gambling. This study explored the personal, social and environmental risk factors of problematic gambling in four high schools in Addis Ababa, Ethiopia, among students (N = 422) ranging from 12 to 21 years of age. Results from the cross-sectional survey showed that personal feelings (e.g., self-esteem, false perceptions about winning, drug abuse), social factors (e.g., peer influence, parental gambling), and environmental factors (e.g., accessibility of gambling venues, advertisements) were significant correlates of problematic gambling. The study also revealed that men were more at risk for severe problematic gambling than females. Among the identified types of gambling activities, the most prevalent ones were playing cards followed by flipping coin and pool gambling while internet gambling was among the least reported gambling activities. By identifying personal, social and environmental correlates of risky gambling activities this study provides evidence-based information for the systematic design and evaluation of educational interventions to prevent problematic gambling in young people.

Comparisons of the prevalence of and risk factors for elderly depression between urban and rural populations in Japan.

PubMed

Abe, Y; Fujise, N; Fukunaga, R; Nakagawa, Y; Ikeda, M

2012-08-01

The aim of the present study was to investigate the differences in the prevalence of and risk factors for elderly depression between urban and rural areas in Japan and to further understanding of the features of elderly depression. A multistage, random sampling procedure and mailing method were used in urban and rural areas in Kumamoto Prefecture. A total of 2,152 participants aged 65 years and older were evaluated for depression using the Geriatric Depression Scale (GDS). Factors associated with depression were also examined. In order to assess the relationship between risk factors and subjective happiness, the Philadelphia Geriatric Center Morale Scale (PGC-MS) was used. Depressive symptoms were associated with living alone, being unemployed, chronic illness, sleep disturbance, suicidal ideation, financial strain, and poor social support; the risk factors for elderly depression were almost the same in the two areas. Although three factors (financial strain, work status, and PGC-MS) were significantly associated with depression in both areas on logistic regression analysis, sleep disturbance was significant only for the urban area, and poor social support was significant only for the rural area. Although factors related to depression did not differ markedly between urban and rural elderly people, some risk factors differed between the two areas. Effective intervention programs for elderly depression should pay more attention to regional differences.

Spatial Clustering and Local Risk Factors of Chronic Obstructive Pulmonary Disease (COPD).

PubMed

Chan, Ta-Chien; Wang, Hsuan-Wen; Tseng, Tzu-Jung; Chiang, Po-Huang

2015-12-10

Chronic obstructive pulmonary disease (COPD) mortality has been steadily increasing in Taiwan since 2009. In order to understand where the hotspot areas are and what the local risk factors are, we integrated an ecological and a case-control study. We used a two-stage approach to identify hotspots and explore the possible risk factors for developing COPD. The first stage used the annual township COPD mortality from 2000 to 2012 and applied the retrospective space-time scan statistic to calculate the local relative risks in each township. In the second stage, we conducted a case-control study, recruiting 200 patients from one local hospital within the one identified hotspot area located in southern Taiwan. Logistic regression was applied for analyzing the personal risk factors of COPD. The univariate analyses showed that higher percentages of aborigines, patients with tuberculosis (TB) history, and those with smoking history had COPD (p < 0.05). After controlling for demographic variables, aboriginal status (adjusted odds ratios (AORs): 3.01, 95% CI: 1.52-5.93) and smoking history (AORs: 2.64, 95% CI: 1.46-4.76) were still the two significant risk factors. This two-stage approach might be beneficial to examine and cross-validate the findings from an aggregate to an individual scale, and can be easily extended to other chronic diseases.

Contributing factors for drought in United States forest ecosystems under projected future climates and their uncertainty

Treesearch

Charlie Luce; James M. Vose; Neil Pederson; John Campbell; Connie Millar; Patrick Kormos; Ross Woods

2016-01-01

Observations of increasing global forest die-off related to drought are leading to more questions about potential increases in drought occurrence, severity, and ecological consequence in the future. Dry soils and warm temperatures interact to affect trees during drought; so understanding shifting risks requires some understanding of changes in both temperature...

Psychobehavioral Attributes of Body Image in College Freshmen and Seniors: Implications for Long-Term Health

ERIC Educational Resources Information Center

Leone, James E.; Partridge, Julie A.; Maurer-Starks, Suanne

2011-01-01

Introduction: Understanding and assessing behavioral risk factors, particularly among college populations, is challenging for health educators. Similarly, issues affecting mental health remain unclear in terms of how body image evolves year to year in college students. A better understanding of how students perceive their bodies and to what extent…

Theoretical Risk and Prevention Model for Secondary Health Conditions and Mortality After SCI: 15 Years of Research

PubMed Central

Krause, James S.; Saunders, Lee L.; DiPiro, Nicole D.; Reed, Karla S.

2013-01-01

Background: To successfully prevent secondary health conditions (SHCs) and promote longevity after spinal cord injury (SCI), we must first understand the risk factors precipitating their occurrence and develop strategies to address these risk factors. Conceptual models may aid in identifying the nature of SHCs and guide research, clinical practice, and the development of prevention strategies. Objective: Our purpose is to review and refine an existing theoretical risk and prevention model (TRPM) as a means of classifying risk and protective factors for SHCs and mortality after SCI and for identifying points of intervention. Methods: We describe conceptual work within the field of SCI research and SHCs, including a description of the TRPM, a review of research using the TRPM, and conceptual enhancements to the TRPM based on previous research. Conclusions: The enhanced TRPM directs research to the timing and chronicity of the SHCs and their relationship with overall health and physiologic decline. Future research should identify differences in the nature of SHCs, the extent to which they relate to risk and protective factors, and the degree to which they may be prevented with appropriate research-based strategies. PMID:23459002

The Interplay between Interpersonal Stress and Psychological Intimate Partner Violence over Time for Young At-Risk Couples

ERIC Educational Resources Information Center

Shortt, Joann Wu; Capaldi, Deborah M.; Kim, Hyoun K.; Tiberio, Stacey S.

2013-01-01

The substantial number of young people in romantic relationships that involve intimate partner violence, a situation deleterious to physical and mental health, has resulted in increased attention to understanding the links between risk factors and course of violence. The current study examined couples' interpersonal stress related to not liking…

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

PubMed

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

2017-06-04

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

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

PubMed Central

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

2017-01-01

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

Strategies to reduce the risk of drug-induced QT interval prolongation: a pharmaceutical company perspective.

PubMed

Pollard, C E; Valentin, J-P; Hammond, T G

2008-08-01

Drug-induced prolongation of the QT interval is having a significant impact on the ability of the pharmaceutical industry to develop new drugs. The development implications for a compound causing a significant effect in the 'Thorough QT/QTc Study' -- as defined in the clinical regulatory guidance (ICH E14) -- are substantial. In view of this, and the fact that QT interval prolongation is linked to direct inhibition of the hERG channel, in the early stages of drug discovery the focus is on testing for and screening out hERG activity. This has led to understanding of how to produce low potency hERG blockers whilst retaining desirable properties. Despite this, a number of factors mean that when an integrated risk assessment is generated towards the end of the discovery phase (by conducting at least an in vivo QT assessment) a QT interval prolongation risk is still often apparent; inhibition of hERG channel trafficking and partitioning into cardiac tissue are just two confounding factors. However, emerging information suggests that hERG safety margins have high predictive value and that when hERG and in vivo non-clinical data are combined, their predictive value to man, whilst not perfect, is >80%. Although understanding the anomalies is important and is being addressed, of greater importance is developing a better understanding of TdP, with the aim of being able to predict TdP rather than using an imperfect surrogate marker (QT interval prolongation). Without an understanding of how to predict TdP risk, high-benefit drugs for serious indications may never be marketed.

Mindfulness and Cardiovascular Disease Risk: State of the Evidence, Plausible Mechanisms, and Theoretical Framework.

PubMed

Loucks, Eric B; Schuman-Olivier, Zev; Britton, Willoughby B; Fresco, David M; Desbordes, Gaelle; Brewer, Judson A; Fulwiler, Carl

2015-12-01

The purpose of this review is to provide (1) a synopsis on relations of mindfulness with cardiovascular disease (CVD) and major CVD risk factors, and (2) an initial consensus-based overview of mechanisms and theoretical framework by which mindfulness might influence CVD. Initial evidence, often of limited methodological quality, suggests possible impacts of mindfulness on CVD risk factors including physical activity, smoking, diet, obesity, blood pressure, and diabetes regulation. Plausible mechanisms include (1) improved attention control (e.g., ability to hold attention on experiences related to CVD risk, such as smoking, diet, physical activity, and medication adherence), (2) emotion regulation (e.g., improved stress response, self-efficacy, and skills to manage craving for cigarettes, palatable foods, and sedentary activities), and (3) self-awareness (e.g., self-referential processing and awareness of physical sensations due to CVD risk factors). Understanding mechanisms and theoretical framework should improve etiologic knowledge, providing customized mindfulness intervention targets that could enable greater mindfulness intervention efficacy.

Model Checking of a Diabetes-Cancer Model

NASA Astrophysics Data System (ADS)

Gong, Haijun; Zuliani, Paolo; Clarke, Edmund M.

2011-06-01

Accumulating evidence suggests that cancer incidence might be associated with diabetes mellitus, especially Type II diabetes which is characterized by hyperinsulinaemia, hyperglycaemia, obesity, and overexpression of multiple WNT pathway components. These diabetes risk factors can activate a number of signaling pathways that are important in the development of different cancers. To systematically understand the signaling components that link diabetes and cancer risk, we have constructed a single-cell, Boolean network model by integrating the signaling pathways that are influenced by these risk factors to study insulin resistance, cancer cell proliferation and apoptosis. Then, we introduce and apply the Symbolic Model Verifier (SMV), a formal verification tool, to qualitatively study some temporal logic properties of our diabetes-cancer model. The verification results show that the diabetes risk factors might not increase cancer risk in normal cells, but they will promote cell proliferation if the cell is in a precancerous or cancerous stage characterized by losses of the tumor-suppressor proteins ARF and INK4a.

Mindfulness and Cardiovascular Disease Risk: State of the Evidence, Plausible Mechanisms, and Theoretical Framework

PubMed Central

Schuman-Olivier, Zev; Britton, Willoughby B.; Fresco, David M.; Desbordes, Gaelle; Brewer, Judson A.; Fulwiler, Carl

2016-01-01

The purpose of this review is to provide (1) a synopsis on relations of mindfulness with cardiovascular disease (CVD) and major CVD risk factors, and (2) an initial consensus-based overview of mechanisms and theoretical framework by which mindfulness might influence CVD. Initial evidence, often of limited methodological quality, suggests possible impacts of mindfulness on CVD risk factors including physical activity, smoking, diet, obesity, blood pressure, and diabetes regulation. Plausible mechanisms include (1) improved attention control (e.g., ability to hold attention on experiences related to CVD risk, such as smoking, diet, physical activity, and medication adherence), (2) emotion regulation (e.g., improved stress response, self-efficacy, and skills to manage craving for cigarettes, palatable foods, and sedentary activities), and (3) self-awareness (e.g., self-referential processing and awareness of physical sensations due to CVD risk factors). Understanding mechanisms and theoretical framework should improve etiologic knowledge, providing customized mindfulness intervention targets that could enable greater mindfulness intervention efficacy. PMID:26482755

Seeing Strengths in a Rural School: Educators' Conceptions of Individual and Environmental Resilience Factors

ERIC Educational Resources Information Center

McMahon, Brenda

2015-01-01

This qualitative study of educators' understandings of resilience contributes to ongoing rural school research that examines educators' beliefs about, and attitudes toward, rural students whom are at-risk and factors that impact rural school success. Semi-structured interviews were conducted with teachers and administrators in one rural Florida…

The role of sex and gender in neuropsychiatric disorders.

PubMed

Thibaut, Florence

2016-12-01

The prevalence, age of onset, and clinical symptoms of many neuropsychiatric diseases substantially differ between males and females. Factors influencing the relationships between brain development and function and sex or gender may help us understand the differences between males and females in terms of risk or resilience factors in brain diseases.

Social Resilience: Challenging Neo-Colonial Thinking and Practices around "Risk"

ERIC Educational Resources Information Center

Gale, Fran; Bolzan, Natalie

2013-01-01

Understandings of resilience which primarily focus on the individual are of limited applicability unless we recognise the historical, economic and political factors in which social life occurs. To explore the social foundations of resilience is to chart the ongoing influence of these factors. An appreciation of this context is pivotal to any…

Family and Racial Factors Associated with Suicide and Emotional Distress among Latino Students

ERIC Educational Resources Information Center

Garcia, Carolyn; Skay, Carol; Sieving, Renee; Naughton, Sandy; Bearinger, Linda H.

2008-01-01

Background: Latino youth experience disproportionate rates of mental health problems including suicide and depression. Better understanding of underlying risk and protective factors on the part of school-based health professionals, teachers, and health care providers in their lives is warranted. The aims of this secondary analysis of 2004…

Acceptance Factors Influencing Adoption of National Institute of Standards and Technology Information Security Standards: A Quantitative Study

ERIC Educational Resources Information Center

Kiriakou, Charles M.

2012-01-01

Adoption of a comprehensive information security governance model and security controls is the best option organizations may have to protect their information assets and comply with regulatory requirements. Understanding acceptance factors of the National Institute of Standards and Technology (NIST) Risk Management Framework (RMF) comprehensive…

77 FR 56854 - Submission for OMB Review; Comment Request: A Multi-Center International Hospital-Based Case...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-14

... of the world. The contribution of environmental, occupational, and genetic factors to the cause of... information to understand and reduce the cancer burden from lymphoid malignancies in the Asian population, the... exposures, and other risk factors for lymphoma overall and specifically for populations in Asia will be...

Risk and Protective Factors Contributing to Depressive Symptoms in Vietnamese American College Students

ERIC Educational Resources Information Center

Han, Meekyung; Lee, Mary

2011-01-01

With the demographic shifts the United States faces, understanding the contributing factors to mental well-being among minority college students is crucial. This study examines the roles of parental and peer attachment, intergenerational conflict, and perceived racial discrimination on depressive symptoms while also analyzing the mediational role…

Genetics, environmental factors and the emerging role of epigenetics in neurodegenerative diseases.

PubMed

Migliore, Lucia; Coppedè, Fabio

2009-07-10

In the present review we summarize recent advances in the understanding of the interaction between genetics and environmental factors involved in complex multi-factorial neurodegenerative disorders such as Alzheimer's disease (AD), Parkinson's disease (PD) and Amyotrophic Lateral Sclerosis (ALS). The discovery of several genes responsible for the familial forms has led to a better comprehension of the molecular pathways involved in the selective neuronal degeneration which is specific for each of these disorders. However, the vast majority of the cases occurs as sporadic forms, likely resulting from complex gene-gene and gene-environment interplay. Several environmental factors, including, pesticides, metals, head injuries, lifestyles and dietary habits have been associated with increased disease risk or even with protection. Hundreds of genetic variants have been investigated as possible risk factors for the sporadic forms, but results are often conflicting, not repeated or inconclusive. New approaches to environmental health research are revealing us that at the basis there could be chemically induced changes in gene regulation and emphasise the importance of understanding the susceptibility of the human epigenome to dietary and other environmental effects.

Risk factors for incident delirium in an acute general medical setting: a retrospective case-control study.

PubMed

Tomlinson, Emily Jane; Phillips, Nicole M; Mohebbi, Mohammadreza; Hutchinson, Alison M

2017-03-01

To determine predisposing and precipitating risk factors for incident delirium in medical patients during an acute hospital admission. Incident delirium is the most common complication of hospital admission for older patients. Up to 30% of hospitalised medical patients experience incident delirium. Determining risk factors for delirium is important for identifying patients who are most susceptible to incident delirium. Retrospective case-control study with two controls per case. An audit tool was used to review medical records of patients admitted to acute medical units for data regarding potential risk factors for delirium. Data were collected between August 2013 and March 2014 at three hospital sites of a healthcare organisation in Melbourne, Australia. Cases were 161 patients admitted to an acute medical ward and diagnosed with incident delirium between 1 January 2012 and 31 December 2013. Controls were 321 patients sampled from the acute medical population admitted within the same time range, stratified for admission location and who did not develop incident delirium during hospitalisation. Identified using logistic regression modelling, predisposing risk factors for incident delirium were dementia, cognitive impairment, functional impairment, previous delirium and fracture on admission. Precipitating risk factors for incident delirium were use of an indwelling catheter, adding more than three medications during admission and having an abnormal sodium level during admission. Multiple risk factors for incident delirium exist; patients with a history of delirium, dementia and cognitive impairment are at greatest risk of developing delirium during hospitalisation. Nurses and other healthcare professionals should be aware of patients who have one or more risk factors for incident delirium. Knowledge of risk factors for delirium has the potential to increase the recognition and understanding of patients who are vulnerable to delirium. Early recognition and prevention of delirium can contribute to improved patients safety and reduction in harm. © 2016 John Wiley & Sons Ltd.

Family and social environmental factors associated with aggression among Chinese adolescents.

PubMed

Dou, Chunxia; Wei, Zhen; Jin, Ke; Wang, He; Wang, Xiulan; Peng, Ziwen

2015-09-01

Family and school environments are assumed to be associated with and influence aggressive behaviors. However, which specific risk factors within these environments that are associated with aggressive behavior are unclear. The goal of this study is to identify family and social environmental qualities that are related to aggression among Chinese adolescents. Survey data were obtained from 3,213 randomly selected urban high school students ages 10 through 18 in southern China. Lower parental attachment, higher family income, mother's higher education levels, father's parenting goals, rough or changeable parenting styles, unsuitable peer relationships, and inadequate social atmospheres at school serve as risk factors for aggression among Chinese adolescents. Our findings provide some implications for understanding aggression among adolescents and suggests possible interventions to help overcome potential environmental risk factors and thus to prevent aggressive behavior in school. (c) 2015 APA, all rights reserved).

Expected time-invariant effects of biological traits on mammal species duration.

PubMed

Smits, Peter D

2015-10-20

Determining which biological traits influence differences in extinction risk is vital for understanding the differential diversification of life and for making predictions about species' vulnerability to anthropogenic impacts. Here I present a hierarchical Bayesian survival model of North American Cenozoic mammal species durations in relation to species-level ecological factors, time of origination, and phylogenetic relationships. I find support for the survival of the unspecialized as a time-invariant generalization of trait-based extinction risk. Furthermore, I find that phylogenetic and temporal effects are both substantial factors associated with differences in species durations. Finally, I find that the estimated effects of these factors are partially incongruous with how these factors are correlated with extinction risk of the extant species. These findings parallel previous observations that background extinction is a poor predictor of mass extinction events and suggest that attention should be focused on mass extinctions to gain insight into modern species loss.

Epidemiology of ovarian cancer.

PubMed

Permuth-Wey, Jennifer; Sellers, Thomas A

2009-01-01

Ovarian cancer represents the sixth most commonly diagnosed cancer among women in the world, and causes more deaths per year than any other cancer of the female reproductive system. Despite the high incidence and mortality rates, the etiology of this disease is poorly understood. Established risk factors for ovarian cancer include age and having a family history of the disease, while protective factors include increasing parity, oral contraceptive use, and oophorectomy. Lactation, incomplete pregnancies, and surgeries such as hysterectomy and tubal ligation may confer a weak protective effect against ovarian cancer. Infertility may contribute to ovarian cancer risk among nulliparous women. Other possible risk factors for ovarian cancer include postmenopausal hormone-replacement therapy and lifestyle factors such as cigarette smoking and alcohol consumption. Many of the causes of ovarian cancer are yet to be identified. Additional research is needed to better understand the etiology of this deadly disease.

Understanding of diabetes mellitus and health-preventive behaviour among Singaporeans.

PubMed

Wong, Lai Yin; Toh, Matthias P H S

2009-06-01

To study the understanding and perceived vulnerability of diabetes mellitus among Singapore residents, and determine the predictors associated with screening for diabetes mellitus among the people without the condition. A population-based survey was conducted from December 2004 to October 2005 involving Singapore residents aged 15 to 69 years. Using a standard questionnaire, Health Survey Officers interviewed household members on their understanding and perceived vulnerability of diabetes mellitus and associated cardiovascular risk factors. Data were analysed using SPSS v13. The response rate was 84.5%. Of 2,632 respondents, 291 (11.1%) have diabetes mellitus. Compared to respondents without diabetes, respondents with the disease had better understanding of diabetes and they had favourable health practice of screening for cardiovascular risk factors. Having diabetes mellitus was not associated with a healthier lifestyle. Among non-diabetics, those who had a family history of diabetes had better knowledge and health practices than those who had not. They were significantly more likely to recognise the symptoms and signs (61.5% vs 54.5%) and the causes of diabetes (70% vs 58.2%); and were more likely to have ever tested for diabetes (76.1% vs 60.4%), with P <0.001. Socio-demographic characteristics, family history, understanding and perception on the vulnerability of diabetes were identified as predictors associated with health screening for the disease. Among all respondents, better understanding was found to be associated with favourable health-preventive behaviours. However, it did not translate into healthier lifestyle. Cultural and socio-demographic profiles must be factored in for any effort on lifestyle modifications.

Risk Factors for Human Immunodeficiency Virus Infection among Brazilian Blood Donors; a Multicenter Case-Control Study Using Audio Computer-Assisted Structured-Interviews

PubMed Central

de Almeida-Neto, Cesar; Goncalez, Thelma T.; Birch, Rebecca Jeffries; de Carvalho, Silvia Maia F.; Capuani, Ligia; Leão, Silvana Carneiro; Miranda, Carolina; Rocha, Pedro Capuani; Carneiro-Proietti, Anna Barbara; Johnson, Bryce R.; Wright, David J.; Murphy, Edward L.; Custer, Brian

2013-01-01

Background Although risk factors for HIV infection are known, it is important for blood centers to understand local epidemiology and disease transmission patterns. Current risk factors for HIV infection in blood donors in Brazil were assessed. Methods A case-control study was conducted at large public blood centers located in four major cities between April 2009 – March 2011. Cases were persons whose donations were confirmed positive by enzyme immunoassays followed by Western Blot confirmation. Audio computer-assisted structured-interviews (ACASI) were completed by all cases and controls. Multivariable logistic regression was used to estimate adjusted odds ratios (AORs) and associated 95% confidence intervals (CIs). Results There were 341 cases, including 47 with recently-acquired infection, and 791 controls. Disclosed risk factors for both females and males were sex with an HIV-positive person (adjusted odds ratio (AOR) 11.3, 95% CI [4.1, 31.7]) and being an IVDU or sexual partner of an IVDU (AOR 4.65 [1.8, 11.7]). For female blood donors, additional risk factors were having male sex partners who also are MSM (AOR 13.5 [3.1, 59.8]), and having unprotected sex with multiple sexual partners (AOR 5.19 [2.1, 12.9]). The primary risk factor for male blood donors was MSM activity (AOR 21.6 [8.8, 52.9.]). Behaviors associated with recently-acquired HIV were being a MSM or sex partner of MSM (13.82, [4.7, 40.3]), and IVDU (11.47, [3.0, 43.2]). Conclusion Risk factors in blood donors parallel those in the general population in Brazil. Identified risk factors suggest that donor compliance with selection procedures at the participating blood centers is inadequate. PMID:23517235

Understanding Prostate Changes

Cancer.gov

Prostate changes and symptoms that are not cancer. Learn about symptoms, risk factors, and treatment for prostatitis, enlarged prostate (BPH), prostate cancer. Talk with doctor about prostate cancer screening tests (DRE, PSA), biopsy, and Gleason score.

