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Sample records for risk factors adjusted

  1. A method to adjust radiation dose-response relationships for clinical risk factors

    DEFF Research Database (Denmark)

    Appelt, Ane Lindegaard; Vogelius, Ivan R

    2012-01-01

    Several clinical risk factors for radiation induced toxicity have been identified in the literature. Here, we present a method to quantify the effect of clinical risk factors on radiation dose-response curves and apply the method to adjust the dose-response for radiation pneumonitis for patients...

  2. [Adjustment for energy intake in the assessment of dietary risk factors

    OpenAIRE

    Thiébaut, Anne,; Kesse, Emmanuelle; Com-Nougué, Catherine; Clavel-Chapelon, Françoise; Bénichou, Jacques

    2004-01-01

    Epidemiologic studies assessing the association between health status and nutritional factors raise the issue of adjusting for energy intake. Indeed, as most nutrients are highly correlated with energy intake which can itself be associated with disease risk, energy intake needs to be adjusted for upon assessing the effect of a specific nutrient. To avoid problems of estimation and interpretation incurred by the use of the standard method which rests on directly adjusting for energy intake, se...

  3. Gaming in risk-adjusted mortality rates: effect of misclassification of risk factors in the benchmarking of cardiac surgery risk-adjusted mortality rates.

    Science.gov (United States)

    Siregar, Sabrina; Groenwold, Rolf H H; Versteegh, Michel I M; Noyez, Luc; ter Burg, Willem Jan P P; Bots, Michiel L; van der Graaf, Yolanda; van Herwerden, Lex A

    2013-03-01

    Upcoding or undercoding of risk factors could affect the benchmarking of risk-adjusted mortality rates. The aim was to investigate the effect of misclassification of risk factors on the benchmarking of mortality rates after cardiac surgery. A prospective cohort was used comprising all adult cardiac surgery patients in all 16 cardiothoracic centers in The Netherlands from January 1, 2007, to December 31, 2009. A random effects model, including the logistic European system for cardiac operative risk evaluation (EuroSCORE) was used to benchmark the in-hospital mortality rates. We simulated upcoding and undercoding of 5 selected variables in the patients from 1 center. These patients were selected randomly (nondifferential misclassification) or by the EuroSCORE (differential misclassification). In the random patients, substantial misclassification was required to affect benchmarking: a 1.8-fold increase in prevalence of the 4 risk factors changed an underperforming center into an average performing one. Upcoding of 1 variable required even more. When patients with the greatest EuroSCORE were upcoded (ie, differential misclassification), a 1.1-fold increase was sufficient: moderate left ventricular function from 14.2% to 15.7%, poor left ventricular function from 8.4% to 9.3%, recent myocardial infarction from 7.9% to 8.6%, and extracardiac arteriopathy from 9.0% to 9.8%. Benchmarking using risk-adjusted mortality rates can be manipulated by misclassification of the EuroSCORE risk factors. Misclassification of random patients or of single variables will have little effect. However, limited upcoding of multiple risk factors in high-risk patients can greatly influence benchmarking. To minimize "gaming," the prevalence of all risk factors should be carefully monitored. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

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

    Science.gov (United States)

    Sanchez-Perez, Noelia; Gonzalez-Salinas, Carmen

    2013-01-01

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

  5. Continuing Bonds, Risk Factors for Complicated Grief, and Adjustment to Bereavement

    Science.gov (United States)

    Field, Nigel P.; Filanosky, Charles

    2010-01-01

    This study examined type of continuing bonds (CB) expression in relation to risk factors for complicated grief and measures of bereavement-related adjustment. Externalized CB expressions involving illusions and hallucinations with the deceased were distinguished from internalized CB expressions involving use of the deceased as an autonomy…

  6. Annual Adjustment Factors

    Data.gov (United States)

    Department of Housing and Urban Development — The Department of Housing and Urban Development establishes the rent adjustment factors - called Annual Adjustment Factors (AAFs) - on the basis of Consumer Price...

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

    Science.gov (United States)

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

    2016-01-01

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

  8. Impact of selected risk factors on quality-adjusted life expectancy in Denmark

    DEFF Research Database (Denmark)

    Brønnum-Hansen, Henrik; Juel, Knud; Davidsen, Michael

    2007-01-01

    AIMS: The construct quality-adjusted life years (QALYs) combines mortality and overall health status and can be used to quantify the impact of risk factors on population health. The purpose of the study was to estimate the impact of tobacco smoking, high alcohol consumption, physical inactivity...... Health Survey 2000, and Danish EQ-5D values. RESULTS: The quality-adjusted life expectancy of 25-year-olds was 10-11 QALYs shorter for heavy smokers than for those who never smoke. The difference in life expectancy was 9-10 years. Men and women with high alcohol consumption could expect to lose about 5...... and 3 QALYs, respectively. Sedentary persons could expect to have about 7 fewer QALYs than physically active persons. Obesity shortened QALYs by almost 3 for men and 6 for women. CONCLUSIONS: Smoking, high alcohol consumption, physical inactivity, and obesity strongly reduce life expectancy and health...

  9. [Adjustment for energy intake in the assessment of dietary risk factors].

    Science.gov (United States)

    Thiébaut, A; Kesse, E; Com-Nougué, C; Clavel-Chapelon, F; Bénichou, J

    2004-12-01

    Epidemiologic studies assessing the association between health status and nutritional factors raise the issue of adjusting for energy intake. Indeed, as most nutrients are highly correlated with energy intake which can itself be associated with disease risk, energy intake needs to be adjusted for upon assessing the effect of a specific nutrient. To avoid problems of estimation and interpretation incurred by the use of the standard method which rests on directly adjusting for energy intake, several other methods have been suggested. Namely, the density method uses the ratio of nutrient intake over total energy intake, the residual method relies on the residuals from the regression of nutrient intake on total energy intake, and the partition method fits energy from the nutrient and energy from other sources. These methods yield estimates of different effects but do not allow direct estimation of specific nutrient effects. Estimated effects combine specific and generic energy effects of nutrients and reflect effects of adding or substituting one nutrient for another. We review and apply these methods to the assessment of the association between protein intake and colorectal adenoma occurrence in the E3N-EPIC cohort. This example illustrates how considering findings from all of these methods rather than one single method can lead to a more in-depth understanding of such associations and provide useful guidance for nutritional recommendations.

  10. Risk and Protective Factors at Age 10: Psychological Adjustment in Children With a Cleft Lip and/or Palate.

    Science.gov (United States)

    Feragen, Kristin Billaud; Stock, Nicola Marie

    2016-03-01

    Objective To explore psychological functioning in children with a cleft at age 10 from a broad perspective, including cognitive, emotional, behavioral, appearance-related, and social adjustment. High-risk groups were identified within each area of adjustment to investigate whether vulnerable children were found across domains or whether risk was limited to specific areas of adjustment. Methods Retrospective chart review from psychological assessments at age 10 (N = 845). The effects of gender, cleft visibility, and the presence of an additional condition were investigated. Results were compared with large national samples. Measures Personality Inventory for Children, Child Experience Questionnaire, Strengths and Difficulties Questionnaire, Satisfaction With Appearance scale. Results The factor affecting psychological adjustment on most domains was the presence of an associated condition in addition to the cleft. As expected, no support was found for cleft visibility as a risk factor, while there were some gender differences related to emotional difficulties and attention. Correlation analyses of risk groups pointed to an association between social experiences and emotional adjustment and between social and behavioral adjustment; whereas, dissatisfaction with appearance was not related to any other domains of risk at age 10. Conclusions The results point to the importance of early screening and assessment of children born with a cleft to identify possible associated conditions and offer adapted and appropriate treatment and care. Future research should investigate how protective factors could counteract potential risk in children with a cleft.

  11. Association of binge eating with work productivity impairment, adjusted for other health risk factors.

    Science.gov (United States)

    Bedrosian, Richard C; Striegel, Ruth H; Wang, Chun; Schwartz, Steven

    2012-04-01

    This study examined the association between binge eating and productivity impairment. Using data drawn from individuals completing a health risk appraisal and the Work Productivity and Activity Impairment questionnaire, analyses examined associations between binge eating and obesity, health risks, and productivity impairment. Regression analysis tested associations between binge eating and Work Productivity and Activity Impairment scores, adjusting for demographics, obesity, and health risks. Unstandardized regression coefficients estimated annual productivity loss due to binge eating using a hypothetical employer. Significant associations were found between binge eating and impairment. Adjusting for demographics, obesity, and other risks, binge eating remained a significant correlate of productivity impairment. Estimated annual productivity loss due to binge eating in a company of 1000 employees was $107,965. Efforts to reduce productivity impairment need to target binge eating as a modifiable risk behavior.

  12. A Comparative Study of CAPM and Seven Factors Risk Adjusted Return Model

    Directory of Open Access Journals (Sweden)

    Madiha Riaz Bhatti

    2014-12-01

    Full Text Available This study is a comparison and contrast of the predictive powers of two asset pricing models: CAPM and seven factor risk-return adjusted model, to explain the cross section of stock rate of returns in the financial sector listed at Karachi Stock Exchange (KSE. To test the models daily returns from January 2013 to February 2014 have been taken and the excess returns of portfolios are regressed on explanatory variables. The results of the tested models indicate that the models are valid and applicable in the financial market of Pakistan during the period under study, as the intercepts are not significantly different from zero. It is consequently established from the findings that all the explanatory variables explain the stock returns in the financial sector of KSE. In addition, the results of this study show that addition of more explanatory variables to the single factor CAPM results in reasonably high values of R2. These results provide substantial support to fund managers, investors and financial analysts in making investment decisions.

  13. Risk and Protective Factors at Age 16: Psychological Adjustment in Children With a Cleft Lip and/or Palate.

    Science.gov (United States)

    Feragen, Kristin Billaud; Stock, Nicola Marie; Kvalem, Ingela Lundin

    2015-09-01

    Explore psychological functioning in adolescents with a cleft at age 16 from a broad perspective, including cognitive, emotional, behavioral, appearance-related, and psychosocial adjustment. High-risk groups were identified within each area of adjustment to investigate whether vulnerable adolescents were found across domains or whether risk was limited to specific areas of adjustment. Cross-sectional data based on psychological assessments at age 16 (N = 857). The effect of gender, cleft visibility, and the presence of an additional condition were investigated on all outcome variables. Results were compared with large national samples. Hopkins Symptom Checklist, Harter Self-Perception Scale for Adolescents, Child Experience Questionnaire, and Satisfaction With Appearance scale. The main factor influencing psychological adjustment across domains was gender, with girls in general reporting more psychological problems, as seen in reference groups. The presence of an additional condition also negatively affected some of the measures. No support was found for cleft visibility as a risk factor except for dissatisfaction with appearance. Correlation analyses of risk groups seem to point to an association between social and emotional risk and between social risk and dissatisfaction with appearance. Associations between other domains were found to be weak. The results point to areas of both risk and strength in adolescents born with a cleft lip and/or palate. Future research should investigate how protective factors could counteract potential risk in adolescents with a cleft.

  14. Public Reporting of Primary Care Clinic Quality: Accounting for Sociodemographic Factors in Risk Adjustment and Performance Comparison.

    Science.gov (United States)

    Wholey, Douglas R; Finch, Michael; Kreiger, Rob; Reeves, David

    2018-01-03

    Performance measurement and public reporting are increasingly being used to compare clinic performance. Intended consequences include quality improvement, value-based payment, and consumer choice. Unintended consequences include reducing access for riskier patients and inappropriately labeling some clinics as poor performers, resulting in tampering with stable care processes. Two analytic steps are used to maximize intended and minimize unintended consequences. First, risk adjustment is used to reduce the impact of factors outside providers' control. Second, performance categorization is used to compare clinic performance using risk-adjusted measures. This paper examines the effects of methodological choices, such as risk adjusting for sociodemographic factors in risk adjustment and accounting for patients clustering by clinics in performance categorization, on clinic performance comparison for diabetes care, vascular care, asthma, and colorectal cancer screening. The population includes all patients with commercial and public insurance served by clinics in Minnesota. Although risk adjusting for sociodemographic factors has a significant effect on quality, it does not explain much of the variation in quality. In contrast, taking into account the nesting of patients within clinics in performance categorization has a substantial effect on performance comparison.

  15. Behavioral Risk Factors: Selected Metropolitan Area Risk Trends (SMART) MMSA Age-adjusted Prevalence Data (2011 to Present)

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2011 to present. BRFSS SMART MMSA age-adjusted prevalence combined land line and cell phone data. The Selected Metropolitan Area Risk Trends (SMART) project uses the...

  16. Towards individualized dose constraints: Adjusting the QUANTEC radiation pneumonitis model for clinical risk factors

    DEFF Research Database (Denmark)

    Appelt, Ane L; Vogelius, Ivan R.; Farr, Katherina P.

    2014-01-01

    -response relationships for clinical risk factors was employed. Effect size estimates (odds ratios) for risk factors were drawn from a recently published meta-analysis. Baseline values for D50 and γ50 were found. The method was tested in an independent dataset (103 patients), comparing the predictive power of the dose......-only QUANTEC model and the model including risk factors. Subdistribution cumulative incidence functions were compared for patients with high/low-risk predictions from the two models, and concordance indices (c-indices) for the prediction of RP were calculated. Results. The reference dose- response relationship......Background. Understanding the dose-response of the lung in order to minimize the risk of radiation pneumonitis (RP) is critical for optimization of lung cancer radiotherapy. We propose a method to combine the dose-response relationship for RP in the landmark QUANTEC paper with known clinical risk...

  17. Ambient Fine Particulate Matter Exposure and Risk of Cardiovascular Mortality: Adjustment of the Meteorological Factors

    Directory of Open Access Journals (Sweden)

    Kai Luo

    2016-11-01

    Full Text Available Few studies have explicitly explored the impacts of the extensive adjustment (with a lag period of more than one week of temperature and humidity on the association between ambient fine particulate matter (PM2.5 and cardiovascular mortality. In a time stratified case-crossover study, we used a distributed lag nonlinear model to assess the impacts of extensive adjustments of temperature and humidity for longer lag periods (for 7, 14, 21, 28 and 40 days on effects of PM2.5 on total cardiovascular mortality and mortality of cerebrovascular and ischemic heart disease and corresponding exposure-response relationships in Beijing, China, between 2008 and 2011. Compared with results only controlled for temperature and humidity for 2 days, the estimated effects of PM2.5 were smaller and magnitudes of exposure-response curves were decreased when longer lag periods of temperature and relative humidity were included for adjustments, but these changes varied across subpopulation, with marked decreases occurring in males and the elderly who are more susceptible to PM2.5-related mortalities. Our findings suggest that the adjustment of meteorological factors using lag periods shorter than one week may lead to overestimated effects of PM2.5. The associations of PM2.5 with cardiovascular mortality in susceptible populations were more sensitive to further adjustments for temperature and relative humidity.

  18. Risk and Protective Factors for Psychological Adjustment among Low-Income, African American Children

    Science.gov (United States)

    Gabalda, Megan K.; Thompson, Martie P.; Kaslow, Nadine J.

    2010-01-01

    This investigation identifies unique risk and protective factors for internalizing and externalizing problems among 8- to 12-year-old, low-income, African American children and tests cumulative risk and protective models. A total of 152 mother-child dyads complete questionnaires. Receipt of food stamps, mother's distress, and child maltreatment…

  19. Risk and protection factors in the peer context: how do other children contribute to the psychosocial adjustment of the adolescent?

    OpenAIRE

    Marie-Hélène Véronneau; Sophie-Caroline Trempe; Alexandra Oliveira Paiva

    2014-01-01

    As children become adolescents, peers assume greater importance in their lives. Peer experiences can either help them thrive or negatively affect their psychosocial adjustment. In this review article definitions for the types of peer experiences are provided followed by an overview of common psychosocial issues encountered by adolescents. Past research that has pointed to risk and protection factors that emerge from peer experiences during adolescence and the role of peer influences in the co...

  20. Behavioral Risk Factor Surveillance System (BRFSS) Age-Adjusted Prevalence Data (2011 to present)

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2011 to present. BRFSS combined land line and cell phone age-adjusted prevalence data. The BRFSS is a continuous, state-based surveillance system that collects...

  1. The influence of adjustment for energy misreporting on relations of cake and cookie intake with cardiometabolic disease risk factors.

    Science.gov (United States)

    Gottschald, M; Knüppel, S; Boeing, H; Buijsse, B

    2016-11-01

    Previous cohort studies elucidated unexpected inverse relations of cake and cookie (CC) consumption with chronic disease risk. We assessed CC intake in relation to cardiometabolic disease risk factors in a well-phenotyped population with emphasis on misreporting as the potential driving force behind inverse relations. In a cross-sectional EPIC-Potsdam sub-study individual usual CC intake was modeled by combining 24 h recall and food frequency questionnaire data. Cardiometabolic risk factors were anthropometry, blood lipids, blood pressure (BP), physical activity and fitness. Analysis of covariance models adjusted for (i) age/education/lifestyle and (ii) additionally for energy misreporting (ratio of energy intake over energy expenditure) were used to compute mean values of risk factors for quartiles of CC intake. Adjustment for misreporting had considerable impact on relations of CC intake. Initial inverse links with anthropometry were reversed to direct associations. Misreporting adjustment also nullified inverse relations with triglycerides and with total cholesterol in women. Negligible associations with high density lipoprotein cholesterol turned inverse (men: cross-quartile difference (ΔQ4-Q1)=-1.7 mg/dl; women: ΔQ4-Q1=-3.6 mg/dl), so did fitness (men: ΔQ4-Q1=-1.2 ml/kg/min; women: ΔQ4-Q1=-0.9 ml/kg/min). Direct relations with total/low density lipoprotein cholesterol in men were not changed by misreporting (ΔQ4-Q1 max. 7.5 or 11.3 mg/dl). Reduced BP was observed in females with increased CC intake; only systolic BP remained relevant after misreporting adjustment (ΔQ4-Q1=-4.6 mmHg). The strong impact of energy misreporting on relations of CC intake with risk factors emphasizes a careful analysis and interpretation of nutritional data. We showed that apparent favorable relations of CC intake changed with a different model specification, highlighting proper modeling considerations when analyzing diet-disease relations.

  2. Emotional Intelligence and Identity Style as Risk Factors for High-Risk Behavior in Prisoners: The Mediating Role of Resiliency and Social Adjustment

    Directory of Open Access Journals (Sweden)

    Maktabi

    2016-02-01

    Full Text Available Background A motivation for the intense scientific interest in high-risk behaviors is to do with firmly held belief that behaviors such as substance abuse and delinquency have ubiquitous, catastrophic outcomes. Objectives The current study aimed to examine a model of risk factors for high-risk behaviors in prisoners. It was hypothesized that emotional intelligence and identity style have an indirect effect on high-risk behaviors via the mediating role of social adjustment and resiliency. Materials and Methods The sample consisted of 293 prisoners that were selected via simple random sampling and participated in this research by completing Schutte’s emotional intelligence scale, Berzonsky identity style inventory, social adjustment scale, Conner-Davidson’s resilience scale, and high risk behavior scale; all these instruments are reliable and have been validated. Structural equation modeling (SEM through SPSS 20 and AMOS 20 were used for data analysis. Results The results suggested that the model had good fit (root mean square of approximation = 0.07, comparative fit index = 0.95, normed fit index = 0.91, goodness of fit index =0.93 with the data. Accordingly, the indirect effect of resiliency on high-risk behavior via social adjustment and resiliency, and the indirect effect of identity style on high-risk behavior via emotional intelligence and resiliency were approved. Conclusions Our findings suggest the importance of high-risk behaviors in terms of etiological pathways, maintenance process and treatment interventions.

  3. Female white-collar workers remain at higher risk of breast cancer after adjustments for individual risk factors related to reproduction and lifestyle.

    Science.gov (United States)

    Kullberg, Cecilia; Selander, Jenny; Albin, Maria; Borgquist, Signe; Manjer, Jonas; Gustavsson, Per

    2017-09-01

    The aim was to investigate the variation in risk of breast cancer between occupational groups with a focus on white-collar and blue-collar workers and to investigate to what extent the differences were explained by risk factors related to reproduction and lifestyle. Between 1991 and 1996, 14 119 women born between 1923 and 1950 and residents of Malmö, Sweden, were included in this cohort study. Individual data on risk factors (eg, age, parity, age at first child, months of breast feeding per child, hormonal replacement therapy, physical activity, alcohol consumption, smoking, height and body mass index) and occupational history were assessed using a questionnaire. First-time diagnoses of invasive breast cancer were identified through the Swedish Cancer Registry up until 31 December 2013. A total of 897 women were diagnosed with breast cancer. Analyses adjusted for age showed an increased risk for white-collar workers compared with blue-collar workers and indicated higher risks in the occupational categories: professionals, administrative and bookkeeping than among women in sales, transportation, production and service work. This difference was only marginally attenuated after adjustment for an extensive set of risk factors related to reproduction and lifestyle. Reproductive and lifestyle factors explain only a minor part of the increased risk of breast cancer in white-collar workers. Further studies are needed to investigate the remaining factors for the difference in risk between occupational groups. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Risk and protection factors in the peer context: how do other children contribute to the psychosocial adjustment of the adolescent?

    Directory of Open Access Journals (Sweden)

    Marie-Hélène Véronneau

    2014-03-01

    Full Text Available As children become adolescents, peers assume greater importance in their lives. Peer experiences can either help them thrive or negatively affect their psychosocial adjustment. In this review article definitions for the types of peer experiences are provided followed by an overview of common psychosocial issues encountered by adolescents. Past research that has pointed to risk and protection factors that emerge from peer experiences during adolescence and the role of peer influences in the context of current issues relevant to adolescent education are discussed. Research suggests that friendships with deviant peers, involvement in bullying and the experience of rejection from the overall peer group are related to adjustment problems, whereas friendships with prosocial and academically oriented peers and social acceptance in the peer group are related to healthy development. Friendship quality, popularity among peers, and involvement in friendship cliques cannot be clearly categorized as either positive or negative influences, because they interact with other factors in shaping the development of adolescents. The promotion of social skills and positive youth leadership as an integral part of the student's learning process in school is recommended.

  5. Risk and protection factors in the peer context: how do other children contribute to the psychosocial adjustment of the adolescent?

    Science.gov (United States)

    Véronneau, Marie-Hélène; Trempe, Sophie-Caroline; Paiva, Alexandra Oliveira

    2014-03-01

    As children become adolescents, peers assume greater importance in their lives. Peer experiences can either help them thrive or negatively affect their psychosocial adjustment. In this review article definitions for the types of peer experiences are provided followed by an overview of common psychosocial issues encountered by adolescents. Past research that has pointed to risk and protection factors that emerge from peer experiences during adolescence and the role of peer influences in the context of current issues relevant to adolescent education are discussed. Research suggests that friendships with deviant peers, involvement in bullying and the experience of rejection from the overall peer group are related to adjustment problems, whereas friendships with prosocial and academically oriented peers and social acceptance in the peer group are related to healthy development. Friendship quality, popularity among peers, and involvement in friendship cliques cannot be clearly categorized as either positive or negative influences, because they interact with other factors in shaping the development of adolescents. The promotion of social skills and positive youth leadership as an integral part of the student's learning process in school is recommended.

  6. Psychosocial Adjustment and Sibling Relationships in Siblings of Children with Autism Spectrum Disorder: Risk and Protective Factors

    Science.gov (United States)

    Walton, Katherine M.; Ingersoll, Brooke R.

    2015-01-01

    This study compared sibling adjustment and relationships in siblings of children with Autism Spectrum Disorder (ASD-Sibs; n = 69) and siblings of children with typical development (TD-Sibs; n = 93). ASD-Sibs and TD-Sibs demonstrated similar emotional/behavioral adjustment. Older male ASD-Sibs were at increased risk for difficulties. Sibling…

  7. Acculturation and Adjustment in Latino Adolescents: How Cultural Risk Factors and Assets Influence Multiple Domains of Adolescent Mental Health

    Science.gov (United States)

    Smokowski, Paul; Buchanan, Rachel L.; Bacallao, Martica L.

    2009-01-01

    The purpose of this study was to examine the relationships among risk factors, cultural assets, and Latino adolescent mental health outcomes. We extend past research by using a longitudinal design and evaluating direct and moderated acculturation effects across a range of internalizing, externalizing, and academic engagement outcomes. The sample…

  8. Adjusted Clinical Groups: a patient classification system through risk adjustment

    OpenAIRE

    Sicras-Mainar, Antonio; Dirección de Planificación, Badalona Serveis Assistencials. Barcelona, España. Médico doctor en Medicina, especialista en Salud Pública.; Navarro-Artieda, Ruth; Hospital Germans Trías i Pujol. Badalona, Barcelona, España. médica especialista en Documentación Médica.

    2014-01-01

    Adjusted Clinical Groups (ACG) are risk adjustment systems that classify people according to their age, sex and medical conditions, these people have a similar consumption of health resources over a given period of time. They were developed by Starfield and Weiner (Johns Hopkins University, USA, 1991), and their objective is to measure the degree of illness among patients based on the levels of comorbidity. Their main applications are: a) the evaluation of the efficiency in the use of hea...

  9. Risk and protection factors in the peer context: how do other children contribute to the psychosocial adjustment of the adolescent?

    National Research Council Canada - National Science Library

    Véronneau, Marie-Hélène; Trempe, Sophie-Caroline; Paiva, Alexandra Oliveira

    2014-01-01

    ... to adolescent education are discussed. Research suggests that friendships with deviant peers, involvement in bullying and the experience of rejection from the overall peer group are related to adjustment...

  10. Risk factors for impaired quality of life and psychosocial adjustment after pediatric heart, kidney, and liver transplantation.

    Science.gov (United States)

    Haavisto, Anu; Korkman, Marit; Sintonen, Harri; Holmberg, Christer; Jalanko, Hannu; Lipsanen, Jari; Qvist, Erik

    2013-05-01

    Few studies compare HRQOL and PSA in children who have undergone different types of solid organ Tx. In this cross-sectional study, HRQOL and PSA were assessed in 74 Tx patients (16 heart, 44 kidney, 14 liver) at a mean age of 11.5 (range 6.3-16.7), 7.2 yr post-Tx (range 1.0-15.0). HRQOL was self-assessed using standardized health utility questionnaires (15D-17D). The patients' PSA was evaluated using the Child Behavior Checklist for parents, Youth Self-Report for patients aged 11-16 yr, and Teacher Report Form. Outcomes did not differ significantly between Tx groups. Preadolescents (8-11 yr) reported poorer HRQOL compared with same-age peers (p = 0.020). In contrast, adolescents reported similar HRQOL and PSA compared to the general population. Proxy-reports revealed more PSA problems compared with age expectations (p < 0.01), mainly in internalizing behavior (p < 0.01). Lower HRQOL was associated with shorter follow-up time since Tx, congenital disease, and a psychiatric or neurological diagnosis. PSA problems were associated with family-related variables, neurological diagnosis, shorter follow-up time, and in teacher-reports longer disease duration before Tx. Different pediatric Tx groups have similar outcome. Neurological comorbidity and shorter follow-up time are important risk factors, but the impact of family-related variables on PSA indicate the need of family interventions. © 2013 John Wiley & Sons A/S.

  11. Cumulative Socioeconomic Status Risk, Allostatic Load, and Adjustment: A Prospective Latent Profile Analysis with Contextual and Genetic Protective Factors

    Science.gov (United States)

    Brody, Gene H.; Yu, Tianyi; Chen, Yi-Fu; Kogan, Steven M.; Evans, Gary W.; Beach, Steven R. H.; Windle, Michael; Simons, Ronald L.; Gerrard, Meg; Gibbons, Frederick X.; Philibert, Robert A.

    2013-01-01

    The health disparities literature has identified a common pattern among middle-aged African Americans that includes high rates of chronic disease along with low rates of psychiatric disorders despite exposure to high levels of cumulative socioeconomic status (SES) risk. The current study was designed to test hypotheses about the developmental…

  12. Effect of Laparoscopic Adjustable Gastric Banding on Metabolic Syndrome and Its Risk Factors in Morbidly Obese Adolescents

    Directory of Open Access Journals (Sweden)

    Rushika Conroy

    2011-01-01

    Full Text Available We examined the effect of laparoscopic adjustable gastric banding (LAGB on weight loss, inflammatory markers, and components of the Metabolic Syndrome (MeS in morbidly obese adolescents and determined if those with MeS lose less weight post-LAGB than those without. Data from 14–18 yr adolescents were obtained at baseline, 6 and 12 months following LAGB. Significant weight loss and improvements in MeS components were observed 6 months and one year following LAGB. The incidence of MeS declined 56.8% after 6 months and 69.6% after 12 months. There was no significant difference in amount of weight lost post-LAGB between those with and without MeS at either timepoint. Correlations between change in weight parameters and components of MeS in those with and without MeS at baseline were examined and found to vary by diagnostic category. LAGB is effective for short-term improvement in weight, inflammatory markers, and components of MeS in morbidly obese adolescents.

  13. Social-Emotional Competence: An Essential Factor for Promoting Positive Adjustment and Reducing Risk in School Children

    Science.gov (United States)

    Domitrovich, Celene E.; Durlak, Joseph A.; Staley, Katharine C.; Weissberg, Roger P.

    2017-01-01

    Social-emotional competence is a critical factor to target with universal preventive interventions that are conducted in schools because the construct (a) associates with social, behavioral, and academic outcomes that are important for healthy development; (b) predicts important life outcomes in adulthood; (c) can be improved with feasible and…

  14. Children's Adjustment Following Divorce: Risk and Resilience Perspectives.

    Science.gov (United States)

    Kelly, Joan B.; Emery, Robert E.

    2003-01-01

    Reviews the empirical literature on the longer-term adjustment of children of divorce from the perspective of (a) the stressors and elevated risks that divorce presents for children and (b) protective factors associated with better adjustment. The resiliency demonstrated by the majority of children is discussed, as are controversies regarding the…

  15. Family risk factors for alcohol-related consequences and poor adjustment in fraternity and sorority members: exploring the role of parent-child conflict.

    Science.gov (United States)

    Turner, A P; Larimer, M E; Sarason, I G

    2000-11-01

    The relationship between perceptions of parent-child conflict and alcohol-related consequences was examined in a sample of first-year fraternity and sorority members. Members (N = 302) were asked to complete measures of conflict with their mothers and fathers and report on parent problem drinking. Drinking rates, alcohol-related consequences, depression, and global psychological distress were assessed 1 year later (N = 233). From a final sample with complete mother and father information (N = 202), parent-child conflict at baseline significantly predicted alcohol-related consequences 1 year later for all students. Father-child conflict was a significantly better predictor for male students. Parent histories of problem drinking did not account for this relationship. Although male students reported substantially higher rates of drinking, the relationship between drinking and alcohol-related consequences was stronger among female students. Parent-child conflict at baseline also predicted adjustment to college at 1-year follow-up. Students who perceived higher levels of mother-child and father-child conflict reported higher levels of depression. Students who perceived higher levels of father-child conflict reported higher levels of global psychological distress. Results indicate that perceptions of conflict in specific parent-child relationships constitute a risk factor for poor college adjustment and the experience of alcohol-related consequences.

  16. Managing commodity risks in highway contracts : quantifying premiums, accounting for correlations among risk factors, and designing optimal price-adjustment contracts.

    Science.gov (United States)

    2011-09-01

    It is a well-known fact that macro-economic conditions, such as prices of commodities (e.g. oil, : cement and steel) affect the cost of construction projects. In a volatile market environment, highway : agencies often pass such risk to contractors us...

  17. Risk-Adjusted Mortality: Problems and Possibilities

    Directory of Open Access Journals (Sweden)

    Daniel Shine

    2012-01-01

    Full Text Available The ratio of observed-to-expected deaths is considered a measure of hospital quality and for this reason will soon become a basis for payment. However, there are drivers of that metric more potent than quality: most important are medical documentation and patient acuity. If hositals underdocument and therefore do not capture the full “expected mortality” they may be tempted to lower their observed/expected ratio by reducing “observed mortality” through limiting access to the very ill. Underdocumentation occurs because hospitals do not recognize, and therefore cannot seek to confirm, specific comorbidities conferring high mortality risk. To help hospitals identify these comorbidities, this paper describes an easily implemented spread-sheet for evaluating comorbid conditions associated, in any particular hospital, with each discharge. This method identifies comorbidities that increase in frequency as mortality risk increases within each diagnostic grouping. The method is inductive and therefore independent of any particular risk-adjustment technique.

  18. High-sensitivity C-reactive protein is only weakly related to cardiovascular damage after adjustment for traditional cardiovascular risk factors

    DEFF Research Database (Denmark)

    Olsen, Michael H; Christensen, Marina K; Hansen, Tine W

    2006-01-01

    The independent prognostic value of high-sensitivity C-reactive protein (hsCRP) has been questioned, and consequently we decided to investigate whether hsCRP was associated with subclinical cardiovascular (CV) damage independently of traditional CV risk factors.......The independent prognostic value of high-sensitivity C-reactive protein (hsCRP) has been questioned, and consequently we decided to investigate whether hsCRP was associated with subclinical cardiovascular (CV) damage independently of traditional CV risk factors....

  19. Risk Factors

    Science.gov (United States)

    ... Many things in our genes , our lifestyle, and the environment around us may increase or decrease our risk ... Being exposed to chemicals and other substances in the environment has been linked to some cancers: Links between ...

  20. Personality, emotional adjustment, and cardiovascular risk: marriage as a mechanism.

    Science.gov (United States)

    Smith, Timothy W; Baron, Carolynne E; Grove, Jeremy L

    2014-12-01

    A variety of aspects of personality and emotional adjustment predict the development and course of coronary heart disease (CHD), as do indications of marital quality (e.g., satisfaction, conflict, strain, disruption). Importantly, the personality traits and aspects of emotional adjustment that predict CHD are also related to marital quality. In such instances of correlated risk factors, traditional epidemiological and clinical research typically either ignores the potentially overlapping effects or examines independent associations through statistical controls, approaches that can misrepresent the key components and mechanisms of psychosocial effects on CHD. The interpersonal perspective in personality and clinical psychology provides an alternative and integrative approach, through its structural and process models of interpersonal behavior. We present this perspective on psychosocial risk and review research on its application to the integration of personality, emotional adjustment, and marital processes as closely interrelated influences on health and disease. © 2013 Wiley Periodicals, Inc.

  1. Malnutrition Increases With Obesity and Is a Stronger Independent Risk Factor for Postoperative Complications: A Propensity-Adjusted Analysis of Total Hip Arthroplasty Patients.

    Science.gov (United States)

    Fu, Michael C; D'Ambrosia, Christopher; McLawhorn, Alexander S; Schairer, William W; Padgett, Douglas E; Cross, Michael B

    2016-11-01

    Obesity is frequently associated with complications after total hip arthroplasty (THA) and is often concomitant with malnutrition. The purpose of this study was to investigate the independent morbidity risk of malnutrition relative to obesity. The National Surgical Quality Improvement Program from 2005 to 2013 was queried for elective primary THA cases. Malnutrition was defined as albumin malnutrition with 30-day outcomes. A total of 40,653 THA cases were identified, of which 20,210 (49.7%) had preoperative albumin measurements. Propensity score adjustment successfully reduced potential selection bias, with P > .05 for differences between those with and without albumin data. Malnutrition incidence increased from 2.8% in obese I to 5.7% in obese III patients. With multivariable propensity-adjusted logistic regression, malnutrition was a more robust predictor than any obesity class for any postoperative complication(s) (odds ratio [OR] 1.61, 95% confidence interval [CI] 1.25-2.08), major complications (OR 1.63, 95% CI 1.21-2.19), respiratory complications (OR 2.35, 95% CI 1.27-4.37), blood transfusions (OR 1.71, 95% CI 1.44-2.03), and extended length of stay (OR 1.35, 95% CI 1.14-1.59). Malnutrition incidence increased significantly from obese I to obese III patients and was a stronger and more consistent predictor than obesity of complications after THA. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Risk Factors for Scleroderma

    Science.gov (United States)

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

  3. 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 ...

  4. 75 FR 33379 - Railroad Cost Recovery Procedures-Productivity Adjustment; Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2010-06-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Surface Transportation Board Railroad Cost Recovery Procedures--Productivity Adjustment; Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board. ] ACTION: Notice and request for comments...

  5. Risk Factors and Prevention

    Science.gov (United States)

    ... Factors & Prevention Back to Patient Resources Risk Factors & Prevention Even people who look healthy and free of ... as possible. Share: The Normal Heart Risk Factors & Prevention Heart Diseases & Disorders Substances & Heart Rhythm Disorders Symptoms & ...

  6. Spatial implications of covariate adjustment on patterns of risk

    DEFF Research Database (Denmark)

    Sabel, Clive Eric; Wilson, Jeff Gaines; Kingham, Simon

    2007-01-01

    localised factors that influence the exposure-response relationship. This paper examines the spatial patterns of relative risk and clusters of hospitalisations based on an illustrative small-area example from Christchurch, New Zealand. A four-stage test of the spatial relocation effects of covariate...... area to a mixed residential/industrial area, possibly introducing new environmental exposures. Researchers should be aware of the potential spatial effects inherent in adjusting for covariates when considering study design and interpreting results. © 2007 Elsevier Ltd. All rights reserved....

  7. Overpaying morbidity adjusters in risk equalization models

    NARCIS (Netherlands)

    R.C. van Kleef (Richard); R.C.J.A. van Vliet (René); W.P.M.M. van de Ven (Wynand)

    2016-01-01

    textabstractMost competitive social health insurance markets include risk equalization to compensate insurers for predictable variation in healthcare expenses. Empirical literature shows that even the most sophisticated risk equalization models—with advanced morbidity adjusters—substantially

  8. Cumulative Family Risk Predicts Increases in Adjustment Difficulties across Early Adolescence

    Science.gov (United States)

    Buehler, Cheryl; Gerard, Jean M.

    2013-01-01

    Family is an important socialization context for youth as they move through early adolescence. A significant feature of this complex socialization context is the accumulation of potential family risk factors that may compromise youth adjustment. This study examined cumulative family risk and adolescents' adjustment difficulties in 416 two-parent…

  9. Incidence, prevalence, mortality, disability-adjusted life years and risk factors of cancer in Australia and comparison with OECD countries, 1990-2015: findings from the Global Burden of Disease Study 2015.

    Science.gov (United States)

    Melaku, Yohannes Adama; Appleton, Sarah L; Gill, Tiffany K; Ogbo, Felix A; Buckley, Elizabeth; Shi, Zumin; Driscoll, Tim; Adams, Robert; Cowie, Benjamin C; Fitzmaurice, Christina

    2018-02-01

    Comparative evidence on the burden, trend, and risk factors of cancer is limited. Using data from the Global Burden of Disease (GBD) study, we aimed to assess cancer burden - incidence, prevalence, mortality, disability-adjusted life years (DALYs) - and attributable risk factors for Australia between 1990 and 2015, and to compare them with those of 34 members of the Organisation for Economic Co-operation and Development (OECD). The general GBD cancer estimation methods were used with data input from vital registration systems and cancer registries. A comparative risk assessment approach was used to estimate the population-attributable fractions due to risk factors. In 2015 there were 198,880 (95% uncertainty interval [UI]: 183,908-217,365) estimated incident cancer cases and 47,562 (95% UI: 46,061-49,004) cancer deaths in Australia. Twenty-nine percent (95% UI: 28.2-29.8) of total deaths and 17.0% (95% UI: 15.0-19.1) of DALYs were caused by cancer in Australia in 2015. Cancers of the trachea, bronchus and lung, colon and rectum, and prostate were the most common causes of cancer deaths. Thirty-six percent (95% UI: 33.1-37.9) of all cancer deaths were attributable to behavioral risks. The age-standardized cancer incidence rate (ASIR) increased between 1990 and 2015, while the age-standardized cancer death rate (ASDR) decreased over the same period. In 2015, compared to 34 other OECD countries Australia ranked first (highest) and 24 th based on ASIR and ASDR, respectively. The incidence of cancer has increased over 25 years, and behavioral risks are responsible for a large proportion of cancer deaths. Scaling up of prevention (using strategies targeting cancer risk factors), early detection, and treatment of cancer is required to effectively address this growing health challenge. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Risk-Adjusted Control Charts for Health Care Monitoring

    Directory of Open Access Journals (Sweden)

    Willem Albers

    2011-01-01

    the distribution involved is negative binomial. However, in health care monitoring, (groups of patients will often belong to different risk categories. In the present paper, we will show how information about category membership can be used to adjust the basic negative binomial charts to the actual risk incurred. Attention is also devoted to comparing such conditional charts to their unconditional counterparts. The latter do take possible heterogeneity into account but refrain from risk-adjustment. Note that in the risk adjusted case several parameters are involved, which will all be typically unknown. Hence, the potentially considerable estimation effects of the new charts will be investigated as well.

  11. Measurement Of Shariah Stock Performance Using Risk Adjusted Performance

    Directory of Open Access Journals (Sweden)

    Zuhairan Y Yunan

    2015-03-01

    Full Text Available The aim of this research is to analyze the shariah stock performance using risk adjusted performance method. There are three parameters to measure the stock performance i.e. Sharpe, Treynor, and Jensen. This performance’s measurements calculate the return and risk factor from shariah stocks. The data that used on this research is using the data of stocks at Jakarta Islamic Index. Sampling method that used on this paper is purposive sampling. This research is using ten companies as a sample. The result shows that from three parameters, the stock that have a best performance are AALI, ANTM, ASII, CPIN, INDF, KLBF, LSIP, and UNTR.DOI: 10.15408/aiq.v7i1.1364

  12. ACA Risk Adjustment - Overview, Context, and Challenges

    Data.gov (United States)

    U.S. Department of Health & Human Services — Volume 4, Issue 3 of the Medicare and Medicaid Research Review includes three articles describing the Department of Health and Human Services (HHS) developed risk...

  13. The risk-adjusted monetary policy rule

    OpenAIRE

    Nakata, Taisuke; Schmidt, Sebastian

    2016-01-01

    Macroeconomists are increasingly using nonlinear models to account for the effects of risk in the analysis of business cycles. In the monetary business cycle models widely used at central banks, an explicit recognition of risk generates a wedge between the inflation-target parameter in the monetary policy rule and the risky steady state (RSS) of inflation - the rate to which inflation will eventually converge - which can be undesirable in some practical applications. We propose a simple modif...

  14. Overall survival in lower IPSS risk MDS by receipt of iron chelation therapy, adjusting for patient-related factors and measuring from time of first red blood cell transfusion dependence: an MDS-CAN analysis.

    Science.gov (United States)

    Leitch, Heather A; Parmar, Ambica; Wells, Richard A; Chodirker, Lisa; Zhu, Nancy; Nevill, Thomas J; Yee, Karen W L; Leber, Brian; Keating, Mary-Margaret; Sabloff, Mitchell; St Hilaire, Eve; Kumar, Rajat; Delage, Robert; Geddes, Michelle; Storring, John M; Kew, Andrea; Shamy, April; Elemary, Mohamed; Lenis, Martha; Mamedov, Alexandre; Ivo, Jessica; Francis, Janika; Zhang, Liying; Buckstein, Rena

    2017-10-01

    Analyses suggest iron overload in red blood cell (RBC) transfusion-dependent (TD) patients with myleodysplastic syndrome (MDS) portends inferior overall survival (OS) that is attenuated by iron chelation therapy (ICT) but may be biassed by unbalanced patient-related factors. The Canadian MDS Registry prospectively measures frailty, comorbidity and disability. We analysed OS by receipt of ICT, adjusting for these patient-related factors. TD International Prognostic Scoring System (IPSS) low and intermediate-1 risk MDS, at RBC TD, were included. Predictive factors for OS were determined. A matched pair analysis considering age, revised IPSS, TD severity, time from MDS diagnosis to TD, and receipt of disease-modifying agents was conducted. Of 239 patients, 83 received ICT; frailty, comorbidity and disability did not differ from non-ICT patients. Median OS from TD was superior in ICT patients (5·2 vs. 2·1 years; P MDS, adjusting for age, frailty, comorbidity, disability, revised IPSS, TD severity, time to TD and receiving disease-modifying agents. This provides additional evidence that ICT may confer clinical benefit. © 2017 John Wiley & Sons Ltd.

  15. The Impact of Paradoxical Comorbidities on Risk-Adjusted...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Persistent uncertainty remains regarding assessments of patient comorbidity based on administrative data for mortality risk adjustment. Some models include comorbid...

  16. Ohio Army National Guard Mental Health Initiative: Risk and Resilience Factors for Combat-Related Posttraumatic Psychopathology and Post Combat Adjustment

    Science.gov (United States)

    2012-10-01

    longitudinal predictor of sexual risk behaviors among US middle and high school students. Pediatrics , 118(1), 189-200. doi: 10.1542/peds.2005-1320. Levin, L...findings from the 2009 BRFSS survey. Pediatric Blood & Cancer, 58(6), 964-970. doi: 10.1002/pbc.23359. Plotzker, R. E., Metzger, D. S., & Holmes, W. C...Adelaide 4 University of Florida College of Dentistry , Gainesville 5Computational Biology Branch, NCB!, NIH, Bethesda, Maryland 6Laboratory of

  17. Ohio Army National Guard Mental Health Initiative: Risk and Resilience Factors for Combat-Related Posttraumatic Psychopathology and Post Combat Adjustment

    Science.gov (United States)

    2013-10-01

    training of men and women in the Ohio Reserve Component. 15. SUBJECT TERMS Risk, Resilience, Combat, Posttraumatic Stress Disorder, Ohio National...implicated in PTSD, as well as ancestry informative markers. Association of previously reported variants with level of Page 10 of 173 PTSD symptoms...Guard with useful, pragmatic information immediately relevant to the training of men and women in the Ohio Reserve Component. The leadership of the

  18. Parental Acceptance-Rejection, Childhood Trauma, Emotion Regulation, and Psychological Adjustment as the Risk Factors of Psychopathic Tendencies in Adolescents of Pakistan

    Directory of Open Access Journals (Sweden)

    Saba Walayat

    2017-06-01

    Full Text Available The present study aimed to explore the psychopathic tendencies in relation to childhood trauma, psychological adjustment, emotion regulation and parental patterns of acceptance-rejection towards their adolescents and the influence of demographic variables in socio-cultural context of Pakistan. Translated versions of Parental Acceptance-Rejection Questionnaire; Child PARQ, Childhood Trauma Questionnaire, Personality Assessment Questionnaire, Emotion Regulation Questionnaire, Youth Psychopathic Trait Inventory and bio-data form containing information regarding different demographic variables were used in order to collect the data from the participants. The sample consisted of 600 adolescents (281 males; 319 females with age ranged between 13 and 17 were selected with convenient random sampling from different private and public schools of the three major cities of Punjab; Lahore, Gujrat and Sialkot. The results indicated psychological maladjustment as the most significant predictor of psychopathic tendencies. However, emotion regulation appeared to be as the most significant predictor of psychopathic tendencies in male adolescents and parental acceptance-rejection (mother in female adolescents. The results further indicated that age, father’s education and profession, mother’s education and monthly income are significant determinants of psychopathic tendencies in participants of the study.

  19. Risk-adjusted models for adverse obstetric outcomes and variation in risk-adjusted outcomes across hospitals.

    Science.gov (United States)

    Bailit, Jennifer L; Grobman, William A; Rice, Madeline Murguia; Spong, Catherine Y; Wapner, Ronald J; Varner, Michael W; Thorp, John M; Leveno, Kenneth J; Caritis, Steve N; Shubert, Phillip J; Tita, Alan T; Saade, George; Sorokin, Yoram; Rouse, Dwight J; Blackwell, Sean C; Tolosa, Jorge E; Van Dorsten, J Peter

    2013-11-01

    Regulatory bodies and insurers evaluate hospital quality using obstetrical outcomes, however meaningful comparisons should take preexisting patient characteristics into account. Furthermore, if risk-adjusted outcomes are consistent within a hospital, fewer measures and resources would be needed to assess obstetrical quality. Our objective was to establish risk-adjusted models for 5 obstetric outcomes and assess hospital performance across these outcomes. We studied a cohort of 115,502 women and their neonates born in 25 hospitals in the United States from March 2008 through February 2011. Hospitals were ranked according to their unadjusted and risk-adjusted frequency of venous thromboembolism, postpartum hemorrhage, peripartum infection, severe perineal laceration, and a composite neonatal adverse outcome. Correlations between hospital risk-adjusted outcome frequencies were assessed. Venous thromboembolism occurred too infrequently (0.03%; 95% confidence interval [CI], 0.02-0.04%) for meaningful assessment. Other outcomes occurred frequently enough for assessment (postpartum hemorrhage, 2.29%; 95% CI, 2.20-2.38, peripartum infection, 5.06%; 95% CI, 4.93-5.19, severe perineal laceration at spontaneous vaginal delivery, 2.16%; 95% CI, 2.06-2.27, neonatal composite, 2.73%; 95% CI, 2.63-2.84). Although there was high concordance between unadjusted and adjusted hospital rankings, several individual hospitals had an adjusted rank that was substantially different (as much as 12 rank tiers) than their unadjusted rank. None of the correlations between hospital-adjusted outcome frequencies was significant. For example, the hospital with the lowest adjusted frequency of peripartum infection had the highest adjusted frequency of severe perineal laceration. Evaluations based on a single risk-adjusted outcome cannot be generalized to overall hospital obstetric performance. Copyright © 2013 Mosby, Inc. All rights reserved.

  20. Factors affecting couples' adjustment to recurrent breast cancer.

    Science.gov (United States)

    Northouse, L L; Dorris, G; Charron-Moore, C

    1995-07-01

    The purpose of this study was to identify factors that affect the adjustment of women and their husbands to recurrent breast cancer and to examine the mutual effect that partners have on one another. An exploratory study was designed to determine the relationship between four predictor variables (support, uncertainty, symptom distress, hopelessness) and women's and husbands' adjustments. The sample consisted of 155 subjects; 81 women, who had a first recurrence of breast cancer, and 74 husbands. Multiple standardized instruments with established reliability and validity were used to measure the study variables. The independent variables were measured with the Social Support Questionnaire, the Mishel Uncertainty in Illness Scale, McCorkle Symptom Distress Scale and the Beck Hopelessness Scale. The dependent variable, psychosocial adjustment, was measured with the Brief Symptom Inventory and the Psychosocial Adjustment to Illness Scale. The results indicated that the independent variables accounted for 43% of the variance in women's distress and 32% of the variance in husbands' distress; they also explained 66% of the variance in women's role adjustment problems and 57% of the variance in husbands' role problems. Symptom distress and hopelessness accounted for the most variance in women's and husbands' levels of adjustment. A significant and positive relationship was found between women's and husbands' adjustment scores, indicating that partners have a mutual influence on one another. The findings suggest that there are multiple factors that influence couples' adjustment to recurrent breast cancer, and that these factors need to be taken into consideration when planning care for women and their partners.

  1. A Machine Learning Framework for Plan Payment Risk Adjustment.

    Science.gov (United States)

    Rose, Sherri

    2016-12-01

    To introduce cross-validation and a nonparametric machine learning framework for plan payment risk adjustment and then assess whether they have the potential to improve risk adjustment. 2011-2012 Truven MarketScan database. We compare the performance of multiple statistical approaches within a broad machine learning framework for estimation of risk adjustment formulas. Total annual expenditure was predicted using age, sex, geography, inpatient diagnoses, and hierarchical condition category variables. The methods included regression, penalized regression, decision trees, neural networks, and an ensemble super learner, all in concert with screening algorithms that reduce the set of variables considered. The performance of these methods was compared based on cross-validated R(2) . Our results indicate that a simplified risk adjustment formula selected via this nonparametric framework maintains much of the efficiency of a traditional larger formula. The ensemble approach also outperformed classical regression and all other algorithms studied. The implementation of cross-validated machine learning techniques provides novel insight into risk adjustment estimation, possibly allowing for a simplified formula, thereby reducing incentives for increased coding intensity as well as the ability of insurers to "game" the system with aggressive diagnostic upcoding. © Health Research and Educational Trust.

  2. Brain Tumor Risk Factors

    Science.gov (United States)

    ... Professional Meetings Order Materials Clinical Trials Support Group Leader Training Adolescent and Young Adult Guidelines For brain ... nitrites), cigarette smoking, cell phone use, and residential power line exposure, for example—are true risk factors ...

  3. ADJUSTED F FACTOR FOR MULTIPLE-OUTLET PIPES.

    OpenAIRE

    Scaloppi, Edmar José [UNESP

    1988-01-01

    An adjusted F factor to compute pressure head loss in pipes having multiple, equally spaced outlets is derived for any given distance from the first outlet to the beginning of the pipe. The proposed factor is dependent on the number of outlets and is expressed as a function of the J. E. Christiansen's F factor. It may be useful to irrigation engineers to estimate friction in sprinkle and trickle irrigation laterals and manifolds, as well as gated pipes.

  4. Risk Factors for Tuberculosis

    Directory of Open Access Journals (Sweden)

    Padmanesan Narasimhan

    2013-01-01

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

  5. State infant mortality: an ecologic study to determine modifiable risks and adjusted infant mortality rates.

    Science.gov (United States)

    Paul, David A; Mackley, Amy; Locke, Robert G; Stefano, John L; Kroelinger, Charlan

    2009-05-01

    To determine factors contributing to state infant mortality rates (IMR) and develop an adjusted IMR in the United States for 2001 and 2002. Ecologic study of factors contributing to state IMR. State IMR for 2001 and 2002 were obtained from the United States linked death and birth certificate data from the National Center for Health Statistics. Factors investigated using multivariable linear regression included state racial demographics, ethnicity, state population, median income, education, teen birth rate, proportion of obesity, smoking during pregnancy, diabetes, hypertension, cesarean delivery, prenatal care, health insurance, self-report of mental illness, and number of in-vitro fertilization procedures. Final risk adjusted IMR's were standardized and states were compared with the United States adjusted rates. Models for IMR in individual states in 2001 (r2 = 0.66, P rate, and smoking during pregnancy remained independently associated with state infant mortality rates for 2001 and 2002. Ninety five percent confidence intervals (CI) were calculated around the regression lines to model the expected IMR. After adjustment, some states maintained a consistent IMR; for instance, Vermont and New Hampshire remained low, while Delaware and Louisiana remained high. However, other states such as Mississippi, which have traditionally high infant mortality rates, remained within the expected 95% CI for IMR after adjustment indicating confounding affected the initial unadjusted rates. Non-modifiable demographic variables, including the percentage of non-Hispanic African-American and Hispanic populations of the state are major factors contributing to individual variation in state IMR. Race and ethnicity may confound or modify the IMR in states that shifted inside or outside the 95% CI following adjustment. Other factors including smoking during pregnancy and teen birth rate, which are potentially modifiable, significantly contributed to differences in state IMR. State risk

  6. Risk adjusting community rated health plan premiums: a survey of risk assessment literature and policy applications.

    Science.gov (United States)

    Giacomini, M; Luft, H S; Robinson, J C

    1995-01-01

    This paper surveys recent health care reform debates and empirical evidence regarding the potential role for risk adjusters in addressing the problem of competitive risk segmentation under capitated financing. We discuss features of health plan markets affecting risk selection, methodological considerations in measuring it, and alternative approaches to financial correction for risk differentials. The appropriate approach to assessing risk differences between health plans depends upon the nature of market risk selection allowed under a given reform scenario. Because per capita costs depend on a health plan's population risk, efficiency, and quality of service, risk adjustment will most strongly promote efficiency in environments with commensurately strong incentives for quality care.

  7. 78 FR 59093 - Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2013-09-25

    ... RCAF Unadjusted (0.975) by the fourth quarter productivity adjustment factor-5 (PAF-5) of 2.4426. The fourth quarter 2013 PAF-5 is calculated by multiplying the third quarter 2013 PAF-5 of 2.4377 by the...

  8. 42 CFR 412.322 - Indirect medical education adjustment factor.

    Science.gov (United States)

    2010-10-01

    ... Payment System for Inpatient Hospital Capital Costs Basic Methodology for Determining the Federal Rate for... reporting period. (3) The measurement of teaching activity is the ratio of the hospital's full-time.... The indirect teaching adjustment factor equals . (c)-(d) Determination of Transition Period Payment...

  9. Factors That Contribute to the Adjustment of International Students

    Science.gov (United States)

    Mesidor, Jean Kesnold; Sly, Kaye F.

    2016-01-01

    Leaving home to attend college is an important milestone for college students. However, the transition from home to college can be challenging, especially for students studying abroad. In this article, the authors explore factors that contribute to the academic, cultural, social, and psychological adjustments of international students. Adjustment…

  10. General Adjustment Influence Factor of Malaysian Construction Expatriates Executives Abroad

    Directory of Open Access Journals (Sweden)

    Zainol Halmi

    2016-01-01

    Full Text Available The success of Malaysian construction companies creates an opportunity to explore abroad. Past studies have shown that the difficulty of expatriates in adjusting to a new environment is the main aspect that leads to failure of assignments. The success in implementing an overseas assignment does not solely depend on an expatriate’s technical expertise. The adjustment issues such as the interaction with the host nationals, and adaptability to the host country’s culture also exert influence on the assignment. The research was conducted to identify the influence of executive expatriate general adjustment on assignment in host countries. The objective of the study was to identify adjustment influence factors relating to general adjustment abroad. Questionnaires were sent to Malaysian expatriate executives. Sixty four Malaysian expatriate executives from Malaysian construction companies overseas were involved in this study. The findings show interaction, social and living environment influences their adjustment during expatriation. Pre-departure training preparation aspects for expatriates is a good step before their departure to host countries.

  11. Portfolio liquidity-adjusted value-at-risk

    Directory of Open Access Journals (Sweden)

    Marius Botha

    2011-09-01

    Full Text Available An important, yet neglected, aspect of risk management is liquidity risk; changes in value due to reduced availability of traded financial instruments. This ubiquitous risk has emerged as one of the key drivers of the developing “credit crunch” with global financial liquidity plummeting since the crisis began. Despite massive cash injections by governments, the crisis continues. Contemporary research has focussed on the liquidity component of single instruments’ value-at-risk. This work is extended in this article to measure portfolio value-at-risk, employing a technique which integrates individual instruments’ liquidity-adjusted VaR into a portfolio environment without a commensurate increase of statistical assumptions.

  12. Factors Moderating the Relationship Between Childhood Trauma and Premorbid Adjustment in First-Episode Schizophrenia.

    Science.gov (United States)

    Kilian, S; Burns, J K; Seedat, S; Asmal, L; Chiliza, B; Du Plessis, S; Olivier, M R; Kidd, M; Emsley, R

    2017-01-01

    Childhood trauma is a recognised risk factor for schizophrenia. It has been proposed that childhood trauma interferes with normal neurodevelopment, thereby establishing a biological vulnerability to schizophrenia. Poor premorbid adjustment is frequently a precursor to schizophrenia, and may be a manifestation of neurodevelopmental compromise. We investigated the relationship between childhood trauma and premorbid adjustment in 77 patients with first-episode schizophrenia spectrum disorders. We also investigated possible mediating roles for other selected risk factors in the relationship. We found several significant correlations between different trauma types and both social and academic premorbid adjustment from childhood to late adolescence. There were no significant moderating effects for family history of schizophrenia or family history of psychiatric disorder. History of obstetric complications, substance abuse and poor motor coordination weakened some of the associations between childhood trauma and premorbid adjustment, while poor sequencing of motor acts strengthened the association. Our results confirm previous studies indicating an association between childhood trauma and premorbid adjustment. Results indicate a general rather than specific association, apparent with different types of trauma, and affecting both social and academic components of premorbid adjustment across childhood, early and late adolescence. Further, our results suggest a complex interplay of various risk factors, supporting the notion of different pathways to psychosis.

  13. Attachment Hierarchies Among At Risk Teens and Psychological Adjustment

    OpenAIRE

    Dangaltcheva, Antonia

    2014-01-01

    The study examined the degree to which teens at high risk for behaviour problems rely on friends and romantic partners rather than parents to meet attachment needs and whether this affected their psychological adjustment. Participants were 158 adolescents recruited from youth custody settings and a mental health facility. Attachment functions shifted from parents to peers much earlier compared to previously published results based on normative samples. Only 9% of participants preferred their ...

