Clustering of Risk Factors for Non-Communicable Diseases among Adolescents from Southern Brazil.

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Nunes, Heloyse Elaine Gimenes; Gonçalves, Eliane Cristina de Andrade; Vieira, Jéssika Aparecida Jesus; Silva, Diego Augusto Santos

2016-01-01

The aim of this study was to investigate the simultaneous presence of risk factors for non-communicable diseases and the association of these risk factors with demographic and economic factors among adolescents from southern Brazil. The study included 916 students (14-19 years old) enrolled in the 2014 school year at state schools in São José, Santa Catarina, Brazil. Risk factors related to lifestyle (i.e., physical inactivity, excessive alcohol consumption, smoking, sedentary behaviour and unhealthy diet), demographic variables (sex, age and skin colour) and economic variables (school shift and economic level) were assessed through a questionnaire. Simultaneous behaviours were assessed by the ratio between observed and expected prevalences of risk factors for non-communicable diseases. The clustering of risk factors was analysed by multinomial logistic regression. The clusters of risk factors that showed a higher prevalence were analysed by binary logistic regression. The clustering of two, three, four, and five risk factors were found in 22.2%, 49.3%, 21.7% and 3.1% of adolescents, respectively. Subgroups that were more likely to have both behaviours of physical inactivity and unhealthy diet simultaneously were mostly composed of girls (OR = 3.03, 95% CI = 1.57-5.85) and those with lower socioeconomic status (OR = 1.83, 95% CI = 1.05-3.21); simultaneous physical inactivity, excessive alcohol consumption, sedentary behaviour and unhealthy diet were mainly observed among older adolescents (OR = 1.49, 95% CI = 1.05-2.12). Subgroups less likely to have both behaviours of sedentary behaviour and unhealthy diet were mostly composed of girls (OR = 0.58, 95% CI = 0.38-0.89); simultaneous physical inactivity, sedentary behaviour and unhealthy diet were mainly observed among older individuals (OR = 0.66, 95% CI = 0.49-0.87) and those of the night shift (OR = 0.59, 95% CI = 0.43-0.82). Adolescents had a high prevalence of simultaneous risk factors for NCDs. Demographic

Arterial stiffness and its association with clustering of metabolic syndrome risk factors

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Wanda R. P. Lopes-Vicente

2017-10-01

Full Text Available Abstract Background Metabolic syndrome (MetS is associated with structural and functional vascular abnormalities, which may lead to increased arterial stiffness, more frequent cardiovascular events and higher mortality. However, the role played by clustering of risk factors and the combining pattern of MetS risk factors and their association with the arterial stiffness have yet to be fully understood. Age, hypertension and diabetes mellitus seem to be strongly associated with increased pulse wave velocity (PWV. This study aimed at determining the clustering and combining pattern of MetS risk factors and their association with the arterial stiffness in non-diabetic and non-hypertensive patients. Methods Recently diagnosed and untreated patients with MetS (n = 64, 49 ± 8 year, 32 ± 4 kg/m2 were selected, according to ATP III criteria and compared to a control group (Control, n = 17, 49 ± 6 year, 27 ± 2 kg/m2. Arterial stiffness was evaluated by PWV in the carotid-femoral segment. Patients were categorized and analyzed according MetS risk factors clustering (3, 4 and 5 factors and its combinations. Results Patients with MetS had increased PWV when compared to Control (7.8 ± 1.1 vs. 7.0 ± 0.5 m/s, p < 0.001. In multivariate analysis, the variables that remained as predictors of PWV were age (β = 0.450, p < 0.001, systolic blood pressure (β = 0.211, p = 0.023 and triglycerides (β = 0.212, p = 0.037. The increased number of risk factors reflected in a progressive increase in PWV. When adjusted to systolic blood pressure, PWV was greater in the group with 5 risk factors when compared to the group with 3 risk factors and Control (8.5 ± 0.4 vs. 7.5 ± 0.2, p = 0.011 and 7.2 ± 0.3 m/s, p = 0.012. Similarly, the 4 risk factors group had higher PWV than the Control (7.9 ± 0.2 vs. 7.2 ± 0.3, p = 0.047. Conclusions The number of risk factors seems to increase arterial stiffness. Notably, besides

Clustering of Multiple Lifestyle Behaviours and Its Association to Cardiovascular Risk Factors in Children

DEFF Research Database (Denmark)

Bel-Serrat, Silvia; Mouratidou, Theodora; Santaliestra-Pasías, Alba María

2013-01-01

ratio, triglycerides, sum of two skinfolds and systolic blood pressure (SBP) z-scores were summed to compute a CVD risk score. Cluster analyses stratified by sex and age groups (2 to ...) consumption, PA performance and television video/DVD viewing. RESULTS: Five clusters were identified. Associations between CVD risk factors and score, and clusters were obtained by multiple linear regression using cluster 5 (‘low beverages consumption and low sedentary’) as the reference cluster. SBP...... association was observed between CVD risk score and clusters 2 (β=0.60; 95% CI: 0.20, 1.01), 3 (β=0.55; 95% CI: 0.14, 0.97) and 4 (β=0.60, 95% CI: 0.18, 1.02) in older boys. CONCLUSIONS: Low television/video/DVD viewing levels and low SSB consumption may result in a healthier CVD profile rather than having...

Fitness, fatness and clustering of cardiovascular risk factors in children from Denmark, Estonia and Portugal

DEFF Research Database (Denmark)

Andersen, Lars B; Sardinha, Luis B; Froberg, Karsten

2008-01-01

BACKGROUND: Levels of overweight have increased and fitness has decreased in children. Potentially, these changes may be a threat to future health. Numerous studies have measured changes in body mass index (BMI), but few have assessed the independent effects of low fitness, overweight and physical...... inactivity on cardiovascular (CVD) risk factors. METHODS: A cross-sectional multi-center study including 1 769 children from Denmark, Estonia and Portugal. The main outcome was clustering of CVD risk factors. Independent variables were waist circumference, skinfolds, physical activity and cardio......-respiratory fitness. RESULTS: Both waist circumference and skinfolds were associated with clustered CVD risk. Odds ratios for clustered CVD risk for the upper quartiles compared with the lowest quartile were 9.13 (95% CI: 5.78-14.43) and 11.62 (95% CI: 7.11-18.99) when systolic blood pressure, triglyceride, insulin...

Inflammatory Markers and Clustered Cardiovascular Disease Risk Factors in Danish Adolescents

DEFF Research Database (Denmark)

Bugge, Anna; El-Naaman, Bianca; McMurray, Robert G

2012-01-01

Aims: To evaluate the associations between inflammatory markers and clustering of cardiovascular disease (CVD) risk factors, and to examine how inflammatory markers and CVD risk are related to fatness and cardiorespiratory fitness (VO(2peak)) in adolescents. Methods: Body mass and height, skinfolds...... and blood pressure of 413 adolescents (mean age 13.4 ± 0.3 years) were measured. Circulating fasting levels of glucose, insulin, lipids, adiponectin, C-reactive protein (CRP), tumor necrosis factor (TNF)α, soluble TNF receptor-1 (sTNFR1), interleukin (IL)-6 and IL-1 receptor antagonist (IL-1Ra) were...

Development of innovative methods for risk assessment in high-rise construction based on clustering of risk factors

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Okolelova, Ella; Shibaeva, Marina; Shalnev, Oleg

2018-03-01

The article analyses risks in high-rise construction in terms of investment value with account of the maximum probable loss in case of risk event. The authors scrutinized the risks of high-rise construction in regions with various geographic, climatic and socio-economic conditions that may influence the project environment. Risk classification is presented in general terms, that includes aggregated characteristics of risks being common for many regions. Cluster analysis tools, that allow considering generalized groups of risk depending on their qualitative and quantitative features, were used in order to model the influence of the risk factors on the implementation of investment project. For convenience of further calculations, each type of risk is assigned a separate code with the number of the cluster and the subtype of risk. This approach and the coding of risk factors makes it possible to build a risk matrix, which greatly facilitates the task of determining the degree of impact of risks. The authors clarified and expanded the concept of the price risk, which is defined as the expected value of the event, 105 which extends the capabilities of the model, allows estimating an interval of the probability of occurrence and also using other probabilistic methods of calculation.

Types of Obesity and Its Association with the Clustering of Cardiovascular Disease Risk Factors in Jilin Province of China

OpenAIRE

Zhang, Peng; Wang, Rui; Gao, Chunshi; Song, Yuanyuan; Lv, Xin; Jiang, Lingling; Yu, Yaqin; Wang, Yuhan; Li, Bo

2016-01-01

Cardiovascular disease (CVD) has become a serious public health problem in recent years in China. Aggregation of CVD risk factors in one individual increases the risk of CVD and the risk increases substantially with each additional risk factor. This study aims to explore the relationship between the number of clustered CVD risk factors and different types of obesity. A multistage stratified random cluster sampling design was used in this population-based cross-sectional study in 2012. Informa...

Insulin sensitivity and clustering of coronary heart disease risk factors in young adults. The Northern Ireland Young Hearts Study

DEFF Research Database (Denmark)

Andersen, Lars Bo; Boreham, Colin A.G.; Young, Ian S.

2006-01-01

risk factor. Subjects with clustered risk were defined as those displaying four or more risk factors. Blood glucose and insulin were measured in the fasting state and 2 h after ingestion of a 75 g glucose load. Results. Fasting insulin and the homeostasis model assessment insulin resistance score (HOMA......) were strong, graded predictors of clustered risk. The odds ratio (OR) for having clustered risk was 10.8 (95% CI: 3.6-32.4) for the upper quartile of fasting insulin compared to the lowest quartile, and the corresponding OR for HOMA was 23.2 (95% CI: 5.3-101.6). Conclusion. HOMA score predicts...

Risk factors associated with cluster size of Mycobacterium tuberculosis (Mtb) of different RFLP lineages in Brazil.

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Peres, Renata Lyrio; Vinhas, Solange Alves; Ribeiro, Fabíola Karla Correa; Palaci, Moisés; do Prado, Thiago Nascimento; Reis-Santos, Bárbara; Zandonade, Eliana; Suffys, Philip Noel; Golub, Jonathan E; Riley, Lee W; Maciel, Ethel Leonor

2018-02-08

Tuberculosis (TB) transmission is influenced by patient-related risk, environment and bacteriological factors. We determined the risk factors associated with cluster size of IS6110 RFLP based genotypes of Mycobacterium tuberculosis (Mtb) isolates from Vitoria, Espirito Santo, Brazil. Cross-sectional study of new TB cases identified in the metropolitan area of Vitoria, Brazil between 2000 and 2010. Mtb isolates were genotyped by the IS6110 RFLP, spoligotyping and RD Rio . The isolates were classified according to genotype cluster sizes by three genotyping methods and associated patient epidemiologic characteristics. Regression Model was performed to identify factors associated with cluster size. Among 959 Mtb isolates, 461 (48%) cases had an isolate that belonged to an RFLP cluster, and six clusters with ten or more isolates were identified. Of the isolates spoligotyped, 448 (52%) were classified as LAM and 412 (48%) as non-LAM. Our regression model found that 6-9 isolates/RFLP cluster were more likely belong to the LAM family, having the RD Rio genotype and to be smear-positive (adjusted OR = 1.17, 95% CI 1.08-1.26; adjusted OR = 1.25, 95% CI 1.14-1.37; crude OR = 2.68, 95% IC 1.13-6.34; respectively) and living in a Serra city neighborhood decrease the risk of being in the 6-9 isolates/RFLP cluster (adjusted OR = 0.29, 95% CI, 0.10-0.84), than in the others groups. Individuals aged 21 to 30, 31 to 40 and > 50 years were less likely of belonging the 2-5 isolates/RFLP cluster than unique patterns compared to individuals cluster group (adjustment OR = 0.45, 95% CI 0.24-0.85) than unique patterns. We found that a large proportion of new TB infections in Vitoria is caused by prevalent Mtb genotypes belonging to the LAM family and RD Rio genotypes. Such information demonstrates that some genotypes are more likely to cause recent transmission. Targeting interventions such as screening in specific areas and social risk groups, should be a priority

Case-control geographic clustering for residential histories accounting for risk factors and covariates

Science.gov (United States)

2006-01-01

Background Methods for analyzing space-time variation in risk in case-control studies typically ignore residential mobility. We develop an approach for analyzing case-control data for mobile individuals and apply it to study bladder cancer in 11 counties in southeastern Michigan. At this time data collection is incomplete and no inferences should be drawn – we analyze these data to demonstrate the novel methods. Global, local and focused clustering of residential histories for 219 cases and 437 controls is quantified using time-dependent nearest neighbor relationships. Business address histories for 268 industries that release known or suspected bladder cancer carcinogens are analyzed. A logistic model accounting for smoking, gender, age, race and education specifies the probability of being a case, and is incorporated into the cluster randomization procedures. Sensitivity of clustering to definition of the proximity metric is assessed for 1 to 75 k nearest neighbors. Results Global clustering is partly explained by the covariates but remains statistically significant at 12 of the 14 levels of k considered. After accounting for the covariates 26 Local clusters are found in Lapeer, Ingham, Oakland and Jackson counties, with the clusters in Ingham and Oakland counties appearing in 1950 and persisting to the present. Statistically significant focused clusters are found about the business address histories of 22 industries located in Oakland (19 clusters), Ingham (2) and Jackson (1) counties. Clusters in central and southeastern Oakland County appear in the 1930's and persist to the present day. Conclusion These methods provide a systematic approach for evaluating a series of increasingly realistic alternative hypotheses regarding the sources of excess risk. So long as selection of cases and controls is population-based and not geographically biased, these tools can provide insights into geographic risk factors that were not specifically assessed in the case

Case-control geographic clustering for residential histories accounting for risk factors and covariates

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Goovaerts Pierre

2006-08-01

Full Text Available Abstract Background Methods for analyzing space-time variation in risk in case-control studies typically ignore residential mobility. We develop an approach for analyzing case-control data for mobile individuals and apply it to study bladder cancer in 11 counties in southeastern Michigan. At this time data collection is incomplete and no inferences should be drawn – we analyze these data to demonstrate the novel methods. Global, local and focused clustering of residential histories for 219 cases and 437 controls is quantified using time-dependent nearest neighbor relationships. Business address histories for 268 industries that release known or suspected bladder cancer carcinogens are analyzed. A logistic model accounting for smoking, gender, age, race and education specifies the probability of being a case, and is incorporated into the cluster randomization procedures. Sensitivity of clustering to definition of the proximity metric is assessed for 1 to 75 k nearest neighbors. Results Global clustering is partly explained by the covariates but remains statistically significant at 12 of the 14 levels of k considered. After accounting for the covariates 26 Local clusters are found in Lapeer, Ingham, Oakland and Jackson counties, with the clusters in Ingham and Oakland counties appearing in 1950 and persisting to the present. Statistically significant focused clusters are found about the business address histories of 22 industries located in Oakland (19 clusters, Ingham (2 and Jackson (1 counties. Clusters in central and southeastern Oakland County appear in the 1930's and persist to the present day. Conclusion These methods provide a systematic approach for evaluating a series of increasingly realistic alternative hypotheses regarding the sources of excess risk. So long as selection of cases and controls is population-based and not geographically biased, these tools can provide insights into geographic risk factors that were not specifically

Clustering of modifiable biobehavioral risk factors for chronic disease in US adults: a latent class analysis.

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Leventhal, Adam M; Huh, Jimi; Dunton, Genevieve F

2014-11-01

Examining the co-occurrence patterns of modifiable biobehavioral risk factors for deadly chronic diseases (e.g. cancer, cardiovascular disease, diabetes) can elucidate the etiology of risk factors and guide disease-prevention programming. The aims of this study were to (1) identify latent classes based on the clustering of five key biobehavioral risk factors among US adults who reported at least one risk factor and (2) explore the demographic correlates of the identified latent classes. Participants were respondents of the National Epidemiologic Survey of Alcohol and Related Conditions (2004-2005) with at least one of the following disease risk factors in the past year (N = 22,789), which were also the latent class indicators: (1) alcohol abuse/dependence, (2) drug abuse/dependence, (3) nicotine dependence, (4) obesity, and (5) physical inactivity. Housing sample units were selected to match the US National Census in location and demographic characteristics, with young adults oversampled. Participants were administered surveys by trained interviewers. Five latent classes were yielded: 'obese, active non-substance abusers' (23%); 'nicotine-dependent, active, and non-obese' (19%); 'active, non-obese alcohol abusers' (6%); 'inactive, non-substance abusers' (50%); and 'active, polysubstance abusers' (3.7%). Four classes were characterized by a 100% likelihood of having one risk factor coupled with a low or moderate likelihood of having the other four risk factors. The five classes exhibited unique demographic profiles. Risk factors may cluster together in a non-monotonic fashion, with the majority of the at-risk population of US adults expected to have a high likelihood of endorsing only one of these five risk factors. © Royal Society for Public Health 2013.

Genomic and Metabolomic Profile Associated to Clustering of Cardio-Metabolic Risk Factors.

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Marrachelli, Vannina G; Rentero, Pilar; Mansego, María L; Morales, Jose Manuel; Galan, Inma; Pardo-Tendero, Mercedes; Martinez, Fernando; Martin-Escudero, Juan Carlos; Briongos, Laisa; Chaves, Felipe Javier; Redon, Josep; Monleon, Daniel

2016-01-01

To identify metabolomic and genomic markers associated with the presence of clustering of cardiometabolic risk factors (CMRFs) from a general population. One thousand five hundred and two subjects, Caucasian, > 18 years, representative of the general population, were included. Blood pressure measurement, anthropometric parameters and metabolic markers were measured. Subjects were grouped according the number of CMRFs (Group 1: profile was assessed by 1H NMR spectra using a Brucker Advance DRX 600 spectrometer. From the total population, 1217 (mean age 54±19, 50.6% men) with high genotyping call rate were analysed. A differential metabolomic profile, which included products from mitochondrial metabolism, extra mitochondrial metabolism, branched amino acids and fatty acid signals were observed among the three groups. The comparison of metabolomic patterns between subjects of Groups 1 to 3 for each of the genotypes associated to those subjects with three or more CMRFs revealed two SNPs, the rs174577_AA of FADS2 gene and the rs3803_TT of GATA2 transcription factor gene, with minimal or no statistically significant differences. Subjects with and without three or more CMRFs who shared the same genotype and metabolomic profile differed in the pattern of CMRFS cluster. Subjects of Group 3 and the AA genotype of the rs174577 had a lower prevalence of hypertension compared to the CC and CT genotype. In contrast, subjects of Group 3 and the TT genotype of the rs3803 polymorphism had a lower prevalence of T2DM, although they were predominantly males and had higher values of plasma creatinine. The results of the present study add information to the metabolomics profile and to the potential impact of genetic factors on the variants of clustering of cardiometabolic risk factors.

Effect of Cardio-Metabolic Risk Factors Clustering with or without Arterial Hypertension on Arterial Stiffness: A Narrative Review

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Vasilios G. Athyros

2013-11-01

Full Text Available The clustering of cardio-metabolic risk factors, either when called metabolic syndrome (MetS or not, substantially increases the risk of cardiovascular disease (CVD and causes mortality. One of the possible mechanisms for this clustering's adverse effect is an increase in arterial stiffness (AS, and in high central aortic blood pressure (CABP, which are significant and independent CVD risk factors. Arterial hypertension was connected to AS long ago; however, other MetS components (obesity, dyslipidaemia, dysglycaemia or MetS associated abnormalities not included in MetS diagnostic criteria (renal dysfunction, hyperuricaemia, hypercoaglutability, menopause, non alcoholic fatty liver disease, and obstructive sleep apnea have been implicated too. We discuss the evidence connecting these cardio-metabolic risk factors, which negatively affect AS and finally increase CVD risk. Furthermore, we discuss the impact of possible lifestyle and pharmacological interventions on all these cardio-metabolic risk factors, in an effort to reduce CVD risk and identify features that should be taken into consideration when treating MetS patients with or without arterial hypertension.

Comparing 3 dietary pattern methods--cluster analysis, factor analysis, and index analysis--With colorectal cancer risk: The NIH-AARP Diet and Health Study.

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Reedy, Jill; Wirfält, Elisabet; Flood, Andrew; Mitrou, Panagiota N; Krebs-Smith, Susan M; Kipnis, Victor; Midthune, Douglas; Leitzmann, Michael; Hollenbeck, Albert; Schatzkin, Arthur; Subar, Amy F

2010-02-15

The authors compared dietary pattern methods-cluster analysis, factor analysis, and index analysis-with colorectal cancer risk in the National Institutes of Health (NIH)-AARP Diet and Health Study (n = 492,306). Data from a 124-item food frequency questionnaire (1995-1996) were used to identify 4 clusters for men (3 clusters for women), 3 factors, and 4 indexes. Comparisons were made with adjusted relative risks and 95% confidence intervals, distributions of individuals in clusters by quintile of factor and index scores, and health behavior characteristics. During 5 years of follow-up through 2000, 3,110 colorectal cancer cases were ascertained. In men, the vegetables and fruits cluster, the fruits and vegetables factor, the fat-reduced/diet foods factor, and all indexes were associated with reduced risk; the meat and potatoes factor was associated with increased risk. In women, reduced risk was found with the Healthy Eating Index-2005 and increased risk with the meat and potatoes factor. For men, beneficial health characteristics were seen with all fruit/vegetable patterns, diet foods patterns, and indexes, while poorer health characteristics were found with meat patterns. For women, findings were similar except that poorer health characteristics were seen with diet foods patterns. Similarities were found across methods, suggesting basic qualities of healthy diets. Nonetheless, findings vary because each method answers a different question.

Cardiorespiratory fitness, cardiovascular workload and risk factors among cleaners; a cluster randomized worksite intervention

DEFF Research Database (Denmark)

Korshøj, Mette; Krustrup, Peter; Jørgensen, Marie Birk

2012-01-01

. The clusters will be balanced on the following criteria: Geographical work location, gender, age and seniority. Cleaners are randomized to either I) a reference group, receiving lectures concerning healthy living, or II) an intervention group, performing worksite aerobic exercise. Data collection......ABSTRACT: BACKGROUND: Prevalence of cardiovascular risk factors is unevenly distributed among occupational groups. The working environment, as well as lifestyle and socioeconomic status contribute to the disparity and variation in prevalence of these risk factors. High physical work demands have...... been shown to increase the risk for cardiovascular disease and mortality, contrary to leisure time physical activity. High physical work demands in combination with a low cardiorespiratory fitness infer a high relative workload and an excessive risk for cardiovascular mortality. Therefore, the aim...

Risk Factors and Spatial Clusters of Cryptosporidium Infection among School-Age Children in a Rural Region of Eastern China.

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Zheng, Hao; He, Jianfeng; Wang, Li; Zhang, Rong; Ding, Zhen; Hu, Wenbiao

2018-05-06

The epidemiological features of Cryptosporidium infection among school-age children in China still remain unclear. Hereby, a cross-sectional study of 1637 children aged 3⁻9 years was designed to investigate the risk factors and spatial clusters of Cryptosporidium infection in a rural region of Eastern China. Stool specimens collected from participants were examined using the auramine-phenol and modified acid-fast staining. Univariable and multivariable analyses were performed to identify the risk factors of Cryptospordium infection. The spatial clusters were analyzed by a discrete Poisson model using SaTScan software. Our results showed that the overall prevalence of Cryptosporidium infection was 11‰ in the research region. At the age of 3⁻6 years (odds ratios (OR) = 3.072, 95% confidence intervals (CI) : 1.001⁻9.427), not washing hands before eating and after defecation (OR = 3.003, 95% CI: 1.060⁻8.511) were recognized as risk factors. Furthermore, a high-risk spatial cluster (relative risk = 4.220, p = 0.025) was identified. These findings call for effective sustainable interventions including family and school-based hygienic education to reduce the prevalence of Cryptosporidium infection. Therefore, an early warning system based spatiotemporal models with risk factors is required to further improve the effectiveness and efficiency of cryptosporidiosis control in the future.

The Metabolic Syndrome in Children and Adolescents: Shifting the Focus to Cardiometabolic Risk Factor Clustering.

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Magge, Sheela N; Goodman, Elizabeth; Armstrong, Sarah C

2017-07-24

Metabolic syndrome (MetS) was developed by the National Cholesterol Education Program Adult Treatment Panel III, identifying adults with at least 3 of 5 cardiometabolic risk factors (hyperglycemia, increased central adiposity, elevated triglycerides, decreased high-density lipoprotein cholesterol, and elevated blood pressure) who are at increased risk of diabetes and cardiovascular disease. The constellation of MetS component risk factors has a shared pathophysiology and many common treatment approaches grounded in lifestyle modification. Several attempts have been made to define MetS in the pediatric population. However, in children, the construct is difficult to define and has unclear implications for clinical care. In this Clinical Report, we focus on the importance of screening for and treating the individual risk factor components of MetS. Focusing attention on children with cardiometabolic risk factor clustering is emphasized over the need to define a pediatric MetS. Copyright © 2017 by the American Academy of Pediatrics.

The triply troubled teenager--chronic conditions associated with fewer protective factors and clustered risk behaviours.

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Nylander, Charlotte; Seidel, Carina; Tindberg, Ylva

2014-02-01

This study aimed to measure protective factors and risk behaviour among adolescents with chronic conditions (CCs) and to evaluate the impact of protective factors on risk-taking. A population-based study of 7262 students aged 15 and 17 years old was performed in Sörmland, Sweden 2008 (response rate 82%). The questionnaire explored background factors, CCs, risk behaviours and protective factors. CCs were reported by 8%, while 58% had no health problems. Girls with CCs encompassed less individual protective factors, while boys with CCs tended to over-report all individual risk behaviours compared with healthy peers. Both boys and girls with CCs were more likely to report few protective factors and co-occurrence of risk behaviours. The adjOR for clustered health risk behaviours was 1.6 (1.0-2.5) in youths with CCs and ≥4 protective factors and 6.3 (3.6-10.9) in youths with CCs and 0-3 protective factors, as compared to healthy peers with ≥4 protective factors. Adolescents with CCs reported fewer protective factors and more risk behaviours than their healthy peers. The vulnerability of adolescents with CCs and few protective factors is important to acknowledge. Professionals should provide stronger protection for these adolescents, to prevent risky behaviour. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

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

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

2007-02-01

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

Analysis of risk factors for cluster behavior of dental implant failures.

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Chrcanovic, Bruno Ramos; Kisch, Jenö; Albrektsson, Tomas; Wennerberg, Ann

2017-08-01

Some studies indicated that implant failures are commonly concentrated in few patients. To identify and analyze cluster behavior of dental implant failures among subjects of a retrospective study. This retrospective study included patients receiving at least three implants only. Patients presenting at least three implant failures were classified as presenting a cluster behavior. Univariate and multivariate logistic regression models and generalized estimating equations analysis evaluated the effect of explanatory variables on the cluster behavior. There were 1406 patients with three or more implants (8337 implants, 592 failures). Sixty-seven (4.77%) patients presented cluster behavior, with 56.8% of all implant failures. The intake of antidepressants and bruxism were identified as potential negative factors exerting a statistically significant influence on a cluster behavior at the patient-level. The negative factors at the implant-level were turned implants, short implants, poor bone quality, age of the patient, the intake of medicaments to reduce the acid gastric production, smoking, and bruxism. A cluster pattern among patients with implant failure is highly probable. Factors of interest as predictors for implant failures could be a number of systemic and local factors, although a direct causal relationship cannot be ascertained. © 2017 Wiley Periodicals, Inc.

A spatial scan statistic for nonisotropic two-level risk cluster.

Science.gov (United States)

Li, Xiao-Zhou; Wang, Jin-Feng; Yang, Wei-Zhong; Li, Zhong-Jie; Lai, Sheng-Jie

2012-01-30

Spatial scan statistic methods are commonly used for geographical disease surveillance and cluster detection. The standard spatial scan statistic does not model any variability in the underlying risks of subregions belonging to a detected cluster. For a multilevel risk cluster, the isotonic spatial scan statistic could model a centralized high-risk kernel in the cluster. Because variations in disease risks are anisotropic owing to different social, economical, or transport factors, the real high-risk kernel will not necessarily take the central place in a whole cluster area. We propose a spatial scan statistic for a nonisotropic two-level risk cluster, which could be used to detect a whole cluster and a noncentralized high-risk kernel within the cluster simultaneously. The performance of the three methods was evaluated through an intensive simulation study. Our proposed nonisotropic two-level method showed better power and geographical precision with two-level risk cluster scenarios, especially for a noncentralized high-risk kernel. Our proposed method is illustrated using the hand-foot-mouth disease data in Pingdu City, Shandong, China in May 2009, compared with two other methods. In this practical study, the nonisotropic two-level method is the only way to precisely detect a high-risk area in a detected whole cluster. Copyright © 2011 John Wiley & Sons, Ltd.

Change in cardiovascular risk factors following early diagnosis of type 2 diabetes: a cohort analysis of a cluster-randomised trial

OpenAIRE

Black, James A; Sharp, Stephen J; Wareham, Nicholas J; Sandbæk, Annelli; Rutten, Guy EHM; Lauritzen, Torsten; Khunti, Kamlesh; Davies, Melanie J; Borch-Johnsen, Knut; Griffin, Simon J; Simmons, Rebecca K

2014-01-01

Background There is little evidence to inform the targeted treatment of individuals found early in the diabetes disease trajectory. Aim To describe cardiovascular disease (CVD) risk profiles and treatment of individual CVD risk factors by modelled CVD risk at diagnosis; changes in treatment, modelled CVD risk, and CVD risk factors in the 5 years following diagnosis; and how these are patterned by socioeconomic status. Design and setting Cohort analysis of a cluster-randomised trial (ADDITION-...

Impaired Fasting Glucose in Nondiabetic Range: Is It a Marker of Cardiovascular Risk Factor Clustering?

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Giovanna Valentino

2015-01-01

Full Text Available Background. Impaired fasting glucose (IFG through the nondiabetic range (100–125 mg/dL is not considered in the cardiovascular (CV risk profile. Aim. To compare the clustering of CV risk factors (RFs in nondiabetic subjects with normal fasting glucose (NFG and IFG. Material and Methods. Cross-sectional study in 3739 nondiabetic subjects. Demographics, medical history, and CV risk factors were collected and lipid profile, fasting glucose levels (FBG, C-reactive protein (hsCRP, blood pressure (BP, anthropometric measurements, and aerobic capacity were determined. Results. 559 (15% subjects had IFG: they had a higher mean age, BMI, waist circumference, non-HDL cholesterol, BP, and hsCRP (p<0.0001 and lower HDL (p<0.001 and aerobic capacity (p<0.001. They also had a higher prevalence of hypertension (34% versus 25%; p<0.001, dyslipidemia (79% versus 74%; p<0.001, and obesity (29% versus 16%; p<0.001 and a higher Framingham risk score (8% versus 6%; p<0.001. The probability of presenting 3 or more CV RFs adjusted by age and gender was significantly higher in the top quintile of fasting glucose (≥98 mg/dL; OR = 2.02; 1.62–2.51. Conclusions. IFG in the nondiabetic range is associated with increased cardiovascular RF clustering.

Neck circumference and clustered cardiovascular risk factors in children and adolescents: cross-sectional study.

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Castro-Piñero, José; Delgado-Alfonso, Alvaro; Gracia-Marco, Luis; Gómez-Martínez, Sonia; Esteban-Cornejo, Irene; Veiga, Oscar L; Marcos, Ascensión; Segura-Jiménez, Víctor

2017-09-11

Early detection of cardiovascular disease (CVD) risk factors, such as obesity, is crucial to prevent adverse long-term effects on individuals' health. Therefore, the aims were: (1) to explore the robustness of neck circumference (NC) as a predictor of CVD and examine its association with numerous anthropometric and body composition indices and (2) to release sex and age-specific NC cut-off values to classify youths as overweight/obese. Cross-sectional study. 23 primary schools and 17 secondary schools from Spain. 2198 students (1060 girls), grades 1-4 and 7-10. Pubertal development, anthropometric and body composition indices, systolic and diastolic blood pressure (SBP and DBP, respectively), cardiorespiratory fitness, blood sampling triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), glucose and inflammatory markers. Homoeostasis model assessment (HOMA-IR) and cluster of CVD risk factors were calculated. NC was negatively associated with maximum oxygen consumption (R2=0.231, P<0.001 for boys; R2=0.018, P<0.001 for girls) and adiponectin (R2=0.049, P<0.001 for boys; R2=0.036, P<0.001 for girls); and positively associated with SBP, DBP, TC/HDL-c, TG, HOMA, complement factors C-3 and C-4, leptin and clustered CVD risk factor in both sexes (R2 from 0.035 to 0.353, P<0.01 for boys; R2 from 0.024 to 0.215, P<0.001 for girls). Moreover, NC was positively associated with serum C reactive protein and LDL-c only in boys (R2 from 0.013 to 0.055, P<0.05). NC is a simple, low-cost and practical screening tool of excess of upper body obesity and CVD risk factors in children and adolescents. Paediatricians can easily use it as a screening tool for overweight/obesity in children and adolescents. For this purpose, sex and age-specific thresholds to classify children and adolescents as normal weight or overweight/obese are provided. © Article author(s) (or their employer(s) unless otherwise stated

Cluster analysis of cardiovascular and metabolic risk factors in women of reproductive age.

