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Sample records for high risk people

  1. People at High Risk of Developing Flu-Related Complications

    Science.gov (United States)

    ... Influenza Types Seasonal Avian Swine Variant Pandemic Other People at High Risk of Developing Flu–Related Complications ... related complications if they get sick with influenza. People at High Risk for Developing Flu-Related Complications ...

  2. Totally "Online” High School for People at Educational Risk

    Directory of Open Access Journals (Sweden)

    Giancarlo De Agostini

    2010-02-01

    Full Text Available The Iberoamerican Virtual Foundation (http://fuvia.org is dedicated to providing e-learning solutions to universities and other institutions that may require it. It is develops a pedagogical, methodological and technological online High School model based on WEB2 tools, which could be easily replicated elsewhere, and is delivered completely through an online ICT technological GNU open source platform, implemented completely online through the “Colegio Virtual Iberoamericano” (http://cvi.edu.ec, which caters to vulnerable students at pedagogical risk who for different reasons were not able to finish their secondary education. The selected students receive scholarships, thus tuition is totally free. The Iberoamerican online High School Project started on October 2004 with UNESCO support, implementing the last six years of High School in four specialties, with student ages being between 16 and 65, located in almost 50 communities both rural and urban-marginal. We are also working in four detention centers of young law violators and with young men and women from street gangs through community centers. Thus far our strategic alliances (over 20 are with central and local governments, and national and international Foundations. In the near future we plan to: extend the online High School coverage to the rest of the Country in order to help decrease the digital divide gap and the student drop out rate from high school (nearly 80 %; replicate the experience in the rest of the region and in other countries in Africa and Asia; and develop a complete professional online digital Library service and a functional online student orientation Department.La Fondation Virtuelle Ibéro-américaine (http://fuvia.org est spécialisée dans la fourniture de solutions d’apprentissage en ligne aux universités et autres institutions. Elle développe un modèle d’enseignement secondaire en ligne à la fois pédagogique, méthodologique et technologique, et bas

  3. High prevalence of suicide risk in people living with HIV: who is at higher risk?

    Science.gov (United States)

    Passos, Susane Müller Klug; Souza, Luciano Dias de Mattos; Spessato, Bárbara Coiro

    2014-01-01

    A cross-sectional study was developed to evaluate suicide risk and associated factors in HIV/AIDS patients at a regional reference center for the treatment of HIV/AIDS in southern Brazil. We assessed 211 patients in regard to suicide risk, clinical and sociodemographic characteristics, drug use, depression, and anxiety. Suicide risk was assessed with Mini International Neuropsychiatric Interview, Module C. Multivariate analysis was performed using Poisson regression. Of the total sample, 34.1% were at risk of suicide. In the multivariate analysis, the following variables were independently associated with suicide risk: female gender; age up to 47 years; unemployment; indicative of anxiety; indicative of depression; and abuse or addiction on psychoactive substances. Suicide risk is high in this population. Psychosocial factors should be included in the physical and clinical evaluation, given their strong association with suicide risk.

  4. Borderline personality pathology in young people at ultra high risk of developing a psychotic disorder.

    Science.gov (United States)

    Ryan, Jaymee; Graham, Anne; Nelson, Barnaby; Yung, Alison

    2017-06-01

    The association between borderline personality disorder and the ultra high risk (UHR) for psychosis state is unclear. The following study aimed to investigate the type of attenuated psychotic symptoms and prevalence of borderline personality pathology in a sample of UHR young people. Additionally, the study aimed to explore whether borderline personality pathology influenced the transition rate to psychosis. Medical records from Orygen Youth Health between 2007 and 2009 were examined. There were 180 patients who met UHR criteria and were included for analysis. Most patients were females (62.8%) and age ranged from 15 to 24 years. A quarter (25.2%) of UHR patients endorsed items consistent with borderline personality pathology. UHR patients with borderline personality pathology experienced a range of attenuated psychotic symptoms and could not be statistically differentiated from UHR patients with less significant or without borderline personality pathology. Borderline personality pathology did not increase or decrease the risk of developing a psychotic disorder. The absence of depression was the only predictor of psychosis. Many UHR patients present with concurrent borderline personality features. The psychotic experiences reported by UHR patients with borderline personality features were not limited to paranoid ideation, supporting the idea that borderline personality disorder may include a wider range of psychotic symptoms than previously thought. It is further possible that the psychotic symptoms experienced in this group could also be indicative of an emerging psychotic disorder. © 2015 Wiley Publishing Asia Pty Ltd.

  5. Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial.

    Science.gov (United States)

    Pham, H; Armstrong, D G; Harvey, C; Harkless, L B; Giurini, J M; Veves, A

    2000-05-01

    Diabetic foot ulceration is a preventable long-term complication of diabetes. A multicenter prospective follow-up study was conducted to determine which risk factors in foot screening have a high association with the development of foot ulceration. A total of 248 patients from 3 large diabetic foot centers were enrolled in a prospective study. Neuropathy symptom score, neuropathy disability score (NDS), vibration perception threshold (VPT), Semmes-Weinstein monofilaments (SWFs), joint mobility, peak plantar foot pressures, and vascular status were evaluated in all patients at the beginning of the study. Patients were followed-up every 6 months for a mean period of 30 months (range 6-40), and all new foot ulcers were recorded. The sensitivity, specificity, and positive predictive value of each risk factor were evaluated. Foot ulcers developed in 95 feet (19%) or 73 patients (29%) during the study. Patients who developed foot ulcers were more frequently men, had diabetes for a longer duration, had nonpalpable pedal pulses, had reduced joint mobility, had a high NDS, had a high VPT, and had an inability to feel a 5.07 SWE NDS alone had the best sensitivity, whereas the combination of the NDS and the inability to feel a 5.07 SWF reached a sensitivity of 99%. On the other hand, the best specificity for a single factor was offered by foot pressures, and the best combination was that of NDS and foot pressures. Univariate logistical regression analysis yielded a statistically significant odds ratio (OR) for sex, race, duration of diabetes, palpable pulses, history of foot ulceration, high NDSs, high VPTs, high SWFs, and high foot pressures. In addition, 94 (99%) of the 95 ulcerated feet had a high NDS and/or SWF which resulted in the highest OR of 26.2 (95% CI 3.6-190). Furthermore, in multivariate logistical regression analysis, the only significant factors were high NDSs, VPTs, SWFs, and foot pressures. Clinical examination and a 5.07 SWF test are the two most sensitive

  6. Impact of rurality and substance use on young people at ultra high risk for psychosis.

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    Stain, Helen J; Halpin, Sean A; Baker, Amanda L; Startup, Mike; Carr, Vaughan J; Schall, Ulrich; Crittenden, Kylie; Clark, Vanessa; Lewin, Terry J; Bucci, Sandra

    2017-07-26

    Longitudinal research into early intervention for youth at ultra high risk (UHR) for psychosis demonstrates beneficial outcomes including increased treatment compliance and greater participation in education and the workforce. Despite known barriers for rural youth accessing mental health services, research comparing urban and rural UHR youth is lacking. The study included an examination of the impact of substance use on functioning of UHR youth. Youth aged 12 to 25 years were recruited from the urban area of Newcastle or the rural area of Orange, New South Wales, Australia, and identified as UHR by the Comprehensive Assessment of At Risk Mental States. Rural and urban youth were compared on clinical profiles, social and occupational functioning and substance use. The rural youth showed different help-seeking behaviours and had greater functional impairment than urban youth. Substance use was common across the sample of 57 youth (mean age 16.5 years, 56% female) and a history of hazardous substance use was associated with higher levels of depression. Rural youth (n = 32) were more likely than urban youth to be taking antidepressants at baseline (44% compared with 16%). Different patterns of help seeking by rural UHR youth suggest a need for greater access to psychosis informed primary care early intervention services. Interventions should target functional decline to prevent adverse outcomes such as reduced community participation and unemployment. In addition, interventions for substance use should be a priority for UHR youth, who should also be screened and monitored for depressive symptoms and treated for depression if indicated. © 2017 John Wiley & Sons Australia, Ltd.

  7. The association between neighborhood socioeconomic disadvantage and high-risk injection behavior among people who inject drugs.

    Science.gov (United States)

    DeCuir, Jennifer; Lovasi, Gina S; El-Sayed, Abdulrahman; Lewis, Crystal Fuller

    2018-02-01

    Although much research has been conducted on the determinants of HIV risk behavior among people who inject drugs (PWID), the influence of the neighborhood context on high-risk injection behavior remains understudied. To address this gap in the literature, we measured associations between neighborhood socioeconomic disadvantage and high-risk injection behavior, and determined whether these associations were modified by drug-related police activity and syringe exchange program (SEP) accessibility. Our sample was comprised of 484 pharmacy-recruited PWID in New York City. Measures of neighborhood socioeconomic disadvantage were created using data from the 2006-2010 American Community Survey. Associations with high-risk injection behavior were estimated using multivariable Poisson regression. Effect modification by drug-related police activity and SEP accessibility was assessed by entering cross-product terms into adjusted models of high-risk injection behavior. Neighborhood socioeconomic disadvantage was associated with decreased receptive syringe sharing and unsterile syringe use. In neighborhoods with high drug-related police activity, associations between neighborhood disadvantage and unsterile syringe use were attenuated to the null. In neighborhoods with high SEP accessibility, neighborhood disadvantage was associated with decreased acquisition of syringes from an unsafe source. PWID in disadvantaged neighborhoods reported safer injection behaviors than their counterparts in neighborhoods that were relatively better off. The contrasting patterns of effect modification by SEP accessibility and drug-related police activity support the use of harm reduction approaches over law enforcement-based strategies for the control of blood borne virus transmission among PWID in disadvantaged urban areas. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Hypertension is associated with cognitive decline in elderly people at high risk for dementia.

    Science.gov (United States)

    Wysocki, Michael; Luo, Xiaodong; Schmeidler, James; Dahlman, Karen; Lesser, Gerson T; Grossman, Hillel; Haroutunian, Vahram; Beeri, Michal Schnaider

    2012-02-01

    Cardiovascular risk factors including hypertension (HTN) have been shown to increase the risk of Alzheimer disease. The current study investigated whether individuals with HTN are more susceptible to increased cognitive decline and whether the influence of HTN on cognitive decline varied as a function of dementia severity. A total of 224 nursing home and assisted living residents, with a mean age of 84.9 (±7.6) years, were assessed longitudinally with Mini Mental State Exams (MMSEs) and Clinical Dementia Ratings (CDR). Baseline dementia status was defined by the CDR score. As described in , MMSE scores in persons with HTN and questionable dementia (CDR = 0.5) declined significantly faster than nonhypertensive questionably demented persons. Hypertensive participants did not decline significantly faster than nonhypertensive participants in persons with intact cognition (CDR = 0) or frank dementia (CDR ≥ 1). These results suggest an increased risk of subsequent cognitive decline in hypertensive individuals who are especially vulnerable to developing dementia and raises the possibility that avoiding or controlling HTN might reduce the rate of cognitive decline in cognitively vulnerable individuals, potentially delaying their conversion to full-fledged dementia.

  9. The Feasibility of Embedding Data Collection into the Routine Service Delivery of a Multi-Component Program for High-Risk Young People

    OpenAIRE

    Knight, Alice; Havard, Alys; Shakeshaft, Anthony; Maple, Myfanwy; Snijder, Mieke; Shakeshaft, Bernie

    2017-01-01

    Background: There is little evidence about how to improve outcomes for high-risk young people, of whom Indigenous young people are disproportionately represented, due to few evaluation studies of interventions. One way to increase the evidence is to have researchers and service providers collaborate to embed evaluation into the routine delivery of services, so program delivery and evaluation occur simultaneously. This study aims to demonstrate the feasibility of integrating best-evidence meas...

  10. The Feasibility of Embedding Data Collection into the Routine Service Delivery of a Multi-Component Program for High-Risk Young People.

    Science.gov (United States)

    Knight, Alice; Havard, Alys; Shakeshaft, Anthony; Maple, Myfanwy; Snijder, Mieke; Shakeshaft, Bernie

    2017-02-20

    There is little evidence about how to improve outcomes for high-risk young people, of whom Indigenous young people are disproportionately represented, due to few evaluation studies of interventions. One way to increase the evidence is to have researchers and service providers collaborate to embed evaluation into the routine delivery of services, so program delivery and evaluation occur simultaneously. This study aims to demonstrate the feasibility of integrating best-evidence measures into the routine data collection processes of a service for high-risk young people, and identify the number and nature of risk factors experienced by participants. The youth service is a rural based NGO comprised of multiple program components: (i) engagement activities; (ii) case management; (iii) diversionary activities; (iv) personal development; and (v) learning and skills. A best-evidence assessment tool was developed by staff and researchers and embedded into the service's existing intake procedure. Assessment items were organised into demographic characteristics and four domains of risk: education and employment; health and wellbeing; substance use; and crime. Descriptive data are presented and summary risk variables were created for each domain of risk. A count of these summary variables represented the number of co-occurring risks experienced by each participant. The feasibility of this process was determined by the proportion of participants who completed the intake assessment and provided research consent. This study shows 85% of participants completed the assessment tool demonstrating that data on participant risk factors can feasibly be collected by embedding a best-evidence assessment tool into the routine data collection processes of a service. The most prevalent risk factors were school absence, unemployment, suicide ideation, mental distress, substance use, low levels of physical activity, low health service utilisation, and involvement in crime or with the juvenile

  11. The Feasibility of Embedding Data Collection into the Routine Service Delivery of a Multi-Component Program for High-Risk Young People

    Directory of Open Access Journals (Sweden)

    Alice Knight

    2017-02-01

    Full Text Available Background: There is little evidence about how to improve outcomes for high-risk young people, of whom Indigenous young people are disproportionately represented, due to few evaluation studies of interventions. One way to increase the evidence is to have researchers and service providers collaborate to embed evaluation into the routine delivery of services, so program delivery and evaluation occur simultaneously. This study aims to demonstrate the feasibility of integrating best-evidence measures into the routine data collection processes of a service for high-risk young people, and identify the number and nature of risk factors experienced by participants. Methods: The youth service is a rural based NGO comprised of multiple program components: (i engagement activities; (ii case management; (iii diversionary activities; (iv personal development; and (v learning and skills. A best-evidence assessment tool was developed by staff and researchers and embedded into the service’s existing intake procedure. Assessment items were organised into demographic characteristics and four domains of risk: education and employment; health and wellbeing; substance use; and crime. Descriptive data are presented and summary risk variables were created for each domain of risk. A count of these summary variables represented the number of co-occurring risks experienced by each participant. The feasibility of this process was determined by the proportion of participants who completed the intake assessment and provided research consent. Results: This study shows 85% of participants completed the assessment tool demonstrating that data on participant risk factors can feasibly be collected by embedding a best-evidence assessment tool into the routine data collection processes of a service. The most prevalent risk factors were school absence, unemployment, suicide ideation, mental distress, substance use, low levels of physical activity, low health service utilisation

  12. A multicentre randomised controlled trial of day hospital-based falls prevention programme for a screened population of community-dwelling older people at high risk of falls

    OpenAIRE

    Conroy, Simon; Kendrick, Denise; Harwood, Rowan; Gladman, John; Coupland, Carol; Sach, Tracey; Drummond, Avril; Youde, Jane; Edmans, Judi; Masud, Tahir

    2010-01-01

    Objective: to determine the clinical effectiveness of a day hospital-delivered multifactorial falls prevention programme, for community-dwelling older people at high risk of future falls identified through a screening process. Design: multicentre randomised controlled trial. Setting: eight general practices and three day hospitals based in the East Midlands, UK. Participants: three hundred and sixty-four participants, mean age 79 years, with a median of three falls risk factors per person at ...

  13. High heterogeneity of HIV-related sexual risk among transgender people in Ontario, Canada: a province-wide respondent-driven sampling survey

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    Bauer Greta R

    2012-04-01

    Full Text Available Abstract Background Studies of HIV-related risk in trans (transgender, transsexual, or transitioned people have most often involved urban convenience samples of those on the male-to-female (MTF spectrum. Studies have detected high prevalences of HIV-related risk behaviours, self-reported HIV, and HIV seropositivity. Methods The Trans PULSE Project conducted a multi-mode survey using respondent-driven sampling to recruit 433 trans people in Ontario, Canada. Weighted estimates were calculated for HIV-related risk behaviours, HIV testing and self-reported HIV, including subgroup estimates for gender spectrum and ethno-racial groups. Results Trans people in Ontario report a wide range of sexual behaviours with a full range of partner types. High proportions – 25% of female-to-male (FTM and 51% of MTF individuals – had not had a sex partner within the past year. Of MTFs, 19% had a past-year high-risk sexual experience, versus 7% of FTMs. The largest behavioural contributors to HIV risk were sexual behaviours some may assume trans people do not engage in: unprotected receptive genital sex for FTMs and insertive genital sex for MTFs. Overall, 46% had never been tested for HIV; lifetime testing was highest in Aboriginal trans people and lowest among non-Aboriginal racialized people. Approximately 15% of both FTM and MTF participants had engaged in sex work or exchange sex and about 2% currently work in the sex trade. Self-report of HIV prevalence was 10 times the estimated baseline prevalence for Ontario. However, given wide confidence intervals and the high proportion of trans people who had never been tested for HIV, estimating the actual prevalence was not possible. Conclusions Results suggest potentially higher than baseline levels of HIV; however low testing rates were observed and self-reported prevalences likely underestimate seroprevalence. Explicit inclusion of trans people in epidemiological surveillance statistics would provide much

  14. [FRAX® thresholds to identify people with high or low risk of osteoporotic fracture in Spanish female population].

    Science.gov (United States)

    Azagra, Rafael; Roca, Genís; Martín-Sánchez, Juan Carlos; Casado, Enrique; Encabo, Gloria; Zwart, Marta; Aguyé, Amada; Díez-Pérez, Adolf

    2015-01-06

    To detect FRAX(®) threshold levels that identify groups of the population that are at high/low risk of osteoporotic fracture in the Spanish female population using a cost-effective assessment. This is a cohort study. Eight hundred and sixteen women 40-90 years old selected from the FRIDEX cohort with densitometry and risk factors for fracture at baseline who received no treatment for osteoporosis during the 10 year follow-up period and were stratified into 3 groups/levels of fracture risk (low20%) according to the real fracture incidence. The thresholds of FRAX(®) baseline for major osteoporotic fracture were: low riskX-ray absorptiometry (DXA-scan) for FRAX(®)≥ 5 (Intermediate and high risk) to reclassify by FRAX(®) with DXA-scan at high/low risk. These thresholds select 17.5% of women for DXA-scan and 10% for treatment. With these thresholds of FRAX(®), compared with the strategy of opportunistic case finding isolated risk factors, would improve the predictive parameters and reduce 82.5% the DXA-scan, 35.4% osteoporosis prescriptions and 28.7% cost to detect the same number of women who suffer fractures. The use of FRAX ® thresholds identified as high/low risk of osteoporotic fracture in this calibration (FRIDEX model) improve predictive parameters in Spanish women and in a more cost-effective than the traditional model based on the T-score ≤ -2.5 of DXA scan. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  15. Emotion-cognition interaction in people at familial high risk for schizophrenia: the impact of sex differences.

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    Phillips, Laura K; Giuliano, Anthony J; Lee, Erica H; Faraone, Stephen V; Tsuang, Ming T; Seidman, Larry J

    2011-11-01

    Cognitive deficits are fundamental to schizophrenia, and research suggests that negative emotion abnormally interferes with certain cognitive processes in those with the illness. To a lesser extent, cognitive impairment is found in persons at risk for schizophrenia, but there is limited research on the impact of emotion on cognitive processing in at-risk groups. It is unknown whether interference of negative emotion precedes illness and contributes to vulnerability for the disorder. We studied the extent to which negative emotional information interferes with working memory in 21 adolescent and young adult first-degree relatives of people with schizophrenia and 22 community controls. Groups were comparable in age, sex, education, ethnicity, and socioeconomic status. Primary measures were n-back tasks varying in cognitive load (1-back, 2-back, 3-back) with emotional faces (neutral, happy, fearful) as stimuli. The control group's response times (RTs) and the women's RTs, regardless of group, differed depending on the emotion condition. In contrast, the RTs of the relatives and of the men, regardless of group, did not differ by emotion. This study is the first to examine emotion-cognition interactions in relatives of individuals with schizophrenia. Reduced efficiency in processing emotional information may contribute to a greater vulnerability for schizophrenia that may be heightened in men. Additional research with larger samples of men and women is needed to test these preliminary findings.

  16. The effectiveness and cost effectiveness of dark chocolate consumption as prevention therapy in people at high risk of cardiovascular disease: best case scenario analysis using a Markov model

    OpenAIRE

    Zomer, Ella; Owen, Alice; Magliano, Dianna J; Liew, Danny; Reid, Christopher M

    2012-01-01

    Objective To model the long term effectiveness and cost effectiveness of daily dark chocolate consumption in a population with metabolic syndrome at high risk of cardiovascular disease. Design Best case scenario analysis using a Markov model. Setting Australian Diabetes, Obesity and Lifestyle study. Participants 2013 people with hypertension who met the criteria for metabolic syndrome, with no history of cardiovascular disease and not receiving antihypertensive therapy. Main outcome measures ...

  17. Cannabis-induced attenuated psychotic symptoms: implications for prognosis in young people at ultra-high risk for psychosis.

    Science.gov (United States)

    McHugh, M J; McGorry, P D; Yung, A R; Lin, A; Wood, S J; Hartmann, J A; Nelson, B

    2017-03-01

    Cannabis use shows a robust dose-dependent relationship with psychosis risk among the general population. Despite this, it has been difficult to link cannabis use with risk for transitioning to a psychotic disorder among individuals at ultra-high risk (UHR) for psychosis. The present study examined UHR transition risk as a function of cannabis use characteristics which vary substantially between individuals including age of first use, cannabis abuse severity and a history of cannabis-induced attenuated psychotic symptoms (APS). Participants were 190 UHR individuals (76 males) recruited at entry to treatment between 2000 and 2006. They completed a comprehensive baseline assessment including a survey of cannabis use characteristics during the period of heaviest use. Outcome was transition to a psychotic disorder, with mean time to follow-up of 5.0 years (range 2.4-8.7 years). A history of cannabis abuse was reported in 58% of the sample. Of these, 26% reported a history of cannabis-induced APS. These individuals were 4.90 (95% confidence interval 1.93-12.44) times more likely to transition to a psychotic disorder (p = 0.001). Greater severity of cannabis abuse also predicted transition to psychosis (p = 0.036). However, this effect was mediated by higher abuse severity among individuals with a history of cannabis-induced APS. Findings suggest that cannabis use poses risk in a subpopulation of UHR individuals who manifest cannabis-induced APS. Whether this reflects underlying genetic vulnerability requires further study. Nevertheless, findings reveal an important early marker of risk with potentially significant prognostic utility for UHR individuals.

  18. Functional Dysconnection of the Inferior Frontal Gyrus in Young People With Bipolar Disorder or at Genetic High Risk.

    Science.gov (United States)

    Roberts, Gloria; Lord, Anton; Frankland, Andrew; Wright, Adam; Lau, Phoebe; Levy, Florence; Lenroot, Rhoshel K; Mitchell, Philip B; Breakspear, Michael

    2017-04-15

    Bipolar disorder (BD) is characterized by a dysregulation of affect and impaired integration of emotion with cognition. These traits are also expressed in probands at high genetic risk of BD. The inferior frontal gyrus (IFG) is a key cortical hub in the circuits of emotion and cognitive control, and it has been frequently associated with BD. Here, we studied resting-state functional connectivity of the left IFG in participants with BD and in those at increased genetic risk. Using resting-state functional magnetic resonance imaging we compared 49 young BD participants, 71 individuals with at least one first-degree relative with BD (at-risk), and 80 control subjects. We performed between-group analyses of the functional connectivity of the left IFG and used graph theory to study its local functional network topology. We also used machine learning to study classification based solely on the functional connectivity of the IFG. In BD, the left IFG was functionally dysconnected from a network of regions, including bilateral insulae, ventrolateral prefrontal gyri, superior temporal gyri, and the putamen (p < .001). A small network incorporating neighboring insular regions and the anterior cingulate cortex showed weaker functional connectivity in at-risk than control participants (p < .006). These constellations of regions overlapped with frontolimbic regions that a machine learning classifier selected as predicting group membership with an accuracy significantly greater than chance. Functional dysconnectivity of the IFG from regions involved in emotional regulation may represent a trait abnormality for BD and could potentially aid clinical diagnosis. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  19. Could In-Home Sensors Surpass Human Observation of People with Parkinson’s at High Risk of Falling? An Ethnographic Study

    Directory of Open Access Journals (Sweden)

    Emma Stack

    2016-01-01

    Full Text Available Self-report underpins our understanding of falls among people with Parkinson’s (PwP as they largely happen unwitnessed at home. In this qualitative study, we used an ethnographic approach to investigate which in-home sensors, in which locations, could gather useful data about fall risk. Over six weeks, we observed five independently mobile PwP at high risk of falling, at home. We made field notes about falls (prior events and concerns and recorded movement with video, Kinect, and wearable sensors. The three women and two men (aged 71 to 79 years having moderate or severe Parkinson’s were dependent on others and highly sedentary. We most commonly noted balance protection, loss, and restoration during chair transfers, walks across open spaces and through gaps, turns, steps up and down, and tasks in standing (all evident walking between chair and stairs, e.g.. Our unobtrusive sensors were acceptable to participants: they could detect instability during everyday activity at home and potentially guide intervention. Monitoring the route between chair and stairs is likely to give information without invading the privacy of people at high risk of falling, with very limited mobility, who spend most of the day in their sitting rooms.

  20. High-speed resistance training and balance training for people with knee osteoarthritis to reduce falls risk: study protocol for a pilot randomized controlled trial.

    Science.gov (United States)

    Levinger, Pazit; Dunn, Jeremy; Bifera, Nancy; Butson, Michael; Elias, George; Hill, Keith D

    2017-08-18

    The number of falls experienced by people with knee osteoarthritis (OA) is almost double the number experienced by people with no OA. The neuromuscular elements required to arrest a fall are more impaired in people with knee OA compared to their asymptomatic counterparts. Therefore, these elements may need to be incorporated into an exercise intervention to reduce the risk of falling. The aim of this study will be to examine the feasibility, safety and patient satisfaction of a high-speed resistance-training program, with and without balance exercises, in people with knee OA compared to a control group. The effect of these exercise programs on lower-limb muscle strength and physiological and functional risk factors for falls will also be examined. This study will be a pilot randomized controlled trial with a pre- and post-intervention design (outcome assessments at baseline and 8 weeks after participation commencement) comparing three groups: a control group (no intervention), a high-speed resistance-training group and a high-speed resistance-training plus balance exercises group. Thirty people with knee osteoarthritis aged 60-90 years will be recruited and randomized to one of the three groups. Feasibility and safety will be assessed by examining adherence to the exercise program, dropout rate, pain level during and following exercise, number of exercises stopped due to pain, and any adverse event or any incident that prevents the participant from completing the prescribed exercise. Secondary measures of lower-limb strength, physical function, self-reported pain and function, fear of falls, and executive function and quality of life will also be assessed. To determine statistical trends of effectiveness and hence to inform sample size for a fully powered study, analyses of the secondary outcomes will be performed to assess the changes within and between groups over time (pre-post) using repeated measure ANOVA. The results of this study will improve understanding

  1. The nature and structure of psychological distress in people at high risk for melanoma: a factor analytic study.

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    Kasparian, Nadine A; Sansom-Daly, Ursula; McDonald, Roderick P; Meiser, Bettina; Butow, Phyllis N; Mann, Graham J

    2012-08-01

    This study examined the psychometric properties of two commonly used measures of psychological distress, the Hospital Anxiety and Depression Scale (HADS) and the Impact of Events Scale (IES) in a sample of individuals at high risk of developing melanoma due to strong family history. One hundred thirty-two individuals with a known family-specific CDKN2A mutation (74% response rate) completed a mailed, self-administered questionnaire including the HADS and the IES. Initial correlational analyses were followed by both exploratory and confirmatory factor analyses, according to a predetermined procedure for order of analyses. Exploratory factor analyses found that neither a two-, three- or four-factor solution satisfactorily accounted for all IES items in the present sample. By contrast, a unidimensional account of the data emerged to best account for all IES items, leaving no items unaccounted for. In contrast, the traditional two-factor (anxiety and depression) structure of the HADS appeared to fit the data well. The traditional, two-factor (intrusion and avoidance) structure of the IES was not borne out within this familial melanoma cohort. Assessment of a single dimension of emotional distress in response to melanoma risk may facilitate more meaningful explorations of psychological adjustment in this context. These findings also raise questions about whether a post-traumatic stress framework is indeed the most appropriate framework to capture the unique nature of melanoma- or cancer-related distress. Copyright © 2011 John Wiley & Sons, Ltd.

  2. A Mismatch between High-Risk Behaviors and Screening of Infectious Diseases among People Who Inject Drugs in Dar es Salaam, Tanzania.

    Directory of Open Access Journals (Sweden)

    Linda Beatrice Mlunde

    Full Text Available People who inject drugs are at risk of various infectious diseases. Despite such a risk, evidence is limited which studied the utilization of screening services for common infectious diseases among people who inject drugs in Tanzania. We aimed to examine their high-risk behaviors; utilization of screening services for HIV infection, hepatitis B/C, any other sexually transmitted infection, and tuberculosis; and their associated factors in Dar es Salaam, Tanzania.We conducted a baseline cross-sectional study as part of a prospective cohort study of people who inject drugs. We included 578 participants comprising of new enrollees of the integrated methadone-assisted treatment program and those who were selected from the communities but not enrolled in the program. We interviewed new enrollees preceding their enrollment and receipt of services from the program. We measured participants' high-risk behaviors and their utilization of screening services. We analyzed the data descriptively and used multiple logistic regressions to identify the factors associated with ever being screened for infectious diseases.Of 578 participants, 14.2% shared injection needles. Of 547 sexually active participants, 37.5% had multiple sexual partners and only 17.4% used a condom. Of all participants, however, only 36.0% had ever been screened for HIV infection, 18.5% for tuberculosis, 11.8% for any other sexually transmitted infection, and 11.6% for hepatitis B/C. They were more likely to have ever been screened for HIV infection if they had education levels above primary education (adjusted odds ratio [AOR]: 2.54, 95% CI: 1.54-4.20, had a history of transactional sex (OR: 2.63, 95% CI: 1.01-6.84, and were new enrollees of the program (AOR: 7.41, 95% CI: 4.41-12.86.People who inject drugs practice high-risk behaviors but their utilization of screening services for infectious diseases is poor in Dar es Salaam, Tanzania. It is crucial to increase the coverage of screening

  3. Examining the physical health and lifestyle of young people at ultra-high risk for psychosis: A qualitative study involving service users, parents and clinicians.

    Science.gov (United States)

    Carney, Rebekah; Cotter, Jack; Bradshaw, Tim; Yung, Alison R

    2017-09-01

    Emerging evidence suggests young people at ultra-high risk for psychosis (UHR) are also at-risk for poor physical health, and display high rates of modifiable cardiometabolic risk factors. However, before we can develop effective interventions there is a need to understand factors affecting lifestyle choices in the UHR group. We conducted semi-structured qualitative interviews with 20 UHR individuals (50% male; mean age 21.7), 5 parents (4 mothers, 1 father), and 6 clinicians from early intervention services in the Northwest of England to identify barriers and facilitators to living a healthy lifestyle, including achieving regular exercise, eating well and refraining from excessive substance use. Thematic analysis revealed the main barriers to living a healthy lifestyle related to psychiatric symptoms, beliefs about self, social withdrawal and practical considerations such as accessibility and cost. Provision of social support and promoting autonomy emerged as the two main themes which would facilitate a healthy lifestyle. Promoting physical health in people with emerging symptoms of psychosis is an important, yet neglected area of mental health practice and warrants further investigation. UHR individuals experience numerous barriers to living a healthy lifestyle, and interventions should focus primarily on targeting autonomous motivation and providing social support to facilitate this change. Copyright © 2017. Published by Elsevier B.V.

  4. [Socio-cultural aspects regarding the perception of quality of life amongst people engaging in extreme (high-risk) sports].

    Science.gov (United States)

    Pimentel, Giuliano Gomes de Assis

    2008-01-01

    Considering the search for adventure activities as a form of improving life quality, the present paper aimed at analyzing the perception of some dimensions of that category among hang-gliding apprentices. A questionnaire was applied to 30 brasilians hang-gliding and paragliding apprentices in order to identify aspects such as, physical activity, preventive behavior, nutrition, stress control and social relationships. Comparing results with the ones found in other adventure sports, it was observed that flyers adopt a competitive and risky behavior, not showing good results in relation to affectionate relationships and physical exercises. On the other hand, all of them are considered as wealthy and more used to dealing with stress. Even not possessing good physical conditioning, individuals practice flight just due to their technical knowledge and the dominium of technology Thus, apprentices use those sport tensions as a form of training the stress control in risky situations. Regarding mental health, activities of active leisure are highly recommended as an escape valve to stress. The group studied showed that besides increasing the tolerance to stress, generated by risky situations, individuals went beyond, once it was observed that the risks of such sport have turned the individuals into more and more insensitive to the professional life pressure.

  5. Low-level radiation risks in people

    International Nuclear Information System (INIS)

    Goloman, M.; Filjushkin, V. lgor

    1993-01-01

    Using the limited human data plus the relationships derived from the laboratory, a leukemia risk model has been developed as well as a suggested model for other cancers in people exposed to low levels of radiation. Theoretical experimental and epidemiological evidence will be presented in an integrated stochastic model for projection of radiation-induced cancer risks

  6. Waste the waist: a pilot randomised controlled trial of a primary care based intervention to support lifestyle change in people with high cardiovascular risk.

    Science.gov (United States)

    Greaves, Colin; Gillison, Fiona; Stathi, Afroditi; Bennett, Paul; Reddy, Prasuna; Dunbar, James; Perry, Rachel; Messom, Daniel; Chandler, Roger; Francis, Margaret; Davis, Mark; Green, Colin; Evans, Philip; Taylor, Gordon

    2015-01-16

    In the UK, thousands of people with high cardiovascular risk are being identified by a national risk-assessment programme (NHS Health Checks). Waste the Waist is an evidence-informed, theory-driven (modified Health Action Process Approach), group-based intervention designed to promote healthy eating and physical activity for people with high cardiovascular risk. This pilot randomised controlled trial aimed to assess the feasibility of delivering the Waste the Waist intervention in UK primary care and of conducting a full-scale randomised controlled trial. We also conducted exploratory analyses of changes in weight. Patients aged 40-74 with a Body Mass Index of 28 or more and high cardiovascular risk were identified from risk-assessment data or from practice database searches. Participants were randomised, using an online computerised randomisation algorithm, to receive usual care and standardised information on cardiovascular risk and lifestyle (Controls) or nine sessions of the Waste the Waist programme (Intervention). Group allocation was concealed until the point of randomisation. Thereafter, the statistician, but not participants or data collectors were blinded to group allocation. Weight, physical activity (accelerometry) and cardiovascular risk markers (blood tests) were measured at 0, 4 and 12 months. 108 participants (22% of those approached) were recruited (55 intervention, 53 controls) from 6 practices and 89% provided data at both 4 and 12 months. Participants had a mean age of 65 and 70% were male. Intervention participants attended 72% of group sessions. Based on last observations carried forward, the intervention group did not lose significantly more weight than controls at 12 months, although the difference was significant when co-interventions and co-morbidities that could affect weight were taken into account (Mean Diff 2.6Kg. 95%CI: -4.8 to -0.3, p = 0.025). No significant differences were found in physical activity. The Waste the Waist

  7. Measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis

    DEFF Research Database (Denmark)

    Kroman, S L; Roos, Ewa M.; Bennell, K L

    2014-01-01

    To systematically appraise the evidence on measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis (OA).......To systematically appraise the evidence on measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis (OA)....

  8. Racial and ethnic differences in physical activity guidelines attainment among people at high risk of or having knee osteoarthritis.

    Science.gov (United States)

    Song, Jing; Hochberg, Marc C; Chang, Rowland W; Hootman, Jennifer M; Manheim, Larry M; Lee, Jungwha; Semanik, Pamela A; Sharma, Leena; Dunlop, Dorothy D

    2013-02-01

    This cross-sectional study examined racial/ethnic differences in meeting the 2008 United States Department of Health and Human Services Physical Activity Guidelines aerobic component (≥150 moderate-to-vigorous minutes/week in bouts of ≥10 minutes) among persons with or at risk of radiographic knee osteoarthritis (RKOA). We evaluated African American versus white differences in guideline attainment using multiple logistic regression, adjusting for sociodemographic (age, sex, site, income, and education) and health factors (comorbidity, depressive symptoms, overweight/obesity, and knee pain). Our analyses included adults ages 49-84 years who participated in accelerometer monitoring at the Osteoarthritis Initiative 48-month visit (n = 1,142 with RKOA and n = 747 at risk of RKOA). Two percent of African Americans and 13.0% of whites met the guidelines. For adults with and at risk of RKOA, significantly lower rates of guidelines attainment among African Americans compared to whites were partially attenuated by health factor differences, particularly overweight/obesity and knee pain (with RKOA: adjusted odds ratio [OR] 0.24, 95% confidence interval [95% CI] 0.08-0.72; at risk of RKOA: OR 0.28, 95% CI 0.07-1.05). Despite known benefits from physical activity, attainment of the physical activity guidelines among persons with and at risk of RKOA was low. African Americans were 72-76% less likely than whites to meet the guidelines. Culturally relevant interventions and environmental strategies in the African American community targeting overweight/obesity and knee pain may reduce future racial/ethnic differences in physical activity and improve health outcomes. Copyright © 2013 by the American College of Rheumatology.

  9. "Where are all the lonely people?" A population-based study of high-risk groups across the life span

    DEFF Research Database (Denmark)

    Lasgaard, Mathias; Friis, Karina; Shevlin, Mark

    2016-01-01

    and socio-demographic and health-related factors across multiple age groups. Methods. This was a combined population-based questionnaire survey and register data study based on a representative sample, including 33,285 Danish individuals aged 16–102 years. Loneliness was measured using the Three......Item Loneliness Scale. Results. The relation between loneliness and age took a shallow U-shaped distribution. Ethnic minority status, receiving disability pensions or being unemployed, living alone, prolonged mental disorder, and psychiatric treatment were strongly associated with severe loneliness. Socio......-demographic and health-related factors were associated with an increased risk of severe loneliness in specific age groups. Being female, having a low educational level and living in a deprived area were only associated with loneliness in adolescence/emerging adulthood. Receiving disability pensions and living alone (i...

  10. Do radiographic disease and pain account for why people with or at high risk of knee osteoarthritis do not meet physical activity guidelines?

    Science.gov (United States)

    White, Daniel K; Tudor-Locke, Catrine; Felson, David T; Gross, K Douglas; Niu, Jingbo; Nevitt, Michael; Lewis, Cora E; Torner, James; Neogi, Tuhina

    2013-01-01

    Knee osteoarthritis (OA) and pain are assumed to be barriers to meeting physical activity guidelines, but this has not been formally evaluated. The purpose of this study was to determine the proportions of people with and those without knee OA and knee pain who meet recommended physical activity levels through walking. We performed a cross-sectional analysis of community-dwelling adults from the Multicenter Osteoarthritis Study who had or who were at high risk of knee OA. Participants wore a StepWatch activity monitor to record steps per day for 7 days. The proportion of participants who met the recommended physical activity levels was defined as those accumulating≥150 minutes per week at ≥100 steps per minute in bouts lasting ≥10 minutes. These proportions were also determined for those with and those without knee OA, as classified by radiography and by severity of knee pain. Of the 1,788 study participants (mean±SD age 67.2±7.7 years, mean±SD body mass index 30.7±6.0 kg/m2, 60% women), lower overall percentages of participants with radiographic knee OA and knee pain met recommended physical activity levels. However, these differences were not statistically significant between those with and those without knee OA; 7.3% and 10.1% of men (P=0.34) and 6.3% and 7.8% of women (P=0.51), respectively, met recommended physical activity levels. Similarly, for those with moderate/severe knee pain and those with no knee pain, 12.9% and 10.9% of men (P=0.74) and 6.7% and 11.0% of women (P=0.40), respectively, met recommended physical activity levels. Disease and pain have little impact on achieving recommended physical activity levels among people with or at high risk of knee OA. Copyright © 2013 by the American College of Rheumatology.

  11. Improving subjective perception of personal cancer risk: systematic review and meta-analysis of educational interventions for people with cancer or at high risk of cancer.

    Science.gov (United States)

    Dieng, Mbathio; Watts, Caroline G; Kasparian, Nadine A; Morton, Rachael L; Mann, Graham J; Cust, Anne E

    2014-06-01

    Newly diagnosed patients with cancer require education about the disease, the available treatments and potential consequences of treatment. Greater understanding of cancer risk has been found to be associated with greater health-related quality of life, improved psychological adjustment and greater health-related behaviours. The aim of this sytematic review was to assess the effectiveness of educational interventions in improving subjective cancer risk perception and to appraise the quality of the studies. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) and prospective observational studies. Eligible studies were identified via Medline, PsycINFO, AMED, CINAHL and Embase databases. After screening titles and abstracts, two reviewers independently assessed the eligibility of 206 full-text articles. Forty papers were included in the review; the majority of studies were conducted among breast cancer patients (n = 29) and evaluated the effect of genetic counselling on personal perceived risk (n = 25). Pooled results from RCTs (n = 12) showed that, both in the short and long term, educational interventions did not significantly influence risk perception level (standardised mean difference 0.05, 95% CI -0.24-0.34; p = 0.74) or accuracy (odds ratio = 1.96, 95% CI: 0.61-6.25; p = 0.26). Only one RCT reported a short-term difference in risk ratings (p = 0.01). Of prospective observational studies (n = 28), many did demonstrate changes in the level of perceived risk and improved risk accuracy and risk ratings in both the short and long term. However, only one (of three) observational studies reported a short-term difference in risk ratings (p < = 0.003). Further development and investigation of educational interventions using good quality, RCTs are warranted. Copyright © 2014 John Wiley & Sons, Ltd.

  12. What risks are Chinese people concerned about?

    Science.gov (United States)

    Xie, Xiaofei; Wang, Mei; Xu, Liancang

    2003-08-01

    The aim of this study is to investigate public perceived risk on various issues in present-day China. Two surveys were conducted in urban China in 1996 and 1998. In the first survey, risk perceptions of different occupational groups are compared. Gender differences within each occupational group are also analyzed. In the second survey, participants with diverse employment status were recruited. The overall risk rankings of both surveys indicate great concern with risks that threaten national stability and economic development, and less concern with high-technology risk such as threat from a nuclear power plant. It is also found that employees from high-profit firms are more concerned about macroscopic catastrophic risks, whereas laid-off workers and employees from money-losing enterprises are more concerned about daily life or self-concerned risks. The importance of actual exposure to risk, mass media coverage, culture, and psychometric dimensions are discussed.

  13. Energy and fructose from beverages sweetened with sugar or high-fructose corn syrup pose a health risk for some people.

    Science.gov (United States)

    Bray, George A

    2013-03-01

    Sugar intake in the United States has increased by >40 fold since the American Revolution. The health concerns that have been raised about the amounts of sugar that are in the current diet, primarily as beverages, are the subject of this review. Just less than 50% of the added sugars (sugar and high-fructose corn syrup) are found in soft drinks and fruit drinks. The intake of soft drinks has increased 5-fold between 1950 and 2000. Most meta-analyses have shown that the risk of obesity, diabetes, cardiovascular disease, and metabolic syndrome are related to consumption of beverages sweetened with sugar or high-fructose corn syrup. Calorically sweetened beverage intake has also been related to the risk of nonalcoholic fatty liver disease, and, in men, gout. Calorically sweetened beverages contribute to obesity through their caloric load, and the intake of beverages does not produce a corresponding reduction in the intake of other food, suggesting that beverage calories are "add-on" calories. The increase in plasma triglyceride concentrations by sugar-sweetened beverages can be attributed to fructose rather than glucose in sugar. Several randomized trials of sugar-containing soft drinks versus low-calorie or calorie-free beverages show that either sugar, 50% of which is fructose, or fructose alone increases triglycerides, body weight, visceral adipose tissue, muscle fat, and liver fat. Fructose is metabolized primarily in the liver. When it is taken up by the liver, ATP decreases rapidly as the phosphate is transferred to fructose in a form that makes it easy to convert to lipid precursors. Fructose intake enhances lipogenesis and the production of uric acid. By worsening blood lipids, contributing to obesity, diabetes, fatty liver, and gout, fructose in the amounts currently consumed is hazardous to the health of some people.

  14. The effectiveness and cost effectiveness of dark chocolate consumption as prevention therapy in people at high risk of cardiovascular disease: best case scenario analysis using a Markov model.

    Science.gov (United States)

    Zomer, Ella; Owen, Alice; Magliano, Dianna J; Liew, Danny; Reid, Christopher M

    2012-05-30

    To model the long term effectiveness and cost effectiveness of daily dark chocolate consumption in a population with metabolic syndrome at high risk of cardiovascular disease. Best case scenario analysis using a Markov model. Australian Diabetes, Obesity and Lifestyle study. 2013 people with hypertension who met the criteria for metabolic syndrome, with no history of cardiovascular disease and not receiving antihypertensive therapy. Treatment effects associated with dark chocolate consumption derived from published meta-analyses were used to determine the absolute number of cardiovascular events with and without treatment. Costs associated with cardiovascular events and treatments were applied to determine the potential amount of funding required for dark chocolate therapy to be considered cost effective. Daily consumption of dark chocolate (polyphenol content equivalent to 100 g of dark chocolate) can reduce cardiovascular events by 85 (95% confidence interval 60 to 105) per 10,000 population treated over 10 years. $A40 (£25; €31; $42) could be cost effectively spent per person per year on prevention strategies using dark chocolate. These results assume 100% compliance and represent a best case scenario. The blood pressure and cholesterol lowering effects of dark chocolate consumption are beneficial in the prevention of cardiovascular events in a population with metabolic syndrome. Daily dark chocolate consumption could be an effective cardiovascular preventive strategy in this population.

  15. Fasting plasma glucose and variation in cardiometabolic risk factors in people with high-risk HbA1c-defined prediabetes: A cross-sectional multiethnic study.

    Science.gov (United States)

    Srivanichakorn, Weerachai; Godsland, Ian F; Thomson, Hazel; Misra, Shivani; Phisalprapa, Pochamana; Charatcharoenwitthaya, Phunchai; Pramyothin, Pornpoj; Washirasaksiri, Chaiwat; Snehalatha, Chamukuttan; Ramachandran, Ambady; Alberti, K George M M; Johnston, Desmond G; Oliver, Nick S

    2017-12-01

    Variation in cardiometabolic risk in prediabetes and any impacts of ethnicity on such variation have been little studied. In an ethnically diverse dataset, selected according to a high-risk HbA1c-based definition of prediabetes, we have investigated relationships between glycaemia and cardiometabolic risk factors and the influence of ethnicity on these relationships. We undertook a cross-sectional analysis of baseline data from a diabetes prevention study in the UK and a chronic care clinic in Thailand, selected for people without diabetes (fasting plasma glucose fasting plasma glucose (FPG), blood pressure (BP), lipids and insulin resistance-related risk factors (IRFs). Independently of individual characteristics including ethnicity, only systolic BP was weakly associated with FPG (beta coefficient 1.76 (95%CI 0.10-3.42), p 0.03) and only LDL-c with IFG (FPG 5.6 to fasting glucose (FPG ≥ 6.1 to <7.0 mmol/L) were considered. Relative to White, South Asian ethnicity was independently associated with lower systolic and diastolic BP, Black with lower triglycerides, cholesterol/HDL-c ratio and having 2 or more IRFs, and Thai with lower cholesterol/HDL-c ratio and all three non-white ethnicities with lower total and LDL cholesterol. In high-risk HbA1c-defined prediabetes additional measurement of FPG will add little to evaluation of cardiometabolic risk. Additionally, UK Whites tend to have the most adverse cardiometabolic profile of any ethnic group. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Implementing and scaling up HCV treatment services for people who inject drugs and other high risk groups in Ukraine: An evaluation of programmatic and treatment outcomes.

    Science.gov (United States)

    Mazhnaya, Alyona; Meteliuk, Anna; Barnard, Tetiana; Zelenev, Alexei; Filippovych, Sergii; Altice, Frederick L

    2017-09-01

    HCV prevalence estimates among people who inject drugs (PWID) in Ukraine is high (60-90%), yet barriers to HCV treatment and care remain substantial including limited access to direct acting antiviral (DAA) medications. A feasibility scale-up project implemented HCV treatment in community-based settings to improve access to DAA treatment for key populations in this context. Using program-level data and verified medical records, we describe the development, implementation processes and outcomes for HCV treatment for PWID and other risks groups. Most participants (76%) received a combination of sofosbuvir, pegylated interferon, and ribavirin for 12 weeks. Treatment enrollment started in June 2015; the first two waves are reported. Data on demographics, HIV characteristics, HCV genotype and RNA levels, including sustained virologic response (SVR) were obtained from verified medical records. We used logistic regression to examine the independent correlates of achieving a SVR. The project was implemented in 19 healthcare institutions from 16 regions of Ukraine, mainly within AIDS specialty centers. Our analytical sample included 1126 participants who were mostly men (73%) and the majority were HIV co-infected (79%). Treatment retention was 97.7%; the proportions of participants who achieved SVR for the overall sample and for those with complete data (N=1029) were 86.2% (95% CI 84.08-88.19%) and 94.3% (95% CI 92.8-95.7%) respectively. The analysis of data restricted to only those with SVR data available showed that PWID who were currently injecting had comparable SVR rates (89.2%, 95% CI 81.5-94.5%) to PWID not injecting (94.4%, 95% CI 92.4-96.1), PWID on methadone (94.4%, 95%CI 92.4-96.1), and 'other' risk groups (95.2%, 95% CI 91.3-97.7). Independent factors associated with achieving a SVR were female sex (AOR: 3.44, 95% CI 1.45-8.14), HCV genotype 3 (AOR: 4.57, 95% CI 1.97-10.59) compared to genotype 1. SVR rates in PWID actively injecting did not differ significantly

  17. Risk factors of fall in elderly people

    Directory of Open Access Journals (Sweden)

    Dijana Avdić

    2004-11-01

    Full Text Available Falls are the leading accidental cause of death among elderly people in their homes. Falls and their consequences are the primary reason in 40% of admissions to hospitals for people older than 65 years. The study population consisted of 77 randomly selected patients of both genders older then 65 years. Each patient was tested in his/her home and was completely informed about the methodology and the goals of investigation. Based on the exclusion criteria, three patients were excluded from the study, which means the investigation was conducted on 27 males (35.06% and 50 females (64.94% with the average age being 71.23 ± 5.63 years.For each patient, a specially prepared questionnaire about risk factors was filled in. The sum of affirmative answers represented a relative index of fall risk. All patients were evaluated through Folstein’s Mini-Mental State Examination Test that is suitable for on-sight use in patient’s home. The score value over 20 excludes dementias, delirium, schizophrenia and affective disorders.Considering the values of the risk factor, scores obtained by the questionnaire and MMSE test scores, statistically significant differences were found between males and females (p < 0.005, respectively p < 0.01, “fallers” and “non-fallers” (p < 0.001, respectively p < 0.01, while considering the relation to the way of living (alone or with family, there were no statistically significant differences (p > 0.05.

  18. Brain structure in people at ultra-high risk of psychosis, patients with first-episode schizophrenia, and healthy controls: a VBM study.

    Science.gov (United States)

    Nenadic, Igor; Dietzek, Maren; Schönfeld, Nils; Lorenz, Carsten; Gussew, Alexander; Reichenbach, Jürgen R; Sauer, Heinrich; Gaser, Christian; Smesny, Stefan

    2015-02-01

    Early intervention research in schizophrenia has suggested that brain structural alterations might be present in subjects at high risk of developing psychosis. The heterogeneity of regional effects of these changes, which is established in schizophrenia, however, has not been explored in prodromal or high-risk populations. We used high-resolution MRI and voxel-based morphometry (VBM8) to analyze grey matter differences in 43 ultra high-risk subjects for psychosis (meeting ARMS criteria, identified through CAARMS interviews), 24 antipsychotic-naïve first-episode schizophrenia patients and 49 healthy controls (groups matched for age and gender). Compared to healthy controls, resp., first-episode schizophrenia patients had reduced regional grey matter in left prefrontal, insula, right parietal and left temporal cortices, while the high-risk group showed reductions in right middle temporal and left anterior frontal cortices. When dividing the ultra-high-risk group in those with a genetic risk vs. those with attenuated psychotic symptoms, the former showed left anterior frontal, right caudate, as well as a smaller right hippocampus, and amygdala reduction, while the latter subgroup showed right middle temporal cortical reductions (each compared to healthy controls). Our findings in a clinical psychosis high-risk cohort demonstrate variability of brain structural changes according to subgroup and background of elevated risk, suggesting frontal and possibly also hippocampal/amygdala changes in individuals with genetic susceptibility. Heterogeneity of structural brain changes (as seen in schizophrenia) appears evident even at high-risk stage, prior to potential onset of psychosis. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Neurocognitive performance of a community-based sample of young people at putative ultra high risk for psychosis: support for the processing speed hypothesis.

    LENUS (Irish Health Repository)

    Kelleher, Ian

    2013-01-01

    A wide variety of neurocognitive deficits have been reported for help-seeking individuals who are at clinical or ultra high risk for psychosis based on fulfilling set criteria for prodromal syndromes\\/at risk mental states. We wished to extend this research by conducting the first population-based assessment of prodromal syndromes and associated neurocognition.

  20. Are people at high risk for diabetes visiting health facility for confirmation of diagnosis? A population-based study from rural India.

    Science.gov (United States)

    Srinivasapura Venkateshmurthy, Nikhil; Soundappan, Kathirvel; Gummidi, Balaji; Bhaskara Rao, Malipeddi; Tandon, Nikhil; Reddy, K Srinath; Prabhakaran, Dorairaj; Mohan, Sailesh

    2018-01-01

    India is witnessing a rising burden of type 2 diabetes mellitus. India's National Programme for Prevention and Control of Diabetes, Cancer, Cardiovascular diseases and Stroke recommends population-based screening and referral to primary health centre for diagnosis confirmation and treatment initiation. However, little is known about uptake of confirmatory tests among screen positives. To estimate the uptake of confirmatory tests and identify the reasons for not undergoing confirmation by those at high risk for developing diabetes. We analysed data collected under project UDAY, a comprehensive diabetes and hypertension prevention and management programme, being implemented in rural Andhra Pradesh, India. Under UDAY, population-based screening for diabetes was carried out by project health workers using a diabetes risk score and capillary blood glucose test. Participants at high risk for diabetes were asked to undergo confirmatory tests. On follow-up visit, health workers assessed if the participant had undergone confirmation and ask for reasons if not so. Of the 35,475 eligible adults screened between April 2015 and August 2016, 10,960 (31%) were determined to be at high risk. Among those at high risk, 9670 (88%) were followed up, and of those, only 616 (6%) underwent confirmation. Of those who underwent confirmation, 'lack of symptoms of diabetes warranting visit to health facility' (52%) and 'being at high risk was not necessary enough to visit' (41%) were the most commonly reported reasons for non-confirmation. Inconvenient facility time (4.4%), no nearby facility (3.2%), un-affordability (2.2%) and long waiting time (1.6%) were the common health system-related factors that affected the uptake of the confirmatory test. Confirmation of diabetes was abysmally low in the study population. Low uptake of the confirmatory test might be due to low 'risk perception'. The uptake can be increased by improving the population risk perception through individual and

  1. Health Insurance without Single Crossing : Why Healthy People have High Coverage

    NARCIS (Netherlands)

    Boone, J.; Schottmuller, C.

    2011-01-01

    Standard insurance models predict that people with high (health) risks have high insurance coverage. It is empirically documented that people with high income have lower health risks and are better insured. We show that income differences between risk types lead to a violation of single crossing in

  2. Validity of the People Risk Framework: Evidence from the FSA

    OpenAIRE

    Chrysostomou, Xenia

    2013-01-01

    The recent Global Financial Crisis was the ultimate manifestation for the recognition and appreciation of people risk, one of the dimensions constituting operational risk, highlighting the necessity of people risk management within the financial industry. In recognition of the magnitude of its impact, ‘people risk’ became a ’hot’ topic amongst the financial regulators, which resulted in the stipulation of assigning capital reserves, exclusively dedicated to its coverage. However, the nature o...

  3. Use of Fibrates Monotherapy in People with Diabetes and High Cardiovascular Risk in Primary Care: A French Nationwide Cohort Study Based on National Administrative Databases.

    Directory of Open Access Journals (Sweden)

    Ronan Roussel

    Full Text Available According to guidelines, diabetic patients with high cardiovascular risk should receive a statin. Despite this consensus, fibrate monotherapy is commonly used in this population. We assessed the frequency and clinical consequences of the use of fibrates for primary prevention in patients with diabetes and high cardiovascular risk.Retrospective cohort study based on nationwide data from the medical and administrative databases of French national health insurance systems (07/01/08-12/31/09 with a follow-up of up to 30 months.Lipid-lowering drug-naive diabetic patients initiating fibrate or statin monotherapy were identified. Patients at high cardiovascular risk were then selected: patients with a diagnosis of diabetes and hypertension, and > 50 (men or 60 (women, but with no history of cardiovascular events. The composite endpoint comprised myocardial infarction, stroke, amputation, or death.Of the 31,652 patients enrolled, 4,058 (12.8% received a fibrate. Age- and gender-adjusted annual event rates were 2.42% (fibrates and 2.21% (statins. The proportionality assumption required for the Cox model was not met for the fibrate/statin variable. A multivariate model including all predictors was therefore calculated by dividing data into two time periods, allowing Hazard Ratios to be calculated before (HR 540 of follow-up. Multivariate analyses showed that fibrates were associated with an increased risk for the endpoint after 540 days: HR 540 = 1.73 (1.28-2.32.Fibrate monotherapy is commonly prescribed in diabetic patients with high cardiovascular risk and is associated with poorer outcomes compared to statin therapy.

  4. High-Risk List

    Science.gov (United States)

    2017-01-01

    economy. The World Bank has said that “corruption creates an unfavorable business environment by undermining the operation efficiency of firms and... Bank Began as ‘Ponzi Scheme,’” 11/27/2012. 64 Independent Joint Anti-Corruption Monitoring and Evaluation Committee, Unfinished Business : The Follow...HIGH RISK AREA 7: Oversight 51 HIGH-RISK AREA 8: Strategy and Planning 55 CONCLUSION HIGH RISK LIST I JANUARY 11, 2017 2 EXECUTIVE SUMMARY

  5. 'Change means sacrificing a good life': perceptions about severity of type 2 diabetes and preventive lifestyles among people afflicted or at high risk of type 2 diabetes in Iganga Uganda.

    Science.gov (United States)

    Mayega, Roy W; Etajak, Samuel; Rutebemberwa, Elizeus; Tomson, Goran; Kiguli, Juliet

    2014-08-21

    Interventions for prevention of type 2 diabetes ought to be acceptable to target communities. We assessed perceptions about type 2 diabetes and lifestyle change among people afflicted or at high risk of this disease in a low income setting in Iganga Uganda. Twelve focus group discussions (FGDs) of eight participants each were conducted, balancing rural and peri-urban (near the Municipality) residence and gender. The FGDs involved people with suspected type 2 diabetes (based on fasting plasma glucose (FPG), people with suspected pre-diabetes and obese people with normal FPG. Content analysis was conducted. Diabetes was perceived to be a very severe disease. Its severity was attributed to its incurability and its numerous health effects. Men were also concerned about reduced sexual performance. However, participants' strong concerns about the severity of diabetes were not reflected in their perceptions about the risk factors and lifestyles associated with it. While people with diabetes perceive obesity as 'sickness', those without diabetes perceive it as a sign of 'success'. Although participants are willing to change their diet, they mention numerous barriers including poverty, family size, and access to some foods. Because of their good taste, reduction of high risk foods like sugar and fried food is perceived as 'sacrificing a good life'. Increments in physical activity were said to be feasible, but only in familiar forms like domestic work. An over-arching theme emerged that 'lifestyle changes are viewed as sacrificing a good life'. Health promotion should target both community norms and individual awareness regarding obesity, physical activity and diet, and should address the notion that obesity and unhealthy foods represent a good life. Health educators should plan with clients on how to overcome barriers and misconceptions to lifestyle change, leveraging the pervasive perception of type 2 diabetes as a severe disease to motivate change.

  6. Risk factors for hip fracture among institutionalised older people.

    Science.gov (United States)

    Chen, Jian Sheng; Sambrook, Philip N; Simpson, Judy M; Cameron, Ian D; Cumming, Robert G; Seibel, Markus J; Lord, Stephen R; March, Lyn M

    2009-07-01

    risk factors for hip fracture in community-dwelling individuals have been extensively studied, but there have been fewer studies of institutionalised older people. a total of 1,894 older people (1,433 females, 461 males; mean age 86 years, SD 7.1 years) were recruited from 52 nursing homes and 30 intermediate-care nursing care facilities in Australia during March 1999 and February 2003. We assessed clinical risk factors for hip fracture and skeletal fragility by calcaneus broadband ultrasound attenuation (BUA) at baseline and then followed up for fracture for 4 years. Hip fractures were validated by x-ray reports. Survival analysis with age as a time-dependent covariate was used to analyse the data. during a mean follow-up period of 2.65 years (SD 1.38), 201 hip fractures in 191 residents were recorded, giving an overall hip fracture incidence rate of 4.0% per person year (males 3.6% and females 4.1%). Residents living in intermediate-care hostels had a higher crude hip fracture rate (4.6% vs. 3.0%) than those living in high-care nursing homes. In multivariate analysis, an increased risk of hip fracture was significantly associated with older age, cognitive impairment, a history of fracture since age 50, lower body weight, longer lower leg length and poorer balance in intermediate-care hostel residents, but not with lower BUA. institutionalised older people, who are at a higher risk of hip fracture than community-dwelling individuals, have differences in some risk factors for hip fracture that should be considered in targeting intervention programs.

  7. Flood Impacts on People: from Hazard to Risk Maps

    Science.gov (United States)

    Arrighi, C.; Castelli, F.

    2017-12-01

    The mitigation of adverse consequences of floods on people is crucial for civil protection and public authorities. According to several studies, in the developed countries the majority of flood-related fatalities occurs due to inappropriate high risk behaviours such as driving and walking in floodwaters. In this work both the loss of stability of vehicles and pedestrians in floodwaters are analysed. Flood hazard is evaluated, based on (i) a 2D inundation model of an urban area, (ii) 3D hydrodynamic simulations of water flows around vehicles and human body and (iii) a dimensional analysis of experimental activity. Exposure and vulnerability of vehicles and population are assessed exploiting several sources of open GIS data in order to produce risk maps for a testing case study. The results show that a significant hazard to vehicles and pedestrians exists in the study area. Particularly high is the hazard to vehicles, which are likely to be swept away by flood flow, possibly aggravate damages to structures and infrastructures and locally alter the flood propagation. Exposure and vulnerability analysis identifies some structures such as schools and public facilities, which may attract several people. Moreover, some shopping facilities in the area, which attract both vehicular and pedestrians' circulation are located in the highest flood hazard zone.The application of the method demonstrates that, at municipal level, such risk maps can support civil defence strategies and education to active citizenship, thus contributing to flood impact reduction to population.

  8. Energy and Fructose From Beverages Sweetened With Sugar or High-Fructose Corn Syrup Pose a Health Risk for Some People 1 2

    OpenAIRE

    Bray, George A.

    2013-01-01

    Sugar intake in the United States has increased by >40 fold since the American Revolution. The health concerns that have been raised about the amounts of sugar that are in the current diet, primarily as beverages, are the subject of this review. Just less than 50% of the added sugars (sugar and high-fructose corn syrup) are found in soft drinks and fruit drinks. The intake of soft drinks has increased 5-fold between 1950 and 2000. Most meta-analyses have shown that the risk of obesity, diabet...

  9. Nutritional strategies to reduce falls risk in older people.

    Science.gov (United States)

    Nash, Louise; Bergin, Nick

    2018-03-23

    A literature review found an association between increased falls risk and malnutrition, sarcopenia, vitamin D deficiency and dehydration. Strategies to identify, prevent and treat these conditions can help to reduce falls risk in at-risk groups such as frail, older people. Nurses can reduce falls risk in older people by raising awareness of risk factors and embedding nutritional strategies in local falls reduction strategies. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  10. Reducing risks, protecting people. A harmonized approach

    International Nuclear Information System (INIS)

    Foster, R.B.

    2000-01-01

    Risk training, education and communication usually refer to the responsibilities of those who generate risk (e.g. operators of nuclear power plants) towards those who are exposed to the risk (e.g. employees working in the plants and those living in the vicinity). In this context training, education and communication are intended to transfer information from risk professionals to a largely uninformed audience, with a view to improving standards or providing reassurance. However, with the growth of media such as the Internet those to whom such training, education and communication have traditionally been directed are now much better informed. In addition, increasing prosperity affects expectations and prompts questions, not only about the adequacy of the control measures intended to address specific hazards, but also about whether the hazardous activity is justified at all. Within the UK (and Europe) this is very evident for nuclear power, other applications of ionizing radiation, and in other areas such as genetically modified food. In consequence regulators of hazardous activities face considerable new challenges. Of course, regulators still have to formulate standards, communicate them to those responsible for risk reduction and see that the necessary controls are in place. But in addition regulators also have to be able to answer questions such as: - why is this hazardous activity (e.g. a nuclear power plant) allowed at all? - what level of risk is unacceptable? - is the approach to risk reduction sufficiently precautionary? - why shouldn't the risk be reduced further? - why are the risks from certain activities (e.g. those from ionizing radiation) controlled to much lower levels than those from other work activities? - how are decisions made, what criteria are applied and how are the stake holders involves? All this does not make life easy for regulators! The full paper will describe how the Health and Safety Executive (HSE) has responded to these challenges by

  11. DIAGNOSIS OF RISK FACTORS FOR BEER DEPENDENCE IN YOUNG PEOPLE

    Directory of Open Access Journals (Sweden)

    G. A. Novikova

    2017-10-01

    Full Text Available In the article the approach to identification of factors influencing beer consumption by young people. Describes the author’s methodology, identifying biological, social, psychological, pedagogical and economic risk factors of development of beer dependence in young people. The data obtained using the proposed methodology can be used to identify risk groups according to the dependent behavior and planning of preventive measures.

  12. [Detecting high risk pregnancy].

    Science.gov (United States)

    Doret, Muriel; Gaucherand, Pascal

    2009-12-20

    Antenatal care is aiming to reduce maternal land foetal mortality and morbidity. Maternal and foetal mortality can be due to different causes. Their knowledge allows identifying pregnancy (high risk pregnancy) with factors associated with an increased risk for maternal and/or foetal mortality and serious morbidity. Identification of high risk pregnancies and initiation of appropriate treatment and/or surveillance should improve maternal and/or foetal outcome. New risk factors are continuously described thanks to improvement in antenatal care and development in biology and cytopathology, increasing complexity in identifying high risk pregnancies. Level of risk can change all over the pregnancy. Ideally, it should be evaluated prior to the pregnancy and at each antenatal visit. Clinical examination is able to screen for intra-uterin growth restriction, pre-eclampsia, threatened for preterm labour; ultrasounds help in the diagnosis of foetal morphological anomalies, foetal chromosomal anomalies, placenta praevia and abnormal foetal growth; biological exams are used to screen for pre-eclampsia, gestational diabetes, trisomy 21 (for which screening method just changed), rhesus immunisation, seroconversion for toxoplasmosis or rubeola, unknown infectious disease (syphilis, hepatitis B, VIH). During pregnancy, most of the preventive strategies have to be initiated during the first trimester or even before conception. Prevention for neural-tube defects, neonatal hypocalcemia and listeriosis should be performed for all women. On the opposite, some measures are concerning only women with risk factors such as prevention for toxoplasmosis, rhesus immunization (which recently changed), tobacco complications and pre-eclampsia and intra-uterine growth factor restriction.

  13. Sexual Risk Assessment for People with Intellectual Disabilities

    Science.gov (United States)

    Embregts, P.; van den Bogaard, K.; Hendriks, L.; Heestermans, M.; Schuitemaker, M.; van Wouwe, H.

    2010-01-01

    Given that sexually offensive behavior on the part of people with intellectual disabilities has been identified as a significant problem, we developed a risk assessment questionnaire, that takes not only various static and dynamic factors into account but also environmental risk variables. Psychologists and staff members completed this Risk…

  14. Do we actually understand how people perceive risk?

    Energy Technology Data Exchange (ETDEWEB)

    Bochud, Francois O.

    2016-11-01

    The best way to understand how people perceive radiation risk is to not consider them as fundamentally different from experts, but rather, to consider how we, as experts, naturally react when we are confronted with a risk and how we like to be treated. Do we have to alter our language to make it understandable by members of the public?.

  15. Perceptions of health risk and smoking decisions of young people.

    Science.gov (United States)

    Gerking, Shelby; Khaddaria, Raman

    2012-07-01

    Using the Annenberg Perception of Tobacco Risk Survey 2, this paper finds that perceived risk deters smoking among persons aged 14-22 years who think that it is relatively difficult to quit smoking and that onset of deleterious health effects occurs relatively quickly. Perceived health risk, however, does not affect the smoking status of young people who hold the opposite beliefs. These results are consistent with predictions of rational addiction models and suggest that young people, who view smoking as more addictive and health effects as more immediate, may have greater incentive to consider long-term health effects in their decision to smoke. Copyright © 2011 John Wiley & Sons, Ltd.