  14. Risk Selection, Risk Adjustment and Choice: Concepts and Lessons from the Americas

    Science.gov (United States)

    Ellis, Randall P.; Fernandez, Juan Gabriel

    2013-01-01

    Interest has grown worldwide in risk adjustment and risk sharing due to their potential to contain costs, improve fairness, and reduce selection problems in health care markets. Significant steps have been made in the empirical development of risk adjustment models, and in the theoretical foundations of risk adjustment and risk sharing. This literature has often modeled the effects of risk adjustment without highlighting the institutional setting, regulations, and diverse selection problems that risk adjustment is intended to fix. Perhaps because of this, the existing literature and their recommendations for optimal risk adjustment or optimal payment systems are sometimes confusing. In this paper, we present a unified way of thinking about the organizational structure of health care systems, which enables us to focus on two key dimensions of markets that have received less attention: what choices are available that may lead to selection problems, and what financial or regulatory tools other than risk adjustment are used to influence these choices. We specifically examine the health care systems, choices, and problems in four countries: the US, Canada, Chile, and Colombia, and examine the relationship between selection-related efficiency and fairness problems and the choices that are allowed in each country, and discuss recent regulatory reforms that affect choices and selection problems. In this sample, countries and insurance programs with more choices have more selection problems. PMID:24284351

  15. Mental Health Risk Adjustment with Clinical Categories and Machine Learning.

    Science.gov (United States)

    Shrestha, Akritee; Bergquist, Savannah; Montz, Ellen; Rose, Sherri

    2017-12-15

    To propose nonparametric ensemble machine learning for mental health and substance use disorders (MHSUD) spending risk adjustment formulas, including considering Clinical Classification Software (CCS) categories as diagnostic covariates over the commonly used Hierarchical Condition Category (HCC) system. 2012-2013 Truven MarketScan database. We implement 21 algorithms to predict MHSUD spending, as well as a weighted combination of these algorithms called super learning. The algorithm collection included seven unique algorithms that were supplied with three differing sets of MHSUD-related predictors alongside demographic covariates: HCC, CCS, and HCC + CCS diagnostic variables. Performance was evaluated based on cross-validated R 2 and predictive ratios. Results show that super learning had the best performance based on both metrics. The top single algorithm was random forests, which improved on ordinary least squares regression by 10 percent with respect to relative efficiency. CCS categories-based formulas were generally more predictive of MHSUD spending compared to HCC-based formulas. Literature supports the potential benefit of implementing a separate MHSUD spending risk adjustment formula. Our results suggest there is an incentive to explore machine learning for MHSUD-specific risk adjustment, as well as considering CCS categories over HCCs. © Health Research and Educational Trust.

  16. [Laryngeal cancer risk factors].

    Science.gov (United States)

    Jurkiewicz, Dariusz; Dzaman, Karolina; Rapiejko, Piotr

    2006-07-01

    Laryngeal cancer is the most common of head and neck cancers. Neoplasm used to develop basing on DNA mutation which leads to uncontrolled growth and cells' division. It is due to spontaneous mutations or influence of chemical, biological and physical factors. Laryngeal cancer generation is conditioned by many synergic factors. Some of them certainly participate in cancer genesis and this thesis is accepted by medical environment and other of them have been discussed giving different information. Definition of the risk factors role in laryngeal cancer etiology is very difficult especially regarding their contemporary occurrence in one person. Most common risk factors are environmental factors, gastroesophageal reflux, viral infections, diet, radiation, individual predisposition. Some of them, such as cigarette smoking and abuse alcohol are significantly oftener confirmed in patients with neoplasm diagnosis and others' role in developing of illness has been still researched. Thus the purpose of the study was to present so far achievements in laryngeal cancer etiology and to emphasize controversies relating to some factors' role in cancer genesis.

  17. [Pathological gambling: risk factors].

    Science.gov (United States)

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

    2011-09-01

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

  18. Risk Factors for Dementia

    Directory of Open Access Journals (Sweden)

    Jen-Hau Chen

    2009-10-01

    Full Text Available Dementia is a complex human disease. The incidence of dementia among the elderly population is rising rapidly worldwide. In the United States, Alzheimer's disease (AD is the leading type of dementia and was the fifth and eighth leading cause of death in women and men aged ≥ 65 years, respectively, in 2003. In Taiwan and many other counties, dementia is a hidden health issue because of its underestimation in the elderly population. In Western countries, the prevalence of AD increases from 1–3% among people aged 60–64 years to 35% among those aged > 85 years. In Taiwan, the prevalence of dementia for people aged ≥ 65 years was 2–4% by 2000. Therefore, it is important to identify protective and risk factors for dementia to prevent this disease at an early stage. Several factors are related to dementia, e.g. age, ethnicity, sex, genetic factors, physical activity, smoking, drug use, education level, alcohol consumption, body mass index, comorbidity, and environmental factors. In this review, we focus on studies that have evaluated the association between these factors and the risk of dementia, especially AD and vascular dementia. We also suggest future research directions for researchers in dementia-related fields.

  19. Breast cancer risk factors

    Directory of Open Access Journals (Sweden)

    Marzena Kamińska

    2015-09-01

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

  20. AFCS (Army Facilities Components System) Climatic Zone Labor Adjustment Factors.

    Science.gov (United States)

    1984-08-01

    13AR 415-17, Cost Estimating for Military Programaing (U.S. Department of the 14Army, February 1980). Hanscomb Associates Inc., CONUS Location...Adjustment Factor Analysis Report DACA -87-C-0040, Task 3, Vol I (U.S. Army Engineer Division, Huntsville, 1983). 15L. Dallania, Estimating General...ReRort, DACA -87-C-0040, Task 3, Vol 1 (U.S. Army Engineer Division, Huntsville, 1983). Havers, J. A., and R. M. Morgan, Optimal Construction Plans for

  1. Risk adjustment for inter-hospital comparison of caesarean delivery rates in low-risk deliveries

    National Research Council Canada - National Science Library

    Stivanello, Elisa; Rucci, Paola; Carretta, Elisa; Pieri, Giulia; Seghieri, Chiara; Nuti, Sabina; Declercq, Eugene; Taglioni, Martina; Fantini, Maria Pia

    2011-01-01

    .... The objective of this study is to determine the extent to which risk adjustment for clinical and socio-demographic variables is needed for inter-hospital comparisons of CD rates in women without...

  2. Salivary Gland Cancer: Risk Factors

    Science.gov (United States)

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

  3. [Cardiovascular risk factors in women].

    Science.gov (United States)

    Cengel, Atiye

    2010-03-01

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

  4. Risk Factor Assessment Branch (RFAB)

    Science.gov (United States)

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

  5. 24 CFR 888.203 - Use of contract rent automatic annual adjustment factors.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Use of contract rent automatic... RENTS AND CONTRACT RENT ANNUAL ADJUSTMENT FACTORS Contract Rent Annual Adjustment Factors § 888.203 Use of contract rent automatic annual adjustment factors. (a) To compute an adjustment to a Contract Rent...

  6. Rational Multi-curve Models with Counterparty-risk Valuation Adjustments

    DEFF Research Database (Denmark)

    Crépey, Stéphane; Macrina, Andrea; Nguyen, Tuyet Mai

    2016-01-01

    We develop a multi-curve term structure set-up in which the modelling ingredients are expressed by rational functionals of Markov processes. We calibrate to London Interbank Offer Rate swaptions data and show that a rational two-factor log-normal multi-curve model is sufficient to match market da...... with regulatory obligations. In order to compute counterparty-risk valuation adjustments, such as credit valuation adjustment, we show how default intensity processes with rational form can be derived. We flesh out our study by applying the results to a basis swap contract....

  7. Perinatal risk factors for strabismus

    DEFF Research Database (Denmark)

    Torp-Pedersen, Tobias; Boyd, Heather A; Poulsen, Gry

    2010-01-01

    Little is known about the aetiological factors underlying strabismus. We undertook a large cohort study to investigate perinatal risk factors for strabismus, overall and by subtype.......Little is known about the aetiological factors underlying strabismus. We undertook a large cohort study to investigate perinatal risk factors for strabismus, overall and by subtype....

  8. Change point detection in risk adjusted control charts.

    Science.gov (United States)

    Assareh, Hassan; Smith, Ian; Mengersen, Kerrie

    2015-12-01

    Precise identification of the time when a change in a clinical process has occurred enables experts to identify a potential special cause more effectively. In this article, we develop change point estimation methods for a clinical dichotomous process in the presence of case mix. We apply Bayesian hierarchical models to formulate the change point where there exists a step change in the odds ratio and logit of risk of a Bernoulli process. Markov Chain Monte Carlo is used to obtain posterior distributions of the change point parameters including location and magnitude of changes and also corresponding probabilistic intervals and inferences. The performance of the Bayesian estimator is investigated through simulations and the result shows that precise estimates can be obtained when they are used in conjunction with the risk-adjusted CUSUM and EWMA control charts. In comparison with alternative EWMA and CUSUM estimators, more accurate and precise estimates are obtained by the Bayesian estimator. These superiorities enhance when probability quantification, flexibility and generaliability of the Bayesian change point detection model are also considered. The Deviance Information Criterion, as a model selection criterion in the Bayesian context, is applied to find the best change point model for a given dataset where there is no prior knowledge about the change type in the process. © The Author(s) 2011.

  9. Risks factoring business: accounting measurement

    Directory of Open Access Journals (Sweden)

    Z.V. Gutsaylyuk

    2015-06-01

    Full Text Available The paper carried out the identification of risk factors for the development of possible accounting software management. Studied theoretical and methodological aspects of the risk classification of factoring operations in the part of the risk assessment factors. It is proposed to consider the risks factors as the risk that is acceptable controlled by accounting instruments and the risks that can not be taken into account in the accounting records. To minimize the risk factor, accounting-driven tools, a method of self-insurance, which is a factor in the creation of provision for factoring transactions designed to cover unexpected expenses and losses. Provision for factoring factor will establish more stable conditions of financial activity and avoid the fluctuations of profit factor in relation to the writing off of losses on factoring operatsіyam.Developed proposals allow for further research to improve the organizational and methodological basis of accounting and analysis of information as a basis for providing risk management factor, particularly in terms of improving the evaluation questions such risks and their qualitative and quantitative analysis.

  10. The Marriage Protective Factors in Married People With Risk Factors

    Directory of Open Access Journals (Sweden)

    شیدا خالدی

    2015-12-01

    Full Text Available This study was conducted to investigate the marriage protective factors in married people with risk factors. The method of this study is qualityative. In this study the researcher-made risk factor check list and Enrich Marital Satisfaction Questionnaire (115-item test were used. to select the sample group, Risk Factor Check List and Enrich marital satisfaction questionnaire were distributed among 100 men and 100 women who had been married for at least 3 years. Among these 200 individuals, 22 people with high risk factors and marital satisfaction were screened. Data reached saturation through Interviewing 18 people. Protective factors based on their frequencies include: relationship, personality traits, skills, adjustment, out-side factors, religion, and beliefs. Each of these protective factors includes several primary components. Some of the components such as respect, desirable sexual relation and commitment have important role in protecting marriage. In addition, some other factors, such as contentment, not being jealous of otherpeople’s lives, accepting the current life situation, were mentioned that seem to be specific to Iranian culture. There was no significant difference between men and women choosing protective factors. There was however a significant difference between men and women in some of the mentioned components.

  11. 76 FR 19524 - Publication of Inflation Adjustment Factor, Nonconventional Source Fuel Credit, and Reference...

    Science.gov (United States)

    2011-04-07

    ... Internal Revenue Service Publication of Inflation Adjustment Factor, Nonconventional Source Fuel Credit...: Notice. SUMMARY: Publication of the inflation adjustment factor, nonconventional source fuel credit, and.... 45K). The inflation adjustment factor and reference price are used to determine the credit allowable...

  12. 78 FR 21008 - Publication of Inflation Adjustment Factor, Nonconventional Source Fuel Credit, and Reference...

    Science.gov (United States)

    2013-04-08

    ... Internal Revenue Service Publication of Inflation Adjustment Factor, Nonconventional Source Fuel Credit...: Notice. SUMMARY: Publication of the inflation adjustment factor, nonconventional source fuel credit, and.... 45K). The inflation adjustment factor and reference price are used to determine the credit allowable...

  13. 77 FR 22067 - Publication of Inflation Adjustment Factor, Nonconventional Source Fuel Credit, and Reference...

    Science.gov (United States)

    2012-04-12

    ... Internal Revenue Service Publication of Inflation Adjustment Factor, Nonconventional Source Fuel Credit...: Notice. SUMMARY: Publication of the inflation adjustment factor, nonconventional source fuel credit, and.... section 45K). The inflation adjustment factor is used to determine the credit allowable under section 45K...

  14. 5 CFR 591.227 - What adjustment factors does OPM add to the price indexes?

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false What adjustment factors does OPM add to...-Nonforeign Areas Cost-Of-Living Allowances § 591.227 What adjustment factors does OPM add to the price indexes? OPM adds to the price index an adjustment factor that reflects differences in need, access to and...

  15. Managing Multiple Risk Factors

    National Research Council Canada - National Science Library

    Lollis, Charlie

    1998-01-01

    ...) contribute to the racial differences in cardiovascular risk and events among women. High levels of socioeconomic stress, higher dietary fat intake and sedentary lifestyle are more prevalent among black than white women...

  16. After Divorce: Personality Factors Related to the Process of Adjustment.

    Science.gov (United States)

    Thomas, Sandra Paul

    1982-01-01

    Considered personality variables related to postdivorce adjustment using a sample of 58 females and 31 males. Found persons with the best adjustment scored significantly higher on dominance/assertiveness, self-assurance, intelligence, creativity/imagination, social boldness, liberalism, self-sufficiency, ego strength and tranquility. (Author/JAC)

  17. Stroke Risk Factors and Symptoms

    Science.gov (United States)

    ... Version » [ pdf, 433 kb ] Order Materials » Stroke Risk Factors and Symptoms Risk Factors for a Stroke Stroke prevention is ... and can be treated with drugs or surgery. Symptoms of a Stroke If you see or have one or more ...

  18. Prevalence of erectile dysfunction and possible risk factors among ...

    African Journals Online (AJOL)

    Unadjusted odds ratios of possible risk factors were calculated by univariate analyses. Binary logistic regression analysis was used to eliminate the effect of possible confounders on the risk factors to get the adjusted odds ratios. Results: The general prevalence of ED in this study was 58.9%. Sixty-seven (47.2%), 16 ...

  19. Environmental risk factors for autism

    Science.gov (United States)

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

    2010-01-01

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

  20. Cardiovascular risk factors in men

    DEFF Research Database (Denmark)

    Gyllenborg, J; Rasmussen, S L; Borch-Johnsen, Knut

    2001-01-01

    Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross-sectional de......Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross...

  1. Rational Multi-Curve Models with Counterparty-Risk Valuation Adjustments

    DEFF Research Database (Denmark)

    Crepey, Stephane; Macrina, Andrea; Nguyen, Tuyet Mai

    2016-01-01

    We develop a multi-curve term structure setup in which the modelling ingredients are expressed by rational functionals of Markov processes. We calibrate to LIBOR swaptions data and show that a rational two-factor lognormal multi-curve model is sufficient to match market data with accuracy. We elu...... obligations. In order to compute counterparty-risk valuation adjustments, such as CVA, we show how positive default intensity processes with rational form can be derived. We flesh out our study by applying the results to a basis swap contract....

  2. Biological risk factors for deep vein trombosis.

    Science.gov (United States)

    Vayá, Amparo; Mira, Yolanda; Martínez, Marcial; Villa, Piedad; Ferrando, Fernando; Estellés, Amparo; Corella, Dolores; Aznar, Justo

    2002-01-01

    Hypercoagulable states due either to inherited or acquired thrombotic risk factors are only present in approximately half of cases of DVT, but the causes in the other half, remain unknown. The importance of biological risk factors such as hyperlipidemia, hypofibrinolysis and hemorheological alterations in the pathogenesis of DVT has not been well established. In order to ascertain whether the above mentioned biological factors are associated with DVT and could constitute independent risk factors, we carried out a case-control study in 109 first DVT patients in whom inherited or acquired thrombophilic risk factors had been ruled out and 121 healthy controls age (42+/-15 years) and sex matched. From all the biological variables analyzed (cholesterol, triglycerides, glucose, fibrinogen, erythrocyte aggregation, hematocrit, plasma viscosity and PAI-1) only fibrinogen concentration reached a statistically significant difference on the comparison of means (290+/-73 mg/dl in cases vs 268+/-58 mg/dl in controls, p220 mg/dl, hematocrit >45% and fibrinogen >300 mg/dl was higher in cases than in controls: 38% vs 22%; p30 ng/ml, 37% vs 25% was borderline significant; p=0.055. Multivariate logistic regression analysis showed that cholesterolemia >220 mg/dl and fibrinogen >300 mg/dl constitute independent predictors of venous thrombotic risk. The adjusted OR's were 2.03 (95% CI; 1.12-3.70) for cholesterolemia and 1.94 (95% CI; 1.07-3.55) for fibrinogen. When these two variables combined DVT risk rose about fourfold (3.96; p<0.05). Our results suggest that hypercholesterolemia and hyperfibrinogenemia should be added to the list of known DVT risk factors and we recommend adopting measures to decrease these variables in the population with a high risk of DVT.

  3. Lactic acidosis, risk factors and predictive laboratory markers: a ...

    African Journals Online (AJOL)

    Results: Lactic acidosis occurred in 79 (17 per 1 000 person-years) of 1 762 people living with HIV on ART. Significant factors were being female [adjusted odds ratio (AOR) of 5.4] and increased body weight (adjusted OR of 1.1 per kg). The risk of lactic acidosis increased 6.6, 6.9 and 95 times (adjusted ORs) as weight ...

  4. Hidden Risk Factors for Women

    Science.gov (United States)

    ... A.S.T. Quiz Hidden Stroke Risk Factors for Women Updated:Nov 22,2016 Excerpted from "What Women ... Cerebral Aneurysms 7 Types of Aphasia 8 Brain Stem Stroke 9 Cognitive Challenges After Stroke 10 Personality ...

  5. Is consanguinity a risk factor for keratoconus?

    Science.gov (United States)

    Gordon-Shaag, Ariela; Millodot, Michel; Essa, Maron; Garth, Jeanne; Ghara, Mohammed; Shneor, Einat

    2013-05-01

    To determine whether consanguinity is a risk factor for keratoconus (KC). A questionnaire was distributed to all patients presenting to St. John Eye Hospital, Jerusalem, Israel. Questionnaire included data on demographic characteristics and potential risk factors. Patients were divided into two groups: cases with KC, in at least one eye, who were diagnosed by the attending ophthalmologist on the basis of abnormal corneal topography and at least one of the common signs of the disease; and controls presenting for problems other than KC and free of systemic and ocular conditions associated with KC. Multivariate logistic analyses were performed to identify risk factors for KC. Seventy cases and 140 controls participated in the study. Groups were similar with respect to sex and age. Univariate analyses found a significant association between KC and parental first-cousin consanguinity, eye rubbing, allergy, positive family history, education (>12 years), and sunglass wear, whereas asthma, eczema, smoking, and second-cousin consanguinity were not. Multivariate analyses showed that total consanguinity (first-cousin and second-cousin) (adjusted odds ratio, 3.96; p = 0.001), eye rubbing and absence of sunglass wear were significant risk factors. Education was also associated with KC, but family history was not so in the multivariate analysis. This study supports the hypothesis that consanguinity is a significant risk factor for KC and provides strong support for a genetic contribution to the disease. Wearing sunglasses in this environment is beneficial, and the study confirmed that eye rubbing, allergy, and education are also significantly associated with KC after adjusting for other predictors.

  6. A new risk-adjusted Bernoulli cumulative sum chart for monitoring binary health data.

    Science.gov (United States)

    Rossi, Giuseppe; Sarto, Simone Del; Marchi, Marco

    2016-12-01

    To monitor a health event in patients with a specific risk of developing the event, a risk-adjusted cumulative sum chart is needed. The risk-adjusted cumulative sum chart proposed in the literature has some limitations. Setting appropriate control limits is not straightforward, there is no simple formula for constructing them, and they remain sensitive to changes in the underlying risk distribution and the baseline incidence rate. To overcome these limits, we propose a new risk-adjusted Bernoulli cumulative sum chart as a simple and efficient solution. Analyses of simulated and real data sets illustrate the performance and usefulness of the proposed procedure. © The Author(s) 2014.

  7. Risk factors of placental abruption

    OpenAIRE

    Ghaheh, Hooria Seyedhosseini; Feizi, Awat; Mousavi, Maryam; Sohrabi, Davood; Mesghari, Leila; Hosseini, Zahra

    2013-01-01

    Background: Placental abruption is one of the most common causes of bleeding during pregnancy. Multiple factors are known to be associated with increase of risk of placental abruption such as alcohol, cocaine use and cigarette smoking. The objective of this study was to identify risk factors for placental abruption in an Iranian women population. Materials and Methods: In a retrospective case ? control study birth records included 78 cases with placental abruption and 780 randomly selected co...

  8. Development and Adjustment of Adopted Adolescents : Longitudinal and Concurrent Factors

    NARCIS (Netherlands)

    Jaffari-Bimmel, Nicole

    2005-01-01

    The first study of this thesis (Chapter 2) showed that the majority of the internationally adopted children are well adjusted, although a relatively large minority of adopted children had behavior problems of clinical significance or were referred to mental health services compared with non-adopted

  9. Cardiovascular risk factors in men

    DEFF Research Database (Denmark)

    Gyllenborg, J; Rasmussen, S L; Borch-Johnsen, Knut

    2001-01-01

    Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross...

  10. Monitoring the evolutionary process of quality: risk-adjusted charting to track outcomes in intensive care.

    Science.gov (United States)

    Cook, David A; Steiner, Stefan H; Cook, Richard J; Farewell, Vern T; Morton, Anthony P

    2003-06-01

    To present graphical procedures for prospectively monitoring outcomes in the intensive care unit. Observational study: risk-adjusted control chart analysis of a case series. Tertiary referral adult intensive care unit: Princess Alexandra Hospital, Brisbane, Australia. A total of 3398 intensive care unit admissions from January 1, 1995, to January 1, 1998. Risk-adjusted process control charting procedures for continuous monitoring of intensive care unit outcomes are proposed as quality management tools. A modified Shewhart p chart and cumulative sum process control chart, using the Acute Physiology and Chronic Health Evaluation III model mortality prediction for risk adjustment, are presented. The risk-adjusted p chart summarizes performance at arbitrary intervals and plots observed against predicted mortality rate to detect large changes in risk-adjusted mortality. The risk-adjusted cumulative sum procedure is a likelihood-based scoring method that adjusts for estimated risk of death, accumulating evidence from outcomes of all previous patients. It formally tests the hypothesis of a change in the odds of death. In this application, we detected a decrease from above to predicted risk-adjusted mortality. This was temporally related to increased senior staffing levels and enhanced ongoing multidisciplinary review of practice, quality improvement, and educational activities. Formulas and analyses are provided as appendices.

  11. 25 CFR 170.220 - What is the Population Adjustment Factor?

    Science.gov (United States)

    2010-04-01

    ... the Population Adjustment Factor? The Population Adjustment Factor (PAF) is a special portion of the... Program funding). The PAF is based upon the population ranges and distribution factors in appendix B to... PAF is derived. The funds generated by the PAF can be used for transportation planning or IRR projects. ...

  12. Psychosocial risk factors for the metabolic syndrome

    DEFF Research Database (Denmark)

    Pedersen, Jolene Masters; Lund, Rikke; Andersen, Ingelise

    2016-01-01

    Background/Objectives: Metabolic deregulations and development of metabolic syndrome may be an important pathway underlying the relationship between stress and cardiovascular disease. We aim to estimate the effect of a comprehensive range of psychosocial factors on the risk of developing metabolic...... syndrome in men and women. Methods: The study population consisted of 3621 men and women from the Copenhagen City Heart Study who were free of metabolic syndrome at baseline and reexamined after 10 years. The data was analyzed by multivariable logistic regression models adjusted for age, education, income.......11) to be risk factors for developing the metabolic syndrome in women, while vital exhaustion (OR 2.09, 95% CI 0.95 to 4.59) and intake of sleep medications (OR 2.54, 95% CI 0.92 to 5.96) may play a more important role in men. Conclusions: Experiencing major life events in work and adult life and...

  13. Atherogenic risk factors and hearing thresholds.

    Science.gov (United States)

    Frederiksen, Thomas Winther; Ramlau-Hansen, Cecilia Høst; Stokholm, Zara Ann; Brødsgaard Grynderup, Matias; Hansen, Åse Marie; Lund, Søren Peter; Medom Vestergaard, Jesper; Kristiansen, Jesper; Bonde, Jens Peter; Kolstad, Henrik Albert

    2014-01-01

    The objective of this study was to evaluate the influence of atherogenic risk factors on hearing thresholds. In a cross-sectional study we analyzed data from a Danish survey in 2009-2010 on physical and psychological working conditions. The study included 576 white- and blue-collar workers from children's day care units, financial services and 10 manufacturing trades. Associations between atherogenic risk factors (blood lipids, glycosylated hemoglobin, smoking habits, body mass index (BMI), and ambulatory blood pressure) and hearing thresholds were analyzed using multiple linear regression models. Adjusted results suggested associations between smoking, high BMI and triglyceride level and low high-density lipoprotein level and increased low-frequency hearing thresholds (average of pure-tone hearing thresholds at 0.25, 0.5 and 1 kHz). Furthermore, an increasing load of atherogenic risk factors seemed associated with increased low-frequency hearing thresholds, but only at a borderline level of statistical significance. Associations were generally strongest with hearing levels of the worst hearing ear. We found no statistically significant associations between atherogenic risk factors and high-frequency hearing thresholds (average of pure-tone hearing thresholds at 4, 6 and 8 kHz). © 2014 S. Karger AG, Basel.

  14. Risk factors for congenital hydrocephalus

    DEFF Research Database (Denmark)

    Munch, Tina Noergaard; Rasmussen, Marie-Louise Hee; Wohlfahrt, Jan

    2014-01-01

    . Furthermore, to identify the risk factors unique for isolated CHC as compared to syndromic CHC. METHODS: We established a cohort of all children born in Denmark between 1978 and 2008. Information on CHC and maternal medical diseases were obtained from the National Patient Discharge Register, maternal intake...... of medicine during pregnancy from the National Prescription Drug Register, and birth characteristics of the child from the Danish National Birth Register. Rate ratios (RR) of isolated and syndromic CHC with 95% CI were estimated using log-linear Poisson regression. RESULTS: In a cohort of 1928666 live...... increased risk of isolated CHC compared to unexposed children (RR 2.52, 95% CI 1.47 to 4.29) (1.5/1000 born children). Risk factors also found for syndromic CHC were: Male gender, multiples and maternal diabetes. CONCLUSIONS: The higher risk for isolated CHC in first-born children as well as behavioural...

  15. Failure of Marfan anatomic criteria to predict risk of aortic dissection in Turner syndrome: necessity of specific adjusted risk thresholds.

    Science.gov (United States)

    Maureira, Juan-Pablo; Vanhuyse, Fabrice; Lekehal, Malik; Hubert, Thierry; Vigouroux, Charlène; Mattei, Marie-Françoise; Grandmougin, Daniel; Villemot, Jean-Pierre

    2012-05-01

    Patients with Turner syndrome are prompt to develop spontaneous acute aortic dissection following insidious aortic dilatation, with abnormal cardiovascular anatomy and consequently require specific guidelines for regular surveillance since they represent a subset of high-risk young patients. We report a rare and uncommon case of spontaneous acute aortic dissection in a 48-year old female patient with Turner syndrome who was not apparently eligible for a prophylactic surgery. A CT scan showed a Stanford type A aortic dissection and was urgently referred for surgical management. We operated on the patient under deep hypothermia (18°C) and circulatory arrest with a retrograde cerebroplegia as the primary entry tear was located in the arch. The postoperative course was uneventful and the patient was discharged at the eighth postoperative day. Following description of this case, special attention was paid to determine predisposing risk factors for aortic dissection to be specifically adjusted to TS patients.

  16. Early risk factors for pubertal asthma.

    Science.gov (United States)

    Hovland, V; Riiser, A; Mowinckel, P; Carlsen, K-H; Lødrup Carlsen, K C

    2015-01-01

    Early life risk factors are previously described for childhood asthma, but less is known related to asthma in adolescence. We aimed to investigate early risk factors (before 2 years) for pubertal asthma and secondarily for pubertal asthma phenotypes based upon allergic comorbidities. Based on data from 550 adolescents in the prospective birth cohort 'Environment and Childhood Asthma' study, subjects were categorized by recurrent bronchial obstruction (rBO) 0-2 years, asthma 2-10 years, and pubertal asthma from 10 to 16 years including incident asthma in puberty and asthma in remission from 10 to 16 years or as never rBO/asthma 0-16 years. Asthma in puberty was further classified based on the comorbidities atopic dermatitis and allergic rhinitis (AR) from 10 to 16 years. Twenty-three common asthma risk factors identified by 2 years of age, including frequency and persistence of bronchial obstruction (severity score), were analysed by weighted logistic regression for each phenotype. In adjusted models, the risk of pubertal asthma increased significantly with higher severity score, parental rhinitis, being the firstborn child, and familial stress around birth. Pubertal asthma in remission was significantly associated with severity score and number of lower respiratory tract infections and inversely associated with breastfeeding beyond 4 months. Pubertal incident asthma was more common among firstborn children. All asthma phenotypes with allergic diseases were significantly associated with severity score, whereas familial perinatal stress increased the risk of asthma only. Asthma combined with AR was associated with parental asthma and being firstborn, whereas the risk of asthma with both atopic dermatitis and AR increased with higher paternal education, atopic dermatitis, being firstborn, and familial perinatal stress. Important early risk factors for pubertal asthma were early airways obstruction, parental rhinitis, being the firstborn child, and perinatal familial

  17. Lifestyle risk factors and chronic kidney disease.

    Science.gov (United States)

    Vupputuri, Suma; Sandler, Dale P

    2003-11-01

    To examine the effects of lifestyle risk factors such as alcohol consumption, cigarette smoking and body mass index (BMI) on the development of chronic kidney disease. We used a case-control study of 554 hospital cases and 516 age, race, and gender-matched community controls. The main outcome measure was newly-diagnosed chronic kidney disease, assessed by chart review. Self-reported history of alcohol consumption, smoking, and BMI as well as other co-variables were obtained during telephone interviews. Logistic regression models assessed the association between lifestyle risk factors and chronic kidney disease and were adjusted for important co-variables. We found no significant associations between alcohol consumption and chronic kidney disease, with the exception of moonshine, which resulted in an increased risk of chronic kidney disease (including all subtypes). The effects of smoking on chronic kidney disease were inconsistent, but pointed to no appreciable excess risk among smokers. Increasing quartiles of BMI were positively and significantly associated with nephrosclerosis (ORs [95% CI]: 2.5 [1.0-6.0], 2.8 [1.2-6.8] and 4.6 [1.8-11.6], for the second, third, and fourth quartiles of BMI, respectively). Our study revealed a significant positive association between BMI and nephrosclerosis. We did not find an increased risk of chronic kidney disease associated with alcohol or cigarette smoking.

  18. Tubal Factor Infertility and Perinatal Risk After Assisted Reproductive Technology

    Science.gov (United States)

    Kawwass, Jennifer F.; Crawford, Sara; Kissin, Dmitry M.; Session, Donna R.; Boulet, Sheree; Jamieson, Denise J.

    2014-01-01

    OBJECTIVE To assess trends of tubal factor infertility and to evaluate risk of miscarriage and delivery of preterm or low birth weight (LBW) neonates among women with tubal factor infertility using assisted reproductive technology (ART). METHODS We assessed trends of tubal factor infertility among all fresh and frozen, donor, and nondonor ART cycles performed annually in the United States between 2000 and 2010 (N=1,418,774) using the National ART Surveillance System. The data set was then limited to fresh, nondonor in vitro fertilization cycles resulting in pregnancy to compare perinatal outcomes for cycles associated with tubal compared with male factor infertility. We performed bivariate and multivariable analyses controlling for maternal characteristics and calculated adjusted risk ratios (RRs) and 95% confidence intervals (CI). RESULTS The percentage of ART cycles associated with tubal factor infertility diagnoses decreased from 2000 to 2010 (26.02–14.81%). Compared with male factor infertility, tubal factor portended an increased risk of miscarriage (14.0% compared with 12.7%, adjusted RR 1.08, 95% CI 1.04–1.12); risk was increased for both early and late miscarriage. Singleton neonates born to women with tubal factor infertility had an increased risk of pre-term birth (15.8% compared with 11.6%, adjusted RR 1.27, 95% CI 1.20–1.34) and LBW (10.9% compared with 8.5%, adjusted RR 1.28, 95% CI 1.20–1.36). Significant increases in risk persisted for early and late preterm delivery and very low and moderately LBW delivery. A significantly elevated risk was also detected for twin, but not triplet, pregnancies. CONCLUSION Tubal factor infertility, which is decreasing in prevalence in the United States, is associated with an increased risk of miscarriage, preterm birth, and LBW delivery as compared with couples with male factor infertility using ART. PMID:23812461

  19. Seasonality of cardiovascular risk factors

    DEFF Research Database (Denmark)

    Marti-Soler, Helena; Gubelmann, Cédric; Aeschbacher, Stefanie

    2014-01-01

    OBJECTIVE: To assess the seasonality of cardiovascular risk factors (CVRF) in a large set of population-based studies. METHODS: Cross-sectional data from 24 population-based studies from 15 countries, with a total sample size of 237 979 subjects. CVRFs included Body Mass Index (BMI) and waist...

  20. Risk factors for undescended testis.

    NARCIS (Netherlands)

    Brouwers, M.M.; Bruijne, L.M. de; Gier, R.P.E. de; Zielhuis, G.A.; Feitz, W.F.J.; Roeleveld, N.

    2012-01-01

    OBJECTIVE: To contribute to the understanding of the etiology of undescended testis (UDT), by exploring a wide range of potential risk factors in a case-referent study. PATIENTS AND METHODS: Cases and referents were recruited at five hospitals and included 200 boys with surgically corrected UDT and

  1. [Psoriasis and cardiovascular risk factors].

    Science.gov (United States)

    Tal, Roy; Pavlovsky, Lev; David, Michael

    2012-10-01

    Psoriasis is a common inflammatory skin disease which may dramatically affect patients' lives. This chronic disease is characterized by a protracted course of alternating remissions and relapses. In recent years, the attention of researchers has focused on the association between psoriasis and cardiovascular disease risk factors. This review summarizes the literature on this topic with an emphasis on research conducted in Israel.

  2. Factors Influencing Adjustment in Siblings of Children with Autism Spectrum Disorders

    Science.gov (United States)

    Meyer, Katherine A.; Ingersoll, Brooke; Hambrick, David Z.

    2011-01-01

    Siblings of children with autism spectrum disorders (ASD) may be at an increased risk of adjustment problems. To examine possible predictors of adjustment difficulties in siblings, 70 mothers with at least one child with ASD and one typical child completed surveys of symptom severity in the child with ASD, impact of the child with ASD on the…

  3. Use of surveillance data for prevention of healthcare-associated infection: risk adjustment and reporting dilemmas.

    LENUS (Irish Health Repository)

    O'Neill, Eoghan

    2009-08-01

    Healthcare-associated or nosocomial infection (HCAI) is of increasing importance to healthcare providers and the public. Surveillance is crucial but must be adjusted for risk, especially when used for interhospital comparisons or for public reporting.

  4. Peer victimization, psychosocial adjustment, and physical activity in overweight and at-risk-for-overweight youth

    National Research Council Canada - National Science Library

    Storch, Eric A; Milsom, Vanessa A; Debraganza, Ninoska; Lewin, Adam B; Geffken, Gary R; Silverstein, Janet H

    To examine the relationship between peer victimization and child and parent reports of psychosocial adjustment and physical activity in a clinical sample of at-risk-for-overweight and overweight children and adolescents...

  5. Risk factors for nosocomial bloodstream infections.

    Science.gov (United States)

    Apostolopolou, Eleni; Katsaris, Georgios; Katostaras, Theophanis

    A retrospective study of 205 patients was performed to identify the risk factors associated with nosocomial bloodstream infection (BSI). The study occurred during a 5-month period in four medical-surgical intensive care units (ICUs) in Athens, Greece. Risk factors were determined using single and multivariate analyses. Thirty-five patients developed nosocomial BSI (17.1%). The incidence density (defined as the number of new cases of BSI divided by the total of patient-days in the population studied; Jarvis, 1997) of BSI was 14.3 per 1000 patient-days (total number of days that patients are in the ICU during the selected time period). A multivariate model showed that only three factors were significantly and independently responsible for nosocomial BSI: the length of ICU stay (adjusted odds ratios (AOR) 1.052, 95% confidence interval (CI) 1.018-1.087, P = 0.002); the presence of trauma at admission (AOR 2.622, 95% CI 1.074-6.404, P = 0.034); and nosocomial ventilator-associated pneumonia (AOR 6.153, 95% CI 2.305-16.422, P = 0.000). These results show that the factors that had most influence on the development of nosocomial BSI were those factors associated with the treatment received by patients during ICU stay.

  6. Adjustment for smoking reduces radiation risk: fifth analysis of mortality of nuclear industry workers in Japan, 1999-2010

    Energy Technology Data Exchange (ETDEWEB)

    Kudo, S.; Ishida, J.; Yoshimoto, K.; Mizuno, S.; Ohshima, S.; Kasagi, F., E-mail: s_kudo@rea.or.jp [Instituto of Radiation Epidemiology, Radiation Effects Association, 1-9-16 Kajicho, Chiyoda-ku, 101-0044 Tokyo (Japan)

    2015-10-15

    Full text: Many cohort studies among nuclear industry workers have been carried out to determine the possible health effects of low-level radiation. In those studies, confounding factors, for example, age was adjusted to exclude the effect of difference of mortality by age to estimate radiation risk. But there are few studies adjusting for smoking that is known as a strong factor which affects mortality. Radiation Effects Association (Rea) initiated a cohort study of nuclear industry workers mortality in 1990. To examine non-radiation factors confounding on the mortality risk among the radiation workers, Rea have performed life-style questionnaire surveys among the part of workers at 1997 and 2003 and found the correlation between radiation dose and smoking rate. Mortality follow-up were made on 75,442 male respondents for an average of 8.3 years during the observation period 1999-2010. Estimates of Excess Relative Risk percent (Err %) per 10 mSv were obtained by using the Poisson regression. The Err for all causes was statistically significant (1.05 (90 % CI 0.31 : 1.80)), but no longer significant after adjusting for smoking (0.45 (-0.24 : 1.13)). The Err for all cancers excluding leukemia was not significant (0.92 (-0.30 : 2.16)), but after adjusting for smoking, it decreased (0.36 (-0.79 : 1.50)). Thus smoking has a large effect to obscure a radiation risk, so adjustment for smoking is important to estimate radiation risk. (Author)

  7. Risk factors of placental abruption

    Directory of Open Access Journals (Sweden)

    Hooria Seyedhosseini Ghaheh

    2013-01-01

    Full Text Available Background: Placental abruption is one of the most common causes of bleeding during pregnancy. Multiple factors are known to be associated with increase of risk of placental abruption such as alcohol, cocaine use and cigarette smoking. The objective of this study was to identify risk factors for placental abruption in an Iranian women population. Materials and Methods: In a retrospective case - control study birth records included 78 cases with placental abruption and 780 randomly selected controls were investigated. Statistical analysis for comparing the studied risk factors between groups was performed using Pearson ′ s Chi-square test along with presenting relevant odds ratio (OR. Results: From 7301 deliveries included in the study, 78 (1% was complicated placental abruption. Women aged 35 or more likely for experiencing (OR = 3.650, 95% confidence interval [CL] = 1.57-6.83 and those who had a previous cesarean section (OR = 2.65, 95% CL = 3.91- 33.41 were in higher risk for placental abruption ([50 cases] 64% vs. [28 cases] 36% P < 0.01. Conclusion: The results indicate that among the placental abruption is one of the most common causes of bleeding during the pregnancy and one of the major obstetrical emergency.

  8. Mental vulnerability--a risk factor for ischemic heart disease

    DEFF Research Database (Denmark)

    Eplov, Lene Falgaard; Jørgensen, Torben; Birket-Smith, Morten

    2006-01-01

    OBJECTIVE: The purpose of this study is to examine whether mental vulnerability is a risk factor for the development of ischemic heart disease (IHD) after adjustment for well-established risk factors. METHODS: In three prospective cohort studies in Copenhagen County, Denmark, we recorded the level...... of mental vulnerability and possible risk factors to IHD at baseline. For follow-up, the sample was linked to relevant registries to identify all cases of fatal and nonfatal IHD. The relationship between mental vulnerability and IHD was examined using both Kaplan-Meir and Cox proportional hazard models...... adjusting for possible confounding factors. RESULTS: Mental vulnerability was significantly associated with the risk for IHD (medium mental vulnerability: hazard ratio 1.41, 95% confidence interval 1.04-1.91; and high mental vulnerability: hazard ratio 2.05; 95% confidence interval 1.46-2.88), after...

  9. [Risk factors associated to preclampsia].

    Science.gov (United States)

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

    2012-01-01

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

  10. Socioeconomic factors and the risk for sarcoma.

    Science.gov (United States)

    Hampras, Shalaka S; Moysich, Kirsten B; Marimuthu, Sathiya P; Ravi, Vinod; Jayaprakash, Vijayvel

    2014-11-01

    Sarcomas are a heterogeneous group of rare malignancies arising from mesenchymal tissue. Although several occupational exposures have been evaluated in association with sarcoma, little is known about the role of socioeconomic indicators such as education. Socioeconomic status has been found to be associated with risk of development of several types of cancers, primarily lung, gastric, and cervical cancers. We conducted a hospital-based case-control study to evaluate the association of socioeconomic level with the risk for sarcoma. A total of 371 incident cases of sarcoma were matched in terms of age, sex, and year of enrollment in the study with 742 cancer-free controls. Education and income levels were evaluated as the indicators of socioeconomic status. Higher education (college level) was associated with a significantly lower risk for sarcoma [odds ratio (OR)=0.48, 95% confidence interval (CI)=0.29-0.80], even after adjusting for important confounders. After stratifying by sex, significantly lower risk for sarcoma was observed among men who had college level education compared with men with a level of education of eighth grade or lower (OR=0.38, 95% CI=0.19-0.74). A significant association between education and the risk for sarcoma remained after stratifying by income (OR=0.49, 95% CI=0.28-0.86, among the low income group). When analyzed as a composite exposure, individuals with high education and high income status had significantly lower risk for sarcoma compared with those with low income and low education status (OR=0.41, 95% CI=0.23-0.71). Thus, socioeconomic factors may play a significant role in determining the risk for sarcoma and should be explored further to elucidate the underlying factors that may explain these sociodemographic inequalities related to sarcoma.

  11. Disability as a risk factor?

    DEFF Research Database (Denmark)

    Bøttcher, Louise; Dammeyer, Jesper

    2013-01-01

    Empirical research has established that children with disabilities are more likely to develop psychopathology than children without disabilities. But too little is known about the association between disability and psychopathology. The aim of this article is to discuss developmental...... psychopathological models that conceptualize the connection between childhood disability and psychopathology. Empirical studies of psychopathology among children with a congenital hearing impairment and children with cerebral palsy will be reviewed, representing in-depth examples of association between disability...... and psychopathology. Both a congenital hearing impairment and cerebral palsy were found to be dominating risk factors for all types of psychopathology, but no relationship was identified between degree of disability and risk of psychopathology. The higher risk cannot be explained by biological impairments alone...

  12. CEREBRAL PALSY : ANTENATAL RISK FACTORS

    OpenAIRE

    Srinivasa Rao; Vidyullatha; Subbalakshmi

    2015-01-01

    INTRODUCTION: Cerebral palsy (CP) is a group of permanent movement disorders that appear in early childhood. Cerebral palsy is caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture. Most often the problems occur during pregnancy; however, they may also occur during childbirth, or shortly after birth. Often the cause is unknown. AIM: To study the different antenatal maternal risk factors associated with cere...

  13. Risk factors for cerebral palsy.

    Science.gov (United States)

    Suvanand, S; Kapoor, S K; Reddaiah, V P; Singh, U; Sundaram, K R

    1997-01-01

    Cerebral palsy is a major cause of crippling in children, but it's etiology is poorly understood. This case control study was done to assess some of the identified risk factors for cerebral palsy, 125 cerebral palsy cases selected from hospital clinic and 125 age and sex matched neighbourhood controls, all aged less than 5 years and residing in Delhi (India) were studied. Information regarding antenatal, natal and postnatal period was collected by mother's interview, and wherever available, from hospital records with the study subjects. Most common type of cerebral palsy was spastic (88%). Quadriplegia was the commonest topographical subtype (86.4%). Birth asphyxia was found to be present in only 25.6% of cases. The commonest risk factor amongst cases was low birth weight (28.8%). The multivariate odds ratios (confidence limits) for the risk factors found to be significantly associated with cerebral palsy were 36.1 (7.76-160) for birth asphyxia, 13.8 (4.95-38.3) for low birth weight, 37.4 (4.47-313) for neonatal convulsion, 23 (4.7-112) for neonatal jaundice, 14.4 (3.69-56.4) for neonatal infection, 24.9 (2.78-223) for instrument assisted delivery and 15.4 (1.57-152) for antepartum hemorrhage. Precipitate labour, caesarean section, twins, toxemia, breech delivery and head injury were not found to be significantly associated with cerebral palsy. Thus birth asphyxia, low birth weight, neonatal convulsions, neonatal jaundice, neonatal infection, instrument assisted delivery and antepartum hemorrhage are significant risk factors for cerebral palsy.

  14. Premorbid adjustment in individuals at ultra-high risk for developing psychosis

    DEFF Research Database (Denmark)

    Dannevang, Anders; Randers, Lasse; Gondan, Matthias

    2017-01-01

    Objective: Deterioration in premorbid adjustment is related to ultra-high risk (UHR) individuals developing psychosis, but it has not been examined how UHR individuals’ development differs compared to healthy controls. This study investigates differences in premorbid adjustment between UHR...... individuals and a healthy control group. Method: 48 UHR individuals and 50 healthy controls matched on group level for age, gender and parents’ socioeconomic status were included in the study. Both groups were assessed with the Premorbid Adjustment Scale (PAS). Based on the PAS scores, composite social...... and academic scales were computed. Results: Compared to the healthy controls the UHR individuals’ social and academic premorbid adjustment declined across age periods. Social premorbid adjustment declined particularly between late adolescence and adulthood. Academic premorbid adjustment declined particularly...

  15. Modeling wind adjustment factor and midflame wind speed for Rothermel's surface fire spread model

    Science.gov (United States)

    Patricia L. Andrews

    2012-01-01

    Rothermel's surface fire spread model was developed to use a value for the wind speed that affects surface fire, called midflame wind speed. Models have been developed to adjust 20-ft wind speed to midflame wind speed for sheltered and unsheltered surface fuel. In this report, Wind Adjustment Factor (WAF) model equations are given, and the BehavePlus fire modeling...

  16. Efficacious Factors for Facilitating the Emotional Adjustment of Children in Remarriage.

    Science.gov (United States)

    Fowler, Rod

    1981-01-01

    Four factors are identified as crucial in facilitating the emotional adjustment of a child in remarriage: (1) the preremarriage adjustment of the child; (2) the age of the child at the time of remarriage; (3) the stepparent-stepchild relationship; and (4) the presence of stepsiblings. (Author)

  17. Risk factors for depression after kidney transplantation.

    Science.gov (United States)

    Tsunoda, T; Yamashita, R; Kojima, Y; Takahara, S

    2010-06-01

    Kidney transplantation is recognized as the only potentially curative treatment for end-stage renal failure. But many psychiatric problems are associated with the procedure. The purpose of this study was to identify predictors of a risk for depression after kidney transplantation. This retrospective cohort study recruited 116 first kidney-only Japanese recipients whose mean age was 50.2 +/- 11.87 years include a male/female ratio of 63/53. They underwent transplantation between 1990 and 2008. At enrollment, we used the Zung Self-rating Depression Scale score as well as characterized demographic and clinical features of recipients and donors. Comparisons between depressed and non-depressed patients concerning sociodemographic and clinical characteristics were used chi(2) tests for categorical variables and Student's t-tests for continuous variables. Risk factors with significant correlation coefficients (P depression after kidney transplantation. The prevalence of depression in this study was 41.4%. Depressed patients were significantly more likely to not have regular incomes, nor to have desired kidney transplantation, to have experienced a rejection episode, and to live alone (P depression was living alone; subjects living alone were 2.51 times more likely to be depressed as those living with others (adjusted odds ratio [OR], 2.51; 95% confidence interval [CI], 1.31-5.22; P depression after kidney transplantation is driven by multiple, complex, and often overlapping risk factors, we observed characteristic features of recipients including their social environment and follow-up treatment.

  18. Is risk-adjusted mortality an indicator of quality of care in general surgery?: a comparison of risk adjustment to peer review.

    Science.gov (United States)

    Shackford, Steven R; Hyman, Neil; Ben-Jacob, Talia; Ratliff, John

    2010-09-01

    Profiling of hospitals using risk-adjusted mortality rates as a measure of quality is becoming increasingly frequent. We sought to determine the validity of this approach by comparing the risk-adjusted predicted mortality to the findings of concurrent peer review and retrospective chart review of deaths that occur on a general surgery service. Consecutive patients admitted to a busy general surgery service from January 2000 to January 2006 were prospectively entered into the Surgical Activity Tracking System. Rigorous, systematic peer review was performed concurrently by service members on all deaths. Adjudication was later validated by an independent senior surgeon. Three methodologies of risk adjustment (University Health Consortium, Physiological and Operative Severity Score for the enUmeration of Mortality, and the Charlson index) were used and compared the "excess mortality" predicted by each to the number of potentially preventable deaths determined by peer review. A total of 9623 patients were admitted and 75 died (0.7%). University Health Consortium and Physiological and Operative Severity Score predicted an excess mortality of 62 and 65 deaths, respectively; Charlson predicted that 73% of the cohort would be dead in 1 year. Concurrent and retrospective peer review found that death was potentially preventable in only 22 and 21 patients, respectively. Peer adjudication and extensive clinical review adds much to the analysis of an adverse outcome, similar to the "black box" in an airplane crash. Although methods of risk adjustment may be helpful in identifying patients for peer review, they should be used for internal process improvement and not published as metrics of hospital or provider performance.

  19. Cardiovascular risk factors in men

    DEFF Research Database (Denmark)

    Gyllenborg, J; Rasmussen, S L; Borch-Johnsen, Knut

    2001-01-01

    Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross...... lipids. We suggest that conflicting results of cross-sectional and intervention studies of sex hormones and lipids, in part, may be explained by interindividual differences or changes in SHBG. Thus, further studies on the potential role of SHBG in the development of ischemic heart disease (IHD) should......-sectional designed study of 508 healthy males, aged 41 to 72 years. We determined total testosterone (T), sex hormone-binding globulin (SHBG), free androgen index (FAI), and estradiol (E2) and studied their relationship to body fat mass (BF), blood pressure (BP), aortic compliance, left ventricular mass (LVM...

  20. Reproductive factors associated with breast cancer risk in northern Iran.

    Science.gov (United States)

    Hajian-Tilaki, K O; Kaveh-Ahangar, T

    2011-06-01

    Breast cancer is a common malignancy for women in most parts of the world and the incidence in Iranian women is growing. The patients are relatively younger than their western counterparts. The aim of study was to investigate the roles of reproductive factors for breast cancer in Babol. In a case-control study in Babol, we recruited a total of 100 new patients with histologically confirmed breast cancer and 200 age-matched controls selected from outpatient clinics. Demographic and reproductive factors were ascertained by in-person interview using a constructed questionnaire. Several potential confounding factors were adjusted using multiple logistic model. The adjusted odds ratio showed that having higher age at first pregnancy and abortion were associated with increased breast cancer risk (the adjusted OR = 4.1, 95% CI: 1.3-13.2 and 2.93, 95% CI: 1.64-5.24, respectively). By increasing parity, the risk had reduced significantly; among women with parity ≥ 5, the adjusted OR was 0.09 (95% CI 0.01-0.7) compared with nulliparous women, and also for each additional parity, the risk reduced by 50% (OR = 0.50, 95% CI: 0.34-0.71). The duration of breast feeding was inversely associated with breast cancer risk, while after additional adjustment for parity, no longer the protective effect of breast feeding was observed. Nulliparity, late age at first birth and abortion were the most important reproductive factors associated with breast cancer risk; therefore, it is recommended to women with these risk factors to perform breast cancer screening tests earlier.

  1. Risk Factors in Derivatives Markets

    Directory of Open Access Journals (Sweden)

    Raimonda Martinkutė-Kaulienė

    2015-02-01

    Full Text Available The objective of the article is to analyse and present the classification of risks actual to derivative securities. The analysis is based on classical and modern literature findings and analysis of newest statistical data. The analysis led to the conclusion, that the main risks typical for derivatives contracts and their traders are market risk, liquidity risk, credit and counterparty risk, legal risk and transactions risk. Pricing risk and systemic risk is also quite important. The analysis showed that market risk is the most important kind of risk that in many situations influences the level of remaining risks.

  2. Factors influencing adjustment to a colostomy in Chinese patients: a cross-sectional study.

    Science.gov (United States)

    Hu, Ailing; Pan, Yunfeng; Zhang, Meifen; Zhang, June; Zheng, Meichun; Huang, Manrong; Ye, Xinmei; Wu, Xianrong

    2014-01-01

    We evaluated persons living with a colostomy in order to characterize and describe relationships among adjustment, self-care ability, and social support. One hundred twenty-nine colostomy patients from 5 hospitals in Guangzhou, capital city of the Guangdong province, were recruited by convenience sampling. Cross-sectional data were collected from a survey that included demographic and pertinent clinical data related to their ostomy. The survey also incorporated Chinese language versions of the Ostomy Adjustment Scale, Exercise of Self-Care Agency Scale, and Perceived Social Support Scale. These scales were used to measure the levels and degrees of adjustment, self-care ability, and social support of colostomy patients. Respondents completed the survey during outpatient clinics visit after creation of a colostomy. Scores from the Ostomy Adjustment Scale revealed that 96.9% of colostomy patients reported low to moderate adjustment (128.6 ± 19.38) to their stoma. Self-care ability and social support of patients were positively correlated with the adjustment level (R = 0.33, R = 0.21). Several factors, including being a housewife, paying medical expense by oneself, inability to manage the ostomy without assistance, and not participating in an ostomy support group, were associated with a lower level of adjustment (P colostomy was moderate. Self-care ability and social support associated with having a colostomy positively influenced adjustment. Adjustment was also influenced by occupation, health insurance provider, and ability to care for the stoma without requiring assistance.

  3. Relationships between language impairment, temperament, behavioural adjustment and maternal factors in a community sample of preschool children.

    Science.gov (United States)

    Prior, Margot; Bavin, Edith; Cini, Eileen; Eadie, Patricia; Reilly, Sheena

    2011-01-01

    Relationships between child language development and temperament have been little studied in young children, although it is known that children with language impairment are at risk in a number of domains of psychosocial development involving temperamental influences. To investigate the relationships between temperament and language development, along with child behavioural adjustment and maternal psychosocial factors. A sample of 4-year-old children with language impairment was compared with typically developing children, from a large community cohort in a longitudinal study, on three temperament dimensions, behavioural and emotional problems, and maternal factors. Participants were part of a large community cohort involved in a longitudinal study. While the groups did not differ significantly on temperamental shyness/sociability, children with language impairment showed more negative dispositions on the persistence/self-regulation factor, and on overall temperamental difficultness. Behavioural problems were elevated in the language impairment group and were associated with temperament in both groups. Maternal measures of education level, reading and vocabulary skills were significantly lower in the language impairment group. Generally the language impairment group showed a constellation of developmental disadvantages which add to the existing developmental vulnerability conferred by the presence of language impairment. Poorer child temperament self-regulation and behavioural adjustment are strong risk factors for school learning, while lower mother education and literacy contribute further disadvantage. Clinicians managing language impairment in children need to be aware of the whole package of risk factors which are common in this population. © 2011 Royal College of Speech and Language Therapists.

  4. Dynamic probability control limits for risk-adjusted Bernoulli CUSUM charts.

    Science.gov (United States)

    Zhang, Xiang; Woodall, William H

    2015-11-10

    The risk-adjusted Bernoulli cumulative sum (CUSUM) chart developed by Steiner et al. (2000) is an increasingly popular tool for monitoring clinical and surgical performance. In practice, however, the use of a fixed control limit for the chart leads to a quite variable in-control average run length performance for patient populations with different risk score distributions. To overcome this problem, we determine simulation-based dynamic probability control limits (DPCLs) patient-by-patient for the risk-adjusted Bernoulli CUSUM charts. By maintaining the probability of a false alarm at a constant level conditional on no false alarm for previous observations, our risk-adjusted CUSUM charts with DPCLs have consistent in-control performance at the desired level with approximately geometrically distributed run lengths. Our simulation results demonstrate that our method does not rely on any information or assumptions about the patients' risk distributions. The use of DPCLs for risk-adjusted Bernoulli CUSUM charts allows each chart to be designed for the corresponding particular sequence of patients for a surgeon or hospital. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Injury risk factors for runners

    Directory of Open Access Journals (Sweden)

    Francisco Rodal Abal

    2013-01-01

    Full Text Available The purpose of this study was to determine those risk factors that may cause running injuries in general, and particularly damage to the muscle mass, and the tendon. Twenty six male and female Galician runners were evaluated about their lower limb flexibility and length, knee Q angle, explosive power and training features such as kilometers and sessions per week, level of competition, shoes, surface, injuries last year, use of insoles, athletic specially, age, weight and height. During next 12 weeks runners continued training as they had been doing regularly and we recorded all injuries that appeared in this period. After that and from the liner regression we obtained different models that explained the variability of general injuries, tendon injuries and damages to the muscle mass. We also find positive correlations between previous injuries and training volume, and these with the dependent variable «injuries in 12 weeks». In regard to tendinopathy and muscle mass injuries, we observed that the synthetic material present in the track is a risk factor for these muscle injuries. Meanwhile, the increasing age and the Q angle, increments the occurrence of tendon injuries.

  6. Conference Innovations in Derivatives Market : Fixed Income Modeling, Valuation Adjustments, Risk Management, and Regulation

    CERN Document Server

    Grbac, Zorana; Scherer, Matthias; Zagst, Rudi

    2016-01-01

    This book presents 20 peer-reviewed chapters on current aspects of derivatives markets and derivative pricing. The contributions, written by leading researchers in the field as well as experienced authors from the financial industry, present the state of the art in: • Modeling counterparty credit risk: credit valuation adjustment, debit valuation adjustment, funding valuation adjustment, and wrong way risk. • Pricing and hedging in fixed-income markets and multi-curve interest-rate modeling. • Recent developments concerning contingent convertible bonds, the measuring of basis spreads, and the modeling of implied correlations. The recent financial crisis has cast tremendous doubts on the classical view on derivative pricing. Now, counterparty credit risk and liquidity issues are integral aspects of a prudent valuation procedure and the reference interest rates are represented by a multitude of curves according to their different periods and maturities. A panel discussion included in the book (featuring D...

  7. Improved implementation of the risk-adjusted Bernoulli CUSUM chart to monitor surgical outcome quality.

    Science.gov (United States)

    Keefe, Matthew J; Loda, Justin B; Elhabashy, Ahmad E; Woodall, William H

    2017-06-01

    The traditional implementation of the risk-adjusted Bernoulli cumulative sum (CUSUM) chart for monitoring surgical outcome quality requires waiting a pre-specified period of time after surgery before incorporating patient outcome information. We propose a simple but powerful implementation of the risk-adjusted Bernoulli CUSUM chart that incorporates outcome information as soon as it is available, rather than waiting a pre-specified period of time after surgery. A simulation study is presented that compares the performance of the traditional implementation of the risk-adjusted Bernoulli CUSUM chart to our improved implementation. We show that incorporating patient outcome information as soon as it is available leads to quicker detection of process deterioration. Deterioration of surgical performance could be detected much sooner using our proposed implementation, which could lead to the earlier identification of problems.

  8. Onset of Impaired Sleep and Cardiovascular Disease Risk Factors

    DEFF Research Database (Denmark)

    Clark, Alice Jessie; Salo, Paula; Lange, Theis

    2016-01-01

    STUDY OBJECTIVES: Impaired sleep has been linked to increased risk of cardiovascular disease (CVD), but the underlying mechanisms are still unsettled. We sought to determine how onset of impaired sleep affects the risk of established physiological CVD risk factors (i.e., hypertension, diabetes......, and dyslipidemia). METHODS: In a longitudinal cohort study with 3 survey waves (2000, 2004, 2008) from the Finnish Public Sector study we used repeated information on sleep duration and disturbances to determine onset of impaired sleep. Information on development of CVD risk factors, as indicated by initiation...... = 1.17, 95% CI: 1.07-1.29) in fully adjusted analyses. CONCLUSIONS: Results suggest that onset of sleep disturbances rather than short or long sleep mark an increase in physiological risk factors, which may partly explain the higher risk of CVD observed among impaired sleepers....