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Tzeng, Chii-Ruey; Chang, Yuan-chin Ivan; Chang, Yu-chia; Wang, Chia-Woei; Chen, Chi-Huang; Hsu, Ming-I

2014-05-01

To study the association between endocrine disturbances and metabolic complications in women seeking gynecologic care. Retrospective study, cluster analysis. Outpatient clinic, university medical center. 573 women, including 384 at low risk and 189 at high risk of cardiometabolic disease. None. Cardiovascular and metabolic parameters and clinical and biochemical characteristics. Risk factors for metabolic disease are associated with a low age of menarche, high levels of high-sensitivity C-reactive protein and liver enzymes, and low levels of sex hormone-binding globulin. Overweight/obese status, polycystic ovary syndrome, oligo/amenorrhea, and hyperandrogenism were found to increase the risk of cardiometabolic disease. However, hyperprolactinemia and premature ovarian failure were not associated with the risk of cardiometabolic disease. In terms of androgens, the serum total testosterone level and free androgen index but not androstenedione or dehydroepiandrosterone sulfate (DHEAS) were associated with cardiometabolic risk. Although polycystic ovary syndrome is associated with metabolic risk, obesity was the major determinant of cardiometabolic disturbances in reproductive-aged women. Hyperprolactinemia and premature ovarian failure were not associated with the risk of cardiovascular and metabolic diseases. NCT01826357. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Clustering of risk factors for non-communicable disease and healthcare expenditure in employees with private health insurance presenting for health risk appraisal: a cross-sectional study.

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Kolbe-Alexander, Tracy L; Conradie, Jaco; Lambert, Estelle V

2013-12-21

The global increase in the prevalence of NCD's is accompanied by an increase in risk factors for these diseases such as insufficient physical activity and poor nutritional habits. The main aims of this research study were to determine the extent to which insufficient physical activity (PA) clustered with other risk factors for non-communicable disease (NCD) in employed persons undergoing health risk assessment, and whether these risk factors were associated with higher healthcare costs. Employees from 68 companies voluntarily participated in worksite wellness days, that included an assessment of self-reported health behaviors and clinical measures, such as: blood pressure (BP), Body Mass Index (BMI), as well as total cholesterol concentrations from capillary blood samples. A risk-related age, 'Vitality Risk Age' was calculated for each participant using an algorithm that incorporated multiplicative pooled relative risks for all cause mortality associated with smoking, PA, fruit and vegetable intake, BMI, BP and cholesterol concentration. Healthcare cost data were obtained for employees (n = 2 789). Participants were 36±10 years old and the most prevalent risk factors were insufficient PA (67%) and BMI ≥ 25 (62%). Employees who were insufficiently active also had a greater number of other NCD risk factors, compared to those meeting PA recommendations (chi2 = 43.55; p employees meeting PA guidelines had significantly fewer visits to their family doctor (GP) (2.5 versus 3.11; p Physical inactivity was associated with clustering of risk factors for NCD in SA employees. Employees with lower BMI, better self-reported health status and readiness to change were more likely to meet the PA guidelines. These employees might therefore benefit from physical activity intervention programs that could result in improved risk profile and reduced healthcare expenditure.

Malaria prevalence, spatial clustering and risk factors in a low endemic area of Eastern Rwanda: a cross sectional study

NARCIS (Netherlands)

Rulisa, Stephen; Kateera, Fredrick; Bizimana, Jean Pierre; Agaba, Steven; Dukuzumuremyi, Javier; Baas, Lisette; de Dieu Harelimana, Jean; Mens, Petra F.; Boer, Kimberly R.; de Vries, Peter J.

2013-01-01

Rwanda reported significant reductions in malaria burden following scale up of control intervention from 2005 to 2010. This study sought to; measure malaria prevalence, describe spatial malaria clustering and investigate for malaria risk factors among health-centre-presumed malaria cases and their

Cardiovascular disease risk factor clustering among rural adult population in West Bengal, India.

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Nag, Tanmay; Ghosh, Arnab

2016-01-01

This study aimed to find out the prevalence of cardiovascular disease (CVD) risk factor clustering in a rural adult population of West Bengal, India. This cross-sectional study was carried out among 1007 participants (645 males and 362 females) aged ≥20 years in a rural community. All participants were grouped: Group I (20-39 years); Group II (40-59 years); Group III (≥60 years). Anthropometric measures were collected using standard techniques. Metabolic profiles and blood pressure were also measured. Mean of minimum waist circumference (MWC), waist-hip ratio (WHR), trunk-extremity ratio (TER), fat free mass (FFM), basal metabolic rate (BMR), intra-abdominal visceral fat (IVF) and arm muscle area (AMA) was found to be higher among males in comparison to females, whereas, the mean of body mass index (BMI), maximum hip circumference (MHC), waist-height ratio (WHtR), sum of four skinfolds (∑SF4), percentage of body fat (%BF), fat mass (FM), insulin, HOMA-IR and arm fat area (AFA) was higher in females. 37% of individuals (males 25% and females 49%) with high triglyceride (TG) also had low high density lipoprotein (HDL), whereas, 25% individuals (males 25% and females 24%) with overweight also had high fasting blood glucose (FBG). The prevalence of high systolic blood pressure (SBP) among individuals having high %BF was higher in the age groups of 40-59 years for both sexes. The study showed that prevalence of CVD risk factor clustering is high in the study population and warranted early intervention to safeguard the cardiovascular health of the nation. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

The relationship between physical fitness and clustered risk, and tracking of clustered risk from adolescence to young adulthood: eight years follow-up in the Danish Youth and Sport Study

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Grønfeldt Vivian

2004-03-01

Full Text Available Abstract Introduction Cardiovascular disease (CVD is usually caused by high levels of many risk factors simultaneously over many years. Therefore, it is of great interest to study if subjects stay within rank order over time in both the biological risk factors and the behaviour that influences these risk factors. Many studies have described stability (tracking in single risk factors, especially in children where hard endpoints are lacking, but few have analysed tracking in clustered risk. Methods Two examinations were conducted 8 years apart. The first time, 133 males and 172 females were 16–19 years of age. Eight years later, 98 males and 137 females participated. They were each time ranked into quartiles by sex in four CVD risk factors all related to the metabolic syndrome. Risk factors were the ratio between total cholesterol and HDL, triglyceride, systolic BP and body fat. The upper quartile was defined as being at risk, and if a subject had two or more risk factors, he/she was defined as a case (15–20 % of the subjects. Odds ratios (OR for being a case was calculated between quartiles of fitness in both cross-sectional studies. The stability of combined risk was calculated as the OR between cases and non-cases at the first examination to be a case at the second examination. Results ORs for having two or more risk factors between quartiles of fitness were 3.1, 3.8 and 4.9 for quartiles two to four, respectively. At the second examination, OR were 0.7, 3.5 and 4.9, respectively. The probability for "a case" at the first examination to be "a case" at the second was 6.0. Conclusions The relationship between an exposure like physical fitness and CVD risk factors is much stronger when clustering of risk factors are analysed compared to the relationship to single risk factors. The stability over time in multiple risk factors analysed together is strong. This relationship should be seen in the light of moderate or weak tracking of single risk

Comparison of cluster-based and source-attribution methods for estimating transmission risk using large HIV sequence databases.

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Le Vu, Stéphane; Ratmann, Oliver; Delpech, Valerie; Brown, Alison E; Gill, O Noel; Tostevin, Anna; Fraser, Christophe; Volz, Erik M

2018-06-01

Phylogenetic clustering of HIV sequences from a random sample of patients can reveal epidemiological transmission patterns, but interpretation is hampered by limited theoretical support and statistical properties of clustering analysis remain poorly understood. Alternatively, source attribution methods allow fitting of HIV transmission models and thereby quantify aspects of disease transmission. A simulation study was conducted to assess error rates of clustering methods for detecting transmission risk factors. We modeled HIV epidemics among men having sex with men and generated phylogenies comparable to those that can be obtained from HIV surveillance data in the UK. Clustering and source attribution approaches were applied to evaluate their ability to identify patient attributes as transmission risk factors. We find that commonly used methods show a misleading association between cluster size or odds of clustering and covariates that are correlated with time since infection, regardless of their influence on transmission. Clustering methods usually have higher error rates and lower sensitivity than source attribution method for identifying transmission risk factors. But neither methods provide robust estimates of transmission risk ratios. Source attribution method can alleviate drawbacks from phylogenetic clustering but formal population genetic modeling may be required to estimate quantitative transmission risk factors. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Cohort study on clustering of lifestyle risk factors and understanding its association with stress on health and wellbeing among school teachers in Malaysia (CLUSTer)--a study protocol.

Science.gov (United States)

Moy, Foong Ming; Hoe, Victor Chee Wai; Hairi, Noran Naqiah; Buckley, Brian; Wark, Petra A; Koh, David; Bueno-de-Mesquita, H Bas; Bulgiba, Awang M

2014-06-17

The study on Clustering of Lifestyle risk factors and Understanding its association with Stress on health and wellbeing among school Teachers in Malaysia (CLUSTer) is a prospective cohort study which aims to extensively study teachers in Malaysia with respect to clustering of lifestyle risk factors and stress, and subsequently, to follow-up the population for important health outcomes. This study is being conducted in six states within Peninsular Malaysia. From each state, schools from each district are randomly selected and invited to participate in the study. Once the schools agree to participate, all teachers who fulfilled the inclusion criteria are invited to participate. Data collection includes a questionnaire survey and health assessment. Information collected in the questionnaire includes socio-demographic characteristics, participants' medical history and family history of chronic diseases, teaching characteristics and burden, questions on smoking, alcohol consumption and physical activities (IPAQ); a food frequency questionnaire, the job content questionnaire (JCQ); depression, anxiety and stress scale (DASS21); health related quality of life (SF12-V2); Voice Handicap Index 10 on voice disorder, questions on chronic pain, sleep duration and obstetric history for female participants. Following blood drawn for predefined clinical tests, additional blood and urine specimens are collected and stored for future analysis. Active follow up of exposure and health outcomes will be carried out every two years via telephone or face to face contact. Data collection started in March 2013 and as of the end of March 2014 has been completed for four states: Kuala Lumpur, Selangor, Melaka and Penang. Approximately 6580 participants have been recruited. The first round of data collection and blood sampling is expected to be completed by the end of 2014 with an expected 10,000 participants recruited. Our study will provide a good basis for exploring the clustering of

Supplier Risk Assessment Based on Best-Worst Method and K-Means Clustering: A Case Study

Directory of Open Access Journals (Sweden)

Merve Er Kara

2018-04-01

Full Text Available Supplier evaluation and selection is one of the most critical strategic decisions for developing a competitive and sustainable organization. Companies have to consider supplier related risks and threats in their purchasing decisions. In today’s competitive and risky business environment, it is very important to work with reliable suppliers. This study proposes a clustering based approach to group suppliers based on their risk profile. Suppliers of a company in the heavy-machinery sector are assessed based on 17 qualitative and quantitative risk types. The weights of the criteria are determined by using the Best-Worst method. Four factors are extracted by applying Factor Analysis to the supplier risk data. Then k-means clustering algorithm is applied to group core suppliers of the company based on the four risk factors. Three clusters are created with different risk exposure levels. The interpretation of the results provides insights for risk management actions and supplier development programs to mitigate supplier risk.

Sedentary behaviour and clustered metabolic risk in adolescents: the HELENA study.

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Rey-López, J P; Bel-Serrat, S; Santaliestra-Pasías, A; de Moraes, A C; Vicente-Rodríguez, G; Ruiz, J R; Artero, E G; Martínez-Gómez, D; Gottrand, F; De Henauw, S; Huybrechts, I; Polito, A; Molnar, D; Manios, Y; Moreno, L A

2013-10-01

Although sedentary behaviours are linked with mortality for cardiovascular reasons, it is not clear whether they are negatively related with cardio-metabolic risk factors. The aim was to examine the association between time engaged in television (TV) viewing or playing with videogames and a clustered cardio-metabolic risk in adolescents. Sedentary behaviours and physical activity were assessed in 769 adolescents (376 boys, aged 12.5-17.5 years) from the HELENA-CSS study. We measured systolic blood pressure, HOMA index, triglycerides, TC/HDL-c, VO₂max and the sum of four skinfolds, and a clustered metabolic risk index was computed. A multilevel regression model (by Poisson) was performed to calculate the prevalence ratio of having a clustered metabolic risk. In boys, playing >4 h/day with videogames (weekend) and moderate to vigorous PA (MVPA) was associated with cardio-metabolic risk after adjustment for age, maternal education and MVPA. In contrast, TV viewing was not associated with the presence of cardio-metabolic risk. In boys, playing with videogames may impair cardio-metabolic health during the adolescence. Adolescents should be encouraged to increase their participation in physical activity of at least moderate intensity to obtain a more favourable risk factor profile. Copyright © 2012 Elsevier B.V. All rights reserved.

Socioeconomic risk factors for cholera in different transmission settings: An analysis of the data of a cluster randomized trial in Bangladesh.

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Saha, Amit; Hayen, Andrew; Ali, Mohammad; Rosewell, Alexander; Clemens, John D; Raina MacIntyre, C; Qadri, Firdausi

2017-09-05

Cholera remains a threat globally, and socioeconomic factors play an important role in transmission of the disease. We assessed socioeconomic risk factors for cholera in vaccinated and non-vaccinated communities to understand whether the socioeconomic risk factors differ by transmission patterns for cholera. We used data from a cluster randomized control trial conducted in Dhaka, Bangladesh. There were 90 geographic clusters; 30 in each of the three arms of the study: vaccine (VAC), vaccine plus behavioural change (VBC), and non-intervention. The data were analysed for the three populations: (1) vaccinees in the vaccinated communities (VAC and VBC arms), (2) non-vaccinated individuals in the vaccinated communities and (3) all individuals in the non-vaccinated communities (non-intervention arm). A generalized estimating equation with logit link function was used to evaluate the risk factors for cholera among these different populations adjusting for household level correlation in the data. A total of 528 cholera and 226 cholera with severe dehydration (CSD) in 268,896 persons were observed during the two-year follow-up. For population 1, the cholera risk was not associated with any socioeconomic factors; however CSD was less likely to occur among individuals living in a household having ≤4 members (aOR=0.55, 95% CI=0.32-0.96). Among population 2, younger participants and individuals reporting diarrhoea during registration were more likely to have cholera. Females and individuals reporting diarrhoea during registration were at increased risk of CSD. Among population 3, individuals living in a household without a concrete floor, in an area with high population density, closer to the study hospital, or not treating drinking water were at significantly higher risk for both cholera and CSD. The profile of socioeconomic factors associated with cholera varies by individuals' vaccination status as well as the transmission setting. In a vaccinated community where

Cohort study on clustering of lifestyle risk factors and understanding its association with stress on health and wellbeing among school teachers in Malaysia (CLUSTer) – a study protocol

Science.gov (United States)

2014-01-01

Background The study on Clustering of Lifestyle risk factors and Understanding its association with Stress on health and wellbeing among school Teachers in Malaysia (CLUSTer) is a prospective cohort study which aims to extensively study teachers in Malaysia with respect to clustering of lifestyle risk factors and stress, and subsequently, to follow-up the population for important health outcomes. Method/design This study is being conducted in six states within Peninsular Malaysia. From each state, schools from each district are randomly selected and invited to participate in the study. Once the schools agree to participate, all teachers who fulfilled the inclusion criteria are invited to participate. Data collection includes a questionnaire survey and health assessment. Information collected in the questionnaire includes socio-demographic characteristics, participants’ medical history and family history of chronic diseases, teaching characteristics and burden, questions on smoking, alcohol consumption and physical activities (IPAQ); a food frequency questionnaire, the job content questionnaire (JCQ); depression, anxiety and stress scale (DASS21); health related quality of life (SF12-V2); Voice Handicap Index 10 on voice disorder, questions on chronic pain, sleep duration and obstetric history for female participants. Following blood drawn for predefined clinical tests, additional blood and urine specimens are collected and stored for future analysis. Active follow up of exposure and health outcomes will be carried out every two years via telephone or face to face contact. Data collection started in March 2013 and as of the end of March 2014 has been completed for four states: Kuala Lumpur, Selangor, Melaka and Penang. Approximately 6580 participants have been recruited. The first round of data collection and blood sampling is expected to be completed by the end of 2014 with an expected 10,000 participants recruited. Discussion Our study will provide a good basis

A community-based cluster randomized survey of noncommunicable disease and risk factors in a peri-urban shantytown in Lima, Peru.

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Heitzinger, Kristen; Montano, Silvia M; Hawes, Stephen E; Alarcón, Jorge O; Zunt, Joseph R

2014-05-21

An estimated 863 million people-a third of the world's urban population-live in slums, yet there is little information on the disease burden in these settings, particularly regarding chronic preventable diseases. From March to May 2012, we conducted a cluster randomized survey to estimate the prevalence of noncommunicable diseases (NCDs) and associated risk factors in a peri-urban shantytown north of Lima, Peru. Field workers administered a questionnaire that included items from the WHO World Health Survey and the WHO STEPS survey of chronic disease risk factors. We used logistic regression to assess the associations of NCDs and related risk factors with age and gender. We accounted for sampling weights and the clustered sampling design using statistical survey methods. A total of 142 adults were surveyed and had a weighted mean age of 36 years (range 18-81). The most prevalent diseases were depression (12%) and chronic respiratory disease (8%), while lifetime prevalence of cancer, arthritis, myocardial infarction, and diabetes were all less than 5%. Fifteen percent of respondents were hypertensive and the majority (67%) was unaware of their condition. Being overweight or obese was common for both genders (53%), but abdominal obesity was more prevalent in women (54% vs. 10% in men, p Peru and suggests that prevention and treatment interventions could be optimized according to age and gender.

Time-dependent risks of cancer clustering among couples: a nationwide population-based cohort study in Taiwan.

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Wang, Jong-Yi; Liang, Yia-Wen; Yeh, Chun-Chen; Liu, Chiu-Shong; Wang, Chen-Yu

2018-02-21

Spousal clustering of cancer warrants attention. Whether the common environment or high-age vulnerability determines cancer clustering is unclear. The risk of clustering in couples versus non-couples is undetermined. The time to cancer clustering after the first cancer diagnosis is yet to be reported. This study investigated cancer clustering over time among couples by using nationwide data. A cohort of 5643 married couples in the 2002-2013 Taiwan National Health Insurance Research Database was identified and randomly matched with 5643 non-couple pairs through dual propensity score matching. Factors associated with clustering (both spouses with tumours) were analysed by using the Cox proportional hazard model. Propensity-matched analysis revealed that the risk of clustering of all tumours among couples (13.70%) was significantly higher than that among non-couples (11.84%) (OR=1.182, 95% CI 1.058 to 1.321, P=0.0031). The median time to clustering of all tumours and of malignant tumours was 2.92 and 2.32 years, respectively. Risk characteristics associated with clustering included high age and comorbidity. Shared environmental factors among spouses might be linked to a high incidence of cancer clustering. Cancer incidence in one spouse may signal cancer vulnerability in the other spouse. Promoting family-oriented cancer care in vulnerable families and preventing shared lifestyle risk factors for cancer are suggested. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Mortality in Danish Swine herds: Spatio-temporal clusters and risk factors

DEFF Research Database (Denmark)

Lopes Antunes, Ana Carolina; Ersbøll, Annette Kjær; Bihrmann, Kristine

2017-01-01

-temporal analysis included data description for spatial, temporal, and spatio-temporal cluster analysis for three age groups: weaners (up to 30 kg), sows and finishers. Logistic regression models were used to assess the potential factors associated with finisher and weaner herds being included within multiple...

Risk perception of aquatic pollution originated from chemical industry clusters in the coastal area of Jiangsu province, China.

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Yao, Hong; Liu, Bo; You, Zhen; Zhao, Li

2018-02-01

According to "the Layout Scheme of the Chemical Industry in Jiangsu Province From 2016 to 2030" and "the Development Planning in the Coastal Area of Jiangsu Province, China," several chemical industry clusters will be located in the coastal area of Jiangsu province, China, and the risk of surface water pollution will be inevitably higher in the densely populated region. To get to know the risk acceptance level of the residents near the clusters, public perception was analyzed from the five risk factors: the basic knowledge about the pollution, the negative effects on aquatic environment imposed by the clusters, the positive effects brought by the clusters, the trust of controlling aquatic pollution, and the acceptance of the clusters. Twenty-four statements were screened out to describe the five factors, and about 600 residents were covered in three typical clusters surveyed. On the whole, the youth showed a higher interest on the survey, and middle-aged people were likely to be more concerned about aquatic pollution incident. There was no significant difference on risk perception of the three clusters. The respondents investigated had good knowledge background on aquatic pollution and the residents identified with the benefits brought by the clusters. They were weak in risk awareness of pollution originated from the chemical enterprises' groups. Although the respondents regarded that chemical industry clusters did not expose all points of pollutants' generation to the public, they inclined to trust the administration agencies on controlling the pollution and welcome the construction of chemical clusters in their dwelling cities. Besides, risk perception showed obvious spatial distribution. The closer were the samples' sites to the clusters and the rivers receiving pollutants, the higher were the residents' perceived risk, benefit, and trust. However, there was no identical spatial difference on risk acceptance, which might be comprehensively influenced by various

Cluster analysis to estimate the risk of preeclampsia in the high-risk Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) study

Science.gov (United States)

Marttinen, Pekka; Gillberg, Jussi; Lokki, A. Inkeri; Majander, Kerttu; Ordén, Maija-Riitta; Taipale, Pekka; Pesonen, Anukatriina; Räikkönen, Katri; Hämäläinen, Esa; Kajantie, Eero; Laivuori, Hannele

2017-01-01

Objectives Preeclampsia is divided into early-onset (delivery before 34 weeks of gestation) and late-onset (delivery at or after 34 weeks) subtypes, which may rise from different etiopathogenic backgrounds. Early-onset disease is associated with placental dysfunction. Late-onset disease develops predominantly due to metabolic disturbances, obesity, diabetes, lipid dysfunction, and inflammation, which affect endothelial function. Our aim was to use cluster analysis to investigate clinical factors predicting the onset and severity of preeclampsia in a cohort of women with known clinical risk factors. Methods We recruited 903 pregnant women with risk factors for preeclampsia at gestational weeks 12+0–13+6. Each individual outcome diagnosis was independently verified from medical records. We applied a Bayesian clustering algorithm to classify the study participants to clusters based on their particular risk factor combination. For each cluster, we computed the risk ratio of each disease outcome, relative to the risk in the general population. Results The risk of preeclampsia increased exponentially with respect to the number of risk factors. Our analysis revealed 25 number of clusters. Preeclampsia in a previous pregnancy (n = 138) increased the risk of preeclampsia 8.1 fold (95% confidence interval (CI) 5.7–11.2) compared to a general population of pregnant women. Having a small for gestational age infant (n = 57) in a previous pregnancy increased the risk of early-onset preeclampsia 17.5 fold (95%CI 2.1–60.5). Cluster of those two risk factors together (n = 21) increased the risk of severe preeclampsia to 23.8-fold (95%CI 5.1–60.6), intermediate onset (delivery between 34+0–36+6 weeks of gestation) to 25.1-fold (95%CI 3.1–79.9) and preterm preeclampsia (delivery before 37+0 weeks of gestation) to 16.4-fold (95%CI 2.0–52.4). Body mass index over 30 kg/m2 (n = 228) as a sole risk factor increased the risk of preeclampsia to 2.1-fold (95%CI 1.1–3

Risk Assessment for Bridges Safety Management during Operation Based on Fuzzy Clustering Algorithm

Directory of Open Access Journals (Sweden)

Xia Hanyu

2016-01-01

Full Text Available In recent years, large span and large sea-crossing bridges are built, bridges accidents caused by improper operational management occur frequently. In order to explore the better methods for risk assessment of the bridges operation departments, the method based on fuzzy clustering algorithm is selected. Then, the implementation steps of fuzzy clustering algorithm are described, the risk evaluation system is built, and Taizhou Bridge is selected as an example, the quantitation of risk factors is described. After that, the clustering algorithm based on fuzzy equivalence is calculated on MATLAB 2010a. In the last, Taizhou Bridge operation management departments are classified and sorted according to the degree of risk, and the safety situation of operation departments is analyzed.

Prevalence and risk factors for scrub typhus in South India.

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Trowbridge, Paul; P, Divya; Premkumar, Prasanna S; Varghese, George M

2017-05-01

To determine the prevalence and risk factors of scrub typhus in Tamil Nadu, South India. We performed a clustered seroprevalence study of the areas around Vellore. All participants completed a risk factor survey, with seropositive and seronegative participants acting as cases and controls, respectively, in a risk factor analysis. After univariate analysis, variables found to be significant underwent multivariate analysis. Of 721 people participating in this study, 31.8% tested seropositive. By univariate analysis, after accounting for clustering, having a house that was clustered with other houses, having a fewer rooms in a house, having fewer people living in a household, defecating outside, female sex, age >60 years, shorter height, lower weight, smaller body mass index and smaller mid-upper arm circumference were found to be significantly associated with seropositivity. After multivariate regression modelling, living in a house clustered with other houses, female sex and age >60 years were significantly associated with scrub typhus exposure. Overall, scrub typhus is much more common than previously thought. Previously described individual environmental and habitual risk factors seem to have less importance in South India, perhaps because of the overall scrub typhus-conducive nature of the environment in this region. © 2017 John Wiley & Sons Ltd.

Clustering of metabolic and cardiovascular risk factors in the polycystic ovary syndrome: a principal component analysis.

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Stuckey, Bronwyn G A; Opie, Nicole; Cussons, Andrea J; Watts, Gerald F; Burke, Valerie

2014-08-01

Polycystic ovary syndrome (PCOS) is a prevalent condition with heterogeneity of clinical features and cardiovascular risk factors that implies multiple aetiological factors and possible outcomes. To reduce a set of correlated variables to a smaller number of uncorrelated and interpretable factors that may delineate subgroups within PCOS or suggest pathogenetic mechanisms. We used principal component analysis (PCA) to examine the endocrine and cardiometabolic variables associated with PCOS defined by the National Institutes of Health (NIH) criteria. Data were retrieved from the database of a single clinical endocrinologist. We included women with PCOS (N = 378) who were not taking the oral contraceptive pill or other sex hormones, lipid lowering medication, metformin or other medication that could influence the variables of interest. PCA was performed retaining those factors with eigenvalues of at least 1.0. Varimax rotation was used to produce interpretable factors. We identified three principal components. In component 1, the dominant variables were homeostatic model assessment (HOMA) index, body mass index (BMI), high density lipoprotein (HDL) cholesterol and sex hormone binding globulin (SHBG); in component 2, systolic blood pressure, low density lipoprotein (LDL) cholesterol and triglycerides; in component 3, total testosterone and LH/FSH ratio. These components explained 37%, 13% and 11% of the variance in the PCOS cohort respectively. Multiple correlated variables from patients with PCOS can be reduced to three uncorrelated components characterised by insulin resistance, dyslipidaemia/hypertension or hyperandrogenaemia. Clustering of risk factors is consistent with different pathogenetic pathways within PCOS and/or differing cardiometabolic outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

Risk factors and clusters of Highly Pathogenic Avian Influenza H5N1 outbreaks in Bangladesh

Science.gov (United States)

Loth, Leo; Gilbert, Marius; Osmani, Mozaffar G.; Kalam, Abul M.; Xiao, Xiangming

2016-01-01

Between March 2007 and July 2009, 325 Highly Pathogenic Avian Influenza (HPAI, subtype H5N1) outbreaks in poultry were reported in 154 out of a total of 486 sub-districts in Bangladesh. This study analyzed the temporal and spatial patterns of HPAI H5N1 outbreaks and quantified the relationship between several spatial risk factors and HPAI outbreaks in sub-districts in Bangladesh. We assessed spatial autocorrelation and spatial dependence, and identified clustering sub-districts with disease statistically similar to or dissimilar from their neighbors. Three significant risk factors associated to HPAI H5N1 virus outbreaks were identified; the quadratic log-transformation of human population density [humans per square kilometer, P = 0.01, OR 1.15 (95% CI: 1.03–1.28)], the log-transformation of the total commercial poultry population [number of commercial poultry per sub-district, P Bangladesh to target surveillance and to concentrate response efforts in areas where disease is likely to occur. Concentrating response efforts may help to combat HPAI more effectively, reducing the environmental viral load and so reducing the number of disease incidents. PMID:20554337

Consanguinity and family clustering of male factor infertility in Lebanon.

Science.gov (United States)

Inhorn, Marcia C; Kobeissi, Loulou; Nassar, Zaher; Lakkis, Da'ad; Fakih, Michael H

2009-04-01

To investigate the influence of consanguineous marriage on male factor infertility in Lebanon, where rates of consanguineous marriage remain high (29.6% among Muslims, 16.5% among Christians). Clinic-based, case-control study, using reproductive history, risk factor interview, and laboratory-based semen analysis. Two IVF clinics in Beirut, Lebanon, during an 8-month period (January-August 2003). One hundred twenty infertile male patients and 100 fertile male controls, distinguished by semen analysis and reproductive history. None. Standard clinical semen analysis. The rates of consanguineous marriage were relatively high among the study sample. Patients (46%) were more likely than controls (37%) to report first-degree (parental) and second-degree (grandparental) consanguinity. The study demonstrated a clear pattern of family clustering of male factor infertility, with patients significantly more likely than controls to report infertility among close male relatives (odds ratio = 2.58). Men with azoospermia and severe oligospermia showed high rates of both consanguinity (50%) and family clustering (41%). Consanguineous marriage is a socially supported institution throughout the Muslim world, yet its relationship to infertility is poorly understood. This study demonstrated a significant association between consanguinity and family clustering of male factor infertility cases, suggesting a strong genetic component.

The relationship between physical fitness and clustered risk, and tracking of clustered risk from adolescence to young adulthood: eight years follow-up in the Danish Youth and Sport Study

DEFF Research Database (Denmark)

Andersen, Lars Bo; Hasselstrøm, Henriette; Hansen, Stig Eiberg

2004-01-01

was defined as being at risk, and if a subject had two or more risk factors, he/she was defined as a case (15-20 % of the subjects). Odds ratios (OR) for being a case was calculated between quartiles of fitness in both cross-sectional studies. The stability of combined risk was calculated as the OR between...... cases and non-cases at the first examination to be a case at the second examination. RESULTS: ORs for having two or more risk factors between quartiles of fitness were 3.1, 3.8 and 4.9 for quartiles two to four, respectively. At the second examination, OR were 0.7, 3.5 and 4.9, respectively....... The probability for "a case" at the first examination to be "a case" at the second was 6.0. CONCLUSIONS: The relationship between an exposure like physical fitness and CVD risk factors is much stronger when clustering of risk factors are analysed compared to the relationship to single risk factors. The stability...

An investigation of war trauma types, symptom clusters, and risk-factors associated with post-traumatic stress disorder: where does gender fit?

Science.gov (United States)

Farhood, Laila; Fares, Souha; Hamady, Carmen

2018-05-25

The female-male ratio in the prevalence of post-traumatic stress disorder (PTSD) is approximately 2:1. Gender differences in experienced trauma types, PTSD symptom clusters, and PTSD risk factors are unclear. We aimed to address this gap using a cross-sectional design. A sample of 991 civilians (522 women, 469 men) from South Lebanon was randomly selected in 2007, after the 2006 war. Trauma types were grouped into disaster and accident, loss, chronic disease, non-malignant disease, and violence. PTSD symptom clusters involved re-experiencing, avoidance, negative cognitions and mood, and arousal. These were assessed using parts I and IV of the Arabic version of the Harvard Trauma Questionnaire (HTQ). Risk factors were assessed using data from a social support and life events questionnaire in multiple regression models. Females were twice as likely as males to score above PTSD threshold (24.3 vs. 10.4%, p ˂ 0.001). Total scores on all trauma types were similar across genders. Females scored higher on all symptom clusters (p < 0.001). Social support, social life events, witnessed traumas, and domestic violence significantly were associated with PTSD in both genders. Social support, social life events, witnessed traumas and domestic violence were significantly associated with PTSD in both genders. Conversely, gender difference in experienced traumas was not statistically significant. These findings accentuate the need to re-consider the role of gender in the assessment and treatment of PTSD.

Cardiovascular Risk Factors Among Low-Income Women: A Population-Based Study in China from 1991 to 2011.

Science.gov (United States)

Lu, Hongyan; Bai, Lingling; Zhan, Changqing; Yang, Li; Tu, Jun; Gu, Hongfei; Shi, Min; Wang, Jinghua; Ning, Xianjia

2016-12-01

Data on long-term trends in the prevalence and clustering of cardiovascular disease (CVD) risk factors among women in China are rare, especially among low-income women. The aim of this study was to investigate the secular trends in the prevalence of CVD risk factors among low-income women in northern China. The prevalence and clustering of CVD risk factors, including hypertension, diabetes, obesity, current smoking status, and alcohol consumption, were assessed and compared in women aged 35-74 years in northern China in 1991 and 2011. The age-adjusted prevalence of cardiovascular risk factors among women was significantly higher in 2011 than in 1991, with increases of 31% (53.6% vs. 41.1%) for hypertension, 148% (20.9% vs. 8.4%) for obesity, 256% (11.7% vs. 3.3%) for diabetes, and 1634% (4.5% vs. 0.3%) for alcohol consumption. Over the 21-year period, there were significant differences in the prevalence of clustering of ≥1, ≥2, and 3 risk factors in all age groups. The greatest increase was observed among women aged 35-44 years, with a 7.3-fold increase in the prevalence of clustering of three risk factors. Simultaneously, the prevalence of clustering of ≥1 risk factors among women aged 35-44 years was 1.7-fold higher in 2011 than in 1991; the prevalence of clustering of ≥2 risk factors was raised by 5.5-fold among elderly women. Our findings suggest that it is crucial to emphasize the prevention and control of cardiovascular risk factors among young women in rural China to reduce the burden of CVDs.