Cardio-respiratory outcomes associated with exposure to wildfire smoke are modified by measures of community health

PubMed Central

2012-01-01

Background Characterizing factors which determine susceptibility to air pollution is an important step in understanding the distribution of risk in a population and is critical for setting appropriate policies. We evaluate general and specific measures of community health as modifiers of risk for asthma and congestive heart failure following an episode of acute exposure to wildfire smoke. Methods A population-based study of emergency department visits and daily concentrations of fine particulate matter during a wildfire in North Carolina was performed. Determinants of community health defined by County Health Rankings were evaluated as modifiers of the relative risk. A total of 40 mostly rural counties were included in the study. These rankings measure factors influencing health: health behaviors, access and quality of clinical care, social and economic factors, and physical environment, as well as, the outcomes of health: premature mortality and morbidity. Pollutant concentrations were obtained from a mathematically modeled smoke forecasting system. Estimates of relative risk for emergency department visits were based on Poisson mixed effects regression models applied to daily visit counts. Results For asthma, the strongest association was observed at lag day 0 with excess relative risk of 66%(28,117). For congestive heart failure the excess relative risk was 42%(5,93). The largest difference in risk was observed after stratifying on the basis of Socio-Economic Factors. Difference in risk between bottom and top ranked counties by Socio-Economic Factors was 85% and 124% for asthma and congestive heart failure respectively. Conclusions The results indicate that Socio-Economic Factors should be considered as modifying risk factors in air pollution studies and be evaluated in the assessment of air pollution impacts. PMID:23006928

Cardio-respiratory outcomes associated with exposure to wildfire smoke are modified by measures of community health.

PubMed

Rappold, Ana G; Cascio, Wayne E; Kilaru, Vasu J; Stone, Susan L; Neas, Lucas M; Devlin, Robert B; Diaz-Sanchez, David

2012-09-24

Characterizing factors which determine susceptibility to air pollution is an important step in understanding the distribution of risk in a population and is critical for setting appropriate policies. We evaluate general and specific measures of community health as modifiers of risk for asthma and congestive heart failure following an episode of acute exposure to wildfire smoke. A population-based study of emergency department visits and daily concentrations of fine particulate matter during a wildfire in North Carolina was performed. Determinants of community health defined by County Health Rankings were evaluated as modifiers of the relative risk. A total of 40 mostly rural counties were included in the study. These rankings measure factors influencing health: health behaviors, access and quality of clinical care, social and economic factors, and physical environment, as well as, the outcomes of health: premature mortality and morbidity. Pollutant concentrations were obtained from a mathematically modeled smoke forecasting system. Estimates of relative risk for emergency department visits were based on Poisson mixed effects regression models applied to daily visit counts. For asthma, the strongest association was observed at lag day 0 with excess relative risk of 66% (28,117). For congestive heart failure the excess relative risk was 42% (5,93). The largest difference in risk was observed after stratifying on the basis of Socio-Economic Factors. Difference in risk between bottom and top ranked counties by Socio-Economic Factors was 85% and 124% for asthma and congestive heart failure respectively. The results indicate that Socio-Economic Factors should be considered as modifying risk factors in air pollution studies and be evaluated in the assessment of air pollution impacts.

The Relationship Between Socioeconomic Status and CV Risk Factors

PubMed Central

Quispe, Renato; Benziger, Catherine P.; Bazo-Alvarez, Juan Carlos; Howe, Laura D.; Checkley, William; Gilman, Robert H.; Smeeth, Liam; Bernabé-Ortiz, Antonio; Miranda, J. Jaime; Bernabé-Ortiz, Antonio; Casas, Juan P.; Smith, George Davey; Ebrahim, Shah; García, Héctor H.; Gilman, Robert H.; Huicho, Luis; Málaga, Germán; Miranda, J. Jaime; Montori, Víctor M.; Smeeth, Liam; Checkley, William; Diette, Gregory B.; Gilman, Robert H.; Huicho, Luis; León-Velarde, Fabiola; Rivera, María; Wise, Robert A.; Checkley, William; García, Héctor H.; Gilman, Robert H.; Miranda, J. Jaime; Sacksteder, Katherine

2016-01-01

Background Variations in the distribution of cardiovascular disease and risk factors by socioeconomic status (SES) have been described in affluent societies, yet a better understanding of these patterns is needed for most low- and middle-income countries. Objective This study sought to describe the relationship between cardiovascular risk factors and SES using monthly family income, educational attainment, and assets index, in 4 Peruvian sites. Methods Baseline data from an age- and sex-stratified random sample of participants, ages ≥35 years, from 4 Peruvian sites (CRONICAS Cohort Study, 2010) were used. The SES indicators considered were monthly family income (n = 3,220), educational attainment (n = 3,598), and assets index (n = 3,601). Behavioral risk factors included current tobacco use, alcohol drinking, physical activity, daily intake of fruits and vegetables, and no control of salt intake. Cardiometabolic risk factors included obesity, elevated waist circumference, hypertension, insulin resistance, diabetes mellitus, low high-density lipoprotein cholesterol, and high triglyceride levels. Results In the overall population, 41.6% reported a monthly family income

Risk Factors for Injuries During Military Static-Line Airborne Operations: A Systematic Review and Meta-Analysis.

PubMed

Knapik, Joseph; Steelman, Ryan

2016-11-01

 To identify and analyze articles in which the authors examined risk factors for soldiers during military static-line airborne operations.  We searched for articles in PubMed, the Defense Technical Information Center, reference lists, and other sources using the key words airborne, parachuting, parachutes, paratrooper, injuries, wounds, trauma, and musculoskeletal.  The search identified 17 684 potential studies. Studies were included if they were written in English, involved military static-line parachute operations, recorded injuries directly from events on the landing zone or from safety or medical records, and provided data for quantitative assessment of injury risk factors. A total of 23 studies met the review criteria, and 15 were included in the meta-analysis.  The summary statistic obtained for each risk factor was the risk ratio, which was the ratio of the injury risk in 1 group to that of another (baseline) group. Where data were sufficient, meta-analyses were performed and heterogeneity and publication bias were assessed.  Risk factors for static-line parachuting injuries included night jumps, jumps with extra equipment, higher wind speeds, higher air temperatures, jumps from fixed-wing aircraft rather than balloons or helicopters, jumps onto certain types of terrain, being a female paratrooper, greater body weight, not using the parachute ankle brace, smaller parachute canopies, simultaneous exits from both sides of an aircraft, higher heat index, winds from the rear of the aircraft on exit entanglements, less experience with a particular parachute system, being an enlisted soldier rather than an officer, and jumps involving a greater number of paratroopers.  We analyzed and summarized factors that increased the injury risk for soldiers during military static-line parachute operations. Understanding and considering these factors in risk evaluations may reduce the likelihood of injury during parachuting.

The Relationship Between Socioeconomic Status and CV Risk Factors: The CRONICAS Cohort Study of Peruvian Adults.

PubMed

Quispe, Renato; Benziger, Catherine P; Bazo-Alvarez, Juan Carlos; Howe, Laura D; Checkley, William; Gilman, Robert H; Smeeth, Liam; Bernabé-Ortiz, Antonio; Miranda, J Jaime

2016-03-01

Variations in the distribution of cardiovascular disease and risk factors by socioeconomic status (SES) have been described in affluent societies, yet a better understanding of these patterns is needed for most low- and middle-income countries. This study sought to describe the relationship between cardiovascular risk factors and SES using monthly family income, educational attainment, and assets index, in 4 Peruvian sites. Baseline data from an age- and sex-stratified random sample of participants, ages ≥35 years, from 4 Peruvian sites (CRONICAS Cohort Study, 2010) were used. The SES indicators considered were monthly family income (n = 3,220), educational attainment (n = 3,598), and assets index (n = 3,601). Behavioral risk factors included current tobacco use, alcohol drinking, physical activity, daily intake of fruits and vegetables, and no control of salt intake. Cardiometabolic risk factors included obesity, elevated waist circumference, hypertension, insulin resistance, diabetes mellitus, low high-density lipoprotein cholesterol, and high triglyceride levels. In the overall population, 41.6% reported a monthly family income

Epidemiology of Invasive Mold Infections in Allogeneic Stem Cell Transplant Recipients: Biological Risk Factors for Infection According to Time after Transplantation

PubMed Central

Garcia-Vidal, Carol; Upton, Arlo; Kirby, Katharine A.; Marr, Kieren A.

2009-01-01

Background Invasive mold infections (IMIs) are common in individuals who have undergone hematopoietic stem cell transplantation (HSCT). We sought to determine clinical and biological risk factors for different IMIs during each period (early and late) after allogeneic HSCT. Methods Cases of proven and probable IMI diagnosed in HSCT recipients at the Fred Hutchinson Cancer Research Center (Seattle, WA) from 1 January 1998 through 31 December 2002 were included. Survival was estimated with Kaplan-Meier curves, and Cox regression models were used for multivariable analyses. Results During the study period, 1248 patients underwent allogeneic HSCT; 163 (13.1%) received a diagnosis of probable or proven IMI. The majority of cases were caused by Aspergillus species (88%). The incidence of IMI caused by other molds remained low (<2%) over the 4-year study period. Risk factors for IMI early after HSCT and late after HSCT differed, with host variables (age) and transplant variables (human leukocyte antigen match) predominating as early risk factors and other clinical complications (graft-versus-host disease and cytomegalovirus disease) predominating later. Biological risk factors that were important during all periods included multiple cytopenias (neutropenia, lymphopenia, and monocytopenia) and iron overload. Conclusions Risk factors for invasive aspergillosis after allogeneic HSCT are multifactorial and differ according to timing after HSCT. Increased attention should be placed on understanding the immunopathogenesis of fungal disease after HSCT. PMID:18781877

The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors.

PubMed

Thayer, Julian F; Yamamoto, Shelby S; Brosschot, Jos F

2010-05-28

Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. The understanding of the risk factors for CVD may yield important insights into the prevention, etiology, course, and treatment of this major public health concern. Autonomic imbalance, characterized by a hyperactive sympathetic system and a hypoactive parasympathetic system, is associated with various pathological conditions. Over time, excessive energy demands on the system can lead to premature aging and diseases. Therefore, autonomic imbalance may be a final common pathway to increased morbidity and mortality from a host of conditions and diseases, including cardiovascular disease. Heart rate variability (HRV) may be used to assess autonomic imbalances, diseases and mortality. Parasympathetic activity and HRV have been associated with a wide range of conditions including CVD. Here we review the evidence linking HRV to established and emerging modifiable and non-modifiable CVD risk factors such as hypertension, obesity, family history and work stress. Substantial evidence exists to support the notion that decreased HRV precedes the development of a number of risk factors and that lowering risk profiles is associated with increased HRV. We close with a suggestion that a model of autonomic imbalance may provide a unifying framework within which to investigate the impact of risk factors, including psychosocial factors and work stress, on cardiovascular disease. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Understanding Clinicians' Use of Cues When Assessing the Future Risk of Violence: A Clinical Judgement Analysis in the Psychiatric Setting.

PubMed

Brown, Barbara; Rakow, Tim

2016-01-01

Research is sparse on how clinicians' judgement informs their violence risk assessments. Yet, determining preferences for which risk factors are used, and how they are weighted and combined, is important to understanding such assessments. This study investigated clinicians' use of static and dynamic cues when assessing risk in individual patients and for dynamic cues considered in the recent and distant past. Clinicians provided three violence risk assessments for 41 separate hypothetical cases of hospitalized patients, each defined by eight cues (e.g., psychopathy and past violence severity/frequency). A clinical judgement analysis, using regression analysis of judgements for multiple cases, created linear models reflecting the major influences on each individual clinician's judgement. Risk assessments could be successfully predicted by between one and four cues, and there was close agreement between different clinicians' models regarding which cues were relevant for a given assessment. However, which cues were used varied between assessments: history of recent violence predicted assessments of in-hospital risk, whereas violence in the distant past predicted the assessed risk in the community. Crucially, several factors included in actuarial/structured risk assessment tools had little influence on clinicians' assessments. Our findings point to the adaptivity in clinicians' violence risk assessments, with a preference for relying on information consistent with the setting for which the assessment applies. The implication is that clinicians are open to using different structured assessment tools for different kinds of risk assessment, although they may seek greater flexibility in their assessments than some structured risk assessment tools afford (e.g., discounting static risk factors). Across three separate violence risk assessments, clinicians' risk assessments were more strongly influenced by dynamic cues that can vary over time (e.g., level of violence) than by static cues that are fixed for a given individual (e.g., a diagnosis of psychopathy). The variation in the factors affecting risk assessments for different settings (i.e., in hospital versus in the community) was greater than the variability between clinicians for such judgements. The findings imply a preference for risk assessment strategies that offer flexibility: either using different risk assessment tools for different purposes and settings or employing a single tool that allows for different inputs into the risk assessment depending upon the nature of the assessment. The appropriateness of these clinical intuitions about violence risk that are implied by our findings warrants further investigation. Copyright © 2015 John Wiley & Sons, Ltd.

Retinal vascular imaging in early life: insights into processes and risk of cardiovascular disease

PubMed Central

Li, Ling‐Jun; Ikram, Mohammad Kamran

2015-01-01

Abstract Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. In recent years, studies have shown that the origins of CVD may be traced to vascular and metabolic processes in early life. Retinal vascular imaging is a new technology that allows detailed non‐invasive in vivo assessment and monitoring of the microvasculature. In this systematic review, we described the application of retinal vascular imaging in children and adolescents, and we examined the use of retinal vascular imaging in understanding CVD risk in early life. We reviewed all publications with quantitative retinal vascular assessment in two databases: PubMed and Scopus. Early life CVD risk factors were classified into four groups: birth risk factors, environmental risk factors, systemic risk factors and conditions linked to future CVD development. Retinal vascular changes were associated with lower birth weight, shorter gestational age, low‐fibre and high‐sugar diet, lesser physical activity, parental hypertension history, childhood hypertension, childhood overweight/obesity, childhood depression/anxiety and childhood type 1 diabetes mellitus. In summary, there is increasing evidence supporting the view that structural changes in the retinal microvasculature are associated with CVD risk factors in early life. Thus, the retina is a useful site for pre‐clinical assessment of microvascular processes that may underlie the future development of CVD in adulthood. PMID:26435039

Updates on esophageal and gastric cancers.

PubMed

Gallo, Amy; Cha, Charles

2006-05-28

Esophageal and gastric cancers are both common and deadly. Patients present most often after disease progression and survival is therefore poor. Due to demographic variability and recent changes in disease incidence, much emphasis has been placed on studying risk factors for both esophageal and gastric cancers. However, with increasing understanding of these diseases, low survival rates persist and continued intensive studies are necessary to optimize treatment plans. This review article discusses updates in the evolving epidemiology, clinical presentation, risk factors, and diagnostic and treatment modalities of esophageal and gastric cancers.

Risk factors associated with domestic abuse directed at adults with disabilities in South Korea.

PubMed

Kim, Kyung Mee; Lee, Byung Hwa

2016-07-01

Most research on domestic abuse and disability has focused on women with disabilities, while research on abuse against men with disabilities and their risk factors is virtually non-existent. The purpose of this research is to understand domestic abuse experienced by people with disabilities by investigating its prevalence and risk factors. This research used the National Survey on Persons with Disabilities (2011). Using a stratified sampling method, 5259 respondents were identified to make up the final sample. Ordered logistic regression was used to verify risk factors for abuse. Risk factors for women with disabilities are age, educational attainment level, ADL, experiences of discrimination, awareness of disability discrimination, external support, and satisfaction with number of friends. Risk factors for men with disabilities are region, experiences of discrimination, awareness of disability discrimination, external support, and satisfaction with number of friends. For both women and men with disabilities, more experience of discrimination, greater awareness of disability discrimination, less external support, and less satisfaction with number of friends are associated with a higher likelihood of having experiences of abuse. Men with disabilities living in rural areas have a higher risk of abuse than those living in cities. Younger women, women with lower educational attainment, and those with lower physical functioning are more likely to have experienced abuse. Based on these findings, the authors make recommendations designed to protect people with disabilities from domestic abuse. Copyright © 2016 Elsevier Inc. All rights reserved.

Biotechnology risks and benefits: Science instructor perspectives and practices

NASA Astrophysics Data System (ADS)

Gardner, Grant Ean

Developing scientifically literate students who understand the socially contextualized nature of science and technology is a national focus of science education reform. Understanding teachers' views on this topic is of equal importance. This document focuses on the topic of risks and benefits posed by science and technology as an important topic for which the socially contextualized nature of science and technology readily emerges. Following introduction of a theoretical model and a review of the literature, two research studies are described that examined teachers' perceptions of the risks posed by biotechnology and the role of risk topics in an undergraduate science course. The first research study examines four groups of science educators; pre-service science teachers, in-service science teachers, science graduate teaching assistants, and science professors (n = 91). The participants completed a survey and card sort task to determine their perceptions of the risks of biotechnology. The results show that teacher perceptions were shaped by the risk severity, regulation processes, public acceptance, fear, reciprocal benefits, and whether the applications would impact humans or the environment. Factors determining risk perception included personal worldviews, trust in communicating institutions, and personal experiences with biotechnology. The different types of science teachers were compared and contrasted in light of these factors and the implications of instructor perceptions on science pedagogy are discussed. The second research manuscript describes a case study in which six biology graduate teaching assistants (GTAs) were observed teaching as lesson on the potential risks and benefits of biotechnology. The data sources included classroom observations and semi-structured interviews. Qualitative analysis reveals that GTAs framed the instruction of risk in one of three ways: analytical, focus on perspectives and biases, and promotion of individual reflection. Interview results suggest that GTAs had a much richer understanding of the importance of the teaching of social aspects of science and technology than emerged in their teaching. Results are discussed in the context of the disconnect between the GTA's teaching practice and perspectives.

Mass media and risk factors for cancer: the under-representation of age.

PubMed

Macdonald, Sara; Cunningham, Yvonne; Patterson, Chris; Robb, Katie; Macleod, Una; Anker, Thomas; Hilton, Shona

2018-04-26

Increasing age is a risk factor for developing cancer. Yet, older people commonly underestimate this risk, are less likely to be aware of the early symptoms, and are more likely to be diagnosed with advanced stage cancer. Mass media are a key influence on the public's understanding health issues, including cancer risk. This study investigates how news media have represented age and other risk factors in the most common cancers over time. Eight hundred articles about the four most common cancers (breast, prostate, lung and colorectal) published within eight UK national newspapers in 2003, 2004, 2013 and 2014 were identified using the Nexis database. Relevant manifest content of articles was coded quantitatively and subjected to descriptive statistical analysis in SPSS to identify patterns across the data. Risk was presented in half of the articles but this was rarely discussed in any depth and around a quarter of all articles introduced more than one risk factor, irrespective of cancer site. Age was mentioned as a risk factor in approximately 12% of all articles and this varied by cancer site. Age was most frequently reported in relation to prostate cancer and least often in articles about lung cancer. Articles featuring personal narratives more frequently focused on younger people and this was more pronounced in non-celebrity stories; only 15% of non-celebrity narratives were about people over 60. Other common risks discussed were family history and genetics, smoking, diet, alcohol, and environmental factors. Family history and genetics together featured as the most common risk factors. Risk factor reporting varied by site and family history was most commonly associated with breast cancer, diet with bowel cancer and smoking with lung cancer. Age and older adults were largely obscured in media representation of cancer and cancer experience. Indeed common risk factors in general were rarely discussed in any depth. Our findings will usefully inform the development of future cancer awareness campaigns and media guidelines. It is important that older adults appreciate their heightened risk, particularly in the context of help-seeking decisions.

A one health framework for estimating the economic costs of zoonotic diseases on society.

PubMed

Narrod, Clare; Zinsstag, Jakob; Tiongco, Marites

2012-06-01

This article presents an integrated epidemiological and economic framework for assessing zoonoses using a "one health" concept. The framework allows for an understanding of the cross-sector economic impact of zoonoses using modified risk analysis and detailing a range of analytical tools. The goal of the framework is to link the analysis outputs of animal and human disease transmission models, economic impact models and evaluation of risk management options to gain improved understanding of factors affecting the adoption of risk management strategies so that investment planning includes the most promising interventions (or sets of interventions) in an integrated fashion. A more complete understanding of the costs of the disease and the costs and benefits of control measures would promote broader implementation of the most efficient and effective control measures, contributing to improved animal and human health, better livelihood outcomes for the poor and macroeconomic growth.

Quantifying risk and assessing outcome in cardiac surgery.

PubMed

Higgins, T L

1998-06-01

Quality improvement, research, and reporting of outcome results can be stratified by preoperative risk by using a logistic regression equation or scores to correct for multiple risk factors. The more than 30-fold mortality differences between lowest and highest risk patients make it critical to stratify outcome results by patient severity. Probabilities are not predictions, however, and caution must be exercised when applying scores to individuals. Outcome assessment will grow in its importance to professionals, initially in the guise of quality reporting and improvement, but increasingly as a tool for risk assessment, patient counseling, and directing therapeutic decisions based on more complete information about patient subgroups. Physicians may be called on for recommendations in choosing systems for their hospitals and communities. Therefore, it is important to have an understanding of how such systems are developed, what factors indicate adequate performance of a system, and how such systems of risk stratification should be applied in practice.