  9. Income and heart disease: Neglected risk factor.

    Science.gov (United States)

    Lemstra, Mark; Rogers, Marla; Moraros, John

    2015-08-01

    To determine the unadjusted and adjusted effects of income on heart disease; its main disease intermediary, high blood pressure; and its main behavioural risk factors, smoking and physical inactivity. Random-digit dialing telephone survey collected through the Canadian Community Health Survey by Statistics Canada. Saskatchewan. A total of 27 090 residents aged 20 years and older; each health region in Saskatchewan was represented. Overall, 178 variables related to demographic characteristics, socioeconomic factors, behaviour, life stress, disease intermediaries, health outcomes, and access to health care were analyzed to determine their unadjusted and adjusted effects on heart disease. The mean age of the sample was 52.6 years. Women represented 55.9% of the sample. Most respondents were married (52.3%) and had some postsecondary or graduate education (52.5%). The mean personal income was $23 931 and the mean household income was $37 533. All models statistically controlled for age. Five covariates independently associated with heart disease included high blood pressure, household income of $29 999 or less per year, being a daily smoker, male sex, and being physically inactive. Five covariates independently associated with high blood pressure included being overweight or obese, being a daily smoker, household income of $29 999 or less per year, male sex, and being physically inactive. Five covariates independently associated with daily smoking included being a visible minority, household income of $29 999 or less per year, not being overweight or obese, education level of less than secondary school, and male sex. Six covariates independently associated with physical inactivity included being a visible minority, being overweight or obese, education level of less than secondary school, male sex, household income of $29 999 or less per year, and being a daily smoker. Household income was strongly and independently associated with heart disease; its main disease

  10. Income poverty, poverty co-factors, and the adjustment of children in elementary school.

    Science.gov (United States)

    Ackerman, Brian P; Brown, Eleanor D

    2006-01-01

    relationship instability), which either have not been described by many researchers or have been described in a way that does not fit the ecology of disadvantage (e.g., marital status). We found that income poverty, key contextual co-factors, and endogenous child attributes tend to show independent and selective associations with child academic competence and externalizing behavior, and that co-factor effects tend to be direct rather than mediated by harsh parenting, tend to have effects that are episodic and concurrent, and are easily- and well-represented by multiple risk indexes that bear powerful relations to child problem behaviors. A second core goal has been to better understand the developmental construction of poor outcomes for disadvantaged children, which requires consideration of dynamic aspects of the ecology and the potential importance of the timing of risk experiences. We found that family instability and change in environmental circumstances predict increases in problem behaviors, and that dose of adversity seems to matter for some variables if it is recent, and not for other variables. Through person-centered research, we also are beginning to understand some factors that seem to underlie the convergence of adjustment problems over grade in school. Many of our co-factor findings and many of our developmental findings seem both complex and double-edged. One edge is that they encourage a certain pessimism in showing how environmental adversity progressively constructs poor outcomes for disadvantaged children in school. Overall, for instance, we saw more problems and more multi-dimensional problems in fifth grade than in first grade, and the impact of environmental change was mostly negative. The other edge, however, is more positive in reflecting the possibility of discontinuity in child adjustment problems associated with positive changes in family circumstances. Findings for minimal persistence and for the strength of recent and concurrent effects argue that

  11. Risk Factors for premature birth in a hospital

    Directory of Open Access Journals (Sweden)

    Margarita E. Ahumada-Barrios

    Full Text Available Abstract Objective: to determine the risk factors for premature birth. Methods: retrospective case-control study of 600 pregnant women assisted in a hospital, with 298 pregnant women in the case group (who gave birth prematurely <37 weeks and 302 pregnant women who gave birth to a full-term newborn in the control group. Stata software version 12.2 was used. The Chi-square test was used in bivariate analysis and logistic regression was used in multivariate analysis, from which Odds Ratios (OR and Confidence Intervals (CI of 95% were derived. Results: risk factors associated with premature birth were current twin pregnancy (adjusted OR= 2.4; p= 0.02, inadequate prenatal care (< 6 controls (adjusted OR= 3.2; p <0.001, absent prenatal care (adjusted OR= 3.0; p <0.001, history of premature birth (adjusted OR= 3.7; p <0.001 and preeclampsia (adjusted OR= 1.9; p= 0.005. Conclusion: history of premature birth, preeclampsia, not receiving prenatal care and receiving inadequate prenatal care were risk factors for premature birth.

  12. Risk Factors for premature birth in a hospital 1

    Science.gov (United States)

    Ahumada-Barrios, Margarita E.; Alvarado, German F.

    2016-01-01

    Abstract Objective: to determine the risk factors for premature birth. Methods: retrospective case-control study of 600 pregnant women assisted in a hospital, with 298 pregnant women in the case group (who gave birth prematurely <37 weeks) and 302 pregnant women who gave birth to a full-term newborn in the control group. Stata software version 12.2 was used. The Chi-square test was used in bivariate analysis and logistic regression was used in multivariate analysis, from which Odds Ratios (OR) and Confidence Intervals (CI) of 95% were derived. Results: risk factors associated with premature birth were current twin pregnancy (adjusted OR= 2.4; p= 0.02), inadequate prenatal care (< 6 controls) (adjusted OR= 3.2; p <0.001), absent prenatal care (adjusted OR= 3.0; p <0.001), history of premature birth (adjusted OR= 3.7; p <0.001) and preeclampsia (adjusted OR= 1.9; p= 0.005). Conclusion: history of premature birth, preeclampsia, not receiving prenatal care and receiving inadequate prenatal care were risk factors for premature birth. PMID:27463110

  13. Skin Cancer: Biology, Risk Factors & Treatment

    Science.gov (United States)

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

  14. Risk factors identified for certain lymphoma subtypes

    Science.gov (United States)

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

  15. Nocturnal Sleep Disturbances: Risk Factors for Suicide

    Science.gov (United States)

    ... insomnia. Sleep Problems as a Risk Factor for Suicide As noted above, sleep problems are associated with ... disorders, both of which are risk factors for suicide (Wong & Brower, 2012). Overarousal, marked by agitation and ...

  16. Functional form and risk adjustment of hospital costs: Bayesian analysis of a Box-Cox random coefficients model.

    Science.gov (United States)

    Hollenbeak, Christopher S

    2005-10-15

    While risk-adjusted outcomes are often used to compare the performance of hospitals and physicians, the most appropriate functional form for the risk adjustment process is not always obvious for continuous outcomes such as costs. Semi-log models are used most often to correct skewness in cost data, but there has been limited research to determine whether the log transformation is sufficient or whether another transformation is more appropriate. This study explores the most appropriate functional form for risk-adjusting the cost of coronary artery bypass graft (CABG) surgery. Data included patients undergoing CABG surgery at four hospitals in the midwest and were fit to a Box-Cox model with random coefficients (BCRC) using Markov chain Monte Carlo methods. Marginal likelihoods and Bayes factors were computed to perform model comparison of alternative model specifications. Rankings of hospital performance were created from the simulation output and the rankings produced by Bayesian estimates were compared to rankings produced by standard models fit using classical methods. Results suggest that, for these data, the most appropriate functional form is not logarithmic, but corresponds to a Box-Cox transformation of -1. Furthermore, Bayes factors overwhelmingly rejected the natural log transformation. However, the hospital ranking induced by the BCRC model was not different from the ranking produced by maximum likelihood estimates of either the linear or semi-log model. Copyright (c) 2005 John Wiley & Sons, Ltd.

  17. Factors associated with the adjustment of foster children in the Netherlands

    NARCIS (Netherlands)

    Strijker, J.; Knorth, E.J.

    Information obtained from 419 case files was used to investigate the associations between the foster child's adjustment to the foster family and factors in the histories of the child and the parents, as well as factors in the relationship between foster children and their biological parents while

  18. Configurations of Common Childhood Psychosocial Risk Factors

    Science.gov (United States)

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

    2009-01-01

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

  19. Breed-specific adjustment factors for reproductive traits in Duroc, Hampshire, Landrace, and Yorkshire swine.

    Science.gov (United States)

    Culbertson, M S; Mabry, J W; Bertrand, J K; Nelson, A H

    1997-09-01

    Number born alive (NBA) and litter weaning weight (LWT) can be influenced by many factors, including environment, parity, age at farrowing, lactation length, and genetic merit as well as number of pigs after transfer (NAT) and weaning age (WNAGE) for LWT. The objectives of this study were to estimate adjustment factors for NBA and LWT using all effects in the model and to refine parity effects by including age of the sow in parity 1 (P1) and parity 2 (P2). The models used included fixed effects of contemporary groups and parity/age class, random direct genetic and permanent environment effects, as well as the fixed effects of NAT and WNAGE for LWT. A large effect due to age of the sow at breeding within P1 and P2 was found and new adjustments were found to differ from previous studies. In the Yorkshire population, for example, the average P1 adjustment was 1.0 pig in this study, compared to the current .69; however, this ranges from 1.46 for the youngest P1 females to .57 for the oldest. Similarly, in P2 the average adjustment was found to be .50, with an adjustment of .99 for the youngest P2 and 0 for the oldest. Also, age of dam was found to contribute variation to P1 litter records for LWT. A residual analysis showed nonsignificant differences (P > .60) across the age classes after using the new adjustments; however, significant differences (P adjustments.

  20. Risk factors for fatigue among airline pilots.

    Science.gov (United States)

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

    2017-01-01

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

  1. Risk Factors for HIV—1 Seroprevalenoe Arnong

    African Journals Online (AJOL)

    The risk of HIV was also significantly higher arnong hotel workers (age-adjusted OR = 4.3; 95% CI. = 1.4—12.9} Women With laboratory evidence of sexually transmitted diseases were at increased risk of HIV. This study shows that HIV is a major public health problem among FP clients in Tanzania. Innovative HIV in-.

  2. Mild gestational diabetes as a risk factor for congenital cryptorchidism

    DEFF Research Database (Denmark)

    Virtanen, Helena E; Tapanainen, Anna E; Kaleva, Marko M

    2006-01-01

    CONTEXT: Cryptorchidism is the most common malformation in newborn boys. Maternal diabetes has previously been suggested to be a risk factor for this disorder in one epidemiological study. OBJECTIVE: Evaluation of the prevalence of maternal glucose metabolism disorders during pregnancy in newborn...... diabetes diagnosis and abnormality of the result of a 2-h 75-g oral glucose tolerance test during pregnancy were obtained from the hospital records after delivery. RESULTS: After adjustment for possible confounding factors, i.e. maternal smoking during pregnancy, maternal age at delivery, and risk factors...

  3. Musculoskeletal Injuries and Their Associated Risk Factors

    Directory of Open Access Journals (Sweden)

    M Jahangiri

    2012-01-01

    Full Text Available Background and aims :Prevalence of musculoskeletal disorders (MSDs is high among office workers. Long time seated posture, working with computer, repetitive movements and inappropriate environmental conditions may have causal effects in these disorders. High prevalence rate of MSDs makes ergonomics assessment and working conditions improvement necessary. Designing an assessment checklist and calculating ergonomics indices can be useful in this evaluation. This study was conducted with the objectives of determination of prevalence rate, ergonomics assessment of working conditions and determination of factors associated with MSDs among office workers. Methods:In this study 400 randomly selected office workers participated. Nordic musculoskeletal disorders questionnaire was applied to determine prevalence rate of MSDs. Working conditions were assessed by the designed ergonomics checklist and ergonomic risk factors were identified. Data were analyzed using statistical tests including t-test, Chi-square and test of proportion by SPSS software (Version 12.0. Results:The highest prevalence rates of MSDs were reported in lower back and neck regions (49% and 47%, respectively. Statistical analysis revealed that there were significant association between occurrence of MSDs and calculated ergonomics indices (P<0.05. The mean of ergonomics index among those suffered from MSDs were less than other healthy workers indicating inappropriate ergonomics conditions. Calculation of OR also revealed that ergonomics conditions was associated with MSDs occurrence among workers (P<0.05. Totally, 53.3% of the office workers studied had poor working conditions. Awkward working posture and inappropriate workstation design were recognized as the main risk factors in the office workplace.  Conclusion:Most ergonomics problems were originated from bad postures and inappropriate design of workstation. Any interventional program for working conditions improvement should

  4. A New Scale Factor Adjustment Method for Magnetic Force Feedback Accelerometer

    Directory of Open Access Journals (Sweden)

    Xiangqing Huang

    2017-10-01

    Full Text Available A new and simple method to adjust the scale factor of a magnetic force feedback accelerometer is presented, which could be used in developing a rotating accelerometer gravity gradient instrument (GGI. Adjusting and matching the acceleration-to-current transfer function of the four accelerometers automatically is one of the basic and necessary technologies for rejecting the common mode accelerations in the development of GGI. In order to adjust the scale factor of the magnetic force rebalance accelerometer, an external current is injected and combined with the normal feedback current; they are then applied together to the torque coil of the magnetic actuator. The injected current could be varied proportionally according to the external adjustment needs, and the change in the acceleration-to-current transfer function then realized dynamically. The new adjustment method has the advantages of no extra assembly and ease of operation. Changes in the scale factors range from 33% smaller to 100% larger are verified experimentally by adjusting the different external coefficients. The static noise of the used accelerometer is compared under conditions with and without the injecting current, and the experimental results find no change at the current noise level, which further confirms the validity of the presented method.

  5. Risk factors associated with rosacea.

    Science.gov (United States)

    Abram, K; Silm, H; Maaroos, H-I; Oona, M

    2010-05-01

    Although rosacea is a common disease, the cause of disease is still a mystery -Helicobacter pylori infection, genetic predisposition, climatic factors, and detrimental habits are implicated as triggers of rosacea. The aim of current study is to evaluate several suspected risk factors coincidently. Patients with rosacea from a dermatology clinic and skin-healthy controls from an randomly selected employees' population enrolled the study. Skin status were evaluated by one and same dermatologist. Participants were queried for age, gender, sun-reactive skin type, and detrimental habits using a questionnaire; blood samples for detecting Helicobacter pylori serostatus were collected. Totally 145 skin-healthy controls and 172 subjects either with flushing episodes or established rosacea included the study. In multivariate analysis, rosacea patients had significantly higher chance to have photosensitive skin types (OR 1.75; 95% CI 1.01-3.04; P < 0.05), positive family history to rosacea (OR 4.31; 95% CI 2.34-7.92; P < 0.0001) or previous smoking status (OR 2.01; 95% CI 1.07-3.80; P < 0.05) comparing with skin-healthy controls. There were no statistically significant differences either in gender, Helicobacter pylori serostatus, caffeine intake, alcohol consumption, occupational environment, or education level between rosacea patients and controls. Rosacea is foremost associated with familial predisposition. There is no association between Helicobacter pylori infection and rosacea in current study.

  6. 77 FR 21775 - Risk Adjustment Meeting-May 7, 2012 and May 8, 2012

    Science.gov (United States)

    2012-04-11

    ... methodology is being developed and we are working through operational issues. ] DATES: Meeting Dates: May 7th...: Please send inquiries about the logistics of the meeting to logistics@isomglobal.com and about the... Federal risk adjustment methodology is being developed and we are working through operational issues. II...

  7. Measuring Profitability Impacts of Information Technology: Use of Risk Adjusted Measures.

    Science.gov (United States)

    Singh, Anil; Harmon, Glynn

    2003-01-01

    Focuses on understanding how investments in information technology are reflected in the income statements and balance sheets of firms. Shows that the relationship between information technology investments and corporate profitability is much better explained by using risk-adjusted measures of corporate profitability than using the same measures…

  8. Risk Adjusted Valuation of the Current Military Retirement and the CY2018 Retirement System

    Science.gov (United States)

    2016-06-01

    of disability (DOD Office of the Actuary, 2015b). Those wounded in the Indian campaigns who could not earn a livelihood were provided aid in...spread across the G, F, C, S, and I Funds to provide diversification and is adjusted over time to meet changing risk profiles. When combined with the

  9. Evidence that Risk Adjustment is Unnecessary in Estimates of the User Cost of Money

    Directory of Open Access Journals (Sweden)

    Diego A. Restrepo-Tobón

    2015-12-01

    Full Text Available Investors value the  special attributes of monetary assets (e.g.,  exchangeability, liquidity, and safety  and pay a premium for holding them in the form of a lower return rate. The user cost of holding monetary assets can be measured approximately by the difference between the  returns on illiquid risky assets and  those of safer liquid assets. A more appropriate measure should adjust this difference by the  differential risk of the  assets in question. We investigate the  impact that time  non-separable preferences has on the  estimation of the  risk-adjusted user cost of money. Using U.K. data from 1965Q1 to 2011Q1, we estimate a habit-based asset pricing model  with money  in the utility function and  find that the  risk  adjustment for risky monetary assets is negligible. Thus, researchers can dispense with risk adjusting the  user cost of money  in constructing monetary aggregate indexes.

  10. Teacher-child relationships and behavioral adjustment: Transactional links for preschool boys at risk

    NARCIS (Netherlands)

    Roorda, D.L.; Verschueren, K.; Vancraeyveldt, C.; Van Craeyevelt, S.; Colpin, H.

    2014-01-01

    In this short-term longitudinal study, transactional links between teacher-child relationships and behavioral adjustment were investigated in a sample of preschool boys (N=175) at risk for developing externalizing problems. Teachers (N = 175) reported about the quality of the teacher-child

  11. Factors Protecting against the Development of Adjustment Difficulties in Young Adults Exposed to Childhood Sexual Abuse.

    Science.gov (United States)

    Lynskey, Michael T.; Fergusson, David M.

    1997-01-01

    A study of 1,025 New Zealand children found that, although those exposed to childhood sexual abuse (CSA) were at increased risks of psychiatric disorder and adjustment difficulties, not all individuals exposed to CSA developed difficulties. The influence of the nature and quality of peer and family relationships is discussed. (Author/CR)

  12. An Online Tool for Global Benchmarking of Risk-Adjusted Surgical Outcomes.

    Science.gov (United States)

    Spence, Richard T; Chang, David C; Chu, Kathryn; Panieri, Eugenio; Mueller, Jessica L; Hutter, Matthew M

    2017-01-01

    Increasing evidence demonstrates significant variation in adverse outcomes following surgery between countries. In order to better quantify these variations, we hypothesize that freely available online risk calculators can be used as a tool to generate global benchmarking of risk-adjusted surgical outcomes. This is a prospective cohort study conducted at an academic teaching hospital in South Africa (GSH). Consecutive adult patients undergoing major general or vascular surgery who met the ACS-NSQIP inclusion criteria for a 3-month period were included. Data variables required by the ACS risk calculator were prospectively collected, and patients were followed for 30 days post-surgery for the occurrence of endpoints. Calculating observed-to-expected ratios for ten outcome measures of interest generated risk-adjusted outcomes benchmarked against the ACS-NSQIP consortium. A total of 373 major general and vascular surgery procedures met the inclusion criteria. The GSH operative cohort varied significantly compared to the 2012 ACS-NSQIP database. The risk-adjusted O/E ratios were significant for any complication O/E 1.91 (95 % CI 1.57-2.31), surgical site infections O/E 4.76 (95 % CI 3.71-6.01), renal failure O/E 3.29 (95 % CI 1.50-6.24), death O/E 3.43 (95 % CI 2.19-5.11), and total length of stay (LOS) O/E 3.43 (95 % CI 2.19-5.11). Freely available online risk calculators can be utilized as tools for global benchmarking of risk-adjusted surgical outcomes.

  13. Anaphylaxis: risk factors for recurrence.

    Science.gov (United States)

    Mullins, R J

    2003-08-01

    There are few studies on the incidence or recurrence of anaphylaxis. To examine the incidence of anaphylaxis and risk factors for recurrence. A prospective study of 432 patients referred to a community-based specialist practice in the Australian Capital Territory with anaphylaxis, followed by a survey to obtain information on recurrence. Of 432 patients (48% male, 73% atopic, mean 27.4 years, SD 19.5, median 26) with anaphylaxis, 260 patients were seen after their first episode; 172 experienced 584 previous reactions. fifty-four percent of index episodes were treated in hospital. Aetiology was identified in 91.6% patients: food (61%), stinging insects (20.4%) or medication (8.3%). The minimum occurrence and incidence of new cases of anaphylaxis was estimated at 12.6 and 9.9 episodes/100,000 patient-years, respectively. Follow-up data were obtained from 304 patients (674 patient-years). One hundred and thirty experienced further symptoms (45 serious), 35 required hospitalization and 19 administered adrenaline. Accidental ingestion of peanut/tree nut caused the largest number of relapses, but the highest risk of recurrence was associated with sensitivity to wheat and/or exercise. Rates of overall and serious recurrence were 57 and 10 episodes/100 patient-years, respectively. Of those prescribed adrenaline, 3/4 carried it, 2/3 were in date, and only 1/2 patients faced with serious symptoms administered adrenaline. Five patients each developed new triggers for anaphylaxis, or re-presented with significant psychiatric symptoms. In any 1 year, 1/12 patients who have suffered anaphylaxis will experience recurrence, and 1/50 will require hospital treatment or use adrenaline. Compliance with carrying and using adrenaline is poor. Occasional patients develop new triggers or suffer psychiatric morbidity.

  14. Bronchopulmonary dysplasia: incidence and risk factors.

    Science.gov (United States)

    Brener Dik, Pablo H; Niño Gualdron, Yeimy M; Galletti, María F; Cribioli, Carolina M; Mariani, Gonzalo L

    2017-10-01

    Bronchopulmonary dysplasia is the most common chronic pulmonary sequela among very low birth weight infants. The objective of this study was to estimate its incidence in our Neonatal Unit over the past 5 years and analyze associated risk factors. An observational and analytical study was conducted in a retrospective cohort, using data obtained from a prospective database of infants born at Hospital Italiano de Buenos Aires with a birth weight of less than 1500 grams between January 2010 and December 2014. The incidence of bronchopulmonary dysplasia and its association with several secondary outcome measures were studied. Two hundred and forty-five patients were included. The incidence of moderate/severe bronchopulmonary dysplasia was 22%, and it was associated with a younger gestational age and lower birth weight. A significant association was observed with surfactant use, mechanical ventilation requirement, and length of mechanical ventilation. Patients with moderate/severe bronchopulmonary dysplasia had a higher incidence of patent ductus arteriosus and late-onset sepsis. A lower birth weight (adjusted odds ratio |-#91;aOR|-#93;: 0.99, 95% confidence interval |-#91;CI|-#93;: 0.991-0.997, pdysplasia in our unit was associated with a lower birth weight and the length of mechanical ventilation. Among infants born at less than 32 weeks of gestation, intrauterine growth restriction accounted for an additional risk.

  15. Dynamic probability control limits for risk-adjusted CUSUM charts based on multiresponses.

    Science.gov (United States)

    Zhang, Xiang; Loda, Justin B; Woodall, William H

    2017-07-20

    For a patient who has survived a surgery, there could be several levels of recovery. Thus, it is reasonable to consider more than two outcomes when monitoring surgical outcome quality. The risk-adjusted cumulative sum (CUSUM) chart based on multiresponses has been developed for monitoring a surgical process with three or more outcomes. However, there is a significant effect of varying risk distributions on the in-control performance of the chart when constant control limits are applied. To overcome this disadvantage, we apply the dynamic probability control limits to the risk-adjusted CUSUM charts for multiresponses. The simulation results demonstrate that the in-control performance of the charts with dynamic probability control limits can be controlled for different patient populations because these limits are determined for each specific sequence of patients. Thus, the use of dynamic probability control limits for risk-adjusted CUSUM charts based on multiresponses allows each chart to be designed for the corresponding patient sequence of a surgeon or a hospital and therefore does not require estimating or monitoring the patients' risk distribution. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  16. Risk Adjustment, Reinsurance Improved Financial Outcomes For Individual Market Insurers With The Highest Claims.

    Science.gov (United States)

    Jacobs, Paul D; Cohen, Michael L; Keenan, Patricia

    2017-04-01

    The Affordable Care Act (ACA) reformed the individual health insurance market. Because insurers can no longer vary their offers of coverage based on applicants' health status, the ACA established a risk adjustment program to equalize health-related cost differences across plans. The ACA also established a temporary reinsurance program to subsidize high-cost claims. To assess the impact of these programs, we compared revenues to claims costs for insurers in the individual market during the first two years of ACA implementation (2014 and 2015), before and after the inclusion of risk adjustment and reinsurance payments. Before these payments were included, for the 30 percent of insurers with the highest claims costs, claims (not including administrative expenses) exceeded premium revenues by $90-$397 per enrollee per month. The effect was reversed after these payments were included, with revenues exceeding claims costs by $0-$49 per month. The risk adjustment and reinsurance programs were relatively well targeted in the first two years. While there is ongoing discussion regarding the future of the ACA, our findings can shed light on how risk-sharing programs can address risk selection among insurers-a pervasive issue in all health insurance markets. Project HOPE—The People-to-People Health Foundation, Inc.

  17. Social adjustment of adolescents at risk for schizophrenia: the Jerusalem Infant Development Study.

    Science.gov (United States)

    Hans, S L; Auerbach, J G; Asarnow, J R; Styr, B; Marcus, J

    2000-11-01

    To better understand whether poor social adjustment, a core characteristic of schizophrenic illness, may also be an indicator of vulnerability in young people who are at genetic risk for schizophrenia, but who do not have schizophrenia. Between 1992 and 1996, 27 Israeli adolescents with a schizophrenic parent, 29 adolescents with no mentally ill parent, and 30 adolescents with a parent having a nonschizophrenic mental disorder were assessed on multiple domains of social adjustment measured using the Social Adjustment Inventory for Children and Adolescents and the Youth Self-Report. Young people with a schizophrenic parent showed poor peer engagement, particularly heterosexual engagement, and social problems characterized by immaturity and unpopularity with peers. These social adjustment difficulties in youths at risk for schizophrenia could not be attributed solely to the presence of early-onset mental disorders, although problems were greater in those with disorders in the schizophrenia spectrum. Young people whose parents had other disorders showed different patterns of social maladjustment characterized by difficult, conflictual relationships with peers and family. Adolescents at risk for schizophrenia have social deficits that extend beyond early-onset psychopathology and that may reflect vulnerability to schizophrenic disorder.

  18. Polyhydramnios. Risk factors and outcome.

    Science.gov (United States)

    Mathew, Mariam; Saquib, Shabnam; Rizvi, Syed G

    2008-02-01

    To determine the risk factors associated with polyhydramnios, and assess the maternal and perinatal outcome in these patients. A prospective study of all deliveries complicated with polyhydramnios in Sultan Qaboos University Hospital, Sultanate of Oman between January 2005 and April 2006. Polyhydramnios was divided into mild and moderate to severe based on the amniotic fluid index values. The demographic data, antenatal complications, gestational age at delivery, mode of delivery, postpartum complications, and perinatal outcome were studied. A total of 2648 singleton deliveries occurred during the study period. Two hundred and eight (7.8%) women with polyhydramnios formed the study group, and 2440 women with normal amniotic fluid formed the control. Polyhydramnios was mild in 179 (86.1%) and moderate to severe in 29 (13.9%) cases. Sixty-eight (32.7%) of these pregnancies were complicated with diabetes as compared with 12.4% of the controls. Preterm delivery occurred in 16 (7.7%) cases. Cesarean delivery rate was 27.9% in the study group compared with 17.3% in the control. Major congenital anomalies were found in 2.8% of newborns compared with 1% among the controls. Eighteen babies were admitted to the special care baby unit. These data demonstrates a significant positive relation with maternal age, diabetes in pregnancy, and fetal macrosomia with polyhydramnios. Anemia during pregnancy, cesarean delivery rate, and congenital anomalies were significantly higher in the study group.

  19. Type 1 diabetes mellitus: psychosocial factors and adjustment of pediatric patient and his/her family. Review.

    Science.gov (United States)

    Pérez-Marín, Marián; Gómez-Rico, Irene; Montoya-Castilla, Inmaculada

    2015-04-01

    Type 1 diabetes mellitus is the most common chronic endocrine disease in children, with a very low incidence in the first months of life and reaching its peak during puberty (10-15 years old is the age group with the highest incidence at the time of onset). Based on the review of the scientific literature, our objective is to study the main psychosocial factors associated with the adjustment of these pediatric patients and their families. Research underscore the following risk factors: situational (stressful life events), personal (additional physical diseases, low self-esteem, emotional disturbances), and interpersonal (family breakdown and conflicts), and also protection factors (coping strategies, social support, fluent communication). There is a pressing need to deal with the disturbances that affect these diabetic patients and their families, by implementing effective health care psychological interventions that take into account psychosocial factors associated with the course of type 1 diabetes mellitus.

  20. Risk adjustment and the trade-off between efficiency and risk selection: an application of the theory of fair compensation.

    Science.gov (United States)

    Schokkaert, E; Dhaene, G; Van de Voorde, C

    1998-08-01

    We exploit the similarity between the problem of risk adjustment with prospective reimbursement schemes in the health care sector and the problem of fair compensation analysed in the social choice literature. The starting point is the distinction between two sets of variables in the explanation of medical expenditures: those for which the insurers (or the providers) can be held responsible, and those for which they have to be compensated. Using this partitioning the objectives of cost-efficiency and no risk selection can be expressed in terms of two simple axioms. If the medical expenditure function is additively separable in the two sets of variables, there exists a natural division rule which is analogous to the standard linear risk adjustment schemes. We show how this rule should be applied if the total level of actual medical expenditures is different from the budget to be divided over the insurers (or providers) and how information from the disturbances in the regression equation can be used in an optimal way. We discuss the analogy with mixed reimbursement systems. If the medical expenditure function is not additively separable in the two sets of variables, the conflict between efficiency and risk selection is unavoidable, even if one has perfect information about that function. The theoretical results are illustrated with empirical results derived from the Belgian setting where the move towards prospective reimbursement of the mutualities has necessitated the introduction of a risk adjustment formula.

  1. The USA National Longitudinal Lesbian Family Study (NLLFS): homophobia, psychological adjustment, and protective factors

    NARCIS (Netherlands)

    Bos, H.M.W.; Gartrell, N.K.; Peyser, H.; van Balen, F.

    2008-01-01

    The study assessed the influence of protective factors on the psychological adjustment of children who had experienced homophobia and whose mothers were participants in a longitudinal study of planned lesbian families. Data were collected as part of the National Longitudinal Lesbian Family Study by

  2. 76 FR 71559 - Acid Rain Program: Notice of Annual Adjustment Factors for Excess Emissions Penalty

    Science.gov (United States)

    2011-11-18

    ... AGENCY Acid Rain Program: Notice of Annual Adjustment Factors for Excess Emissions Penalty AGENCY.... SUMMARY: The Acid Rain Program under title IV of the Clean Air Act provides for automatic excess emissions penalties in dollars per ton of excess emissions for sources that do not meet their annual Acid Rain...

  3. 78 FR 64496 - Acid Rain Program: Notice of Annual Adjustment Factors for Excess Emissions Penalty

    Science.gov (United States)

    2013-10-29

    ... AGENCY Acid Rain Program: Notice of Annual Adjustment Factors for Excess Emissions Penalty AGENCY.... SUMMARY: The Acid Rain Program under title IV of the Clean Air Act provides for automatic excess emissions penalties in dollars per ton of excess emissions for sources that do not meet their annual Acid Rain...

  4. ADHD Symptomatology and its Relationship to Factors Associated with College Adjustment

    Science.gov (United States)

    Norwalk, Kate; Norvilitis, Jill M.; MacLean, Michael G.

    2009-01-01

    Objective: The present study assessed the relationship between self-reported ADHD symptomatology in college students and various factors that are associated with persistence in college. Method: A total of 321 students completed questionnaires examining ADHD symptoms, academic and social adjustment to college, career decision-making self-efficacy,…

  5. Identification of Behavioral Risk Factors During Pregnancy

    Directory of Open Access Journals (Sweden)

    Ruţa Florina

    2015-06-01

    Full Text Available Exposure to smoking during pregnancy is known to be one of the main modifiable risk factors, which threatens maternal and child health. Along with this factor, are not to be neglected also other risk factors belonging to lifestyle sphere, such as alcohol, sedentary, irregular daily meal serving plan, lack of knowledge.

  6. Risk factors for reintervention after surgery for perforated gastroduodenal ulcer

    DEFF Research Database (Denmark)

    Hasselager, R B; Lohse, N; Duch, P

    2016-01-01

    BACKGROUND: Perforated gastroduodenal ulcer carries a high mortality rate. Need for reintervention after surgical repair is associated with worse outcome, but knowledge on risk factors for reintervention is limited. The aim was to identify prognostic risk factors for reintervention after perforated...... gastroduodenal ulcer in a nationwide cohort. METHODS: All patients treated surgically for perforated gastroduodenal ulcer in Denmark between 2003 and 2014 were included using data from the Danish Clinical Register of Emergency Surgery. Potential risk factors for reintervention were assessed, and their crude...... and adjusted associations calculated by the competing risks subdistribution hazards approach. RESULTS: A total of 4086 patients underwent surgery for perforated gastroduodenal ulcer during the study interval. Median age was 71·1 (i.q.r. 59·6-81·0) years and the overall 90-day mortality rate was 30·8 per cent...

  7. Risk adjustment for coronary artery bypass graft surgery: an administrative approach versus EuroSCORE.

    Science.gov (United States)

    Ugolini, Cristina; Nobilio, Lucia

    2004-04-01

    To determine the ability of administrative data in predicting in-hospital mortality for patients undergoing coronary artery bypass graft surgery. Patient data were obtained from the administrative databases on hospital discharge abstracts of the Italian region Emilia Romagna for the years 2000-2001. We used a multivariate logistic regression analysis to compare an ICD-9-CM risk adjustment approach based on administrative variables (such as age, gender, principal diagnosis, combined operation, previous cardiac surgery, emergency admission, and Charlson comorbidity index) with a risk adjustment approach based on the clinical European System for Cardiac Operative Risk Evaluation (EuroSCORE) to predict in-hospital mortality and to assess hospital performance. In order to distinguish complications of care from comorbidities, we linked hospital data across multiple episodes of care up to 1 year before the admission for coronary artery bypass graft (CABG). The risk adjustment approach based on ICD-9-CM data provides good explanatory ability in models assessing in-hospital mortality (the c statistics obtained are very close: c = 0.76 in 2000 and c = 0.80 in 2001 for the administrative model versus 0.78 in 2000 and 0.77 in 2001 for the clinical one) and in those ranking the centres (c = 0.78 in 2000 in both approaches, and c = 0.82 for the administrative model versus c = 0.78 for the clinical one in 2001). Adding some administrative variables considered proxy for clinical complexity to the administrative model and linking hospital data across patients' multiple episodes of care eliminated much of the difference in effectiveness between the clinical and administrative risk adjustment approach. Focusing on the health policy context of measuring CABG death rates, our study strengthened the thesis that, with the growing improvement in accurate coding practice, administrative databases could provide a valuable and economical source for health planning and research.

  8. CDC Behavioral Risk Factor Surveillance System (BRFSS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based system of health surveys that collects information on health risk behaviors, preventive...

  9. Premorbid adjustment profiles in psychosis and the role of familial factors.

    Science.gov (United States)

    Quee, Piotr J; Meijer, Julia H; Islam, Md Atiqul; Aleman, André; Alizadeh, Behrooz Z; Meijer, Carin J; van den Heuvel, Edwin R

    2014-08-01

    Disease heterogeneity in patients with psychotic disorder may be explained by distinct profiles of premorbid adjustment. The current study explored premorbid adjustment profiles in patients with psychotic disorders, associations with cognitive and clinical characteristics after disease onset, and the role of familial factors. A total of 666 patients with psychosis (predominantly schizophrenia), 673 siblings, 575 parents, and 585 controls were included in this study. Cluster analyses were performed on the patients' scores of the Premorbid Adjustment Scale (PAS), using information on domains (social, academic) and age epochs (childhood, early adolescence, late adolescence). Resulting profiles were compared with characteristics in patients and their unaffected relatives. Six clusters, labeled normal, social intermediate, academic decline, overall decline, overall intermediate, and overall impaired adjustment, were identified in patients. Patients in different clusters differed from each other on cognitive, clinical, and functional characteristics after disease onset. Heterogeneity in the patient population may be explained in part by the adjustment profile prior to disease onset. This is in line with theories that propose different etiologies in the development of psychosis. Patient profiles were expressed in unaffected siblings, suggesting a role for familial factors. (c) 2014 APA, all rights reserved.

  10. Cardiovascular risk factors in children.

    Science.gov (United States)

    Fraporti, Marisete Inês; Scherer Adami, Fernanda; Dutra Rosolen, Michele

    2017-10-01

    Systemic hypertension is one of the main risk factors for cardiovascular disease (CVD). Early diagnosis and treatment of hypertension in childhood can potentially have a significant impact on future adverse outcomes. To investigate the relationship of diastolic (DBP) and systolic blood pressure (SBP) with anthropometric data and area of residence of children in municipalities of Rio Grande do Sul state, Brazil. This is a cross-sectional study of 709 children between six and nine years of age. Blood pressure, weight, height and waist circumference (WC) were measured. Statistical tests had a maximum significance level of 5% (p≤0.05) and the software used was SPSS version 13.0. Obesity was significantly associated with pre-hypertension, and stage 1 and 2 hypertension as assessed by DBP and SBP (≤0.05); high WC was significantly associated with a classification of pre-hypertension and stage 1 hypertension based on DBP and a classification of stage 1 and 2 hypertension based on SBP (≤0.01). Children living in urban areas had significantly higher mean SBP than those living in rural areas. Those with high WC presented higher SBP and DBP compared to children with normal WC. Obese children showed higher mean SBP and DBP compared to those who were overweight or normal weight and mean SBP and DBP also increased with older age and higher mean body mass index and WC. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Is use of fall risk-increasing drugs in an elderly population associated with an increased risk of hip fracture, after adjustment for multimorbidity level

    DEFF Research Database (Denmark)

    Thorell, Kristine; Ranstad, Karin; Midlöv, Patrik

    2014-01-01

    BACKGROUND: Risk factors for hip fracture are well studied because of the negative impact on patients and the community, with mortality in the first year being almost 30% in the elderly. Age, gender and fall risk-increasing drugs, identified by the National Board of Health and Welfare in Sweden...... level and risk of hip fracture in an elderly population. METHODS: Data were from Östergötland County, Sweden, and comprised the total population in the county aged 75 years and older during 2006. The odds ratio (OR) for hip fracture during use of fall risk-increasing drugs was calculated by multivariate...... logistic regression, adjusted for age, gender and individual multimorbidity level. Multimorbidity level was estimated with the Johns Hopkins ACG Case-Mix System and grouped into six Resource Utilization Bands (RUBs 0-5). RESULTS: 2.07% of the study population (N = 38,407) had a hip fracture during 2007...

  12. Cardiovascular risk factors in men

    DEFF Research Database (Denmark)

    Gyllenborg, J; Rasmussen, S L; Borch-Johnsen, Knut

    2001-01-01

    -sectional designed study of 508 healthy males, aged 41 to 72 years. We determined total testosterone (T), sex hormone-binding globulin (SHBG), free androgen index (FAI), and estradiol (E2) and studied their relationship to body fat mass (BF), blood pressure (BP), aortic compliance, left ventricular mass (LVM......), and plasma lipids (total cholesterol, high-density lipoprotein [HDL], low-density lipoprotein [LDL], very--low-density lipoprotein [VLDL], and triglycerides). In quartile analyses after adjustment for confounders (age, body mass index [BMI], alcohol consumption, and smoking), SHBG and E2 were positively...... and BF. E2 was negatively associated with LVM. No hormone varied with total cholesterol, LDL, BP, and aortic compliance in the adjusted analyses. In multiple regression analyses, SHBG was the main predictive variable of HDL, VLDL, and triglycerides explaining 12%, 17%, and 17% of the variation...

  13. [Incidence of singleton macrosomia in Beijing and its risk factors].

    Science.gov (United States)

    Ren, J H; Wang, C; Wei, Y M; Yang, H X

    2016-06-25

    To evaluate the prevalence of macrosomia in Beijing in 2013 and identify its risk factors. Retrospective six months analysis of 14 188 full-term singleton pregnant women from 15 hospitals with different levels in Beijing in 2013. Each participant's demographic data and medical information were collected individually by questionnaires. Multiple logistic regression analysis was used to examine the associations between variables and the risk of macrosomia. (1)The total prevalence of macrosomia was 7.069% (1 003/14 188) in Beijing in 2013. (2)The prevalence varied between the 15 hospitals, the lowest was 5.36% (89/1 659), while the highest reached 8.80%(46/523). Furthermore, the incidence of macrosomia was 1.284 times (95% CI: 1.114- 1.480, P=0.001) higher in the second graded hospitals than that in the tertiary hospitals. (3) Multiple logistic regression analyses showed that risk factors for macrosomia were maternal height≥160 cm (adjusted OR=1.875, 95% CI: 1.559- 2.256), pre-pregnant body mass index (p-BMI) ≥24.0 kg/m(2) (24.0- 27.9 kg/m(2): adjusted OR=1.696, 95% CI: 1.426- 2.018; p-BMI≥28.0 kg/m(2): adjusted OR=2.393, 95% CI: 1.831- 3.127), gestational weight gain (GWG) ≥15.9 kg (adjusted OR=2.462, 95% CI: 2.125- 2.853), gravidity>1 (adjusted OR=1.408, 95% CI: 1.224- 1.620), gestational weeks≥40 (adjusted OR=2.007, 95%CI: 1.745-2.308) and gestational diabetes mellitus (adjusted OR=1.522, 95%CI: 1.298-1.784). GWG≥15.9 kg, p-BMI≥28.0 kg/m(2) and gestational weeks≥40 were three risk factors that had the strongest associations with macrosomia (all Pmacrosomia in hospitals with different levels is obvious different. Gestational weeks, p-BMI and GWG are three main controllable risk factors for macrosomia, thus should receive more attentions.

  14. Factors associated to lifestyle and risk of adult onset asthma.

    Science.gov (United States)

    Huovinen, E; Kaprio, J; Koskenvuo, M

    2003-03-01

    Asthma prevalence has been increasing especially in developed countries. The change seems to be associated with changes in lifestyle. We have made a prospective study to assess the effect of lifestyle factors, including smoking, educational level, physical activity and obesity on adult onset asthma. A population of 10,597 adult twins, initially free of asthma was followed for 9 years. The main outcome measure was questionnaire-based report of physician diagnosed asthma. Logistic regression was used to estimate the risk of asthma predicted by lifestyle factors, with adjustment for atopy and respiratory symptoms. Obesity at baseline increased asthma risk (multivariable adjusted OR = 3.00, 95% CI: 1.64-5.50 for those with BMI > or = 30 compared to those with normal weight BMI: 20-24.99). Taller height was associated to lower asthma incidence. Leisure time physical activity had a slightly protective effect on asthma risk among men (P for trend = 0.037) while smoking and education did not have significant effects on the risk of adult onset asthma. Obesity was associated to the risk of adult onset asthma, while short height and low leisure time physical activity can be considered as other potential risk factors.

  15. Using Both Clinical Registry and Administrative Claims Data to Measure Risk-adjusted Surgical Outcomes.

    Science.gov (United States)

    Lawson, Elise H; Louie, Rachel; Zingmond, David S; Sacks, Greg D; Brook, Robert H; Hall, Bruce Lee; Ko, Clifford Y

    2016-01-01

    To examine the validity of hybrid quality measures that use both clinical registry and administrative claims data, capitalizing on the strengths of each data source. Previous studies demonstrate substantial disagreement between clinical registry and administrative claims data on the occurrence of postoperative complications. Clinical data have greater validity than claims data for quality measurement but can be burdensome for hospitals to collect. American College of Surgeons National Surgical Quality Improvement Program records were linked to Medicare inpatient claims (2005-2008). National Quality Forum-endorsed risk-adjusted measures of 30-day postoperative complications or death assessed hospital quality for patients undergoing colectomy, lower extremity bypass, or all surgical procedures. Measures use hierarchical multivariable logistic regression to identify statistical outliers. Measures were applied using clinical data, claims data, or a hybrid of both data sources. Kappa statistics assessed agreement on determinations of hospital quality. A total of 111,984 patients participated from 206 hospitals. Agreement on hospital quality between clinical and claims data was poor. Hybrid models using claims data to risk-adjust complications identified by clinical data had moderate agreement with all clinical data models, whereas hybrid models using clinical data to risk-adjust complications identified by claims data had routinely poor agreement with all clinical data models. Assessments of hospital quality differ substantially when using clinical registry versus administrative claims data. A hybrid approach using claims data for risk adjustment and clinical data for complications may be a valid alternative with lower data collection burden. For quality measures focused on postoperative complications to be meaningful, such policies should require, at a minimum, collection of clinical outcomes data.

  16. prevalence and obstetric risk factors

    African Journals Online (AJOL)

    risk of developing pelvic floor disorders 5 - 10 years after their first delivery. Our finding of a non-significant association between AI and instrumental delivery at 6 weeks after delivery differs from that of. Donnelly et al.,[6] who showed that instrumentation, mainly forceps delivery, carried the greatest risk for sphincter disruption ...

  17. Postpartum depression risk factors: A narrative review.

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2016-10-01

    An improved model for risk stratification can be useful for guiding public health strategies of breast cancer prevention. To evaluate combined risk stratification utility of common low penetrant single nucleotide polymorphisms (SNPs) and epidemiologic risk factors. Using a total of 17 171 cases and 19 862 controls sampled from the Breast and Prostate Cancer Cohort Consortium (BPC3) and 5879 women participating in the 2010 National Health Interview Survey, a model for predicting absolute risk of breast cancer was developed combining information on individual level data on epidemiologic risk factors and 24 genotyped SNPs from prospective cohort studies, published estimate of odds ratios for 68 additional SNPs, population incidence rate from the National Cancer Institute-Surveillance, Epidemiology, and End Results Program cancer registry and data on risk factor distribution from nationally representative health survey. The model is used to project the distribution of absolute risk for the population of white women in the United States after adjustment for competing cause of mortality. Single nucleotide polymorphisms, family history, anthropometric factors, menstrual and/or reproductive factors, and lifestyle factors. Degree of stratification of absolute risk owing to nonmodifiable (SNPs, family history, height, and some components of menstrual and/or reproductive history) and modifiable factors (body mass index [BMI; calculated as weight in kilograms divided by height in meters squared], menopausal hormone therapy [MHT], alcohol, and smoking). The average absolute risk for a 30-year-old white woman in the United States developing invasive breast cancer by age 80 years is 11.3%. A model that includes all risk factors provided a range of average absolute risk from 4.4% to 23.5% for women in the bottom and top deciles of the risk distribution, respectively. For women who were at the lowest and highest deciles of nonmodifiable risks, the 5th and 95th percentile range

  19. An investigation on important factors influencing on forecasted earnings adjustment: Evidence from Tehran Stock Exchange

    Directory of Open Access Journals (Sweden)

    Fatemeh Babakhani

    2014-01-01

    Full Text Available This paper presents an empirical investigation to detect important factors influencing earning adjustment on firms selected on Tehran Stock Exchange over the period 2006-2011. There are four independent variables associated with the proposed study of this paper including Proportion of shares owned by institutional investors, Return on assets, Profit change and Market value to book value. In addition, Investment restructuring is considered as control variable. The results of the implementation of regression analysis indicate that there was a reverse relationship between earning forecasted adjustment and two independent variables including size of firm as well as the ratio of market value to book value. However, Net profit has a direct and positive relationship with earning forecast adjustment.

  20. A risk-adjusted approach to comparing the return on investment in health care programs.

    Science.gov (United States)

    Sendi, Pedram; Al, Maiwenn J; Zimmermann, Heinz

    2004-09-01

    The league table approach to rank ordering health care programs according to the incremental cost-effectiveness ratio is a common method to guide policy makers in setting priorities for resource allocation. In the presence of uncertainty, however, ranking programs is complicated by the degree of variability associated with each program. Confidence intervals for cost-effectiveness ratios may be overlapping. Moreover, confidence intervals may include negative ratios and the interpretation of negative cost-effectiveness ratios is ambiguous. We suggest to rank mutually exclusive health care programs according to their rate of return which is defined as the net monetary benefit over the costs of the program. However, how does a program with a higher expected return but higher uncertainty compare to a program with a lower expected return but lower risk? In the present paper we propose a risk-adjusted measure to compare the return on investment in health care programs. Financing a health care program is treated as an investment in a risky asset. The risky asset is combined with a risk-free asset in order to construct a combined portfolio. The weights attributed to the risk-free and risky assets are chosen in such a manner that all programs under consideration exhibit the same degree of uncertainty. We can then compare the performance of the individual programs by constructing a risk-adjusted league table of expected returns.

  1. LIQUIDITY ADJUSTED VALUE AT RISK: INTEGRATING THE UNCERTAINTY IN DEPTH AND TIGHTNESS

    Directory of Open Access Journals (Sweden)

    Levent C. Uslu

    2017-02-01

    Full Text Available Efficient market risk management should also focus on the market liquidity risk, which is generally ignored by the conventional Value at Risk Metrics. We propose two alternative parametric methods to existing studies for the estimation of Liquidity Adjusted Value at Risk (LVaR. The first model is based on the volatility dynamics of VNET (Engle and Lange, 2001 whereas the second model also incorporates the first two moments of the tightness dimension to the latter, as measured by relative weighted bid-ask spreads. Considering a portfolio with different underlying volatility assumptions (EWMA, GARCH-CCC, GARCH-DCC, validation results indicate that both parametric LVaR approaches are strong alternatives to tightness based LVaR models and strictly superior to conventional VaR models, with respect to performance related to regulatory compliance, statistical coverage and overall relative cost of liquidity vs. loss size on violation days.

  2. Risk factors and risk reduction of breast and ovarian cancer

    NARCIS (Netherlands)

    C.T. Brekelmans (Cecile)

    2003-01-01

    textabstractPurpose of review: Breast and ovarian cancer remain a significant burden for women living in the Western world. This paper reviews the risk factors and current strategies to prevent these diseases. Recent findings: Established factors associated with the risk of breast cancer include

  3. Environmental risk factors for oesophageal cancer in Malawi: A case ...

    African Journals Online (AJOL)

    Environmental risk factors for oesophageal cancer in Malawi: A case-control study. ... Results Firewood cooking, cigarette smoking, and use of white maize flour all had strong associations with squamous cell carcinoma of the oesophagus, with adjusted odds ratios of 12.6 (95% CI: 4.2-37.7), 5.4 (95% CI: 2.0-15.2) and 6.6 ...

  4. RISK FACTOR DIAGNOSTIC SCORE IN DIABETIC FOOT

    Directory of Open Access Journals (Sweden)

    Mohamed Shameem P. M

    2016-09-01

    Full Text Available INTRODUCTION Diabetic foot ulcers vary in their clinical presentation and nature of severity and therefore create a challenging problem to the treating surgeon regarding the prediction of the clinical course and the end result of the treatment. Clinical studies have shown that there are certain risk factors for the progression of foot ulcers in diabetics and it may therefore be possible to predict the course of an ulcer foot at presentation itself, thus instituting proper therapy without delay. Spoken otherwise clinical scoring may tell that this particular ulcer is having highest chance of amputation, then one may be able to take an early decision for the same and avoid the septic complications, inconvenience to the patient, long hospital stay and cost of treatments. AIM OF THE STUDY Aim of the study is to evaluate the above-mentioned scoring system in predicting the course the diabetic foot ulcers. MATERIALS AND METHODS 50 patients with Diabetic Foot attending the OPD of Department of Surgery of Government Hospital attached to Calicut Medical College are included in the present study. After thorough history taking and clinical examination, six risk factors like Age, pedal vessels, renal function, neuropathy, radiological findings and ulcers were observed in the patients by giving certain scoring points to each of them. The total number of points scored by the patients at the time of admission or OPD treatment was correlated with the final outcome in these patients, whether leading to amputation or conservative management. All the data was analysed using standard statistical methods. OBSERVATIONS AND RESULTS There were 12 females and 38 males with a female to male ratio 1:3.1. All were aged above 30 years. Twenty-four (48% of them were between 30-60 years and twenty six (52% were above 60 years. 10 patients were treated conservatively with risk score range: 10 to 35. Six had single toe loss with risk score: 25 to 35. Six had multiple toe loss

  5. Developmental Risk Factors for Sexual Offending.

    Science.gov (United States)

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

    2002-01-01

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

  6. Early life risk factors for testicular cancer

    DEFF Research Database (Denmark)

    Piltoft, Johanne Spanggaard; Larsen, Signe Benzon; Dalton, Susanne Oksbjerg

    2017-01-01

    PURPOSE: One established risk factors for testicular cancer is cryptorchidism. However, it remains unclear whether cryptorchidism is a risk factor in itself or whether the two conditions share common causes in early life (estrogen hypothesis), such as birth weight and birth order. The objective...

  7. [Work-related stress and risk factors among Korean employees].

    Science.gov (United States)

    Choi, Eun Sook; Ha, Yeongmi

    2009-08-01

    Work-related stress and risk factors among Korean employees were identified in this study. Data were obtained from employees aged 20 to 64 using the Korean Working Conditions Survey 2006 (KWCS). Multiple logistic regression analysis using SAS version 9.1 was performed to examine risk factors of work-related stress by gender. The age-adjusted prevalence of work-related stress among male and female employees was 18.4% and 15.1% respectively. After adjustments for multiple variables among both male and female employees, there was a significant relationship between work-related stress and risk factors including education, company size, work time, ergonomic risks, biological.chemical risks, and job demands. The significant variables for male employees were housework load, occupational class, and shift work, and for female employees, type of employment. There is a need to develop and support intensive stress management programs nationally giving consideration to work-related stress associated with working time, physical working environment, and job demands. Based on gender specific approaches, for male employes, stress management programs should be developed with consideration being given to occupational class and shift work. For stress management programs for female employees, consideration needs to be given to permanent employment status, specifically those in small companies.

  8. Epidemiology of conventional cardiovascular risk factors among ...

    African Journals Online (AJOL)

    Impaired fasting or glucose tolerance and/or diabetes can occur with hypertension, which theoretically predicts a worse cardiovascular risk profile, and consequently requires intensive cardiovasular risk management. Objectives. To characterise the frequency of the occurence of conventional cardiovascular risk factors ...

  9. Factors to adjust litter weight of pigs to a standard 21 days of age.

    Science.gov (United States)

    Wood, C M; Christian, L L; Rothschild, M F

    1990-09-01

    Factors to standardize litter weights of nursing pigs to 21 d of age were calculated from daily weights measured on 64 crossbred litters from 10 to 32 d of age. The results were compared to published factors derived from a data set of Duroc pigs weighed every 3 to 4 d. Dams in the present study were white crossbred sows and gilts, and sires were maternal or terminal breed types. Multiplicative factors were calculated by dividing the mean 21-d litter weight (LW21) by mean daily litter weight. Linear and quadratic regression coefficients of LW21 on age at weighing were fitted to the factors (R2 = .997). The final equation for adjusting litter weights to a 21-d basis was 2.5246 - .1041 x (d of age) + .0015 x (d of age)2. There were good agreement with published factors for d 19 to 25, but divergence for younger and older litters resulted in significant differences between the linear coefficients. These differences may be due to departure from a linear growth curve, which daily measurements would incorporate, or differences in sow populations. Thus, use of the new factors should be considered for white crossbred sow populations. A least squares analysis indicated that LW21 was significantly altered by parity, not by the number of pigs allowed to nurse or by breed of sire. After adjustment to 21 d, litter weights also should be adjusted for differences in parity before evaluating sow productivity, by using additive factors such as those recommended by the National Swine Improvement Federation.

  10. Lifestyle and other risk factors for diverticulitis.

    Science.gov (United States)

    Böhm, Stephan K; Kruis, Wolfgang

    2017-06-01

    Diverticulosis is a very common condition. Around 20% of the carriers of diverticula are believed to suffer from diverticular disease during their lifetime. This makes diverticular disease one of the clinically and economically most significant diseases in gastroenterology. The etiopathogenesis of diverticulosis and diverticular disease is not well understood. Epidemiological studies allow defining risk factors for the development of diverticulitis and its complications. A comprehensive literature search was performed and the current knowledge about risk factors for diverticulitis and associated conditions reviewed. Besides non-controllable risk factors like age and sex, lifestyle factors like food, drinks and physical activity, drugs are described to increase or decrease the risk to develop diverticulitis or to suffer from complications. The recognition of risk factors for the development of diverticular disease or even complicated disease like lifestyle habits or medication is crucial for patient management.

  11. Exposure to violence and socioemotional adjustment in low-income youth: an examination of protective factors.

    Science.gov (United States)

    Hardaway, Cecily R; McLoyd, Vonnie C; Wood, Dana

    2012-03-01

    Using a sample of 391 low-income youth ages 13-17, this study investigated the potential moderating effects of school climate, participation in extracurricular activities, and positive parent-child relations on associations between exposure to violence (i.e., witnessing violence and violent victimization) and adolescent socioemotional adjustment (i.e., internalizing and externalizing problems). Exposure to violence was related to both internalizing and externalizing problems. High levels of participation in extracurricular activities and positive parent-child relations appeared to function as protective factors, weakening the positive association between exposure to violence and externalizing problems. Contrary to prediction, school climate did not moderate associations between exposure to violence and socioemotional adjustment. Further, none of the hypothesized protective factors moderated the association between exposure to violence and internalizing problems.

  12. Prepregnancy risk factors for antepartum stillbirth in the United States.

    Science.gov (United States)

    Reddy, Uma M; Laughon, S Katherine; Sun, Liping; Troendle, James; Willinger, Marian; Zhang, Jun

    2010-11-01

    To identify possible prepregnancy risk factors for antepartum stillbirth and to determine whether these factors identify women at higher risk for term stillbirth. This retrospective cohort study of prepregnancy risk factors compared 712 singleton antepartum stillbirths with 174,097 singleton live births at or after 23 weeks of gestation. The risk of term antepartum stillbirth then was assessed in a subset of 155,629 singleton pregnancies. In adjusted multivariable analyses, African-American race, Hispanic ethnicity, maternal age 35 years or older, nulliparity, prepregnancy body mass index (BMI) 30 or higher, preexisting diabetes, chronic hypertension, smoking, and alcohol use were independently associated with stillbirth. Prior cesarean delivery and history of preterm birth were associated with increased stillbirth risk in multiparous women. The risk of a term stillbirth for women who were white, 25-29 years old, normal weight, multiparous, no chronic hypertension, and no preexisting diabetes was 0.8 per 1,000. Term stillbirth risk increased with the following conditions: preexisting diabetes (3.1 per 1,000), chronic hypertension (1.7 per 1,000), African-American race (1.8 per 1,000), maternal age 35 years or older (1.3 per 1,000), BMI 30 or higher (1 per 1,000), and nulliparity (0.9 per 1,000). There are multiple independent risk factors for antepartum stillbirth. However, the value of individual risk factors of race, parity, advanced maternal age (35-39 years old), and BMI to predict term stillbirth is poor. Our results do not support routine antenatal surveillance for any of these risk factors when present in isolation. II.

  13. Sacrococcygeal pilonidal disease: analysis of previously proposed risk factors

    Directory of Open Access Journals (Sweden)

    Ali Harlak

    2010-01-01

    Full Text Available PURPOSE: Sacrococcygeal pilonidal disease is a source of one of the most common surgical problems among young adults. While male gender, obesity, occupations requiring sitting, deep natal clefts, excessive body hair, poor body hygiene and excessive sweating are described as the main risk factors for this disease, most of these need to be verified with a clinical trial. The present study aimed to evaluate the value and effect of these factors on pilonidal disease. METHOD: Previously proposed main risk factors were evaluated in a prospective case control study that included 587 patients with pilonidal disease and 2,780 healthy control patients. RESULTS: Stiffness of body hair, number of baths and time spent seated per day were the three most predictive risk factors. Adjusted odds ratios were 9.23, 6.33 and 4.03, respectively (p<0.001. With an adjusted odds ratio of 1.3 (p<.001, body mass index was another risk factor. Family history was not statistically different between the groups and there was no specific occupation associated with the disease. CONCLUSIONS: Hairy people who sit down for more than six hours a day and those who take a bath two or less times per week are at a 219-fold increased risk for sacrococcygeal pilonidal disease than those without these risk factors. For people with a great deal of hair, there is a greater need for them to clean their intergluteal sulcus. People who engage in work that requires sitting in a seat for long periods of time should choose more comfortable seats and should also try to stand whenever possible.

  14. One idea of portfolio risk control for absolute return strategy risk adjustments by signals from correlation behavior

    Science.gov (United States)

    Nishiyama, N.