Association of Parental Overweight and Cardiometabolic Diseases and Pediatric Adiposity and Lifestyle Factors with Cardiovascular Risk Factor Clustering in Adolescents

Directory of Open Access Journals (Sweden)

Chun-Ying Lee

2016-09-01

Full Text Available Cardiometabolic risk factors or their precursors are observed in childhood and may continue into adulthood. We investigated the effects of parental overweight and cardiometabolic diseases and pediatric lifestyle factors on the clustering of cardiovascular risk factors among adolescents, and examined the mediating and modifying effects of pediatric adiposity on these associations. Representative adolescents (n = 2727; age, 12–16 years were randomly recruited through multistage stratified sampling from 36 schools in Southern Taiwan. Adolescent and parent surveys were conducted in schools and participant homes, respectively. Their demographic factors, diet patterns, and physical, anthropometric, and clinical parameters were collected and analyzed. Adolescents with 1–2 and ≥3 risk components for pediatric metabolic syndrome (MetS were defined as potential MetS (pot-MetS and MetS, respectively. Adolescents whose parents were overweight/obese, or with diabetes and hypertension had a higher prevalence ratio of pot-MetS and MetS (1.5–1.6 and 1.9–4.2-fold, respectively. Low physical activity (<952.4 MET·min/week, long screen time (≥3 h/day and high sugar-sweetened beverage intake (>500 mL/day were associated with a 3.3- (95% confidence intervals (CI = 1.5–7.3, 2.2- (95% CI = 1.1–4.4, and 26.9-fold (95% CI = 3.2–229.0 odds ratio (OR of MetS, respectively. Pediatric body mass index (BMI accounted for 18.8%–95.6% and 16.9%–60.3% increased prevalence ratios of these parental and pediatric risk factors for MetS. The OR of pot-MetS + MetS for sugar-sweetened beverage consumption was multiplicatively enhanced among adolescents with overweight/obesity (combined OR, 8.6-fold (95% CI = 4.3–17.3; p for multiplicative interaction, 0.009. The results suggest that parental overweight and cardiometabolic diseases and pediatric sedentary and high sugar-intake lifestyles correlate with the development of adolescent MetS, and an elevated child BMI

Socio-demographic association of multiple modifiable lifestyle risk factors and their clustering in a representative urban population of adults: a cross-sectional study in Hangzhou, China

Directory of Open Access Journals (Sweden)

Wang Shengfeng

2011-05-01

Full Text Available Abstract Background To plan long-term prevention strategies and develop tailored intervention activities, it is important to understand the socio-demographic characteristics of the subpopulations at high risk of developing chronic diseases. This study aimed to examine the socio-demographic characteristics associated with multiple lifestyle risk factors and their clustering. Methods We conducted a simple random sampling survey to assess lifestyle risk factors in three districts of Hangzhou, China between 2008 and 2009. A two-step cluster analysis was used to identify different health-related lifestyle clusters based on tobacco use, physical activity, fruit and vegetable consumption, and out-of-home eating. Multinomial logistic regression was used to model the association between socio-demographic factors and lifestyle clusters. Results A total of 2016 eligible people (977 men and 1039 women, ages 18-64 years completed the survey. Three distinct clusters were identified from the cluster analysis: an unhealthy (UH group (25.7%, moderately healthy (MH group (31.1%, and healthy (H group (43.1%. UH group was characterised by a high prevalence of current daily smoking, a moderate or low level of PA, low FV consumption with regard to the frequency or servings, and more occurrences of eating out. H group was characterised by no current daily smoking, a moderate level of PA, high FV consumption, and the fewest times of eating out. MH group was characterised by no current daily smoking, a low or high level of PA, and an intermediate level of FV consumption and frequency of eating out. Men were more likely than women to have unhealthy lifestyles. Adults aged 50-64 years were more likely to live healthy lifestyles. Adults aged 40-49 years were more likely to be in the UH group. Adults whose highest level of education was junior high school or below were more likely to be in the UH group. Adults with a high asset index were more likely to be in the MH group

Sociomedical risk factors for male infecundity

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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

Participatory ergonomics to reduce exposure to psychosocial and physical risk factors for low back pain and neck pain: Results of a cluster randomised controlled trial

NARCIS (Netherlands)

Driessen, M.T.; Proper, K.I.; Anema, J.R.; Knol, D.L.; Bongers, P.M.; Beek, A.J. van der

2011-01-01

Objectives: This study investigated the effectiveness of the Stay@Work participatory ergonomics programme to reduce workers9 exposure to psychosocial and physical risk factors. Methods: 37 departments (n=3047 workers) from four Dutch companies participated in this cluster randomised controlled

Factored Translation with Unsupervised Word Clusters

DEFF Research Database (Denmark)

Rishøj, Christian; Søgaard, Anders

2011-01-01

Unsupervised word clustering algorithms — which form word clusters based on a measure of distributional similarity — have proven to be useful in providing beneficial features for various natural language processing tasks involving supervised learning. This work explores the utility of such word...... clusters as factors in statistical machine translation. Although some of the language pairs in this work clearly benefit from the factor augmentation, there is no consistent improvement in translation accuracy across the board. For all language pairs, the word clusters clearly improve translation for some...... proportion of the sentences in the test set, but has a weak or even detrimental effect on the rest. It is shown that if one could determine whether or not to use a factor when translating a given sentence, rather substantial improvements in precision could be achieved for all of the language pairs evaluated...

A clustering approach to segmenting users of internet-based risk calculators.

Science.gov (United States)

Harle, C A; Downs, J S; Padman, R

2011-01-01

Risk calculators are widely available Internet applications that deliver quantitative health risk estimates to consumers. Although these tools are known to have varying effects on risk perceptions, little is known about who will be more likely to accept objective risk estimates. To identify clusters of online health consumers that help explain variation in individual improvement in risk perceptions from web-based quantitative disease risk information. A secondary analysis was performed on data collected in a field experiment that measured people's pre-diabetes risk perceptions before and after visiting a realistic health promotion website that provided quantitative risk information. K-means clustering was performed on numerous candidate variable sets, and the different segmentations were evaluated based on between-cluster variation in risk perception improvement. Variation in responses to risk information was best explained by clustering on pre-intervention absolute pre-diabetes risk perceptions and an objective estimate of personal risk. Members of a high-risk overestimater cluster showed large improvements in their risk perceptions, but clusters of both moderate-risk and high-risk underestimaters were much more muted in improving their optimistically biased perceptions. Cluster analysis provided a unique approach for segmenting health consumers and predicting their acceptance of quantitative disease risk information. These clusters suggest that health consumers were very responsive to good news, but tended not to incorporate bad news into their self-perceptions much. These findings help to quantify variation among online health consumers and may inform the targeted marketing of and improvements to risk communication tools on the Internet.

An Investigation into the Lifestyle, Health Habits and Risk Factors of Young Adults

Directory of Open Access Journals (Sweden)

Yahya Al-Nakeeb

2015-04-01

Full Text Available This project examined the lifestyle, health habits and risk factors of young adults at Qatar University. It explored the clustering and differences in dietary habits, body mass index (BMI and physical activity (PA amongst male and female students, both Qatari and non-Qatari. Seven hundred thirty two students aged 18–25 years completed a self-reported questionnaire and an objective measure of BMI. Males and females had a high prevalence of being overweight and obesity and low levels of PA, according to well-established international standards. Three clusters were identified based on the students’ lifestyle and dietary habits. Cluster 1 (high risk factors included those who engaged the least in healthy dietary practices and consumed the most unhealthy foods, participated in less PA and had the highest BMI. Cluster 2 (moderate risk factors included those with considerably more habits falling into the moderate category, engagement in the most PA, the least TV and computer viewing time and had the lowest BMI. Cluster 3 (low risk factors included those who engaged the most with the four healthy dietary practices, the least with the four unhealthy dietary practices and participated in moderate PA per week. This project provides valuable data that could be used by policy makers to address issues concerning student’s health.

Co-occurrence of behavioral risk factors for chronic non-communicable diseases in adolescents: Prevalence and associated factors

Directory of Open Access Journals (Sweden)

Alessandra Silva Dias de OLIVEIRA

Full Text Available ABSTRACT Objective To examine the prevalence of the behavioral risk factors – both isolated and clustered – for chronic diseases, among adolescents. Additionally, its association with various social and demographic variables was estimated. Methods This was a cross-sectional study conducted on 1,039 high school students, from public and private schools, elected for convenience, in Rio de Janeiro, Brazil. A Chi-square test, Mann-Whitney U test, as well as crude and adjusted ordinal logistic regression were used to assess the association between the variables. Results The most frequently observed risk factors were sedentary behavior (68.8%, alcohol consumption (36.8%, and overweight (26.8%. The clustering of risk factors was observed in 67.5% of the students. Being a girl (OR=1.28; 95%CI=1.01–1.63, Caucasian (OR=1.35; 95%CI=1.06–1.72 or private school student (OR=1.46; 95%CI=1.12–1.88 increased the chance of the clustering of risk factors. The co-occurrence of risk factors was predominantly observed in the case of smoking (OR=4.94; 95%CI=1.46–16.75, alcohol consumption (OR=1.43; 95%CI=1.09–1.88, high consumption of ultra-processed foods (OR=1.57; 95%CI=1.19–2.07, and sedentary behavior (OR=1.40; 95%CI=1.07–1.82. Conclusion The co-occurrence of behavioral risk factors was observed to be higher among girls, Caucasian adolescents, and private school students, as well as, among smokers, alcohol users and adolescents with sedentary habits and a high consumption of ultra-processed foods.

[High risk groups in health behavior defined by clustering of smoking, alcohol, and exercise habits: National Heath and Nutrition Examination Survey].

Science.gov (United States)

Kang, Kiwon; Sung, Joohon; Kim, Chang Yup

2010-01-01

We investigated the clustering of selected lifestyle factors (cigarette smoking, heavy alcohol consumption, lack of physical exercise) and identified the population characteristics associated with increasing lifestyle risks. Data on lifestyle risk factors, sociodemographic characteristics, and history of chronic diseases were obtained from 7,694 individuals >/=20 years of age who participated in the 2005 Korea National Health and Nutrition Examination Survey (KNHANES). Clustering of lifestyle risks involved the observed prevalence of multiple risks and those expected from marginal exposure prevalence of the three selected risk factors. Prevalence odds ratio was adopted as a measurement of clustering. Multiple correspondence analysis, Kendall tau correlation, Man-Whitney analysis, and ordinal logistic regression analysis were conducted to identify variables increasing lifestyle risks. In both men and women, increased lifestyle risks were associated with clustering of: (1) cigarette smoking and excessive alcohol consumption, and (2) smoking, excessive alcohol consumption, and lack of physical exercise. Patterns of clustering for physical exercise were different from those for cigarette smoking and alcohol consumption. The increased unhealthy clustering was found among men 20-64 years of age with mild or moderate stress, and among women 35-49 years of age who were never-married, with mild stress, and increased body mass index (>30 kg/m(2)). Addressing a lack of physical exercise considering individual characteristics including gender, age, employment activity, and stress levels should be a focus of health promotion efforts.

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.

Science.gov (United States)

Lim, Stephen S; Vos, Theo; Flaxman, Abraham D; Danaei, Goodarz; Shibuya, Kenji; Adair-Rohani, Heather; Amann, Markus; Anderson, H Ross; Andrews, Kathryn G; Aryee, Martin; Atkinson, Charles; Bacchus, Loraine J; Bahalim, Adil N; Balakrishnan, Kalpana; Balmes, John; Barker-Collo, Suzanne; Baxter, Amanda; Bell, Michelle L; Blore, Jed D; Blyth, Fiona; Bonner, Carissa; Borges, Guilherme; Bourne, Rupert; Boussinesq, Michel; Brauer, Michael; Brooks, Peter; Bruce, Nigel G; Brunekreef, Bert; Bryan-Hancock, Claire; Bucello, Chiara; Buchbinder, Rachelle; Bull, Fiona; Burnett, Richard T; Byers, Tim E; Calabria, Bianca; Carapetis, Jonathan; Carnahan, Emily; Chafe, Zoe; Charlson, Fiona; Chen, Honglei; Chen, Jian Shen; Cheng, Andrew Tai-Ann; Child, Jennifer Christine; Cohen, Aaron; Colson, K Ellicott; Cowie, Benjamin C; Darby, Sarah; Darling, Susan; Davis, Adrian; Degenhardt, Louisa; Dentener, Frank; Des Jarlais, Don C; Devries, Karen; Dherani, Mukesh; Ding, Eric L; Dorsey, E Ray; Driscoll, Tim; Edmond, Karen; Ali, Suad Eltahir; Engell, Rebecca E; Erwin, Patricia J; Fahimi, Saman; Falder, Gail; Farzadfar, Farshad; Ferrari, Alize; Finucane, Mariel M; Flaxman, Seth; Fowkes, Francis Gerry R; Freedman, Greg; Freeman, Michael K; Gakidou, Emmanuela; Ghosh, Santu; Giovannucci, Edward; Gmel, Gerhard; Graham, Kathryn; Grainger, Rebecca; Grant, Bridget; Gunnell, David; Gutierrez, Hialy R; Hall, Wayne; Hoek, Hans W; Hogan, Anthony; Hosgood, H Dean; Hoy, Damian; Hu, Howard; Hubbell, Bryan J; Hutchings, Sally J; Ibeanusi, Sydney E; Jacklyn, Gemma L; Jasrasaria, Rashmi; Jonas, Jost B; Kan, Haidong; Kanis, John A; Kassebaum, Nicholas; Kawakami, Norito; Khang, Young-Ho; Khatibzadeh, Shahab; Khoo, Jon-Paul; Kok, Cindy; Laden, Francine; Lalloo, Ratilal; Lan, Qing; Lathlean, Tim; Leasher, Janet L; Leigh, James; Li, Yang; Lin, John Kent; Lipshultz, Steven E; London, Stephanie; Lozano, Rafael; Lu, Yuan; Mak, Joelle; Malekzadeh, Reza; Mallinger, Leslie; Marcenes, Wagner; March, Lyn; Marks, Robin; Martin, Randall; McGale, Paul; McGrath, John; Mehta, Sumi; Mensah, George A; Merriman, Tony R; Micha, Renata; Michaud, Catherine; Mishra, Vinod; Mohd Hanafiah, Khayriyyah; Mokdad, Ali A; Morawska, Lidia; Mozaffarian, Dariush; Murphy, Tasha; Naghavi, Mohsen; Neal, Bruce; Nelson, Paul K; Nolla, Joan Miquel; Norman, Rosana; Olives, Casey; Omer, Saad B; Orchard, Jessica; Osborne, Richard; Ostro, Bart; Page, Andrew; Pandey, Kiran D; Parry, Charles D H; Passmore, Erin; Patra, Jayadeep; Pearce, Neil; Pelizzari, Pamela M; Petzold, Max; Phillips, Michael R; Pope, Dan; Pope, C Arden; Powles, John; Rao, Mayuree; Razavi, Homie; Rehfuess, Eva A; Rehm, Jürgen T; Ritz, Beate; Rivara, Frederick P; Roberts, Thomas; Robinson, Carolyn; Rodriguez-Portales, Jose A; Romieu, Isabelle; Room, Robin; Rosenfeld, Lisa C; Roy, Ananya; Rushton, Lesley; Salomon, Joshua A; Sampson, Uchechukwu; Sanchez-Riera, Lidia; Sanman, Ella; Sapkota, Amir; Seedat, Soraya; Shi, Peilin; Shield, Kevin; Shivakoti, Rupak; Singh, Gitanjali M; Sleet, David A; Smith, Emma; Smith, Kirk R; Stapelberg, Nicolas J C; Steenland, Kyle; Stöckl, Heidi; Stovner, Lars Jacob; Straif, Kurt; Straney, Lahn; Thurston, George D; Tran, Jimmy H; Van Dingenen, Rita; van Donkelaar, Aaron; Veerman, J Lennert; Vijayakumar, Lakshmi; Weintraub, Robert; Weissman, Myrna M; White, Richard A; Whiteford, Harvey; Wiersma, Steven T; Wilkinson, James D; Williams, Hywel C; Williams, Warwick; Wilson, Nicholas; Woolf, Anthony D; Yip, Paul; Zielinski, Jan M; Lopez, Alan D; Murray, Christopher J L; Ezzati, Majid; AlMazroa, Mohammad A; Memish, Ziad A

2012-12-15

Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. In 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% [95% uncertainty interval 6·2-7·7] of global DALYs), tobacco smoking including second-hand smoke (6·3% [5·5-7·0]), and alcohol use (5·5% [5·0-5·9]). In 1990, the leading risks were childhood underweight (7·9% [6·8-9·4]), household air pollution from solid fuels (HAP; 7·0% [5·6-8·3]), and tobacco smoking including second-hand smoke (6·1% [5·4-6·8]). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2-10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved

Clustering of Risk Factors for Non-Communicable Diseases among Adolescents from Southern Brazil

OpenAIRE

Nunes, Heloyse Elaine Gimenes; Gon?alves, Eliane Cristina de Andrade; Vieira, J?ssika Aparecida Jesus; Silva, Diego Augusto Santos

2016-01-01

Introduction The aim of this study was to investigate the simultaneous presence of risk factors for non-communicable diseases and the association of these risk factors with demographic and economic factors among adolescents from southern Brazil. Methods The study included 916 students (14?19 years old) enrolled in the 2014 school year at state schools in S?o Jos?, Santa Catarina, Brazil. Risk factors related to lifestyle (i.e., physical inactivity, excessive alcohol consumption, smoking, sede...

Prediction of difficult mask ventilation using a systematic assessment of risk factors vs. existing practice - a cluster randomised clinical trial in 94,006 patients

DEFF Research Database (Denmark)

Nørskov, A K; Wetterslev, J; Rosenstock, C V

2017-01-01

We compared implementation of systematic airway assessment with existing practice of airway assessment on prediction of difficult mask ventilation. Twenty-six departments were cluster-randomised to assess eleven risk factors for difficult airway management (intervention) or to continue with their......We compared implementation of systematic airway assessment with existing practice of airway assessment on prediction of difficult mask ventilation. Twenty-six departments were cluster-randomised to assess eleven risk factors for difficult airway management (intervention) or to continue...... with their existing airway assessment (control). In both groups, patients predicted as a difficult mask ventilation and/or difficult intubation were registered in the Danish Anaesthesia Database, with a notational summary of airway management. The trial's primary outcome was the respective incidence of unpredicted...... difficult and easy mask ventilation in the two groups. Among 94,006 patients undergoing mask ventilation, the incidence of unpredicted difficult mask ventilation in the intervention group was 0.91% and 0.88% in the control group; (OR) 0.98 (95% CI 0.66-1.44), p = 0.90. The incidence of patients predicted...

High prevalence of cardiometabolic risk factors in young employees of Information Technology industry.

Science.gov (United States)

Limaye, Tejas Y; Kulkarni, Ravindra L; Deokar, Manisha R; Kumaran, Kalyanaraman

2016-01-01

We assessed the burden of cardiometabolic risk factors in Information Technology (IT) employees as they are exposed to adverse lifestyle. In this cross-sectional study, health records were obtained from two IT industries in Pune. Prevalence of cardiometabolic risk factors [hyperglycemia, high blood pressure (BP), hypertriglyceridemia, high low-density lipoprotein (LDL)-cholesterol, low high-density lipoprotein (HDL)-cholesterol, and overweight/obesity] was determined using standard cutoffs. We also examined clustering of risk factors (≥two risk factors). Data were available on 1,350 of 5,800 employees (mean age: 33 ± 6 years, 78% men). Prevalence of diabetes and hypertension was 2.5% and 13.5%, respectively. Prevalence of prediabetes, borderline high BP, hypertriglyceridemia, high LDL-cholesterol, low HDL-cholesterol, and overweight/obesity was 6.5%, 20.3%, 21%, 22.1%, 70.1%, and 51.4%, respectively. Risk factor clustering was observed in 63.5% that increased with age (P < 0.001). Given the high burden of risk factors at relatively young age, spreading awareness and promoting healthy lifestyle through workplace interventions are warranted.

Perceived risk and benefit of nuclear waste repositories: four opinion clusters.

Science.gov (United States)

Seidl, Roman; Moser, Corinne; Stauffacher, Michael; Krütli, Pius

2013-06-01

Local public resistance can block the site-selection process, construction, and operation of nuclear waste repositories. Social science has established that the perception of risks and benefits, trust in authorities, and opinion on nuclear energy play important roles in acceptance. In particular, risk and benefit evaluations seem critical for opinion formation. However, risks and benefits have rarely been studied independently and, most often, the focus has been on the two most salient groups of proponents and opponents. The aim of this exploratory study is to examine the often-neglected majority of people holding ambivalent or indifferent opinions. We used cluster analysis to examine the sample (N = 500, mailed survey in German-speaking Switzerland) in terms of patterns of risk and benefit perception. We reveal four significantly different and plausible clusters: one cluster with high-benefit ratings in favor of a repository and one cluster with high-risk ratings opposing it; a third cluster shows ambivalence, with high ratings on both risk and benefit scales and moderate opposition, whereas a fourth cluster seems indifferent, rating risks and benefits only moderately compared to the ambivalent cluster. We conclude that a closer look at the often neglected but considerable number of people with ambivalent or indifferent opinions is necessary. Although the extreme factions of the public will most probably not change their opinion, we do not yet know how the opinion of the ambivalent and indifferent clusters might develop over time. © 2012 Society for Risk Analysis.

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

Science.gov (United States)

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

2012-01-01

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

Community risk factors for ocular Chlamydia infection in Niger: pre-treatment results from a cluster-randomized trachoma trial.

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Abdou Amza

Full Text Available Trachoma control programs utilize mass azithromycin distributions to treat ocular Chlamydia trachomatis as part of an effort to eliminate this disease world-wide. But it remains unclear what the community-level risk factors are for infection.This cluster-randomized, controlled trial entered 48 randomly selected communities in a 2×2 factorial design evaluating the effect of different treatment frequencies and treatment coverage levels. A pretreatment census and examination established the prevalence of risk factors for clinical trachoma and ocular chlamydia infection including years of education of household head, distance to primary water source, presence of household latrine, and facial cleanliness (ocular discharge, nasal discharge, and presence of facial flies. Univariate and multivariate associations were tested using linear regression and Bayes model averaging.There were a total of 24,536 participants (4,484 children aged 0-5 years in 6,235 households in the study. Before treatment in May to July 2010, the community-level prevalence of active trachoma (TF or TI utilizing the World Health Organization [WHO] grading system was 26.0% (95% CI: 21.9% to 30.0% and the mean community-level prevalence of chlamydia infection by Amplicor PCR was 20.7% (95% CI: 16.5% to 24.9% in children aged 0-5 years. Univariate analysis showed that nasal discharge (0.29, 95% CI: 0.04 to 0.54; P = 0.03, presence of flies on the face (0.40, 95% CI: 0.17 to 0.64; P = 0.001, and years of formal education completed by the head of household (0.07, 95% CI: 0.07 to 0.13; P = 0.03 were independent risk factors for chlamydia infection. In multivariate analysis, facial flies (0.26, 95% CI: 0.02 to 0.49; P = 0.03 and years of formal education completed by the head of household (0.06, 95% CI: 0.008 to 0.11; P = 0.02 were associated risk factors for ocular chlamydial infection.We have found that the presence of facial flies and years of education of the head

Chronic periodontitis with multiple risk factor syndrome: a case report.

Science.gov (United States)

Shimoe, Masayuki; Yamamoto, Tadashi; Iwamoto, Yoshihiro; Shiomi, Nobuyuki; Maeda, Hiroshi; Nishimura, Fusanori; Takashiba, Shogo

2011-07-01

Multiple risk factor syndrome is a clustering of cardiovascular risk factors, such as diabetes, dyslipidemia, hypertension, and obesity associated epidemiologically with insulin resistance. This report describes the clinical course of a patient suffering from severe periodontitis with multiple risk factor syndrome, and discusses the association between periodontal infection and systemic health. The patient had a history of type 2 diabetes, dyslipidemia, and hypertension for over 10 years. At baseline, her hemoglobin A1 c was 8.1%. However, she had no diabetic complications except periodontitis. The IgG antibody titers against Porphyromonas gingivalis FDC 381 and SU63 were elevated above the mean of healthy subjects +2 standard deviations. Intensive periodontal treatment, including periodontal surgery, was performed to reduce periodontal infection and bacteremia. Her systemic and periodontal conditions were evaluated longitudinally for 10 years. Following periodontal treatment, antibody titers against Porphyromonas gingivalis and hemoglobin A1c values were significantly improved. The other clinical data and medication for her systemic condition also remained stable during supportive periodontal therapy. However, she developed myocardial infarction, and showed continuous deterioration of hemoglobin A1 c level and periodontitis. The long-term clustering of risk factors, such as diabetes, dyslipidemia, hypertension, and periodontitis, are associated with the development of myocardial infarction. Treatment of systemic conditions in combination with comprehensive periodontal treatment is important in management of patients with multiple risk factor syndrome.

Behavioral Health Risk Profiles of Undergraduate University Students in England, Wales, and Northern Ireland: A Cluster Analysis.

Science.gov (United States)

El Ansari, Walid; Ssewanyana, Derrick; Stock, Christiane

2018-01-01

Limited research has explored clustering of lifestyle behavioral risk factors (BRFs) among university students. This study aimed to explore clustering of BRFs, composition of clusters, and the association of the clusters with self-rated health and perceived academic performance. We assessed (BRFs), namely tobacco smoking, physical inactivity, alcohol consumption, illicit drug use, unhealthy nutrition, and inadequate sleep, using a self-administered general Student Health Survey among 3,706 undergraduates at seven UK universities. A two-step cluster analysis generated: Cluster 1 (the high physically active and health conscious) with very high health awareness/consciousness, good nutrition, and physical activity (PA), and relatively low alcohol, tobacco, and other drug (ATOD) use. Cluster 2 (the abstinent) had very low ATOD use, high health awareness, good nutrition, and medium high PA. Cluster 3 (the moderately health conscious) included the highest regard for healthy eating, second highest fruit/vegetable consumption, and moderately high ATOD use. Cluster 4 (the risk taking) showed the highest ATOD use, were the least health conscious, least fruit consuming, and attached the least importance on eating healthy. Compared to the healthy cluster (Cluster 1), students in other clusters had lower self-rated health, and particularly, students in the risk taking cluster (Cluster 4) reported lower academic performance. These associations were stronger for men than for women. Of the four clusters, Cluster 4 had the youngest students. Our results suggested that prevention among university students should address multiple BRFs simultaneously, with particular focus on the younger students.

Resting Heart Rate Is Not a Good Predictor of a Clustered Cardiovascular Risk Score in Adolescents: The HELENA Study.

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Augusto César Ferreira de Moraes

Full Text Available Resting heart rate (RHR reflects sympathetic nerve activity a significant association between RHR and all-cause and cardiovascular mortality has been reported in some epidemiologic studies.To analyze the predictive power and accuracy of RHR as a screening measure for individual and clustered cardiovascular risk in adolescents. The study comprised 769 European adolescents (376 boys participating in the HELENA cross-sectional study (2006-2008 were included in this study. Measurements on systolic blood pressure, HOMA index, triglycerides, TC/HDL-c, VO2máx and the sum of four skinfolds were obtained, and a clustered cardiovascular disease (CVD risk index was computed. The receiver operating characteristics curve was applied to calculate the power and accuracy of RHR to predict individual and clustered CVD risk factors.RHR showed low accuracy for screening CVD risk factors in both sexes (range 38.5%-54.4% in boys and 45.5%-54.3% in girls. Low specificity's (15.6%-19.7% in boys; 18.1%-20.0% in girls were also found. Nevertheless, the sensitivities were moderate-to-high (61.4%-89.1% in boys; 72.9%-90.3% in girls.RHR is a poor predictor of individual CVD risk factors and of clustered CVD and the estimates based on RHR are not accurate. The use of RHR as an indicator of CVD risk in adolescents may produce a biased screening of cardiovascular health in both sexes.

Forming homogeneous clusters for differential risk information

International Nuclear Information System (INIS)

Maardberg, B.

1996-01-01

Latent risk situations are always present in society. General information on these risk situations is supposed to be received differently by different groups of people in the population. In the aftermath of specific accidents different groups presumably have need of specific information about how to act to survive, to avoid injuries, to find more information, to obtain facts about the accidents etc. As targets for information these different groups could be defined in different ways. The conventional way is to divide the population according to demographic variables, such as age, sex, occupation etc. Another way would be to structure the population according to dependent variables measured in different studies. They may concern risk perception, emotional reactions, specific technical knowledge of the accidents, and belief in the information sources. One procedure for forming such groupings of people into homogeneous clusters would be by statistical clustering methods on dependent variables. Examples of such clustering procedures are presented and discussed. Data are from a Norwegian study on the perception of radiation from nuclear accidents and other radiation sources. Speculations are made on different risk information strategies. Elements of a research programme are proposed. (author)

Work stress and metabolic and hemostatic risk factors

NARCIS (Netherlands)

Vrijkotte, T. G.; van Doornen, L. J.; de Geus, E. J.

1999-01-01

A high level of work stress has been associated with cardiovascular disease. However, the pathophysiological mechanisms underlying this association remain unclear. This study examined the effect of work stress on a cluster of metabolic and hemostatic risk factors. Blood was collected three times, on

Behavioral Health Risk Profiles of Undergraduate University Students in England, Wales, and Northern Ireland: A Cluster Analysis

Directory of Open Access Journals (Sweden)

Walid El Ansari

2018-05-01

Full Text Available BackgroundLimited research has explored clustering of lifestyle behavioral risk factors (BRFs among university students. This study aimed to explore clustering of BRFs, composition of clusters, and the association of the clusters with self-rated health and perceived academic performance.MethodWe assessed (BRFs, namely tobacco smoking, physical inactivity, alcohol consumption, illicit drug use, unhealthy nutrition, and inadequate sleep, using a self-administered general Student Health Survey among 3,706 undergraduates at seven UK universities.ResultsA two-step cluster analysis generated: Cluster 1 (the high physically active and health conscious with very high health awareness/consciousness, good nutrition, and physical activity (PA, and relatively low alcohol, tobacco, and other drug (ATOD use. Cluster 2 (the abstinent had very low ATOD use, high health awareness, good nutrition, and medium high PA. Cluster 3 (the moderately health conscious included the highest regard for healthy eating, second highest fruit/vegetable consumption, and moderately high ATOD use. Cluster 4 (the risk taking showed the highest ATOD use, were the least health conscious, least fruit consuming, and attached the least importance on eating healthy. Compared to the healthy cluster (Cluster 1, students in other clusters had lower self-rated health, and particularly, students in the risk taking cluster (Cluster 4 reported lower academic performance. These associations were stronger for men than for women. Of the four clusters, Cluster 4 had the youngest students.ConclusionOur results suggested that prevention among university students should address multiple BRFs simultaneously, with particular focus on the younger students.

Clustering of chronic disease risk factors with tobacco smoking habits among adults in the work place in Sousse, Tunisia.

Science.gov (United States)

Sonia, Hmad; Jihene, Maatoug; Imed, Harrabi; Rim, Ghammem; Mylene, Belkacem; Mounir, Saadi; Souad, Amimi; Khaoula, Knani; Mustafa, Al'Absi; Harry, Lando; Najib, Mrizak; Hassen, Ghannem

2016-01-01

The aim of our study was to explore the major non-communicable risk factors (unhealthy diet, sedentarily, alcohol consumption) of smokers and nonsmokers in workplaces. A cross-sectional study was derived from an initial assessment in workplaces which was part of a community-based intervention to prevent chronic disease risk factors conducted in 2009 in the region of Sousse, Tunisia. The surveyed subjects were employees in six factories spread across three delegations in the region. Overall, 1770 of 2250 employees participated in the assessment. In this study, the clustering of non-communicable diseases risk factors with smoking habits was made only for male employees including in this study 1099 among 2250. Data were collected at worksites by a questionnaire, via interview or self-report. The main items assessed socio-demographics characteristics, smoking status, eating habits, level of physical activity and alcohol use of the participants. The percentage of male smokers was 54.0%(n=594). Their average age of daily smoking initiation was 19.22 (±4.24 years). The percentage of male smokers consuming 5 fruits and vegetables per day was significantly lower than nonsmokers (57.2% vs 63.5%, p=0.04). The proportion of male smokers consuming alcohol was about three times that of nonsmokers (16.5% vs 5.8%, p=0.001). The proportion of male employees who agree with anti-smoking laws in work places was higher for nonsmokers than for smokers. A strong association existed between smoking and risky lifestyles factors in the work place. Such findings are potentially useful in directing intervention efforts regarding smoking cessation in occupational settings.

Research on the method of information system risk state estimation based on clustering particle filter

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Cui Jia

2017-05-01

Full Text Available With the purpose of reinforcing correlation analysis of risk assessment threat factors, a dynamic assessment method of safety risks based on particle filtering is proposed, which takes threat analysis as the core. Based on the risk assessment standards, the method selects threat indicates, applies a particle filtering algorithm to calculate influencing weight of threat indications, and confirms information system risk levels by combining with state estimation theory. In order to improve the calculating efficiency of the particle filtering algorithm, the k-means cluster algorithm is introduced to the particle filtering algorithm. By clustering all particles, the author regards centroid as the representative to operate, so as to reduce calculated amount. The empirical experience indicates that the method can embody the relation of mutual dependence and influence in risk elements reasonably. Under the circumstance of limited information, it provides the scientific basis on fabricating a risk management control strategy.