Understanding Risk Tolerance and Building an Effective Safety Culture

NASA Technical Reports Server (NTRS)

Loyd, David

2018-01-01

Estimates range from 65-90 percent of catastrophic mishaps are due to human error. NASA's human factors-related mishaps causes are estimated at approximately 75 percent. As much as we'd like to error-proof our work environment, even the most automated and complex technical endeavors require human interaction... and are vulnerable to human frailty. Industry and government are focusing not only on human factors integration into hazardous work environments, but also looking for practical approaches to cultivating a strong Safety Culture that diminishes risk. Industry and government organizations have recognized the value of monitoring leading indicators to identify potential risk vulnerabilities. NASA has adapted this approach to assess risk controls associated with hazardous, critical, and complex facilities. NASA's facility risk assessments integrate commercial loss control, OSHA (Occupational Safety and Health Administration) Process Safety, API (American Petroleum Institute) Performance Indicator Standard, and NASA Operational Readiness Inspection concepts to identify risk control vulnerabilities.

Transitions Into Underage and Problem Drinking

PubMed Central

Windle, Michael; Spear, Linda P.; Fuligni, Andrew J.; Angold, Adrian; Brown, Jane D.; Pine, Daniel; Smith, Greg T.; Giedd, Jay; Dahl, Ronald E.

2009-01-01

Adolescents ages 10–15 experience dramatic changes in their biological, cognitive, emotional, and social development as well as in their physical and social environments. These include the physiological and psychological changes associated with puberty; further development of the brain; changes in family, peer, and romantic relationships; and exposure to new societal and cultural influences. During this period, many adolescents also begin to use alcohol. Alcohol use during adolescence has adverse effects on the body and increases the risk of alcohol dependence later in life. To better understand why some children drink whereas others do not, researchers are examining nonspecific and alcohol-specific factors that put adolescents at risk for, or which protect them from, early alcohol use and its associated problems. Nonspecific risk factors include certain temperamental and personality traits, family factors, and nonnormative development. Examples of nonspecific protective factors include certain temperamental characteristics, religiosity, and parenting factors (e.g., parental nurturance and monitoring). Among the most influential alcohol-specific risk and protective factors are a family history of alcoholism and the influences of siblings and peers, all of which shape an adolescent’s expectancies about the effects of alcohol, which in turn help determine alcohol use behaviors. PMID:23104445

Environmental risk factors for allergy and socioeconomic status in a birth cohort (BAMSE).

PubMed

Lannerö, E; Kull, I; Wickman, M; Pershagen, G; Nordvall, S L

2002-06-01

Associations between parental educational level and possible risk factors for atopic disease during the first months of life were explored in a cohort of 4089 neonate children born 1994-96 in Stockholm, Sweden. Reports concerning a number of life style factors during pregnancy and after the baby was born were obtained by questionnaire. There was a strong negative association between duration of education and maternal smoking during pregnancy, parental smoking after the baby was born and keeping of cat and dog (p-trend < 0.001), respectively. For example, smoking during pregnancy was reported by 6.7% (95% CI 5.5-7.9) of mothers with college or university degree and by 22.2% (95% CI 20.1-24.5) of those with the shortest education. Indicators of dampness and poor ventilation were also more common in homes of those with the shortest education. The results show that the educational level has an influence on risk factors for development of atopic disease in childhood and indicates a need of deeper understanding of life style in different socioeconomic groups. The data also indicate that various possible confounding factors need to be thoroughly investigated when analysing studies of risk factors for allergic disease in childhood.

Transitions Into Underage and Problem Drinking

PubMed Central

Windle, Michael; Spear, Linda P.; Fuligni, Andrew J.; Angold, Adrian; Brown, Jane D.; Pine, Daniel; Smith, Greg T.; Giedd, Jay; Dahl, Ronald E.

2010-01-01

Adolescents ages 10–15 experience dramatic changes in their biological, cognitive, emotional, and social development as well as in their physical and social environments. These include the physiological and psychological changes associated with puberty; further development of the brain; changes in family, peer, and romantic relationships; and exposure to new societal and cultural influences. During this period, many adolescents also begin to use alcohol. Alcohol use during adolescence has adverse effects on the body and increases the risk of alcohol dependence later in life. To better understand why some children drink whereas others do not, researchers are examining nonspecific and alcohol-specific factors that put adolescents at risk for, or which protect them from, early alcohol use and its associated problems. Nonspecific risk factors include certain temperamental and personality traits, family factors, and nonnormative development. Examples of nonspecific protective factors include certain temperamental characteristics, religiosity, and parenting factors (e.g., parental nurturance and monitoring). Among the most influential alcohol-specific risk and protective factors are a family history of alcoholism and the influences of siblings and peers, all of which shape an adolescent’s expectancies about the effects of alcohol, which in turn help determine alcohol use behaviors. PMID:18381494

The role of personality in predicting drug and alcohol use among sexual minorities.

PubMed

Livingston, Nicholas A; Oost, Kathryn M; Heck, Nicholas C; Cochran, Bryan N

2015-06-01

Research consistently demonstrates that sexual minority status is associated with increased risk of problematic substance use. Existing literature in this area has focused on group-specific minority stress factors (e.g., victimization and internalized heterosexism). However, no known research has tested the incremental validity of personality traits as predictors of substance use beyond identified group-specific risk factors. A sample of 704 sexual minority adults was recruited nationally from lesbian, gay, bisexual, transgender, queer, and questioning community organizations and social networking Web sites and asked to complete an online survey containing measures of personality, sexual minority stress, and substance use. Hierarchical regression models were constructed to test the incremental predictive validity of five-factor model personality traits over and above known sexual minority risk factors. Consistent with hypotheses, extraversion and conscientiousness were associated with drug and alcohol use after accounting for minority stress factors, and all factors except agreeableness were associated with substance use at the bivariate level of analysis. Future research should seek to better understand the role of normal personality structures and processes conferring risk for substance use among sexual minorities. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Do adverse pregnancy outcomes contribute to accelerated cardiovascular events seen in young women with systemic lupus erythematosus?

PubMed

Soh, M C; Nelson-Piercy, C; Westgren, M; McCowan, L; Pasupathy, D

2017-11-01

Cardiovascular events (CVEs) are prevalent in patients with systemic lupus erythematosus (SLE), and it is the young women who are disproportionately at risk. The risk factors for accelerated cardiovascular disease remain unclear, with multiple studies producing conflicting results. In this paper, we aim to address both traditional and SLE-specific risk factors postulated to drive the accelerated vascular disease in this cohort. We also discuss the more recent hypothesis that adverse pregnancy outcomes in the form of maternal-placental syndrome and resultant preterm delivery could potentially contribute to the CVEs seen in young women with SLE who have fewer traditional cardiovascular risk factors. The pathophysiology of how placental-mediated vascular insufficiency and hypoxia (with the secretion of placenta-like growth factor (PlGF) and soluble fms-tyrosine-like kinase-1 (sFlt-1), soluble endoglin (sEng) and other placental factors) work synergistically to damage the vascular endothelium is discussed. Adverse pregnancy outcomes ultimately are a small contributing factor to the complex pathophysiological process of cardiovascular disease in patients with SLE. Future collaborative studies between cardiologists, obstetricians, obstetric physicians and rheumatologists may pave the way for a better understanding of a likely multifactorial aetiological process.

Bats and emerging zoonoses: henipaviruses and SARS.

PubMed

Field, H E

2009-08-01

Nearly 75% of all emerging infectious diseases (EIDs) that impact or threaten human health are zoonotic. The majority have spilled from wildlife reservoirs, either directly to humans or via domestic animals. The emergence of many can be attributed to predisposing factors such as global travel, trade, agricultural expansion, deforestation/habitat fragmentation, and urbanization; such factors increase the interface and/or the rate of contact between human, domestic animal, and wildlife populations, thereby creating increased opportunities for spillover events to occur. Infectious disease emergence can be regarded as primarily an ecological process. The epidemiological investigation of EIDs associated with wildlife requires a trans-disciplinary approach that includes an understanding of the ecology of the wildlife species, and an understanding of human behaviours that increase risk of exposure. Investigations of the emergence of Nipah virus in Malaysia in 1999 and severe acute respiratory syndrome (SARS) in China in 2003 provide useful case studies. The emergence of Nipah virus was associated with the increased size and density of commercial pig farms and their encroachment into forested areas. The movement of pigs for sale and slaughter in turn led to the rapid spread of infection to southern peninsular Malaysia, where the high-density, largely urban pig populations facilitated transmission to humans. Identifying the factors associated with the emergence of SARS in southern China requires an understanding of the ecology of infection both in the natural reservoir and in secondary market reservoir species. A necessary extension of understanding the ecology of the reservoir is an understanding of the trade, and of the social and cultural context of wildlife consumption. Emerging infectious diseases originating from wildlife populations will continue to threaten public health. Mitigating and managing the risk requires an appreciation of the connectedness between human, livestock and wildlife health, and of the factors and processes that disrupt the balance.

Less Drinking, Yet More Problems: Understanding African American Drinking and Related Problems

PubMed Central

Zapolski, Tamika C. B.; Pedersen, Sarah L.; McCarthy, Denis M.; Smith, Gregory T.

2013-01-01

Researchers have found that, compared to European Americans, African Americans report later initiation of drinking, lower rates of use, and lower levels of use across almost all age groups. Nevertheless, African Americans also have higher levels of alcohol problems than European Americans. After reviewing current data regarding these trends, we provide a theory to understand this apparent paradox as well as to understand variability in risk among African Americans. Certain factors appear to operate as both protective factors against heavy use and risk factors for negative consequences from use. For example, African American culture is characterized by norms against heavy alcohol use or intoxication, which protects against heavy use but which also provides within group social disapproval when use does occur. African Americans are more likely to encounter legal problems from drinking than European Americans, even at the same levels of consumption, perhaps thus resulting in reduced consumption but more problems from consumption. There appears to be one particular group of African Americans, low-income African American men, who are at the highest risk for alcoholism and related problems. We theorize that this effect is due to the complex interaction of residential discrimination, racism, age of drinking, and lack of available standard life reinforcers (e.g., stable employment and financial stability). Further empirical research will be needed to test our theories and otherwise move this important field forward. A focus on within group variation in drinking patterns and problems is necessary. We suggest several new avenues of inquiry. PMID:23477449

Investigation of possible risk factors for depression in Alzheimer's disease: A systematic review of the evidence.

PubMed

Steck, Natassa; Cooper, Claudia; Orgeta, Vasiliki

2018-08-15

Depression is common in people with Alzheimer's disease (AD), and is associated with increased risk of institutionalization and mortality. Understanding risk factors for depression in AD is key to its development and treatment. We searched the MEDLINE, EMBASE, PsycINFO, and CINAL databases for longitudinal prospective cohort studies that evaluated risk factors for depression in people with AD. Two authors independently selected articles for inclusion and assessed quality of studies using predetermined criteria. In seven studies that met the inclusion criteria, 2029 participants were followed up for a median of 5 years. Gender and educational attainment were not predictors of depression risk. History of a past psychiatric disorder and greater cognitive impairment predicted increased risk of depression in more than one study. In single studies, younger age, having a family history of psychiatric disorder, neuroticism, functional decline, presence of sleep disturbance and aggression, and increased cardiovascular risk predicted depression risk. Not being within 6 months of dementia onset and, counterintuitively having two comorbid disorders were protective factors in one study. A small number of studies exist overall and only a few have examined the same risk factors. Most of the studies have measured depression using scales that are not validated in AD. These results inform a preliminary model of depression risk in people with AD. Unlike in the general population, men and women and those with higher and lower educational levels of attainment may be equally at risk of depression. Clinicians should be aware of these possible differences in the risk profile for depression in AD populations, to assist detection and enable early treatment. Interventions to delay cognitive and functional decline may reduce depression risk. Copyright © 2018 Elsevier B.V. All rights reserved.

Morbidity and Health Risk Factors Among New Mexico Miners: A Comparison Across Mining Sectors.

PubMed

Shumate, Alice M; Yeoman, Kristin; Victoroff, Tristan; Evans, Kandace; Karr, Roger; Sanchez, Tami; Sood, Akshay; Laney, Anthony Scott

2017-08-01

This study examines differences in chronic health outcomes between coal, uranium, metal, and nonmetal miners. In a cross-sectional study using data from a health screening program for current and former New Mexico miners, log-binomial logistic regression models were used to estimate relative risks of respiratory and heart disease, cancer, osteoarthritis, and back pain associated with mining in each sector as compared with coal, adjusting for other relevant risk factors. Differential risks in angina, pulmonary symptoms, asthma, cancer, osteoarthritis, and back pain between mining sectors were found. New Mexico miners experience different chronic health challenges across sectors. These results demonstrate the importance of using comparable data to understand how health risks differ across mining sectors. Further investigation among a broader geographic population of miners will help identify the health priorities and needs in each sector.

Cybervictimization of Young People With an Intellectual or Developmental Disability: Risks Specific to Sexual Solicitation.

PubMed

Normand, Claude L; Sallafranque-St-Louis, François

2016-03-01

Studies demonstrate that youth are vulnerable to online sexual solicitation. However, no study has estimated this risk for youth diagnosed with an intellectual or developmental disability (IDD). A literature review of the risk factors associated with online sexual solicitation in youths was done using electronic databases, such as PsychInFO, ERIC, MEDLINE and Scopus. Fifty-seven published papers were found relevant. However, only two pertained to the population with IDD. Sexual and physical abuse, social isolation, loneliness, depression, and chatting were found to increase the risk of being prey to sexual solicitation on the Internet. Many of these risk factors are even more prevalent in youth with IDD than in the general population. Recommendations are made for future research to help understand and prevent sexual cybersolicitation. © 2015 John Wiley & Sons Ltd.

Resilient parenting of preschool children at developmental risk.

PubMed

Ellingsen, R; Baker, B L; Blacher, J; Crnic, K

2014-07-01

Given the great benefits of effective parenting to child development under normal circumstances, and the even greater benefits in the face of risk, it is important to understand why some parents manage to be effective in their interactions with their child despite facing formidable challenges. This study examined factors that promoted effective parenting in the presence of child developmental delay, high child behaviour problems, and low family income. Data were obtained from 232 families at child age 3 and 5 years. Using an adapted ABCX model, we examined three risk domains (child developmental delay, child behaviour problems, and low family income) and three protective factors (mother's education, health, and optimism). The outcome of interest was positive parenting as coded from mother-child interactions. Levels of positive parenting differed across levels of risk. Education and optimism appeared to be protective factors for positive parenting at ages 3 and 5, and health appeared to be an additional protective factor at age 5. There was an interaction between risk and education at age 3; mothers with higher education engaged in more positive parenting at higher levels of risk than did mothers with less education. There was also an interaction between risk and optimism at age 3; mothers with higher optimism engaged in more positive parenting at lower levels of risk than did mothers with less optimism. The risk index did not predict change in positive parenting from age 3-5, but the protective factor of maternal health predicted positive changes. This study examined factors leading to positive parenting in the face of risk, a topic that has received less attention in the literature on disability. Limitations, future directions, and implications for intervention are discussed. © 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Risk factors and impact on bone mineral density in postmenopausal Mexican mestizo women.

PubMed

Rojano-Mejía, David; Aguilar-Madrid, Guadalupe; López-Medina, Guillermo; Cortes-Espinosa, Leticia; Hernández-Chiu, Maria C; Canto-Cetina, Thelma; Vergara-López, Alma; Coral-Vázquez, Ramon M; Canto, Patricia

2011-03-01

Considering that the Mexican mestizo population seems to be the result of a genetic admixture, we proposed that further research is needed to evaluate the role of ethnicity in conjunction with health-related factors to better understand ethnic differences in bone mineral density (BMD). The aim of this study was to analyze several risk factors related to the development of osteoporosis in postmenopausal Mexican mestizo women. We included 567 postmenopausal Mexican mestizo women. A structured questionnaire for risk factors was applied and BMD was measured in total hip and lumbar spine by dual-energy x-ray absorptiometry. Nonconditional logistic regression was used to estimate crude and adjusted odds ratio. Using World Health Organization criteria, 28.7% of postmenopausal women had osteoporosis, 46.4% had osteopenia, and 24.9% had normal BMD. Each clinical risk factor had a different significance for osteopenia/osteoporosis; however, duration of total breast-feeding, body mass index, and number of years since menopause remained significantly associated with osteopenia/osteoporosis after bone density was added to the nonconditional model. Interestingly, extended periods of accumulated breast-feeding for 24 and 36 months were, in both cases, significantly associated with osteopenia/osteoporosis. Our results confirm the importance of considering the duration of breast-feeding as an important risk factor for osteopenia/osteoporosis. In addition, we find that body mass index is positively associated with BMD. Because of the heterogeneity of the Mexican mestizo population, the risk factor for osteoporosis may not be the same in different ethnic groups.

Psychosocial Risk Factors for Low Back Pain and Absenteeism among Slovenian Professional Drivers.

PubMed

Kresal, Friderika; Suklan, Jana; Roblek, Vasja; Jerman, Andrej; Meško, Maja

2017-06-01

The aim of this study was to determine the most common psychosocial risk factors for absenteeism and the extent to which low back pain occurs among Slovenian professional drivers as result of various psychosocial risk factors. The study involved 275 professional drivers, mostly men (mean age 41.6 years). Statistical data analysis was conducted using SPSS package version 21, MS Excel version 2007 and Pajek, version 3. The main method for data processing was regression analysis. The results of the quantitative survey showed that lower back pain is mostly caused by lifting and carrying heavy loads, inadequate working conditions, poor physical fitness, regular nights out, shift work, and stress. Dissatisfaction with work, shift work and unsuitable working conditions significantly affect the incidence of low back pain. Absenteeism is influenced by factors such as dissatisfaction at work, disrespectful attitude of managers, unsuitable working conditions, personal dissatisfaction, lack of understanding of the partner, and enjoying nightlife on a regular basis. The study clarifies the unexplained holistic psychosocial risk factors and treatment effects on health in the population of professional drivers. Such factors can lead to absenteeism. The study also provides initial demonstration research in the Slovenian practice. Furthermore, it provides solutions in a holistic approach to solve the problem of risk factors management. Copyright© by the National Institute of Public Health, Prague 2017

Diesel engine exhaust and lung cancer mortality: time-related factors in exposure and risk.

PubMed

Moolgavkar, Suresh H; Chang, Ellen T; Luebeck, Georg; Lau, Edmund C; Watson, Heather N; Crump, Kenny S; Boffetta, Paolo; McClellan, Roger

2015-04-01

To develop a quantitative exposure-response relationship between concentrations and durations of inhaled diesel engine exhaust (DEE) and increases in lung cancer risks, we examined the role of temporal factors in modifying the estimated effects of exposure to DEE on lung cancer mortality and characterized risk by mine type in the Diesel Exhaust in Miners Study (DEMS) cohort, which followed 12,315 workers through December 1997. We analyzed the data using parametric functions based on concepts of multistage carcinogenesis to directly estimate the hazard functions associated with estimated exposure to a surrogate marker of DEE, respirable elemental carbon (REC). The REC-associated risk of lung cancer mortality in DEMS is driven by increased risk in only one of four mine types (limestone), with statistically significant heterogeneity by mine type and no significant exposure-response relationship after removal of the limestone mine workers. Temporal factors, such as duration of exposure, play an important role in determining the risk of lung cancer mortality following exposure to REC, and the relative risk declines after exposure to REC stops. There is evidence of effect modification of risk by attained age. The modifying impact of temporal factors and effect modification by age should be addressed in any quantitative risk assessment (QRA) of DEE. Until there is a better understanding of why the risk appears to be confined to a single mine type, data from DEMS cannot reliably be used for QRA. © 2015 Society for Risk Analysis.

Improving antenatal risk assessment in women exposed to high risks.

PubMed

Perry, Natasha; Newman, Louise K; Hunter, Mick; Dunlop, Adrian

2015-01-01

Antenatal substance use and related psychosocial risk factors are known to increase the likelihood of child protection involvement; less is known about the predictive nature of maternal reflective functioning (RF) in this population. This preliminary study assessed psychosocial and psychological risk factors for a group of substance dependent women exposed to high risks in pregnancy, and their impact on child protection involvement. Pregnant women on opiate substitution treatment (n = 11) and a comparison group (n = 15) were recruited during their third trimester to complete measures of RF (Pregnancy Interview), childhood trauma, mental health and psychosocial assessments. At postnatal follow-up, RF was reassessed (Parent Development Interview - Revised Short Version) and mother-infant dyads were videotaped to assess emotional availability (EA). Child protection services were contacted to determine if any concerns had been raised for infant safety. Significant between-group differences were observed for demographics, psychosocial factors, trauma and mental health symptoms. Unexpectedly, no significant differences were found for RF or EA between groups. Eight women in the 'exposed to high risks' group became involved with child protection services. Reflective functioning was not significantly associated with psychosocial risk factors, and therefore did not mediate the outcome of child protection involvement. Women 'exposed to high risks' were equally able to generate a model of their own and their infants' mental states and should not be seen within a deficit perspective. Further research is required to better understand the range of risk factors that predict child protection involvement in high risk groups. © The Author(s) 2013.