    2001-12-01

    Absolute return strategy provided from fund of funds (FOFs) investment schemes is the focus in Japanese Financial Community. FOFs investment mainly consists of hedge fund investment and it has two major characteristics which are low correlation against benchmark index and little impact from various external changes in the environment given maximizing return. According to the historical track record of survival hedge funds in this business world, they maintain a stable high return and low risk. However, one must keep in mind that low risk would not be equal to risk free. The failure of Long-term capital management (LTCM) that took place in the summer of 1998 was a symbolized phenomenon. The summer of 1998 exhibited a certain limitation of traditional value at risk (VaR) and some possibility that traditional VaR could be ineffectual to the nonlinear type of fluctuation in the market. In this paper, I try to bring self-organized criticality (SOC) into portfolio risk control. SOC would be well known as a model of decay in the natural world. I analyzed nonlinear type of fluctuation in the market as SOC and applied SOC to capture complicated market movement using threshold point of SOC and risk adjustments by scenario correlation as implicit signals. Threshold becomes the control parameter of risk exposure to set downside floor and forecast extreme nonlinear type of fluctuation under a certain probability. Simulation results would show synergy effect of portfolio risk control between SOC and absolute return strategy.

  15. The Pennsylvania Trauma Outcomes Study Risk-Adjusted Mortality Model: Results of a Statewide Benchmarking Program.

    Science.gov (United States)

    Wiebe, Douglas J; Holena, Daniel N; Delgado, M Kit; McWilliams, Nathan; Altenburg, Juliet; Carr, Brendan G

    2017-05-01

    Trauma centers need objective feedback on performance to inform quality improvement efforts. The Trauma Quality Improvement Program recently published recommended methodology for case mix adjustment and benchmarking performance. We tested the feasibility of applying this methodology to develop risk-adjusted mortality models for a statewide trauma system. We performed a retrospective cohort study of patients ≥16 years old at Pennsylvania trauma centers from 2011 to 2013 (n = 100,278). Our main outcome measure was observed-to-expected mortality ratios (overall and within blunt, penetrating, multisystem, isolated head, and geriatric subgroups). Patient demographic variables, physiology, mechanism of injury, transfer status, injury severity, and pre-existing conditions were included as predictor variables. The statistical model had excellent discrimination (area under the curve = 0.94). Funnel plots of observed-to-expected identified five centers with lower than expected mortality and two centers with higher than expected mortality. No centers were outliers for management of penetrating trauma, but five centers had lower and three had higher than expected mortality for blunt trauma. It is feasible to use Trauma Quality Improvement Program methodology to develop risk-adjusted models for statewide trauma systems. Even with smaller numbers of trauma centers that are available in national datasets, it is possible to identify high and low outliers in performance.

  16. Risk factors for severe dental anxiety among medical students

    Directory of Open Access Journals (Sweden)

    Janković Slobodan M.

    2014-01-01

    Full Text Available Background/Aim. Severe dental anxiety (SDA is the most severe form of dental anxiety, thus the aim of this study was to determine the factors associated with SDA in students of health-related disciplines. Methods. In this case-control study the cases were students with severe dental anxiety. The study was conducted at the Faculty of Medical Sciences, University of Kragujevac, Serbia. The participants were undergraduate students attending lectures during spring semester 2010/2011 (n = 1,812. A random sample of 800 students was assessed for the association between various risk factors and the severe dental anxiety. The main outcome measures were the data on demographics, dental anxiety, habits concerning oral hygiene, nutrition, general anxiety and (comorbidity which were collected from the study participants by semi-structured questionnaire. Results. Less frequent visits to the dentist (OR adjusted = 7.02 [2.65; 18.60] and visiting the dentist only when there is a dental problem (OR adjusted = 8.08 [1.28; 50.93] were associated with severe dental anxiety. The same was true for improper oral hygiene (OR adjusted = 4.25 [1.16; 15.60]. Factors as changing toothbrush more frequently (OR adjusted = 0.33 [0.14; 0.76] and having chronic disease (OR adjusted = 0.01 [0.00; 0.09] were inversely associated with severe dental anxiety. The level of education of students was not associated with severe dental anxiety. Conclusion. Inappropriate oral hygiene, less frequent changes of a toothbrush and less frequent visits to the dentist are important risk factors for severe dental anxiety. [Projekat Ministarstva nauke Republike Srbije, br. 175007

  17. Tracking suicide risk factors through Twitter in the US.

    Science.gov (United States)

    Jashinsky, Jared; Burton, Scott H; Hanson, Carl L; West, Josh; Giraud-Carrier, Christophe; Barnes, Michael D; Argyle, Trenton

    2014-01-01

    Suicide is a leading cause of death in the United States. Social media such as Twitter is an emerging surveillance tool that may assist researchers in tracking suicide risk factors in real time. To identify suicide-related risk factors through Twitter conversations by matching on geographic suicide rates from vital statistics data. At-risk tweets were filtered from the Twitter stream using keywords and phrases created from suicide risk factors. Tweets were grouped by state and departures from expectation were calculated. The values for suicide tweeters were compared against national data of actual suicide rates from the Centers for Disease Control and Prevention. A total of 1,659,274 tweets were analyzed over a 3-month period with 37,717 identified as at-risk for suicide. Midwestern and western states had a higher proportion of suicide-related tweeters than expected, while the reverse was true for southern and eastern states. A strong correlation was observed between state Twitter-derived data and actual state age-adjusted suicide data. Twitter may be a viable tool for real-time monitoring of suicide risk factors on a large scale. This study demonstrates that individuals who are at risk for suicide may be detected through social media.

  18. Intrinsic Risk Factors of Falls in Elderly

    Directory of Open Access Journals (Sweden)

    Yasmin Amatullah

    2016-09-01

    Full Text Available Background: Falls are common geriatric problems. The risk factors of falls are the intrinsic and extrinsic risk factors. Studies on falls are scarcely conducted in Indonesia, especially in Bandung. Therefore, this study was conducted to identify the intrinsic risk factors of falls among elderly. Methods: A descriptive study was carried out from August to October 2013 at the Geriatric Clinic of Dr. Hasan Sadikin General Hospital Bandung. Fifty three participants were selected according to the inclusion and exclusion criteria using consecutive sampling. The determined variables in this study were classification of the risk of falls, demographic profile, history of falls, disease, and medications. After the selection, the participants were tested by Timed up-and-go test (TUGT. Moreover, an interview and analysis of medical records were carried out to discover the risk factors of falls. The collected data were analyzed and presented in the form of percentages shown in tables. Results: From 53 patients, women (35.66% were considered to have higher risk of fall than men (18.34%. The majority of patients (66% with the risk of fall were from the age group 60–74 years. The major diseases suffered by patients were hypertension, osteoarthritis and diabetes mellitus. Drugs that were widely used were antihypertensive drugs; analgesic and antipyretic drugs and antidiabetic drugs. Conclusions: There are various intrinsic risk factors of falls in elderly and each of the elderly has more than one intrinsic risk factor of falls.

  19. Fruit and vegetable consumption and risk factors for cardiovascular disease.

    Science.gov (United States)

    Mirmiran, Parvin; Noori, Nazanin; Zavareh, Maryam Beheshti; Azizi, Fereidoun

    2009-04-01

    The international guidelines issued by the World Health Organization recommend reduction in dietary saturated fat and cholesterol intakes as means to prevent hypercholesterolemia and cardiovascular disease (CVD); however, only limited data are available on the benefits of fruit and vegetable consumption on CVD risk factors in a community-based population. The aim of this study was to examine whether, and to what extent, intake of fruits and vegetables is inversely associated with CVD risk factors in adults. In this population-based cross-sectional study, a representative sample of 840 Tehranian adults (male and female) aged 18 to 74 years was randomly selected in 1998. Multivariate logistic regression adjusted for lifestyle and nutritional confounders was used in 2 models. After adjusting for confounders, dietary fruit and vegetable were found to be significantly and inversely associated with CVD risk factors. Adjusted odds ratio for high low-density lipoprotein concentrations were 1.00, 0.88, 0.81, and 0.75 (P for trend energy intake, smoking status, dietary cholesterol, and history of diabetes mellitus and coronary artery disease, a trend which was not appreciably altered by additional adjustment for education, physical activity, and saturated, polyunsaturated, and total fat intakes. This association was observed across categories of smoking status, physical activity, and tertiles of the Keys score. Exclusion of subjects with prevalent diabetes mellitus or coronary artery disease did not alter these results significantly. Consumption of fruits and vegetables is associated with lower concentrations of total and low-density lipoprotein cholesterol and with the risk of CVD per se in a dose-response manner.

  20. Smoking might be a risk factor for contact allergy

    DEFF Research Database (Denmark)

    Linneberg, Allan; Nielsen, Niels Henrik; Menné, Torkil

    2003-01-01

    BACKGROUND: Contact allergy is a major public health problem in industrialized countries. Hitherto, known risk factors for contact allergy have mainly included increased exposure to allergens. There are no published data on the relation between smoking and contact allergy. OBJECTIVE: To investigate...... the association between smoking and contact allergy. METHODS: The study population comprised a cross-sectional, general population-based sample of 15- to 69-year-old persons living in Copenhagen, Denmark. A total of 1056 persons (73.6% of the invited) were given a patch test (TRUE test). Contact allergy....... A detailed smoking history was obtained in a questionnaire. RESULTS: Contact allergy (adjusted odds ratio, 1.8; 95% CI, 1.2 to 2.9), nickel contact allergy (adjusted odds ratio, 2.7; 95% CI, 1.4 to 5.2), and allergic nickel contact dermatitis (adjusted odds ratio, 3.0; 95% CI, 1.5 to 6.2) were significantly...

  1. Can Risk Adjustment prevent Risk Selection in a Competitive Long-Term Care Insurance Market?

    NARCIS (Netherlands)

    P.L.H. Bakx (Pieter); F.T. Schut (Erik); E.K.A. van Doorslaer (Eddy)

    2013-01-01

    textabstractWhen public long-term care (LTC) insurance is provided by insurers, they typically lack incentives for purchasing cost-effective LTC. Providing insurers with appropriate incentives for efficiency without jeopardizing access for high-risk individuals requires, among other things, an

  2. Risk factors of different congenital heart defects in Guangdong, China.

    Science.gov (United States)

    Ou, Yanqiu; Mai, Jinzhuang; Zhuang, Jian; Liu, Xiaoqing; Wu, Yong; Gao, Xiangmin; Nie, Zhiqiang; Qu, Yanji; Chen, Jimei; Kielb, Christine; Lauper, Ursula; Lin, Shao

    2016-04-01

    Limited studies have evaluated the risk factors for congenital heart defects (CHDs) in China and compared them for different types of CHDs. This study examined risk factors between isolated and multiple CHDs as well as among CHDs subtypes in Guangdong, Southern China. This population-based case-control study included 4,034 pairs of case and control infants enrolled in the Guangdong Registry of CHD study, 2004-2013. Multivariate logistic regression was used to compute adjusted odds ratios (ORs) while simultaneously controlling for confounders. Multiple maternal environmental exposures, including living in newly renovated rooms, residential proximity to main traffic, paternal smoking, and maternal occupation as manual worker, were significantly associated with CHDs with ORs ranging 1.30-9.43. Maternal perinatal diseases (including maternal fever, diabetes, influenza, and threatened abortion), maternal medication use (antibiotic use), advanced maternal age, low socioeconomic status, and paternal alcohol intake were also significantly associated with CHDs, with ORs ranging 1.60-3.96. Isolated CHDs and multiple defects have different profiles of risk factors, while subtype of CHD shares common risk factors. These results suggest that maternal environmental exposures/occupation and perinatal diseases/medication use were dominant risk factors associated with CHDs in Southern China. Isolated and multiple CHDs may have different etiologic factors.

  3. Age-parity-season adjustment factors for milk and fat yields of dairy goats.

    Science.gov (United States)

    Finley, C M; Thompson, J R; Bradford, G E

    1984-08-01

    Dairy Herd Improvement records from 1976 through 1981 were used to obtain dairy goat age-parity-season adjustment factors for milk and fat yields. Only records from purebred and American Alpine, Nubian, Saanen, and Toggenburg does were used. Nubians were analyzed separately from other breeds. Factors were calculated for two parity groups, two seasons, and two regions. Mixed model equations were used to remove effects of doe, breed, and year. Only lactations of at least 120 days were used. Resulting curves showed maximum production between 24 and 50 mo of age. Does from the northeastern United States reached maximum production earlier than does from western states.

  4. Predictive risk factors for persistent postherniotomy pain

    DEFF Research Database (Denmark)

    Aasvang, Eske K; Gmaehle, Eliza; Hansen, Jeanette B

    2010-01-01

    BACKGROUND: Persistent postherniotomy pain (PPP) affects everyday activities in 5-10% of patients. Identification of predisposing factors may help to identify the risk groups and guide anesthetic or surgical procedures in reducing risk for PPP. METHODS: A prospective study was conducted in 464 pa...... to a standardized heat stimulus may preferably be treated using an operative technique with lowest risk for nerve damage.......BACKGROUND: Persistent postherniotomy pain (PPP) affects everyday activities in 5-10% of patients. Identification of predisposing factors may help to identify the risk groups and guide anesthetic or surgical procedures in reducing risk for PPP. METHODS: A prospective study was conducted in 464...... patients undergoing open or laparoscopic transabdominal preperitoneal elective groin hernia repair. Primary outcome was identification of risk factors for substantial pain-related functional impairment at 6 months postoperatively assessed by the validated Activity Assessment Scale (AAS). Data on potential...

  5. Glaucoma history and risk factors

    Directory of Open Access Journals (Sweden)

    Charles W. McMonnies

    2017-04-01

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

  6. Relationship Satisfaction and Risk Factors for Suicide.

    Science.gov (United States)

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

    2017-01-01

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

  7. Seismic Risk Perception compared with seismic Risk Factors

    Science.gov (United States)

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

    2016-04-01

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

  8. HUMAN PROSTATE CANCER RISK FACTORS

    Science.gov (United States)

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

  9. BREAST CANCER: IS OBESITY A RISK FACTOR?

    OpenAIRE

    Anjali; Deepak; Dinesh Kumar

    2015-01-01

    Most epidemiological studies established obesity as an important risk factor for breast cancer. It is one of the few risk factors that women can modify. Now-a-days breast cancer is considered to be a life-style disease. The relation of obesity to breast cancer is complex one. Obesity is found to be associated with increased risk of cancer in post-menopausal women, but relation is reverse in pre-menopausal women. In these patients, obesity increases risk due to enhanced oestrogenic...

  10. Attachment styles and demographic factors as predictors of sociocultural and psychological adjustment of Eastern European immigrants in the Netherlands.

    Science.gov (United States)

    Polek, Elżbieta; van Oudenhoven, Jan Pieter; Ten Berge, Jos M F

    2008-10-01

    The present study examined the relationship between adult attachment styles and psychological and sociocultural adjustment of Polish, Russian, and Hungarian immigrants (N = 631) to Dutch society. In addition, it also examined the relationship between demographic factors and adjustment and compared the predictive value of attachment styles and demographic factors for immigrants' adjustment. The Attachment Style Questionnaire was used to assess respondents' attachment. Psychological adjustment was measured with the Psychological Health Scale and the Satisfaction With Life Scale. Sociocultural adjustment was measured with the Social Support List - Interactions scale. Two scales for measuring identification and contact with the native and with the Dutch culture were developed and used as indicators of cultural adjustment. We found relations between attachment styles and psychological and sociocultural adjustment. Secure attachment was positively related (ppsychological and sociocultural adjustment, fearful attachment was negatively (ppsychological adjustment, and more negatively with identification with the Dutch culture than with identification with the native culture. Preoccupied attachment was negatively related (ppsychological adjustment and to identification with the Dutch culture. Dismissing attachment was weakly negatively related (padjustment. Correlation patterns across the three immigrants' samples indicate that dismissing individuals remain relatively indifferent towards their native and the Dutch culture. Regarding demographic factors we found that education and age at immigration were positively associated with psychological and sociocultural adjustment, and length of residence appeared to be positively related to sociocultural adjustment. In general, demographic factors showed a stronger association with sociocultural than with psychological adjustment. Regression analysis revealed that attachment styles were better predictors of immigrants' psychological

  11. Factors associated with relationship dissolution and post-dissolution adjustment among lesbian adoptive couples.

    Science.gov (United States)

    Farr, Rachel H

    2017-01-02

    Same-sex adoptive couples are increasingly visible, yet few studies have addressed relationship stability and dissolution among these couples. In this study, using a theoretical framework based on Investment Models and Vulnerability-Stress-Adaptation Theory, factors associated with dissolution and post-dissolution adjustment among 27 lesbian adoptive couples were examined across two points. At Wave 1, all 27 couples were together; children were on average 3 years old. Results revealed that nearly one third broke up over 5 years (between Waves 1 and 2). Factors related to shorter relationship length and undermining coparenting at Wave 1 distinguished women who later broke up versus stayed together. Worse mental health at Wave 2 characterized women in dissolved rather than sustained relationships, even with comparable individual adjustment at Wave 1. Weaker parenting alliance and greater dissatisfaction with childcare divisions were reported by women no longer with their partners at Wave 2 as compared with those in enduring partnerships. This research has implications for understanding lesbian relationship dynamics and associations with individual adjustment.

  12. Vascular Risk Factors and Clinical Progression in Spinocerebellar Ataxias

    Directory of Open Access Journals (Sweden)

    Raymond Y. Lo

    2015-02-01

    Full Text Available Background: The contributions of vascular risk factors to spinocerebellar ataxia (SCA are not known.Methods: We studied 319 participants with SCA 1, 2, 3, and 6 and repeatedly measured clinical severity using the Scale for Assessment and Rating of Ataxia (SARA for 2 years. Vascular risk factors were summarized by CHA2DS2-VASc scores as the vascular risk factor index. We employed regression models to study the effects of vascular risk factors on ataxia onset and progression after adjusting for age, sex, and pathological CAG repeats. Our secondary analyses took hyperlipidemia into account.Results: Nearly 60% of SCA participants were at low vascular risks with CHA2DS2-VASc = 0, and 31% scored 2 or greater. Higher CHA2DS2-VASc scores were not associated with either earlier onset or faster progression of ataxia. These findings were not altered after accounting for hyperlipidemia. Discussion: Vascular risks are not common in SCAs and are not associated with earlier onset or faster ataxia progression.

  13. Risk Factors for Complications of Traumatic Injuries.

    Science.gov (United States)

    de Aguiar Júnior, Wagner; Saleh, Carmen Mohamad Rida; Whitaker, Iveth Yamaguchi

    2016-01-01

    Complications in hospitalized trauma patients are major causes of morbidity and mortality. The aims of this study were to identify the in-hospital trauma patients' complications and identify the risk factors for complications in this population. A retrospective analysis was conducted in a sample from a Brazilian hospital. The sample consisted of 407 patients, 194 (47.66%) of whom had records of complications. The most common complications were infections (41.80%). The risk factors related to the complications were age, length of hospital stay, external causes, and injury severity. The complications were frequent in this sample, and the risk for complications was characterized by multiple factors.

  14. Glaucoma history and risk factors.

    Science.gov (United States)

    McMonnies, Charles W

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

  15. Risk factors for multiple sclerosis, neuromyelitis optica and transverse myelitis.

    Science.gov (United States)

    Simon, K C; Schmidt, H; Loud, S; Ascherio, A

    2015-05-01

    Little is known about risk factors for neuromyelitis optica (NMO) or transverse myelitis (TM). The objective of this paper is to evaluate whether established multiple sclerosis (MS) risk factors, including smoking history, a history of infectious mononucleosis (IM), anti-EBNA1 Ab titers and HLA-DR15 are associated with NMO or TM. We conducted a case-control study among participants in the Accelerated Cure Project for Multiple Sclerosis (ACP) Repository, which includes patients with MS, NMO and TM. Controls include related and unrelated individuals without evidence of demyelinating disease. Analyses included 1237 cases of MS, 98 cases of NMO, 133 cases of TM and 488 healthy controls. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were used to assess the association between smoking, HLA-DR15, anti-EBNA1 Ab titers and a history of IM adjusting for gender, study site and ethnicity. Overall, the association between smoking, IM, HLA-DR15 and anti-EBNA1 Ab titers and odds of MS were as expected and no significant interactions were observed. However, there was little evidence of association between these MS risk factors and odds of NMO or TM. Established MS risk factors do not appear to be associated with susceptibility to TM or NMO and, among MS patients, these risk factors appear to act independently. © The Author(s), 2014.

  16. Epidemiology and risk factors of schizophrenia.

    Science.gov (United States)

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

    2016-01-01

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

  17. Ectasia risk factors in refractive surgery

    Directory of Open Access Journals (Sweden)

    Santhiago MR

    2016-04-01

    Full Text Available Marcony R Santhiago,1 Natalia T Giacomin,1 David Smadja,2 Samir J Bechara1 1Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil, 2Ophthalmology Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel Abstract: This review outlines risk factors of post-laser in situ keratomileusis (LASIK ectasia that can be detected preoperatively and presents a new metric to be considered in the detection of ectasia risk. Relevant factors in refractive surgery screening include the analysis of intrinsic biomechanical properties (information obtained from corneal topography/tomography and patient’s age, as well as the analysis of alterable biomechanical properties (information obtained from the amount of tissue altered by surgery and the remaining load-bearing tissue. Corneal topo­graphy patterns of placido disk seem to play a pivotal role as a surrogate of corneal strength, and abnormal corneal topography remains to be the most important identifiable risk factor for ectasia. Information derived from tomography, such as pachymetric and epithelial maps as well as computational strategies, to help in the detection of keratoconus is additional and relevant. High percentage of tissue altered (PTA is the most robust risk factor for ectasia after LASIK in patients with normal preoperative corneal topography. Compared to specific residual stromal bed (RSB or central corneal thickness values, percentage of tissue altered likely provides a more individualized measure of biomechanical alteration because it considers the relationship between thickness, tissue altered through ablation and flap creation, and ultimate RSB thickness. Other recognized risk factors include low RSB, thin cornea, and high myopia. Age is also a very important risk factor and still remains as one of the most overlooked ones. A comprehensive screening approach with the Ectasia Risk Score System, which evaluates multiple risk factors simultaneously, is also a

  18. Risk factors for macrosomia in infants born to Latina women

    Science.gov (United States)

    Wojcicki, JM.; Hessol, NA.; Heyman, MB.; Fuentes-Afflick, E.

    2015-01-01

    Objective To assess risk factors for macrosomic infant birth among Latina women. Study Design Prospective study of Latina women recruited during pregnancy from prenatal clinic at San Francisco General Hospital. Information was obtained through a structured interview and review of medical records. Result A total of 11% of women delivered macrosomic infants (birth weight >4000 g). In unadjusted analyses, significant risk factors for macrosomia included older maternal age, increasing gravidity, previous history of macrosomic birth and pre-pregnancy overweight. After adjusting for confounders using multivariate analyses, older mothers (10-year increments) had an elevated risk of macrosomia (odds ratio (OR) 2.59; 95% confidence interval (CI) 1.28 to 5.24). Conclusion Efforts to reduce macrosomia in Latina women should focus on older mothers. PMID:18596709

  19. Psychosocial Factors and Adjustment to Chronic Pain in Persons With Physical Disabilities: A Systematic Review

    Science.gov (United States)

    Jensen, Mark P.; Moore, Michael R.; Bockow, Tamara B.; Ehde, Dawn M.; Engel, Joyce M.

    2011-01-01

    Objective To systematically review the research findings regarding the associations between psychosocial factors and adjustment to chronic pain in persons with physical disabilities. Data Sources A key word literature search was conducted using articles listed in PubMed, PsychInfo, and CINAHL up to March 2010, and manual searches were made of all retrieved articles to identify published articles that met the review inclusion criteria. Study Selection To be included in the review, articles needed to (1) be written in English, (2) include adults with a physical disability who report having pain, (3) include at least 1 measure of a psychosocial predictor domain, (4) include at least 1 criterion measure of pain or patient functioning, and (5) report the results of associations between the psychosocial factors and criterion measures used in the study. Twenty-nine studies met the inclusion criteria. Data Extraction Three reviewers tabulated study details and findings. Data Synthesis The disability groups studied included spinal cord injury (SCI), acquired amputation, cerebral palsy (CP), multiple sclerosis (MS), and muscular dystrophy (MD). Psychosocial factors were shown to be significantly associated with pain and dysfunction in all disability groups. The psychosocial factors most closely associated with pain and dysfunction across the samples included (1) catastrophizing cognitions; (2) task persistence, guarding, and resting coping responses; and (3) perceived social support and solicitous responding social factors. Pain-related beliefs were more strongly associated with pain and dysfunction in the SCI, CP, MS, and MD groups than in the acquired amputation group. Conclusions The findings support the importance of psychosocial factors as significant predictors of pain and functioning in persons with physical disabilities. Clinical trials to test the efficacy of psychosocial treatments for pain and dysfunction are warranted, as are studies to determine whether

  20. Resting heart rate and cardiovascular events: risk factor or risk ...

    African Journals Online (AJOL)

    Review: Resting heart rate and cardiovascular events: risk factor or risk marker? 128. Vol 52 No 2. SA Fam Pract 2010. SA Fam Pract 2010;52(2): 128-129. Heart rate in epidemiological studies. Over the last 25 years numerous reports demonstrated a significant association between resting heart rate and all- cause mortality ...

  1. Childhood ADHD symptoms and risk for cigarette smoking during adolescence: School adjustment as a potential mediator.

    Science.gov (United States)

    Flory, Kate; Malone, Patrick S; Lamis, Dorian A

    2011-06-01

    Although a large body of research suggests that children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for cigarette smoking during adolescence compared with their non-ADHD peers, much less research has examined why. The current study addressed this gap in the literature by examining middle school adjustment, broadly defined, as a possible mediator of the relation between childhood ADHD symptoms and cigarette smoking during middle adolescence (10th grade). Longitudinal data were collected from a community sample of 754 youth using self-report and parent report along with school records, and a novel statistical technique was used in the process of testing for mediation. Consistent with hypotheses, school adjustment was found to mediate the relation between childhood ADHD symptoms and later cigarette smoking, even after controlling for early externalizing problems. Results have implications for etiological theories of adolescent deviant behavior and suggest that successful smoking prevention programs targeting youth with ADHD should include a school adjustment component. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

  2. Teacher-child relationships and behavioral adjustment: transactional links for preschool boys at risk.

    Science.gov (United States)

    Roorda, Debora L; Verschueren, Karine; Vancraeyveldt, Caroline; Van Craeyevelt, Sanne; Colpin, Hilde

    2014-10-01

    In this short-term longitudinal study, transactional links between teacher-child relationships and behavioral adjustment were investigated in a sample of preschool boys (N=175) at risk for developing externalizing problems. Teachers (N=175) reported about the quality of the teacher-child relationship (i.e., Closeness, Conflict, and Dependency) and about children's behavioral adjustment (i.e., Externalizing Behavior, Internalizing Behavior, and Prosocial Behavior) at three occasions within one school year. Cross-lagged path-analytic models showed positive bidirectional associations between Conflict and both Externalizing and Internalizing Behavior from Time 1 to Time 2, but not from Time 2 to Time 3. In addition, there was a transactional sequence with more Conflict at Time 1 leading to less Prosocial Behavior at Time 2 which, in turn, predicted more Conflict at Time 3. Closeness was reciprocally and positively related to Prosocial Behavior over time, and was positively and unidirectionally predicted by Internalizing Behavior. Dependency showed positive reciprocal links with Internalizing Behavior over time, and negatively and unidirectionally predicted Prosocial Behavior. These findings suggest that interventions may be most effective if they adjust their focus and strategy depending on children's specific behavioral and relational needs. Copyright © 2014 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  3. When does cardiovascular risk start? Past and present socioeconomic circumstances and risk factors in adulthood

    OpenAIRE

    Brunner, E; Shipley, M J; Blane, D; Smith, G.D.; Marmot, M. G.

    1999-01-01

    STUDY OBJECTIVES: To compare associations of childhood and adult socioeconomic position with cardiovascular risk factors measured in adulthood. To estimate the effects of adult socioeconomic position after adjustment for childhood circumstances. DESIGN: Cross sectional survey, using the relative index of inequality method to compare socioeconomic differences at different life stages. SETTING: The Whitehall II longitudinal study of men and women employed in London offices of the Civil S...

  4. Risk factors for knee instability after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Ahn, Ji Hyun; Lee, Sung Hyun

    2016-09-01

    The objective of this study was to estimate risk factors that influence postoperative instability after anterior cruciate ligament (ACL) reconstruction using multivariate logistic regression analysis. A total of 152 consecutive patients with symptomatic ACL insufficiency underwent arthroscopic ACL reconstruction between 2005 and 2011. Loss to follow-up and previous ligament reconstruction were exclusion criteria, resulting in 131 patients remaining for this retrospective study. The median follow-up was 55 months (range 25-100 months). Patients were sorted into two groups by anterior translation on stress radiograph and pivot shift test grade and were analysed for the statistical significance of various risk factors including age at surgery, gender, body mass index, preoperative instability, time from injury to surgery, single-bundle reconstruction with preserved abundant remnant versus double-bundle reconstruction with scanty remnant, and concomitant ligament, meniscus, and articular cartilage injury with use of multivariate logistic regression analysis. Time from injury to surgery over 12 weeks was found to be a significant risk factor for postoperative instability [p ligament (MCL) was also a risk factor (p = 0.02, adjusted OR 13.60; 95 % CI 1.24-148.25). The other variables were not found to be a significant risk factor. Among the risk factor variables, concomitant grade 2 MCL injury and surgical delay of more than 12 weeks from injury were significant risk factors for postoperative knee instability after ACL reconstruction. The overall results suggest that surgery <12 weeks from injury and meticulous attention to concomitant MCL injury should be considered. Retrospective case-control study, Level III.

  5. Occupational Risk Factors of Lymphohematopoietic Cancer in Rayong Province, Thailand.

    Science.gov (United States)

    Punjindasup, Apinya; Sangrajrang, Suleeporn; Ekpanyaskul, Chatchai

    2015-11-01

    The Lymphohematopoietic Cancer (LHC) incidence rate in Thailand has been rising over the past decade with unknown etiology, including Rayong province. One hypothesis of LHC risks is exposure to occupational carcinogens. To determine the association of occupational exposure and LHC risks in Rayong province, Thailand. This matched hospital-based case-control study was conducted in a Rayong provincial hospital from September 2009 to January 2013. One LHC case was matched with four controls in gender and age, ±5 years. Demographic data, residential factors, behavioral factors, and occupational exposure-including chemical exposure-were obtained by interviews and collected by occupational health care officers. The risk factor was analyzed by conditional logistic regression and reported in odds ratio with 95% confidence interval. This study found 105 LHC cases which met the inclusion criteria and were included in the study, yielding a 66% cover rate of cases reported in the database. The histology of LHC were 51 leukemia cases (47.7%), 43 lymphoma cases (42.0%), and 11 multiple myeloma cases (10.3%). The results revealed that occupational exposure to pesticide and smoke were statistically significantly associated with LHC with adjusted ORs 2.26 (95% CI 1.30-3.91) and 1.99 (95% CI = 1.13-3.51), respectively. When stratified to histological subtype of LHC by WHO 2000, leukemia was statistically significantly associated with occupational exposure to smoke, adjusted ORs 2.43 (95% CI 1.11-5.36), with occupational pesticide exposure a significant risk of lymphoma, adjusted ORs 4.69 (95% CI 2.01-10.96). However, neither fumes, wood dust, working outdoors, cleaners, contact with animals, petroleum products and chlorine; nor occupational exposure to volatile organic compounds (VOCs) such as benzene or organic solvents, were statistically significant risk factors of LHC. In addition, there were no significant risks in the demographic data, residential factors, and behavioral

  6. The role of motor impulsivity in socioemotional adjustment in high-risk seven year old children and healthy controls: a follow-up study

    Directory of Open Access Journals (Sweden)

    José C. Perales

    2014-01-01

    Full Text Available The main aim of the present study was two-wise: first, to assess the presence of behavioral and intellectual disturbances in high-risk 7-year-old children, compared to healthy controls; and, second, and most importantly, to evaluate the discriminative validity of a motor impulsivity neuropsychological task (Go/No-go as an indicator of daily-life socioemotional adjustment. We administered the Behavior Assessment Scale for Children (BASC, the Weschler Intelligence Scale for Children (WISCIV, and the Go/No-go task to 14 high-risk 7 year-olds and 20 matched healthy controls. High-risk children had been classified as so shortly after birth, due to the presence of perinatal risk factors, and later released from the early care unit. They are currently schooled according to their age. We expected performance in the Go/No-go task to be a good indicator of behavioral disturbances in high-risk children, and more specifically of those related to socioemotional adjustment. Accordingly to such a hypothesis, high-risk children showed significantly worse scores in most BASC and WISC subscales, and committed more commission and omission errors on the Go/No-go task. Most importantly, regression analyses showed that performance on the Go/No-go task (but not WISC scores was an independent indicator of socioemotional adjustment problems. This result is in accordance with proposals that motor impulsivity is an important mediator between altered executive function development and socioemotional adjustment.

  7. Cardiovascular risk factors among women with self-reported infertility.

    Science.gov (United States)

    Mahalingaiah, Shruthi; Sun, Fangui; Cheng, J Jojo; Chow, Erika T; Lunetta, Kathryn L; Murabito, Joanne M

    2017-01-01

    Amongst women with certain types of ovulatory disorder infertility, the studies are conflicting whether there is an increased risk of long-term cardiovascular disease risk. This paper evaluates the associations of several CVD risk factors among Framingham women with self-reported infertility. Women who completed the Framingham Heart Study Third Generation and Omni Cohort 2 Exam 2 (2008-2011), and reported on past history of infertility and current cardiovascular disease status were included in this cross-sectional study. Directly measured CVD risk factors were: resting blood pressure, fasting lipid levels, fasting blood glucose, waist circumference, and body mass index (BMI). Multivariable models adjusted for age, smoking, physical activity, and cohort. Generalized estimating equations adjusted for family correlations. We performed sensitivity analyses to determine whether the association between infertility and CVD risk factors is modified by menopausal status and menstrual cycle length. Comparing women who self-reported infertility to those who did not, there was an average increase in BMI (β = 1.03 kg/m(2), 95% CI: 0.18, 1.89), waist circumference (β = 3.08 in., 95% CI: 1.06, 5.09), triglycerides (β = 4.47 mg/dl, 95% CI:-1.54, 10.49), and a decrease in HDL cholesterol (β = -1.60 mg/dl, 95% CI: -3.76, 0.56). We estimated that infertile premenopausal women have an increased odds of obesity (BMI ≥ 30 kg/m(2)) (OR = 1.56, 95% CI: 1.11, 4.49) and diabetes (OR = 1.96, 95% CI: 0.86, 4.49). BMI and waist circumference were the most strongly correlated CVD risk factors amongst women reporting a history of infertility.

  8. RISK FACTORS FOR STROKE AND USE OF ...

    African Journals Online (AJOL)

    Kateee

    2003-04-04

    Apr 4, 2003 ... Objective: To review risk factors for stroke and the use of echocardiography in ... echocardiography may enhance the diagnosis but not necessarily change management. ..... Task Force on Practice Guidelines (Committee on.

  9. Atherogenic risk factors and hearing thresholds

    DEFF Research Database (Denmark)

    Frederiksen, Thomas Winther; Ramlau-Hansen, Cecilia Høst; Stokholm, Zara Ann

    2014-01-01

    children's day care units, financial services and 10 manufacturing trades. Associations between atherogenic risk factors (blood lipids, glycosylated hemoglobin, smoking habits, body mass index (BMI), and ambulatory blood pressure) and hearing thresholds were analyzed using multiple linear regression models...

  10. Epilepsy Risk Factors Following Neonatal Seizures

    OpenAIRE

    J Gordon Millichap

    2004-01-01

    Clinical and polysomnographic risk factors as early predictors for the development of postnatal epilepsy were determined in 158 infants presenting with two or more seizures, in a study at Hospital Sao Lucas, Porto Alegre, Brazil.

  11. Awareness of risk factors for cancer

    DEFF Research Database (Denmark)

    Lagerlund, Magdalena; Hvidberg, Line; Hajdarevic, Senada

    2015-01-01

    Background: Sweden and Denmark are neighbouring countries with similarities in culture, healthcare, and economics, yet notable differences in cancer statistics. A crucial component of primary prevention is high awareness of risk factors in the general public. We aimed to determine and compare...... awareness of risk factors for cancer between a Danish and a Swedish population sample, and to examine whether there are differences in awareness across age groups. Methods: Data derive from Module 2 of the International Cancer Benchmarking Partnership. Telephone interviews were conducted with 3000 adults...... in Denmark and 3070 in Sweden using the Awareness and Beliefs about Cancer measure. Data reported here relate to awareness of 13 prompted risk factors for cancer. Prevalence ratios with 95 % confidence intervals were calculated to examine associations between country, age, and awareness of risk factors...

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

    Science.gov (United States)

    ... changing, depending on your age and other factors unique to you. High Blood Pressure —Blood pressure is ... cholesterol raise your LDL cholesterol level. A high-sodium (salt) diet can raise your risk for high ...

  13. Smoldering multiple myeloma risk factors for progression

    DEFF Research Database (Denmark)

    Sørrig, Rasmus; Klausen, Tobias W; Salomo, Morten

    2016-01-01

    Several risk scores for disease progression in patients with smoldering multiple myeloma (SMM) have been proposed; however, all have been developed using single-center registries. To examine risk factors for time to progression (TTP) to multiple myeloma (MM) for SMM, we analyzed a nationwide...... population-based cohort of 321 patients with newly diagnosed SMM registered within the Danish Multiple Myeloma Registry between 2005 and 2014. Significant univariable risk factors for TTP were selected for multivariable Cox regression analyses. We found that both an M-protein ≥30 g/L and immunoparesis...... as having ultra high-risk of transformation to MM. Using only immunoparesis and M-protein ≥30 g/L, we created a scoring system to identify low-, intermediate-, and high-risk SMM. This first population-based study of patients with SMM confirms that an M-protein ≥30 g/L and immunoparesis remain important risk...

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

    Science.gov (United States)

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

    2016-12-01

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

  15. Ectasia risk factors in refractive surgery

    OpenAIRE

    de Santhiago, MR; Giacomin NT; Smadja D; Bechara SJ

    2016-01-01

    Marcony R Santhiago,1 Natalia T Giacomin,1 David Smadja,2 Samir J Bechara1 1Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil, 2Ophthalmology Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel Abstract: This review outlines risk factors of post-laser in situ keratomileusis (LASIK) ectasia that can be detected preoperatively and presents a new metric to be considered in the detection of ectasia risk. Relevant factors in refracti...

  16. Risk factors for osteoporosis and associated fractures.

    OpenAIRE

    Kelsey, J L

    1989-01-01

    Established risk factors for osteoporosis and associated fractures are increasing age, female sex, white race, removal of the ovaries at an early age, prolonged immobility, and prolonged use of corticosteroids. Obesity and use of estrogen replacement therapy are protective. Factors that probably or possibly increase risk in postmenopausal white women include a low calcium intake, cigarette smoking, and, at least for hip fractures, use of long half-life psychotrophic drugs and heavy alcohol co...

  17. Self-management of vascular risk factors

    OpenAIRE

    Sol-de Rijk, B.G.M.

    2009-01-01

    Summary The aim of this thesis was to provide insight into the potential of a self-management approach in treatment of vascular risk factors and to develop a self-management intervention. Furthermore to examine if this intervention, based on self-efficacy promoting theory, is effective in reducing vascular risk factors in patients with established vascular diseases. Patients with different manifestations of vascular diseases appeared to have high levels of self-efficacy concerning the self-ma...

  18. Modifiable risk factors for surgical site infection.

    Science.gov (United States)

    Moucha, Calin S; Clyburn, Terry A; Evans, Richard P; Prokuski, Laura

    2011-01-01

    Multiple risk factors for orthopaedic surgical site infection have been identified. Some of these factors directly affect the wound-healing process, whereas others can lead to blood-borne sepsis or relative immunosuppression. Modifying a patient's medications; screening for comorbidities, such as HIV or diabetes mellitus; and advising the patient on options to diminish or eliminate adverse behaviors, such as smoking, should lower the risk for surgical site infections.

  19. A Bayesian adaptive blinded sample size adjustment method for risk differences.

    Science.gov (United States)

    Hartley, Andrew Montgomery

    2015-01-01

    Adaptive sample size adjustment (SSA) for clinical trials consists of examining early subsets of on trial data to adjust estimates of sample size requirements. Blinded SSA is often preferred over unblinded SSA because it obviates many logistical complications of the latter and generally introduces less bias. On the other hand, current blinded SSA methods for binary data offer little to no new information about the treatment effect, ignore uncertainties associated with the population treatment proportions, and/or depend on enhanced randomization schemes that risk partial unblinding. I propose an innovative blinded SSA method for use when the primary analysis is a non-inferiority or superiority test regarding a risk difference. The method incorporates evidence about the treatment effect via the likelihood function of a mixture distribution. I compare the new method with an established one and with the fixed sample size study design, in terms of maximization of an expected utility function. The new method maximizes the expected utility better than do the comparators, under a range of assumptions. I illustrate the use of the proposed method with an example that incorporates a Bayesian hierarchical model. Lastly, I suggest topics for future study regarding the proposed methods. Copyright © 2015 John Wiley & Sons, Ltd.

  20. Behavioural adjustment in response to increased predation risk: a study in three duck species.

    Directory of Open Access Journals (Sweden)

    Cédric Zimmer

    Full Text Available Predation directly triggers behavioural decisions designed to increase immediate survival. However, these behavioural modifications can have long term costs. There is therefore a trade-off between antipredator behaviours and other activities. This trade-off is generally considered between vigilance and only one other behaviour, thus neglecting potential compensations. In this study, we considered the effect of an increase in predation risk on the diurnal time-budget of three captive duck species during the wintering period. We artificially increased predation risk by disturbing two groups of 14 mallard and teals at different frequencies, and one group of 14 tufted ducks with a radio-controlled stressor. We recorded foraging, vigilance, preening and sleeping durations the week before, during and after disturbance sessions. Disturbed groups were compared to an undisturbed control group. We showed that in all three species, the increase in predation risk resulted in a decrease in foraging and preening and led to an increase in sleeping. It is worth noting that contrary to common observations, vigilance did not increase. However, ducks are known to be vigilant while sleeping. This complex behavioural adjustment therefore seems to be optimal as it may allow ducks to reduce their predation risk. Our results highlight the fact that it is necessary to encompass the whole individual time-budget when studying behavioural modifications under predation risk. Finally, we propose that studies of behavioural time-budget changes under predation risk should be included in the more general framework of the starvation-predation risk trade-off.

  1. Preventing Cardiovascular Disease Risk Factors through Aerobic ...

    African Journals Online (AJOL)

    This paper focused on the reduction of cardiovascular disease risk factors, through aerobic exercises. The central argument here is that through exercise there is the tendency for increased strength of the heart muscles. When this is the case, what follows is a reduction in body weight and ultimately less risk on the ...

  2. Cardiovascular risk factors over the life course

    NARCIS (Netherlands)

    Hulsegge, G.

    2016-01-01

    Cardiovascular disease (CVD) usually manifests itself at middle age or beyond, but it is the result of an ongoing disease process. This stresses the need for insight into changes in lifestyle and metabolic risk factors that occur throughout the life course, and their effect on CVD. We studied risk

  3. Risk factors in prevention of drug dependences

    NARCIS (Netherlands)

    Orosova, Ol'ga; Gajdosova, Beata; Madarasova-Geckova, Andrea; Van Dijk, Jitse P.

    2007-01-01

    The study presents the state-of-art of knowledge of risk factors of drug use as a form of risk behaviour in adolescents in individual, interpersonal, and environmental domain (family, school, society). The attention is paid to general deviation syndrome and to the construct of general tendency to

  4. What Are Coronary Heart Disease Risk Factors?

    Science.gov (United States)

    ... is high mainly because the body doesn't use its insulin properly. Over time, a high blood sugar level can lead to ... plaque buildup in their heart arteries by the time they’re in their 70s. ... of CHD. Gender Some risk factors may affect CHD risk differently ...

  5. [Aflatoxins--health risk factors].

    Science.gov (United States)

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

    2010-01-01

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

  6. Impact of risk adjusted clinical outcomes methodology--quality measures on hospital mortality data: a statistical and case study approach.

    Science.gov (United States)

    Lied, T R; Kazandjian, V A; Hohman, S F

    1999-01-01

    The effectiveness of risk adjustment in improving mortality as a performance measure for hospitals remains uncertain. New techniques of risk adjustment should be empirically tested, and health care professionals, using the data derived from such measures, should be queried before final acceptance of these technologies of measurement is warranted. The Risk Adjusted Clinical Outcomes Methodology-Quality Measures (RACOM-QM), a relatively new risk-adjustment methodology developed by the QuadraMed Corporation, was used by Maryland hospitals for risk adjustment for the first time in 1997. A research study was undertaken by the Maryland Hospital Association to determine the impact of RACOM-QM on mortality rates, its empirical validity, and its acceptance in the field. The relationship between RACOM-QM mean risk scores and mortality rates was examined using inpatient hospital mortality data for Maryland in 1996. Using these same data, the empirical relationship between risk-adjusted and unadjusted mortality by diagnosis-related group (DRG) was also investigated. Case studies were undertaken to glean information about the use and acceptability of this new methodology in 2 hospital settings in Maryland. There was a strong relationship between mean mortality risk scores and mortality rates. The analysis of the empirical relationship between risk-adjusted and unadjusted mortality by DRG yielded support for the impact of RACOM-QM in adjusting inpatient mortality rates. The case studies supported the utility of this method of risk adjustment in increasing the interpretation of mortality data and in helping to identify areas in which to investigate quality in more depth in 2 hospital settings. This study provides overall support for the usefulness of risk adjustment and, specifically, the RACOM-QM, in increasing the interpretation of inpatient mortality rates in Maryland's acute care hospitals. This study also suggests that use of the RACOM-QM improved comparative analysis of

  7. Risk Factors for Homelessness Among US Veterans

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A.

    2015-01-01

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

  8. Risk factors for homelessness among US veterans.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A

    2015-01-01

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

  9. Association between lifestyle factors and quality-adjusted life years in the EPIC-NL cohort.

    Directory of Open Access Journals (Sweden)

    Heidi P Fransen

    Full Text Available The aim of our study was to relate four modifiable lifestyle factors (smoking status, body mass index, physical activity and diet to health expectancy, using quality-adjusted life years (QALYs in a prospective cohort study. Data of the prospective EPIC-NL study were used, including 33,066 healthy men and women aged 20-70 years at baseline (1993-7, followed until 31-12-2007 for occurrence of disease and death. Smoking status, body mass index, physical activity and adherence to a Mediterranean-style diet (excluding alcohol were investigated separately and combined into a healthy lifestyle score, ranging from 0 to 4. QALYs were used as summary measure of healthy life expectancy, combining a person's life expectancy with a weight for quality of life when having a chronic disease. For lifestyle factors analyzed separately the number of years living longer in good health varied from 0.12 year to 0.84 year, after adjusting for covariates. A combination of the four lifestyle factors was positively associated with higher QALYs (P-trend <0.0001. A healthy lifestyle score of 4 compared to a score of 0 was associated with almost a 2 years longer life in good health (1.75 QALYs [95% CI 1.37, 2.14].

  10. Risk factors for homelessness among women veterans.

    Science.gov (United States)

    Washington, Donna L; Yano, Elizabeth M; McGuire, James; Hines, Vivian; Lee, Martin; Gelberg, Lillian

    2010-02-01

    Women veterans are three to four times more likely than non-veteran women to become homeless. However, their risk factors for homelessness have not been defined. Case-control study of non-institutionalized homeless women veterans (n533) and age-matched housed women veterans (n=165). Health, health care, and factors associated with homelessness were assessed using multiple logistic regression with a Monte Carlo algorithm to estimate exact standard errors of the model coefficients and p-values. Characteristics associated with homelessness were sexual assault during military service, being unemployed, being disabled, having worse overall health, and screening positive for an anxiety disorder or post-traumatic stress disorder. Protective factors were being a college graduate or married. Efforts to assess housed women veterans' risk factors for homelessness should be integrated into clinical care programs within and outside the Veterans Administration. Programs that work to ameliorate risk factors may prevent these women's living situations from deteriorating over time.

  11. Yale FICSIT: risk factor abatement strategy for fall prevention.

    Science.gov (United States)

    Tinetti, M E; Baker, D I; Garrett, P A; Gottschalk, M; Koch, M L; Horwitz, R I

    1993-03-01

    Based on finding a strong association between number of impairments and risk of falling in earlier studies, Yale FICSIT investigators are conducting an intervention trial comparing the effectiveness of usual care plus social visits (SV) and a targeted risk abatement intervention (TI) strategy in reducing falls among at risk community elderly persons. Subjects include members of a participating HMO who are > or = 70 years of age, cognitively intact, not terminally ill, not too physically active, and possess at least one fall risk factor. The targeted risk factors include postural hypotension; sedative use; at least four targeted medications; upper and lower extremity strength and range of motion impairments; foot problems; and balance, gait, and transfer dysfunctions. The interventions include medication adjustments, behavioral change recommendations, education and training, and home-based exercise regimens targeting the identified risk factors. The interventions are carried out by the study nurse practitioner and physical therapist in TI subjects' homes. The SV subjects receive a comparable number of home visits as the TI subjects during which a structured life review is performed by social work students. The primary outcome is occurrence of falls during the 12-month followup. Secondary outcomes include change in mobility performance and fall-related efficacy.

  12. Risk Factors Incident Preterm Labor

    Directory of Open Access Journals (Sweden)

    Liva Maita

    2012-11-01

    Full Text Available Preterm labor or parturition Prematurus is labor that occurs at age less than 37 weeks of pregnancy is calculated from the first day of last period. Data in hospitals Arifin Achmad Pekanbaru data obtained in 2010 obtained data on the number of labor as much as 2400 cases, with 190 cases of preterm labor (7.91%, in 2011 the number of births as 2287 cases with 279 cases of preterm labor (12% and in the period January-April 2012 Number 780 cases of preterm labor (11.5%. The purpose of research is knowing the relationship of the complications of pregnancy, a history of preterm labor, anemia, age and parity with preterm labor. Type of research is a case-control study. The population in this study were all mothers giving birth at hospitals Arifin achmad Pekanbaru. Size of the sample consisted of 245 cases and 245 controls. Data analysis was performed by univariate, bivariate and multivariate Logistic Regression method Ganda. The results is a complication of pregnancy (95% CI: 4.09 to 9.21, age (95% CI: 1.58 to 3.69, and parity (95% CI: 1.05 to 2.36 associated with preterm labor. The conclusion that the dominant variables associated with the incidence of preterm birth is a complication of pregnancy and no variable counfounding. Advice to pregnant women who experience pregnancy complications during their pregnancy on a regular basis at least four times during pregnancy and high parity mothers are advised to use contraception; To health professionals to classify the status of patients at risk to facilitate the provision of IEC.

  13. Faculty Behavior and Other Key Factors in Student Adjustment to Medical School.

    Science.gov (United States)

    Dennis, Kay S.

    2000-01-01

    Physicians today need a number of non-cognitive attributes and skills in order to be maximally effective. However, these attributes and skills, such as caring and respect for others, self-awareness, and communication skills, are not always addressed in medical education. Many would-be physicians find that medical school is a grueling experience characterized by chronic stress, the need to recognize one's strengths and limitations, and dissonance between their own values and beliefs and those of the school. The faculty and administrators at one medical school developed a special extra-curricular program to render their undergraduate program more humanistic in supporting student socialization and adjustment. The program featured intentionally structured, faculty-facilitated small groups of first-year students.This study used focus group interviews to explore student perceptions of the effectiveness of the "Personal, Professional, and Leadership Development Program" and thereby to gain insight into the phenomena that affect the development of medical students as future health care providers. Findings showed that students described social support and academic support from peers and faculty as contributing to their adjustment. The most compelling factor in student adjustment was faculty behavior and attitudes. Implications for adult learning and humanistic education practices are described.

  14. Solar radiation increases suicide rate after adjusting for other climate factors in South Korea.

    Science.gov (United States)

    Jee, Hee-Jung; Cho, Chul-Hyun; Lee, Yu Jin; Choi, Nari; An, Hyonggin; Lee, Heon-Jeong

    2017-03-01

    Previous studies have indicated that suicide rates have significant seasonal variations. There is seasonal discordance between temperature and solar radiation due to the monsoon season in South Korea. We investigated the seasonality of suicide and assessed its association with climate variables in South Korea. Suicide rates were obtained from the National Statistical Office of South Korea, and climatic data were obtained from the Korea Meteorological Administration for the period of 1992-2010. We conducted analyses using a generalized additive model (GAM). First, we explored the seasonality of suicide and climate variables such as mean temperature, daily temperature range, solar radiation, and relative humidity. Next, we identified confounding climate variables associated with suicide rate. To estimate the adjusted effect of solar radiation on the suicide rate, we investigated the confounding variables using a multivariable GAM. Suicide rate showed seasonality with a pattern similar to that of solar radiation. We found that the suicide rate increased 1.008 times when solar radiation increased by 1 MJ/m 2 after adjusting for other confounding climate factors (P Solar radiation has a significant linear relationship with suicide after adjusting for region, other climate variables, and time trends. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2013-05-01

    Schizophrenia and autism are two poorly understood clinical syndromes that differ in age of onset and clinical profile. However, recent genetic and epidemiological research suggests that these two neurodevelopmental disorders share certain risk factors. The aims of this review are to describe modifiable risk factors that have been identified in both disorders, and, where available, collate salient systematic reviews and meta-analyses that have examined shared risk factors. Based on searches of Medline, Embase and PsycINFO, inspection of review articles and expert opinion, we first compiled a set of candidate modifiable risk factors associated with autism. Where available, we next collated systematic-reviews (with or without meta-analyses) related to modifiable risk factors associated with both autism and schizophrenia. We identified three modifiable risk factors that have been examined in systematic reviews for both autism and schizophrenia. Advanced paternal age was reported as a risk factor for schizophrenia in a single meta-analysis and as a risk factor in two meta-analyses for autism. With respect to pregnancy and birth complications, for autism one meta-analysis identified maternal diabetes and bleeding during pregnancy as risks factors for autism whilst a meta-analysis of eight studies identified obstetric complications as a risk factor for schizophrenia. Migrant status was identified as a risk factor for both autism and schizophrenia. Two separate meta-analyses were identified for each disorder. Despite distinct clinical phenotypes, the evidence suggests that at least some non-genetic risk factors are shared between these two syndromes. In particular, exposure to drugs, nutritional excesses or deficiencies and infectious agents lend themselves to public health interventions. Studies are now needed to quantify any increase in risk of either autism or schizophrenia that is associated with these modifiable environmental factors. Copyright © 2012 Elsevier Inc

  16. Ectasia risk factors in refractive surgery.

    Science.gov (United States)

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

    2016-01-01

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

  17. Risk factors for esophageal candidiasis.

    Science.gov (United States)

    Chocarro Martínez, A; Galindo Tobal, F; Ruiz-Irastorza, G; González López, A; Alvarez Navia, F; Ochoa Sangrador, C; Martín Arribas, M I

    2000-02-01

    The role of gastric acid inhibitors as predisposing factors for Candida esophagitis is unknown. A retrospective case-control study of esophageal candidiasis was conducted in human immunodeficiency virus (HIV)-negative patients diagnosed from January 1991 to December 1997. The diagnosis of esophageal candidiasis was always made on the basis of endoscopic and histological criteria. Fifty-one patients were diagnosed with esophageal candidiasis, 15 of whom had esophageal complaints and 48 of whom suffered from another previous chronic disease (17 had cancer). In addition, 20 patients had previously been treated with antibiotics, 13 with steroids and 14 with omeprazole. In the multivariate analysis, neoplasm (odds ratio, 5.50; 95% confidence interval, 1.94-15.56) and therapy with antibiotics (odds ratio, 11.97; 95% confidence interval, 3.82-37.45), steroids (odds ratio, 35.52; 95% confidence interval, 3.90-324.01) or omeprazole (odds ratio, 18.23; 95% confidence interval, 4.67-71.03) were all associated with esophageal candidiasis. These data suggest that Candida esophagitis tends to occur in patients with chronic diseases, most of whom have been previously treated with antibiotics, steroids or omeprazole. The findings support the hypothesis that treatment with omeprazole favors the development of esophageal candidiasis.

  18. Recruitment-adjusted estimates of HIV prevalence and risk among men who have sex with men: effects of weighting venue-based sampling data.

    Science.gov (United States)

    Jenness, Samuel M; Neaigus, Alan; Murrill, Christopher S; Gelpi-Acosta, Camila; Wendel, Travis; Hagan, Holly

    2011-01-01

    We investigated the impact of recruitment bias within the venue-based sampling (VBS) method, which is widely used to estimate disease prevalence and risk factors among groups, such as men who have sex with men (MSM), that congregate at social venues. In a 2008 VBS study of 479 MSM in New York City, we calculated venue-specific approach rates (MSM approached/MSM counted) and response rates (MSM interviewed/MSM approached), and then compared crude estimates of HIV risk factors and seroprevalence with estimates weighted to address the lower selection probabilities of MSM who attend social venues infrequently or were recruited at high-volume venues. Our approach rates were lowest at dance clubs, gay pride events, and public sex strolls, where venue volumes were highest; response rates ranged from 39% at gay pride events to 95% at community-based organizations. Sixty-seven percent of respondents attended MSM-oriented social venues at least weekly, and 21% attended such events once a month or less often in the past year. In estimates adjusted for these variations, the prevalence of several past-year risk factors (e.g., unprotected anal intercourse with casual/exchange partners, ≥5 total partners, group sex encounters, at least weekly binge drinking, and hard-drug use) was significantly lower compared with crude estimates. Adjusted HIV prevalence was lower than unadjusted prevalence (15% vs. 18%), but not significantly. Not adjusting VBS data for recruitment biases could overestimate HIV risk and prevalence when the selection probability is greater for higher-risk MSM. While further examination of recruitment-adjustment methods for VBS data is needed, presentation of both unadjusted and adjusted estimates is currently indicated.

  19. Risk factors for serious morbidity in term nonanomalous neonates.

    Science.gov (United States)

    Spain, Janine E; Tuuli, Methodius G; Macones, George A; Roehl, Kimberly A; Odibo, Anthony O; Cahill, Alison G

    2015-06-01

    The purpose of this study was to identify ante- and intrapartum risk factors for serious morbidity in term nonanomalous neonates. We analyzed the first 5000 subjects within an ongoing prospective cohort study of consecutive term births from 2010-2012. The primary outcome was a composite of serious neonatal morbidity defined as ≥1 cases of hypoxic ischemic encephalopathy, meconium aspiration with pulmonary hypertension, requirement of hypothermia therapy, respiratory distress syndrome, seizures, sepsis or suspected sepsis, or death. We calculated odds ratios for the composite morbidity that is associated with ante- and intrapartum factors. Multivariable logistic regression was used to estimate adjusted odds ratios. Of 5000 term nonanomalous births, 393 had the composite morbidity. Significant risk factors for morbidity were nulliparity, presence of meconium, first stage of labor >95th percentile, second stage of labor >95th percentile, pregestational diabetes mellitus, chronic hypertension, obesity, maternal intrapartum fever, and cesarean delivery. In contrast, induction of labor and gestational age ≥41 weeks were not associated with significant morbidity. We identified several significant risk factors for serious morbidity in term nonanomalous neonates. Clinicians may use these risk factors to help anticipate the potential need for additional neonatal support at delivery. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Risk Adjusted Production Efficiency of Maize Farmers in Ethiopia: Implication for Improved Maize Varieties Adoption

    Directory of Open Access Journals (Sweden)

    Sisay Diriba Lemessa

    2017-09-01

    Full Text Available This study analyzes the technical efficiency and production risk of 862 maize farmers in major maize producing regions of Ethiopia. It employs the stochastic frontier approach (SFA to estimate the level of technical efficiencies of stallholder farmers. The stochastic frontier approach (SFA uses flexible risk properties to account for production risk. Thus, maize production variability is assessed from two perspectives, the production risk and the technical efficiency. The study also attempts to determine the socio-economic and farm characteristics that influence technical efficiency of maize production in the study area. The findings of the study showed the existence of both production risk and technical inefficiency in maize production process. Input variables (amounts per hectare such as fertilizer and labor positively influence maize output. The findings also show that farms in the study area exhibit decreasing returns to scale. Fertilizer and ox plough days reduce output risk while labor and improved seed increase output risk. The mean technical efficiency for maize farms is 48 percent. This study concludes that production risk and technical inefficiency prevents the maize farmers from realizing their frontier output. The best factors that improve the efficiency of the maize farmers in the study area include: frequency of extension contact, access to credit and use of intercropping. It was also realized that altitude and terracing in maize farms had influence on farmer efficiency.

  1. The relationship between the C-statistic of a risk-adjustment model and the accuracy of hospital report cards: a Monte Carlo Study.