Research on the method of information system risk state estimation based on clustering particle filter

Science.gov (United States)

Cui, Jia; Hong, Bei; Jiang, Xuepeng; Chen, Qinghua

2017-05-01

With the purpose of reinforcing correlation analysis of risk assessment threat factors, a dynamic assessment method of safety risks based on particle filtering is proposed, which takes threat analysis as the core. Based on the risk assessment standards, the method selects threat indicates, applies a particle filtering algorithm to calculate influencing weight of threat indications, and confirms information system risk levels by combining with state estimation theory. In order to improve the calculating efficiency of the particle filtering algorithm, the k-means cluster algorithm is introduced to the particle filtering algorithm. By clustering all particles, the author regards centroid as the representative to operate, so as to reduce calculated amount. The empirical experience indicates that the method can embody the relation of mutual dependence and influence in risk elements reasonably. Under the circumstance of limited information, it provides the scientific basis on fabricating a risk management control strategy.

Prioritizing the risk of plant pests by clustering methods; self-organising maps, k-means and hierarchical clustering

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Susan Worner

2013-09-01

Full Text Available For greater preparedness, pest risk assessors are required to prioritise long lists of pest species with potential to establish and cause significant impact in an endangered area. Such prioritization is often qualitative, subjective, and sometimes biased, relying mostly on expert and stakeholder consultation. In recent years, cluster based analyses have been used to investigate regional pest species assemblages or pest profiles to indicate the risk of new organism establishment. Such an approach is based on the premise that the co-occurrence of well-known global invasive pest species in a region is not random, and that the pest species profile or assemblage integrates complex functional relationships that are difficult to tease apart. In other words, the assemblage can help identify and prioritise species that pose a threat in a target region. A computational intelligence method called a Kohonen self-organizing map (SOM, a type of artificial neural network, was the first clustering method applied to analyse assemblages of invasive pests. The SOM is a well known dimension reduction and visualization method especially useful for high dimensional data that more conventional clustering methods may not analyse suitably. Like all clustering algorithms, the SOM can give details of clusters that identify regions with similar pest assemblages, possible donor and recipient regions. More important, however SOM connection weights that result from the analysis can be used to rank the strength of association of each species within each regional assemblage. Species with high weights that are not already established in the target region are identified as high risk. However, the SOM analysis is only the first step in a process to assess risk to be used alongside or incorporated within other measures. Here we illustrate the application of SOM analyses in a range of contexts in invasive species risk assessment, and discuss other clustering methods such as k

Descriptive epidemiology of cardiovascular risk factors and diabetes in sub-Saharan Africa.

Science.gov (United States)

Mensah, George A

2013-01-01

Reliable data on risk factor levels, exposure history, and population distribution can help inform policies and programs for disease prevention and control. With rare exception however, ideal local data on major risk factors and causes of death and disease burden have been scarce in sub-Saharan Africa (SSA). Basic community surveys in some countries and recent systematic analysis of disease burden attributable to 67 risk factors and risk factor clusters in 21 regions of the world provide an opportunity to examine and relate diabetes and cardiovascular risk factors to mortality and burden in SSA. Rising body mass index, especially in women in Southern Africa; and rising systolic blood pressure in East Africa for both sexes, and in West Africa for women are the major cardiometabolic risk factors. Harmful use of alcohol, especially in Southern SSA, tobacco use, and physical inactivity are also important. Improving vital registration and risk factor surveillance remain major challenges. © 2013.

The association between serum brain-derived neurotrophic factor and a cluster of cardiovascular risk factors in adolescents

DEFF Research Database (Denmark)

Pedersen, Natascha Holbæk; Tarp, Jakob; Andersen, Lars Bo

2017-01-01

BACKGROUND AND OBJECTIVE: Cardiovascular disease and type 2 diabetes pose a global health burden. Therefore, clarifying the pathology of these risk factors is essential. Previous studies have found positive and negative associations between one or more cardiovascular risk factors and brain...... fitness (CRF), anthropometrics, pubertal status, blood pressure (BP), serum BDNF, high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), blood glucose and insulin were measured. Information about alcohol consumption and socio-economic status was collected via questionnaires. Associations were...

Participatory ergonomics to reduce exposure to psychosocial and physical risk factors for low back pain and neck pain: results of a cluster randomised controlled trial.

Science.gov (United States)

Driessen, Maurice T; Proper, Karin I; Anema, Johannes R; Knol, Dirk L; Bongers, Paulien M; van der Beek, Allard J

2011-09-01

This study investigated the effectiveness of the Stay@Work participatory ergonomics programme to reduce workers' exposure to psychosocial and physical risk factors. 37 departments (n=3047 workers) from four Dutch companies participated in this cluster randomised controlled trial; 19 (n=1472 workers) were randomised to an intervention group (participatory ergonomics) and 18 (n=1575 workers) to a control group (no participatory ergonomics). During a 6 h meeting guided by an ergonomist, working groups devised ergonomic measures to reduce psychosocial and physical workload and implemented them within 3months in their departments. Data on psychosocial and physical risk factors for low back pain and neck pain were collected at baseline and after 6 months. Psychosocial risk factors were measured using the Job Content Questionnaire and physical risk factors using the Dutch Musculoskeletal Questionnaire. Intervention effects were studied using multilevel analysis. Intervention group workers significantly increased on decision latitude (0.29 points; 95% CI 0.07 to 0.52) and decision authority (0.16 points; 95% CI 0.04 to 0.28) compared to control workers. However, exposure to awkward trunk working postures significantly increased in the intervention group (OR 1.86; 95% CI 1.15 to 3.01) compared to the control group. No significant differences between the intervention and control group were found for the remaining risk factors. After 6months, loss to follow-up was 35% in the intervention group and 29% in the control group. Participatory ergonomics was not effective in reducing exposure to psychosocial and physical risk factors for low back pain and neck pain among a large group of workers. ISRCTN27472278.

Associations of cardiovascular risk factors in Al Ain- United Arab Emirates

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Nazirudeen Mohammad K

2009-04-01

Full Text Available Abstract Background Over the last 30 years the citizens of the United Arab Emirates have experienced major changes in life-style secondary to increased affluence. Currently, 1 in 5 adults have diabetes mellitus, but the associations (clustering among risk factors, as well as the relevance of the concept of the metabolic syndrome, in this population is unknown. Aim To investigate the prevalence and associations among cardiovascular risk factors in this population, and explore to what extent associations can be explained by the metabolic syndrome according to ATP-III criteria. Method A community based survey, of conventional risk factors for cardiovascular disease was conducted among 817 national residents of Al Ain city, UAE. These factors were fasting blood sugar, blood pressure, lipid profile, BMI, waist circumference, smoking, or CHD family history. Odds ratios between risks factors, both unadjusted and adjusted for age and sex as well as adjusted for age, sex, and metabolic syndrome were calculated. Results Various risk factors were positively associated in this population; associations that are mostly unexplained by confounding by age and sex. For example, hypertension and diabetes were still strongly related (OR 2.5; 95% CI 1.7–3.7 after adjustment. An increased waist circumference showed similar relationship with hypertension (OR 2.3; 95% CI 1.5–3.5. Diabetes was related to an increased BMI (OR 1.5; 96% CI 1.0–2.3. Smoking was also associated with diabetes (OR 1.9, 95% CI 1.0–3.3. Further adjustment for metabolic syndrome reduced some associations but several remained. Conclusion In this population risk-factors cluster, but associations do not appear to be explained by the presence/absence of the ATP-III metabolic syndrome. Associations provide valuable information in planning interventions for screening and management.

Associations of cardiovascular risk factors in Al Ain- United Arab Emirates

Science.gov (United States)

Baynouna, Latifa M; Revel, Anthony D; Nagelkerke, Nico JD; Jaber, Tariq M; Omar, Aziza O; Ahmed, Nader M; Nazirudeen, Mohammad K; Al Sayed, Mamdouh F; Nour, Fuad A; Abdouni, Sameh

2009-01-01

Background Over the last 30 years the citizens of the United Arab Emirates have experienced major changes in life-style secondary to increased affluence. Currently, 1 in 5 adults have diabetes mellitus, but the associations (clustering) among risk factors, as well as the relevance of the concept of the metabolic syndrome, in this population is unknown. Aim To investigate the prevalence and associations among cardiovascular risk factors in this population, and explore to what extent associations can be explained by the metabolic syndrome according to ATP-III criteria. Method A community based survey, of conventional risk factors for cardiovascular disease was conducted among 817 national residents of Al Ain city, UAE. These factors were fasting blood sugar, blood pressure, lipid profile, BMI, waist circumference, smoking, or CHD family history. Odds ratios between risks factors, both unadjusted and adjusted for age and sex as well as adjusted for age, sex, and metabolic syndrome were calculated. Results Various risk factors were positively associated in this population; associations that are mostly unexplained by confounding by age and sex. For example, hypertension and diabetes were still strongly related (OR 2.5; 95% CI 1.7–3.7) after adjustment. An increased waist circumference showed similar relationship with hypertension (OR 2.3; 95% CI 1.5–3.5). Diabetes was related to an increased BMI (OR 1.5; 96% CI 1.0–2.3). Smoking was also associated with diabetes (OR 1.9, 95% CI 1.0–3.3). Further adjustment for metabolic syndrome reduced some associations but several remained. Conclusion In this population risk-factors cluster, but associations do not appear to be explained by the presence/absence of the ATP-III metabolic syndrome. Associations provide valuable information in planning interventions for screening and management. PMID:19371412

Trachoma Prevalence and Risk Factors in Eight Local Government ...

African Journals Online (AJOL)

A regression analysis, however, showed that only access to latrine and knowledge of trachoma prevention remained significantly protective (OR < 1, P < 0.05). Conclusion: The risk factors for trachoma are endemic in the study areas, and active control measures are needed. The burden of the disease is, however, clustered ...

Risk factors for vaginal fistula symptoms in Sub-Saharan Africa

DEFF Research Database (Denmark)

Maheu-Giroux, Mathieu; Filippi, Véronique; Maulet, Nathalie

2016-01-01

Background Vaginal fistula (VF) is one of the most severe maternal morbidities with the immediate consequence of chronic urinary and/or fecal incontinence. The epidemiological evidence regarding risk factors for VF is dominated by facility-based studies. Our aim is to estimate the effect size...... of selected risk factors for VF using population-based survey data.  Methods We pooled all available Demographic and Health Surveys and Multiple Indicators Cluster Surveys carried out in sub-Saharan Africa that collected information on VF symptoms. Bayesian matched logistic regression models that accounted...

Cardiovascular Disease Risk Factor Patterns and Their Implications for Intervention Strategies in Vietnam

Directory of Open Access Journals (Sweden)

Quang Ngoc Nguyen

2012-01-01

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

Cardiovascular disease risk factors in persons with paraplegia: the Stockholm spinal cord injury study.

Science.gov (United States)

Wahman, Kerstin; Nash, Mark S; Westgren, Ninni; Lewis, John E; Seiger, Ake; Levi, Richard

2010-03-01

To examine cardiovascular disease risk factors and risk clusters in Swedish persons with traumatic wheelchair-dependent paraplegia. Prospective examination. A total of 135 individuals aged 18-79 years with chronic (>or= 1 year) post-traumatic paraplegia. Cardiovascular disease risk factors; dyslipidemia, impaired fasting glucose, hypertension, overweight, smoking, and medication usage for dyslipidemia, hypertension, and diabetes mellitus, were analyzed according to authoritative guidelines. Stepwise regression tested the effects of age, gender, and injury characteristics on cardiovascular disease risks. High-prevalence risk factors were dyslipidemia (83.1%), hypertension (39.3%), and overweight (42.2%) with pervasive clustering of these risks. Being older was related to increased cardiovascular disease risk, except for dyslipidemia. Hypertension was more common in low-level paraplegia. Prevalence of impaired fasting glucose was lower than previously reported after paraplegia. A high percentage of persons being prescribed drug treatment for dyslipidemia and hypertension failed to reach authoritative targets for cardiovascular disease risk reduction. Swedish persons with paraplegia are at high risk for dyslipidemia, hypertension, and overweight. Impaired fasting glucose was not as common as reported in some previous studies. Pharmacotherapy for dyslipidemia and hypertension often failed to achieve recommended targets. Population-based screening and therapeutic countermeasures to these cardiovascular disease risks are indicated.

A Hypothesis: Could Portable Natural Grass be a Risk Factor for Knee Injuries?

Science.gov (United States)

Orchard, John; Rodas, Gil; Til, Lluis; ArdevÒl, Jordi; Chivers, Ian

2008-01-01

Previous study has shown a likely link between increased shoe- surface traction and risk of knee Anterior Cruciate Ligament (ACL) injury. Portable natural grass systems are being used more often in sport, but no study to date has investigated their relative safety. By their nature, they must have high resistance to falling apart and therefore newly laid systems may be at risk of creating excessive shoe-surface traction. This study describes two clusters of knee injuries (particularly non-contact ACL injuries), each occurring to players of one professional football team at single venue, using portable grass, in a short space of time. The first series included two ACL injuries, one posterolateral complex disruption and one lateral ligament tear occurring in two rugby league games on a portable bermudagrass surface in Brisbane, Australia. The second series included four non-contact ACL injuries over a period of ten weeks in professional soccer games on a portable Kentucky bluegrass/perennial ryegrass surface in Barcelona, Spain. Possible intrinsic risk factors are discussed but there was no common risk shared by the players. Although no measures of traction were made at the Brisbane venue, average rotational traction was measured towards the end of the injury cluster at Camp Nou, Barcelona, to be 48 Nm. Chance undoubtedly had a part to play in these clusters, but the only obvious common risk factor was play on a portable natural grass surface soon after it was laid. Further study is required to determine whether portable natural grass systems may exhibit high shoe-surface traction soon after being laid and whether this could be a risk factor for knee injury. Key pointsExcessive shoe-surface traction is a hypothesised risk factor for knee ligament injuries, including anterior cruciate ligament injuries.Portable natural grass systems (by their nature in order to prevent grass rolls or squares from falling apart) will tend to exhibit high resistance to tearing when first

Malaria prevalence, risk factors and spatial distribution in a hilly forest area of Bangladesh.

Directory of Open Access Journals (Sweden)

Ubydul Haque

Full Text Available BACKGROUND: Malaria is a major public health concern in Bangladesh and it is highly endemic in the Chittagong Hill Tracts where prevalence was 11.7% in 2007. One sub-district, Rajasthali, had a prevalence of 36%. Several interventions were introduced in early 2007 to control malaria. This study was undertaken to evaluate the impacts of these intensive early stage interventions on malaria in Bangladesh. This prevalence study assesses whether or not high malaria prevalence remains, and if so, which areas and individuals remain at high risk of infection. METHODS AND PRINCIPAL FINDINGS: A 2-stage cluster sampling technique was used to sample 1,400 of 5,322 (26.3% households in Rajasthali, and screened using a rapid diagnostic test (Falci-vax. Overall malaria prevalence was 11.5%. The proportions of Plasmodium falciparum, Plasmodium vivax and infection with both species were 93.2%, 1.9% and 5.0%, respectively. Univariate, multivariate logistic regression, and spatial cluster analyses were performed separately. Sex, age, number of bed nets, forest cover, altitude and household density were potential risk factors. A statistically significant malaria cluster was identified. Significant differences among risk factors were observed between cluster and non-cluster areas. CONCLUSION AND SIGNIFICANCE: Malaria has significantly decreased within 2 years after onset of intervention program. Both aspects of the physical and social environment, as well as demographic characteristics are associated with spatial heterogeneity of risk. The ability to identify and locate these areas provides a strategy for targeting interventions during initial stages of intervention programs. However, in high risk clusters of transmission, even extensive coverage by current programs leaves transmission ongoing at reduced levels. This indicates the need for continued development of new strategies for identification and treatment as well as improved understanding of the patterns and

Multilevel Analysis of Trachomatous Trichiasis and Corneal Opacity in Nigeria: The Role of Environmental and Climatic Risk Factors on the Distribution of Disease.

Science.gov (United States)

Smith, Jennifer L; Sivasubramaniam, Selvaraj; Rabiu, Mansur M; Kyari, Fatima; Solomon, Anthony W; Gilbert, Clare

2015-01-01

The distribution of trachoma in Nigeria is spatially heterogeneous, with large-scale trends observed across the country and more local variation within areas. Relative contributions of individual and cluster-level risk factors to the geographic distribution of disease remain largely unknown. The primary aim of this analysis is to assess the relationship between climatic factors and trachomatous trichiasis (TT) and/or corneal opacity (CO) due to trachoma in Nigeria, while accounting for the effects of individual risk factors and spatial correlation. In addition, we explore the relative importance of variation in the risk of trichiasis and/or corneal opacity (TT/CO) at different levels. Data from the 2007 National Blindness and Visual Impairment Survey were used for this analysis, which included a nationally representative sample of adults aged 40 years and above. Complete data were available from 304 clusters selected using a multi-stage stratified cluster-random sampling strategy. All participants (13,543 individuals) were interviewed and examined by an ophthalmologist for the presence or absence of TT and CO. In addition to field-collected data, remotely sensed climatic data were extracted for each cluster and used to fit Bayesian hierarchical logistic models to disease outcome. The risk of TT/CO was associated with factors at both the individual and cluster levels, with approximately 14% of the total variation attributed to the cluster level. Beyond established individual risk factors (age, gender and occupation), there was strong evidence that environmental/climatic factors at the cluster-level (lower precipitation, higher land surface temperature, higher mean annual temperature and rural classification) were also associated with a greater risk of TT/CO. This study establishes the importance of large-scale risk factors in the geographical distribution of TT/CO in Nigeria, supporting anecdotal evidence that environmental conditions are associated with increased

A Feature Analysis of Risk Factors for Stroke in the Middle-Aged Adults

OpenAIRE

Haewon Byeon; Hyeung Woo Koh

2015-01-01

In order to maintain health during middle age and achieve successful aging, it is important to elucidate and prevent risk factors of middle-age stroke. This study investigated high risk groups of stroke in middle age population of Korea and provides basic material for establishment of stroke prevention policy by analyzing sudden perception of speech/language problems and clusters of multiple risk factors. This study analyzed 2,751 persons (1,191 males and 1,560 females) aged 40–59 who partici...

Psychological Factors Predict Local and Referred Experimental Muscle Pain: A Cluster Analysis in Healthy Adults

Science.gov (United States)

Lee, Jennifer E.; Watson, David; Frey-Law, Laura A.

2012-01-01

Background Recent studies suggest an underlying three- or four-factor structure explains the conceptual overlap and distinctiveness of several negative emotionality and pain-related constructs. However, the validity of these latent factors for predicting pain has not been examined. Methods A cohort of 189 (99F; 90M) healthy volunteers completed eight self-report negative emotionality and pain-related measures (Eysenck Personality Questionnaire-Revised; Positive and Negative Affect Schedule; State-Trait Anxiety Inventory; Pain Catastrophizing Scale; Fear of Pain Questionnaire; Somatosensory Amplification Scale; Anxiety Sensitivity Index; Whiteley Index). Using principal axis factoring, three primary latent factors were extracted: General Distress; Catastrophic Thinking; and Pain-Related Fear. Using these factors, individuals clustered into three subgroups of high, moderate, and low negative emotionality responses. Experimental pain was induced via intramuscular acidic infusion into the anterior tibialis muscle, producing local (infusion site) and/or referred (anterior ankle) pain and hyperalgesia. Results Pain outcomes differed between clusters (multivariate analysis of variance and multinomial regression), with individuals in the highest negative emotionality cluster reporting the greatest local pain (p = 0.05), mechanical hyperalgesia (pressure pain thresholds; p = 0.009) and greater odds (2.21 OR) of experiencing referred pain compared to the lowest negative emotionality cluster. Conclusion Our results provide support for three latent psychological factors explaining the majority of the variance between several pain-related psychological measures, and that individuals in the high negative emotionality subgroup are at increased risk for (1) acute local muscle pain; (2) local hyperalgesia; and (3) referred pain using a standardized nociceptive input. PMID:23165778

Improvements on Cardiovascular Diseases Risk Factors in Obese Adolescents

DEFF Research Database (Denmark)

Gomes Silva, Humberto José; Andersen, Lars Bo; Lofrano-Prado, Mara Cristina

2015-01-01

BACKGROUND: It is unclear how different exercise intensities affect cardiovascular disease (CVD) risk factors in obese adolescents. The aim of this study was to compare the effects of high intensity (HIT) vs. low intensity (LIT) aerobic training on CVD risk factors in obese adolescents. METHODS......: Forty-three obese adolescents (age: 15.7±1.3y, BMI: 34.3±4.1kg/m2) participated this study either HIT (corresponding to ventilatory threshold-I, VT1; N=20) or LIT (20% below VT1; N=23) for 12 weeks (12W). All sessions were isocaloric (350 kcal). All participants received the same nutritional......, psychological and clinical counseling. Subjects were assessed in fatness, fitness, lipid profile and glucose at baseline and after 12W. The CVD risk factors assessed were waist circumference (WC), total cholesterol (TC), HDL, glucose and fitness, which were single and clustered analyzed (Z-scores sum). RESULTS...

A HYPOTHESIS: COULD PORTABLE NATURAL GRASS BE A RISK FACTOR FOR KNEE INJURIES?

Directory of Open Access Journals (Sweden)

John Orchard

2008-03-01

Full Text Available Previous study has shown a likely link between increased shoe- surface traction and risk of knee Anterior Cruciate Ligament (ACL injury. Portable natural grass systems are being used more often in sport, but no study to date has investigated their relative safety. By their nature, they must have high resistance to falling apart and therefore newly laid systems may be at risk of creating excessive shoe-surface traction. This study describes two clusters of knee injuries (particularly non-contact ACL injuries, each occurring to players of one professional football team at single venue, using portable grass, in a short space of time. The first series included two ACL injuries, one posterolateral complex disruption and one lateral ligament tear occurring in two rugby league games on a portable bermudagrass surface in Brisbane, Australia. The second series included four non-contact ACL injuries over a period of ten weeks in professional soccer games on a portable Kentucky bluegrass/perennial ryegrass surface in Barcelona, Spain. Possible intrinsic risk factors are discussed but there was no common risk shared by the players. Although no measures of traction were made at the Brisbane venue, average rotational traction was measured towards the end of the injury cluster at Camp Nou, Barcelona, to be 48 Nm. Chance undoubtedly had a part to play in these clusters, but the only obvious common risk factor was play on a portable natural grass surface soon after it was laid. Further study is required to determine whether portable natural grass systems may exhibit high shoe-surface traction soon after being laid and whether this could be a risk factor for knee injury

Risk factors for pulmonary cavitation in tuberculosis patients from China.

Science.gov (United States)

Zhang, Liqun; Pang, Yu; Yu, Xia; Wang, Yufeng; Lu, Jie; Gao, Mengqiu; Huang, Hairong; Zhao, Yanlin

2016-10-12

Pulmonary cavitation is one of the most frequently observed clinical characteristics in tuberculosis (TB). The objective of this study was to investigate the potential risk factors associated with cavitary TB in China. A total of 385 smear-positive patients were enrolled in the study, including 192 (49.9%) patients with cavitation as determined by radiographic findings. Statistical analysis revealed that the distribution of patients with diabetes in the cavitary group was significantly higher than that in the non-cavitary group (adjusted odds ratio (OR) (95% confidence interval (CI)):12.08 (5.75-25.35), Ptuberculosis strains, 330 strains (85.7%) were classified as the Beijing genotype, which included 260 strains that belonged to the modern Beijing sublineage and 70 to the ancient Beijing sublineage. In addition, there were 80 and 31 strains belonging to large and small clusters, respectively. Statistical analysis revealed that cavitary disease was observed more frequently among the large clusters than the small clusters (P=0.037). In conclusion, our findings demonstrate that diabetes and multidrug resistance are risk factors associated with cavitary TB. In addition, there was no significant difference in the cavitary presentation between patients infected with the Beijing genotype strains and those infected with the non-Beijing genotype strains.

Spatial clustering and local risk of leprosy in São Paulo, Brazil.

Directory of Open Access Journals (Sweden)

Antônio Carlos Vieira Ramos

2017-02-01

Full Text Available Although the detection rate is decreasing, the proportion of new cases with WHO grade 2 disability (G2D is increasing, creating concern among policy makers and the Brazilian government. This study aimed to identify spatial clustering of leprosy and classify high-risk areas in a major leprosy cluster using the SatScan method.Data were obtained including all leprosy cases diagnosed between January 2006 and December 2013. In addition to the clinical variable, information was also gathered regarding the G2D of the patient at diagnosis and after treatment. The Scan Spatial statistic test, developed by Kulldorff e Nagarwalla, was used to identify spatial clustering and to measure the local risk (Relative Risk-RR of leprosy. Maps considering these risks and their confidence intervals were constructed.A total of 434 cases were identified, including 188 (43.31% borderline leprosy and 101 (23.28% lepromatous leprosy cases. There was a predominance of males, with ages ranging from 15 to 59 years, and 51 patients (11.75% presented G2D. Two significant spatial clusters and three significant spatial-temporal clusters were also observed. The main spatial cluster (p = 0.000 contained 90 census tracts, a population of approximately 58,438 inhabitants, detection rate of 22.6 cases per 100,000 people and RR of approximately 3.41 (95%CI = 2.721-4.267. Regarding the spatial-temporal clusters, two clusters were observed, with RR ranging between 24.35 (95%CI = 11.133-52.984 and 15.24 (95%CI = 10.114-22.919.These findings could contribute to improvements in policies and programming, aiming for the eradication of leprosy in Brazil. The Spatial Scan statistic test was found to be an interesting resource for health managers and healthcare professionals to map the vulnerability of areas in terms of leprosy transmission risk and areas of underreporting.

Spatial clustering and local risk of leprosy in São Paulo, Brazil.

Science.gov (United States)

Ramos, Antônio Carlos Vieira; Yamamura, Mellina; Arroyo, Luiz Henrique; Popolin, Marcela Paschoal; Chiaravalloti Neto, Francisco; Palha, Pedro Fredemir; Uchoa, Severina Alice da Costa; Pieri, Flávia Meneguetti; Pinto, Ione Carvalho; Fiorati, Regina Célia; Queiroz, Ana Angélica Rêgo de; Belchior, Aylana de Souza; Dos Santos, Danielle Talita; Garcia, Maria Concebida da Cunha; Crispim, Juliane de Almeida; Alves, Luana Seles; Berra, Thaís Zamboni; Arcêncio, Ricardo Alexandre

2017-02-01

Although the detection rate is decreasing, the proportion of new cases with WHO grade 2 disability (G2D) is increasing, creating concern among policy makers and the Brazilian government. This study aimed to identify spatial clustering of leprosy and classify high-risk areas in a major leprosy cluster using the SatScan method. Data were obtained including all leprosy cases diagnosed between January 2006 and December 2013. In addition to the clinical variable, information was also gathered regarding the G2D of the patient at diagnosis and after treatment. The Scan Spatial statistic test, developed by Kulldorff e Nagarwalla, was used to identify spatial clustering and to measure the local risk (Relative Risk-RR) of leprosy. Maps considering these risks and their confidence intervals were constructed. A total of 434 cases were identified, including 188 (43.31%) borderline leprosy and 101 (23.28%) lepromatous leprosy cases. There was a predominance of males, with ages ranging from 15 to 59 years, and 51 patients (11.75%) presented G2D. Two significant spatial clusters and three significant spatial-temporal clusters were also observed. The main spatial cluster (p = 0.000) contained 90 census tracts, a population of approximately 58,438 inhabitants, detection rate of 22.6 cases per 100,000 people and RR of approximately 3.41 (95%CI = 2.721-4.267). Regarding the spatial-temporal clusters, two clusters were observed, with RR ranging between 24.35 (95%CI = 11.133-52.984) and 15.24 (95%CI = 10.114-22.919). These findings could contribute to improvements in policies and programming, aiming for the eradication of leprosy in Brazil. The Spatial Scan statistic test was found to be an interesting resource for health managers and healthcare professionals to map the vulnerability of areas in terms of leprosy transmission risk and areas of underreporting.

Nutrition and cardiovascular risk factors in four age groups of female individuals: The pep family heart study

Directory of Open Access Journals (Sweden)

Peter Schwandt

2010-01-01

Conclusions: The prevalence of CVD risk factors increased con-tinuously from girls and adolescents to junior and senior women. However, dietary intake was different in the four age groups. Ca-loric intake was associated with overweight and clustering of risk factors in adult women.

Low Birth Weight as a Predictor of Cardiovascular Risk Factors in Childhood and Adolescence? The PEP Family Heart Study

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Haas, Gerda-Maria; Liepold, Evelyn; Schwandt, Peter

2015-01-01

Background: Low birth weight is considered a risk factor for cardiovascular disease (CVD) in later life. Because data in children and adolescents are sparse and controversial, we assessed the association of birth weight with CVD risk factors in German youths. Methods: We categorized 843 urban children and adolescents aged 3-18 years by quintiles of birth weight and measured nine traditional risk factors in terms of body mass index (BMI), waist circumference (WC), systolic (SBP) and diastolic (DBP) blood pressure, total cholesterol (TC), LDL-C, HDL-C, Non HDL-C and triglycerides (TG). SPSS 21 was used for statistical analysis. Results: Mean values and prevalence of nine anthropometric and lipid risk variables were equally distributed over the five birth weight groups. Though risk factors clustered between 3.0 kg and 4.0 kg of birth weight in both genders we found only one significant correlation of birth weight with TG for males and females and another one for HDL-C in males. The strongest clustering of significant regression coefficients occurred in the 2nd birth weight quintile for SBP (ß 0.018), TC (ß -0.050), LDL-C (ß -0.039), non LDL-C (ß -0.049) and log TG (ß -0.001) in males and females. Conclusions: Overall we did not find significant associations between birth weight and nine traditional cardiovascular risk factors in children and adolescents. However, the 2nd quintile of birth weight might suggest clustering of risk factors. PMID:26900435

Characteristic and factors of competitive maritime industry clusters in Indonesia

Science.gov (United States)

Marlyana, N.; Tontowi, A. E.; Yuniarto, H. A.

2017-12-01

Indonesia is situated in the strategic position between two oceans therefore is identified as a maritime state. The fact opens big opportunity to build a competitive maritime industry. However, potential factors to boost the competitive maritime industry still need to be explored. The objective of this paper is then to determine the main characteristics and potential factors of competitive maritime industry cluster. Qualitative analysis based on literature review has been carried out in two aspects. First, benchmarking analysis conducted to distinguish the most relevant factors of maritime clusters in several countries in Europe (Norway, Spain, South West of England) and Asia (China, South Korea, Malaysia). Seven key dimensions are used for this benchmarking. Secondly, the competitiveness of maritime clusters in Indonesia was diagnosed through a reconceptualization of Porter’s Diamond model. There were four interlinked of advanced factors in and between companies within clusters, which can be influenced in a proactive way by government.

Low birth weight as a predictor of cardiovascular risk factors in childhood and adolescence? The pep family heart study

Directory of Open Access Journals (Sweden)

Gerda-Maria Haas

2015-01-01

Conclusions: Overall we did not find significant associations between birth weight and nine traditional cardiovascular risk factors in children and adolescents. However, the 2 nd quintile of birth weight might suggest clustering of risk factors.

Identifying Children at Risk of Problematic Development: Latent Clusters Among Childhood Arrestees

NARCIS (Netherlands)

Geluk, C.A.M.L.; van Domburgh, L.; Doreleijers, T.A.H.; Jansen, L.M.C.; Bouwmeester, S.; Galindo Garre, F.; Vermeiren, R.R.J.M.

2014-01-01

The presence of clusters characterized by distinct profiles of individual, family and peer characteristics among childhood arrestees was investigated and cluster membership stability after 2 years was determined. Identification of such clusters in this heterogeneous at-risk group can extend insight

Cultural, social and intrapersonal factors associated with clusters of co-occurring health-related behaviours among adolescents.

Science.gov (United States)

Klein Velderman, Mariska; Dusseldorp, Elise; van Nieuwenhuijzen, Maroesjka; Junger, Marianne; Paulussen, Theo G W M; Reijneveld, Sijmen A

2015-02-01

Adverse health-related behaviours (HRBs) have been shown to co-occur in adolescents. Evidence lacks on factors associated with these co-occurring HRBs. The Theory of Triadic Influence (TTI) offers a route to categorize these determinants according to type (social, cultural and intrapersonal) and distance in the causal pathway (ultimate or distal). Our aims were to identify cultural, social and intrapersonal factors associated with co-occurring HRBs and to assess the relative importance of ultimate and distal factors for each cluster of co-occurring HRBs. Respondents concerned a random sample of 898 adolescents aged 12-18 years, stratified by age, sex and educational level of head of household. Data were collected via face-to-face computer-assisted interviewing and internet questionnaires. Analyses were performed for young (12-15 years) and late (16-18 years) adolescents regarding two and three clusters of HRB, respectively. For each cluster of HRBs (e.g. smoking, delinquency), associated factors were found. These accounted for 27 to 57% of the total variance per cluster. Factors came in particular from the intrapersonal stream of the TTI at the ultimate level and the social stream at the distal level. Associations were strongest for parenting practices, risk behaviours of friends and parents and self-control. Results of this study confirm that it is possible to identify a selection of cultural, social and intrapersonal factors associated with co-occurring HRBs among adolescents. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Bovine respiratory syncytial virus and bovine coronavirus antibodies in bulk tank milk - risk factors and spatial analysis.