Advanced maternal age and risk perception: A qualitative study

PubMed Central

2012-01-01

Background Advanced maternal age (AMA) is associated with several adverse pregnancy outcomes, hence these pregnancies are considered to be “high risk.” A review of the empirical literature suggests that it is not clear how women of AMA evaluate their pregnancy risk. This study aimed to address this gap by exploring the risk perception of pregnant women of AMA. Methods A qualitative descriptive study was undertaken to obtain a rich and detailed source of explanatory data regarding perceived pregnancy risk of 15 women of AMA. The sample was recruited from a variety of settings in Winnipeg, Canada. In-depth interviews were conducted with nulliparous women aged 35 years or older, in their third trimester, and with singleton pregnancies. Interviews were recorded and transcribed verbatim, and content analysis was used to identify themes and categories. Results Four main themes emerged: definition of pregnancy risk, factors influencing risk perception, risk alleviation strategies, and risk communication with health professionals. Conclusions Several factors may influence women's perception of pregnancy risk including medical risk, psychological elements, characteristics of the risk, stage of pregnancy, and health care provider’s opinion. Understanding these influential factors may help health professionals who care for pregnant women of AMA to gain insight into their perspectives on pregnancy risk and improve the effectiveness of risk communication strategies with this group. PMID:22988825

Socioeconomic indicators of heat-related health risk supplemented with remotely sensed data

PubMed Central

Johnson, Daniel P; Wilson, Jeffrey S; Luber, George C

2009-01-01

Background Extreme heat events are the number one cause of weather-related fatalities in the United States. The current system of alert for extreme heat events does not take into account intra-urban spatial variation in risk. The purpose of this study is to evaluate a potential method to improve spatial delineation of risk from extreme heat events in urban environments by integrating sociodemographic risk factors with estimates of land surface temperature derived from thermal remote sensing data. Results Comparison of logistic regression models indicates that supplementing known sociodemographic risk factors with remote sensing estimates of land surface temperature improves the delineation of intra-urban variations in risk from extreme heat events. Conclusion Thermal remote sensing data can be utilized to improve understanding of intra-urban variations in risk from extreme heat. The refinement of current risk assessment systems could increase the likelihood of survival during extreme heat events and assist emergency personnel in the delivery of vital resources during such disasters. PMID:19835578

Risk perception of sexually transmitted infections and HIV in Nigerian commercial sex workers living in Barcelona: a study protocol

PubMed Central

Coma Auli, Núria; Mejía-Lancheros, Cília; Berenguera, Anna; Mayans, Martí Vall; Lasagabaster, Maider Arando; Pujol-Ribera, Enriqueta

2013-01-01

Introduction Sexually transmitted infections (STIs) and HIV are a serious global public health issue. These diseases are largely preventable, as they are directly and indirectly associated with potentially modifiable factors, including socioeconomic conditions. Sexual transmission is responsible for over 75% of new HIV infections worldwide. Moreover, commercial sex workers and their clients are two of the groups at the highest risk of acquiring and transmitting these infectious diseases, due to an extensive number of sexual encounters and the various factors related to commercial sex situations. This qualitative study aims to deepen the understanding of the risk perception of STIs and HIV and their associated factors in Nigerian commercial sex workers in the city of Barcelona. Methods and analysis This is a qualitative, descriptive, interpretive study based on a social constructivist and phenomenological perspective conducted on a saturated sample of Nigerian commercial sex workers in the city of Barcelona. Data will be collected through semistructured individual and triangular group interviews. Information will be examined using a sociological discourse analysis, allowing us to understand the social and individual factors related to the risk perception of STIs and HIV in commercial sex workers. Discussion Qualitative studies are an important element in identifying individual, social and contextual factors directly or indirectly related to the health/disease process. This qualitative study will provide essential knowledge to improve health promotion, prevention strategies and effective management of STIs both for commercial sex workers and their clients. Ethics This study has been approved by the clinical research ethics committee (CEIC) of IDIAP Jordi Gol in Barcelona, 2012. PMID:23901029

The predictive role of health-promoting behaviours and perceived stress in aneurysmal rupture.

PubMed

Lee, Mi-Sun; Park, Chang G; Hughes, Tonda L; Jun, Sang-Eun; Whang, Kum; Kim, Nahyun

2018-03-01

To examine the roles of two modifiable factors-health-promoting behaviours and perceived stress-in predicting aneurysmal rupture. Unruptured intracranial aneurysm detection produces significant stress and anxiety in patients because of the risk of rupture. Compared to nonmodifiable risk factors for rupture such as age, gender and aneurysm size/location, less attention has been given to modifiable risk factors. Two modifiable factors, health-promoting behaviours and perceived stress, have hardly been examined as potential predictors of rupture. This study used a cross-sectional design. We assessed 155 patients with intracranial aneurysms-that is, subarachnoid haemorrhage (n = 77) or unruptured intracranial aneurysm (n = 78)-to examine (i) baseline characteristics (patient and aneurysmal factors), (ii) health-related factors (lifestyle habits and health-promoting behaviour) and (iii) perceived stress levels (psychological stress and physical stress). Patient records provided medical histories and aneurysmal factors; other data were collected using a structured questionnaire addressing lifestyle habits, the Health-Promoting Lifestyle Profile-II to measure health-promoting behaviour and the Perceived Stress Questionnaire to measure perceived-psychological stress and perceived-physical stress levels. Bivariate analysis indicated that aneurysm rupture risk was associated with female gender, aneurysm size/location, defecation frequency, hyperlipidaemia, sedentary time, low Health-Promoting Lifestyle Profile-II mean scores and high perceived-psychological stress scores. After adjusting for known risk factors, the mean Health-Promoting Lifestyle Profile-II and perceived-psychological stress scores remained robust predictors of rupture. Furthermore, known risk factors combined with these scores had greater predictive power than known risk factors alone. Health-promoting behaviour and psychological stress are promising modifiable factors for reducing risk of aneurysmal rupture. Our findings may stimulate greater understanding of mechanisms underlying aneurysmal rupture and suggest practical strategies for nurses to employ in optimising conservative management of rupture risk by teaching patients how to modify their risk. Both health-promoting behaviour and perceived stress should be addressed when designing preventive nursing interventions for patients with unruptured intracranial aneurysm. © 2017 John Wiley & Sons Ltd.

“Making it”: Understanding adolescent resilience in two informal settlements (slums) in Nairobi, Kenya

PubMed Central

Kabiru, Caroline W.; Beguy, Donatien; Ndugwa, Robert P.; Zulu, Eliya M.; Jessor, Richard

2013-01-01

Many adolescents living in contexts characterized by adversity achieve positive outcomes. We adopt a protection-risk conceptual framework to examine resilience (academic achievement, civic participation, and avoidance of risk behaviors) among 1,722 never-married 12-19 year olds living in two Kenyan urban slums. We find stronger associations between explanatory factors and resilience among older (15-19 years) than younger (12-14 years) adolescents. Models for pro-social behavior and models for anti-social behavior emerge as key predictors of resilience. Further accumulation of evidence on risk and protective factors is needed to inform interventions to promote positive outcomes among youth situated in an ecology of adversity. PMID:24382935

"Making it": Understanding adolescent resilience in two informal settlements (slums) in Nairobi, Kenya.

PubMed

Kabiru, Caroline W; Beguy, Donatien; Ndugwa, Robert P; Zulu, Eliya M; Jessor, Richard

2012-03-16

Many adolescents living in contexts characterized by adversity achieve positive outcomes. We adopt a protection-risk conceptual framework to examine resilience (academic achievement, civic participation, and avoidance of risk behaviors) among 1,722 never-married 12-19 year olds living in two Kenyan urban slums. We find stronger associations between explanatory factors and resilience among older (15-19 years) than younger (12-14 years) adolescents. Models for pro-social behavior and models for anti-social behavior emerge as key predictors of resilience. Further accumulation of evidence on risk and protective factors is needed to inform interventions to promote positive outcomes among youth situated in an ecology of adversity.

A comparison of risk assessment models for term and preterm low birthweight.

PubMed

Michielutte, R; Ernest, J M; Moore, M L; Meis, P J; Sharp, P C; Wells, H B; Buescher, P A

1992-01-01

Most epidemiological research dealing with the assessment of risk for low birthweight has focused on all low birthweight births. Studies that have attempted to distinguish between term and preterm low birthweights have tended to examine preterm low birthweight, since the risk of perinatal mortality and morbidity is greatest for this group of infants. This study uses data from 25,408 singleton births in a 20-county region in North Carolina to identify and compare risk factors for term and preterm low birthweights, and also examines the usefulness of separate multivariate risk assessment systems for term and preterm low birthweights that could be used in the clinical setting. Risk factors that overlap as significant predictors of both types of low birthweight include race, no previous live births, smoking, weight under 100 lb, and previous preterm or low birthweight birth. Age also is a significant predictor of both types of low birthweight, but in opposite directions. Younger age is associated with reduced risk of term low birthweight and increased risk of pattern low birthweight. Comparison of all risk factors indicates that different multivariate models are needed to understand the epidemiology of preterm and term low birthweights. In terms of clinical value, a general risk assessment model that combines all low birthweight births is as effective as the separate models.

Understanding Risk and Protective Factors for Child Maltreatment: The Value of Integrated, Population-Based Data

ERIC Educational Resources Information Center

Putnam-Hornstein, Emily; Needell, Barbara; Rhodes, Anne E.

2013-01-01

In this article, we argue for expanded efforts to integrate administrative data systems as a "practical strategy" for developing a richer understanding of child abuse and neglect. Although the study of child maltreatment is often critiqued for being atheoretical, we believe that a more pressing concern is the absence of population-based and…

Risk perception and choice of place of birth in women with high risk pregnancies: A qualitative study.

PubMed

Lee, Suzanne; Ayers, Susan; Holden, Des

2016-07-01

Objective To examine the perception of risk among a group of women with high risk pregnancies who were either planning to give birth in hospital, or at home despite medical advice to the contrary. The intention was to consider differences and similarities between the groups to examine how perception of risk relates to choice of place of birth. Design Qualitative study using semi-structured interviews. Setting Maternity department in a hospital in South East England. Participants Twenty-six women with high risk pregnancies, at least 32 weeks pregnant. Half were planning hospital births and half homebirths. Measurements and findings Semi-structured interviews to investigate women's understanding and assessment of risk. Results were analysed using thematic analysis. Five themes emerged: understanding of situation; judgement of risk; reassuring factors; impact of risk; and coping with risk. Women from both groups had some understanding of the implications of their medical/obstetric conditions. They displayed concerns about their babies' wellbeing. Women planning homebirths assessed their risks as lower and expressed less concerns than women planning hospital births. Women planning hospital births more frequently described following professional advice. Key conclusions Risk perception is individual and subjective. Women with high risk pregnancies who plan to give birth at home perceive risk differently to women who plan hospital births. Implications for practice Healthcare professionals working with women with high risk pregnancies should be aware of the potential for differences in definitions and perceptions of risk within this group. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cumulative Social Risk and Obesity in Early Childhood

PubMed Central

Duarte, Cristiane S.; Chambers, Earle C.; Boynton-Jarrett, Renée

2012-01-01

OBJECTIVES: The goal of this study was to examine the relationship between cumulative social adversity and childhood obesity among preschool-aged children (N = 1605) in the Fragile Families and Child Wellbeing Study. METHODS: Maternal reports of intimate partner violence, food insecurity, housing insecurity, maternal depressive symptoms, maternal substance use, and father’s incarceration were obtained when the child was 1 and 3 years of age. Two cumulative social risk scores were created by summing the 6 factors assessed at ages 1 and 3 years. Child height and weight were measured at 5 years of age. Logistic regression models stratified according to gender were used to estimate the association between cumulative social risk and obesity, adjusting for sociodemographic factors. RESULTS: Seventeen percent of children were obese at age 5 years, and 57% had at least 1 social risk factor. Adjusting for sociodemographic factors, girls experiencing high cumulative social risk (≥2 factors) at age 1 year only (odds ratio [OR]: 2.1 [95% confidence interval [CI]: 1.1–4.1]) or at 3 years only (OR: 2.2 [95% CI: 1.2–4.2]) were at increased odds of being obese compared with girls with no risk factors at either time point. Those experiencing high cumulative risk at age 1 and 3 years were not at statistically significant odds of being obese (OR: 1.9 [95% CI: 0.9–4.0]). No significant associations were noted among boys. CONCLUSIONS: There seems to be gender differences in the effects of cumulative social risk factors on the prevalence of obesity at 5 years of age. Understanding the social context of families could make for more effective preventive efforts to combat childhood obesity. PMID:22508921

Analyzing risks to protected areas using the human modification framework: a Colorado case study

Treesearch

David M. Theobald; Alisa Wade; Grant Wilcox; Nate Peterson

2010-01-01

A framework that organizes natural and protected areas is often used to help understand the potential risks to natural areas and aspects of their ecological and human dimensions. The spatial (or landscape) context of these dynamics is also a critical, but, rarely considered, factor. Common classification systems include the U.S. Geological (USGS) Gap Analysis Program...

But I'm Married: Understanding Relationship Status and College Students' Sexual Behaviors

ERIC Educational Resources Information Center

Oswalt, Sara B.; Wyatt, Tammy J.

2014-01-01

Sexual health programs on college campuses are often directed toward single individuals with a focus on sexual risk. Using a sample of college students, this study examines how relationship status relates to sexual behaviors and may be a factor for sexual risk. Based on the study's results, expansion of sexual health programming on college…

Can We Distinguish Juvenile Violent Sex Offenders, Violent Non-Sex Offenders, and Versatile Violent Sex Offenders Based on Childhood Risk Factors?

ERIC Educational Resources Information Center

Wanklyn, Sonya G.; Ward, Ashley K.; Cormier, Nicole S.; Day, David M.; Newman, Jennifer E.

2012-01-01

Understanding the developmental precursors of juvenile violent sex offending can contribute to the promotion of effective early intervention and prevention programs for high-risk children and youth. However, there is currently a lack of research on the early characteristics of adolescents who commit violent sex offenses. Drawing on the literature…

An Examination of Emotion Regulation, Temperament, and Parenting Style as Potential Predictors of Adolescent Depression Risk Status: A Correlational Study

ERIC Educational Resources Information Center

Betts, Jennifer; Gullone, Eleonora; Allen, J. Sabura

2009-01-01

Given that depression is a debilitating disorder, it is critical that we advance our understanding about the aetiology of this disorder. This study investigated both traditional (temperament and parenting) and novel (emotion regulation strategy) risk factors associated with adolescent depression. Forty-four adolescents (12-16 years; 64% females)…

Utilizing Biopsychosocial and Strengths-Based Approaches within the Field of Child Health: What We Know and Where We Can Grow

ERIC Educational Resources Information Center

Black, Jessica M.; Hoeft, Fumiko

2015-01-01

We continue to increase our understanding of the experiences and settings that contribute to positive developmental outcomes in childhood, and those that confer greater risk. Although the mechanisms by which the risk and protective factors affect developmental outcomes need to be further elucidated through research, converging findings from the…

Impact of male obesity on infertility: a critical review of the current literature.

PubMed

Hammoud, Ahmad O; Gibson, Mark; Peterson, C Matthew; Meikle, A Wayne; Carrell, Douglas T

2008-10-01

To evaluate the current understanding of the effects and potential mechanisms of obesity on male fertility. Literature review of articles pertaining to obesity and male infertility. Recent population-based studies suggest an elevated risk for subfertility among couples in which the male partner is obese and an increased likelihood of abnormal semen parameters among heavier men. Male factor infertility is associated with a higher incidence of obesity in the male partner. Obese men exhibit reduced androgen and SHBG levels accompanied by elevated estrogen levels. Reduced inhibin B levels correlate with degree of obesity and are not accompanied by compensatory increases in FSH. This complexly altered reproductive hormonal profile suggests that endocrine dysregulation in obese men may explain the increased risk of altered semen parameters and infertility. Additional features of male obesity that may contribute to an increased risk for infertility are altered retention and metabolism of environmental toxins, altered lifestyle factors, and increased risks for sexual dysfunction. Neither reversibility of obesity-associated male infertility with weight loss nor effective therapeutic interventions have been studied yet. The increasing prevalence of obesity calls for greater clinician awareness of its effects on fertility, better understanding of underlying mechanisms, and eventually avenues for mitigation or treatment.

Environmental risk factors for inflammatory bowel diseases: Evidence based literature review

PubMed Central

Abegunde, Ayokunle T; Muhammad, Bashir H; Bhatti, Owais; Ali, Tauseef

2016-01-01

AIM: Advances in genetics and immunology have contributed to the current understanding of the pathogenesis of inflammatory bowel diseases (IBD). METHODS: The current opinion on the pathogenesis of IBD suggests that genetically susceptible individuals develop intolerance to dysregulated gut microflora (dysbiosis) and chronic inflammation develops as a result of environmental insults. Environmental exposures are innumerable with varying effects during the life course of individuals with IBD. Studying the relationship between environmental factors and IBD may provide the missing link to increasing our understanding of the etiology and increased incidence of IBD in recent years with implications for prevention, diagnosis, and treatment. Environmental factors are heterogeneous and genetic predisposition, immune dysregulation, or dysbiosis do not lead to the development of IBD in isolation. RESULTS: Current challenges in the study of environmental factors and IBD are how to effectively translate promising results from experimental studies to humans in order to develop models that incorporate the complex interactions between the environment, genetics, immunology, and gut microbiota, and limited high quality interventional studies assessing the effect of modifying environmental factors on the natural history and patient outcomes in IBD. CONCLUSION: This article critically reviews the current evidence on environmental risk factors for IBD and proposes directions for future research. PMID:27468219

Methodological and Design Considerations in Evaluating the Impact of Prevention Programs on Violence and Related Health Outcomes.

PubMed

Massetti, Greta M; Simon, Thomas R; Smith, Deborah Gorman

2016-10-01

Drawing on research that has identified specific predictors and trajectories of risk for violence and related negative outcomes, a multitude of small- and large-scale preventive interventions for specific risk behaviors have been developed, implemented, and evaluated. One of the principal challenges of these approaches is that a number of separate problem-specific programs targeting different risk areas have emerged. However, as many negative health behaviors such as substance abuse and violence share a multitude of risk factors, many programs target identical risk factors. There are opportunities to understand whether evidence-based programs can be leveraged for potential effects across a spectrum of outcomes and over time. Some recent work has documented longitudinal effects of evidence-based interventions on generalized outcomes. This work has potential for advancing our understanding of the effectiveness of promising and evidence-based prevention strategies. However, conducting longitudinal follow-up of established interventions presents a number of methodological and design challenges. To answer some of these questions, the Centers for Disease Control and Prevention convened a panel of multidisciplinary experts to discuss opportunities to take advantage of evaluations of early prevention programs and evaluating multiple long-term outcomes. This special section of the journal Prevention Science includes a series of papers that begin to address the relevant considerations for conducting longitudinal follow-up evaluation research. This collection of papers is intended to inform our understanding of the challenges and strategies for conducting longitudinal follow-up evaluation research that could be used to drive future research endeavors.

Cross-Country Individual Participant Analysis of 4.1 Million Singleton Births in 5 Countries with Very High Human Development Index Confirms Known Associations but Provides No Biologic Explanation for 2/3 of All Preterm Births

PubMed Central

Ferrero, David M.; Jacobsson, Bo; Di Renzo, Gian Carlo; Norman, Jane E.; Martin, James N.; D’Alton, Mary; Castelazo, Ernesto; Howson, Chris P.; Sengpiel, Verena; Bottai, Matteo; Mayo, Jonathan A.; Shaw, Gary M.; Verdenik, Ivan; Tul, Nataša; Velebil, Petr; Cairns-Smith, Sarah; Rushwan, Hamid; Arulkumaran, Sabaratnam; Howse, Jennifer L.; Simpson, Joe Leigh

2016-01-01

Background Preterm birth is the most common single cause of perinatal and infant mortality, affecting 15 million infants worldwide each year with global rates increasing. Understanding of risk factors remains poor, and preventive interventions have only limited benefit. Large differences exist in preterm birth rates across high income countries. We hypothesized that understanding the basis for these wide variations could lead to interventions that reduce preterm birth incidence in countries with high rates. We thus sought to assess the contributions of known risk factors for both spontaneous and provider-initiated preterm birth in selected high income countries, estimating also the potential impact of successful interventions due to advances in research, policy and public health, or clinical practice. Methods We analyzed individual patient-level data on 4.1 million singleton pregnancies from four countries with very high human development index (Czech Republic, New Zealand, Slovenia, Sweden) and one comparator U.S. state (California) to determine the specific contribution (adjusting for confounding effects) of 21 factors. Both individual and population-attributable preterm birth risks were determined, as were contributors to cross-country differences. We also assessed the ability to predict preterm birth given various sets of known risk factors. Findings Previous preterm birth and preeclampsia were the strongest individual risk factors of preterm birth in all datasets, with odds ratios of 4.6–6.0 and 2.8–5.7, respectively, for individual women having those characteristics. In contrast, on a population basis, nulliparity and male sex were the two risk factors with the highest impact on preterm birth rates, accounting for 25–50% and 11–16% of excess population attributable risk, respectively (p<0.001). The importance of nulliparity and male sex on population attributable risk was driven by high prevalence despite low odds ratios for individual women. More than 65% of the total aggregated risk of preterm birth within each country lacks a plausible biologic explanation, and 63% of difference between countries cannot be explained with known factors; thus, research is necessary to elucidate the underlying mechanisms of preterm birth and, hence, therapeutic intervention. Surprisingly, variation in prevalence of known risk factors accounted for less than 35% of the difference in preterm birth rates between countries. Known risk factors had an area under the curve of less than 0.7 in ROC analysis of preterm birth prediction within countries. These data suggest that other influences, as yet unidentified, are involved in preterm birth. Further research into biological mechanisms is warranted. Conclusions We have quantified the causes of variation in preterm birth rates among countries with very high human development index. The paucity of explicit and currently identified factors amenable to intervention illustrates the limited impact of changes possible through current clinical practice and policy interventions. Our research highlights the urgent need for research into underlying biological causes of preterm birth, which alone are likely to lead to innovative and efficacious interventions. PMID:27622562

Cross-Country Individual Participant Analysis of 4.1 Million Singleton Births in 5 Countries with Very High Human Development Index Confirms Known Associations but Provides No Biologic Explanation for 2/3 of All Preterm Births.

PubMed

Ferrero, David M; Larson, Jim; Jacobsson, Bo; Di Renzo, Gian Carlo; Norman, Jane E; Martin, James N; D'Alton, Mary; Castelazo, Ernesto; Howson, Chris P; Sengpiel, Verena; Bottai, Matteo; Mayo, Jonathan A; Shaw, Gary M; Verdenik, Ivan; Tul, Nataša; Velebil, Petr; Cairns-Smith, Sarah; Rushwan, Hamid; Arulkumaran, Sabaratnam; Howse, Jennifer L; Simpson, Joe Leigh

2016-01-01

Preterm birth is the most common single cause of perinatal and infant mortality, affecting 15 million infants worldwide each year with global rates increasing. Understanding of risk factors remains poor, and preventive interventions have only limited benefit. Large differences exist in preterm birth rates across high income countries. We hypothesized that understanding the basis for these wide variations could lead to interventions that reduce preterm birth incidence in countries with high rates. We thus sought to assess the contributions of known risk factors for both spontaneous and provider-initiated preterm birth in selected high income countries, estimating also the potential impact of successful interventions due to advances in research, policy and public health, or clinical practice. We analyzed individual patient-level data on 4.1 million singleton pregnancies from four countries with very high human development index (Czech Republic, New Zealand, Slovenia, Sweden) and one comparator U.S. state (California) to determine the specific contribution (adjusting for confounding effects) of 21 factors. Both individual and population-attributable preterm birth risks were determined, as were contributors to cross-country differences. We also assessed the ability to predict preterm birth given various sets of known risk factors. Previous preterm birth and preeclampsia were the strongest individual risk factors of preterm birth in all datasets, with odds ratios of 4.6-6.0 and 2.8-5.7, respectively, for individual women having those characteristics. In contrast, on a population basis, nulliparity and male sex were the two risk factors with the highest impact on preterm birth rates, accounting for 25-50% and 11-16% of excess population attributable risk, respectively (p<0.001). The importance of nulliparity and male sex on population attributable risk was driven by high prevalence despite low odds ratios for individual women. More than 65% of the total aggregated risk of preterm birth within each country lacks a plausible biologic explanation, and 63% of difference between countries cannot be explained with known factors; thus, research is necessary to elucidate the underlying mechanisms of preterm birth and, hence, therapeutic intervention. Surprisingly, variation in prevalence of known risk factors accounted for less than 35% of the difference in preterm birth rates between countries. Known risk factors had an area under the curve of less than 0.7 in ROC analysis of preterm birth prediction within countries. These data suggest that other influences, as yet unidentified, are involved in preterm birth. Further research into biological mechanisms is warranted. We have quantified the causes of variation in preterm birth rates among countries with very high human development index. The paucity of explicit and currently identified factors amenable to intervention illustrates the limited impact of changes possible through current clinical practice and policy interventions. Our research highlights the urgent need for research into underlying biological causes of preterm birth, which alone are likely to lead to innovative and efficacious interventions.