    Science.gov (United States)

    Austin, Peter C; Reeves, Mathew J

    2013-03-01

    Hospital report cards, in which outcomes following the provision of medical or surgical care are compared across health care providers, are being published with increasing frequency. Essential to the production of these reports is risk-adjustment, which allows investigators to account for differences in the distribution of patient illness severity across different hospitals. Logistic regression models are frequently used for risk adjustment in hospital report cards. Many applied researchers use the c-statistic (equivalent to the area under the receiver operating characteristic curve) of the logistic regression model as a measure of the credibility and accuracy of hospital report cards. To determine the relationship between the c-statistic of a risk-adjustment model and the accuracy of hospital report cards. Monte Carlo simulations were used to examine this issue. We examined the influence of 3 factors on the accuracy of hospital report cards: the c-statistic of the logistic regression model used for risk adjustment, the number of hospitals, and the number of patients treated at each hospital. The parameters used to generate the simulated datasets came from analyses of patients hospitalized with a diagnosis of acute myocardial infarction in Ontario, Canada. The c-statistic of the risk-adjustment model had, at most, a very modest impact on the accuracy of hospital report cards, whereas the number of patients treated at each hospital had a much greater impact. The c-statistic of a risk-adjustment model should not be used to assess the accuracy of a hospital report card.

  2. Risk adjusting cesarean delivery rates: a comparison of hospital profiles based on medical record and birth certificate data.

    OpenAIRE

    DiGiuseppe, D L; Aron, D C; Payne, S M; Snow, R J; Dierker, L; Rosenthal, G E

    2001-01-01

    OBJECTIVES: Compare the discrimination of risk-adjustment models for primary cesarean delivery derived from medical record data and birth certificate data and determine if the two types of models yield similar hospital profiles of risk-adjusted cesarean delivery rates. DATA SOURCES/STUDY SETTING: The study involved 29,234 women without prior cesarean delivery admitted for labor and delivery in 1993-95 to 20 hospitals in northeast Ohio for whom data abstracted from patient medical records and ...

  3. Java project on periodontal diseases. The natural development of periodontitis: risk factors, risk predictors and risk determinants : risk factors, risk predictors and risk determinants

    NARCIS (Netherlands)

    Van der Velden, U.; Abbas, F.; Armand, S.; Loos, B. G.; Timmerman, M. F.; Van der Weijden, G. A.; Van Winkelhoff, A. J.; Winkel, E. G.

    Objective: To identify risk factors, risk predictors and risk determinants for onset and progression of periodontitis. Material and Methods: For this longitudinal, prospective study all subjects in the age range 15-25 years living in a village of approximately 2000 inhabitants at a tea estate on

  4. Tuberculosis: distribution, risk factors, mortality.

    Science.gov (United States)

    Kochi, A

    1994-10-01

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

  5. Occupational risk factors for Parkinson disease

    NARCIS (Netherlands)

    van der Mark, M.

    2014-01-01

    Environmental factors probably play an important role in the etiology of Parkinson disease (PD). However, not many environmental factors have been identified for which unequivocal evidence is available for a relation with PD risk. The main focus of the research described in this thesis was on

  6. Maternal Adjustment and Infant Outcome in Medically Defined High-Risk Pregnancy.

    Science.gov (United States)

    Levy-Shiff, Rachel; Lerman, Maya; Har-Even, Dov; Hod, Moshe

    2002-01-01

    Explored relation of biological and psychosocial risk factors to infant development among pregnant women who had pregestational diabetes, gestational diabetes, or were nondiabetic. Found that infants of diabetic mothers scored lower on the Bayley Scales at 1 year and revealed fewer positive and more negative behaviors than infants of nondiabetic…

  7. First-rank symptoms and premorbid adjustment in young individuals at increased risk of developing psychosis.

    Science.gov (United States)

    Morcillo, C; Stochl, J; Russo, D A; Zambrana, A; Ratnayake, N; Jones, P B; Perez, J

    2015-01-01

    Individuals at clinical high risk (CHR) for psychosis represent a heterogeneous group with a high rate of comorbid psychiatric disorders. There is little information on whether certain qualitative aspects of psychotic symptoms among CHR individuals may be predictive of future psychosis. This study focused on describing the prevalence of first-rank symptoms (FRS) among a sample of CHR individuals and its association with future transition to psychosis and, from a neurodevelopmental perspective, the level of adjustment of individuals at CHR during their childhood was also analysed. Participants comprised 60 individuals at CHR (according to the Comprehensive Assessment of At-Risk Mental States, CAARMS) at the time of their referral to an early intervention service and 60 healthy volunteers (HVs). All subjects were assessed by senior research clinicians using the Mini International Neuropsychiatric Interview (MINI), and the Positive and Negative Syndrome Scale (PANSS). FRS were defined according to Kurt Schneider's original classification, and information was collected from PANSS, CAARMS and clinical reports. Early premorbid functioning was measured using the Premorbid Adjustment Scale (PAS). We grouped individuals by number and type of FRS and analysed transitions to full-blown psychosis over a 2-year follow-up period. We also correlated the general social and functional adjustment of these individuals during their childhood (6-11 years of age) with the future development of mental states at CHR and FRS. Over 69% of CHR individuals had more than one DSM-IV psychiatric diagnosis, mainly within the affective and anxiety diagnostic spectra. At least one FRS was present in 43.3% of CHR individuals, and 21.6% of these had more than one. Auditory hallucinations and passivity experiences were the most commonly reported. Only 10% of individuals at CHR made a transition to first-episode psychosis (FEP) over 2 years and, except for passivity experiences, the presence of one or

  8. Transient risk factors of acute occupational injuries

    DEFF Research Database (Denmark)

    Østerlund, Anna H; Lander, Flemming; Nielsen, Kent

    2017-01-01

    occupational injuries seen in 2013 at two emergency departments in Denmark. Effect estimates were calculated using the matched-pair interval approach. Results Increased risk for an occupational injury was found for time pressure [odds ratio (OR) 1.6, 95% confidence interval (95% CI) 1.3-2.0], feeling sick (OR......Objectives The objectives of this study were to (i) identify transient risk factors of occupational injuries and (ii) determine if the risk varies with age, injury severity, job task, and industry risk level. Method A case-crossover design was used to examine the effect of seven specific transient...... risk factors (time pressure, disagreement with someone, feeling sick, being distracted by someone, non-routine task, altered surroundings, and broken machinery and materials) for occupational injuries. In the study, 1693 patients with occupational injuries were recruited from a total of 4002...

  9. External risk factors affecting construction costs

    Science.gov (United States)

    Mubarak, Husin, Saiful; Oktaviati, Mutia

    2017-11-01

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

  10. Risk factors for post-tonsillectomy hemorrhage.

    Science.gov (United States)

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

    2014-08-01

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

  11. Risk factors for and assessment of constipation.

    Science.gov (United States)

    Chapman, Sherree; Hungerford, Catherine

    2015-04-01

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

  12. Direct and Indirect Links between Peer Factors and Adolescent Adjustment Difficulties

    Science.gov (United States)

    Houltberg, Benjamin J.; Cui, Lixian; Bosler, Cara D.; Morris, Amanda Sheffield; Silk, Jennifer S.

    2016-01-01

    The purpose of the current investigation was to examine the role of emotion regulation in the link between peer factors and adolescent adjustment difficulties. The sample consisted of 206 adolescents (ages 10–18 years) and parents. Peer factors (i.e., peer antisocial behavior, peer co-rumination, peer emotion regulation) and youth depressive symptoms were based on youth reports. Youth emotion regulation and antisocial behavior were assessed using parent and youth ratings. Results showed that peer antisocial behavior was directly (but not indirectly) related to youth antisocial behavior and depressive symptoms, whereas peer emotion regulation was indirectly (but not directly) related to both adolescent outcomes. In addition, peer co-rumination was indirectly related to youth antisocial behavior and directly and indirectly related to youth depressive symptoms. In general, the results indicated little evidence of moderation by adolescent age, sex, or ethnic differences. Implications for peer relationships as socialization contexts are discussed. PMID:26893530

  13. Adjustment to chronic obstructive pulmonary disease: the importance of psychological factors.

    Science.gov (United States)

    McCathie, H C F; Spence, S H; Tate, R L

    2002-01-01

    Research has indicated a weak relationship between the degree of physical problems and quality of life in patients with chronic obstructive pulmonary disease (COPD). The importance of adaptive psychological functioning to maintain optimum quality of life has long been recognized, but there is a lack of empirical evidence concerning the nature of psychological factors involved in adjustment to COPD. Ninety-two males completed questionnaires to determine their coping strategies, levels of self-efficacy of symptom management and social support. Adjustment was measured in terms of depression, anxiety and quality of life. Symptom severity, socioeconomic status, duration of disease and age, which have been demonstrated to be of consequence in COPD, were used as control variables in hierarchical multiple regression analyses. Higher levels of catastrophic withdrawal coping strategies and lower levels of self-efficacy of symptom management were associated with higher levels of depression, anxiety and a reduced quality of life. Higher levels of positive social support were linked to lower levels of depression and anxiety, while higher levels of negative social support were linked to higher levels of depression and anxiety. To maximize quality of life in patients with chronic obstructive pulmonary disease, psychological factors need to be carefully assessed and addressed.

  14. Cardiovascular risk factors and primary selection into shift work

    DEFF Research Database (Denmark)

    Nabe-Nielsen, Kirsten; Garde, Anne Helene; Tüchsen, Finn

    2008-01-01

    OBJECTIVES: This study examined differences between future shift workers and future day workers as regards cardiovascular risk factors before they began different work schedules and the differences that remained after control for sociodemographic factors and general self-efficacy. METHODS......: Altogether 2870 newly educated social and health care workers filled out a questionnaire a few weeks before finishing their formal training and again 1 year after graduation. They answered questions on diabetes, hypertension, lifestyle habits, sociodemographic factors, and general self-efficacy. RESULTS......, fixed night work, and two- or three- shift work including night work. After adjustment for sociodemographic factors and general self-efficacy, smoking was prospectively associated with fixed evening work [OR 1.56, 95% confidence interval (95% CI) 1.21-2.02] and fixed night work (OR 1.64, 95% CI 1...

  15. Hunger and Behavioral Risk Factors for Noncommunicable Diseases in School-Going Adolescents in Bolivia, 2012.

    Science.gov (United States)

    Romo, Matthew L

    2016-04-21

    Hunger may play a role in noncommunicable disease (NCD) risk. This study used the 2012 Global School-based Student Health Survey from Bolivia to determine the association between hunger and risk factors for NCDs among adolescents. Hunger was associated with increased odds of nondaily fruit and vegetable consumption (adjusted odds ratio [AOR] = 1.21; P Bolivia should address hunger, in addition to traditional behavioral risk factors.

  16. Risk adjustment using administrative data-based and survey-derived methods for explaining physician utilization.

    Science.gov (United States)

    Sibley, Lyn M; Moineddin, Rahim; Agha, Mohammad M; Glazier, Richard H

    2010-02-01

    The objective of this study was to evaluate an administrative data-based risk adjustment method for predicting physician utilization and the contribution of survey-derived indicators of health status. The results of this study will support the use of administrative data for planning, reimbursement, and assessing equity of physician utilization. The Ontario portion of the 2000-2001 Canadian Community Health Survey was linked with administrative physician claims data from 2002-2003 and 2003-2004. Explanatory models of family physician (FP) and specialist physician (SP) utilization were run using demographic information and The Johns Hopkins University Adjusted Clinical Groups (ACG) Case-mix System. Survey-based measures of health status were then added to the models. The coefficient of determination, R, indicated the models' explanatory power. The study sample consisted of 25,558 individuals aged 20 to 79 years representing approximately 7.8 million people. Over the 2 years of study period, 82.5% of the study population had a FP visit with a median of 6 visits and 53.2% had a SP visit with a median of 1 visit. The R values based on administrative data alone were 33% and 21% for the frequency of FP and SP visits and 16% and 35% for having one or more visit to an FPs and SPs, respectively. The addition of the survey-based measures to the administrative data-based models produced less than a 2% increase in explanatory power for any outcome. Administrative data-based measures of morbidity burden are valid and useful indicators of future physician utilization. The survey-derived measures used in this study did not contribute significantly to models on the basis of administrative data-based measures. These findings support the future use of administrative data-based data and Adjusted Clinical Groups for planning, reimbursement, and research.

  17. Risk Factors and Risk-Based Protective Factors for Violent Offending: A Study of Young Victorians.

    Science.gov (United States)

    Hemphill, Sheryl A; Heerde, Jessica A; Scholes-Balog, Kirsty E

    2016-06-01

    The present study aims to examine risk factors and risk-based and interactive protective factors for violent offending in a group of 437 young Australians. Participants were recruited into the study when they were in Grade 5 (10-11 years) and followed up almost annually until young adulthood (18-19 years). Measures of violent offending, risk and protective factors, and demographics were obtained through a modification of the Communities That Care youth survey. The data collected enabled identification of groups of students at-risk of violent offending according to drug use, low family socioeconomic status, and antisocial behavior. Results showed that there were very few associations between the risk factors and risk-based protective factors measured in this study (e.g., belief in the moral order, religiosity, peer recognition for prosocial involvement, attachment to parents, low commitment to school, and poor academic performance) and later self-reported violent offending. There were no statistically significant interactive protective factors. Further longitudinal analyses with large sample sizes are needed to examine risk factors and risk-based protective factors and interactive protective factors in at-risk groups. The findings support the need for multi-faceted prevention and early intervention approaches that target multiple aspects of youth's lives.

  18. Factors affecting the risk of blood bank specimen hemolysis.

    Science.gov (United States)

    Tanabe, Paula; Kyriacou, Demetrios N; Garland, Franklyn; Kyriacou, Demetrious

    2003-08-01

    To evaluate simultaneously several possible risk factors for blood bank specimen hemolysis. This was a prospective cohort study of emergency department and labor and delivery patients to estimate the effect of various factors on the risk of blood bank specimen hemolysis. Study variables included patient demographics, type and gauge of needle or catheter, anatomic location of venipuncture, and patient care area. Hemolysis was determined by blood bank laboratory technicians. Cox proportional hazards multivariate regression modeling was performed to estimate the adjusted relative risks for hemolysis. Of the 605 subjects with complete data, 194 (32.1%) subjects had blood specimens drawn directly with a steel needle, and 411 (69.1%) had specimens drawn through a Vialon (BD Medical Systems, Inc., Sandy, UT) intravenous (IV) angiocatheter. The overall risk of hemolysis for all was 7%, 10% for Vialon IV angiocatheters and 1.5% for steel needles. In the multivariate analysis, the factors most closely associated with hemolysis were the use of Vialon IV catheters and sampling from an anatomic site other than the antecubital area. Blood bank specimens drawn from Vialon IV catheters (particularly smaller gauge catheters) and from veins outside the antecubital area are at significantly increased risk to hemolyze.

  19. Endocrine Risk Factors for Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Jae Hoon Moon

    2016-06-01

    Full Text Available Cognitive impairment, including Alzheimer's disease and other kinds of dementia, is a major health problem in older adults worldwide. Although numerous investigators have attempted to develop effective treatment modalities or drugs, there is no reasonably efficacious strategy for preventing or recovering from cognitive impairment. Therefore, modifiable risk factors for cognitive impairment have received attention, and the growing literature of metabolic risk factors for cognitive impairment has expanded from epidemiology to molecular pathogenesis and therapeutic management. This review focuses on the epidemiological evidence for the association between cognitive impairment and several endocrine risk factors, including insulin resistance, dyslipidemia, thyroid dysfunction, vitamin D deficiency, and subclinical atherosclerosis. Researches suggesting possible mechanisms for this association are reviewed. The research investigating modifiable endocrine risk factors for cognitive impairment provides clues for understanding the pathogenesis of cognitive impairment and developing novel treatment modalities. However, so far, interventional studies investigating the beneficial effect of the "modification" of these "modifiable risk factors" on cognitive impairment have reported variable results. Therefore, well-designed, randomized prospective interventional studies are needed.

  20. Psychological Adjustment: Are adopted adolescents at greater risk for negative outcomes?

    Directory of Open Access Journals (Sweden)

    Caroline Tozzi Reppold

    2010-06-01

    Full Text Available During the last decades several authors have indicated that being an adopted child resulted in a higher risk of psychological maladjustment. The objective of this research was to investigate the changes in perception of parental styles in adopted and no-adopted adolescents Brazilians. The sample comprised 524 adolescents (68 were adopted and 456 were raised by their biological parents. The instruments used were a demographic questionnaire and theResponsiveness Scales and Parental Demands. The findings indicated that adoptive parents are significantly more indulgent than biological parents. In comparison, the adolescents described their biological parents as more negligent. The findings corroborated the transcultural effects of parental styles on the psychological adjustment and confirmed the hypothesis that the parental socialization strategies moderate the development of adoptedadolescent.

  1. Environmental Risk Factors for Inflammatory Bowel Disease

    Science.gov (United States)

    Molodecky, Natalie A.

    2010-01-01

    Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the gastrointestinal tract and is associated with significant morbidity. The etiology of IBD has been extensively studied during the last several decades; however, causative factors in disease pathology are not yet fully understood. IBD is thought to result from the interaction between genetic and environmental factors that influence the normal intestinal commensal flora to trigger an inappropriate mucosal immune response. Although many IBD susceptibility genes have been discovered, similar advances in defining environmental risk factors have lagged. A number of environmental risk factors have been explored, including smoking, appendectomy, oral contraceptives, diet, breastfeeding, infections/ vaccinations, antibiotics, and childhood hygiene. However, most of these factors have demonstrated inconsistent findings, thus making additional studies necessary to better understand the etiology of IBD. PMID:20567592

  2. Risk factors of cardiac allograft vasculopathy.

    Science.gov (United States)

    Szyguła-Jurkiewicz, Bożena; Szczurek, Wioletta; Gąsior, Mariusz; Zembala, Marian

    2015-12-01

    Despite advances in prevention and treatment of heart transplant rejection, development of cardiac allograft vasculopathy (CAV) remains the leading factor limiting long-term survival of the graft. Cardiac allograft vasculopathy etiopathogenesis is not fully understood, but a significant role is attributed to endothelial cell damage, caused by immunological and non-immunological mechanisms. Immunological factors include the differences between the recipient's and the donor's HLA systems, the presence of alloreactive antibodies and episodes of acute rejection. Among the non-immunological factors the most important are the age of the donor, ischemia-reperfusion injury and cytomegalovirus infection. The classical cardiovascular risk factors (diabetes, hypertension, obesity and hyperlipidemia) are also important. This study presents an up-to-date overview of current knowledge on the vasculopathy etiopathogenesis and the role played by endothelium and inflammatory processes in CAV, and it also investigates the factors which may serve as risk markers of cardiac allograft vasculopathy.

  3. Gender differences in cardiovascular risk factors in incident diabetes.

    Science.gov (United States)

    Schroeder, Emily B; Bayliss, Elizabeth A; Daugherty, Stacie L; Steiner, John F

    2014-01-01

    Cardiovascular disease is a major cause of morbidity and mortality for women and men with diabetes. Previous cross-sectional studies of prevalent diabetes have found that women are less likely to meet American Diabetes Association (ADA) and American Heart Association guidelines for control of cardiovascular risk factors (hemoglobin A1c, low-density lipoprotein [LDL] cholesterol, and blood pressure), but have not studied the critical period immediately after diagnosis. To assess gender differences in cardiovascular risk factors at the time of diabetes diagnosis (baseline) and 1 year later (follow-up), we conducted a retrospective cohort study of 6,547 individuals with incident diabetes in an integrated care delivery system. We assessed mean cardiovascular risk factor values by gender and adjusted odds ratios of attaining ADA goals. Compared with men, at baseline women had lower hemoglobin A1c (7.9% vs. 8.2%; p LDL cholesterol (118.9 vs. 111.5 mg/dL; p LDL cholesterol (104.0 vs. 98.2 mg/dL; p risk factor control at the time of diabetes diagnosis. These differences varied by age and decreased over time. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  4. Fatness and Fitness With Cardiometabolic Risk Factors in Adolescents.

    Science.gov (United States)

    Demmer, Denise L; Beilin, Lawrence J; Hands, Beth; Burrows, Sally; Cox, Kay L; Oddy, Wendy H; Mori, Trevor A

    2017-12-01

    The relative importance of fitness and fatness with cardiometabolic risk factors is uncertain during the crucial developmental stage of late adolescence. We aimed to compare the concurrent influences of cardiorespiratory fitness and fatness in relationship to cardiometabolic risk factors in adolescents from the Western Australian Pregnancy Cohort Study. Cross-sectional analysis was performed on 1128 participants with complete blood pressure (BP) data and 963 participants with complete blood biochemistry at 17 years of age. Fatness (waist circumference) and cardiorespiratory fitness (physical work capacity 170) were assessed as continuous measures to avoid the use of arbitrary cut points. Analyses used linear regression models adjusted for sex and potential lifestyle confounders. Cardiometabolic risk factors. Fatness was positively associated with systolic BP (coefficient, 0.19; P fitness on any of these measures. A positive association between homeostasis model of assessment for insulin resistance and fatness (log coefficient, 0.02; P fitness (log coefficient, -0.0.18; P fitness was positively associated with HDL-C only in females (coefficient, 0.08; P = 0.03; β coefficient, 0.15). The adverse effects of central adiposity seen across a broad range of cardiometabolic risk factors were only partially ameliorated by fitness in this adolescent population.

  5. Allergies, obesity, other risk factors and survival from pancreatic cancer.

    Science.gov (United States)

    Olson, Sara H; Chou, Joanne F; Ludwig, Emmy; O'Reilly, Eileen; Allen, Peter J; Jarnagin, William R; Bayuga, Sharon; Simon, Jennifer; Gonen, Mithat; Reisacher, William R; Kurtz, Robert C

    2010-11-15

    Survival from pancreatic adenocarcinoma remains extremely poor, approximately 5% at 5 years. Risk factors include smoking, high body mass index (BMI), family history of pancreatic cancer, and long-standing diabetes; in contrast, allergies are associated with reduced risk. Little is known about associations between these factors and survival. We analyzed overall survival in relation to risk factors for 475 incident cases who took part in a hospital based case-control study. Analyses were conducted separately for those who did (160) and did not (315) undergo tumor resection. Kaplan-Meier methods were used to describe survival according to smoking, BMI, family history, diabetes, and presence of allergies. Cox proportional hazards models were used to adjust for covariates. There was no association with survival based on smoking, family history, or history of diabetes in either group. Among patients with resection, those with allergies showed nonstatistically significant longer survival, a median of 33.1 months (95% CI: 19.0-52.5) vs. 21.8 months (95% CI: 18.0-33.1), p = 0.25. The adjusted hazard ratio (HR) was 0.72 (95% CI: 0.43-1.23), p = 0.23. Among patients without resection, those with self-reported allergies survived significantly longer than those without allergies: 13.3 months (95% CI: 10.6-16.9) compared to 10.4 months (95% CI: 8.8-11.0), p = 0.04, with an adjusted HR of 0.68 (95% CI: 0.49-0.95), p = 0.02. Obesity was nonsignificantly associated with poorer survival, particularly in the resected group (HR = 1.62, 95% CI: 0.76-3.44). The mechanisms underlying the association between history of allergies and improved survival are unknown. These novel results need to be confirmed in other studies.

  6. [Do laymen understand information about hospital quality? An empirical verification using risk-adjusted mortality rates as an example].

    Science.gov (United States)

    Sander, Uwe; Kolb, Benjamin; Taheri, Fatemeh; Patzelt, Christiane; Emmert, Martin

    2017-11-01

    The effect of public reporting to improve quality in healthcare is reduced by the limited intelligibility of information about the quality of healthcare providers. This may result in worse health-related choices especially for older people and those with lower levels of education. There is, as yet, little information as to whether laymen understand the concepts behind quality comparisons and if this comprehension is correlated with hospital choices. An instrument with 20 items was developed to analyze the intelligibility of five technical terms which were used in German hospital report cards to explain risk-adjusted death rates. Two online presentations of risk-adjusted death rates for five hospitals in the style of hospital report cards were developed. An online survey of 353 volunteers tested the comprehension of the risk-adjusted mortality rates and included an experimental hospital choice. The intelligibility of five technical terms was tested: risk-adjusted, actual and expected death rate, reference range and national average. The percentages of correct answers for the five technical terms were in the range of 75.0-60.2%. Between 23.8% and 5.1% of the respondents were not able to answer the question about the technical term itself. The least comprehensible technical terms were "risk-adjusted death rate" and "reference range". The intelligibility of the 20 items that were used to test the comprehension of the risk-adjusted mortality was between 89.5% and 14.2%. The two items that proved to be least comprehensible were related to the technical terms "risk-adjusted death rate" and "reference range". For all five technical terms it was found that a better comprehension correlated significantly with better hospital choices. We found a better than average intelligibility for the technical terms "actual and expected death rate" and for "national average". The least understandable were "risk-adjusted death rate" and "reference range". Since the self

  7. Microbial translocation and cardiometabolic risk factors in HIV infection

    DEFF Research Database (Denmark)

    Trøseid, Marius; Manner, Ingjerd W; Pedersen, Karin K

    2014-01-01

    The widespread access to antiretroviral treatment during the past decades has transformed HIV infection from a lethal disease to a chronic condition, in which the relative burden of non-AIDS-related chronic disorders such as cardiovascular disease, malignancy, renal, liver, and bone disease has...... is crucial in order to tailor novel strategies for prophylaxis and treatment. This review will focus on advances in the field that possibly link HIV-induced alterations of the gut mucosa and consequent microbial translocation to cardiometabolic risk factors in HIV infection. Recent work suggests that markers...... increased. The adjusted relative risk for myocardial infarction is reported to be around 2-fold compared to that of the general population, which over time is likely to translate into increased absolute risk in an aging population. Thus, delineating potentially HIV-specific pathogenetic mechanisms...

  8. Attachment styles and demographic factors as predictors of sociocultural and psychological adjustment of Eastern European immigrants in the Netherlands

    NARCIS (Netherlands)

    Polek, Elzbieta; van Oudenhoven, Jan Pieter; ten Berge, Jos M. F.

    2008-01-01

    The present study examined the relationship between adult attachment styles and psychological and sociocultural adjustment of Polish, Russian, and Hungarian immigrants (N=631) to Dutch society. In addition, it also examined the relationship between demographic factors and adjustment and compared the

  9. [Risk factors for development of cerebrovascular stroke].

    Science.gov (United States)

    Petrović, G

    2000-01-01

    Nowadays stroke has a dominant place in the structure of neurological morbidity. According to data of the World Health Organization, stroke is the third highest cause of morbidity and mortality in the developed countries of the world, immediately following ischemic heart disease and malignant diseases. The appearance of the disease is influenced by many etiological factors, that is risk factors. Natural risk factors are: heredity, sex, age, geographical and climatic factors. Other diseases being risk factors include: hypertension, heart disease and diabetes. Bad habits as risk factors are: eating habits, obesity, smoking, alcoholism and physical and mental inactivity. The paper presents a review of risk factors, their categorization and the influence of each individual risk factor on the development of stroke. Hereditary factors have a significant role in development of stroke and they may serve as a basis for determining the person's susceptibility to stroke in a certain period of life. SEX: It has been proved that persons of female sex in the period prior to menopause are less susceptible to atherosclerosis risk and its side effects--ischemic heart disease and stroke. It is due to the fact that in this period of life women have a higher concentration of high-density lipoproteins, which are known to protect blood vessels against atherosclerosis. AGE: The incidence of stroke is higher at an older age, although nowadays there is evidence that younger people may develop the disease as well. It has been noticed that the frequency and intensity of insult are connected with abrupt changes of the front (weather conditions with certain values of atmospheric factors). A high correlation between the frequency of cerebrovascular insult and abrupt change of the front is evident during spells of warm front in cold months and during spells of cold front in warm months. Moreover, changes during the circadian cycle are of utmost importance. Hypertension is one of the factors

  10. Cancer Risk Factor Knowledge Among Young Adults.

    Science.gov (United States)

    Merten, Julie Williams; Parker, Alexander; Williams, Adrienne; King, Jessica L; Largo-Wight, Erin; Osmani, Morsal

    2017-12-01

    Cancer is the second leading cause of death in the USA. Incidence and mortality rates for cancer have risen steadily and cost the healthcare system over $264 billion annually. Cancer risk can be reduced by restricting alcohol consumption, avoiding tobacco, eating a balanced diet, limiting sun exposure, exercising, and seeking routine cancer screenings. The purpose of this study is to examine cancer risk factor knowledge among college students. Researchers surveyed undergraduate and graduate students (n = 758) at a mid-sized public university in the Southeast about their knowledge regarding cancer risk factors including smoking, alcohol consumption, diet, obesity, hypertension, and human papillomavirus (HPV). Participants were mostly able to identify the association between cancers and health risk behaviors that have received widespread media coverage, are somewhat intuitive, or are salient to their life stage such as drinking, tanning, and smoking. Nearly all participants correctly reported exposure to ultraviolet (UV) rays, and smoking increased risk of developing skin and lung cancer, respectively. Most students correctly identified an increased risk of liver cancer associated with alcohol use but missed head/neck and breast cancer. However, knowledge of less publicized relationships was insufficient. The findings offer encouragement to public health professionals that campaigns have increased awareness of cancer risk. However, there were many relationships that revealed a lack of knowledge, and future campaigns can target lesser-known cancer risk relationships to reduce the personal tragedy and societal burden of cancer.

  11. Perioperative Factors Affecting Ambulatory Outcomes Following Laparoscopic-Adjustable Gastric Banding.

    Science.gov (United States)

    Dupanovic, Mirsad; Krebill, Ron; Dupanovic, Iris; Nachtigal, John; Rockford, Melissa; Orr, Walter

    2017-10-01

    Morbidly obese patients are traditionally hospitalised following bariatric surgery. However, laparoscopic-adjustable gastric banding (LAGB) is amenable for ambulatory care. We hypothesised that the majority of patients can receive an ambulatory LAGB and that both surgical and anaesthetic perioperative factors will significantly affect non-ambulatory LAGB outcomes. Medical records of 201 consecutive LAGB patients performed at the University of Kansas Medical Centre during a 3-y period were reviewed. Demographic, medical, laboratory, anaesthetic, intraoperative and postoperative data were collected. Factors associated with non-ambulatory outcomes were identified and analysed using logistic regression, and a classification tree analysis was used to rank the descriptive model factor to the non-ambulatory outcome. Average patient age was 43.4±11.4 years, and average body mass index was 48.2±10.3 kg m2-1. A total of 155 patients (77.1%; 95% confidence interval, 71%-83%; pambulatory outcomes. Obstructive sleep apnoea was not associated with a non-ambulatory outcome (p=0.83). The majority of patients received an ambulatory LAGB. Meticulous laparoscopic surgical technique with the least feasible number of access ports and multimodal analgesic technique aimed at reduction of postoperative opioid consumption are the most important factors for a successful ambulatory LAGB outcome.

  12. Risk Factors for Developing Atopic Dermatitis

    DEFF Research Database (Denmark)

    G. Carson, Charlotte

    2013-01-01

    The aim of this thesis was to investigate possible risk factors affecting the development of AD. AD is a frequent disease among children and has a substantial impact on the lives of both the child and its family. A better understanding of the disease would enable better treatment, prevention...... exposure to dog was the only environmental exposure that significantly reduced the disease manifestation, suggesting other, yet unknown environmental factors affecting the increasing prevalence of AD in children. Length at birth was shown to be inversely associated with the risk of later developing AD.......016). In addition, there was a significant effect of duration of exclusive breastfeeding (p=0.043), as the relative risk of AD was increased in proportion to increased duration of breastfeeding. The risk associated with exclusive breastfeeding was not explained by the fatty acid composition of mother's milk, though...

  13. Estimation of the Disease Burden Attributable to 11 Risk Factors in Hubei Province, China: A Comparative Risk Assessment.

    Science.gov (United States)

    Cui, Fangfang; Zhang, Lan; Yu, Chuanhua; Hu, Songbo; Zhang, Yunquan

    2016-09-23

    In order to estimate the health losses caused by common risk factors in the Hubei province, China, we calculated the deaths and disability-adjusted life years (DALYs) attributable to 11 risk factors. We estimated the exposure distributions of risk factors in Hubei Province in 2013 from the monitoring system on chronic disease and related risk factors, combined with relative risk (RR) in order to calculate the population attributable fraction. Deaths and DALYs attributed to the selected risk factors were then estimated together with cause-specific deaths and DALYs. In total, 53.39% of the total deaths and 36.23% of the total DALYs in Hubei were a result of the 11 selected risk factors. The top five risk factors were high blood pressure, smoking, high body mass index, diet low in fruits and alcohol use, accounting for 14.68%, 12.57%, 6.03%, 3.90% and 3.19% of total deaths, respectively, and 9.41%, 7.22%, 4.42%, 2.51% and 2.44% of total DALYs, respectively. These risk factors, especially high blood pressure, smoking and high body mass index, significantly influenced quality of life, causing a large number of deaths and DALYs. The burden of chronic disease could be substantially reduced if these risk factors were effectively controlled, which would allow people to enjoy healthier lives.

  14. Metabolite Signatures of Metabolic Risk Factors and their Longitudinal Changes

    NARCIS (Netherlands)

    Yin, X.; Subramanian, S.; Willinger, C.M.; Chen, G.; Juhasz, P.; Courchesne, P.; Chen, B.H.; Li, X.; Hwang, S.J.; Fox, C.S.; O'Donnell, C.J.; Muntendam, P.; Fuster, V.; Bobeldijk-Pastorova, I.; Sookoian, S.C.; Pirola, C.J.; Gordon, N.; Adourian, A.; Larson, M.G.; Levy, D.

    2016-01-01

    Context: Metabolic dysregulation underlies key metabolic risk factors—obesity, dyslipidemia, and dysglycemia. Objective: To uncover mechanistic links between metabolomic dysregulation and metabolic risk by testing metabolite associations with risk factors cross-sectionally and with risk factor

  15. Time trends in osteoporosis risk factor profiles

    DEFF Research Database (Denmark)

    Holm, Jakob Præst; Hyldstrup, Lars; Jensen, Jens-Erik Beck

    2016-01-01

    The aim of this article was to identify prevalent osteoporosis risk factors, medications and comorbidities associated with bone mineral density (BMD). Furthermore to evaluate changes in risk factor profiles over 12 years. 6285 women consecutively referred to an osteoporosis specialist clinic were...... included. Information of potential risk factors was obtained by questionnaire and clinical examination. Additional information on medication use, comorbidities and fractures were obtained from national registries. An association (bone health.......7), hyperthyroidism (OR = 1.5), previous major osteoporotic fracture (OR = 1.7), former osteoporosis treatment (OR = 3.5), higher BMI (OR = 0.87), use of calcium supplementation (OR = 1.2), high exercise level (OR = 0.7), and use of thiazide diuretics (OR = 0.7) were identified as predictors of osteoporosis by DXA...

  16. Vitamin D, Cardiovascular Disease and Risk Factors.

    Science.gov (United States)

    Skaaby, Tea; Thuesen, Betina H; Linneberg, Allan

    2017-01-01

    Observational studies have suggested a possible protective role of vitamin D on the cardiovascular system. The available evidence does not support either cardiovascular benefits or harms of vitamin D supplementation. This chapter provides an overview and discussion of the current knowledge of vitamin D effects from a cardiovascular health perspective. It focuses on vitamin D in relation to cardiovascular disease, i.e. ischemic heart disease, and stroke; the traditional cardiovascular risk factors hypertension, abnormal blood lipids, obesity; and the emerging risk factors hyperparathyroidism, microalbuminuria, chronic obstructive pulmonary diseases, and non-alcoholic fatty liver disease. Meta-analyses of observational studies have largely found vitamin D levels to be inversely associated with cardiovascular risk and disease. However, Mendelian randomization studies and randomized, controlled trials (RCTs) have not been able to consistently replicate the observational findings. Several RCTs are ongoing, and the results from these are needed to clarify whether vitamin D deficiency is a causal and reversible factor to prevent cardiovascular disease.

  17. Vitamin D, cardiovascular disease and risk factors

    DEFF Research Database (Denmark)

    Skaaby, Tea; Thuesen, Betina H.; Linneberg, Allan

    2017-01-01

    of vitamin D effects from a cardiovascular health perspective. It focuses on vitamin D in relation to cardiovascular disease, i.e. ischemic heart disease, and stroke; the traditional cardiovascular risk factors hypertension, abnormal blood lipids, obesity; and the emerging risk factors hyperparathyroidism......, microalbuminuria, chronic obstructive pulmonary diseases, and non-alcoholic fatty liver disease. Meta-analyses of observational studies have largely found vitamin D levels to be inversely associated with cardiovascular risk and disease. However, Mendelian randomization studies and randomized, controlled trials...... (RCTs) have not been able to consistently replicate the observational findings. Several RCTs are ongoing, and the results from these are needed to clarify whether vitamin D deficiency is a causal and reversible factor to prevent cardiovascular disease....

  18. Vitamin D, Cardiovascular Disease and Risk Factors

    DEFF Research Database (Denmark)

    Skaaby, Tea; Thuesen, Betina H; Linneberg, Allan

    2017-01-01

    of vitamin D effects from a cardiovascular health perspective. It focuses on vitamin D in relation to cardiovascular disease, i.e. ischemic heart disease, and stroke; the traditional cardiovascular risk factors hypertension, abnormal blood lipids, obesity; and the emerging risk factors hyperparathyroidism......, microalbuminuria, chronic obstructive pulmonary diseases, and non-alcoholic fatty liver disease. Meta-analyses of observational studies have largely found vitamin D levels to be inversely associated with cardiovascular risk and disease. However, Mendelian randomization studies and randomized, controlled trials...... (RCTs) have not been able to consistently replicate the observational findings. Several RCTs are ongoing, and the results from these are needed to clarify whether vitamin D deficiency is a causal and reversible factor to prevent cardiovascular disease....

  19. Cardiovascular risk factors in subjects with psoriasis

    DEFF Research Database (Denmark)

    Jensen, Peter; Thyssen, Jacob P; Zachariae, Claus

    2013-01-01

    Background Epidemiological data have established an association between cardiovascular disease and psoriasis. Only one general population study has so far compared prevalences of cardiovascular risk factors among subjects with psoriasis and control subjects. We aimed to determine the prevalence...... of cardiovascular risk factors in subjects with and without psoriasis in the general population. Methods During 2006-2008, a cross-sectional study was performed in the general population in Copenhagen, Denmark. A total of 3471 subjects participated in a general health examination that included assessment of current...... between subjects with and without psoriasis with regard to traditional cardiovascular risk factors. Conclusions Our results contrast with the hitherto-reported increased prevalence of metabolic syndrome in subjects with psoriasis in the general US population. However, our results agree with those of other...

  20. EVALUATION OF RISK FACTORS IN ACUTE STROKE

    Directory of Open Access Journals (Sweden)

    Putta

    2015-03-01

    Full Text Available Introduction: Cerebrovascular disease is the third most common cause of death in the developed world after cancer and ischemic heart disease. In India, community surveys have shown a crude prevalence rate of 200 per 100000 population for hemiplegia. Aims and objectives: Identification of risk factors for c erebrovascular disease. Materials and Methods: Inclusion Criteria: Cases of acute stroke admitted in S.V.R.R.G.G.H, Tirupati were taken for the study. Exclusion Criteria: Head injury cases, neoplasm cases producing cerebrovascular disease were excluded. Re sults: Stroke was more common in male, 54% patients were male 46% were female. It was more common in 6 th and 7 th decade. More common risk factors were hypertension followed by smoking, diabetes mellitus. More common pathology was infarction. Conclusion: Com mon risk factors for acute stroke are hypertension, smoking, diabetes mellitus, alcoholism, obesity, cardiac disease. Stroke was confirmed by CT scan of brain.

  1. Psychological Factors Linked to Risk Perception

    Science.gov (United States)

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

    2012-04-01

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

  2. Risk Factors for Anterior Cruciate Ligament Injury

    OpenAIRE

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

    2012-01-01

    Context: Injuries to the anterior cruciate ligament (ACL) of the knee are immediately debilitating and can cause long-term consequences, including the early onset of osteoarthritis. It is important to have a comprehensive understanding of all possible risk factors for ACL injury to identify individuals who are at risk for future injuries and to provide an appropriate level of counseling and programs for prevention. Objective: This review, part 1 of a 2-part series, highlights what is known an...

  3. Risk Factors for Anterior Cruciate Ligament Injury

    OpenAIRE

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

    2012-01-01

    Context: Injuries to the anterior cruciate ligament (ACL) are immediately disabling and are associated with long-term consequences, such as posttraumatic osteoarthritis. It is important to have a comprehensive understanding of all possible risk factors for ACL injury to identify individuals who are at risk for future injuries and to provide an appropriate level of counseling and programs for prevention. Objective: This review, part 2 of a 2-part series, highlights what is known and still unkn...

  4. Survey of risk factors urinary tract infection

    Directory of Open Access Journals (Sweden)

    A Dehghani

    2016-09-01

    Full Text Available Introduction: Women are very susceptible to urinary tract infections and pregnancy raises the risk of urinary tract infection. In general, little information on the risk factors of urinary tract infection in pregnancy is underway. Urinary tract infection in pregnancy is an important risk factor for pregnancy dire consequences. The purpose of this study is to find risk factors associated with urinary tract infection in pregnant women. Methods: The study was observational and retrospective analysis was carried on in the winter of which 310 pregnant women participated in 11 health centers in Shahrekord. Of these 155 cases (patients and 155 controls (healthy that were matched for age Information required from the health records of pregnant women and complete Czech list of researcher whose validity was confirmed by experts were gathered. Information needed by pregnant women health records and complete list researcher was collected. Czech list contains a number of possible risk factors for illness and demographic characteristics of the study participants was Statistical analysis software spss version 16 by using chi square tests and logistic regression and t analysis was performed. Results: Among the variables vomiting (p = 0/00 a history of urinary tract infection in a previous pregnancy (P =.001, CI = 1.508-4.408, OR = 2.578 abortion own history (P =.014, CI = 1.165 -3.847, OR = 2.117, respectively, the most important risk factors for urinary tract infection in pregnant women were determined. Conclusion: Prevention and treatment of vomiting in pregnancy prevention of urinary tract infections during pregnancy. Prevention of abortion can play an important role in the prevention of urinary tract infection and its complications in pregnancy. The study also revealed a number of factors can have an impact on urinary tract infection in pregnancy that has not been enough attention and it is necessary that more attention be placed on health programs and

  5. Risk factors for coronary heart disease in the Indians of Durban ...

    African Journals Online (AJOL)

    In a study of 778 subjects aged 15 - 69 years (408 men), 15,3% (sex and age adjusted 13,4%) had a history of CHD. The important risk factors in men were hypercholesterolaemia, hypertriglyceridaemia, diabetes, and smoking, and in women diabetes, hypercholesterolaemia, and hypertriglyceridaemia. The minor risk ...

  6. The ABO blood group genotype and factor VIII levels as independent risk factors for venous thromboembolism.

    Science.gov (United States)

    Tirado, Isabel; Mateo, José; Soria, José Manuel; Oliver, Arturo; Martínez-Sánchez, Elisabeth; Vallvé, Cristina; Borrell, Monserrat; Urrutia, Teresa; Fontcuberta, Jordi

    2005-03-01

    Factor VIII (FVIII), von Willebrand factor (vWF) and the ABO blood groups have been associated with thrombosis. The ABO locus has functional effects on vWF and FVIII levels and is genetically correlated with FVIII, vWF and thrombosis. We carried out a case-control study to assess the role of FVIII, vWF and ABO types on thrombotic risk. We analyzed 250 patients with venous thrombosis and 250 unrelated controls. FVIII, vWF and other factors related to thrombophilia were measured, ABO groups were analyzed by genotyping. FVIII and vWF were higher in non-O individuals. Group O was more frequent in the controls (44.3% v 23.3%; difference 21.1%; 95% CI: 13.0-29.3%) and Group A in patients (59.2% v. 41.5%; difference 17.7%, 95% CI: 9.1-26.4%). Individuals carrying the A1 allele had a higher risk of thrombosis (OR 2.6; 95% CI, 1.8-3.8). The risk attributed to vWF disappeared after adjusting for the ABO group. Patients with FVIII above the 90th percentile had a high thrombotic risk (adjusted OR 3.7; 95% CI, 2.1-6.5), and a high risk of recurrence (OR 2.3; 95% CI: 1.3-4.1). In conclusion, high FVIII levels and non-O blood groups, likely those with the A1 allele, are independent risk factors for venous thromboembolism and should be considered in evaluating of thrombophilia.

  7. Cardiovascular Risk Factors in the Antiphospholipid Syndrome

    Directory of Open Access Journals (Sweden)

    Felipe Freire da Silva

    2014-01-01

    Full Text Available A major cause of morbidity and mortality in the context of the antiphospholipid syndrome (APS is the occurrence of thrombotic events. Besides the pathogenic roles of antiphospholipid antibodies (aPL, other risk factors and medical conditions, which are conditions for traditional risk of an individual without the APS, can coexist in this patient, raising their risk of developing thrombosis. Therefore, the clinical and laboratory investigation of comorbidities known to increase cardiovascular risk in patients with antiphospholipid antibody syndrome is crucial for the adoption of a more complete and effective treatment. Experimental models and clinical studies show evidence of association between APS and premature formation of atherosclerotic plaques. Atherosclerosis has major traditional risk factors: hypertension, diabetes mellitus, obesity, dyslipidemia, smoking, and sedentary lifestyle that may be implicated in vascular involvement in patients with APS. The influence of nontraditional risk factors as hyperhomocysteinemia, increased lipoprotein a, and anti-oxLDL in the development of thromboembolic events in APS patients has been studied in scientific literature. Metabolic syndrome with all its components also has been recently studied in antiphospholipid syndrome and is associated with arterial events.

  8. Preoperative modifiable risk factors in colorectal surgery

    DEFF Research Database (Denmark)

    van Rooijen, Stefanus; Carli, Francesco; Dalton, Susanne O

    2017-01-01

    complications (CCI ≥20). Multivariate logistic regression analysis was done to explore the combined effect of individual risk factors. RESULTS: In this 139 patient cohort, smoking, malnutrition, alcohol consumption, neoadjuvant therapy, higher age, and male sex, were seen more frequently in the severe...... in higher mortality rates and greater hospital costs. The number and severity of complications is closely related to patients' preoperative performance status. The aim of this study was to identify the most important preoperative modifiable risk factors that could be part of a multimodal prehabilitation...

  9. Maternal risk factors for postterm pregnancy and cesarean delivery following labor induction.

    Science.gov (United States)

    Roos, Nathalie; Sahlin, Lena; Ekman-Ordeberg, Gunvor; Kieler, Helle; Stephansson, Olof

    2010-08-01

    To investigate risk factors associated with postterm pregnancy and cesarean delivery following labor induction. Population-based cohort study. Sweden. From the Swedish Medical Birth Register, a total of 1,176,131 singletons births from gestational week 37 and onwards, between 1992 and 2006. Unconditional logistic regression analysis. Risk of postterm pregnancy (delivery at >or=42 weeks) and cesarean delivery following labor induction. Among 1,176,131 births, 8.94% were delivered postterm. Compared to normal weight women, the risk of postterm pregnancy in obese women was almost doubled (adjusted OR: 1.63, 95% CI 1.59-1.67). The risk of postterm pregnancy increased with increasing maternal age and was higher among primiparous women. The risk of cesarean section (CS) following labor induction postterm, increased with maternal age and BMI, and was more than doubled among women 35 years and older (adjusted OR 2.28, 95% CI 2.04-2.56). A fivefold risk of CS was seen among nulliparous women (adjusted OR 5.05, 95% CI 4.71-5.42). Parous women with a previous CS undergoing labor induction had a sevenfold increased risk of CS postterm (adjusted OR 7.19, 95% CI 5.93-8.71). Nulliparity, advanced maternal age and obesity were the strongest risk factors for postterm pregnancy and CS following labor induction in postterm pregnancy. Including maternal risk factors to the cervical assessment may improve prediction of vaginal delivery following labor induction in postterm pregnancy.

  10. Risk factors for benign breast disease.

    Science.gov (United States)

    Brinton, L A; Vessey, M P; Flavel, R; Yeates, D

    1981-03-01

    The importance of various risk factors for benign breast disorders has been assessed an analysis of data obtained from a multicenter cohort study of contraceptive use among women in the United Kingdom (the Oxford Family Planning Association Contraceptive Study). Cases comprised all women diagnosed as having any type of benign breast lesion; 74 had fibroadenoma, 211 had histologically confirmed chronic cystic disease, 331 had breast lumps not subjected to biopsy and 70 had other disease. Each case was individually matched with another study participant who was free from recognized breast disease. Matching factors were center of recruitment, date of recruitment, age at entry, and continuation in the study. An inverse association was found between use of oral contraceptives and the risk of the first three conditions. Current users of the pill had the lowest risk, particularly when the use was for an extended period. In contrast, past users demonstrated no reduction in risk. The reduction in risk for chronic cystic disease appeared to relate to the amount of progestogen contained in the pill. No significant association was observed between the risk of any of the conditions and either parity or age at first livebirth. Women of low social class and obese women were at low risk, perhaps reflecting diagnostic biases.

  11. Sociomedical risk factors for male infecundity

    Directory of Open Access Journals (Sweden)

    E. A. Epanchintseva

    2016-01-01

    Full Text Available Subjects and methods. A total of 917 men from infertile couples with abnormal ejaculate indicators were examined. Their age was 34.1 ± 6.3 years; the infertility period was 4.6 ± 3.9 years. A retrospective analysis of their case histories, clinical examination, questioning to identify risk factors for infertility, and anthropometric measurements of weight and height were made. Weight was rated normal at a body mass index (BMI of ≤ 24.9 kg/m2 ; overweight at 25.0–29.9 kg/m2 , and obesity at ≥ 30 kg/m2 . When identifying infertility risk factors, the investigators kept in mind 24 risk factors at the moment of examination or in the patient histories, which were grouped into 3 clusters: 1 – environmental factors and occupational hazards; 2 – evidence of congenital and acquired abnormalities; 3 – social and quality-of-life factors; this cluster also includes history and examination evidence of tuberculosis, sexually transmitted diseases, and other social diseases, such as hepatitis B and C, or human immunodeficiency infection. Then the men who did not show an exacerbation of somatic diseases, genetic anomalies associated with reproductive disorders, or an exacerbation of social diseases at the moment of examination were selected from the total sample. These were divided into 2 groups: normal weight and obese patients. The frequency of the above mentioned infertility risk factors and additionally the proportion of persons engaged in intellectual or manual labor were calculated in each group.Results and discussion. In the total sample, the frequency of infertility risk factors including occupational hazards and environmental factors was < 20 %; the incidence of congenital and acquired abnormalities was 1–39 %. The highest frequency of risk factors was noted in cluster 3. Among them, alcohol consumption (75 % occupied the first place; next were the rate of sexually transmitted infections (59 %, emotional stress (44 %, and smoking (42

  12. 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 ...

  13. Empiric model for mean generation time adjustment factor for classic point kinetics equations

    Energy Technology Data Exchange (ETDEWEB)

    Goes, David A.B.V. de; Martinez, Aquilino S.; Goncalves, Alessandro da C., E-mail: david.goes@poli.ufrj.br, E-mail: aquilino@lmp.ufrj.br, E-mail: alessandro@con.ufrj.br [Coordenacao de Pos-Graduacao e Pesquisa de Engenharia (COPPE/UFRJ), Rio de Janeiro, RJ (Brazil). Departamento de Engenharia Nuclear

    2017-11-01

    Point reactor kinetics equations are the easiest way to observe the neutron production time behavior in a nuclear reactor. These equations are derived from the neutron transport equation using an approximation called Fick's law leading to a set of first order differential equations. The main objective of this study is to review classic point kinetics equation in order to approximate its results to the case when it is considered the time variation of the neutron currents. The computational modeling used for the calculations is based on the finite difference method. The results obtained with this model are compared with the reference model and then it is determined an empirical adjustment factor that modifies the point reactor kinetics equation to the real scenario. (author)

  14. Evolution of chemical-specific adjustment factors (CSAF) based on recent international experience; increasing utility and facilitating regulatory acceptance.

    Science.gov (United States)

    Bhat, Virunya S; Meek, M E Bette; Valcke, Mathieu; English, Caroline; Boobis, Alan; Brown, Richard

    2017-10-01

    The application of chemical-specific toxicokinetic or toxicodynamic data to address interspecies differences and human variability in the quantification of hazard has potential to reduce uncertainty and better characterize variability compared with the use of traditional default or categorically-based uncertainty factors. The present review summarizes the state-of-the-science since the introduction of the World Health Organization/International Programme on Chemical Safety (WHO/IPCS) guidance on chemical-specific adjustment factors (CSAF) in 2005 and the availability of recent applicable guidance including the WHO/IPCS guidance on physiologically-based pharmacokinetic (PBPK) modeling in 2010 as well as the U.S. EPA guidance on data-derived extrapolation factors in 2014. A summary of lessons learned from an analysis of more than 100 case studies from global regulators or published literature illustrates the utility and evolution of CSAF in regulatory decisions. Challenges in CSAF development related to the adequacy of, or confidence in, the supporting data, including verification or validation of PBPK models. The analysis also identified issues related to adequacy of CSAF documentation, such as inconsistent terminology and often limited and/or inconsistent reporting, of both supporting data and/or risk assessment context. Based on this analysis, recommendations for standardized terminology, documentation and relevant interdisciplinary research and engagement are included to facilitate the continuing evolution of CSAF development and guidance.

  15. Predictive factors of insulin resistance resolution with adjustable gastric band surgery.

    Science.gov (United States)

    Colsa Gutiérrez, Pablo; Kharazmi Taghavi, Mahgol; Sosa Medina, Rocío; Gutiérrez Cabezas, José Manuel; Ovejero Gómez, Víctor Jacinto; Ruiz, José Luis; Ingelmo Setién, Alfredo

    2015-03-01

    The aim of the study was to evaluate preoperative factors associated with remission of diabetes and weight loss after laparoscopic gastric band surgery. A retrospective cohort of 95 patients who had an adjustable gastric band placed were included. A preliminary descriptive study of prognostic factors was performed using the logistic regression model with SPSS 17.0. The independent variables were age, sex, body mass index (BMI), diabetes status and degree of obesity; dependent variables were the proportion of weight loss, change in diabetes status score and percent changes in fasting sugar and glycosylated hemoglobin. The variables that were significantly associated with the percentage of changes in fasting blood sugar and glycated hemoglobin were: the degree of obesity in the first year; preoperative and diabetes status respectively. The analysis of the need for antidiabetic treatment using the modified diabetes status score showed preoperative BMI, age and gender as significant predictors. In patients undergoing gastric band surgery, weight loss is the fundamental mechanism by which insulin sensitivity increases. This improvement in glucose metabolism is influenced by factors such as sex, age, insulin treatment, duration of diabetes and degree of preoperative obesity. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Dementia risk factors for Australian baby boomers.

    Science.gov (United States)

    Panegyres, Peter K; Gray, Victoria

    2010-06-21

    Baby boomers are individuals born in the years 1946 to 1965. The objective of this paper was to define the risk factors for dementia and Alzheimer's disease (AD) and their relevance to Australian baby boomers, with the aim of providing evidence-based guidelines for dementia prevention. A series of PubMed searches (1994-2010) were conducted with relevant key words. Data was included from the Australian Bureau of Statistics (ABS) in relation to baby boomers in Australia. Article titles and abstracts were assessed by two reviewers for inclusion. Searches through ABS revealed no specific study on baby boomers at a national level; information was only available for Western Australia, South Australia and Queensland. A number of genetic and non-genetic risk factors for dementia were identified most of which remain controversial and require further study. We did not identify significant differences in the prevalence and incidence of dementia in those under 65 years in Queensland, South Australia and Western Australia. There were no correlations of risk factors and dementia between the Australian states. Modification of risk factors has not been proven to reduce the incidence and prevalence of dementia and AD in baby boomers. Nevertheless, on available evidence, we recommend: i) active management of cardiovascular risk factors such as hypertension; ii) the encouragement of a healthy lifestyle (eg, weight reduction, exercise) as offering the best pathways to reduce the emerging dementia risk for baby boomers. The implications are that activities promoting a healthy heart might lead to a healthy brain and help to prevent dementia.

  17. Dementia risk factors for Australian baby boomers

    Directory of Open Access Journals (Sweden)

    Peter K. Panegyres

    2010-07-01

    Full Text Available Baby boomers are individuals born in the years 1946 to 1965. The objective of this paper was to define the risk factors for dementia and Alzheimer’s disease (AD and their relevance to Australian baby boomers, with the aim of providing evidence-based guidelines for dementia prevention. A series of PubMed searches (1994-2010 were conducted with relevant key words. Data was included from the Australian Bureau of Statistics (ABS in relation to baby boomers in Australia. Article titles and abstracts were assessed by two reviewers for inclusion. Searches through ABS revealed no specific study on baby boomers at a national level; information was only available for Western Australia, South Australia and Queensland. A number of genetic and non-genetic risk factors for dementia were identified most of which remain controversial and require further study. We did not identify significant differences in the prevalence and incidence of dementia in those under 65 years in Queensland, South Australia and Western Australia. There were no correlations of risk factors and dementia between the Australian states. Modification of risk factors has not been proven to reduce the incidence and prevalence of dementia and AD in baby boomers. Nevertheless, on available evidence, we recommend: i active management of cardiovascular risk factors such as hypertension; ii the encouragement of a healthy lifestyle (eg, weight reduction, exercise as offering the best pathways to reduce the emerging dementia risk for baby boomers. The implications are that activities promoting a healthy heart might lead to a healthy brain and help to prevent dementia.

  18. Adolescent sexual aggression: risk and protective factors.

    Science.gov (United States)

    Borowsky, I W; Hogan, M; Ireland, M

    1997-12-01

    Little research addresses the correlates of sexual aggression in nonclinical populations of adolescents. The purpose of this study was to identify risk and protective factors associated with sexual violence among male and female adolescents. We analyzed data on 71,594 students in the 9th and 12th grades responding to the 1992 Minnesota Student Survey, an anonymous, self-report survey examining an array of risk environments, health-compromising behaviors, and protective factors. The responses of students reporting a history of forcing someone into a sexual act were compared with those who reported that they had never forced someone into a sexual act. Separate analyses were conducted for males and females. A history of sexual violence perpetration was reported by 4.8% of male and 1.3% of female adolescents. Using a logistic regression model, sexual aggression was associated with experiencing intrafamilial or extrafamilial sexual abuse, witnessing family violence, frequent use of illegal drugs, anabolic steroid use, daily alcohol use, gang membership, high levels of suicide risk behavior, and excessive time spent "hanging out." Emotional health and connectedness with friends and adults in the community were protective factors for male adolescents against sexually aggressive behavior, and academic achievement was a protective factor for female adolescents. A history of forcing someone into a sexual act was associated with several risk and protective factors. Efforts to prevent adolescent sexual violence should target individuals at increased risk. Through their psychosocial assessment of young people, health care professionals can play a role in identifying, counseling, and making appropriate referrals for adolescents at risk for sexually aggressive behavior.

  19. Risk factors for mortality in Down syndrome.

    Science.gov (United States)

    Uppal, H; Chandran, S; Potluri, R

    2015-09-01

    Down syndrome is a genetic condition that contributes to a significantly shorter life expectancy compared with the general population. We investigated the most common comorbidities in a population of acute hospital patients with Down syndrome and further explored what the most common risk factors for mortality are within this population. From our database of one million patients admitted to National Health Service (NHS) Trusts in northern England, we identified 558 people who had Down syndrome. We compared this group with an age- and gender-matched control group of 5580 people. The most prevalent comorbid diseases within the Down's population were hypothyroidism (22.9%) and epilepsy (20.3%). However, the conditions that had the highest relative risks (RRs) in the Down's population were septal defects and dementia. Respiratory failure, dementia and pneumonia were the most significantly related comorbidities to mortality in the Down syndrome population. In the control population, respiratory failure, dementia and renal failure were the most significant disease contributors. When these contributors were analysed using multivariate analysis, heart failure, respiratory failure, pneumonia and epilepsy were the identified risk factors for in-hospital mortality in the Down syndrome population. Respiratory failure was the sole risk factor for mortality in the Down syndrome population [RR = 9.791 (1.6-59.9) P ≤ 0.05], when compared with the risk factors for mortality in the control population. There is significant medical morbidity in Down syndrome. This morbidity contributes to the lower life expectancy. Respiratory failure is a risk factor for mortality in Down syndrome. We need to thoroughly investigate people with Down syndrome to ensure any treatable illnesses are well managed. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  20. Reproductive factors and Parkinson's disease risk in Danish women

    DEFF Research Database (Denmark)

    Greene, N; Lassen, C F; Rugbjerg, K

    2014-01-01

    BACKGROUND AND PURPOSE: Parkinson's disease is more common in men than women by a ratio of about 1.5:1 and yet there is no consensus to date as to whether female reproductive factors including hormone use affect Parkinson's disease risk. Our objective was to examine the relationship between...... Parkinson's disease and female reproductive factors in the largest population-based Parkinson's disease case-control study to date. METHODS: Seven hundred and forty-three female Parkinson's disease cases diagnosed between 1996 and 2009 were selected from the Danish National Hospital Register, diagnoses...... and lifestyle factors. RESULTS: After adjusting for smoking, caffeine and alcohol use, education, age, and family Parkinson's disease history, inverse associations between Parkinson's disease and early menarche (first period at ≤11 years), oral contraceptives, high parity (≥4 children) and bilateral...