  16. Implementation of a consumer-focused eHealth intervention for people with moderate-to-high cardiovascular disease risk: protocol for a mixed-methods process evaluation.

    Science.gov (United States)

    Coorey, Genevieve M; Neubeck, Lis; Usherwood, Timothy; Peiris, David; Parker, Sharon; Lau, Annie Y S; Chow, Clara; Panaretto, Kathryn; Harris, Mark; Zwar, Nicholas; Redfern, Julie

    2017-01-11

    Technology-mediated strategies have potential to engage patients in modifying unhealthy behaviour and improving medication adherence to reduce morbidity and mortality from cardiovascular disease (CVD). Furthermore, electronic tools offer a medium by which consumers can more actively navigate personal healthcare information. Understanding how, why and among whom such strategies have an effect can help determine the requirements for implementing them at a scale. This paper aims to detail a process evaluation that will (1) assess implementation fidelity of a multicomponent eHealth intervention; (2) determine its effective features; (3) explore contextual factors influencing and maintaining user engagement; and (4) describe barriers, facilitators, preferences and acceptability of such interventions. Mixed-methods sequential design to derive, examine, triangulate and report data from multiple sources. Quantitative data from 3 sources will help to inform both sampling and content framework for the qualitative data collection: (1) surveys of patients and general practitioners (GPs); (2) software analytics; (3) programme delivery records. Qualitative data from interviews with patients and GPs, focus groups with patients and field notes taken by intervention delivery staff will be thematically analysed. Concurrent interview data collection and analysis will enable a thematic framework to evolve inductively and inform theory building, consistent with a realistic evaluation perspective. Eligible patients are those at moderate-to-high CVD risk who were randomised to the intervention arm of a randomised controlled trial of an eHealth intervention and are contactable at completion of the follow-up period; eligible GPs are the primary healthcare providers of these patients. Ethics approval has been received from the University of Sydney Human Research Ethics Committee and the Aboriginal Health and Medical Research Council (AH&MRC) of New South Wales. Results will be disseminated

  17. Cognitive representations of peripheral neuropathy and self-reported foot-care behaviour of people at high risk of diabetes-related foot complications

    DEFF Research Database (Denmark)

    Perrin, B. M.; Swerissen, H.; Payne, C. B.

    2014-01-01

    Aim: The aim of this study was to explore the cognitive representations of peripheral neuropathy and self-reported foot-care behaviour in an Australian sample of people with diabetes and peripheral neuropathy. Methods: This cross-sectional study was undertaken with 121 participants with diabetes...... and peripheral neuropathy. Cognitive representations of peripheral neuropathy were measured by the Patients' Interpretation of Neuropathy questionnaire and two aspects of self-foot-care behaviour were measured using a self-report questionnaire. Hierarchical cluster analysis using the average linkage method...... was used to identify distinct illness schemata related to peripheral neuropathy. Results: Three clusters of participants were identified who exhibited distinct illness schemata related to peripheral neuropathy. One cluster had more misperceptions about the nature of peripheral neuropathy, one cluster...

  18. SSRIs and risk of suicide attempts in young people

    DEFF Research Database (Denmark)

    Christiansen, Erik; Agerbo, Esben; Bilenberg, Niels

    2016-01-01

    BACKGROUND: SSRIs are widely used in the treatment of mental illness for both children and adults. Studies have found a slightly increased risk of suicidal thoughts and suicide attempts in young people using SSRIs but SSRIs' impact on risk for suicides in youth is not well-established. AIM......: Is there indication that SSRIs might raise risk for suicide attempts in young people? METHODS: We used an observational register-based historical cohort design, a large cohort of all Danish individuals born in 1983-1989 (n = 392,458) and a propensity score approach to analyse the impact from SSRIs on risk for suicide...... attempts. Every suicide attempt and redeemed prescription of SSRIs was analysed by Cox regression. RESULTS: We found a significant overlap between redeeming a prescription on SSRIs and subsequent suicide attempt. The risk for suicide attempt was highest in the first 3 months after redeeming the first...

  19. Young People's Perceptions of Advice about Sexual Risk Taking

    Science.gov (United States)

    Donoghue, Christopher; Bonillas, Consuelo; Moreno, Jeniffer; Cardoza, Omara; Cheung, Melissa

    2017-01-01

    Sexual and reproductive health indicators for young people in the USA have improved in recent decades, but teenage pregnancies remain high, and large differences between Whites and non-Whites persist in teenage births, abortions, and the acquisition of sexually transmitted infections. Prior research shows that young people are receptive to…

  20. Development of an integrated e-health tool for people with, or at high risk of, cardiovascular disease: The Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) web application.

    Science.gov (United States)

    Neubeck, Lis; Coorey, Genevieve; Peiris, David; Mulley, John; Heeley, Emma; Hersch, Fred; Redfern, Julie

    2016-12-01

    Cardiovascular disease is the leading killer globally and secondary prevention substantially reduces risk. Uptake of, and adherence to, face-to-face preventive programs is often low. Alternative models of care are exploiting the prominence of technology in daily life to facilitate lifestyle behavior change. To inform the development of a web-based application integrated with the primary care electronic health record, we undertook a collaborative user-centered design process to develop a consumer-focused e-health tool for cardiovascular disease risk reduction. A four-phase iterative process involved ten multidisciplinary clinicians and academics (primary care physician, nurses and allied health professionals), two design consultants, one graphic designer, three software developers and fourteen proposed end-users. This 18-month process involved, (1) defining the target audience and needs, (2) pilot testing and refinement, (3) software development including validation and testing the algorithm, (4) user acceptance testing and beta testing. From this process, researchers were able to better understand end-user needs and preferences, thereby improving and enriching the increasingly detailed system designs and prototypes for a mobile responsive web application. We reviewed 14 relevant applications/websites and sixteen observational and interventional studies to derive a set of core components and ideal features for the system. These included the need for interactivity, visual appeal, credible health information, virtual rewards, and emotional and physical support. The features identified as essential were: (i) both mobile and web-enabled 'apps', (ii) an emphasis on medication management, (iii) a strong psychosocial support component. Subsequent workshops (n=6; 2×1.5h) informed the development of functionality and lo-fidelity sketches of application interfaces. These ideas were next tested in consumer focus groups (n=9; 3×1.5h). Specifications for the application were

  1. Measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis: a systematic review.

    Science.gov (United States)

    Kroman, S L; Roos, E M; Bennell, K L; Hinman, R S; Dobson, F

    2014-01-01

    To systematically appraise the evidence on measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis (OA). Electronic searches were performed in MEDLINE, CINAHL, Scopus and SPORTDiscus in May 2013. Two reviewers independently rated the measurement properties using the 4-point COSMIN checklist. Best evidence synthesis was made using COSMIN quality, consistency and direction of findings and sample size. Twenty of 2736 papers were eligible for inclusion and 24 different performance-based outcome measures knee or obese populations were evaluated. No tests related to hip populations were included. Twenty-five measurement properties including reliability (nine studies), construct validity (hypothesis testing) (nine studies), measurement error (three studies), structural validity (two studies), interpretability (one study) and responsiveness (one study) were evaluated. A positive rating was given to 12.5% (30/240) of all possible measurement ratings. Tests were grouped into two categories based on the population characteristics. The one-legged hop for distance, followed by the 6-m timed hop and cross over hop for distance were the best-rated tests for the knee-injured population. Whereas the 6-min walk test was the only included test for the obese population. This review highlights the many gaps in knowledge about the measurement properties of performance-based outcome measures for young and middle-aged people known to be at high risk of hip and/or knee OA. There is a need for consensus on which outcome measures should be used and/or combined when assessing physical function in this population. Further good quality research is required. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  2. Decision making in young people at familial risk of depression.

    Science.gov (United States)

    Mannie, Z N; Williams, C; Browning, M; Cowen, P J

    2015-01-01

    Major depression is associated with abnormalities in reward processing at neural and behavioural levels. Neural abnormalities in reward have been described in young people at familial risk of depression but behavioural changes in reward-based decision making have been less studied in this group. We studied 63 young people (mean age 18.9 years) with a parent with a diagnosis of major depression but who had never been depressed themselves, that is with a positive family history of depression (the FH+ group). Participants performed the Cambridge Gambling Task (CGT), which provides several measures of decision making including deliberation time, quality of decision making, risk taking, risk adjustment and delay aversion. A control group of 49 age- and gender-matched young people with no history of mood disorder in a first-degree relative undertook the same task. Both FH+ participants and controls had low and equivalent scores on anxiety and depression self-rating scales. Compared to controls, the FH+ participants showed overall lower risk taking, although like controls they made more risky choices as the odds of a favourable outcome increased. No other measures of decision making differed between the two groups. Young people at increased familial risk of depression have altered risk taking that is not accounted for by current affective symptomatology. Lowered risk taking might represent an impairment in reward seeking, which is one of several changes in reward-based behaviours seen in acutely depressed patients; however, our findings suggest that decreased reward seeking could be part of a risk endophenotype for depression.

  3. Physical Health Risk Behaviours in Young People with Mental Illness.

    Science.gov (United States)

    McCloughen, Andrea; Foster, Kim; Marabong, Nikka; Miu, David; Fethney, Judith

    2015-01-01

    Comorbid physical health conditions, commonly associated with mental illness, contribute to increased morbidity and reduced life expectancy. The trajectory to poorer health begins with the onset of mental illness. For young people with mental illness, health risk behaviours and poor physical health can progress to adulthood with long-term detrimental impacts. Using a cross-sectional survey design, self-reported health risk behaviours were gathered from 56 young (16-25 years) Australians who had been hospitalised for mental illness and taking psychotropic medication. Smoking, alcohol use, minimal physical activity, and lack of primary health care were evident. While these behaviours are typical of many young people, those with mental illness have substantially increased vulnerability to poor health and reduced life expectancy. Priority needs to be given to targeted health promotion strategies for young people with mental illness to modify their risky long-term health behaviours and improve morbidity and mortality outcomes. Nurses in mental health settings play a vital role in promoting young peoples' well-being and preventing poorer physical health outcomes. Implementation of a cardiometabolic health nurse role in inpatient settings for young people with mental illness could facilitate prevention and early intervention for health risk behaviours.

  4. Differences in omega-3 and omega-6 polyunsaturated fatty acid consumption in people at ultra-high risk of psychosis, first-episode schizophrenia, and in healthy controls.

    Science.gov (United States)

    Pawełczyk, Tomasz; Trafalska, Elżbieta; Pawełczyk, Agnieszka; Kotlicka-Antczak, Magdalena

    2017-12-01

    Supplementation with omega-3 PUFA showed efficacy in reducing the risk of transition into psychosis in UHR individuals. It is uncertain whether dietary patterns can be partly responsible for n-3 deficiencies observed in susceptible participants before the diagnosis of schizophrenia. The study was designed to assess differences in omega-3 and omega-6 PUFA consumption in healthy controls (HC), UHR participants and FES patients as well as to verify the hypothesis that dietary changes in PUFA consumption are present before active psychosis develops, that is, in UHR individuals. Dietary habits during the previous year were assessed in 34 patients at UHR of psychosis, 33 patients diagnosed with FES and 33 HC participants using a validated Food-Frequency Questionnaire and the Polish Food Composition Tables. Significant differences in omega-3 and omega-6 PUFA intake were observed between study groups. UHR and FES groups reported significantly higher consumption of omega-6 PUFA in comparison with HC. FES patients also reported a higher consumption of alpha-linolenic acid (omega-3) in comparison with HC. No significant differences were seen in consumption of long-chain marine PUFA. Differences in omega-6 and omega-3 PUFA consumption exist before development of psychotic symptoms, fulfilling the criteria of schizophrenia. © 2015 Wiley Publishing Asia Pty Ltd.

  5. First Nations people's challenge in managing coronary artery disease risk.

    Science.gov (United States)

    King, Kathryn M; Sanguins, Julianne; McGregor, Lisa; LeBlanc, Pamela

    2007-10-01

    First Nations peoples bring a particular history and cultural perspective to healing and well-being that significantly influences their health behaviors. The authors used grounded theory methods to describe and explain how ethnocultural affiliation and gender influence the process that 22 First Nations people underwent when making lifestyle changes related to their coronary artery disease (CAD) risk. The transcribed interviews revealed a core variable, meeting the challenge. Meeting the challenge of CAD risk management was influenced by intrapersonal, interpersonal (relationships with others), extrapersonal (i.e., the community and government), sociodemographic, and gendered factors. Salient elements for the participants included their beliefs about origins of illness, the role of family, challenges to accessing information, financial and resource management, and the gendered element of body image. Health care providers need to understand the historical, social, and culturally embedded factors that influence First Nations people's appraisal of their CAD.

  6. Young people's perspectives on health-related risks

    Directory of Open Access Journals (Sweden)

    Grace Elisabeth Spencer

    2008-07-01

    Full Text Available Drawing upon current socio-cultural understandings of risk, this study highlights the disjunction between the expert risk discourses that permeate official public health policy and practice, and young people’s own perspectives on health and risk. Data were collected from young people aged 14-16 years through the use of group and individual interviews in a school and community youth centre setting. Findings from this study question the saliency of expert-defined health-related risks to young people’s everyday lives. Young people in this study saw health as closely linked to ‘being happy’. Friendships and a sense of personal achievement were particularly important to participants’ health and well-being. When accounting for their participation in health-related practices identified as ‘risky’ in government policy – such as smoking, alcohol and substance use – young people emphasised the levels of pressure they experienced. Sources of pressure included arguments and bullying, school work, and negative stereotypes of young people in general. These areas indicated young people’s concerns that reach beyond the official prescriptions permeating current health policy.

  7. People's Risk Recognition Preceding Evacuation and Its Role in Demand Modeling and Planning.

    Science.gov (United States)

    Urata, Junji; Pel, Adam J

    2018-05-01

    Evacuation planning and management involves estimating the travel demand in the event that such action is required. This is usually done as a function of people's decision to evacuate, which we show is strongly linked to their risk awareness. We use an empirical data set, which shows tsunami evacuation behavior, to demonstrate that risk recognition is not synonymous with objective risk, but is instead determined by a combination of factors including risk education, information, and sociodemographics, and that it changes dynamically over time. Based on these findings, we formulate an ordered logit model to describe risk recognition combined with a latent class model to describe evacuation choices. Our proposed evacuation choice model along with a risk recognition class can evaluate quantitatively the influence of disaster mitigation measures, risk education, and risk information. The results obtained from the risk recognition model show that risk information has a greater impact in the sense that people recognize their high risk. The results of the evacuation choice model show that people who are unaware of their risk take a longer time to evacuate. © 2017 Society for Risk Analysis.

  8. Lifestyle and risk factor management in people at high risk of cardiovascular disease. A report from the European Society of Cardiology European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV cross-sectional survey in 14 European regions

    OpenAIRE

    Kotseva, Kornelia; De Bacquer, Dirk; De Backer, Guy; Ryden, Lars; Jennings, Catriona; Gyberg, Viveca; Abreu, Ana; Aguiar, Carlos; Conde, Almudena C.; Davletov, Kairat; Dilic, Mirza; Dolzhenko, Maryna; Gaita, Dan; Georgiev, Borislav; Gotcheva, Nina

    2016-01-01

    BACKGROUND: European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV in primary care was a cross-sectional survey carried out by the European Society of Cardiology, EURObservational Research Programme in 2014-2015 in 71 centres from 14 European countries. The main objective was to determine whether the 2012 Joint European Societies' guidelines on cardiovascular disease (CVD) prevention in people at high CVD risk have been followed in clinical practi...

  9. Mapping spatial patterns of people's risk perception of landslides

    Science.gov (United States)

    Kofler, Christian; Pedoth, Lydia; Elzbieta Stawinoga, Agnieszka; Schneiderbauer, Stefan

    2016-04-01

    The resilience of communities against natural hazards is largely influenced by how the individuals perceive risk. A good understanding of people's risk perception, awareness and hazard knowledge is crucial for developing and improving risk management and communication strategies between authorities and the affected population. A lot of research has been done in investigating the social aspects of risks to natural hazards by means of interviews or questionnaires. However, there is still a lack of research in the investigation of the influence of the spatial distance to a hazard event on peoples risk perception. While the spatial dimension of a natural hazard event is always assessed in works with a natural science approach, it is often neglected in works on social aspects of natural hazards. In the present study, we aimed to overcome these gaps by combining methods from different disciplines and assessing and mapping the spatial pattern of risk perception through multivariate statistical approaches based on empirical data from questionnaires. We will present results from a case study carried out in Badia, located in the Province of South Tyrol- Italy, where in December 2012 a landslide destroyed four residential buildings and led to the evacuation of 36 people. By means of questionnaires distributed to all adults living in the case study area we assessed people's risk perception and asked respondents to allocate their place of residence on a map of the case study area subdivided in 7 zones. Based on the data of the questionnaire results we developed a risk perception factor in order to express various assessed aspects linked to risk perception with one metric. We analyzed and mapped this factor according to the different zones reflecting the spatial distance to the event. Furthermore, a cluster analysis identified various risk behavior profiles within the population. We also investigated the spatial patterns of these risk profiles. We revealed that the residential

  10. Informing people about radiation risks: a review of obstacles to public understanding and effective risk communication

    International Nuclear Information System (INIS)

    Covello, V.T.

    1988-01-01

    This paper reviews the literature on informing people about radiation risks. The paper focuses on obstacles to public understanding and effective risk communication. The paper concludes with a set of guidelines for communicating information about radiation risks to the public. The paper also includes an appendix that reviews the literature on one of the most important tools for communicating information about radiation risks: risk comparisons

  11. Visual risk factors for falls in older people.

    Science.gov (United States)

    Lord, Stephen R

    2006-09-01

    Poor vision reduces postural stability and significantly increases the risk of falls and fractures in older people. Most studies have found that poor visual acuity increases the risk of falls. However, studies that have included multiple visual measures have found that reduced contrast sensitivity and depth perception are the most important visual risk factors for falls. Multifocal glasses may add to this risk because their near-vision lenses impair distance contrast sensitivity and depth perception in the lower visual field. This reduces the ability of an older person to detect environmental hazards. There is now evidence that maximising vision through cataract surgery is an effective strategy for preventing falls. Further randomised controlled trials are required to determine whether individual strategies (such as restriction of use of multifocal glasses) or multi-strategy visual improvement interventions can significantly reduce falls in older people. Public health initiatives are required to raise awareness in older people and their carers of the importance of regular eye examinations and use of appropriate prescription glasses.

  12. Fall risk factors in community-dwelling elderly people

    Directory of Open Access Journals (Sweden)

    Astrid Bergland

    2012-11-01

    Full Text Available Falls are a common and serious problem for older adults. Approximately one-third of older communitydwelling people fall at least once a year. The main purpose of this paper is to present risk factors for fall in older people living at home. The databases used for identifying documentation of risk factors are Cinahl, Eric, ISI Web of Science, Cochrane Medline, Psycinfo and dissertation. Many psychosocial and medical conditions and impairment of sensorimotor function, balance and gait have been shown in large epidemiological studies to be strongly associated with falls. Several of the risk factors are interrelated. The intrinsic-extrinsic distinction seem to be an oversimplification. A better understanding of falls is usually obtained when examining the person in association with the environmental factors. Advanced age, history of falls, ADL limitations, impaired gait and mobility, visual impairment, reduced sensation, muscular weakness, poor reaction time, impaired cognition, diseases as stroke, use of psychoactive medication and use of many medications are risk factors shown to be strongly associated with falls. This means recommendation of multifactorial fall risk assessment must incorporate a range of physiological and mental tests in addition to assessing balance and gait as well as taking multiple chronic diseases and medications into account. These finding underscore the importance of multidimensional fall intervention with special focus on modifiable risk factors

  13. Determinants of disparities between perceived and physiological risk of falling among elderly people: cohort study.

    Science.gov (United States)

    Delbaere, Kim; Close, Jacqueline C T; Brodaty, Henry; Sachdev, Perminder; Lord, Stephen R

    2010-08-18

    To gain an understanding of elderly people's fear of falling by exploring the prevalence and determinants of perceived and physiological fall risk and to understand the role of disparities in perceived and physiological risk in the cause of falls. Prospective cohort study. Community sample drawn from eastern Sydney, Australia. 500 men and women aged 70-90 years. Baseline assessment of medical, physiological, and neuropsychological measures, with physiological fall risk estimated with the physiological profile assessment, and perceived fall risk estimated with the falls efficacy scale international. Participants were followed up monthly for falls over one year. Multivariate logistic regression analyses showed that perceived and physiological fall risk were both independent predictors of future falls. Classification tree analysis was used to split the sample into four groups (vigorous, anxious, stoic, and aware) based on the disparity between physiological and perceived risk of falling. Perceived fall risk was congruent with physiological fall risk in the vigorous (144 (29%)) and aware (202 (40%)) groups. The anxious group (54 (11%)) had a low physiological risk but high perceived fall risk, which was related to depressive symptoms (P=0.029), neurotic personality traits (P=0.026), and decreased executive functioning (P=0.010). The stoic group (100 (20%)) had a high physiological risk but low perceived fall risk, which was protective for falling and mediated through a positive outlook on life (P=0.001) and maintained physical activity and community participation (P=0.048). Many elderly people underestimated or overestimated their risk of falling. Such disparities between perceived and physiological fall risk were primarily associated with psychological measures and strongly influenced the probability of falling. Measures of both physiological and perceived fall risk should be included in fall risk assessments to allow tailoring of interventions for preventing falls in

  14. Rationale and design of the Kanyini guidelines adherence with the polypill (Kanyini-GAP study: a randomised controlled trial of a polypill-based strategy amongst Indigenous and non Indigenous people at high cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Usherwood Tim

    2010-08-01

    Full Text Available Abstract Background The Kanyini Guidelines Adherence with the Polypill (Kanyini-GAP Study aims to examine whether a polypill-based strategy (using a single capsule containing aspirin, a statin and two blood pressure-lowering agents amongst Indigenous and non-Indigenous people at high risk of experiencing a cardiovascular event will improve adherence to guideline-indicated therapies, and lower blood pressure and cholesterol levels. Methods/Design The study is an open, randomised, controlled, multi-centre trial involving 1000 participants at high risk of cardiovascular events recruited from mainstream general practices and Aboriginal Medical Services, followed for an average of 18 months. The participants will be randomised to one of two versions of the polypill, the version chosen by the treating health professional according to clinical features of the patient, or to usual care. The primary study outcomes will be changes, from baseline measures, in serum cholesterol and systolic blood pressure and self-reported current use of aspirin, a statin and at least two blood pressure lowering agents. Secondary study outcomes include cardiovascular events, renal outcomes, self-reported barriers to indicated therapy, prescription of indicated therapy, occurrence of serious adverse events and changes in quality-of-life. The trial will be supplemented by formal economic and process evaluations. Discussion The Kanyini-GAP trial will provide new evidence as to whether or not a polypill-based strategy improves adherence to effective cardiovascular medications amongst individuals in whom these treatments are indicated. Trial Registration This trial is registered with the Australian New Zealand Clinical Trial Registry ACTRN126080005833347.

  15. Suffering from Loneliness Indicates Significant Mortality Risk of Older People

    Directory of Open Access Journals (Sweden)

    Reijo S. Tilvis

    2011-01-01

    Full Text Available Background. The harmful associates of suffering from loneliness are still in dispute. Objective. To examine the association of feelings of loneliness with all-cause mortality in a general aged population. Methods. A postal questionnaire was sent to randomly selected community-dwelling of elderly people (>74 years from the Finnish National Population Register. The questionnaire included demographic characteristics, living conditions, functioning, health, and need for help. Suffering from loneliness was assessed with one question and participants were categorized as lonely or not lonely. Total mortality was retrieved from the National Population Information System. Results. Of 3687 respondents, 39% suffered from loneliness. Lonely people were more likely to be deceased during the 57-month follow-up (31% than subjects not feeling lonely (23%, <.001. Excess mortality (HR=1.38, 95% CI=1.21-1.57 of lonely people increased over time. After controlling for age and gender, the mortality risk of the lonely individuals was 1.33 (95% CI=1.17-1.51 and after further controlling for subjective health 1.17 (CI=1.02-1.33. The excess mortality was consistent in all major subgroups. Conclusion. Suffering from loneliness is common and indicates significant mortality risk in old age.

  16. Coral Reefs and People in a High-CO2 World: Where Can Science Make a Difference to People?

    Science.gov (United States)

    Langdon, Chris; Ekstrom, Julia A.; Cooley, Sarah R.; Suatoni, Lisa; Beck, Michael W.; Brander, Luke M.; Burke, Lauretta; Cinner, Josh E.; Doherty, Carolyn; Edwards, Peter E. T.; Gledhill, Dwight; Jiang, Li-Qing; van Hooidonk, Ruben J.; Teh, Louise; Waldbusser, George G.; Ritter, Jessica

    2016-01-01

    Reefs and People at Risk Increasing levels of carbon dioxide in the atmosphere put shallow, warm-water coral reef ecosystems, and the people who depend upon them at risk from two key global environmental stresses: 1) elevated sea surface temperature (that can cause coral bleaching and related mortality), and 2) ocean acidification. These global stressors: cannot be avoided by local management, compound local stressors, and hasten the loss of ecosystem services. Impacts to people will be most grave where a) human dependence on coral reef ecosystems is high, b) sea surface temperature reaches critical levels soonest, and c) ocean acidification levels are most severe. Where these elements align, swift action will be needed to protect people’s lives and livelihoods, but such action must be informed by data and science. An Indicator Approach Designing policies to offset potential harm to coral reef ecosystems and people requires a better understanding of where CO2-related global environmental stresses could cause the most severe impacts. Mapping indicators has been proposed as a way of combining natural and social science data to identify policy actions even when the needed science is relatively nascent. To identify where people are at risk and where more science is needed, we map indicators of biological, physical and social science factors to understand how human dependence on coral reef ecosystems will be affected by globally-driven threats to corals expected in a high-CO2 world. Western Mexico, Micronesia, Indonesia and parts of Australia have high human dependence and will likely face severe combined threats. As a region, Southeast Asia is particularly at risk. Many of the countries most dependent upon coral reef ecosystems are places for which we have the least robust data on ocean acidification. These areas require new data and interdisciplinary scientific research to help coral reef-dependent human communities better prepare for a high CO2 world. PMID:27828972

  17. Social isolation and risk for malnutrition among older people.

    Science.gov (United States)

    Boulos, Christa; Salameh, Pascale; Barberger-Gateau, Pascale

    2017-02-01

    Social isolation and loneliness are emerging issues among the geriatric population. The relationships between both, and their impact on health and nutritional status in older people are complex. The purpose of the present study was to evaluate the association between three components of social isolation: social network, feeling of loneliness, commensality and nutritional status. A total of 1200 randomly selected elderly individuals aged ≥65 years and living in rural areas of Lebanon participated in the present study. Data were collected during a face-to-face interview including nutritional status (Mini-Nutritional Assessment), measures of social isolation (Lubben Social Network Scale), subjective loneliness (Jong-Gierveld Loneliness Scale), sociodemographic conditions, and health and functional status. Both social isolation and loneliness were independently associated with a higher risk of malnutrition (OR 1.58, P = 0.011; OR 1.15, P = 0.020, respectively). However no association was found between the frequency of sharing meals and the risk of malnutrition. The present study showed that social isolation and subjective loneliness are two independent risk factors for malnutrition among older people. Geriatr Gerontol Int 2017; 17: 286-294. © 2016 Japan Geriatrics Society.

  18. [Play behavior in people with various degrees of pathological gambling risk].

    Science.gov (United States)

    Prilutskaya, M V; Kuliev, R S

    2015-01-01

    We studied play behavior of customers of betting offices. A study included 216 people who were surveyed using the Canadian problem gambling index. According to the results of the test, we stratified the sample by the risk of pathological gambling. The high prevalence of people with medium and high risk of pathological gambling was identified. Significant differences in the characteristics of gambling behavior were found. We described the qualitative and quantitative indicators of gaming activity that proved the appearance of the addicted dominant in the high-risk group (changes in the motivational sphere, financial loss, using alternative forms of the game, the regular play activity and low level of the reflection of problems caused by the game).

  19. Fall prevalence, time trend and its related risk factors among elderly people in China.

    Science.gov (United States)

    Wu, Hong; Ouyang, Peng

    2017-11-01

    To study the fall prevalence, time trends and related risk factors among elderly people in the Chinese mainland from 2011 to 2013. Our data were from China Health and Retirement Longitudinal Study in 2011 and 2013. The population sample included people aged 60 years and over. Whether the person had experienced fall accident in the last two years was used to measure fall incidence. The time trend and age groups were investigated through the chi-square test. The related risk factors were examined based on the binary logistic regression model. In 2011, 19.64% (95% CI, 18.66%, 20.67%) of elderly people experienced fall incidents and in 2013, 19.28% (95% CI, 18.46%, 20.13%) of elderly people experienced fall incidents. However, no significant difference was seen in the fall prevalence between 2011 and 2013. The fall prevalence among elderly people aged 66-70 declined significantly while that among people aged over 80 showed an increasing time trend. The fall prevalence was affected significantly by factors including age (66-70), gender, marital status, self-rated health, quantity of chronic diseases, quantity of disability items, activities of daily living and physical functioning. It is revealed the fall prevalence showed no increment from 2011 to 2013 but at a high level. More efforts should be made to reduce the fall prevalence, and special attention should be paid to the elderly people aged over 80 and older. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. How Many People Are Affected by or at Risk for Endometriosis?

    Science.gov (United States)

    ... Share Facebook Twitter Pinterest Email Print How many people are affected by or at risk for endometriosis? ... Gynecology, 202 , 534.e1–534.e6. How many people are affected by or at risk for endometriosis? ...

  1. Two-Year Trajectory of Fall Risk in People With Parkinson Disease: A Latent Class Analysis.

    Science.gov (United States)

    Paul, Serene S; Thackeray, Anne; Duncan, Ryan P; Cavanaugh, James T; Ellis, Theresa D; Earhart, Gammon M; Ford, Matthew P; Foreman, K Bo; Dibble, Leland E

    2016-03-01

    To examine fall risk trajectories occurring naturally in a sample of individuals with early to middle stage Parkinson disease (PD). Latent class analysis, specifically growth mixture modeling (GMM), of longitudinal fall risk trajectories. Assessments were conducted at 1 of 4 universities. Community-dwelling participants with PD of a longitudinal cohort study who attended at least 2 of 5 assessments over a 2-year follow-up period (N=230). Not applicable. Fall risk trajectory (low, medium, or high risk) and stability of fall risk trajectory (stable or fluctuating). Fall risk was determined at 6 monthly intervals using a simple clinical tool based on fall history, freezing of gait, and gait speed. The GMM optimally grouped participants into 3 fall risk trajectories that closely mirrored baseline fall risk status (P=.001). The high fall risk trajectory was most common (42.6%) and included participants with longer and more severe disease and with higher postural instability and gait disability (PIGD) scores than the low and medium fall risk trajectories (Pfall risk (posterior probability fall risk trajectories over 2 years. Further investigation is required to determine whether interventions to improve gait and balance may improve fall risk trajectories in people with PD. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  2. Coral Reefs and People in a High-CO2 World: Where Can Science Make a Difference to People?

    Science.gov (United States)

    Pendleton, Linwood; Comte, Adrien; Langdon, Chris; Ekstrom, Julia A; Cooley, Sarah R; Suatoni, Lisa; Beck, Michael W; Brander, Luke M; Burke, Lauretta; Cinner, Josh E; Doherty, Carolyn; Edwards, Peter E T; Gledhill, Dwight; Jiang, Li-Qing; van Hooidonk, Ruben J; Teh, Louise; Waldbusser, George G; Ritter, Jessica

    2016-01-01

    Increasing levels of carbon dioxide in the atmosphere put shallow, warm-water coral reef ecosystems, and the people who depend upon them at risk from two key global environmental stresses: 1) elevated sea surface temperature (that can cause coral bleaching and related mortality), and 2) ocean acidification. These global stressors: cannot be avoided by local management, compound local stressors, and hasten the loss of ecosystem services. Impacts to people will be most grave where a) human dependence on coral reef ecosystems is high, b) sea surface temperature reaches critical levels soonest, and c) ocean acidification levels are most severe. Where these elements align, swift action will be needed to protect people's lives and livelihoods, but such action must be informed by data and science. Designing policies to offset potential harm to coral reef ecosystems and people requires a better understanding of where CO2-related global environmental stresses could cause the most severe impacts. Mapping indicators has been proposed as a way of combining natural and social science data to identify policy actions even when the needed science is relatively nascent. To identify where people are at risk and where more science is needed, we map indicators of biological, physical and social science factors to understand how human dependence on coral reef ecosystems will be affected by globally-driven threats to corals expected in a high-CO2 world. Western Mexico, Micronesia, Indonesia and parts of Australia have high human dependence and will likely face severe combined threats. As a region, Southeast Asia is particularly at risk. Many of the countries most dependent upon coral reef ecosystems are places for which we have the least robust data on ocean acidification. These areas require new data and interdisciplinary scientific research to help coral reef-dependent human communities better prepare for a high CO2 world.

  3. Coral Reefs and People in a High-CO2 World: Where Can Science Make a Difference to People?

    Directory of Open Access Journals (Sweden)

    Linwood Pendleton

    Full Text Available Increasing levels of carbon dioxide in the atmosphere put shallow, warm-water coral reef ecosystems, and the people who depend upon them at risk from two key global environmental stresses: 1 elevated sea surface temperature (that can cause coral bleaching and related mortality, and 2 ocean acidification. These global stressors: cannot be avoided by local management, compound local stressors, and hasten the loss of ecosystem services. Impacts to people will be most grave where a human dependence on coral reef ecosystems is high, b sea surface temperature reaches critical levels soonest, and c ocean acidification levels are most severe. Where these elements align, swift action will be needed to protect people's lives and livelihoods, but such action must be informed by data and science.Designing policies to offset potential harm to coral reef ecosystems and people requires a better understanding of where CO2-related global environmental stresses could cause the most severe impacts. Mapping indicators has been proposed as a way of combining natural and social science data to identify policy actions even when the needed science is relatively nascent. To identify where people are at risk and where more science is needed, we map indicators of biological, physical and social science factors to understand how human dependence on coral reef ecosystems will be affected by globally-driven threats to corals expected in a high-CO2 world. Western Mexico, Micronesia, Indonesia and parts of Australia have high human dependence and will likely face severe combined threats. As a region, Southeast Asia is particularly at risk. Many of the countries most dependent upon coral reef ecosystems are places for which we have the least robust data on ocean acidification. These areas require new data and interdisciplinary scientific research to help coral reef-dependent human communities better prepare for a high CO2 world.

  4. Sexual health risk reduction interventions for people with severe mental illness: a systematic review.

    Science.gov (United States)

    Pandor, Abdullah; Kaltenthaler, Eva; Higgins, Agnes; Lorimer, Karen; Smith, Shubulade; Wylie, Kevan; Wong, Ruth

    2015-02-12

    Despite variability in sexual activity among people with severe mental illness, high-risk sexual behavior (e.g. unprotected intercourse, multiple partners, sex trade and illicit drug use) is common. Sexual health risk reduction interventions (such as educational and behavioral interventions, motivational exercises, counselling and service delivery), developed and implemented for people with severe mental illness, may improve participants' knowledge, attitudes, beliefs behaviors or practices (including assertiveness skills) and could lead to a reduction in risky sexual behavior. This systematic review evaluates the effectiveness of sexual health risk reduction interventions for people with severe mental illness. Thirteen electronic databases (including MEDLINE, EMBASE and PsycINFO) were searched to August 2014, and supplemented by hand-searching relevant articles and contacting experts. All controlled trials (randomized or non-randomized) comparing the effectiveness of sexual health risk reduction interventions with usual care for individuals living in the community with severe mental illness were included. Outcomes included a range of biological, behavioral and proxy endpoints. Narrative synthesis was used to combine the evidence. Thirteen controlled trials (all from the USA) were included. Although there was no clear and consistent evidence that interventions reduce the total number of sex partners or improved behavioral intentions in sexual risk behavior, positive effects were generally observed in condom use, condom protected intercourse and on measures of HIV knowledge, attitudes to condom use and sexual behaviors and practices. However, the robustness of these findings is low due to the large between study variability, small sample sizes and low-to-moderate quality of included studies. There is insufficient evidence at present to fully support or reject the identified sexual health risk reduction interventions for people with severe mental illness. Given the

  5. HIV Risk Perception and Risky Behavior Among People Who Inject Drugs in Kermanshah, Western Iran.

    Science.gov (United States)

    Noroozi, Mehdi; Ahounbar, Elahe; Karimi, Salah Eddin; Ahmadi, Sina; Najafi, Mohammad; Bazrafshan, Ali; Shushtari, Zahra Jorjoran; Farhadi, Mohammad Hassan; Higgs, Peter; Rezaei, Fatemeh; Ghiasvand, Hesam; Sharhani, Asaad; Armoon, Bahram; Waye, Katherine

    2017-08-01

    Understanding and increasing awareness on individual risk for HIV infection as well as HIV risk perception's effects on different behavioral outcomes for people who inject drugs (PWID) is important for policymaking and planning purposes. The objectives of the present study were to determine whether HIV risk perception was associated with greater injection and sexual risk-taking behaviors among PWIDs. We surveyed 460 PWID in Kermanshah regarding their demographic characteristics, sexual risk behaviors, HIV risk perception, and drug-related risk behaviors in the month prior to the study. Three classes of HIV risk perception were identified using ordinal regression to determine factors associated with HIV risk perception. Study participants were categorized as follows: "low" (n = 100, 22%), "moderate" (n = 150, 32%), and "high" (n = 210, 46%) risk perception for becoming infected with HIV. The odds of categorizing as "high" risk for HIV was significantly greater in PWID that reported unprotected sex (adjusted odds ratio (AOR) 2.4, p value 0.02), receptive syringe sharing (AOR 1.8, p value 0.01), and multiple sex partners (AOR 1.4, p value 0.03). PWID who reported unprotected sex had 2.7 times the odds of "high" risk perception when compared to PWID with "low" risk perception. Findings show that PWID could rate their HIV risk with acceptable accuracy. Additionally, perceived HIV risk was associated with many risk factors for transmission of HIV, emphasizing the importance of developing targeted prevention and harm reduction programs for all domains of risk behaviors, both sexual and drug-related use.

  6. Enablement, Constraint, and "The 7 Habits of Highly Effective People."

    Science.gov (United States)

    Carlone, David

    2001-01-01

    Uses interviews to examine how the self-help book "The 7 Habits of Highly Effective People" shapes the identity of organization members who read and use the book. Suggests that such people are simultaneously enabled and constrained as they confront tensions between individualism and community, competition and cooperation, and domination and…

  7. Depressed mood as a risk factor for unprotected sex in young people.

    Science.gov (United States)

    Brown, Adrienne; Yung, Alison; Cosgrave, Elizabeth; Killackey, Eóin; Buckby, Joe; Stanford, Carrie; Godfrey, Katherine; McGorry, Patrick

    2006-09-01

    Young people may place themselves and others at risk of sexually transmitted infections (STI) and/or the human immunodeficiency virus (HIV) through engaging in unprotected sex. Mental health problems may play an important role in sex-related risk behaviour. The current research was an investigation of depressed mood and condom use in a help-seeking sample of young people in Melbourne, Australia. The sample comprised 76 sexually active young people aged 15-24 years who were referred to ORYGEN Youth Health, a public mental health service in Melbourne, Australia. Controlling for demographic characteristics and substance use, multivariate logistic regression examined depressed mood as a predictor of condom use at last sexual intercourse. Half of the sample reported condom use the last time they had sexual intercourse. Depressed mood, female gender and unemployment increased the likelihood that participants engaged in unprotected sex. A high proportion of young people, particularly those who are depressed, are failing to protect themselves from STI/HIV. Mental health services working with young people have the opportunity to implement initiatives aimed at reducing risk of STI/HIV infection.

  8. Symptoms of anxiety or depression and risk of fracture in older people: the Hertfordshire Cohort Study.

    Science.gov (United States)

    Gale, Catharine R; Dennison, Elaine M; Edwards, Mark; Sayer, Avan Aihie; Cooper, Cyrus

    2012-01-01

    The aim of this study was to examine the prospective association between symptoms of anxiety and depression and risk of fracture in older people. Results showed that men, but not women, with probable anxiety at baseline had an increased risk of fracture. The use of psychotropic drugs has been linked with an increased risk of fracture in older people, but there are indications that the conditions for which these drugs were prescribed may themselves influence fracture risk. The aim of this study was to investigate the relation between symptoms of anxiety and depression and risk of fracture in older people. The study design is a prospective cohort study. One thousand eighty-seven men and 1,050 women aged 59-73 years completed the Hospital Anxiety and Depression Scale (HADS). Data on incident fracture during an average follow-up period of 5.6 years were collected through interview and a postal questionnaire. Compared to men with no or few symptoms of anxiety (score ≤7 on the HADS anxiety subscale), men with probable anxiety (score ≥11) had an increased risk of fracture: After adjustment for age and potential confounding factors, the odds ratio (OR) (95 % confidence interval) was 4.03 (1.55, 10.5). There were no associations between levels of anxiety and fracture risk in women. Few men or women had probable depression at baseline (score ≥11 on the HADS depression subscale). Amongst men with possible depression (score 8-10), there was an increased risk of fracture that was of borderline significance: multivariate-adjusted OR 3.57 (0.99, 12.9). There was no association between possible depression and fracture risk in women. High levels of anxiety in older men may increase their risk of fracture. Future research needs to replicate this finding in other populations and investigate the underlying mechanisms.

  9. Related factors and incidence risk of acute myocardial infarction among the people with disability: A national population-based study.

    Science.gov (United States)

    Huang, Ying-Ying; Kung, Pei-Tseng; Chiu, Li-Ting; Tsai, Wen-Chen

    2014-11-06

    Cardiovascular disease has always been a leading cause of death worldwide. Because the mobility of people with disability is relatively decreased, their risk of cardiovascular disease is increased. This study investigated the risks and relevant factors of acute myocardial infarction (AMI) among people with disability. This is a retrospective cohort study based on secondary data analysis. This study focused on 798,328 people with disability who were aged 35 and above during 2002-2008 and were registered in the National Disability Registration Database; the relevant medical data from 2000 to 2011 were acquired from the National Health Insurance Research Database. A Cox proportional hazards model was adopted for analyzing the relative AMI risks among different disability types and finding latent risk factors. The results indicated that the AMI incidence rate (per 1000 patient-years) among people with disability was 2.48. Men had an AMI incidence rate of 2.68 per 1000 patient-years, which was significantly higher than that of women (2.21; pdisability aged 65 and above had an AMI risk that was 5.01-6.03 times the risk for people with disability aged below 45. Disabled indigenous people had a relatively higher AMI risk (HR=1.35, 95% CI=1.19-1.52). The AMI risk for people with disability with a Charlson comorbidity index (CCI) of 4 and above was 5.89 times (95% CI=5.56-6.25) the risk for those with a CCI of 0. Compared with people with physical disabilities, people with visual impairment and people with dysfunctional primary organs had significantly higher AMI risks (HR=1.15; HR=1.66). This study found that people with disability who were male, aged 65 and above, married, indigenous, with physical disabilities, with high comorbidity, or with high disability levels had relatively higher AMI risks than other people with disability. The research outcomes can be used as references by public health authorities to improve the engagement of people with disability in AMI

  10. Perceptions of risk of coronary heart disease among people living with type 2 diabetes mellitus.

    Science.gov (United States)

    Ammouri, Ali Ahmad; Abu Raddaha, Ahmad H; Natarajan, Jansi; D'Souza, Melba Sheila

    2018-02-01

    Our aim is to assess perception of risk of developing coronary heart disease and to examine its associations with individuals' characteristics and health behaviours among Omani people with type 2 diabetes mellitus (T2DM). Evaluating perceptions of being at risk of developing a disease may give insight into health promotion behaviours. People with diabetes are at high risk of coronary heart disease. The management of diabetes mellitus should include prevention and control of coronary heart disease. A cross-sectional correlational study was conducted. A convenience sample of 160 adults with T2DM was invited to participate in this study between November 2014 and March 2015. Descriptive and regression analyses were performed to examine associations between study variables. Perception of risk of developing coronary heart disease was significantly associated with low educational level (β = 0.191, P diabetes mellitus (β = 0.200, P healthy diet more frequently. Teaching people with T2DM about the risk of developing coronary heart disease is essential as it could motivate them to perform health promotion behaviours, which may assist in controlling and reducing coronary heart disease. © 2017 John Wiley & Sons Australia, Ltd.

  11. Analysis on difference of risk perception between people engaged in nuclear business and general public

    International Nuclear Information System (INIS)

    Terado, M.; Yoshikawa, H.; Sugiman, T.; Hibino, A.; Akimoto, M.

    2004-01-01

    A new research project has started to develop two kinds of on-the-web communication systems which are aimed at effective social risk information on nuclear energy. One is mutual communication system for fostering safety culture among the workers in nuclear industry while the other is to enlighten general public about the risk issues on final disposal of high-level radioactive waste. Prior to the on-the-web systems development, social investigations have been conducted on risk perception for nuclear power for both the nuclear experts and women in the metropolitan area, in order to know how and what should be considered for the effective risk communication methods. It was found from the statistical analysis of the results of social investigation that the majority of nuclear people take business risk seriously but there is a fraction of nuclear people who are afraid of present practice of nuclear power operation while women in metropolitan area are evenly afraid of radioactive risk. The obtained results of social investigation gave useful insight for developing two kinds of risk communication systems and the related field study for enhancing safety culture in nuclear industries. (authors)

  12. "Couldn't you have done just as well without the screening?". A qualitative study of benefits from screening as perceived by people without a high cardiovascular risk score.

    Science.gov (United States)

    Nielsen, Karen-Dorthe Bach; Dyhr, Lise; Lauritzen, Torsten; Malterud, Kirsti

    2009-01-01

    To explore how individuals whose health screening does not reveal a high cardiovascular risk score (CRS) interpret and respond to this result. Qualitative semi-structured interviews. Purposeful sampling reflected variations in age, gender, and self-rated health within the sample. Analysis and interpretation were informed by the Health Belief Model concerning individuals' cues to act when told there is a health threat, and by Hollnagel and Malterud's theories about personal self-assessed health resources. Participants were recruited among participants without a high cardiovascular risk score in a Danish health-screening project. Seven men and 15 women aged 36-50 years with a low or moderate cardiovascular risk score. The screening confirmed the participants' feeling of being in good health and they put emphasis on this acquired peace of mind. Participants used the results to eliminate worries and confirm their lifestyle up to now but were aware that the results gave no guarantee that there was nothing the matter elsewhere. Some paid a price for the reassurance since they had to undergo further examinations, had unfulfilled expectations, or were irritated at not being left in peace with their reassurance. Screened individuals who were shown not to have a high risk score appear to be reassured and confirmed in their own feeling of being healthy, and to be aware of the limitations of the screening. Consideration should be given to the possible risk of creating either insecurity or over-complacency through population screening.

  13. Chronic disease health risk behaviours amongst people with a mental illness.

    Science.gov (United States)

    Bartlem, Kate M; Bowman, Jennifer A; Bailey, Jacqueline M; Freund, Megan; Wye, Paula M; Lecathelinais, Christophe; McElwaine, Kathleen M; Campbell, Elizabeth M; Gillham, Karen E; Wiggers, John H

    2015-08-01

    Amongst people with a mental illness, modifiable health risk behaviours contribute substantially to increased chronic disease morbidity and mortality. This study examined the prevalence of and interest in changing such behaviours amongst community mental health service clients in Australia. A telephone interview was undertaken with Australian community mental health service clients. Participants reported engagement in four health risk behaviours: tobacco smoking, fruit and vegetable consumption, alcohol consumption, and physical activity. Participants were classified as at risk based upon Australian national guidelines. At-risk participants were asked whether they were considering improving their health risk behaviour within the next month. The association between psychiatric diagnosis and risk, and interest in improving health risk behaviours was examined. Risk prevalence was highest for inadequate vegetable consumption (78.3%), followed by inadequate fruit consumption (60%), smoking (50.7%), physical inactivity (46.8%), short-term alcohol risk (40.3%) and chronic alcohol risk (35.3%). A majority of at-risk participants were considering improving their health risk behaviour for smoking, physical inactivity and inadequate fruit and vegetable consumption (65.1%, 71.1%, and 53.3%, respectively). After adjusting for demographic factors, no diagnostic categories were associated with risk for any behaviour. Those with a diagnosis of depression were more likely to be interested in quitting smoking and increasing physical activity. Regardless of diagnosis, a high prevalence of chronic disease health risk behaviours was identified, with many participants expressing an interest in improving these behaviours. Such findings reinforce recommendations that preventive care addressing the chronic disease risks of clients be provided routinely by mental health clinicians. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12613000693729. URL: www.anzctr.org.au/. © The

  14. Cohort study of institutionalized elderly people: fall risk factors from the nursing diagnosis

    Directory of Open Access Journals (Sweden)

    Karine Marques Costa dos Reis

    2015-12-01

    Full Text Available Objective: to determine the incidence of falls in elderly residents of long-stay institutions of the Federal District, to identify the aspects involved in the falls, in terms of risk factors, from the application of scales and the Taxonomy II of NANDA-I, and to define the level of accuracy with its sensitivity and specificity for application in the clinical nursing practice. Method: this was a cohort study with the evaluation of 271 elderly people. Cognition, functionality, mobility and other intrinsic factors were evaluated. After six months, the elderly people who fell were identified, with significance analysis then performed to define the risk factors. Results: the results showed an incidence of 41%. Of the 271 patients included, 69 suffered 111 episodes of falls during the monitoring period. Risk factors were the presence of stroke with its sequelae (OR: 1.82, 95% CI 1.01 - 3.28, p=.045, presenting more than five chronic diseases (OR: 2.82, 95% CI 1.43 - 5.56, p=.0028, foot problem (OR: 2.45, 95% CI 1.35 - 4.44, p=.0033 and motion (OR: 2.04, 95% CI 1.15 - 3.61, p=.0145. Conclusion: the taxonomy has high validity regarding the detection of elderly people at risk of falling and should be applied consistently in the clinical nursing practice.

  15. Risk profile of young people admitted to hospital for suicidal behaviour in Melbourne, Australia.

    Science.gov (United States)

    Borschmann, Rohan; Stark, Patrick; Prakash, Chidambaram; Sawyer, Susan M

    2018-05-20

    Self-harm and suicidal behaviour is most prevalent during adolescence, but little is known about the risk profile of adolescents admitted to hospital for suicidal behaviour. Young people who self-harm are at an increased risk of mortality compared to those who do not self-harm; adolescents admitted to hospital for suicidal behaviour are particularly at risk. The aim of this study was to generate a risk profile of adolescents admitted to hospital with suicidal behaviour. We conducted a 12-month retrospective audit of adolescent admissions to the mental health inpatient unit at a tertiary children's hospital in Melbourne, Australia. Routinely collected data were used to generate a risk profile. We found that 212 of 271 (78.2%) admissions were due to suicidal behaviour. Of these, 107 (51%) adolescents were diagnosed with one or more mental disorders at discharge, most commonly major depressive disorder. Beyond known distal determinants of health risk, the proximal risk profile of these adolescents included factors relating to gender, substance use, prior mental health diagnoses and prior admission to hospital. Poor sleep was also a risk factor, with 159 (75%) reporting a recent history of sleeping problems. The very high proportion of admissions to the mental health inpatient unit due to suicidal behaviour reinforces the importance of finding effective methods of identification of the risk processes underpinning suicidal behaviours to reduce the unnecessary waste of young lives by suicide. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  16. An Overview. High Risk Series.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    This report provides an overview of efforts undertaken by the U.S. General Accounting Office (GAO) in 1990 to review and report on federal program areas its work identified as high risk because of vulnerabilities to waste, fraud, abuse, and mismanagement. It reviews the current status of efforts to address these concerns. The six categories of…

  17. High variability of HIV and HCV seroprevalence and risk behaviours among people who inject drugs: results from a cross-sectional study using respondent-driven sampling in eight German cities (2011–14

    Directory of Open Access Journals (Sweden)

    Benjamin Wenz

    2016-09-01

    Full Text Available Abstract Background People who inject drugs (PWID are at increased risk of acquiring and transmitting HIV and Hepatitis C (HCV due to sharing injection paraphernalia and unprotected sex. To generate seroprevalence data on HIV and HCV among PWID and related data on risk behaviour, a multicentre sero- and behavioural survey using respondent driven sampling (RDS was conducted in eight German cities between 2011 and 2014. We also evaluated the feasibility and effectiveness of RDS for recruiting PWID in the study cities. Methods Eligible for participation were people who had injected drugs within the last 12 months, were 16 years or older, and who consumed in one of the study cities. Participants were recruited, using low-threshold drop-in facilities as study sites. Initial seeds were selected to represent various sub-groups of people who inject drugs (PWID. Participants completed a face-to-face interview with a structured questionnaire about socio-demographics, sexual and injecting risk behaviours, as well as the utilisation of health services. Capillary blood samples were collected as dried blood spots and were anonymously tested for serological and molecular markers of HIV and HCV. The results are shown as range of proportions (min. and max. values (% in the respective study cities. For evaluation of the sampling method we applied criteria from the STROBE guidelines. Results Overall, 2,077 PWID were recruited. The range of age medians was 29–41 years, 18.5–35.3 % of participants were female, and 9.2–30.6 % were foreign born. Median time span since first injection were 10–18 years. Injecting during the last 30 days was reported by 76.0–88.4 % of participants. Sharing needle/syringes (last 30 days ranged between 4.7 and 22.3 %, while sharing unsterile paraphernalia (spoon, filter, water, last 30 days was reported by 33.0–43.8 %. A majority of participants (72.8–85.8 % reported incarceration at least once, and 17.8–39.8

  18. High variability of HIV and HCV seroprevalence and risk behaviours among people who inject drugs: results from a cross-sectional study using respondent-driven sampling in eight German cities (2011-14).

    Science.gov (United States)

    Wenz, Benjamin; Nielsen, Stine; Gassowski, Martyna; Santos-Hövener, Claudia; Cai, Wei; Ross, R Stefan; Bock, Claus-Thomas; Ratsch, Boris-Alexander; Kücherer, Claudia; Bannert, Norbert; Bremer, Viviane; Hamouda, Osamah; Marcus, Ulrich; Zimmermann, Ruth

    2016-09-05

    People who inject drugs (PWID) are at increased risk of acquiring and transmitting HIV and Hepatitis C (HCV) due to sharing injection paraphernalia and unprotected sex. To generate seroprevalence data on HIV and HCV among PWID and related data on risk behaviour, a multicentre sero- and behavioural survey using respondent driven sampling (RDS) was conducted in eight German cities between 2011 and 2014. We also evaluated the feasibility and effectiveness of RDS for recruiting PWID in the study cities. Eligible for participation were people who had injected drugs within the last 12 months, were 16 years or older, and who consumed in one of the study cities. Participants were recruited, using low-threshold drop-in facilities as study sites. Initial seeds were selected to represent various sub-groups of people who inject drugs (PWID). Participants completed a face-to-face interview with a structured questionnaire about socio-demographics, sexual and injecting risk behaviours, as well as the utilisation of health services. Capillary blood samples were collected as dried blood spots and were anonymously tested for serological and molecular markers of HIV and HCV. The results are shown as range of proportions (min. and max. values (%)) in the respective study cities. For evaluation of the sampling method we applied criteria from the STROBE guidelines. Overall, 2,077 PWID were recruited. The range of age medians was 29-41 years, 18.5-35.3 % of participants were female, and 9.2-30.6 % were foreign born. Median time span since first injection were 10-18 years. Injecting during the last 30 days was reported by 76.0-88.4 % of participants. Sharing needle/syringes (last 30 days) ranged between 4.7 and 22.3 %, while sharing unsterile paraphernalia (spoon, filter, water, last 30 days) was reported by 33.0-43.8 %. A majority of participants (72.8-85.8 %) reported incarceration at least once, and 17.8-39.8 % had injected while incarcerated. Between 30.8 and 66.2 % were

  19. Using multiple sampling approaches to measure sexual risk-taking among young people in Haiti: programmatic implications.

    Science.gov (United States)

    Speizer, Ilene S; Beauvais, Harry; Gómez, Anu Manchikanti; Outlaw, Theresa Finn; Roussel, Barbara

    2009-12-01

    No previous published research has examined the applicability of varying methods for identifying young people who are at high risk of experiencing unintended pregnancy and acquiring HIV infection. This study compares three surveys of young people aged 15-24 in Port-au-Prince, Haiti, in terms of their sociodemographic characteristics and sexual behaviors and the surveys'usefulness for identifying young people at high risk and for program planning. The surveys consist of responses from: a representative sample of young people in the 2005-06 Haiti Demographic and Health Survey (HDHS), a 2004 facility-based study, and a 2006-07 venue-based study that used the Priorities for Local AIDS Control Efforts (PLACE) method. The facility-based and PLACE studies included larger proportions of single, sexually experienced young people and people who knew someone with HIV/ AIDS than did the HDHS. More respondents in the PLACE sample had multiple sex partners in the past year and received money or gifts in return for sex, compared with respondents in the facility study. At first and last sex, more PLACE respondents used contraceptives, including condoms. Experience of pregnancy was most commonly reported in the data from the facility-based sample; however, more ever-pregnant PLACE respondents than others reported ever having terminated a pregnancy. Program managers seeking to implement prevention activities should consider using facility- or venue-based methods to identify and understand the behaviors of young people at high risk.

  20. The Risk of Mercury Exposure to the People Consuming Fish from Lake Phewa, Nepal

    Directory of Open Access Journals (Sweden)

    Devna Singh Thapa

    2014-06-01

    Full Text Available The risk of mercury exposure through consumption of fish from Lake Phewa, Nepal was investigated. A total of 170 people were surveyed to know their fish consumption levels. The weekly mercury (Hg intake in the form of methylmercury (MeHg through fish was calculated by using the data on average MeHg concentrations in fish, the average consumption of fish per week, and an average body weight of the people. Hotel owners were consuming significantly high amounts of fish, followed by fishermen, in comparison to the government staff, army/police, locals and others (visitors. Some individuals exceeded the Provisional Tolerable Weekly Intake (PTWI of 1.6 µg per kg body weight of MeHg (FAO/WHO. The minimum intake of MeHg (0.05 µg/kg/week was found in the visitors (others category, whereas the hotel owners had the maximum intake (3.71 µg/kg/week. In general, it was found that a person of 60 kg can consume at least 2 kg of fish per week without exceeding PTWI such that it does not pose any health risk associated with Hg poisoning at the present contamination level. Hg based PTWI values for Nepal has not been proposed yet in fishery resources so as to reduce health risk of the people.

  1. Transitions to Long-Term Unemployment Risk among Young People: Evidence from Ireland

    Science.gov (United States)

    Kelly, Elish; McGuinness, Seamus; O'Connell, Philip J.

    2012-01-01

    Many young people have short spells of unemployment during their transition from school to work; however, some often get trapped in unemployment and risk becoming long-term unemployed. Much research has been undertaken on the factors that influence unemployment risk for young people during their school-to-work transition. However, very little is…

  2. Clinical high risk for psychosis

    DEFF Research Database (Denmark)

    van der Steen, Y; Gimpel-Drees, J; Lataster, T

    2017-01-01

    OBJECTIVE: The aim of this study was to assess associations between momentary stress and both affective and psychotic symptoms in everyday life of individuals at clinical high risk (CHR), compared to chronic psychotic patients and healthy controls, in search for evidence of early stress...... and 26 healthy controls. RESULTS: Multilevel models showed significantly larger associations between negative affect (NA) and activity-related stress for CHR patients than for psychotic patients (P = 0.008) and for CHR compared to controls (P

  3. Factors influencing perception of radiation risk in people around Chernobyl. Survey in Ukraine

    International Nuclear Information System (INIS)

    Shibata, Yoshisada

    2010-01-01

    To elucidate the factors influencing perception of radiation risk in people around Chernobyl, we conducted a survey in Ukraine using self-administered questionnaire consisting of 37 questions including 5 questions about radiation contamination of their living places and foodstuffs, and 9 questions about radiation and risk. The subjects were high school or university students and their parents living in Zhytomyr, Rivne, Kirovograd and Odesa regions, and Slavutych city. In each of these 5 survey areas, we distributed 330 questionnaires to students and their parents, respectively. A total of 1,536 students (93%) responded to the questionnaire, while in parents only 861 (52%) responded. In students, a significant difference by place of residence was observed in the frequency of those regarding radiation accident or radon in dwellings being highly dangerous. (author)

  4. Perceptions of health risk and smoking decisions of young people

    NARCIS (Netherlands)

    Gerking, S.D.; Khaddaria, R.

    2012-01-01

    Using the Annenberg Perception of Tobacco Risk Survey 2, this paper finds that perceived risk deters smoking among persons aged 14–22 years who think that it is relatively difficult to quit smoking and that onset of deleterious health effects occurs relatively quickly. Perceived health risk,

  5. Interaction of social role functioning and coping in people with recent-onset attenuated psychotic symptoms: a case study of three Chinese women at clinical high risk for psychosis

    Directory of Open Access Journals (Sweden)

    Zhang TH

    2015-07-01

    Full Text Available TianHong Zhang,1 HuiJun Li,2,3 Kristen A Woodberry,3 Larry J Seidman,3 Annabelle Chow,4 ZePing Xiao,1 JiJun Wang1 1Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Department of Psychology, Florida A&M University, Tallahassee, FL, USA; 3Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA; 4Department of Psychological Medicine, Changi General Hospital, Singapore Abstract: Clinical high risk of psychosis is defined as the period in which the first signs of psychotic symptoms begin to appear. During this period, there is an increased probability of developing frank psychosis. It is crucial to investigate the interaction between psychotic symptoms and the individual’s personality and life experiences in order to effectively prevent, or delay the development of psychosis. This paper presents case reports of three Chinese female subjects with attenuated positive symptoms, attending their initial outpatient assessment in a mental health service, and their longitudinal clinical outcomes. Information regarding each subject’s symptoms and life stressors was collected at 2-month intervals over a 6-month period. The assessments indicated that these women were suffering from the recent onset of symptoms in different ways. However, all three hid their symptoms from others in their school or workplace, and experienced a decline in performance related to their social roles and in their daily functioning. They were often excluded from the social groups to which they had previously belonged. A decline in social activities may be a risk factor in the development of psychosis and a mediator of functional sequelae in psychosis. Effective treatment strategies may include those that teach individuals to gain insights related to their symptoms and a service that provides a context in which individuals can discuss their psychotic symptoms

  6. Being an 'adolescent': The consequences of gendered risks for young people in rural Uganda.

    Science.gov (United States)

    Bernays, Sarah; Bukenya, Dominic; Thompson, Claire; Ssembajja, Fatuma; Seeley, Janet

    2018-02-01

    The behaviour of adolescents is recognised increasingly as having substantial and long-term consequences for their health. We examined the meaning of 'adolescence' in southern Uganda with HIV-positive young people aged 11-24 years. Adolescent girls and boys are described differently in the local language (Luganda). Adolescence is described as a behavioural rather than a life course category and an inherently dangerous one. The practices, risks and consequences of 'adolescent' behaviour are highly gendered. Local understandings of adolescence are likely to have a significant impact on the efficacy of interventions designed to minimise their 'risky behaviour'.

  7. Being an ‘adolescent’: The consequences of gendered risks for young people in rural Uganda

    Science.gov (United States)

    Bernays, Sarah; Bukenya, Dominic; Thompson, Claire; Ssembajja, Fatuma; Seeley, Janet

    2017-01-01

    The behaviour of adolescents is recognised increasingly as having substantial and long-term consequences for their health. We examined the meaning of ‘adolescence’ in southern Uganda with HIV-positive young people aged 11–24 years. Adolescent girls and boys are described differently in the local language (Luganda). Adolescence is described as a behavioural rather than a life course category and an inherently dangerous one. The practices, risks and consequences of ‘adolescent’ behaviour are highly gendered. Local understandings of adolescence are likely to have a significant impact on the efficacy of interventions designed to minimise their ‘risky behaviour’. PMID:29472746

  8. People

    Directory of Open Access Journals (Sweden)

    Mohammad Aref

    2010-04-01

    Full Text Available This article attempts to analyze a part of the findings of documentation survey and field work carried out for five years in two cities and 67villages in Komeijan region of Markazi province, Iran, from some new perspectives such as ritual morphography, dramatic origin studies, eastern Scapegoat’s and anthropology of rituals. Using methods of current, and interviewing with 119 of the eldest native settlers ,as informants, and regarding the biochronology of man’s life in this region from the primitive form to civility which have been assigned to go back from the third millennium B.C.up to the present time, the morphography of 48 popular Dramatic Rituals has been determined. Among the findings of the study, one of the Archetypal Dramatic rituals, called Qaraiskurmah in the field of Anthropology of rituals, is Scapegoat’s. All these show the high IQ, innovative mind, and creative artistic tastes of the people in this region of Iran, whether they are Turkish, Persia, or Tats speakers.

  9. Alexithymia predicts loss chasing for people at risk for problem gambling.

    Science.gov (United States)

    Bibby, Peter A; Ross, Katherine E

    2017-12-01

    Background and aims The aim of this research was to investigate the relationship between alexithymia and loss-chasing behavior in people at risk and not at risk for problem gambling. Methods An opportunity sample of 58 (50 males and 8 females) participants completed the Problem Gambling Severity Index and the Toronto Alexithymia Scale (TAS-20). They then completed the Cambridge Gambling Task from which a measure of loss-chasing behavior was derived. Results Alexithymia and problem gambling risk were significantly positively correlated. Subgroups of non-alexithymic and at or near caseness for alexithymia by low risk and at risk for problem gambling were identified. The results show a clear difference for loss-chasing behavior for the two alexithymia conditions, but there was no evidence that low and at-risk problem gamblers were more likely to loss chase. The emotion-processing components of the TAS-20 were shown to correlate with loss chasing. Discussion and conclusion These findings suggest that loss-chasing behavior may be particularly prevalent in a subgroup of problem gamblers those who are high in alexithymia.

  10. Use of a screening tool and primary health care gerontology nurse specialist for high-needs older people.

    Science.gov (United States)

    King, Anna; Boyd, Michal; Dagley, Lynelle

    2017-02-01

    To describe implementation of an innovative gerontology nurse specialist role within one primary health organisation in Auckland, New Zealand. Quantitative outcomes of the screening tool as well as the nurse specialist assessment will be presented. The intervention involved use of the Brief Risk Identification for Geriatric Health Tool (BRIGHT) to identify high-needs older people with subsequent comprehensive geriatric assessment (CGA) performed by the gerontology nurse specialist. A total 384 of the 416 BRIGHTs were completed (92% response rate) and 15% of these were identified as high risk (n = 57). The BRIGHTs for high-risk older people revealed the highest scoring question was 'needing help with housework' (26%). The most frequent intervention by the gerontology nurse specialist was education (30%). The primary health care gerontology nurse specialist model delivers a proactive case finding and specialist gerontology intervention for older people at high risk of functional or health decline.

  11. Study Shows Aspirin Reduces Colorectal Cancer in Those at High Risk

    Science.gov (United States)

    Findings from the first large clinical trial of its kind indicate that taking high doses of aspirin daily for at least 2 years substantially reduces the risk of colorectal cancer among people at increased risk of the disease.

  12. Cardiovascular Disease Risk Factors in Older People with Intellectual Disabilities

    NARCIS (Netherlands)

    C.F. de Winter (Channa)

    2014-01-01

    markdownabstract__Abstract__ Chapter 1 General introduction There is an increasing group of older people with intellectual disability in The Netherlands, reaching almost the same life expectancy as the general population. Age-related diseases, such as cardiovascular disease, cancer and dementia

  13. ARE PEOPLE INEQUALITY AVERSE OR JUST RISK AVERSE?

    OpenAIRE

    Carlsson, Fredrik; Daruvala, Dinky; Johansson-Stenman, Olof

    2001-01-01

    Individuals’ preferences for risk and inequality are measured through experimental choices between hypothetical societies and lotteries. The median relative risk aversion, which is often seen to reflect social inequality aversion, is between 2 and 3. We also estimate the individual inequality aversion, reflecting individuals’ willingness to pay for living in a more equal society. Left-wing voters and women are both more risk- and inequality averse than others. The model allows for non-monoton...

  14. Sexual risk and bridging behaviors among young people in Hai Phong, Vietnam.

    Science.gov (United States)

    Duong, Cong Thanh; Nguyen, Tran Hien; Hoang, Thi Thanh Ha; Nguyen, Van Vi; Do, Thi Minh Nguyet; Pham, Van Han; Detels, Roger

    2008-07-01

    The risk of the HIV epidemic spreading from high-risk groups to the general population in Vietnam depends on sexual risk and bridging behaviors between high- and low-risk individuals. A cross-sectional study was used to describe sexual activities of youth aged 18-29 years. Nearly half (41.4%) were sexually active. Premarital sex was reported by 43.3% of them; 78.3% of sexually active males and 13.5% of sexually active females. Multiple sex partners were reported by 31.0%; 56.7% of males and 9.2% of females. Almost 27% of males and 5% of females engaged in sexual bridging behaviors. Being unmarried was significantly associated with having sex with non-regular partners. Being unmarried and early age at first intercourse were associated with having sex with a sex worker. Consistent condom use was high with commercial sex workers but low with regular partners. Education to delay early sexual debut, increased employment, and strategies to inform young sexually active people to adopt safer behaviors are urgently needed.