Science.gov (United States)

Toftaker, Ingrid; Sanchez, Javier; Stokstad, Maria; Nødtvedt, Ane

2016-10-01

Bovine respiratory syncytial virus (BRSV) and bovine coronavirus (BCoV) are considered widespread among cattle in Norway and worldwide. This cross-sectional study was conducted based on antibody-ELISA of bulk tank milk (BTM) from 1347 herds in two neighboring counties in western Norway. The study aims were to determine the seroprevalence at herd level, to evaluate risk factors for BRSV and BCoV seropositivity, and to assess how these factors were associated with the spatial distribution of positive herds. The overall prevalence of BRSV and BCoV positive herds in the region was 46.2% and 72.2%, respectively. Isopleth maps of the prevalence risk distribution showed large differences in prevalence risk across the study area, with the highest prevalence in the northern region. Common risk factors of importance for both viruses were herd size, geographic location, and proximity to neighbors. Seropositivity for one virus was associated with increased odds of seropositivity for the other virus. Purchase of livestock was an additional risk factor for BCoV seropositivity, included in the model as in-degree, which was defined as the number of incoming movements from individual herds, through animal purchase, over a period of five years. Local dependence and the contribution of risk factors to this effect were assessed using the residuals from two logistic regression models for each virus. One model contained only the x- and y- coordinates as predictors, the other had all significant predictors included. Spatial clusters of high values of residuals were detected using the normal model of the spatial scan statistic and visualized on maps. Adjusting for the risk factors in the final models had different impact on the spatial clusters for the two viruses: For BRSV the number of clusters was reduced from six to four, for BCoV the number of clusters remained the same, however the log-likelihood ratios changed notably. This indicates that geographical differences in proximity to

Psychosocial risk factors, weight changes and risk of obesity: the Copenhagen City Heart Study

DEFF Research Database (Denmark)

Iversen, Louise Bagger; Strandberg-Larsen, Katrine; Prescott, Eva

2012-01-01

The aim of the study was to establish the effects of a range of psychosocial factors on weight changes and risk of obesity. The study population consisted of the 4,753 participants in the third (1991-1994) and fourth wave (2001-2003) of the Copenhagen City Heart Study, Denmark. At baseline...... the participants were asked comprehensive questions on major life events, work stress, vital exhaustion, social network, economic hardship, and intake of sleep medication. Weight and height were measured by health professionals. Weight changes and incident obesity was used as outcome measures. The participants...... in the associations between social network, economic hardship and weight gain or obesity. The number of psychosocial risk factors, as an indicator for clustering, was not associated with weight gain or obesity. In conclusion, major life events and vital exhaustion seem to play a role for weight gain and risk...

Multi-view clustering via multi-manifold regularized non-negative matrix factorization.

Science.gov (United States)

Zong, Linlin; Zhang, Xianchao; Zhao, Long; Yu, Hong; Zhao, Qianli

2017-04-01

Non-negative matrix factorization based multi-view clustering algorithms have shown their competitiveness among different multi-view clustering algorithms. However, non-negative matrix factorization fails to preserve the locally geometrical structure of the data space. In this paper, we propose a multi-manifold regularized non-negative matrix factorization framework (MMNMF) which can preserve the locally geometrical structure of the manifolds for multi-view clustering. MMNMF incorporates consensus manifold and consensus coefficient matrix with multi-manifold regularization to preserve the locally geometrical structure of the multi-view data space. We use two methods to construct the consensus manifold and two methods to find the consensus coefficient matrix, which leads to four instances of the framework. Experimental results show that the proposed algorithms outperform existing non-negative matrix factorization based algorithms for multi-view clustering. Copyright © 2017 Elsevier Ltd. All rights reserved.

The role of exogenous risk factors of antituberculosis treatment failure.

Science.gov (United States)

Lesnic, Evelina; Ustian, Aurelia; Pop, Carmen Monica

2016-01-01

The Republic of Moldova reports the highest incidence of tuberculosis and the lowest treatment success rate among European region countries. In most of the patients the antituberculosis treatment failure is correlated with social risk factors (low socio-economical state, epidemiological danger characteristics) and biological factors (young age, male sex, physiological conditions, associated diseases). Clinical factors (advanced forms of tuberculosis, chronic evolution, immune disturbances), therapeutic factors (treatment errors and interruptions, individualized regimens) and administrative factors (drug interruption in supply, suboptimal treatment quality) prevail in regions with defficient in health care delivery. The association of risk factors has a higher impact than the severity of one risk factor. The risk factor assessment is very important before initiation of the treatment, for establishing the plan of risk reduction measures for increasing the success rate. The aim of the study was to determine the impact of exogenous risk factors on antituberculosis treatment failure. The study was conducted on 201 patients with pulmonary tuberculosis and treatment failure and 105 patients with pulmonary tuberculosis who successfully finished the antituberculosis treatment. Selected cases were investigated according national standards. The treatment failure occurred in patients belonging to socially disadvantaged groups, patients with harmful habits (alcohol abuse, drug use, active smoking), patients from infectious clusters. Migration, homelessness and detention releasing imperil the quality of treatment, thus predisposing to the treatment failure. Social, educational support and the substitutive therapy and withdrawal techniques (tobacco, alcohol, psycho-active substances) must be implemented in the high risk groups in order to diminish the risk of treatment failure and to increase the treatment success rate. The study of exogenous risk factors in vulnerable groups

Factors Associated With Increased Cesarean Risk Among African American Women: Evidence From California, 2010

Science.gov (United States)

Doctor, Jason N.

2015-01-01

Objectives. We studied if both observed and unobserved maternal health in African American women in hospitals or communities were associated with cesarean delivery of infants. Methods. We examined the relationship between African American race and cesarean delivery among 493 433 women discharged from 255 Californian hospitals in 2010 using administrative data; we adjusted for patient comorbidities and maternal, fetal, and placental risk factors, as well as clustering of patients within hospitals. Results. Cesarean rates were significantly higher overall for African American women than other women (unadjusted rate 36.8% vs 32.7%), as were both elective and emergency primary cesarean rates. Elevated risks persisted after risk adjustment (odds ratio generally > 1.27), but the prevalence of particular risk factors varied. Although African American women were clustered in some hospitals, the proportion of African Americans among all women delivering in a hospital was not related to its overall cesarean rate. Conclusions. To address the higher likelihood of elective cesarean delivery, attention needs to be given to currently unmeasured patient-level health factors, to the quality of provider–physician interactions, as well as to patient preferences. PMID:25790391

Risk Factors

Science.gov (United States)

... cells do not invade nearby tissues or spread. Risk Factors Key Points Factors That are Known to ... chemicals . Factors That are Known to Increase the Risk of Cancer Cigarette Smoking and Tobacco Use Tobacco ...

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Science.gov (United States)

Forouzanfar, Mohammad H; Alexander, Lily; Anderson, H Ross; Bachman, Victoria F; Biryukov, Stan; Brauer, Michael; Burnett, Richard; Casey, Daniel; Coates, Matthew M; Cohen, Aaron; Delwiche, Kristen; Estep, Kara; Frostad, Joseph J; Astha, K C; Kyu, Hmwe H; Moradi-Lakeh, Maziar; Ng, Marie; Slepak, Erica Leigh; Thomas, Bernadette A; Wagner, Joseph; Aasvang, Gunn Marit; Abbafati, Cristiana; Abbasoglu Ozgoren, Ayse; Abd-Allah, Foad; Abera, Semaw F; Aboyans, Victor; Abraham, Biju; Abraham, Jerry Puthenpurakal; Abubakar, Ibrahim; Abu-Rmeileh, Niveen M E; Aburto, Tania C; Achoki, Tom; Adelekan, Ademola; Adofo, Koranteng; Adou, Arsène K; Adsuar, José C; Afshin, Ashkan; Agardh, Emilie E; Al Khabouri, Mazin J; Al Lami, Faris H; Alam, Sayed Saidul; Alasfoor, Deena; Albittar, Mohammed I; Alegretti, Miguel A; Aleman, Alicia V; Alemu, Zewdie A; Alfonso-Cristancho, Rafael; Alhabib, Samia; Ali, Raghib; Ali, Mohammed K; Alla, François; Allebeck, Peter; Allen, Peter J; Alsharif, Ubai; Alvarez, Elena; Alvis-Guzman, Nelson; Amankwaa, Adansi A; Amare, Azmeraw T; Ameh, Emmanuel A; Ameli, Omid; Amini, Heresh; Ammar, Walid; Anderson, Benjamin O; Antonio, Carl Abelardo T; Anwari, Palwasha; Argeseanu Cunningham, Solveig; Arnlöv, Johan; Arsenijevic, Valentina S Arsic; Artaman, Al; Asghar, Rana J; Assadi, Reza; Atkins, Lydia S; Atkinson, Charles; Avila, Marco A; Awuah, Baffour; Badawi, Alaa; Bahit, Maria C; Bakfalouni, Talal; Balakrishnan, Kalpana; Balalla, Shivanthi; Balu, Ravi Kumar; Banerjee, Amitava; Barber, Ryan M; Barker-Collo, Suzanne L; Barquera, Simon; Barregard, Lars; Barrero, Lope H; Barrientos-Gutierrez, Tonatiuh; Basto-Abreu, Ana C; Basu, Arindam; Basu, Sanjay; Basulaiman, Mohammed O; Batis Ruvalcaba, Carolina; Beardsley, Justin; Bedi, Neeraj; Bekele, Tolesa; Bell, Michelle L; Benjet, Corina; Bennett, Derrick A; Benzian, Habib; Bernabé, Eduardo; Beyene, Tariku J; Bhala, Neeraj; Bhalla, Ashish; Bhutta, Zulfiqar A; Bikbov, Boris; Bin Abdulhak, Aref A; Blore, Jed D; Blyth, Fiona M; Bohensky, Megan A; Bora Başara, Berrak; Borges, Guilherme; Bornstein, Natan M; Bose, Dipan; Boufous, Soufiane; Bourne, Rupert R; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas J; Brenner, Hermann; Briggs, Adam D M; Broday, David M; Brooks, Peter M; Bruce, Nigel G; Brugha, Traolach S; Brunekreef, Bert; Buchbinder, Rachelle; Bui, Linh N; Bukhman, Gene; Bulloch, Andrew G; Burch, Michael; Burney, Peter G J; Campos-Nonato, Ismael R; Campuzano, Julio C; Cantoral, Alejandra J; Caravanos, Jack; Cárdenas, Rosario; Cardis, Elisabeth; Carpenter, David O; Caso, Valeria; Castañeda-Orjuela, Carlos A; Castro, Ruben E; Catalá-López, Ferrán; Cavalleri, Fiorella; Çavlin, Alanur; Chadha, Vineet K; Chang, Jung-Chen; Charlson, Fiona J; Chen, Honglei; Chen, Wanqing; Chen, Zhengming; Chiang, Peggy P; Chimed-Ochir, Odgerel; Chowdhury, Rajiv; Christophi, Costas A; Chuang, Ting-Wu; Chugh, Sumeet S; Cirillo, Massimo; Claßen, Thomas K D; Colistro, Valentina; Colomar, Mercedes; Colquhoun, Samantha M; Contreras, Alejandra G; Cooper, Cyrus; Cooperrider, Kimberly; Cooper, Leslie T; Coresh, Josef; Courville, Karen J; Criqui, Michael H; Cuevas-Nasu, Lucia; Damsere-Derry, James; Danawi, Hadi; Dandona, Lalit; Dandona, Rakhi; Dargan, Paul I; Davis, Adrian; Davitoiu, Dragos V; Dayama, Anand; de Castro, E Filipa; De la Cruz-Góngora, Vanessa; De Leo, Diego; de Lima, Graça; Degenhardt, Louisa; del Pozo-Cruz, Borja; Dellavalle, Robert P; Deribe, Kebede; Derrett, Sarah; Des Jarlais, Don C; Dessalegn, Muluken; deVeber, Gabrielle A; Devries, Karen M; Dharmaratne, Samath D; Dherani, Mukesh K; Dicker, Daniel; Ding, Eric L; Dokova, Klara; Dorsey, E Ray; Driscoll, Tim R; Duan, Leilei; Durrani, Adnan M; Ebel, Beth E; Ellenbogen, Richard G; Elshrek, Yousef M; Endres, Matthias; Ermakov, Sergey P; Erskine, Holly E; Eshrati, Babak; Esteghamati, Alireza; Fahimi, Saman; Faraon, Emerito Jose A; Farzadfar, Farshad; Fay, Derek F J; Feigin, Valery L; Feigl, Andrea B; Fereshtehnejad, Seyed-Mohammad; Ferrari, Alize J; Ferri, Cleusa P; Flaxman, Abraham D; Fleming, Thomas D; Foigt, Nataliya; Foreman, Kyle J; Paleo, Urbano Fra; Franklin, Richard C; Gabbe, Belinda; Gaffikin, Lynne; Gakidou, Emmanuela; Gamkrelidze, Amiran; Gankpé, Fortuné G; Gansevoort, Ron T; García-Guerra, Francisco A; Gasana, Evariste; Geleijnse, Johanna M; Gessner, Bradford D; Gething, Pete; Gibney, Katherine B; Gillum, Richard F; Ginawi, Ibrahim A M; Giroud, Maurice; Giussani, Giorgia; Goenka, Shifalika; Goginashvili, Ketevan; Gomez Dantes, Hector; Gona, Philimon; Gonzalez de Cosio, Teresita; González-Castell, Dinorah; Gotay, Carolyn C; Goto, Atsushi; Gouda, Hebe N; Guerrant, Richard L; Gugnani, Harish C; Guillemin, Francis; Gunnell, David; Gupta, Rahul; Gupta, Rajeev; Gutiérrez, Reyna A; Hafezi-Nejad, Nima; Hagan, Holly; Hagstromer, Maria; Halasa, Yara A; Hamadeh, Randah R; Hammami, Mouhanad; Hankey, Graeme J; Hao, Yuantao; Harb, Hilda L; Haregu, Tilahun Nigatu; Haro, Josep Maria; Havmoeller, Rasmus; Hay, Simon I; Hedayati, Mohammad T; Heredia-Pi, Ileana B; Hernandez, Lucia; Heuton, Kyle R; Heydarpour, Pouria; Hijar, Martha; Hoek, Hans W; Hoffman, Howard J; Hornberger, John C; Hosgood, H Dean; Hoy, Damian G; Hsairi, Mohamed; Hu, Guoqing; Hu, Howard; Huang, Cheng; Huang, John J; Hubbell, Bryan J; Huiart, Laetitia; Husseini, Abdullatif; Iannarone, Marissa L; Iburg, Kim M; Idrisov, Bulat T; Ikeda, Nayu; Innos, Kaire; Inoue, Manami; Islami, Farhad; Ismayilova, Samaya; Jacobsen, Kathryn H; Jansen, Henrica A; Jarvis, Deborah L; Jassal, Simerjot K; Jauregui, Alejandra; Jayaraman, Sudha; Jeemon, Panniyammakal; Jensen, Paul N; Jha, Vivekanand; Jiang, Fan; Jiang, Guohong; Jiang, Ying; Jonas, Jost B; Juel, Knud; Kan, Haidong; Kany Roseline, Sidibe S; Karam, Nadim E; Karch, André; Karema, Corine K; Karthikeyan, Ganesan; Kaul, Anil; Kawakami, Norito; Kazi, Dhruv S; Kemp, Andrew H; Kengne, Andre P; Keren, Andre; Khader, Yousef S; Khalifa, Shams Eldin Ali Hassan; Khan, Ejaz A; Khang, Young-Ho; Khatibzadeh, Shahab; Khonelidze, Irma; Kieling, Christian; Kim, Daniel; Kim, Sungroul; Kim, Yunjin; Kimokoti, Ruth W; Kinfu, Yohannes; Kinge, Jonas M; Kissela, Brett M; Kivipelto, Miia; Knibbs, Luke D; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kose, M Rifat; Kosen, Soewarta; Kraemer, Alexander; Kravchenko, Michael; Krishnaswami, Sanjay; Kromhout, Hans; Ku, Tiffany; Kuate Defo, Barthelemy; Kucuk Bicer, Burcu; Kuipers, Ernst J; Kulkarni, Chanda; Kulkarni, Veena S; Kumar, G Anil; Kwan, Gene F; Lai, Taavi; Lakshmana Balaji, Arjun; Lalloo, Ratilal; Lallukka, Tea; Lam, Hilton; Lan, Qing; Lansingh, Van C; Larson, Heidi J; Larsson, Anders; Laryea, Dennis O; Lavados, Pablo M; Lawrynowicz, Alicia E; Leasher, Janet L; Lee, Jong-Tae; Leigh, James; Leung, Ricky; Levi, Miriam; Li, Yichong; Li, Yongmei; Liang, Juan; Liang, Xiaofeng; Lim, Stephen S; Lindsay, M Patrice; Lipshultz, Steven E; Liu, Shiwei; Liu, Yang; Lloyd, Belinda K; Logroscino, Giancarlo; London, Stephanie J; Lopez, Nancy; Lortet-Tieulent, Joannie; Lotufo, Paulo A; Lozano, Rafael; Lunevicius, Raimundas; Ma, Jixiang; Ma, Stefan; Machado, Vasco M P; MacIntyre, Michael F; Magis-Rodriguez, Carlos; Mahdi, Abbas A; Majdan, Marek; Malekzadeh, Reza; Mangalam, Srikanth; Mapoma, Christopher C; Marape, Marape; Marcenes, Wagner; Margolis, David J; Margono, Christopher; Marks, Guy B; Martin, Randall V; Marzan, Melvin B; Mashal, Mohammad T; Masiye, Felix; Mason-Jones, Amanda J; Matsushita, Kunihiro; Matzopoulos, Richard; Mayosi, Bongani M; Mazorodze, Tasara T; McKay, Abigail C; McKee, Martin; McLain, Abigail; Meaney, Peter A; Medina, Catalina; Mehndiratta, Man Mohan; Mejia-Rodriguez, Fabiola; Mekonnen, Wubegzier; Melaku, Yohannes A; Meltzer, Michele; Memish, Ziad A; Mendoza, Walter; Mensah, George A; Meretoja, Atte; Mhimbira, Francis Apolinary; Micha, Renata; Miller, Ted R; Mills, Edward J; Misganaw, Awoke; Mishra, Santosh; Mohamed Ibrahim, Norlinah; Mohammad, Karzan A; Mokdad, Ali H; Mola, Glen L; Monasta, Lorenzo; Montañez Hernandez, Julio C; Montico, Marcella; Moore, Ami R; Morawska, Lidia; Mori, Rintaro; Moschandreas, Joanna; Moturi, Wilkister N; Mozaffarian, Dariush; Mueller, Ulrich O; Mukaigawara, Mitsuru; Mullany, Erin C; Murthy, Kinnari S; Naghavi, Mohsen; Nahas, Ziad; Naheed, Aliya; Naidoo, Kovin S; Naldi, Luigi; Nand, Devina; Nangia, Vinay; Narayan, K M Venkat; Nash, Denis; Neal, Bruce; Nejjari, Chakib; Neupane, Sudan P; Newton, Charles R; Ngalesoni, Frida N; Ngirabega, Jean de Dieu; Nguyen, Grant; Nguyen, Nhung T; Nieuwenhuijsen, Mark J; Nisar, Muhammad I; Nogueira, José R; Nolla, Joan M; Nolte, Sandra; Norheim, Ole F; Norman, Rosana E; Norrving, Bo; Nyakarahuka, Luke; Oh, In-Hwan; Ohkubo, Takayoshi; Olusanya, Bolajoko O; Omer, Saad B; Opio, John Nelson; Orozco, Ricardo; Pagcatipunan, Rodolfo S; Pain, Amanda W; Pandian, Jeyaraj D; Panelo, Carlo Irwin A; Papachristou, Christina; Park, Eun-Kee; Parry, Charles D; Paternina Caicedo, Angel J; Patten, Scott B; Paul, Vinod K; Pavlin, Boris I; Pearce, Neil; Pedraza, Lilia S; Pedroza, Andrea; Pejin Stokic, Ljiljana; Pekericli, Ayfer; Pereira, David M; Perez-Padilla, Rogelio; Perez-Ruiz, Fernando; Perico, Norberto; Perry, Samuel A L; Pervaiz, Aslam; Pesudovs, Konrad; Peterson, Carrie B; Petzold, Max; Phillips, Michael R; Phua, Hwee Pin; Plass, Dietrich; Poenaru, Dan; Polanczyk, Guilherme V; Polinder, Suzanne; Pond, Constance D; Pope, C Arden; Pope, Daniel; Popova, Svetlana; Pourmalek, Farshad; Powles, John; Prabhakaran, Dorairaj; Prasad, Noela M; Qato, Dima M; Quezada, Amado D; Quistberg, D Alex A; Racapé, Lionel; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Sajjad Ur; Raju, Murugesan; Rakovac, Ivo; Rana, Saleem M; Rao, Mayuree; Razavi, Homie; Reddy, K Srinath; Refaat, Amany H; Rehm, Jürgen; Remuzzi, Giuseppe; Ribeiro, Antonio L; Riccio, Patricia M; Richardson, Lee; Riederer, Anne; Robinson, Margaret; Roca, Anna; Rodriguez, Alina; Rojas-Rueda, David; Romieu, Isabelle; Ronfani, Luca; Room, Robin; Roy, Nobhojit; Ruhago, George M; Rushton, Lesley; Sabin, Nsanzimana; Sacco, Ralph L; Saha, Sukanta; Sahathevan, Ramesh; Sahraian, Mohammad Ali; Salomon, Joshua A; Salvo, Deborah; Sampson, Uchechukwu K; Sanabria, Juan R; Sanchez, Luz Maria; Sánchez-Pimienta, Tania G; Sanchez-Riera, Lidia; Sandar, Logan; Santos, Itamar S; Sapkota, Amir; Satpathy, Maheswar; Saunders, James E; Sawhney, Monika; Saylan, Mete I; Scarborough, Peter; Schmidt, Jürgen C; Schneider, Ione J C; Schöttker, Ben; Schwebel, David C; Scott, James G; Seedat, Soraya; Sepanlou, Sadaf G; Serdar, Berrin; Servan-Mori, Edson E; Shaddick, Gavin; Shahraz, Saeid; Levy, Teresa Shamah; Shangguan, Siyi; She, Jun; Sheikhbahaei, Sara; Shibuya, Kenji; Shin, Hwashin H; Shinohara, Yukito; Shiri, Rahman; Shishani, Kawkab; Shiue, Ivy; Sigfusdottir, Inga D; Silberberg, Donald H; Simard, Edgar P; Sindi, Shireen; Singh, Abhishek; Singh, Gitanjali M; Singh, Jasvinder A; Skirbekk, Vegard; Sliwa, Karen; Soljak, Michael; Soneji, Samir; Søreide, Kjetil; Soshnikov, Sergey; Sposato, Luciano A; Sreeramareddy, Chandrashekhar T; Stapelberg, Nicolas J C; Stathopoulou, Vasiliki; Steckling, Nadine; Stein, Dan J; Stein, Murray B; Stephens, Natalie; Stöckl, Heidi; Straif, Kurt; Stroumpoulis, Konstantinos; Sturua, Lela; Sunguya, Bruno F; Swaminathan, Soumya; Swaroop, Mamta; Sykes, Bryan L; Tabb, Karen M; Takahashi, Ken; Talongwa, Roberto T; Tandon, Nikhil; Tanne, David; Tanner, Marcel; Tavakkoli, Mohammad; Te Ao, Braden J; Teixeira, Carolina M; Téllez Rojo, Martha M; Terkawi, Abdullah S; Texcalac-Sangrador, José Luis; Thackway, Sarah V; Thomson, Blake; Thorne-Lyman, Andrew L; Thrift, Amanda G; Thurston, George D; Tillmann, Taavi; Tobollik, Myriam; Tonelli, Marcello; Topouzis, Fotis; Towbin, Jeffrey A; Toyoshima, Hideaki; Traebert, Jefferson; Tran, Bach X; Trasande, Leonardo; Trillini, Matias; Trujillo, Ulises; Dimbuene, Zacharie Tsala; Tsilimbaris, Miltiadis; Tuzcu, Emin Murat; Uchendu, Uche S; Ukwaja, Kingsley N; Uzun, Selen B; van de Vijver, Steven; Van Dingenen, Rita; van Gool, Coen H; van Os, Jim; Varakin, Yuri Y; Vasankari, Tommi J; Vasconcelos, Ana Maria N; Vavilala, Monica S; Veerman, Lennert J; Velasquez-Melendez, Gustavo; Venketasubramanian, N; Vijayakumar, Lakshmi; Villalpando, Salvador; Violante, Francesco S; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Wagner, Gregory R; Waller, Stephen G; Wallin, Mitchell T; Wan, Xia; Wang, Haidong; Wang, JianLi; Wang, Linhong; Wang, Wenzhi; Wang, Yanping; Warouw, Tati S; Watts, Charlotte H; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; Wessells, K Ryan; Westerman, Ronny; Whiteford, Harvey A; Wilkinson, James D; Williams, Hywel C; Williams, Thomas N; Woldeyohannes, Solomon M; Wolfe, Charles D A; Wong, John Q; Woolf, Anthony D; Wright, Jonathan L; Wurtz, Brittany; Xu, Gelin; Yan, Lijing L; Yang, Gonghuan; Yano, Yuichiro; Ye, Pengpeng; Yenesew, Muluken; Yentür, Gökalp K; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Younoussi, Zourkaleini; Yu, Chuanhua; Zaki, Maysaa E; Zhao, Yong; Zheng, Yingfeng; Zhou, Maigeng; Zhu, Jun; Zhu, Shankuan; Zou, Xiaonong; Zunt, Joseph R; Lopez, Alan D; Vos, Theo; Murray, Christopher J

2015-12-05

The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol. All risks combined account for 57·2% (95% uncertainty interval

Relation of Cardiometabolic Risk Factors between Parents and Children.

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Halvorsen, Tanya; Moran, Antoinette; Jacobs, David R; Steffen, Lyn M; Sinaiko, Alan R; Zhou, Xia; Steinberger, Julia

2015-11-01

To explore the relations of parent-child cardiometabolic risk factors and assess the influence of adiposity on these associations. Associations of adiposity, blood pressure (BP), lipids, fasting insulin and glucose, and a risk factor cluster score (CS) were evaluated in a cross-sectional study of 179 parents and their children (6-18 years, N = 255). Insulin resistance was assessed by euglycemic clamp in parents and children aged 10 years or older. Metabolic syndrome in parents was defined by National Cholesterol Education Program's Adult Treatment Panel III criteria. CSs of the risk factors were created based on age-specific z-scores. Analyses included Pearson correlation and linear regression, adjusted for parent and child age, sex, race, and body mass index (BMI), accounting for within-family correlation. We found positive parent-child correlations for measures of adiposity (BMI, BMI percentile, waist, subcutaneous fat, and visceral fat; r = 0.22-0.34, all P ≤ .003), systolic BP (r = 0.20, P = .002), total cholesterol (r = 0.39, P parent-child correlations, except systolic BP, remained significant. Although adiposity is strongly correlated between parents and children, many cardiometabolic risk factors correlate independent of parent and child BMI. Adverse parental cardiometabolic profiles may identify at-risk children independent of the child's adiposity status. Copyright © 2015 Elsevier Inc. All rights reserved.

Identifying At-Risk Students in General Chemistry via Cluster Analysis of Affective Characteristics

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Chan, Julia Y. K.; Bauer, Christopher F.

2014-01-01

The purpose of this study is to identify academically at-risk students in first-semester general chemistry using affective characteristics via cluster analysis. Through the clustering of six preselected affective variables, three distinct affective groups were identified: low (at-risk), medium, and high. Students in the low affective group…

Clustering of risk factors in parents of patients with type 1 diabetes and nephropathy.

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Thorn, Lena M; Forsblom, Carol; Fagerudd, Johan; Pettersson-Fernholm, Kim; Kilpikari, Riika; Groop, Per-Henrik

2007-05-01

To assess the impact of parental risk factors for diabetic nephropathy. This cross-sectional study included 2,355 type 1 diabetic patients from the FinnDiane (Finnish Diabetic Nephropathy) study. Diabetic nephropathy was defined as macroalbuminuria (urinary albumin excretion rate >200 microg/min or >300 mg/24 h) or end-stage renal disease. Information was available from 4,676 parents. Parental scores were calculated based on the number of various traits in the parents. Patients with diabetic nephropathy, compared with those without diabetic nephropathy, had a higher prevalence of maternal (41 vs. 35%, P = 0.046) and parental (62 vs. 55%, P = 0.044) hypertension, maternal stroke (7.6 vs. 5.1%, P = 0.044), and maternal (1.4 vs. 0.7%, P = 0.058) and parental (4.3 vs. 2.9%, P = 0.030) type 1 diabetes. If both, compared with none, of the parents had hypertension, the adjusted odds ratio (OR) for diabetic nephropathy in offspring was 1.56 (95% CI 1.13-2.15). The adjusted OR for diabetic nephropathy was 2.13 (1.36-3.33) for the parental hypertension-diabetes score (3-4 vs. 0 points) and 2.13 (1.37-3.33) for the parental hypertension-cardiovascular disease (CVD)-diabetes score (4-6 vs. 0 points). Fathers of patients with diabetic nephropathy, compared with those without diabetic nephropathy, had reduced overall survival (log-rank P = 0.04) and reduced cardiovascular survival (log-rank P = 0.03). A cluster of parental hypertension, CVD, and diabetes is associated with diabetic nephropathy in type 1 diabetes, as is paternal mortality.

Adaptation of a Counseling Intervention to Address Multiple Cancer Risk Factors among Overweight/Obese Latino Smokers

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Castro, Yessenia; Fernández, Maria E.; Strong, Larkin L.; Stewart, Diana W.; Krasny, Sarah; Hernandez Robles, Eden; Heredia, Natalia; Spears, Claire A.; Correa-Fernández, Virmarie; Eakin, Elizabeth; Resnicow, Ken; Basen-Engquist, Karen; Wetter, David W.

2015-01-01

More than 60% of cancer-related deaths in the United States are attributable to tobacco use, poor nutrition, and physical inactivity, and these risk factors tend to cluster together. Thus, strategies for cancer risk reduction would benefit from addressing multiple health risk behaviors. We adapted an evidence-based intervention grounded in social…

A Cluster-Randomized Controlled Trial to Reduce Diarrheal Disease and Dengue Entomological Risk Factors in Rural Primary Schools in Colombia.

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Hans J Overgaard

2016-11-01

Full Text Available As many neglected tropical diseases are co-endemic and have common risk factors, integrated control can efficiently reduce disease burden and relieve resource-strained public health budgets. Diarrheal diseases and dengue fever are major global health problems sharing common risk factors in water storage containers. Where provision of clean water is inadequate, water storage is crucial. Fecal contamination of stored water is a common source of diarrheal illness, but stored water also provides breeding sites for dengue vector mosquitoes. Integrating improved water management and educational strategies for both diseases in the school environment can potentially improve the health situation for students and the larger community. The objective of this trial was to investigate whether interventions targeting diarrhea and dengue risk factors would significantly reduce absence due to diarrheal disease and dengue entomological risk factors in schools.A factorial cluster randomized controlled trial was carried out in 34 rural primary schools (1,301 pupils in La Mesa and Anapoima municipalities, Cundinamarca, Colombia. Schools were randomized to one of four study arms: diarrhea interventions (DIA, dengue interventions (DEN, combined diarrhea and dengue interventions (DIADEN, and control (CON. Interventions had no apparent effect on pupil school absence due to diarrheal disease (p = 0.45 or on adult female Aedes aegypti density (p = 0.32 (primary outcomes. However, the dengue interventions reduced the Breteau Index on average by 78% (p = 0.029, with Breteau indices of 10.8 and 6.2 in the DEN and DIADEN arms, respectively compared to 37.5 and 46.9 in the DIA and CON arms, respectively. The diarrhea interventions improved water quality as assessed by the amount of Escherichia coli colony forming units (CFU; the ratio of Williams mean E. coli CFU being 0.22, or 78% reduction (p = 0.008.Integrated control of dengue and diarrhea has never been conducted before

A Cluster-Randomized Controlled Trial to Reduce Diarrheal Disease and Dengue Entomological Risk Factors in Rural Primary Schools in Colombia

Science.gov (United States)

Overgaard, Hans J.; Alexander, Neal; Matiz, Maria Ines; Jaramillo, Juan Felipe; Olano, Victor Alberto; Vargas, Sandra; Sarmiento, Diana; Lenhart, Audrey; Stenström, Thor Axel

2016-01-01

Background As many neglected tropical diseases are co-endemic and have common risk factors, integrated control can efficiently reduce disease burden and relieve resource-strained public health budgets. Diarrheal diseases and dengue fever are major global health problems sharing common risk factors in water storage containers. Where provision of clean water is inadequate, water storage is crucial. Fecal contamination of stored water is a common source of diarrheal illness, but stored water also provides breeding sites for dengue vector mosquitoes. Integrating improved water management and educational strategies for both diseases in the school environment can potentially improve the health situation for students and the larger community. The objective of this trial was to investigate whether interventions targeting diarrhea and dengue risk factors would significantly reduce absence due to diarrheal disease and dengue entomological risk factors in schools. Methodology/Principal Findings A factorial cluster randomized controlled trial was carried out in 34 rural primary schools (1,301 pupils) in La Mesa and Anapoima municipalities, Cundinamarca, Colombia. Schools were randomized to one of four study arms: diarrhea interventions (DIA), dengue interventions (DEN), combined diarrhea and dengue interventions (DIADEN), and control (CON). Interventions had no apparent effect on pupil school absence due to diarrheal disease (p = 0.45) or on adult female Aedes aegypti density (p = 0.32) (primary outcomes). However, the dengue interventions reduced the Breteau Index on average by 78% (p = 0.029), with Breteau indices of 10.8 and 6.2 in the DEN and DIADEN arms, respectively compared to 37.5 and 46.9 in the DIA and CON arms, respectively. The diarrhea interventions improved water quality as assessed by the amount of Escherichia coli colony forming units (CFU); the ratio of Williams mean E. coli CFU being 0.22, or 78% reduction (p = 0.008). Conclusions/Significance Integrated

Detecting space-time cancer clusters using residential histories

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Jacquez, Geoffrey M.; Meliker, Jaymie R.