  1. Risk factors associated with provoked pulmonary embolism.

    Science.gov (United States)

    Gjonbrataj, Endri; Kim, Ji Na; Gjonbrataj, Juarda; Jung, Hye In; Kim, Hyun Jung; Choi, Won-Il

    2017-01-01

    This study aimed to investigate the risk factors associated with provoked pulmonary embolism (PE). This retrospective cohort study included 237 patients with PE. Patients that had transient risk factors at diagnosis were classified as having provoked PE, with the remaining patients being classified as having unprovoked PE. The baseline clinical characteristics and factors associated with coagulation were compared. We evaluated the risk factors associated with provoked PE. Of the 237 PE patients, 73 (30.8%) had provoked PE. The rate of respiratory failure and infection, as well as the disseminated intravascular coagulation score and ratio of right ventricular diameter to left ventricular diameter were significantly higher in patients with provoked PE than in those with unprovoked PE. The protein and activity levels associated with coagulation, including protein C antigen, protein S antigen, protein S activity, anti-thrombin III antigen, and factor VIII, were significantly lower in patients with provoked PE than in those with unprovoked PE. Multivariate analysis showed that infection (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.4 to 7.4) and protein S activity (OR, 0.97; 95% CI, 0.95 to 0.99) were significantly associated with provoked PE. Protein S activity and presence of infection were important factors associated with provoked PE. We should pay attention to the presence of infection in patients with provoked PE.

  2. A risk-adjusted financial model to estimate the cost of a video-assisted thoracoscopic surgery lobectomy programme.

    Science.gov (United States)

    Brunelli, Alessandro; Tentzeris, Vasileios; Sandri, Alberto; McKenna, Alexandra; Liew, Shan Liung; Milton, Richard; Chaudhuri, Nilanjan; Kefaloyannis, Emmanuel; Papagiannopoulos, Kostas

    2016-05-01

    To develop a clinically risk-adjusted financial model to estimate the cost associated with a video-assisted thoracoscopic surgery (VATS) lobectomy programme. Prospectively collected data of 236 VATS lobectomy patients (August 2012-December 2013) were analysed retrospectively. Fixed and variable intraoperative and postoperative costs were retrieved from the Hospital Accounting Department. Baseline and surgical variables were tested for a possible association with total cost using a multivariable linear regression and bootstrap analyses. Costs were calculated in GBP and expressed in Euros (EUR:GBP exchange rate 1.4). The average total cost of a VATS lobectomy was €11 368 (range €6992-€62 535). Average intraoperative (including surgical and anaesthetic time, overhead, disposable materials) and postoperative costs [including ward stay, high dependency unit (HDU) or intensive care unit (ICU) and variable costs associated with management of complications] were €8226 (range €5656-€13 296) and €3029 (range €529-€51 970), respectively. The following variables remained reliably associated with total costs after linear regression analysis and bootstrap: carbon monoxide lung diffusion capacity (DLCO) 0.05) in 86% of the samples. A hypothetical patient with COPD and DLCO less than 60% would cost €4270 more than a patient without COPD and with higher DLCO values (€14 793 vs €10 523). Risk-adjusting financial data can help estimate the total cost associated with VATS lobectomy based on clinical factors. This model can be used to audit the internal financial performance of a VATS lobectomy programme for budgeting, planning and for appropriate bundled payment reimbursements. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  3. Effect of unemployment on cardiovascular risk factors and mental health.

    Science.gov (United States)

    Zagożdżon, P; Parszuto, J; Wrotkowska, M; Dydjow-Bendek, D

    2014-09-01

    Following the economic changes in Poland, increasing health discrepancies were observed during a period of 20 years, which may be partly attributable to the consequences of unemployment. To assess the association between unemployment, major cardiovascular risk factors and mental health. A cross-sectional study in which data were collected between 2009 and 2010 during preventive health examinations by an occupational medicine service in Gdansk, Poland. Data on blood pressure, resting heart rate, information about smoking habits, body mass index and history of use of mental health services were collected during these assessments. Multiple logistic regression was used during data analysis to adjust for age, gender, education and length of employment. Study participants comprised 3052 unemployed and 2059 employed individuals. After adjustment for age, gender, education and number of previous employments, the odds ratio (OR) for hypertension in relation to unemployment was 1.02 [95% confidence interval (95% CI) 0.84-1.23]. There was a statistically significant negative association between being overweight and unemployment (OR = 0.81, 95% CI: 0.66-0.99). Smoking was positively associated with unemployment after adjustment for age and sex (OR = 1.45, 95% CI: 1.25-1.67). There was a positive relationship between mental ill-health and unemployment among study participants (OR = 2.05, 95% CI: 0.91-4.65), but this was not statistically significant. The patterns of major cardiovascular risk factors differed between unemployed and employed individuals in Poland. Our observations suggest employment status is a predictor of specific disease risk profiles; consequently, specific preventive measures are needed in unemployed individuals. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Pain, Depression, and Fatigue: Loneliness as a Longitudinal Risk Factor

    Science.gov (United States)

    Jaremka, Lisa M.; Andridge, Rebecca R.; Fagundes, Christopher P.; Alfano, Catherine M.; Povoski, Stephen P.; Lipari, Adele M.; Agnese, Doreen M.; Arnold, Mark W.; Farrar, William B.; Yee, Lisa D.; Carson, William E.; Bekaii-Saab, Tanios; Martin, Edward W.; Schmidt, Carl R.; Kiecolt-Glaser, Janice K.

    2013-01-01

    Objective Pain, depression, and fatigue function as a symptom cluster and thus may share common risk factors. Interpersonal relationships clearly influence health, suggesting that loneliness may promote the development of the pain, depression, and fatigue symptom cluster. We hypothesized that loneliness would be related to concurrent symptom cluster levels and increases in symptom cluster levels over time. Methods We utilized two observational studies with distinct longitudinal samples. Study 1 was a sample of cancer survivors and benign controls (N=115) assessed annually for 2 years. Study 2 was a sample of older adults caring for a spouse with dementia (caregivers) and non-caregiver controls (N=229) assessed annually for 4 years. Participants completed annual measures assessing loneliness, pain, depression, and fatigue. Results Across both samples, lonelier participants experienced more concurrent pain, depression, and fatigue and larger increases in symptom cluster levels from one year to the next than less lonely participants. Sleep quality did not mediate the results in either study. All analyses were adjusted for relevant demographic and health variables. Conclusions Two longitudinal studies with different populations demonstrated that loneliness was a risk factor for the development of the pain, depression, and fatigue symptom cluster over time. The current research helps identify people most at risk for pain, depression, and fatigue, and lays the groundwork for research about their diagnosis and treatment. These data also highlight the health risks of loneliness; pain, depression, and fatigue often accompany serious illness and place people at risk for poor health and mortality. PMID:23957903

  5. Risk and protective factors for urban African-American youth.

    Science.gov (United States)

    Li, Susan Tinsley; Nussbaum, Karin M; Richards, Maryse H

    2007-03-01

    The present study investigated risk and resilience processes in a sample of urban African-American youth. Risk and protective factors were assessed across ecological levels including individual, family and community. Both externalizing and internalizing symptomatology were included as measures of child adjustment. Youth and parental reports as well as various methods, such as the Experience Sampling Method, were used to capture the daily experiences of the adolescents from different perspectives. Poverty, hassles, and exposure to violence predicted higher rates of externalizing and internalizing symptoms. Individual and family protective variables emerged as powerful sources of resilience. An inner sense of confidence and helpful family support were associated with reductions in the deleterious effects of community poverty. Two main patterns, protective-stabilizing and overwhelming-risk, seemed to characterize most of the risk by protective factor interactions. The present findings are important for understanding the complex experiences of urban youth and furthering the literature on sources of risk and protection for African-Americans.

  6. Seizure After Cranioplasty: Incidence and Risk Factors.

    Science.gov (United States)

    Wang, Haifeng; Zhang, Kewei; Cao, Hongshi; Zhang, Xiaohong; Li, Ye; Wei, Qiang; Zhang, Dezhi; Jia, Qian; Bie, Li

    2017-09-01

    To investigate clinical characteristics of postcranioplasty seizures (PCS) first observed after cranioplasty after decompressive craniectomy (DC) to treat traumatic brain injury and to define factors that increase PCS risk. This retrospective study, covering the period between January 2008 and July 2015, compared PCS in postcranioplasty patients. Postcranioplasty seizures risk factors included diabetes mellitus, hypertension, time between DC and cranioplasty, duraplasty material, cranioplasty contusion location, electrocautery method, PCS type, and infection. Multivariate logistic regression analysis was performed and confidence intervals (CIs) were calculated (95% CI). Of 270 patients, 32 exhibited initial PCS onset postcranioplasty with 11.9% incidence (32/270). Patients fell into immediate (within 24 hours), early (from 1 to 7 days), and late (after 7 days) PCS groups with frequencies of 12, 5, and 15 patients, respectively. Generalized, partial, and mixed seizure types were observed in 13, 13, and 6 patients, respectively. Multivariate logistic regression analysis showed increased risk with increasing age (>50 years). Cranioplasty contusion location, precranioplasty deficits, duraplasty material, and monopolar electrocautery were predictive of PCS onset (P < 0.05). Increased DC to cranioplasty interval increased risk but was not statistically significant (P = 0.062). Understanding risk factors for PCS will benefit the management of cranioplasty patients.

  7. Exploring Risk Factors for Follicular Lymphoma

    Directory of Open Access Journals (Sweden)

    Alexander J. Ambinder

    2012-01-01

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

  8. Risk factors and effective management of preeclampsia

    Directory of Open Access Journals (Sweden)

    English FA

    2015-03-01

    Full Text Available Fred A English,1 Louise C Kenny,1 Fergus P McCarthy1,2 1Irish Centre for Fetal and Neonatal Translational Research (INFANT, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland; 2Women’s Health Academic Centre, King's Health Partners, St Thomas' Hospital, London, UK Abstract: Preeclampsia, a hypertensive disorder of pregnancy is estimated to complicate 2%–8% of pregnancies and remains a principal cause of maternal and fetal morbidity and mortality. Preeclampsia may present at any gestation but is more commonly encountered in the third trimester. Multiple risk factors have been documented, including: family history, nulliparity, egg donation, diabetes, and obesity. Significant progress has been made in developing tests to predict risk of preeclampsia in pregnancy, but these remain confined to clinical trial settings and center around measuring angiogenic profiles, including placental growth factor or newer tests involving metabolomics. Less progress has been made in developing new treatments and therapeutic targets, and aspirin remains one of the few agents shown to consistently reduce the risk of developing preeclampsia. This review serves to discuss recent advances in risk factor identification, prediction techniques, and management of preeclampsia in antenatal, intrapartum, and postnatal patients. Keywords: pregnancy, treatment, risk reduction, prediction

  9. Number of Coronary Heart Disease Risk Factors and Mortality in Patients With First Myocardial Infarction

    Science.gov (United States)

    Canto, John G.; Kiefe, Catarina I.; Rogers, William J.; Peterson, Eric D.; Frederick, Paul D.; French, William J.; Gibson, C. Michael; Pollack, Charles V.; Ornato, Joseph P.; Zalenski, Robert J.; Penney, Jan; Tiefenbrunn, Alan J.; Greenland, Philip

    2013-01-01

    Context Few studies have examined the association between the number of coronary heart disease risk factors and outcomes of acute myocardial infarction in community practice. Objective To determine the association between the number of coronary heart disease risk factors in patients with first myocardial infarction and hospital mortality. Design Observational study from the National Registry of Myocardial Infarction, 1994-2006. Patients We examined the presence and absence of 5 major traditional coronary heart disease risk factors (hypertension, smoking, dyslipidemia, diabetes, and family history of coronary heart disease) and hospital mortality among 542 008 patients with first myocardial infarction and without prior cardiovascular disease. Main Outcome Measure All-cause in-hospital mortality. Results A majority (85.6%) of patients who presented with initial myocardial infarction had at least 1 of the 5 coronary heart disease risk factors, and 14.4% had none of the 5 risk factors. Age varied inversely with the number of coronary heart disease risk factors, from a mean age of 71.5 years with 0 risk factors to 56.7 years with 5 risk factors (P for trend <.001). The total number of in-hospital deaths for all causes was 50 788. Unadjusted in-hospital mortality rates were 14.9%, 10.9%, 7.9%, 5.3%, 4.2%, and 3.6% for patients with 0, 1, 2, 3, 4, and 5 risk factors, respectively. After adjusting for age and other clinical factors, there was an inverse association between the number of coronary heart disease risk factors and hospital mortality adjusted odds ratio (1.54; 95% CI, 1.23-1.94) among individuals with 0 vs 5 risk factors. This association was consistent among several age strata and important patient subgroups. Conclusion Among patients with incident acute myocardial infarction without prior cardiovascular disease, in-hospital mortality was inversely related to the number of coronary heart disease risk factors. PMID:22089719

  10. Benchmarking risk-adjusted adult antibacterial drug use in 70 US academic medical center hospitals.

    Science.gov (United States)

    Polk, Ron E; Hohmann, Samuel F; Medvedev, Sofia; Ibrahim, Omar

    2011-12-01

    Antimicrobial stewardship programs are advised to measure and risk-adjust antimicrobial use to facilitate interhospital comparisons, a process called benchmarking. The purpose of this investigation was to evaluate a new benchmarking strategy for antibacterials. Hospital-wide adult antibacterial drug use in 2009 was measured as days of therapy (DOT) and length of therapy (LOT) from billing records in 70 US academic medical centers (AMCs). Patients were assigned to 1 of 35 clinical service lines (CSL) based on their Medicare Severity Diagnosis Related Group. Expected (E) use was determined by indirect standardization and compared with observed (O) use. Of 1,791 ,180 discharged adults, 63.7% received antibacterial drugs; the range by CSL was 14.3% (psychiatry) to 99.7% (lung transplant). Mean ± SD hospital-wide use was 839 ± 106 DOTs (range, 594-1109) and 536 ± 53.0 LOT (range, 427-684) per 1000 patient-days. The ventilator support CSL had the most DOT per discharge, 39.4 ± 9.4 days; the LOT was 21.5 ± 4.5 days. The hospital-wide O/E ratio range was 0.7-1.45; in 5 AMCs the ratio exceeded the 90% confidence interval (CI) and was below the 90% CI in 6. Variability in use was explained by the proportion of treated patients within each CSL and mean LOT and DOT per discharge. Adult antibacterial drug use was benchmarked to expected use adjusted for patient mix, and outlier hospitals were identified. Differences between expected and observed use reflect usage patterns that were benchmarked and are targets for evaluation and intervention.

  11. Premorbid adjustment profiles in psychosis and the role of familial factors

    NARCIS (Netherlands)

    Quee, Piotr J.; Meijer, Julia H.; Islam, Md Atiqul; Aleman, André; Alizadeh, Behrooz Z.; Meijer, Carin J.; van den Heuvel, Edwin R.

    2014-01-01

    Disease heterogeneity in patients with psychotic disorder may be explained by distinct profiles of premorbid adjustment. The current study explored premorbid adjustment profiles in patients with psychotic disorders, associations with cognitive and clinical characteristics after disease onset, and

  12. Premorbid Adjustment Profiles in Psychosis and the Role of Familial Factors

    NARCIS (Netherlands)

    Quee, Piotr J.; Meijer, Julia H.; Islam, Md Atiqul; Aleman, Andre; Alizadeh, Behrooz Z.; Meijer, Carin J.; van den Heuvel, Edwin R.

    Disease heterogeneity in patients with psychotic disorder may be explained by distinct profiles of premorbid adjustment. The current study explored premorbid adjustment profiles in patients with psychotic disorders, associations with cognitive and clinical characteristics after disease onset, and

  13. Risk factors associated with postpartum depression in the Saudi population

    Directory of Open Access Journals (Sweden)

    Alharbi AA

    2014-02-01

    Full Text Available Abeer A Alharbi,1 Hamza Mohammad Abdulghani2 1Department of Family and Community Medicine, 2Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia Introduction: Postpartum depression (PPD is one of the major psychological disorders worldwide that affects both mother and child. The aim of this study was to correlate the risk of PPD with obstetric and demographic variables in Saudi females. Materials and methods: Data were collected by interviewing females 8–12 weeks postpartum. PPD symptoms were defined as present when subjects had an Edinburgh Postnatal Depression Scale score of 10 or higher. Variables included in this study were age, education, occupation, parity, baby's sex, pregnancy period, delivery type, hemoglobin level, anemia, and iron pills taken during pregnancy. Results: Of the 352 postpartum females, the prevalence of PPD symptom risk was 117 (33.2%. Among the PPD symptomatic females, 66 (39.8% had low hemoglobin levels, and 45 (40.5% females were anemic during pregnancy (P≤0.05. These results suggest that early postpartum anemia, indicated by low hemoglobin level, is a significant risk factor for PPD (adjusted odds ratio 1.70, 95% confidence interval 1.05–2.74; P=0.03. Other variables, including age, parity, education, occupation, and delivery type, were not significantly correlated (P=0.15–0.95, but marginally indicative of the risk of depressive symptoms. Conclusion: Low hemoglobin level and anemia during pregnancy were risk factors for PPD in Saudi females. Many other factors may be considered risk factors, such as age, occupation, and parity. Anemic women need more attention and to be checked regarding their PPD, and treated if necessary. Keywords: postpartum depression, hemoglobin level, anemia, EPDS

  14. Risk factors of recurrent anal sphincter ruptures

    DEFF Research Database (Denmark)

    Jangö, Hanna; Langhoff-Roos, J; Rosthøj, Steen

    2012-01-01

    augmentation, epidural, episiotomy, vacuum extraction, forceps, shoulder dystocia, delivery interval and year of second delivery. Results  Out of 159 446 women, 7336 (4.6%) experienced an ASR at first delivery, and 521 (7.1%) had a recurrent ASR (OR 5.91). The risk factors of recurrent ASR in the multivariate...

  15. Risk factors for permanent hypernasality after adenoidectomy ...

    African Journals Online (AJOL)

    Risk factors for permanent hypernasality after adenoidectomy. ... Design. Retrospective and descriptive design. ... speech; and (iv) the hypernasality was rated as severe by a speech therapist, could not be remedied by speech therapy alone and required further management by a plastic surgeon through pharyngosplasty.

  16. Self-management of vascular risk factors

    NARCIS (Netherlands)

    Sol-de Rijk, B.G.M.

    2009-01-01

    Summary The aim of this thesis was to provide insight into the potential of a self-management approach in treatment of vascular risk factors and to develop a self-management intervention. Furthermore to examine if this intervention, based on self-efficacy promoting theory, is effective in reducing

  17. Major Risk Factors for Heart Disease: Diabetes

    Science.gov (United States)

    ... medicines as prescribed. Ask your doctor about taking aspirin. Ask others to help you manage your diabetes. "I wasn't aware of my risk factors, such as being diabetic and having a family history of heart problems." — Ann Preventing Diabetes If you ...

  18. Hypospadias: risk factor patterns and different phenotypes.

    NARCIS (Netherlands)

    Brouwers, M.M.; Zanden, L.F.M. van der; Gier, R.P.E. de; Barten, E.J.; Zielhuis, G.A.; Feitz, W.F.J.; Roeleveld, N.

    2010-01-01

    OBJECTIVE: To obtain more insight into the origin of hypospadias by exploring a wide range of potential risk factors in a case-referent study in which a distinction was made between different phenotypes. PATIENTS AND METHODS: Cases and referents were 305 boys with hypospadias and 629 boys with

  19. Risk factors for primary sclerosing cholangitis

    NARCIS (Netherlands)

    Boonstra, Kirsten; de Vries, Elisabeth M G; van Geloven, Nan; van Erpecum, Karel J.; Spanier, Marcel; Poen, Alexander C; van Nieuwkerk, Carin M; Witteman, Ben J; Tuynman, Hans A; Naber, Anton H; Kingma, Paul J; Beuers, Ulrich; Ponsioen, Cyriel Y

    BACKGROUND & AIMS: Primary sclerosing cholangitis (PSC) is a progressive cholestatic liver disease of unknown cause, but strongly associated with inflammatory bowel disease (IBD). Potential risk factors triggering PSC have never been studied on a population level. The aim of this study was to

  20. Chronic Renal Allograft Dysfunction: Risk Factors, Immunology

    African Journals Online (AJOL)

    associated with an increased risk of graft loss, but less is known regarding the severity of rejection [18]. Factors contributing to ongoing alloimmune responses include breakdown in immunosuppression as a result of patient non compliance, therapeutic decisions to minimize exposure to complications of immunosuppressive ...

  1. Macrosomia - maternal and fetal risk factors

    African Journals Online (AJOL)

    of the high perinatal mortality and morbidity rates, as well as maternal morbidity, are discussed. S Afr Med J 1995; 85: 43-46. Little attention has been paid to fetal macrosomia in black. African populations, despite the fact that as a high-risk factor in pregnancy and delivery macrosomia probably deserves as much attention as ...

  2. Depression: risk factor for cardiovascular disease

    NARCIS (Netherlands)

    Kuehl, L.K.; Penninx, B.W.J.H.; Otte, C.

    2012-01-01

    Major depression is an independent risk factor for the development of cardiovascular disease. In patients with existing cardiovascular disease, major depression has a large impact on the quality of life and is associated with a poor course and prognosis. Potential mechanisms responsible for this

  3. Nutritional risk factors for postmenopausal osteoporosis | Berriche ...

    African Journals Online (AJOL)

    Background: Osteoporosis is a bone disease that combines both a decrease in bone density and its internal architecture changes. Nutrition is one of the major determinants of osteoporosis. Aim: The purpose of our study was to identify nutritional risk factors of osteoporosis of two groups of osteoporotic women and ...

  4. Environmental Factors and Breast Cancer Risk

    Science.gov (United States)

    Breast Cancer Risk and Environmental Factors For millions of women whose lives have been affected by breast cancer, the 1994 discovery of the first breast ... gene by researchers from the National Institute of Environmental Health Sciences (NIEHS) and their collaborators, was a ...

  5. Risk Factors for Depression in Early Adolescence

    Science.gov (United States)

    MacPhee, Angela R.; Andrews, Jac J. W.

    2006-01-01

    The purpose of this study was to identify salient risk factors for depression in early adolescence from a group of common predictors. The following nine predictors were examined: (1) perceived quality of peer relationships, (2) perceived parental nurturance, (3) perceived parental rejection, (4) self-esteem, (5) body image, (6) pubertal status,…

  6. Adolescent Suicide Risk: Four Psychosocial Factors

    Science.gov (United States)

    Rutter, Philip A.; Behrendt, Andrew E.

    2004-01-01

    Suicide is a leading cause of death among adolescents. This study examined the suicidal ideation, behavior, and attempt history of 100 adolescents ages seventeen to nineteen. Four psychosocial factors were found to be important for overall suicide risk: hopelessness, hostility, negative self-concept, and isolation. It is suggested that focusing on…

  7. Exogenous risk factors for amyotrophic lateral sclerosis

    NARCIS (Netherlands)

    Huisman, M.H.B.

    2015-01-01

    The aims of this thesis were to determine the epidemiology of ALS in the Netherlands, to determine the familial aggregation of ALS with Parkinson disease (PD), dementia, and vascular diseases, and to determine the association between several environmental and lifestyle factors and risk for sporadic

  8. Lifestyle factors and risk of cardiovascular diseases

    NARCIS (Netherlands)

    Hoevenaar-Blom, M.P.

    2013-01-01

     Background Evidence is accumulating that lifestyle factors influence the incidence of fatal and non-fatal cardiovascular diseases (CVD). A healthy diet, being physically active, moderate alcohol consumption and not smoking are associated with a lower CVD risk. In addition to

  9. Risk factors for domestic violence in Curacao

    NARCIS (Netherlands)

    van Wijk, N.Ph.L.; de Bruijn, J.G.M.

    2012-01-01

    One out of three people (25% of men, 38% of women) in Curacao have experienced some form of domestic violence at some point in their adult lives. The most significant risk factors for domestic violence in Curacao are the female gender, a young age, low education, and experiencing domestic violence

  10. Risk Factors for Domestic Violence in Curacao

    Science.gov (United States)

    van Wijk, N. Ph. L.; de Bruijn, J. G. M.

    2012-01-01

    One out of three people (25% of men, 38% of women) in Curacao have experienced some form of domestic violence at some point in their adult lives. The most significant risk factors for domestic violence in Curacao are the female gender, a young age, low education, and experiencing domestic violence victimization in childhood. Divorce, single…

  11. 459 Preventing Cardiovascular Disease Risk Factors through ...

    African Journals Online (AJOL)

    FIRST LADY

    2011-01-18

    Jan 18, 2011 ... exercise there is the tendency for increased strength of the heart muscles. When this is the case, what follows is a ... Key words: Cardiovascular disease, Risk factor, Aerobic Exercise. Introduction. There has always ... Oftentimes, problems appear to be more prevalent among the elderly. This may not be far.

  12. Risk Factors of γ-Hydroxybutyrate Overdosing

    NARCIS (Netherlands)

    Korf, D.J.; Nabben, T.; Benschop, A.; Ribbink, K.; van Amsterdam, J.G.C.

    2013-01-01

    The aim of this study was to identify in recreational drug users the factors which increase the risk of overdosing (OD) with γ-hydroxybutyrate (GHB). A purposive sample of 45 experienced GHB users was interviewed, equally divided into three groups (never OD, occasional OD, and repeat OD). The repeat

  13. Risk Factors for Smoking Behaviors among Adolescents

    Science.gov (United States)

    Chung, Sung Suk; Joung, Kyoung Hwa

    2014-01-01

    Many students in Korea begin to use tobacco and develop a regular smoking habit before they reach adulthood. Yet, little is known about various signs contributing to the transition of the student smoking behaviors. This study used a national sample to explore and compare risk factors for smoking behaviors. Three types of smoking behaviors were…

  14. Is malnutrition a risk factor of stroke?

    Science.gov (United States)

    Habib, M A; Dey, S K; Alam, M R; Bhuiyan, M; Bhuiyan, S I; Khatun, M H; Rizvi, A N; Haque, A

    2015-04-01

    Obesity is an established risk factor of stroke. Malnutrition in post-stroke period is common and can influence outcome. But malnutrition, though predicted, has not yet been established as a risk factor of stroke. This descriptive study was carried out in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Department of Neurology, Dhaka Medical College (DMC), from January 2009 to December 2010 to explore whether malnutrition is an independent risk factor of stroke. Nutritional status of 100 stroke patients and 100 healthy controls were assessed in this study. Anthropometric measurements including Body Mass Index (BMI), Triceps skin fold (TSF), Mid-arm circumference (MAC) and Arm-muscle circumference (AMC) were measured within 7 days of stroke. Haemoglobin and haematocrit percentage, serum iron and serum albumin were measured at the same time. No significant difference was observed regarding TSF thickness, MAC, AMC, mean Hb and mean albumin level between the stroke patients and the control group, although iron level was significantly lower in stroke group. Multiple logistic regressions analysis showed that increase in age, smoking and decreased serum iron level has a positive association with stroke. Malnutrition is, according to this study, not a significant risk factor of stroke and triceps skin fold (TSF) thickness, mid-arm circumference (MAC), arm-muscle circumference (AMC), hemoglobin and serum albumin are not appropriate predictor of stroke.

  15. Risk Factors and Prodromal Eating Pathology

    Science.gov (United States)

    Stice, Eric; Ng, Janet; Shaw, Heather

    2010-01-01

    Prospective studies have identified factors that increase risk for eating pathology onset, including perceived pressure for thinness, thin-ideal internalization, body dissatisfaction, dietary restraint, and negative affect. Research also suggests that body dissatisfaction and dietary restraint may constitute prodromal stages of the development of…

  16. Risk factors for hypospadias in China

    Science.gov (United States)

    Xu, Ling-Fan; Liang, Chao-Zhao; Lipianskaya, Julia; Chen, Xian-Guo; Fan, Song; Zhang, Li; Zhou, Jun; Tai, Sheng; Jiang, Chang-Qin

    2014-01-01

    This case-controlled study was designed to evaluate the association between various baseline parental factors and the risk of hypospadias in China. Patients were selected from tertiary referral hospitals in Anhui, a province in mid-eastern China. A questionnaire was given to the parents of each patient. The final database included 193 cases and 835 controls. The incidence of additional coexistent anomalies was 13.0%, primarily cryptorchidism (9.8%). Ten patients (5.1%) were from families with genital anomaly, including five families (2.6%) with hypospadias. The risks of hypospadias was higher for children of mothers > 35 (odds ratio [OR] =1.47) and hypospadias was also higher when mothers (OR = 1.68) and fathers (OR = 1.74) were engaged in agriculture. Other factors assessed were not associated with the risk of hypospadias. PMID:24875823

  17. Identification of risk aversion factor for radiation workers in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Fadul, Abdulbagi [KAIST, Daejeon (Korea, Republic of); Na, Seong H. [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2016-10-15

    Radiation aversion factor reflects the degree of avoidance of radiation exposure which is considered a fundamental element in the optimization of radiation protection and a key factor in determining the real monetary value of the man-Sievert (Sv). This study provides an adjusted risk aversion factor, which was prescribed by the Korea Institute for Nuclear Safety (KINS), a regulatory body in Korea. Specifically, the Korea Hydro and Nuclear Power Co., Ltd. (KHNP) evaluated the monetary value of the man-Sv for Korean Nuclear Power Plants (NPPs) workers. This monetary value was assessed by the radiation aversion factor. Consequently, identifying the monetary value of the man-Sv in this study will enhance not only the effectiveness of optimization of radiation protection in Korea but also contribute to reduce doses to As Low As Reasonably Achievable (ALARA) when accounting for economic and societal aspects. The primary purpose of this study is to obtain the risk aversion factor for radiation workers in medical and industrial facilities in Korea. The secondary purpose is to evaluate the real monetary value of the man-Sv.These objectives will be accomplished by collecting data from surveys that consider a variety of socio-economic conditions. The value of 1.45 represents considerable avoidance of radiation risk for the majority of NDT radiographers due to familiarity and work experience with radiation hazards. On the other hand, the value 1.57 indicates that most of radiation medical practitioners, in particular, interventional radiologists have a strong will to avoid radiation risk. However, they will accept more risk with incremental salary increases. For international comparison, the concept of Purchasing Power Parity (PPP) should be adopted to obtain the alpha values in real term. Certainly, this monetary value of the man-Sv is expected to contribute effectively in optimization of radiation protection in both medical and industrial fields. The findings of this study

  18. Patterns of multisite pain and associations with risk factors

    Science.gov (United States)

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

    2013-01-01

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

  19. Risk factors for bacterial vaginosis in pregnancy: a population-based study on Danish women

    DEFF Research Database (Denmark)

    Thorsen, Poul; Vogel, Ida; Molsted, Kirsten

    2006-01-01

    , and sociodemographic factors) were computed. Results. At enrolment, bacterial vaginosis was diagnosed in 13.7% of Danish pregnant women. Significant risk factors for bacterial vaginosis were: daily coitus (adjusted relative risk 2.09 [1.43-3.04]), being single (1.76 [1.21-2.56]), smoking more than 10 cigarettes daily......, with a previous sexually transmitted disease, or with high alcohol consumption in pregnancy are at increased risk for bacterial vaginosis. Information on these risk factors may be important when planning preventive and treatment strategies of bacterial vaginosis in pregnancy....

  20. Risk Factors for Pancreatic Cancer in China: A Multicenter Case-Control Study.

    Science.gov (United States)

    Zheng, Zhaoxu; Zheng, Rongshou; He, Yutong; Sun, Xibin; Wang, Ning; Chen, Tianhui; Chen, Wanqing

    2016-01-01

    Despite having one of the highest mortality rates of all cancers, the risk factors of pancreatic cancer remain unclear. We assessed risk factors of pancreatic cancer in China. A case-control study design was conducted using data from four hospital-based cancer registries (Henan Provincial Cancer Hospital, Beijing Cancer Hospital, Hebei Provincial Cancer Hospital, and Cancer Hospital of Chinese Academy of Medical Sciences). Controls were equally matched and selected from family members of non-pancreatic cancer patients in the same hospitals. Face-to-face interviews were conducted by trained staff using questionnaires. Conditional logistic regression models were used to assess odd ratios (ORs) and 95% confident intervals (CIs). Among 646 recruited participants, 323 were pancreatic cancer patients and 323 were controls. Multivariate logistic analysis suggested that pancreatic cancer family history (adjusted OR 1.23; 95% CI, 1.11-3.70), obesity (adjusted OR 1.77; 95% CI, 1.22-2.57), diabetes (adjusted OR 2.96; 95% CI, 1.48-5.92) and smoking (adjusted OR 1.78; 95% CI, 1.02-3.10) were risk factors for pancreatic cancer, but that drinking tea (adjusted OR 0.49; 95% CI, 0.25-0.84) was associated with reduced risk of pancreatic cancer. Cigarette smoking, family history, obesity, and diabetes are risk factors of pancreatic cancer, which is important information for designing early intervention and preventive strategies for pancreatic cancer and may be beneficial to pancreatic cancer control in China.

  1. Chronic disease risk factors among hotel workers.

    Science.gov (United States)

    Gawde, Nilesh Chandrakant; Kurlikar, Prashika R

    2016-01-01

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

  2. Risk factors associated with lambing traits.

    Science.gov (United States)

    McHugh, N; Berry, D P; Pabiou, T

    2016-01-01

    The objective of this study was to establish the risk factors associated with both lambing difficulty and lamb mortality in the Irish sheep multibreed population. A total of 135 470 lambing events from 42 675 ewes in 839 Irish crossbred and purebred flocks were available. Risk factors associated with producer-scored ewe lambing difficulty score (scale of one (no difficulty) to four (severe difficulty)) were determined using linear mixed models. Risk factors associated with the logit of the probability of lamb mortality at birth (i.e. binary trait) were determined using generalised estimating equations. For each dependent variable, a series of simple regression models were developed as well as a multiple regression model. In the simple regression models, greater lambing difficulty was associated with quadruplet bearing, younger ewes, of terminal breed origin, lambing in February; for example, first parity ewes experienced greater (P7.0 kg) birth weights, quadruplet born lambs and lambs that experienced a more difficult lambing (predicted probability of death for lambs that required severe and veterinary assistance of 0.15 and 0.32, respectively); lambs from dual-purpose breeds and born to younger ewes were also at greater risk of mortality. In the multiple regression model, the association between ewe parity, age at first lambing, year of lambing and lamb mortality no longer persisted. The trend in solutions of the levels of each fixed effect that remained associated with lamb mortality in the multiple regression model, did not differ from the trends observed in the simple regression models although the differential in relative risk between the different lambing difficulty scores was greater in the multiple regression model. Results from this study show that many common flock- and animal-level factors are associated with both lambing difficulty and lamb mortality and management of different risk category groups (e.g. scanned litter sizes, ewe age groups) can be used

  3. Postpartum venous thromboembolism: incidence and risk factors.

    Science.gov (United States)

    Tepper, Naomi K; Boulet, Sheree L; Whiteman, Maura K; Monsour, Michael; Marchbanks, Polly A; Hooper, W Craig; Curtis, Kathryn M

    2014-05-01

    To calculate incidence of postpartum venous thromboembolism by week after delivery and to examine potential risk factors for venous thromboembolism overall and at different times during the postpartum period. A deidentified health care claims information database from employers, health plans, hospitals, and Medicaid programs across the United States was used to identify delivery hospitalizations among women aged 15-44 years during the years 2005-2011. International Classification of Diseases, 9th Revision, Clinical Modification diagnosis and procedure codes were used to identify instances of venous thromboembolism and associated characteristics and conditions among women with recent delivery. Incidence proportions of venous thromboembolism by week postpartum through week 12 were calculated per 10,000 deliveries. Logistic regression was used to calculate odds ratios for selected risk factors among women with postpartum venous thromboembolism and among women with venous thromboembolism during the early or later postpartum periods. The incidence proportion of postpartum venous thromboembolism was highest during the first 3 weeks after delivery, dropping from nine per 10,000 during the first week to one per 10,000 at 4 weeks after delivery and decreasing steadily through the 12th week. Certain obstetric procedures and complications such as cesarean delivery, preeclampsia, hemorrhage, and postpartum infection conferred an increased risk for venous thromboembolism (odds ratios ranging from 1.3 to 6.4), which persisted over the 12-week period compared with women without these risk factors. Risk for postpartum venous thromboembolism is highest during the first 3 weeks after delivery. Women with obstetric complications are at highest risk for postpartum venous thromboembolism, and this risk remains elevated throughout the first 12 weeks after delivery. II.

  4. Risk factors of preseptal and orbital cellulitis.

    Science.gov (United States)

    Babar, Tariq Farooq; Zaman, Mir; Khan, Mohammad Naeem; Khan, Mohammad Daud

    2009-01-01

    To estimate the frequency and major risk factors of preseptal and orbital cellulitis. A cross-sectional analytical study. The Khyber Institute of Ophthalmic Medical Sciences, Hayatabad Medical Complex, Peshawar from July 2003 to December 2006. All consecutive patients between ages 6 and 40 years, admitted to the institute with the diagnosis of preseptal and orbital cellulitis were included in the study. The patients were divided into two groups. Group I included patients with ages 6-16 years and group II with ages 17-40 years. The clinical features, diagnosis and risk factors were entered on a specially-designed proforma. The risk factors included were trauma, insect bite, localized or systemic infection and postsurgical. Odd ratio and p-values were calculated for potential risk factors. The frequency of orbital cellulitis was 0.1% of total admission. Out of 26 patients, 42.30% patients were in group I and 57 in group II. In group I, insect bite was the most common risk factor identified in 40% of patients with preseptal cellulitis and trauma as a common cause in 50% with orbital cellulitis. In group II, trauma was the leading cause in 50% of patients with preseptal cellulitis and sinusitis as a common cause in 18.1% with those of orbital cellulitis. In both groups the p-values were found insignificant (p>0.5). Complications included cicatricial ectropion in 44.4% and orbital abscess in 41.1%. For preseptal cellulitis, insect bite was the most common cause in group I and trauma was the leading cause in group II. For orbital cellulitis, trauma was important cause in group I and sinusitis in group II.

  5. Risk factors for voice problems in teachers.

    Science.gov (United States)

    Kooijman, P G C; de Jong, F I C R S; Thomas, G; Huinck, W; Donders, R; Graamans, K; Schutte, H K

    2006-01-01

    In order to identify factors that are associated with voice problems and voice-related absenteeism in teachers, 1,878 questionnaires were analysed. The questionnaires inquired about personal data, voice complaints, voice-related absenteeism from work and conditions that may lead to voice complaints and absenteeism. Different factors play a role in the development and consolidation of voice problems. Physical and psycho-emotional factors appear to be the most important risk factors. Remarkably, voice load and environment seem to be less important as risk factors in the development and consolidation of voice complaints. Teachers who experienced voice problems during their training reported more voice problems during their career. The results of this study stress the importance of a multifactorial approach in the diagnosis and treatment of voice problems, whereby physical and psycho-emotional aspects should be considered as sensitive to the risk of developing voice problems. Moreover, this study shows the crucial importance of adequate voice training during the teacher training programme.

  6. Risk factors of coercion among psychiatric inpatients

    DEFF Research Database (Denmark)

    Thomsen, Christoffer; Starkopf, Liis; Hastrup, Lene Halling

    2017-01-01

    PURPOSE: Reducing the use of coercion among patients with mental disorders has long been a political priority. However, risk factors for coercive measures have primarily been investigated in smaller studies. To reduce the use of coercion, it is crucial to identify people at risk which we aim to do...... measure (21.9%). Clinical characteristics were the foremost predictors of coercion and patients with organic mental disorder had the highest increased risk of being subjected to a coercive measure (OR = 5.56; 95% CI = 5.04, 6.14). The risk of coercion was the highest in the first admission and decreased...... with the number of admissions (all p income countries (all p 

  7. Risk Factors for Norovirus Gastroenteritis among Nicaraguan Children.

    Science.gov (United States)

    Gruber, Joann F; Bowman, Natalie M; Becker-Dreps, Sylvia; Reyes, Yaoska; Belson, Connor; Michaels, Kenan C; Bucardo, Filemon

    2017-09-01

    Norovirus is a leading cause of pediatric gastroenteritis. Understanding norovirus epidemiology is essential for reducing disease burden. We conducted a case-control study to describe the distribution, clinical features, and risk factors of norovirus gastroenteritis among children norovirus and controls were children living in the cases' communities. Study staff interviewed mothers of enrolled cases and controls to obtain detailed exposure information including food, water, and sanitation sources; recent exposures; household characteristics; and handwashing practices. In addition, study staff requested stool samples to be tested for norovirus from select household members. We used descriptive statistics to understand the epidemiologic and clinical features of gastroenteritis episodes. To analyze potential risk factors, we used Firth's penalized logistic regression to estimate crude and adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs). There were 102 children with gastroenteritis, 18 cases of norovirus and 31 controls. Norovirus cases occurred later in the year, corresponding to a delay in the rainy season. Cases were more likely to have a household member with norovirus in their stool as compared with controls [crude OR: 13.3 (95% CI: 2.5, 136.2) and adjusted OR: 11.5 (95% CI: 1.6, 223.2)]. In addition, alcohol-based hand sanitizer use among household members was reported for 10 (32%) of controls and but never for cases. Further research is needed to understand household transmission of norovirus in low- and middle-income countries and the potential impact of hand sanitizer use.

  8. Process monitoring in intensive care with the use of cumulative expected minus observed mortality and risk-adjusted P charts.

    Science.gov (United States)

    Cockings, Jerome G L; Cook, David A; Iqbal, Rehana K

    2006-02-01

    A health care system is a complex adaptive system. The effect of a single intervention, incorporated into a complex clinical environment, may be different from that expected. A national database such as the Intensive Care National Audit & Research Centre (ICNARC) Case Mix Programme in the UK represents a centralised monitoring, surveillance and reporting system for retrospective quality and comparative audit. This can be supplemented with real-time process monitoring at a local level for continuous process improvement, allowing early detection of the impact of both unplanned and deliberately imposed changes in the clinical environment. Demographic and UK Acute Physiology and Chronic Health Evaluation II (APACHE II) data were prospectively collected on all patients admitted to a UK regional hospital between 1 January 2003 and 30 June 2004 in accordance with the ICNARC Case Mix Programme. We present a cumulative expected minus observed (E-O) plot and the risk-adjusted p chart as methods of continuous process monitoring. We describe the construction and interpretation of these charts and show how they can be used to detect planned or unplanned organisational process changes affecting mortality outcomes. Five hundred and eighty-nine adult patients were included. The overall death rate was 0.78 of predicted. Calibration showed excess survival in ranges above 30% risk of death. The E-O plot confirmed a survival above that predicted. Small transient variations were seen in the slope that could represent random effects, or real but transient changes in the quality of care. The risk-adjusted p chart showed several observations below the 2 SD control limits of the expected mortality rate. These plots provide rapid analysis of risk-adjusted performance suitable for local application and interpretation. The E-O chart provided rapid easily visible feedback of changes in risk-adjusted mortality, while the risk-adjusted p chart allowed statistical evaluation. Local analysis of

  9. Student-Teacher Relationships As a Protective Factor for School Adjustment during the Transition from Middle to High School.

    Science.gov (United States)

    Longobardi, Claudio; Prino, Laura E; Marengo, Davide; Settanni, Michele

    2016-01-01

    A robust body of research has identified school transitions during adolescence, and in particular the transition from middle to high school, as one of the riskiest phases for school failure, being characterized by significant social, emotional and behavioral changes. This transition is critical even with respect to academic achievement: in Italy, the highest frequency of school dropout can be observed in the 9th and 10th grades, partly as a consequence of poor adjustment to the new school context. The impact of students' relationships with their teachers may be particularly relevant during critical developmental periods. Indeed, student-teacher relationships have been widely recognized as protective factors in school adjustment and, in case of negative relationships, also as a factor that increases the risk of maladjustment. Positive and affective student-teacher relationships may play an important role in students' adaptation to the school environment, favoring both academic achievement and adaptive behaviors. The aim of this study was to investigate the effects of the quality of teacher-student relationships, as perceived by pupils, on academic achievement, and problem and prosocial behaviors during the relevant school transition. The sample consisted of 122 students (55% female). We employed a self-report questionnaire to collect information on: demographic characteristics, quality of the relationship with teachers, problem and prosocial behaviors, and academic achievement. Students filled in the questionnaires twice: once during the 8th grade and 1 year later, during their first year of high school (9th grade). Regression analyses indicated that both average and varying levels of closeness with teachers significantly predicted changes in academic achievement: A perceived increase in closeness in 9th grade, as well as a higher mean closeness level, was associated with an increase in academic achievement. In turn, an increase in the level of perceived conflict

  10. Student-Teacher Relationships As a Protective Factor for School Adjustment during the Transition from Middle to High School

    Science.gov (United States)

    Longobardi, Claudio; Prino, Laura E.; Marengo, Davide; Settanni, Michele

    2016-01-01

    A robust body of research has identified school transitions during adolescence, and in particular the transition from middle to high school, as one of the riskiest phases for school failure, being characterized by significant social, emotional and behavioral changes. This transition is critical even with respect to academic achievement: in Italy, the highest frequency of school dropout can be observed in the 9th and 10th grades, partly as a consequence of poor adjustment to the new school context. The impact of students' relationships with their teachers may be particularly relevant during critical developmental periods. Indeed, student-teacher relationships have been widely recognized as protective factors in school adjustment and, in case of negative relationships, also as a factor that increases the risk of maladjustment. Positive and affective student-teacher relationships may play an important role in students' adaptation to the school environment, favoring both academic achievement and adaptive behaviors. The aim of this study was to investigate the effects of the quality of teacher-student relationships, as perceived by pupils, on academic achievement, and problem and prosocial behaviors during the relevant school transition. The sample consisted of 122 students (55% female). We employed a self-report questionnaire to collect information on: demographic characteristics, quality of the relationship with teachers, problem and prosocial behaviors, and academic achievement. Students filled in the questionnaires twice: once during the 8th grade and 1 year later, during their first year of high school (9th grade). Regression analyses indicated that both average and varying levels of closeness with teachers significantly predicted changes in academic achievement: A perceived increase in closeness in 9th grade, as well as a higher mean closeness level, was associated with an increase in academic achievement. In turn, an increase in the level of perceived conflict

  11. Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults.

    Science.gov (United States)

    Ludwig, D S; Pereira, M A; Kroenke, C H; Hilner, J E; Van Horn, L; Slattery, M L; Jacobs, D R

    1999-10-27

    Dietary composition may affect insulin secretion, and high insulin levels, in turn, may increase the risk for cardiovascular disease (CVD). To examine the role of fiber consumption and its association with insulin levels, weight gain, and other CVD risk factors compared with other major dietary components. The Coronary Artery Risk Development in Young Adults (CARDIA) Study, a multicenter population-based cohort study of the change in CVD risk factors over 10 years (1985-1986 to 1995-1996) in Birmingham, Ala; Chicago, III; Minneapolis, Minn; and Oakland, Calif. A total of 2909 healthy black and white adults, 18 to 30 years of age at enrollment. Body weight, insulin levels, and other CVD risk factors at year 10, adjusted for baseline values. After adjustment for potential confounding factors, dietary fiber showed linear associations from lowest to highest quintiles of intake with the following: body weight (whites: 174.8-166.7 lb [78.3-75.0 kg], PFiber was also associated with blood pressure and levels of triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and fibrinogen; these associations were substantially attenuated by adjustment for fasting insulin level. In comparison with fiber, intake of fat, carbohydrate, and protein had inconsistent or weak associations with all CVD risk factors. Fiber consumption predicted insulin levels, weight gain, and other CVD risk factors more strongly than did total or saturated fat consumption. High-fiber diets may protect against obesity and CVD by lowering insulin levels.

  12. Risk factors and their identification. First Part: What is a risk factor?

    Science.gov (United States)

    Balkau, B; Eschwege, E

    1995-02-01

    This series of three articles reviews the designs of studies which can be used to identify risk factors of a disease, here: diabetes or complications of diabetes. In the present issue of Diabete & Metabolisme, the first article of the series, we give the definition of a risk factor, along with measures of its force--relative risk and odds ratio, followed by the epidemiological definitions of the diseases: diabetes, coronary heart disease and hypertension. Risk factors are further discussed and we complete the discussion by some observations on the bias which can arise from a study or from its analysis, which can lead the researcher to the wrong conclusion. The three types of epidemiological studies which are used to determine whether factors are associated with a disease: observational or cross-sectional studies, cohort studies and case-cohort studies will be described in the second of the series in the next issue of the journal. Examples will be provided of each of these study types; their advantages and disadvantages will be discussed. In a third issue, the final paper will provide some examples of the study types and the identification of risk factors. The first examples involve diabetes and pancreatic cancer, the second birth weight and non-insulin dependent diabetes. Having found an association between a risk factor and diabetes, then we will discuss whether it can be considered to be a risk factor and if so and whether it is likely to be a cause of the disease.

  13. Risk factors and their identification second part: study designs for identification of risk factors.

    Science.gov (United States)

    Balkau, B; Eschwege, E

    1995-06-01

    This is the second a series of three articles which reviews the identification of risk factors of a disease, here: diabetes or complications of diabetes. In the first of the series [1], we gave the definition of a risk factor, along with measures of its force-relative risk and odds ratio, followed by the epidemiological definitions of the diseases: diabetes, coronary heart disease and hypertension. Risk factors were further discussed and we completed the discussion by some observations on the bias which can arise from a study or from its analysis, which can lead the researcher to the wrong conclusion. In this second article we define the three types of epidemiological studies which are used to determine whether factors are associated with a disease: observational or cross-sectional studies, cohort studies and casecohort studies. Examples are provided of each of these study types; their advantages and disadvantages are discussed. The final paper will provide some examples of the identification of risk factors from the literature. The first example involves diabetes and pancreatic cancer, the second birth weight and non-insulin dependent diabetes. Having found an association between a risk factor and diabetes, we will discuss whether it can be considered to be a risk factor, and if so whether it is likely to be a cause of the disease.

  14. [Cigarette smoking initiation among Tunisian adolescents: Risk and protective factors].

    Science.gov (United States)

    Fakhfakh, R; Jaidane, I; Hsairi, M; Ben Hamida, A M

    2015-12-01

    Since smoking is a major public health problem among Tunisian teenagers, it is important to identify the underlying risk and protective factors associated with initiation of this behavior. A cross-sectional, school-based survey of students was conducted by the Tunisian Ministry of Health among a nationally representative sample of 4172 adolescents aged between 12 and 20 years attending public, private, and professional secondary schools across Tunisia who participated in the Survey of the Health of Tunisian adolescents in 2000. For data analysis, we first calculated crude odds ratios (OR) followed by calculating adjusted OR after using multivariate logistic regression models. Almost one-third of respondents had already started smoking at an average age of 13 years, 6.4% among them smoked daily. Demographic vulnerabilities to smoking behavior were gender (boys more than girls), age and residence in urban areas and particularly in Greater Tunis and the North East. Familial and school factors were parental divorce, poor relationship with parents, poor integration into the peer group, and poor school investment. Psychological and behavioral factors were low self-esteem level and the occurrence of stressful life events, risk taking and alcohol consumption when there was no association with the depression, anxiety and body image. Protective factors against the experimental cigarettes were mainly sports and reading. There are many factors associated with smoking behavior among adolescents. All of these predictors need to be considered in smoking prevention among Tunisian teenagers. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. Joint effect of modifying selected risk factors on attributable burden of Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Fatemeh Khosravi Shadmani

    2013-01-01

    Full Text Available Background: There are few published studies that consider the joint effect of multiple risk factors on avoidable burden of cardiovascular diseases (CVDs. This study aimed to estimate the joint effect of avoidable burden of multiple risk factors to CVDs. Methods : Estimates of avoidable burden to CVDs were made using potential impact fraction (PIF. In order to calculate PIF, data on the Prevalence of the risk factors include diabetes, hypertension, central obesity, and hypercholesterolemia were obtained from 3 rd national Surveillance of Risk Factors of Non-Communicable Diseases-2007 in Iran and data on corresponding measures of effect were derived from a cohort study with multivariate adjusted hazard ratios. Then, joint effect of risk factors was calculated. Results : About 37% (95% uncertainty interval: 21.7-50.2 of attributable disability adjusted life years (DALYs to CVDs in adult males and 59.4% (95% uncertainty interval: 30-76 in adult females due to selected risk factors are avoidable in theoretical minimum risk levels. After changing the current prevalence of these risk factors to the plausible minimum risk levels, 17.8% (95% uncertainty interval: 10.1-25.1 of CVDs′ attributable DALYs among adult males and 34% (95% uncertainty interval: 20-46.7 in adult females can be avoided. Conclusions : To better priority setting as well as reporting the magnitude of avoidable DALYs rather than the percentage of avoidable burden, PIF should be applied to updated and revised burden of CVDs.

  16. Prevalence of health risk factors among fishermen

    DEFF Research Database (Denmark)

    Frantzeskou, Elpida; Jensen, Olaf; Linos, Athena

    2014-01-01

    Background Studies have shown that fishermen have a higher mortality from cardiovascular diseases, cancer and accidents. The majority of cardiovascular disease is caused by external risk factors such as the diet, tobacco, alcohol and lack of physical activity. The purpose of this paper was to rev......Background Studies have shown that fishermen have a higher mortality from cardiovascular diseases, cancer and accidents. The majority of cardiovascular disease is caused by external risk factors such as the diet, tobacco, alcohol and lack of physical activity. The purpose of this paper...... the Scottish, the Greek and the Turkish fishermen respectively. For the diet, 23% of the Scottish fishermen reported eating fruit and vegetables more than once a day at sea and only 29% at home. The Spanish study reported “excessive calorie consumption while on shore, notably high in animal fats....... Of the Danish fishermen 25%-, 34% and 37% were obese in the 18-24, 25-44 and 45-64 years age groups. Conclusion Health risk factors among fishermen need to be highlighted and further investigated as they represent occupational risks of major impact to chronic diseases prevalence with projections to quality...

  17. Risk factors for age-related maculopathy.

    LENUS (Irish Health Repository)

    Connell, Paul P

    2012-02-01

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

  18. Risk Factors for Age-Related Maculopathy

    Directory of Open Access Journals (Sweden)

    Paul P. Connell

    2009-01-01

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

  19. Risk factors for suicidal behavior in adolescents.

    Science.gov (United States)

    Kirkcaldy, B D; Siefen, G R; Urkin, J; Merrick, J

    2006-10-01

    Adolescent suicide is today a public health problem among the leading cause of mortality among adolescents and young adults. There seems to be many reasons for this increase (which has different trends in different populations), but associations have been found with increased substance abuse, television and video violence, socio-economic status and easy access to firearms. Gender differences have also been observed with crime, suicide and substance abuse higher among males, while eating disorder, depression and suicidal behavior more prevalent among females. This paper will review prevalence and incidence of adolescent suicidal behavior, socio-demographic and psychological risk factors, associated cognitive factors and socio-economic factors. Risk factors include previous suicide attempts, a history of others in the family who have been suicidal, mental illness, alcohol and drug use, and other self-destructive behaviors as well as consideration being given to hopelessness, hostility, negative self-concept and isolation. At the individual difference level, factors such as trait depression, anger and hostility, perfectionism and social sensitivity would seem critical variables, as would age, gender and intellectual functioning. Sociological and family-related factors may also be implicated including dysfunctional family organizations, a history of physical or psychological abuse (sexual abuse) and limited extent of social support networks. A frequently reported precipitating event of suicidal behavior is family adversity including rejection, separation and interpersonal conflict. At a socio-economic level it would seem essential to provide comprehensive document about the social and economic conditions from which the adolescent comes.

  20. Risk factors for infant mortality in rural and urban Nigeria: evidence from the national household survey.

    Science.gov (United States)

    Adewuyi, Emmanuel Olorunleke; Zhao, Yun; Lamichhane, Reeta

    2017-07-01

    This study investigates the rural-urban differences in infant mortality rates (IMRs) and the associated risk factors in Nigeria. The dataset from the 2013 Nigeria demographic and health survey (NDHS), disaggregated by rural-urban residence, was analyzed using complex samples statistics. A multivariable logistic regression analysis was computed to explore the adjusted relationship and identify risk factors for infant mortality. In rural and urban Nigeria, IMRs were 70 and 49 deaths per 1000 live births, respectively. Risk factors in rural residence were past maternal marital union (adjusted odds ratio (AOR): 1.625, p = 0.020), small birth size (AOR: 1.550, p Infants in rural residence had higher rates of mortality than their urban counterparts and disparities in risk factors exist between the residences.

  1. Obesity, diabetes, and associated risk factors.

    Science.gov (United States)

    AlJaroudi, Wael A; Petersen, John L

    2006-02-01

    The prevalence of obesity has increased in the past 10 years. Recent studies have associated obesity with other cardiovascular risk factors, and an increased risk of diabetes and cardiovascular death. Patients with obesity should undergo a global evaluation cardiovascular risk, including measurement of abdominal waist circumference, assessment of standard cardiovascular risk factors, screening for dyslipidemia, abnormal glucose metabolism, and hypertension. Recommendations for dietary modification should be tailored to the patient's associated medical conditions, such as diabetes, dyslipidemia, and hypertension, and all patients should be instructed on the importance of monitoring caloric intake. For patients who can engage in regular physical activity, we recommend a minimum regimen of 150 min/wk of moderate intensity exercise, such as brisk walking. Use of pharmacotherapy for obesity can be considered when efforts at therapeutic lifestyle modification have been ineffective, but patients must be carefully screened because many agents have potential side effects. Surgical approaches for obesity have also been demonstrated to be effective in achieving and sustaining weight loss and improving markers of cardiovascular risk and should be considered in patients who are refractory to therapeutic lifestyle modification. All diabetic patients should be treated comprehensively to reduce other comorbid conditions, including hypertension and dyslipidemia. Hypoglycemic therapy should be initiated when efforts to reduce hyperglycemia to target thresholds fail.

  2. Risk factors for statin-associated rhabdomyolysis.

    Science.gov (United States)

    Schech, Stephanie; Graham, David; Staffa, Judy; Andrade, Susan E; La Grenade, Lois; Burgess, Margaret; Blough, David; Stergachis, Andy; Chan, K Arnold; Platt, Richard; Shatin, Deborah

    2007-03-01

    To identify and characterize risk factors for rhabdomyolysis in patients prescribed statin monotherapy or statin plus fibrate therapy. A nested case-control study was conducted within a cohort of 252,460 new users of lipid-lowering medications across 11 geographically dispersed U.S. health plans. Twenty-one cases of rhabdomyolysis confirmed by medical record review were compared to 200 individually matched controls without rhabdomyolysis. A conditional logistic regression model was applied to evaluate the effects of age, gender, comorbidities, concurrent medication use, dosage, and duration of statin use on the development of rhabdomyolysis. Statin users 65 years of age and older have four times the risk of hospitalization for rhabdomyolysis than those under age 65 (odds ratio (OR) = 4.36, 95% confidence interval (CI): 1.5,14.1). We also observed a joint effect of high statin dosage and renal disease (p = 0.022). When these two variables were added to the model with age, we obtained an OR of 5.73 for dosage (95%CI: 0.63, 52.6) and 6.26 for renal disease (95%CI: 0.46, 63.38). Although not statistically significant, we did observe a greater than twofold increase in risk for rhabdomyolysis among females (OR = 2.53, 95%CI: 0.91, 7.32). Findings of this study indicate that older age is a risk factor for rhabdomyolysis among statin users. Although the evidence is not as strong, high statin dosage, renal disease, and female gender may be additional risk factors. Patients at higher risk of developing rhabdomyolysis should be closely monitored for signs and symptoms of the disease. (c) 2006 John Wiley & Sons, Ltd.