Demographics as predictors of suicidal thoughts and behaviors: A meta-analysis

PubMed Central

Huang, Xieyining; Ribeiro, Jessica D.; Musacchio, Katherine M.; Franklin, Joseph C.

2017-01-01

Background Certain demographic factors have long been cited to confer risk or protection for suicidal thoughts and behaviors. However, many studies have found weak or non-significant effects. Determining the effect strength and clinical utility of demographics as predictors is crucial for suicide risk assessment and theory development. As such, we conducted a meta-analysis to determine the effect strength and clinical utility of demographics as predictors. Methods We searched PsycInfo, PubMed, and GoogleScholar for studies published before January 1st, 2015. Inclusion criteria required that studies use at least one demographic factor to longitudinally predict suicide ideation, attempt, or death. The initial search yielded 2,541 studies, 159 of which were eligible. A total of 752 unique statistical tests were included in analysis. Results Suicide death was the most commonly studied outcome, followed by attempt and ideation. The average follow-up length was 9.4 years. The overall effects of demographic factors studied in the field as risk factors were significant but weak, and that of demographic factors studied as protective factors were non-significant. Adjusting for publication bias further reduced effect estimates. No specific demographic factors appeared to be strong predictors. The effects were consistent across multiple moderators. Conclusions At least within the narrow methodological constraints of the existing literature, demographic factors were statistically significant risk factors, but not protective factors. Even as risk factors, demographics offer very little improvement in predictive accuracy. Future studies that go beyond the limitations of the existing literature are needed to further understand the effects of demographics. PMID:28700728

Understanding epigenetic architecture of suicide neurobiology: A critical perspective

PubMed Central

Roy, Bhaskar; Dwivedi, Yogesh

2016-01-01

Current understanding of environmental cross-talk with genetic makeup is found to be mediated through an epigenetic interface which is associated with prominent reversible and heritable changes at gene expression level. Recent emergence of epigenetic modulation in shaping the genetic information has become a key regulatory factor in answering the underlying complexities associated with several mental disorders. A comprehensive understanding of the pertinent changes in the epigenetic makeup of suicide phenotype exhibits a characteristic signature with the possibility of using it as a biomarker to help predict the risk factors associated with suicide. Within the scope of this current review, the most sought after epigenetic changes of DNA methylation and histone modification are thoroughly scrutinized to understand their close functional association with the broad spectrum of suicide phenotype. PMID:27836463

Helicobacter pylori virulence and cancer pathogenesis

PubMed Central

Yamaoka, Yoshio; Graham, David Y

2014-01-01

Helicobacter pylori is human gastric pathogen that causes chronic and progressive gastric mucosal inflammation and is responsible for the gastric inflammation-associated diseases, gastric cancer and peptic ulcer disease. specific outcomes reflect the interplay between host-, environmental- and bacterial-specific factors. Progress in understanding putative virulence factors in disease pathogenesis has been limited and many false leads have consumed scarce resources. Few in vitro–in vivo correlations or translational applications have proved clinically relevant. Reported virulence factor-related outcomes reflect differences in relative risk of disease rather than specificity for any specific outcome. Studies of individual virulence factor associations have provided conflicting results. Since virulence factors are linked, studies of groups of putative virulence factors are needed to provide clinically useful information. Here, the authors discuss the progress made in understanding the role of H. pylori virulence factors CagA, vacuolating cytotoxin, OipA and DupA in disease pathogenesis and provide suggestions for future studies. PMID:25052757

Helicobacter pylori virulence and cancer pathogenesis.

PubMed

Yamaoka, Yoshio; Graham, David Y

2014-06-01

Helicobacter pylori is human gastric pathogen that causes chronic and progressive gastric mucosal inflammation and is responsible for the gastric inflammation-associated diseases, gastric cancer and peptic ulcer disease. Specific outcomes reflect the interplay between host-, environmental- and bacterial-specific factors. Progress in understanding putative virulence factors in disease pathogenesis has been limited and many false leads have consumed scarce resources. Few in vitro-in vivo correlations or translational applications have proved clinically relevant. Reported virulence factor-related outcomes reflect differences in relative risk of disease rather than specificity for any specific outcome. Studies of individual virulence factor associations have provided conflicting results. Since virulence factors are linked, studies of groups of putative virulence factors are needed to provide clinically useful information. Here, the authors discuss the progress made in understanding the role of H. pylori virulence factors CagA, vacuolating cytotoxin, OipA and DupA in disease pathogenesis and provide suggestions for future studies.

Predictors of Suicide Ideation in a Random Digit Dial Study: Exposure to Suicide Matters.

PubMed

van de Venne, Judy; Cerel, Julie; Moore, Melinda; Maple, Myfanwy

2017-07-03

Suicide is an important public health concern requiring ongoing research to understand risk factors for suicide ideation. A dual-frame, random digit dial survey was utilized to identify demographic and suicide-related factors associated with suicide ideation in a statewide sample of 1,736 adults. The PH-Q 9 Depression scale suicide ideation question was used to assess current suicide ideation in both the full sample and suicide exposed sub-sample. Being non-married and having previous suicide exposure were separately associated with higher risks of suicide ideation in the full sample. Being male, having increased suicide exposures, and having increased perceptions of closeness to the decedent increased risks, while older age decreased risks for the suicide exposed. Implications for future screening and research are discussed.

Treatment of multiple-risk patients: using combination therapy to treat beyond LDL lowering.

PubMed

Weintraub, Howard S

2005-08-01

During the past 25 years, the role of traditional "risk factors" in the genesis of atherosclerotic vascular disease has been convincingly validated. The impact of elevated low-density lipoprotein cholesterol, hypertension, type II diabetes, and metabolic syndrome are now well accepted. However, until recently, there was guilt by association without a clear understanding of the manner in which the crime was committed. It is now acknowledged that the presence of multiple risk factors can increase the likelihood of an ischemic event. This has become a great concern, given the very high prevalence of patients who fall into this category. In light of this information, the mandate for appropriate guideline-driven therapy has become even stronger, and we must consider the use of multiple medications to effectively neutralize this risk.

Sociodemographic, Behavioral, and Psychological Correlates of Current Overweight and Obesity in Older, Urban African American Women

ERIC Educational Resources Information Center

Patt, Madhavi Reddy; Yanek, Lisa R.; Moy, Taryn F.; Becker, Diane M.

2004-01-01

To better understand obesity and overweight among urban African American women, the authors examined sociodemographic, behavioral, and psychological factors within body mass index (BMI) categories. A total of 496 women were recruited for cardiovascular risk factor screening from 20 urban African American churches. Study participants had a mean age…

Distracted Driving and Associated Crash Risks : Research Project Capsule

DOT National Transportation Integrated Search

2012-10-01

Factors aff ecting the : cognitive tasks : associated with : driving are becoming : increasingly critical to : the overall roadway : safety performance. : Therefore, more research is needed in order to understand the complexity and : impact of distra...

Quantifying Heterogeneous Malaria Exposure and Clinical Protection in a Cohort of Ugandan Children

PubMed Central

Rodriguez-Barraquer, Isabel; Arinaitwe, Emmanuel; Jagannathan, Prasanna; Boyle, Michelle J.; Tappero, Jordan; Muhindo, Mary; Kamya, Moses R.; Dorsey, Grant; Drakeley, Chris; Ssewanyana, Isaac; Smith, David L.; Greenhouse, Bryan

2016-01-01

Background. Plasmodium falciparum malaria remains a leading cause of childhood morbidity and mortality. There are important gaps in our understanding of the factors driving the development of antimalaria immunity as a function of age and exposure. Methods. We used data from a cohort of 93 children participating in a clinical trial in Tororo, Uganda, an area of very high exposure to P. falciparum. We jointly quantified individual heterogeneity in the risk of infection and the development of immunity against infection and clinical disease. Results. Results showed significant heterogeneity in the hazard of infection and independent effects of age and cumulative number of infections on the risk of infection and disease. The risk of developing clinical malaria upon infection decreased on average by 6% (95% confidence interval [CI], 0%–12%) for each additional year of age and by 2% (95% CI, 1%–3%) for each additional prior infection. Children randomly assigned to receive dihydroartemisinin-piperaquine for treatment appeared to develop immunity more slowly than those receiving artemether-lumefantrine. Conclusions. Heterogeneity in P. falciparum exposure and immunity can be independently evaluated using detailed longitudinal studies. Improved understanding of the factors driving immunity will provide key information to anticipate the impact of malaria-control interventions and to understand the mechanisms of clinical immunity. PMID:27481862

Screening and Treatment for Iron Deficiency Anemia in Women: Results of a Survey of Obstetrician-Gynecologists.

PubMed

Marcewicz, Lauren H; Anderson, Britta L; Byams, Vanessa R; Grant, Althea M; Schulkin, Jay

2017-08-01

Objective To better understand the knowledge, attitudes and practices of obstetrician-gynecologists with respect to screening and treatment for iron deficiency anemia (IDA). Methods A total of 1,200 Fellows and Junior Fellows of the American College of Obstetricians and Gynecologists were invited to participate in a survey on blood disorders. Respondents completed a questionnaire regarding their patient population, screening and treatment practices for IDA, and general knowledge about IDA and its risk factors. Results Overall response rate was 42.4%. Thirty-eight percent of respondents screen non-pregnant patients regularly, based on risk factors; 30.5% screen only when symptoms of anemia are present. For pregnant patients, 50.0% of respondents screen patients at their initial visit, while 46.2% screen every trimester. Sixty-one percent of respondents supplement pregnant patients when there is laboratory evidence of anemia; 31.6% supplement all pregnant patients. Forty-two percent of respondents screen post-partum patients based on their risk factors for IDA. However, when asked to identify risk factors for post-partum anemia, slightly more than half of respondents correctly identified young age and income level as risk factors for post-partum anemia; only 18.9% correctly identified pre-pregnancy obesity as a risk factor. Conclusion There are opportunities for increased education on IDA for obstetrician-gynecologists, specifically with respect to risk factors. There also appears to be substantial practice variance regarding screening and supplementation for IDA, which may correspond to variability in professional guidelines. Increased education on IDA, especially the importance of sociodemographic factors, and further research and effort to standardize guidelines is needed.

Modelling determinants, impact, and space-time risk of age-specific mortality in rural South Africa: integrating methods to enhance policy relevance.

PubMed

Sartorius, Benn

2013-01-24

There is a lack of reliable data in developing countries to inform policy and optimise resource allocation. Health and socio-demographic surveillance sites (HDSS) have the potential to address this gap. Mortality levels and trends have previously been documented in rural South Africa. However, complex space-time clustering of mortality, determinants, and their impact has not been fully examined. To integrate advanced methods enhance the understanding of the dynamics of mortality in space-time, to identify mortality risk factors and population attributable impact, to relate disparities in risk factor distributions to spatial mortality risk, and thus, to improve policy planning and resource allocation. Agincourt HDSS supplied data for the period 1992-2008. Advanced spatial techniques were used to identify significant age-specific mortality 'hotspots' in space-time. Multivariable Bayesian models were used to assess the effects of the most significant covariates on mortality. Disparities in risk factor profiles in identified hotspots were assessed. Increasing HIV-related mortality and a subsequent decrease possibly attributable to antiretroviral therapy introduction are evident in this rural population. Distinct space-time clustering and variation (even in a small geographic area) of mortality were observed. Several known and novel risk factors were identified, and population impact was quantified. Significant differences in the risk factor profiles of the identified 'hotspots' included ethnicity; maternal, partner, and household deaths; household head demographics; migrancy; education; and poverty. A complex interaction of highly attributable multilevel factors continues to demonstrate differential space-time influences on mortality risk (especially for HIV). High-risk households and villages displayed differential risk factor profiles. This integrated approach could prove valuable to decision makers. Tailored interventions for specific child and adult high-risk mortality areas are needed, such as preventing vertical transmission, ensuring maternal survival, and improving water and sanitation infrastructure. This framework can be applied in other settings within the region.

An Explanatory Model of Dating Violence Risk Factors in Spanish Adolescents.

PubMed

Aizpitarte, Alazne; Alonso-Arbiol, Itziar; Van de Vijver, Fons J R

2017-12-01

Dating violence is a serious public health issue that needs further understanding in terms of risk factors that may be involved in it. The main goal of this study was to test a mediational model of dating violence risk factors. The sample was composed of 477 secondary and college students from Spain (59% females). A dynamic developmental explanatory model considering aggressiveness, insecure attachment, interparental conflict, and peer dating violence was tested using a multigroup structural equation model. Aggressiveness partially mediated the relation between anxious attachment and dating violence and fully mediated the association between interparental conflict resolution and dating violence. Furthermore, perceived peer dating violence was a direct predictor of dating violence. Implications for prevention and intervention plans are discussed. © 2017 The Authors. Journal of Research on Adolescence © 2017 Society for Research on Adolescence.

Factors associated with the risk perception and purchase decisions of Fukushima-related food in South Korea

PubMed Central

Song, Min Kyoung; Lee, Hyang Ki; Park, Sunhoo; Jin, Young Woo

2017-01-01

Following the Fukushima nuclear power plant accident, the risk level perceived by Koreans on the radioactive contamination of Japanese food that is being distributed in Korea remains high. Many of these perceptions are based on subjective risk perception rather than an objective measure with scientific evidence, which makes communicating risks more difficult; therefore, it is critical to understand factors associated with risk perception for effective risk communication. In this study, we identified variables that are associated with buying tendencies and opinions about the regulatory policy of Japanese seafood after the accident. A survey was conducted with 1045 adults aged over 20 years in Korea. The majority (68.8%) responded that they would not purchase Japanese seafood when radioactivity levels in the food were non-detectable. Moreover, 82.2% responded that the current levels of import restrictions on Japanese seafood must be maintained. Despite many concerns regarding the exposure to radiation and the effects from food products following the Fukushima accident, the opportunities to encounter and to collect correct information remain limited and average radioactive knowledge scores were low (3.63 out of 9). Of the various characteristics associated with purchase decisions and agreement on the current import restraints of Japanese seafood, trust levels in the government and the mass media for providing information on radioactivity were major factors that influenced risk perception. While the scope of this study was limited to seafood, it is very closely tied to daily lives, where we revealed differences about risk perceptions and agreement on import restraints of Japanese seafood per a complex mixture of individual characteristics and the surrounding environment. These results provide useful information to understand the risk perception of the potential radioactive contamination of food and to predict the public’s responses to food consumption and import restraint policies due to nuclear accidents in neighboring countries. PMID:29117237

Factors associated with the risk perception and purchase decisions of Fukushima-related food in South Korea.

PubMed

Lee, Dalnim; Seo, Songwon; Song, Min Kyoung; Lee, Hyang Ki; Park, Sunhoo; Jin, Young Woo

2017-01-01

Following the Fukushima nuclear power plant accident, the risk level perceived by Koreans on the radioactive contamination of Japanese food that is being distributed in Korea remains high. Many of these perceptions are based on subjective risk perception rather than an objective measure with scientific evidence, which makes communicating risks more difficult; therefore, it is critical to understand factors associated with risk perception for effective risk communication. In this study, we identified variables that are associated with buying tendencies and opinions about the regulatory policy of Japanese seafood after the accident. A survey was conducted with 1045 adults aged over 20 years in Korea. The majority (68.8%) responded that they would not purchase Japanese seafood when radioactivity levels in the food were non-detectable. Moreover, 82.2% responded that the current levels of import restrictions on Japanese seafood must be maintained. Despite many concerns regarding the exposure to radiation and the effects from food products following the Fukushima accident, the opportunities to encounter and to collect correct information remain limited and average radioactive knowledge scores were low (3.63 out of 9). Of the various characteristics associated with purchase decisions and agreement on the current import restraints of Japanese seafood, trust levels in the government and the mass media for providing information on radioactivity were major factors that influenced risk perception. While the scope of this study was limited to seafood, it is very closely tied to daily lives, where we revealed differences about risk perceptions and agreement on import restraints of Japanese seafood per a complex mixture of individual characteristics and the surrounding environment. These results provide useful information to understand the risk perception of the potential radioactive contamination of food and to predict the public's responses to food consumption and import restraint policies due to nuclear accidents in neighboring countries.

Risk of thromboembolic complications in adult congenital heart disease: A literature review.

PubMed

Karsenty, Clement; Zhao, Alexandre; Marijon, Eloi; Ladouceur, Magalie

2018-05-30

Adult congenital heart disease (ACHD) is a constantly expanding population with challenging issues. Initial medical and surgical treatments are seldom curative, and the majority of patients still experience late sequelae and complications, especially thromboembolic events. These common and potentially life-threating adverse events are probably dramatically underdiagnosed. Better identification and understanding of thromboembolic risk factors are essential to prevent long-term related morbidities. In addition to specific situations associated with a high risk of thromboembolic events (Fontan circulation, cyanotic congenital heart disease), atrial arrhythmia has been recognized as an important risk factor for thromboembolic events in ACHD. Unlike in patients without ACHD, thromboembolic risk stratification scores, such as the CHA 2 DS 2 -VASc score, may not be applicable in ACHD. Overall, after a review of the scientific data published so far, it is clear that the complexity of the underlying congenital heart disease represents a major risk factor for thromboembolic events. As a consequence, prophylactic anticoagulation is indicated in patients with complex congenital heart disease and atrial arrhythmia, regardless of the other risk factors, as opposed to simple heart defects. The landscape of ACHD is an ongoing evolving process, and specific thromboembolic risk scores are needed, especially in the setting of simple heart defects; these should be coupled with specific trials or long-term follow-up of multicentre cohorts. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Genetic risk factors for ovarian cancer and their role for endometriosis risk.

PubMed

Burghaus, Stefanie; Fasching, Peter A; Häberle, Lothar; Rübner, Matthias; Büchner, Kathrin; Blum, Simon; Engel, Anne; Ekici, Arif B; Hartmann, Arndt; Hein, Alexander; Beckmann, Matthias W; Renner, Stefan P

2017-04-01

Several genetic variants have been validated as risk factors for ovarian cancer. Endometriosis has also been described as a risk factor for ovarian cancer. Identifying genetic risk factors that are common to the two diseases might help improve our understanding of the molecular pathogenesis potentially linking the two conditions. In a hospital-based case-control analysis, 12 single nucleotide polymorphisms (SNPs), validated by the Ovarian Cancer Association Consortium (OCAC) and the Collaborative Oncological Gene-environment Study (COGS) project, were genotyped using TaqMan® OpenArray™ analysis. The cases consisted of patients with endometriosis, and the controls were healthy individuals without endometriosis. A total of 385 cases and 484 controls were analyzed. Odds ratios and P values were obtained using simple logistic regression models, as well as from multiple logistic regression models with adjustment for clinical predictors. rs11651755 in HNF1B was found to be associated with endometriosis in this case-control study. The OR was 0.66 (95% CI, 0.51 to 0.84) and the P value after correction for multiple testing was 0.01. None of the other genotypes was associated with a risk for endometriosis. As rs11651755 in HNF1B modified both the ovarian cancer risk and also the risk for endometriosis, HNF1B may be causally involved in the pathogenetic pathway leading from endometriosis to ovarian cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

Understanding the major risk factors in the beginning and the progression of rheumatoid arthritis: current scenario and future prospects.

PubMed

Verma, Mahendra Kumar; Sobha, Kota

2015-09-01

Rheumatoid arthritis (RA), a chronic progressive inflammatory autoimmune disorder characterized by chronic pain and swelling primarily, affects the peripheral joints. RA had attained global concern in the last few decades, affecting more than 1.5 % of the world's population with higher female percentage than male. In the advanced stage, the disease is associated with the destruction of cartilage and bone along with a variety of systemic manifestations leading to functional disability. Inadequate early/preliminary diagnosis and non-specific therapeutics are the major challenges in the management of RA. Till date, the exact cause(s) of the disease remain(s) obscure, and several genetic, hormonal, and environmental factors are associated with the beginning and the progression of the disease. Rheumatoid factor is the only clinically approved bio-marker for the diagnosis, and RA is not restricted to bones, but also affects several vital organs in the advanced stages. Genome-wide association studies have explored novel genetic loci underlying common autoimmune diseases including RA. Recent discoveries of risk alleles have made it possible to define genetic risk profiles of patients with RA. The conventional non-steroidal anti-inflammatory drugs and steroidal drugs are still the choice for the treatment of RA under acute and chronic pathological conditions respectively. However, disease-modifying anti-rheumatic drugs have shown remarkable success in the last decade. The present review provides a comprehensive understanding of the major risk factors and the molecular biology involved in the initiation and the progression of RA with a note on the recent trends in RA therapy.

Socio-Ecological Risk Factors for Prime-Age Adult Death in Two Coastal Areas of Vietnam

PubMed Central

Kim, Deok Ryun; Ali, Mohammad; Thiem, Vu Dinh; Wierzba, Thomas F.

2014-01-01

Background Hierarchical spatial models enable the geographic and ecological analysis of health data thereby providing useful information for designing effective health interventions. In this study, we used a Bayesian hierarchical spatial model to evaluate mortality data in Vietnam. The model enabled identification of socio-ecological risk factors and generation of risk maps to better understand the causes and geographic implications of prime-age (15 to less than 45 years) adult death. Methods and Findings The study was conducted in two sites: Nha Trang and Hue in Vietnam. The study areas were split into 500×500 meter cells to define neighborhoods. We first extracted socio-demographic data from population databases of the two sites, and then aggregated the data by neighborhood. We used spatial hierarchical model that borrows strength from neighbors for evaluating risk factors and for creating spatially smoothed risk map after adjusting for neighborhood level covariates. The Markov chain Monte Carlo procedure was used to estimate the parameters. Male mortality was more than twice the female mortality. The rates also varied by age and sex. The most frequent cause of mortality was traffic accidents and drowning for men and traffic accidents and suicide for women. Lower education of household heads in the neighborhood was an important risk factor for increased mortality. The mortality was highly variable in space and the socio-ecological risk factors are sensitive to study site and sex. Conclusion Our study suggests that lower education of the household head is an important predictor for prime age adult mortality. Variability in socio-ecological risk factors and in risk areas by sex make it challenging to design appropriate intervention strategies aimed at decreasing prime-age adult deaths in Vietnam. PMID:24587031

Socio-ecological risk factors for prime-age adult death in two coastal areas of Vietnam.