2007-04-01

Methods for analyzing geographic clusters of disease typically ignore the space-time variability inherent in epidemiologic datasets, do not adequately account for known risk factors (e.g., smoking and education) or covariates (e.g., age, gender, and race), and do not permit investigation of the latency window between exposure and disease. Our research group recently developed Q-statistics for evaluating space-time clustering in cancer case-control studies with residential histories. This technique relies on time-dependent nearest neighbor relationships to examine clustering at any moment in the life-course of the residential histories of cases relative to that of controls. In addition, in place of the widely used null hypothesis of spatial randomness, each individual's probability of being a case is instead based on his/her risk factors and covariates. Case-control clusters will be presented using residential histories of 220 bladder cancer cases and 440 controls in Michigan. In preliminary analyses of this dataset, smoking, age, gender, race and education were sufficient to explain the majority of the clustering of residential histories of the cases. Clusters of unexplained risk, however, were identified surrounding the business address histories of 10 industries that emit known or suspected bladder cancer carcinogens. The clustering of 5 of these industries began in the 1970's and persisted through the 1990's. This systematic approach for evaluating space-time clustering has the potential to generate novel hypotheses about environmental risk factors. These methods may be extended to detect differences in space-time patterns of any two groups of people, making them valuable for security intelligence and surveillance operations.

The role of age, ethnicity and environmental factors in modulating malaria risk in Rajasthali, Bangladesh

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Haque Ubydul

2011-12-01

Full Text Available Abstract Background Malaria is endemic in the Rajasthali region of the Chittagong Hill Tracts in Bangladesh and the Rajasthali region is the most endemic area of Bangladesh. Quantifying the role of environmental and socio-economic factors in the local spatial patterns of malaria endemicity can contribute to successful malaria control and elimination. This study aimed to investigate the role of environmental factors on malaria risk in Rajasthali and to quantify the geographical clustering in malaria risk unaccounted by these factors. Method A total of 4,200 (78.9%; N = 5,322 households were targeted in Rajasthali in July, 2009, and 1,400 individuals were screened using a rapid diagnostic test (Falci-vax. These data were linked to environmental and socio-economic data in a geographical information system. To describe the association between environmental factors and malaria risk, a generalized linear mixed model approach was utilized. The study investigated the role of environmental factors on malaria risk by calculating their population-attributable fractions (PAF, and used residual semivariograms to quantify the geographical clustering in malaria risk unaccounted by these factors. Results Overall malaria prevalence was 11.7%. Out of 5,322 households, 44.12% households were living in areas with malaria prevalence of ≥ 10%. The results from statistical analysis showed that age, ethnicity, proximity to forest, household density, and elevation were significantly and positively correlated with the malaria risk and PAF estimation. The highest PAF of malaria prevalence was 47.7% for third tertile (n = 467 of forest cover, 17.6% for second tertile (n = 467 of forest cover and 19.9% for household density >1,000. Conclusion Targeting of malaria health interventions at small spatial scales in Bangladesh should consider the social and socio-economic risk factors identified as well as alternative methods for improving equity of access to interventions

The association between serum brain-derived neurotrophic factor and a cluster of cardiovascular risk factors in adolescents: The CHAMPS-study DK.

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Pedersen, Natascha Holbæk; Tarp, Jakob; Andersen, Lars Bo; Gejl, Anne Kær; Huang, Tao; Peijs, Lone; Bugge, Anna

2017-01-01

Cardiovascular disease and type 2 diabetes pose a global health burden. Therefore, clarifying the pathology of these risk factors is essential. Previous studies have found positive and negative associations between one or more cardiovascular risk factors and brain-derived neurotrophic factor (BDNF) probably due to diverse methodological approaches when analysing peripheral BDNF levels. Moreover, only a few studies have been performed in youth populations. Consequently, the main objective of this study was to examine the association between serum BDNF and a composite z-score consisting of six cardiovascular risk factors. A secondary aim was to examine the associations between serum BDNF and each of the six risk factors. Four hundred and forty-seven apparently healthy adolescents between 11-17 years of age participated in this cross-sectional study. Cardiorespiratory fitness (CRF), anthropometrics, pubertal status, blood pressure (BP), serum BDNF, high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), blood glucose and insulin were measured. Information about alcohol consumption and socio-economic status was collected via questionnaires. Associations were modelled using linear regression analysis. Serum BDNF was positively associated with the composite z-score in the total study sample (standardized beta coefficient (std.β) = 0.10, P = 0.037). In males, serum BDNF was positively associated with the composite z-score (Std. β = 0.14, P = 0.034) and HOMA-IR (Std. β = 0.19, P = 0.004), and negatively associated with CRF (Std. β = -0.15, P = 0.026). In females, BDNF was positively associated with TG (Std. β = 0.14, P = 0.030) and negatively associated with waist circumference (WC) (Std. β = -0.16, P = 0.012). Serum BDNF was positively associated with a composite z-score of cardiovascular risk factors. This association seems to be mainly driven by the association between TG, HOMA-IR and serum BDNF, and particularly for males. Further longitudinal research

The association between serum brain-derived neurotrophic factor and a cluster of cardiovascular risk factors in adolescents: The CHAMPS-study DK.

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Natascha Holbæk Pedersen

Full Text Available Cardiovascular disease and type 2 diabetes pose a global health burden. Therefore, clarifying the pathology of these risk factors is essential. Previous studies have found positive and negative associations between one or more cardiovascular risk factors and brain-derived neurotrophic factor (BDNF probably due to diverse methodological approaches when analysing peripheral BDNF levels. Moreover, only a few studies have been performed in youth populations. Consequently, the main objective of this study was to examine the association between serum BDNF and a composite z-score consisting of six cardiovascular risk factors. A secondary aim was to examine the associations between serum BDNF and each of the six risk factors.Four hundred and forty-seven apparently healthy adolescents between 11-17 years of age participated in this cross-sectional study. Cardiorespiratory fitness (CRF, anthropometrics, pubertal status, blood pressure (BP, serum BDNF, high-density lipoprotein cholesterol (HDL-C, triglyceride (TG, blood glucose and insulin were measured. Information about alcohol consumption and socio-economic status was collected via questionnaires. Associations were modelled using linear regression analysis.Serum BDNF was positively associated with the composite z-score in the total study sample (standardized beta coefficient (std.β = 0.10, P = 0.037. In males, serum BDNF was positively associated with the composite z-score (Std. β = 0.14, P = 0.034 and HOMA-IR (Std. β = 0.19, P = 0.004, and negatively associated with CRF (Std. β = -0.15, P = 0.026. In females, BDNF was positively associated with TG (Std. β = 0.14, P = 0.030 and negatively associated with waist circumference (WC (Std. β = -0.16, P = 0.012.Serum BDNF was positively associated with a composite z-score of cardiovascular risk factors. This association seems to be mainly driven by the association between TG, HOMA-IR and serum BDNF, and particularly for males. Further longitudinal

Heart disease - risk factors

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Heart disease - prevention; CVD - risk factors; Cardiovascular disease - risk factors; Coronary artery disease - risk factors; CAD - risk ... a certain health condition. Some risk factors for heart disease you cannot change, but some you can. ...

Clustering of obesity and dental caries with lifestyle factors among Danish adolescents

DEFF Research Database (Denmark)

Cinar, Ayse Basak; Christensen, Lisa Boge; Hede, Borge

2011-01-01

To assess any clustering between obesity, dental health, and lifestyle factors (dietary patterns, physical activity, smoking, and alcohol consumption) among adolescents.......To assess any clustering between obesity, dental health, and lifestyle factors (dietary patterns, physical activity, smoking, and alcohol consumption) among adolescents....

Modifiable Cardiovascular Disease Risk Factors among Indigenous Populations

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Adam A. Lucero

2014-01-01

Full Text Available Objective. To identify modifiable cardio-metabolic and lifestyle risk factors among indigenous populations from Australia (Aboriginal Australians/Torres Strait Islanders, New Zealand (Māori, and the United States (American Indians and Alaska Natives that contribute to cardiovascular disease (CVD. Methods. National health surveys were identified where available. Electronic databases identified sources for filling missing data. The most relevant data were identified, organized, and synthesized. Results. Compared to their non-indigenous counterparts, indigenous populations exhibit lower life expectancies and a greater prevalence of CVD. All indigenous populations have higher rates of obesity and diabetes, hypertension is greater for Māori and Aboriginal Australians, and high cholesterol is greater only among American Indians/Alaska Natives. In turn, all indigenous groups exhibit higher rates of smoking and dangerous alcohol behaviour as well as consuming less fruits and vegetables. Aboriginal Australians and American Indians/Alaska Natives also exhibit greater rates of sedentary behaviour. Conclusion. Indigenous groups from Australia, New Zealand, and the United States have a lower life expectancy then their respective non-indigenous counterparts. A higher prevalence of CVD is a major driving force behind this discrepancy. A cluster of modifiable cardio-metabolic risk factors precede CVD, which, in turn, is linked to modifiable lifestyle risk factors.

Charge form factors and alpha-cluster internal structure of 12C

International Nuclear Information System (INIS)

Luk'yanov, V.K.; Zemlyanaya, E.V.; Kadrev, D.N.; Antonov, A.N.; Spasova, K.; Anagnostatos, G.S.; Ginis, P.; Giapitzakis, J.

1999-01-01

The transition densities and form factors of 0 + , 2 + , and 3 - states in 12 C are calculated in alpha-cluster model using the triangle frame with clusters in the vertices. The wave functions of nucleons in the alpha clusters are taken as they were obtained in the framework of the models used for the description of the 4 He form factor and momentum distribution which are based on the one-body density matrix construction. They contain effects of the short-range NN correlations, as well as the d-shell admixtures in 4 He. Calculations and the comparison with the experimental data show that visible effects on the form and magnitude of the 12 C form factors take place, especially at relatively large momentum transfers

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

Science.gov (United States)

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

2004-04-01

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

Selenium Homeostasis and Clustering of Cardiovascular Risk Factors: A Systematic Review.

Science.gov (United States)

Gharipour, Mojgan; Sadeghi, Masoumeh; Behmanesh, Mehrdad; Salehi, Mansour; Nezafati, Pouya; Gharpour, Amin

2017-10-23

  Selenium is a trace element required for a range of cellular functions. It is widely used for the biosynthesis of the unique amino acid selenocysteine [Sec], which is a structural element of selenoproteins. This systematic review focused on the possible relation between selenium and metabolic risk factors. The literature was searched via PubMed, Scopus, ISI Web of Science, and Google Scholar. Searches were not restricted by time or language. Relevant studies were selected in three phases. After an initial quality assessment, two reviewers extracted all the relevant data, whereas the third reviewer checked their extracted data. All evidence came from experimental and laboratory studies. Selenoprotein P is the best indicator for selenium nutritional levels. In addition, high levels of selenium may increase the risk of metabolic syndrome while the lack of sufficient selenium may also promote metabolic syndrome. selenium supplementation in subjects with sufficient serum selenium levels has a contrary effect on blood pressure, LDL, and total cholesterol. According to the bioavailability of different types of selenium supplementation such as selenomethionine, selenite and selenium-yeast, it seems that the best nutritional type of selenium is selenium-yeast. Regarding obtained results of longitudinal studies and randomized controlled trials, selenium supplementation should not be recommended for primary or secondary cardio-metabolic risk prevention in populations with adequate selenium status.

Typical patterns of modifiable health risk factors (MHRFs) in elderly women in Germany: results from the cross-sectional German Health Update (GEDA) study, 2009 and 2010.

Science.gov (United States)

Jentsch, Franziska; Allen, Jennifer; Fuchs, Judith; von der Lippe, Elena

2017-04-04

Modifiable health risk factors (MHRFs) significantly affect morbidity and mortality rates and frequently occur in specific combinations or risk clusters. Using five MHRFs (smoking, high-risk alcohol consumption, physical inactivity, low intake of fruits and vegetables, and obesity) this study investigates the extent to which risk clusters are observed in a representative sample of women aged 65 and older in Germany. Additionally, the structural composition of the clusters is systematically compared with data and findings from other countries. A pooled data set of Germany's representative cross-sectional surveys GEDA09 and GEDA10 was used. The cohort comprised 4,617 women aged 65 and older. Specific risk clusters based on five MHRFs are identified, using hierarchical cluster analysis. The MHRFs were defined as current smoking (daily or occasionally), risk alcohol consumption (according to the Alcohol Use Disorders Identification Test, a sum score of 4 or more points), physical inactivity (less active than 5 days per week for at least 30 min and lack of sports-related activity in the last three months), low intake of fruits and vegetables (less than one serving of fruits and one of vegetables per day), and obesity (a body mass index equal to or greater than 30). A total of 4,292 cases with full information on these factors are included in the cluster analysis. Extended analyses were also performed to include the number of chronic diseases by age and socioeconomic status of group members. A total of seven risk clusters were identified. In a comparison with data from international studies, the seven risk clusters were found to be stable with a high degree of structural equivalency. Evidence of the stability of risk clusters across various study populations provides a useful starting point for long-term targeted health interventions. The structural clusters provide information through which various MHRFs can be evaluated simultaneously.

Chemical exposure and leukemia clusters

International Nuclear Information System (INIS)

Cartwright, R.A.

1992-01-01

This paper draws attention to the heterogeneous distribution of leukemia in childhood and in adults. The topic of cluster reports and generalized clustering is addressed. These issues are applied to what is known of the risk factor for both adult and childhood leukemia. Finally, the significance of parental occupational exposure and childhood leukemia is covered. (author). 23 refs

To evaluate the differences of risk factors in patients with lower extremity venous disease

International Nuclear Information System (INIS)

Sadikoglu, G.; Ozcakir, A.; Ercan, I.; Ozkaya, G.; Sadikoglu, Y.M.

2007-01-01

To determine whether there is difference between risk factors in patients diagnosed to have clinically documented lower extremity venous disease after confirming the diagnosis radiologically by ultrasonographic and venographic evaluation. This study was performed from January 2002 to January 2005 in Bursa, the fourth biggest city of Turkey situated in the west of country in the Marmara region. The study center is a private imaging center working in conjunction with the Department of Health, which performs diagnostic and therapeutic vascular protocols in the region. Five hundred and fifty-three cases with clinically and radiologically documented diagnoses were evaluated with Multi-Variate Statistical Package 3.13 for the presence of pre-defined clusters of 14 different variables. Other statistical analyses were performed by the Statistical Package for Social sciences, version 13.0. Three different clusters were defined. The variables used to define the clusters were: age, gender, educational level, presence of smoking, amount of smoking (pack/per year), disease symptoms, presence of heart disease and radiologically documented diagnosis. Chronic venous insufficiency and varicose veins are venous system diseases that are most commonly present in association with more than one concomitant risk factors. (author)

Factor-cluster analysis and enrichment study of Mangrove sediments - An example from Mengkabong, Sabah

International Nuclear Information System (INIS)

Praveena, S.M.; Ahmed, A.; Radojevic, M.; Mohd Harun Abdullah; Aris, A.Z.

2007-01-01

This paper examines the tidal effects in the sediment of Mengkabong mangrove forest, Sabah. Generally, all the studied parameters showed high value at high tide compared to low tide. Factor-cluster analyses were adopted to allow the identification of controlling factors at high and low tides. Factor analysis extracted six controlling factors at high tide and seven controlling factors at low tide. Cluster analysis extracted two district clusters at high and low tides. The study showed that factor-cluster analysis application is a useful tool to single out the controlling factors at high and low tides. this will provide a basis for describing the tidal effects in the mangrove sediment. The salinity and electrical conductivity clusters as well as component loadings at high and low tide explained the tidal process where there is high contribution of seawater to mangrove sediments that controls the sediment chemistry. The geo accumulation index (T geo ) values suggest the mangrove sediments are having background concentrations for Al, Cu, Fe and Zn and unpolluted for Pb. (author)

[Adolescence, sexual behavior and risk factors to health].

Science.gov (United States)

Assis, Simone Gonçalves de; Gomes, Romeu; Pires, Thiago de Oliveira

2014-02-01

To analyze the relationships between sexual behavior and risk factors to physical and mental health in adolescents. Study of 3,195 pupils aged 15 to 19 in secondary education, in public and private schools in 10 state capitals in Brazil between 2007 and 2008. Multi-stage (schools and pupils) cluster sampling was used in each city and public and private educational network. All of the students selected completed a questionnaire on the following items: socioeconomic and demographic data; sexual behavior; having sex with those of the same sex, the opposite sex, or both; alcohol and cannabis use; using condoms; traumatic sexual experiences as a child or adolescent; suicidal thoughts. The analysis included describing frequencies, Chi-square test, analysis of multiple and cluster correspondence. Responses to an open ended question in which the adolescent expressed general comments about themselves and their lives were qualitatively analyzed using content analysis. Around 3.0% of adolescents reported homosexual or bisexual behavior, with no difference according to sex, age, skin color, social status family structure or educational network. Adolescents with homosexual/bisexual sexual behavior, compared to their heterosexual peers, reported: (p sexual violence (11.7% and 1.5%; respectively). Adolescents with homosexual/bisexual sexual behavior reported that they used condoms less frequently (74.2%) than their heterosexual peers (48.6%, p sexual violence, never using a condom, suicidal thoughts, frequent cannabis use; another composed of occasional cannabis and condom users, who got drunk frequently, and adolescents with heterosexual behavior and none of the risk factors investigated. More of the risk factors were found in adolescents with homosexual/bisexual behavior compared with those with heterosexual behavior. Adolescents with homosexual/bisexual sexual behavior were more likely to talk about their positive personal experiences and negative relationship experiences that

Sample size estimation to substantiate freedom from disease for clustered binary data with a specific risk profile

DEFF Research Database (Denmark)

Kostoulas, P.; Nielsen, Søren Saxmose; Browne, W. J.

2013-01-01

and power when applied to these groups. We propose the use of the variance partition coefficient (VPC), which measures the clustering of infection/disease for individuals with a common risk profile. Sample size estimates are obtained separately for those groups that exhibit markedly different heterogeneity......, thus, optimizing resource allocation. A VPC-based predictive simulation method for sample size estimation to substantiate freedom from disease is presented. To illustrate the benefits of the proposed approach we give two examples with the analysis of data from a risk factor study on Mycobacterium avium...

Cardiovascular risk factors are major determinants of thrombotic risk in patients with the lupus anticoagulant.

Science.gov (United States)

Posch, Florian; Gebhart, Johanna; Rand, Jacob H; Koder, Silvia; Quehenberger, Peter; Pengo, Vittorio; Ay, Cihan; Pabinger, Ingrid

2017-03-10

Patients with the lupus anticoagulant (LA) are at an increased risk of thrombotic events, which in turn increase the risk of death. Understanding the determinants of thrombotic risk in patients with LA may pave the way towards targeted thromboprophylaxis. In the Vienna Lupus Anticoagulant and Thrombosis Study (LATS), we systematically evaluate risk factors for thrombotic events in patients with LA. We followed 150 patients (mean age: 41.3 years, female gender: n = 122 (81.3%), history of thrombosis or pregnancy complications: n = 111 (74.0%)), who tested repeatedly positive for LA until development of thrombosis, death, or censoring. The primary endpoint was a composite of arterial or venous thrombotic events (TEs). During a median follow-up of 9.5 years (range: 12 days-13.6 years) and 1076 person-years, 32 TEs occurred (arterial: n = 16, venous: n = 16; cumulative 10-year TE incidence: 24.3%). A prolonged lupus-sensitive activated partial thromboplastin time (aPTT-LA) (adjusted subdistribution hazard ratio (SHR) = 2.31, 95% CI: 1.07--5.02), diabetes (adjusted SHR = 4.39, 95% CI: 1.42-13.57), and active smoking (adjusted SHR = 2.31, 95% CI: 1.14-5.02) emerged as independent risk factors of both arterial and venous thrombotic risk. A risk model that includes a prolonged lupus-sensitive aPTT, smoking, and diabetes enabled stratification of LA patients into subgroups with a low, intermediate, and high risk of thrombosis (5-year TE risk of 9.7% (n = 77), 30.9% (n = 51), and 56.8% (n = 22). Long-term thrombotic risk in patients with LA is clustered within subjects harboring typical cardiovascular risk factors in addition to a prolonged lupus-sensitive aPTT, whereas patients with none of these risk factors represent a large subgroup with a low risk of thrombosis.

Risk factors

International Nuclear Information System (INIS)

Dennery, M.; Dupont, M.A.

2007-01-01

This article deals with the development of risk management in the gas sector business: why a risk factor legal mention must precede any published financial information? Do gas companies have to face new risks? Is there specific risks bound to gas activities? Why companies want to master their risks? Is it mandatory or just a new habit? Do they expect a real benefit in return? These are the risk management questions that are analyzed in this article which is based on the public communication of 15 gas companies randomly selected over the world. The information comes from their annual reports or from documents available on their web sites. The intention of this document is not to be exhaustive or to make statistics but only to shade light on the risk factors of the gas sector. (J.S.)

Factors influencing the quality of life of haemodialysis patients according to symptom cluster.

Science.gov (United States)

Shim, Hye Yeung; Cho, Mi-Kyoung

2018-05-01

To identify the characteristics in each symptom cluster and factors influencing the quality of life of haemodialysis patients in Korea according to cluster. Despite developments in renal replacement therapy, haemodialysis still restricts the activities of daily living due to pain and impairs physical functioning induced by the disease and its complications. Descriptive survey. Two hundred and thirty dialysis patients aged >18 years. They completed self-administered questionnaires of Dialysis Symptom Index and Kidney Disease Quality of Life instrument-Short Form 1.3. To determine the optimal number of clusters, the collected data were analysed using polytomous variable latent class analysis in R software (poLCA) to estimate the latent class models and the latent class regression models for polytomous outcome variables. Differences in characteristics, symptoms and QOL according to the symptom cluster of haemodialysis patients were analysed using the independent t test and chi-square test. The factors influencing the QOL according to symptom cluster were identified using hierarchical multiple regression analysis. Physical and emotional symptoms were significantly more severe, and the QOL was significantly worse in Cluster 1 than in Cluster 2. The factors influencing the QOL were spouse, job, insurance type and physical and emotional symptoms in Cluster 1, with these variables having an explanatory power of 60.9%. Physical and emotional symptoms were the only influencing factors in Cluster 2, and they had an explanatory power of 37.4%. Mitigating the symptoms experienced by haemodialysis patients and improving their QOL require educational and therapeutic symptom management interventions that are tailored according to the characteristics and symptoms in each cluster. The findings of this study are expected to lead to practical guidelines for addressing the symptoms experienced by haemodialysis patients, and they provide basic information for developing nursing

Assessing a risk tailored intervention to prevent disabling low back pain - protocol of a cluster randomized controlled trial

Directory of Open Access Journals (Sweden)

Marnitz Ulf

2010-01-01

Full Text Available Abstract Background Although most patients with low back pain (LBP recover within a few weeks a significant proportion has recurrent episodes or will develop chronic low back pain. Several mainly psychosocial risk factors for developing chronic LBP have been identified. However, effects of preventive interventions aiming at behavioural risk factors and unfavourable cognitions have yielded inconsistent results. Risk tailored interventions may provide a cost efficient and effective means to take systematic account of the individual risk factors but evidence is lacking. Methods/Design This study will be a cluster-randomised controlled trial comparing screening and a subsequent risk tailored intervention for patients with low back pain to prevent chronic low back pain compared to treatment as usual in primary care. A total of 600 patients from 20 practices in each study arm will be recruited in Berlin and Goettingen. The intervention comprises the following elements: Patients will be assigned to one of four risk groups based on a screening questionnaire. Subsequently they receive an educational intervention including information and counselling tailored to the risk group. A telephone/email consulting service for back pain related problems are offered independent of risk group assignment. The primary outcomes will be functional capacity and sick leave. Discussion This trial will evaluate the effectiveness of screening for risk factors for chronic low back pain followed by a risk tailored intervention to prevent chronic low back pain. This trial will contribute new evidence regarding the flexible use of individual physical and psychosocial risk factors in general practice. Trial registration ISRCTN 68205910

Nutrition and Cardiovascular Risk Factors in Four Age Groups of Female Individuals: The PEP Family Heart Study

Directory of Open Access Journals (Sweden)

Peter Schwandt

2010-01-01

Full Text Available Objectives: Assessment of nutritional habits and associations with cardio-metabolic risk factors in four age groups of women partici-pating in the Prevention Education Program, Family Heart Study.Methods: Anthropometric variables, systolic and diastolic blood pressures (SBP, DBP, lipoproteins, glucose and insulin were measured in 141 children, 211 adolescents, 151 women 3 times more common in adolescents. Thirty six percent of junior women were overweight (BMI ≥25 kg/m² and 21% had central adiposity obese. Sixty eight year-old women had a far more adverse risk profile than 35 year-old women. In terms of energy consumption, 14 year-old women had the lowest fat intake and the highest consumption of carbohydrates whereas intake of protein was lowest in 10 year-old girls. Intake of unsaturated fat was lower in youths than in adults amounting to 37 g unsaturated fat respectively 53.4% of total fat consumption. The asso-ciation between energy consumption and overweight was significant and calorie intake was associated with clustering of ≥3 cardiovascular risk factors (OR :4.72; 95% CI 1.22-18.33.Conclusions: The prevalence of CVD risk factors increased continuously from girls and adolescents to junior and senior women. However, dietary intake was different in the four age groups. Caloric intake was associated with overweight and clustering of risk factors in adult women.

Influence of physical fitness on cardio-metabolic risk factors in European children. The IDEFICS study.

Science.gov (United States)

Zaqout, M; Michels, N; Bammann, K; Ahrens, W; Sprengeler, O; Molnar, D; Hadjigeorgiou, C; Eiben, G; Konstabel, K; Russo, P; Jiménez-Pavón, D; Moreno, L A; De Henauw, S

2016-07-01

The aim of the study was to assess the associations of individual and combined physical fitness components with single and clustering of cardio-metabolic risk factors in children. This 2-year longitudinal study included a total of 1635 European children aged 6-11 years. The test battery included cardio-respiratory fitness (20-m shuttle run test), upper-limb strength (handgrip test), lower-limb strength (standing long jump test), balance (flamingo test), flexibility (back-saver sit-and-reach) and speed (40-m sprint test). Metabolic risk was assessed through z-score standardization using four components: waist circumference, blood pressure (systolic and diastolic), blood lipids (triglycerides and high-density lipoprotein) and insulin resistance (homeostasis model assessment). Mixed model regression analyses were adjusted for sex, age, parental education, sugar and fat intake, and body mass index. Physical fitness was inversely associated with clustered metabolic risk (P<0.001). All coefficients showed a higher clustered metabolic risk with lower physical fitness, except for upper-limb strength (β=0.057; P=0.002) where the opposite association was found. Cardio-respiratory fitness (β=-0.124; P<0.001) and lower-limb strength (β=-0.076; P=0.002) were the most important longitudinal determinants. The effects of cardio-respiratory fitness were even independent of the amount of vigorous-to-moderate activity (β=-0.059; P=0.029). Among all the metabolic risk components, blood pressure seemed not well predicted by physical fitness, while waist circumference, blood lipids and insulin resistance all seemed significantly predicted by physical fitness. Poor physical fitness in children is associated with the development of cardio-metabolic risk factors. Based on our results, this risk might be modified by improving mainly cardio-respiratory fitness and lower-limb muscular strength.

Collagen content as a risk factor in breast cancer? A pilot clinical study

Science.gov (United States)

Pifferi, Antonio; Quarto, Giovanna; Abbate, Francesca; Balestreri, Nicola; Menna, Simona; Cassano, Enrico; Cubeddu, Rinaldo; Taroni, Paola

2015-07-01

A retrospective pilot clinical study on time domain multi-wavelength (635 to 1060 nm) optical mammography was exploited to assess collagen as a breast-cancer risk factor on a total of 109 subjects (53 healthy and 56 with malignant lesions). An increased cancer occurrence is observed on the 15% subset of patients with higher age-matched collagen content. Further, a similar clustering based on the percentage breast density leads to a different set of patients, possibly indicating collagen as a new independent breast cancer risk factor. If confirmed statistically and on larger numbers, these results could have huge impact on personalized diagnostics, health care systems, as well as on basic research.

Internal validation of risk models in clustered data: a comparison of bootstrap schemes

NARCIS (Netherlands)

Bouwmeester, W.; Moons, K.G.M.; Kappen, T.H.; van Klei, W.A.; Twisk, J.W.R.; Eijkemans, M.J.C.; Vergouwe, Y.

2013-01-01

Internal validity of a risk model can be studied efficiently with bootstrapping to assess possible optimism in model performance. Assumptions of the regular bootstrap are violated when the development data are clustered. We compared alternative resampling schemes in clustered data for the estimation

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 ...

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 ...

Risk factors and spatial distribution of Schistosoma mansoni infection among primary school children in Mbita District, Western Kenya.

Directory of Open Access Journals (Sweden)

Sachiyo Nagi

2014-07-01

Full Text Available An increasing risk of Schistosoma mansoni infection has been observed around Lake Victoria, western Kenya since the 1970s. Understanding local transmission dynamics of schistosomiasis is crucial in curtailing increased risk of infection.We carried out a cross sectional study on a population of 310 children from eight primary schools. Overall, a total of 238 (76.8% children were infected with S. mansoni, while seven (2.3% had S. haematobium. The prevalence of hookworm, Trichuris trichiura and Ascaris lumbricoides were 6.1%, 5.2% and 2.3%, respectively. Plasmodium falciparum was the only malaria parasite detected (12.0%. High local population density within a 1 km radius around houses was identified as a major independent risk factor of S. mansoni infection. A spatial cluster of high infection risk was detected around the Mbita causeway following adjustment for population density and other potential risk factors.Population density was shown to be a major factor fuelling schistosome infection while individual socio-economic factors appeared not to affect the infection risk. The high-risk cluster around the Mbita causeway may be explained by the construction of an artificial pathway that may cause increased numbers of S. mansoni host snails through obstruction of the waterway. This construction may have, therefore, a significant negative impact on the health of the local population, especially school-aged children who frequently come in contact with lake water.

BMI, total and abdominal fat distribution, and cardiovascular risk factors in school-age children.

Science.gov (United States)

Gishti, Olta; Gaillard, Romy; Durmus, Busra; Abrahamse, Marieke; van der Beek, Eline M; Hofman, Albert; Franco, Oscar H; de Jonge, Layla L; Jaddoe, Vincent W V

2015-05-01

More specific total body and abdominal fat mass measures might be stronger associated with cardiovascular risk factors in childhood, than BMI. We examined the independent associations of total and abdominal fat measures with cardiovascular risk factors in school age children. We performed a population-based cohort study among 6,523 children. At the age of 6 y, we measured childhood BMI, and general and abdominal fat mass, using dual-energy X-ray absorptiometry, and ultrasound and cardiovascular risk factors. Conditional on BMI, higher fat mass percentage and abdominal fat mass were associated with higher blood pressure, total- and low-density lipoprotein (LDL)-cholesterol, insulin and c-peptide levels, but with lower left ventricular mass and high-density lipoprotein (HDL)-cholesterol (P values children. Higher childhood adiposity measures were associated with increased odds of cardiovascular risk factors clustering, with the strongest effect for fat mass percentage (odds ratios: 3.01 (95% confidence interval: 2.67, 3.9). Our results suggest that general and abdominal fat measures are associated with cardiovascular risk factors in childhood, independent from BMI. These measures may provide additional information for identification of children with an adverse cardiovascular profile.

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

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.

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

Science.gov (United States)

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

2015-07-01

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

Space-time clusters of breast cancer using residential histories

DEFF Research Database (Denmark)

Nordsborg, Rikke Baastrup; Meliker, Jaymie R; Ersbøll, Annette Kjær

2014-01-01

BACKGROUND: A large proportion of breast cancer cases are thought related to environmental factors. Identification of specific geographical areas with high risk (clusters) may give clues to potential environmental risk factors. The aim of this study was to investigate whether clusters of breast...... cancer existed in space and time in Denmark, using 33 years of residential histories. METHODS: We conducted a population-based case-control study of 3138 female cases from the Danish Cancer Registry, diagnosed with breast cancer in 2003 and two independent control groups of 3138 women each, randomly...

Stroke - risk factors

Science.gov (United States)

... oxygen. Brain cells can die, causing lasting damage. Risk factors are things that increase your chance of ... a disease or condition. This article discusses the risk factors for stroke and things you can do ...

Alpha-cluster preformation factor within cluster-formation model for odd-A and odd-odd heavy nuclei

Science.gov (United States)

Saleh Ahmed, Saad M.

2017-06-01

The alpha-cluster probability that represents the preformation of alpha particle in alpha-decay nuclei was determined for high-intensity alpha-decay mode odd-A and odd-odd heavy nuclei, 82 CSR) and the hypothesised cluster-formation model (CFM) as in our previous work. Our previous successful determination of phenomenological values of alpha-cluster preformation factors for even-even nuclei motivated us to expand the work to cover other types of nuclei. The formation energy of interior alpha cluster needed to be derived for the different nuclear systems with considering the unpaired-nucleon effect. The results showed the phenomenological value of alpha preformation probability and reflected the unpaired nucleon effect and the magic and sub-magic effects in nuclei. These results and their analyses presented are very useful for future work concerning the calculation of the alpha decay constants and the progress of its theory.

Interrelationships of Physical Activity and Sleep with Cardiovascular Risk Factors: a Person-Oriented Approach.