  15. Expanding the epidemiologic profile: risk factors for active tuberculosis in people immigrating to Ontario

    Science.gov (United States)

    Wobeser, Wendy L.; Yuan, Lilian; Naus, Monika; Corey, Paul; Edelson, Jeff; Heywood, Neil; Holness, D. Linn

    2000-01-01

    Background Many people immigrating to Canada come from countries with a high burden of tuberculosis. The aim of this study was to develop a detailed epidemiologic profile of foreign-born people with tuberculosis living in Ontario. Methods In this population-based case-control study, cases of tuberculosis diagnosed in 1994-1995 were identified from the database of the Ontario Reportable Disease Information Service and were considered eligible for analysis if a record of landing (receipt of permission to establish residence in Canada) from the period 1986-1995 was found in the Citizenship and Immigration Canada (CIC) database, if the person was at least 11 years of age at the time their visa was issued, and if the person had not been diagnosed with tuberculosis before becoming legally landed in Canada. Control subjects, who met the same criteria as the case subjects but who did not have tuberculosis in 1994-1995, were identified from a CIC database for landed immigrants. Results A total of 1341 cases of tuberculosis in foreign-born people were reported in Ontario in 1994-1995. A record of landing was found in CIC databases for 1099 of these people, 224 of whom were not legally landed at the time of diagnosis. In total, 602 cases met the inclusion criteria. The 2 strongest determinants of risk among those who had become landed within the preceding 10 years were referral for medical surveillance by immigration officials (odds ratio [OR] 3.8, 95% confidence interval [CI] 2.6-6.0) and world region of origin (Somalia [OR 67.7, 95% CI 31.3-154.9], Vietnam [OR 25.0, 95% CI 12.5-50.0], the Philippines [OR 11.9, 95% CI 6.0-23.3], other sub-Saharan African countries [OR 11.6, 95% CI 5.7-23.2], India [OR 9.7, 95% CI 4.9-18.9], China [OR 6.1, 95% CI 3.1-12.1], other Asian countries [OR 4.7, 95% CI 2.4-9.1], the Middle East [OR 4.1, 95% CI 2.0-8.3], Latin America [OR 1.9, 95% CI 0.9-3.8), and the former socialist countries of Europe [OR 1.8, 95% CI 0.8-3.8]; the reference

  16. Prevalence of risk factors for falls among elderly people living in long-term care homes

    OpenAIRE

    Pradnya Dhargave, PhD; Ragupathy Sendhilkumar, MSc, MPT

    2016-01-01

    Background: Falls are common among the geriatric population, causing frequent morbidity and mortality. There is an increased risk of fall among older people living in long-term care homes. Identifying risk factors for falls among older people living in old-age homes can help in the care and prevention of falls in this population. Aim: To evaluate the prevalence of various risk factors for falls among older people living in long-term care homes. Methods: A total of 163 elderly men and wo...

  17. Prevalence of hypertension and associated risk factors in people with long-term spinal cord injury living in the Netherlands

    NARCIS (Netherlands)

    Adriaansen, Jacinthe J E; Douma-Haan, Yvonne; van Asbeck, Floris W A; van Koppenhagen, Casper F; de Groot, Sonja; Smit, Christof A; Visser-Meily, Johanna M A; Post, Marcel W M

    PURPOSE: To describe the prevalence of hypertension and associated risk factors in people with long-term spinal cord injury (SCI) and to compare the prevalence of high blood pressure and/or the use of antihypertensive drugs with the prevalence in the Dutch general population. METHOD: Multicentre

  18. Alcohol-Related Problems And High Risk Sexual Behaviour In ...

    African Journals Online (AJOL)

    There was a significant association between alcohol-related problems and risky sexual behavior. Alcohol-related problems are fairly common in people already infected with HIV/AIDS and are associated with high-risk sexual behavior. Thus, screening and treatment should be part of an effective HIV intervention program.

  19. SExUAL RISK BEHAVIOUR AMONGST YOUNG PEOPLE IN THE ...

    African Journals Online (AJOL)

    2010-11-08

    Nov 8, 2010 ... This work ... The objectives of this study were (1) to identify sexual risk behaviour, (2) to establish the prevalence of substance use before sexual intercourse, .... translated into Xitsonga and back into English to ensure that the.

  20. Obstetrical complications in people at risk for developing schizophrenia

    OpenAIRE

    Ballon, Jacob S; Seeber, Katherine; Cadenhead, Kristin S

    2007-01-01

    Many factors have been associated with the development of schizophrenia, yet few studies have looked at these same factors in individuals considered at risk for schizophrenia, but who have not yet reached diagnostic threshold. The rate of obstetrical complications was assessed as part of a comprehensive battery in subjects at risk (N=52), or in the first episode of schizophrenia (N=18), and in normal comparison subjects (N=43). The rate of obstetrical complications was increased in the at ris...

  1. People at risk - nexus critical infrastructure and society

    Science.gov (United States)

    Heiser, Micha; Thaler, Thomas; Fuchs, Sven

    2016-04-01

    Strategic infrastructure networks include the highly complex and interconnected systems that are so vital to a city or state that any sudden disruption can result in debilitating impacts on human life, the economy and the society as a whole. Recently, various studies have applied complex network-based models to study the performance and vulnerability of infrastructure systems under various types of attacks and hazards - a major part of them is, particularly after the 9/11 incident, related to terrorism attacks. Here, vulnerability is generally defined as the performance drop of an infrastructure system under a given disruptive event. The performance can be measured by different metrics, which correspond to various levels of resilience. In this paper, we will address vulnerability and exposure of critical infrastructure in the Eastern Alps. The Federal State Tyrol is an international transport route and an essential component of the north-south transport connectivity in Europe. Any interruption of the transport flow leads to incommensurable consequences in terms of indirect losses, since the system does not feature redundant elements at comparable economic efficiency. Natural hazard processes such as floods, debris flows, rock falls and avalanches, endanger this infrastructure line, such as large flood events in 2005 or 2012, rock falls 2014, which had strong impacts to the critical infrastructure, such as disruption of the railway lines (in 2005 and 2012), highways and motorways (in 2014). The aim of this paper is to present how critical infrastructures as well as communities and societies are vulnerable and can be resilient against natural hazard risks and the relative cascading effects to different compartments (industrial, infrastructural, societal, institutional, cultural, etc.), which is the dominant by the type of hazard (avalanches, torrential flooding, debris flow, rock falls). Specific themes will be addressed in various case studies to allow cross

  2. Using participatory risk mapping (PRM to identify and understand people's perceptions of crop loss to animals in Uganda.

    Directory of Open Access Journals (Sweden)

    Amanda D Webber

    Full Text Available Considering how people perceive risks to their livelihoods from local wildlife is central to (i understanding the impact of crop damage by animals on local people and (ii recognising how this influences their interactions with, and attitudes towards, wildlife. Participatory risk mapping (PRM is a simple, analytical tool that can be used to identify and classify risk within communities. Here we use it to explore local people's perceptions of crop damage by wildlife and the animal species involved. Interviews (n = 93, n = 76 and seven focus groups were conducted in four villages around Budongo Forest Reserve, Uganda during 2004 and 2005. Farms (N = 129 were simultaneously monitored for crop loss. Farmers identified damage by wildlife as the most significant risk to their crops; risk maps highlighted its anomalous status compared to other anticipated challenges to agricultural production. PRM was further used to explore farmers' perceptions of animal species causing crop damage and the results of this analysis compared with measured crop losses. Baboons (Papio anubis were considered the most problematic species locally but measurements of loss indicate this perceived severity was disproportionately high. In contrast goats (Capra hircus were considered only a moderate risk, yet risk of damage by this species was significant. Surprisingly, for wild pigs (Potamochoerus sp, perceptions of severity were not as high as damage incurred might have predicted, although perceived incidence was greater than recorded frequency of damage events. PRM can assist researchers and practitioners to identify and explore perceptions of the risk of crop damage by wildlife. As this study highlights, simply quantifying crop loss does not determine issues that are important to local people nor the complex relationships between perceived risk factors. Furthermore, as PRM is easily transferable it may contribute to the identification and development of

  3. Prevalence and risk factors for HIV among people aged 50 years ...

    African Journals Online (AJOL)

    JOHN

    reproductive and sexual health characteristics of the participants, knowledge on HIV ... Keywords: HIV, older adults, prevalence, knowledge, risk factors, Tanzania ... With increased availability of ART, people are living longer and age with HIV ...

  4. Risks, consequences, and prevention of falls of older people in oral healthcare centers.

    NARCIS (Netherlands)

    Baat, C. de; Baat, P. de; Gerritsen, A.E.; Flohil, K.A.; Putten, G.J. van der; Maarel-Wierink, C.D. van der

    2017-01-01

    One-third of community-dwelling people older than 65 years of age fall each year, and half of them fall at least twice a year. Older care home residents are approximately three times more likely to fall when compared to community-dwelling older people. Risk indicators for falls are related to the

  5. Two-year trajectory of fall risk in people with Parkinson’s disease: a latent class analysis

    Science.gov (United States)

    Paul, Serene S; Thackeray, Anne; Duncan, Ryan P; Cavanaugh, James T; Ellis, Theresa D; Earhart, Gammon M; Ford, Matthew P; Foreman, K Bo; Dibble, Leland E

    2015-01-01

    Objective To examine fall risk trajectories occurring naturally in a sample of individuals with early to middle stage Parkinson’s disease (PD). Design Latent class analysis, specifically growth mixture modeling (GMM) of longitudinal fall risk trajectories. Setting Not applicable. Participants 230 community-dwelling PD participants of a longitudinal cohort study who attended at least two of five assessments over a two year period. Interventions Not applicable. Main Outcome Measures Fall risk trajectory (low, medium or high risk) and stability of fall risk trajectory (stable or fluctuating). Fall risk was determined at 6-monthly intervals using a simple clinical tool based on fall history, freezing of gait, and gait speed. Results The GMM optimally grouped participants into three fall risk trajectories that closely mirrored baseline fall risk status (p=.001). The high fall risk trajectory was most common (42.6%) and included participants with longer and more severe disease and with higher postural instability and gait disability (PIGD) scores than the low and medium risk trajectories (pfall risk (posterior probability fall risk trajectories over two years. Further investigation is required to determine whether interventions to improve gait and balance may improve fall risk trajectories in people with PD. PMID:26606871

  6. people who inject drugs, HIV risk, and HIV testing uptake in sub-Saharan Africa.

    Science.gov (United States)

    Asher, Alice K; Hahn, Judith A; Couture, Marie-Claude; Maher, Kelsey; Page, Kimberly

    2013-01-01

    Dramatic rises in injection drug use (IDU) in sub-Saharan Africa account for increasingly more infections in a region already overwhelmed by the HIV epidemic. There is no known estimate of the number of people who inject drugs (PWID) in the region, or the associated HIV prevalence in PWID. We reviewed literature with the goal of describing high-risk practices and exposures in PWID in sub-Saharan Africa, as well as current HIV prevention activities aimed at drug use. The literature search looked for articles related to HIV risk, injection drug users, stigma, and HIV testing in sub-Saharan Africa. This review found evidence demonstrating high rates of HIV in IDU populations in sub-Saharan Africa, high-risk behaviors of the populations, lack of knowledge regarding HIV, and low HIV testing uptake. There is an urgent need for action to address IDU in order to maintain recent decreases in the spread of HIV in sub-Saharan Africa. Copyright © 2013 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  7. Agent of opportunity risk mitigation: people, engineering, and security efficacy.

    Science.gov (United States)

    Graham, Margaret E; Tunik, Michael G; Farmer, Brenna M; Bendzans, Carly; McCrillis, Aileen M; Nelson, Lewis S; Portelli, Ian; Smith, Silas; Goldberg, Judith D; Zhang, Meng; Rosenberg, Sheldon D; Goldfrank, Lewis R

    2010-12-01

    Agents of opportunity (AO) are potentially harmful biological, chemical, radiological, and pharmaceutical substances commonly used for health care delivery and research. AOs are present in all academic medical centers (AMC), creating vulnerability in the health care sector; AO attributes and dissemination methods likely predict risk; and AMCs are inadequately secured against a purposeful AO dissemination, with limited budgets and competing priorities. We explored health care workers' perceptions of AMC security and the impact of those perceptions on AO risk. Qualitative methods (survey, interviews, and workshops) were used to collect opinions from staff working in a medical school and 4 AMC-affiliated hospitals concerning AOs and the risk to hospital infrastructure associated with their uncontrolled presence. Secondary to this goal, staff perception concerning security, or opinions about security behaviors of others, were extracted, analyzed, and grouped into themes. We provide a framework for depicting the interaction of staff behavior and access control engineering, including the tendency of staff to "defeat" inconvenient access controls. In addition, 8 security themes emerged: staff security behavior is a significant source of AO risk; the wide range of opinions about "open" front-door policies among AMC staff illustrates a disparity of perceptions about the need for security; interviewees expressed profound skepticism concerning the effectiveness of front-door access controls; an AO risk assessment requires reconsideration of the security levels historically assigned to areas such as the loading dock and central distribution sites, where many AOs are delivered and may remain unattended for substantial periods of time; researchers' view of AMC security is influenced by the ongoing debate within the scientific community about the wisdom of engaging in bioterrorism research; there was no agreement about which areas of the AMC should be subject to stronger access

  8. People's responses to risks of electromagnetic fields and trust in government policy: the role of perceived risk, benefits and control

    NARCIS (Netherlands)

    Dongen, D.; Claassen, L.; Smid, T.; Timmermans, D.R.M.

    2013-01-01

    Trust in government policy affects the way people perceive and handle risks. In our study, we investigated the relationships between trust in government policy regarding electromagnetic fields (EMF), perceived risk and perceived benefits of public and personal EMF sources, perceived control over

  9. Petroleum business of high risk

    International Nuclear Information System (INIS)

    Carta Petrolera

    2001-01-01

    The paper is about the economic risk and of the geologic risk that assist the industry of the petroleum; an analysis of these types of risk, possibilities of success and investments to carry out in the search of hydrocarbons are made

  10. Falls in older people: risk factors and strategies for prevention

    National Research Council Canada - National Science Library

    Lord, Stephen R. (Stephen Ronald)

    2007-01-01

    ... on visual, neuropsychological and medical risk factors. The book also reviews the numerous new randomized controlled trials that have examined the effects of exercise, visual, cardiovascular and environmental interventions in preventing falls. The new edition will be an invaluable update for medical practitioners, physiotherapists, occupational therap...

  11. People with Increased Risk of Eye Damage from UV Light

    Science.gov (United States)

    ... With Increased Risk of Eye Damage from UV Light Leer en Español: Algunas Personas Están en Mayor Riesgo de Sufrir Daño Ocular por los Rayos UV Written By: Shirley Dang Apr. 30, 2014 Everyone of any age and any degree of skin pigmentation is susceptible to UV damage. Children are ...

  12. Risk factors of suicide attempt among people with suicidal ideation in South Korea: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Soo Beom Choi

    2017-06-01

    Full Text Available Abstract Background Suicide is a serious public health concern worldwide, and the fourth leading cause of death in Korea. Few studies have focused on risk factors for suicide attempt among people with suicidal ideation. The aim of the present study was to investigate the risk factors and develop prediction models for suicide attempt among people with suicidal ideation in the Korean population. Method This study included 1567 men and 3726 women aged 20 years and older who had suicidal ideation from the Korea National Health and Nutrition Examination Survey from 2007 to 2012. Among them, 106 men and 188 women attempted suicide. Multivariate logistic regression analysis with backward stepwise elimination was performed to find risk factors for suicide attempt. Sub-group analysis, dividing participants into under 50 and at least 50 years old was also performed. Results Among people with suicidal ideation, age, education, cancer, and depressive disorder were selected as risk factors for suicide attempt in men. Age, education, national basic livelihood security, daily activity limitation, depressive disorder, stress, smoking, and regular exercise were selected in women. Area under curves of our prediction models in men and women were 0.728 and 0.716, respectively. Conclusions It is important to pay attention to populations with suicidal ideation and the risk factors mentioned above. Prediction models using the determined risk factors could be useful to detect high-risk groups early for suicide attempt among people with suicidal ideation. It is necessary to develop specific action plans for these high-risk groups to prevent suicide.

  13. Risk factors of suicide attempt among people with suicidal ideation in South Korea: a cross-sectional study.

    Science.gov (United States)

    Choi, Soo Beom; Lee, Wanhyung; Yoon, Jin-Ha; Won, Jong-Uk; Kim, Deok Won

    2017-06-15

    Suicide is a serious public health concern worldwide, and the fourth leading cause of death in Korea. Few studies have focused on risk factors for suicide attempt among people with suicidal ideation. The aim of the present study was to investigate the risk factors and develop prediction models for suicide attempt among people with suicidal ideation in the Korean population. This study included 1567 men and 3726 women aged 20 years and older who had suicidal ideation from the Korea National Health and Nutrition Examination Survey from 2007 to 2012. Among them, 106 men and 188 women attempted suicide. Multivariate logistic regression analysis with backward stepwise elimination was performed to find risk factors for suicide attempt. Sub-group analysis, dividing participants into under 50 and at least 50 years old was also performed. Among people with suicidal ideation, age, education, cancer, and depressive disorder were selected as risk factors for suicide attempt in men. Age, education, national basic livelihood security, daily activity limitation, depressive disorder, stress, smoking, and regular exercise were selected in women. Area under curves of our prediction models in men and women were 0.728 and 0.716, respectively. It is important to pay attention to populations with suicidal ideation and the risk factors mentioned above. Prediction models using the determined risk factors could be useful to detect high-risk groups early for suicide attempt among people with suicidal ideation. It is necessary to develop specific action plans for these high-risk groups to prevent suicide.

  14. IRSN 2011 opinion survey. The perception of risks and safety by French people. Global results

    International Nuclear Information System (INIS)

    2011-01-01

    Like every year, this report presents and comments the results of an opinion survey on risks, and more particularly on nuclear and radiological risks. The first part addresses the current concerns of French people (the main concerns in the present society and with respect to the environment, how science is considered). The second part addresses the opinion on expertise (who should control a hazardous installation, the role and image of experts, the access to expertise files, the perception of pluralist bodies). The third part examines the reaction of people in front of 33 different hazardous situations (risks to which people feel being exposed, confidence in authorities, confidence in information on hazards, hierarchy of 33 situations and relationship with installation acceptability). The fourth part addresses the nuclear issue (nuclear risk, ability and credibility of nuclear actors, the Chernobyl accident, radioactive wastes, demand of information on the nuclear risk).

  15. Is the way young people drive a reflection of the way their parents drive? An econometric study of the relation between parental risk and their children's risk.

    Science.gov (United States)

    Lahatte, Agénor; Le Pape, Marie-Clémence

    2008-06-01

    This article aims to investigate parental influence on high-risk behavior by young people. Although research on the topic of perception of risk demonstrates that it is socially constructed, the role of the family in this construction has rarely been studied. Using a French national survey of more than 1,200 young drivers between the ages of 18 and 25, and their parents, we attempt to understand the transmission of risk within families. Our econometric study shows that parents influence both the practices and representations of their children. When parental norms and values are transmitted, they are by no means accepted in a wholly passive way. Indeed, the parental model is in competition with other models that originate from both inside the family (brothers and sisters) and outside it (instructors). Furthermore, parental influence decreases over time as young people become more experienced drivers and construct their own identity with regard to risk.

  16. Can people with Raynaud's phenomenon travel to high altitude?

    Science.gov (United States)

    Luks, Andrew M; Grissom, Colin K; Jean, Dominique; Swenson, Erik R

    2009-01-01

    To determine whether high altitude travel adversely affects mountain enthusiasts with Raynaud's phenomenon. Volunteers with Raynaud's phenomenon were recruited using announcements disseminated by organizations dedicated to climbing or wilderness travel and Internet discussion boards dedicated to mountain activities to complete an online, anonymous survey. Survey questions addressed demographic variables, aspects of their Raynaud's phenomenon, and features of their mountain activities. Respondents compared experiences with Raynaud's phenomenon between high (>2440 m; 8000 feet) and low elevations and rated agreement with statements concerning their disease and the effects of high altitude. One hundred forty-two people, 98% of whom had primary Raynaud's phenomenon, completed the questionnaire. Respondents spent 5 to 7 days per month at elevations above 2440 m and engaged in 5.4 +/- 2.0 different activities. Eighty-nine percent of respondents engaged in winter sports and only 22% reported changing their mountain activities because of Raynaud's phenomenon. Respondents reported a variety of tactics to prevent and treat Raynaud's attacks, but only 12% used prophylactic medications. Fifteen percent of respondents reported an episode of frostbite following a Raynaud's phenomenon attack at high altitude. There was considerable heterogeneity in participants' perceptions of the frequency, duration, and severity of attacks at high altitude compared to their home elevation. Motivated individuals with primary Raynaud's phenomenon, employing various prevention and treatment strategies, can engage in different activities, including winter sports, at altitudes above 2440 m. Frostbite may be common in this population at high altitude, and care must be taken to prevent its occurrence.

  17. Indoor Tanning and the MC1R Genotype: Risk Prediction for Basal Cell Carcinoma Risk in Young People

    OpenAIRE

    Molinaro, Annette M.; Ferrucci, Leah M.; Cartmel, Brenda; Loftfield, Erikka; Leffell, David J.; Bale, Allen E.; Mayne, Susan T.

    2015-01-01

    Basal cell carcinoma (BCC) incidence is increasing, particularly in young people, and can be associated with significant morbidity and treatment costs. To identify young individuals at risk of BCC, we assessed existing melanoma or overall skin cancer risk prediction models and built a novel risk prediction model, with a focus on indoor tanning and the melanocortin 1 receptor gene, MC1R. We evaluated logistic regression models among 759 non-Hispanic whites from a case-control study of patients...

  18. Risk factors associated with reduced work productivity among people with chronic knee pain.

    Science.gov (United States)

    Agaliotis, M; Fransen, M; Bridgett, L; Nairn, L; Votrubec, M; Jan, S; Heard, R; Mackey, M

    2013-09-01

    To determine the burden and risk factors associated with reduced work productivity among people with chronic knee pain. A longitudinal study, nested within a randomised controlled trial (RCT) evaluating the long-term effects of dietary supplements, was conducted among people with chronic knee pain in paid employment (n = 360). Participants recorded days off work (absenteeism) and reduced productivity while at work (presenteeism) for seven days every two months over a 12-month period in a study specific diary. Examined risk factors included knee pain severity, occupational group, radiographic disease severity, physical activity, body mass index (BMI), health-related quality of life (SF-12) and co-morbidity. Over the 12-month follow up period, 50 (14%) participants reported one or more days off work due to knee problems, while 283 (79%) reported reduced productivity while at work (presenteeism absenteeism was having an SF-12 Mental Component Summary (MCS) score labour (OR: 2.23 [1.09-4.59]) or manual labour (OR: 6.40 [1.44-28.35]) or a high maximum knee pain (4-6 out of 10) (OR: 2.29 [1.17-4.46]). This longitudinal study found that among this cohort of people with chronic knee pain, the burden of reduced work productivity is mainly attributable to presenteeism rather absenteeism. This study demonstrated that effective strategies to increase work productivity should focus on reducing knee pain or physical disability especially among workers in manual or semi-manual labour. © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  19. High school incompletion and childhood maltreatment among street-involved young people in Vancouver, Canada.

    Science.gov (United States)

    Barker, Brittany; Kerr, Thomas; Dong, Huiru; Wood, Evan; DeBeck, Kora

    2017-03-01

    While the link between educational attainment and future health and wellness is well understood, little investigation has considered the potential impacts of distinct forms of childhood maltreatment on high school completion. In the present study, the relationship between five categories of childhood maltreatment (physical, emotional, and sexual abuse, and physical and emotional neglect) and completion of high school education were examined using the Childhood Trauma Questionnaire (CTQ). From September 2005 to May 2013, data were collected for the At-Risk Youth Study (ARYS), a cohort of street-involved young people who use illicit drugs in Vancouver, Canada. We used logistic regression to examine the relationship between childhood maltreatment and high school completion, while controlling for a range of potential confounding variables. Specifically, five separate models for each category of maltreatment and two combined models were employed to examine the relative associations between, and cumulative impact of, different forms of childhood maltreatment and educational attainment. Among 974 young people, 737 (76%) reported not completing high school. In separate multivariable analyses physical abuse, emotional abuse, physical neglect, and emotional neglect remained positively and independently associated with an incomplete high school education. In a combined multivariable model with all forms of childhood maltreatment considered together, emotional abuse (adjusted odds ratio = 2.08; 95% confidence interval: 1.51-2.86) was the only form of maltreatment that remained significantly associated with an incomplete high school education. The cumulative impact assessment indicated a moderate dose-dependent trend where the greater the number of different forms of childhood maltreatment the greater the risk of not completing a high school education. These findings point to the need for trauma-informed interventions to improve educational attainment among vulnerable young

  20. Hegemonic Masculinity, HIV/AIDS Risk Perception, and Sexual Behavior Change Among Young People in Ghana.

    Science.gov (United States)

    Ganle, John Kuumuori

    2016-05-01

    Among the youth in some parts of sub-Saharan Africa, a paradoxical mix of adequate knowledge of HIV/AIDS and high-risk behavior characterizes their daily lives. Based on original qualitative research in Ghana, I explore in this article the ways in which the social construction of masculinity influences youth's responses to behavior change HIV/AIDS prevention interventions. Findings show that although awareness of the HIV/AIDS epidemic and the risks of infection is very high among the youth, a combination of hegemonic masculinity and perceptions of personal invulnerability acts to undermine the processes of young people's HIV/AIDS risk construction and appropriate behavioral change. I argue that if HIV/AIDS prevention is to be effective and sustained, school- and community-based initiatives should be developed to provide supportive social spaces in which the construction of masculinity, the identity of young men and women as gendered persons, and perceptions of their vulnerability to HIV/AIDS infection are challenged. © The Author(s) 2015.

  1. Living alone, receiving help, helplessness, and inactivity are strongly related to risk of undernutrition among older home-dwelling people

    Directory of Open Access Journals (Sweden)

    Tomstad ST

    2012-03-01

    Full Text Available Solveig T Tomstad1, Ulrika Söderhamn2, Geir Arild Espnes3, Olle Söderhamn21Department of Social Work and Health Science, Faculty of Sciences and Technology Management, NTNU, Trondheim, Norway and Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway; 2Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway; 3Research Centre for Health Promotion and Resources HiST-NTNU, Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, NTNU, Trondheim, NorwayBackground: Being at risk of undernutrition is a global problem among older people. Undernutrition can be considered inadequate nutritional status, characterized by insufficient food intake and weight loss. There is a lack of Norwegian studies focusing on being at risk of undernutrition and self-care ability, sense of coherence, and health-related issues among older home-dwelling people.Aim: To describe the prevalence of being at risk of undernutrition among a group of older home-dwelling individuals in Norway, and to relate the results to reported self-care ability, sense of coherence, perceived health and other health-related issues.Methods: A cross-sectional design was applied. A questionnaire with instruments for nutritional screening, self-care ability, and sense of coherence, and health-related questions was sent to a randomized sample of 450 persons (aged 65+ years in southern Norway. The study group included 158 (35.1% participants. Data were analysed using statistical methods.Results: The results showed that 19% of the participants were at medium risk of undernutrition and 1.3% at high risk. Due to the low response rate it can be expected that the nonparticipants can be at risk of undernutrition. The nutritional at-risk group had lower self-care ability and weaker sense of coherence. Living alone, receiving help

  2. Seroepidemiological Study of Brucellosis in High Risk Groups in Boyerahmad 1384

    Directory of Open Access Journals (Sweden)

    AM Khosravani

    2007-01-01

    Full Text Available ABSTRACT: Introduction & Objective: Brucellosis is a zoonotic disease that may have a major public health and economic impact in most countries. The disease appears as a Malt fever in humans and abortion in animals. This study was designed to determine the serologic titer of Brucella in high risk and non high risk people in Boyerahmad. Materials & Methods: A retrospective seroepidemiological study was performed on samples collected from 604 high risk and non high risk people using Rose Bengol test, tube standard test as a rapid test and 2 mercaptoethanol (2ME and comb's wright as a confirmatory test. The data collected were analyzed by X2 test via SPSS. Results: Seroprevalence of Brucellosis in high risk people appeared to be high in the Rose Bengal and tube standard test (TST 6.62 at titer ≥1/40 whereas for non high risk it was 0%. Confirmation test in high risk people was shown with 2ME in four people. Conclusion: Brucellosis is a major cause of disease in high risk people which can be due to direct or indirect contact with diary products of the related animals.

  3. The relation of vitamin D, metabolic risk and negative symptom severity in people with psychotic disorders

    NARCIS (Netherlands)

    Bruins, J.; Jörg, F.; van den Heuvel, E.R.; Bartels-Velthuis, A.A.; Corpeleijn, E.; Muskiet, F.A.J.; Pijnenborg, G.H.M.; Bruggeman, R.

    2018-01-01

    People with psychotic disorders have an increased metabolic risk and their mean life expectancy is reduced with circa 28 years (Olfson et al., 2015).Predictors of this increased metabolic risk are genetic predisposition (Liu et al., 2013), lifestyle factors such as unhealthy diet, physical

  4. Coronary Heart Disease Risk Factors in Young People of Differing Socio-Economic Status

    Science.gov (United States)

    Thomas, Non-Eleri; Cooper, Stephen-Mark; Williams, Simon P.; Baker, Julien S.; Davies, Bruce

    2005-01-01

    This study determined the prevalence of coronary heart disease (CHD) risk factors in young people of differing socio-economic status (SES). A cohort of 100 boys and 108 girls, aged 12.9, SD 0.3 years drawn of differing SES were assessed for CHD risk factors. Measurements included indices of obesity, blood pressure, aerobic fitness, diet, blood…

  5. A longitudinal study of change in falls risk and balance and mobility in healthy older people and people with Alzheimer disease.

    Science.gov (United States)

    Suttanon, Plaiwan; Hill, Keith D; Said, Catherine M; Dodd, Karen J

    2013-08-01

    The aim of this study was to determine the rate of change in falls risk and balance and mobility performance in people with Alzheimer disease (AD) compared with those of healthy older people over a 1-yr period. A 1-yr follow-up study of change in levels of falls risk, balance, and mobility performance in 15 community-dwelling older people with mild to moderate AD and 15 healthy age-matched older people was conducted. Each participant completed a comprehensive assessment of balance and mobility, falls and falls risk, and level of physical activity at baseline and 1 yr later. The rate of increase in the number of falls and risk of falling was greater in people with AD. The rate of deterioration on a number of balance and mobility measures was also significantly greater in people with AD compared with the healthy older people. People with mild to moderate AD have an increased rate of decline in falls risk, balance, and mobility over a 12-mo period compared with age-matched healthy older people. Given this increased rate of decline, intermittent review of falls, balance and mobility, and interventions to address identified contributory risk factors should be considered by health practitioners.

  6. People with insomnia: experiences with sedative hypnotics and risk perception.

    Science.gov (United States)

    Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Ellis, Jason G; Saini, Bandana

    2016-08-01

    Sedative hypnotics form an important part of managing insomnia and are recommended for short-term use. It is standard practice for clinicians to inform the patient to use medications only 'when required', but the use of these medications is often chronic. Little is known about the impact of standard labelling/instructions on promoting appropriate medication use for managing insomnia. To explore patient medication-taking beliefs, experiences and behavioural practices relating to the use of pharmacological/complementary sleep aids for insomnia. Specialist sleep/psychology clinics and the general community in Sydney, Australia. Semi-structured interviews were conducted with 51 people with insomnia using a schedule of questions to gauge their experiences, beliefs and current practices relating to insomnia medication use. Interviews were audio-recorded, transcribed verbatim and subjected to Framework Analysis to identify emergent themes. Participants held distinctive views about the safety and efficacy of complementary and pharmacological agents but do not intuitively turn to medications to resolve their sleep complaint. Medication use was affirmed through tangible medication-taking cues due to the ambivalence in current instructions and labelling. Practices such as dosage modification, medication substitution and delaying medication use might be important drivers for psychological dependence. Current labelling and instructions do not necessarily promote the quality use of sedative hypnotics due to the variability in patient interpretations. Clarifying the timing, quantity and frequency of medication administration as well as insomnia symptom recognition would play a significant role in optimizing the role of pharmacotherapy in the management of insomnia. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  7. Risk perception in women with high-risk pregnancies

    OpenAIRE

    Lee, S.

    2014-01-01

    Risk perception in women with high risk pregnancies affects the decisions they make about antenatal care and so may therefore influence the wellbeing of mother and baby. This article addresses the factors which influence women when making risk assessments and how these assessments may differ from those of healthcare professionals.\\ud \\ud Women use multiple sources of information to determine their risk status including advice from professionals, from other trusted sources, and their own intui...

  8. The relative contribution of physical and cognitive fall risk factors in people with Parkinson's disease: a large prospective cohort study.

    Science.gov (United States)

    Paul, Serene S; Sherrington, Catherine; Canning, Colleen G; Fung, Victor S C; Close, Jacqueline C T; Lord, Stephen R

    2014-01-01

    In order to develop multifaceted fall prevention strategies for people with Parkinson's disease (PD), greater understanding of the impact of physical and cognitive performance on falls is required. We aimed to identify the relative contribution of a comprehensive range of physical and cognitive risk factors to prospectively-measured falls in a large sample of people with PD and develop an explanatory multivariate fall risk model in this group. METHODS MEASURES: of PD signs and symptoms, freezing of gait, balance, mobility, proprioception, leg muscle strength, and cognition were collected on 205 community-dwelling people with PD. Falls were monitored prospectively for 6 months using falls diaries. A total of 120 participants (59%) fell during follow-up. Freezing of gait (P falls in univariate analyses. Freezing of gait (risk ratio [RR] = 1.03, 95% confidence interval [CI] = 1.00-1.05, P = .02), impaired anticipatory (RR = 1.01, 95% CI = 1.00-1.02, P = .03) and reactive (RR = 1.26, 95% CI = 1.01-1.58, P = .04) balance, and impaired orientation (RR = 1.28, 95% CI = 1.01-1.62, P = .04) maintained significant associations with falls in multivariate analysis. The study findings elucidate important physical and cognitive determinants of falls in people with PD and may assist in developing efficacious fall prevention strategies for this high-risk group.

  9. Achieving High Reliability with People, Processes, and Technology.

    Science.gov (United States)

    Saunders, Candice L; Brennan, John A

    2017-01-01

    High reliability as a corporate value in healthcare can be achieved by meeting the "Quadruple Aim" of improving population health, reducing per capita costs, enhancing the patient experience, and improving provider wellness. This drive starts with the board of trustees, CEO, and other senior leaders who ingrain high reliability throughout the organization. At WellStar Health System, the board developed an ambitious goal to become a top-decile health system in safety and quality metrics. To achieve this goal, WellStar has embarked on a journey toward high reliability and has committed to Lean management practices consistent with the Institute for Healthcare Improvement's definition of a high-reliability organization (HRO): one that is committed to the prevention of failure, early identification and mitigation of failure, and redesign of processes based on identifiable failures. In the end, a successful HRO can provide safe, effective, patient- and family-centered, timely, efficient, and equitable care through a convergence of people, processes, and technology.

  10. People

    Science.gov (United States)

    2001-01-01

    Thrilled at @Bristol Kathy Sykes in conversation with Liz Whitelegg. Kathy Sykes is Senior Science Consultant at @Bristol - a new area on Bristol's Harbourside with a Science Centre Explore, a Wildlife Centre Wildscreen, with sculptures and fountains. Kathy was one of five people in 1999 to be awarded an IOP Public Awareness of Physics award. Dr Kathy Sykes What attracted you to Physics in the first place? It was really when I discovered that Physics was all about making models of the world, because then suddenly the ability to be creative became important. I liked the idea that you could have a picture of the world that might work quite well but you could always replace that with a better one. That was what made science come alive and make it seem like something that I'd really love to be involved in, rather than science as a stale body of facts that I needed to learn. I was much more interested in ideas than in facts. I think that finding out about 'models' happened around the time I was discovering quantum mechanics and how the act of observing something can actually affect the outcome. I found it incredibly exciting - especially how that changed the whole philosophy of science. I also had a fantastic teacher in physics and I owe an awful lot to him. He just swooped in at the last moment when I was considering giving it up so that made an enormous difference. After my degree I went to teach maths and physics A-level in Zimbabwe with the VSO, and it was partly wanting to share my excitement with other people about physics that made me want to go and teach abroad. When I came back and began my PhD in Physics at Bristol University, I missed teaching and thought it was important to get the public more involved in science and debates about science. My supervisor, Pete Barham, was doing lots of this himself, and he helped and encouraged me enormously. I can't thank him enough. Did you consider teaching as a career? Well I like having the carpet whipped away from

  11. BMI and risk of dementia in two million people over two decades: a retrospective cohort study.

    Science.gov (United States)

    Qizilbash, Nawab; Gregson, John; Johnson, Michelle E; Pearce, Neil; Douglas, Ian; Wing, Kevin; Evans, Stephen J W; Pocock, Stuart J

    2015-06-01

    Dementia and obesity are increasingly important public health issues. Obesity in middle age has been proposed to lead to dementia in old age. We investigated the association between BMI and risk of dementia. For this retrospective cohort study, we used a cohort of 1,958,191 individuals derived from the United Kingdom Clinical Practice Research Datalink (CPRD) which included people aged 40 years or older in whom BMI was recorded between 1992 and 2007. Follow-up was until the practice's final data collection date, patient death or transfer out of practice, or first record of dementia (whichever occurred first). People with a previous record of dementia were excluded. We used Poisson regression to calculate incidence rates of dementia for each BMI category. Our cohort of 1,958,191 people from UK general practices had a median age at baseline of 55 years (IQR 45-66) and a median follow-up of 9·1 years (IQR 6·3-12·6). Dementia occurred in 45,507 people, at a rate of 2·4 cases per 1000 person-years. Compared with people of a healthy weight, underweight people (BMI risk of dementia. Furthermore, the incidence of dementia continued to fall for every increasing BMI category, with very obese people (BMI >40 kg/m(2)) having a 29% lower (95% CI 22-36) dementia risk than people of a healthy weight. These patterns persisted throughout two decades of follow-up, after adjustment for potential confounders and allowance for the J-shape association of BMI with mortality. Being underweight in middle age and old age carries an increased risk of dementia over two decades. Our results contradict the hypothesis that obesity in middle age could increase the risk of dementia in old age. The reasons for and public health consequences of these findings need further investigation. None. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Biomedical Risk Factors of Achilles Tendinopathy in Physically Active People: a Systematic Review

    OpenAIRE

    Kozlovskaia, Maria; Vlahovich, Nicole; Ashton, Kevin J.; Hughes, David C.

    2017-01-01

    Background Achilles tendinopathy is the most prevalent tendon disorder in people engaged in running and jumping sports. Aetiology of Achilles tendinopathy is complex and requires comprehensive research of contributing risk factors. There is relatively little research focussing on potential biomedical risk factors for Achilles tendinopathy. The purpose of this systematic review is to identify studies and summarise current knowledge of biomedical risk factors of Achilles tendinopathy in physica...

  13. IRSN 2017 opinion survey. The perception of risks and safety by French people. Global results

    International Nuclear Information System (INIS)

    El Jammal, Marie-Helene; Charron, Sylvie; Mur, Emmanuelle; Schuler, Matthieu; Tchernia, Jean-francois

    2017-07-01

    Like every year, this report presents and comments the results of an opinion survey on risks, and more particularly on risks related to nuclear and radiological activities. The first part addresses the current concerns of French people (main concerns in the present society, with respect to the environment, and risks related to industrial installations). The second part addresses the opinion on expertise (the role and image of experts, diffusion and sharing of scientific expertise, and the perception of pluralistic structures). The third part examines the reaction of people in front of 34 different hazardous situations (risks to which people feel being exposed, confidence people have in authorities to protect them, confidence in information on hazards, hierarchy of the 34 situations according to three different aspects, and relationship with installation acceptability). The fourth part addresses the nuclear domain: expectations related to the control of the nuclear risk, benefits and drawbacks of nuclear energy, fear of a severe accident, attention given by French people to nuclear energy, expertise and credibility of interveners in the nuclear sector

  14. Sociodemographic differences in myocardial infarction risk perceptions among people with coronary heart disease

    DEFF Research Database (Denmark)

    Aalto, Anna-Mari; Weinman, John; French, David P

    2007-01-01

    This study examines sociodemographic differences in myocardial infarction (MI) risk perceptions among people with coronary heart disease (CHD) (N = 3130). Two variables for comparative risk perceptions were computed: (1) own risk compared to that of an average person; and (2) own risk compared...... to that of an average person with CHD. Comparative optimism in MI risk perceptions was common, particularly among men and those with higher education. CHD severity and psychosocial resources mediated these sociodemographic differences. These results suggest challenges for secondary prevention in CHD, particularly...

  15. General evaluation of hard dental tissue and risk factors of dental caries in young people

    Directory of Open Access Journals (Sweden)

    Антоніна Михайлівна Політун

    2016-04-01

    Full Text Available The prognostication of caries in youth is important for determination and prescription of individual prophylactic arrangements and its further influence on mineralization of the hard dental tissues.Aim of the work: the study of the prevalence and intensity of caries among the young people and determination of possible connection with the risk factor of caries development for further choice of the reasonable prophylactic arrangement.Materials and methods of research: epidemiological, clinical, statistic ones.Results of research: The article describes results of the comprehensive dental examination of 135 persons18-25 years old. There was determined the high prevalence of caries (96,3±0,74 % with considerable intensity (8,87±0,39. The main etiological factors among youth are: poor nutrition with prevalence of carbohydrate (74,81±0,56 %, lack of oral hygiene (59,27±0,73 %, quantitative and qualitative composition of oral fluid, presence of somatic diseases (40±0,30 %, bad habits (31,85±0,24 %, neglect of the sport (48,88±0,36 %, chronic emotional stress (38,51±0,29 %, due to the increased workload and related stress factors.Conclusions: the high prevalence (96,3±0,74 % and intensity of carious process (8,87±0,39 is caused by the unsatisfactory state of oral cavity, (1,91±0,06, under the influence of general factors (somatic diseases, stress, poor nutrition the reactivity of protective mechanisms is lowered and the risk of dental morbidity of youth increases. So, it proves the necessity of elaboration and introduction of the active arrangements of primary prophylaxis directed on the raise of caries resistance of the hard dental tissues in young people

  16. Social dataset analysis and mapping tools for Risk Perception: resilience, people preparation and communication tools

    Science.gov (United States)

    Peters-Guarin, Graciela; Garcia, Carolina; Frigerio, Simone

    2010-05-01

    Perception has been identified as resource and part of the resilience of a community to disasters. Risk perception, if present, may determine the potential damage a household or community experience. Different levels of risk perception and preparedness can influence directly people's susceptibility and the way they might react in case of an emergency caused by natural hazards. In spite of the profuse literature about risk perception, works to spatially portray this feature are really scarce. The spatial relationship to danger or hazard is being recognised as an important factor of the risk equation; it can be used as a powerful tool either for better knowledge or for operational reasons (e.g. management of preventive information). Risk perception and people's awareness when displayed in a spatial format can be useful for several actors in the risk management arena. Local authorities and civil protection can better address educational activities to increase the preparation of particularly vulnerable groups of clusters of households within a community. It can also be useful for the emergency personal in order to optimally direct the actions in case of an emergency. In the framework of the Marie Curie Research Project, a Community Based Early Warning System (CBEWS) it's been developed in the Mountain Community Valtellina of Tirano, northern Italy. This community has been continuously exposed to different mass movements and floods, in particular, a large event in 1987 which affected a large portion of the valley and left 58 dead. The actual emergency plan for the study area is composed by a real time, highly detailed, decision support system. This emergency plan contains detailed instructions for the rapid deployment of civil protection and other emergency personal in case of emergency, for risk scenarios previously defined. Especially in case of a large event, where timely reaction is crucial for reducing casualties, it is important for those in charge of emergency

  17. IRSN 2015 opinion survey. The perception of risks and safety by French people. Global results

    International Nuclear Information System (INIS)

    El Jammal, Marie-Helene; Mur, Emmanuelle; Rollinger, Francois; Schuler, Matthieu; Tchernia, Jean-Francois

    2015-07-01

    Like every year, this report presents and comments the results of an opinion survey on risks, and more particularly on risks related to nuclear and radiological activities. The first part addresses the current concerns of French people (main concerns in the present society, with respect to the environment, and risks related to industrial installations). The second part addresses the opinion on expertise (the role and image of experts, diffusion and sharing of scientific expertise, and who should control a hazardous installation). The third part examines the reaction of people in front of 34 different hazardous situations (risks to which people feel being exposed, confidence people have in authorities to protect them, confidence in information on hazards, hierarchy of the 34 situations according to three different aspects, and relationship with installation acceptability). The fourth part addresses the nuclear domain: expectations related to the control of the nuclear risk, fear of a severe accident, benefits and drawbacks of nuclear energy, expertise and credibility of interveners in the nuclear sector. The fifth part addresses the presence of radon in dwellings (awareness of the risk, measures related to the control of radon in dwellings)

  18. Indoor Airflow Patterns, Dispersion of Human Exhalation Flow and Risk of Airborne Cross-infection between People in a Room

    DEFF Research Database (Denmark)

    Olmedo, Inés

    In recent years, an interest in understanding the mechanisms of cross-infection between people in the same room has increased significantly. The SARS (Severe Acute Respiratory Syndrome) outbreak occurred in Asia in 2003 reopened the study of the airborne disease transmission as one of the most...... in the air. These tiny particles or droplet nuclei can follow the air flow pattern in the room and produce high contaminant concentration in different areas of the indoor environment. This fact can provoke a high exposure to exhaled contaminants and a risk of cross-infection to a susceptible person situated...... in the same room. Abundant evidence shows that the air flow distribution systems play a crucial role in the dispersion of these human exhaled contaminants. However, there are many parameters that influence the cross-infection risk between people situated close to each other in a ventilated room, such as...

  19. Indoor Airflow Patterns, Dispersion of Human Exhalation Flow and Risk of Airborne Cross-Infection between People in a Room

    DEFF Research Database (Denmark)

    Olmedo, Inés

    In recent years, an interest in understanding the mechanisms of cross-infection between people in the same room has increased significantly. The SARS (Severe Acute Respiratory Syndrome) outbreak occurred in Asia in 2003 reopened the study of the airborne disease transmission as one of the most...... in the air. These tiny particles or droplet nuclei can follow the air flow pattern in the room and produce high contaminant concentration in different areas of the indoor environment. This fact can provoke a high exposure to exhaled contaminants and a risk of cross-infection to a susceptible person situated...... in the same room. Abundant evidence shows that the air flow distribution systems play a crucial role in the dispersion of these human exhaled contaminants. However, there are many parameters that influence the cross-infection risk between people situated close to each other in a ventilated room, such as...

  20. A social work study high-risk behavior among teenagers

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Iravani

    2012-01-01

    Full Text Available Teenagers are believed the people who are supposed to build the world's future. High-risk behaviors such as addiction to drugs, smoking cigarettes, sex, etc. could significantly hurts teenagers and there must be some supporting programs to reduce these issues as much as possible. This paper performs an empirical investigation to study the different factors influencing high- risk behavior among teenagers who live in a city of Esfahan, Iran. The proposed study designs a questionnaire and distribute between two groups of female and male teenagers. The results indicate that while there is a meaningful relationship between high-risk behaviors and average high school marks among male students there is no meaningful relationship between high-risk behaviors and high school grades among female students. The results also indicate that there is a meaningful difference between gender and high-risk behavior. The season of birth for female and male students is another important factor for having high-risk behaviors. While the order of birth plays an important role among male students, the order of birth is not an important factor among female teenagers. Finally, the results indicate that teenagers' parental financial affordability plays a vital role on both female and male teenagers.

  1. List of High risk countries

    International Development Research Centre (IDRC) Digital Library (Canada)

    Francine Sinzinkayo

    2013-07-26

    Higher Risk Countries and Territories. Reviewed regularly. Last update: July 26, 2013. Country/Territory. Note (1). Sources of Concern. Canadian. Law or. Policy. Knowledge of research setting. Ability to monitor research activities. (Note 2). Operational. Issues. (Note 3). Banking. Restrictions. (Note 4). Afghanistan. X. X.

  2. Relationship between subjective fall risk assessment and falls and fall-related fractures in frail elderly people

    Directory of Open Access Journals (Sweden)

    Shimada Hiroyuki

    2011-08-01

    Full Text Available Abstract Background Objective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests. The study examined the relationship between a subjective risk rating of specific tasks (SRRST to screen for fall risks and falls and fall-related fractures in frail elderly people. Methods The SRRST was investigated in 5,062 individuals aged 65 years or older who were utilized day-care services. The SRRST comprised 7 dichotomous questions to screen for fall risks during movements and behaviours such as walking, transferring, and wandering. The history of falls and fall-related fractures during the previous year was reported by participants or determined from an interview with the participant's family and care staff. Results All SRRST items showed significant differences between the participants with and without falls and fall-related fractures. In multiple logistic regression analysis adjusted for age, sex, diseases, and behavioural variables, the SRRST score was independently associated with history of falls and fractures. Odds ratios for those in the high-risk SRRST group (≥ 5 points compared with the no risk SRRST group (0 point were 6.15 (p Conclusion These results suggest that subjective ratings by care staff can be utilized to determine the risks of falls and fall-related fractures in the frail elderly, however, these preliminary results require confirmation in further prospective research.

  3. State of oral hygiene and identification of the main risk factors for inflammatory diseases of periodontal tissues in young people.

    OpenAIRE

    Makarenko, M. V.

    2014-01-01

    A high percentage of prevalence of inflammatory periodontal diseases in young age causes urgency of treatment and prevention of inflammatory diseases of periodontal tissue in young age. Therefore, the research purpose was to investigate the hygienic condition and identification of the main risk factors for gingivitis in patients aged 18-30 years. 286 people aged from 18 to 30 years were observed in the study. To assess hygienic condition of the oral cavity and to determine the thickness of pl...

  4. People

    Science.gov (United States)

    2001-09-01

    ASE: Attend, Socialize, Enjoy Bob Kibble reflects on the enriching effects of the annual meeting Bob Kibble is a teacher trainer at the University of Edinburgh, Scotland. I remember my first ASE meeting in Reading. Perhaps in 1978 or thereabouts. I had been teaching for a few years and thought I'd check out this local convention of science teachers. It was indeed a revelation that so many people had so much to say about teaching science. There was talk about N and F levels and the 'I level grill'. Someone had ordered something called a BBC machine (later revealed to me as the latest in hi-tech teaching). I remember it well. But it was a lonely affair for a recent recruit. People seemed to know each other and there was much friendly exchanging. However, nobody knew me and I knew nobody else. The professional revelations were accompanied by a personal isolation. A strange set of memories indeed for a new recruit, unskilled and clumsy in the social arena. Bob practising for the ASE singalong session this year. This year I went to the ASE Centenary meeting in Guildford, my sixteenth ASE annual meeting. Things have changed since the early days. Thursday started with a formal Cathedral service in celebration of 100 years of the ASE. I sat next to a lady from Oxford and behind my good friend Dave from Croydon. Things snowballed from there. I went to a workshop on the water cycle and was brought face to face with my own misconceptions about the life story of a water molecule. Got a freebie coloured bracelet as well. Thanks Margaret. A chap from Bournemouth gave me loads of ideas about how best to set up a shared lesson observation scheme as well as how to run a professional development workshop. Thanks Stuart. At a third session I joined Brenda from Cambridge and we spent an enjoyable hour discovering ways to approach the teaching of light and in particular Ibn al Haytham's revelations courtesy of a chap from Kingston. That afternoon I was invited to present a talk to

  5. High Framingham risk score decreases quality of life in adults

    Directory of Open Access Journals (Sweden)

    Christian Yosaputra

    2010-04-01

    Full Text Available Cardiovascular disease (CVD risk factors, such as diabetes, hypertension, hypercholesterolemia, smoking, and obesity tend to occur together in the general population. Increasing prevalence of multiple CVD risk factors has been related to increased risk of death from coronary heart disease and stroke. Studies have suggested that people with several risk factors of CVD may have impaired health-related quality of life. The objective of this study was to assess the association of CVD risk factors with quality of life (QOL among adults aged 40 to 65 years. A cross-sectional study was conducted involving 220 subjects 40 - 65 years of age at a health center. The CVD risk factors were assessed using the Framingham risk score that is the standard instrument for assessment of the risk of a first cardiac event. The risk factors assessed were age, smoking, blood pressure, total cholesterol and high density lipoprotein cholesterol concentrations. QOL was assessed by means of the WHOQOL-BREF instrument that had been prevalidated. The results of the study showed that 28.2% of subjects were smokers, 56.4% had stage 1 hypertension, 42.8% high total cholesterol and 13.6% low HDL cholesterol. The high risk group amounted to 45.5% and 42.3% constitued an intermediate risk group. High CVD risk scores were significantly associated with a low QOL for all domains (physical, psychological, social and environment (p=0.000. Preventing or reducing the multiple CVD risk factors to improve QOL is necessary among adults.

  6. Everyday behaviour and everyday risk: An approach to study people's responses to frequently encountered food related health risks

    NARCIS (Netherlands)

    Fischer, Arnout R.H.; de Vries, Pieter Walter

    2008-01-01

    Food consumption constitutes behaviour that is carried out on a daily basis. The risks and benefits associated with such behaviours are often small, and the time and effort people are, consequently, willing to invest in behavioural decisions are limited. Instead, experience, in the form of an

  7. People

    Science.gov (United States)

    2001-05-01

    microscopes, chemical analyses etc. The NHM has big labs—like a university—in the basement. I write papers, give talks... For the public galleries of the NHM my group provides expert input to exhibitions-when the meteorite pavilion was recently refurbished we suggested a layout, wrote text and selected samples, but this was then 'edited' by the exhibition designers. I'm also working on a new website with virtual meteorite specimens. As an expert on Martian meteorites I often get interviewed by the media: for example, I am on a new Channel 4 programme called Destination Mars. I have also just finished a general interest book—it's called Search for Life; the NHM have just published it (in March). And do you get to go to exciting places? As a researcher I go to conferences I am just off to the States this week. I went to Antarctica ten years ago meteorite collecting and I am hoping to go to Australia this year. It is good fun but they really do need an expert who can recognise a meteorite. I'll be going to the Nullarbor region of Australia for 2 3 weeks depending on the weather if it's too green there is too much grass, so you can't see the meteorites. How do you find people respond to meteorites? People love touching rocks from outer space, especially primary school children. You can see how they are burnt on the outside. When you feel the weight of them it really brings it home: iron meteorites are heavy! They'll often say 'Wow, it fell from the sky' as they glance upwards, half expecting another one to come crashing through the ceiling. Everyone finds it amazing that a solid object has come as if from nowhere. And they are so old. They can't believe how old they are. We want to know where we come from. There is always lots of media coverage about what is happening in the sky (eclipses and the like). It's there and it's a bit of a mystery. If we can get to grips with how our planets and how our own Sun formed it can put us in the picture as to where we have come from and

  8. Is transition to disability pension in young people associated with changes in risk of attempted suicide?

    Science.gov (United States)

    Mittendorfer-Rutz, E; Alexanderson, K; Westerlund, H; Lange, T

    2014-08-01

    The aim of the present study was to investigate trajectories of suicide attempt risks before and after granting of disability pension in young people. The analytic sample consisted of all persons 16-30 years old and living in Sweden who were granted a disability pension in the years 1995-1997; 2000-2002 as well as 2005-2006 (n = 26,624). Crude risks and adjusted odds ratios for suicide attempt were computed for the 9-year window around the year of disability pension receipt by repeated-measures logistic regressions. The risk of suicide attempt was found to increase continuously up to the year preceding the granting of disability pension in young people, after which the risk declined. These trajectories were similar for women and men and for disability pension due to mental and somatic diagnoses. Still, the multivariate odds ratios for suicide attempts for women and for disability pension due to mental disorders were 2.5- and 3.8-fold increased compared with the odds ratios for men and disability pension due to somatic disorders, respectively. Trajectories of suicide attempts differed for young individuals granted a disability pension during 2005-2006 compared with those granted during 1995-1997 and 2000-2002. We found an increasing risk of suicide attempt up until the granting of a disability pension in young individuals, after which the risk decreased. It is of clinical importance to monitor suicide attempt risk among young people waiting for the granting of a disability pension.

  9. Knowledge of heart disease risk in a multicultural community sample of people with diabetes.

    Science.gov (United States)

    Wagner, Julie; Lacey, Kimberly; Abbott, Gina; de Groot, Mary; Chyun, Deborah

    2006-06-01

    Prevention of coronary heart disease (CHD) is a primary goal of diabetes management. Unfortunately, CHD risk knowledge is poor among people with diabetes. The objective is to determine predictors of CHD risk knowledge in a community sample of people with diabetes. A total of 678 people with diabetes completed the Heart Disease Facts Questionnaire (HDFQ), a valid and reliable measure of knowledge about the relationship between diabetes and heart disease. In regression analysis with demographics predicting HDFQ scores, sex, annual income, education, and health insurance status predicted HDFQ scores. In a separate regression analysis, having CHD risk factors did not predict HDFQ scores, however, taking medication for CHD risk factors did predict higher HDFQ scores. An analysis of variance showed significant differences between ethnic groups for HDFQ scores; Whites (M = 20.9) showed more CHD risk knowledge than African Americans (M = 19.6), who in turn showed more than Latinos (M = 18.2). Asians scored near Whites (M = 20.4) but did not differ significantly from any other group. Controlling for numerous demographic, socioeconomic, health care, diabetes, and cardiovascular health variables, the magnitude of ethnic differences was attenuated, but persisted. Education regarding modifiable risk factors must be delivered in a timely fashion so that lifestyle modification can be implemented and evaluated before pharmacotherapy is deemed necessary. African Americans and Latinos with diabetes are in the greatest need of education regarding CHD risk.

  10. IRSN 2016 opinion survey. The perception of risks and safety by French people. Global results

    International Nuclear Information System (INIS)

    El Jammal, Marie-Helene; Charron, Sylvie; Mur, Emmanuelle; Schuler, Matthieu; Tchernia, Jean-francois

    2016-07-01

    Like every year, this report presents and comments the results of an opinion survey on risks, and more particularly on risks related to nuclear and radiological activities. The first part addresses the current concerns of French people (main concerns in the present society, with respect to the environment, and risks related to industrial installations). The second part addresses the opinion on expertise (the role and image of experts, diffusion and sharing of scientific expertise, and the perception of pluralistic structures). The third part examines the reaction of people in front of 34 different hazardous situations (risks to which people feel being exposed, confidence people have in authorities to protect them, confidence in information on hazards, hierarchy of the 34 situations according to three different aspects, and relationship with installation acceptability). The fourth part addresses the nuclear domain: expectations related to the control of the nuclear risk, fear of a severe accident, benefits and drawbacks of nuclear energy, expertise and credibility of interveners in the nuclear sector, fear of serious nuclear accidents, perception of the two main nuclear accidents: Chernobyl (1986) and Fukushima (2011)

  11. [A model list of high risk drugs].

    Science.gov (United States)

    Cotrina Luque, J; Guerrero Aznar, M D; Alvarez del Vayo Benito, C; Jimenez Mesa, E; Guzman Laura, K P; Fernández Fernández, L

    2013-12-01

    «High-risk drugs» are those that have a very high «risk» of causing death or serious injury if an error occurs during its use. The Institute for Safe Medication Practices (ISMP) has prepared a high-risk drugs list applicable to the general population (with no differences between the pediatric and adult population). Thus, there is a lack of information for the pediatric population. The main objective of this work is to develop a high-risk drug list adapted to the neonatal or pediatric population as a reference model for the pediatric hospital health workforce. We made a literature search in May 2012 to identify any published lists or references in relation to pediatric and/or neonatal high-risk drugs. A total of 15 studies were found, from which 9 were selected. A model list was developed mainly based on the ISMP one, adding strongly perceived pediatric risk drugs and removing those where the pediatric use was anecdotal. There is no published list that suits pediatric risk management. The list of pediatric and neonatal high-risk drugs presented here could be a «reference list of high-risk drugs » for pediatric hospitals. Using this list and training will help to prevent medication errors in each drug supply chain (prescribing, transcribing, dispensing and administration). Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  12. MYPLAN - A Mobile Phone Application for Supporting People at Risk of Suicide

    DEFF Research Database (Denmark)

    Skovgaard Larsen, Jette L; Frandsen, Hanne; Erlangsen, Annette

    2016-01-01

    describes MYPLAN, a mobile phone application designed to support people at risk of suicide by letting them create a safety plan. METHOD: MYPLAN was developed in collaboration with clinical psychiatric staff at Danish suicide preventive clinics. The mobile application lets the user create an individualized......BACKGROUND: Safety plans have been suggested as an intervention for people at risk of suicide. Given the impulsive character of suicidal ideation, a safety plan in the format of a mobile phone application is likely to be more available and useful than traditional paper versions. AIMS: The study......,000 times. Users at risk of suicide as well as clinical staff have provided positive feedback on the mobile application. CONCLUSION: Support via mobile phone applications might be particularly useful for younger age groups at risk of suicide as well as in areas or countries where support options are lacking...

  13. Increased risk of stomach and esophageal malignancies in people with AIDS.

    Science.gov (United States)

    Persson, E Christina; Shiels, Meredith S; Dawsey, Sanford M; Bhatia, Kishor; Anderson, Lesley A; Engels, Eric A

    2012-10-01

    People infected with human immunodeficiency virus (HIV) have an increased risk of some malignancies, but little is known about the effects of infection on risk of cancers of the upper gastrointestinal tract. We evaluated the risks of different histologic and anatomic subtypes of carcinomas and non-Hodgkin lymphomas (NHLs) of the stomach and esophagus in people with acquired immunodeficiency syndrome (AIDS). We analyzed data from the HIV/AIDS Cancer Match Study, which links data collected from 1980 to 2007 for 16 US population-based HIV and AIDS and cancer registries. We compared risks of stomach and esophageal malignancies in people with AIDS (N = 596,955) with those of the general population using standardized incidence ratios (SIRs). We assessed calendar trends using Poisson regression. People with AIDS had increased risks of carcinomas of the esophagus (SIR, 1.69; 95% confidence interval [CI], 1.37-2.07; n = 95) and stomach (SIR, 1.44; 95% CI, 1.17-1.76; n = 96). Risk was increased for esophageal adenocarcinoma (SIR, 1.91; 95% CI, 1.31-2.70) and squamous cell carcinoma (SIR, 1.47; 95% CI, 1.10-1.92). People with AIDS had greater risks of carcinomas of the gastric cardia (SIR, 1.36; 95% CI, 0.83-2.11) and noncardia (SIR, 1.53; 95% CI, 1.12-2.05) than the general population. Although most stomach and esophageal NHLs that developed in people with AIDS were diffuse large B-cell lymphomas, these individuals also had an increased risk of stomach mucosa-associated lymphoid tissue lymphoma (SIR, 5.99; 95% CI, 3.19-10.2; n = 13). The incidence of carcinomas remained fairly constant over time, but rates of NHL decreased from 1980 to 2007 (P(trend) AIDS are at increased risk for developing esophageal and stomach carcinomas and NHLs. Although the incidence of NHL decreased from 1980 to 2007 as treatments for HIV infection improved, HIV-infected individuals face continued risks of esophageal and stomach carcinomas. Copyright © 2012 AGA Institute. Published by Elsevier Inc

  14. Assessment of balance control in relation to fall risk among older people

    OpenAIRE

    Nordin, Ellinor

    2008-01-01

    Falls and their consequences among older people are a serious medical and public health problem. Identifying individuals at risk of falling is therefore a major concern. The purpose of this thesis was to evaluate measurement tools of balance control and their predictive value when screening for fall risk in physically dependent individuals ≥65 years old living in residential care facilities, and physically independent individuals ≥75 years old living in the community. Following baseline asses...

  15. What are the Main Physical Functioning Factors Associated With Falls Among Older People With Different Perceived Fall Risk?

    Science.gov (United States)

    Moreira, Mirian N; Bilton, Tereza L; Dias, Rosangela C; Ferriolli, Eduardo; Perracini, Monica R

    2017-07-01

    Fall risk perceptions may influence the judgement over physical and functional competencies to avoid falls. However, few studies have explored the physical functioning characteristics associated with falls among older people with low perceived fall risk. This study aimed to identify the prevalence of falls and physical functioning factors associated with falling among community-dwelling older adults with low and high perceived fall risk. We conducted a cross-sectional population based study with 773 community-dwelling elders. Perceived fall risk was investigated using Falls Efficacy Scale International. We considered fallers those who reported at least one fall in the previous 12 months. Physical functioning measures used were grip strength, usual gait speed, sit-to-stand test, five step test, timed up and go test, one-legged stance test, anterior and lateral functional reach test. At least one fall was reported by 103 (30%) participants with low perceived fall risk and by 196 (46%) participants with high perceived fall risk. The odds of falling were lower among those with greater grip strength and with a greater stance time in one-legged test, and the odds of falling among elders with high perceived fall risk were higher among those who took more time in performing the five step test. We believe that our results highlight the need of not neglecting the risk of falls among active older adults with low perceived fall risk, particularly in those elders that show reduced stability in a small base of support and a lower leg strength. In addition, we suggest that elders with high perceived fall risk should be assessed using anticipatory postural adjustment tests. Particularly, our results may help physiotherapists to identify eligible elders with different perceptions of fall risk for tailored interventions aimed at reducing falls. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  16. Risks, consequences, and prevention of falls of older people in oral healthcare centers.

    Science.gov (United States)

    de Baat, Cees; de Baat, Paul; Gerritsen, Anneloes E; Flohil, Karien A; van der Putten, Gert-Jan; van der Maarel-Wierink, Claar D

    2017-03-01

    One-third of community-dwelling people older than 65 years of age fall each year, and half of them fall at least twice a year. Older care home residents are approximately three times more likely to fall when compared to community-dwelling older people. Risk indicators for falls are related to the older people's body, environment, behavior, and activities. An important health risk indicator is (orthostatic or postprandial) hypotension, which may induce cerebral hypoperfusion. Although the majority of falls remain without major consequences, 10% to 25% of falls in care homes result in bodily trauma. Prevalent fall-related injuries are brain injury, lower extremity fracture including hip fracture and forearm/wrist fracture, facial fracture, humeral fracture, and rib/scapular fracture. As fall accidents by older people can have severe consequences, prevention of falls is of paramount importance. Healthcare providers, including oral healthcare providers, should inform older people on risks of falling and draw attention to potentially hazardous arrangements. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

  17. Risk of fall-related injury in people with lower limb amputations: A prospective cohort study.

    Science.gov (United States)

    Wong, Christopher Kevin; Chihuri, Stanford T; Li, Guohua

    2016-01-01

    To assess fall-related injury risk and risk factors in people with lower limb amputation. Prospective longitudinal cohort with follow-up every 6 months for up to 41 months. Community-dwelling adults with lower limb amputations of any etiology and level recruited from support groups and prosthetic clinics. Demographic and clinical characteristics were obtained by self-reported questionnaire and telephone or in-person follow-up. Fall-related injury incidence requiring medical care per person-month and adjusted hazard ratio of fall-related injury were calculated using multivariable proportional hazards regression modeling. A total of 41 subjects, with 782 follow-up person-months in total, had 11 fall-related injury incidents (14.1/1,000 person-months). During follow-up, 56.1% of subjects reported falling and 26.8% reported fall-related injury. Multivariable proportional hazard modeling showed that women were nearly 6 times more likely as men to experience fall-related injury and people of non-white race were 13 times more likely than people of white race to experience fall-related injury. The final predictive model also included vascular amputation and age. Risk of fall-related injury requiring medical care in people with lower limb amputation appears to be higher than in older adult inpatients. Intervention programs to prevent fall-related injury in people with lower limb amputation should target women and racial minorities.

  18. Young people at risk of psychosis: a user-led exploration of interpersonal relationships and communication of psychological difficulties.

    Science.gov (United States)

    Byrne, Rory; Morrison, Anthony P

    2010-05-01

    The aim of the present study was to qualitatively explore experiences and perceptions of interpersonal relationships and interpersonal communication among young people at risk of psychosis. Semi-structured interviews were conducted using a qualitative grounded theory approach. Participants had entered into a service providing psychological interventions for young people assessed to be at a high risk of developing psychosis (Northwest UK). Our sample comprised one female and seven male participants (n = 8), ranging in age from 16 to 28 years, with a mean age of 22.4 years. Analyses identified three central themes: difficulty with interpersonal relationships and reduced opportunities for helpful communication, difficulty talking to others about psychological problems, and experiences of talking to others about psychological problems. Individuals at risk of psychosis may have experienced significant difficulties with interpersonal relationships. Such difficulties may contribute directly to the development of unusual psychological experiences, and to an inability or reluctance to communicate these to others. In addition, commonly held stigmatizing ideas associated with unusual psychological experiences may contribute to a fear among at-risk individuals that they are 'going mad', and this may lead to concealment of their difficulties, and to delayed help-seeking. For at-risk individuals, helpful communication of psychological distress offers significant benefits, including improved psychological and emotional well-being and reduced risk of psychosis. Thus, while concealment of distress may directly impact on the development of unusual psychological difficulties, communication of such difficulties may be central to recovery.