  3. Psychosocial risk factors for coronary heart disease.

    Science.gov (United States)

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

    2013-08-05

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

  4. Emotional Reactivity, Behavior Problems, and Social Adjustment at School Entry in a High-risk Sample.

    Science.gov (United States)

    Kalvin, Carla B; Bierman, Karen L; Gatzke-Kopp, Lisa M

    2016-11-01

    Prior research suggests that heightened emotional reactivity to emotionally distressing stimuli may be associated with elevated internalizing and externalizing behaviors, and contribute to impaired social functioning. These links were explored in a sample of 169 economically-disadvantaged kindergarteners (66 % male; 68 % African American, 22 % Hispanic, 10 % Caucasian) oversampled for elevated aggression. Physiological measures of emotional reactivity (respiratory sinus arrhythmia [RSA], heart rate [HR], and cardiac pre-ejection period [PEP]) were collected, and teachers and peers provided ratings of externalizing and internalizing behavior, prosocial competence, and peer rejection. RSA withdrawal, HR reactivity, and PEP shortening (indicating increased arousal) were correlated with reduced prosocial competence, and RSA withdrawal and HR reactivity were correlated with elevated internalizing problems. HR reactivity was also correlated with elevated externalizing problems and peer rejection. Linear regressions controlling for age, sex, race, verbal proficiency, and resting physiology showed that HR reactivity explained unique variance in both teacher-rated prosocial competence and peer rejection, and contributed indirectly to these outcomes through pathways mediated by internalizing and externalizing problems. A trend also emerged for the unique contribution of PEP reactivity to peer-rated prosocial competence. These findings support the contribution of emotional reactivity to behavior problems and social adjustment among children living in disadvantaged urban contexts, and further suggest that elevated reactivity may confer risk for social difficulties in ways that overlap only partially with internalizing and externalizing behavior problems.

  5. Risk factors in child sexual abuse.

    Science.gov (United States)

    Davies, Eryl A; Jones, Alyson C

    2013-04-01

    To quantify the incidence of child sexual abuse allegations referred to a forensic examination centre; to identify possible risk factors predisposing children to sexual abuse by measuring their prevalence among the complainant population. The records of children involved in sexual abuse allegations presenting over a 12 month period were reviewed retrospectively. Demographic data such as nature of case, sex, ethnicity, number of previous allegations, assailant relationship, month of presentation, and age were compiled. Potential risk factors such as alcohol or drug use, being 'looked after', physical disability, learning disability, previous consensual sexual intercourse, past psychiatric history, and history of psychiatric support were compiled. Descriptive statistics were calculated. 138 cases were recorded, of which the majority were acute. Epidemiological data demonstrated a higher incidence in females and most complainants were of White British origin. Most of the cases were of first allegations and the assailant relationship was most frequently an acquaintance. The incidence was highest in January. The modal age was 15 years and age distribution was positively skewed. Of the potential risk factors studied, alcohol and drug use was the most prevalent. Prevalence increased with age for the majority of factors studied. Alcohol and drug use may be an area in which preventative strategies would be beneficial. Ethnic minorities may hold a large amount of unreported cases. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  6. Breast cancer epidemiology and risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Broeders, M. J. M.; Verbeek, A. L. M. [Nijmegen, Univ. (Netherlands). Dept. of Epidemiology

    1997-09-01

    Breast cancer is the most common malignancy among women in the Western society. Over the past decades it has become apparent that breast cancer incidence rates are increasing steadily, whereas the mortality rates for breast cancer have remained relatively constant. Information through the media on this rising number of cases has increased breast health awareness but has also introduced anxiety in the female population. This combination of factors has made the need for prevention of breast cancer an urgent matter. Breast cancer does not seem to be a single disease entity. A specific etiologic factor may therefore have more influence on one form may therefore have more influence on one form of breast cancer than another. So far though, as shown in their summary of current knowledge on established and dubious risk factors, no risk factors have been identified that can explain a major part of the incidence. Efforts to identify other ways for primary prevention have also been discouraging, even though breast cancer is one of the most investigated tumours world-wide. Thus, at this point i time, the most important strategy to reduce breast cancer mortality is early detection through individual counselling and organised breast screening programs. The recent isolation of breast cancer susceptibility genes may introduce new ways to reduce the risk of breast cancer in a small subset of women.

  7. Factors affecting ejection risk in rollover crashes.

    Science.gov (United States)

    Funk, James R; Cormier, Joseph M; Bain, Charles E; Wirth, Jeffrey L; Bonugli, Enrique B; Watson, Richard A

    2012-01-01

    Ejection greatly increases the risk of injury and fatality in a rollover crash. The purpose of this study was to determine the crash, vehicle, and occupant characteristics that affect the risk of ejection in rollovers. Information from real world rollover crashes occurring from 2000 - 2010 was obtained from the National Automotive Sampling System (NASS) in order to analyze the effect of the following parameters on ejection risk: seatbelt use, rollover severity, vehicle type, seating position, roof crush, side curtain airbag deployment, glazing type, and occupant age, gender, and size. Seatbelt use was found to reduce the risk of partial ejection and virtually eliminate the risk of complete ejection. For belted occupants, the risk of partial ejection risk was significantly increased in rollover crashes involving more roof inversions, light trucks and vans (LTVs), and larger occupants. For unbelted occupants, the risk of complete ejection was significantly increased in rollover crashes involving more roof inversions, LTVs, far side occupants, and higher levels of roof crush. Roof crush was not a significant predictor of ejection after normalizing for rollover severity. Curtain airbag deployment was associated with reduced rates of partial and complete ejection, but the effect was not statistically significant, perhaps due to the small sample size (n = 89 raw cases with curtain deployments). A much greater proportion of occupants who were ejected in spite of curtain airbag deployment passed through the sunroof and other portals as opposed to the adjacent side window compared to occupants who were ejected in rollovers without a curtain airbag deployment. The primary factors that reduce ejection risk in rollover crashes are, in generally decreasing order of importance: seatbelt use, fewer roof inversions, passenger car body type, curtain airbag deployment, near side seating position, and small occupant size.

  8. Early life risk factors for obesity in childhood: cohort study

    Science.gov (United States)

    Reilly, John J; Armstrong, Julie; Dorosty, Ahmad R; Emmett, Pauline M; Ness, A; Rogers, I; Steer, Colin; Sherriff, Andrea

    2005-01-01

    Objective To identify risk factors in early life (up to 3 years of age) for obesity in children in the United Kingdom. Design Prospective cohort study. Setting Avon longitudinal study of parents and children, United Kingdom. Participants 8234 children in cohort aged 7 years and a subsample of 909 children (children in focus) with data on additional early growth related risk factors for obesity. Main outcome measures Obesity at age 7 years, defined as a body mass index 3 95th centile relative to reference data for the UK population in 1990. Results Eight of 25 putative risk factors were associated with a risk of obesity in the final models: parental obesity (both parents: adjusted odds ratio, 10.44, 95% confidence interval 5.11 to 21.32), very early (by 43 months) body mass index or adiposity rebound (15.00, 5.32 to 42.30), more than eight hours spent watching television per week at age 3 years (1.55, 1.13 to 2.12), catch-up growth (2.60, 1.09 to 6.16), standard deviation score for weight at age 8 months (3.13, 1.43 to 6.85) and 18 months (2.65, 1.25 to 5.59); weight gain in first year (1.06, 1.02 to 1.10 per 100 g increase); birth weight, per 100 g (1.05, 1.03 to 1.07); and short (< 10.5 hours) sleep duration at age 3 years (1.45, 1.10 to 1.89). Conclusion Eight factors in early life are associated with an increased risk of obesity in childhood. PMID:15908441

  9. Depressive symptoms, vascular risk factors, and Alzheimer's disease.

    Science.gov (United States)

    Luchsinger, José A; Honig, Lawrence S; Tang, Ming-Xin; Devanand, Devangere P

    2008-09-01

    Depressive symptoms in the elderly are associated with an increased Alzheimer's disease (AD) risk. We sought to determine whether the association between depressive symptoms and AD is explained by a history of vascular risk factors and stroke. Five hundred and twenty-six elderly persons from New York City without dementia at baseline were followed for a mean of 5 years. Depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale (HAM). Incident AD was ascertained using standard criteria. Diabetes, hypertension, heart disease, current smoking and stroke were ascertained by self-report. Proportional hazards regression was used to relate HAM scores to incident AD. HAM scores were higher in persons with hypertension, heart disease, and stroke, which in turn were related to higher AD risk. AD risk increased with increasing HAM scores as a continuous logarithmically transformed variable (HR for one point increase=1.4; 95% CI=1.1,1.8) and as a categorical variable (HR for HAM >or= 10=3.4; 95% CI=1.5,8.1; p for trend=0.004 with HAM=0 as the reference). These results were virtually unchanged after adjustment for vascular risk factors and stroke, individually (HR for HAM >or= 10=3.4; 95% CI=1.5,8.1; p for trend = 0.004), and in a composite measure (HR for HAM >or= 10=3.0; 95% CI=1.2,7.8; p for trend=0.02). The prospective relation between depressive symptoms and AD is not explained by a history of vascular risk factors and stroke, suggesting that other mechanisms may account for this association.

  10. Risk factors for sporadic ovarian cancer

    Directory of Open Access Journals (Sweden)

    M. M. Vysotsky

    2010-01-01

    Full Text Available The review of the literature on the problems of sporadic ovarian cancer details the present views of its disputable risk factors, such as dietary habits, body weight, contraception, and labor, and age of commencing a sexual activity. It discusses the dietary and sexual behavior model that has changed since the Neolithic, as well as the number of menses and ovulations throughout the reproductive peri- od. The works by authors dealing with the impact of smoking and alcohol consumption on the risk of ovarian cancer are analyzed.

  11. Risk factors for sudden cardiac death among patients with schizophrenia.

    Science.gov (United States)

    Hou, Ping-Yi; Hung, Galen Chin-Lun; Jhong, Jia-Rong; Tsai, Shang-Ying; Chen, Chiao-Chicy; Kuo, Chian-Jue

    2015-10-01

    Patients with schizophrenia suffer from excessive premature mortality, and sudden cardiac death (SCD) is receiving growing attention as a potential cause. The present study investigated the incidence of SCD and its risk factors in a large schizophrenia cohort. We enrolled a consecutive series of 8264 patients diagnosed with schizophrenia (according to DSM-III-R and DSM-IV criteria) who were admitted to a psychiatric center in northern Taiwan from January 1, 1985 through December 31, 2008. By linking with national mortality database, 64 cases of SCD were identified. The standardized mortality ratio (SMR) for SCD was estimated. The cases were matched with controls randomly selected using risk-set sampling in a 1:2 ratio. A standardized chart review process was used to collect socio-demographic and clinical characteristics and the prescribed drugs for each study subject. Multivariate conditional logistic regression analysis was used to identify correlates of SCD at the index admission and the latest admission. The SMR for SCD was 4.5. For the clinical profiles at the index admission, physical disease (adjusted risk ratio [aRR]=2.91, Paggressive behaviors (aRR=3.99, Paggressive behaviors (aRR=3.26, Paggression is a crucial risk factor that deserves ongoing work for clarifying the mechanisms mediating SCD in schizophrenia. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Female sex as a risk factor for penicillin allergy.

    Science.gov (United States)

    Park, Miguel A; Matesic, Damir; Markus, Patricia J; Li, James T C

    2007-07-01

    Identification of risk factors is an integral part of a physician's evaluation of a patient. To determine whether female sex is an independent risk factor for penicillin allergy. Rates of positive penicillin skin test (PST) results, according to sex, were determined in patients with a history of penicillin allergy undergoing penicillin allergy evaluation with major and minor determinants of penicillin between June 1, 2002, and June 30, 2004. Univariate and multivariate logistic regression analyses were used to calculate unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for sex differences in the rates of positive PST results. Of the 1,921 patients, 1,759 underwent PST and 157 did not; 5 medical records were not available for review. The mean patient age was 60 years. Sixty-four patients (4%) had a positive PST reaction; of these, 53 (83%) were females and 11 (17%) were males (OR, 3.6; 95% CI, 1.9-7.2; P allergies, and elapsed time from the initial penicillin adverse drug reaction to PST, female sex again had a significant risk of a positive PST reaction (OR, 3.2; 95% CI, 1.6-6.7; P = .001). A greater risk of penicillin allergy exists in association with female sex in patients with a history of penicillin allergy.

  13. Risk factors for nuchal cord entanglement at delivery.

    Science.gov (United States)

    Nkwabong, Elie; Ndoumbe Mballo, Jacky; Dohbit, Julius Sama

    2017-12-07

    To identify nuchal cord risk factors. The present case-control study was carried out between December 2016 and April 2017 at two hospitals in Yaoundé, Cameroon. Singletons with a nuchal cord at delivery (case group) as well as the two neonates without a nuchal cord delivered immediately after each case (control group), all in cephalic presentation, were included. Undated pregnancies were excluded. The main variables studied were maternal age, parity, pregnancy duration at delivery, cord insertion site, cord length, delivery weight, and fetal sex. A nuchal cord was present in 121 (6.0%) of 2015 singletons. The final analysis included 114 and 228 neonates in the case and control groups, respectively, with similar maternal age, parity, pregnancy duration, and delivery weight. Significant independent risk factors for nuchal cord formation were a cord length of 70 cm or more (adjusted odds ratio [aOR] 19.10, 95% confidence interval [CI] 8.63-42.04), a pregnancy duration of more than 42 weeks (aOR 7.43, 95% CI 1.46-37.21), marginal cord insertion (aOR 2.90, 95% CI 1.11-9.35), and a male fetus (aOR 2.14, 95% CI 1.16-7.74). Marginal cord insertion and post-term pregnancy should be added to the list of known nuchal cord risk factors. © 2017 International Federation of Gynecology and Obstetrics.

  14. Serum insulin-like growth factors, insulin-like growth factor binding proteins, and breast cancer risk in postmenopausal women

    DEFF Research Database (Denmark)

    Grønbæk, Henning; Flyvbjerg, Allan; Mellemkjær, L.

    2004-01-01

    BACKGROUND: Studies have shown a positive association between serum insulin-like growth factor (IGF)-I and breast cancer risk in premenopausal but not postmenopausal women. IGF-II and estrogen receptor (ER) status has never been investigated. We examined the association between IGF-I, IGF-II, IGF...... cases with breast cancer and a matched control group including 397 cohort members. We estimated breast cancer risk using Cox regression analysis with adjustment for known breast cancer risk factors. RESULTS: We observed no association for IGF-I but a positive association between levels of IGFBP-3...

  15. Risk factors for fracture in elderly men: a population-based prospective study

    DEFF Research Database (Denmark)

    Frost, M; Abrahamsen, B; Masud, Tahir

    2012-01-01

    Risk factors for fractures were assessed in a random sample of 4,696 elderly men followed for 5.4 years. Results highlighted the importance of assessment of falls and dizziness as well as novel risk factors including frequent urination and erectile dysfunction. INTRODUCTION: Knowledge about risk.......30-3.09) and pulmonary illness (1.90; 1.03-3.53) were associated with increased risk of osteoporotic fractures in adjusted models. CONCLUSION: These results underline the importance of assessment of dizziness, falls and those with a family history of hip fracture. Frequent urination and erectile dysfunction were...... factors for fracture in men is limited. The aim of this study was to evaluate factors potentially associated with fracture risk in men. METHODS: A questionnaire enquiring about potential risk factors for fractures in men was posted to a random sample of 9,314 men aged 60-74 years. A completed...

  16. Neighborhood disadvantage, neighborhood safety and cardiometabolic risk factors in African Americans: biosocial associations in the Jackson Heart study.

    OpenAIRE

    Albert, Michelle; Clark, CR; Ommerborn, MJ; Hickson, DA; Grooms, KN; Sims, M; Taylor, HA; Albert, MA

    2013-01-01

    We examined associations between neighborhood socioeconomic disadvantage, perceived neighborhood safety and cardiometabolic risk factors, adjusting for health behaviors and socioeconomic status (SES) among African Americans.Study participants were non-diab

  17. Major Risk Factors for Heart Disease: High Blood Cholesterol

    Science.gov (United States)

    ... Major Risk Factors for Heart Disease High Blood Cholesterol High blood cholesterol is another major risk factor for heart disease ... can do something about. The higher your blood cholesterol level, the greater your risk for developing heart ...

  18. [Elevated blood pressure as cardiovascular risk factor].

    Science.gov (United States)

    Kowalewski, Wiesław; Hebel, Kazimiera

    2013-01-01

    Cardiovascular diseases for decades have been and still are the main and current health problem of the Polish society and there are many reasons for these diseases. Hypertension is one of the major risk factors for developing cardiovascular disease. The factors significantly increasing risk the of cardiovascular disease are in addition to high blood pressure, smoking (also passive), high blood fats (cholesterol and its HDL, LDL fractions as well as triglyceride levels, obesity, lack of exercise, diabetes and hereditary features. Other important factors which play an important role are external factors such as e.g. environmental pollution, lifestyle, stress. Prediction of cardiovascular disease should start from the evaluation of the fetal period because low birth weight may be a risk of coronary heart disease, hypertension, obesity or diabetes in adulthood. The authors of the referred tests showed that the level of blood pressure observed during childhood is closely associated with the level of blood pressure in adults and is also dependent on the body weight. Since the issue of the effects of high pressure on the cardiovascular system is inherent in the issue of the metabolic syndrome, it should be mentioned also that another causative factor may be an irregularity in the removal of urine from the body and the amount of insulin. The control of hypertension is a complex problem, at least in view of the wide range of adverse factors affecting the human body: hypertension is often either a constituent of other lesions. Therefore, it is difficult to treat high blood pressure in the strict sense; more often it is a combination therapy based on pharmacology caused for other reasons.

  19. [Risk factors and prognostic factors in nosocomial pneumonia outside the intensive care units setting].

    Science.gov (United States)

    Barreiro-López, Bienvenido; Tricas, Josep Maria; Mauri, Elisabeth; Quintana, Salvador; Garau, Javier

    2005-11-01

    Nosocomial pneumonia (NP) is the second most frequent cause of hospital-acquired infection and is associated with elevated morbidity and mortality rates, particularly in intensive care units (ICU). The objectives of this study were to determine the incidence, risk factors and prognostic factors of NP acquired outside the ICU. A prospective case-control study was performed. All NP cases were acquired outside the ICU, and each case was paired with a control subject matched for gender, age, date of admission and hospitalization area. Epidemiological, clinical and microbiological data were obtained from cases and controls, and the risk factors and prognostic factors for NP were established. During the study period a total of 67 cases of NP outside the ICU were diagnosed. Estimated incidence was 3.35 cases/1,000 admissions. Mean age of the patients was 70 +/- 13 years and 48 of them were men. On multivariate analysis adjusted for confounding factors, bronchoaspiration, previous surgery and steroids were significantly associated with the development of NP. Mortality attributable to NP was 27%. The existence of an ultimately or rapidly fatal underlying condition and the presence of leukocytosis or leukopenia were associated with poor prognosis. The incidence of NP outside the ICU setting is low. Measures to reduce bronchoaspiration and judicial steroid use are necessary to decrease the risk of acquiring NP and to improve the prognosis.

  20. Risk factors for amyotrophic lateral sclerosis

    Science.gov (United States)

    Ingre, Caroline; Roos, Per M; Piehl, Fredrik; Kamel, Freya; Fang, Fang

    2015-01-01

    Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease. It is typically fatal within 2–5 years of symptom onset. The incidence of ALS is largely uniform across most parts of the world, but an increasing ALS incidence during the last decades has been suggested. Although recent genetic studies have substantially improved our understanding of the causes of ALS, especially familial ALS, an important role of non-genetic factors in ALS is recognized and needs further study. In this review, we briefly discuss several major genetic contributors to ALS identified to date, followed by a more focused discussion on the most commonly examined non-genetic risk factors for ALS. We first review factors related to lifestyle choices, including smoking, intake of antioxidants, physical fitness, body mass index, and physical exercise, followed by factors related to occupational and environmental exposures, including electromagnetic fields, metals, pesticides, β-methylamino-L-alanine, and viral infection. Potential links between ALS and other medical conditions, including head trauma, metabolic diseases, cancer, and inflammatory diseases, are also discussed. Finally, we outline several future directions aiming to more efficiently examine the role of non-genetic risk factors in ALS. PMID:25709501

  1. Association between intake of dairy products and short-term memory with and without adjustment for genetic and family environmental factors: A twin study.

    Science.gov (United States)

    Ogata, Soshiro; Tanaka, Haruka; Omura, Kayoko; Honda, Chika; Hayakawa, Kazuo

    2016-04-01

    Previous studies have indicated associations between intake of dairy products and better cognitive function and reduced risk of dementia. However, these studies did not adjust for genetic and family environmental factors that may influence food intake, cognitive function, and metabolism of dairy product nutrients. In the present study, we investigated the association between intake of dairy products and short-term memory with and without adjustment for almost all genetic and family environmental factors using a genetically informative sample of twin pairs. A cross-sectional study was conducted among twin pairs aged between 20 and 74. Short-term memory was assessed as primary outcome variable, intake of dairy products was analyzed as the predictive variable, and sex, age, education level, marital status, current smoking status, body mass index, dietary alcohol intake, and medical history of hypertension or diabetes were included as possible covariates. Generalized estimating equations (GEE) were performed by treating twins as individuals and regression analyses were used to identify within-pair differences of a twin pair to adjust for genetic and family environmental factors. Data are reported as standardized coefficients and 95% confidence intervals (CI). Analyses were performed on data from 78 men and 278 women. Among men, high intake of dairy products was significantly associated with better short-term memory after adjustment for the possible covariates (standardized coefficients = 0.22; 95% CI, 0.06-0.38) and almost all genetic and family environmental factors (standardized coefficients = 0.38; 95% CI, 0.07-0.69). Among women, no significant associations were found between intake of dairy products and short-term memory. Subsequent sensitivity analyses were adjusted for small samples and showed similar results. Intake of dairy product may prevent cognitive declines regardless of genetic and family environmental factors in men. Copyright © 2015 Elsevier Ltd

  2. Adjustable hybrid gas bearing – Influence of piezoelectrically adjusted injection on damping factors and natural frequencies of a flexible rotor operating under critical speeds

    DEFF Research Database (Denmark)

    Pierart, Fabián G.; Santos, Ilmar F.

    2016-01-01

    Damping factors and natural frequencies of a flexible rotor supported by a gas bearing with piezoelectrically adjusted flow, are theoretically determined using a rotor finite element model coupled with the modified Reynolds equation. An extra term is added to the standard formulation of Reynolds...... fourradial injectors equally pressurized. For the two configurations, the theoretical results are experimentally validated as afunction of the piezoactuators input voltage and the journal angular velocity. Results show a good agreement for natural frequencies and damping factors. Theoretical and experimental...... results show qualitatively as well as quantitatively that the injectors position and the injection flow (dependent on the piezoactuator input voltage) have an important influence on the dynamic characteristics of the rotor-bearing system. By using one single injector positioned at the bearing bottom...

  3. Risk factors for lymphedema after breast cancer treatment

    Science.gov (United States)

    Norman, Sandra A.; Localio, A. Russell; Kallan, Michael J.; Weber, Anita L.; Simoes Torpey, Heather A.; Potashnik, Sheryl L.; Miller, Linda T.; Fox, Kevin R.; DeMichele, Angela; Solin, Lawrence J.

    2010-01-01

    Background As cancer treatments evolve, it is important to re-evaluate their impact on lymphedema risk in breast cancer survivors. Methods A population-based random sample of 631 women from metropolitan Philadelphia, PA, diagnosed with incident breast cancer 1999–2001, was followed for five years. Risk factor information was obtained by questionnaire and medical records review. Lymphedema was assessed with a validated questionnaire. Using Cox proportional hazards models, we estimated relative incidence rates (hazard ratios:HRs) of lymphedema with standard adjusted multivariable analyses ignoring interactions, followed by models including clinically plausible treatment interactions. Results Compared to no lymph node surgery, adjusted HRs for lymphedema were increased following axillary lymph node dissection (ALND) (HR 2.61; 95% CI 1.77,3.84) but not sentinel lymph node biopsy (SLNB) (HR 1.04; 95% CI 0.58,1.88). Risk was not increased following irradiation: breast/chest wall only (HR 1.18; 95% CI 0.80,1.73), breast/chest wall plus supraclavicular field (+/− full axilla) (HR 0.86; 95% CI 0.48,1.54). Eighty-one percent of chemotherapy was anthracycline-based. The HR for anthracycline chemotherapy vs no chemotherapy was 1.46; 95% CI 1.04,2.04, persisting after stratifying on stage at diagnosis or number of positive nodes. Treatment combinations involving ALND or chemotherapy resulted in approximately 4–5 fold increases in HRs for lymphedema (e.g. HR 4.16; 95% CI 1.32,12.45 for SLNB/chemotherapy/no radiation) compared to no treatment. Conclusion With standard multivariable analyses, ALND and chemotherapy increased lymphedema risk while radiation therapy and SLNB did not. However, risk varied by combinations of exposures. Impact Treatment patterns should be considered when counseling and monitoring patients for lymphedema. PMID:20978176

  4. Dietary factors are associated with coronary heart disease risk factors in college students.

    Science.gov (United States)

    Fernandes, Jill; Arts, Jennifer; Dimond, Elizabeth; Hirshberg, Shira; Lofgren, Ingrid E

    2013-08-01

    It is hypothesized that healthy dietary and physical activity choices will be inversely associated with coronary heart disease (CHD) risk factors. Results from a cross-sectional study of 294 first-year University of Rhode Island students were used for the analyses. The presence of CHD risk factors was defined by the National Cholesterol Education Program Adult Treatment Panel III guidelines. Diet was assessed by three 24-hour food recalls, and physical activity was assessed by the International Physical Activity Questionnaire. Logistic regression models adjusted for sex estimated the odds of having CHD risk factors. A higher percent of kilocalories from alcohol was associated with a 9.9% increased risk for elevated triacylglycerol (odds ratio [OR], 1.099; 95% confidence interval [CI], 1.000-1.207). Sugar intake (OR, 1.015; 95% CI, 1.004-1.026), saccharin intake (OR, 1.047; 95% CI, 1.015-1.080), and body mass index (BMI; OR, 1.139; 95% CI, 1.037-1.252) were associated with an increased risk of low high-density lipoprotein cholesterol; dietary fiber intake (OR, 0.934; 95% CI, 0.873-1.000) was associated with a decreased risk of low high-density lipoprotein cholesterol. Participants with a higher BMI were 9.4% more likely to have elevated fasting glucose (OR, 1.094; 95% CI, 1.004-1.192) and 193.6% more likely to have a larger waist circumference (OR, 2.936; 95% CI, 1.543-5.586). Dietary factors and BMI are better indicators of CHD risk than physical activity is in this population. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Familial risk factors favoring drug addiction onset.

    Science.gov (United States)

    Zimić, Jadranka Ivandić; Jukić, Vlado

    2012-01-01

    This study, primarily aimed at identification of familial risk factors favoring drug addiction onset, was carried out throughout 2008 and 2009. The study comprised a total of 146 addicts and 134 control subjects. Based on the study outcome, it can be concluded that in the families the addicts were born into, familial risk factors capable of influencing their psychosocial development and favoring drug addiction onset had been statistically more frequently encountered during childhood and adolescence as compared to the controls. The results also indicated the need for further research into familial interrelations and the structure of the families addicts were born into, as well as the need for the implementation of family-based approaches to both drug addiction prevention and therapy.

  6. RISK FACTORS FOR INTIMATE PARTNER VIOLENCE

    Directory of Open Access Journals (Sweden)

    Ceren Atakay

    2014-06-01

    Full Text Available Intimate partner violence has kept being one of the major societal issues in our country over the past year. It is absolutely necessary to intervene in this substantially psychological issue multi-directionally. In order to intervene in the problem from psychological aspect, it is important to estimate and interpret the risk factors for intimate partner violence. Therefore in the current study, ‘I-cube theory’ which is about the risk factors for intimate partner violence has been explained first. Afterwards, the findings of content analysis which was obtained from newspaper reports about femicide in 2013 have been shown and these findings have been discussed within the context of I-cube theory, respectively. Finally, solutions to prevent this violence has been suggested.

  7. Psychosocial risk factors and heart failure hospitalization

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej; Andersen, Ingelise; Prescott, Eva

    2011-01-01

    Prospective studies on the role of psychosocial factors in heart failure development are virtually nonexistent. The authors aimed to address the effect of psychosocial factors on the risk of heart failure hospitalization in men and women free of cardiovascular disease. In 1991-1993, the 8......-fourth of the population reported some degree of vital exhaustion. The vital exhaustion score was associated with a higher risk of heart failure in a dose-response manner (P heart failure in both men (hazard ratio = 1.93, 95% confidence...... interval: 1.20, 3.10) and women (hazard ratio = 2.56, 95% confidence interval: 1.80, 3.65). Contrary to expectation, major life events, social network, and sleeping medication did not play an individual role for heart failure hospitalization. Because of the high prevalence of vital exhaustion...

  8. Risk Factor Analysis In Oral Cancers

    Directory of Open Access Journals (Sweden)

    Bharti A.R

    1992-01-01

    Full Text Available A case-control study involving 54 cases and 108 matched controls was conducted to find out the association of risk factors like smoking, chewing paan and tobacco and the occurrence of cancers of the oral cavity. More than 80% of the cases were over 40 years of age, with a male: female ratio of 2:1, paan and tobacco chewing were significantly related to the oral cancers (Odds Ratio of 9.3 and 7.8 respectively. Smoking showed a statistically significant relationship with oral cancers among male patients. In addition, the study also established dose-response and time-response relationship these risk factors and oral cancer.

  9. [Secondary cancers: Incidence, risk factors and recommendations].

    Science.gov (United States)

    Demoor-Goldschmidt, Charlotte; Fayech, Chiraz; Girard, Pauline; Plantaz, Dominique

    2015-01-01

    Cure rates for most childhood cancers and adolescents have made remarkable progress over the last thirty to forty years. The development of secondary malignancies has become an important question for these patients. The frequency is low, but the risk is significantly higher (between 3 and 10 times) and it is the leading cause of long-term mortality off relapse. In this literature review, we discuss the epidemiological aspect and the risk factors contributing to this increased risk, and conclude with a summary of current recommendations for screening and surveillance. We also discuss briefly the constitutional predisposing genetic contributions to other cancers. Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  10. Contextual Factors and Sexual Risk Behaviors Among Young, Black Men.

    Science.gov (United States)

    Jones, Jamal; Salazar, Laura F; Crosby, Richard

    2017-05-01

    Young Black men (YBM), aged 13 to 24 years, face a disproportionate burden of sexually transmitted infections (STIs). STI acquisition among YBM is due to incorrect and inconsistent condom use and is exacerbated by multiple sexual partners. Sexual and reproductive health is influenced by a complex interaction of biological, psychological, and social determinants that contribute to increased risk for STI acquisition. However, there are key social determinants of sexual health that play a major role in adolescent sexual risk-taking behaviors: gender norms, environment, peers, and families as well as a desire to impregnate a woman. Associations between contextual factors (risky environmental context, desire to impregnate a woman, and peer norms supportive of unsafe sex) and sexual risk behaviors were examined among a sample of YBM attending adolescent health clinics. This study used baseline data from a randomized controlled trial ( N = 702). Parental monitoring was also examined as an effect modifier of those associations. Sexual risk behaviors were the frequency of condomless vaginal sex, number of sexual partners within the previous 2 months, and lifetime number of sexual partners. Mean age was 19.7. In the adjusted model, peer norms was the only significant predictor for all sexual risk outcomes ( p effect modifier for the perceived peer norms and lifetime sexual partners association ( p = .053) where the effect of peer norms on lifetime sexual partners was lower for participants with higher levels of perceived parental monitoring.

  11. Epidemiology and risk factors for drug allergy

    Science.gov (United States)

    Thong, Bernard Y-H; Tan, Teck-Choon

    2011-01-01

    The aim of this review was to describe the current evidence-based knowledge of the epidemiology, prevalence, incidence, risk factors and genetic associations of drug allergy. Articles published between 1966 and 2010 were identified in MEDLINE using the key words adult, adverse drug reaction reporting systems, age factors, anaphylactoid, anaphylaxis, anaesthetics, antibiotics, child, drug allergy, drug eruptions, ethnic groups, hypersensitivity, neuromuscular depolarizing agents, neuromuscular nondepolarizing agents, sex factors, Stevens Johnson syndrome and toxic epidermal necrolysis. Additional studies were identified from article reference lists. Relevant, peer-reviewed original research articles, case series and reviews were considered for review. Current epidemiological studies on adverse drug reactions (ADRs) have used different definitions for ADR-related terminology, often do not differentiate immunologically and non-immunologically mediated drug hypersensitivity, study different study populations (different ethnicities, inpatients or outpatients, adults or children), utilize different methodologies (spontaneous vs. non-spontaneous reporting, cohort vs. case-control studies), different methods of assessing drug imputability and different methods of data analyses. Potentially life-threatening severe cutaneous adverse reactions (SCAR) are associated with a high risk of morbidity and mortality. HLA associations for SCAR associated with allopurinol, carbamazepine and abacavir have been reported with the potential for clinical use in screening prior to prescription. Identification of risk factors for drug allergy and appropriate genetic screening of at-risk ethnic groups may improve the outcomes of drug-specific SCAR. Research and collaboration are necessary for the generation of clinically-relevant, translational pharmacoepidemiological and pharmacogenomic knowledge, and success of health outcomes research and policies on drug allergies. PMID:21480948

  12. Longitudinal Risk Factors for Cyberbullying in Adolescence

    OpenAIRE

    Sticca, Fabio; Ruggieri, Sabrina; Alsaker, Françoise; Perren, Sonja

    2013-01-01

    Cyberbullying has emerged as a new form of antisocial behaviour in the context of online communication over the last decade. The present study investigates potential longitudinal risk factors for cyberbullying. A total of 835 Swiss seventh graders participated in a short-term longitudinal study (two assessments 6 months apart). Students reported on the frequency of cyberbullying, traditional bullying, rule-breaking behaviour, cybervictimisation, traditional victimisation, and frequency of onl...

  13. Risk Factors of Chronic Atrophic Gastritis

    OpenAIRE

    Siregar, Gontar Alamsyah; Laksmi, Lidya Imelda

    2016-01-01

    Background: Chronic atrophic gastritis is a well-established precursor of gastric cancer. The development of atrophic chronic gastritis is multifactorial, involving the environment as well as host responses to the Helicobacter pylori (H. pylori) infection. The aim of this study is to determine prevalence and risk factors of chronic atrophic gastritis.Method: The study was a cross sectional study on gastritis patients admitted to endoscopy units at Adam Malik General Hospital and P...

  14. Studying risk factors associated with Human Leptospirosis

    Directory of Open Access Journals (Sweden)

    Ramachandra Kamath

    2014-01-01

    Full Text Available Background: Leptospirosis is one of the most under diagnosed and underreported disease in both developed and developing countries including India. It is established that environmental conditions and occupational habit of the individuals put them at risk of acquiring disease, which varies from community to community. Various seroprevalence studies across the world have documented emerging situation of this neglected tropical disease, but limited have probed to identify the risk factors, especially in India. Objectives: The objective of this study was to identify the environmental and occupational risk factors associated with the disease in Udupi District. Materials and Methods: This population-based case-control study was carried out in Udupi, a District in Southern India from April 2012 until August 2012. Udupi is considered to be endemic for Leptospirosis and reported 116 confirmed cases in the year 2011. Seventy of 116 laboratory confirmed cases and 140 sex matched neighborhood healthy controls participated in the study. A predesigned, semi-structured and validated questionnaire was used for data collection through house to house visit and observations were noted about environmental conditions. Univariate analysis followed by multivariate analysis (back ward conditional logistic regression was performed by using STATA version 9.2 (StataCorp, College Station, TX, USA to identify potential risk factors. Results: Occupational factors such as outdoor activities (matched odds ratio [OR] of 3.95, 95% confidence interval [CI]: 1.19-13.0, presence of cut or wound at body parts during work (matched OR: 4.88, CI: 1.83-13.02 and environmental factors such as contact with rodents through using the food materials ate by rat (matched OR: 4.29, CI: 1.45-12.73 and contact with soil or water contaminated with urine of rat (matched OR: 4.58, CI: 1.43-14.67 were the risk factors identified to be associated with disease. Conclusion: Leptospirosis is still

  15. Do repeated risk factor measurements influence the impact of education on cardiovascular mortality?

    Science.gov (United States)

    Ariansen, Inger; Graff-Iversen, Sidsel; Stigum, Hein; Strand, Bjørn Heine; Wills, Andrew K; Næss, Øyvind

    2015-12-01

    It has been questioned if the excess cardiovascular disease (CVD) mortality by lower educational level can be fully explained by conventional modifiable CVD risk factors. Our objective was to examine whether repeated measures over time of risk factors (smoking, physical inactivity, blood pressure, total cholesterol and body mass index) explain more of the socioeconomic gradient in CVD mortality than if they are measured only once. A cohort of 34 884 men and women attended all three screenings (1974-1978, 1977-1983 and 1985-1988) in the Norwegian Counties Study and were followed for CVD mortality through 2009 by linkage to the Norwegian Cause of Death Registry. Age-adjusted and sex-adjusted HR of CVD mortality was 2.32 (95% CI 1.93 to 2.80) for basic relative to tertiary educated individuals. The HR was attenuated by 48% (HR 1.54 (1.28 to 1.87)) when adjusted for CVD risk factors measured at baseline and by 56% (HR 1.45 (1.20 to 1.75)) when two repeated measurements ascertained 5 years apart were added to the model. Similarly, absolute risk difference in CVD mortality by education was attenuated by 62% when adjusted for baseline and by 72% when adjusted for repeated measurements of risk factors. In this cohort, repeated measurements of risk factors seemed to explain more of the educational gradient in CVD mortality. This suggests that a substantial part of the excess CVD mortality among those with lower education might be explained by conventional risk factors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. Risk factors for hypospadias in China

    Directory of Open Access Journals (Sweden)

    Ling-Fan Xu

    2014-10-01

    Full Text Available This case-controlled study was designed to evaluate the association between various baseline parental factors and the risk of hypospadias in China. Patients were selected from tertiary referral hospitals in Anhui, a province in mid-eastern China. A questionnaire was given to the parents of each patient. The final database included 193 cases and 835 controls. The incidence of additional coexistent anomalies was 13.0%, primarily cryptorchidism (9.8%. Ten patients (5.1% were from families with genital anomaly, including five families (2.6% with hypospadias. The risks of hypospadias was higher for children of mothers > 35 (odds ratio [OR] =1.47 and < 18 (OR = 2.95 years of age, and in mothers who had consumed alcohol (OR = 2.67, used drugs (OR = 1.53 and had an infection (OR = 1.87 during pregnancy. The risk of hypospadias was also higher when mothers (OR = 1.68 and fathers (OR = 1.74 were engaged in agriculture. Other factors assessed were not associated with the risk of hypospadias.

  17. Risk factors of intestinal obstruction in pregnancy

    Directory of Open Access Journals (Sweden)

    Khvorostukhina N.F.

    2012-09-01

    Full Text Available

    Objective: to study risk factors and options for clinical course of acute intestinal obstruction in pregnancy. Materials and methods. A detailed study of history, clinical course, diagnosis and treatment characteristics of acute intestinal obstruction in 79 pregnant women was undertaken. Results: It was determined that a combination of intestinal obstruction, and pregnancy is more common for II and III trimester of gestation (88,5%, with more likely to develop mechanical obstruction caused by the adhesive process (77,2%. Risk factors for intestinal obstruction in pregnancy are: chronic diseases of gastrointestinal tract, surgery of abdominal cavity and pelvis, burdened obstetric and gynecological history and long-term use of progestogens during pregnancy. Difficulties in diagnosis are associated with absence of classical symptoms of disease that is caused by changes in topographical relations of abdominal cavity, increasing size of uterus, as well as lack of immune response to the emergence of a pathological process. Conclusion. Formation of pregnant women at risk for development of intestinal obstruction and preventive measures to address violations of intestinal motor function can reduce the risk of disease. Algorithm of medical tactics for suspected acute intestinal obstruction in pregnancy, allowing to reduce time of diagnosis and provision of medical care.

  18. Psychosocial factors and adjustment to pain in individuals with postpolio syndrome.

    Science.gov (United States)

    Hirsh, Adam T; Kupper, Amy E; Carter, Gregory T; Jensen, Mark P

    2010-03-01

    The purpose of the current study was to examine the associations among measures of psychosocial factors, pain, and adjustment in persons with postpoliomyelitis syndrome. A cross-sectional survey design was used. Sixty-three community-dwelling individuals with postpoliomyelitis syndrome returned completed questionnaires (71% response rate) that included measures of pain intensity and interference, psychological functioning, pain catastrophizing, social support, and pain-related beliefs and coping. After controlling for demographic variables, the group of psychosocial variables accounted for an additional 23% of the variance in pain intensity. These variables explained an additional 35% and 50% of the variance in pain interference and psychological functioning, respectively, after accounting for demographic variables and pain intensity. Social support was associated with both psychological functioning and pain interference, whereas catastrophizing was most closely related to psychological functioning. Individual pain beliefs and coping strategies were variably related to the three criterion measures. The overall results of the current study are consistent with a biopsychosocial framework for understanding pain and functioning in individuals with postpoliomyelitis syndrome. Although additional research is needed to clarify the nature of the relationships between individual psychosocial variables and functional indices, the findings suggest the need for a multidisciplinary approach to pain management in individuals with postpoliomyelitis syndrome.

  19. A factor-adjusted multiple testing procedure for ERP data analysis.

    Science.gov (United States)

    Causeur, David; Chu, Mei-Chen; Hsieh, Shulan; Sheu, Ching-Fan

    2012-09-01

    Event-related potentials (ERPs) are now widely collected in psychological research to determine the time courses of mental events. When event-related potentials from treatment conditions are compared, often there is no a priori information on when or how long the differences should occur. Testing simultaneously for differences over the entire set of time points creates a serious multiple comparison problem in which the probability of false positive errors must be controlled, while maintaining reasonable power for correct detection. In this work, we extend the factor-adjusted multiple testing procedure developed by Friguet, Kloareg, and Causeur (Journal of the American Statistical Association, 104, 1406-1415, 2009) to manage the multiplicity problem in ERP data analysis and compare its performance with that of the Benjamini and Hochberg (Journal of the Royal Statistical Society B, 57, 289-300, 1995) false discovery rate procedure, using simulations. The proposed procedure outperformed the latter in detecting more truly significant time points, in addition to reducing the variability of the false discovery rate, suggesting that corrections for mass multiple testings of ERPs can be much improved by modeling the strong local temporal dependencies.

  20. Risk factors and management of diabetic nephropathy

    Directory of Open Access Journals (Sweden)

    Mohamed Akheel Ahmed

    2013-01-01

    Full Text Available To determine the risk factors for nephropathy in diabetic patients and to study the management of diabetic nephropathy (DN, we conducted a hospital-based prospective study in the Internal Medicine department of our hospital on 60 patients with DN and 60 diabetic patients without DN. An odds ratio (OR disclosed the following risk factors: Hypertension (OR = 2.06, family history of diabetes (OR = 1.23, family history of DN (OR = 2.86, uncontrolled hyperglycemia (OR = 11.80, obesity (OR = 1.07, duration of diabetes between 11 and 20 years (OR = 4.69, smoking (OR = 2.79, alcohol consumption (OR = 3.75, other complications (OR = 2.03, lack of physical activity (OR = 1.51 and anemia (OR = 2.29. According to these risk factors, we suggest that improving patient′s knowledge on diabetes and its treatment, life style modifications and aggressive management of the disease may delay the progression of disease to advanced stages.

  1. Social risk factors in the elderly.

    Directory of Open Access Journals (Sweden)

    Yanelis Emilia Tabio Henry

    2011-09-01

    Full Text Available There are social risk factors that can rebound negatively in the functional capacity of elder people thus they associate to an enchancement of the vulnerability to have them develop a state of fragility and necessity. A descriptive investigation was done with the objective of determinig the social risk factors of elder people in the dispensaries 28 of policlinic ll from Jatibonico municipality from january 1 st to december 31 st, 2009 .The sample was conformed by 103 older people. Different variables were used like: age, sex, marital status, associated desease and basic components of the family functions disminished or null. It prevailed the 60-64 and 70-74 year old group (24.3%, female sex (60.2%, the elder widow women (20,3 %, the hypertension (60,2% and family comprehension about conduct and elderly points of view (50,4%. There was a high incidence of the social risk factors associated to the presence of old women, alone and widows, the lessen of economic resources, the retirement, the incomprehension of elder people by their families and the presence of non transmisible chronic desease.

  2. Risk factors for developing diabetic foot

    Directory of Open Access Journals (Sweden)

    Julia Estela Willrich Boell

    2014-06-01

    Full Text Available The goal of the present study is to identify the risk factors for developing diabetic foot. A cross-sectional study, with a convenience sample, developed with 70 individuals with diabetes mellitus (DM, registered in three basic health units in the municipality of Florianópolis/SC, Brazil, in the period from November 2010 to May 2011. Biometric data was collected regarding their sociodemographic, health and illness conditions. An assessment of the feet was also carried out. The average participant age was 66.17 years and time with diagnosed disease was under ten years (61.42%. The following risk factors were identified: advanced age; time of DM diagnosis; few years of schooling; overweight/obesity; inadequate diet; physical inactivity; inadequate metabolic control; lack of proper and specific foot care; and arterial hypertension. We conclude that the majority of the population presented one or more risk factors that favor the appearance of foot-related complications. doi: 10.5216/ree.v16i2.20460.

  3. Corneal Graft Rejection: Incidence and Risk Factors

    Directory of Open Access Journals (Sweden)

    Alireza Baradaran-Rafii

    2008-12-01

    Full Text Available

    PURPOSE: To determine the incidence and risk factors of late corneal graft rejection after penetrating keratoplasty (PKP. METHODS: Records of all patients who had undergone PKP from 2002 to 2004 without immunosuppressive therapy other than systemic steroids and with at least one year of follow up were reviewed. The role of possible risk factors such as demographic factors, other host factors, donor factors, indications for PKP as well as type of rejection were evaluated. RESULTS: During the study period, 295 PKPs were performed on 286 patients (176 male, 110 female. Mean age at the time of keratoplasty was 38±20 (range, 40 days to 90 years and mean follow up period was 20±10 (range 12-43 months. Graft rejection occurred in 94 eyes (31.8% at an average of 7.3±6 months (range, 20 days to 39 months after PKP. The most common type of rejection was endothelial (20.7%. Corneal vascularization, regrafting, anterior synechiae, irritating sutures, active inflammation, additional anterior segment procedures, history of trauma, uncontrolled glaucoma, prior graft rejection, recurrence of herpetic infection and eccentric grafting increased the rate of rejection. Patient age, donor size and bilateral transplantation had no significant influence on graft rejection. CONCLUSION: Significant risk factors for corneal graft rejection include

  4. Obesity is associated with fatal coronary heart disease independently of traditional risk factors and deprivation.

    Science.gov (United States)

    Logue, Jennifer; Murray, Heather M; Welsh, Paul; Shepherd, James; Packard, Chris; Macfarlane, Peter; Cobbe, Stuart; Ford, Ian; Sattar, Naveed

    2011-04-01

    The effect of body mass index (BMI) on coronary heart disease (CHD) risk is attenuated when mediators of this risk (such as diabetes, hypertension and hyperlipidaemia) are accounted for. However, there is now evidence of a differential effect of risk factors on fatal and non-fatal CHD events, with markers of inflammation more strongly associated with fatal than non-fatal events. To describe the association with BMI separately for both fatal and non-fatal CHD risk after accounting for classical risk factors and to assess any independent effects of obesity on CHD risk. In the West of Scotland Coronary Prevention Study BMI in 6082 men (mean age 55 years) with hypercholesterolaemia, but no history of diabetes or CVD, was related to the risk of fatal and non-fatal CHD events. After excluding participants with any event in the first 2 years, 1027 non-fatal and 214 fatal CHD events occurred during 14.7 years of follow-up. A minimally adjusted model (age, sex, statin treatment) and a maximally adjusted model (including known CVD risk factors and deprivation) were compared, with BMI 25-27.4 kg/m² as referent. The risk of non-fatal events was similar across all BMI categories in both models. The risk of fatal CHD events was increased in men with BMI 30.0-39.9 kg/m² in both the minimally adjusted model (HR = 1.75 (95% CI 1.12 to 2.74)) and the maximally adjusted model (HR = 1.60 (95% CI 1.02 to 2.53)). These hypothesis generating data suggest that obesity is associated with fatal, but not non-fatal, CHD after accounting for known cardiovascular risk factors and deprivation. Clinical trial registration WOSCOPS was carried out and completed before the requirement for clinical trial registration.

  5. Assessing Factors in Adolescent Adjustment as Precursors to Recidivism in Court-Referred Youth

    Science.gov (United States)

    Balkin, Richard S.; Miller, Janeen; Ricard, Richard J.; Garcia, Roberto; Lancaster, Chloe

    2011-01-01

    Court-referred youth participated in an intervention program and completed the Reynolds Adolescent Adjustment Screening Inventory. Reoffending rates were tracked for 2 years. Antisocial behavior, anger control, and emotional distress were influencing characteristics for recidivism. The Reynolds Adolescent Adjustment Screening Inventory may serve…

  6. Associations and Risk Factors of Diabetic Maculopathy.

    Science.gov (United States)

    Islam, M M; Ali, M; Naher, Z U; Akhanda, A H; Motaleb, M A; Uddin, M S; Islam, M R

    2016-04-01

    Diabetic maculopathy is characterised by increased capillary leakage in the main retinal vessels and by alterations in the microcirculation of the macula. Maculopathy occurs frequently in type 1 and type 2 diabetic patients. Prevalence is higher in type 2 than in type 1 diabetic patients. Factors associated with the development of maculopathy are mostly unknown. As maculopathy is the main cause of vision deprivation in diabetic patients it is essential to know the associations and risk factors of diabetic maculopathy so that appropriate measures can be taken to prevent as well as treat diabetic maculopathy. We started the research work to find out the relation between diabetic maculopathy and various associated factors and risk factors for patients with diabetic retinopathy with maculopathy. This cross-sectional observational study done at the Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka & National Institute of Ophthalmology & Hospital (NIO & H), Sher-e-Bangla Nagar, Dhaka, Bangladesh from January 2006 to June 2006. In this study out of 50 patients, diabetes was controlled in 20(40%) patients and uncontrolled in 30(60%). A significant percentage of patients (40%) had elevated blood pressure. Diabetic autonomic neuropathy was observed in 24% cases and polyneuropathy was observed in 36% cases. It is evident that diabetic maculopathy has association with dyslipidaemia, abnormal renal function due to nephropathy. This study lighted on the association of diabetic maculopathy with diabetic nephropathy, cardiac abnormalities and diabetic neuropathy.

  7. Maternal and Gestational Risk Factors for Hypospadias

    Science.gov (United States)

    Akre, Olof; Boyd, Heather A.; Ahlgren, Martin; Wilbrand, Kerstin; Westergaard, Tine; Hjalgrim, Henrik; Nordenskjöld, Agneta; Ekbom, Anders; Melbye, Mads

    2008-01-01

    Background An increase in the prevalence of hypospadias has been reported, but the environmental causes remain virtually unknown. Objectives Our goal was to assess the association between risk of hypospadias and indicators of placental function and endogenous hormone levels, exposure to exogenous hormones, maternal diet during pregnancy, and other environmental factors. Methods We conducted a case–control study in Sweden and Denmark from 2000 through 2005 using self-administered questionnaires completed by mothers of hypospadias cases and matched controls. The response rate was 88% and 81% among mothers of cases and controls, respectively. The analyses included 292 cases and 427 controls. Results A diet during pregnancy lacking both fish and meat was associated with a more than 4-fold increased risk of hypospadias [odds ratio (OR) = 4.6; 95% confidence interval (CI), 1.6–13.3]. Boys born to obese [body mass index (BMI) ≥ 30] women had a more than 2-fold increased risk of hypospadias (OR = 2.6; 95% CI, 1.2–5.7) compared with boys born to mothers with a normal weight (BMI = 20–24). Maternal hypertension during pregnancy and absence of maternal nausea increased a boy’s risk of hypospadias 2.0-fold (95% CI, 1.1–3.7) and 1.8-fold (95% CI, 1.2–2.8), respectively. Nausea in late pregnancy also appeared to be positively associated with hypospadias risk (OR = 7.6; 95% CI, 1.1–53). Conclusions A pregnancy diet lacking meat and fish appears to increase the risk of hypospadias in the offspring. Other risk associations were compatible with a role for placental insufficiency in the etiology of hypospadias. PMID:18709149

  8. Vitamin D intake and cardiometabolic risk factors in adolescents.

    Science.gov (United States)

    Moreira, Carla; Moreira, Pedro; Abreu, Sandra; Santos, Paula C; Moreira-Silva, Isabel; Póvoas, Susana; Mota, Jorge; Santos, Rute

    2014-04-01

    A growing body of research suggests that vitamin D might play an important role in overall health. No data exist on vitamin D intake for the Azorean adolescent population. The purpose of this study was to assess vitamin D intake and investigate a possible association between vitamin D intake and cardiometabolic risk factors in Azorean adolescents. A cross-sectional school-based study was conducted on 496 adolescents (288 girls) aged 15-18 years from the Azorean Islands, Portugal. Anthropometric measurements (waist circumference and height), blood pressure (systolic), and plasma biomarkers [fasting glucose, insulin, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TGs)] were measured to assess metabolic risk. Homeostasis model assessment (HOMA), TC-to-HDL-C ratio, and waist-to-height ratio were calculated. For each of these variables, a Z-score was computed by age and sex. A metabolic risk score was constructed by summing the Z-scores of all individual risk factors. High risk was considered when the individual had ≥1 standard deviation (SD) of this score. Vitamin D intake was assessed with a semiquantitative food frequency questionnaire. Participants were classified into quartiles of vitamin D intake. Logistic regression was used to determine odds ratios for high cardiometabolic risk scores after adjusting for total energy intake, pubertal stage, fat mass percentage, and cardiorespiratory fitness. Mean (SD) vitamin D intake was 5.8 (6.5) μg/day, and 9.1% of Azorean adolescents achieved the estimated average requirement of vitamin D (10 μg/day or 400 IU). Logistic regression showed that the odds ratio for a high cardiometabolic risk score was 3.35 [95% confidence interval (CI) 1.28-8.75] for adolescents in the lowest vitamin D intake quartile in comparison with those in the highest vitamin D intake quartile, even after adjustment for confounders. A lower level of vitamin D intake was associated with worse metabolic

  9. Evaluation of an automated safety surveillance system using risk adjusted sequential probability ratio testing

    Directory of Open Access Journals (Sweden)

    Matheny Michael E

    2011-12-01

    Full Text Available Abstract Background Automated adverse outcome surveillance tools and methods have potential utility in quality improvement and medical product surveillance activities. Their use for assessing hospital performance on the basis of patient outcomes has received little attention. We compared risk-adjusted sequential probability ratio testing (RA-SPRT implemented in an automated tool to Massachusetts public reports of 30-day mortality after isolated coronary artery bypass graft surgery. Methods A total of 23,020 isolated adult coronary artery bypass surgery admissions performed in Massachusetts hospitals between January 1, 2002 and September 30, 2007 were retrospectively re-evaluated. The RA-SPRT method was implemented within an automated surveillance tool to identify hospital outliers in yearly increments. We used an overall type I error rate of 0.05, an overall type II error rate of 0.10, and a threshold that signaled if the odds of dying 30-days after surgery was at least twice than expected. Annual hospital outlier status, based on the state-reported classification, was considered the gold standard. An event was defined as at least one occurrence of a higher-than-expected hospital mortality rate during a given year. Results We examined a total of 83 hospital-year observations. The RA-SPRT method alerted 6 events among three hospitals for 30-day mortality compared with 5 events among two hospitals using the state public reports, yielding a sensitivity of 100% (5/5 and specificity of 98.8% (79/80. Conclusions The automated RA-SPRT method performed well, detecting all of the true institutional outliers with a small false positive alerting rate. Such a system could provide confidential automated notification to local institutions in advance of public reporting providing opportunities for earlier quality improvement interventions.

  10. Lung Cancer Among Firefighters: Smoking-Adjusted Risk Estimates in a Pooled Analysis of Case-Control Studies

    NARCIS (Netherlands)

    Bigert, C; Gustavsson, P; Straif, K; Taeger, D; Pesch, B; Kendzia, B; Schuz, J; Stucker, I; Guida, F; Bruske, I; Wichmann, H E; Pesatori, A C; Landi, M T; Caporaso, N; Tse, L A; Yu, I T; Siemiatycki, J; Lavoue, J; Richiardi, L; Mirabelli, D; Simonato, L; Jockel, K H; Ahrens, W; Pohlabeln, H; Tardon, A; Zaridze, D; Field, J K; t Mannetje, A; Pearce, N; McLaughlin, J; Demers, P; Szeszenia-Dabrowska, N; Lissowska, J; Rudnai, P; Fabianova, E; Stanescu Dumitru, R; Bencko, V; Foretova, L; Janout, V; Boffetta, P; Peters, S|info:eu-repo/dai/nl/304822930; Vermeulen, R|info:eu-repo/dai/nl/216532620; Kromhout, H|info:eu-repo/dai/nl/074385224; Bruning, T; Olsson, A C

    2016-01-01

    OBJECTIVES: The aim of this study was to explore lung cancer risk among firefighters, with adjustment for smoking. METHODS: We used pooled information from the SYNERGY project including 14 case-control studies conducted in Europe, Canada, New Zealand, and China, with lifetime work histories and

  11. The Relations between Contextual Risk, Earned Income, and the School Adjustment of Children from Economically Disadvantaged Families

    Science.gov (United States)

    Ackerman, Brian P.; Brown, Eleanor D.; Izard, Carroll E.

    2004-01-01

    This longitudinal study examined the relations between multiple risk indexes representing contextual adversity, income-to-needs ratios, and the elementary school adjustment of children from economically disadvantaged families. The results provide evidence for volatility in family circumstances over 2-year intervals from preschool to 5th grade, for…

  12. Identification of caries risk factors in toddlers.

    Science.gov (United States)

    Fontana, M; Jackson, R; Eckert, G; Swigonski, N; Chin, J; Zandona, A Ferreira; Ando, M; Stookey, G K; Downs, S; Zero, D T

    2011-02-01

    The purpose of this study was to identify risk factors to predict caries progression in toddlers in primary-healthcare settings for the cost-effective targeting of preventive and referral strategies. We examined 329 children (26 ± 6 mos old) twice, one year apart, in Indiana, USA. A 107-item structured interview was used to collect information from the primary caregiver and child on factors/beliefs/perceptions/behaviors that could affect caries development, transmission of bacteria, medical-dental health, and access to care. Bacterial levels, gingivitis, dental plaque, and caries experience were assessed. Multiple-variable logistic regression models of caries progression toward cavitation included family caries experience, transmission-related behaviors, dietary factors, health beliefs, and lower income, but differed in selected predictors/predictive power by race/ethnicity. Addition of clinical variables did not significantly improve the prediction.

  13. Improved hospital-level risk adjustment for surveillance of healthcare-associated bloodstream infections: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Jones MA

    2009-09-01

    Full Text Available Abstract Background To allow direct comparison of bloodstream infection (BSI rates between hospitals for performance measurement, observed rates need to be risk adjusted according to the types of patients cared for by the hospital. However, attribute data on all individual patients are often unavailable and hospital-level risk adjustment needs to be done using indirect indicator variables of patient case mix, such as hospital level. We aimed to identify medical services associated with high or low BSI rates, and to evaluate the services provided by the hospital as indicators that can be used for more objective hospital-level risk adjustment. Methods From February 2001-December 2007, 1719 monthly BSI counts were available from 18 hospitals in Queensland, Australia. BSI outcomes were stratified into four groups: overall BSI (OBSI, Staphylococcus aureus BSI (STAPH, intravascular device-related S. aureus BSI (IVD-STAPH and methicillin-resistant S. aureus BSI (MRSA. Twelve services were considered as candidate risk-adjustment variables. For OBSI, STAPH and IVD-STAPH, we developed generalized estimating equation Poisson regression models that accounted for autocorrelation in longitudinal counts. Due to a lack of autocorrelation, a standard logistic regression model was specified for MRSA. Results Four risk services were identified for OBSI: AIDS (IRR 2.14, 95% CI 1.20 to 3.82, infectious diseases (IRR 2.72, 95% CI 1.97 to 3.76, oncology (IRR 1.60, 95% CI 1.29 to 1.98 and bone marrow transplants (IRR 1.52, 95% CI 1.14 to 2.03. Four protective services were also found. A similar but smaller group of risk and protective services were found for the other outcomes. Acceptable agreement between observed and fitted values was found for the OBSI and STAPH models but not for the IVD-STAPH and MRSA models. However, the IVD-STAPH and MRSA models successfully discriminated between hospitals with higher and lower BSI rates. Conclusion The high model goodness

  14. Risk Factors for Hepatic Steatosis in Children

    Directory of Open Access Journals (Sweden)

    Yu.M. Stepanov

    2016-06-01

    Full Text Available Nonalcoholic fatty liver disease has become the most common cause of liver disease in children worldwide. Purpose: to identify risk factors (RF for hepatic steatosis in children. Methods. Thirty two children with gastrointestinal disorders were examined by us. The presence and severity of hepatic steatosis was determined using FibroScan® 502 touch with controlled attenuation parameter (CAP. According to the results of CAP the children were divided into 2 groups: group 1 (basic — 13 children with steatosis (40.6 %, group 2 (control — 19 children without steatosis (59.4 %. To determine the risk factors we analyzed a history of life and disease, objective clinical and laboratory examination of patients. Results. Analysis of the age distribution showed that children older than 10 years old dominated in the basic group (RR 3.3; OR 4.0; p = 0.1. Obesity was found in 12 (92.3 % children in the group with steatosis and in 9 (47 % children without steatosis. Increased waist circumference values above 95 percentile according to age and sex of a child was observed in 12 (92.3 % children in the basic group and in 8 (42.1 % children in the control group (RR 7.2; OR 16.5; p < 0.05. It was found that the presence of pubertal hypothalamic syndrome is associated with risk of hepatic steatosis in children (RR 30.6; OR 4.8; p < 0.05. Discussion. Abdominal type of obesity in combination with diseases of the endocrine system, namely, hypothalamic syndrome should be considered as the leading risk factors for hepatic steatosis in children.