Science.gov (United States)

Wennman, Heini; Kronholm, Erkki; Partonen, Timo; Tolvanen, Asko; Peltonen, Markku; Vasankari, Tommi; Borodulin, Katja

2015-12-01

Associations of behaviorally modifiable factors like physical activity (PA), sedentary behaviors, and sleep with cardiovascular diseases (CVDs) are complicated. We examined whether membership in latent classes (LCs) differentiated by PA and sleep profiles (real-life clustering of behaviors in population subgroups) associate with metabolic risk factors and CVD risk. The National FINRISK 2012 Study comprise a cross-sectional sample of 10,000 Finns aged 25 to 74 years. Analyses included participants with complete data on a health questionnaire, a health examination, who had no prevalent CVD (n = 4031). LCs with PA and sleep profiles were previously defined using latent class analysis. Ten metabolic risk factors and the Framingham 10-year CVD risk score were compared between the LCs. PA and sleep class profiles were substantially similar for genders. Compared to LC-1, with a profile including high PA and sufficient sleep, membership in LC-4, with a profile including sedentariness and insufficient sleep was associated with high metabolic risk factors in women but not in men. In women, also membership in LC-2, with a profile including light PA, sufficient sleep, and high sedentariness was associated with high metabolic risk factors. The Framingham 10-year CVD risk score was highest in LCs 2 and 4 in both genders. Membership in LCs differentiated by PA and sleep profiles was associated with metabolic risk factors merely in women, suggesting gender differences in the interrelationships of health behaviors and metabolic risk factors. Total CVD risk differed between the LCs despite of gender; however, the effect was small.

Directed clustering coefficient as a measure of systemic risk in complex banking networks

Science.gov (United States)

Tabak, Benjamin M.; Takami, Marcelo; Rocha, Jadson M. C.; Cajueiro, Daniel O.; Souza, Sergio R. S.

2014-01-01

Recent literature has focused on the study of systemic risk in complex networks. It is clear now, after the crisis of 2008, that the aggregate behavior of the interaction among agents is not straightforward and it is very difficult to predict. Contributing to this debate, this paper shows that the directed clustering coefficient may be used as a measure of systemic risk in complex networks. Furthermore, using data from the Brazilian interbank network, we show that the directed clustering coefficient is negatively correlated with domestic interest rates.

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

Science.gov (United States)

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

2017-06-04

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

Effect of a computer-guided, quality improvement program for cardiovascular disease risk management in primary health care: the treatment of cardiovascular risk using electronic decision support cluster-randomized trial.

Science.gov (United States)

Peiris, David; Usherwood, Tim; Panaretto, Kathryn; Harris, Mark; Hunt, Jennifer; Redfern, Julie; Zwar, Nicholas; Colagiuri, Stephen; Hayman, Noel; Lo, Serigne; Patel, Bindu; Lyford, Marilyn; MacMahon, Stephen; Neal, Bruce; Sullivan, David; Cass, Alan; Jackson, Rod; Patel, Anushka

2015-01-01

Despite effective treatments to reduce cardiovascular disease risk, their translation into practice is limited. Using a parallel arm cluster-randomized controlled trial in 60 Australian primary healthcare centers, we tested whether a multifaceted quality improvement intervention comprising computerized decision support, audit/feedback tools, and staff training improved (1) guideline-indicated risk factor measurements and (2) guideline-indicated medications for those at high cardiovascular disease risk. Centers had to use a compatible software system, and eligible patients were regular attendees (Aboriginal and Torres Strait Islander people aged ≥ 35 years and others aged ≥ 45 years). Patient-level analyses were conducted using generalized estimating equations to account for clustering. Median follow-up for 38,725 patients (mean age, 61.0 years; 42% men) was 17.5 months. Mean monthly staff support was improved overall risk factor measurements (62.8% versus 53.4% risk ratio; 1.25; 95% confidence interval, 1.04-1.50; P=0.02), but there was no significant differences in recommended prescriptions for the high-risk cohort (n=10,308; 56.8% versus 51.2%; P=0.12). There were significant treatment escalations (new prescriptions or increased numbers of medicines) for antiplatelet (17.9% versus 2.7%; Pquality improvement intervention, requiring minimal support, improved cardiovascular disease risk measurement but did not increase prescription rates in the high-risk group. Computerized quality improvement tools offer an important, albeit partial, solution to improving primary healthcare system capacity for cardiovascular disease risk management. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=336630. Australian New Zealand Clinical Trials Registry No. 12611000478910. © 2015 American Heart Association, Inc.

On the Equivalence of Nonnegative Matrix Factorization and K-means- Spectral Clustering

Energy Technology Data Exchange (ETDEWEB)

Ding, Chris; He, Xiaofeng; Simon, Horst D.; Jin, Rong

2005-12-04

We provide a systematic analysis of nonnegative matrix factorization (NMF) relating to data clustering. We generalize the usual X = FG{sup T} decomposition to the symmetric W = HH{sup T} and W = HSH{sup T} decompositions. We show that (1) W = HH{sup T} is equivalent to Kernel K-means clustering and the Laplacian-based spectral clustering. (2) X = FG{sup T} is equivalent to simultaneous clustering of rows and columns of a bipartite graph. We emphasizes the importance of orthogonality in NMF and soft clustering nature of NMF. These results are verified with experiments on face images and newsgroups.

Clusters of Adolescent and Young Adult Thyroid Cancer in Florida Counties

Directory of Open Access Journals (Sweden)

Raid Amin

2014-01-01

Full Text Available Background. Thyroid cancer is a common cancer in adolescents and young adults ranking 4th in frequency. Thyroid cancer has captured the interest of epidemiologists because of its strong association to environmental factors. The goal of this study is to identify thyroid cancer clusters in Florida for the period 2000–2008. This will guide further discovery of potential risk factors within areas of the cluster compared to areas not in cluster. Methods. Thyroid cancer cases for ages 15–39 were obtained from the Florida Cancer Data System. Next, using the purely spatial Poisson analysis function in SaTScan, the geographic distribution of thyroid cancer cases by county was assessed for clusters. The reference population was obtained from the Census Bureau 2010, which enabled controlling for population age, sex, and race. Results. Two statistically significant clusters of thyroid cancer clusters were found in Florida: one in southern Florida (SF (relative risk of 1.26; P value of <0.001 and the other in northwestern Florida (NWF (relative risk of 1.71; P value of 0.012. These clusters persisted after controlling for demographics including sex, age, race. Conclusion. In summary, we found evidence of thyroid cancer clustering in South Florida and North West Florida for adolescents and young adult.

Fracture Risk and Risk Factors for Osteoporosis.

Science.gov (United States)

Schürer, Christian; Wallaschofski, Henri; Nauck, Matthias; Völzke, Henry; Schober, Hans-Christof; Hannemann, Anke

2015-05-25

As the population ages, diseases of the elderly are becoming more common, including osteoporosis. Ways to assess the risk of fracture and the distribution and effects of known risk factors for osteoporosis will be important in planning for future healthcare needs, as well as in the development of preventive strategies. The study population included 6029 men and women aged 20-90 who underwent examination in the second follow-up wave of the Study of Health in Pomerania (SHIP-2) or in the basal SHIP-Trend Study. The risk of fracture was estimated on the basis of quantitative ultrasonography of the calcaneus. Prior fractures and risk factors for osteoporosis were ascertained in standardized interviews. 4.6% of the male subjects and 10.6% of the female subjects were judged to have an elevated risk of fracture. The corresponding percentages among subjects over age 65 were 8.8% for men and 28.2% for women. Even among subjects under age 55, risk factors for osteoporosis were associated with lower bone stiffness: the mean stiffness index was 103/98 (men/women) without risk factors, 99/96 with one risk factor, and 93/95 with more than one risk factor. Logistic regression analysis yielded an odds ratio of 1.89 (95% confidence interval: 1.44-2.50; p<0.01) for prevalent fractures among subjects aged 75 and older compared to subjects under age 55. The data indicate a high prevalence of osteoporosis from age 65 onward. These findings are consistent with those of other studies from Germany and across Europe. Younger men and women should already begin taking steps to counteract modifiable risk factors.

Analyzing the factors affecting network lifetime cluster-based wireless sensor network

International Nuclear Information System (INIS)

Malik, A.S.; Qureshi, A.

2010-01-01

Cluster-based wireless sensor networks enable the efficient utilization of the limited energy resources of the deployed sensor nodes and hence prolong the node as well as network lifetime. Low Energy Adaptive Clustering Hierarchy (Leach) is one of the most promising clustering protocol proposed for wireless sensor networks. This paper provides the energy utilization and lifetime analysis for cluster-based wireless sensor networks based upon LEACH protocol. Simulation results identify some important factors that induce unbalanced energy utilization between the sensor nodes and hence affect the network lifetime in these types of networks. These results highlight the need for a standardized, adaptive and distributed clustering technique that can increase the network lifetime by further balancing the energy utilization among sensor nodes. (author)

Food consumption and cardiovascular risk factors in European children: the IDEFICS study.

Science.gov (United States)

Bel-Serrat, S; Mouratidou, T; Börnhorst, C; Peplies, J; De Henauw, S; Marild, S; Molnár, D; Siani, A; Tornaritis, M; Veidebaum, T; Krogh, V; Moreno, L A

2013-06-01

Few studies addressing the relationship between food consumption and cardiovascular disease or metabolic risk have been conducted in children. Previous findings have indicated greater metabolic risk in children with high intakes of solid hydrogenated fat and white bread, and low consumption of fruits, vegetables and dairy products. In a large multinational sample of 2 to 9 years old children, high consumption of sweetened beverages and low intake of nuts and seeds, sweets, breakfast cereals, jam and honey and chocolate and nut-based spreads were directly associated with increased clustered cardiovascular disease risk. These findings add new evidence to the limited literature available in young populations on the role that diet may play on cardiovascular health. To investigate food consumption in relation to clustered cardiovascular disease (CVD) risk. Children (n = 5548, 51.6% boys) from eight European countries participated in the IDEFICS study baseline survey (2007-2008). Z-scores of individual CVD risk factors were summed to compute sex- and age-specific (2-chocolate and nut-based spreads (boys: OR = 0.46; 95% CI = 0.32-0.69; girls: OR = 0.60; 95% CI = 0.42-0.86), jam and honey (girls: OR = 0.45; 95% CI = 0.26-0.78) and sweets (boys: OR = 0.69; 95% CI = 0.48-0.98). OR of being at risk significantly increased with the highest consumption of soft drinks (younger boys) and manufactured juices (older girls). Concerning CVD risk score B, older boys and girls in the highest tertile of consumption of breakfast cereals were 0.41 (95% CI = 0.21-0.79) and 0.45 (95% CI = 0.22-0.93) times, respectively, less likely to be at risk than those in tertile 1. High consumption of sugar-sweetened beverages and low intake of breakfast cereals, jam and honey, sweets and chocolate and nut-based spreads seem to adversely affect clustered CVD risk. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of

Prevalence of asthenopia and its risk factors in Chinese college students.

Science.gov (United States)

Han, Cheng-Cheng; Liu, Rong; Liu, Ru-Ru; Zhu, Zhong-Hai; Yu, Rong-Bin; Ma, Le

2013-01-01

To determine the prevalence of asthenopia and identify any associated risk factors in the college students in Xi'an, China. From April to September 2012, 1 500 students from five universities in Xi'an were selected according to a multi-stage stratified cluster sampling method. Data on demographic features, lifestyle or dietary habits, health status, living environment conditions, sleep and mental status, and asthenopia symptoms were collected through a self-administered validated questionnaire. Univariate logistic regression and multivariate logistic regression analysis modified by the factor analysis were performed to evaluate risk factors for asthenopia. Fifty-seven percent of the college students complained of asthenopia. Statistically significant risk factors for asthenopia in the univariate analysis included 13 variables. Multivariate analysis revealed a significant relationship between the use of computer and asthenopia (OR 1.21, 95%CI: 1.09 to 1.35). Good sleep and mental status (OR 0.86, 95%CI: 0.76 to 0.97), good living environment conditions (OR 0.67, 95%CI: 0.60 to 0.76), and high intake of green leafy vegetables (OR 0.89, 95%CI: 0.80 to 0.98) were found to be strong predictors of decreasing the occurrence of asthenopia complaints. Asthenopia symptom appears to be common among college students; and it is strongly associated with computer use, psychosocial state, environment conditions and dietary habits, suggesting that additional studies are warranted to verify these risk factors and establish prevention guidelines, especially for college students.

Genetics of Cd36 and the clustering of multiple cardiovascular risk factors in spontaneous hypertension

Czech Academy of Sciences Publication Activity Database

Pravenec, Michal; Zídek, Václav; Šimáková, Miroslava; Křen, Vladimír; Křenová, D.; Horký, K.; Jáchymová, M.; Míková, B.; Kazdová, L.; Aitman, T. J.; Churchill, P. C.; Webb, R. C.; Hingarh, N. H.; Yang, Y.; Wang, J. M.; St.Lezin, E. M.; Kurtz, W. T.

1999-01-01

Roč. 103, č. 12 (1999), s. 1651-1657 ISSN 0021-9738 R&D Projects: GA ČR GA306/97/0521; GA ČR GV204/98/K015 Grant - others:NIH(US) ROI HL-56028; NIH(US) PO1 HL-35018; NIH(US) HL-18575 Institutional research plan: CEZ:AV0Z5011922 Keywords : Cd36 * cardiovascular risk factors * spontaneous hypertension Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 10.921, year: 1999

Prevalence and risk factors of physical or sexual intimate violence perpetration amongst men in four districts in the central region of Ghana: Baseline findings from a cluster randomised controlled trial.

Science.gov (United States)

Chirwa, Esnat D; Sikweyiya, Yandisa; Addo-Lartey, Adolphina Addoley; Ogum Alangea, Deda; Coker-Appiah, Dorcas; Adanu, Richard M K; Jewkes, Rachel

2018-01-01

Evidence-based interventions are essential in the prevention of violence against women (VAW). An understanding of risk factors for male perpetration of VAW using population-based research is crucial for developing such interventions. This study is a baseline assessment of a two-arm unmatched cluster randomised controlled trial (C-RCT), set up to assess the impact of a Rural Response System (RRS) intervention for preventing violence against women and girls in Ghana. This study aims at assessing past year prevalence and risk factors for sexual or physical intimate partner violence (IPV) perpetration among men. The population-based survey involved 2126 men aged 18 and above living in selected communities in 4 districts in the central region of Ghana. Logistic regression techniques were used to determine risk factors for sexual or physical IPV perpetration. All models adjusted for age of respondent and took into account the study design. Half of the men had perpetrated at least one form of violence against their intimate partners in their lifetime while 41% had perpetrated sexual or physical IPV. Majority (93%) of the men had been in relationships in the 12 months preceding the survey, and of these, 23% had perpetrated sexual or physical IPV. Childhood factors associated with sexual or physical IPV included witnessing abuse of mother (aOR:1.40(1.06-1.86)), and neglect (aOR:1.81(1.30-2.50)). Other major risk factors for IPV perpetration were: having multiple partners (aOR:1.76(1.36-2.26)), (involvement in transactional sex (aOR:1.76(1.36-2.26)), substance use (aOR:1.74(1.25-2.43)) and gender inequitable attitudes (aOR:0.94(0.91-0.97)). Childhood violence experience and witnessing, risky behaviour (multiple partners, transactional sex, substance use) and gender inequitable attitudes are major risk factors for sexual or physical IPV perpetration. Perpetration of sexual or physical IPV tend to co-occur with non-partner violence and emotional IPV perpetration. Interventions

Communication: A Jastrow factor coupled cluster theory for weak and strong electron correlation

International Nuclear Information System (INIS)

Neuscamman, Eric

2013-01-01

We present a Jastrow-factor-inspired variant of coupled cluster theory that accurately describes both weak and strong electron correlation. Compatibility with quantum Monte Carlo allows for variational energy evaluations and an antisymmetric geminal power reference, two features not present in traditional coupled cluster that facilitate a nearly exact description of the strong electron correlations in minimal-basis N 2 bond breaking. In double-ζ treatments of the HF and H 2 O bond dissociations, where both weak and strong correlations are important, this polynomial cost method proves more accurate than either traditional coupled cluster or complete active space perturbation theory. These preliminary successes suggest a deep connection between the ways in which cluster operators and Jastrow factors encode correlation

Spatial modelling of malaria risk factors in Ruhuha sector in the east ...

African Journals Online (AJOL)

Spatial clusters of malaria occurrence were subsequently determined using Getis and Ord spatial statistics. This cluster analysis showed that malaria distribution is characterized by zones with high malaria risk, so called hot spots, zones with moderate malaria risk known as not significant spots and zones of low malaria risk ...

Identification of novel risk factors for community-acquired Clostridium difficile infection using spatial statistics and geographic information system analyses.

Directory of Open Access Journals (Sweden)

Deverick J Anderson

Full Text Available The rate of community-acquired Clostridium difficile infection (CA-CDI is increasing. While receipt of antibiotics remains an important risk factor for CDI, studies related to acquisition of C. difficile outside of hospitals are lacking. As a result, risk factors for exposure to C. difficile in community settings have been inadequately studied.To identify novel environmental risk factors for CA-CDI.We performed a population-based retrospective cohort study of patients with CA-CDI from 1/1/2007 through 12/31/2014 in a 10-county area in central North Carolina. 360 Census Tracts in these 10 counties were used as the demographic Geographic Information System (GIS base-map. Longitude and latitude (X, Y coordinates were generated from patient home addresses and overlaid to Census Tracts polygons using ArcGIS; ArcView was used to assess "hot-spots" or clusters of CA-CDI. We then constructed a mixed hierarchical model to identify environmental variables independently associated with increased rates of CA-CDI.A total of 1,895 unique patients met our criteria for CA-CDI. The mean patient age was 54.5 years; 62% were female and 70% were Caucasian. 402 (21% patient addresses were located in "hot spots" or clusters of CA-CDI (p<0.001. "Hot spot" census tracts were scattered throughout the 10 counties. After adjusting for clustering and population density, age ≥ 60 years (p = 0.03, race (<0.001, proximity to a livestock farm (0.01, proximity to farming raw materials services (0.02, and proximity to a nursing home (0.04 were independently associated with increased rates of CA-CDI.Our study is the first to use spatial statistics and mixed models to identify important environmental risk factors for acquisition of C. difficile and adds to the growing evidence that farm practices may put patients at risk for important drug-resistant infections.

[Prevalence survey of cardiovascular risk factors in the general population in St. Louis (Senegal)].

Science.gov (United States)

Pessinaba, S; Mbaye, A; Yabéta, G A D; Harouna, H; Sib, A E; Kane, A D; Bodian, M; Ndiaye, M B; Mbaye-Ndour, M; Niang, K; Diagne-Sow, D; Diack, B; Kane, M; Diao, M; Mathieu, J-B S; Kane, A

2013-08-01

Cardiovascular diseases are becoming with their risk factors a real health problem in Africa. The objectives of this study were to assess the prevalence of risk factors for cardiovascular diseases in the general population in Saint-Louis, Senegal. This is a cross-sectional, descriptive and analytical made in May 2010, in the Senegalese aged 15, residing in the city of Saint-Louis, Senegal. A systematic random sampling and stratified cluster has been achieved. Cardiovascular risk factors for research were: hypertension, diabetes, dyslipidemia, smoking, obesity, physical inactivity and metabolic syndrome. The survey involved 1424 individuals with 983 women (69%). The average age was 43.4±17.8years. The prevalence of risk factors was: hypertension (46%), diabetes (10.4%), total cholesterol (36.3%), hyperLDLcholesterol (20.6%), obesity (body mass index≥30kg/m(2)) (23%), abdominal obesity (48.7% according to International Diabetes Federation and 33.2% according to National Cholesterol Education Program) physical inactivity (64.7%), smoking (5.8%) and metabolic syndrome (15.7%). There was predominance in women of risk factors except for smoking and diabetes. The overall cardiovascular risk was high in 24.9% according to the Framingham model, 28.8% (European Society of Hypertension) and 6.1% (SCORE). This survey found a high prevalence of cardiovascular risk factors in a general population in Senegal, predominant in women. This should lead to better develop a strategy to prevent cardiovascular diseases. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Cluster models, factors and characteristics for the competitive advantage of Lithuanian Maritime sector

OpenAIRE

Viederytė, Rasa; Didžiokas, Rimantas

2014-01-01

Paper analyses several cluster models on the basis of competitiveness: Nine-factor model, Double diamond model, Funnel model of cluster determinants, Destination Competitiveness and sustainability models, which are related to Porter’s Diamond model and concentrate to the classical one - adopt M. Porter’s Diamond model methodology to the evaluation of Lithuanian Maritime sector’s clustering on the basis of competitiveness. Despite the advances in cluster research, this model remains a complex ...

Criteria of waist circumference according to computed tomography-measured visceral fat area and the clustering of cardiovascular risk factors

International Nuclear Information System (INIS)

Kashihara, Hidetoshi; Tamura, Masaki; Lee, J.S.; Akabayashi, Akira; Kawakubo, Kiyoshi

2009-01-01

The purpose of this study was to determine the discriminate gender-specific cutoff values of waist circumference (WC) for detecting the clustering of cardiovascular risk factors (CCRF), which reflects the intra-abdominal visceral fat area (VFA) using a large Japanese population. The study population consisted of 6,736 men and women who underwent a periodic health check-up and had a computed tomography scan for VFA measurement at the PL Tokyo Health Care Center in Tokyo, Japan. The CCRF was defined according to the Japanese Committee of the Criteria for Metabolic Syndrome. The discriminate values for detecting the CCRF were tested using receiver operating characteristics analysis. The discriminate values of VFA were 103.0 cm 2 with 68.7% sensitivity and 61.8% specificity for men and 69.0 cm 2 with 80.8% sensitivity and 70.0% specificity for women. The WC values corresponding to the VFA were 89.1 cm for men and 86.3 cm for women. The discriminate values of VFA and WC were not substantially different between people with or without raised blood pressure. For the early detection and management of the CCRF and VFA in the primary screening setting, the discriminate and convenient gender-specific WC criteria would be 90 cm for men and 85 cm for women. (author)

Gender differences in metabolic risk factor prevalence in a South African student population.

Science.gov (United States)

Smith, Carine; Essop, M Faadiel

2009-01-01

We determined selected risk factors for the metabolic syndrome and assessed the metabolic risk status (using IDF criteria) of third-year physiology students at Stellenbosch University (88 males and 178 females). Outcome measures included anthropometry [body mass index (BMI), waist circumference, waist-to-hip ratio], blood pressure (BP), resting pulse rate, and fasting blood glucose, total cholesterol and triglyceride levels. In addition, students completed a lifestyle questionnaire. A number of gender-based differences were found, with male students displaying a greater incidence of risk factors for the metabolic syndrome: 6% of males versus 3% of females displayed a cluster of three risk factors. Twenty-five per cent of female students (but only 14% of males) exhibited waist circumferences above the accepted range, which was positively correlated, for males and females, with both systolic and diastolic BP, and in females only, also with total cholesterol levels. Male students on average exercised more than their female counterparts, but also exhibited poorer eating habits. Average blood triglyceride levels for both male and female students exceeded the accepted threshold (1.85 +/- 1.62 mmol/l and 2.15 +/- 1.79 mmol/l, respectively). We concluded that metabolic risk factors were evident in a much younger population than commonly expected. Moreover, the gender-specific differences observed may impact on future risk assessment and preventative measures adopted.

[Risk factors of schizophrenia].

Science.gov (United States)

Suvisaari, Jaana

2010-01-01

Schizophrenia is a multifactorial, neurodevelopmental disorder caused by a combination of genetic and environmental risk factors. Disturbances of brain development begin prenatally, while different environmental insults further affect postnatal brain maturation during childhood and adolescence. Genome-wide association studies (GWAS) have succeeded in identifying hundreds of new risk variants for common, multifactorial diseases. In schizophrenia research, GWAS have found several rare copy number variants that considerably increase the risk of schizophrenia, and have shown an association between schizophrenia and the major histocompatibility complex. Research on environmental risk factors in recent years has provided new information particularly on risk factors related to pregnancy and childhood rearing environment. Gene-environment interactions have become a central research topic. There is evidence that genetically susceptible children are more vulnerable to the effects of unstable childhood rearing environment and other environmental risk factors.

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

NARCIS (Netherlands)

Lim, S.S.; Vos, T.; Flaxman, A.D.; Danaei, G.; Shibuya, K.; Adair-Rohani, H.; Amann, M.; Anderson, H.R.; Andrews, K.G.; Aryee, M.; Atkinson, C.; Bacchus, L.J.; Bahalim, A.N.; Balakrishnan, K.; Balmes, J.; Barker-Collo, S.; Baxter, A.; Bell, M.L.; Blore, J.D.; Blyth, F.; Bonner, C.; Borges, G.; Bourne, R.; Boussinesq, M.; Brauer, M.|info:eu-repo/dai/nl/31149157X; Brooks, P.; Bruce, N.G.; Brunekreef, B.|info:eu-repo/dai/nl/067548180; Bryan-Hancock, C.; Bucello, C.; Buchbinder, R.; Bull, F.; Burnett, R.T.; Byers, T.E.; Calabria, B.; Carapetis, J.; Carnahan, E.; Chafe, Z.; Charlson, F.; Chen, H.; Chen, J.S.; Cheng, A.T.; Child, J.C.; Cohen, A.; Colson, K.E.; Cowie, B.C.; Darby, S.; Darling, S.; Davis, A.; Degenhardt, L.; Dentener, F.; Des Jarlais, D.C.; Devries, K.; Dherani, M.; Ding, E.L.; Dorsey, E.R.; Driscoll, T.; Edmond, K.; Ali, S.E.; Engell, R.E.; Erwin, P.J.; Fahimi, S.; Falder, G.; Farzadfar, F.; Ferrari, A.; Finucane, M.M.; Flaxman, S.; Fowkes, F.G.R.; Freedman, G.; Freeman, M.K.; Gakidou, E.; Ghosh, S.; Giovannucci, E.; Gmel, G.; Graham, K.; Grainger, R.; Grant, B.; Gunnell, D.; Gutierrez, H.R.; Hall, W.; Hoek, H.W.; Hogan, A.; Hosgood, H.D.; Hoy, D.; Hu, H.; Hubbell, B.J.; Hutchings, S.J.; Ibeanusi, S.E.; Jacklyn, G.L.; Jasrasaria, R.; Jonas, J.B.; Kan, H.; Kanis, J.A.; Kassebaum, N.; Kawakami, N.; Khang, Y-H.; Khatibzadeh, S.; Khoo, J-P.; de Kok, C.; Laden, F.; Lalloo, R.; Lan, Q.; Lathlean, T.; Leasher, J.L.; Leigh, J.; Li, Y.; Lin, J.K.; Lipshultz, S.E.; London, S.; Lozano, R.; Lu, Y.; Mak, J.; Malekzadeh, R.; Mallinger, L.; Marcenes, W.; March, L.; Marks, R.; Martin, R.; McGale, P.; McGrath, J.; Mehta, S.; Mensah, G.A.; Merriman, T.R.; Micha, R.; Michaud, C.; Mishra, V.; Hanafiah, K.M.; Mokdad, A.A.; Morawska, L.; Mozaffarian, D.; Murphy, T.; Naghavi, M.; Neal, B.; Nelson, P.K.; Nolla, J.M.; Norman, R.; Olives, C.; Omer, S. B; Orchard, J.; Osborne, R.; Ostro, B.; Page, A.; Pandey, K.D.; Parry, C.D.H.; Passmore, E.; Patra, J.; Pearce, N.; Pelizzari, P.M.; Petzold, M.; Phillips, M.R.; Pope, D.; Pope, C.A.; Powles, J.; Rao, M.; Razavi, H.; Rehfuess, E.A.; Rehm, J.T.; Ritz, B.; Rivara, F.P.; Roberts, T.; Robinson, C.; Rodriguez-Portales, J.A.; Romieu, I.; Room, R.; Rosenfeld, L.C.; Roy, A.; Rushton, L.; Salomon, J.A.; Sampson, U.; Sanchez-Riera, L.; Sanman, E.; Sapkota, A.; Seedat, S.; Shi, P.; Shield, K.; Shivakoti, R.; Singh, G.M.; Sleet, D.A.; Smith, E.; Smith, K.R.; Stapelberg, N.J.C.; Steenland, K.; Stöckl, H.; Stovner, L.J.; Straif, K.; Straney, L.; Thurston, G.D.; Tran, J.H.; van Dingenen, R.; van Donkelaar, A.; Veerman, J.L.; Vijayakumar, L.; Weintraub, R.; Weissman, M.M.; White, R.A.; Whiteford, H.; Wiersma, S.T.; Wilkinson, J.D.; Williams, H.C.; Williams, W.; Wilson, N.; Woolf, A.D.; Yip, P.; Zielinski, J.M.; Lopez, A.D.; Murray, C.J.L.; Ezzati, M.

2012-01-01

BACKGROUND Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk

Risk factors for stress fractures.

Science.gov (United States)

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

1999-08-01

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

Generalised linear mixed models analysis of risk factors for contamination of Danish broiler flocks with Salmonella typhimurium

DEFF Research Database (Denmark)

Chriél, Mariann; Stryhn, H.; Dauphin, G.

1999-01-01

are the broiler flocks (about 4000 flocks) which are clustered within producers. Broiler flocks with ST-infected parent stocks show increased risk of salmonella infection, and also the hatchery affects the salmonella status significantly. Among the rearing factors, only the use of medicine as well as the time......We present a retrospective observational study of risk factors associated with the occurrence of Salmonella typhimurium (ST) in Danish broiler flocks. The study is based on recordings from 1994 in the ante-mortem database maintained by the Danish Poultry Council. The epidemiological units...

Spatial analysis of under-5 mortality and potential risk factors in the Basse Health and Demographic Surveillance System, the Gambia.

Science.gov (United States)

Quattrochi, John; Jasseh, Momodou; Mackenzie, Grant; Castro, Marcia C

2015-07-01

To describe the spatial pattern in under-5 mortality rates in the Basse Health and Demographic Surveillance System (BHDSS) and to test for associations between under-5 deaths and biodemographic and socio-economic risk factors. Using data on child survival from 2007 to 2011 in the BHDSS, we mapped under-5 mortality by km(2) . We tested for spatial clustering of high or low death rates using Kulldorff's spatial scan statistic. Associations between child death and a variety of biodemographic and socio-economic factors were assessed with Cox proportional hazards models, and deviance residuals from the best-fitting model were tested for spatial clustering. The overall death rate among children under 5 was 0.0195 deaths per child-year. We found two spatial clusters of high death rates and one spatial cluster of low death rates; children in the two high clusters died at a rate of 0.0264 and 0.0292 deaths per child-year, while in the low cluster, the rate was 0.0144 deaths per child-year. We also found that children born to Fula mothers experienced, on average, a higher hazard of death, whereas children born in the households in the upper two quintiles of asset ownership experienced, on average, a lower hazard of death. After accounting for the spatial distribution of biodemographic and socio-economic characteristics, we found no residual spatial pattern in child mortality risk. This study demonstrates that significant inequality in under-5 death rates can occur within a relatively small area (1100 km(2) ). Risks of under-5 mortality were associated with mother's ethnicity and household wealth. If high mortality clusters persist, then equity concerns may require additional public health efforts in those areas. © 2015 John Wiley & Sons Ltd.

Prevalence of asthenopia and its risk factors in Chinese college students

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Cheng-Cheng Han

2013-10-01

Full Text Available AIM:To determine the prevalence of asthenopia and identify any associated risk factors in the college students in Xi’an, China.METHODS:From April to September 2012, 1 500 students from five universities in Xi’an were selected according to a multi-stage stratified cluster sampling method. Data on demographic features, lifestyle or dietary habits, health status, living environment conditions, sleep and mental status, and asthenopia symptoms were collected through a self-administered validated questionnaire. Univariate logistic regression and multivariate logistic regression analysis modified by the factor analysis were performed to evaluate risk factors for asthenopia.RESULTS:Fifty-seven percent of the college students complained of asthenopia. Statistically significant risk factors for asthenopia in the univariate analysis included 13 variables. Multivariate analysis revealed a significant relationship between the use of computer and asthenopia (OR 1.21, 95%CI:1.09 to 1.35. Good sleep and mental status (OR 0.86, 95%CI:0.76 to 0.97, good living environment conditions (OR 0.67, 95%CI:0.60 to 0.76, and high intake of green leafy vegetables (OR 0.89, 95%CI:0.80 to 0.98 were found to be strong predictors of decreasing the occurrence of asthenopia complaints.CONCLUSION:Asthenopia symptom appears to be common among college students; and it is strongly associated with computer use, psychosocial state, environment conditions and dietary habits, suggesting that additional studies are warranted to verify these risk factors and establish prevention guidelines, especially for college students.

Risk factors for trachoma in Mali.