  19. Surveillance of STI risk behaviour among young people attending a music festival in Australia, 2005-08.

    Science.gov (United States)

    Lim, Megan S C; Hellard, Margaret E; Aitken, Campbell K; Hocking, Jane S

    2009-10-01

    To explain rising rates of sexually transmitted infections it is necessary to monitor trends among high risk groups, such as youth. Surveillance of risk behaviours and testing among a variety of populations in different settings is required. We monitored self-reported sexual behaviour among music festival attendees. Cross-sectional studies of young people's behaviour were conducted annually at a music festival between 2005 and 2008 using self-administered questionnaires. Logistic regression, adjusted for age and gender, determined trends in risk behaviours. More than 5,000 questionnaires were completed. The proportion reporting multiple sexual partners in the past year remained stable from 2005 to 2008 and condom use with these partners increased. Reporting a new sexual partner in the past three months decreased, while condom use with new partners increased. Reporting a casual sexual partner increased and condom use with casual partners remained stable. Reporting a recent STI test increased from 23% in 2006 to 32% in 2008. Despite increases in STI notifications, most risk behaviours are decreasing in this group, possibly as a function of increased STI testing. Music festivals are a useful setting for monitoring behaviour trends within a sub-population of young people at relatively high risk of STIs.

  20. Schistosomiasis and water resources development: systematic review, meta-analysis, and estimates of people at risk.

    Science.gov (United States)

    Steinmann, Peter; Keiser, Jennifer; Bos, Robert; Tanner, Marcel; Utzinger, Jürg

    2006-07-01

    An estimated 779 million people are at risk of schistosomiasis, of whom 106 million (13.6%) live in irrigation schemes or in close proximity to large dam reservoirs. We identified 58 studies that examined the relation between water resources development projects and schistosomiasis, primarily in African settings. We present a systematic literature review and meta-analysis with the following objectives: (1) to update at-risk populations of schistosomiasis and number of people infected in endemic countries, and (2) to quantify the risk of water resources development and management on schistosomiasis. Using 35 datasets from 24 African studies, our meta-analysis showed pooled random risk ratios of 2.4 and 2.6 for urinary and intestinal schistosomiasis, respectively, among people living adjacent to dam reservoirs. The risk ratio estimate for studies evaluating the effect of irrigation on urinary schistosomiasis was in the range 0.02-7.3 (summary estimate 1.1) and that on intestinal schistosomiasis in the range 0.49-23.0 (summary estimate 4.7). Geographic stratification showed important spatial differences, idiosyncratic to the type of water resources development. We conclude that the development and management of water resources is an important risk factor for schistosomiasis, and hence strategies to mitigate negative effects should become integral parts in the planning, implementation, and operation of future water projects.

  1. Pathways between stigma and suicidal ideation among people at risk of psychosis.

    Science.gov (United States)

    Xu, Ziyan; Müller, Mario; Heekeren, Karsten; Theodoridou, Anastasia; Metzler, Sibylle; Dvorsky, Diane; Oexle, Nathalie; Walitza, Susanne; Rössler, Wulf; Rüsch, Nicolas

    2016-04-01

    Mental illness stigma may contribute to suicidality and is associated with social isolation and low self-esteem among young people at risk of psychosis. However, it is unclear whether mental illness stigma contributes to suicidality in this population. We therefore examined the associations of self-labeling and stigma stress with suicidality among young people at risk. Self-labeling as "mentally ill", stigma stress, social isolation, self-esteem, symptoms and suicidal ideation were assessed in 172 individuals at risk of psychosis. Self-labeling and stigma stress were examined as predictors of suicidality by path analysis. Increased self-labeling as "mentally ill" was associated with suicidality, directly as well as indirectly mediated by social isolation. More stigma stress was related to social isolation which in turn was associated with low self-esteem, depression and suicidal ideation. Social isolation fully mediated the link between stigma stress and suicidal ideation. Interventions to reduce the public stigma associated with risk of psychosis as well as programs to facilitate non-stigmatizing awareness of at-risk mental state and to reduce stigma stress among young people at risk of psychosis might strengthen suicide prevention in this population. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. People

    Science.gov (United States)

    2001-11-01

    the war Hoyle returned to Cambridge, but kept in close contact with his collaborators. Fred Hoyle was a canny and media-savvy scientist, 40 years before such things were recognized. Martin Rees said after his death '[He] also had other dimensions to his career, his inventiveness and skill as a communicator'. It is hard to realize now the impact that Hoyle's broadcasts had in post-war Britain. His programmes for the BBC on The Nature of the Universe won greater audiences than such unlikely rivals as Bertrand Russell and Tommy Handley. Even today many people recall how they were affected by listening to these broadcasts. Hoyle used one of his broadcasts to ridicule the hot explosion theory. He referred to the idea of a 'big bang as fanciful'. Unfortunately the name stuck, much to Hoyle's chagrin. In the 1950s Hoyle began a fruitful collaboration with Willy Fowler of the California Institute of Technology in Pasadena. Hoyle was interested in the origin of the chemical elements. Hans Bethe, Charles Critchfield and Karl-Frederich von Weizsäcker had calculated in 1939 how stars could turn protons into helium nuclei by nuclear fusion. Part of the Vela supernova remmant, the debris left after the type of massive explosion in which Hoyle predicted that heavy nuclei were formed. (© Royal Observatory, Edinburgh, Anglo-Australian Observatory.) Building on earlier collaboration with Ed Saltpeter, Hoyle used data supplied by Geoffrey and Margaret Burbidge and, working with Fowler, began to piece together how the elements were formed. By looking at very large stars near the end of their lives and examining their chemical composition, they noticed that the abundances of elements almost exactly corresponded to those with a low nuclear capture cross section. Hoyle argued that all of the elements in our bodies had been formed in stars that had been and gone before our solar system had even formed. In their classic paper the elements are produced by three basic methods. The

  3. Timed Up And Go Risk Predictor Of Falls In Elderly People Residing In The Community?

    Directory of Open Access Journals (Sweden)

    Mayara Muniz Peixoto Rodrigues

    2017-04-01

    Full Text Available Objective: evaluate the risk of falls of elderly people residing in a community in northeastern Brazil using the “Timed up and go”. Method: descriptive study, with a quantitative approach, performed with elderly people residing in a community. The collected data related to the sociodemographic and economic characteristics of episodes of falls in the last two years, regular practice of physical exercise and complaint of pain at the time of the interview; and, at last, the application of the “Timed Up and Go” test. Result: Most of the elderly were classified as free and independent and independent. There is a direct relationship between advanced age and increased time to perform the test. Conclusion: the "Timed Up and Go" test was not effective in predicting risk of falls alone and should associate with other indicators. Descriptors: Elderly people; Accidents by fall; Walking; Postural balance.

  4. People's Risk Recognition Preceding Evacuation and Its Role in Demand Modeling and Planning

    NARCIS (Netherlands)

    Urata, Junji; Pel, A.J.

    2017-01-01

    Evacuation planning and management involves estimating the travel demand in the event that such action is required. This is usually done as a function of people's decision to evacuate, which we show is strongly linked to their risk awareness. We use an empirical data set, which shows tsunami

  5. Risk Factors for Dementia in People with Down Syndrome: Issues in Assessment and Diagnosis

    Science.gov (United States)

    Bush, Alick; Beail, Nigel

    2004-01-01

    It has been clearly established that there is an increased incidence of early onset dementia of the Alzheimer type (DAT) in people who have Down syndrome. There are variations in the age of onset of the clinical signs of DAT, which may be accounted for by different risk factors. In this review we examined the evidence that different biological and…

  6. Prevalence and risk factors for HIV among people aged 50 years ...

    African Journals Online (AJOL)

    Background: It is estimated that over ten percent of the 36.7 million people living with HIV (PLWHIV) globally, are those aged ≥50 years. The objective of this study was to determine the prevalence and risk factors for HIV among adult aged 50 years and above in Rombo district, northern Tanzania. Methods: This cross ...

  7. A Collaborative Approach To Health Promotion Targeting People With Mental Illness At Risk Of Diabetes

    DEFF Research Database (Denmark)

    Folmann Hempler, Nana; Saurbrey Pals, Regitze; Oest, Lone

    People with mental illness (users) have a notable higher risk of developing type 2 diabetes than the general population. Recent studies show that traditional lifestyle interventions focusing solely on exercise and diet targeting users have small effect. Studies suggest that collaborative approaches...

  8. A re-examination of the effect of contextual group size on people's attitude to risk

    Directory of Open Access Journals (Sweden)

    Kazumi Shimizu

    2011-02-01

    Full Text Available Using Kahneman and Tversky's life-death decision paradigm, Wang and colleagues (e.g., Wang and Johnston, 1995; Wang, 1996a, 1996b, 1996c, 2008; Wang et al., 2001 have shown two characteristic phenomena regarding people's attitude to risk when the contextual group size is manipulated. In both positive and negative frames, people tend to take greater risks in life-death decisions as the contextual group size becomes smaller; this risk-seeking attitude is greater when framed positively than negatively. (This second characteristic often leads to the disappearance of the framing effect in small group contexts comprising of 6 or 60 people. Their results could shed new light on the effect of contextual group size on people's risk choice. However these results are usually observed in laboratory experiments with university student samples. This study aims to examine the external validity of these results through different ways of experimentation and with a different sample base. The first characteristic was replicated in both a face-to-face interview with a randomly selected sample of the Japanese general public, and a web-based experiment with a non-student sample, but not the second.

  9. The risk of developing malnutrition in people living with HIV/AIDS ...

    African Journals Online (AJOL)

    Objectives: The objectives of this study were 1) to determine the proportion of people living with HIV/AIDS (PLWHA) at risk of developing malnutrition, 2) to determine the prevalence of malnutrition (BMI < 18.5 kg/m2), and 3) to describe the dietary intake and other nutrition parameters of PLWHA with membership in support ...

  10. Resuscitation of newborn in high risk deliveries

    International Nuclear Information System (INIS)

    Yousaf, U.F.; Hayat, S.

    2015-01-01

    High risk deliveries are usually associated with increased neonatal mortality and morbidity. Neonatal resuscitation can appreciably affect the outcome in these types of deliveries. Presence of personnel trained in basic neonatal resuscitation at the time of delivery can play an important role in reducing perinatal complications in neonates at risk. The study was carried out to evaluate the effects of newborn resuscitation on neonatal outcome in high risk deliveries. Methods: This descriptive case series was carried out at the Department of Obstetrics and Gynecology, Jinnah Hospital, Lahore. Ninety consecutive high risk deliveries were included and attended by paediatricians trained in newborn resuscitation. Babies delivered by elective Caesarean section, normal spontaneous vaginal deliveries and still births were excluded. Neonatal resuscitation was performed in babies who failed to initiate breathing in the first minute after birth. Data was analyzed using SPSS-16.0. Results: A total of 90 high risk deliveries were included in the study. Emergency caesarean section was the mode of delivery in 94.4% (n=85) cases and spontaneous vaginal delivery in 5.6% (n=5). Preterm pregnancy was the major high risk factor. Newborn resuscitation was required in 37.8% (n=34) of all high risk deliveries (p=0.013). All the new-borns who required resuscitation survived. Conclusion: New-born resuscitation is required in high risk pregnancies and personnel trained in newborn resuscitation should be available at the time of delivery. (author)

  11. Risk mapping of clonorchiasis in the People's Republic of China: A systematic review and Bayesian geostatistical analysis.

    Directory of Open Access Journals (Sweden)

    Ying-Si Lai

    2017-03-01

    Full Text Available Clonorchiasis, one of the most important food-borne trematodiases, affects more than 12 million people in the People's Republic of China (P.R. China. Spatially explicit risk estimates of Clonorchis sinensis infection are needed in order to target control interventions.Georeferenced survey data pertaining to infection prevalence of C. sinensis in P.R. China from 2000 onwards were obtained via a systematic review in PubMed, ISI Web of Science, Chinese National Knowledge Internet, and Wanfang Data from January 1, 2000 until January 10, 2016, with no restriction of language or study design. Additional disease data were provided by the National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention in Shanghai. Environmental and socioeconomic proxies were extracted from remote-sensing and other data sources. Bayesian variable selection was carried out to identify the most important predictors of C. sinensis risk. Geostatistical models were applied to quantify the association between infection risk and the predictors of the disease, and to predict the risk of infection across P.R. China at high spatial resolution (over a grid with grid cell size of 5×5 km.We obtained clonorchiasis survey data at 633 unique locations in P.R. China. We observed that the risk of C. sinensis infection increased over time, particularly from 2005 onwards. We estimate that around 14.8 million (95% Bayesian credible interval 13.8-15.8 million people in P.R. China were infected with C. sinensis in 2010. Highly endemic areas (≥ 20% were concentrated in southern and northeastern parts of the country. The provinces with the highest risk of infection and the largest number of infected people were Guangdong, Guangxi, and Heilongjiang.Our results provide spatially relevant information for guiding clonorchiasis control interventions in P.R. China. The trend toward higher risk of C. sinensis infection in the recent past urges the Chinese government to

  12. Young people's beliefs about the risk of bowel cancer and its link with physical activity.

    Science.gov (United States)

    Newby, Katie V; Cook, Chloe; Meisel, Susanne F; Webb, Thomas L; Fisher, Bernadette; Fisher, Abi

    2017-09-01

    The primary objective was to explore young people's risk appraisals of bowel cancer, including whether they had a coherent understanding of the protective effects of physical activity (PA). A secondary objective was to examine whether the illness risk representations (IRRs) framework could be used to understand beliefs underlying bowel cancer risk appraisals. Qualitative. Framework analysis of semi-structured interviews with 19 people aged 14-17 years. Participants judged their risk of getting bowel cancer as low. This was based on a lack of family history of cancer and their current lifestyle behaviours, which were viewed as having a protective effect, or because they planned on making change to their lifestyle in the future when disease risk became more relevant. Participants were not aware of, and struggled to understand, the link between PA and bowel cancer. They also lacked knowledge of the effects of, or treatments for, bowel cancer. Beliefs underlying judgements about the risk of bowel cancer fitted the IRR framework reasonably well. The present research suggests that interventions designed to increase PA with a view to reducing the risk of bowel cancer should aim to make the future risk of bowel cancer feel more tangible, help young people to understand the full range of consequences, explain how and why preventative behaviours such as PA are effective in reducing risk, and emphasize that the typical late presentation of symptoms, and therefore investigation by health care services, reduces treatability. Statement of contribution What is already known on this subject? Physical activity (PA) performed throughout the lifespan can have a protective effect on bowel cancer, but levels of PA are low among young people. Changing beliefs about the risk of getting bowel cancer may be a useful strategy in motivating PA. What does this study add? Increased understanding of how young people think about bowel cancer and the relationship between PA and cancer

  13. IRSN 2007 barometer: perception of risks and security by French people. Global results

    International Nuclear Information System (INIS)

    2007-07-01

    This report presents under the form of graphs and comments the results of the annual IRSN opinion poll on matters of risk and security. The IRSN is the French Institute of Radioprotection and Nuclear Safety. Different themes are analysed: the present concerns for French people (in the present society, for the environment, about industrial risks and the image of science), the perception of expertise (who should control an installation, the role and the image of scientific experts, access to expertise documents), the public interest in risk issues (topic of interest, participation to information sessions), the attitude in front of 30 risk situations (presently perceived risks, confidence in public authorities to ensure their protection, truth about information on hazards, hierarchy of 30 situations). The last part is dedicated to the nuclear domain (nuclear risk, skill and credibility of interveners)

  14. Sports Cardiology: Core Curriculum for Providing Cardiovascular Care to Competitive Athletes and Highly Active People.

    Science.gov (United States)

    Baggish, Aaron L; Battle, Robert W; Beckerman, James G; Bove, Alfred A; Lampert, Rachel J; Levine, Benjamin D; Link, Mark S; Martinez, Matthew W; Molossi, Silvana M; Salerno, Jack; Wasfy, Meagan M; Weiner, Rory B; Emery, Michael S

    2017-10-10

    The last few decades have seen substantial growth in the populations of competitive athletes and highly active people (CAHAP). Although vigorous physical exercise is an effective way to reduce the risk of cardiovascular (CV) disease, CAHAP remain susceptible to inherited and acquired CV disease, and may be most at risk for adverse CV outcomes during intense physical activity. Traditionally, multidisciplinary teams comprising athletic trainers, physical therapists, primary care sports medicine physicians, and orthopedic surgeons have provided clinical care for CAHAP. However, there is increasing recognition that a care team including qualified CV specialists optimizes care delivery for CAHAP. In recognition of the increasing demand for CV specialists competent in the care of CAHAP, the American College of Cardiology has recently established a Sports and Exercise Council. An important primary objective of this council is to define the essential skills necessary to practice effective sports cardiology. Copyright © 2017. Published by Elsevier Inc.

  15. Relationship Between Physiological and Perceived Fall Risk in People With Multiple Sclerosis: Implications for Assessment and Management.

    Science.gov (United States)

    Gunn, Hilary; Cameron, Michelle; Hoang, Phu; Lord, Stephen; Shaw, Steve; Freeman, Jennifer

    2018-04-24

    This study evaluated the relationship between physiological and perceived fall risk in people with multiple sclerosis (MS). Secondary analysis of data from prospective cohort studies undertaken in Australia, the United Kingdom, and the United States. Community. Ambulatory people with MS (N=416) (age 51.5±12.0 years; 73% female; 62% relapsing-remitting MS; 13.7±9.9 years disease duration). Not applicable. All participants completed measures of physiological (Physiological Profile Assessment [PPA]) and perceived (Falls Efficacy Scale-international [FESi]) fall risk and prospectively recorded falls for 3 months. 155 (37%) of the participants were recurrent fallers (≥2 falls). Mean PPA and FESi scores were high (PPA 2.14±1.87, FESi 34.27±11.18). The PPA and the FESi independently predicted faller classification in logistic regression, which indicated that the odds of being classified as a recurrent faller significantly increased with increasing scores (PPA odds ratio [OR] 1.30 [95% CI 1.17-1.46], FESi OR 1.05 [95% CI 1.03-1.07]). Classification and regression tree analysis divided the sample into four groups based on cutoff values for the PPA: (1) low physiological/low perceived risk (PPA 27.5), (3) high physiological/low perceived risk (PPA >2.83, FESi 35.5). Over 50% of participants had a disparity between perceived and physiological fall risk; most were in group 2. It is possible that physiological risk factors not detected by the PPA may also be influential. This study highlights the importance of considering both physiological and perceived fall risk in MS and the need for further research to explore the complex interrelationships of perceptual and physiological risk factors in this population. This study also supports the importance of developing behavioral and physical interventions that can be tailored to the individual's needs. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  16. Differences in perception of risk between people who have and have not experienced Salmonella food poisoning.

    Science.gov (United States)

    Parry, Sharon M; Miles, Susan; Tridente, Ascanio; Palmer, Stephen R

    2004-02-01

    It is believed that food hygiene precautions in domestic kitchens are an important strategy in efforts to reduce the incidence of sporadic food poisoning, but recent research has shown that people who have suffered food poisoning handle the same types of foods and adopt similar food hygiene precautions in their kitchens to the rest of the population. This suggests the need to examine other factors. A case-control study of sporadic Salmonella food poisoning was conducted to investigate several domestic kitchen risk factors. Measures of perception of risk, knowledge, and control associated with food poisoning in case and control respondents are reported here. It was found that perceived personal risk from food poisoning in the home was less than perceived risk to other people. In contrast, ratings of personal knowledge about food poisoning and personal control over food poisoning in the home were seen to be greater than other people's knowledge and control. There were no differences between the cases and the controls in their ratings of knowledge about food poisoning or their control over food poisoning. However, cases perceived their personal risk from food poisoning to be higher than controls. Both case and control samples exhibited optimistic bias but this was reduced in the case sample, suggesting that experience with food poisoning may reduce optimistic bias.

  17. People

    Science.gov (United States)

    2001-07-01

    several quick passes, leaving an incomplete image of only half of the planet. This, and observations made from Earth, provide almost all of our knowledge of Mercury. Earth observations, however, are hampered by the planet's proximity to the Sun, making observations possible only at dawn and dusk. A mosaic of images of Mercury from the NASA Mariner 10 spacecraft. ©NASA In the mid-80s improved radar equipment allowed high resolution mapping of surface features from the Earth. Amongst the results were two tantalising mysteries: a large dome feature, similar in some ways to shield volcanoes seen on Mars, observed on the unimaged side of the planet and complex scattering of returned radar from distinct areas around the poles, suggesting that water ice may exist in craters there. Both NASA and the European Space Agency (ESA) are now planning missions to Mercury. The US team are using a newly discovered trajectory that will allow them to reach Mercury using traditional chemical propulsion, incorporating various planetary flybys so-called 'gravity assist' manoeuvres. The European team, on the other hand, has proposed a much more complex mission. In order to get to Mercury, ESA have adopted a novel technology knows as 'solar electric propulsion' (SEP). The basic principle is that electrical energy is produced using solar cells, and this is used to accelerate ions of gas, producing a continuous, if low thrust. The upshot is that the mission is much less constrained by the alignment of the planets and other trajectory concerns and can complete the journey in only two and a half years. BepiColombo, ESA's Mercury mission, will actually consist of three spacecraft! The planetary orbiter will stay close to Mercury and perform remote sensing and mapping of the surface environment. The magnetospheric orbiter, now going to be built by the Institute for Space and Astronautical Science (ISAS) in Japan, will fly in a highly eccentric orbit that takes it from within a few hundred kilometres

  18. Prospective validation of a predictive model that identifies homeless people at risk of re-presentation to the emergency department.

    Science.gov (United States)

    Moore, Gaye; Hepworth, Graham; Weiland, Tracey; Manias, Elizabeth; Gerdtz, Marie Frances; Kelaher, Margaret; Dunt, David

    2012-02-01

    To prospectively evaluate the accuracy of a predictive model to identify homeless people at risk of representation to an emergency department. A prospective cohort analysis utilised one month of data from a Principal Referral Hospital in Melbourne, Australia. All visits involving people classified as homeless were included, excluding those who died. Homelessness was defined as living on the streets, in crisis accommodation, in boarding houses or residing in unstable housing. Rates of re-presentation, defined as the total number of visits to the same emergency department within 28 days of discharge from hospital, were measured. Performance of the risk screening tool was assessed by calculating sensitivity, specificity, positive and negative predictive values and likelihood ratios. Over the study period (April 1, 2009 to April 30, 2009), 3298 presentations from 2888 individuals were recorded. The homeless population accounted for 10% (n=327) of all visits and 7% (n=211) of all patients. A total of 90 (43%) homeless people re-presented to the emergency department. The predictive model included nine variables and achieved 98% (CI, 0.92-0.99) sensitivity and 66% (CI, 0.57-0.74) specificity. The positive predictive value was 68% and the negative predictive value was 98%. The positive likelihood ratio 2.9 (CI, 2.2-3.7) and the negative likelihood ratio was 0.03 (CI, 0.01-0.13). The high emergency department re-presentation rate for people who were homeless identifies unresolved psychosocial health needs. The emergency department remains a vital access point for homeless people, particularly after hours. The risk screening tool is key to identify medical and social aspects of a homeless patient's presentation to assist early identification and referral. Copyright © 2012 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

  19. The Psychosis High-Risk State

    Science.gov (United States)

    Fusar-Poli, Paolo; Borgwardt, Stefan; Bechdolf, Andreas; Addington, Jean; Riecher-Rössler, Anita; Schultze-Lutter, Frauke; Keshavan, Matcheri; Wood, Stephen; Ruhrmann, Stephan; Seidman, Larry J.; Valmaggia, Lucia; Cannon, Tyrone; Velthorst, Eva; De Haan, Lieuwe; Cornblatt, Barbara; Bonoldi, Ilaria; Birchwood, Max; McGlashan, Thomas; Carpenter, William; McGorry, Patrick; Klosterkötter, Joachim; McGuire, Philip; Yung, Alison

    2014-01-01

    Context During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5. Objective To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain. Data Sources Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences. Study Selection and Data Extraction Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field. Data Synthesis Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures. Conclusions The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses. PMID:23165428

  20. People

    Science.gov (United States)

    2001-03-01

    classroom competence (in the early 1970s most such courses still had written examinations). I thought it was fantastic. We spent three days a week from October to May in one school. I had one regular third-year class every week and the rest of my teaching timetable varied from term to term. It was like being a 0.3/0.4 member of staff and for that one third-year class I had to do parents' evenings, reports etc. The teachers were paid to act as tutors for the preparation of schemes of work, lessons and tutorial work and they assessed my teaching. Teachers, tutors and trainees attended seminars together. My first teaching job was at Holland Park School in London, at a time when it was famous, perhaps even infamous! It was a real baptism of fire - over 2000 pupils, tens of different first languages, a real mix of class and ethnicity, and newly introduced mixed ability teaching for the first three years. We worked very hard writing schemes of work and developing worksheets and audiovisual materials but, on reflection, I am not sure that we were that effective in developing the science curriculum. I remember using Nuffield Combined Science with the first two years and that was in danger of becoming death by a thousand worksheets. After three years I went to teach in a small private school in Madrid for a year. I was the physics department and my title of Head of Physics meant I was in charge of myself. This was highly formative as a teacher - I had nobody to ask if I didn't understand some physics. As the school was poorly equipped I learned to make apparatus and be very resourceful. There was no pupils' practical work in school science in Spain at that time and I spent a lot of time in hardware stores and medical suppliers! After Spain all of my teaching career was in 11-18 mixed comprehensives, in Cheshire and then Peterborough, and I rose to the dizzy heights of Head of Science. By the time I left the school in Peterborough in 1986 we had established the curriculum framework

  1. Does exposure to lahars risk affect people's risk-preferences and other attitudes? Field data from incentivized experiments and surveys in Arequipa - Peru

    Science.gov (United States)

    Heitz, C.; Bchir, M. A.; Willinger, M.

    2012-04-01

    Many individuals are exposed to risks which are either difficult to insure or hard to mitigate, such as tsunamis, floods, volcanic eruption,... Little is known about how exposure to such risks shapes individuals' risk-preferences. Are they more (less) risk-averse than people who are unexposed to such hazard risk? We provide empirical evidence about this question for the case of individuals exposed to lahars risk. Lahars are sediments laden flows from volcanic origin. We compare the risk-attitude of people exposed - versus non-exposed ones - to lahars risk. The originality of our approach is that we combine standard survey data to behavioural data collected by means of incentivized experiments. We collected data in various locations of the city of Arequipa (Peru), a densely populated area down the volcano El Misti. Participants in our experiment were identified as (non-)exposed to lahars risk based on risk zoning. Our survey questionnaire allows us to compare assessed exposure and the perceived exposure. We elicit risk-preference, time-preference, and trusting behaviour (a measure of social capital) for each respondent in addition to standard survey data. Our field experiment involved a total of 209 respondents from exposed and non-exposed areas. While respondents endow legitimacy in risk reduction (more than 74%) to a national authority (Defensa Civil) in charge of the management of risk in the city, more than 64% of them consider that they are not sufficiently informed about the behaviours to adopt in case of a disaster. Respondents are therefore poorly motivated to adopt initiatives of self-protection (23%) and express instead high expectations with respect to authorities' actions for decreasing their vulnerability (73%). The experimental data show that participants who live in exposed areas are not significantly more risk-averse than those living in non-exposed ones. Furthermore, there is no significant difference in time-preference between exposed and non

  2. Improving antenatal risk assessment in women exposed to high risks.

    Science.gov (United States)

    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.

  3. Use of focus groups to develop methods to communicate cardiovascular disease risk and potential for risk reduction to people with type 2 diabetes.

    Science.gov (United States)

    Price, Hermione C; Dudley, Christina; Barrow, Beryl; Kennedy, Ian; Griffin, Simon J; Holman, Rury R

    2009-10-01

    People need to perceive a risk in order to build an intention-to-change behaviour yet our ability to interpret information about risk is highly variable. We aimed to use a user-centred design process to develop an animated interface for the UK Prospective Diabetes Study (UKPDS) Risk Engine to illustrate cardiovascular disease (CVD) risk and the potential to reduce this risk. In addition, we sought to use the same approach to develop a brief lifestyle advice intervention. Three focus groups were held. Participants were provided with examples of materials used to communicate CVD risk and a leaflet containing a draft brief lifestyle advice intervention and considered their potential to increase motivation-to-change behaviours including diet, physical activity, and smoking in order to reduce CVD risk. Discussions were tape-recorded, transcribed and coded and recurring themes sought. Sixty-two percent of participants were male, mean age was 66 years (range = 47-76 years) and median age at leaving full-time education was 18 years (range = 15-40 years). Sixteen had type 2 diabetes and none had a prior history of CVD. Recurring themes from focus group discussions included the following: being less numerate is common, CVD risk reduction is important and a clear visual representation aids comprehension. A simple animated interface of the UKPDS Risk Engine to illustrate CVD risk and the potential for reducing this risk has been developed for use as a motivational tool, along with a brief lifestyle advice intervention. Future work will investigate whether use of this interactive version of the UKPDS Risk Engine and brief lifestyle advice is associated with increased behavioural intentions and changes in health behaviours designed to reduce CVD risk.

  4. Religion and the risk of suicide: longitudinal study of over 1 million people.

    Science.gov (United States)

    O'Reilly, Dermot; Rosato, Michael

    2015-06-01

    Durkheim's seminal historical study demonstrated that religious affiliation reduces suicide risk, but it is unclear whether this protective effect persists in modern, more secular societies. To examine suicide risk according to Christian religious affiliation and by inference to examine underlying mechanisms for suicide risk. If church attendance is important, risk should be lowest for Roman Catholics and highest for those with no religion; if religiosity is important, then 'conservative' Christians should fare best. A 9-year study followed 1 106 104 people aged 16-74 years at the 2001 UK census, using Cox proportional hazards models adjusted for census-based cohort attributes. In fully adjusted models analysing 1119 cases of suicide, Roman Catholics, Protestants and those professing no religion recorded similar risks. The risk associated with conservative Christians was lower than that for Catholics (HR = 0.71, 95% CI 0.52-0.97). The relationship between religious affiliation and suicide established by Durkheim may not pertain in societies where suicide rates are highest at younger ages. Risks are similar for those with and without a religious affiliation, and Catholics (who traditionally are characterised by higher levels of church attendance) do not demonstrate lower risk of suicide. However, religious affiliation is a poor measure of religiosity, except for a small group of conservative Christians, although their lower risk of suicide may be attributable to factors such as lower risk behaviour and alcohol consumption. © The Royal College of Psychiatrists 2015.

  5. Prediabetes: a high-risk state for diabetes development.

    Science.gov (United States)

    Tabák, Adam G; Herder, Christian; Rathmann, Wolfgang; Brunner, Eric J; Kivimäki, Mika

    2012-06-16

    Prediabetes (intermediate hyperglycaemia) is a high-risk state for diabetes that is defined by glycaemic variables that are higher than normal, but lower than diabetes thresholds. 5-10% of people per year with prediabetes will progress to diabetes, with the same proportion converting back to normoglycaemia. Prevalence of prediabetes is increasing worldwide and experts have projected that more than 470 million people will have prediabetes by 2030. Prediabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction-abnormalities that start before glucose changes are detectable. Observational evidence shows associations between prediabetes and early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease. Multifactorial risk scores using non-invasive measures and blood-based metabolic traits, in addition to glycaemic values, could optimise estimation of diabetes risk. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention, with evidence of a 40-70% relative-risk reduction. Accumulating data also show potential benefits from pharmacotherapy. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Highly Enhanced Risk Management Emergency Satellite

    DEFF Research Database (Denmark)

    Dalmeir, Michael; Gataullin, Yunir; Indrajit, Agung

    HERMES (Highly Enhanced Risk Management Emergency Satellite) is potential European satellite mission for global flood management, being implemented by Technical University Munich and European Space Agency. With its main instrument - a reliable and precise Synthetic Aperture Radar (SAR) antenna...

  7. The high-risk plaque initiative

    DEFF Research Database (Denmark)

    Falk, Erling; Sillesen, Henrik; Muntendam, Pieter

    2011-01-01

    The High-Risk Plaque (HRP) Initiative is a research and development effort to advance the understanding, recognition, and management of asymptomatic individuals at risk for a near-term atherothrombotic event such as myocardial infarction or stroke. Clinical studies using the newest technologies...... have been initiated, including the BioImage Study in which novel approaches are tested in a typical health plan population. Asymptomatic at-risk individuals were enrolled, including a survey-only group (n = 865), a group undergoing traditional risk factor scoring (n = 718), and a group in which all...

  8. The risk on contact people with different serotypes of sticks the Yersinia

    Directory of Open Access Journals (Sweden)

    Nimfa Maria Stojek

    2011-03-01

    Full Text Available Experts are anxious because “American serotype” Yersinia entorocolitica O:8 unexpectedly appeared in Europe in the years 2000 because of its high pathogenicity. The aim of the investigations was to determine people risk contact with different serotypes of Yersinia, based on serological investigations in the years 1997–99 in relation to current epidemiological situation. The study covered 573 sera, from 300 healthy persons and 157 suspicious of yersiniosis, and 116 suspicious of other zoonosis. Tests were performed by passive hemaglutination reaction with antigens viewed as pathogenic to humans Y. enterocolitica O:3, O:5, O:6, O:8, O:9 and Y. pseudotuberculosis group I and III. The most frequently detected antibodies were anti-Y.e. O:5 (41,2% and then anti-Y.e. O:8 (36,6%, anti-Y.e. O;3 (20,1%, anti-Y.e. O;6 (9,2%, anti-Y.e. O:9 (4,6% and anti-Y. pseudotuberculosis I i III (11,8% and 10,3%. The results of investigations show, that already in the years 1997–1999 over 30% of population had contact with Yersinia sticks, including serotypes thought as pathogenic: Y. enterocolitica O:3 (20,1 %, Y. enterocolitica O:9 (4,6 % and particularly with Y. enterocolitica O:8 (36,6 %.

  9. 76 FR 64301 - High Pressure Steel Cylinders From the People's Republic of China: Preliminary Affirmative...

    Science.gov (United States)

    2011-10-18

    ... DEPARTMENT OF COMMERCE International Trade Administration [C-570-978] High Pressure Steel... producers and exporters of high pressure steel cylinders from the People's Republic of China. For... initiation in the Federal Register. See High Pressure Steel Cylinders From the People's Republic of China...

  10. 76 FR 77964 - High Pressure Steel Cylinders From the People's Republic of China: Preliminary Determination of...

    Science.gov (United States)

    2011-12-15

    ... DEPARTMENT OF COMMERCE International Trade Administration [A-570-977] High Pressure Steel... determines that high pressure steel cylinders (``steel cylinders'') from the People's Republic of China... Imposition of Antidumping and Countervailing Duties: High Pressure Steel Cylinders From the People's Republic...

  11. 78 FR 55059 - High Pressure Steel Cylinders from the People's Republic of China: Rescission of Countervailing...

    Science.gov (United States)

    2013-09-09

    ... DEPARTMENT OF COMMERCE International Trade Administration [C-570-978] High Pressure Steel... duty order on high pressure steel cylinders (cylinders) from the People's Republic of China (PRC) for... High Pressure Steel Cylinders from the People's Republic of China.'' \\3\\ See BTIC's August 23, 2013...

  12. 76 FR 33239 - High Pressure Steel Cylinders From the People's Republic of China; Initiation of Countervailing...

    Science.gov (United States)

    2011-06-08

    ... DEPARTMENT OF COMMERCE International Trade Administration [C-570-978] High Pressure Steel... countervailing duty (``CVD'') petition concerning imports of high pressure steel cylinders (``steel cylinders... of Antidumping Duties and Countervailing Duties on High Pressure Steel Cylinders from the People's...

  13. [The risk of general anaesthesia and sedation in the older people].

    Science.gov (United States)

    Oomens, M A E M; Booij, L H D; Baart, J A

    2015-12-01

    Temporary memory problems and aggravation of pre-existing memory disorders may occur after treatment under general anaesthesia. A frequency of postoperative cognition disorders between 10 and 50% has been identified in the literature. Risk factors for the occurrence of postoperative memory disorders are advanced age, low level of education, intellectual comorbidity, the onset of dementia and other neurodegenerative disorders, existing sleep disorders and the experience of postoperative pain. The morphological changes seen in the brain after general anaesthesia are similar to the changes occurring in Alzheimer's disease. In addition to metabolic changes, general anaesthetics directly enhance the apoptosis of brain cells. Older people are already familiar with a decrease in the number of neurons, which provides them with a limited spare capacity. Moreover, older people are often known to have the risk factors for the occurrence of postoperative memory disorders as mentioned before. Caution and restraint in the indication for dental -treatment under general anaesthesia or sedation is therefore required.

  14. Psychological characteristics in high-risk MSM in China

    Directory of Open Access Journals (Sweden)

    Chen Guanzhi

    2012-01-01

    Full Text Available Abstract Background Men who have sex with men (MSM have become a high-risk group of HIV infection in China. To date, little is known regarding the behavioral, social and psychological characteristics in Chinese MSM, which makes the implementation of preventive and therapeutic strategies for this high-risk subpopulation of people extremely difficult. Methods A total of 714 questionnaires were retrieved from the database of a Chinese government-sponsored National Key Research Project titled "Risk Analysis and Strategic Prevention of HIV Transmission from MSM to the General Population in China". The respondents were categorized into a high-risk group and a control group. Their behavioral, social and psychological characteristics were comparatively analyzed. Results Of the 714 MSM analyzed, 59 (8.26% had high-risk homosexual behaviors. This sub-group of MSM had a higher in-marriage rate, a higher monthly income, heavier alcohol consumption and more serious problems with sexual abuse in childhood, intentional suicide attempts and mistaken assumption on condom's role in protecting HIV infection, as compared with the control group (P P > 0.05. A vast majority of the individuals in both behavior categories expressed support of legally protected gay clubs as well as gay marriage legislation in China. There was a strong correlation between high-risk behaviors and sexual abuse in childhood, alcohol drinking, income level and a mistaken belief in perfect HIV protection through the use of condoms. Conclusions MSM with and without high-risk homosexual behaviors have different social and psychological characteristics, which should be taken into account when implementing behavioral and therapeutic interventions aimed at preventing HIV/AIDS transmission among MSM as well as from MSM to the general population in China.

  15. Basic prerequisites of appearance and resocialization of children and young people of the risk group

    Directory of Open Access Journals (Sweden)

    Тамара Василівна Говорун

    2015-08-01

    Full Text Available Social and psychological factors of the appearance of young people of the "risk" group, the best practices of their resocialization have been determined. Children of vulnerable categories from young age have predispositions for acquiring properties and antisocial behavior caused by everyday stress in family life, conflict situations in school interaction. Youth is marked by lag in education, substance abuse, criminal acts, variance of exploitation. Psychocorrectional programs activate subjectivity of undergrads in anger management skills, education and communication

  16. Prevalence and associated risk factors of chronic bronchitis in First Nations people

    OpenAIRE

    Pahwa, Punam; Karunanayake, Chandima P.; Rennie, Donna C.; Lawson, Joshua A.; Ramsden, Vivian R.; McMullin, Kathleen; Gardipy, P. Jenny; MacDonald, Judy; Abonyi, Sylvia; Episkenew, Jo-Ann; Dosman, James A.

    2017-01-01

    Background Inadequate housing, low family income, household smoking, personal smoking status, and poor schooling are some of the conditions that have been significantly associated with the prevalence and incidence of chronic bronchitis. The aim of the current study was to determine the prevalence of chronic bronchitis (CB) and associated risk factors among First Nations people. Methods An interviewer-administered survey was conducted as part of the First Nations Lung Health Project in 2012 an...

  17. Evaluating Fall Risk in People with Low Vision: A Case Series

    OpenAIRE

    Kierstyn Napier-Dovorany, OD; Victoria Graham, DPT

    2013-01-01

    Background: People with low vision have increased risk for falls and preventable health conditions due to sedentary lifestyle and reduced participation in social activities. This case series describes an interprofessional low vision, balance, and mobility evaluation of two patients referred to our low vision optometric clinic. Case Report: RM, an 82-year-old white female with diabetic retinopathy, and PC, a 55-year-old white female with retinopathy of prematurity, completed a comprehensive lo...

  18. Relationship between subjective fall risk assessment and falls and fall-related fractures in frail elderly people.

    Science.gov (United States)

    Shimada, Hiroyuki; Suzukawa, Megumi; Ishizaki, Tatsuro; Kobayashi, Kumiko; Kim, Hunkyung; Suzuki, Takao

    2011-08-12

    Objective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests. The study examined the relationship between a subjective risk rating of specific tasks (SRRST) to screen for fall risks and falls and fall-related fractures in frail elderly people. The SRRST was investigated in 5,062 individuals aged 65 years or older who were utilized day-care services. The SRRST comprised 7 dichotomous questions to screen for fall risks during movements and behaviours such as walking, transferring, and wandering. The history of falls and fall-related fractures during the previous year was reported by participants or determined from an interview with the participant's family and care staff. All SRRST items showed significant differences between the participants with and without falls and fall-related fractures. In multiple logistic regression analysis adjusted for age, sex, diseases, and behavioural variables, the SRRST score was independently associated with history of falls and fractures. Odds ratios for those in the high-risk SRRST group (≥ 5 points) compared with the no risk SRRST group (0 point) were 6.15 (p fall, 15.04 (p falls, and 5.05 (p fall-related fractures. The results remained essentially unchanged in subgroup analysis accounting for locomotion status. These results suggest that subjective ratings by care staff can be utilized to determine the risks of falls and fall-related fractures in the frail elderly, however, these preliminary results require confirmation in further prospective research.

  19. Self-compassion and Risk Behavior among People Living with HIV/AIDS

    OpenAIRE

    Dawson Rose, Carol; Webel, Allison; Sullivan, Kathleen M.; Cuca, Yvette P.; Wantland, Dean; Johnson, Mallory O.; Brion, John; Portillo, Carmen J.; Corless, Inge B.; Voss, Joachim; Chen, Wei-Ti; Phillips, J. Craig; Tyer-Viola, Lynda; Rivero-Méndez, Marta; Nicholas, Patrice K.

    2014-01-01

    Sexual risk behavior and illicit drug use among people living with HIV/AIDS (PLWHA) contribute to poor health and onward transmission of HIV. The aim of this collaborative multi-site nursing research study was to explore the association between self-compassion and risk behaviors in PLWHA. Nurse researchers in Canada, China, Namibia, Puerto Rico, Thailand and the U.S. enrolled 2,182 PLWHA using convenience sampling. Over half of study participants were sexually active in the past three months....

  20. The cardiovascular risk management for people living with HIV in Europe

    DEFF Research Database (Denmark)

    Shahmanesh, M; Schultze, A; Burns, F

    2016-01-01

    . Moderate to high risk was defined as 5-year CV risk >5% and risk modification as two measurements meeting the European AIDSClinical Society guidelines. Factors associated with risk development and modifications were investigated using Poisson regression. RESULTS: Of 8762 individuals, 32.1% were...... Europe, with traditional CV-risk factors. Men who have sex with men, with longer exposure to antiretroviral therapy,low CD4 nadir, higher current CD4, and prior AIDs events were more likely to develop CV-risk. Those on antihypertensive treatment and living in central Europe wereless likely to develop CV-risk....... Of those clinically indicated for risk modification, 1205/2077(58.0%) successfully modified BP; 1283/3919(32.8%) stopped smoking; 277/1394(19.9%) modified cholesterol and 543/2163(25.1%) reduced their BMI. There was variation in modification of individual risk factors, by gender, age, HIV related factors...

  1. Risk factors of military training-related injuries in recruits of Chinese People's Armed Police Forces.

    Science.gov (United States)

    Wang, Xin; Wang, Pei-shan; Zhou, Wei

    2003-02-01

    To assess the incidence, types and risk factors of military training-related injuries in recruits of Chinese People's Armed Police Forces (CPAPF). A cohort study was made on the risk factors of injuries in 805 male recruits during the military training from December 25, 1999 to December 25, 2000. A total of 111 recruits (14%) experienced one or more injuries, and the cumulative incidence was 16.1 injuries per 100 soldiers in a year. And 77.7% of the injuries belonged to overuse injuries of the skeletal and muscular systems, the most common type of which was stress fractures. Most injuries occurred in the 3rd month of training. Univariate analysis and logistic regression analysis of possible risk factors for overuse injuries were carried out, and a number of risk factors were identified: history of agricultural labor, history of lower limb injury, flatfoot and less running exercise before entry into the army. But a suitable body mass index (BMI) was a protective factor. Examination of age, body height, smoking, body flexibility and frequency of 2-mile running revealed no significant association with the injuries. History of agricultural labor, history of lower limb injury, flatfoot, less running exercise before entry into the army and lower BMI were risk factors of the overuse injuries. In order to decrease the incidence of overuse injuries, the young people with good physical ability and shapely body type should be selected during conscription. During the training, nutrition should be improved so as to decrease the incidence of injuries.

  2. Risk management in providing specialized care for people living with AIDS.

    Science.gov (United States)

    Leadebal, Oriana Deyze Correia Paiva; Medeiros, Leidyanny Barbosa de; Morais, Kalline Silva de; Nascimento, João Agnaldo do; Monroe, Aline Aparecida; Nogueira, Jordana de Almeida

    2016-01-01

    Analyzing the provision of actions related to managing clinical risk in managing specialized care for people living with AIDS. A cross-sectional study carried out in a reference outpatient clinic in Paraíba, with a sample of 150 adults with AIDS. Data were collected through primary and secondary sources using a structured questionnaire, analyzed using descriptive statistics, multiple correspondence analysis and logistic regression model to determine the association between "providing care" and "clinical risk." Actions with satisfactory provision express a biological care focus; the dimensions that most contributed to a satisfactory assessment of care provision were "clinical and laboratory evaluations" and "prevention and self-care incentivization"; 45.3% of participants were categorized into high clinical risk, 34% into average clinical risk, and 20.7% into low clinical risk; a positive association between providing care and clinical risk was found. The need to use risk classification technologies to direct the planning of local care provision became evident considering its requirements, and thus qualifying the care provided in these areas. Analisar a oferta de ações relacionadas ao manejo de risco clínico na gestão do cuidado especializado a pessoas vivendo com aids. Estudo transversal realizado em ambulatório de referência na Paraíba, com amostra de 150 adultos com aids. Os dados foram coletados por meio de fontes primárias e secundárias utilizando-se de formulário estruturado, e analisados através de estatística descritiva, análise de correspondência múltipla e modelo de regressão logística para averiguar a associação entre "oferta" e "risco clínico". As ações de oferta satisfatória expressam foco biologicista do cuidado; as dimensões que mais contribuíram para o julgamento satisfatório da oferta foram "avaliação clínica e laboratorial" e "prevenção e estímulo ao autocuidado"; 45,3% dos participantes foram categorizados em risco

  3. Relative Risk of Acute Myocardial Infarction in People with Schizophrenia and Bipolar Disorder: A Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Shu-I Wu

    Full Text Available Despite high mortality associated with serious mental illness, risk of acute myocardial infarction (AMI remains unclear, especially for patients with bipolar disorder. The main objective was to investigate the relative risk of AMI associated with schizophrenia and bipolar disorders in a national sample.Using nationwide administrative data, an 11-year historic cohort study was assembled, comprised of cases aged 18 and above who had received a diagnosis of schizophrenia or bipolar disorder, compared to a random sample of all other adults excluding those with diagnoses of serious mental illness. Incident AMI as a primary diagnosis was ascertained. Hazard ratios stratified by age and gender were calculated and Cox regression models were used to adjust for other covariates.A total of 70,225 people with schizophrenia or bipolar disorder and 207,592 people without serious mental illness were compared. Hazard ratios in men adjusted for age, income and urbanization were 1.15 (95% CI 1.01~1.32 for schizophrenia and 1.37 (1.08~1.73for bipolar disorder, and in women, 1.85 (1.58~2.18 and 1.88(1.47~2.41 respectively. Further adjustment for treated hypertension, diabetes and hyperlipidaemia attenuated the hazard ratio for men with schizophrenia but not the other comparison groups. Hazard ratios were significantly stronger in women than men and were stronger in younger compared to older age groups for both disorders; however, gender modification was only significant in people with schizophrenia, and age modification only significant in people with bipolar disorder.In this large national sample, schizophrenia and bipolar disorder were associated with raised risk of AMI in women and in the younger age groups although showed differences in potential confounding and modifying factors.

  4. Relative Risk of Acute Myocardial Infarction in People with Schizophrenia and Bipolar Disorder: A Population-Based Cohort Study.

    Science.gov (United States)

    Wu, Shu-I; Chen, Su-Chiu; Liu, Shen-Ing; Sun, Fang-Ju; Juang, Jimmy J M; Lee, Hsin-Chien; Kao, Kai-Liang; Dewey, Michael E; Prince, Martin; Stewart, Robert

    2015-01-01

    Despite high mortality associated with serious mental illness, risk of acute myocardial infarction (AMI) remains unclear, especially for patients with bipolar disorder. The main objective was to investigate the relative risk of AMI associated with schizophrenia and bipolar disorders in a national sample. Using nationwide administrative data, an 11-year historic cohort study was assembled, comprised of cases aged 18 and above who had received a diagnosis of schizophrenia or bipolar disorder, compared to a random sample of all other adults excluding those with diagnoses of serious mental illness. Incident AMI as a primary diagnosis was ascertained. Hazard ratios stratified by age and gender were calculated and Cox regression models were used to adjust for other covariates. A total of 70,225 people with schizophrenia or bipolar disorder and 207,592 people without serious mental illness were compared. Hazard ratios in men adjusted for age, income and urbanization were 1.15 (95% CI 1.01~1.32) for schizophrenia and 1.37 (1.08~1.73)for bipolar disorder, and in women, 1.85 (1.58~2.18) and 1.88(1.47~2.41) respectively. Further adjustment for treated hypertension, diabetes and hyperlipidaemia attenuated the hazard ratio for men with schizophrenia but not the other comparison groups. Hazard ratios were significantly stronger in women than men and were stronger in younger compared to older age groups for both disorders; however, gender modification was only significant in people with schizophrenia, and age modification only significant in people with bipolar disorder. In this large national sample, schizophrenia and bipolar disorder were associated with raised risk of AMI in women and in the younger age groups although showed differences in potential confounding and modifying factors.

  5. Perceptions of genetic discrimination among people at risk for Huntington's disease: a cross sectional survey.

    Science.gov (United States)

    Bombard, Yvonne; Veenstra, Gerry; Friedman, Jan M; Creighton, Susan; Currie, Lauren; Paulsen, Jane S; Bottorff, Joan L; Hayden, Michael R

    2009-06-09

    To assess the nature and prevalence of genetic discrimination experienced by people at risk for Huntington's disease who had undergone genetic testing or remained untested. Cross sectional, self reported survey. Seven genetics and movement disorders clinics servicing rural and urban communities in Canada. 233 genetically tested and untested asymptomatic people at risk for Huntington's disease (response rate 80%): 167 underwent testing (83 had the Huntington's disease mutation, 84 did not) and 66 chose not to be tested. Self reported experiences of genetic discrimination and related psychological distress based on family history or genetic test results. Discrimination was reported by 93 respondents (39.9%). Reported experiences occurred most often in insurance (29.2%), family (15.5%), and social (12.4%) settings. There were few reports of discrimination in employment (6.9%), health care (8.6%), or public sector settings (3.9%). Although respondents who were aware that they carried the Huntington's disease mutation reported the highest levels of discrimination, participation in genetic testing was not associated with increased levels of genetic discrimination. Family history of Huntington's disease, rather than the result of genetic testing, was the main reason given for experiences of genetic discrimination. Psychological distress was associated with genetic discrimination (PGenetic discrimination was commonly reported by people at risk for Huntington's disease and was a source of psychological distress. Family history, and not genetic testing, was the major reason for genetic discrimination.

  6. Parents' Attitudes to Risk and Injury to Children and Young People on Farms.

    Science.gov (United States)

    Nilsson, Kerstin

    2016-01-01

    Children and young people growing up in a farm environment run a greater risk of being injured or dying in an accident than their non-farming counterparts. This study examines farming parents' attitudes and experiences of having their children grow up on farms, one of the most dangerous work environments as their home, everyday environment and playground. Data were collected using two ethnological methods, a question list and interviews, with a study population of 20 parents. The data were analysed phenomenologically. The analysis pursued four themes: i) the most dangerous places and situations on the farm; ii) children's tasks on the farm; iii) children as a safety risk on the farm; and iv) farm risk education for children. Most parents know the risks on their farm, but are sometimes careless when working under stress or exhaustion. Some parents wanted more information and some wanted compulsory preventative or safety measures by manufacturers, e.g. a safety belt as standard on the extra seat in tractors. Children's friends were described as one of the greatest risks for injury due to peer pressure. Some parents mentioned that people who grow up on farms are sometimes 'blind' to the dangers. Other parents seemed to overlook the risks and had their children carrying out tasks for which they were not mentally or physically equipped. Some of the tasks the children reportedly carried out on farms contravened Swedish legislation. It is thus important for farming parents to be repeatedly reminded of the risks to their children and to increase their awareness of how to prevent and eliminate risks in order to avoid accidents on the farm. The situation for farm children is highlighted in a critical discussion.

  7. Parents' Attitudes to Risk and Injury to Children and Young People on Farms.

    Directory of Open Access Journals (Sweden)

    Kerstin Nilsson

    Full Text Available Children and young people growing up in a farm environment run a greater risk of being injured or dying in an accident than their non-farming counterparts. This study examines farming parents' attitudes and experiences of having their children grow up on farms, one of the most dangerous work environments as their home, everyday environment and playground.Data were collected using two ethnological methods, a question list and interviews, with a study population of 20 parents. The data were analysed phenomenologically.The analysis pursued four themes: i the most dangerous places and situations on the farm; ii children's tasks on the farm; iii children as a safety risk on the farm; and iv farm risk education for children.Most parents know the risks on their farm, but are sometimes careless when working under stress or exhaustion. Some parents wanted more information and some wanted compulsory preventative or safety measures by manufacturers, e.g. a safety belt as standard on the extra seat in tractors. Children's friends were described as one of the greatest risks for injury due to peer pressure. Some parents mentioned that people who grow up on farms are sometimes 'blind' to the dangers. Other parents seemed to overlook the risks and had their children carrying out tasks for which they were not mentally or physically equipped. Some of the tasks the children reportedly carried out on farms contravened Swedish legislation. It is thus important for farming parents to be repeatedly reminded of the risks to their children and to increase their awareness of how to prevent and eliminate risks in order to avoid accidents on the farm. The situation for farm children is highlighted in a critical discussion.

  8. Relationship between subjective fall risk assessment and falls and fall-related fractures in frail elderly people

    OpenAIRE

    Shimada, Hiroyuki; Suzukawa, Megumi; Ishizaki, Tatsuro; Kobayashi, Kumiko; Kim, Hunkyung; Suzuki, Takao

    2011-01-01

    Abstract Background Objective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests. The study examined the relationship between a subjective risk rating of specific tasks (SRRST) to screen for fall risks and falls and fall-related fractures in frail elderly people. Methods The SRRST was investigated in 5,062 individuals aged 65 years or older who were utilized day-care services. The SRRST comprised 7 dichotom...

  9. Diagnostic Accuracy of Fall Risk Assessment Tools in People With Diabetic Peripheral Neuropathy

    Science.gov (United States)

    Pohl, Patricia S.; Mahnken, Jonathan D.; Kluding, Patricia M.

    2012-01-01

    Background Diabetic peripheral neuropathy affects nearly half of individuals with diabetes and leads to increased fall risk. Evidence addressing fall risk assessment for these individuals is lacking. Objective The purpose of this study was to identify which of 4 functional mobility fall risk assessment tools best discriminates, in people with diabetic peripheral neuropathy, between recurrent “fallers” and those who are not recurrent fallers. Design A cross-sectional study was conducted. Setting The study was conducted in a medical research university setting. Participants The participants were a convenience sample of 36 individuals between 40 and 65 years of age with diabetic peripheral neuropathy. Measurements Fall history was assessed retrospectively and was the criterion standard. Fall risk was assessed using the Functional Reach Test, the Timed “Up & Go” Test, the Berg Balance Scale, and the Dynamic Gait Index. Sensitivity, specificity, positive and negative likelihood ratios, and overall diagnostic accuracy were calculated for each fall risk assessment tool. Receiver operating characteristic curves were used to estimate modified cutoff scores for each fall risk assessment tool; indexes then were recalculated. Results Ten of the 36 participants were classified as recurrent fallers. When traditional cutoff scores were used, the Dynamic Gait Index and Functional Reach Test demonstrated the highest sensitivity at only 30%; the Dynamic Gait Index also demonstrated the highest overall diagnostic accuracy. When modified cutoff scores were used, all tools demonstrated improved sensitivity (80% or 90%). Overall diagnostic accuracy improved for all tests except the Functional Reach Test; the Timed “Up & Go” Test demonstrated the highest diagnostic accuracy at 88.9%. Limitations The small sample size and retrospective fall history assessment were limitations of the study. Conclusions Modified cutoff scores improved diagnostic accuracy for 3 of 4 fall risk

  10. Cyberbullying in those at clinical high risk for psychosis.

    Science.gov (United States)

    Magaud, Emilie; Nyman, Karissa; Addington, Jean

    2013-11-01

    Several studies suggest an association between experiences of childhood trauma including bullying and the development of psychotic symptoms. The use of communications technology has created a new media for bullying called 'cyberbullying'. Research has demonstrated associations between traditional bullying and cyberbullying. Negative effects of cyberbullying appear similar in nature and severity to the reported effects of traditional bullying. Our aim was to examine the prevalence and correlates of cyberbullying in those at clinical high risk (CHR) for psychosis. Fifty young people at CHR for psychosis were administered the Childhood Trauma Questionnaire with added questions about cyberbullying. Cyberbullying was reported in 38% of the sample. Those who experienced cyberbullying also reported experiencing previous trauma. It is possible that cyberbullying may be a problem for those at CHR of psychosis, and due to the vulnerable nature of these young people may have longitudinal implications. © 2013 Wiley Publishing Asia Pty Ltd.

  11. Condom availability in high risk places and condom use

    DEFF Research Database (Denmark)

    Sandøy, Ingvild Fossgard; Blystad, Astrid; Shayo, Elizabeth H.

    2012-01-01

    study findings indicate that substantial further efforts should be made to secure that condoms are easily accessible in places where sexual relationships are initiated. Although condom distribution in drinking places has been pinpointed in the HIV/AIDS prevention strategies of all the three countries......Background A number of studies from countries with severe HIV epidemics have found gaps in condom availability, even in places where there is a substantial potential for HIV transmission. Although reported condom use has increased in many African countries, there are often big differences...... in the availability of condoms in places where people meet new sexual partners in these three African districts. Considering that previous studies have found that improved condom availability and accessibility in high risk places have a potential to increase condom use among people with multiple partners, the present...

  12. MYPLAN - A Mobile Phone Application for Supporting People at Risk of Suicide.

    Science.gov (United States)

    Skovgaard Larsen, Jette L; Frandsen, Hanne; Erlangsen, Annette

    2016-05-01

    Safety plans have been suggested as an intervention for people at risk of suicide. Given the impulsive character of suicidal ideation, a safety plan in the format of a mobile phone application is likely to be more available and useful than traditional paper versions. The study describes MYPLAN, a mobile phone application designed to support people at risk of suicide by letting them create a safety plan. MYPLAN was developed in collaboration with clinical psychiatric staff at Danish suicide preventive clinics. The mobile application lets the user create an individualized safety plan by filling in templates with strategies, actions, and direct links to contact persons. MYPLAN was developed in 2013 and is freely available in Denmark and Norway. It is designed for iPhone and android platforms. As of December 2015, the application has been downloaded almost 8,000 times. Users at risk of suicide as well as clinical staff have provided positive feedback on the mobile application. Support via mobile phone applications might be particularly useful for younger age groups at risk of suicide as well as in areas or countries where support options are lacking. Yet, it is important to examine the effectiveness of this type of intervention.

  13. Risk factors for secondary substance use disorders in people with childhood and adolescent-onset bipolar disorder: opportunities for prevention.

    Science.gov (United States)

    Kenneson, Aileen; Funderburk, Jennifer S; Maisto, Stephen A

    2013-07-01

    Compared to other mental illnesses, bipolar disorder is associated with a disproportionately high rate of substance use disorders (SUDs), and the co-occurrence is associated with significant morbidity and mortality. Early diagnosis of primary bipolar disorder may provide opportunities for SUD prevention, but little is known about the risk factors for secondary SUD among individuals with bipolar disorder. The purposes of this study were to describe the population of people with childhood and adolescent-onset primary bipolar disorder, and to identify risk factors for secondary SUD in this population. Using data collected from the National Comorbidity Survey Replication study, we identified 158 individuals with childhood-onset (adolescent-onset (13-18 years) primary bipolar disorder (I, II or subthreshold). Survival analysis was used to identify risk factors for SUD. Compared to adolescent-onset, people with childhood-onset bipolar disorder had increased likelihoods of attention deficit hyperactivity disorder (ADHD) (adjusted odds ratio=2.81) and suicide attempt (aOR=3.61). Males were more likely than females to develop SUD, and did so at a faster rate. Hazard ratios of risk factors for SUD were: lifetime oppositional defiant disorder (2.048), any lifetime anxiety disorder (3.077), adolescent-onset bipolar disorder (1.653), and suicide attempt (15.424). SUD was not predicted by bipolar disorder type, family history of bipolar disorder, hospitalization for a mood episode, ADHD or conduct disorder. As clinicians struggle to help individuals with bipolar disorder, this study provides information that might be useful in identifying individuals at higher risk for SUD. Future research can examine whether targeting these risk factors may help prevent secondary SUD. Published by Elsevier Inc.

  14. Suicide risk in a representative sample of people receiving HIV care: Time to target most-at-risk populations (ANRS VESPA2 French national survey).

    Science.gov (United States)

    Carrieri, Maria Patrizia; Marcellin, Fabienne; Fressard, Lisa; Préau, Marie; Sagaon-Teyssier, Luis; Suzan-Monti, Marie; Guagliardo, Valérie; Mora, Marion; Roux, Perrine; Dray-Spira, Rosemary; Spire, Bruno

    2017-01-01

    Suicide risk is high among people living with HIV (PLHIV). This study aimed to identify major correlates of suicide risk in a representative sample of PLHIV in France, in order to help target individuals who would benefit from suicide risk screening and psychiatric care. The ANRS VESPA2 cross-sectional survey (April 2011-January 2012) collected socio-demographic, medical and behavioral data from 3,022 PLHIV recruited in 73 French HIV hospital departments. The study sample comprised the 2,973 participants with available self-reported data on suicide risk (defined as having either thought about and planned to commit suicide during the previous 12 months or attempted suicide during the same period of time) and medical data on comorbidities. Weighted Poisson models adjusted for HCV co-infection and significant clinical variables were used to estimate the relationship between suicide risk and HIV transmission groups, experience with HIV disease and other psychosocial factors. Suicide risk was reported by 6.3% of PLHIV in the study sample. After adjustment for HIV immunological status and HCV co-infection, women (IRR [95%CI]:1.93 [1.17; 3.19]) and men who have sex with men (MSM) (1.97 [1.22; 3.19]) had a higher suicide risk than the rest of the sample. Moreover, the number of discrimination-related social contexts reported (1.39 [1.19; 1.61]), homelessness (4.87 [1.82; 13.02]), and reporting a feeling of loneliness (4.62 [3.06; 6.97]) were major predictors of suicide risk. Reducing the burden of precarious social conditions and discrimination is an important lever for preventing suicide risk among PLHIV in France. Comprehensive care models involving peer/community social interventions targeted at women and MSM need to be implemented to lower the risk of suicide in these specific subgroups of PLHIV.

  15. Suicide risk in a representative sample of people receiving HIV care: Time to target most-at-risk populations (ANRS VESPA2 French national survey.

    Directory of Open Access Journals (Sweden)

    Maria Patrizia Carrieri

    Full Text Available Suicide risk is high among people living with HIV (PLHIV. This study aimed to identify major correlates of suicide risk in a representative sample of PLHIV in France, in order to help target individuals who would benefit from suicide risk screening and psychiatric care.The ANRS VESPA2 cross-sectional survey (April 2011-January 2012 collected socio-demographic, medical and behavioral data from 3,022 PLHIV recruited in 73 French HIV hospital departments. The study sample comprised the 2,973 participants with available self-reported data on suicide risk (defined as having either thought about and planned to commit suicide during the previous 12 months or attempted suicide during the same period of time and medical data on comorbidities. Weighted Poisson models adjusted for HCV co-infection and significant clinical variables were used to estimate the relationship between suicide risk and HIV transmission groups, experience with HIV disease and other psychosocial factors.Suicide risk was reported by 6.3% of PLHIV in the study sample. After adjustment for HIV immunological status and HCV co-infection, women (IRR [95%CI]:1.93 [1.17; 3.19] and men who have sex with men (MSM (1.97 [1.22; 3.19] had a higher suicide risk than the rest of the sample. Moreover, the number of discrimination-related social contexts reported (1.39 [1.19; 1.61], homelessness (4.87 [1.82; 13.02], and reporting a feeling of loneliness (4.62 [3.06; 6.97] were major predictors of suicide risk.Reducing the burden of precarious social conditions and discrimination is an important lever for preventing suicide risk among PLHIV in France. Comprehensive care models involving peer/community social interventions targeted at women and MSM need to be implemented to lower the risk of suicide in these specific subgroups of PLHIV.

  16. Still "at risk": An examination of how street-involved young people understand, experience, and engage with "harm reduction" in Vancouver's inner city.

    Science.gov (United States)

    Bozinoff, Nikki; Small, Will; Long, Cathy; DeBeck, Kora; Fast, Danya

    2017-07-01

    Vancouver is an international leader in implementing interventions to reduce harms related to drug use. However, street-involved young people who use drugs continue to be vulnerable to overdose death, hepatitis C (HCV) infection, and high rates of syringe sharing. To better understand this in the context of the intensive public health response, we examined how young people, who are involved in the 'street drug scene', understood, experienced and engaged with harm reduction. Twelve semi-structured interviews were conducted in 2013 with 13 young people (ages 17-28) recruited from the At-Risk Youth Study, a prospective cohort of street-involved and drug-using young people. These interviews were embedded within a larger, eight-year program of ethnographic research and explored participants' understandings of harm reduction, their use of specific services, and their ideas about improving their day-to-day lives. Interviews were transcribed verbatim and a thematic analysis was performed. Young peoples' ideas about harm reduction were diverse and expansive. They articulated the limitations of existing programs, indicating that while they are positioned to reduce the risk of HIV and HCV transmission, they offer little meaningful support to improve young peoples' broader life chances. Young people described strategies to mitigate risk and harm in their own lives, including transitioning to drugs deemed less harmful and attempting to gain access to drug treatment. Finally, young people indicated that spatial considerations (e.g., distance from Vancouver's Downtown Eastside) strongly determined access to services. In Vancouver, a large, well established harm reduction infrastructure seeks to reduce HIV and HCV transmission among street-involved young people. However, young peoples' multiple understandings, experiences and engagements with harm reduction in this setting illustrate the limitations of the existing infrastructure in improving their broader life chances. Copyright

  17. Prevalence, types, risk factors and clinical correlates of anaemia in older people in a rural Ugandan population.

    Directory of Open Access Journals (Sweden)

    Joseph O Mugisha

    Full Text Available BACKGROUND: Studies conducted in high income countries have shown that anaemia is a common medical condition among older people, but such data are scarce in Africa. The objectives of this study were to estimate the prevalence, types, risk factors and clinical correlates of anaemia in older people. METHODS: Participants were aged (≥ 50 years recruited from a general population cohort from January 2012 to January 2013. Blood samples were collected for assessing hemoglobin, serum ferritin, serum vitamin B12, serum folate, C-reactive protein, malaria infection and stool samples for assessment of hookworm infection. HIV status was assessed using an algorithm for HIV rapid testing. Questionnaires were used to collect data on sociodemographic characteristics and other risk factors for anaemia. RESULTS: In total, 1449 people participated (response rate 72.3%. The overall prevalence of anaemia was 20.3 % (95% CI 18.2-22.3%, and this was higher for males (24.1%, 95% CI=20.7-27.7% than females (17.5%, 95% CI=15.0-20.1%. In males, the prevalence of anaemia increased rapidly with age almost doubling between 50 and 65 years (p-trend<0.001. Unexplained anaemia was responsible for more than half of all cases (59.7%. Anaemia was independently associated with infections including malaria (OR 3.49, 95% CI 1.78-6.82, HIV (OR 2.17, 1.32-3.57 heavy hookworm infection (OR 3.45, 1.73-6.91, low fruit consumption (OR 1.55, 1.05-2.29 and being unmarried (OR 1.37 , 95% CI 1.01-1.89. However, the odds of anaemia were lower among older people with elevated blood pressure (OR 0.47, 95% CI 0.29-0.77. CONCLUSION: Anaemia control programmes in Uganda should target older people and should include interventions to treat and control hookworms and educational programs on diets that enhance iron absorption. Clinicians should consider screening older people with HIV or malaria for anaemia. Further studies should be done on unexplained anaemia and serum ferritin levels that predict

  18. Sexting: Prevalence, Predictors, and Associated Sexual Risk Behaviors among Postsecondary School Young People in Ibadan, Nigeria.