  15. Personality factors and suicide risk in a representative sample of the German general population.

    Directory of Open Access Journals (Sweden)

    Victor Blüml

    Full Text Available OBJECTIVE: Previous research has shown an association between certain personality characteristics and suicidality. Methodological differences including small sample sizes and missing adjustment for possible confounding factors could explain the varying results. The aim of this study was to assess the impact of the Big Five personality dimensions on suicidality in a representative population based sample of adults. METHOD: Interviews were conducted in a representative German population-based sample (n=2555 in 2011. Personality characteristics were assessed using the Big Five Inventory-10 (BFI-10 and suicide risk was assessed with the Suicidal Behaviors Questionnaire-Revised (SBQ-R. Multivariate logistic regression models were calculated adjusting for depression, anxiety, and various sociodemographic variables. RESULTS: Neuroticism and openness were significantly associated with suicide risk, while extraversion and conscientiousness were found to be protective. Significant sex differences were observed. For males, extraversion and conscientiousness were protective factors. Neuroticism and openness were found to be associated with suicide risk only in females. These associations remained significant after adjusting for covariates. CONCLUSION: The results highlight the role of personality dimensions as risk factors for suicide-related behaviors. Different personality dimensions are significantly associated with suicide-related behaviors even when adjusting for other known risk factors of suicidality.

  16. Risk factors for idiopathic optic neuritis recurrence.

    Directory of Open Access Journals (Sweden)

    Yi Du

    Full Text Available Approximately 30-50% of idiopathic optic neuritis (ION patients experience one or multiple episodes of recurrence. The aim of this study was to search for risk factors for ION recurrence.Clinical data on hospitalized patients diagnosed with ION between January 2003 and January 2011 at the First Affiliated Hospital of Guangxi Medical University were retrospectively collected. Univariate and multivariate analyses were performed on factors that might cause ION recurrence. In total, 115 ION cases (32 recurrent and 83 non-recurrent cases with complete data were analyzed. The length of the follow-up period ranged from 12 to 108 months (median: 42 months.The univariate analysis showed that the recurrence rate for unilateral ION was higher than that for bilateral ION (40% vs. 12%, p=0.001. Underlying diseases had a significant impact on recurrence (p<0.001: the recurrence rates due to neuromyelitis optica (NMO, multiple sclerosis (MS, demyelinating lesions alone of the central nervous system, and unknown causes were 89%, 70%, 41%, and 8.7%, respectively. The multivariate analysis showed that the factors causing relatively high recurrence rates included NMO (odds ratio [OR], 73.5; 95% confidence interval [CI], 7.3 to 740.9, MS (OR, 33.9; 95% CI, 5.2 to 222.2, and demyelinating lesions alone (OR, 8.9; 95% CI, 2.3 to 34.4, unilateral involvement (OR, 5.7; 95% CI, 1.5 to 21.3, relatively low initial glucocorticoid dosage (equivalent to ≤ 100 mg prednisone/day (OR, 4.3; 95% CI, 1.0 to 17.9.Underlying diseases, laterality (unilateral or bilateral, and initial glucocorticoid dosage are important risk factors of ION recurrence. Clinical physicians are advised to treat ION patients with a sufficient dose of glucocorticoid in the initial treatment stage to reduce the recurrence risk.

  17. Modifiable risk factors for increased arterial stiffness in outpatient nephrology.

    Directory of Open Access Journals (Sweden)

    Usama Elewa

    Full Text Available Arterial stiffness, as measured by pulse wave velocity (PWV, is an independent predictor of cardiovascular events and mortality. Arterial stiffness increases with age. However, modifiable risk factors such as smoking, BP and salt intake also impact on PWV. The finding of modifiable risk factors may lead to the identification of treatable factors, and, thus, is of interest to practicing nephrologist. We have now studied the prevalence and correlates of arterial stiffness, assessed by PWV, in 191 patients from nephrology outpatient clinics in order to identify modifiable risk factors for arterial stiffness that may in the future guide therapeutic decision-making. PWV was above normal levels for age in 85/191 (44.5% patients. Multivariate analysis showed that advanced age, systolic BP, diabetes mellitus, serum uric acid and calcium polystyrene sulfonate therapy or calcium-containing medication were independent predictors of PWV. A new parameter, Delta above upper limit of normal PWV (Delta PWV was defined to decrease the weight of age on PWV values. Delta PWV was calculated as (measured PWV - (upper limit of the age-adjusted PWV values for the general population. Mean±SD Delta PWV was 0.76±1.60 m/sec. In multivariate analysis, systolic blood pressure, active smoking and calcium polystyrene sulfonate therapy remained independent predictors of higher delta PWV, while age, urinary potassium and beta blocker therapy were independent predictors of lower delta PWV. In conclusion, arterial stiffness was frequent in nephrology outpatients. Systolic blood pressure, smoking, serum uric acid, calcium-containing medications, potassium metabolism and non-use of beta blockers are modifiable factors associated with increased arterial stiffness in Nephrology outpatients.

  18. Risk factors for dental caries in children with developmental disabilities.

    Science.gov (United States)

    Braúna, Ana Paula Vasques Sales; Abreu, Mauro Henrique Nogueira Guimarães de; Resende, Vera Lúcia Silva; Castilho, Lia Silva de

    2016-06-14

    The aim of the present study was to investigate risk factors for dental caries in children with developmental disabilities who were treated at a clinical reference service for patients with special needs in Belo Horizonte, MG, Brazil. This is a retrospective cohort study that evaluated 401 dental charts of individuals without dental caries or restorations in their first dental appointment. The dependent variable was the time of occurrence of new dental caries or restorations and was measured in months. Gender, age, International Code of Diseases (ICD), mother´s education, sugar consumption, use of fluoride toothpaste, oral hygiene, mouth breathing, reports of xerostomia, gingival status, use of psychotropic or asthma drugs, and history of asthma were covariates. The Cox proportional hazards regression model was used to estimate the raw and adjusted hazard ratios and their respective 95% confidence intervals. The average time that individuals remained free of dental caries/restoration was equal to 107.46 months (95%CI 95.41 to 119.51), with a median of caries-free children up to 94 months. For each point increase in the scale of sucrose consumption, the increase in caries risk was 1.07 (95%CI 1.01 to 1.15). Sucrose consumption was the only risk factor for dental caries found in this group of individuals with developmental disabilities.

  19. Early life course risk factors for childhood obesity: the IDEFICS case-control study.

    Directory of Open Access Journals (Sweden)

    Karin Bammann

    Full Text Available BACKGROUND: The early life course is assumed to be a critical phase for childhood obesity; however the significance of single factors and their interplay is not well studied in childhood populations. OBJECTIVES: The investigation of pre-, peri- and postpartum risk factors on the risk of obesity at age 2 to 9. METHODS: A case-control study with 1,024 1:1-matched case-control pairs was nested in the baseline survey (09/2007-05/2008 of the IDEFICS study, a population-based intervention study on childhood obesity carried out in 8 European countries in pre- and primary school settings. Conditional logistic regression was used for identification of risk factors. RESULTS: For many of the investigated risk factors, we found a raw effect in our study. In multivariate models, we could establish an effect for gestational weight gain (adjusted OR = 1.02; 95%CI 1.00-1.04, smoking during pregnancy (adjusted OR = 1.48; 95%CI 1.08-2.01, Caesarian section (adjusted OR = 1.38; 95%CI 1.10-1.74, and breastfeeding 4 to 11 months (adjusted OR = 0.77; 95%CI 0.62-0.96. Birth weight was related to lean mass rather than to fat mass, the effect of smoking was found only in boys, but not in girls. After additional adjustment for parental BMI and parental educational status, only gestational weight gain remained statistically significant. Both, maternal as well as paternal BMI were the strongest risk factors in our study, and they confounded several of the investigated associations. CONCLUSIONS: Key risk factors of childhood obesity in our study are parental BMI and gestational weight gain; consequently prevention approaches should target not only children but also adults. The monitoring of gestational weight seems to be of particular importance for early prevention of childhood obesity.

  20. Early life course risk factors for childhood obesity: the IDEFICS case-control study.

    Science.gov (United States)

    Bammann, Karin; Peplies, Jenny; De Henauw, Stefaan; Hunsberger, Monica; Molnar, Denes; Moreno, Luis A; Tornaritis, Michael; Veidebaum, Toomas; Ahrens, Wolfgang; Siani, Alfonso

    2014-01-01

    The early life course is assumed to be a critical phase for childhood obesity; however the significance of single factors and their interplay is not well studied in childhood populations. The investigation of pre-, peri- and postpartum risk factors on the risk of obesity at age 2 to 9. A case-control study with 1,024 1:1-matched case-control pairs was nested in the baseline survey (09/2007-05/2008) of the IDEFICS study, a population-based intervention study on childhood obesity carried out in 8 European countries in pre- and primary school settings. Conditional logistic regression was used for identification of risk factors. For many of the investigated risk factors, we found a raw effect in our study. In multivariate models, we could establish an effect for gestational weight gain (adjusted OR = 1.02; 95%CI 1.00-1.04), smoking during pregnancy (adjusted OR = 1.48; 95%CI 1.08-2.01), Caesarian section (adjusted OR = 1.38; 95%CI 1.10-1.74), and breastfeeding 4 to 11 months (adjusted OR = 0.77; 95%CI 0.62-0.96). Birth weight was related to lean mass rather than to fat mass, the effect of smoking was found only in boys, but not in girls. After additional adjustment for parental BMI and parental educational status, only gestational weight gain remained statistically significant. Both, maternal as well as paternal BMI were the strongest risk factors in our study, and they confounded several of the investigated associations. Key risk factors of childhood obesity in our study are parental BMI and gestational weight gain; consequently prevention approaches should target not only children but also adults. The monitoring of gestational weight seems to be of particular importance for early prevention of childhood obesity.

  1. Development of a Risk-adjustment Model for the Inpatient Rehabilitation Facility Discharge Self-care Functional Status Quality Measure.

    Science.gov (United States)

    Deutsch, Anne; Pardasaney, Poonam; Iriondo-Perez, Jeniffer; Ingber, Melvin J; Porter, Kristie A; McMullen, Tara

    2017-07-01

    Functional status measures are important patient-centered indicators of inpatient rehabilitation facility (IRF) quality of care. We developed a risk-adjusted self-care functional status measure for the IRF Quality Reporting Program. This paper describes the development and performance of the measure's risk-adjustment model. Our sample included IRF Medicare fee-for-service patients from the Centers for Medicare & Medicaid Services' 2008-2010 Post-Acute Care Payment Reform Demonstration. Data sources included the Continuity Assessment Record and Evaluation Item Set, IRF-Patient Assessment Instrument, and Medicare claims. Self-care scores were based on 7 Continuity Assessment Record and Evaluation items. The model was developed using discharge self-care score as the dependent variable, and generalized linear modeling with generalized estimation equation to account for patient characteristics and clustering within IRFs. Patient demographics, clinical characteristics at IRF admission, and clinical characteristics related to the recent hospitalization were tested as risk adjusters. A total of 4769 patient stays from 38 IRFs were included. Approximately 57% of the sample was female; 38.4%, 75-84 years; and 31.0%, 65-74 years. The final model, containing 77 risk adjusters, explained 53.7% of variance in discharge self-care scores (P<0.0001). Admission self-care function was the strongest predictor, followed by admission cognitive function and IRF primary diagnosis group. The range of expected and observed scores overlapped very well, with little bias across the range of predicted self-care functioning. Our risk-adjustment model demonstrated strong validity for predicting discharge self-care scores. Although the model needs validation with national data, it represents an important first step in evaluation of IRF functional outcomes.

  2. Risk factors for asthma exacerbation in patients presenting to an ...

    African Journals Online (AJOL)

    Background: Asthma exacerbations are caused by a variety of risk factors. Reducing exposure to these risk factors improves the control of asthma and reduces medication needs. Knowledge of the particular risk factors is essential in formulating controlling and treatment protocols. This study set out to determine the risk ...

  3. Risk Factors for Placenta Praevia in Jos, North Central Nigeria ...

    African Journals Online (AJOL)

    About half (44.8%) of the cases had no known risk factor. Conclusion: Uterine scaring following abortion management is an important risk factor for placenta praevia. However, majority of patients with placenta praevia in this work have no identifiable risk factor. Key Words: placenta praevia, antepartum haemorrhage, risk ...

  4. Relation of physical activity to cardiovascular disease mortality and the influence of cardiometabolic risk factors.

    Science.gov (United States)

    Reddigan, Jacinta I; Ardern, Chris I; Riddell, Michael C; Kuk, Jennifer L

    2011-11-15

    Physical activity can improve several metabolic risk factors associated with cardiovascular disease (CVD) and is associated with a lower risk of CVD mortality. We sought to evaluate the extent to which metabolic risk factors mediate the association between physical activity and CVD mortality and whether physical activity provides protective effects against CVD mortality in healthy adults and those with metabolic risk factors. A sample of 10,261 adults from the Third National Health and Nutrition Examination Survey with public-access mortality data linkage (follow-up 13.4 ± 3.9 years) was used. Physical activity was assessed by questionnaire and classified into inactive, light, and moderate/vigorous activity categories. Metabolic risk factors (dyslipidemia, type 2 diabetes mellitus, obesity, hypertension, inflammation, and insulin resistance) were categorized using clinical thresholds. After adjusting for basic confounders, engaging in light or moderate/vigorous physical activity was associated with a lower risk of CVD mortality (p activity remained at lower risk of CVD mortality. In addition, physical activity provided protective effects for CVD mortality in healthy subjects and those with metabolic risk factors in isolation or in clusters. In conclusion, physical activity was associated with a lower risk of CVD mortality independent of traditional and inflammatory risk factors. Taken together these results suggest that physical activity may protect against CVD mortality regardless of the presence of metabolic risk factors. Copyright © 2011 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2017-12-01

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

  6. Applications of spectral band adjustment factors (SBAF) for cross-calibration

    Science.gov (United States)

    Chander, Gyanesh

    2013-01-01

    To monitor land surface processes over a wide range of temporal and spatial scales, it is critical to have coordinated observations of the Earth's surface acquired from multiple spaceborne imaging sensors. However, an integrated global observation framework requires an understanding of how land surface processes are seen differently by various sensors. This is particularly true for sensors acquiring data in spectral bands whose relative spectral responses (RSRs) are not similar and thus may produce different results while observing the same target. The intrinsic offsets between two sensors caused by RSR mismatches can be compensated by using a spectral band adjustment factor (SBAF), which takes into account the spectral profile of the target and the RSR of the two sensors. The motivation of this work comes from the need to compensate the spectral response differences of multispectral sensors in order to provide a more accurate cross-calibration between the sensors. In this paper, radiometric cross-calibration of the Landsat 7 Enhanced Thematic Mapper Plus (ETM+) and the Terra Moderate Resolution Imaging Spectroradiometer (MODIS) sensors was performed using near-simultaneous observations over the Libya 4 pseudoinvariant calibration site in the visible and near-infrared spectral range. The RSR differences of the analogous ETM+ and MODIS spectral bands provide the opportunity to explore, understand, quantify, and compensate for the measurement differences between these two sensors. The cross-calibration was initially performed by comparing the top-of-atmosphere (TOA) reflectances between the two sensors over their lifetimes. The average percent differences in the long-term trends ranged from $-$5% to $+$6%. The RSR compensated ETM+ TOA reflectance (ETM+$^{ast}$) measurements were then found to agree with MODIS TOA reflectance to within 5% for all bands when Earth Observing-1 Hy- erion hyperspectral data were used to produce the SBAFs. These differences were later

  7. WBGT clothing adjustment factors for four clothing ensembles and the effects of metabolic demands.

    Science.gov (United States)

    Bernard, Thomas E; Caravello, Victor; Schwartz, Skai W; Ashley, Candi D

    2008-01-01

    This study measured the clothing adjustment factors (CAFs) for four clothing ensembles (Cotton Coveralls, Tyvek 1427 Coveralls, NexGen Coveralls, and Tychem QC Coveralls; all coveralls were worn without hoods) against a baseline of cotton work clothes to determine whether the CAFs would be affected by the metabolic rate. Fifteen participants wore one of the five ensembles while walking on a treadmill at low, moderate, and high rates of work in an environment maintained at 50% relative humidity. A climatic chamber was used to slowly increase the level of heat stress by increasing air temperature. When the participant's core temperature reached a steady-state, the dry bulb temperature was increased. The point at which the core temperature began to increase was defined as the inflection point, and the WBGT recorded 5 min before the inflection point was the critical WBGT for each ensemble. A three-way mixed effects linear model with ensemble by metabolic rate category interactions demonstrated that the CAF did not change with metabolic rate, so CAFs can be used over a wide range of metabolic rates. The data at the moderate metabolic rate were combined with data on 14 participants from a previous study under the same conditions. The CAFs in degrees C WBGT were 0 for cotton coveralls, 1.0 for Tyvek 1422A, and 2.5 for NexGen. Although the value of 7.5 for Tychem QC was found, the recommendation remained at 10 to account for the effects of humidity. The standard error for the determination of WBGT crit at 50% relative humidity was 1.60 degrees C WBGT.

  8. Risk factors of periodontal disease in Vietnamese patients.

    Science.gov (United States)

    Pham, Thuy A V; Kieu, Thoai Q; Ngo, Lan T Q

    2017-05-12

    The aim of the present study was to assess the association of periodontitis with dental and smoking behaviors, self-perception of oral status, dental knowledge, and obesity in Vietnamese patients. A cross-sectional study was conducted on 367 adults who first visited the Faculty of Odonto-Stomatology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam. Information on demographic characteristics, dental and smoking behaviors, self-perception of oral status, dental knowledge, and nutritional status was investigated by a self-administered questionnaire. Periodontal status, including plaque index, probing depth, and bleeding on probing, was examined. Multiple logistic regression analysis was performed to explore risk factors that were associated with periodontitis after adjusting for confounding factors. Dental and smoking behaviors, dental knowledge, and nutritional status were all significantly related to periodontitis. The multiple logistic regression analysis showed that patients who had risk factors significantly associated with periodontitis were those who had dental scaling during the past year (odds ratio [OR]: 2.2), current smokers (OR: 2.47), who received instructions on oral hygiene (OR=1.73), and those who were overweight/obese (OR: 4.78). Periodontitis was correlated with dental and smoking behaviors, dental knowledge, and nutritional status in Vietnamese dental patients. Promoting a healthy lifestyle, reducing tobacco consumption, motivating oral self-care behaviors, together with normal weight maintenance, are necessary to reduce periodontal disease burdens. © 2017 John Wiley & Sons Australia, Ltd.

  9. Risk factors for breast cancer among Filipino women in Manila.

    Science.gov (United States)

    Gibson, Lorna J; Héry, Clarisse; Mitton, Nicolas; Gines-Bautista, Abigail; Parkin, D Maxwell; Ngelangel, Corazon; Pisani, Paola

    2010-01-15

    Age-adjusted incidence rates of breast cancer vary greatly worldwide with highest rates found in the typically 'westernised' countries of North America and Europe. Much lower rates are observed in Asian and African populations but an exception to this has been reported for the Manila Cancer Registry in the Philippines. The reason for this high rate is unknown but may be associated with the change in lifestyle that has occurred in urban Manila since the 1960s. In 1995, a randomised controlled trial was set up in Manila to evaluate the feasibility of a screening intervention by clinical breast examination as an alternative to mammography. The cohort of 151,168 women was followed-up to 2001 for cancer incidence and a nested case-control study carried out. This aimed to evaluate the increase in breast cancer risk associated with known risk factors. Increased risks were seen for a high level of education (OR = 1.9 95%CI 1.1-3.3 for education stopped at > or =13 versus or =30 versus Manila, especially when compared to other urban Asian populations. We conclude that it is too simplistic to ascribe the high risk to 'westernisation'.

  10. Internet Abuse Risk Factors among Spanish Adolescents.

    Science.gov (United States)

    Carballo, José L; Marín-Vila, María; Espada, José P; Orgilés, Mireia; Piqueras, José A

    2015-11-27

    Empirical evidence has revealed various factors that contribute to the development and maintenance of Internet abuse. The aim of this paper was to analyze, on a sample of Spanish adolescents, the relationship between Internet abuse and: (1) Personal and interpersonal risk factors, including social skills in both virtual and real-life contexts; (2) Drug use. A total of 814 high school students aged between 13 and 17 participated in this study, and were divided into two groups: Internet Abusers (IA = 173) and Non-Internet Abusers (NIA = 641). Questionnaires were used to analyze Internet and drug use/abuse, as well as social skills, in virtual and real contexts. Various interpersonal risk factors (family and group of friends) were also assessed. IA showed a more severe pattern of Internet and drug use, as well as poorer social skills in both contexts. Moreover, their groups of friends appeared more likely to become involved in risky situations related to Internet and drug abuse. Both IA and NIA showed more adaptive social skills in the virtual context than in the real one. There is a need for further research to build on these findings, with a view to designing specific preventive programs that promote responsible Internet use.

  11. Assessing risk factors for periodontitis using regression

    Science.gov (United States)

    Lobo Pereira, J. A.; Ferreira, Maria Cristina; Oliveira, Teresa

    2013-10-01

    Multivariate statistical analysis is indispensable to assess the associations and interactions between different factors and the risk of periodontitis. Among others, regression analysis is a statistical technique widely used in healthcare to investigate and model the relationship between variables. In our work we study the impact of socio-demographic, medical and behavioral factors on periodontal health. Using regression, linear and logistic models, we can assess the relevance, as risk factors for periodontitis disease, of the following independent variables (IVs): Age, Gender, Diabetic Status, Education, Smoking status and Plaque Index. The multiple linear regression analysis model was built to evaluate the influence of IVs on mean Attachment Loss (AL). Thus, the regression coefficients along with respective p-values will be obtained as well as the respective p-values from the significance tests. The classification of a case (individual) adopted in the logistic model was the extent of the destruction of periodontal tissues defined by an Attachment Loss greater than or equal to 4 mm in 25% (AL≥4mm/≥25%) of sites surveyed. The association measures include the Odds Ratios together with the correspondent 95% confidence intervals.

  12. Age-adjusted high-sensitivity troponin T cut-off value for risk stratification of pulmonary embolism.

    Science.gov (United States)

    Kaeberich, Anja; Seeber, Valerie; Jiménez, David; Kostrubiec, Maciej; Dellas, Claudia; Hasenfuß, Gerd; Giannitsis, Evangelos; Pruszczyk, Piotr; Konstantinides, Stavros; Lankeit, Mareike

    2015-05-01

    High-sensitivity troponin T (hsTnT) helps in identifying pulmonary embolism patients at low risk of an adverse outcome. In 682 normotensive pulmonary embolism patients we investigate whether an optimised hsTnT cut-off value and adjustment for age improve the identification of patients at elevated risk. Overall, 25 (3.7%) patients had an adverse 30-day outcome. The established hsTnT cut-off value of 14 pg·mL(-1) retained its high prognostic value (OR (95% CI) 16.64 (2.24-123.74); p=0.006) compared with the cut-off value of 33 pg·mL(-1) calculated by receiver operating characteristic analysis (7.14 (2.64-19.26); pvalue of 45 pg·mL(-1) but not the established cut-off value of 14 pg·mL(-1) predicted an adverse outcome. An age-adjusted hsTnT cut-off value (≥14 pg·mL(-1) for patients aged risk (12.4% adverse outcome). Risk assessment of normotensive pulmonary embolism patients was improved by the introduction of an age-adjusted hsTnT cut-off value. A three-step approach helped identify patients at higher risk of an adverse outcome who might benefit from advanced therapy. Copyright ©ERS 2015.

  13. Cancer risk assessment on trihalomethanes and haloacetic acids in drinking water of China using disability-adjusted life years.

    Science.gov (United States)

    Pan, Shenling; An, Wei; Li, Hongyan; Su, Ming; Zhang, Jinliang; Yang, Min

    2014-09-15

    The cancer risks from exposure to trihalomethanes (THMs) and haloacetic acids (HAAs) through multiple pathways were assessed based on the result of a water quality survey in 35 major cities of China. To express the risks in disability-adjusted life years (DALYs), the excess cancer incidence estimates were combined with a two-stage disease model for calculation. The median total cancer risk of THMs and HAAs was calculated as 7.34 × 10(-7) DALYs per person-year (ppy), lower than the reference level of risk (10(-6)DALYsppy) set by WHO. The risk from ingestion and inhalation exposures contributed 93.6% and 6.3% of the total risk respectively, while dermal contact made a negligible contribution. The median risk of trichloroacetic acid (TCAA) (2.12 × 10(-7)DALYsppy) was highest among the disinfection by-products (DBPs) considered. The risk ratio of total HAAs (THAA) to total THMs (TTHM) was 1.12. The risk was highest in northeast China while lowest in northwest China. As for the 35 cities, Tianjin had the highest risk while Yinchuan had the lowest. This study attempted to use DALYs for the risk assessment of DBPs, which will provide useful information for risk comparison and prioritization of hazards in drinking water. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Persistent postsurgical pain: risk factors and prevention

    DEFF Research Database (Denmark)

    Kehlet, Henrik; Jensen, Troels Staehelin; Woolf, Clifford J.

    2006-01-01

    Acute postoperative pain is followed by persistent pain in 10-50% of individuals after common operations, such as groin hernia repair, breast and thoracic surgery, leg amputation, and coronary artery bypass surgery. Since chronic pain can be severe in about 2-10% of these patients, persistent...... therapy for postoperative pain should be investigated, since the intensity of acute postoperative pain correlates with the risk of developing a persistent pain state. Finally, the role of genetic factors should be studied, since only a proportion of patients with intraoperative nerve damage develop...... chronic pain. Based on information about the molecular mechanisms that affect changes to the peripheral and central nervous system in neuropathic pain, several opportunities exist for multimodal pharmacological intervention. Here, we outline strategies for identification of patients at risk...

  15. OCCUPATIONAL RISK FACTORS IN KNEE OSTEOARTHRITIS

    Directory of Open Access Journals (Sweden)

    Muralidhara

    2015-12-01

    Full Text Available INTRODUCTION Osteoarthritis (OA, also often called “osteoarthrosis” or “degenerative joint disease” is the most common form of arthritis. MATERIALS AND METHODS Present retrospective statistical study was conducted at the Department of orthopaedics in a tertiary care hospital (Catering to a largely agricultural population over a period of 2 years from January 2012 to December 2014. RESULTS Prevalence of osteoarthritis common in farmers accounting to 70%. Other occupations at risk of OA of knee were, Teachers 12%, Housewives 08%, Athletes 04%, Policemen 04% and Drivers 02%. It is in conformity with most previous studies reviewed. CONCLUSION Osteoarthritis of Knee is a major health issue and important cause of disability in elderly population. Occupational risk factors are important in development of osteoarthritis.

  16. Analysis of Hepatitis B Transmission Risk Factors in HIV Patients

    Directory of Open Access Journals (Sweden)

    Iman Ghasemzadeh

    2016-09-01

    Full Text Available Co-infection with Hepatitis B (HBV virus and HIV is common due to similarity of their transmission methods. However, the prevalence of concurrent infection in different societies, shows the crucial role of various risk factors in different populations. Therefore, the present study was performed to examine risk factors of transmission of HBV in patients with HIV in a care center for AIDS patients in Rasht City. This case-control study was carried out on 60 HIV positive patients, who visited the Infectious Diseases Center of Razi Hospital of Rasht from November, 2015 to March, 2016. Participants were assigned to two 30-member experiment and control groups. They were adjusted in terms of age group (18-30, 30-40, 40-50, and 50-60, gender (male and female, and marital status (married, single, divorced, and widowed and visited by an infectious diseases specialist according to routine examinations. Data was recorded in a questionnaire for each subject. The mean age for the experimental group was 35±6.1, and for control group was 36.6± 5.7 years. Both univariate and multivariate analyses of development of HBV infection and variables including Illegitimate sexual intercourse, use of intravenous injection drugs, positive history of imprisonment, and tattooing (p value < 0.05 showed existence of significant relationships. Injection of illegal intravenous drugs, history of imprisonment, illegitimate sexual intercourse, and tattooing are four important risk factors for transmission of HBV infection to HIV patients. In addition, the master risk reduction program may include provision of clean disposable tools for intravenous injection of drugs and tattooing.

  17. Adolescent self-harm and risk factors.

    Science.gov (United States)

    Zhang, Jixiang; Song, Jianwei; Wang, Jing

    2016-12-01

    This study aims to define the characteristics of adolescents who have engaged in self-harm behavior and ascertain the risk factors. From January 2013 to January 2014, 4,176 adolescents from senior middle schools in Linyi, China, were administered four questionnaire surveys to ascertain the following: incidence of self-harm behavior regarding the frequency of different self-harm behaviors by group (never/one to five times/greater than five times in the last 6 months) and then comparing the self-harm behavior of the different subgroups; symptom self-check, comparing the differences between the adolescents with self-harm behavior and without in nine subscales (somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, fear, paranoid, and psychosis); Adolescent Self-Rating Life Events Check List scores; and Egna Minnenav Barndoms Uppfostran (EMBU) scores. Multivariate logistic regression analysis was used to determine the risk factors of self-harm in adolescents. The incidence of adolescent self-harm was 27.60%; the occurrence of adolescent self-harm was closely related to their mental health status, stressful life events, and EMBU. Being female, an urban student, or an only child; having poor school performance or experiences of stressful life events, harsh parenting styles, or excessive interference; and poor mental health were the risk factors for adolescent self-harm. The incidence of adolescent self-harm was high, and their mental health status, stressful life events, and EMBU affected the occurrence of adolescent self-harm, which is an issue that needs greater attention. © 2016 John Wiley & Sons Australia, Ltd.

  18. Are low wages risk factors for hypertension?

    Science.gov (United States)

    Leigh, J Paul; Du, Juan

    2012-12-01

    Socio-economic status (SES) is strongly correlated with hypertension. But SES has several components, including income and correlations in cross-sectional data need not imply SES is a risk factor. This study investigates whether wages-the largest category within income-are risk factors. We analysed longitudinal, nationally representative US data from four waves (1999, 2001, 2003 and 2005) of the Panel Study of Income Dynamics. The overall sample was restricted to employed persons age 25-65 years, n = 17 295. Separate subsamples were constructed of persons within two age groups (25-44 and 45-65 years) and genders. Hypertension incidence was self-reported based on physician diagnosis. Our study was prospective since data from three base years (1999, 2001, 2003) were used to predict newly diagnosed hypertension for three subsequent years (2001, 2003, 2005). In separate analyses, data from the first base year were used to predict time-to-reporting hypertension. Logistic regressions with random effects and Cox proportional hazards regressions were run. Negative and strongly statistically significant correlations between wages and hypertension were found both in logistic and Cox regressions, especially for subsamples containing the younger age group (25-44 years) and women. Correlations were stronger when three health variables-obesity, subjective measures of health and number of co-morbidities-were excluded from regressions. Doubling the wage was associated with 25-30% lower chances of hypertension for persons aged 25-44 years. The strongest evidence for low wages being risk factors for hypertension among working people were for women and persons aged 25-44 years.

  19. Are low wages risk factors for hypertension?

    Science.gov (United States)

    Du, Juan

    2012-01-01

    Objective: Socio-economic status (SES) is strongly correlated with hypertension. But SES has several components, including income and correlations in cross-sectional data need not imply SES is a risk factor. This study investigates whether wages—the largest category within income—are risk factors. Methods: We analysed longitudinal, nationally representative US data from four waves (1999, 2001, 2003 and 2005) of the Panel Study of Income Dynamics. The overall sample was restricted to employed persons age 25–65 years, n = 17 295. Separate subsamples were constructed of persons within two age groups (25–44 and 45–65 years) and genders. Hypertension incidence was self-reported based on physician diagnosis. Our study was prospective since data from three base years (1999, 2001, 2003) were used to predict newly diagnosed hypertension for three subsequent years (2001, 2003, 2005). In separate analyses, data from the first base year were used to predict time-to-reporting hypertension. Logistic regressions with random effects and Cox proportional hazards regressions were run. Results: Negative and strongly statistically significant correlations between wages and hypertension were found both in logistic and Cox regressions, especially for subsamples containing the younger age group (25–44 years) and women. Correlations were stronger when three health variables—obesity, subjective measures of health and number of co-morbidities—were excluded from regressions. Doubling the wage was associated with 25–30% lower chances of hypertension for persons aged 25–44 years. Conclusions: The strongest evidence for low wages being risk factors for hypertension among working people were for women and persons aged 25–44 years. PMID:22262559

  20. Reproductive Risk Factors and Coronary Heart Disease in the Women's Health Initiative Observational Study.

    Science.gov (United States)

    Parikh, Nisha I; Jeppson, Rebecca P; Berger, Jeffrey S; Eaton, Charles B; Kroenke, Candyce H; LeBlanc, Erin S; Lewis, Cora E; Loucks, Eric B; Parker, Donna R; Rillamas-Sun, Eileen; Ryckman, Kelli K; Waring, Molly E; Schenken, Robert S; Johnson, Karen C; Edstedt-Bonamy, Anna-Karin; Allison, Matthew A; Howard, Barbara V

    2016-05-31

    Reproductive factors provide an early window into a woman's coronary heart disease (CHD) risk; however, their contribution to CHD risk stratification is uncertain. In the Women's Health Initiative Observational Study, we constructed Cox proportional hazards models for CHD including age, pregnancy status, number of live births, age at menarche, menstrual irregularity, age at first birth, stillbirths, miscarriages, infertility ≥1 year, infertility cause, and breastfeeding. We next added each candidate reproductive factor to an established CHD risk factor model. A final model was then constructed with significant reproductive factors added to established CHD risk factors. Improvement in C statistic, net reclassification index (or net reclassification index with risk categories of reproductive risk factor model had a C statistic of 0.675 for CHD. In a model adjusted for established CHD risk factors, younger age at first birth, number of still births, number of miscarriages, and lack of breastfeeding were positively associated with CHD. Reproductive factors modestly improved model discrimination (C statistic increased from 0.726 to 0.730; integrated discriminatory index, 0.0013; Preproductive factors are associated with CHD independently of established CHD risk factors, very modestly improve model discrimination, and do not materially improve net reclassification. © 2016 American Heart Association, Inc.

  1. Maternal and fetal risk factors for stillbirth: population based study.

    Science.gov (United States)

    Gardosi, Jason; Madurasinghe, Vichithranie; Williams, Mandy; Malik, Asad; Francis, André

    2013-01-24

    To assess the main risk factors associated with stillbirth in a multiethnic English maternity population. Cohort study. National Health Service region in England. 92,218 normally formed singletons including 389 stillbirths from 24 weeks of gestation, delivered during 2009-11. Risk of stillbirth. Multivariable analysis identified a significant risk of stillbirth for parity (para 0 and para ≥ 3), ethnicity (African, African-Caribbean, Indian, and Pakistani), maternal obesity (body mass index ≥ 30), smoking, pre-existing diabetes, and history of mental health problems, antepartum haemorrhage, and fetal growth restriction (birth weight below 10th customised birthweight centile). As potentially modifiable risk factors, maternal obesity, smoking in pregnancy, and fetal growth restriction together accounted for 56.1% of the stillbirths. Presence of fetal growth restriction constituted the highest risk, and this applied to pregnancies where mothers did not smoke (adjusted relative risk 7.8, 95% confidence interval 6.6 to 10.9), did smoke (5.7, 3.6 to 10.9), and were exposed to passive smoke only (10.0, 6.6 to 15.8). Fetal growth restriction also had the largest population attributable risk for stillbirth and was fivefold greater if it was not detected antenatally than when it was (32.0% v 6.2%). In total, 195 of the 389 stillbirths in this cohort had fetal growth restriction, but in 160 (82%) it had not been detected antenatally. Antenatal recognition of fetal growth restriction resulted in delivery 10 days earlier than when it was not detected: median 270 (interquartile range 261-279) days v 280 (interquartile range 273-287) days. The overall stillbirth rate (per 1000 births) was 4.2, but only 2.4 in pregnancies without fetal growth restriction, increasing to 9.7 with antenatally detected fetal growth restriction and 19.8 when it was not detected. Most normally formed singleton stillbirths are potentially avoidable. The single largest risk factor is unrecognised fetal

  2. Pain, depression, and fatigue: loneliness as a longitudinal risk factor.

    Science.gov (United States)

    Jaremka, Lisa M; Andridge, Rebecca R; Fagundes, Christopher P; Alfano, Catherine M; Povoski, Stephen P; Lipari, Adele M; Agnese, Doreen M; Arnold, Mark W; Farrar, William B; Yee, Lisa D; Carson, William E; Bekaii-Saab, Tanios; Martin, Edward W; Schmidt, Carl R; Kiecolt-Glaser, Janice K

    2014-09-01

    Pain, depression, and fatigue function as a symptom cluster and thus may share common risk factors. Interpersonal relationships clearly influence health, suggesting that loneliness may promote the development of the pain, depression, and fatigue symptom cluster. We hypothesized that loneliness would be related to concurrent symptom cluster levels and increases in symptom cluster levels over time. We utilized two observational studies with distinct longitudinal samples. Study 1 was a sample of cancer survivors and benign controls (N = 115) assessed annually for 2 years. Study 2 was a sample of older adults caring for a spouse with dementia (caregivers) and non-caregiver controls (N = 229) assessed annually for 4 years. Participants completed annual measures assessing loneliness, pain, depression, and fatigue. Across both samples, lonelier participants experienced more concurrent pain, depression, and fatigue and larger increases in symptom cluster levels from one year to the next than less lonely participants. Sleep quality did not mediate the results in either study. All analyses were adjusted for relevant demographic and health variables. Two longitudinal studies with different populations demonstrated that loneliness was a risk factor for the development of the pain, depression, and fatigue symptom cluster over time. The current research helps identify people most at risk for pain, depression, and fatigue, and lays the groundwork for research about their diagnosis and treatment. These data also highlight the health risks of loneliness; pain, depression, and fatigue often accompany serious illness and place people at risk for poor health and mortality. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  3. Sleep disturbances as an evidence-based suicide risk factor.

    Science.gov (United States)

    Bernert, Rebecca A; Kim, Joanne S; Iwata, Naomi G; Perlis, Michael L

    2015-03-01

    Increasing research indicates that sleep disturbances may confer increased risk for suicidal behaviors, including suicidal ideation, suicide attempts, and death by suicide. Despite increased investigation, a number of methodological problems present important limitations to the validity and generalizability of findings in this area, which warrant additional focus. To evaluate and delineate sleep disturbances as an evidence-based suicide risk factor, a systematic review of the extant literature was conducted with methodological considerations as a central focus. The following methodologic criteria were required for inclusion: the report (1) evaluated an index of sleep disturbance; (2) examined an outcome measure for suicidal behavior; (3) adjusted for presence of a depression diagnosis or depression severity, as a covariate; and (4) represented an original investigation as opposed to a chart review. Reports meeting inclusion criteria were further classified and reviewed according to: study design and timeframe; sample type and size; sleep disturbance, suicide risk, and depression covariate assessment measure(s); and presence of positive versus negative findings. Based on keyword search, the following search engines were used: PubMed and PsycINFO. Search criteria generated N = 82 articles representing original investigations focused on sleep disturbances and suicide outcomes. Of these, N = 18 met inclusion criteria for review based on systematic analysis. Of the reports identified, N = 18 evaluated insomnia or poor sleep quality symptoms, whereas N = 8 assessed nightmares in association with suicide risk. Despite considerable differences in study designs, samples, and assessment techniques, the comparison of such reports indicates preliminary, converging evidence for sleep disturbances as an empirical risk factor for suicidal behaviors, while highlighting important, future directions for increased investigation.

  4. Subconjunctival hemorrhage: risk factors and potential indicators

    Directory of Open Access Journals (Sweden)

    Tarlan B

    2013-06-01

    Full Text Available Bercin Tarlan,1 Hayyam Kiratli21Department of Ophthalmology, Kozluk State Hospital, Batman, Turkey; 2Ocular Oncology Service, Hacettepe University Schoolof Medicine, Ankara, TurkeyAbstract: Subconjunctival hemorrhage is a benign disorder that is a common cause of acute ocular redness. The major risk factors include trauma and contact lens usage in younger patients, whereas among the elderly, systemic vascular diseases such as hypertension, diabetes, and arteriosclerosis are more common. In patients in whom subconjunctival hemorrhage is recurrent or persistent, further evaluation, including workup for systemic hypertension, bleeding disorders, systemic and ocular malignancies, and drug side effects, is warranted.Keywords: subconjunctival hemorrhage, contact lens, hypertension, red eye

  5. Resistant hypertension: epidemiology and risk factors

    Directory of Open Access Journals (Sweden)

    I. E. Deneka

    2016-01-01

    Full Text Available Despite the possibilities of contemporary pharmacotherapy, more than 80% of hypertensive patients do not achieve target blood pressure levels. Besides the obvious reasons – poor adherence of patients to treatment and non-rational therapy, there are other objective risk factors of resistance. Three main modifiable causes of resistant hypertension, that are often underestimated, are considered: obesity, obstructive sleep apnea syndrome and primary hyperaldosteronism. Understanding these mechanisms of resistance and their diagnostic criteria can improve the results of resistant hypertension treatment.

  6. [Environmental risk factors and epidemiologic study].

    Science.gov (United States)

    Signorelli, C; Limina, R M

    2002-01-01

    The problems regarding communication of risks in the environmental sector and the analysis of certain causes of pollution, together with their effects on human health are the subjects of this article. In an illustrative and concise manner results of the most important epidemiological studies concerning the effects of non-ionizing radiations, of radon and of air pollution have been analyzed. Throughout this analysis emphasis has been placed on the difficulty of obtaining clear and scientifically based results. Such results are needed in order to provide the population with satisfying information and thus meet the increasing demand for unambiguous answers. Among the risk factors for human health are the high frequency electromagnetic fields used for mobile phones (radiofrequency--RF) nd extremely low frequency electromagnetic fields (ELF-EMFs) of power-lines. Even though these risk factors may be minimal the high number of persons exposed could make them an important impact on public health. Regarding the topic of air pollution, effects on particular segments of the population (children, elderly people and subjects with chronic diseases) have been found in various studies; for example, for an increase of PM(10) of 10 microg/m(3) an increase in daily mortality of 0.69% (CI 0.40-0.98) due to cardiovascular and respiratory causes has been estimated as well as an increase in general daily mortality of 0.54% (CI 0.33-0.76). Due to the populations' low risk perception (caused by unawareness of the problem) radon is undoubtedly the environmental pollutant which has the most impact on public health. This is true even in Italy where 4,000 cases of lung cancer attributable to radon (about 11% of total lung cancer) have been estimated per year; this risk is heightened by the combined effect with smoking. When dealing with health risks the tools of communication must be simple and correct; the mass-media are the most important mediators between the scientific community and the

  7. Subclinical hypothyroidism as an independent risk factor for colorectal neoplasm.

    Science.gov (United States)

    Mu, Guifang; Mu, Xuefeng; Xing, Huizhi; Xu, Ruibiao; Sun, Guangxi; Dong, Chonghai; Pan, Qichuan; Xu, Chao

    2015-04-01

    Recently, the prevalence of colorectal neoplasm is increasing sharply. It has been reported that both colorectal neoplasm and cardiovascular disease share similar common risk factors. Subclinical hypothyroidism (SCH) occurs in 4-20% of the adult population and is an independent risk factor for cardiovascular disease. However, no study has yet explored the relationship between SCH and colorectal neoplasm. Our objectives were to clarify the association between the two conditions. This is a case-control study. A total of 273 cases of colorectal neoplasm were first identified, and a 1:3 matched random sample of 819 controls was then collected using strata according to age, and gender. The medical records of all these patients were retrieved. Blood pressure, body mass index, and thyroid function were determined. Colonoscopies were performed by experienced gastroenterologists. A logistic regression analysis was carried out to explore the relationship between SCH and colorectal neoplasm. Remarkably, the prevalence rate of SCH was significantly higher in colorectal neoplasm (+) group, compared with colorectal neoplasm (-) group (Pneoplasm was found in 67 (34.9%) subjects in SCH group, which was more than that in euthyroid group (P=0.002). Moreover, patients with SCH were more likely to have advanced colonic lesion and colorectal cancer compared with euthyroid subjects (P=0.028 and 0.036, respectively). After adjusting for the factors of blood pressure, body mass index, history of hypertension and smoking, an association still existed between colorectal neoplasm and SCH (OR=1.689, 95% CI: 1.207-2.362, P=0.002). A strong association between SCH and colorectal neoplasm was firstly identified. SCH was found to be an independent risk factor for colorectal neoplasm. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  8. [Risk factors of children overweight and obesity].

    Science.gov (United States)

    Abdelkafi Koubaa, Afifa; Younes, Kawthar; Gabsi, Zvinemira; Bouslah, Amel; Maalel, Issam; Maatouk El May, Wahiba; Dahmen, Hayet; Bel Abed, Najet; Bchir, Nedra; Gabsi, Abdallah; Tekaya, Mohamed Salah; Jebara, Hassen

    2012-05-01

    The increase of the prevalence of children obesity in some countries as Tunisia, necessitate to welling known risk factors for obesity, to prevent and early management. To determine the prevalence of overweight and of obesity in a group of 4-6 year-old school children in Monastir and to investigate the association with possible risk factors. A descriptive transversal study including 121 children aged 4-6 years old (637 males, 698 females), was conducted in 10 Kindergartens in Monastir, in 2011. Personal data such as age, sex, birth weight, breastfeeding history and parental data including parental weights and heights, parental education level and occupation were collected by questionnaires completed by parents. Height and weight were measured with a weighing-scale and body mass index (BMI; kg/m²) was calculated. The prevalence of overweight and obesity was defined based according to the curves of the french reference of Rolland Cachera. Prevalence of overweight and obesity was 9.1% and 11.6% respectively. Parental factors associated with overweight were: parental obesity: 44% vs 17% (p=0.005) (OR = 3.65: 1.27-10.57), artificial feeding: 68% vs 33% (p=0.0016) (OR= 4.25: 1.51-12.27), and the early diversification of food before the age of 6 months: 88% vs 65% (p=0.029) (OR= 3.84: 0.98 - 17.66). Exclusive breast feeding duration ≥ 6mois is probably protector factor against obesity: 0% vs 21% (p=0. 01) (OR=0: 0.00 overweight and non-overweight schoolchildren in frequency of high degree educated mother and father, birth weight, breakfast intake, eating habits and exercise. However overweight children intake high-caloric food, low in fiber, with troubles of nutritional comportment, and a sedentary lifestyle. Risk factors for obesity, well known in most industrialized countries, necessitate to be more understood in Tunisia, to place a preventive strategy included supervision of children weight, nutritional education and promote physical activity and reducing the time

  9. Role of hemostatic factors on the risk of venous thrombosis in people with impaired kidney function.

    Science.gov (United States)

    Ocak, Gürbey; Vossen, Carla Y; Lijfering, Willem M; Verduijn, Marion; Dekker, Friedo W; Rosendaal, Frits R; Cannegieter, Suzanne C

    2014-02-11

    Factors explaining the association between impaired kidney function and venous thrombosis have not been identified so far. The aim of our study was to determine whether the association between impaired kidney function and venous thrombosis can be explained by the concurrent presence of genetic or acquired venous thrombosis risk factors. The glomerular filtration rate was estimated (eGFR) in 2473 venous thrombosis patients and 2936 controls from a population-based case-control study. Kidney function was grouped into 6 categories based on percentiles of the eGFR in the controls (>50th [reference], 10th-50th, 5th-10th, 2.5th-5th, 1st-2.5th, and percentile). Several hemostatic factors showed a procoagulant shift with decreasing kidney function in controls, most notably factor VIII and von Willebrand factor. Compared with eGFR >50th percentile, factor VIII levels (adjusted mean difference, 60 IU/dL for the percentile category) and von Willebrand factor levels (adjusted mean difference, 60 IU/dL for the percentile category) increased with each percentile category. The odds ratios for venous thrombosis similarly increased across the categories from 1.1 (95% confidence interval, 0.9-1.3) for the 10th to 50th percentile to 3.7 (95% confidence interval, 2.4-5.7) for the percentile category. Adjustment for factor VIII or von Willebrand factor attenuated these odds ratios, indicating an effect of eGFR on thrombosis through these factors. Adjustments for other risk factors for venous thrombosis did not affect the odds ratios. Impaired kidney function affects venous thrombosis risk via concurrently raised factor VIII and von Willebrand factor levels.

  10. Perceptions of cancer risk factors and socioeconomic status. A French study.

    Science.gov (United States)

    Peretti-Watel, Patrick; Fressard, Lisa; Bocquier, Aurélie; Verger, Pierre

    2016-06-01

    The present paper investigates on lay people's beliefs regarding cancer risk factors' and their correlates, especially people's socioeconomic status (SES), as they may heavily contribute to social health inequalities. We used data from the 2010 Baromètre Cancer, a national representative telephone survey conducted in France (N = 3359, age 15-75, participation rate 52%). Respondents differentiate behavioral factors (smoking, drinking, unprotected sun exposure, etc.), environmental risk factors (air pollution, chemicals in food, etc.) and psychosocial risk factors (stress, painful experiences, etc.) for cancer. Those with a higher SES were more likely to emphasize behavioral and psychosocial factors, while those with an intermediate SES were more likely to do so for environmental ones. Perceived financial vulnerability was associated to higher perceptions for both environmental and psychosocial factors. After adjustment on socio-demographic background and SES, respondents who emphasized behavioral risk factors were less prone to endorse fatalistic attitudes (considering that nothing can be done to avoid cancer), while those who emphasized environmental risk factors were more prone to do so, and were also more frequently daily smokers. These results suggest that lay people's beliefs regarding cancer risk factors are shaped by their conceptions regarding one's body and health, and especially their health locus of control, as the tendency to either emphasize behavioral or environmental factors was correlated to fatalistic attitudes. Prevention campaigns designed to tackle lay people's perceptions regarding cancer risk factors should not consider they simply reflect ignorance or misinformation, as they are embedded in social and cultural contexts.

  11. Incidence and risk factors for capecitabine-induced symptomatic cardiotoxicity

    DEFF Research Database (Denmark)

    Polk, Anne; Shahmarvand, Nahid; Vistisen, Kirsten

    2016-01-01

    Objectives Case reports of capecitabine cardiotoxicity resemble those seen with intravenous 5-fluorouracil (5-FU) with chest pain as the predominant manifestation, but few studies of capecitabine cardiotoxicity are available. We aimed to determine the incidence of symptomatic cardiotoxicity from...... capecitabine in patients with breast cancer and to identify risk factors. Methods We reviewed medical records of consecutive women with breast cancer treated with capecitabine (1000 mg/m2 two times per day) from 2002 to 2012 at one institution. Results 22 of 452 patients (4.9%) (95% CI 2.9% to 6.9%) had...... adjusted for age. Patients with cardiac comorbidity were 5.5 times (95% CI 2.0 to 14.8) more likely to develop cardiotoxicity. In the subgroup of patients with apparently no cardiac comorbidity, the incidence of cardiotoxicity was lower (3.7%) and hypercholesterolaemia (p=0.035) and current smoking (p=0...

  12. HIV-infection as a self-reported risk factor for attempted suicide in ...

    African Journals Online (AJOL)

    to some studies.4. Diverse variables can affect suicidal behaviour in people with HIV/AIDS who are vulnerable to: various psychiatric disorders (including acute stress reactions, adjustment disorders, obsessive compulsive disorders involving. HIV-infection as a self-reported risk factor for attempted suicide in South Africa.

  13. Killing the mother of one's child: psychiatric risk factors among male perpetrators and offspring health consequences.

    Science.gov (United States)

    Lysell, Henrik; Dahlin, Marie; Långström, Niklas; Lichtenstein, Paul; Runeson, Bo

    2016-03-01

    To study possible psychiatric and criminological risk factors of intimate partner femicide (IPF) as well as the bereaved offspring's psychiatric morbidity and premature death. We conducted a nested case-control study, based on Swedish national registries, including all perpetrators of IPF. We computed risk estimates relative to matched population controls, which were compared to those of non-IPF homicide offenders. Exposed children were matched to population controls and followed longitudinally up to 37 years. Offspring outcomes were psychiatric and substance use disorders (according to ICD) self-harm; violent crime; suicide; and premature, all-cause death. We identified 261 male IPF perpetrators and 494 bereaved children from 1973 through 2009. Multivariable logistic regression suggested that major mental disorder (adjusted odds ratio [OR] = 5.9; 95% CI, 3.3-10.6) and violent crime convictions (adjusted OR = 4.4; 95% CI, 2.7-7.2) were independent risk factors of IPF, but substance use disorders were not (aOR = 0.4; 95% CI, 0.2-1.0). Children exposed to IPF before age 18 years had elevated risks of major mental disorder (adjusted hazard ratio [HR] = 5.7; 95% Cl, 3.0-10.6), substance use disorders (adjusted HR = 5.8; 95% CI, 2.8-11.9) and self-harm (adjusted HR = 5.7; 95% CI, 3.0-11.1). Offspring 18 years or older at the IPF had an increased risk of completed suicide (adjusted HR = 4.3; 95% CI, 1.3-14.5). Previous major mental disorder and violent behavior were strong independent risk factors for IPF. Bereavement caused by IPF had significant associations with the offspring's future life, especially for those below 18 years of age at exposure. Our findings demonstrate the need of direct support to the exposed offspring by health care providers and social services. © Copyright 2016 Physicians Postgraduate Press, Inc.

  14. Socioemotional and Academic Adjustment Among Children with Learning Disorders: The Mediational Role of Attachment-Based Factors

    Science.gov (United States)

    Al-Yagon, Michal; Mikulincer, Mario

    2004-01-01

    This study examined the role of attachment-based factors (children's attachment style, children's appraisal of teacher as a secure base, and teacher's feelings of closeness to child) in explaining differences in Israeli children's socioemotional adjustment (self-rated sense of coherence, loneliness) and academic functioning (teacher-rated). The…

  15. Factors Negatively Affecting University Adjustment from the Views of First-Year University Students: The Case of Mersin University

    Science.gov (United States)

    Sevinç, Seda; Gizir, Cem Ali

    2014-01-01

    This qualitative case study aims to investigate the most common factors that negatively affect adjustment to university and coping strategies used by first-year university students in the adaptation process from the viewpoint of first-year university students. The participants were 25 first-year university students from various faculties at Mersin…

  16. Explaining the adjustment of adolescents with type 1 diabetes: Role of diabetes-specific and psychosocial factors

    NARCIS (Netherlands)

    Malik, J.A.; Koot, H.M.

    2009-01-01

    OBJECTIVE - The aim of this study was to explain adjustment (diabetes-related quality of life, general well-being, and psychopathology) in adolescents with type 1 diabetes by testing the direct, mediating, and moderating effects of diabetes-specific and psychosocial factors, using an adapted version

  17. Risk Factors of Erythrocytosis Post Renal Transplantation

    Directory of Open Access Journals (Sweden)

    Razeghi Effat

    2008-01-01

    Full Text Available Post-transplant erythrocytosis (PTE is characterized by persistently ele-vated hematocrit level 0 51%. This complication is reported to develop in 10-20% of renal allografts recipients, mostly 2 years after kidney transplantation. PTE is self-limited in 25% of the patients; however it may persist in patients with an increased susceptibility for thrombosis and potential fatal outcome. To evaluate the prevalence and risk factors of PTE in our center, we reviewed the records of 235 patients who received renal allografts from 1999 to 2004. Polycythemia was found in 45 (19% patients. There was no significant correlation of polycythemia and age, history of hypertension, diabetes, pre-transplant hematocrit level, pre-transplant history of transfusion, graft′s function, and source of kidney. A significantly higher proportion of PTE patients were males, patients with history of polycystic kidney disease, and patients with glomerulonephritis. We conclude that PTE is an important complication of kidney transplantation. There are several risk factors that should be addressed to prevent this complication.

  18. Risk factors for repeat abortion in Nepal.

    Science.gov (United States)

    Thapa, Shyam; Neupane, Shailes

    2013-01-01

    To examine the incidence of and risk factors for repeat abortion in Nepal. Data were analyzed from a survey of 1172 women who had surgical abortions between December 2009 and March 2010 in 2 clinics in Kathmandu, Nepal. Bivariate and multivariate logistic regressions were performed to estimate odds ratios for the risk factors. Among the respondents, 32.3% (95% confidence interval, 29.6-34.9) had repeat abortions. This incidence rose sharply with age and parity, and was higher among those with no intention of having a future child, those attaining primary or secondary level education, and those attending the non-governmental sector clinic. Women with repeat abortion were similar to those with 1 abortion in terms of contraceptive practice. Among women not using contraceptives at the time of the unintended pregnancy, the 3 most commonly cited reasons were ill health, non-compliance with the method intended for use, and dislike of the method. Women with repeat abortion showed a pattern of contraceptive acceptance immediately after the procedure similar to that of women who had 1 abortion. Repeat abortion is emerging as a major public health issue in Nepal, with implications for counseling and provision of abortion, and for family planning services. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  19. CLIMATE AS A RISK FACTOR FOR TOURISM

    Directory of Open Access Journals (Sweden)

    ÁKOS NÉMETH

    2009-12-01

    Full Text Available Weather and climate risk factors for tourism are surveyed and illustrated with regard to the expected climate changes in Hungary. These changes are not at all advantageous and which affect the business in question both directly and indirectly. These are the summer resort tourism (characterised by bioclimatic indices. Green tourism is the next one to characterise, including skiing, mountain climbing and eco-tourism, as well. Here both day-to-day weather extremes and long-lasting effects on the biota (e.g. drought, or inundation for plain-area eco-tourism. Last, but not least the urban (cultural- and shopping- tourism is presented, since the large towns exhibit their special climate and different risks. The paper intends to specify these meteorological factors and effects also in terms of the different types of touristic activities. The general statements on the effect of weather and climate on tourism are illustrated by a few individual parameters and also by the so called Physiologically Equivalent Temperature. Annual and diurnal course of this parameter are presented, together with various trends in this variable at different sites and in different (hot and cold extremities of the occurring values. Other examples, helping the tourism industry are presented in various climate conditions of the country. They include high precipitation and high relative humidity information. The paper also lists the possible adaptation measures to extreme events and also their likely changes in time.

  20. Vascular risk factors, cognitve decline, and dementia

    Directory of Open Access Journals (Sweden)

    E Duron

    2008-04-01

    Full Text Available E Duron, Olivier HanonBroca Hospital, Paris, FranceAbstract: Dementia is one of the most important neurological disorders in the elderly. Aging is associated with a large increase in the prevalence and incidence of degenerative (Alzheimer’s disease and vascular dementia, leading to a devastating loss of autonomy. In view of the increasing longevity of populations worldwide, prevention of dementia has turned into a major public health challenge. In the past decade, several vascular risk factors have been found to be associated with vascular dementia but also Alzheimer’s disease. Some longitudinal studies, have found significant associations between hypertension, diabetus mellitus, and metabolic syndrome, assessed at middle age, and dementia. Studies assessing the link between hypercholesterolemia, atrial fibrillation, smoking, and dementia have given more conflicting results. Furthermore, some studies have highlighted the possible protective effect of antihypertensive therapy on cognition and some trials are evaluating the effects of statins and treatments for insulin resistance. Vascular risk factors and their treatments are a promising avenue of research for prevention of dementia, and further long-term, placebo-controlled, randomized studies, need to be performed.Keywords: dementia, hypertension, diabetus mellitus, hypercholesterolemia, metabolic syndrome