PubMed

Kim, Deok Ryun; Ali, Mohammad; Thiem, Vu Dinh; Wierzba, Thomas F

2014-01-01

Hierarchical spatial models enable the geographic and ecological analysis of health data thereby providing useful information for designing effective health interventions. In this study, we used a Bayesian hierarchical spatial model to evaluate mortality data in Vietnam. The model enabled identification of socio-ecological risk factors and generation of risk maps to better understand the causes and geographic implications of prime-age (15 to less than 45 years) adult death. The study was conducted in two sites: Nha Trang and Hue in Vietnam. The study areas were split into 500×500 meter cells to define neighborhoods. We first extracted socio-demographic data from population databases of the two sites, and then aggregated the data by neighborhood. We used spatial hierarchical model that borrows strength from neighbors for evaluating risk factors and for creating spatially smoothed risk map after adjusting for neighborhood level covariates. The Markov chain Monte Carlo procedure was used to estimate the parameters. Male mortality was more than twice the female mortality. The rates also varied by age and sex. The most frequent cause of mortality was traffic accidents and drowning for men and traffic accidents and suicide for women. Lower education of household heads in the neighborhood was an important risk factor for increased mortality. The mortality was highly variable in space and the socio-ecological risk factors are sensitive to study site and sex. Our study suggests that lower education of the household head is an important predictor for prime age adult mortality. Variability in socio-ecological risk factors and in risk areas by sex make it challenging to design appropriate intervention strategies aimed at decreasing prime-age adult deaths in Vietnam.

Predictors of re-entry into the child protection system in Singapore: a cumulative ecological-transactional risk model.

PubMed

Li, Dongdong; Chu, Chi Meng; Ng, Wei Chern; Leong, Wai

2014-11-01

This study examines the risk factors of re-entry for 1,750 child protection cases in Singapore using a cumulative ecological-transactional risk model. Using administrative data, the present study found that the overall percentage of Child Protection Service (CPS) re-entry in Singapore is 10.5% based on 1,750 cases, with a range from 3.9% (within 1 year) to 16.5% (within 8 years after case closure). One quarter of the re-entry cases were observed to occur within 9 months from case closure. Seventeen risk factors, as identified from the extant literature, were tested for their utility to predict CPS re-entry in this study using a series of Cox regression analyses. A final list of seven risk factors (i.e., children's age at entry, case type, case closure result, duration of case, household income, family size, and mother's employment status) was used to create a cumulative risk score. The results supported the cumulative risk model in that higher risk score is related to higher risk of CPS re-entry. Understanding the prevalence of CPS re-entry and the risk factors associated with re-entry is the key to informing practice and policy in a culturally relevant way. The results from this study could then be used to facilitate critical case management decisions in order to enhance positive outcomes of families and children in Singapore's care system. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Role of Psychological and Physiological Factors in Decision Making under Risk and in a Dilemma

PubMed Central

Fooken, Jonas; Schaffner, Markus

2016-01-01

Different methods to elicit risk attitudes of individuals often provide differing results despite a common theory. Reasons for such inconsistencies may be the different influence of underlying factors in risk-taking decisions. In order to evaluate this conjecture, a better understanding of underlying factors across methods and decision contexts is desirable. In this paper we study the difference in result of two different risk elicitation methods by linking estimates of risk attitudes to gender, age, and personality traits, which have been shown to be related. We also investigate the role of these factors during decision-making in a dilemma situation. For these two decision contexts we also investigate the decision-maker's physiological state during the decision, measured by heart rate variability (HRV), which we use as an indicator of emotional involvement. We found that the two elicitation methods provide different individual risk attitude measures which is partly reflected in a different gender effect between the methods. Personality traits explain only relatively little in terms of driving risk attitudes and the difference between methods. We also found that risk taking and the physiological state are related for one of the methods, suggesting that more emotionally involved individuals are more risk averse in the experiment. Finally, we found evidence that personality traits are connected to whether individuals made a decision in the dilemma situation, but risk attitudes and the physiological state were not indicative for the ability to decide in this decision context. PMID:26834591

Probabilistic Risk Assessment for Astronaut Post Flight Bone Fracture

NASA Technical Reports Server (NTRS)

Lewandowski, Beth; Myers, Jerry; Licata, Angelo

2015-01-01

Introduction: Space flight potentially reduces the loading that bone can resist before fracture. This reduction in bone integrity may result from a combination of factors, the most common reported as reduction in astronaut BMD. Although evaluating the condition of bones continues to be a critical aspect of understanding space flight fracture risk, defining the loading regime, whether on earth, in microgravity, or in reduced gravity on a planetary surface, remains a significant component of estimating the fracture risks to astronauts. This presentation summarizes the concepts, development, and application of NASA's Bone Fracture Risk Module (BFxRM) to understanding pre-, post, and in mission astronaut bone fracture risk. The overview includes an assessment of contributing factors utilized in the BFxRM and illustrates how new information, such as biomechanics of space suit design or better understanding of post flight activities may influence astronaut fracture risk. Opportunities for the bone mineral research community to contribute to future model development are also discussed. Methods: To investigate the conditions in which spaceflight induced changes to bone plays a critical role in post-flight fracture probability, we implement a modified version of the NASA Bone Fracture Risk Model (BFxRM). Modifications included incorporation of variations in physiological characteristics, post-flight recovery rate, and variations in lateral fall conditions within the probabilistic simulation parameter space. The modeled fracture probability estimates for different loading scenarios at preflight and at 0 and 365 days post-flight time periods are compared. Results: For simple lateral side falls, mean post-flight fracture probability is elevated over mean preflight fracture probability due to spaceflight induced BMD loss and is not fully recovered at 365 days post-flight. In the case of more energetic falls, such as from elevated heights or with the addition of lateral movement, the contribution of space flight quality changes is much less clear, indicating more granular assessments, such as Finite Element modeling, may be needed to further assess the risks in these scenarios.

Body Composition Indices and Single and Clustered Cardiovascular Disease Risk Factors in Adolescents: Providing Clinical-Based Cut-Points.

PubMed

Gracia-Marco, Luis; Moreno, Luis A; Ruiz, Jonatan R; Ortega, Francisco B; de Moraes, Augusto César Ferreira; Gottrand, Frederic; Roccaldo, Romana; Marcos, Ascensión; Gómez-Martínez, Sonia; Dallongeville, Jean; Kafatos, Anthony; Molnar, Denes; Bueno, Gloria; de Henauw, Stefaan; Widhalm, Kurt; Wells, Jonathan C

2016-01-01

The aims of the present study in adolescents were 1) to examine how various body composition-screening tests relate to single and clustered cardiovascular disease (CVD) risk factors, 2) to examine how lean mass and body fatness (independently of each other) relate to clustered CVD risk factors, and 3) to calculate specific thresholds for body composition indices associated with an unhealthier clustered CVD risk. We measured 1089 European adolescents (46.7% boys, 12.5-17.49years) in 2006-2007. CVD risk factors included: systolic blood pressure, maximum oxygen uptake, homeostasis model assessment, C-reactive protein (n=748), total cholesterol/high density lipoprotein cholesterol and triglycerides. Body composition indices included: height, body mass index (BMI), lean mass, the sum of four skinfolds, central/peripheral skinfolds, waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR). Most body composition indices are associated with single CVD risk factors. The sum of four skinfolds, WHtR, BMI, WC and lean mass are strong and positively associated with clustered CVD risk. Interestingly, lean mass is positively associated with clustered CVD risk independently of body fatness in girls. Moderate and highly accurate thresholds for the sum of four skinfolds, WHtR, BMI, WC and lean mass are associated with an unhealthier clustered CVD risk (all AUC>0.773). In conclusion, our results support an association between most of the assessed body composition indices and single and clustered CVD risk factors. In addition, lean mass (independent of body fatness) is positively associated with clustered CVD risk in girls, which is a novel finding that helps to understand why an index such as BMI is a good index of CVD risk but a bad index of adiposity. Moderate to highly accurate thresholds for body composition indices associated with a healthier clustered CVD risk were found. Further studies with a longitudinal design are needed to confirm these findings. Copyright © 2015 Elsevier Inc. All rights reserved.

Association between salivary level of infection with Streptococcus mutans/Lactobacilli and caries-risk factors in mothers.

PubMed

Latifi-Xhemajli, B; Véronneau, J; Begzati, A; Bytyci, A; Kutllovci, T; Rexhepi, A

2016-03-01

Understanding factors in mothers associated with high and low salivary levels of Streptococcus mutans and Lactobacilli is an important strategy for early childhood caries prevention. Aim of the study was to identify the association between salivary levels of Streptococcus mutans/Lactobacillus and potential caries risk factors in mothers. Cross-sectional design used a voluntary sample of 300 mothers of young children. Close-ended questions and observations were used to identify mothers' potential caries risk factors. The presence of Streptococcus mutans and Lactobacilli was determined using the CRT bacteria test (Ivoclar Vivadent). All collected information was converted into frequency and proportion describing the prevalence factor in correlation with Streptococcus mutans and Lactobacilli cariogenic bacteria levels of infection. Results Sample participants showed a high caries risk based on socioeconomic, behavioural and clinical factors. also showed high levels (>105) of Streptococcus mutans and Lactobacilli infections among 28% of mothers. Three factors were significantly associated with Streptococcus mutans infection: level of education, past caries experiences, and observable dental plaque, whereas, a fourth factor, frequency of daily tooth brushing, was associated to Lactobacilli infection. This study showed that easily collectible informations such as maternal level of education, frequency of daily tooth brushing and past clinical factors tend to be associated with high level of Streptococcus mutans and Lactobacilli infections in caregivers.

Assessment of public perception of radioactive waste management in Korea.

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

Trone, Janis R.; Cho, SeongKyung; Whang, Jooho

2011-11-01

The essential characteristics of the issue of radioactive waste management can be conceptualized as complex, with a variety of facets and uncertainty. These characteristics tend to cause people to perceive the issue of radioactive waste management as a 'risk'. This study was initiated in response to a desire to understand the perceptions of risk that the Korean public holds towards radioactive waste and the relevant policies and policy-making processes. The study further attempts to identify the factors influencing risk perceptions and the relationships between risk perception and social acceptance.

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

Risk characterization of hospitalizations for mental illness and/or behavioral disorders with concurrent heat-related illness

PubMed Central

2017-01-01

Background Many studies have found significant associations between high ambient temperatures and increases in heat-related morbidity and mortality. Several studies have demonstrated that increases in heat-related hospitalizations are elevated among individuals with diagnosed mental illnesses and/or behavioral disorders (MBD). However, there are a limited number of studies regarding risk factors associated with specific mental illnesses that contribute, at least in part, to heat-related illnesses (HRI) in the United States. Objective To identify and characterize individual and environmental risk factors associated with MBD hospitalizations with a concurrent HRI diagnosis. Methods This study uses hospitalization data from the Nationwide Inpatient Sample (2001–2010). Descriptive analyses of primary and secondary diagnoses of MBDs with an HRI were examined. Risk ratios (RR) were calculated from multivariable models to identify risk factors for hospitalizations among patients with mental illnesses and/or behavioral disorders and HRI. Results Nondependent alcohol/drug abuse, dementia, and schizophrenia were among the disorders that were associated with increased frequency of HRI hospitalizations among MBD patients. Increased risk of MBD hospitalizations with HRI was observed for Males (RR, 3.06), African Americans (RR, 1.16), Native Americans (RR, 1.70), uninsured (RR, 1.92), and those 40 years and older, compared to MBD hospitalizations alone. Conclusions Previous studies outside the U.S. have found that dementia and schizophrenia are significant risk factors for HRI hospitalizations. Our results suggest that hospitalizations among substance abusers may also be an important risk factor associated with heat morbidity. Improved understanding of these relative risks could help inform future public health strategies. PMID:29036206

Parachuting and pregnancy: what do we know about pregnant skydivers and the risks they are taking?

PubMed

Ebner, Florian; Wöckel, Achim; Janni, Wolfgang; Paterson, Helen

2014-11-01

There is little medical knowledge about the risks of skydiving during pregnancy. Some national parachuting associations ask for a doctor's permission; others recommend not jumping at all during pregnancy. This article provides survey data and a literature review of pregnancy and parachuting/skydiving related issues to help the pregnant skydiver and her obstetrician make an informed decision. Survey data presented include pregnancy, delivery, and parachuting information from skydivers who jumped during pregnancy. International retrospective anonymous online questionnaire considering the Checklist for Reporting Results of Internet E-Surveys (CHERRIE). The PubMed database was searched with using the terms "skydive," "pregnancy," and "parachute" (query April 2013). Web page questionnaire on skydivers' epidemiology, experience, and pregnancy-related information. Fifty-seven parous female skydivers. Information on athletes' experience, weather conditions, obstetric history (gravida, gestational week), delivery mode was obtained. Epidemiology of pregnant skydivers and literature review to provide information on skydiving risks. Women do actively decide to skydive while pregnant. The majority of our participants were between 25-year-old and 35-year-old primips with 100 to 1000 jumps experience, answering the questionnaire from a European IP address. Precautions are taken in terms of weather conditions, gear, or sports partner. The literature review found no relevant literature regarding the question. Literature is searched for risk factors that come close to the ones in skydiving (ie, oxygen saturation, shock forces, and others). Further studies are needed to show the long-term effect of stress or low O2 saturation on antenatal programming, or short-term hypoxia and pregnancy outcome in pregnant skydiving women and their offspring. Pregnancy itself is a risk factor for injuries. Injuries in pregnancy are clearly associated with an unfavorable pregnancy outcome. The recommendation "do not skydive during pregnancy" is the safest approach. A possible lesser risk alternative to skydiving could be wind-tunnel training. This article provides insights into the pregnant skydiver's decision making regarding the sports. In combination with the literature review, we provide up-to-date easy to understand information on the possible risk factors. This is a valuable source of information for the care providers of female skydivers to understand and compare the risk factors of this sport. With this information, the professional recommendation and relationship are strengthened. This article also guides the need for further research. Possible research areas include pregnancy and sports-related risk factors, placentation and prenatal programming, physical and psychological factors associated with skydiving.

Using the CAUSE Model to Understand Public Communication about Water Risks: Perspectives from Texas Groundwater District Officials on Drought and Availability.

PubMed

VanDyke, Matthew S; King, Andy J

2017-12-05

Public communication about drought and water availability risks poses challenges to a potentially disinterested public. Water management professionals, though, have a responsibility to work with the public to engage in communication about water and environmental risks. Because limited research in water management examines organizational communication practices and perceptions, insights into research and practice can be gained through investigation of current applications of these risk communication efforts. Guided by the CAUSE model, which explains common goals in communicating risk information to the public (e.g., creating Confidence, generating Awareness, enhancing Understanding, gaining Satisfaction, and motivating Enactment), semistructured interviews of professionals (N = 25) employed by Texas groundwater conservation districts were conducted. The interviews examined how CAUSE model considerations factor in to communication about drought and water availability risks. These data suggest that many work to build constituents' confidence in their districts. Although audiences and constituents living in drought-prone areas were reported as being engaged with water availability risks and solutions, many district officials noted constituents' lack of perceived risk and engagement. Some managers also indicated that public understanding was a secondary concern of their primary responsibilities and that the public often seemed apathetic about technical details related to water conservation risks. Overall, results suggest complicated dynamics between officials and the public regarding information access and motivation. The article also outlines extensions of the CAUSE model and implications for improving public communication about drought and water availability risks. © 2017 Society for Risk Analysis.

Risk factors for unfavorable outcome of pulmonary tuberculosis in adults in Taipei, Taiwan.

PubMed

Yen, Yung-Feng; Yen, Muh-Yong; Shih, Hsiu-Chen; Deng, Chung-Yeh

2012-05-01

This study was undertaken to identify factors associated with unfavorable outcomes in patients with pulmonary tuberculosis (PTB) in Taipei, Taiwan in 2007-2008. Taiwanese adults with culture-positive PTB diagnosed in Taipei during the study period were included in this retrospective cohort study. Unfavorable outcomes were classified as treatment default, death, treatment failure, or transfer. Of 1616 eligible patients, 22.6% (365) had unfavorable outcomes, mainly death. After controlling for patient sociodemographic factors, clinical findings, and underlying disease, independent risk factors for unfavorable outcomes included advanced age, unemployment, end-stage renal disease requiring dialysis, malignancy, acid-fast bacilius smear-positivity, multidrug-resistant TB, and notification from ordinary ward or intensive care unit. In contrast, patients receiving directly observed treatment, and with a high school or higher education were significantly less likely to have unfavorable outcomes. This study advanced our understanding by revealing that a high school or higher education might lower the risk of an unfavorable outcome. Our results also confirmed the risk factors for unfavorable outcomes shown in previous research. Future TB control programmes in Taiwan should target particularly high-risk patients including those who had lower educational levels. Copyright © 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

Educating medical professionals about suicide prevention among military veterans.

PubMed

Ganz, Debora; Sher, Leo

2013-01-01

The aim of this paper was to discuss the results of a review of literature related to suicide in military veteran populations. Suicide in veteran populations has been increasing in recent years, and continues to be a medical and social problem across the globe. For medical health professionals, knowledge of the risk factors for suicide, careful assessment, and appropriate interventions are key to suicide prevention. The main aim of this review is to better understand the risk factors present in veteran suicide and find ways by which to educate medical professionals in suicide prevention. Key suicide risk factors found in veteran populations include posttraumatic stress disorder, major depressive disorder, physical injuries, substance use disorders, traumatic brain injury, combat-related guilt, access to firearms, and insufficient social support. Some psychosocial difficulties are unique to veteran populations, and medical professionals should be culturally sensitive to these factors. Psychosocial changes upon discharge from active duty, as well as stigma against mental health disorders and treatment, should also be considered and assessed. Given that general practitioners may be the first line of defense for these veterans, they should be educated in risk factors for veteran suicide and proper assessment techniques. Any suicide risk in a veteran population should be taken very seriously, and responded to appropriately.

The Impact of Operative Approach on Postoperative Complications Following Colectomy for Colon Caner.

PubMed

Mungo, Benedetto; Papageorge, Christina M; Stem, Miloslawa; Molena, Daniela; Lidor, Anne O

2017-08-01

Colectomy is one of the most common major abdominal procedures performed in the USA. A better understanding of risk factors and the effect of operative approach on adverse postoperative outcomes may significantly improve quality of care. Adult patients with a primary diagnosis of colon cancer undergoing colectomy were selected from the National Surgical Quality Improvement Program 2013-2015 targeted colectomy database. Patients were stratified into five groups based on specific operative approach. Univariate and multivariate analyses were used to compare the five groups and identify risk factors for 30-day anastomotic leak, readmission, and mortality. In total, 25,097 patients were included in the study, with a 3.32% anastomotic leak rate, 1.20% mortality rate, and 9.57% readmission rate. After adjusting for other factors, open surgery and conversion to open significantly increased the odds for leak, mortality, and readmission compared to laparoscopy. Additionally, smoking and chemotherapy increased the risk for leak and readmission, while total resection was associated with increased mortality and leak. Operative approach and several other potentially modifiable perioperative factors have a significant impact on risk for adverse postoperative outcomes following colectomy. To improve quality of care for these patients, efforts should be made to identify and minimize the influence of such risk factors.

Informing Policy for Reducing Stroke Health Disparities from the Experience of African-American Male Stroke Survivors.

PubMed

Perzynski, Adam; Blixen, Carol; Cage, Jamie; Colón-Zimmermann, Kari; Sajatovic, Martha

2016-09-01

The burden of stroke is severe among African-Americans. Despite overall declines in the rate of stroke since 2000, outcomes are largely unimproved or have worsened for African-American men. Adverse psychosocial challenges may hinder adherence to a regimen of risk factor reduction. Focus group analysis was combined with a review of current published guidelines and epidemiologic evidence on risk factors to better understand stroke health disparities and potential policy solutions. Transcripts from three focus groups with ten African-American male stroke survivors under age 65 and their care partners (N = 7) were analyzed and compared with existing published data on (a) the burden of stroke (b) trends in clinical risk factors, and (c) trends in behavioral risk factors. Participants described myriad psychosocial barriers that impede reduction of risk indicators, including low trust in providers, poor social support, access difficulties, depression, and distress. In order to be effective, policies and programs must target mechanisms consistent with the challenges faced by African-American men. Infrastructure is needed to better identify and share practices effective for improving cardiovascular outcomes within specific racial and ethnic groups.

A Review on Automatic Mammographic Density and Parenchymal Segmentation

PubMed Central

He, Wenda; Juette, Arne; Denton, Erika R. E.; Oliver, Arnau

2015-01-01

Breast cancer is the most frequently diagnosed cancer in women. However, the exact cause(s) of breast cancer still remains unknown. Early detection, precise identification of women at risk, and application of appropriate disease prevention measures are by far the most effective way to tackle breast cancer. There are more than 70 common genetic susceptibility factors included in the current non-image-based risk prediction models (e.g., the Gail and the Tyrer-Cuzick models). Image-based risk factors, such as mammographic densities and parenchymal patterns, have been established as biomarkers but have not been fully incorporated in the risk prediction models used for risk stratification in screening and/or measuring responsiveness to preventive approaches. Within computer aided mammography, automatic mammographic tissue segmentation methods have been developed for estimation of breast tissue composition to facilitate mammographic risk assessment. This paper presents a comprehensive review of automatic mammographic tissue segmentation methodologies developed over the past two decades and the evidence for risk assessment/density classification using segmentation. The aim of this review is to analyse how engineering advances have progressed and the impact automatic mammographic tissue segmentation has in a clinical environment, as well as to understand the current research gaps with respect to the incorporation of image-based risk factors in non-image-based risk prediction models. PMID:26171249

Cardiovascular Consequences of Metabolic Syndrome

PubMed Central

Tune, Johnathan D.; Goodwill, Adam G.; Sassoon, Daniel J.; Mather, Kieren J.