    Science.gov (United States)

    Olatunde, Oluwatoyin; Balogun, Folusho

    2017-01-01

    Sending and receiving sexually suggestive or explicit images or texts (sexting) have been shown to be associated with health risk behaviors but literature about this phenomenon is scarce in Nigeria. This study looked at the prevalence, predictors, and associated sexual risk behaviors of sexting among postsecondary school young persons in Ibadan, Nigeria. This was a cross-sectional study using a self-administered questionnaire. Data were obtained for sociodemographic characteristics and sexual orientation, sexting behavior, personality assessment (using the International Personality Item Pool Big-Five factor markers), indicators for problematic phone use (using Mobile Phone Problem Use Scale), and sexual behavior. Chi square test and logistic regression were used for data analysis with p  = 0.05. Five hundred seventy-five participants were recruited, age range 14-24 years, and 46.0% were males. Twenty percent had sent sexts, while 33.2% had received sexts. Fifty-four percent had high scores in extraversion, 46.5% had moderate-severe problematic phone use. Sixteen percent had ever had sex, and 40.0% of these had multiple sexual partners. Males were more likely than females to have sent sexts (OR = 2.67, 95% CI: 1.68-4.24). Having a high extraversion score (OR = 2.44, 95% CI: 1.35-4.41) and moderate-severe problematic phone use (OR = 5.56, 95% CI: 2.73-11.32) was predictive of sexting. Sending and receiving of sext were significantly associated with ever having sexual intercourse (OR = 4.01, 95% CI: 2.25-7.17 and OR = 2.96, 95% CI: 1.72-5.12, respectively). Sexting was prevalent among postsecondary school young persons in Ibadan and was associated with male sex and problematic phone use. Intervention targeted at the identified susceptible group of young people may reduce its associated problems in this study group.

  19. Sexting: Prevalence, Predictors, and Associated Sexual Risk Behaviors among Postsecondary School Young People in Ibadan, Nigeria

    Directory of Open Access Journals (Sweden)

    Oluwatoyin Olatunde

    2017-05-01

    Full Text Available Background and aimsSending and receiving sexually suggestive or explicit images or texts (sexting have been shown to be associated with health risk behaviors but literature about this phenomenon is scarce in Nigeria. This study looked at the prevalence, predictors, and associated sexual risk behaviors of sexting among postsecondary school young persons in Ibadan, Nigeria.MethodsThis was a cross-sectional study using a self-administered questionnaire. Data were obtained for sociodemographic characteristics and sexual orientation, sexting behavior, personality assessment (using the International Personality Item Pool Big-Five factor markers, indicators for problematic phone use (using Mobile Phone Problem Use Scale, and sexual behavior. Chi square test and logistic regression were used for data analysis with p = 0.05.ResultsFive hundred seventy-five participants were recruited, age range 14–24 years, and 46.0% were males. Twenty percent had sent sexts, while 33.2% had received sexts. Fifty-four percent had high scores in extraversion, 46.5% had moderate–severe problematic phone use. Sixteen percent had ever had sex, and 40.0% of these had multiple sexual partners. Males were more likely than females to have sent sexts (OR = 2.67, 95% CI: 1.68–4.24. Having a high extraversion score (OR = 2.44, 95% CI: 1.35–4.41 and moderate–severe problematic phone use (OR = 5.56, 95% CI: 2.73–11.32 was predictive of sexting. Sending and receiving of sext were significantly associated with ever having sexual intercourse (OR = 4.01, 95% CI: 2.25–7.17 and OR = 2.96, 95% CI: 1.72–5.12, respectively.ConclusionSexting was prevalent among postsecondary school young persons in Ibadan and was associated with male sex and problematic phone use. Intervention targeted at the identified susceptible group of young people may reduce its associated problems in this study group.

  20. Renal transplantation in high cardiovascular risk patients.

    Science.gov (United States)

    Bittar, Julio; Arenas, Paula; Chiurchiu, Carlos; de la Fuente, Jorge; de Arteaga, Javier; Douthat, Walter; Massari, Pablo U

    2009-10-01

    Current transplant success allows recipients with previous contraindications to transplant to have access to this procedure with more frequency and safety. The concept of high-risk patient has changed since the first stages of transplantation. In the first studies, the high-risk concept was based on probability of early graft failure or on a patient's clinical condition to cope with high perioperatory morbimortality. Later on, this concept implied immunological factors that were crucial to ensure transplant success because hypersensitized or polytransfused patients experienced a higher risk of acute rejection and subsequent graft loss. Afterward, the presence of various comorbidities would redefine the high-risk concept for renal transplant mainly considering recipient's clinical aspects. Currently, the change in epidemiological characteristics of patients starting dialysis causes that we now deal with a greater increase of elderly patients, diabetic patients, and patients with history of cardiovascular disease. Today, high-risk patients are those with clinical features that predict an increase in the risk of perioperative morbimortality or death with functioning graft. In this review, we will attempted to analyze currents results of renal transplant outcomes in terms of patients and graft survival in elderly patients, diabetic patients, and patients with previous cardiovascular disease from the most recent experiences in the literature and from experiences in our center. In any of the groups previously analyzed, survival offered by renal transplant is significantly higher compared to dialysis. Besides, these patients are the recipient group that benefit the most with the transplant because their mortality while remaining on dialysis is extremely high. Hence, renal transplantation should be offered more frequently to older patients, diabetic patients, and patients with pretransplant cardiac and peripheral vascular disease. A positive attitude toward renal

  1. High-Risk Behaviors among Youth and Their Reasons for Not Getting Tested for HIV

    Science.gov (United States)

    Moyer, Matthew B.; Silvestre, Anthony J.; Lombardi, Emilia L.; Taylor, Christopher A.

    2007-01-01

    Concerned about reports of a 15% decline in HIV testing among high-risk youth in an earlier study in Pittsburgh, this study was initiated to explore reasons why young people are not getting tested for HIV, while gathering data on their respective level of risk taking behaviors. A total of 580 surveys were collected from youth aged between 14 and…

  2. High risk process control system assessment methodology

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Venetia [Pontificia Universidade Catolica do Rio de Janeiro (PUC-Rio), RJ (Brazil); Zamberlan, Maria Cristina [National Institute of Tehnology (INT), Rio de Janeiro, RJ (Brazil). Human Reliability and Ergonomics Research Group for the Oil, Gas and Energy Sector

    2009-07-01

    The evolution of ergonomics methodology has become necessary due to the dynamics imposed by the work environment, by the increase of the need of human cooperation and by the high interaction between various sections within a company. In the last 25 years, as of studies made in the high risk process control, we have developed a methodology to evaluate these situations that focus on the assessment of activities and human cooperation, the assessment of context, the assessment of the impact of work of other sectors in the final activity of the operator, as well as the modeling of existing risks. (author)

  3. [Muscle and bone health as a risk factor of fall among the elderly. An approach to identify high-risk fallers by risk assessment].

    Science.gov (United States)

    Kikuchi, Reiko; Kozaki, Koichi; Nakamura, Tetsuro; Toba, Kenji

    2008-06-01

    Fall-induced hip fracture is one of the major causes rendering the elderly to be in a low ADL or bed-ridden status. Fall is not only the cause for fractures, but it lowers elderly peoples'ADL. History of fall, age, decline of motor function, orthostatic hypotension, balance deficit, dementia, drug and environmental factors were raised as possible risk factor for falls. We created a fall predicting score which consist of 21 risk factors and a history of falls. We found that the score is useful to identify high-risk fallers. It would be necessary to identify high-risk fallers early and give an appropriate individual approach.

  4. Does natural disaster influence people's risk preference and trust? An experiment from cyclone prone coast of Bangladesh

    DEFF Research Database (Denmark)

    Ahsan, Dewan

    2014-01-01

    Natural catastrophic events may have enormous negative effects on economic growth. People affected by the disaster might be risk averse because of anxiety about the future uncertainty of economic returns. The purpose of this empirical study is to highlight the effect of natural disasters...... (specifically coastal cyclonic storm surges) on individuals' risk preference and level of trust. This study also aims to disentangle risk propensity from trust. It reveals that natural disasters can significantly reduce people's risk-taking attitudes, whereas the catastrophic events have no influence...... on trusting behavior. The study suggests that risk attitudes are significantly negatively correlated with trust....

  5. New information on high risk breast screening

    International Nuclear Information System (INIS)

    Riedl, C.C.; Ponhold, L.; Gruber, R.; Pinker, K.; Helbich, T.H.

    2010-01-01

    Women with an elevated risk for breast cancer require intensified screening beginning at an early age. Such high risk screening differs considerably from screening in the general population. After an expert has evaluated the exact risk a breast MRI examination should be offered at least once a year and beginning latest at the age of 30 depending on the patients risk category. Complementary mammograms should not be performed before the age of 35. An additional ultrasound examination is no longer recommended. To ensure a high sensitivity and specificity high risk screening should be performed only at a nationally or regionally approved and audited service. Adequate knowledge about the phenotypical characteristics of familial breast cancer is essential. Besides the common malignant phenotypes, benign morphologies (round or oval shape and smooth margins) as well as a low prevalence of calcifications have been described. Using MRI benign contrast media kinetics as well as non-solid lesions with focal, regional and segmental enhancement can often be visualized. (orig.) [de

  6. A Web-Based Respondent Driven Sampling Pilot Targeting Young People at Risk for Chlamydia Trachomatis in Social and Sexual Networks with Testing: A Use Evaluation

    NARCIS (Netherlands)

    Theunissen, Kevin; Hoebe, Christian; Kok, Gerjo; Crutzen, Rik; Kara-Zaïtri, Chakib; de Vries, Nanne; van Bergen, Jan; Hamilton, Robert; van der Sande, Marianne; Dukers-Muijrers, Nicole

    2015-01-01

    With the aim of targeting high-risk hidden heterosexual young people for Chlamydia trachomatis (CT) testing, an innovative web-based screening strategy using Respondent Driven Sampling (RDS) and home-based CT testing, was developed, piloted and evaluated. Two STI clinic nurses encouraged 37 CT

  7. A Web-Based Respondent Driven Sampling Pilot Targeting Young People at Risk for Chlamydia Trachomatis in Social and Sexual Networks with Testing : A Use Evaluation

    NARCIS (Netherlands)

    Theunissen, Kevin; Hoebe, Christian; Kok, Gerjo; Crutzen, Rik; Kara-Zaïtri, Chakib; de Vries, Nanne; van Bergen, Jan; Hamilton, Robert; van der Sande, Marianne; Dukers-Muijrers, Nicole

    BACKGROUND: With the aim of targeting high-risk hidden heterosexual young people for Chlamydia trachomatis (CT) testing, an innovative web-based screening strategy using Respondent Driven Sampling (RDS) and home-based CT testing, was developed, piloted and evaluated. METHODS: Two STI clinic nurses

  8. Not all risks are equal: the risk taking inventory for high-risk sports.

    Science.gov (United States)

    Woodman, Tim; Barlow, Matt; Bandura, Comille; Hill, Miles; Kupciw, Dominika; Macgregor, Alexandra

    2013-10-01

    Although high-risk sport participants are typically considered a homogenous risk-taking population, attitudes to risk within the high-risk domain can vary considerably. As no validated measure allows researchers to assess risk taking within this domain, we validated the Risk Taking Inventory (RTI) for high-risk sport across four studies. The RTI comprises seven items across two factors: deliberate risk taking and precautionary behaviors. In Study 1 (n = 341), the inventory was refined and tested via a confirmatory factor analysis used in an exploratory fashion. The subsequent three studies confirmed the RTI's good model-data fit via three further separate confirmatory factor analyses. In Study 2 (n = 518) and in Study 3 (n = 290), concurrent validity was also confirmed via associations with other related traits (sensation seeking, behavioral activation, behavioral inhibition, impulsivity, self-esteem, extraversion, and conscientiousness). In Study 4 (n = 365), predictive validity was confirmed via associations with mean accidents and mean close calls in the high-risk domain. Finally, in Study 4, the self-report version of the inventory was significantly associated with an informant version of the inventory. The measure will allow researchers and practitioners to investigate risk taking as a variable that is conceptually distinct from participation in a high-risk sport.

  9. Constructing definitions of safety risks while nurses care for hospitalised older people: Secondary analysis of qualitative data.

    Science.gov (United States)

    Dahlke, Sherry; Hall, Wendy A; Baumbusch, Jennifer

    2017-09-01

    The aim of this secondary qualitative descriptive analysis was to examine how nurses construct a definition of older peoples' safety risks and provide care while working within organisational contexts that are focused on diminishing patient risks. Numbers of older patients are increasing in acute hospital contexts-contexts that place their focus on patient safety. Nurses need to manage tensions between older peoples' risks, evidence-informed practice decisions, limited resources and organisational emphases on patient falls. To date, their practice dilemmas have not been well examined. A secondary qualitative descriptive analysis was conducted using data that were collected between June 2010 and May 2011 to examine nursing practice with hospitalised older people. All field notes and transcribed data were reviewed to generate themes representing 18 Registered Nurses' perceptions about safe care for hospitalised older people. The first author generated categories that described how nurses construct definitions of safety risks for older people. All authors engaged in an iterative analytic process that resulted in themes capturing nurses' efforts to provide care in limited resource environments while considering older peoples' safety risks. Nurses constructed definitions of patient safety risks in the context of institutional directives. Nurses provided care using available resources as efficiently as possible and accessing co-worker support. They also minimised the importance of older people's functional abilities by setting priorities for medically delegated tasks and immobilising their patients to reduce their risks. Nurses' definitions of patient risk, which were shaped by impoverished institutional resources and nurses' lack of valuing of functional abilities, contributed to suboptimal care for older adults. Nurses' definitions of risk as physical injury reduced their attention to patients' functional abilities, which nurses reported suffered declines as a result

  10. Using intervention mapping for the development of a targeted secure web-based outreach strategy named SafeFriend, for Chlamydia trachomatis testing in young people at risk.

    Science.gov (United States)

    Theunissen, Kevin A T M; Hoebe, Christian J P A; Crutzen, Rik; Kara-Zaïtri, Chakib; de Vries, Nanne K; van Bergen, Jan E A M; van der Sande, Marianne A B; Dukers-Muijrers, Nicole H T M

    2013-10-22

    Many young people at high risk for Chlamydia trachomatis (Ct) are not reached by current sexual health care systems, such as general practitioners and public sexual health care centres (sexually transmitted infection clinics).Ct is the most frequently diagnosed bacterial sexually transmitted infection (STI) among sexually active people and in particular young heterosexuals. Innovative screening strategies are needed to interrupt the transmission of Ct among young people and connect the hidden cases to care. Intervention Mapping (IM), a systematic approach to develop theory- and evidence-based interventions, was used to develop a strategy to target Ct testing towards young people who are currently hidden to care in The Netherlands. Both clinical users (i.e. sexual health care nurses) and public users (i.e., young people at risk for Ct) were closely involved in the IM process. A needs assessment study was carried out using semi-structured interviews among users (N = 21), a literature search and by taking lessons learned from existing screening programmes. Theoretical methods and practical applications to reach high risk young people and influence testing were selected and translated into specific programme components. The IM approach resulted in the development of a secure and web-based outreach Ct screening strategy, named SafeFriend. It is developed to target groups of high-risk young people who are currently hidden to care. Key methods include web-based Respondent Driven Sampling, starting from young Ct positive sexual health care centre clients, to reach and motivate peers (i.e., sex partners and friends) to get tested for Ct. Testing and the motivation of peers were proposed as the desired behavioural outcomes and the Precaution Adoption Process Model was chosen as theoretical framework. End users, i.e., young people and sexual health care nurses were interviewed and included in the development process to increase the success of implementation. IM proved useful

  11. Understanding self-Blame as a risk for unemployed young people

    DEFF Research Database (Denmark)

    Pultz, Sabina

    and make sense of it and how they position themselves in regards to this normative demand to blame themselves. Personal branding and networking are identified as strategies enforced by the employment system and can be viewed as technologies of the self (Rose, 1996) encouraging young people to modulate......Young people face the risk of unemployment in a labor market characterized by a drift towards precarious employment (Kalleberg, 2013). Building on governmentality perspectives this study documents how understanding of unemployment is affected by neoliberal discourses reflected in the technologies...... applied by the institutions in the employment area. As a result, responsibility for unemployment is increasingly placed on the individual and self-blame is promoted as the predominant explanation, revitalizing attributional theory in a new way. This qualitative study consists of a combination of ten field...

  12. Co-endemicity of Cysticercosis and Schistosomiasis in Africa - how many people are at risk?

    DEFF Research Database (Denmark)

    Saarnak, Christopher; Braae, Uffe Christian; Magnussen, Pascal

    The World Health Organisation (WHO) is aiming for elimination of schistosomiasis by 2020 through mass drug administration (MDA). However, the drug used for this, praziquantel, has been reported to cause dramatic side effects, even death, among people suffering from neurocysticercosis (NCC). Both...... countries were identified. The co-endemicity dataset was then combined with modelled data on population density for 2015 derived from the WorldPop database (http://www.worldpop.org). We used the open source GIS software QGIS and GRASS to overlay the two datasets and identified the number of people living...... in co-endemic districts. Over 135 million people live in co-endemic areas. Of these, almost 44 million live in high prevalence areas for schistosomiasis where WHO recommend MDA for the entire population. In co-endemic areas resources need to be allocated for evaluating the extent of adverse effects...

  13. Telephone consultation for improving health of people living with or at risk of HIV: a systematic review.

    Directory of Open Access Journals (Sweden)

    Michelle H M M T van Velthoven

    Full Text Available BACKGROUND: Low cost, effective interventions are needed to deal with the major global burden of HIV/AIDS. Telephone consultation offers the potential to improve health of people living with HIV/AIDS cost-effectively and to reduce the burden on affected people and health systems. The aim of this systematic review was to assess the effectiveness of telephone consultation for HIV/AIDS care. METHODS: We undertook a comprehensive search of peer-reviewed and grey literature. Two authors independently screened citations, extracted data and assessed the quality of randomized controlled trials which compared telephone interventions with control groups for HIV/AIDS care. Telephone interventions were voice calls with landlines or mobile phones. We present a narrative overview of the results as the obtained trials were highly heterogeneous in design and therefore the data could not be pooled for statistical analysis. RESULTS: The search yielded 3321 citations. Of these, nine studies involving 1162 participants met the inclusion criteria. The telephone was used for giving HIV test results (one trial and for delivering behavioural interventions aimed at improving mental health (four trials, reducing sexual transmission risk (one trial, improving medication adherence (two trials and smoking cessation (one trial. Limited effectiveness of the intervention was found in the trial giving HIV test results, in one trial supporting medication adherence and in one trial for smoking cessation by telephone. CONCLUSIONS: We found some evidence of the benefits of interventions delivered by telephone for the health of people living with HIV or at risk of HIV. However, only limited conclusions can be drawn as we only found nine studies for five different interventions and they mainly took place in the United States. Nevertheless, given the high penetration of low-cost mobile phones in countries with high HIV endemicity, more evidence is needed on how telephone consultation

  14. Cardiovascular Risk and Quality of Life in Elderly People with Mild Thyroid Hormone Deficiency

    Directory of Open Access Journals (Sweden)

    Sara eTognini

    2014-10-01

    Full Text Available Subclinical hypothyroidism (sHT is a common condition in the general population, the prevalence increasing with ageing, especially in women. An association between sHT and increased coronary heart disease (CHD and heart failure (HF risk and mortality has been described. However, this association is far to be established in older people (>65 years, especially in the oldest old (>85 years. Individuals with sHT may experience symptoms that resemble those observed in the overt form of the disease, leading to an impaired quality of life (QoL. Although very old people are frequently frail and potentially more susceptible to the effects of a disease, few studies were designed to assess the effect of sHT on QoL in this subset of population. Interestingly, the serum TSH concentration curve of general population has a skewed distribution with a tail toward higher values, which is amplified with ageing. Thus, the diagnosis of sHT and the interpretation of its potential effects on CV function and QoL in older people may be a challenge for the clinician. Giving these premises, we reviewed the English scientific literature available on National Library of Medicine (www.pubmed.com since 1980 regarding: hypothyroidism, subclinical hypothyroidism, elderly, cardiovascular risk, coronary heart disease (CHD or heart failure (HF events and mortality, health-related QoL, LT4 therapy. Consistent results among large prospective cohort studies suggest an age-independent relationship between sHT and HF progression while, an impact of sHT on CHD events and mortality is essentially reported in young adults (aged below 65-70 years with long-lasting disease. Scanty data are available on QoL of older people with sHT (>65 years and, generally, no significant alterations are described.

  15. Risk of suicide in high risk pregnancy: an exploratory study.

    Science.gov (United States)

    Benute, Gláucia Rosana Guerra; Nomura, Roseli Mieko Yamamoto; Jorge, Vanessa Marques Ferreira; Nonnenmacher, Daniele; Fráguas Junior, Renério; Lucia, Mara Cristina Souza de; Zugaib, Marcelo

    2011-01-01

    To identify the risk of suicidal behavior in high-risk pregnant women at a public hospital in São Paulo. We conducted a semi-structured interview with each of the participants (n = 268) through a previously prepared questionnaire. Risk of suicidal behavior was assessed by the Portuguese version of PRIME-MD. The mean age of patients was 29 years (SD = 0.507) and gestation period was 30 weeks (SD = 0.556). Of the total sample, specific risk of suicide was found in 5% (n = 14). Of these, 85% have a stable relationship (married or cohabitating), the pregnancy was planned in 50% of cases, and 71% have no religion or professional activities. The correlation of risk of suicide with data from marital status, planned birth, age, education, professional practice, risk of prematurity, and religion showed that having a religion is statistically significant (p = 0.012). There were no positive associations for any of the other selected variables when compared with the risk of suicide. By correlating the risk of suicide with other characteristic symptoms of major depression, there was statistical significance in the sample with regard to insomnia or hypersomnia (p = 0.003), fatigue or loss of energy (p = 0.001), decreased or increased appetite (p = 0.005), less interest in daily activities (p = 0.000), depressed mood (p = 0.000), feelings of worthlessness or guilt (p = 0.000), decreased concentration (p = 0.002), and agitation or psychomotor retardation (p = 0.002). We found that religion can be a protective factor against suicidal behavior. Besides providing a social support network needed by women during pregnancy, religion supports belief in life after death and in a loving God, giving purpose to life and self esteem and providing models for coping with crises. The results show the importance of prevention and early diagnosis of suicidal behavior, since suicide is an attempt to move from one sphere to another by force, seeking to solve what seems impossible.

  16. Thrombotic Thrombocytopenic Purpura in Black People: Impact of Ethnicity on Survival and Genetic Risk Factors.

    Directory of Open Access Journals (Sweden)

    Suella Martino

    Full Text Available Black people are at increased risk of thrombotic thrombocytopenic purpura (TTP. Whether clinical presentation of TTP in Black patients has specific features is unknown. We assessed here differences in TTP presentation and outcome between Black and White patients. Clinical presentation was comparable between both ethnic groups. However, prognosis differed with a lower death rate in Black patients than in White patients (2.7% versus 11.6%, respectively, P = .04. Ethnicity, increasing age and neurologic involvement were retained as risk factors for death in a multivariable model (P < .05 all. Sixty-day overall survival estimated by the Kaplan-Meier curves and compared with the Log-Rank test confirmed that Black patients had a better survival than White patients (P = .03. Salvage therapies were similarly performed between both groups, suggesting that disease severity was comparable. The comparison of HLA-DRB1*11, -DRB1*04 and -DQB1*03 allele frequencies between Black patients and healthy Black individuals revealed no significant difference. However, the protective allele against TTP, HLA-DRB1*04, was dramatically decreased in Black individuals in comparison with White individuals. Black people with TTP may have a better survival than White patients despite a comparable disease severity. A low natural frequency of HLA-DRB1*04 in Black ethnicity may account for the greater risk of TTP in this population.

  17. Thrombotic Thrombocytopenic Purpura in Black People: Impact of Ethnicity on Survival and Genetic Risk Factors.

    Science.gov (United States)

    Martino, Suella; Jamme, Mathieu; Deligny, Christophe; Busson, Marc; Loiseau, Pascale; Azoulay, Elie; Galicier, Lionel; Pène, Frédéric; Provôt, François; Dossier, Antoine; Saheb, Samir; Veyradier, Agnès; Coppo, Paul

    2016-01-01

    Black people are at increased risk of thrombotic thrombocytopenic purpura (TTP). Whether clinical presentation of TTP in Black patients has specific features is unknown. We assessed here differences in TTP presentation and outcome between Black and White patients. Clinical presentation was comparable between both ethnic groups. However, prognosis differed with a lower death rate in Black patients than in White patients (2.7% versus 11.6%, respectively, P = .04). Ethnicity, increasing age and neurologic involvement were retained as risk factors for death in a multivariable model (P Black patients had a better survival than White patients (P = .03). Salvage therapies were similarly performed between both groups, suggesting that disease severity was comparable. The comparison of HLA-DRB1*11, -DRB1*04 and -DQB1*03 allele frequencies between Black patients and healthy Black individuals revealed no significant difference. However, the protective allele against TTP, HLA-DRB1*04, was dramatically decreased in Black individuals in comparison with White individuals. Black people with TTP may have a better survival than White patients despite a comparable disease severity. A low natural frequency of HLA-DRB1*04 in Black ethnicity may account for the greater risk of TTP in this population.

  18. Protein and energy supplementation in elderly people at risk from malnutrition.

    Science.gov (United States)

    Milne, Anne C; Potter, Jan; Vivanti, Angela; Avenell, Alison

    2009-04-15

    Evidence for the effectiveness of nutritional supplements containing protein and energy, often prescribed for older people, is limited. Malnutrition is more common in this age group and deterioration of nutritional status can occur during illness. It is important to establish whether supplementing the diet is an effective way of improving outcomes for older people at risk from malnutrition. This review examined trials for improvement in nutritional status and clinical outcomes when extra protein and energy were provided, usually as commercial 'sip-feeds'. We searched The Cochrane Library, MEDLINE, EMBASE, Healthstar, CINAHL, BIOSIS, CAB abstracts. We also hand searched nutrition journals and reference lists and contacted 'sip-feed' manufacturers. Randomised and quasi-randomised controlled trials of oral protein and energy supplementation in older people, with the exception of groups recovering from cancer treatment or in critical care. Two reviewers independently assessed trials prior to inclusion and independently extracted data and assessed trial quality. Authors of trials were contacted for further information as necessary. Sixty-two trials with 10,187 randomised participants have been included in the review. Maximum duration of intervention was 18 months. Most included trials had poor study quality. The pooled weighted mean difference (WMD) for percentage weight change showed a benefit of supplementation of 2.2% (95% confidence interval (CI) 1.8 to 2.5) from 42 trials. There was no significant reduction in mortality in the supplemented compared with control groups (relative risk (RR) 0.92, CI 0.81 to 1.04) from 42 trials. Mortality results were statistically significant when limited to trials in which participants (N = 2461) were defined as undernourished (RR 0.79, 95% CI 0.64 to 0.97).The risk of complications was reduced in 24 trials (RR 0.86, 95% CI 0.75 to 0.99). Few trials were able to suggest any functional benefit from supplementation. The WMD for length

  19. Laser prostatectomy in high-risk patients

    International Nuclear Information System (INIS)

    Tayib, Abdulmalik M.

    2008-01-01

    Objective was to evaluate the short-term tolerability and outcome of high power green light potassium titanyl phosphate laser prostatectomy in high-risk patients with symptomatic benign prostatic hyperplasia. Eleven high risk operative patients were included in this study at the International Medical Center, Jeddah, Kingdom of Saudi Arabia, between January and September 2007. Patients enrolled in this study underwent preoperative and postoperative, cardiac and anesthesia evaluation. Clinical presentations, ultrasound of urinary tract and preoperative laboratory investigation were recorded. All patients underwent high power green light laser prostatectomy using the green light photo vaporization system with setting of 120 watts. The intraoperative and postoperative complications and follow-up were recorded. The patient's age varied between 65-82 years with a mean age of 75.3+-8.6 years old. Seven patients presented with refractory acute urinary retention and 4 patients presented with severe lower urinary tract symptoms. The average prostate volume was 61.22 cc. All patients had uneventful intra- and postoperative course, without the intensive care. The average blood loss was insignificant and only one of the patients required blood transfusion. Foley catheters were removed one day after the procedure. All patients voided satisfactorily after removal of catheter and 8 patients complained of urgency. High power green light laser prostatectomy is a safe and effective method of treating symptomatic benign prostatic hyperplasia in patients with high operative risk. (author)

  20. Feasibility of Pilates exercise to decrease falls risk: a pilot randomized controlled trial in community-dwelling older people.

    Science.gov (United States)

    Barker, Anna L; Talevski, Jason; Bohensky, Megan A; Brand, Caroline A; Cameron, Peter A; Morello, Renata T

    2016-10-01

    To evaluate the feasibility of Pilates exercise in older people to decrease falls risk and inform a larger trial. Pilot Randomized controlled trial. Community physiotherapy clinic. A total of 53 community-dwelling people aged ⩾60 years (mean age, 69.3 years; age range, 61-84). A 60-minute Pilates class incorporating best practice guidelines for exercise to prevent falls, performed twice weekly for 12 weeks. All participants received a letter to their general practitioner with falls risk information, fall and fracture prevention education and home exercises. Indicators of feasibility included: acceptability (recruitment, retention, intervention adherence and participant experience survey); safety (adverse events); and potential effectiveness (fall, fall injury and injurious fall rates; standing balance; lower limb strength; and flexibility) measured at 12 and 24 weeks. Recruitment was achievable but control group drop-outs were high (23%). Of the 20 participants who completed the intervention, 19 (95%) attended ⩾75% of the classes and reported classes were enjoyable and would recommend them to others. The rate of fall injuries at 24 weeks was 42% lower and injurious fall rates 64% lower in the Pilates group, however, was not statistically significant (P = 0.347 and P = 0.136). Standing balance, lower-limb strength and flexibility improved in the Pilates group relative to the control group (P fall injury rates. A definitive randomized controlled trial analysing the effect of Pilates in older people would be feasible and is warranted given the acceptability and potential positive effects of Pilates on fall injuries and fall risk factors. The protocol for this study is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN1262000224820). © The Author(s) 2015.

  1. HIV prevalence and risk behaviour among men who have sex with men in Vientiane Capital, Lao People's Democratic Republic, 2007.

    Science.gov (United States)

    Sheridan, Sarah; Phimphachanh, Chansy; Chanlivong, Niramonh; Manivong, Sisavath; Khamsyvolsvong, Sod; Lattanavong, Phonesay; Sisouk, Thongchanh; Toledo, Carlos; Scherzer, Martha; Toole, Mike; van Griensven, Frits

    2009-01-28

    Men who have sex with men are at high risk for HIV infection. Here we report the results of the first assessment of HIV prevalence and risk behaviour in this group in Vientiane, Lao People's Democratic Republic. Between August and September 2007, 540 men were enrolled from venues around Vientiane, using venue-day-time sampling. Men of Lao nationality, 15 years and over, reporting oral or anal sex with a man in the previous 6 months were eligible for participation. Demographic and socio-behavioural information was self-collected using hand-held computers. Oral fluid was tested for HIV infection. Logistic regression was used to evaluate risk factors for prevalent HIV infection. The median age of participants was 21 years; the HIV prevalence was 5.6%. Of participants, 39.6% reported exclusive attraction to men and 57.6% reported sex with women. Of those who reported having regular and nonregular sexual partner(s) in the past 3 months, consistent condom use with these partners was 14.4 and 24.2%, respectively. A total of 42.2% self-reported any sexually transmitted infection symptoms and 6.3% had previously been tested for HIV. Suicidal ideation was reported by 17.0%, which was the only variable significantly and independently associated with HIV infection in multivariate analysis. Although the HIV prevalence is low compared with neighbouring countries in the region, men who have sex with men in Lao People's Democratic Republic are at high behavioural risk for HIV infection. To prevent a larger HIV epidemic occurrence and transmission into the broader community, higher coverage of HIV prevention interventions is required.

  2. New Zealand Diabetes Cohort Study cardiovascular risk score for people with Type 2 diabetes: validation in the PREDICT cohort.

    Science.gov (United States)

    Robinson, Tom; Elley, C Raina; Wells, Sue; Robinson, Elizabeth; Kenealy, Tim; Pylypchuk, Romana; Bramley, Dale; Arroll, Bruce; Crengle, Sue; Riddell, Tania; Ameratunga, Shanthi; Metcalf, Patricia; Drury, Paul L

    2012-09-01

    New Zealand (NZ) guidelines recommend treating people for cardiovascular disease (CVD) risk on the basis of five-year absolute risk using a NZ adaptation of the Framingham risk equation. A diabetes-specific Diabetes Cohort Study (DCS) CVD predictive risk model has been developed and validated using NZ Get Checked data. To revalidate the DCS model with an independent cohort of people routinely assessed using PREDICT, a web-based CVD risk assessment and management programme. People with Type 2 diabetes without pre-existing CVD were identified amongst people who had a PREDICT risk assessment between 2002 and 2005. From this group we identified those with sufficient data to allow estimation of CVD risk with the DCS models. We compared the DCS models with the NZ Framingham risk equation in terms of discrimination, calibration, and reclassification implications. Of 3044 people in our study cohort, 1829 people had complete data and therefore had CVD risks calculated. Of this group, 12.8% (235) had a cardiovascular event during the five-year follow-up. The DCS models had better discrimination than the currently used equation, with C-statistics being 0.68 for the two DCS models and 0.65 for the NZ Framingham model. The DCS models were superior to the NZ Framingham equation at discriminating people with diabetes who will have a cardiovascular event. The adoption of a DCS model would lead to a small increase in the number of people with diabetes who are treated with medication, but potentially more CVD events would be avoided.

  3. Gender Differences in Factors Related to HIV Risk Behaviors among People Who Inject Drugs in North-East India.

    Directory of Open Access Journals (Sweden)

    Bushra Sabri

    Full Text Available People who inject drugs (PWID in India are at high risk for HIV, with women being at elevated risk. Using a socio-ecological framework, this study assessed whether factors associated with HIV transmission risk behaviors differed across men and women PWID. Data for this cross-sectional study were collected from 6449 PWID in 7 cities in Northeast India. Men (n = 5653 and women (n = 796 PWID were recruited using respondent-driven sampling (RDS. We assessed sex differences in two recent HIV transmission risk behaviors: multiple sex partners and needle/syringe sharing. We used multi-level logistic regression models, which incorporated sampling weights and random intercepts for city, to assess factors associated with these HIV risks, separately among men and women. The prevalence of HIV was significantly higher among women than men (53% vs 18.4%, p<0.01. Nearly 13% of men and 8% of women (p = .30 had multiple partners. Employment in men and relationship status and stigma in women were significantly associated with multiple partners. Approximately 25% of men and 19% of women engaged in needle sharing (p = .16. Younger age in women and depression symptoms in men were significantly associated with increased risk for sharing needles. We found that sexual and drug related risk behaviors were common among PWID in Northeast India, and there were differences between men and women in the socio-ecologic correlates of these behaviors. Contextually-integrated and gender-specific HIV prevention and intervention efforts are needed that consider factors at individual, interpersonal- and community-levels that uniquely impact HIV risks among PWID.

  4. Quality of life of people living with HIV/AIDS and on highly active ...

    African Journals Online (AJOL)

    Quality of life of people living with HIV/AIDS and on highly active ... the Short Form-36 Health Survey (SF-36) was used to measure quality of life among patients on ... instrument for use in Ethiopia to assess the quality of life of people living with ...

  5. Avoidant Attachment Style Indicates Job Adaptation of People with High Functional Autistic Spectrum Disorders

    Science.gov (United States)

    Yokotani, Kenji

    2011-01-01

    The aim of the present study was to investigate whether or not the avoidant attachment style indicates job adaptation of people with High Functional Autistic Spectrum Disorders (HFASD). HFASD are groups of developmental disorders characterized by impairment of social interaction and normal level of intelligence. Twenty-two people with HFASD…

  6. The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations

    Science.gov (United States)

    Fazel, Seena; Geddes, John R; Kushel, Margot

    2015-01-01

    In the European Union, more than 400 000 individuals are homeless on any one night and more than 600 000 are homeless in the USA. The causes of homelessness are an interaction between individual and structural factors. Individual factors include poverty, family problems, and mental health and substance misuse problems. The availability of low-cost housing is thought to be the most important structural determinant for homelessness. Homeless people have higher rates of premature mortality than the rest of the population, especially from suicide and unintentional injuries, and an increased prevalence of a range of infectious diseases, mental disorders, and substance misuse. High rates of non-communicable diseases have also been described with evidence of accelerated ageing. Although engagement with health services and adherence to treatments is often compromised, homeless people typically attend the emergency department more often than non-homeless people. We discuss several recommendations to improve the surveillance of morbidity and mortality in homeless people. Programmes focused on high-risk groups, such as individuals leaving prisons, psychiatric hospitals, and the child welfare system, and the introduction of national and state-wide plans that target homeless people are likely to improve outcomes. PMID:25390578

  7. [Mortality and life expectancy that attributable to high blood pressure in Chinese people in 2013].

    Science.gov (United States)

    Zeng, X Y; Liu, S W; Wang, L J; Zhang, M; Yin, P; Liu, Y N; Zhao, Z P; Wang, L M

    2017-08-10

    Objective: To estimate the deaths (mortality) and life expectancy that attributable to high blood pressure in people from different regions and gender, in China in 2013. Methods: Data was from the 'China Chronic Disease Risk Factor Surveillance 2013' and the 'China National Mortality Surveillance 2013'. According to the comparative risk assessment theory, population attributable fraction ( PAF ) of high blood pressure by gender, urban-rural, east-central-west regions was calculated before the estimations on deaths (mortality) and life expectancy attributable to high blood pressure was made. Results: In 2013, among the Chinese people aged 25 years old and above, the mean SBP was (129.48±20.27) mmHg. High blood pressure[SBP>(115±6) mmHg]caused 20.879 million deaths and accounted for 22.78% of the total deaths. SBP, deaths, mortality rate and standardized mortality rate that attributable to high blood pressure all appeared higher in men [(131.15±18.73) mmHg, 11.517 million, 165.56/100 000 and 106.97/100 000, respectively]than in women[(127.79±21.60) mmHg, 9.362 million, 141.99/100 000 and 68.93/100 000, respectively]. SBP, deaths, mortality rate and PAF were all seen higher in rural[(130.25±20.66) mmHg, 11.234 million, 178.58/100 000 and 23.59%, respectively]than in urban[(128.58±19.77) mmHg, 9.645 million, 132.87/100 000 and 21.54%, respectively]areas. However, levels of SBP were similar in the east, central or west regions, with attributable deaths, attributable mortality rate and PAF the highest as 7.658 million 179.93/100 000, and 26.72% respectively. In 2013, among the Chinese people aged 25 years old and above, deaths caused by cardiovascular disease and chronic kidney disease attributable to high blood pressure were 19.912 million and 0.966 million, accounting for 52.31% of the total deaths due to cardiovascular diseases and 62.11% to the total chronic kidney diseases. The top three deaths attributable to high blood pressure were ischemic heart disease (6

  8. Alcohol Use, Risk Taking, Leisure Activities and Health Care Use Among Young People in Northern Vietnam

    Directory of Open Access Journals (Sweden)

    Le Thi Kim Thoa

    2013-10-01

    Full Text Available Alcohol consumption is associated with a wide range of health and social consequences. It is also associated with a number of risk taking behaviours. These include illicit drug use and unsafe sex.  Alcohol consumption appears to be increasing in Vietnam. The purpose of this paper is to examine the patterns of alcohol consumption and its relationship with a number of other risk taking behaviours amongst young people.  Information was also obtained concerning leisure activities and use of health care. The paper also sets out to examine possible gender differences in relation to alcohol consumption and risk behaviour and to propose the development and implementation of alcohol monitoring and prevention programs in Vietnam.  The study involved a cross-sectional, community survey using a standardised interview.  This was conducted during face-to-face interviews with 1,408 young people aged 10-19 years.  Respondents were recruited randomly through the lists of the households from 12 selected communes in three areas in Northern Vietnam. The findings presented here were part of a larger health risk behaviour survey.  Levels of alcohol use were low. Overall, 16.5% of participants were experienced drinkers, and only 4% of them were current drinkers. Males were significantly more likely than females to report drinking. This study also showed that rates of alcohol consumption were associated with age, education, geographical area, gender, tobacco smoking, involvement in violence, watching television, computer use and playing computer games, wearing safety helmets and use of health services. Alcohol consumption tended to increase with age for both males and females.  Alcohol and its effects on young people are clearly a growing public health issue in Vietnam.  Because of this, more detailed behavioral research should be conducted into the relationship between alcohol consumption and other risky behaviours amongst young people.  It is also

  9. CORONARY ARTERY DISEASE RISK FACTORS IN DRIVERS VERSUS PEOPLE IN OTHER OCCUPATIONS

    Directory of Open Access Journals (Sweden)

    Hamidreza Nasri

    2010-12-01

    Full Text Available   Abstract INTRODUCTION: The link between occupational factors and coronary artery diseases (CAD has been studied and confirmed in many countries. Conditions associated with driving such as stress, and factors such as long working hours and the environment can increase the risk of CAD. In this study, we measured potential CAD risk factors in bus and taxi drivers and compared them with a control group. methods: 135 taxi drivers, 194 bus drivers and 121 non-drivers (control group were evaluated for CAD risk factors, i.e. age, body mass index (BMI>24, cigarette smoking, hypertension, high-density and low-density lipoprotein cholesterol (HDL, LDL, triglyceride >200, blood sugar >126 and familial history of CAD. Univariate and multivariate logistic regression tests were used to distinguish major risk factors. results: Taxi drivers have an increased risk of hypertension compared with the control group (odds ratio: crude=5.94, adjusted=9.09; P<0001. Cigarette smoking in taxi and bus drivers was 1.4 (P<0.3 and 3.24 (P<0001 times as high as the control group, respectively. The risk of increased LDL and decreased HDL in bus drivers was 4.38 and 5.28 (P<0001 times as high as the control group, respectively. The risk of obesity, high blood sugar and high triglyceride was not significantly different between the groups. CONCLUSIONS: Driving is an independent risk factor for hypertension. Known CAD risk factors are also more frequent in drivers.     Keywords: Driving, cardiovascular disease, risk factor.

  10. Volcanic risk perception of young people in the urban areas of Vesuvius: Comparisons with other volcanic areas and implications for emergency management

    Science.gov (United States)

    Carlino, S.; Somma, R.; Mayberry, G.C.

    2008-01-01

    More than 600 000 people are exposed to volcanic risk in the urban areas near the volcano, Vesuvius, and may need to be evacuated if there is renewed volcanic activity. The success of a future evacuation will strongly depend on the level of risk perception and preparedness of the at-risk communities during the current period of quiescence. The volcanic risk perception and preparedness of young people is of particular importance because hazard education programs in schools have been shown to increase the clarity of risk perception and students often share their knowledge with their parents. In order to evaluate young people's risk perception and preparedness for a volcanic crisis, a multiple choice questionnaire was distributed to 400 high-school students in three municipalities located close to the volcano. The overall results suggest that despite a 60-year period of quiescence at Vesuvius, the interviewed students have an accurate perception of the level of volcanic risk. On the other hand, the respondents demonstrate a clear lack of understanding of volcanic processes and their related hazards. Also, the interviewed students show high levels of fear, poor perceived ability to protect themselves from the effects of a future eruption, and insufficient knowledge of the National Emergency Plan for Vesuvian Area (NEPVA). The latter result suggests that in comparison with volcanic crises in other regions, during a future eruption of Vesuvius, there may not be enough time to educate the large number of people living near the volcano about how to appropriately respond. The inadequate risk education and preparedness of respondents implies that a strong effort is needed to improve communication strategies in order to facilitate successful evacuations. Therefore, it is important to take advantage of the present period of quiescence at Vesuvius to improve the accuracy of risk perception of youth in local communities. ?? 2008.

  11. The use of community-based social services by elderly people at risk of institutionalization: An evaluation

    NARCIS (Netherlands)

    van Bilsen, P.M.A.; Hamers, J.P.H.; Groot, W.; Spreeuwenberg, C.

    2008-01-01

    Objective: To examine the use of community-based social services by elderly people at risk of institutionalization, who prefer to remain at home. Methods: A study with a longitudinal design (measurements at two points in time) was conducted. Results: One hundred and thirty-four elderly people (mean

  12. Prediabetes: A high-risk state for developing diabetes

    Science.gov (United States)

    Tabák, Adam G.; Herder, Christian; Rathmann, Wolfgang; Brunner, Eric J.; Kivimäki, Mika

    2013-01-01

    Summary Prediabetes (or “intermediate hyperglycaemia”), based on glycaemic parameters above normal but below diabetes thresholds is a high risk state for diabetes with an annualized conversion rate of 5%–10%; with similar proportion converting back to normoglycaemia. The prevalence of prediabetes is increasing worldwide and it is projected that >470 million people will have prediabetes in 2030. Prediabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction, abnormalities that start before glucose changes are detectable. Observational evidence shows associations of prediabetes with early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease. Multifactorial risk scores could optimize the estimation of diabetes risk using non-invasive parameters and blood-based metabolic traits in addition to glycaemic values. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention with evidence of a 40%–70% relative risk reduction. Accumulating data also suggests potential benefits from pharmacotherapy. PMID:22683128

  13. Lowering Cardiovascular Disease Risk for People with Severe Mental Illnesses in Primary Care: A Focus Group Study.

    Directory of Open Access Journals (Sweden)

    Alexandra Burton

    Full Text Available People with severe mental illnesses die early from cardiovascular disease. Evidence is lacking regarding effective primary care based interventions to tackle this problem.To identify current procedures for, barriers to, and facilitators of the delivery of primary care based interventions for lowering cardiovascular risk for people with severe mental illnesses.75 GPs, practice nurses, service users, community mental health staff and carers in UK GP practice or community mental health settings were interviewed in 14 focus groups which were audio-recorded, transcribed and analysed using Framework Analysis.Five barriers to delivering primary care based interventions for lowering cardiovascular risk in people with severe mental illnesses were identified by the groups: negative perceptions of people with severe mental illnesses amongst some health professionals, difficulties accessing GP and community-based services, difficulties in managing a healthy lifestyle, not attending appointments, and a lack of awareness of increased cardiovascular risk in people with severe mental illnesses by some health professionals. Identified facilitators included involving supportive others, improving patient engagement with services, continuity of care, providing positive feedback in consultations and goal setting.We identified a range of factors which can be incorporated in to the design, delivery and evaluation of services to reduce cardiovascular risk for people with severe mental illnesses in primary care. The next step is determining the clinical and cost effectiveness of primary care based interventions for lowering cardiovascular risk in people with severe mental illnesses, and evaluating the most important components of such interventions.

  14. Lowering Cardiovascular Disease Risk for People with Severe Mental Illnesses in Primary Care: A Focus Group Study.

    Science.gov (United States)

    Burton, Alexandra; Osborn, David; Atkins, Lou; Michie, Susan; Gray, Ben; Stevenson, Fiona; Gilbert, Hazel; Walters, Kate

    2015-01-01

    People with severe mental illnesses die early from cardiovascular disease. Evidence is lacking regarding effective primary care based interventions to tackle this problem. To identify current procedures for, barriers to, and facilitators of the delivery of primary care based interventions for lowering cardiovascular risk for people with severe mental illnesses. 75 GPs, practice nurses, service users, community mental health staff and carers in UK GP practice or community mental health settings were interviewed in 14 focus groups which were audio-recorded, transcribed and analysed using Framework Analysis. Five barriers to delivering primary care based interventions for lowering cardiovascular risk in people with severe mental illnesses were identified by the groups: negative perceptions of people with severe mental illnesses amongst some health professionals, difficulties accessing GP and community-based services, difficulties in managing a healthy lifestyle, not attending appointments, and a lack of awareness of increased cardiovascular risk in people with severe mental illnesses by some health professionals. Identified facilitators included involving supportive others, improving patient engagement with services, continuity of care, providing positive feedback in consultations and goal setting. We identified a range of factors which can be incorporated in to the design, delivery and evaluation of services to reduce cardiovascular risk for people with severe mental illnesses in primary care. The next step is determining the clinical and cost effectiveness of primary care based interventions for lowering cardiovascular risk in people with severe mental illnesses, and evaluating the most important components of such interventions.

  15. Risk factors of suicide attempt among people with suicidal ideation in South Korea: a cross-sectional study

    OpenAIRE

    Soo Beom Choi; Wanhyung Lee; Jin-Ha Yoon; Jong-Uk Won; Deok Won Kim

    2017-01-01

    Background Suicide is a serious public health concern worldwide, and the fourth leading cause of death in Korea. Few studies have focused on risk factors for suicide attempt among people with suicidal ideation. The aim of the present study was to investigate the risk factors and develop prediction models for suicide attempt among people with suicidal ideation in the Korean population. Method This study included 1567 men and 3726 women aged 20?years and older who had suicidal ideation from the...

  16. Perceptions of genetic discrimination among people at risk for Huntington?s disease: a cross sectional survey

    OpenAIRE

    Bombard, Yvonne; Veenstra, Gerry; Friedman, Jan M; Creighton, Susan; Currie, Lauren; Paulsen, Jane S; Bottorff, Joan L; Hayden, Michael R

    2009-01-01

    Objective To assess the nature and prevalence of genetic discrimination experienced by people at risk for Huntington?s disease who had undergone genetic testing or remained untested. Design Cross sectional, self reported survey. Setting Seven genetics and movement disorders clinics servicing rural and urban communities in Canada. Participants 233 genetically tested and untested asymptomatic people at risk for Huntington?s disease (response rate 80%): 167 underwent testing (83 had the Huntingt...

  17. Mental health, life functioning and risk factors among people exposed to frequent natural disasters and chronic poverty in Vietnam

    OpenAIRE

    Pollack, Amie Alley; Weiss, Bahr; Trung, Lam Tu

    2016-01-01

    Background People living in low- and middle-income countries (LMIC) are at increased risk for exposure to major natural disasters, which places them at increased risk for mental health problems. Evidence is less clear, however, regarding the effects of less severe but more frequent natural disasters, which are likely to increase due to global climate change. Aims To examine the mental health and life functioning, and their predictors, of people living in central coastal Vietnam ? an area char...

  18. High body mass index and cancer risk

    DEFF Research Database (Denmark)

    Benn, Marianne; Tybjærg-Hansen, Anne; Smith, George Davey

    2016-01-01

    of follow-up (range 0-37), 8002 developed non-skin cancer, 3347 non-melanoma skin cancer, 1396 lung cancer, 637 other smoking related cancers, 1203 colon cancer, 159 kidney cancer, 1402 breast cancer, 1062 prostate cancer, and 2804 other cancers. Participants were genotyped for five genetic variants...... with a BMI ≥ 30 versus 18.5-24.9 kg/m(2). Corresponding risk of breast cancer was 20 % (0-44 %) higher in postmenopausal women. BMI was not associated with risk of colon, kidney, other smoking related cancers, prostate cancer, or other cancers. In genetic analyses, carrying 7-10 versus 0-4 BMI increasing......High body mass index (BMI) has been associated with increased risk of some cancer. Whether these reflect causal associations is unknown. We examined this issue. Using a Mendelian randomisation approach, we studied 108,812 individuals from the general population. During a median of 4.7 years...

  19. Serum cystatin C level is associated with locomotive syndrome risk and can be an early predictor in community-living people: The Yakumo study.

    Science.gov (United States)

    Tanaka, Satoshi; Ando, Kei; Kobayashi, Kazuyoshi; Hida, Tetsuro; Ito, Kenyu; Tsushima, Mikito; Morozumi, Masayoshi; Machino, Masaaki; Ota, Kyotaro; Seki, Taisuke; Suzuki, Koji; Nishida, Yoshihiro; Ishiguro, Naoki; Hasegawa, Yukiharu; Imagama, Shiro

    2018-03-02

    The locomotive syndrome (LS) risk has been recently proposed as a criterion for evaluating physical ability. Serum cystatin C level is an early renal function marker and a cardiovascular disease predictor. This study aimed to evaluate the relationship between serum cystatin C level and LS risk. We enrolled 54 participants and conducted the two-step test, stand-up test, 25-question geriatric locomotive function scale, LS risk test, Timed Up and Go test, back muscle strength, grip strength, blood test and serum cystatin C level measurement. A comparative study was conducted in participants with and without LS risk and in subgroups aged C level in subgroups aged C level for LS risk was 0.824. The serum cystatin C level is significantly related to LS risk and can be an early predictor. In middle-aged and elderly people with high serum cystatin C levels, it is strongly recommended to enforce LS risk test and intervention.

  20. Racialized risk environments in a large sample of people who inject drugs in the United States.

    Science.gov (United States)

    Cooper, Hannah L F; Linton, Sabriya; Kelley, Mary E; Ross, Zev; Wolfe, Mary E; Chen, Yen-Tyng; Zlotorzynska, Maria; Hunter-Jones, Josalin; Friedman, Samuel R; Des Jarlais, Don; Semaan, Salaam; Tempalski, Barbara; DiNenno, Elizabeth; Broz, Dita; Wejnert, Cyprian; Paz-Bailey, Gabriela

    2016-01-01

    Substantial racial/ethnic disparities exist in HIV infection among people who inject drugs (PWID) in many countries. To strengthen efforts to understand the causes of disparities in HIV-related outcomes and eliminate them, we expand the "Risk Environment Model" to encompass the construct "racialized risk environments," and investigate whether PWID risk environments in the United States are racialized. Specifically, we investigate whether black and Latino PWID are more likely than white PWID to live in places that create vulnerability to adverse HIV-related outcomes. As part of the Centers for Disease Control and Prevention's National HIV Behavioral Surveillance, 9170 PWID were sampled from 19 metropolitan statistical areas (MSAs) in 2009. Self-reported data were used to ascertain PWID race/ethnicity. Using Census data and other administrative sources, we characterized features of PWID risk environments at four geographic scales (i.e., ZIP codes, counties, MSAs, and states). Means for each feature of the risk environment were computed for each racial/ethnic group of PWID, and were compared across racial/ethnic groups. Almost universally across measures, black PWID were more likely than white PWID to live in environments associated with vulnerability to adverse HIV-related outcomes. Compared to white PWID, black PWID lived in ZIP codes with higher poverty rates and worse spatial access to substance abuse treatment and in counties with higher violent crime rates. Black PWID were less likely to live in states with laws facilitating sterile syringe access (e.g., laws permitting over-the-counter syringe sales). Latino/white differences in risk environments emerged at the MSA level (e.g., Latino PWID lived in MSAs with higher drug-related arrest rates). PWID risk environments in the US are racialized. Future research should explore the implications of this racialization for racial/ethnic disparities in HIV-related outcomes, using appropriate methods. Copyright © 2015

  1. Evidence for low high-density lipoprotein cholesterol levels in Australian indigenous peoples: a systematic review.

    Science.gov (United States)

    Lyons, Jasmine G; O'Dea, Kerin; Walker, Karen Z

    2014-06-02

    Low plasma high-density lipoprotein cholesterol (HDL-C) levels are a strong, independent, but poorly understood risk factor for cardiovascular disease (CVD). Although this atherogenic lipid abnormality has been widely reported in Australia's Indigenous peoples, Aboriginal and Torres Strait Islanders, the evidence has not come under systematic review. This review therefore examines published data for Indigenous Australians reporting 1) mean HDL-C levels for both sexes and 2) factors associated with low HDL-C. PubMed, Medline and Informit ATSI Health databases were systematically searched between 1950 and 2012 for studies on Indigenous Australians reporting mean HDL-C levels in both sexes. Retrieved studies were evaluated by standard criteria. Low HDL-C was defined as: Indigenous populations living in rural and remote communities. Inverse associations between HDL-C and central obesity, diabetes prevalence and inflammatory markers suggest a particularly adverse CVD risk factor profile. An absence of sex dichotomy in HDL-C levels warrants further investigation.

  2. Skin Cancer Concerns in People of Color: Risk Factors and Prevention

    Science.gov (United States)

    Gupta, Alpana K; Bharadwaj, Mausumi; Mehrotra, Ravi

    2016-01-01

    Background: Though people of color (POC) are less likely to become afflicted with skin cancer, they are much more likely to die from it due to delay in detection or presentation. Very often, skin cancer is diagnosed at a more advanced stage in POC, making treatment difficult. The purpose of this research was to improve awareness regarding skin cancers in people of color by providing recommendations to clinicians and the general public for early detection and photo protection preventive measures. Methods: Data on different types of skin cancers were presented to POC. Due to limited research, there are few resources providing insights for evaluating darkly pigmented lesions in POC. Diagnostic features for different types of skin cancers were recorded and various possible risk factors were considered. Results: This study provided directions for the prevention and early detection of skin cancer in POC based on a comprehensive review of available data. Conclusions: The increased morbidity and mortality rate associated with skin cancer in POC is due to lack of awareness, diagnosis at a more advanced stage and socioeconomic barriers hindering access to care. Raising public health concerns for skin cancer prevention strategies for all people, regardless of ethnic background and socioeconomic status, is the key to timely diagnosis and treatment. PMID:28125871

  3. Out-of-School and "At Risk?" Socio-Demographic Characteristics, AIDS Knowledge and Risk Perception among Young People in Northern Tanzania

    Science.gov (United States)

    Bastien, Sheri

    2008-01-01

    This paper investigates the reasons why young people in urban and rural Kilimanjaro, Tanzania do not attend school, their socio-demographic characteristics, AIDS knowledge and risk perception. A structured face-to-face interview was conducted with 1007 young people between the ages of 13 and 18. Findings suggest that non-attendance is the product…

  4. How young people communicate risks of snowmobiling in northern Norway: a focus group study.

    Science.gov (United States)

    Mehus, Grete; Germeten, Sidsel; Henriksen, Nils

    2011-04-01

    This study aims to understand how the risks of snowmobiling are communicated among northern Norwegian youths. Study design. A qualitative design with focus group interviews was chosen. Interviews centred on safety precautions and estimation of risks related to snowmobiling and driving patterns. Eighty-one students (31 girls and 50 boys) aged between 16 and 23 years from 8 high schools were interviewed in 17 focus groups that were segregated by gender. Interview data were analysed using qualitative content analysis. Boys and girls communicated differently about risks. Peer-group conformity appeared stronger among boys than girls. Boys did not spontaneously relate risks to their snowmobile activities, while girls did. Boys focused upon training, coping and balance between control and lack of control while driving. Girls talked about risks, were aware of risks and sought to avoid risky situations, in contrast to boys. Boys' risk communication in groups was about how to manage challenging situations. Their focus overall was on trying to maintain control while simultaneously testing their limits. Three risk categories emerged: those who drive as they ought to (mostly girls), those who occasionally take some risks (boys and girls) and those who are extreme risk-takers (a smaller number of boys). Perceptions of and communication about risk are related to gender, peer group and familiarity with risk-taking when snowmobiling. Northern Norwegian boys' driving behaviour highlights a specific need for risk reduction, but this must also draw upon factors such as acceptance of social and cultural codes and common sense related to snowmobiling.

  5. Biomedical Risk Factors of Achilles Tendinopathy in Physically Active People: a Systematic Review.

    Science.gov (United States)

    Kozlovskaia, Maria; Vlahovich, Nicole; Ashton, Kevin J; Hughes, David C

    2017-12-01

    Achilles tendinopathy is the most prevalent tendon disorder in people engaged in running and jumping sports. Aetiology of Achilles tendinopathy is complex and requires comprehensive research of contributing risk factors. There is relatively little research focussing on potential biomedical risk factors for Achilles tendinopathy. The purpose of this systematic review is to identify studies and summarise current knowledge of biomedical risk factors of Achilles tendinopathy in physically active people. Research databases were searched for relevant articles followed by assessment in accordance with PRISMA statement and standards of Cochrane collaboration. Levels of evidence and quality assessment designation were implemented in accordance with OCEBM levels of evidence and Newcastle-Ottawa Quality Assessment Scale, respectively. A systematic review of the literature identified 22 suitable articles. All included studies had moderate level of evidence (2b) with the Newcastle-Ottawa score varying between 6 and 9. The majority (17) investigated genetic polymorphisms involved in tendon structure and homeostasis and apoptosis and inflammation pathways. Overweight as a risk factor of Achilles tendinopathy was described in five included studies that investigated non-genetic factors. COL5A1 genetic variants were the most extensively studied, particularly in association with genetic variants in the genes involved in regulation of cell-matrix interaction in tendon and matrix homeostasis. It is important to investigate connections and pathways whose interactions might be disrupted and therefore alter collagen structure and lead to the development of pathology. Polymorphisms in genes involved in apoptosis and inflammation, and Achilles tendinopathy did not show strong association and, however, should be considered for further investigation. This systematic review suggests that biomedical risk factors are an important consideration in the future study of propensity to the development

  6. [What do adolescents and young people think about recreational drug use and sexual risks?].

    Science.gov (United States)

    Rodríguez García de Cortázar, Ainhoa; Hernán García, Mariano; Cabrera León, Andrés; García Calleja, José María; Romo Avilés, Nuria

    2007-01-01

    The objective of this article is to analyse the opinions of adolescents and young people, from gypsy and non-gypsy populations, on the relationship between recreational drug use and sexual practices that increase the risk of HIV infection. A descriptive qualitative research was undertaken. 14 focus groups were conducted with 98 adolescents and young people, and 7 semi-structured interviews with young recreational drug users. Both sort of results were triangulated. Two major discursive lines emerge in the analysis. The first one defends the notion that moderate consumption of alcohol facilitates the sexual encounter, but it does not imply risky behaviours. However, polydrug use or an elevated use of recreational drugs is related to a lack of concern for sexual risks, and in men with the loss of sexual sensitivity that sometimes justifies not using a condom. The second line argues other reasons for the non-use of condoms, such as their lack of availability, confidence in one's sexual partner, a concept of desire as something uncontrollable, infatuation and the state of mind or self-esteem. Some recommendations to prevent sexual transmission of HIV are derived from the results, such as the distribution of condoms in places where alcohol and other drugs are consumed, publicising the use of condoms and other latex barriers for oral genital sexual practices, working with young males on the optimisation of pleasure, designing preventive interventions targeting stable partners, and training adolescent girls in the social skills needed to negotiate the use of condoms.

  7. Behavioral problems in people with intellectual disability: Basic facts, incidence and risk factors

    Directory of Open Access Journals (Sweden)

    Buha Nataša

    2013-01-01

    Full Text Available In people with intellectual disabilities, behavioral problems result from the interaction of multiple risk factors of different origin, which undoubtedly indicates the importance of knowing their individual characteristics and life circumstances. Incidence, specific forms and topography of behavioral problems depend on different factors, both socio-demographic and inherent ones. Behavioral problems significantly impede acquiring new adaptive skills and have a negative influence on the interaction with the environment. Emotional and behavioral problems are a significant source of stress in children with intellectual disability, as well as their parents and professional staff. These difficulties, especially aggression and disruptiveness, have a big influence on the selection of education model, i.e. on how much the child will be involved in the educational process and the decision whether or not a person will be institutionalized. Better understanding of behavioral problems in people with intellectual disability is the basis of eliminating or reducing risk factors, as well as creating a comprehensive treatment model.

  8. Neuropsychological and social cognitive function in young people at genetic risk of bipolar disorder.

    Science.gov (United States)

    McCormack, C; Green, M J; Rowland, J E; Roberts, G; Frankland, A; Hadzi-Pavlovic, D; Joslyn, C; Lau, P; Wright, A; Levy, F; Lenroot, R K; Mitchell, P B

    2016-03-01

    Impairments in key neuropsychological domains (e.g. working memory, attention) and social cognitive deficits have been implicated as intermediate (endo) phenotypes for bipolar disorder (BD), and should therefore be evident in unaffected relatives. Neurocognitive and social cognitive ability was examined in 99 young people (age range 16-30 years) with a biological parent or sibling diagnosed with the disorder [thus deemed to be at risk (AR) of developing BD], compared with 78 healthy control (HC) subjects, and 52 people with a confirmed diagnosis of BD. Only verbal intelligence and affective response inhibition were significantly impaired in AR relative to HC participants; the BD participants showed significant deficits in attention tasks compared with HCs. Neither AR nor BD patients showed impairments in general intellectual ability, working memory, visuospatial or language ability, relative to HC participants. Analysis of BD-I and BD-II cases separately revealed deficits in attention and immediate memory in BD-I patients (only), relative to HCs. Only the BD (but not AR) participants showed impaired emotion recognition, relative to HCs. Selective cognitive deficits in the capacity to inhibit negative affective information, and general verbal ability may be intermediate markers of risk for BD; however, the extent and severity of impairment in this sample was less pronounced than has been reported in previous studies of older family members and BD cases. These findings highlight distinctions in the cognitive profiles of AR and BD participants, and provide limited support for progressive cognitive decline in association with illness development in BD.

  9. Health risks, correlates, and interventions to reduce sedentary behavior in young people.

    Science.gov (United States)

    Salmon, Jo; Tremblay, Mark S; Marshall, Simon J; Hume, Clare

    2011-08-01

    Opportunities for young people to be sedentary have increased during leisure time, study time, and transportation time. This review paper focuses on sedentary behaviors among young people aged 2-18 years and includes evidence of the relationship between sedentary behavior and health risk indicators, an overview of public health recommendations, the prevalence of key sedentary behaviors, evidence of correlates of sedentary behavior and the effectiveness of interventions to reduce sedentary behaviors. Although this is a narrative style review and not systematic, where possible, findings from relevant review papers were summarized and a search of more recent literature was performed using computer-based databases such as PubMed, Google Scholar, ERIC, PsycINFO, Social Science Index, SportDiscus, and Health Reference Center - Academic. Young people spend 2-4 hours per day in screen-based behaviors and 5-10 hours per day sedentary. Ethnicity, sociodemographic status, having a TV set in the bedroom, and parental behavior appear to be the most consistent correlates of TV viewing time; however, few recent studies aiming to reduce TV viewing or sedentary time among young people have been successful. A growing body of evidence supports the development of public health recommendations to limit the time spent in screen-based behaviors. More research is needed to examine the prospective and experimental evidence of associations between overall sedentary time and health, determinants of sedentary behaviors other than screen-based behaviors, and interventions to reduce overall sedentary time or even alternative sedentary behaviors, such as transport- or education-related sitting time. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  10. High-Risk Series: An Update

    Science.gov (United States)

    2015-02-01

    the Medicare Trustees, the Office of the Actuary , and the Congressional Budget Office have raised concerns about whether some of the Medicare... actuarially sound. For more information, see the National Flood Insurance Program section of this High-Risk report. Among other things, the report...and mathematics (STEM) functional community. In addition to the efforts of the Working Group, the President’s Fiscal Year 2013 budget—released in

  11. Fall incidence and associated risk factors among people with a lower limb amputation during various stages of recovery - a systematic review.

    Science.gov (United States)

    Steinberg, Noam; Gottlieb, Amihai; Siev-Ner, Itzhak; Plotnik, Meir

    2018-03-14

    The objective of this study was to estimate fall incidence and describe associated risk factors among people with a lower limb amputation (LLA) during various stages of recovery: the surgical ward, in-patient rehabilitation and return to community life. A systematic search of relevant English language articles was performed using PubMed and EMBASE. Out of 310 initial "hits," six retrospective cohort studies, one prospective cohort study and eleven cross-sectional studies from which fall incidence and risk factors could be extracted, were selected for critical review. Fall incidence and associated risk factors were extracted and analyzed in the context of various clinical stages of recovery after amputation. The studies were evaluated for quality using the "Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies." Results showed that during all stages of recovery, people with a LLA are at increased risk of falling compared with able-bodied individuals, as well as other clinical populations. Each stage of recovery is associated with different fall risk factors. The current review is limited mainly by the paucity of studies on the topic. Specialised care focusing on the most relevant risk factors for each stage of recovery may enhance fall prevention during post-fall recovery. Implications for rehabilitation •  People with a lower limb amputation are at a high risk of falling in all stages of their clinical course.      •  Health professionals should be aware that people with a lower limb amputation in the first 4 years ofamputation or with four or more health-related problems are at an increased risk.      •  Health professionals should also be aware that increased gait variability, excess confidence in balance andwalking abilities and less cautious stair walking, impose an elevated risk of falling and should focus theirefforts in reducing these factors.

  12. Risk of cardiovascular events in people prescribed glucocorticoids with iatrogenic Cushing’s syndrome: cohort study

    Science.gov (United States)

    Petersen, Irene; Nazareth, Irwin

    2012-01-01

    Objective To investigate whether there is an increased risk of cardiovascular events in people who exhibit iatrogenic Cushing’s syndrome during treatment with glucocorticoids. Design Cohort study. Setting 424 UK general practices contributing to The Health Improvement Network database. Participants People prescribed systemic glucocorticoids and with a diagnosis of iatrogenic Cushing’s syndrome (n=547) and two comparison groups: those prescribed glucocorticoids and with no diagnosis of iatrogenic Cushing’s syndrome (n=3231) and those not prescribed systemic glucocorticoids (n=3282). Main outcome measures Incidence of cardiovascular events within a year after diagnosis of iatrogenic Cushing’s syndrome or after a randomly selected date, and association between iatrogenic Cushing’s syndrome and risk of cardiovascular events. Results 417 cardiovascular events occurred in 341 patients. Taking into account only the first event by patient (coronary heart disease n=177, heart failure n=101, ischaemic stroke n=63), the incidence rates of cardiovascular events per 100 person years at risk were 15.1 (95% confidence interval 11.8 to 18.4) in those prescribed glucocorticoids and with a diagnosis of iatrogenic Cushing’s syndrome, 6.4 (5.5 to 7.3) in those prescribed glucocorticoids without a diagnosis of iatrogenic Cushing’s syndrome, and 4.1 (3.4 to 4.8) in those not prescribed glucocorticoids. In multivariate analyses adjusted for sex, age, intensity of glucocorticoid use, underlying disease, smoking status, and use of aspirin, diabetes drugs, antihypertensive drugs, lipid lowering drugs, or oral anticoagulant drugs, the relation between iatrogenic Cushing’s syndrome and cardiovascular events was strong (adjusted hazard ratios 2.27 (95% confidence interval 1.48 to 3.47) for coronary heart disease, 3.77 (2.41 to 5.90) for heart failure, and 2.23 (0.96 to 5.17) for ischaemic cerebrovascular events). The adjusted hazard ratio for any cardiovascular event was 4

  13. Risk of cardiovascular events in people prescribed glucocorticoids with iatrogenic Cushing's syndrome: cohort study.

    Science.gov (United States)

    Fardet, Laurence; Petersen, Irene; Nazareth, Irwin

    2012-07-30

    To investigate whether there is an increased risk of cardiovascular events in people who exhibit iatrogenic Cushing's syndrome during treatment with glucocorticoids. Cohort study. 424 UK general practices contributing to The Health Improvement Network database. People prescribed systemic glucocorticoids and with a diagnosis of iatrogenic Cushing's syndrome (n = 547) and two comparison groups: those prescribed glucocorticoids and with no diagnosis of iatrogenic Cushing's syndrome (n = 3231) and those not prescribed systemic glucocorticoids (n = 3282). Incidence of cardiovascular events within a year after diagnosis of iatrogenic Cushing's syndrome or after a randomly selected date, and association between iatrogenic Cushing's syndrome and risk of cardiovascular events. 417 cardiovascular events occurred in 341 patients. Taking into account only the first event by patient (coronary heart disease n = 177, heart failure n = 101, ischaemic stroke n = 63), the incidence rates of cardiovascular events per 100 person years at risk were 15.1 (95% confidence interval 11.8 to 18.4) in those prescribed glucocorticoids and with a diagnosis of iatrogenic Cushing's syndrome, 6.4 (5.5 to 7.3) in those prescribed glucocorticoids without a diagnosis of iatrogenic Cushing's syndrome, and 4.1 (3.4 to 4.8) in those not prescribed glucocorticoids. In multivariate analyses adjusted for sex, age, intensity of glucocorticoid use, underlying disease, smoking status, and use of aspirin, diabetes drugs, antihypertensive drugs, lipid lowering drugs, or oral anticoagulant drugs, the relation between iatrogenic Cushing's syndrome and cardiovascular events was strong (adjusted hazard ratios 2.27 (95% confidence interval 1.48 to 3.47) for coronary heart disease, 3.77 (2.41 to 5.90) for heart failure, and 2.23 (0.96 to 5.17) for ischaemic cerebrovascular events). The adjusted hazard ratio for any cardiovascular event was 4.16 (2.98 to 5.82) when the group prescribed glucocorticoids and with

  14. Low cardiorespiratory fitness in people at risk for type 2 diabetes: early marker for insulin resistance

    Directory of Open Access Journals (Sweden)

    Leite Silmara AO

    2009-09-01

    Full Text Available Abstract Purpose There is a significant association between insulin resistance and low cardiorespiratory fitness in nondiabetic subjects. In a population with risk factors for type 2 diabetes (T2DM, before they are insulin resistant, we investigated low exercise capacity (VO2max as an early marker of impaired insulin sensitivity in order to determine earlier interventions to prevent development of insulin resistance syndrome (IRS and T2DM. Methods Cross-sectional analyses of data on 369 (78 men and 291 women people at risk for IRS and T2DM, aged 45.6 +/- 10 years (20-65 years old from the Community Diabetes Prevention Project in Minnesota were carried out. The cardiorespiratory fitness (VO2max by respiratory gas exchange and bicycle ergometer were measured in our at risk non insulin resistant population and compared with a control group living in the same geographic area. Both groups were equally sedentary, matched for age, gender and BMI. Results The most prevalent abnormality in the study population was markedly low VO2max when compared with general work site screening control group, (n = 177; 137F; 40 M, mean age 40 ± 11 years; BMI = 27.8 ± 6.1 kg/m2. Individuals at risk for IRS and T2DM had a VO2max (22 ± 6 ml/kg/min 15% lower than the control group VO2max (26 ± 9 ml/kg/min (p 2max was inversely correlated with HOMA-IR (r = -0.30, p Conclusions Decreased VO2max is correlated with impaired insulin sensitivity and was the most prevalent abnormality in a population at risk for IRS and T2DM but without overt disease. This raises the possibility that decreased VO2 max is among the earliest indicators of IRS and T2DM therefore, an important risk factor for disease progression.

  15. Mental health, life functioning and risk factors among people exposed to frequent natural disasters and chronic poverty in Vietnam.

    Science.gov (United States)

    Pollack, Amie Alley; Weiss, Bahr; Trung, Lam Tu

    2016-06-01

    People living in low- and middle-income countries (LMIC) are at increased risk for exposure to major natural disasters, which places them at increased risk for mental health problems. Evidence is less clear, however, regarding the effects of less severe but more frequent natural disasters, which are likely to increase due to global climate change. To examine the mental health and life functioning, and their predictors, of people living in central coastal Vietnam, an area characterized by high risk for natural disasters and poverty. 1000 individuals were randomly selected from 5 provinces in central coastal Vietnam. Individuals were assessed cross-sectionally for exposure to major storms and other traumatic events (Post-traumatic Diagnostic Scale; PDS), financial stress (Chronic Financial Stress Scale), depression (PHQ-9), anxiety (GAD-7), PTSD (PDS), somatic syndrome (SCL-90-R), alcohol dependency (ICD-10), self-perceived general physical health (SF 36), and functional impairment (PDS life functioning section); caseness was determined using the various measures' algorithms. 22.7% percent of the sample ( n =227) met caseness criteria in one or more mental health domains, and 22.1% ( n =221) reported moderate to severe functional impairment. Lifetime exposure to typhoons and other major storms was 99% ( n =978), with 77% ( n =742) reporting traumatic major storm exposure. Moderate to high levels of financial stress were reported by 30% ( n =297). Frequency of exposure to major storms was not associated with increased risk for mental health problems but traumatic exposure to a major storm was. Overall, the strongest predictor of mental health problems was financial stress. Number of traumatic typhoons and other major storms in turn were significant predictors (r 2 = .03) of financial stress. The primary predictor of alcohol dependency was male gender, highlighting the importance of gender roles in development of alcohol abuse in countries like Vietnam. Individuals

  16. The experiences of high intensity therapists delivering cognitive behavioural therapy to people with intellectual disabilities.

    Science.gov (United States)

    Marwood, Hayley; Chinn, Deborah; Gannon, Kenneth; Scior, Katrina

    2018-01-01

    People with intellectual disabilities (ID) should be able to access the Improving Access to Psychological Therapies (IAPT) programme, currently a main provider of mainstream mental health services in England. IAPT offer cognitive behavioural therapy (CBT) to individuals experiencing mental health problems, although its effectiveness for people with ID, when delivered within IAPT, is unclear. Ten high-intensity therapists took part in semi-structured interviews, analysed using thematic analysis, regarding their experiences of delivering CBT to people with ID in IAPT. The rigidity of the IAPT model appears to offer a poor fit with the needs of people with ID. Therapists appeared uncertain about how to modify CBT and highlighted training and service development needs. Findings suggest barriers to accessing IAPT largely remain unaddressed where people with ID are concerned. Services may need to reconsider what constitutes appropriate reasonable adjustments to ensure equitable access. © 2017 John Wiley & Sons Ltd.

  17. The effects of infographics and several quantitative versus qualitative formats for cardiovascular disease risk, including heart age, on people's risk understanding.

    Science.gov (United States)

    Damman, Olga C; Vonk, Suzanne I; van den Haak, Maaike J; van Hooijdonk, Charlotte M J; Timmermans, Danielle R M

    2018-03-11

    To study how comprehension of cardiovascular disease (CVD) risk is influenced by: (1) infographics about qualitative risk information, with/without risk numbers; (2) which qualitative risk dimension is emphasized; (3) heart age vs. traditional risk format. For aim 1, a 2 (infographics versus text) x 2 (risk number versus no risk number) between-subjects design was used. For aim 2, three pieces of information were tested within-subjects. Aim 3 used a simple comparison group. Participants (45-65 yrs old) were recruited through an online access panel; low educated people were oversampled. They received hypothetical risk information (20%/61yrs). Primary outcomes: recall, risk appraisals, subjective/objective risk comprehension. behavioral intentions, information evaluations. Infographics of qualitative risk dimensions negatively affected recall, subjective risk comprehension and information evaluations. No effect of type of risk dimension was found on risk perception. Heart age influenced recall, comprehension, evaluations and affective risk appraisals. Infographics of hypothetical CVD risk information had detrimental effects on measures related to risk perception/comprehension, but effects were mainly seen in undereducated participants. Heart age influenced perceptions/comprehension of hypothetical risk in a way that seemed to support understanding. Heart age seems a fruitful risk communication approach in disease risk calculators. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. People with multiple tattoos and/or piercings are not at increased risk for HBV or HCV in The Netherlands

    NARCIS (Netherlands)

    Urbanus, Anouk T.; van den Hoek, Anneke; Boonstra, Albert; van Houdt, Robin; de Bruijn, Lotte J.; Heijman, Titia; Coutinho, Roel A.; Prins, Maria

    2011-01-01

    Although published results are inconsistent, it has been suggested that tattooing and piercing are risk factors for HBV and HCV infections. To examine whether tattooing and piercing do indeed increase the risk of infection, we conducted a study among people with multiple tattoos and/or piercings in

  19. 77 FR 1060 - High Pressure Steel Cylinders From the People's Republic of China: Postponement of Final...

    Science.gov (United States)

    2012-01-09

    ... DEPARTMENT OF COMMERCE International Trade Administration [A-570-977] High Pressure Steel... (``Department'') initiated an antidumping duty investigation on high pressure steel cylinders from the People's... investigation is currently due 75 days after the date of the Preliminary Determination.\\3\\ \\1\\ See High Pressure...

  20. 76 FR 59658 - High Pressure Steel Cylinders From the People's Republic of China: Postponement of Preliminary...

    Science.gov (United States)

    2011-09-27

    ... DEPARTMENT OF COMMERCE International Trade Administration [A-570-977] High Pressure Steel... (``Department'') initiated an antidumping duty investigation on high pressure steel cylinders from the People's... for this investigation is currently due no later than October 18, 2011. \\1\\ See High Pressure Steel...

  1. 77 FR 37377 - High Pressure Steel Cylinders From the People's Republic of China: Antidumping Duty Order

    Science.gov (United States)

    2012-06-21

    ... DEPARTMENT OF COMMERCE International Trade Administration [A-570-977] High Pressure Steel... Department is issuing an antidumping duty order on high pressure steel cylinders from the People's Republic... determination of material injury to a U.S. industry.\\1\\ \\1\\ See High Pressure Steel Cylinders from China...

  2. 77 FR 26738 - High Pressure Steel Cylinders From the People's Republic of China: Final Affirmative...

    Science.gov (United States)

    2012-05-07

    ... DEPARTMENT OF COMMERCE International Trade Administration [C-570-978] High Pressure Steel... producers and exporters of high pressure steel cylinders (steel cylinders) from the People's Republic of... The following events have occurred since the Preliminary Determination.\\1\\ \\1\\ See High Pressure Steel...

  3. 77 FR 37384 - High Pressure Steel Cylinders From the People's Republic of China: Countervailing Duty Order

    Science.gov (United States)

    2012-06-21

    ... DEPARTMENT OF COMMERCE International Trade Administration [C-570-978] High Pressure Steel...''), the Department is issuing a countervailing duty order on high pressure steel cylinders (``steel... investigation of steel cylinders from the PRC. See High Pressure Steel Cylinders From the People's Republic of...

  4. TATTOOS: What Do People Really Know About the Medical Risks of Body Ink?

    Science.gov (United States)

    Rahimi, Iliana A; Eberhard, Igor; Kasten, Erich

    2018-03-01

    Background: Tattoos have become increasing popular; however, medical complications and health risks can occur when getting a tattoo. Aim: The objective of this study is to determine whether people are properly informed about the medical risks and complications associated with tattoos and how the level of knowledge differs between those who have gotten tattooed and those who have not. Method: A cross-sectional online survey was performed. One-hundred participants had tattoos (32% male, 67% female) and 111 had no tattoos (53% male, 47% female); the average age was 26.9 years; level of education of both groups was comparable. There was a considerable (but not significant) difference between the two randomly selected samples with respect to sex and age, but both variables had no significant influence on the knowledge about medical risks, so no adjustment of the groups was carried out. The following variables were examined: demographics, characteristics of the tattoo, the intensity of the decision-making process that participants underwent before getting a tattoo, and the knowledge of medical risks and complications of tattoos. Results: More than 50 percent of the answers from both groups were incorrect (i.e., 55% of the answers from tattooed subjects were incorrect, and 58% of the non-tattooed group were incorrect). Neither sex (t-test, p =0.81) nor age (t-test, p =0.11) had any significant influence on the presence of knowledge. No significant correlations between sociodemographic variables and knowledge of medical risks of tattoos were found. No differences were found between characteristics of the tattoo and knowledge of medical risks apart from the size of the tattooed area (i.e., the larger the tattoo, the more information was sought by the person being tattooed). Differences were also found between educational levels and the knowledge of medical risks and complications of tattoos. Conclusions: Educating the public on the medical risks of tattoos might assist

  5. Impact of Conflict and Displacement on Risk Behaviours Amongst People Who Inject Drugs in Kabul, Afghanistan

    Science.gov (United States)

    Todd, Catherine S.; Nasir, Abdul; Stanekzai, Mohammad Raza; Fiekert, Katja; Sipsma, Heather L.; Strathdee, Steffanie A.; Vlahov, David

    2015-01-01

    Background Theoretical work posits that drug-related risk behaviour increases during armed conflict; however, few studies have been conducted in conflict settings. The objective of this analysis is to determine whether conflict or local displacement impact risk behaviours among people who inject drugs (PWID) in Kabul, Afghanistan. Methods Consenting PWIDs aged ≥18 years completed interviews at 3, 6, 9, 12, 18, and 24 months of follow-up. Quarters with peak conflict or local displacement exposure were defined and associations with injecting drug use and sexual risk behaviours analysed with generalized estimating equations. Results Of 483 PWID enrolled, 385 completed ≥1 follow-up visit (483.8 person-years) between 2007 and 2009. All participants were male, with 35% initiating injecting as a refugee. Sharing syringes (Odds Ratio (OR))=8.53, 95% Confidence Interval (CI): 2.58 – 28.2) and sexually transmitted infection (STI) symptoms (OR=1.72, 95% CI: 1.00 – 2.96) increased significantly during peak conflict quarters, while odds of STI symptoms (OR=0.06, 95% CI: 0.02 – 0.20) and arrest (OR=0.61, 95% CI: 0.40 – 0.93) were significantly lower during periods of displacement. Conclusion Syringe sharing significantly increased during peak conflict periods amongst PWID in Kabul. Programming should include instruction for coping with conflict and prepare clients for harm reduction needs during conflict. PMID:26303577

  6. Seroprevalence of Brucellosis and Risk Factors Related to High Risk Occupational Groups in Kazeroon, South of Iran

    Directory of Open Access Journals (Sweden)

    S Beheshti

    2010-03-01

    Full Text Available Background: Brucellosis is a major zoonosis worldwide. Many people for their professions are at higher risk of contracting the disease. Objective: To determine the seroprevalence of brucellosis and its risk factors in a group of high risk professions. Methods: In a cross-sectional study, all personnel or students of veterinary schools, slaughters and butchers working in the city were invited to participate (n=141. A comparison group (n=44 randomly selected from patients who were selected at random from people attended our healthcare center for reasons other than the infectious diseases. Results: 4 veterinarians, 15 veterinary assistants, 42 veterinarian students, 52 butchers, 17 slaughters, 8 slaughterhouse workers and 3 chefs made the first group and 14 storekeepers, 5 students of engineering, 11 clerks, 13 freelance workers, and 1 high school student made the comparison group. While the rate of consumption of most of the studied dairy products was almost similar in both groups, comparison group patients consumed more often milk (p<0.001 and cream (p<0.001 than the high risk group. 11 (7.8%; 95% CI: 3.4%–12.2% cases from high risk group and none of the comparison group were found seropositive for Brucella. Conclusion: Profession is the main factor in seropositivity. Consumption of dairy products and raw milk is not associated with a higher risk of seropositivity.

  7. Depression and risk of mortality in people with diabetes mellitus: a systematic review and meta-analysis.

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    Fleur E P van Dooren

    Full Text Available OBJECTIVE: To examine the association between depression and all-cause and cardiovascular mortality in people with diabetes by systematically reviewing the literature and carrying out a meta-analysis of relevant longitudinal studies. RESEARCH DESIGN AND METHODS: PUBMED and PSYCINFO were searched for articles assessing mortality risk associated with depression in diabetes up until August 16, 2012. The pooled hazard ratios were calculated using random-effects models. RESULTS: Sixteen studies met the inclusion criteria, which were pooled in an overall all-cause mortality estimate, and five in a cardiovascular mortality estimate. After adjustment for demographic variables and micro- and macrovascular complications, depression was associated with an increased risk of all-cause mortality (HR = 1.46, 95% CI = 1.29-1.66, and cardiovascular mortality (HR = 1.39, 95% CI = 1.11-1.73. Heterogeneity across studies was high for all-cause mortality and relatively low for cardiovascular mortality, with an I-squared of respectively 78.6% and 39.6%. Subgroup analyses showed that the association between depression and mortality not significantly change when excluding three articles presenting odds ratios, yet this decreased heterogeneity substantially (HR = 1.49, 95% CI = 1.39-1.61, I-squared = 15.1%. A comparison between type 1 and type 2 diabetes could not be undertaken, as only one study reported on type 1 diabetes specifically. CONCLUSIONS: Depression is associated with an almost 1.5-fold increased risk of mortality in people with diabetes. Research should focus on both cardiovascular and non-cardiovascular causes of death associated with depression, and determine the underlying behavioral and physiological mechanisms that may explain this association.

  8. Health risk behaviours of high school learners and their perceptions ...

    African Journals Online (AJOL)

    Background: Adolescence spans nearly a decade in which young people may initiate health risk behaviours such as unsafe sexual practices and the use of alcohol, tobacco and other drugs (ATOD use). Most adolescent mortality and morbidity, attributable to such health risk behaviours, are preventable. Managing the ...

  9. Risk of Malnutrition Evaluated by Mini Nutritional Assessment and Sarcopenia in Noninstitutionalized Elderly People.

    Science.gov (United States)

    Liguori, Ilaria; Curcio, Francesco; Russo, Gennaro; Cellurale, Michele; Aran, Luisa; Bulli, Giulia; Della-Morte, David; Gargiulo, Gaetano; Testa, Gianluca; Cacciatore, Francesco; Bonaduce, Domenico; Abete, Pasquale

    2018-02-13

    Malnutrition indices and muscle mass and strength in the elderly are poorly investigated. Moreover, malnutrition seems to be 1 of the more important factors in the cause of sarcopenia. The presence of sarcopenia and its relationship with malnutrition indices were studied in noninstitutionalized elderly people who underwent Comprehensive Geriatric Assessment (CGA). A total of 473 elderly subjects (mean age, 80.9 ± 6.6 years) admitted to CGA were studied. Malnutrition risk was evaluated with Mini Nutritional Assessment (MNA) score, whereas muscle mass and muscle strength were evaluated by bioimpedentiometry and hand grip, respectively. Sarcopenia was assessed as indicated in the European Working Group on Sarcopenia in Older People (EWGSOP) consensus. Overall prevalence of sarcopenia was 13.1%, and it increased from 6.1% to 31.4% as MNA decreased (P elderly subjects with sarcopenia (15.4 ± 4.2) than without sarcopenia (22.0 ± 4.0) (P = .024). Linear regression analysis showed that MNA score is linearly related both with muscle mass (r = 0.72; P elderly subjects with sarcopenia, and it is linearly related to muscle mass and muscle strength. These data indicate that MNA score, when evaluated with muscle mass and strength, may recognize elderly subjects with sarcopenia. © 2018 American Society for Parenteral and Enteral Nutrition.

  10. Low Leptin Availability as a Risk Factor for Dementia in Chilean Older People

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    Cecilia Albala

    2016-07-01

    Full Text Available Objective: The aim was to study the role of leptin in the development of dementia. Methods: Follow-up of the ALEXANDROS cohorts, with baseline measurements in 2000. From 1,136 available subjects free of dementia at baseline, 667 subjects had frozen baseline blood samples for measuring leptin and soluble leptin receptor (sOB-R. The free leptin index (FLI was calculated as the ratio of leptin to sOB-R. Dementia was defined as an MMSE score 5 in the Pfeffer Activities Questionnaire. Results: After 15 years of follow-up, 42 incident cases of dementia were identified. No difference in serum leptin was observed between people with and without dementia, but sOB-R was higher in demented than in nondemented subjects (sOB-R: 44.94 ± 23.97 vs. 33.73 ± 21.13 ng/ml. The adjusted risk for dementia increased, the higher the log sOB (hazard ratio = 3.58; 95% CI 1.72-7.45, p = 0.001. Conclusion: Lower availability of free leptin was found in demented than in nondemented people, suggesting a role of leptin in cognition.

  11. Recruiting older people at nutritional risk for clinical trials: what have we learned?

    Science.gov (United States)

    Piantadosi, Cynthia; Chapman, Ian M; Naganathan, Vasi; Hunter, Peter; Cameron, Ian D; Visvanathan, Renuka

    2015-04-15

    The difficulty of recruiting older people to clinical trials is well described, but there is limited information about effective ways to screen and recruit older people into trials, and the reasons for their reluctance to enrol. This paper examines recruitment efforts for a community-based health intervention study that targeted older adults. One year randomized control trial. Undernourished men and women, aged ≥ 65 years and living independently in the community were recruited in three Australian states. Participants were allocated to either oral testosterone undecanoate and high calorie oral nutritional supplement or placebo medication and low calorie oral nutritional supplementation. Hospital admissions, functional status, nutritional health, muscle strength, and other variables were assessed. 4023 potential participants were identified and 767 were screened by a variety of methods: hospital note screening, referrals from geriatric health services, advertising and media segments/appearances. 53 participants (7% of total screened) were recruited. The majority of potentially eligible participants declined participation in the trial after reading the information sheet. Media was the more successful method of recruiting, whereas contacting people identified by screening a large number of hospital records was not successful in recruiting any participants. Recruitment of frail and older participants is difficult and multiple strategies are required to facilitate participation. Australian Clinical Trial Registry: ACTRN 12610000356066 date registered 4/5/2010.

  12. Risk of violence in drug rehabilitation centers: perceptions of people who inject drugs in Tijuana, Mexico.

    Science.gov (United States)

    Harvey-Vera, Alicia Yolanda; González-Zúñiga, Patricia; Vargas-Ojeda, Adriana Carolina; Medina-Mora, Maria Elena; Magis-Rodríguez, Carlos Leonardo; Wagner, Karla; Strathdee, Steffanie Anne; Werb, Daniel

    2016-01-26

    In 2009, Mexico reformed its health law to partially decriminalize drug possession considered for personal use and to increase mandatory referrals to certified drug rehabilitation centers in lieu of incarceration. Concurrently, news media reported violent attacks perpetrated by drug cartels against Mexican drug rehabilitation centers and instances of human rights violations by staff against people who inject drugs (PWID) in treatment. In many cases, these violent situations took place at "Peer Support" (Ayuda Mutua) drug rehabilitation centers that house a large number of drug-dependent PWID. In an effort to understand barriers to treatment uptake, we examined prevalence and correlates of perceived risk of violence at drug rehabilitation centers among PWID in Tijuana, Mexico. Secondary analysis of baseline data collected between March 2011 and May 2013 of PWID recruited into a prospective cohort study in Tijuana. Interviewer-administered surveys measured perceived risk of violence at drug rehabilitation centers by asking participants to indicate their level of agreement with the statement "going to rehabilitation puts me at risk of violence". Logistic regression was used to examine factors associated with perceived risk of violence. Of 733 PWID, 34.5 % perceived risk of violence at drug rehabilitation centers. In multivariate analysis, reporting ever having used crystal methamphetamine and cocaine (separately), having a great or urgent need to get help for drug use, and ever receiving professional help for drug/alcohol use were negatively associated with perceived risk of violence at drug rehabilitation centers, while having been told by law enforcement that drug rehabilitation attendance is mandatory was positively associated with perceived risk of violence. All associations were significant at a 0.05 alpha level. The perception of violence at drug rehabilitation centers among PWID does not represent the lived experience of those PWID who attended

  13. Young people with epilepsy have an increased risk of eating disorder and poor quality diet.

    Science.gov (United States)

    Kolstad, Eivind; Bjørk, Marte; Gilhus, Nils Erik; Alfstad, Kristin; Clench-Aas, Jocelyn; Lossius, Morten

    2018-03-01

    To investigate whether adolescents with epilepsy are at increased risk of having self-reported eating disorder symptoms and poor quality diet compared to young people from the general population. We used data from the Health Profile for Children and Youth in Akershus Study, a cross-sectional population-based study based on a voluntary self-reported questionnaire. There were 19,995 participants (response rate 85%) aged 13-19 years; 247 (1.2%) reported a lifetime diagnosis of epilepsy. Odds ratios (OR) and 95% confidence intervals (CI) for eating disorders, unhealthy diet, dieting, satisfaction with looks, and participation in sports were estimated by using a logistic regression model. All estimates were adjusted for single parents and poor family economy. Children and adolescents with epilepsy had more eating disorders than their peers (OR 1.8, CI 1.0-3.0, p = 0.03). They were less satisfied with their own appearance (OR 0.7, CI 0.5-0.9, p = 0.02), and they eat more unhealthily (OR 1.7, CI 1.3-2.2, p = 0.001). Males with epilepsy were more likely to have been dieting (OR 3.1, CI 1.2-7.9, p = 0.02) and less satisfied with their own appearance (OR 0.4, CI 0.3-0.7, p < 0.001). Females with epilepsy were more likely to eat unhealthily (OR 1.7, CI 1.1-2.5, p = 0.01). Adolescents with epilepsy are at increased risk of having eating disorder symptoms. They eat less healthily and are less satisfied with their looks. Health workers should be aware of this and bring diet and lifestyle into the dialogue with young people with epilepsy.

  14. Prediction of Risk of Falling Among Institutionalized Elderly People in Iran

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    Ahmad Ali Akbari-Kamrani

    2003-07-01

    Full Text Available Objective: Aging decline abilities and leads to increased risk of falling and subsequently poorer quality of life. The objective of this study was to identify a proper assessment for risk of falling among institutionalized elderly people. Materials & Methods: Prospective non–interventional methodological discriminative–validation study in order to make a comparative assessment of the discriminative validity of the two clinical assessment methods among the elderly people with/ without history of falling. The frequency of falls within 6 months among institutionalized elderly individuals was prospectively studied. Finally, those having had two or more falls within 6 months were enrolled in the faller group and those having no falls within 6 months were enrolled in the non-faller group. Twenty-one women and 33 men (mean age: 75.79, standard deviation [SD]: 8.47, range: 61-98 independent in their daily activities and able to walk 10 meters using / without assistive devices volunteered to participate in the study with awareness. Background variables included age, gender, use / nonuse of assistive devices, height, weight, number of the drugs used, and number of the diseases independent variable was history of falling and dependent variables were the results of the two functional assessment methods. In order to accomplish the aim of study, two functional assessment methods, Berg scale and Tinetti scale, were used and the validity indices of these methods were calculated. Results: Independent t test indicated a significant difference between the two groups of fallers and non-fallers in the mean scores on Berg Balance Scale (p=0.00l and Tinetti Scale (p=0.00l. Conclusion: The results of logistic regression test indicated much more discriminative validity for Berg Balance Scale test than Tinetti Scale test. Studying the validity of Berg Balance Scale assessment method showed that all validity indices should be regarded as bases for clinical decision.

  15. [Risk factors for falls and survival after falling in elderly people in a community].

    Science.gov (United States)

    Kato, Ryuichi; Takagi, Chika; Sakurai, Naoko; Hoshi, Tanji

    2012-05-01

    The purpose of this study was to assess the risk factors associated with falls and to examine the effects of falls on survival of elderly people in a community. A questionnaire survey was conducted in 16,462 urban elderly dwellers aged 65 years or more in City A in September 2001. A follow-up survey was carried out in September 2004. We analyzed the data of 8,285 subjects who answered both questionnaires and had not relocated by August 2007. Baseline assessments of health and functioning were carried out in 2001. Falls experienced during the 1-year period before September 2004 were recorded, and the deaths were recorded until August 2007. Statistical analysis was performed using a logistic regression model and Cox's proportional hazards analysis. A total of 6,420 subjects (3,127 men and 3,293 women) who had provided complete answers about their falls were included in the analyses. Of these, 27.8% of women and 16.4% of men had experienced falls, while 6.2% of women and 2.1% of men had experienced falls that caused fractures. We found that the likelihood of fall, with or without fracture development, was greater in women than in men (P falls tended to increase with age in both women and men. Risk factors associated with falls, in addition to age and gender, were pain (odds ratio [OR], 1.75), lack of instrumental activities of daily living (IADL; OR, 1.45), poor self-rated health status (OR, 1.42), and presence of disease (OR, 1.35). Risk factors associated with falls that caused fracture were pain (OR, 1.85) and lack of IADL (OR, 1.61). Cox's proportional hazards analysis showed a significant increase in mortality in both men and women who had experienced falls than in those who had not (hazard ratio [HR], 1.94, 1.43). Aging, pain and disease, lack of IADL, and poor self-rated health status were all significant risk factors for falls in elderly people, and a fall was related to subsequent mortality.

  16. People-centred landslide early warning systems in the context of risk management

    Science.gov (United States)

    Haß, S.; Asch, K.; Fernandez-Steeger, T.; Arnhardt, C.

    2009-04-01

    In the current hazard research people-centred warning becomes more and more important, because different types of organizations and groups have to be involved in the warning process. This fact has to be taken into account when developing early warning systems. The effectiveness of early warning depends not only on technical capabilities but also on the preparedness of decision makers and their immediate response on how to act in case of emergency. Hence early warning systems have to be regarded in the context of an integrated and holistic risk management. Disaster Risk Reduction (DRR) measures include people-centred, timely and understandable warning. Further responsible authorities have to be identified in advance and standards for risk communication have to be established. Up to now, hazard and risk assessment for geohazards focuses on the development of inventory, susceptibility, hazard and risk maps. But often, especially in Europe, there are no institutional structures for managing geohazards and in addition there is a lack of an authority that is legally obliged to alarm on landslides at national or regional level. One of the main characteristics within the warning process for natural hazards e.g. in Germany is the split of responsibility between scientific authorities (wissenschaftliche Fachbehörde) and enforcement authorities (Vollzugsbehörde). The scientific authority provides the experts who define the methods and measures for monitoring and evaluate the hazard level. The main focus is the acquisition and evaluation of data and subsequently the distribution of information. The enforcement authority issues official warnings about dangerous natural phenomena. Hence the information chain in the context of early warning ranges over two different institutions, the forecast service and the warning service. But there doesn't exist a framework for warning processes in terms of landslides as yet. The concept for managing natural disasters is often reduced to

  17. The prevention access and risk taking in young people (PARTY) project protocol: a cluster randomised controlled trial of health risk screening and motivational interviewing for young people presenting to general practice.

    Science.gov (United States)

    Sanci, Lena; Grabsch, Brenda; Chondros, Patty; Shiell, Alan; Pirkis, Jane; Sawyer, Susan; Hegarty, Kelsey; Patterson, Elizabeth; Cahill, Helen; Ozer, Elizabeth; Seymour, Janelle; Patton, George

    2012-06-06

    There are growing worldwide concerns about the ability of primary health care systems to manage the major burden of illness in young people. Over two thirds of premature adult deaths result from risks that manifest in adolescence, including injury, neuropsychiatric problems and consequences of risky behaviours. One policy response is to better reorientate primary health services towards prevention and early intervention. Currently, however, there is insufficient evidence to support this recommendation for young people. This paper describes the design and implementation of a trial testing an intervention to promote psychosocial risk screening of all young people attending general practice and to respond to identified risks using motivational interviewing. clinicians' detection of risk-taking and emotional distress, young people's intention to change and reduction of risk taking. pathways to care, trust in the clinician and likelihood of returning for future visits. The design of the economic and process evaluation are not detailed in this protocol. PARTY is a cluster randomised trial recruiting 42 general practices in Victoria, Australia. Baseline measures include: youth friendly practice characteristics; practice staff's self-perceived competency in young people's care and clinicians' detection and response to risk taking behaviours and emotional distress in 14-24 year olds, attending the practice. Practices are then stratified by a social disadvantage index and billing methods and randomised. Intervention practices receive: nine hours of training and tools; feedback of their baseline data and two practice visits over six weeks. Comparison practices receive a three hour seminar in youth friendly practice only. Six weeks post-intervention, 30 consecutive young people are interviewed post-consultation from each practice and followed-up for self-reported risk taking behaviour and emotional distress three and 12 months post consultation. The PARTY trial is the

  18. Risk of falls in older people during fast-walking--the TASCOG study.

    Science.gov (United States)

    Callisaya, M L; Blizzard, L; McGinley, J L; Srikanth, V K

    2012-07-01

    To investigate the relationship between fast-walking and falls in older people. Individuals aged 60-86 years were randomly selected from the electoral roll (n=176). Gait speed, step length, cadence and a walk ratio were recorded during preferred- and fast-walking using an instrumented walkway. Falls were recorded prospectively over 12 months. Log multinomial regression was used to estimate the relative risk of single and multiple falls associated with gait variables during fast-walking and change between preferred- and fast-walking. Covariates included age, sex, mood, physical activity, sensorimotor and cognitive measures. The risk of multiple falls was increased for those with a smaller walk ratio (shorter steps, faster cadence) during fast-walking (RR 0.92, CI 0.87, 0.97) and greater reduction in the walk ratio (smaller increase in step length, larger increase in cadence) when changing to fast-walking (RR 0.73, CI 0.63, 0.85). These gait patterns were associated with poorer physiological and cognitive function (prisk of multiple falls was also seen for those in the fastest quarter of gait speed (p=0.01) at fast-walking. A trend for better reaction time, balance, memory and physical activity for higher categories of gait speed was stronger for fallers than non-fallers (prisk of multiple falls. There may be two distinct groups at risk--the frail person with short shuffling steps, and the healthy person exposed to greater risk. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. People with epilepsy and their relatives want more information about risks of injuries and premature death.

    Science.gov (United States)

    Henning, Oliver; Nakken, Karl O; Lossius, Morten I

    2018-05-01

    For most people with chronic diseases such as epilepsy, thorough knowledge of the disease is important in order to reduce feelings of insecurity and to enable better management of everyday life. Whether and when to inform patients and their families about all the risks associated with epilepsy is a matter of controversy. Using a web-based survey, patients with epilepsy (PWE) (n=1183) and carers, family members, or guardians of PWE, who could either answer on behalf of the patients (CBP) (n=676) or on their own behalf (CAR) (n=231) were asked whether they wanted information about the risk of epilepsy-related injuries and premature death and also whether they had received such information. Ninety percent or more of PWE, CBP, and CAR reported that they wanted such information, and 50% of CAR, 81% of CBP, and 70% of PWE had received some information about seizure-related injuries. Regarding risk of unexpected death, 31% of PWE, 35% of CBP, and 28% of CAR had received information on this issue. Those with tonic-clonic seizures were most eager to obtain information on these matters, and those best informed about epilepsy-related risks were males and the youngest part of the cohort. The wish for more information or the likelihood of having already received information was independent of the individual's seizure situation. This study demonstrates that there is a considerable gap between what the patients want regarding information and what they are actually given by healthcare providers. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. [Development of a portable fall risk index for elderly people living in the community].

    Science.gov (United States)

    Toba, Kenji; Okochi, Jiro; Takahashi, Tai; Matsubayashi, Kozo; Nishinaga, Masanori; Yamada, Shizuru; Takahashi, Ryutaro; Nishijima, Reiko; Kobayashi, Yoshio; Machida, Ayako; Akishita, Masahiro; Sasaki, Hidetada

    2005-05-01

    To develop a portable risk index for falls. Risk factors were chosen from previously established factors then we added several environmental factors to the risk index; previous falls in the last 12 month, trippig or stumbling, inability to ascend or descend stairs without help, decreased walking speed, inability to cross a road within the green signal interval, inability to walk 1km without a break, inability to stand on one leg for 5 seconds (eyes open), using a cane, inability to wring out a towel, dizziness or faintness, stooped or rounded back, knee joint pain, visual disturbance, hearing disturbance, cognitive decline, fear of falling, receiving 5 or more prescribed drugs, sensation of darkness at home, obstacles inside, barrier on the carpet or floor, using steps daily at home, steep slopes around home. The questionnaire sheet was completed by 2,439 community-dwelling elderly subjects (76.3 +/- 7.4 years old). The frequency of each items of fall risk index was compared between fallers (history of fall within one year) and non-fallers. Multiple regression analysis was performed to identify independent risk factors for previous falls. Except barrier, step use and steep slope around home, all items in the fall risk index were more frequent in fallers. Multivariate analysis revealed that tripping or stumbling, inability to cross a road within the green signal interval, dizziness or faintness, obstacles inside, inability to wring out a towel, cane use and knee joint pain were independent risk factors for previous falls. These 7 selected items were further analyzed as predictors. The maximum sum of sensitivity and specificity was reached at the cut-off point of 2/3 (sensitivity 0.65, specificity 0.72) by receiver operating curve. Portable fall risk index is useful for clinical settings to identify high-risk subjects.

  1. A partner-related risk behavior index to identify people at elevated risk for sexually transmitted infections.

    Science.gov (United States)

    Crosby, Richard; Shrier, Lydia A

    2013-04-01

    The purpose of this study was to develop and test a sexual-partner-related risk behavior index to identify high-risk individuals most likely to have a sexually transmitted infection (STI). Patients from five STI and adolescent medical clinics in three US cities were recruited (N = 928; M age = 29.2 years). Data were collected using audio-computer-assisted self-interviewing. Of seven sexual-partner-related variables, those that were significantly associated with the outcomes were combined into a partner-related risk behavior index. The dependent variables were laboratory-confirmed infection with Chlamydia trachomatis, Neisseria gonorrhoeae, and/or Trichomonas vaginalis. Nearly one-fifth of the sample (169/928; 18.4%) tested positive for an STI. Three of the seven items were significantly associated with having one or more STIs: sex with a newly released prisoner, sex with a person known or suspected of having an STI, and sexual concurrency. In combined form, this three-item index was significantly associated with STI prevalence (p one or more of three STIs. This index could be used to prioritize and guide intensified clinic-based counseling for high-risk patients of STI and other clinics.

  2. Wide variation in absolute cardiovascular risk assessment in Aboriginal and Torres Strait Islander people with Type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Bhakti Ramesh Vasant

    2016-03-01

    Full Text Available Background: Absolute cardiovascular risk assessment (CVRA is based on the combined effects of multiple risk factors and can identify asymptomatic individuals at high risk of cardiovascular disease. Aboriginal and Torres Strait Islander people are disproportionately affected by cardiovascular disease and diabetes. Our study aimed to investigate variations in the use of absolute CVRA in patients with diabetes at Indigenous community healthcare centres, and to identify patient and health centre characteristics that may contribute to this variation. Methods: Audits of clinical records of 1,728 patients with a known diagnosis of diabetes across 121 health centres over the period 2012–2014 were conducted as part of a large-scale continuous quality improvement program. Multilevel regression modelling was used to quantify variation in recording of CVRA attributable to health centre and patient characteristics. Results: The proportion of eligible patients with documented CVRA was 33% (n=574/1,728. The majority (95% of assessments were conducted in the Northern Territory (NT. Multilevel regression analysis showed health centre characteristics accounted for 70% of the variation in assessments in the NT. Government-operated health centres had 18.8 times the odds (95% CI 7.7–46.2 of recording CVRA delivery compared with other health centres. Conclusion: Health centres in the NT delivered the majority of absolute CVRA to Indigenous patients with diabetes in our study. Health systems factors that may have facilitated provision of CVRA in the NT include decision support tools and a reporting process for CVRA delivery. Implementation of similar systems in other jurisdictions may help improve CVRA delivery. Early identification and treatment of high risk individuals through wider use of CVRA may help reduce the burden of cardiovascular disease in Indigenous Australians with diabetes.

  3. High affective risk perception is associated with more lung cancer-specific distress in CT screening for lung cancer

    NARCIS (Netherlands)

    Bunge, Eveline M.; van den Bergh, Karien A. M.; Essink-Bot, Marie-Louise; van Klaveren, Rob J.; de Koning, Harry J.

    2008-01-01

    Screening for cancer can cause distress. People who perceive their risk of cancer as high may be more vulnerable to distress. This study evaluated whether participants of a lung cancer Computed Tomography (CT) screening trial with a high affective risk perception of developing lung cancer had a

  4. Age of Onset of Cannabis Use Is Associated With Age of Onset of High-Risk Symptoms for Psychosis

    NARCIS (Netherlands)

    Dragt, Sara; Nieman, Dorien H.; Becker, Hiske E.; van de Fliert, Reinaud; Dingemans, Peter M.; de Haan, Lieuwe; van Amelsvoort, Thérèse A.; Linszen, Don H.

    2010-01-01

    Objective: Increasing interest in the prodromal stage of schizophrenia over the past decade led us to perform our study to monitor people at high risk for developing a psychosis. We hypothesized that cannabis use or a cannabis use disorder at a younger age relates to high-risk symptoms at a younger

  5. Educational strategies for diabetic people at risk for foot neuropathy: synthesis of good evidence

    Directory of Open Access Journals (Sweden)

    Luciana Catunda Gomes de Menezes

    2016-12-01

    Full Text Available The aim of the present study was to identify the best evidence concerning health education strategies used in teaching-learning for people with diabetes mellitus who are at risk for foot neuropathy. An integrative review was conducted in the databases PubMed, LILACS, CINAHL and SCOPUS in January 2015; a total of 14 papers was analyzed in detail. The results are shown in a summary table and categories are discussed, covering various health education strategies for prevention and management with patients at risk of foot neuropathy (group; individual in face-to-face visits or via telephone; and using interactive technologies, and a synthesis of the best evidence for the effectiveness of these interventions in reducing diabetic foot complications. It was concluded that all the educational strategies are effective in promoting diabetic foot self-care. However, the group strategies showed greater effectiveness, enabling significant improvements in the knowledge, attitude, and practices of care for feet and general health of diabetic patients.

  6. Benefits and Risks for People and Livestock of Keeping Companion Animals: Searching for a Healthy Balance.

    Science.gov (United States)

    Sterneberg-van der Maaten, T; Turner, D; Van Tilburg, J; Vaarten, J

    2016-07-01

    The mission of the CALLISTO (Companion Animals multisectoriaL interprofessionaL Interdisciplinary Strategic Think tank On zoonoses) project was to provide an overview of the current situation on the role of companion animals as a source of infectious diseases for people and food animals. It also aimed to identify knowledge and technology gaps for the most important zoonoses and propose targeted actions to reduce the risk of zoonotic diseases transmitted via companion animals. After a 3-year study, its members have developed practical recommendations for improved data collection on companion animal numbers and the mechanisms for disease surveillance in companion animals. They highlight the importance of introducing a system for the unique identification of dogs and other companion animals with an implanted microchip transponder and storage of the details it contains on an internationally accessible online database. Their report also emphasises the need for balanced communication with the public on the risks and benefits of pet ownership and the value of the 'One Health' concept to encourage closer collaboration between veterinary and human medical professionals. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Knowledge about infertility risk factors, fertility myths and illusory benefits of healthy habits in young people.

    Science.gov (United States)

    Bunting, Laura; Boivin, Jacky

    2008-08-01

    Previous research has highlighted a lack of fertility awareness in the general population especially in relation to the optimal fertile period during the menstrual cycle, incidence of infertility and duration of the reproductive life span. The current study assessed fertility knowledge more broadly in young people and investigated three areas of knowledge, namely risk factors associated with female infertility (e.g. smoking), beliefs in false fertility myths (e.g. benefits of rural living) and beliefs in the illusory benefits of healthy habits (e.g. exercising regularly) on female fertility. The sample (n = 149) consisted of 110 female and 39 male postgraduate and undergraduate university students (average age 24.01, SD = 7.81). Knowledge scores were based on a simple task requiring the participants to estimate the effect a factor would have on a group of 100 women trying to get pregnant. Items (n = 21) were grouped according to three categories: risk factors (e.g. smoking; 7 items), myths (e.g. living in countryside; 7 items) and healthy habits (e.g. being normal weight; 7 items). An analysis of variance showed a significant main effect of factor (P healthy habits (P healthy habits. We suggest that the public education campaigns should be directed to erroneous beliefs about pseudo protective factors.

  8. [Study of intrinsic risk factors for falls in institutionalized elderly people].

    Science.gov (United States)

    de Menezes, Ruth Losada; Bachion, Maria Márcia

    2008-01-01

    The objective of this research was to identify intrinsic risk factors that predispose elderly people living in long-term institutions in the city of Goiânia (GO) to falls. The present descriptive transversal study was carried out in six long-term institutions for seniors in the city of Goiânia. The investigated sample consisted of 95 elderly that fitted the inclusion and exclusion criteria. A questionnaire was used for collecting clinical data related to health-disease conditions; cognitive data; capacity to develop basic daily life activities and equilibrium and gait. In general terms, as pointed out the literature, the examined elderly presented different fall risk factors such as: motor difficulty in lower limbs (90%), visual deficit (81,1%), use of 3 or more kinds of medicines (59,7%), suspected depression (37,9%), lack of equilibrium/unstable unipodal support (37,9%) abnormally decreased height in step (32,6%). The obtained data allow us to set indicators for the increase in falls among the studied sample, demonstrating the need for creating strategies for health promotion, prevention of injuries and rehabilitation.

  9. Reaching Sustainable Financial Health: Gender Differences in Risk-Taking Patterns of Financially Excluded People

    Directory of Open Access Journals (Sweden)

    Eunmi Kim

    2018-04-01

    Full Text Available Providing sufficient financial accessibility to low-income individuals is considered a way to decrease income inequality and could be a key factor in sustainable economic growth. To make the financial accessibility policy more effective, analyses of individuals’ understanding of financial risk within low-income groups need to be conducted. The current authors investigated individuals’ attitudes towards loan financial risk in terms of gender difference. Using South Korean survey data, we examined the relationship between gender and attitude towards loan financial risk with a regression analysis. We found that within a low-income group, males were more willing to pay higher interest rates than females. In addition, males’ willingness to pay high interest rates became stronger when their current financial costs were high. The results indicate that males are less careful with the risks that high interest rates can bring. Thus, the results imply that interventions, such as more substantial financial education, are required for males to make financial accessibility polices more effective.

  10. Effects of High-Intensity Interval Training on People Living with Type 2 Diabetes: A Narrative Review.

    Science.gov (United States)

    Wormgoor, Shohn G; Dalleck, Lance C; Zinn, Caryn; Harris, Nigel K

    2017-10-01

    People with type 2 diabetes typically present with comorbidities, such as elevated blood pressure, high cholesterol, high blood glucose, obesity and decreased fitness, all contributive to increased risk for cardiovascular complications. Determination of effective exercise modalities for the management of such complications is important. One such modality is high-intensity interval training (HIIT). To conduct the review, PubMed and EBSCOHost databases were searched through June 1, 2016, for all HIIT intervention studies conducted in people living with type 2 diabetes. Thereafter, the central characteristics of HIIT were analyzed to obtain a broader understanding of the cardiometabolic benefits achievable by HIIT. Fourteen studies were included for review, but the heterogeneity of the participants with type 2 diabetes, the training equipment and HIIT parameters, accompanied by variations in supervision, dietary advice and medications, prevented direct comparisons. However HIIT, regardless of the specific parameters employed, was a suitable option in pursuing improved glycemic control, body composition, aerobic fitness, blood pressure and lipidemia measures in individuals with type 2 diabetes. HIIT is a therapy with at least equivalent benefit to moderate-intensity continuous training; hence, HIIT should be considered when prescribing exercise interventions for people living with type 2 diabetes. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

  11. Risk of cardiovascular disease? A qualitative study of risk interpretation among patients with high cholesterol

    DEFF Research Database (Denmark)

    Kirkegaard, P.; Edwards, A.; Risor, M. B.

    2013-01-01

    Background: Previous studies have shown the importance of paying attention to lay peoples' interpretations of risk of disease, in order to explain health-related behavior. However, risk interpretations interplay with social context in complex ways. The objective was to explore how asymptomatic...

  12. Concerns about Genetic Testing for Schizophrenia among Young Adults at Clinical High Risk for Psychosis.

    Science.gov (United States)

    Lawrence, Ryan E; Friesen, Phoebe; Brucato, Gary; Girgis, Ragy R; Dixon, Lisa

    Genetic tests for schizophrenia may introduce risks and benefits. Among young adults at clinical high-risk for psychosis, little is known about their concerns and how they assess potential risks. We conducted semi-structured interviews with 15 young adults at clinical high-risk for psychosis to ask about their concerns. Participants expressed concerns about test reliability, data interpretation, stigma, psychological harm, family planning, and privacy. Participants' responses showed some departure from the ethics literature insofar as participants were primarily interested in reporting their results to people to whom they felt emotionally close, and expressed little consideration of biological closeness. Additionally, if tests showed an increased genetic risk for schizophrenia, four clinical high-risk persons felt obligated to tell an employer and another three would "maybe" tell an employer, even in the absence of clinical symptoms. These findings suggest opportunities for clinicians and genetic counselors to intervene with education and support.

  13. [Nitrates (V) in drinking water as factor of a health risk for people in Podlaskie Voivodship].

    Science.gov (United States)

    Szczerbiński, Robert; Karczewski, Jan; Fiłon, Joanna

    2006-01-01

    The aim of this article was to evaluate of a health danger and to estimate the risk due to the presence of nitrates (V) in drinking water used by people in Podlaskie Voivodship. For research I used water specimens taken in 14 poviats (smaller administration districts) in Podlaskie Voivodship as part of drinking water quality monitoring in the years 2001-2003. Evaluation of danger of nitrates (V) taken in with drinking water by the population of Podlaskie Voivodship was carried out by comparing ADI (Acceptable Daily Intake) with value of EDI (Evaluated Daily Intake) and TMDI (Theoretical Maximum Daily Intake) Risk was estimated by calculating safety margin between ADI and EDI. On the basis of the obtained results it was stated that on the territory of Podlaskie Voivodship 1.79% of urban population and 4.86% of rural population, was taking in nitrates (V) with water supplied by waterworks in doses below the safety margin. Nitrates (V) from drinking water in doses below the safety margin were taken in by population of 10 poviats, with the highest percentage of the population noted in the poviats of: Grajewo (10.97%), Augustów (10.77%) and Sejny (10.43%). Among the urban population the highest percentage noted in the Poviat of Augustów (9.46%), and among the rural population--in the Poviat of Grajewo (22.46%). The highest percentage of the population (69.97%) in Podlaskie Voivodship consumed nitrates (V) with drinking water supplied by waterworks in the range of the safety margin from 1 to 10, including 78.86% of urban population and 53.3% of rural population. It seems useful to continue the environmental research on the exposure of Podlaskie Voivodship inhabitants to nitrates by correlating the risk expressed by the safety margin with cancer epidemiology.

  14. [Fall risk assessment and knee extensor muscle activity in elderly people].

    Science.gov (United States)

    Oya, Yukiko; Nakamura, Masumi; Tabata, Emi; Morizono, Ryo; Mori, Sachiko; Kimuro, Yukari; Horikawa, Etsuo

    2008-05-01

    The purpose of this study was to analyze relationships between the history of falls, tripping, sway, and knee extensor muscle strengths as a tool for fall risk assessment in elderly people. We examined effective fall prevention measures. We investigated 102 elderly volunteers in the community. The subjects were classified according to history of falls, tripping, sway and 5 performance tests conducted to assess fall risk including Timed up-and-go test (TUG), Functional Reach test (FR), Hand grip and Reaction time (RT). In addition, the time serial data of the knee extensor muscle strength were acquired using a hand-held dynamometer. In comparison to the non-faller group, the faller group showed a significantly higher incident rate of tripping and sway. A frequency analysis using the Maximum Entropy Method revealed that the fallers group showed lower peak frequency (p=0.025). Also, the slope of the logarithmical spectrum was less steep in the fallers group (p=0.035). Also results from analysis of the peak force latency from the beginning of measurement to 50%, 80%, and 100% muscle strength, also showed that the faller group took more time for maximal voluntary contraction. The frequency analysis of the time series date of peak force latency of knee extensor muscle strength revealed that the muscle activity differs in faller compared to non-fallers. This study suggested that knee extensor muscle isometric performance could possibly be used as a new tool for fall risk assessment. We concluded that exercises to raise maximal muscle strength and muscle response speed are useful for the prevention of falls.

  15. Chernobyl Nuclear Catastrophe and the High Risk Potential for Mental Retardation.

    Science.gov (United States)

    Holowinsky, Ivan Z.

    1993-01-01

    This report considers potential effects of the 1986 nuclear explosion at the Chernobyl (Ukraine) nuclear reactor. Approximately 17 million people, of whom 2.5 million were below the age of 5, are thought to have suffered some radioactive contamination. Many of these children are at high risk for mental retardation and learning disorders.…

  16. The Psychosis High-Risk State A Comprehensive State-of-the-Art Review

    NARCIS (Netherlands)

    Fusar-Poli, Paolo; Borgwardt, Stefan; Bechdolf, Andreas; Addington, Jean; Riecher-Rössler, Anita; Schultze-Lutter, Frauke; Keshavan, Matcheri; Wood, Stephen; Ruhrmann, Stephan; Seidman, Larry J.; Valmaggia, Lucia; Cannon, Tyrone; Velthorst, Eva; de Haan, Lieuwe; Cornblatt, Barbara; Bonoldi, Ilaria; Birchwood, Max; McGlashan, Thomas; Carpenter, William; McGorry, Patrick; Klosterkötter, Joachim; McGuire, Philip; Yung, Alison

    2013-01-01

    Context: During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms.

  17. Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: The Rural Chinese Cohort Study.

    Science.gov (United States)

    Zhang, Ming; Wang, Bingyuan; Liu, Yu; Sun, Xizhuo; Luo, Xinping; Wang, Chongjian; Li, Linlin; Zhang, Lu; Ren, Yongcheng; Zhao, Yang; Zhou, Junmei; Han, Chengyi; Zhao, Jingzhi; Hu, Dongsheng

    2017-03-01

    Risk of type 2 diabetes mellitus (T2DM) is increased in metabolically obese but normal-weight people. However, we have limited knowledge of how to prevent T2DM in normal-weight people. We aimed to evaluate the association between triglyceride glucose (TyG) index and incident T2DM among normal-weight people in rural China. We included data from 5706 people with normal body mass index (BMI) (18.5-23.9 kg/m 2 ) without baseline T2DM in a rural Chinese cohort followed for a median of 6.0 years. A Cox proportional-hazard model was used to assess the risk of incident T2DM by quartiles of TyG index and difference in TyG index between follow-up and baseline (TyG-D), estimating hazard ratios (HRs) and 95% confidence intervals (CIs). A generalized additive plot was used to show the nonparametric smoothed exposure-response association between risk of T2DM and TyG index as a continuous variable. TyG was calculated as ln [fasting triglyceride level (mg/dl) × fasting plasma glucose level (mg/dl)/2]. Risk of incident T2DM was increased with quartiles 2, 3 and 4 versus quartile 1 of TyG index (adjusted HR [aHR] 2.48 [95% CI 1.20-5.11], 3.77 [1.83-7.79], and 5.30 [2.21-12.71], P trend  index). Risk of incident T2DM was increased with quartile 4 versus quartile 1 of TyG-D (aHR 3.91 [2.22-6.87]). The results were consistent when analyses were restricted to participants without baseline metabolic syndrome and impaired fasting glucose level. The generalized additive plot showed cumulative increased risk of T2DM with increasing TyG index. Risk of incident T2DM is increased with increasing TyG index among rural Chinese people, so the index might be an important indicator for identifying people at high risk of T2DM.

  18. High resolution fire risk mapping in Italy

    Science.gov (United States)

    Fiorucci, Paolo; Biondi, Guido; Campo, Lorenzo; D'Andrea, Mirko

    2014-05-01

    The high topographic and vegetation heterogeneity makes Italy vulnerable to forest fires both in the summer and in winter. In particular, northern regions are predominantly characterized by a winter fire regime, mainly due to frequent extremely dry winds from the north, while southern and central regions and the large islands are characterized by a severe summer fire regime, because of the higher temperatures and prolonged lack of precipitation. The threat of wildfires in Italy is not confined to wooded areas as they extend to agricultural areas and urban-forest interface areas. The agricultural and rural areas, in the last century, have been gradually abandoned, especially in areas with complex topography. Many of these areas were subject to reforestation, leading to the spread of pioneer species mainly represented by Mediterranean conifer, which are highly vulnerable to fire. Because of the frequent spread of fire, these areas are limited to the early successional stages, consisting mainly of shrub vegetation; its survival in the competition with the climax species being ensured by the spread of fire itself. Due to the frequency of fire ignition — almost entirely man caused — the time between fires on the same area is at least an order of magnitude less than the time that would allow the establishment of forest climax species far less vulnerable to fire. In view of the limited availability of fire risk management resources, most of which are used in the management of national and regional air services, it is necessary to precisely identify the areas most vulnerable to fire risk. The few resources available can thus be used on a yearly basis to mitigate problems in the areas at highest risk by defining a program of forest management interventions, which is expected to make a significant contribution to the problem in a few years' time. The goal of such detailed planning is to dramatically reduce the costs associated with water bombers fleet management and fire

  19. Personality differences in high risk sports amateurs and instructors.

    Science.gov (United States)

    Watson, Alison E; Pulford, Briony D

    2004-08-01

    This study investigated the personality differences of 21 amateurs and 20 instructors who participated in the high risk sports of skydiving, hang-gliding, paragliding, scuba diving, microlighting, and rock climbing, versus those who did not. 38 men and 28 women (M age=32.6 yr., SD= 10.0) were assessed using the Eysenck Personality Questionnaire-Revised, the General Health Questionnaire, the Generalised Self-efficacy Scale, and a Type A/B personality measure. Instructors and Amateurs scored significantly higher on Extroversion and lower on Neuroticism than Nonparticipants; however, they differed from each other on the General Health Questionnaire and Type A/B personality scores. Amateurs scored significantly higher on Psychoticism and Self-efficacy than Instructors and Nonparticipants. In conclusion, these test scores suggest that people who are attracted to high risk sports tend to be at the extroverted and emotionally stable end of the scale, with a tendency to exhibit Type A characteristics; however, Instructors' scores on Psychoticism and Self-efficacy are more akin to those of Nonparticipants.

  20. Protection of people and environment from radiation risk through good regulatory practice

    Science.gov (United States)

    Jais, Azlina Mohammad; Hassan, Najwa

    2017-01-01

    The term "good regulatory practice" has seen growing frequency of usage worldwide, especially since the 2011 Fukushima nuclear incident. However, the term appears quite ambiguous as it may mean differently to different people. This leads us to the first important question: what does "good regulatory practice" actually mean? When used in conjunction with the Fukushima incident, do we imply that there is an absence of "good regulatory practice" in the Japanese' Nuclear and Industry Safety Agency (NISA)? This is quite troubling. It is clear that the term should be defined formally so that our understanding of "good regulatory practice" can be standardized. There is still another important question beyond agreeing on what "good regulatory practice" is: is "good regulatory practice" specific to a region, or is it global? And is it applicable only to nuclear regulators, or to all types of regulators per se? This paper aims to deliberate on the above mentioned questions. Specifically, we hope to discuss the "good regulatory practice" for atomic energy activities in order to protect the people and the environment from radiation risk of such activities. By understanding what "good regulatory practice" truly means, a newcomer country such as Malaysia can quickly learn and adopt these practices so as to assure a competent national nuclear regulatory authority who will be responsible in ensuring the safety, security and safeguards of peaceful atomic energy activities in the country including nuclear liability. In understanding this concept, a holistic approach will be taken by looking into example of advanced and newcomer countries of various nuclear regulatory authorities all around the world. Then the paper will focus on the challenges that the current nuclear regulatory authority in Malaysia which is Atomic Energy Licensing Board has, its challenges to follow the concept of "good regulatory practice" and its ways to overcome it. This study explore the initiatives could be

  1. Differential impact of two risk communications on antipsychotic prescribing to people with dementia in Scotland: segmented regression time series analysis 2001-2011.

    Science.gov (United States)

    Guthrie, Bruce; Clark, Stella A; Reynish, Emma L; McCowan, Colin; Morales, Daniel R

    2013-01-01

    Regulatory risk communications are an important method for disseminating drug safety information, but their impact varies. Two significant UK risk communications about antipsychotic use in older people with dementia were issued in 2004 and 2009. These varied considerably in their content and dissemination, allowing examination of their differential impact. Segmented regression time-series analysis 2001-2011 for people aged ≥65 years with dementia in 87 Scottish general practices, examining the impact of two pre-specified risk communications in 2004 and 2009 on antipsychotic and other psychotropic prescribing. The percentage of people with dementia prescribed an antipsychotic was 15.9% in quarter 1 2001 and was rising by an estimated 0.6%/quarter before the 2004 risk communication. The 2004 risk communication was sent directly to all prescribers, and specifically recommended review of all patients prescribed relevant drugs. It was associated with an immediate absolute reduction in antipsychotic prescribing of 5.9% (95% CI -6.6 to -5.2) and a change to a stable level of prescribing subsequently. The 2009 risk communication was disseminated in a limited circulation bulletin, and only specifically recommended avoiding initiation if possible. There was no immediate associated impact, but it was associated with a significant decline in prescribing subsequently which appeared driven by a decline in initiation, with the percentage prescribed an antipsychotic falling from 18.4% in Q1 2009 to 13.5% in Q1 2011. There was no widespread substitution of antipsychotics with other psychotropic drugs. The two risk communications were associated with reductions in antipsychotic use, in ways which were compatible with marked differences in their content and dissemination. Further research is needed to ensure that the content and dissemination of regulatory risk communications is optimal, and to track their impact on intended and unintended outcomes. Although rates are falling

  2. Differential Impact of Two Risk Communications on Antipsychotic Prescribing to People with Dementia in Scotland: Segmented Regression Time Series Analysis 2001–2011

    Science.gov (United States)

    Guthrie, Bruce; Clark, Stella A.; Reynish, Emma L.; McCowan, Colin; Morales, Daniel R.

    2013-01-01

    Background Regulatory risk communications are an important method for disseminating drug safety information, but their impact varies. Two significant UK risk communications about antipsychotic use in older people with dementia were issued in 2004 and 2009. These varied considerably in their content and dissemination, allowing examination of their differential impact. Methods Segmented regression time-series analysis 2001–2011 for people aged ≥65 years with dementia in 87 Scottish general practices, examining the impact of two pre-specified risk communications in 2004 and 2009 on antipsychotic and other psychotropic prescribing. Results The percentage of people with dementia prescribed an antipsychotic was 15.9% in quarter 1 2001 and was rising by an estimated 0.6%/quarter before the 2004 risk communication. The 2004 risk communication was sent directly to all prescribers, and specifically recommended review of all patients prescribed relevant drugs. It was associated with an immediate absolute reduction in antipsychotic prescribing of 5.9% (95% CI −6.6 to −5.2) and a change to a stable level of prescribing subsequently. The 2009 risk communication was disseminated in a limited circulation bulletin, and only specifically recommended avoiding initiation if possible. There was no immediate associated impact, but it was associated with a significant decline in prescribing subsequently which appeared driven by a decline in initiation, with the percentage prescribed an antipsychotic falling from 18.4% in Q1 2009 to 13.5% in Q1 2011. There was no widespread substitution of antipsychotics with other psychotropic drugs. Conclusions The two risk communications were associated with reductions in antipsychotic use, in ways which were compatible with marked differences in their content and dissemination. Further research is needed to ensure that the content and dissemination of regulatory risk communications is optimal, and to track their impact on intended and

  3. Differential impact of two risk communications on antipsychotic prescribing to people with dementia in Scotland: segmented regression time series analysis 2001-2011.

    Directory of Open Access Journals (Sweden)

    Bruce Guthrie

    Full Text Available Regulatory risk communications are an important method for disseminating drug safety information, but their impact varies. Two significant UK risk communications about antipsychotic use in older people with dementia were issued in 2004 and 2009. These varied considerably in their content and dissemination, allowing examination of their differential impact.Segmented regression time-series analysis 2001-2011 for people aged ≥65 years with dementia in 87 Scottish general practices, examining the impact of two pre-specified risk communications in 2004 and 2009 on antipsychotic and other psychotropic prescribing.The percentage of people with dementia prescribed an antipsychotic was 15.9% in quarter 1 2001 and was rising by an estimated 0.6%/quarter before the 2004 risk communication. The 2004 risk communication was sent directly to all prescribers, and specifically recommended review of all patients prescribed relevant drugs. It was associated with an immediate absolute reduction in antipsychotic prescribing of 5.9% (95% CI -6.6 to -5.2 and a change to a stable level of prescribing subsequently. The 2009 risk communication was disseminated in a limited circulation bulletin, and only specifically recommended avoiding initiation if possible. There was no immediate associated impact, but it was associated with a significant decline in prescribing subsequently which appeared driven by a decline in initiation, with the percentage prescribed an antipsychotic falling from 18.4% in Q1 2009 to 13.5% in Q1 2011. There was no widespread substitution of antipsychotics with other psychotropic drugs.The two risk communications were associated with reductions in antipsychotic use, in ways which were compatible with marked differences in their content and dissemination. Further research is needed to ensure that the content and dissemination of regulatory risk communications is optimal, and to track their impact on intended and unintended outcomes. Although rates

  4. Ethnicity and cardiovascular risk: variations in people of African ancestry and South Asian origin.

    Science.gov (United States)

    Cappuccio, F P

    1997-09-01

    Mortality from coronary heart disease (CHD), stroke and end-stage renal failure are high in South Asian migrants in the UK. This is associated with high prevalence of diabetes and hypertension. These seem to be manifestations of a metabolic syndrome with insulin resistance (hyperinsulinaemia) and central obesity (based on high waist-to-hip ratio rather than on conventional measures of body mass index). This is associated with sedentary lifestyle, high serum triglycerides and low HDL-cholesterol. Mortality from stroke and end-stage renal failure are high in black migrants to the UK (both Caribbeans and West Africans). However, CHD mortality is low in this group. This pattern of mortality is associated with high prevalence of hypertension and diabetes. This group tends to be obese (particularly women) according to conventional measures of body mass index and to have hyperinsulinaemia, low serum triglycerides and high HDL-cholesterol. Conventional risk factors such as cigarette smoking and hypercholesterolaemia are less prevalent in ethnic minority populations in the United Kingdom and unlikely to explain the differences seen between groups, although each risk factor is likely to contribute to the variation in vascular disease within each group. There is difficulty in reconciling the results of migration studies (eg, from rural to urban environments) pointing to major environmental influences on the changes in cardiovascular risk factors with the consistent pattern of disease of ethnic groups across the world and in subsequent generations, suggesting a certain degree of genetic susceptibility. Important environment-gene interplays might be underlying some of these processes. The detection and management of hypertension and diabetes are still unsatisfactory in inner city areas and show variations by ethnic origin. Strategies for the control of CHD and stroke adopted in European countries directed mostly to white populations may be inappropriate for ethnic minority

  5. The prevention access and risk taking in young people (PARTY project protocol: A cluster randomised controlled trial of health risk screening and motivational interviewing for young people presenting to general practice

    Directory of Open Access Journals (Sweden)

    Sanci Lena

    2012-06-01

    Full Text Available Abstract Background There are growing worldwide concerns about the ability of primary health care systems to manage the major burden of illness in young people. Over two thirds of premature adult deaths result from risks that manifest in adolescence, including injury, neuropsychiatric problems and consequences of risky behaviours. One policy response is to better reorientate primary health services towards prevention and early intervention. Currently, however, there is insufficient evidence to support this recommendation for young people. This paper describes the design and implementation of a trial testing an intervention to promote psychosocial risk screening of all young people attending general practice and to respond to identified risks using motivational interviewing. Main outcomes: clinicians’ detection of risk-taking and emotional distress, young people’s intention to change and reduction of risk taking. Secondary outcomes: pathways to care, trust in the clinician and likelihood of returning for future visits. The design of the economic and process evaluation are not detailed in this protocol. Methods PARTY is a cluster randomised trial recruiting 42 general practices in Victoria, Australia. Baseline measures include: youth friendly practice characteristics; practice staff’s self-perceived competency in young people’s care and clinicians’ detection and response to risk taking behaviours and emotional distress in 14–24 year olds, attending the practice. Practices are then stratified by a social disadvantage index and billing methods and randomised. Intervention practices receive: nine hours of training and tools; feedback of their baseline data and two practice visits over six weeks. Comparison practices receive a three hour seminar in youth friendly practice only. Six weeks post-intervention, 30 consecutive young people are interviewed post-consultation from each practice and followed-up for self-reported risk taking

  6. Prescription of the High Risk Narcotics and Trading or Illicit Purchasing of High Risk Narcotics

    Directory of Open Access Journals (Sweden)

    Nicoleta-Elena Buzatu

    2012-05-01

    Full Text Available The present essay will analyze the offence of prescribing high risk narcotics and trading or illicit purchasing of high risk narcotics, as it was regulated - together with other offences - by Law no 143 of July 26, 2000 on preventing and fighting against the traffic and illicit consumption of narcotics. The same law defines the meaning of such a phrase “substances which are under national control” by mentioning the fact that they are the narcotics and their precursors listed in Annexes I-IV of the law. The analysis of the offence of prescribing the high risk narcotics and trading or illicit purchasing of high risk narcotics is following the already known structure mentioned in the doctrine and which consists of: object and subjects of the offence, its constituent content: the objective side with its material element, the immediate consequence and causality connections; the subjective side of the offence, as well as forms and modalities of these offences, and the applicable sanctions, of course.