2017-01-01

The metabolic syndrome (MetS) is defined as the concurrence of obesity-associated cardiovascular risk factors including abdominal obesity, impaired glucose tolerance, hypertriglyceridemia, decreased HDL cholesterol, and/or hypertension. Earlier conceptualizations of the MetS focused on insulin resistance as a core feature, and it is clearly coincident with the above list of features. Each component of the MetS is an independent risk factor for cardiovascular disease and the combination of these risk factors elevates rates and severity of cardiovascular disease, related to a spectrum of cardiovascular conditions including microvascular dysfunction, coronary atherosclerosis and calcification, cardiac dysfunction, myocardial infarction, and heart failure. While advances in understanding the etiology and consequences of this complex disorder have been made, the underlying pathophysiologic mechanisms remain incompletely understood, and it is unclear how these concurrent risk factors conspire to produce the variety of obesity-associated adverse cardiovascular diseases. In this review we highlight current knowledge regarding the pathophysiologic consequences of obesity and the MetS on cardiovascular function and disease, including considerations of potential physiologic and molecular mechanisms that may contribute to these adverse outcomes. PMID:28130064

HIV information and behavioral skills moderate the effects of relationship type and substance use on HIV risk behaviors among African American youth.

PubMed

Mustanski, Brian; Byck, Gayle R; Newcomb, Michael E; Henry, David; Bolland, John; Dick, Danielle

2013-06-01

The HIV/AIDS epidemic is disproportionately impacting young African Americans. Efforts to understand and address risk factors for unprotected sex in this population are critical in improving prevention efforts. Situational risk factors, such as relationship type and substance use before sex, are in need of further study. This study explored how established cognitive predictors of risky sexual behavior moderated the association between situational factors and unprotected sex among low-income, African American adolescents. The largest main effect on the number of unprotected sex acts was classifying the relationship as serious (event rate ratio=10.18); other significant main effects were alcohol use before sex, participant age, behavioral skills, and level of motivation. HIV information moderated the effect of partner age difference, motivation moderated the effects of partner age difference and drug use before sex, and behavioral skills moderated the effects of alcohol and drug use before sex. This novel, partnership-level approach provides insight into the complex interactions of situational and cognitive factors in sexual risk taking.

HIV Information and Behavioral Skills Moderate the Effects of Relationship Type and Substance Use on HIV Risk Behaviors Among African American Youth

PubMed Central

Byck, Gayle R.; Newcomb, Michael E.; Henry, David; Bolland, John; Dick, Danielle

2013-01-01

Abstract The HIV/AIDS epidemic is disproportionately impacting young African Americans. Efforts to understand and address risk factors for unprotected sex in this population are critical in improving prevention efforts. Situational risk factors, such as relationship type and substance use before sex, are in need of further study. This study explored how established cognitive predictors of risky sexual behavior moderated the association between situational factors and unprotected sex among low-income, African American adolescents. The largest main effect on the number of unprotected sex acts was classifying the relationship as serious (event rate ratio=10.18); other significant main effects were alcohol use before sex, participant age, behavioral skills, and level of motivation. HIV information moderated the effect of partner age difference, motivation moderated the effects of partner age difference and drug use before sex, and behavioral skills moderated the effects of alcohol and drug use before sex. This novel, partnership-level approach provides insight into the complex interactions of situational and cognitive factors in sexual risk taking. PMID:23701198

Evolution of natural risk: research framework and perspectives

NASA Astrophysics Data System (ADS)

Hufschmidt, G.; Crozier, M.; Glade, T.

2005-05-01

This study presents a conceptual framework for addressing temporal variation in natural risk. Numerous former natural risk analyses and investigations have demonstrated that time and related changes have a crucial influence on risk. For natural hazards, time becomes a factor for a number of reasons. Using the example of landslides to illustrate this point, it is shown that: 1. landslide history is important in determining probability of occurrence, 2. the significance of catchment variables in explaining landslide susceptibility is dependent on the time scale chosen, 3. the observer's perception of the geosystem's state changes with different time spans, and 4. the system's sensitivity varies with time. Natural hazards are not isolated events but complex features that are connected with the social system. Similarly, elements at risk and their vulnerability are highly dynamic through time, an aspect that is not sufficiently acknowledged in research. Since natural risk is an amalgam of hazard and vulnerability, its temporal behaviour has to be considered as well. Identifying these changes and their underlying processes contributes to a better understanding of natural risk today and in the future. However, no dynamic models for natural risks are currently available. Dynamic behaviour of factors affecting risk is likely to create increasing connectivity and complexity. This demands a broad approach to natural risk, since the concept of risk encapsulates aspects of many disciplines and has suffered from single-discipline approaches in the past. In New Zealand, dramatic environmental and social change has occurred in a relatively short period of time, graphically demonstrating the temporal variability of the geosystem and the social system. To understand these changes and subsequent interactions between both systems, a holistic perspective is needed. This contribution reviews available frameworks, demonstrates the need for further concepts, and gives research perspectives on a New Zealand example.

Parsing protection and risk for problem behavior versus pro-social behavior among US and Chinese adolescents.

PubMed

Jessor, Richard; Turbin, Mark S

2014-07-01

This study investigates the different roles played by protective factors and risk factors-and by particular protective and risk factors-when the concern is with accounting for adolescent problem behavior than when the concern is with accounting for adolescent pro-social behavior. The protective and risk factor literature on adolescent problem behavior reveals considerable conceptual and operational ambiguity; an aim of the present study was to advance understanding in this domain of inquiry by providing a systematic conceptualization of protection and risk and of their measurement. Within the systematic framework of Problem Behavior Theory, four protective and four risk factors are assessed in a cross-national study of both problem behavior and pro-social behavior involving large adolescent samples in China (N = 1,368) and the US (N = 1,087), in grades 9, 10, and 11; females 56 %, US; 50 %, China. The findings reveal quite different roles for protection and risk, and for particular protective and risk factors, when the outcome criterion is problem behavior than when it is pro-social behavior. The protective factor, Controls Protection, which engages rule and regulations and sanctions in the adolescent's ecology, emerges as most important in influencing problem behavior, but it plays a relatively minor role in relationship to pro-social behavior. By contrast, Models Protection, the presence of pro-social models in the adolescent's ecology, and Support Protection, the presence of interest and care in that same ecology, have no significant relationship to problem behavior variation, but they are both the major predictors of variation in pro-social behavior. The findings are robust across the samples from the two very diverse societies. These results suggest that greater attention be given to protection in problem behavior research and that a more nuanced perspective is needed about the roles that particular protective and risk factors play in reducing problem behavior and in promoting pro-social behavior.

Integrating Survey and Molecular Approaches to Better Understand Wildlife Disease Ecology

PubMed Central

Cowled, Brendan D.; Ward, Michael P.; Laffan, Shawn W.; Galea, Francesca; Garner, M. Graeme; MacDonald, Anna J.; Marsh, Ian; Muellner, Petra; Negus, Katherine; Quasim, Sumaiya; Woolnough, Andrew P.; Sarre, Stephen D.

2012-01-01

Infectious wildlife diseases have enormous global impacts, leading to human pandemics, global biodiversity declines and socio-economic hardship. Understanding how infection persists and is transmitted in wildlife is critical for managing diseases, but our understanding is limited. Our study aim was to better understand how infectious disease persists in wildlife populations by integrating genetics, ecology and epidemiology approaches. Specifically, we aimed to determine whether environmental or host factors were stronger drivers of Salmonella persistence or transmission within a remote and isolated wild pig (Sus scrofa) population. We determined the Salmonella infection status of wild pigs. Salmonella isolates were genotyped and a range of data was collected on putative risk factors for Salmonella transmission. We a priori identified several plausible biological hypotheses for Salmonella prevalence (cross sectional study design) versus transmission (molecular case series study design) and fit the data to these models. There were 543 wild pig Salmonella observations, sampled at 93 unique locations. Salmonella prevalence was 41% (95% confidence interval [CI]: 37–45%). The median Salmonella DICE coefficient (or Salmonella genetic similarity) was 52% (interquartile range [IQR]: 42–62%). Using the traditional cross sectional prevalence study design, the only supported model was based on the hypothesis that abundance of available ecological resources determines Salmonella prevalence in wild pigs. In the molecular study design, spatial proximity and herd membership as well as some individual risk factors (sex, condition score and relative density) determined transmission between pigs. Traditional cross sectional surveys and molecular epidemiological approaches are complementary and together can enhance understanding of disease ecology: abundance of ecological resources critical for wildlife influences Salmonella prevalence, whereas Salmonella transmission is driven by local spatial, social, density and individual factors, rather than resources. This enhanced understanding has implications for the control of diseases in wildlife populations. Attempts to manage wildlife disease using simplistic density approaches do not acknowledge the complexity of disease ecology. PMID:23071552

Parent-related mechanisms underlying the social gradient of childhood overweight and obesity: a systematic review.

PubMed

Mech, P; Hooley, M; Skouteris, H; Williams, J

2016-09-01

Low socio-economic status (SES) is a significant risk factor for childhood overweight and obesity (COWOB) in high-income countries. Parents to young children buffer and accentuate social and cultural influences, and are central to the development of this disease. An understanding of the parent-related mechanisms that underlie the SES-COWOB relationship is needed to improve the efficacy of prevention and intervention efforts. A systematic review of relevant literature was conducted to investigate the mechanisms by which levels of SES (low, middle and high) are associated to COWOB, by exploring mediation and interaction effects. Six electronic databases were searched yielding 5155 initial records, once duplicates were removed. Studies were included if they investigated COWOB, SES, parent-related factors and the multivariate relationship between these factors. Thirty studies were included. Factors found to be mediating the SES-COWOB relationship or interacting with SES to influence COWOB were categorized according to an ecological systems framework, at child, parent, household and social system level factors. High parent body mass index, ethnicity, child-care attendance, high TV time (mother and child), breastfeeding (early weaning), food intake behaviours and birthweight potentially mediate the relationship between SES and COWOB. Different risk factors for COWOB in different SES groups were found. For low SES families, parental obesity and maternal depressive symptoms were strong risk factors for COWOB, whereas long maternal working hours and a permissive parenting style were risk factors for higher SES families. None of the studies investigated parental psychological attributes such as attitudes, beliefs, self-esteem and so on as potential mechanisms/risk factors. Families from different SES groups have different risk and protective factors for COWOB. Prevention and intervention efforts may have improved efficacy if they are tailored to address specific risk factors within SES. © 2016 John Wiley & Sons Ltd.

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

Let us fight and support one another: adolescent girls and young women on contributors and solutions to HIV risk in Zambia

PubMed Central

Butts, Stefani A; Parmley, Lauren E; Alcaide, Maria L; Rodriguez, Violeta J; Kayukwa, Annette; Chitalu, Ndashi; Weiss, Stephen M; Jones, Deborah L

2017-01-01

In Zambia, adolescent girls and young women (AGYW) are disproportionately affected by human immunodeficiency virus (HIV), social, cultural and economic factors making them particularly vulnerable. This study was designed to understand the context in which AGYW are at risk and to identify perceived drivers of the epidemic and potential strategies to reduce HIV risk. Focus group discussions were conducted with AGYW in Zambian districts with the highest HIV prevalence from February through August 2016. The focus group guide addressed HIV risk factors and strategies for HIV prevention in AGYW. Focus group discussions were recorded, translated and transcribed, themes identified and responses coded. Results suggest that gender inequality undermined potentially protective factors against HIV among AGYW. Poverty and stigmatization were major barriers to accessing available HIV prevention services as well as primary risk factors for HIV infection. Sponsorship to support AGYW school attendance, programs for boys and girls to foster gender equality and financial assistance from the government of Zambia to support AGYW most in need were proposed as strategies to reduce HIV risk. Results highlight the utility of using community-based research to guide potential interventions for the affected population. Future research should explore the use of multilevel interventions to combat HIV among AGYW. PMID:29033613

Risk factors for roadway single- and multi-vehicle all-terrain vehicle crashes in Pennsylvania: 2010-2013.

PubMed

Gorucu, Serap; Murphy, Dennis; Kassab, Cathy

2017-01-01

All Terrain Vehicles on public roadways become major risk factors for the motorists. To compare characteristics of crashes and injury severity related to single vehicle (SV) and multi-vehicle (MV) All-Terrain Vehicle (ATV) roadway crashes in Pennsylvania, USA. Data on ATV crashes occurring on public roads during the years 2010-2013 was obtained from the Pennsylvania Department of Transportation (PennDOT) and analyzed. Almost two-thirds of the incidents were single-vehicle incidents. Single-ATV incidents have a greater risk for incapacitating injury to drivers than do multi-vehicle ATV incidents. Other factors that increase risk for incapacitating injury in SV crashes include being male, being a driver, alcohol/drug involvement, hitting a fixed object, and the incidents in non-daylight hours. For MV ATV incidents, head on and rear-end crashes and drivers who had alcohol/drug involvement were the two major incapacitating injury risk factors. This study has enabled us to better understand roadway ATV incidents, characteristics of SV and MV ATV crashes, and the incapacitating injury risks in both SV and MV crash incidents. Our study suggests that road safety and public health programs should focus on the users' knowledge on laws regarding ATV usage on public roadways.

PANCREATITIS - DIABETES - PANCREATIC CANCER: Summary of an NIDDK-NCI Workshop

PubMed Central

Andersen, Dana K.; Andren-Sandberg, Åke; Duell, Eric J.; Goggins, Michael; Korc, Murray; Petersen, Gloria M.; Smith, Jill P.; Whitcomb, David C.

2013-01-01

A workshop sponsored by the NIDDK and the NCI on “Pancreatitis-Diabetes-Pancreatic Cancer” focused on the risk factors of chronic pancreatitis (CP) and diabetes mellitus (DM) on the development of pancreatic ductal adenocarcinoma (PDAC). Sessions were held on a) an overview of the problem of PDAC, b) CP as a risk factor for PDAC, c) DM as a risk factor for PDAC, d) pancreatogenic, or type 3c DM (T3cDM), e) genomic associations of CP, DM, and PDAC, f) surveillance of high-risk populations and early detection of PDAC, and g) effects of DM treatment on PDAC. Recent data and current understandings of the mechanisms of CP- and DM-associated factors on PDAC development were discussed, and a detailed review of the possible risks of DM treatment on the development of PDAC was provided by representatives from academia, industry, and the Food and Drug Administration. The current status of possible biomarkers of PDAC and surveillance strategies for high-risk populations were discussed, and the gaps in knowledge and opportunities for further research were elucidated. A broad spectrum of expertise of the speakers and discussants provided an unusually productive workshop, the highlights of which are summarized in the accompanying article. PMID:24152948

Risk Engagement and Protection Survey (REPS): developing and validating a survey tool on fathers' attitudes towards child injury protection and risk engagement.

PubMed

Olsen, Lise L; Ishikawa, Takuro; Mâsse, Louise C; Chan, Grace; Brussoni, Mariana

2018-04-01

Fathers play a unique role in keeping children safe from injury yet understanding of their views and attitudes towards protecting children from injury and allowing them to engage in risks is limited. The purpose of this study was to develop and validate an instrument to measure fathers' attitudes towards these two constructs. An instrument was developed that used prior qualitative research to inform item generation. The questions were assessed for content validity with experts, then pilot-tested with fathers. The survey was completed by 302 fathers attending hospital with their child for an injury or non-injury reason. Results of confirmatory factor analysis identified eight items relating to the protection from injury factor and six items relating to the risk engagement factor. Correlation between the two factors was low, suggesting these are two independent constructs. The Risk Engagement and Protection Survey offers a tool for measuring attitudes and assisting with intervention strategy development in ways that reflect fathers' views and promotes a balanced view of children's needs for safety with their needs for engaging in active, healthy risk-taking. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Trends and risk factors for human Q fever in Australia, 1991-2014.

PubMed

Sloan-Gardner, T S; Massey, P D; Hutchinson, P; Knope, K; Fearnley, E

2017-03-01

Australian abattoir workers, farmers, veterinarians and people handling animal birthing products or slaughtering animals continue to be at high risk of Q fever despite an effective vaccine being available. National Notifiable Diseases Surveillance System data were analysed for the period 1991-2014, along with enhanced risk factor data from notified cases in the states of New South Wales and Queensland, to examine changes in the epidemiology of Q fever in Australia. The national Q fever notification rate reduced by 20% [incident rate ratio (IRR) 0·82] following the end of the National Q fever Management Program in 2006, and has increased since 2009 (IRR 1·01-1·34). Highest rates were in males aged 40-59 years (5·9/100 000) and 87% of Q fever cases occurred in New South Wales and Queensland. The age of Q fever cases and proportion of females increased over the study period. Based on the enhanced risk factor data, the most frequently listed occupation for Q fever cases involved contact with livestock, followed by 'no known risk' occupations. More complete and comparable enhanced risk factor data, at the State/Territory and national levels, would aid in further understanding of the epidemiology of Q fever.

Let us fight and support one another: adolescent girls and young women on contributors and solutions to HIV risk in Zambia.

PubMed

Butts, Stefani A; Parmley, Lauren E; Alcaide, Maria L; Rodriguez, Violeta J; Kayukwa, Annette; Chitalu, Ndashi; Weiss, Stephen M; Jones, Deborah L

2017-01-01

In Zambia, adolescent girls and young women (AGYW) are disproportionately affected by human immunodeficiency virus (HIV), social, cultural and economic factors making them particularly vulnerable. This study was designed to understand the context in which AGYW are at risk and to identify perceived drivers of the epidemic and potential strategies to reduce HIV risk. Focus group discussions were conducted with AGYW in Zambian districts with the highest HIV prevalence from February through August 2016. The focus group guide addressed HIV risk factors and strategies for HIV prevention in AGYW. Focus group discussions were recorded, translated and transcribed, themes identified and responses coded. Results suggest that gender inequality undermined potentially protective factors against HIV among AGYW. Poverty and stigmatization were major barriers to accessing available HIV prevention services as well as primary risk factors for HIV infection. Sponsorship to support AGYW school attendance, programs for boys and girls to foster gender equality and financial assistance from the government of Zambia to support AGYW most in need were proposed as strategies to reduce HIV risk. Results highlight the utility of using community-based research to guide potential interventions for the affected population. Future research should explore the use of multilevel interventions to combat HIV among AGYW.

Applying the Problem Behavior Theory to Adolescent Drug Use Among a Cross-Sectional Sample of Boys Participating in a Community-Based Youth Organization.

PubMed

Alexander, Adam C; Obong'o, Christopher O; Chavan, Prachi; Vander Weg, Mark W; Ward, Kenneth D

2018-03-21

Drug use remains an important public health concern in the United States, and understanding drug use among young adolescents is vital towards improving the health of the population. This study applied the Problem Behavior Theory (PBT) to lifetime drug use among a cross-sectional sample of Boy Scouts (N = 770). The PBT provides a conceptual framework for identifying risk and protective factors for adolescent problem behaviors, including drug use. Scouts reported their drug use and socio-demographics, and were assessed on several risk and protective factors. For analyses, sociodemographic and risk and protective factors were selected according to the framework provided by PBT, and use of each drug was regressed logistically on these selected factors. Final logistic models were assessed for goodness of fit and discriminatory power. The PBT demonstrated discriminatory power for all drugs (Tjur's R 2 values ≥.29), but fell sharply for illicit drug use (Tjur's R 2 =.20). There were no consistent correlates of drug use. Conclusions/Importance: The PBT had less explanatory power for illicit drug use compared to tobacco, alcohol, and marijuana, which suggests different risk and protective factors were associated with illicit drug use.

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

PubMed

Bower, Julienne E

2014-10-01

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

Community and Individual Risk Factors for Physical Child Abuse and Child Neglect: Variations by Poverty Status.

PubMed

Maguire-Jack, Kathryn; Font, Sarah A

2017-08-01

Families are impacted by a variety of risk and protective factors for maltreatment at multiple levels of the social ecology. Individual- and neighborhood-level poverty has consistently been shown to be associated with higher risk for child abuse and neglect. The current study sought to understand the ways in which individual- and neighborhood-level risk and protective factors affect physical child abuse and child neglect and whether these factors differed for families based on their individual poverty status. Specifically, we used a three-level hierarchical linear model (families nested within census tracts and nested within cities) to estimate the relationships between physical child abuse and child neglect and neighborhood structural factors, neighborhood processes, and individual characteristics. We compared these relationships between lower and higher income families in a sample of approximately 3,000 families from 50 cities in the State of California. We found that neighborhood-level disadvantage was especially detrimental for families in poverty and that neighborhood-level protective processes (social) were not associated with physical child abuse and child neglect for impoverished families, but that they had a protective effect for higher income families.

Risk Factors for Community-Associated Staphylococcus aureus Skin Infection in Children of Maui

PubMed Central

Seifried, Steven E

2012-01-01

The prevalence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection, and Staphylococcus aureus (S. aureus) infection overall, has dramatically increased in the past 10 years. Children and Native Hawaiians and Pacific Islanders (NHPI) are disproportionately affected by CA-MRSA infection. The purpose of this case-control study was to identify risk factors for CA-S. aureus skin infections in children of Maui, Hawai‘i, as a foundation for reducing the transmission of these infections. Survey data were obtained from patients in pediatric clinician offices over an 8-month period. NHPI participants were well-represented as 58% of cases and 54% of controls. Chi-square analysis and logistic regression were used to identify risk factors. Significant risk factors predictive of infection among all participants were (a) skin abrasions or wounds, (b) household contact, and (c) overweight or obesity. Risk factors predictive of infection among NHPI were (a) skin abrasions or wounds, (b) antibiotic use within 6 months, (c) overweight or obesity, and (d) a history of eczema or other skin disorder. The role of overweight or obesity in S. aureus skin infections among NHPI has not been identified in previous research and indicates a focus for additional education. Further research is needed to better understand the role of eczema, antibiotic use, overweight and obesity, and socio-cultural factors in these infections. PMID:22900237

Influence of early-life and parental factors on childhood overweight and obesity.

PubMed

Parrino, C; Vinciguerra, F; La Spina, N; Romeo, L; Tumminia, A; Baratta, R; Squatrito, S; Vigneri, R; Frittitta, L

2016-11-01

We recently reported that a high BMI and high waist circumference prevalence is present in Sicilian children and that the male gender is associated with a significant risk of obesity. Early-life and parent-related risk factors were investigated 1521 Sicilian children (752 females and 769 males, aged 9.0-14.0 years) to identify biological and environmental factors that can contribute to obesity onset. Anthropometric measurements of children, their urban vs rural area provenience, birth weight and neonatal feeding were collected. In addition, the BMI and educational level of their parents and the perception of their child weight status were investigated. In the study cohort, the prevalence of overweight and obesity was 27.2 and 14.1 %, respectively, significantly (p < 0.05) higher in males than in females. Breastfeeding emerged as a protective factor (OR 0.64; p < 0.0005), while risk factors for developing childhood obesity were a birth weight ≥4.0 kg (OR 1.83; p < 0.05), an overweight or obese mother (OR 2.33; p < 0.0001) or father (OR 1.68; p < 0.0001) and a mother with a low/medium education level (OR 1.72; p < 0.005). Understanding risk factors for pediatric obesity is a prerequisite to identify children at highly risk of being obese and to predispose early intervention strategies.