  7. Technology in Community-Based Organizations that Serve Older People: High Tech Meets High Touch

    Science.gov (United States)

    Renold, Carl; Meronk, Cheryl; Kelly, Christopher

    2005-01-01

    Appropriate implementation of information technology (IT) can help create a more efficient, less costly, and higher-quality service-delivery environment for community-based organizations that serve older people. Relevant studies and reports on technology in healthcare can be compared and applied to these organizations. This study is the result of…

  8. High proportions of older people with normal nutritional status have poor protein intake and low diet quality.

    Science.gov (United States)

    Jyväkorpi, S K; Pitkälä, K H; Puranen, T M; Björkman, M P; Kautiainen, H; Strandberg, T E; Soini, H H; Suominen, M H

    2016-01-01

    The Mini Nutritional Assessment (MNA) is a well-validated instrument examining the nutritional status of older people. The aim of this study was to examine how older people's energy and nutrient intakes are associated with the MNA and to determine how sensitive and specific MNA is in identifying those having low energy and protein intakes. This cross-sectional study combined data from five nutritional studies (N=900): both home-dwelling and institutionalized older people without and with disabilities. Their nutritional status was assessed with MNA, and nutrient intakes were retrieved from 1 to 3day food diaries. Nutrient intakes were divided according to MNA status (normal nutritional status, at-risk of malnutrition, malnourished). Sensitivity, specificity, and likelihood ratios of MNA of various cut-off points were tested with recommended protein and energy intakes. ROC curves was constructed. Energy, protein and most nutrient intakes showed logical linear trends according to MNA classes. However, more than three-fourths of the participants with MNA>23.5 had lower than recommended protein intakes. Sensitivity of MNA ranged from 0.32 to 0.82 for recommended energy (F:1570kcal/d/M:2070kcal/d) and protein intakes (1.0g/kg BW or 1.2g/kgBW) cut-off points, and specificity from 0.75 to 0.25, respectively. AUC values were low (0.52-0.53). MNA status was consistently associated with nutrient intakes and diet quality. However, a high proportion of older people even with normal nutritional status had poor energy and protein intakes. Thus, MNA does not identify all those with poor nutrient intakes who may be at risk of developing malnutrition. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. State of oral hygiene and identification of the main risk factors for inflammatory diseases of periodontal tissues in young people

    Directory of Open Access Journals (Sweden)

    Makarenko M.V.

    2014-09-01

    Full Text Available A high percentage of prevalence of inflammatory periodontal diseases in young age causes urgency of treatment and prevention of inflammatory diseases of periodontal tissue in young age. Therefore, the research purpose was to investigate the hygienic condition and identification of the main risk factors for gingivitis in patients aged 18-30 years. 286 people aged from 18 to 30 years were observed in the study. To assess hygienic condition of the oral cavity and to determine the thickness of plaque indices OHI-S (simplified oral hygiene index Green Vermilyona and Silness Loe were used. Studies of oral hygiene status suggests that in patients with different etiologies of periodontal tissue inflammation, oral hygienic condition ranged from "satisfactory" to "poor." Therefore the results of study of hygiene and periodontal indices and samples confirmed presence of moderately expressed inflammation in the gums in young adults with chronic catarrhal gingivitis. Most often inflammation in the gums, namely, chronic catarrhal gingivitis was determined in patients with fixed prosthesis designs in the mouth or in violation of the bite, related to the major risk factors for periodontal disease occurring in young adults aged from 18 to 30 years.

  10. Synergistic effect of oral corticosteroids use on risk of hepatocellular carcinoma in high risk populations.

    Science.gov (United States)

    Lai, Shih-Wei; Lin, Cheng-Li; Liao, Kuan-Fu

    2018-06-01

    Little evidence is available on the relationship between oral corticosteroids use and hepatocellular carcinoma. The objective of this study was to investigate whether oral corticosteroids use correlates with the risk of hepatocellular carcinoma in high risk populations in Taiwan. Using representative claims database established from the Taiwan National Health Insurance Program with a population coverage rate of 99.6%, we identified 102,182 subjects aged 20-84 years with newly diagnosed hepatocellular carcinoma in 2000-2011 as the cases and 102,182 randomly selected subjects aged 20-84 years without hepatocellular carcinoma as the matched controls. In subjects with any one of comorbidities including alcohol-related disease, chronic liver disease, and diabetes mellitus, the adjusted OR of hepatocellular carcinoma was 29.9 (95% CI 28.7, 31.1) for subjects with never use of oral corticosteroids, and the adjusted OR would increase to 33.7 (95% CI 32.3, 35.3) for those with ever use of oral corticosteroids. The adjusted OR of hepatocellular carcinoma was 1.03 for subjects with increasing cumulative duration of oral corticosteroids use for every one year (95% CI 1.01, 1.06), with a duration-dependent effect. The largest OR occurred in subjects with ever use of oral corticosteroids and concurrently comorbid with alcohol-related disease, chronic liver disease, and diabetes mellitus (adjusted OR 122.7, 95% CI 108.5, 138.8). There is a synergistic effect between oral corticosteroids use and the traditional risk factors on the risk of hepatocellular carcinoma. People with risk factors for hepatocellular carcinoma should receive regular ultrasound surveillance, particularly when they currently use oral corticosteroids. Copyright © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  11. Love, lifestyles and the risk of AIDS: the moral worlds of young people in Bobo-Dioulasso, Burkina Faso.

    Science.gov (United States)

    Samuelsen, Helle

    2006-01-01

    The HIV epidemic has had a profound impact on people's everyday life in most African societies. A large proportion of all new HIV infections involves young people between 15 and 25 years. The objective of this paper is to explore local moral worlds of young people in Bobo-Dioulasso, Burkina Faso, and discuss how the HIVS epidemic affects their reflections on their everyday life and their perceptions of sexual relationships. Based on anthropological fieldwork, including focus-group discussions, in-depth interviews and participant observation, a total of 57 young people between 15 and 25 years were followed over a 3-month period. Using the notion of 'lifestyle', the paper shows how structural factors of unemployment and poverty paired with global discourse on AIDS present the young people with frustrations and quandaries in relation to their hopes and images of love, faithfulness and modern living. The data shows that the HIV epidemic contributes to and accelerates their feeling of living in a risk society and of being at risk. In order to cope with these uncertainties and contingencies, local discourses of trust and fidelity become extremely important and to most young people HIV prevention is synonymous with finding a faithful partner and/or using condoms.

  12. Prediction of Risk of Falling among Institutionalized Elderly People in Iran

    Directory of Open Access Journals (Sweden)

    Ahmad Ali Akbari Kamrani

    2005-09-01

    Full Text Available Aging declines abilities and leads to increased risk of falling and subsequently poorer quality of life. The objective of this study was to identify a proper assessment for risk of falling among institutionalized elderly. In order to accomplish this aim, two functional assessment methods, Berg Scale and Tinetti Scale, were used and the validity indices of these methods were calculated. Prospective non-interventional methodological discriminative-validation study in order to make a comparative assessment of the discriminative validity of the two clinical assessment methods among the elderly people with/without history of falling. The frequency of falls within 6 months among institutionalized elderly individuals was prospectively studied. Finally, those having had two or more falls within 6 months were enrolled in the faller group and those having no falls within 6 months were enrolled in the non-faller group. Twenty-one women and 33 men (mean age: 75.79, standard deviation [SD]: 8.47, range: 61-98 independent in their daily activities and able to walk 10 meters using/without assistive devices volunteered to participate in the study with awareness. Background variables included age, gender, use/nonuse of assistive devices, height, weight, number of the drugs used, and number of the diseases; independent variable was history of falling; and dependent variables were the results of the two functional assessment methods. Independent t-test indicated a significant difference between the two groups of fallers and non-fallers in the mean scores on Berg Balance Scale (P=0.0001 and Tinetti Scale (P=0.0001. The results of logistic regression test indicated much more discriminative validity for Berg Balance Scale test than Tinetti Scale test. Studying the validity of Berg Balance Scale assessment method showed that all validity indices should be regarded as bases for clinical decision.

  13. Environmental toxins and risk of narcolepsy among people with HLA DQB1*0602

    Science.gov (United States)

    Ton, Thanh G.N.; Longstreth, WT; Koepsell, Thomas D.

    2010-01-01

    One etiologic model for narcolepsy suggests that some environmental toxin selectively and irreversibly destroys hypocretin-producing cells in individuals with human leukocyte antigen (HLA) DQB1*0602. Between 2001-2005, the authors conducted a population-based case-control study in King County, Washington to examine narcolepsy risk in relation to toxins found in jobs, hobbies and other non-vocational activities. Sixty-seven cases and 95 controls were enrolled; all were between ages 18-50 and positive for HLA DQB1*0602. All were administered in-person interviews about jobs, hobbies or other non-vocational activities before age 21. All analyses were adjusted for African American race and income. Risk increased significantly for jobs involving heavy metals (odds ratio [OR]=4.7; 95% confidence interval [CI]: 1.5, 14.5) and for highest levels of exposure to woodwork (OR: 3.0; 95% CI: 1.0, 8.9), fertilizer (OR=3.1; 95% CI: 1.1, 9.1), and bug or weed killer (OR=4.5; 95% CI: 1.5, 13.4). Associations were of borderline significance for activities involving ceramics, pesticides, and painting projects. Significant dose-response relationships were evident for jobs involving metals (p<0.03), paints (p<0.03), and bug or weed killer (p<0.02). Additional studies are needed to replicate these findings and continue the search for specific toxins that could damage hypocretin neurons in genetically susceptible people. PMID:20519130

  14. Attentional Blink in Young People with High-Functioning Autism and Asperger's Disorder

    Science.gov (United States)

    Rinehart, Nicole; Tonge, Bruce; Brereton, Avril; Bradshaw, John

    2010-01-01

    The aim of the study was to examine the temporal characteristics of information processing in individuals with high-functioning autism and Asperger's disorder using a rapid serial visual presentation paradigm. The results clearly showed that such people demonstrate an attentional blink of similar magnitude to comparison groups. This supports the…

  15. Dare to share? How people share high-quality knowledge in online communities

    NARCIS (Netherlands)

    Rotundo, Enrico; Blank, M.; Moser, C.; Leopold, H.

    The Internet has fundamentally changed how work gets done in the 21st century. For example, people increasingly spend time on the Internet where they share and develop knowledge in online communities. Yet, little is known about how high-quality knowledge comes about in these communities. This is

  16. Vitamin D analogue therapy, cardiovascular risk and kidney function in people with Type 1 diabetes mellitus and diabetic nephropathy

    DEFF Research Database (Denmark)

    Joergensen, C; Tarnow, L; Goetze, J P

    2015-01-01

    AIM: To evaluate the effects of therapy with the vitamin D analogue paricalcitol on markers of cardiovascular risk and kidney function in people with Type 1 diabetes mellitus and diabetic nephropathy. METHODS: In a double-blind, randomized placebo-controlled, crossover trial, 48 participants on s...

  17. Unnoticed Post-Void Residual Urine Volume in People with Moderate to Severe Intellectual Disabilities: Prevalence and Risk Factors

    Science.gov (United States)

    de Waal, K. H.; Tinselboer, B. M.; Evenhuis, H. M.; Penning, C.

    2009-01-01

    Background: Increased post-void residual urine volume (PVR) is often seen in geriatric populations. People with intellectual disabilities (ID) have risk factors in common with these populations. Aims: To investigate in adults with ID: (1) Feasibility of portable ultrasound bladder scanning; (2) Prevalence of PVR; and (3) Relations with proposed…

  18. A simple test of choice stepping reaction time for assessing fall risk in people with multiple sclerosis.

    Science.gov (United States)

    Tijsma, Mylou; Vister, Eva; Hoang, Phu; Lord, Stephen R

    2017-03-01

    Purpose To determine (a) the discriminant validity for established fall risk factors and (b) the predictive validity for falls of a simple test of choice stepping reaction time (CSRT) in people with multiple sclerosis (MS). Method People with MS (n = 210, 21-74y) performed the CSRT, sensorimotor, balance and neuropsychological tests in a single session. They were then followed up for falls using monthly fall diaries for 6 months. Results The CSRT test had excellent discriminant validity with respect to established fall risk factors. Frequent fallers (≥3 falls) performed significantly worse in the CSRT test than non-frequent fallers (0-2 falls). With the odds of suffering frequent falls increasing 69% with each SD increase in CSRT (OR = 1.69, 95% CI: 1.27-2.26, p = falls in people with MS. This test may prove useful in documenting longitudinal changes in fall risk in relation to MS disease progression and effects of interventions. Implications for rehabilitation Good choice stepping reaction time (CSRT) is required for maintaining balance. A simple low-tech CSRT test has excellent discriminative and predictive validity in relation to falls in people with MS. This test may prove useful documenting longitudinal changes in fall risk in relation to MS disease progression and effects of interventions.

  19. Predicting ecstasy use among young people at risk: a prospective study of initially ecstasy-naive subjects

    NARCIS (Netherlands)

    Vervaeke, H.K.E.; Benschop, A.; van den Brink, W.; Korf, D.J.

    2008-01-01

    Our aim is to identify predictors of first-time ecstasy use in a prospective study among young people at risk. As part of the multidisciplinary Netherlands XTC Toxicity Study (NeXT), we monitored 188 subjects aged ≥ 18 who were ecstasy-naive at baseline but seemed likely to start taking ecstasy in

  20. Predicting ecstasy use among young people at risk: a prospective study of initially ecstasy-naive subjects

    NARCIS (Netherlands)

    Vervaeke, Hylke K. E.; Benschop, Annemieke; van den Brink, Wim; Korf, Dirk J.

    2008-01-01

    Our aim is to identify predictors of first-time ecstasy use in a prospective study among young people at risk. As part of the multidisciplinary Netherlands XTC Toxicity Study (NeXT), we monitored 188 subjects aged > or = 18 who were ecstasy-naive at baseline but seemed likely to start taking ecstasy

  1. Predicting Ecstasy Use among Young People at Risk: A Prospective Study of Initially Ecstasy-Naive Subjects

    Science.gov (United States)

    Vervaeke, Hylke K.E.; Benschop, Annemieke; Van Den Brink, Wim; Korf, Dirk J.

    2008-01-01

    Our aim is to identify predictors of first-time ecstasy use in a prospective study among young people at risk. As part of the multidisciplinary Netherlands XTC Toxicity Study (NeXT), we monitored 188 subjects aged up to 18 years who were ecstasy-naive at baseline but seemed likely to start taking ecstasy in the near future. After an 11- to…

  2. What Are Young People Doing on Internet? Use of ICT, Parental Supervision Strategies and Exposure to Risks

    Science.gov (United States)

    Giménez, Ana M.; Luengo, José A.; Bartrina, M. José

    2017-01-01

    Introduction: Current research emphasizes young people's access to and use of social networks, chat and WhatsApp. However, this situation is not associated with active parental mediation to protect them from the risks involved. This study analyzes Murcian students' perception of cell phone and computer use, parental mediation strategies and their…

  3. Client experiences with perinatal healthcare for high-risk and low-risk women

    NARCIS (Netherlands)

    van Stenus, Cherelle M.V.; Boere-Boonekamp, Magda M.; Kerkhof, Erna F.G.M.; Need, Ariana

    2018-01-01

    Problem: It is unknown if client experiences with perinatal healthcare differ between low-risk and high-risk women. Background: In the Netherlands, risk selection divides pregnant women into low- and high-risk groups. Receiving news that a pregnancy or childbirth has an increased likelihood of

  4. Features of distribution and causes of risk-oriented behavior among young people (by the example of psychoactive substances use

    Directory of Open Access Journals (Sweden)

    I. L. Kukovska

    2017-02-01

    Full Text Available The aim of the present study was to investigate the university students’ views of possible situations and the reasons for the use of substances that can be addictive by their peers. So-called psychoactive substances (tobacco, alcohol, drugs, energy drinks can act as risk factors and  contribute to the development of a number of socially significant diseases.  The study did not provide for the study of the spread of harmful habits among young people, but only an analysis of the responses concerning the situation and the reasons for these phenomena.  The study involved 137 students aged 17 to 21 years.  It was found that the majority of respondents can not identify a single best reason, but pointed out a few of these reasons and situations.  It is shown that in the opinion of young people, the freer use of psychoactive substances among young people is primarily promoted by visits to discos, meeting with friends who are on the background of the lack of interesting activities and hobbies, as well as the situation, accompanied by an insufficient level of adult supervision, including the holidays period.  Analysis of the study results suggests a lack of skill level output from "uncomfortable" psychological situations among young people. The survey results indicate key influence of family and social environment on the degree of the risk-oriented behavior manifestation of young people.  Taking into account the significant contribution of risk factors in the state of public health indicators, analysis of the processes of formation and perception of health risks among young people requires special attention.  Conducting further systematic sociological studies, which will condition the direction and influence the quality of health preservation programs seems relevant and appropriate.

  5. Prevalence and associated risk factors of chronic bronchitis in First Nations people.

    Science.gov (United States)

    Pahwa, Punam; Karunanayake, Chandima P; Rennie, Donna C; Lawson, Joshua A; Ramsden, Vivian R; McMullin, Kathleen; Gardipy, P Jenny; MacDonald, Judy; Abonyi, Sylvia; Episkenew, Jo-Ann; Dosman, James A

    2017-06-29

    Inadequate housing, low family income, household smoking, personal smoking status, and poor schooling are some of the conditions that have been significantly associated with the prevalence and incidence of chronic bronchitis. The aim of the current study was to determine the prevalence of chronic bronchitis (CB) and associated risk factors among First Nations people. An interviewer-administered survey was conducted as part of the First Nations Lung Health Project in 2012 and 2013 with 874 individuals from 406 households in two First Nations communities located in the province of Saskatchewan, Canada. The questionnaire collected information on individual and contextual determinants of health and a history of ever diagnosed with CB (outcome variable) from the two communities participating in the First Nations Lung Health Project. Clustering effect within households was adjusted using Generalized Estimating Equations. The prevalence of CB was 8.9% and 6.8% among residents (18 years and older) of community A and community B respectively and was not significantly different. CB prevalence was positively associated with odour or musty smell of mildew/mould in the house [OR adj (95% CI) = 2.33 (1.21, 4.50)], allergy to house dust [3.49 (1.75, 6.97)], an air conditioner in home [2.33 (1.18, 4.24)], and increasing age [0.99 (0.33, 2.95), 4.26 (1.74, 10.41), 6.08 (2.58, 14.33)]. An interaction exposure to environmental tobacco smoke in the house*body mass index showed that exposure to household smoke increased the risk of CB for overweight and obese participants (borderline). Some of the variables of interest were not significantly associated with the prevalence of CB in multivariable analysis, possibly due to small numbers. Our results suggest that significant determinants of CB were: increasing age; odour or musty smell of mildew/mould in the house; allergy to house dust; and, body mass index. Modifiable risk factors identified were: (i) community level

  6. Alcohol service provision for older people in an area experiencing high alcohol use and health inequalities.

    Science.gov (United States)

    McCabe, Karen E; Ling, Jonathan; Wilson, Graeme B; Crosland, Ann; Kaner, Eileen F S; Haighton, Catherine A

    2016-03-01

    UK society is ageing. Older people who drink alcohol, drink more than those from previous generations, drink more frequently than other age groups and are more likely to drink at home and alone. Alcohol problems in later life however are often under-detected and under-reported meaning older people experiencing alcohol problems have high levels of unmet need. This study sought to identify existing services within South of Tyne, North East England to capture the extent of service provision for older drinkers and identify any gaps. The Age UK definition of 'older people' (aged 50 and over) was used. Services were contacted by telephone, managers or their deputy took part in semi-structured interviews. Forty six service providers were identified. Only one provided a specific intervention for older drinkers. Others typically provided services for age 18+. Among providers, there was no definitive definition of an older person. Data collection procedures within many organisations did not enable them to confirm whether older people were accessing services. Where alcohol was used alongside other drugs, alcohol use could remain unrecorded. To enable alcohol services to meet the needs of older people, greater understanding is needed of the patterns of drinking in later life, the experiences of older people, the scale and scope of the issue and guidance as to the most appropriate action to take. An awareness of the issues related to alcohol use in later life also needs to be integrated into commissioning of other services that impact upon older people. © Royal Society for Public Health 2015.

  7. Impact of a high intensity training program on glucose tolerance in people with multiple sclerosis

    OpenAIRE

    Patyn, Cédric

    2014-01-01

    Abstract Background: Recent research reported a higher prevalence of impaired glucose tolerance (IGT) in MS patients than in healthy people. The influence of high intensity exercise on IGT in MS was never investigated before. Objective: To investigate the effect of high intensity aerobic interval (HIIT) or continuous endurance (CT) training, both in combination with resistance training, on glucose tolerance muscle strength and body composition. Methods: 34 subjects were randomly as...

  8. Increasing fluid intake and reducing dehydration risk in older people living in long-term care: a systematic review.

    Science.gov (United States)

    Bunn, Diane; Jimoh, Florence; Wilsher, Stephanie Howard; Hooper, Lee

    2015-02-01

    To assess the efficacy of interventions and environmental factors on increasing fluid intake or reducing dehydration risk in older people living in long-term care facilities. Systematic review of intervention and observational studies. Thirteen electronic databases were searched from inception until September 2013 in all languages. References of included papers and reviews were checked. Intervention and observational studies investigating modifiable factors to increase fluid intake and/or reduce dehydration risk in older people (≥65 years) living in long-term care facilities who could drink orally. Two reviewers independently screened, selected, abstracted data, and assessed risk of bias from included studies; narrative synthesis was performed. A total of 4328 titles and abstracts were identified, 325 full-text articles were obtained and 23 were included in the review. Nineteen intervention and 4 observational studies from 7 countries investigated factors at the resident, institutional, or policy level. Overall, the studies were at high risk of bias due to selection and attrition bias and lack of valid outcome measures of fluid intake and dehydration assessment. Reported findings from 6 of the 9 intervention studies investigating the effect of multicomponent strategies on fluid intake or dehydration described a positive effect. Components included greater choice and availability of beverages, increased staff awareness, and increased staff assistance with drinking and toileting. Implementation of the US Resident Assessment Instrument reduced dehydration prevalence from 3% to 1%, P = .01. Two smaller studies reported positive effects: one on fluid intake in 9 men with Alzheimer disease using high-contrast red cups, the other involved supplementing 13 mildly dehydrated residents with oral hydration solution over 5 days to reduce dehydration. Modifications to the dining environment, advice to residents, presentation of beverages, and mode of delivery (straw vs beaker

  9. [Cognitive deficits in first episode psychosis patients and people at risk for psychosis: from diagnosis to treatment].

    Science.gov (United States)

    Lecardeur, L; Meunier-Cussac, S; Dollfus, S

    2013-05-01

    Up to now, studies have not demonstrated significant efficacy of antipsychotics on cognitive impairments in patients with psychotic disorders. These cognitive deficits are of particular interest since they traditionally start early before the diagnosis of psychosis. They are observed during premorbid and prodromal stages, and during the first episode of psychosis. Moreover, cognitive impairments may be detected without any psychotic symptoms (such as positive symptoms) suggesting their development independently of the psychotic symptoms. Cognitive disturbances consist of impairments of episodic and working memories, intellectual functioning, executive functions (planning, inhibition, and cognitive flexibility), selective and sustained attentions and social cognition (emotion, recognition, theory of mind). The altered cognitive functions observed in schizophrenia are the same as in earlier stages but at a lower level of severity. Data suggest that cognitive deficits can be considered as vulnerability markers of psychosis since they have been described in healthy relatives of psychotic patients with high genetic risk. Cognitive deficits might also be considered as predictive of the occurrence of the disease after the first episode of psychosis. Indeed, retrospective studies suggest cognitive impairments in patients with schizophrenia during premorbid and prodromal phases but not in bipolar patients. Cognitive assessment might be of particular interest in people at risk for psychosis, in order to differentiate diagnostic outcomes. Cognitive functioning impairs until the diagnosis of first episode psychosis, even though cognitive profiles are quite heterogeneous in these patients. Once the diagnosis of schizophrenia is considered, cognitive deficits may be stable, although the literature is still controversial. Several factors such as symptoms and gender can contribute in diversifying the cognitive profiles. Moreover, age of onset might worsen the prognosis because of

  10. Risk factors for hepatitis C seropositivity among young people who inject drugs in New York City: Implications for prevention.

    Directory of Open Access Journals (Sweden)

    Benjamin Eckhardt

    Full Text Available Hepatitis C virus (HCV infection remains a significant problem in the United States, with people who inject drugs (PWID disproportionately afflicted. Over the last decade rates of heroin use have more than doubled, with young persons (18-25 years demonstrating the largest increase.We conducted a cross-sectional study in New York City from 2005 to 2012 among young people who injected illicit drugs, and were age 18 to 35 or had injected drugs for ≤5 years, to examine potentially modifiable factors associated with HCV among young adults who began injecting during the era of syringe services.Among 714 participants, the median age was 24 years; the median duration of drug injection was 5 years; 31% were women; 75% identified as white; 69% reported being homeless; and 48% [95% CI 44-52] had HCV antibodies. Factors associated with HCV included older age (adjusted odds ratio [AOR], 1.99 [1.52-2.63]; p<0.001, longer duration of injection drug use (AOR, 1.68 [1.39-2.02]; p<0.001,more frequent injection (AOR, 1.26 [1.09-1.45]; p = 0.001, using a used syringe with more individuals (AOR, 1.26 [1.10-1.46]; p = 0.001, less confidence in remaining uninfected (AOR, 1.32 [1.07-1.63]; p<0.001, injecting primarily in public or outdoors spaces (AOR, 1.90 [1.33-2.72]; p<0.001, and arrest for carrying syringes (AOR, 3.17 [1.95-5.17]; p<0.001.Despite the availability of harm reduction services, the seroprevalence of HCV in young PWID in New York City remained high and constant during 2005-2012. Age and several injection behaviors conferred independent risk. Individuals were somewhat aware of their own risk. Public and outdoor injection and arrest for possession of a syringe are risk factors for HCV that can be modified through structural interventions.

  11. Prevalence and Risk Factors of High Risk Human Papillomavirus ...

    African Journals Online (AJOL)

    Cervical cancer is the most common female cancer in northern Nigeria, yet the pattern of infection with human papillomavirus, the principal aetiologic agent is unknown. This was a preliminary study conducted in two referral hospitals in order to establish base-line data on the prevalence and risk factors for the infection in ...

  12. High-Risk Sexual Behavior at Social Venues in Madagascar

    Science.gov (United States)

    KHAN, MARIA R.; RASOLOFOMANANA, JUSTIN R.; McCLAMROCH, KRISTI J.; RALISIMALALA, ANDRIAMAMPIANINA; ZAFIMANJAKA, MAURICE G.; BEHETS, FRIEDA; WEIR, SHARON S.

    2018-01-01

    Background Persistent high levels of sexually transmitted infection (STI) in Madagascar indicate current prevention strategies are inadequate. STI/HIV prevention based in social venues may play an important role in reaching individuals at risk of infection. We identified venues where people meet sexual partners and measured the need and potential for venue-based prevention. Methods Interviews were conducted in 7 Madagascar towns with 1) community informants to identify social venues, 2) individuals socializing at a sample of venues to assess sexual behavior among venue patrons, and 3) venue representatives to assess the potential for venue-based intervention. Results Community informants identified numerous venues (range: 67–211 venues, depending on the town); streets, bars, and hotels were most commonly reported. Among 2982 individuals socializing at venues, 78% of men and 74% of women reported new sexual partnership or sex trade for money, goods, or services in the past 4 weeks and 19% of men and 18% of women reported symptoms suggestive of STI in the past 4 weeks. STI symptom levels were disproportionately high among respondents reporting either sex trade or new sexual partnership in the past 4 weeks. Twenty-eight percent of men and 41% of women reported condom use during the last sex act with a new partner. Although 24% to 45% of venues had hosted STI/HIV interventions, interventions were deemed possible at 73% to 90% venues according to 644 interviews with venue representatives. Conclusions Venue-based intervention is possible and would reach a spectrum of populations vulnerable to STI/HIV including sex workers, their clients, and other high-risk populations. PMID:18496471

  13. More than 30 years of opinion of French people on nuclear risks - Special release of the 2012 IRSN opinion survey

    International Nuclear Information System (INIS)

    El Jammal, Marie-Helene; Rollinger, Francois; Mur, Emmanuelle; Schuler, Matthieu; Tchernia, Jean-Francois

    2013-01-01

    Illustrated by many graphs and tables, this report comments and discusses the evolution of opinion surveys performed in France on the perception of nuclear risks through thirty annual IRSN opinion surveys. It appears that the opinion on nuclear is rather steady, and that French people have a rather rational perception of risk hierarchy. The first part outlines that unemployment is the main concern for French people, and that environmental concerns depend on current events. The second part analyses the perception of the nuclear risk with respect to other societal concerns and to other risks, and discusses the evolution of opinion from a quantitative to a qualitative sensitivity. The third part addresses the representations people have of nuclear activities and how they challenge the reality: perception of nuclear plants and of radioactive wastes, fear of a serious accident. The last part deals with issues related to responsibilities, abilities and governance: how actors of nuclear risk management are perceived, and expectations in terms of transparency and opinion plurality

  14. Neuropsychological, balance, and mobility risk factors for falls in people with multiple sclerosis: a prospective cohort study.

    Science.gov (United States)

    Hoang, Phu D; Cameron, Michelle H; Gandevia, Simon C; Lord, Stephen R

    2014-03-01

    To determine whether impaired performance in a range of vision, proprioception, neuropsychological, balance, and mobility tests and pain and fatigue are associated with falls in people with multiple sclerosis (PwMS). Prospective cohort study with 6-month follow-up. A multiple sclerosis (MS) physiotherapy clinic. Community-dwelling people (N=210; age range, 21-74y) with MS (Disease Steps 0-5). Not applicable. Incidence of falls during 6 months' follow-up. In the 6-month follow-up period, 83 participants (39.7%) experienced no falls, 57 (27.3%) fell once or twice, and 69 (33.0%) fell 3 or more times. Frequent falling (≥3) was associated with increased postural sway (eyes open and closed), poor leaning balance (as assessed with the coordinated stability task), slow choice stepping reaction time, reduced walking speed, reduced executive functioning (as assessed with the difference between Trail Making Test Part B and Trail Making Test Part A), reduced fine motor control (performance on the 9-Hole Peg Test [9-HPT]), and reported leg pain. Increased sway with the eyes closed, poor coordinated stability, and reduced performance in the 9-HPT were identified as variables that significantly and independently discriminated between frequent fallers and nonfrequent fallers (model χ(2)3=30.1, Pbalance, coordination, and cognitive determinants of falls in PwMS. These should assist the development of effective strategies for prevention of falls in this high-risk group. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Alcohol use disorders among people living with HIV/AIDS in Southern Brazil: prevalence, risk factors and biological markers outcomes.

    Science.gov (United States)

    da Silva, Cláudio Moss; Mendoza-Sassi, Raúl Andrés; da Mota, Luisa Dias; Nader, Maíba Mikhael; de Martinez, Ana Maria Barral

    2017-04-11

    Alcohol abuse is an important public health problem, frequently unrecognized among people living with HIV/AIDS (PLWHA), and requires investigation and intervention. It is usually associated with lower adherence to highly active antiretroviral therapy (HAART). It can also produce adverse clinical outcomes, such as changes in certain HIV markers, particularly CD4 cell counts and HIV viral loads (VLs). Thus, this study aimed to evaluate the prevalence of alcohol abuse among PLWHA, its associated risk factors and effects on CD4 cell counts and HIV VLs in southern Brazil. Between December 2012 and July 2013, 343 patients were interviewed at a reference hospital in southern Brazil. The instrument used was the Alcohol Use Disorder Identification Test (AUDIT), and a cutoff of eight points or more was applied. Socioeconomic, demographic, clinical and laboratory data were also collected. The statistical analysis included a Poisson regression to evaluate the factors associated with alcohol use disorder, and a linear regression was performed to assess the relationship between AUDIT scores and CD4 cell counts and HIV VLs. Alcohol abuse was present in 28.6% of the respondents, and possible dependence was present in 5%. The risk factors identified included being male, mixed or black skin color, low education and the use of intravenous or inhaled drugs. A higher AUDIT score was associated with a lower CD4 cell count but was not associated with higher HIV VL values. Our results show the importance of screening for alcohol abuse in this group. The prevalence of alcohol abuse was high, and it was associated with socioeconomic factors and the use of illicit drugs. Moreover, AUDIT score negatively affected CD4 cell counts as well.

  16. Cardiometabolic risk factors in people with psychotic disorders: the second Australian national survey of psychosis.

    Science.gov (United States)

    Galletly, Cherrie A; Foley, Debra L; Waterreus, Anna; Watts, Gerald F; Castle, David J; McGrath, John J; Mackinnon, Andrew; Morgan, Vera A

    2012-08-01

    To determine the prevalence of cardiometabolic risk factors in Australian adults with a psychotic disorder. Data were collected during the interview phase of the second Australian survey of psychosis, a population-based survey of Australians aged 18 to 64 years with a psychotic disorder. Body mass index, waist circumference and blood pressure were measured. Participants were asked about diagnoses of relevant medical conditions, medications, smoking and physical activity. Fasting blood samples were analysed for glucose, high-density lipoprotein cholesterol, total cholesterol and triglycerides. The prevalence of metabolic syndrome was determined using the harmonized criteria developed by the International Diabetes Federation and other bodies. A total of 1087 men (60%) and 738 women (40%) participated. Their mean age was 38.36 (SD 11.16) years; 773 (42%) were aged 18-34 years and 1052 (58%) 35-64 years. Three-quarters were overweight or obese and 82% had abdominal obesity. Almost half were hypertensive. Two-thirds were current smokers and 81% had a lifetime history of smoking. Levels of physical activity were very low. About 30% reported a diagnosis of hypertension or high cholesterol, 20% knew they had diabetes or high blood sugar and 18% had cardiovascular disease. Half of those with self-reported hypertension were taking antihypertensive drugs, and about 40% with hypercholesterolemia or hyperglycaemia were receiving medication for these conditions. Seventy per cent (N = 1286) of participants provided fasting blood samples. Abnormal levels of high-density lipoprotein cholesterol and triglycerides were each found in almost half of participants and almost one-third had elevated fasting glucose. More than half of participants (54.8%) met criteria for metabolic syndrome. Australians living with psychosis have high rates of cardiometabolic risk factors. There are a number of obvious targets for prevention and treatment, including obesity (especially in women), smoking

  17. Traffic risk behaviors at nightlife: drinking, taking drugs, driving, and use of public transport by young people.

    Science.gov (United States)

    Calafat, A; Blay, N; Juan, M; Adrover, D; Bellis, M A; Hughes, K; Stocco, P; Siamou, I; Mendes, F; Bohrn, K

    2009-04-01

    Road traffic crashes associated with nightlife alcohol and recreational drug use are a major health problem for young people. This study explores use of different forms of transport to and from nightlife environments and the relationships between traffic risk behaviors, drunkenness, and drug consumption. 1363 regular nightlife users from nine European cities in 2006 completed a self-administered and anonymous questionnaire. Sampling utilized a variation of respondent-driven sampling. Private car was the most frequent form of transport used when going out, especially by males and older individuals. Drug use was related to crashes and traffic risk behaviors, including having a lift from someone drunk or driving drunk or driving having taken drugs; drunkenness was related to risk behaviors but not to crashes (possibly because drunk people tend to use the private car less). Males showed higher levels of drunkenness and drug consumption, traffic risk behaviors, and traffic crashes. Age is not related to the traffic risk behaviors, but older individuals had less crashes. There are serious health problems related to transport and recreational nightlife activities. It is necessary to improve later public transport services, complemented by actions that deter the use of private cars. The relationships of both drunkenness and cannabis/cocaine use with traffic risk behaviors should be addressed and programs implemented to change risk perceptions on the effects of illegal drugs on driving.

  18. Comparative performance of diabetes-specific and general population-based cardiovascular risk assessment models in people with diabetes mellitus.

    Science.gov (United States)

    Echouffo-Tcheugui, J-B; Kengne, A P

    2013-10-01

    Multivariable models for estimating cardiovascular disease (CVD) risk in people with diabetes comprise general population-based models and those from diabetic cohorts. Whether one set of models should receive preference is unclear. We evaluated the evidence on direct comparisons of the performance of general population vs diabetes-specific CVD risk models in people with diabetes. MEDLINE and EMBASE databases were searched up to March 2013. Two reviewers independently identified studies that compared the performance of general CVD models vs diabetes-specific ones in the same group of people with diabetes. Independent, dual data extraction on study design, risk models, outcomes; and measures of performance was conducted. Eleven articles reporting on 22 pair wise comparisons of a diabetes-specific model (UKPDS, ADVANCE and DCS risk models) to a general population model (three variants of the Framingham model, Prospective Cardiovascular Münster [PROCAM] score, CardioRisk Manager [CRM], Joint British Societies Coronary Risk Chart [JBSRC], Progetto Cuore algorithm and the CHD-Riskard algorithm) were eligible. Absolute differences in C-statistic of diabetes-specific vs general population-based models varied from -0.13 to 0.09. Comparisons for other performance measures were unusual. Outcomes definitions were congruent with those applied during model development. In 14 comparisons, the UKPDS, ADVANCE or DCS diabetes-specific models were superior to the general population CVD risk models. Authors reported better C-statistic for models they developed. The limited existing evidence suggests a possible discriminatory advantage of diabetes-specific over general population-based models for CVD risk stratification in diabetes. More robust head-to-head comparisons are needed to confirm this trend and strengthen recommendations. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  19. Group Music Therapy as a Preventive Intervention for Young People at Risk: Cluster-Randomized Trial.

    Science.gov (United States)

    Gold, Christian; Saarikallio, Suvi; Crooke, Alexander Hew Dale; McFerran, Katrina Skewes

    2017-07-01

    Music forms an important part of the lives and identities of adolescents and may have positive or negative mental health implications. Music therapy can be effective for mental disorders such as depression, but its preventive potential is unknown. The aim of this study was to examine whether group music therapy (GMT) is an effective intervention for young people who may be at risk of developing mental health problems, as indicated via unhealthy music use. The main question was whether GMT can reduce unhealthy uses of music and increase potentials for healthy uses of music, compared to self-directed music listening (SDML). We were also interested in effects of GMT on depressive symptoms, psychosocial well-being, rumination, and reflection. In an exploratory cluster-randomized trial in Australian schools, 100 students with self-reported unhealthy music use were invited to GMT (weekly sessions over 8 weeks) or SDML. Changes in the Healthy-Unhealthy Music Scale (HUMS) and mental health outcomes were measured over 3 months. Both interventions were well accepted. No effects were found between GMT and SDML (all p > 0.05); both groups tended to show small improvements over time. Younger participants benefited more from GMT, and older ones more from SDML (p = 0.018). GMT was associated with similar changes as SDML. Further research is needed to improve the processes of selecting participants for targeted interventions; to determine optimal dosage; and to provide more reliable evidence of effects of music-based interventions for adolescents. © the American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  20. Communicating Science to Officials and People at Risk During a Slow-Motion Lava Flow Crisis

    Science.gov (United States)

    Neal, C. A.; Babb, J.; Brantley, S.; Kauahikaua, J. P.

    2015-12-01

    From June 2014 through March 2015, Kīlauea Volcano's Púu ´Ō´ō vent on the East Rift Zone produced a tube-fed pāhoehoe lava flow -the "June 27th flow" - that extended 20 km downslope. Within 2 months of onset, flow trajectory towards populated areas in the Puna District caused much concern. The USGS Hawaiian Volcano Observatory (HVO) issued a news release of increased hazard on August 22 and began participating in public meetings organized by Hawai`i County Mayor and Civil Defense two days later. On September 4, HVO upgraded the volcano alert level to WARNING based on an increased potential for lava to reach homes and infrastructure. Ultimately, direct impacts were modest: lava destroyed one unoccupied home and one utility pole, crossed a rural roadway, and partially inundated a waste transfer station, a cemetery, and agricultural land. Anticipation that lava could reach Pāhoa Village and cross the only major access highway, however, caused significant disruption. HVO scientists employed numerous methods to communicate science and hazard information to officials and the at-risk public: daily (or more frequent) written updates of the lava activity, flow front locations and advance rates; frequent updates of web-hosted maps and images; use of the 'lines of steepest descent' method to indicate likely lava flow paths; consistent participation in well-attended community meetings; bi-weekly briefings to County, State, and Federal officials; correspondence with the public via email and recorded phone messages; participation in press conferences and congressional briefings; and weekly newspaper articles (Volcano Watch). Communication lessons both learned and reinforced include: (1) direct, frequent interaction between scientists and officials and at-risk public builds critical trust and understanding; (2) images, maps, and presentations must be tailored to audience needs; (3) many people are unfamiliar with maps (oblique aerial photographs were more effective); (4

  1. Decision, risk and uncertainty. Withdrawal or reunification of children and young people in danger?

    Directory of Open Access Journals (Sweden)

    Paulo Delgado Ferreira

    2016-06-01

    Full Text Available This study aims to better understand what influences and determines decisions in contexts characterized by complexity and uncertainty, and contributes to the development of recommendations for practice. Based on the work of Davidson-Arad and Benbenishty (2008, 2010, we intended to understand how students from higher education, in scientific areas related to professions involved in decision making processes of children and young people at risk individual care plan, would decide in the presence of a specific case with different scenarios. Participated in the study 200 university students from different regions of Portugal. We used a factorial design (2×2 that involved a questionnaire vignette with four versions. The questionnaire describes the case of a child suspected of being a victim of violence and requires the students to make a decision about the kind of intervention that should be applied in that moment. In addition they must also decide, if the child was removed from her home, whether or not the child should be reunited with the biological family after two years. Among the key findings we highlight the fact that students recognized the risk posed to the child as suffering significant physical and emotional harm. Nevertheless, most decided in favour of an intervention with the biological family, avoiding the removal of the child from their life context. However, in the case of a decision favouring foster care, the majority of the students considered that the child should remain with the foster family when they were asked to reassess the case after two years. It is noted, with statistical significance, that the decision was influenced at first by the agreement or not of the mother to withdrawal and secondly by the child’s desire to be reunited or not with the birth family. We concluded that the development of professional evaluation criteria and decision making should be addressed by including in the curriculum of higher education

  2. [Targeting high-risk drugs to optimize clinical pharmacists' intervention].

    Science.gov (United States)

    Mouterde, Anne-Laure; Bourdelin, Magali; Maison, Ophélie; Coursier, Sandra; Bontemps, Hervé

    2016-12-01

    By the Order of 6 April 2011, the pharmacist must validate all the prescriptions containing "high-risk drugs" or those of "patients at risk". To optimize this clinical pharmacy activity, we identified high-risk drugs. A list of high-risk drugs has been established using literature, pharmacists' interventions (PI) performed in our hospital and a survey sent to hospital pharmacists. In a prospective study (analysis of 100 prescriptions for each high-risk drug selected), we have identified the most relevant to target. We obtained a statistically significant PI rate (P<0.05) for digoxin, oral anticoagulants direct, oral methotrexate and colchicine. This method of targeted pharmaceutical validation based on high-risk drugs is relevant to detect patients with high risk of medicine-related illness. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  3. Risk communication system for high level radioactive waste disposal

    International Nuclear Information System (INIS)

    Kugo, Akihide; Uda, Akinobu; Shimoda, Hirosi; Yoshikawa, Hidekazu; Ito, Kyoko; Wakabayashi, Yasunaga

    2005-01-01

    In order to gain a better understanding and acceptance of the task of implementing high level radioactive waste disposal, a study on new communication system about social risk information has been initiated by noticing the rapid expansion of Internet in the society. First, text mining method was introduced to identify the core public interest, examining public comments on the technical report of high level radioactive waste disposal. Then we designed the dialog-mode contents based on the theory of norm activation by Schwartz. Finally, the discussion board was mounted on the web site. By constructing such web communication system which includes knowledge base contents, introspective contents, and interactive discussion board, we conducted the experiment for verifying the principles such as that the basic technical knowledge and trust, and social ethics are indispensable in this process to close the perception gap between nuclear specialists and the general public. The participants of the experiment increased their interest in the topics with which they were not familiar and actively posted their opinions on the BBS. The dialog-mode contents were significantly more effective than the knowledge-based contents in promoting introspection that brought people into a greater awareness of problems such as social dilemma. (author)

  4. Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis.

    Science.gov (United States)

    Vancampfort, Davy; Stubbs, Brendon; Mitchell, Alex J; De Hert, Marc; Wampers, Martien; Ward, Philip B; Rosenbaum, Simon; Correll, Christoph U

    2015-10-01

    Metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. The primary aim of this systematic review and meta-analysis was to assess the prevalence of MetS and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder, comparing subjects with different disorders and taking into account demographic variables and psychotropic medication use. The secondary aim was to compare the MetS prevalence in persons with any of the selected disorders versus matched general population controls. The pooled MetS prevalence in people with severe mental illness was 32.6% (95% CI: 30.8%-34.4%; N = 198; n = 52,678). Relative risk meta-analyses established that there was no significant difference in MetS prevalence in studies directly comparing schizophrenia versus bipolar disorder, and in those directly comparing bipolar disorder versus major depressive disorder. Only two studies directly compared people with schizophrenia and major depressive disorder, precluding meta-analytic calculations. Older age and a higher body mass index were significant moderators in the final demographic regression model (z = -3.6, p = 0.0003, r(2)  = 0.19). People treated with all individual antipsychotic medications had a significantly (ppeople with severe mental illness had a significantly increased risk for MetS (RR = 1.58; 95% CI: 1.35-1.86; p<0.001) and all its components, except for hypertension (p = 0.07). These data suggest that the risk for MetS is similarly elevated in the diagnostic subgroups of severe mental illness. Routine screening and multidisciplinary management of medical and behavioral conditions is needed in these patients. Risks of individual antipsychotics should be considered when making treatment choices. © 2015 World Psychiatric Association.

  5. Risk of suicide according to the level of psychiatric contact in the older people: Analysis of national health insurance databases in Taiwan.

    Science.gov (United States)

    Yeh, Shin-Ting; Ng, Yee-Yung; Wu, Shiao-Chi

    2017-04-01

    Suicide in the older people is a serious problem worldwide; however the effect of psychiatric contact on the risk of suicide has not been fully explored. The aim of this study was to investigate the relationship between psychiatric contact and suicide in the older people in Taiwan. A population-based database was used in this national case-control study. Propensity score matching was used to match older people who did and did not commit suicide from 2010 to 2012 by calendar year, gender, age, and area of residence. The level of psychiatric contact in the preceding year was classified as "no psychiatric contact," "only outpatient psychiatric contact," "psychiatric emergency room contact," or "psychiatric hospital admission". Conditional logistic regression analysis was used to assess associations between variables and the risk of suicide. A total of 2528 older people committed suicide from 2010 to 2012, with a crude suicide mortality rate of 3.37/10,000. Compared to those who had no psychiatric contact in the preceding year, the adjusted odds ratios of suicide were 10.15 (95% CI=5.8-17.7) for those who had psychiatric emergency room contact, 6.57 (95% CI=3.7-11.6) for those who had psychiatric hospital admissions, and 3.64 (95% CI=3.0-4.4) for those with only outpatient psychiatric contact. The risk of suicide was higher in those who had depression (OR=3.49, 95% CI=2.2-5.4) and bipolar disorder (OR=1.98, 95% CI=1.1-3.6). Patients with cancer were associated with suicide (OR=8.96, 95% CI=5.6-14.4). The positive association with suicide and the level of psychiatric contact in the preceding year in older people indicated that the health personnel need to do a better job in determining possible risk for older people who had psychiatric contact, especially in emergency visit or psychiatric admission. A systematic approach to quality improvement in these settings is both available and necessary. Careful discharge planning and safe transitions of care to outpatient

  6. Forgotten people: poverty, risk and social security in Indonesia: the case of the Madurese

    NARCIS (Netherlands)

    Nooteboom, G.

    2015-01-01

    Forgotten People deals with people living at the fringes of the Indonesian society. It describes and analyses their livelihoods and styles of making a living from an insider perspective. While Indonesia has experienced steady economic growth for more than a decade, the livelihoods and lifestyles of

  7. Perceptions of the Risks and Benefits of Internet Access and Use by People with Intellectual Disabilities

    Science.gov (United States)

    Chadwick, Darren D.; Quinn, Sally; Fullwood, Chris

    2017-01-01

    Background: Information and communication technologies, with the Internet at the forefront, have the potential to enhance the knowledge, service, employment, development and social interactional opportunities available to people with intellectual disabilities. Despite this, people with intellectual disabilities are not accessing the Internet to…

  8. Risk Factors of Active Tuberculosis in People Living with HIV/AIDS ...

    African Journals Online (AJOL)

    BACKGROUND: Determinants of active tuberculosis among People Living with HIV/AIDS (PLHA) are not well elucidated in countries with limited resources. The objective of this study was to assess distal and proximate determinants of active tuberculosis among people living with HIV/AIDS in southwest. Ethiopia.

  9. "I Don't Want to Live like This Anymore": Disrupted Habitus in Young People "At Risk" of Diagnosis of Personality Disorder

    Science.gov (United States)

    Gilbert, Tony; Farrand, Paul; Lankshear, Gloria

    2013-01-01

    This article reports on interview data gathered from 27 young people involved with a street-level service for young people considered "at risk" of diagnosis of personality disorder. Interviews with a self-selecting sample of young people explored the events that led to their initial contact with the service. Using Silverman's twin-track…

  10. Higher Risk of Abdominal Obesity, Elevated LDL Cholesterol and Hypertriglyceridemia, but not of Hypertension, in People Living with HIV

    DEFF Research Database (Denmark)

    Gelpi, Marco; Afzal, Shoaib; Lundgren, Jens

    2018-01-01

    Background: People living with HIV (PLWH) have lower life expectancy than uninfected individuals, partly explained by excess risk of cardiovascular diseases (CVD) and CVD risk factors. We investigated the association between HIV infection and abdominal obesity, elevated LDL cholesterol (LDL...... and underwent blood pressure, waist-, hip-, weight-, and height-measurements. Non-fasting blood samples were obtained from all participants. We assessed whether HIV was independently associated with abdominal obesity, elevated LDL-C, hypertriglyceridemia and hypertension using logistic regression models...... adjusted for known risk factors. Results: HIV infection was associated with higher risk of abdominal obesity (adjusted odds ratio (aOR): 1.92[1.60-2.30]) for a given BMI, elevated LDL-C (aOR: 1.32[1.09-1.59]), hypertriglyceridemia (aOR 1.76[1.49-2.08]), and lower risk of hypertension (aOR: 0.63[0.54 - 0...

  11. Local level epidemiological analysis of TB in people from a high incidence country of birth

    OpenAIRE

    Massey Peter D; Durrheim David N; Stephens Nicola; Christensen Amanda

    2013-01-01

    Abstract Background The setting for this analysis is the low tuberculosis (TB) incidence state of New South Wales (NSW), Australia. Local level analysis of TB epidemiology in people from high incidence countries-of-birth (HIC) in a low incidence setting has not been conducted in Australia and has not been widely reported. Local level analysis could inform measures such as active case finding and targeted earlier diagnosis. The aim of this study was to use a novel approach to identify local ar...

  12. Central executive network in young people with familial risk for psychosis--the Oulu Brain and Mind Study.

    Science.gov (United States)

    Jukuri, Tuomas; Kiviniemi, Vesa; Nikkinen, Juha; Miettunen, Jouko; Mäki, Pirjo; Mukkala, Sari; Koivukangas, Jenni; Nordström, Tanja; Parkkisenniemi, Juha; Moilanen, Irma; Barnett, Jennifer H; Jones, Peter B; Murray, Graham K; Veijola, Juha

    2015-02-01

    The central executive network controls and manages high-level cognitive functions. Abnormal activation in the central executive network has been related to psychosis and schizophrenia but it is not established how this applies to people with familial risk for psychosis (FR). We conducted a resting-state functional MRI (R-fMRI) in 72 (29 males) young adults with a history of psychosis in one or both parents (FR) but without psychosis themselves, and 72 (29 males) similarly healthy control subjects without parental psychosis. Both groups in the Oulu Brain and Mind Study were drawn from the Northern Finland Birth Cohort 1986. Participants were 20-25years old. Parental psychosis was established using the Care Register for Health Care. R-fMRI data pre-processing was conducted using independent component analysis with 30 and 70 components. A dual regression technique was used to detect between-group differences in the central executive network with pcontrol subjects in the right inferior frontal gyrus, a key area of central executive network corresponding to Brodmann areas 44 and 45, known as Broca's area. The volume of the lower activation area with 30 components was 896mm(3) and with 70 components was 1151mm(3). The activity of the central executive network differed in the right inferior frontal gyrus between FR and control groups. This suggests that abnormality of the right inferior frontal gyrus may be a central part of vulnerability for psychosis. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Effects of Combined exergame and conventional exercise to reduce and prevent fall risk among elderly people: A Hypothesis

    Directory of Open Access Journals (Sweden)

    Hassan Sadeghi

    2017-10-01

    Full Text Available Background: Falling among old individuals has provoked ceaseless discussion among gerontologists and physical therapists and it is still one of the greatest issues among this population. Loss of the balance and functional mobility is the main reason of falling. There have been numerous studies conducting the effect of the conventional balance exercise and exergame independently on balance and functional mobility of elderly. Previous studies lacked dealing with the effect of combined exergame and conventional exercise on the balance and functional mobility. Combined exercises are enjoyable and may have more effective to improve balance and performance to reduce risk of fall among elderly people. This package would be preferable for older people. Objective: We hypothesize that while conventional balance exercise and exergame improve balance and functional mobility, combined both types of exercise would superior improvements in elderly performance. Conclusion: Ultimately we expect that this hypothesis will provide a useful framework for facilitating combined exergame and conventional balance intervention in older people.

  14. Feasibility of ecological momentary assessment to study mood and risk behavior among young people who inject drugs.

    Science.gov (United States)

    Mackesy-Amiti, Mary E; Boodram, Basmattee

    2018-04-16

    To test the acceptability and feasibility of ecological momentary assessment (EMA) of mood and injection risk behavior among young people who inject drugs (PWID), using mobile phones. Participants were 185 PWID age 18-35 recruited from two sites of a large syringe service program in Chicago. After completing a baseline interview, participants used a mobile phone app to respond to momentary surveys on mood, substance use, and injection risk behavior for 15 days. Participants were assigned to receive surveys 4, 5, or 6 times per day. Participants were 68% male, 61% non-Hispanic white, 24% Hispanic, and 5% non-Hispanic Black. Out of 185 participants, 8% (n = 15) failed to complete any EMA assessments. Among 170 EMA responders, the mean number of days reporting was 10 (SD 4.7), the mean proportion of assessments completed was 0.43 (SD 0.27), and 76% (n = 130) completed the follow-up interview. In analyses adjusted for age and race/ethnicity, women were more responsive than men to the EMA surveys in days reporting (IRR = 1.33, 95% CI 1.13-1.56), and total number of surveys completed (IRR = 1.51, 95% CI 1.18-1.93). Homeless participants responded on fewer days (IRR = 0.76, 95% CI 0.64-0.90) and completed fewer surveys (IRR = 0.70, 95% CI 0.54-0.91), and were less likely to return for follow-up (p = 0.016). EMA responsiveness was not significantly affected by the number of assigned daily assessments. This study demonstrated high acceptability and feasibility of EMA among young PWID, with up to 6 survey prompts per day. However, homelessness significantly hampered successful participation. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Web-based system for assessing risk factors for falls in community-dwelling elderly people using the Analytic Hierarchy Process

    OpenAIRE

    Pecchia, Leandro; Bath, Peter A.; Pendleton, Neil; Bracale, Marcello

    2010-01-01

    Falls occur frequently among older people and represent the most common cause of injury-related morbidity and mortality in later life. Preventing falls is an important way to reduce injuries, hospitalizations, and injury-related morbidity and mortality among older people. The research literature has identified hundreds of risk factors for falls among elderly people. Prioritizing risk factors for falls is useful for designing effective and efficacious prevention programs.\\ud The aim of this st...

  16. An assessment of high risk sexual behaviour and HIV transmission ...

    African Journals Online (AJOL)

    An assessment of high risk sexual behaviour and HIV transmission among migrant oil workers in the Niger Delta area of Nigeria. ... questionnaires to evaluate key highrisk sexual behavioral parameters such as multiplicity of sexual partners, bisexuality (closet homosexuality), high grade sexual behaviour and lesbianism.

  17. Reckless lending: how Canada's Export Development Corporation puts people and environment at risk

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-03-01

    This report documents the negative impacts of several projects financed by Canada's Export Development Corporation (EDC), how these investments put people and the environment at risk, and highlights the need for ensuring that EDC, an agency of the Canadian Government, is compelled to uphold public policies and international standards protecting human rights, the environment and the social needs of communities. By way of proving its case, authors of this report describe several international projects --the Three Gorges Dam in China; the Urra Hydro Project in Colombia; the Marcopper Mine in the Philippines; the BioBio Dam in Chile; the Ok Tedi Copper Mine in Papua New Guinea; the Yacyreta Dam in Argentina and Paraguay; and CANDU reactors in Argentina, China, Romania, South Korea and Turkey -- as proof of human rights violations and environmental disasters in which EDC has been an accessory. It is emphasized that unlike the World Bank and the U.S. export credit agencies, EDC is not required to undertake environmental assessment, or to take into account the impact on human rights or communities of project which they help to finance. The authors recommend amendments to the Export Development Act that would require the EDC to disclose information about proposed project at least 60 days before approval by the Board, including description of the project, the terms of financing, along with any environmental, social and human rights information collected. EDC should be required to establish an autonomous accountability mechanism, using the mechanisms of the World Bank Group as a model to track and guide EDC's policy implementation, and to receive and address complaints from external parties affected by EDC-supported activities. EDC should require social, environmental and human rights assessments, using World Bank standards and methodology as the base, and ensure implementation of recommendations by separately specifying them in the contract. EDC should not be

  18. Substance abuse and the risk of readmission of people with schizophrenia at Amanuel Psychiatric Hospital, Ethiopia

    Directory of Open Access Journals (Sweden)

    M.S. Bimerew

    2007-09-01

    Full Text Available Frequent readmissions of people with schizophrenia pose considerable pressure on the psychiatric service provision of Amanuel Psychiatric Hospital. The purpose of the study was to ascertain factors mainly contributing to the rate of readmissions of people with schizophrenia. Descriptive survey methods and qualitative focus group interviews were employed to conduct the study. Random sampling techniques were used to select 43 respondents of people with schizophrenia from 231 people with schizophrenia who were readmitted for two or more times in the last two years and who gained access during the time of the study. Structured interviews were used for respondents of people with schizophrenia. Fourteen (N = 14 family members/caregivers were selected using purposive sampling methods for focus group discussions. Quantitative data was analyzed using the SPSS Version 11.00 program and the qualitative data was analyzed by generating themes and categories. The results suggest that alcohol and that abuse were contributing factors for the rate of readmissions of people with schizophrenia into the Amanuel Psychiatric Hospital. It was found that communities contribute to the problems of substance abuse by providing and/or selling it to those mentally ill people. The study also revealed that patients use alcohol and that in order to tolerate the severe side effects of the anti-psychotic drugs, to suppress hunger due to shortage of food and to avoid drowsiness. Raising community awareness, psycho-education, strengthening the capacities of caretakers and laws to prevent substance abuse, as well as campaigning to prevent people from abusing mentally ill sufferers, should be established.

  19. FRAT-up, a Web-based fall-risk assessment tool for elderly people living in the community.

    Science.gov (United States)

    Cattelani, Luca; Palumbo, Pierpaolo; Palmerini, Luca; Bandinelli, Stefania; Becker, Clemens; Chesani, Federico; Chiari, Lorenzo

    2015-02-18

    About 30% of people over 65 are subject to at least one unintentional fall a year. Fall prevention protocols and interventions can decrease the number of falls. To be effective, a prevention strategy requires a prior step to evaluate the fall risk of the subjects. Despite extensive research, existing assessment tools for fall risk have been insufficient for predicting falls. The goal of this study is to present a novel web-based fall-risk assessment tool (FRAT-up) and to evaluate its accuracy in predicting falls, within a context of community-dwelling persons aged 65 and up. FRAT-up is based on the assumption that a subject's fall risk is given by the contribution of their exposure to each of the known fall-risk factors. Many scientific studies have investigated the relationship between falls and risk factors. The majority of these studies adopted statistical approaches, usually providing quantitative information such as odds ratios. FRAT-up exploits these numerical results to compute how each single factor contributes to the overall fall risk. FRAT-up is based on a formal ontology that enlists a number of known risk factors, together with quantitative findings in terms of odds ratios. From such information, an automatic algorithm generates a rule-based probabilistic logic program, that is, a set of rules for each risk factor. The rule-based program takes the health profile of the subject (in terms of exposure to the risk factors) and computes the fall risk. A Web-based interface allows users to input health profiles and to visualize the risk assessment for the given subject. FRAT-up has been evaluated on the InCHIANTI Study dataset, a representative population-based study of older persons living in the Chianti area (Tuscany, Italy). We compared reported falls with predicted ones and computed performance indicators. The obtained area under curve of the receiver operating characteristic was 0.642 (95% CI 0.614-0.669), while the Brier score was 0.174. The Hosmer

  20. Fall prevention in high-risk patients.

    Science.gov (United States)

    Shuey, Kathleen M; Balch, Christine

    2014-12-01

    In the oncology population, disease process and treatment factors place patients at risk for falls. Fall bundles provide a framework for developing comprehensive fall programs in oncology. Small sample size of interventional studies and focus on ambulatory and geriatric populations limit the applicability of results. Additional research is needed. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Systems reliability in high risk situations

    International Nuclear Information System (INIS)

    Hunns, D.M.

    1974-12-01

    A summary is given of five papers and the discussion of a seminar promoted by the newly-formed National Centre of Systems Reliability. The topics covered include hazard analysis, reliability assessment, and risk assessment in both nuclear and non-nuclear industries. (U.K.)

  2. Adherence to the Mediterranean Diet and the Risk of Frailty in Old People: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Wang, Y; Hao, Q; Su, L; Liu, Y; Liu, S; Dong, B

    2018-01-01

    Frailty is a common geriatric syndrome in old people. It remains controversial whether Mediterranean diet could prevent old people from developing into frailty. The aim of this study is to summarize the relevant studies and assess the effectiveness of adherence to Mediterranean diet on frailty in old people. A systematic search of MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials was conducted to identify all relevant studies up to Oct 2017. We included studies regarding the associations between adherence to Mediterranean diet and risk of frailty among elders. A meta-analysis was performed to explore the effects of Mediterranean diet on frailty. Six studies matched the inclusion criteria, of which five were prospective and one was cross-sectional. A total of 10,210 participants from the five prospective cohort studies were included to perform the meta-analyses. In comparison with lowest adherence to Mediterranean diet, elders with highest adherence to Mediterranean diet were significantly associated with lower risk of frailty in the future (RR= 0.56, 95% CI=0.36-0.89, p=0.015). Furthermore, the pooled estimates from four studies performed among participants in western countries (European and North American) showed that higher adherence to Mediterranean diet was associated with a 52% reduced risk of frailty (RR= 0.48, 95% CI=0.32-0.72, pMediterranean diet and frailty among Asian elders (RR=1.06, 95% CI=0.83-1.36, p=0.638). A higher adherence to Mediterranean diet is associated with a lower risk of frailty in old people. Meanwhile, the benefits may be more obvious among elders from western countries.

  3. A scoping review of prevalence, incidence and risk factors for HIV infection amongst young people in Brazil

    OpenAIRE

    Saffier, I. P.; Kawa, H.; Harling, G.

    2017-01-01

    Background Despite young people being a key population for HIV prevention, the HIV epidemic amongst young Brazilians is perceived to be growing. We therefore reviewed all published literature on HIV prevalence and risk factors for HIV infection amongst 10-25 year olds in Brazil. Methods We searched Embase, LILACS, Proquest, PsycINFO, PubMed, Scopus and Web of Science for studies published up to March 2017 and analyzed reference lists of relevant studies. We included published stud...

  4. Innerselfie: can we use Immersive Virtual Reality to change cancer risk perceptions and promote physical activity in young people?

    Directory of Open Access Journals (Sweden)

    Abi Fisher

    2015-10-01

    Results: Phase I is currently underway and has involved identifying an appropriate partner company with expertise in IVR, collecting qualitative data on colon cancer risk perceptions from young people (thematic analyses currently underway, assembling a steering committee, as well as conducting workshops with our Young People’s Partnership Board (YPPB to get continuous feedback on creative ideas. Conclusions: This is a novel exploratory study that is still underway, and the presentation will outline the Innerselfie project and summarise findings to date.

  5. Risk of venous thromboembolism in people admitted to hospital with selected immune-mediated diseases: record-linkage study

    Directory of Open Access Journals (Sweden)

    Handel Adam E

    2011-01-01

    Full Text Available Abstract Background Venous thromboembolism (VTE is a common complication during and after a hospital admission. Although it is mainly considered a complication of surgery, it often occurs in people who have not undergone surgery, with recent evidence suggesting that immune-mediated diseases may play a role in VTE risk. We, therefore, decided to study the risk of deep vein thrombosis (DVT and pulmonary embolism (PE in people admitted to hospital with a range of immune-mediated diseases. Methods We analysed databases of linked statistical records of hospital admissions and death certificates for the Oxford Record Linkage Study area (ORLS1:1968 to 1998 and ORLS2:1999 to 2008 and the whole of England (1999 to 2008. Rate ratios for VTE were determined, comparing immune-mediated disease cohorts with comparison cohorts. Results Significantly elevated risks of VTE were found, in all three populations studied, in people with a hospital record of admission for autoimmune haemolytic anaemia, chronic active hepatitis, dermatomyositis/polymyositis, type 1 diabetes mellitus, multiple sclerosis, myasthenia gravis, myxoedema, pemphigus/pemphigoid, polyarteritis nodosa, psoriasis, rheumatoid arthritis, Sjogren's syndrome, and systemic lupus erythematosus. Rate ratios were considerably higher for some of these diseases than others: for example, for systemic lupus erythematosus the rate ratios were 3.61 (2.36 to 5.31 in the ORLS1 population, 4.60 (3.19 to 6.43 in ORLS2 and 3.71 (3.43 to 4.02 in the England dataset. Conclusions People admitted to hospital with immune-mediated diseases may be at an increased risk of subsequent VTE. Our findings need independent confirmation or refutation; but, if confirmed, there may be a role for thromboprophylaxis in some patients with these diseases.

  6. Hearing Loss is Associated With Risk of Alzheimer’s Disease: A Case-Control Study in Older People

    OpenAIRE

    Shih-Chang Hung; Kuan-Fu Liao; Chih-Hsin Muo; Shih-Wei Lai; Chia-Wei Chang; Hung-Chang Hung

    2015-01-01

    Background: It remains unknown whether hearing loss increases the risk of Alzheimer’s disease. This study aimed to examine the association between hearing loss and risk of Alzheimer’s disease in older people in Taiwan. Methods: Analyzing the database from Taiwan’s National Health Insurance Program, this case-control study enrolled 488 subjects ≥65 years old with newly diagnosed Alzheimer’s disease as a case group and 1952 subjects without Alzheimer’s disease as a control group from 1998–20...

  7. Finding You on the Internet: an approach for finding on-line presences of people for fraud risk analysis

    OpenAIRE

    Been, Henry; van Keulen, Maurice

    2014-01-01

    Fraud risk analysis on data from formal information sources, being a ‘paper reality', suffers from blindness to false information. Moreover, the very act of providing false information is a strong indicator for fraud. The technology presented in this paper provides one step towards the vision of harnessing real-world data from social media and internet for fraud risk analysis. We introduce a novel iterative search, monitor, and match approach for finding on-line presences of people. A real-wo...

  8. Evaluation of Risk Management Strategies for a Low-Cost, High-Risk Project

    Science.gov (United States)

    Shishko, Robert; Jorgensen, Edward J.

    1996-01-01

    This paper summarizes work in progress to define and implement a risk management process tailored to a low-cost, high-risk, NASA mission -the Microrover Flight Experiment (MFEX, commonly called the Mars microrover).

  9. Prevalence and risk of violence against people with and without disabilities: findings from an Australian population-based study.

    Science.gov (United States)

    Krnjacki, Lauren; Emerson, Eric; Llewellyn, Gwynnyth; Kavanagh, Anne M

    2016-02-01

    There are no population-based estimates of the prevalence of interpersonal violence among people with disabilities in Australia. The project aimed to: 1) estimate the prevalence of violence for men and women according to disability status; 2) compare the risk of violence among women and men with disabilities to their same-sex non-disabled counterparts and; 3) compare the risk of violence between women and men with disabilities. We analysed the 2012 Australian Bureau of Statistics Survey on Personal Safety of more than 17,000 adults and estimated the population-weighted prevalence of violence (physical, sexual and intimate partner violence and stalking/harassment) in the past 12 months and since the age of 15. Population-weighted, age-adjusted, logistic regression was used to estimate the odds of violence by disability status and gender. People with disabilities were significantly more likely to experience all types of violence, both in the past 12 months and since the age of 15. Women with disabilities were more likely to experience sexual and partner violence and men were more likely to experience physical violence. These results underscore the need to understand risk factors for violence, raise awareness about violence and to target policies and services to reduce violence against people with disabilities in Australia. © 2015 Public Health Association of Australia.