Family obligation values as a protective and vulnerability factor among low-income adolescent girls.

PubMed

Milan, Stephanie; Wortel, Sanne

2015-06-01

Adolescents' beliefs about family obligation often reflect cultural variations in their family context, and thus are important for understanding development among diverse youth. In this study, we test hypotheses about the role of family obligation values in risk behavior and mental health in a sample of 194 low-income adolescent girls (mean age = 15.2; 58% Latina, 28% African-American/Black). We hypothesized that family obligation values can be both a protective and vulnerability factor, depending on the type of outcome and the presence of other risk factors. Across the sample, higher family obligation values tended to occur with indicators of positive family functioning (e.g., more frequent communication, less maternal hostility) based on mother and adolescent reports. As hypothesized, family obligation values moderated the relationship between established risk factors and adjustment in distinct ways, such that high family obligation values decreased risk in some domains (i.e., a protective factor) but increased risk in other domains (i.e., a vulnerability factor). Specifically, high family obligation values diminished the relationship between peer norms for risky behavior (sex and substance use) and individual engagement in those behaviors. At the same time, high family obligation values magnified the relationship between exposure to negative life events and poor mental health (PTSD and depressive symptoms). The results suggest that family obligation is an important but complex aspect of development among diverse adolescent girls.

Prenatal Risk Factors and the Etiology of ADHD-Review of Existing Evidence.

PubMed

Sciberras, Emma; Mulraney, Melissa; Silva, Desiree; Coghill, David

2017-01-01

While it is well accepted that attention-deficit/hyperactivity disorder (ADHD) is a highly heritable disorder, not all of the risk is genetic. It is estimated that between 10 and 40% of the variance associated with ADHD is likely to be accounted for by environmental factors. There is considerable interest in the role that the prenatal environment might play in the development of ADHD with previous reviews concluding that despite demonstration of associations between prenatal risk factors (e.g. prematurity, maternal smoking during pregnancy) and ADHD, there remains insufficient evidence to support a definite causal relationship. This article provides an update of research investigating the relationship between prenatal risk factors and ADHD published over the past 3 years. Recently, several epidemiological and data linkage studies have made substantial contributions to our understanding of this relationship. In particular, these studies have started to account for some of the genetic and familial confounds that, when taken into account, throw several established findings into doubt. None of the proposed prenatal risk factors can be confirmed as causal for ADHD, and the stronger the study design, the less likely it is to support an association. We need a new benchmark for studies investigating the etiology of ADHD whereby there is an expectation not only that data will be collected prospectively but also that the design allows the broad range of genetic and familial factors to be accounted for.

Older Adult Falls: Effective Approaches to Prevention

PubMed Central

Dellinger, Ann

2017-01-01

Purpose The issue of older adult falls combines a problem with high incidence and high injury susceptibility with an increasing population at risk. A firm understanding of both fall risk factors and effective strategies is required to reduce risk and prevent these injuries. Recent Findings Each year, 28.7% of older adults aged ≥65 sustain a fall. At the national level, this represents 29 million falls resulting in 27,000 deaths and 7 million injuries requiring medical treatment or restricted activity for at least 1 day. There are several strategies that have been shown to effectively reduce the risk or the incidence of falls. Summary More than 90% of older adults see a medical provider at least once a year providing an opportunity to identify and address fall risk factors. Comprehensive fall prevention in the primary care setting is both feasible and practical. PMID:28845383

Primary Prevention of Eating Disorders.

ERIC Educational Resources Information Center

Shisslak, Catherine M.; And Others

1987-01-01

Summarizes current understanding of anorexia nervosa and bulimia (clinical symptoms and outcome, prevalence and risk factors), offering suggestions for the primary prevention of these disorders at the individual, family, and community levels, and emphasizing prevention in the schools. (Author/KS)

Neurocysticercosis: regional status, epidemiology, impact and control measures in the Americas.

PubMed

Flisser, Ana; Sarti, Elsa; Lightowlers, Marshall; Schantz, Peter

2003-06-01

The analysis of epidemiological data concerning human cysticercosis point to important advances in understanding the magnitude and distribution of this parasitic disease in Latin America, as well as the relationship of the elements that conform the life cycle of Taenia solium. The data indicate that the main risk factor for acquiring human neurocysticercosis and swine cysticercosis is the presence of the tapeworm carrier in the household. Therefore, several intervention measures for the control of cysticercosis have been evaluated: mass treatment in order to cure tapeworm carriers, health education towards understanding the risk factors, pig control by restraining them, experimental vaccination of pigs and treatment of swine cysticercosis. In this paper, we review the information obtained in these areas. We hope it will be useful in other endemic countries that wish to elaborate an action plan for the control and ultimate eradication of T. solium.

Nutrigenetics: bridging two worlds to understand type 2 diabetes.

PubMed

Harrington, Janas M; Phillips, Catherine M

2014-04-01

The increasing global prevalence of type 2 diabetes mellitus (T2DM) is a major public health concern. Accumulating data provides strong evidence of the shared contribution of genetic and environmental factors to T2DM risk. Genome-wide association studies have hugely improved our understanding of the genetic basis of T2DM. However, it is obvious that genetics only partly account for an individuals' predisposition to T2DM. The dietary environment has changed remarkably over the last century. Examination of individual macronutrients and more recently of foods and dietary patterns is becoming increasingly important in terms of developing public health strategies. Nutrigenetics offers the potential to improve diet-related disease prevention and therapy, but is not without its own challenges. In this review we present evidence on the dietary environment and genetics as risk factors for T2DM and bridging the 2 disciplines we highlight some key gene-nutrient interactions.

Spontaneous preterm birth and single nucleotide gene polymorphisms: a recent update.

PubMed

Sheikh, Ishfaq A; Ahmad, Ejaz; Jamal, Mohammad S; Rehan, Mohd; Assidi, Mourad; Tayubi, Iftikhar A; AlBasri, Samera F; Bajouh, Osama S; Turki, Rola F; Abuzenadah, Adel M; Damanhouri, Ghazi A; Beg, Mohd A; Al-Qahtani, Mohammed

2016-10-17

Preterm birth (PTB), birth at <37 weeks of gestation, is a significant global public health problem. World-wide, about 15 million babies are born preterm each year resulting in more than a million deaths of children. Preterm neonates are more prone to problems and need intensive care hospitalization. Health issues may persist through early adulthood and even be carried on to the next generation. Majority (70 %) of PTBs are spontaneous with about a half without any apparent cause and the other half associated with a number of risk factors. Genetic factors are one of the significant risks for PTB. The focus of this review is on single nucleotide gene polymorphisms (SNPs) that are reported to be associated with PTB. A comprehensive evaluation of studies on SNPs known to confer potential risk of PTB was done by performing a targeted PubMed search for the years 2007-2015 and systematically reviewing all relevant studies. Evaluation of 92 studies identified 119 candidate genes with SNPs that had potential association with PTB. The genes were associated with functions of a wide spectrum of tissue and cell types such as endocrine, tissue remodeling, vascular, metabolic, and immune and inflammatory systems. A number of potential functional candidate gene variants have been reported that predispose women for PTB. Understanding the complex genomic landscape of PTB needs high-throughput genome sequencing methods such as whole-exome sequencing and whole-genome sequencing approaches that will significantly enhance the understanding of PTB. Identification of high risk women, avoidance of possible risk factors, and provision of personalized health care are important to manage PTB.

Maternal history of adoption or foster care placement in childhood: a risk factor for preterm birth.

PubMed

Bublitz, Margaret H; Rodriguez, Daniel; Polly Gobin, Asi; Waldemore, Marissa; Magee, Susanna; Stroud, Laura R

2014-10-01

The objective of the study was to assess the impact of maternal history of adoption or foster care placement in childhood on the risk for preterm birth (PTB), controlling for other known risk factors for PTB. Participants were 302 pregnant women from a low-income, diverse sample drawn from 2 intensive prospective studies of maternal mood and behavior and fetal and infant development. Gestational age was determined by best obstetric estimate. Maternal history of adoption or foster care placement prior to age 18 years was determined by maternal report. Other maternal characteristics, including maternal medical conditions, psychosocial characteristics, and health behaviors, were measured during the second and third trimesters of pregnancy. The odds of delivering preterm (gestational age <37 weeks) were approximately 4 times greater among women with a history of childhood adoption or foster care placement compared with women who were never placed out of the home during childhood. This association remained significant after adjusting for other known risk factors for PTB including maternal medical conditions, psychosocial characteristics, and negative health behaviors in pregnancy. Findings suggest that a history of adoption/foster care placement is an important risk factor for PTB and may be comparable with other established risk factors for PTB including prior history of PTB, body mass index, African-American race, and advanced maternal age. More studies are needed to understand why women with placement histories may be at increased risk to deliver preterm. Copyright © 2014 Elsevier Inc. All rights reserved.

Twenty-Year Systematic Review of the Hip Pathology, Risk Factors, Treatment, and Clinical Outcomes in Artistic Athletes-Dancers, Figure Skaters, and Gymnasts.

PubMed

Bolia, Ioanna; Utsunomiya, Hajime; Locks, Renato; Briggs, Karen; Philippon, Marc J

2018-01-01

To identify (1) the predominant level of evidence of the clinical studies regarding the hip pathology, risk factors, treatment, and clinical outcomes in artistic athletes (dancers, figure skaters, and gymnasts) (2) the most commonly reported hip pathology, risk factors, treatments, and clinical outcomes in dancers, figure skaters, and gymnasts. To conduct this systematic review PubMed, EMBASE, and Scopus databases were searched for relevant studies and pertinent data were collected from the eligible articles. Included were studies which reported hip injuries in artistic athletes, the risk factors, treatment, and/or the clinical outcomes. We excluded case reports or irrelevant studies. No meta-analysis was performed because of study heterogeneity. The methodical index for nonrandomized studies (MINORS) criteria were used for quality control. Thirty-eight studies were included in the analysis. The mean MINORS score was 13.6 ± 4.6 points indicating fair quality of evidence of the included articles. The predominant level of evidence was level IV. Chondrolabral pathology and muscle injuries were the most commonly reported pathologies. We found only 2 risk factor analysis studies; however, many studies reported risk correlation between artistic sports or imaging findings and hip pathology. Treatment strategies were reported in only 7 studies, clinical outcomes are significantly underreported. Chondrolabral pathology was the most commonly reported hip pathology in artistic athletes, however, prospective cohort studies are necessary to really understand these injuries and their associated risk factors. The lack of clinical outcomes is significant and future data collection is required to assess the effectiveness of the various treatments.

Growth Trajectories of Mexican-Origin Adolescent Mothers’ Educational Expectations

PubMed Central

Bravo, Diamond Y.; Toomey, Russell B.; Umaña-Taylor, Adriana J.; Updegraff, Kimberly A.; Jahromi, Laudan B.

2015-01-01

Pregnant and parenting adolescents are at significant risk for educational underachievement. Educational expectations play a critical role for understanding subsequent educational attainment; yet, limited empirical attention has been given to changes in educational expectations across the transition to parenthood among adolescent mothers. This longitudinal study explored stability and change in educational expectations across the transition to parenthood among 191 first-time pregnant Mexican-origin adolescents (Mage = 16.76, SD = .98). The current study also examined how several contextually relevant risk and protective factors were associated with differential patterns of educational trajectories across this transition and subsequent educational attainment. Latent class growth analyses revealed three educational expectation trajectories: low and stable (< high school degree), moderate and increasing (≈ associate degree), and high and increasing (≈ bachelor’s degree). Adolescent mothers in the low and stable group encountered several educational risk factors that partially explained their probability of membership in this trajectory and subsequent lower attainment. Conversely, probability of membership in the high and increasing expectations class was partially explained by adolescents’ on-track school status at the time of pregnancy and their mother figures’ educational expectations for their pregnant daughters. These findings have implications for understanding the malleable factors that help to explain why some adolescent mothers describe consistently high educational expectations and subsequent higher attainment, while others do not. PMID:28392610

RESEARCH ON ADOLESCENT SEXUAL ORIENTATION: DEVELOPMENT, HEALTH DISPARITIES, STIGMA AND RESILIENCE

PubMed Central

Saewyc, Elizabeth M.

2016-01-01

The decade between 1998 and 2008 saw rapid increases in research on adolescent sexual orientation development and related health issues, both in quantity and in quality of studies. While much of the research originated in North America, studies from other countries also contributed to emerging understanding of developmental trajectories and social influences on the health of sexual minority adolescents. This paper reviews the body of research from the past decade on adolescent sexual orientation, focused on issues of measurement, developmental trajectories, evidence related to health disparities, and the risks and protective factors that help explain the health and developmental challenges some lesbian, gay, and bisexual adolescents experience. Although many sexual minority adolescents face stigma and rejection within their families, their schools, or their communities, it should be noted that most successfully navigate the developmental tasks of adolescence, and attain similar levels of health and well-being as their heterosexual peers, often despite the stigma and discrimination they encounter. Further research is needed to understand population trends as well as individual patterns of development; cultural variations in both development and health disparities; the interplay of general and unique risk factors that contribute to various health disparities and protective factors that buffer those risks; and interventions to promote the healthy development of sexual minority adolescents. PMID:27099454

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

The MaBwana Black men's study: community and belonging in the lives of African, Caribbean and other Black gay men in Toronto.

PubMed

George, Clemon; Adam, Barry A; Read, Stanley E; Husbands, Winston C; Remis, Robert S; Makoroka, Lydia; Rourke, Sean B

2012-01-01

In Canada, there is a paucity of research aimed at understanding Black gay men and the antecedents to risk factors for HIV. This study is an attempt to move beyond risk factor analysis and explore the role of sexual and ethnic communities in the lives of these men. The study utilized a community-based research and critical race theory approach. Semi-structured interviews were conducted with eight key informants to augment our understanding of Black gay men and to facilitate recruitment of participants. In-depth interviews were done with 24 Black gay men. Our data showed that the construction of community for Black gay men is challenged by their social and cultural environment. However, these men use their resilience to navigate gay social networks. Black gay men expressed a sense of abjuration from both gay and Black communities because of homophobia and racism. It is essential for health and social programmers to understand how Black gay men interact with Black and gay communities and the complexities of their interactions in creating outreach educational, preventive and support services.

Clinical implications of drug abuse epidemiology.

PubMed

Schulden, Jeffrey D; Lopez, Marsha F; Compton, Wilson M

2012-06-01

Research on the epidemiology of illicit drug use disorders provides continued critical insights into the distribution and determinants of drug use and drug use disorders in the United States. This research serves as a foundation for understanding the etiology of these disorders, helping to disentangle the complex interrelationship of developmental, genetic, and environmental risk and protective factors. Building on an understanding of this research in substance abuse epidemiology, it is important for clinicians to understand the unique trends in drug use in the overall communities that they serve and the unique risk factors for given individuals. The generally high prevalence of substance use disorders, along with their high comorbidity with other psychiatric disorders and with the HIV epidemic, make prevention, evaluation, and referral for treatment for drug abuse an important part of routine clinical practice in a range of clinical settings, including primary care, psychiatric, and emergency department settings. Ongoing efforts to ensure insurance coverage parity for the treatment of mental health and substance use disorders offer the promise of continued improvements in the integration and availability of such services in the broader US health care system.

Dynamics of Diabetes and Obesity: Epidemiological Perspective

PubMed Central

Boles, Annette; Kandimalla, Ramesh; Reddy, P. Hemachandra

2017-01-01

The purpose of this review article is to understand the current literature on obesity, diabetes and therapeutic avenues across the world. Diabetes is a chronic lifestyle condition that affects millions of people worldwide and it is a major health concern in our society. Diabetes and obesity are associated with various conditions, including non-modifiable and modifiable risk factors. Early detectable markers are not well established to detect pre-diabetes and as a result, it becomes diabetes. Several published epidemiological studies were assessed and the findings were summarized. Resources from published studies were used to identify criteria used for pre-diabetes, the role of diet in pre-diabetics and potential risks and characteristics associated with pre-diabetes. Preventive strategies are needed to combat diabetes. Individuals diagnosed with pre-diabetes need detailed education, need to fully understand the risk factors and have the ability to manage diabetes. Interventions exist that include chronic disease self-management programs, lifestyle interventions and pharmacological strategies. Obesity plays a large role in causing pre-diabetes and diabetes. Critical analysis of existing epidemiological research data suggests that additional research is needed to determine the efficacy of interventions. PMID:28130199

Introduction to the Centers for Disease Control and Prevention and Healthcare Infection Control Practices Advisory Committee Guideline for Prevention of Surgical Site Infection: Prosthetic Joint Arthroplasty Section.

PubMed

Segreti, John; Parvizi, Javad; Berbari, Elie; Ricks, Philip; Berríos-Torres, Sandra I

Peri-prosthetic joint infection (PJI) is a severe complication of total joint arthroplasty that appears to be increasing as more of these procedures are performed. Numerous risk factors for incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSIs) have been identified. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional SSI and PJI. The Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recently updated the national Guideline for Prevention of Surgical Site Infection. The updated guideline applies evidence-based methodology, presents recommendations for potential strategies to reduce the risk of SSI, and includes an arthroplasty-specific section. This article serves to introduce the guideline development process and to complement the Prosthetic Joint Arthroplasty section with background information on PJI-specific economic burden, epidemiology, pathogenesis and microbiology, and risk factor information.

Clinical review: Ethnic differences in bone mass--clinical implications.

PubMed

Leslie, William D

2012-12-01

Differences in bone mineral density (BMD) as assessed with dual-energy x-ray absorptiometry are observed between geographic and ethnic groups, with important implications in clinical practice. PubMed was employed to identify relevant studies. A review of the literature was conducted, and data were summarized and integrated. The available data highlight the complex ethnic variations in BMD, which only partially account for observed variations in fracture rates. Factors contributing to ethnic differences include genetics, skeletal size, body size and composition, lifestyle, and social determinants. Despite BMD differences, the gradient of risk for fracture from BMD and other clinical risk factors appears to be similar across ethnic groups. Furthermore, BMD variation is greater within an ethnic population than between ethnic populations. New imaging technologies have identified ethnic differences in bone geometry, volumetric density, microarchitecture, and estimated bone strength that may contribute to a better understanding of ethnic differences in fracture risk. Factors associated with ethnicity affect BMD and fracture risk through direct and indirect mechanisms.

Serum lipoprotein-A levels in healthy subjects indicate a lurking cerebro- and cardio-vascular risk in the younger population.

PubMed

Oliveira, Samuel Henrique Vieira; de Miranda, Marciano Robson; Santos Morais, Charles Augusto; Palotás, András; Lima, Luciana Moreira

2013-08-01

Lipoprotein-A (LpA) is an emerging independent risk factor for cerebro- and cardio-vascular diseases (CCVD). Recognizing its function and its normal distribution is of fundamental importance for a better understanding of CCVD patho-physiology. The present study evaluated plasma LpA levels of healthy university students using turbidimetric methods. Medians and inter-quartile differences obtained for male and female participants were 11.3mg/dL (3.1-30.7) and 20.9mg/dL (6.5-42.3), respectively, demonstrating a significant difference (P=0.017) between men and women. A third of students showed plasma concentrations above reference values. Our results indicate that 33% of students possess a hidden independent risk factor for CCVD. Multi-disciplinary evaluation and characterization of young individuals should be recommended in an attempt to take early preventive measures and to eliminate possible modifiable risk factors such as sedentary lifestyle, smoking, hypertension, obesity and atherogenic diet. Copyright © 2013 Elsevier Inc. All rights reserved.

Environmental risk factors and their role in the management of atopic dermatitis

PubMed Central

Kantor, Robert; Silverberg, Jonathan I.

2016-01-01

Introduction The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors. Areas covered We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD. Expert commentary The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures. PMID:27417220

Design of psychosocial factors questionnaires: a systematic measurement approach

PubMed Central

Vargas, Angélica; Felknor, Sarah A

2012-01-01

Background Evaluation of psychosocial factors requires instruments that measure dynamic complexities. This study explains the design of a set of questionnaires to evaluate work and non-work psychosocial risk factors for stress-related illnesses. Methods The measurement model was based on a review of literature. Content validity was performed by experts and cognitive interviews. Pilot testing was carried out with a convenience sample of 132 workers. Cronbach’s alpha evaluated internal consistency and concurrent validity was estimated by Spearman correlation coefficients. Results Three questionnaires were constructed to evaluate exposure to work and non-work risk factors. Content validity improved the questionnaires coherence with the measurement model. Internal consistency was adequate (α=0.85–0.95). Concurrent validity resulted in moderate correlations of psychosocial factors with stress symptoms. Conclusions Questionnaires´ content reflected a wide spectrum of psychosocial factors sources. Cognitive interviews improved understanding of questions and dimensions. The structure of the measurement model was confirmed. PMID:22628068

Environmental risk factors and their role in the management of atopic dermatitis.

PubMed

Kantor, Robert; Silverberg, Jonathan I

2017-01-01

The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors. Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD. Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.

Enhancing Interdisciplinary Human System Risk Research Through Modeling and Network Approaches

NASA Technical Reports Server (NTRS)

Mindock, Jennifer; Lumpkins, Sarah; Shelhamer, Mark

2015-01-01

NASA's Human Research Program (HRP) supports research to reduce human health and performance risks inherent in future human space exploration missions. Understanding risk outcomes and contributing factors in an integrated manner allows HRP research to support development of efficient and effective mitigations from cross-disciplinary perspectives, and to enable resilient human and engineered systems for spaceflight. The purpose of this work is to support scientific collaborations and research portfolio management by utilizing modeling for analysis and visualization of current and potential future interdisciplinary efforts.

The Perpetuation of Risk: Organizational and Institutional Policies and Practices in a Title 1 School

ERIC Educational Resources Information Center

McMahon, Brenda

2011-01-01

This empirical mixed methods study examines educators' understandings of student risk factors. The research was conducted in a Title 1 combination middle high school in the Florida panhandle that had been open for three years and had received a grade of F school in each of these years. In Florida, schools are graded according to the Florida…