  10. Relative risk of diabetes, dyslipidaemia, hypertension and the metabolic syndrome in people with severe mental illnesses: Systematic review and metaanalysis

    Directory of Open Access Journals (Sweden)

    King Michael B

    2008-09-01

    Full Text Available Abstract Background Severe mental illnesses (SMI may be independently associated with cardiovascular risk factors and the metabolic syndrome. We aimed to systematically assess studies that compared diabetes, dyslipidaemia, hypertension and metabolic syndrome in people with and without SMI. Methods We systematically searched MEDLINE, EMBASE, CINAHL & PsycINFO. We hand searched reference lists of key articles. We employed three search main themes: SMI, cardiovascular disease, and each cardiovascular risk factor. We selected cross-sectional, case control, cohort or intervention studies comparing one or more risk factor in both SMI and a reference group. We excluded studies without any reference group. We extracted data on: study design, cardiovascular risk factor(s and their measurement, diagnosis of SMI, study setting, sampling method, nature of comparison group and data on key risk factors. Results Of 14592 citations, 134 papers met criteria and 36 were finally included. 26 reported on diabetes, 12 hypertension, 11 dyslipidaemia, and 4 metabolic syndrome. Most studies were cross sectional, small and several lacked comparison data suitable for extraction. Meta-analysis was possible for diabetes, cholesterol and hypertension; revealing a pooled risk ratio of 1.70 (1.21 to 2.37 for diabetes and 1.11 (0.91 to 1.35 of hypertension. Restricting SMI to schizophreniform illnesses yielded a pooled risk ratio for diabetes of 1.87 (1.68 to 2.09. Total cholesterol was not higher in people with SMI (Standardized Mean Difference -0.10 (-0.55 to 0.36 and there were inconsistent data on HDL, LDL and triglycerides with some, but not all, reporting lower levels of HDL cholesterol and raised triglyceride levels. Metabolic syndrome appeared more common in SMI. Conclusion Diabetes (but not hypertension is more common in SMI. Data on other risk factors were limited by poor quality or inconsistent research findings, but a small number of studies show greater prevalence

  11. Clever sillies: why high IQ people tend to be deficient in common sense.

    Science.gov (United States)

    Charlton, Bruce G

    2009-12-01

    In previous editorials I have written about the absent-minded and socially-inept 'nutty professor' stereotype in science, and the phenomenon of 'psychological neoteny' whereby intelligent modern people (including scientists) decline to grow-up and instead remain in a state of perpetual novelty-seeking adolescence. These can be seen as specific examples of the general phenomenon of 'clever sillies' whereby intelligent people with high levels of technical ability are seen (by the majority of the rest of the population) as having foolish ideas and behaviours outside the realm of their professional expertise. In short, it has often been observed that high IQ types are lacking in 'common sense'--and especially when it comes to dealing with other human beings. General intelligence is not just a cognitive ability; it is also a cognitive disposition. So, the greater cognitive abilities of higher IQ tend also to be accompanied by a distinctive high IQ personality type including the trait of 'Openness to experience', 'enlightened' or progressive left-wing political values, and atheism. Drawing on the ideas of Kanazawa, my suggested explanation for this association between intelligence and personality is that an increasing relative level of IQ brings with it a tendency differentially to over-use general intelligence in problem-solving, and to over-ride those instinctive and spontaneous forms of evolved behaviour which could be termed common sense. Preferential use of abstract analysis is often useful when dealing with the many evolutionary novelties to be found in modernizing societies; but is not usually useful for dealing with social and psychological problems for which humans have evolved 'domain-specific' adaptive behaviours. And since evolved common sense usually produces the right answers in the social domain; this implies that, when it comes to solving social problems, the most intelligent people are more likely than those of average intelligence to have novel but

  12. Effects of vertical and side-alternating vibration training on fall risk factors and bone turnover in older people at risk of falls.

    Science.gov (United States)

    Corrie, Heather; Brooke-Wavell, Katherine; Mansfield, Neil J; Cowley, Alison; Morris, Robert; Masud, Tahir

    2015-01-01

    whole-body vibration training may improve neuromuscular function, falls risk and bone density, but previous studies have had conflicting findings. this study aimed to evaluate the influence of vertical vibration (VV) and side-alternating vibration (SV) on musculoskeletal health in older people at risk of falls. single-blind, randomised, controlled trial comparing vibration training to sham vibration (Sham) in addition to usual care. participants were 61 older people (37 women and 24 men), aged 80.2 + 6.5 years, referred to an outpatient falls prevention service. participants were randomly assigned to VV, SV or Sham in addition to the usual falls prevention programme. Participants were requested to attend three vibration sessions per week for 12 weeks, with sessions increasing to six, 1 min bouts of vibration. Falls risk factors and neuromuscular tests were assessed, and blood samples collected for determination of bone turnover, at baseline and following the intervention. chair stand time, timed-up-and-go time, fear of falling, NEADL index and postural sway with eyes open improved in the Sham group. There were significantly greater gains in leg power in the VV than in the Sham group and in bone formation in SV and VV compared with the Sham group. Conversely, body sway improved less in the VV than in the Sham group. Changes in falls risk factors did not differ between the groups. whole-body vibration increased leg power and bone formation, but it did not provide any additional benefits to balance or fall risk factors beyond a falls prevention programme in older people at risk of falls. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. A metasynthesis of risk perception in women with high risk pregnancies

    OpenAIRE

    Lee, S.; Ayers, S.; Holden, D.

    2014-01-01

    Introduction: Risk perception in women with high risk pregnancies affects their decisions about perinatal care and is of interest to anyone involved in the care of pregnant women. This paper provides a metasynthesis of qualitative studies of risk perception in women with high risk pregnancies.\\ud \\ud Methods: A systematic search of eight electronic databases was conducted. Additional papers were obtained through searching references of identified articles. Six studies were identified that rep...

  14. Hazard proximity and risk perception of tsunamis in coastal cities: Are people able to identify their risk?

    Science.gov (United States)

    Arias, Juan Pablo; Bronfman, Nicolás C; Cisternas, Pamela C; Repetto, Paula B

    2017-01-01

    Researchers have previously reported that hazard proximity can influence risk perception among individuals exposed to potential hazards. Understanding this relationship among coastline communities at risk of flood events caused by storms and/or tsunamis, is important because hazard proximity, should be recognized when planning and implementing preparation and mitigation actions against these events. Yet, we are not aware of studies that have examined this relationship among coastline inhabitants facing the risk of a tsunami. Consequently, the aim of this study was to examine the relationship between hazard proximity and perceived risk from tsunamis among coastline inhabitants. Participants were 487 residents of the coastal city of Iquique, Chile. They completed a survey during the spring of 2013 that assessed their perceived risk from several natural and non-natural hazards. We found that hazard proximity maintains a negative relationship with the perception of tsunami risk among coastline inhabitants. While this result confirms the general trend obtained in previous studies, this one is conclusive and significant. In contradiction with previous findings, we found that participants from the highest socioeconomic status reported the highest levels of risk perception. This finding can be explained by the fact that most participants from the highest socioeconomic status live closer to the coastline areas, so their risk perception reflects the place where they live, that is in a tsunami inundation zone. Once again, hazard proximity proved to be a determinant factor of risk perception. Our findings have important implications for the development of plans and programs for tsunami preparedness and mitigation. These indicate that individuals do use environmental cues to evaluate their own risk and can potentially make correct choices when having or not to evacuate. Also suggest that preparedness should incorporate how hazard proximity is recognized by individuals and

  15. Hazard proximity and risk perception of tsunamis in coastal cities: Are people able to identify their risk?

    Science.gov (United States)

    Arias, Juan Pablo; Bronfman, Nicolás C.; Cisternas, Pamela C.; Repetto, Paula B.

    2017-01-01

    Researchers have previously reported that hazard proximity can influence risk perception among individuals exposed to potential hazards. Understanding this relationship among coastline communities at risk of flood events caused by storms and/or tsunamis, is important because hazard proximity, should be recognized when planning and implementing preparation and mitigation actions against these events. Yet, we are not aware of studies that have examined this relationship among coastline inhabitants facing the risk of a tsunami. Consequently, the aim of this study was to examine the relationship between hazard proximity and perceived risk from tsunamis among coastline inhabitants. Participants were 487 residents of the coastal city of Iquique, Chile. They completed a survey during the spring of 2013 that assessed their perceived risk from several natural and non-natural hazards. We found that hazard proximity maintains a negative relationship with the perception of tsunami risk among coastline inhabitants. While this result confirms the general trend obtained in previous studies, this one is conclusive and significant. In contradiction with previous findings, we found that participants from the highest socioeconomic status reported the highest levels of risk perception. This finding can be explained by the fact that most participants from the highest socioeconomic status live closer to the coastline areas, so their risk perception reflects the place where they live, that is in a tsunami inundation zone. Once again, hazard proximity proved to be a determinant factor of risk perception. Our findings have important implications for the development of plans and programs for tsunami preparedness and mitigation. These indicate that individuals do use environmental cues to evaluate their own risk and can potentially make correct choices when having or not to evacuate. Also suggest that preparedness should incorporate how hazard proximity is recognized by individuals and

  16. Relationship of child abuse with personality features and high risk behaviors in adolescents

    Directory of Open Access Journals (Sweden)

    Mehdi Ghezelseflo

    2015-05-01

    Full Text Available Background: Children are one of the most vulnerable groups of the society and are constantly threatened by different people in their family or society. The aim of this study was investigating the correlation of child abuse with personality features and high risk behavior in high school students of Islamshahr, Iran. Methods: This study cross-sectional analytical was conducted on the high school girls and boys of Islamshahr in spring 2014.528 students were selected by cluster random sampling among 4 high schools (two female and two male high schools. Childhood trauma questionnaire, NEO-Five Factor Inventory and Youth Risk-Taking Scale were used for data collection. Data were analyzed by independence t-test, Pearson's correlation coefficient and multiple linear regression. Results: The results of independence t-test indicated significant differences between girls and boys in terms of child abuse and high risk experience (t=-2.16,p=0.03 and t=-5.03, P=0.001, respectively. Also, the results demonstrated a significant relationship between child abuse and personality characteristics, high risk behavior and all its subscales (P<0.05. The findings of multiple linear regressionindicated that child abuse could explain 14% total risk-taking, 25% neurotic personality feature , 14% extroversion, 10% agreeableness, 1% flexibility and 13% conscientiousness (P<0.05. Conclusion: According to the research findings, appropriate behavior with children is of great importance. Therefore, child abuse would form inappropriate personality features and increase risk behaviors among children.

  17. Has the Time Come to Stratify and Score SUDEP Risk to Inform People With Epilepsy of Their Changes in Safety?

    Directory of Open Access Journals (Sweden)

    Rohit Shankar

    2018-04-01

    Full Text Available Recent publication of the American Academy of Neurology SUDEP guidance highlighted the importance to American clinicians of making people with epilepsy aware of SUDEP risk. It is the first guideline to do this in the United States. It follows precedent set out in the UK by National Institute of Clinical Excellence in 2004. While a significant achievement, the lack of clarity of how to deliver this guidance in an enduring and person-centered manner, raises concerns on how its long-term effectiveness in risk mitigation. Shared decision-making with an emphasis on delivering person-centered communication to foster self-management strategies is increasingly recognized as the ideal model of patient–clinician communication in chronic diseases such as epilepsy. The tension between delivering evidence-based risk information, yet, tailoring it to the individual is complex. It needs to incorporate the potential for change not only in seizure factors but also other health and social factors. Safety advice needs to be dynamic and situation sensitive as opposed to a “one off” discussion. As a significant minority of people with epilepsy have drug-resistant seizures, the importance of keeping the advice contextual at different intervals of the person’s life cannot be overstated as many of them are managed in primary care. We present some exploratory work, which identifies the need to improve communication at a primary care level and to review risks regularly. Regular reviews using a structured risk factor checklist as a screening tool could identify, sooner, people who’s health issues are worsening and justify referrals to specialists.

  18. Private adaptation strategies and implementation in flood risk management: why people do nothing?

    Science.gov (United States)

    Karagiorgos, Konstantinos; Thaler, Thomas; Maris, Fotios; Paparrizos, Spyros; Fuchs, Sven

    2015-04-01

    In the past decades, vulnerability assessment has emerged as an important field of research in flood risk management, in particular with respect to climate change and necessary adaptation strategies for the society. Probably starting with Chamber's seminal article on vulnerability, coping and policy (Chambers 1989), and further developed as the causal structure of vulnerability by Bohle (2001) and others, at least two research paradigms exist: an internal side focusing on societal resilience and coping capacities, and an external side targeted at a reduction of negative effects in terms of loss reduction (Fuchs 2009). Despite considerable research effects, however, different definitions and concepts still dominate the debate; it is surely that different scientific disciplines are working with this term: natural scientists, engineers, social scientists or economists, to name just a few. Each discipline defines vulnerability in a way which fits to their disciplinary purposes (Fuchs et al. 2011). But why has there been so little progress in our ability to adapt to flood hazards? White et al. (2001) summarised this paradox in an article with the title "Knowing better and losing even more - the use of knowledge in hazard management". One of the fundamental reasons for the lack of progress is the continuing separation of research on natural processes and socio-economic processes without considering interaction between these systems (Fuchs & Keiler 2013), as well as between scientific research results and the policy implementation (Medd & Marvin 2005). Moreover, as many studies were focused on the vulnerability of least developed societies to natural hazards (O'Brien et al. 2008), there is a particular lack in studies targeted at an implementation of existing adaptation frameworks at the level of highly-developed countries (Field et al. 2012; Scolobig et al. 2012). This gap results in a challenge for attempts to develop formal models into practical application and policy

  19. Radical prostatectomy for high-risk prostate cancer.

    Science.gov (United States)

    Yossepowitch, Ofer; Eastham, James A

    2008-06-01

    Consensus recommendations for the identification and treatment of men whose apparent organ confined prostate cancer has high risk features are lacking. Despite ongoing refinements in surgical technique and improvements in morbidity and functional outcomes, the tradition of steering high-risk patients away from radical prostatectomy (RP) remains steadfast. We performed a medical literature search in English using MEDLINE/PubMed that addressed high risk prostate cancer. We analyzed the literature with respect to the historical evolution of this concept, current risk stratification schemes and treatment guidelines and related short and long term outcomes following RP. Contemporary evidence suggest that patients classified with high-risk prostate cancer by commonly used definitions do not have a uniformly poor prognosis after RP. Many cancers categorized clinically as high risk are actually pathologically confined to the prostate, and most men with such cancers who undergo RP are alive and free of additional therapy long after surgery. RP in the high-risk setting appears to be associated with a similar morbidity as in lower-risk patients. Men with clinically localized high-risk prostate cancer should not be categorically disqualified from local definitive therapy with RP. With careful attention to surgical technique, cancer control rates should improve further, and adverse effects on quality of life after RP should continue to decrease.

  20. Stepping reaction time and gait adaptability are significantly impaired in people with Parkinson's disease: Implications for fall risk.

    Science.gov (United States)

    Caetano, Maria Joana D; Lord, Stephen R; Allen, Natalie E; Brodie, Matthew A; Song, Jooeun; Paul, Serene S; Canning, Colleen G; Menant, Jasmine C

    2018-02-01

    Decline in the ability to take effective steps and to adapt gait, particularly under challenging conditions, may be important reasons why people with Parkinson's disease (PD) have an increased risk of falling. This study aimed to determine the extent of stepping and gait adaptability impairments in PD individuals as well as their associations with PD symptoms, cognitive function and previous falls. Thirty-three older people with PD and 33 controls were assessed in choice stepping reaction time, Stroop stepping and gait adaptability tests; measurements identified as fall risk factors in older adults. People with PD had similar mean choice stepping reaction times to healthy controls, but had significantly greater intra-individual variability. In the Stroop stepping test, the PD participants were more likely to make an error (48 vs 18%), took 715 ms longer to react (2312 vs 1517 ms) and had significantly greater response variability (536 vs 329 ms) than the healthy controls. People with PD also had more difficulties adapting their gait in response to targets (poorer stepping accuracy) and obstacles (increased number of steps) appearing at short notice on a walkway. Within the PD group, higher disease severity, reduced cognition and previous falls were associated with poorer stepping and gait adaptability performances. People with PD have reduced ability to adapt gait to unexpected targets and obstacles and exhibit poorer stepping responses, particularly in a test condition involving conflict resolution. Such impaired stepping responses in Parkinson's disease are associated with disease severity, cognitive impairment and falls. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. A metasynthesis of risk perception in women with high risk pregnancies.

    Science.gov (United States)

    Lee, Suzanne; Ayers, Susan; Holden, Des

    2014-04-01

    risk perception in women with high risk pregnancies affects their decisions about perinatal care and is of interest to anyone involved in the care of pregnant women. This paper provides a metasynthesis of qualitative studies of risk perception in women with high risk pregnancies. a systematic search of eight electronic databases was conducted. Additional papers were obtained through searching references of identified articles. Six studies were identified that reported qualitative research into risk perception in relation to high risk pregnancy. A metasynthesis was developed to describe and interpret the studies. the synthesis resulted in the identification of five themes: determinants of risk perception; not seeing it the way others do; normality versus risk; if the infant is ok, I׳m ok; managing risk. this metasynthesis suggests women at high risk during pregnancy use multiple sources of information to determine their risk status. It shows women are aware of the risks posed by their pregnancies but do not perceive risk in the same way as healthcare professionals. They will take steps to ensure the health of themselves and their infants but these may not include following all medical recommendations. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. High Blood Pressure, Afib and Your Risk of Stroke

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More High Blood Pressure, AFib and Your Risk of Stroke Updated:Aug ... have a stroke for the first time have high blood pressure . And an irregular atrial heart rhythm — a condition ...

  3. Development of a questionnaire to measure heart disease risk knowledge in people with diabetes: the Heart Disease Fact Questionnaire.

    Science.gov (United States)

    Wagner, Julie; Lacey, Kimberly; Chyun, Deborah; Abbott, Gina

    2005-07-01

    This paper describes a paper and pencil questionnaire that measures heart disease risk knowledge in people with diabetes. The Heart Disease Fact Questionnaire (HDFQ) is a 25-item questionnaire that was developed to tap into respondents' knowledge of major risk factors for the development of CHD. Approximately half of these items specifically address diabetes-related CHD risk factors. Based on extensive pilot data, the current study analyzed responses from 524 people with diabetes to assess the psychometric properties. The HDFQ is readable to an average 13-year old and imposes little burden. It shows good content and face validity. It demonstrates adequate internal consistency, with Kuder-Richardson-20 formula = 0.77 and good item-total correlations. Item analysis showed a desirable range in P-values. In discriminant function analyses, HDFQ scores differentiated respondents by knowledge of their own cardiovascular health, use of lipid lowering medications, health insurance status, and educational attainment, thus indicating good criterion related validity. This measure of heart disease risk knowledge is brief, understandable to respondents, and easy to administer and score. Its potential for use in research and practice is discussed. Future research should establish norms as well as investigate its test-retest reliability and predictive validity.

  4. Risk of melanoma in people with HIV/AIDS in the pre- and post-HAART eras: a systematic review and meta-analysis of cohort studies.

    Science.gov (United States)

    Olsen, Catherine M; Knight, Lani L; Green, Adèle C

    2014-01-01

    Following the introduction of highly active antiretroviral therapy (HAART) the risk of AIDS-defining cancers decreased but incidence of many non-AIDS-defining cancers has reportedly increased in those with HIV/AIDS. Whether melanoma risk has also changed in HIV/AIDS patients post-HAART is unknown and therefore we evaluated this in comparison with the risk before HAART. Systematic review and meta-analysis. We searched Medline, Embase and ISI science citation index databases to April 2013. All cohort studies of patients diagnosed with HIV/AIDS that permitted quantitative assessment of the association with melanoma were eligible. Detailed quality assessment of eligible studies was conducted, focussing particularly on adjustment for ethnicity, a priori considered essential for an unbiased assessment of melanoma risk. Data were pooled using a random effects model. From 288 articles, we identified 21 that met the inclusion criteria, 13 presenting data for the post-HAART era and 8 for the pre-HAART era. Post-HAART the pooled relative risk (pRR) for the association between HIV/AIDS and melanoma was 1.26 (95% CI, 0.97-1.64) and 1.50 (95% CI 1.12-2.01) among studies that accounted for ethnicity, with evidence of significant heterogeneity (P = 0.004, I2 = 55.5). Pre-HAART pRRs were 1.26 (95% CI 1.11-1.43; P het = 0.82) and 1.28 (95% CI 1.10-1.49) among studies adjusted for ethnicity. People with HIV/AIDS remain at a significantly increased risk of developing melanoma in the post-HAART era. White skinned people with HIV/AIDS should be screened regularly and counselled against excessive sun exposure.

  5. Latent classes of polydrug and polyroute use and associations with human immunodeficiency virus risk behaviours and overdose among people who inject drugs in Tijuana, Baja California, Mexico.

    Science.gov (United States)

    Meacham, Meredith C; Roesch, Scott C; Strathdee, Steffanie A; Lindsay, Suzanne; Gonzalez-Zuniga, Patricia; Gaines, Tommi L

    2018-01-01

    Patterns of polydrug use among people who inject drugs (PWID) may be differentially associated with overdose and unique human immunodeficiency virus (HIV) risk factors. Subgroups of PWID in Tijuana, Mexico, were identified based on substances used, route of administration, frequency of use and co-injection indicators. Participants were PWID residing in Tijuana age ≥18 years sampled from 2011 to 2012 who reported injecting an illicit substance in the past month (n = 735). Latent class analysis identified discrete classes of polydrug use characterised by 11 indicators of past 6 months substance use. Multinomial logistic regression examined class membership association with HIV risk behaviours, overdose and other covariates using an automated three-step procedure in mplus to account for classification error. Participants were classified into five subgroups. Two polydrug and polyroute classes were defined by use of multiple substances through several routes of administration and were primarily distinguished from each other by cocaine use (class 1: 5%) or no cocaine use (class 2: 29%). The other classes consisted primarily of injectors: cocaine, methamphetamine and heroin injection (class 3: 4%); methamphetamine and heroin injection (class 4: 10%); and heroin injection (class 5: 52%). Compared with the heroin-only injection class, memberships in the two polydrug and polyroute use classes were independently associated with both HIV injection and sexual risk behaviours. Substance use patterns among PWID in Tijuana are highly heterogeneous, and polydrug and polyroute users are a high-risk subgroup who may require more tailored prevention and treatment interventions. [Meacham MC, Roesch SC, Strathdee SA, Lindsay S, Gonzalez-Zuniga P, Gaines TL. Latent classes of polydrug and polyroute use and associations with human immunodeficiency virus risk behaviours and overdose among people who inject drugs in Tijuana, Baja California, Mexico. Drug Alcohol Rev 2018;37:128-136].

  6. High risk behaviour near OPG dams and power stations : results from two surveys

    Energy Technology Data Exchange (ETDEWEB)

    Giesbrecht, N.; Schmidt, R.; Ialomiteanu, A. [Centre for Addiction and Mental Health, Toronto, ON (Canada)

    2009-07-01

    High risk behaviour near dams is not uncommon. This presentation discussed the results from 2 surveys on high risk behaviour near dams and power stations operated by Ontario Power Generation (OPG). The main components of the project were presented, with particular reference to analyses of recent literature on high-risk behaviour; interviews with OPG managers and staff in 4 regions; main survey of respondents from 4 regions; follow-up interviews with high-risk respondents; interviews with community members and contacts from recreational associations; and recommendations. Specific questions and results were provided from each survey. From the first survey, the characteristics of respondents that used OPG sites for recreation were identified. One hundred high risk respondents completed a follow-up interview. The survey showed that although high-risk behaviour is not uncommon, the main reason people use the facilities are for recreation and relaxation, and not for thrill seeking purposes. Recommendations stemming from the surveys included the need for definition of boundaries and delivery of messages via children, recreational associations, and law enforcement personnel. tabs., figs.

  7. Alcohol consumption and high risk sexual behaviour among female ...

    African Journals Online (AJOL)

    Alcohol consumption has been associated with high risk sexual behaviour among key populations such as female sex workers. We explored the drivers of alcohol consumption and its relationship to high risk sexual behaviour. Participants were drawn from a cohort of 1 027 women selected from 'hot spots' in the suburbs of ...

  8. Correlation between high-risk pregnancy and developmental delay ...

    African Journals Online (AJOL)

    Background: The future development of children is considered more than ever now due to the advances in medical knowledge and thus the increase in survival rates of high-risk infants. This study investigated the correlation between high-risk pregnancy and developmental delay in children aged 4- 60 months. Methods: ...

  9. Drug response prediction in high-risk multiple myeloma

    DEFF Research Database (Denmark)

    Vangsted, A J; Helm-Petersen, S; Cowland, J B

    2018-01-01

    from high-risk patients by GEP70 at diagnosis from Total Therapy 2 and 3A to predict the response by the DRP score of drugs used in the treatment of myeloma patients. The DRP score stratified patients further. High-risk myeloma with a predicted sensitivity to melphalan by the DRP score had a prolonged...

  10. Elevated level of serum triglyceride among high risk stress bank ...

    African Journals Online (AJOL)

    The objective of this study was to estimate lipid profile among high risk stress bank employees' correlated with heart disorders in Riyadh, Saudi Arabia. A total of 129 patients with high risk stress employees were involved in this study, which were divided into 69 males and 60 females between the age of 25 to 55 years.

  11. High Risk Sexual Behaviors for HIV among the In-School Youth in Swaziland: A Structural Equation Modeling Approach

    OpenAIRE

    Sacolo, Hlengiwe Nokuthula; Chung, Min-Huey; Chu, Hsin; Liao, Yuan-Mei; Chen, Chiung-Hua; Ou, Keng-Liang; Chang, Lu-I; Chou, Kuei-Ru

    2013-01-01

    BACKGROUND: Global efforts in response to the increased prevalence of the human immunodeficiency virus (HIV) are mainly aimed at reducing high risk sexual behaviors among young people. However, knowledge regarding intentions of young people to engage in protective sexual behaviors is still lacking in many countries around the world, especially in Sub-Saharan Africa where prevalence of human immunodeficiency virus is the highest. The objective of this study was to test the theory of planned be...

  12. Insomnia in people with epilepsy: A review of insomnia prevalence, risk factors and associations with epilepsy-related factors.

    Science.gov (United States)

    Macêdo, Philippe Joaquim Oliveira Menezes; Oliveira, Pedro Sudbrack de; Foldvary-Schaefer, Nancy; Gomes, Marleide da Mota

    2017-09-01

    Insomnia is a common sleep complaint in the general population, and sleep loss may be a trigger for epileptic seizures. To conduct a comprehensive review of the literature of insomnia symptoms and insomnia disorder, their prevalence and epilepsy-related risk factors in people with epilepsy (PWE). A PUBMED search was performed for articles indexed to June 2016 involving human subjects, excluding papers in languages other than English, Spanish and Portuguese and case reports. Eligible studies were those using a clear definition of insomnia and reporting quantitative data on prevalence rates and risk factors. The search included the following terms: insomnia, sleep disorder(s), sleep disturbance(s) and sleep-wake in the title and abstract; and epilep* in the title. 425 papers were reviewed and 31 were selected for the final analysis (21 adult and 10 paediatric). Twenty-one studies used a control group. Two reviewer authors independently extracted all data and a third author resolved disagreements. Most studies were hospital-based, cross-sectional and evaluated convenience samples representing highly select populations. Various insomnia inventories were used. Fourteen assessed insomnia (10 in adults, four, children), but only five as primary outcome (none in children). Four evaluated insomnia disorder based on international classification criteria (International Classification of Sleep Disorders - ICSD-2-in 3, and DSM-IV-TR, in 1). In adults, insomnia prevalence was 28.9-51% based on the Insomnia Severity Index ≥15 and 36-74.4% based on DSM-IV-TR or ICSD-2. The prevalence of insomnia in children was 13.1-31.5% using the Sleep Disturbance Scale for Children and 11% based on ICSD-2 diagnostic criteria. Compared to control groups, PWE usually had higher frequencies of insomnia symptoms and disorder. Insomnia was associated with greater impairment in quality of life and higher degree of depressive symptoms in several studies, and was inconsistently related to female

  13. High performance communication by people with paralysis using an intracortical brain-computer interface

    Science.gov (United States)

    Pandarinath, Chethan; Nuyujukian, Paul; Blabe, Christine H; Sorice, Brittany L; Saab, Jad; Willett, Francis R; Hochberg, Leigh R

    2017-01-01

    Brain-computer interfaces (BCIs) have the potential to restore communication for people with tetraplegia and anarthria by translating neural activity into control signals for assistive communication devices. While previous pre-clinical and clinical studies have demonstrated promising proofs-of-concept (Serruya et al., 2002; Simeral et al., 2011; Bacher et al., 2015; Nuyujukian et al., 2015; Aflalo et al., 2015; Gilja et al., 2015; Jarosiewicz et al., 2015; Wolpaw et al., 1998; Hwang et al., 2012; Spüler et al., 2012; Leuthardt et al., 2004; Taylor et al., 2002; Schalk et al., 2008; Moran, 2010; Brunner et al., 2011; Wang et al., 2013; Townsend and Platsko, 2016; Vansteensel et al., 2016; Nuyujukian et al., 2016; Carmena et al., 2003; Musallam et al., 2004; Santhanam et al., 2006; Hochberg et al., 2006; Ganguly et al., 2011; O’Doherty et al., 2011; Gilja et al., 2012), the performance of human clinical BCI systems is not yet high enough to support widespread adoption by people with physical limitations of speech. Here we report a high-performance intracortical BCI (iBCI) for communication, which was tested by three clinical trial participants with paralysis. The system leveraged advances in decoder design developed in prior pre-clinical and clinical studies (Gilja et al., 2015; Kao et al., 2016; Gilja et al., 2012). For all three participants, performance exceeded previous iBCIs (Bacher et al., 2015; Jarosiewicz et al., 2015) as measured by typing rate (by a factor of 1.4–4.2) and information throughput (by a factor of 2.2–4.0). This high level of performance demonstrates the potential utility of iBCIs as powerful assistive communication devices for people with limited motor function. Clinical Trial No: NCT00912041 DOI: http://dx.doi.org/10.7554/eLife.18554.001 PMID:28220753

  14. Local level epidemiological analysis of TB in people from a high incidence country of birth

    Directory of Open Access Journals (Sweden)

    Massey Peter D

    2013-01-01

    Full Text Available Abstract Background The setting for this analysis is the low tuberculosis (TB incidence state of New South Wales (NSW, Australia. Local level analysis of TB epidemiology in people from high incidence countries-of-birth (HIC in a low incidence setting has not been conducted in Australia and has not been widely reported. Local level analysis could inform measures such as active case finding and targeted earlier diagnosis. The aim of this study was to use a novel approach to identify local areas in an Australian state that have higher TB rates given the local areas’ country of birth profiles. Methods TB notification data for the three year period 2006–2008 were analysed by grouping the population into those from a high-incidence country-of-birth and the remainder. Results During the study period there were 1401 notified TB cases in the state of NSW. Of these TB cases 76.5% were born in a high-incidence country. The annualised TB notification rate for the high-incidence country-of-birth group was 61.2/100,000 population and for the remainder of the population was 1.8/100,000. Of the 152 Local Government Areas (LGA in NSW, nine had higher and four had lower TB notification rates in their high-incidence country-of-birth populations when compared with the high-incidence country-of-birth population for the rest of NSW. The nine areas had a higher proportion of the population with a country of birth where TB notification rates are >100/100,000. Those notified with TB in the nine areas also had a shorter length of stay in Australia than the rest of the state. The areas with higher TB notification rates were all in the capital city, Sydney. Among LGAs with higher TB notification rates, four had higher rates in both people with a high-incidence country of birth and people not born in a high-incidence country. The age distribution of the HIC population was similar across all areas, and the highest differential in TB rates across areas was in the 5–19

  15. Local level epidemiological analysis of TB in people from a high incidence country of birth.

    Science.gov (United States)

    Massey, Peter D; Durrheim, David N; Stephens, Nicola; Christensen, Amanda

    2013-01-22

    The setting for this analysis is the low tuberculosis (TB) incidence state of New South Wales (NSW), Australia. Local level analysis of TB epidemiology in people from high incidence countries-of-birth (HIC) in a low incidence setting has not been conducted in Australia and has not been widely reported. Local level analysis could inform measures such as active case finding and targeted earlier diagnosis. The aim of this study was to use a novel approach to identify local areas in an Australian state that have higher TB rates given the local areas' country of birth profiles. TB notification data for the three year period 2006-2008 were analysed by grouping the population into those from a high-incidence country-of-birth and the remainder. During the study period there were 1401 notified TB cases in the state of NSW. Of these TB cases 76.5% were born in a high-incidence country. The annualised TB notification rate for the high-incidence country-of-birth group was 61.2/100,000 population and for the remainder of the population was 1.8/100,000. Of the 152 Local Government Areas (LGA) in NSW, nine had higher and four had lower TB notification rates in their high-incidence country-of-birth populations when compared with the high-incidence country-of-birth population for the rest of NSW. The nine areas had a higher proportion of the population with a country of birth where TB notification rates are >100/100,000. Those notified with TB in the nine areas also had a shorter length of stay in Australia than the rest of the state. The areas with higher TB notification rates were all in the capital city, Sydney. Among LGAs with higher TB notification rates, four had higher rates in both people with a high-incidence country of birth and people not born in a high-incidence country. The age distribution of the HIC population was similar across all areas, and the highest differential in TB rates across areas was in the 5-19 years age group. Analysing local area TB rates and possible

  16. THE RISKS IN SOCIO-PROFESSIONAL INTEGRATION OF YOUNG PEOPLE SUFFERING FROM AIDS

    Directory of Open Access Journals (Sweden)

    Daniela G. CALTEA

    2014-04-01

    Full Text Available The intention in writing this article is to provide a general presentation relating to Romanian HIV infected young people social-professional integration. It will speak in particularly about Iassy.The topics are: teenage, respectively youth as a stage in human being development, general aspects related to AIDS/HIV infection, statistics that include general information about Romanian (Iassy HIV infected youth, legislation about HIV infected people rights, HIV infected young people discrimination in the social-professional integration and preventive measures against discrimination.HIV/AIDS infection should not be a barrier in socio-professional integration way, and if a person is qualified and prepared in the field he/she wants to work, than that person should have all the benefits to be accepted in that job.We consider that employers mentality is based on the lack of information, which generates prejudice, fear against infected people, they are afraid to get HIV or to lose the rest of employees. We think that this fact must be changed.

  17. Risk Factors and Prevention

    Science.gov (United States)

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

  18. Science for the People: High School Students Investigate Community Air Quality

    Science.gov (United States)

    Marks-Block, Tony

    2011-01-01

    Over a year, a small group of high school students risked their afternoons and summer to participate in a science program that was "much different from science class." This was one of several after-school programs in Oakland and Richmond that the author was leading as an instructor with the East Bay Academy for Young Scientists (EBAYS). Students…

  19. Patients at High-Risk for Surgical Site Infection.

    Science.gov (United States)

    Mueck, Krislynn M; Kao, Lillian S

    Surgical site infections (SSIs) are a significant healthcare quality issue, resulting in increased morbidity, disability, length of stay, resource utilization, and costs. Identification of high-risk patients may improve pre-operative counseling, inform resource utilization, and allow modifications in peri-operative management to optimize outcomes. Review of the pertinent English-language literature. High-risk surgical patients may be identified on the basis of individual risk factors or combinations of factors. In particular, statistical models and risk calculators may be useful in predicting infectious risks, both in general and for SSIs. These models differ in the number of variables; inclusion of pre-operative, intra-operative, or post-operative variables; ease of calculation; and specificity for particular procedures. Furthermore, the models differ in their accuracy in stratifying risk. Biomarkers may be a promising way to identify patients at high risk of infectious complications. Although multiple strategies exist for identifying surgical patients at high risk for SSIs, no one strategy is superior for all patients. Further efforts are necessary to determine if risk stratification in combination with risk modification can reduce SSIs in these patient populations.

  20. Towards a comprehensive assessment and framework for low and high flow water risks

    Science.gov (United States)

    Motschmann, Alina; Huggel, Christian; Drenkhan, Fabian; León, Christian

    2017-04-01

    Driven by international organizations such as the Intergovernmental Panel on Climate Change (IPCC) the past years have seen a move from a vulnerability concept of climate change impacts towards a risk framework. Risk is now conceived at the intersection of climate-driven hazard and socioeconomic-driven vulnerability and exposure. The concept of risk so far has been mainly adopted for sudden-onset events. However, for slow-onset and cumulative climate change impacts such as changing water resources there is missing clarity and experience how to apply a risk framework. Research has hardly dealt with the challenge of how to integrate both low and high flow risks in a common framework. Comprehensive analyses of risks related to water resources considering climate change within multi-dimensional drivers across different scales are complex and often missing in climate-sensitive mountain regions where data scarcity and inconsistencies represent important limitations. Here we review existing vulnerability and risk assessments of low and high flow water conditions and identify critical conceptual and practical gaps. Based on this, we develop an integrated framework for low and high flow water risks which is applicable to both past and future conditions. The framework explicitly considers a water balance model simulating both water supply and demand on a daily basis. We test and apply this new framework in the highly glacierized Santa River catchment (SRC, Cordillera Blanca, Peru), representative for many developing mountain regions with both low and high flow water risks and poor data availability. In fact, in the SRC, both low and high flow hazards, such as droughts and floods, play a central role especially for agricultural, hydropower, domestic and mining use. During the dry season (austral winter) people are increasingly affected by water scarcity due to shrinking glaciers supplying melt water. On the other hand during the wet season (austral summer) high flow water

  1. High Center Volume Does Not Mitigate Risk Associated with Using High Donor Risk Organs in Liver Transplantation.

    Science.gov (United States)

    Beal, Eliza W; Black, Sylvester M; Mumtaz, Khalid; Hayes, Don; El-Hinnawi, Ashraf; Washburn, Kenneth; Tumin, Dmitry

    2017-09-01

    High-risk donor allografts increase access to liver transplant, but potentially reduce patient and graft survival. It is unclear whether the risk associated with using marginal donor livers is mitigated by increasing center experience. The United Network for Organ Sharing registry was queried for adult first-time liver transplant recipients between 2/2002 and 12/2015. High donor risk was defined as donor risk index >1.9, and 1-year patient and graft survival were compared according to donor risk index in small and large centers. Multivariable Cox regression estimated the hazard ratio (HR) associated with using high-risk donor organs, according to a continuous measure of annual center volume. The analysis included 51,770 patients. In 67 small and 67 large centers, high donor risk index predicted increased mortality (p = 0.001). In multivariable analysis, high-donor risk index allografts predicted greater mortality hazard at centers performing 20 liver transplants per year (HR 1.35; 95% CI 1.22, 1.49; p donor risk index and center volume was not statistically significant (p = 0.747), confirming that the risk associated with using marginal donor livers was comparable between smaller and larger centers. Results were consistent when examining graft loss. At both small and large centers, high-risk donor allografts were associated with reduced patient and graft survival after liver transplant. Specific strategies to mitigate the risk of liver transplant involving high-risk donors are needed, in addition to accumulation of center expertise.

  2. Postural Control in Young People with Visual Impairments and Various Risks of Falls

    Science.gov (United States)

    Sadowska, Dorota; Stemplewski, Rafal; Szeklicki, Robert

    2017-01-01

    Introduction: Early diagnosis of postural control deficiencies facilitates implementation of an individual rehabilitation plan to prevent falls. The aim of the study was to assess the risk of falling in individuals with visual impairments, and to compare performance-based and theoretical limits of stability in subjects with various risks of…

  3. Incidence and risk factors for suicide attempts in a general population of young people

    DEFF Research Database (Denmark)

    Christiansen, Erik; Juul Larsen, Kim; Agerbo, Esben

    2013-01-01

    OBJECTIVE: To estimate the Danish epidemiological long-term incidence rates for suicide attempts in the general population of children and adolescents, and to analyze the impact from single and multiple risk factors on the risk of suicide attempts. METHOD: We used longitudinal register data from ...... on the increase in the period studied. Individuals exposed to multiple risk factors are at the highest risk for suicide attempts, and when spotted or in contact with authorities they should be given proper care and treatment to prevent suicide attempts and death.......OBJECTIVE: To estimate the Danish epidemiological long-term incidence rates for suicide attempts in the general population of children and adolescents, and to analyze the impact from single and multiple risk factors on the risk of suicide attempts. METHOD: We used longitudinal register data from...... a total cohort of all individuals born between 1983 and 1989 and living in Denmark to calculate incidence rates. From the cohort, we identified all who have attempted suicide, and matched 50 controls to each case. A nested case-control design was used to estimate the impact from risk factors on the risk...

  4. Partners of people on ART - a New Evaluation of the Risks (The PARTNER study)

    DEFF Research Database (Denmark)

    Bruun, Tina; Rodger, Alison; Weait, Matthew

    2012-01-01

    It is known that being on antiretroviral therapy reduces the risk of HIV transmission through sex. However it remains unknown what the absolute level of risk of transmission is in a person on ART with most recent measured HIV plasma viral load...

  5. Social Desirability Bias and Prevalence of Sexual HIV Risk Behaviors Among People Who Use Drugs in Baltimore, Maryland: Implications for Identifying Individuals Prone to Underreporting Sexual Risk Behaviors.

    Science.gov (United States)

    Rao, Amrita; Tobin, Karin; Davey-Rothwell, Melissa; Latkin, Carl A

    2017-07-01

    The role of social desirability bias (SDB) in self-reported HIV risk behaviors continues to be problematic. This study examined whether SDB was associated with self-reported, via audio computer assisted self-interviewing, sexual risk behaviors among people who use drugs. The present study was conducted among 559 participants who reported having a recent sexual partner at their 6-month visit of a longitudinal study. Robust Poisson regression was used to model the association between SDB and five risk behaviors. Analyses were stratified by gender and partner type. Higher scores of SDB were associated with decreased reporting of selling sex and having more than one sexual partner. Higher SDB scores were associated with increased reporting of always using condoms during oral, vaginal, and anal sex. Gender-specific differences were observed. The inclusion of a measure of SDB in data collection, along with other strategies, can be used to both identify and reduce self-report biases.

  6. Cooperation in multicultural negotiations: How the cultures of people with low and high power interact.

    Science.gov (United States)

    Kopelman, Shirli; Hardin, Ashley E; Myers, Christopher G; Tost, Leigh Plunkett

    2016-05-01

    This study examined whether the cultures of low- and high-power negotiators interact to influence cooperative behavior of low-power negotiators. Managers from 4 different cultural groups (Germany, Hong Kong, Israel, and the United States) negotiated face-to-face in a simulated power-asymmetric commons dilemma. Results supported an interaction effect in which cooperation of people with lower power was influenced by both their culture and the culture of the person with higher power. In particular, in a multicultural setting, low-power managers from Hong Kong, a vertical-collectivist culture emphasizing power differences and group alignment, adjusted their cooperation depending on the culture of the high-power manager with whom they interacted. This study contributes to understanding how culture shapes behavior of people with relatively low power, illustrates how a logic of appropriateness informs cooperation, and highlights the importance of studying multicultural social interactions in the context of negotiations, work teams, and global leadership. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  7. Hypoglycemia in Older People - A Less Well Recognized Risk Factor for Frailty

    Science.gov (United States)

    Abdelhafiz, Ahmed H; Rodríguez-Mañas, Leocadio; Morley, John E.; Sinclair, Alan J

    2015-01-01

    Recurrent hypoglycemia is common in older people with diabetes and is likely to be less recognized and under reported by patients and health care professionals. Hypoglycemia in this age group is associated with significant morbidities leading to both physical and cognitive dysfunction. Repeated hospital admissions due to frequent hypoglycemia are also associated with further deterioration in patients’ general health. This negative impact of hypoglycemia is likely to eventually lead to frailty, disability and poor outcomes. It appears that the relationship between hypoglycemia and frailty is bidirectional and mediated through a series of influences including under nutrition. Therefore, attention should be paid to the management of under nutrition in the general elderly population by improving energy intake and maintaining muscle mass. Increasing physical activity and having a more conservative approach to glycemic targets in frail older people with diabetes may be worthwhile. PMID:25821643

  8. The Effects of Medication on Activity and Rehabilitation of Older People – Opportunities and Risks

    Directory of Open Access Journals (Sweden)

    Clare L Clarke

    2017-06-01

    Full Text Available Multiple medication use, or polypharmacy, is common in people undergoing rehabilitation. Polypharmacy is also common in older people, where it has the potential to impact on habitual physical activity. Despite this, the interactions between medication, disease, activity, and rehabilitation outcomes are insufficiently researched. In this review, we consider common classes of medications that can affect physical activity levels and outcomes of rehabilitation. We consider medications that improve disease processes and improve limiting symptoms (eg, breathlessness in heart failure and lung disease, pain in arthritis, unwanted side effects of medications (eg, central slowing caused by opioids and hypnotics, and also medication classes that might have the ability to improve activity and rehabilitation outcomes via beneficial effects on neuromuscular function (eg, angiotensin-converting enzyme inhibitors. We conclude by giving practical advice on how to review and optimise medication use to support habitual physical activity and ensure the best results from rehabilitation.

  9. The Very High Risk Prostate Cancer – a Contemporary Update

    Science.gov (United States)

    Mano, Roy; Eastham, James; Yossepowitch, Ofer

    2017-01-01

    Background Treatment of high-risk prostate cancer has evolved considerably over the past two decades, yet patients with very high-risk features may still experience poor outcome despite aggressive therapy. We review the contemporary literature focusing on current definitions, role of modern imaging and treatment alternatives in very high-risk prostate cancer. Methods We searched the MEDLINE database for all clinical trials or practice guidelines published in English between 2000 – 2016 with the following search terms: ‘prostatic neoplasms’ (MeSH Terms) AND (‘high risk’ (keyword) OR ‘locally advanced’ (keyword) OR ‘node positive’ (keyword)). Abstracts pertaining to very high-risk prostate cancer were evaluated and 40 pertinent studies served as the basis for this review. Results The term ‘very’ high-risk prostate cancer remains ill defined. The EAU and NCCN guidelines provide the only available definitions, categorizing those with clinical stage T3-4 or minimal nodal involvement as very-high risk irrespective of PSA level or biopsy Gleason score. Modern imaging with mpMRI and PET-PSMA scans plays a role in pretreatment assessment. Local definitive therapy by external beam radiation combined with androgen deprivation is supported by several randomized clinical trials whereas the role of surgery in the very high-risk setting combined with adjuvant radiation/ androgen deprivation therapy is emerging. Growing evidence suggest neoadjuvant taxane based chemotherapy in the context of a multimodal approach may be beneficial. Conclusions Men with very high-risk tumors may benefit from local definitive treatment in the setting of a multimodal regimen, offering local control and possibly cure in well selected patients. Further studies are necessary to better characterize the ‘very’ high-risk category and determine the optimal therapy for the individual patient. PMID:27618950

  10. Using case-based reasoning to detect risk scenarios of elderly people living alone at home

    OpenAIRE

    Lupiani, Eduardo; Juarez, Jose M.; Palma, Jose; Sauer, Christian; Roth-Berghofer, Thomas

    2014-01-01

    In today’s ageing societies, the proportion of elderly people living alone in their own homes is dramatically increasing. Smart homes provide the appropriate environment for keeping them independent and, therefore, enhancing their quality of life. One of the most important requirements of these systems is that they have to provide a pervasive environment without disrupting elderly people’s daily activities. The present paper introduces a CBR agent used within a commercial Smart Home system, d...

  11. Monitoring people at risk of drinking by a rapid urinary ethyl glucuronide test

    Directory of Open Access Journals (Sweden)

    Fucci Nadia

    2017-12-01

    Full Text Available Alcohol and illicit drug abuse are major public health problems worldwide. Since alcohol is the predominant substance of choice in polydrug abusers, monitoring its use, along with urinary drug screening in patients in rehabilitation programs, appeared to be crucial in identifying patients at risk of alcohol disorders leading to impaired quality of life. Ethyl β-D-6-glucuronide, a non-oxidative, non-volatile, stable and minor direct ethanol metabolite, has a 6h to 4 day window of detection in urine after the last alcohol intake. Each of the 119 subjects (85 males, 34 females registered with the Public Health Service for Drug Dependence Treatment provided a urine sample for ethylglucoronide (EtG determination in an immunochemical test with a 500 ng/ml cutoff. All results were evaluated with confirmation criteria of a fully validated gas chromatography/mass spectrometry assay. The diagnostic performance of the EtG immunochemical test was assessed using Receiver Operating Characteristic Curve analysis. The immunochemical test specificity was 100% for EtG urinary values above 500 ng/ml. No false positive results were found. With levels below 500 ng/ml, 12% of the samples were classified as negative. The average consumption of the incorrectly classified subjects was 171 ng/ml, with a misclassification error of 6.5% to 18.5%. High agreement between EtG as determined in an immunochemical test and gas chromatography/mass spectrometry, suggests that the rapid EtG test is a reliable, cost-effective alcohol monitoring assay for patient management in many non-forensic settings, such as drug rehabilitation programs.

  12. Measuring Appetite with the Simplified Nutritional Appetite Questionnaire Identifies Hospitalised Older People at Risk of Worse Health Outcomes.

    Science.gov (United States)

    Pilgrim, A L; Baylis, D; Jameson, K A; Cooper, C; Sayer, A A; Robinson, S M; Roberts, H C

    2016-01-01

    Poor appetite is commonly reported by older people but is rarely measured. The Simplified Nutritional Appetite Questionnaire (SNAQ) was validated to predict weight loss in community dwelling older adults but has been little used in hospitals. We evaluated it in older women on admission to hospital and examined associations with healthcare outcomes. Longitudinal observational with follow-up at six months. Female acute Medicine for Older People wards at a University hospital in England. 179 female inpatients. Age, weight, Body Mass Index (BMI), grip strength, SNAQ, Barthel Index Score, Mini Mental State Examination (MMSE), Geriatric Depression Scale: Short Form (GDS-SF), Malnutrition Universal Screening Tool (MUST), category of domicile and receipt of care were measured soon after admission and repeated at six month follow-up. The length of hospital stay (LOS), hospital acquired infection, readmissions and deaths by follow-up were recorded. 179 female participants mean age 87 (SD 4.7) years were recruited. 42% of participants had a low SNAQ score (appetite). A low SNAQ score was associated with an increased risk of hospital acquired infection (OR 3.53; 95% CI: 1.48, 8.41; p=0.004) and with risk of death (HR 2.29; 95% CI: 1.12, 4.68; p = 0.023) by follow-up. Poor appetite was common among the older hospitalised women studied, and was associated with higher risk of poor healthcare outcomes.

  13. Risk factors and most common traumatic injuries in people who practice long-distance running

    Directory of Open Access Journals (Sweden)

    Anna Lewandowska

    2017-08-01

    Full Text Available Undoubtedly, the fashion of running comes. Initially people used to run for fun, pleasure, to forget about worries or problems. With time, however, was no longer just about the idea itself, people more and more fascinated with jogging went one step further. At the same time, not realizing how important changes may occur in their body. These are usually overload or inflammatory changes. The aim of this paper is to present the most frequent injuries of long distance runners and the main predisposing factors for their trauma. The work will also cover the possibility of prevention of these injuries. The most important factors predisposing to injury include: the awareness of running people, the overweight and obesity, the incorrect running pattern and the inappropriate training plan. The consequences of these factors may be: runner's knee, leg overload syndrome, Achilles tendonitis, plantar fasciitis, fatigue fractures, and iliotibial-band syndrome. The injuries are, unfortunately, inscribed into the life of every runner, regardless of the level of advancement. However, it is worth remembering that they can be effectively prevented, and at the moment of their appearance, effectively heal. The injuries of runners depend primarily on their approach to practicing this form of physical activity, to a lesser extent from genetic or mechanical factors.

  14. Frailty as a Risk Factor for Falls Among Community Dwelling People: Evidence From a Meta-Analysis.

    Science.gov (United States)

    Cheng, Mei-Hsun; Chang, Shu-Fang

    2017-09-01

    This study was conducted to investigate the relationships between different frailty stages and the fall incidence rates of community-dwelling older adults. The differences between various frailty indicators regarding assessment accuracy of the fall incidence rates of community-dwelling elders were also analyzed. Finally, the relationship between frailty and recurrent falls was explored. This study comprised a systematic literature review and meta-analysis. Two researchers independently examined and extracted the related literature. The key search terms included frailty, frail, fall, older people, older, geriatric, and senior. The literature sampling period was from January 2001 to December 2016. The quality of each paper was assessed according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The databases of the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and MEDLINE were used to conduct a systematic literature search by using the random effect mode to analyze the compiled papers. A total of 102,130 community-dwelling older adults ≥65 years of age and 33,503 older adults who had experienced a fall were compiled to investigate the relationship between frailty and falls. The meta-analysis results revealed that compared with robust older adults, frail older adults demonstrated the greatest risk for falls, followed by prefrail older adults. Furthermore, the use of different frailty indicators to predict the fall incidence rates of older adults yielded nonsignificantly different outcomes. In short, studies of either cardiovascular health or osteoporotic fracture indicators are effective for predicting the risk for falls in older people. Finally, this study confirmed that compared with robust older adults, frail older adults were more likely to experience recurrent falls. Frailty is a crucial healthcare topic of people with geriatric syndromes. Frail older adults are

  15. A scoping review of prevalence, incidence and risk factors for HIV infection amongst young people in Brazil.

    Science.gov (United States)

    Saffier, Igor Pedrosa; Kawa, Hélia; Harling, Guy

    2017-10-11

    Despite young people being a key population for HIV prevention, the HIV epidemic amongst young Brazilians is perceived to be growing. We therefore reviewed all published literature on HIV prevalence and risk factors for HIV infection amongst 10-25 year olds in Brazil. We searched Embase, LILACS, Proquest, PsycINFO, PubMed, Scopus and Web of Science for studies published up to March 2017 and analyzed reference lists of relevant studies. We included published studies from any time in the HIV epidemic which provided estimates specific to ages 10-25 (or some subset of this age range) for Brazilians on either: (a) HIV prevalence or incidence; or (b) the association between HIV and socio-demographic or behavioral risk factors. Forty eight publications met the inclusion criteria: 44 cross-sectional, two case-control, two cohort. Four studies analysed national data. Forty seven studies provided HIV prevalence estimates, largely for six population subgroups: Counselling and Testing Center attendees; blood donors; pregnant women; institutional individuals; men-who-have-sex-with-men (MSM) and female sex workers (FSW); four provided HIV incidence estimates. Twelve studies showed HIV status to be associated with a wide range of risk factors, including age, sexual and reproductive history, infection history, substance use, geography, marital status, mental health and socioeconomic status. Few published studies have examined HIV amongst young people in Brazil, and those published have been largely cross-sectional and focused on traditional risk groups and the south of the country. Despite these limitations, the literature shows raised HIV prevalence amongst MSM and FSW, as well as amongst those using drugs. Time trends are harder to identify, although rates appear to be falling for pregnant women, possibly reversing an earlier de-masculinization of the epidemic. Improved surveillance of HIV incidence, prevalence and risk factors is a key component of efforts to eliminate HIV in

  16. There is more to life than risk avoidance - elderly people's experiences of falls, fall-injuries and compliant flooring.

    Science.gov (United States)

    Gustavsson, Johanna; Jernbro, Carolina; Nilson, Finn

    2018-12-01

    Falls are the most common cause of injury in all ages and are especially difficult to prevent among residential care residents. Compliant flooring that absorbs energy generated within the fall, has been proposed as a measure to prevent fall-injury, however little is known regarding the implementation aspects in clinical settings. The aim of this study is to explore the experiences of falls, the risk of fall-injury, prevention in general and specifically compliant flooring as an injury preventative measure amongst frail elderly people living in a residential care facility with compliant flooring. Through this, generate a theory that further explains the underlying barriers of active prevention amongst elderly people. We used the grounded theory method and conducted semi-structured in-depth interviews with eight elderly people in residential care (data collected between February and December 2017). The identified categories were Falling as a part of life, Fearing the consequences and A wish to prevent falls and injuries. Through the results it was clear that There is more to life than risk avoidance, permeated the interviews, therefore forming the grounded theory. The interviewees viewed falls as something common and normal, and were uninterested in focusing on the risk of falls. Although they wanted to prevent falls, it was often difficult to integrate preventative measures into their everyday life. They embraced the idea of an injury-reducing compliant flooring, however their main interests lay elsewhere, preferring to focus on social interaction and issues concerning daily activities. The theory generated in this paper proposes explanations on the obstacles of implementing fall prevention measures in an elderly frail population. The findings give insights as to why interest and compliance for active fall prevention measures are low. We conclude that complaint flooring, from the perspective of the residents, can work well in residential care.

  17. Perceptions of genetic discrimination among people at risk for Huntington’s disease: a cross sectional survey

    Science.gov (United States)

    Bombard, Yvonne; Veenstra, Gerry; Friedman, Jan M; Creighton, Susan; Currie, Lauren; Paulsen, Jane S; Bottorff, Joan L

    2009-01-01

    Objective To assess the nature and prevalence of genetic discrimination experienced by people at risk for Huntington’s disease who had undergone genetic testing or remained untested. Design Cross sectional, self reported survey. Setting Seven genetics and movement disorders clinics servicing rural and urban communities in Canada. Participants 233 genetically tested and untested asymptomatic people at risk for Huntington’s disease (response rate 80%): 167 underwent testing (83 had the Huntington’s disease mutation, 84 did not) and 66 chose not to be tested. Main outcome measures Self reported experiences of genetic discrimination and related psychological distress based on family history or genetic test results. Results Discrimination was reported by 93 respondents (39.9%). Reported experiences occurred most often in insurance (29.2%), family (15.5%), and social (12.4%) settings. There were few reports of discrimination in employment (6.9%), health care (8.6%), or public sector settings (3.9%). Although respondents who were aware that they carried the Huntington’s disease mutation reported the highest levels of discrimination, participation in genetic testing was not associated with increased levels of genetic discrimination. Family history of Huntington’s disease, rather than the result of genetic testing, was the main reason given for experiences of genetic discrimination. Psychological distress was associated with genetic discrimination (PGenetic discrimination was commonly reported by people at risk for Huntington’s disease and was a source of psychological distress. Family history, and not genetic testing, was the major reason for genetic discrimination. PMID:19509425

  18. The Effect of Risk Reduction Intervention on Earthquake Disaster Preparedness of the Elderly People

    Directory of Open Access Journals (Sweden)

    Kian Nourozi

    2016-01-01

    Conclusion: Preparedness programs for disaster risk reduction has a positive effect on the elders’ preparedness. Thus, similar multimodal preparedness programs should be used more frequently for this vulnerable community citizens.

  19. risk factors of active tuberculosis in people living with hiv/aids

    African Journals Online (AJOL)

    Abrham

    2011-07-02

    Jul 2, 2011 ... The objective of this study was to assess distal ... KEYWORDS: Active TB, HIV, risk factors, case control study, Southwest Ethiopia ... and Khat (stimulant plant from Chata Edulis), .... to live in a house made of a cement floor.

  20. Patients at high risk of tuberculosis recurrence

    Directory of Open Access Journals (Sweden)

    Mehdi Mirsaeidi

    2018-01-01

    Full Text Available Recurrent tuberculosis (TB continues to be a significant problem and is an important indicator of the effectiveness of TB control. Recurrence can occur by relapse or exogenous reinfection. Recurrence of TB is still a major problem in high-burden countries, where there is lack of resources and no special attention is being given to this issue. The rate of recurrence is highly variable and has been estimated to range from 4.9% to 47%. This variability is related to differences in regional epidemiology of recurrence and differences in the definitions used by the TB control programs. In addition to treatment failure from noncompliance, there are several key host factors that are associated with high rates of recurrence. The widely recognized host factors independent of treatment program that predispose to TB recurrence include gender differences, malnutrition; comorbidities such as diabetes, renal failure, and systemic diseases, especially immunosuppressive states such as human immunodeficiency virus; substance abuse; and environmental exposures such as silicosis. With improved understanding of the human genome, proteome, and metabolome, additional host-specific factors that predispose to recurrence are being identified. Information on temporal and geographical trends of TB cases as well as studies with whole-genome sequencing might provide further information to enable us to fully understand TB recurrence and discriminate between reactivation and new infection. The recently launched World Health Organization End TB Strategy emphasizes the importance of integrated, patient-centered TB care. Continued improvement in diagnosis, treatment approaches, and an understanding of host-specific factors are needed to fully understand the clinical epidemiological and social determinants of TB recurrence.

  1. Patients at high risk of tuberculosis recurrence.

    Science.gov (United States)

    Mirsaeidi, Mehdi; Sadikot, Ruxana T

    2018-01-01

    Recurrent tuberculosis (TB) continues to be a significant problem and is an important indicator of the effectiveness of TB control. Recurrence can occur by relapse or exogenous reinfection. Recurrence of TB is still a major problem in high-burden countries, where there is lack of resources and no special attention is being given to this issue. The rate of recurrence is highly variable and has been estimated to range from 4.9% to 47%. This variability is related to differences in regional epidemiology of recurrence and differences in the definitions used by the TB control programs. In addition to treatment failure from noncompliance, there are several key host factors that are associated with high rates of recurrence. The widely recognized host factors independent of treatment program that predispose to TB recurrence include gender differences, malnutrition; comorbidities such as diabetes, renal failure, and systemic diseases, especially immunosuppressive states such as human immunodeficiency virus; substance abuse; and environmental exposures such as silicosis. With improved understanding of the human genome, proteome, and metabolome, additional host-specific factors that predispose to recurrence are being identified. Information on temporal and geographical trends of TB cases as well as studies with whole-genome sequencing might provide further information to enable us to fully understand TB recurrence and discriminate between reactivation and new infection. The recently launched World Health Organization End TB Strategy emphasizes the importance of integrated, patient-centered TB care. Continued improvement in diagnosis, treatment approaches, and an understanding of host-specific factors are needed to fully understand the clinical epidemiological and social determinants of TB recurrence.

  2. Metabolic disorders and cardiovascular risk in people living with HIV/AIDS without the use of antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Mariana Amaral Raposo

    Full Text Available Abstract INTRODUCTION: Metabolic disorders in people living with HIV/AIDS (PLH have been described even before the introduction of antiretroviral (ARV drugs in the treatment of HIV infection and are risk factors for cardiovascular diseases. Based on this, the purpose of this study was to assess metabolic disorders and cardiovascular risk in PLH before the initiation of antiretroviral treatment (ART. METHODS: This was a cross-sectional descriptive study of 87 PLH without the use of ART, which was carried out between January and September 2012 at a specialized infectious diseases center in Minas Gerais, Brazil. RESULTS: The main metabolic disorders in the population were low serum levels of HDL-cholesterol, hypertriglyceridemia and abdominal obesity. Dyslipidemia was prevalent in 62.6% of the study population, whereas metabolic syndrome (MS was prevalent in 11.5% of patients assessed by the International Diabetes Federation (IDF criteria and 10.8% assessed by the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATPIII criteria. Regarding cardiovascular risk, 89.7% of the population presented a low coronary risk according to the Framingham Risk Score. A greater proportion of patients diagnosed with MS presented low cardiovascular risk (80% assessed by IDF criteria and 77.8% assessed by NCEP-ATPIII criteria. CONCLUSIONS: Metabolic disorders in this population may be due to HIV infection or lifestyle (smoking, sedentary lifestyle and inadequate diet. The introduction of ART can enhance dyslipidemia, increasing cardiovascular risk, especially among those who have classic risks of cardiovascular disease.

  3. High risk for obstructive sleep apnea in patients with acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Carla Renata Silva Andrechuk

    2015-10-01

    Full Text Available Objectives: to stratify the risk for obstructive sleep apnea in patients with acute myocardial infarction, treated at a public, tertiary, teaching hospital of the state of São Paulo, Brazil, and to identify related sociodemographic and clinical factors.Method: cross-sectional analytical study with 113 patients (mean age 59.57 years, 70.8% male. A specific questionnaire was used for the sociodemographic and clinical characterization and the Berlin Questionnaire for the stratification of the risk of obstructive sleep apnea syndrome.Results: the prevalence of high risk was 60.2% and the outcome of clinical worsening during hospitalization was more frequent among these patients. The factors related to high risk were body mass index over 30 kg/m2, arterial hypertension and waist circumference indicative of cardiovascular risk, while older age (60 years and over constituted a protective factor.Conclusion: considering the high prevalence of obstructive sleep apnea and its relation to clinical worsening, it is suggested that nurses should monitor, in their clinical practice, people at high risk for this syndrome, guiding control measures of modifiable factors and aiming to prevent the associated complications, including worsening of cardiovascular diseases.

  4. High-Risk and Low-Risk Human Papillomavirus and the Absolute Risk of Cervical Intraepithelial Neoplasia or Cancer

    DEFF Research Database (Denmark)

    Thomsen, Louise T; Frederiksen, Kirsten; Munk, Christian

    2014-01-01

    OBJECTIVE: To determine the absolute risk of cervical intraepithelial neoplasia (CIN) grade 3 or cervical cancer (CIN 3 or worse) after detection of low-risk human papillomavirus (HPV) and after a negative high-risk HPV test. METHODS: In this prospective cohort study, consecutive liquid......-based cervical cytology samples were collected from women screened for cervical cancer in Copenhagen, Denmark, during 2002-2005. Samples were tested with a clinical test for 13 high-risk and five low-risk HPV types. The cohort (N=35,539; aged 14-90 years) was monitored in a nationwide pathology register for up...... cytology. Detection of low-risk HPV does not predict CIN 3 or worse. Cervical cancer screening should not include testing for low-risk HPV types. LEVEL OF EVIDENCE: II....

  5. A scoping review of prevalence, incidence and risk factors for HIV infection amongst young people in Brazil

    OpenAIRE

    Saffier, Igor Pedrosa; Kawa, Hélia; Harling, Guy

    2017-01-01

    Background Despite young people being a key population for HIV prevention, the HIV epidemic amongst young Brazilians is perceived to be growing. We therefore reviewed all published literature on HIV prevalence and risk factors for HIV infection amongst 10-25 year olds in Brazil. Methods We searched Embase, LILACS, Proquest, PsycINFO, PubMed, Scopus and Web of Science for studies published up to March 2017 and analyzed reference lists of relevant studies. We included published studies from any...

  6. Risk Factors for Six Types of Disability among the Older People in Thailand in 2002, 2007, and 2011.

    Science.gov (United States)

    Khongboon, Pattaraporn; Pongpanich, Sathirakorn; Chapman, Robert S

    2016-01-01

    Background. There is an important need to characterize risk factors for disability in Thailand, in order to inform effective prevention and control strategies. This study investigated factors associated with risk of 6 types of disability in Thailand's ageing population in 2002, 2007, and 2011. Methods. Data came from the Cross-Sectional National Surveys of Older Persons in Thailand conducted by the National Statistical Office (NSO) in 2002, 2007, and 2011. Stratified two-stage sampling was employed. Interviews of 24,835, 30,427, and 34,173 elderly people aged 60 and above were conducted in the respective study years. Prevalence of disabilities was measured, and factors associated with disability risk were assessed with probability-weighted multiple logistic regression. Results. Disability prevalence decreased slightly over the study period. The characteristics with greatest positive impact on disability prevalence were not working over the past week (average impact: 61.2%), age (53.7% per decade), and suffering from one or more chronic illnesses (46.3%). Conclusions. The strong observed positive impact of not working on disability prevalence suggests that raising the mandatory retirement age might result in some reduction of disability risk. Also, the observed positive impact of living with others (versus alone) on disability risk was somewhat unexpected.

  7. Risk-adaptive optimization: Selective boosting of high-risk tumor subvolumes

    International Nuclear Information System (INIS)

    Kim, Yusung; Tome, Wolfgang A.

    2006-01-01

    Background and Purpose: A tumor subvolume-based, risk-adaptive optimization strategy is presented. Methods and Materials: Risk-adaptive optimization employs a biologic objective function instead of an objective function based on physical dose constraints. Using this biologic objective function, tumor control probability (TCP) is maximized for different tumor risk regions while at the same time minimizing normal tissue complication probability (NTCP) for organs at risk. The feasibility of risk-adaptive optimization was investigated for a variety of tumor subvolume geometries, risk-levels, and slopes of the TCP curve. Furthermore, the impact of a correlation parameter, δ, between TCP and NTCP on risk-adaptive optimization was investigated. Results: Employing risk-adaptive optimization, it is possible in a prostate cancer model to increase the equivalent uniform dose (EUD) by up to 35.4 Gy in tumor subvolumes having the highest risk classification without increasing predicted normal tissue complications in organs at risk. For all tumor subvolume geometries investigated, we found that the EUD to high-risk tumor subvolumes could be increased significantly without increasing normal tissue complications above those expected from a treatment plan aiming for uniform dose coverage of the planning target volume. We furthermore found that the tumor subvolume with the highest risk classification had the largest influence on the design of the risk-adaptive dose distribution. The parameter δ had little effect on risk-adaptive optimization. However, the clinical parameters D 5 and γ 5 that represent the risk classification of tumor subvolumes had the largest impact on risk-adaptive optimization. Conclusions: On the whole, risk-adaptive optimization yields heterogeneous dose distributions that match the risk level distribution of different subvolumes within the tumor volume

  8. People at Risk of Influenza Pandemics: The Evolution of Perception and Behavior.</