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Schémann, J-F; Sacko, D; Malvy, D; Momo, G; Traore, L; Bore, O; Coulibaly, S; Banou, A

2002-02-01

Prior to commencing a campaign to eliminate blinding trachoma in Mali, a national disease prevalence survey was conducted from March 1996 to June 1997. The prevalence of trachoma was estimated and potential risk factors were studied. In each of Mali's seven regions (excluding the capital Bamako), a sample of 30 clusters was taken from the general population, in accordance with the principle of probability proportional to the size of the community. All children under 10 years of age were examined. The simplified clinical coding system proposed by the World Health Organization was used. The position of each village was established and subsequently related to the nearest meteorological station. Socioeconomic and environmental information was collected at both village and household level. The mother or caretaker of each child was questioned about availability and use of water for washing the child. At the time of examination, facial cleanliness and the presence of flies on the face were noted. A total of 15,187 children under 10 years of age were examined. The prevalence of active trachoma (follicular [TF] or intense trachoma [TI]) was 34.9% (95% CI : 32.3-37.6) and the prevalence of TI was 4.2% (95% CI : 3.5-5.0). Aridity/environmental dryness appears to be a risk factor influencing the current geographical distribution of trachoma. Small villages had considerably higher trachoma prevalence than their larger neighbours. The proximity of a medical centre and the existence of social organizations such as a women's association were associated with lower levels of trachoma. Crowded living conditions increased the risk. Using a monetary marker of wealth, we observed a linear inverse relation between wealth and trachoma prevalence. The presence of a dirty face was strongly associated with trachoma (odds ratio [OR] = 3.67) as was the presence of flies on the child's face (OR = 3.62). Trachoma prevalence increased with distance to a water source. Disease prevalence decreased

Cluster form factor calculation in the ab initio no-core shell model

International Nuclear Information System (INIS)

Navratil, Petr

2004-01-01

We derive expressions for cluster overlap integrals or channel cluster form factors for ab initio no-core shell model (NCSM) wave functions. These are used to obtain the spectroscopic factors and can serve as a starting point for the description of low-energy nuclear reactions. We consider the composite system and the target nucleus to be described in the Slater determinant (SD) harmonic oscillator (HO) basis while the projectile eigenstate to be expanded in the Jacobi coordinate HO basis. This is the most practical case. The spurious center of mass components present in the SD bases are removed exactly. The calculated cluster overlap integrals are translationally invariant. As an illustration, we present results of cluster form factor calculations for 5 He vertical bar 4 He+n>, 5 He vertical bar 3 H+d>, 6 Li vertical bar 4 He+d>, 6 Be vertical bar 3 He+ 3 He>, 7 Li vertical bar 4 He+ 3 H>, 7 Li vertical bar 6 Li+n>, 8 Be vertical bar 6 Li+d>, 8 Be vertical bar 7 Li+p>, 9 Li vertical bar 8 Li+n>, and 13 C vertical bar 12 C+n>, with all the nuclei described by multi-(ℎ/2π)Ω NCSM wave functions

Elucidating the underlying causes of oral cancer through spatial clustering in high-risk areas of Taiwan with a distinct gender ratio of incidence

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Chi-Ting Chiang

2010-05-01

Full Text Available This study aimed to elucidate whether or not high-risk clusters of oral cancer (OC incidence spatially correlate with the prevalence rates of betel quid chewing (BQC and cigarette smoking (CS in Taiwan. The spatial autocorrelation and potential clusters of OC incidence among the 307 townships and heavy metal content of soil throughout Taiwan were identified using the Anselin’s local Moran test. Additionally, the spatial correlations among the incidence of OC, the prevalence of BQC and CS and heavy metal content of soil were determined based on a comparison of spatial clusters. High-risk OC (Moran’s I = 0.638, P <0.001 clusters were located in central and eastern Taiwan, while “hot spots” of BQC and CS prevalence were located mainly in eastern Taiwan. The distributions of BQC and CS lifestyle factors (P <0.001 were spatially autocorrelated. The “hot spots” of OC largely coincided with the “hot spots” of BQC, except for the Changhua and Yunlin counties, which are located in central Taiwan. However, high soil contents of nickel and chromium (P <0.001 in central Taiwan also coincided with the high-risk areas of OC incidence. In particular, Changhua county has incurred several decades of serious heavy-metal pollution, with inhabitants living in polluted areas having high-risk exposure to these metals. Results of this study suggest that, in addition to BQC and CS, anthropogenic pollution may profoundly impact the complexity of OC aetiology in central Taiwan.

Symmetric nonnegative matrix factorization: algorithms and applications to probabilistic clustering.

Science.gov (United States)

He, Zhaoshui; Xie, Shengli; Zdunek, Rafal; Zhou, Guoxu; Cichocki, Andrzej

2011-12-01

Nonnegative matrix factorization (NMF) is an unsupervised learning method useful in various applications including image processing and semantic analysis of documents. This paper focuses on symmetric NMF (SNMF), which is a special case of NMF decomposition. Three parallel multiplicative update algorithms using level 3 basic linear algebra subprograms directly are developed for this problem. First, by minimizing the Euclidean distance, a multiplicative update algorithm is proposed, and its convergence under mild conditions is proved. Based on it, we further propose another two fast parallel methods: α-SNMF and β -SNMF algorithms. All of them are easy to implement. These algorithms are applied to probabilistic clustering. We demonstrate their effectiveness for facial image clustering, document categorization, and pattern clustering in gene expression.

Performance of the modified Poisson regression approach for estimating relative risks from clustered prospective data.

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Yelland, Lisa N; Salter, Amy B; Ryan, Philip

2011-10-15

Modified Poisson regression, which combines a log Poisson regression model with robust variance estimation, is a useful alternative to log binomial regression for estimating relative risks. Previous studies have shown both analytically and by simulation that modified Poisson regression is appropriate for independent prospective data. This method is often applied to clustered prospective data, despite a lack of evidence to support its use in this setting. The purpose of this article is to evaluate the performance of the modified Poisson regression approach for estimating relative risks from clustered prospective data, by using generalized estimating equations to account for clustering. A simulation study is conducted to compare log binomial regression and modified Poisson regression for analyzing clustered data from intervention and observational studies. Both methods generally perform well in terms of bias, type I error, and coverage. Unlike log binomial regression, modified Poisson regression is not prone to convergence problems. The methods are contrasted by using example data sets from 2 large studies. The results presented in this article support the use of modified Poisson regression as an alternative to log binomial regression for analyzing clustered prospective data when clustering is taken into account by using generalized estimating equations.

Prevalence, risk factors and spatial analysis of liver fluke infections in Danish cattle herds

DEFF Research Database (Denmark)

Olsen, Abbey; Frankena, Klaas; Bødker, Rene

2015-01-01

fitted the observed spatial pattern. Results: During the investigated period (2011-2013), an increase in annual herd prevalence was noted (2011-25.6%; 2012-28.4%; 2013-29.3%). The spatial analysis suggested significant clustering of positive and negative herds. Presence of streams, wetlands and pastures...... on farms showed a significant association with the presence of infection in cattle herds. Buying animals from positive herds was a risk factor on conventional farms. Additionally, risk of being infected with Fasciola hepatica was higher in non-dairy herds of medium size (>= 30 and ... to dairy and large (>= 100) cattle herds. The observed spatial pattern could be reproduced by predictions of the risk factor model. Conclusions: This study showed an increase in annual herd level prevalence (2011 to 2013) indicating that an increasing proportion of herds are infected with Fasciola hepatica...

Is the cluster risk model of parental adversities better than the cumulative risk model as an indicator of childhood physical abuse?: findings from two representative community surveys.

Science.gov (United States)

Fuller-Thomson, E; Sawyer, J-L

2014-01-01

Screening strategies for childhood physical abuse (CPA) need to be improved in order to identify those most at risk. This study uses two regionally representative community samples to examine whether a cluster or cumulative model of risk indicators (i.e. parental divorce, parental unemployment, and parental addictions) explains a larger proportion of the variation in CPA. Data were drawn from Statistics Canada's National Population Health Survey (1994-1995) and Canadian Community Health Survey 3.1 (2005). Response rates were greater than 80% in both samples. Each survey had approximately 13,000 respondents aged 18 and over who answered questions about the above adverse childhood experiences. A gradient was shown with similar outcomes in each data set. Only 3.4% of adults who experienced none of the three risk indicators reported they had been physically abused during childhood or adolescence. The prevalence of CPA was greater among those who experienced parental divorce alone (8.3%-10.7%), parental unemployment alone (8.9%-9.7%) or parental addictions alone (18.0%-19.5%). When all three risk indicators were present, the prevalence of CPA ranged from 36.0%-41.0% and the age-sex-race adjusted odds were greater than 15 times that of individuals with none of the three risk indicators. The cluster model explained a statistically significantly larger proportion of the variation than the cumulative model although the difference between the two models was modest. For the purposes of parsimony, the cumulative model may be the better alternative. Adults who were exposed to two or more childhood risk indicators were much more likely to report that they were physically abused during their childhood than those with only one or no risk factors. Medical professionals may use this information on cumulative risk factors to more effectively target screening for potential CPA. Future research should include prospective studies. © 2012 John Wiley & Sons Ltd.

Community-based stillbirth rates and risk factors in rural Sarlahi, Nepal.

Science.gov (United States)

Lee, Anne C; Mullany, Luke C; Tielsch, James M; Katz, Joanne; Khatry, Subarna K; Leclerq, Steven C; Adhikari, Ramesh K; Darmstadt, Gary L

2011-06-01

To assess stillbirth rates and antepartum risk factors in rural Nepal. Data were collected prospectively during a cluster-randomized, community-based trial in Sarlahi, Nepal, from 2002 to 2006. Multivariate regression modeling was performed to calculate adjusted relative risk estimates. Among 24531 births, the stillbirth rate was 35.4 per 1000 births (term stillbirth rate 21.2 per 1000 births). Most births occurred at home without a skilled birth attendant. The majority (69%) of intrapartum maternal deaths resulted in stillbirth. The adjusted RR (aRR) of stillbirth was 2.74 among nulliparas and 1.47 among mothers with history of a child death. Mothers above the age of 30 years carried a 1.59-fold higher risk for stillbirth than mothers who were 20-24 years old. The stillbirth risk was lower among households where the father had any formal education (aRR 0.70). Land ownership (aRR 0.85) and Pahadi ethnicity (aRR 0.67; reference: Madhesi ethnicity) were associated with significantly lower risks of stillbirth. Stillbirth rates were high in rural Nepal, with the majority of stillbirths occurring at full-term gestation. Nulliparity, history of prior child loss, maternal age above 30 years, Madhesi ethnicity, and socioeconomic disadvantage were significant risk factors for stillbirth. Clinicaltrials.govNCT00 109616. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Risk factors for suicide completion in major depression: a case-control study of impulsive and aggressive behaviors in men.

Science.gov (United States)

Dumais, A; Lesage, A D; Alda, M; Rouleau, G; Dumont, M; Chawky, N; Roy, M; Mann, J J; Benkelfat, C; Turecki, Gustavo

2005-11-01

Major depression is a major risk factor for suicide. However, not all individuals with major depression commit suicide. Impulsive and aggressive behaviors have been proposed as risk factors for suicide, but it remains unclear whether their effect on the risk of suicide is at least partly explained by axis I disorders commonly associated with suicide, such as major depression. With a case-control design, a comparison of the level of impulsive and aggressive behaviors and the prevalence of associated psychopathology was carried out with control for the presence of primary psychopathology. One hundred and four male suicide completers who died during an episode of major depression and 74 living depressed male comparison subjects were investigated with proxy-based interviews by using structured diagnostic instruments and personality trait assessments. The authors found that current (6-month prevalence) alcohol abuse/dependence, current drug abuse/dependence, and cluster B personality disorders increased the risk of suicide in individuals with major depression. Also, higher levels of impulsivity and aggression were associated with suicide. An analysis by age showed that these risk factors were more specific to younger suicide victims (ages 18-40). A multivariate analysis indicated that current alcohol abuse/dependence and cluster B personality disorder were two independent predictors of suicide. Impulsive-aggressive personality disorders and alcohol abuse/dependence were two independent predictors of suicide in major depression, and impulsive and aggressive behaviors seem to underlie these risk factors. A developmental hypothesis of suicidal behavior, with impulsive and aggressive behaviors as the starting point, is discussed.

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.

Cardiovascular risk factors and dementia.

Science.gov (United States)

Fillit, Howard; Nash, David T; Rundek, Tatjana; Zuckerman, Andrea

2008-06-01

Dementias, such as Alzheimer's disease (AD) and vascular dementia, are disorders of aging populations and represent a significant economic burden. Evidence is accumulating to suggest that cardiovascular disease (CVD) risk factors may be instrumental in the development of dementia. The goal of this review was to discuss the relationship between specific CVD risk factors and dementia and how current treatment strategies for dementia should focus on reducing CVD risks. We conducted a review of the literature for the simultaneous presence of 2 major topics, cardiovascular risk factors and dementia (eg, AD). Special emphasis was placed on clinical outcome studies examining the effects of treatments of pharmacologically modifiable CVD risk factors on dementia and cognitive impairment. Lifestyle risk factors for CVD, such as obesity, lack of exercise, smoking, and certain psychosocial factors, have been associated with an increased risk of cognitive decline and dementia. Some evidence suggests that effectively managing these factors may prevent cognitive decline/dementia. Randomized, placebo-controlled trials of antihypertensive medications have found that such therapy may reduce the risk of cognitive decline, and limited data suggest a benefit for patients with AD. Some small open-label and randomized clinical trials of statins have observed positive effects on cognitive function; larger studies of statins in patients with AD are ongoing. Although more research is needed, current evidence indicates an association between CVD risk factors--such as hypertension, dyslipidemia, and diabetes mellitus--and cognitive decline/dementia. From a clinical perspective, these data further support the rationale for physicians to provide effective management of CVD risk factors and for patients to be compliant with such recommendations to possibly prevent cognitive decline/dementia.

AN EMPIRICAL ANALYSIS OF THE INFLUENCE OF RISK FACTORS ON THE FREQUENCY AND IMPACT OF SEVERE EVENTS ON THE SUPPLY CHAIN IN THE CZECH REPUBLIC

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José María Caridad

2014-12-01

Full Text Available Purpose: This paper is focused on an analysis and evaluation of severe events according to their frequency of occurrence and their impact on the company's manufacturing and distribution supply chains performance in the Czech Republic. Risk factors are introduced for critical events.Design/methodology: An identification and classification of severe events are realized on the basis of median mapping and mapping of ordinal variability acquired through the questionnaire survey of 82 companies. Analysis of 46 risk factors was sorted into 5 groups. We used asymmetric Somers's d statistics for testing the dependence of frequency and impact of a severe event on selected risk sources. The hierarchical cluster analysis is performed to identify relatively homogeneous groups of critical severe events according to their dependency on risk factors and its strength.Findings: Results showed that ‘a lack of contracts’ is considered to be the most critical severe event. Groups of demand and supply side and an external risk factor group were identified to be the most significant sources of risk factors. The worst cluster encompasses 11% of examined risk factors which should be prevented. We concluded that organizations need to adopt appropriate precautions and risk management methods in logistics.Originality: In this paper, the methodology for severe events evaluation in supply chain is designed. This methodology involves assessing the critical factors which influence the critical events and which should be prevented.

The association between serum brain-derived neurotrophic factor and a cluster of cardiovascular risk factors in adolescents

DEFF Research Database (Denmark)

Pedersen, Natascha Holbæk; Tarp, Jakob; Andersen, Lars Bo

2017-01-01

.034) and HOMA-IR (Std. β = 0.19, P = 0.004), and negatively associated with CRF (Std. β = -0.15, P = 0.026). In females, BDNF was positively associated with TG (Std. β = 0.14, P = 0.030) and negatively associated with waist circumference (WC) (Std. β = -0.16, P = 0.012). Conclusion: Serum BDNF was positively...... associated with a composite z-score of cardiovascular risk factors. This association seems to be mainly driven by the association between TG, HOMA-IR and serum BDNF, and particularly for males. Further longitudinal research is warranted to determine the temporal relationship between BDNF and cardiovascular...

The Amish furniture cluster in Ohio: competitive factors and wood use estimates

Science.gov (United States)

Matthew Bumgardner; Robert Romig; William Luppold

2008-01-01

This paper is an assessment of wood use by the Amish furniture cluster located in northeastern Ohio. The paper also highlights the competitive and demographic factors that have enabled cluster growth and new business formation in a time of declining market share for the overall U.S. furniture industry. Several secondary information sources and discussions with local...

Risk factors affecting fatal bus accident severity: Their impact on different types of bus drivers.

Science.gov (United States)

Feng, Shumin; Li, Zhenning; Ci, Yusheng; Zhang, Guohui

2016-01-01

While the bus is generally considered to be a relatively safe means of transportation, the property losses and casualties caused by bus accidents, especially fatal ones, are far from negligible. The reasons for a driver to incur fatalities are different in each case, and it is essential to discover the underlying risk factors of bus fatality severity for different types of drivers in order to improve bus safety. The current study investigates the underlying risk factors of fatal bus accident severity to different types of drivers in the U.S. by estimating an ordered logistic model. Data for the analysis are retrieved from the Buses Involved in Fatal Accidents (BIFA) database from the USA for the years 2006-2010. Accidents are divided into three levels by counting their equivalent fatalities, and the drivers are classified into three clusters by the K-means cluster analysis. The analysis shows that some risk factors have the same impact on different types of drivers, they are: (a) season; (b) day of week; (c) time period; (d) number of vehicles involved; (e) land use; (f) manner of collision; (g) speed limit; (h) snow or ice surface condition; (i) school bus; (j) bus type and seating capacity; (k) driver's age; (l) driver's gender; (m) risky behaviors; and (n) restraint system. Results also show that some risk factors only have impact on the "young and elder drivers with history of traffic violations", they are: (a) section type; (b) number of lanes per direction; (c) roadway profile; (d) wet road surface; and (e) cyclist-bus accident. Notably, history of traffic violations has different impact on different types of bus drivers. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cluster-cluster clustering

International Nuclear Information System (INIS)

Barnes, J.; Dekel, A.; Efstathiou, G.; Frenk, C.S.; Yale Univ., New Haven, CT; California Univ., Santa Barbara; Cambridge Univ., England; Sussex Univ., Brighton, England)

1985-01-01

The cluster correlation function xi sub c(r) is compared with the particle correlation function, xi(r) in cosmological N-body simulations with a wide range of initial conditions. The experiments include scale-free initial conditions, pancake models with a coherence length in the initial density field, and hybrid models. Three N-body techniques and two cluster-finding algorithms are used. In scale-free models with white noise initial conditions, xi sub c and xi are essentially identical. In scale-free models with more power on large scales, it is found that the amplitude of xi sub c increases with cluster richness; in this case the clusters give a biased estimate of the particle correlations. In the pancake and hybrid models (with n = 0 or 1), xi sub c is steeper than xi, but the cluster correlation length exceeds that of the points by less than a factor of 2, independent of cluster richness. Thus the high amplitude of xi sub c found in studies of rich clusters of galaxies is inconsistent with white noise and pancake models and may indicate a primordial fluctuation spectrum with substantial power on large scales. 30 references

Gender differences on effectiveness of a school-based physical activity intervention for reducing cardiometabolic risk: a cluster randomized trial.

Science.gov (United States)

Martínez-Vizcaíno, Vicente; Sánchez-López, Mairena; Notario-Pacheco, Blanca; Salcedo-Aguilar, Fernando; Solera-Martínez, Montserrat; Franquelo-Morales, Pablo; López-Martínez, Sara; García-Prieto, Jorge C; Arias-Palencia, Natalia; Torrijos-Niño, Coral; Mora-Rodríguez, Ricardo; Rodríguez-Artalejo, Fernando

2014-12-10

Studies that have examined the impact of a physical activity intervention on cardiometabolic risk factors have yielded conflicting results. The objective of this study was to assess the impact of a standardized physical activity program on adiposity and cardiometabolic risk factors in schoolchildren. Cluster randomized trial study of 712 schoolchildren, 8-10 years, from 20 public schools in the Province of Cuenca, Spain. The intervention (MOVI-2) consisted of play-based and non-competitive activities. MOVI-2 was conducted during two 90-minute sessions on weekdays and one 150-minute session on Saturday mornings every week between September 2010 and May 2011. We measured changes in adiposity (overweight/obesity prevalence, body mass index [BMI], triceps skinfold thickness [TST], body fat %, fat-free mass, waist circumference) and other cardiometabolic risk factors (LDL-cholesterol, triglycerides/HDL-cholesterol ratio, insulin, C-reactive protein and blood pressure). The analyses used mixed regression models to adjust for baseline covariates under cluster randomization. Among girls, we found a reduction of adiposity in intervention versus control schools, with a decrease in TST (-1.1 mm; 95% confidence interval [CI] -2.3 to -0.7), body fat % (-0.9%; 95% CI -1.3 to -0.4), waist circumference (-2.7 cm; 95% CI -4.5 to -0.9), and an increase in fat-free mass (0.3 kg; 95% CI 0.01 to 0.6). The intervention also led to lower serum LDL-cholesterol and insulin levels. Among boys, a reduction in waist circumference (-1.4 cm; 95% CI -2.6 to -0.1; P = 0.03), and an increase in fat-free mass (0.5 kg; 95% CI 0.2 to 0.9; P = 0.003) was associated with the intervention versus control schools. The prevalence of overweight/obesity or underweight, BMI, and other cardiometabolic risk factors was not modified by the intervention. No important adverse events were registered. An extracurricular intervention of non-competitive physical activity during an academic year, targeting all

Clustering of risk-related modifiable behaviours and their association with overweight and obesity among a large sample of youth in the COMPASS study.

Science.gov (United States)

Laxer, Rachel E; Brownson, Ross C; Dubin, Joel A; Cooke, Martin; Chaurasia, Ashok; Leatherdale, Scott T

2017-01-21

Canadian youth exhibit a number of risky behaviours, some of which are associated with overweight and obesity. The purpose of this study was to examine the prevalence of 15 modifiable risk behaviours in a large sample of Canadian youth, to identify underlying subgroups based on patterns of health behaviours, and to examine the association between identified subgroups and overweight/obesity. Data from 18,587 grades 9-12 students in Year 1 (2012-13) of the COMPASS study and latent class analysis were used to identify patterns and clustering among 15 health behaviours (e.g., physical inactivity, sedentary behaviour, unhealthy eating, substance use). A logistic regression model examined the associations between these clusters and overweight/obesity status. Four distinct classes were identified: traditional school athletes, inactive screenagers, health conscious, and moderately active substance users. Each behavioural cluster demonstrated a distinct pattern of behaviours, some with a greater number of risk factors than others. Traditional school athletes (odds ratio (OR) 1.15, 95% CI 1.03-1.29), inactive screenagers (OR 1.33; 1.19-1.48), and moderately active substance users (OR 1.27; 1.14-1.43) were all significantly more likely to be overweight/obese compared to the health conscious group. Four distinct subpopulations of youth were identified based on their patterns of health and risk behaviours. The three clusters demonstrating poorer health behaviour were all at an increased risk of being overweight/obese compared to their somewhat healthier peers. Obesity-related public health interventions and health promotion efforts might be more effective if consideration is given to population segments with certain behavioural patterns, targeting subgroups at greatest risk of overweight or obesity.

Risk factors for neoplasms

International Nuclear Information System (INIS)

Brachner, A.; Grosche, B.

1991-06-01

A broad survey is given of risk factors for neoplasms. The main carcinogenic substances (including also ionizing radiation and air pollution) are listed, and are correlated with the risk factors for various cancers most frequently explained and discussed in the literature. The study is intended to serve as a basis for a general assessment of the incidence of neoplasms in children, and of cancer mortality in the entire population of Bavaria in the years 1983-1989, or 1979-1988, respectively, with the principal idea of drawing up an environment-related health survey. The study therefore takes into account not only ionizing radiation as a main risk factor, but also other risk factors detectable within the ecologic context, as e.g. industrial installations and their effects, refuse incineration plants or waste dumps, or the social status. (orig./MG) [de

A spatial hazard model for cluster detection on continuous indicators of disease: application to somatic cell score.

Science.gov (United States)

Gay, Emilie; Senoussi, Rachid; Barnouin, Jacques

2007-01-01

Methods for spatial cluster detection dealing with diseases quantified by continuous variables are few, whereas several diseases are better approached by continuous indicators. For example, subclinical mastitis of the dairy cow is evaluated using a continuous marker of udder inflammation, the somatic cell score (SCS). Consequently, this study proposed to analyze spatialized risk and cluster components of herd SCS through a new method based on a spatial hazard model. The dataset included annual SCS for 34 142 French dairy herds for the year 2000, and important SCS risk factors: mean parity, percentage of winter and spring calvings, and herd size. The model allowed the simultaneous estimation of the effects of known risk factors and of potential spatial clusters on SCS, and the mapping of the estimated clusters and their range. Mean parity and winter and spring calvings were significantly associated with subclinical mastitis risk. The model with the presence of 3 clusters was highly significant, and the 3 clusters were attractive, i.e. closeness to cluster center increased the occurrence of high SCS. The three localizations were the following: close to the city of Troyes in the northeast of France; around the city of Limoges in the center-west; and in the southwest close to the city of Tarbes. The semi-parametric method based on spatial hazard modeling applies to continuous variables, and takes account of both risk factors and potential heterogeneity of the background population. This tool allows a quantitative detection but assumes a spatially specified form for clusters.

Familial clustering in burnout: a twin-family study

NARCIS (Netherlands)

Middeldorp, C.M.; Stubbe, J.H.; Cath, D.C.; Boomsma, D.I.

2005-01-01

Background. Research on risk factors for burnout has mainly focused on circumstances at work and on personal characteristics. The aim of this study was to investigate whether burnout clusters within families and, if so, whether this is due to genetic influences or to environmental factors shared by

The effect of milk and milk proteins on risk factors of metabolic syndrome in overweight adolecents

DEFF Research Database (Denmark)

Arnberg, Karina

This PhD is based on data from an intervention study with milk and milk proteins conducted in Danish adolescents with overweight. There is a high prevalence of overweight in Danish adolescents. Metabolic syndrome is a cluster of risk factors related to overweight and believed to increase the risk...... of type-2 diabetes and atherosclerotic cardiovascular diseases. Overweight children have higher concentrations of the metabolic syndrome risk factors than normal weight children and the pathological condition underlying cardiovascular diseases, called atherosclerosis, seems to start in childhood. A well...... skimmed milk, whey, casein or water for three months. The background for the intervention is that milk is an important source of protein in the Western diet and epidemiological studies in children have shown that children drinking low amounts of milk have higher concentrations of the metabolic risk...

Incidence and Risk Factors for Neonatal Jaundice among Newborns in Southern Nepal

Science.gov (United States)

Scrafford, Carolyn G.; Mullany, Luke C.; Katz, Joanne; Khatry, Subarna K.; LeClerq, Steven C.; Darmstadt, Gary L.; Tielsch, James M.

2016-01-01

Objective To quantify the incidence of and risk factors for neonatal jaundice among infants referred for care from a rural, low-resource, population-based cohort in southern Nepal. Methods Study participants were 18,985 newborn infants born in Sarlahi District in Southern Nepal from May 2003 through January 2006 who participated in a cluster-randomized, placebo-controlled, community-based trial to evaluate the effect of newborn chlorhexidine cleansing on neonatal mortality and morbidity. Jaundice was assessed based on visual assessment of the infant by a study worker and referral for care. Adjusted relative risks (RR) were estimated to identify risk factors for referral for neonatal jaundice using Poisson regression. Results The incidence of referral for neonatal jaundice was 29.3 per 1,000 live births (95% Confidence Interval: 26.9, 31.7). Male sex, high birth weight, breastfeeding patterns, warm air temperature, primiparity, skilled birth attendance, place of delivery, prolonged labor, oil massage, paternal education, and ethnicity were significant risk factors (p-valuesjaundice, whereas exclusive breastfeeding was protective among infants with no report of difficulty feeding. Conclusions Several known risk factors for neonatal jaundice in a low-resource setting were confirmed in this study. Unique observed associations of jaundice with ambient air temperature and oil massage may be explained by the opportunity for phototherapy based on the cultural practices of this study population. Future research should investigate the role of an infant’s difficulty in feeding as a potential modifier in the association between exclusive breastfeeding and jaundice. PMID:24112359

Prevalence of Pre-Pregnancy Risk Factors and its Relationship with Preconception Care in Isfahan- Iran

Directory of Open Access Journals (Sweden)

Parisa Shadab

2017-08-01

Full Text Available Background Preconception care means interventions required for maternal and fetal health care and detection of pre-pregnancy risk factors. Some risk factors that have a significant effect on the outcome of pregnancy can be detected and controlled before pregnancy. The present study aimed to determine the prevalence of pre-pregnancy risk factors, and its relationship with preconception care in Isfahan-Iran. Materials and Methods This descriptive study was a cross-sectional research which was conducted with multi-stage sampling (stratified and cluster from April to May 2016 on 702 women giving birth in hospitals in Isfahan (Iran. Data collection tool was a researcher made questionnaire and data were analyzed using SPSS software, descriptive statistics and chi-square test. Results The results showed that, the interval between current pregnancy with a previous pregnancy less than 4 years 22.8%, abnormal weight (13%, sexually transmitted infections (11.3%, thyroid disorders (11 % , and history of hospitalization of infants in the intensive care unit (11.1%, were the highest pre-pregnancy risk factors reported. There was a significant positive correlation between thyroid disorder and polycystic ovary (P

Longitudinal patterns of gambling activities and associated risk factors in college students

NARCIS (Netherlands)

Goudriaan, Anna E.; Slutske, Wendy S.; Krull, Jennifer L.; Sher, Kenneth J.

2009-01-01

To investigate which clusters of gambling activities exist within a longitudinal study of college health, how membership in gambling clusters change over time and whether particular clusters of gambling are associated with unhealthy risk behaviour. Four-year longitudinal study (2002-2006). Large,

Low muscle strength is associated with metabolic risk factors in Colombian children: the ACFIES study.

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Daniel Dylan Cohen

Full Text Available PURPOSE: In youth, poor cardiorespiratory and muscular strength are associated with elevated metabolic risk factors. However, studies examining associations between strength and risk factors have been done exclusively in high income countries, and largely in Caucasian cohorts. The aim of this study was to assess these interactions in schoolchildren in Colombia, a middle income Latin American country. METHODS: We measured body mass index, body composition, handgrip strength (HG, cardiorespiratory fitness (CRF and metabolic risk factors in 669 low-middle socioeconomic status Colombian schoolchildren (mean age 11.52±1.13, 47% female. Associations between HG, CRF and metabolic risk factors were evaluated. RESULTS: HG and CRF were inversely associated with blood pressure, HOMA index and a composite metabolic risk score (p = 0.001, HOMA (β = -0.164; p = 0.005, triglycerides (β = -0.583; p = 0.026 and CRP (β = -0.183; p = 0.037 but not glucose (p = 0.698 or HDL cholesterol (p = 0.132. The odds ratios for having clustered risk in the weakest quartile compared with the strongest quartile were 3.0 (95% confidence interval: 1.81-4.95. CONCLUSIONS: In Colombian schoolchildren both poorer handgrip strength/kg body mass and cardiorespiratory fitness were associated with a worse metabolic risk profile. Associations were stronger and more consistent between handgrip and risk factors than between cardiorespiratory fitness and these risk factors. Our findings indicate the addition of handgrip dynamometry to non-invasive youth health surveillance programs would improve the accuracy of the assessment of cardio-metabolic health.

Pregnancy-related maternal risk factors of attention-deficit hyperactivity disorder: a case-control study.

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Amiri, Shahrokh; Malek, Ayyoub; Sadegfard, Majid; Abdi, Salman

2012-01-01

Background. The etiology of attention-deficit hyperactivity disorder (ADHD) is complex.This study was conducted to evaluate the pregnancy-related maternal risk factors of ADHD. Methods. 164 ADHD children attending to Child and Adolescent Psychiatric Clinics compared with 166 normal children selected in a random-cluster method from primary schools. ADHD rating scale and clinical interview based on Schedule for Affective disorders and Schizophrenia for School-Aged Children (K-SADS) were used to diagnose ADHD cases and to select the control group. Results. The mean maternal age at pregnancy, duration of pregnancy, and the mean paternal age were alike in two groups. The ADHD children's mothers compared with those of control group had higher frequencies of somatic diseases, psychiatric disorders, and alcohol and cigarette exposure during the pregnancies (P birth by cesarean section was more common among mothers of ADHD children (P < 0.001). These factors plus trauma to the abdomen during pregnancy were significantly predictors of ADHD in children. Conclusions. Some pregnancy-related maternal factors may be considered as environmental risk factors for ADHD. Each of these factors considered in our study as a risk factor needs to be tested and confirmed through next methodologically appropriate researches in this field.

Prevalence of coronary artery disease risk factors in Iran: a population based survey

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Gafarzadeh Motlag A

2007-10-01

Full Text Available Abstract Background Coronary artery disease (CAD is a leading cause of mortality, morbidity, and disability with high health care cost in Iran. It accounts for nearly 50 percent of all deaths per year. Yet little is known about CAD and CAD risk factors in the Iranian population. We aimed to assess the prevalence of different CAD risk factors in an Iranian population. Methods A descriptive cross sectional survey was conducted involving 3000 healthy adults at 18 years of age or above who were recruited with cluster random sampling. Demographic data and risk factors were determined by taking history, physical examination and laboratory tests. Results The average age was 36.23 ± 15.26. There was 1381 female (46% and 1619 male (54% out of which 6.3% were diabetic, 21.6% were smoker, and 15% had positive familial heart disease history. 61% had total cholesterol level > 200 mg/dL, 32% triglyceride > 200 mg/dl, 47.5% LDL-c > 130 mg/dl, 5.4% HDL-c 140 mmHg, 9.1% diastolic blood pressure > 90 mmHg and 87% of them were physically inactive. Conclusion Clinical and Para-clinical data indicated that Iranian adult population are of a high level of CAD risk factors, which may require urgent decision making to address national control measures regarding CAD.

[Application of negative binomial regression and modified Poisson regression in the research of risk factors for injury frequency].

Science.gov (United States)

Cao, Qingqing; Wu, Zhenqiang; Sun, Ying; Wang, Tiezhu; Han, Tengwei; Gu, Chaomei; Sun, Yehuan

2011-11-01

To Eexplore the application of negative binomial regression and modified Poisson regression analysis in analyzing the influential factors for injury frequency and the risk factors leading to the increase of injury frequency. 2917 primary and secondary school students were selected from Hefei by cluster random sampling method and surveyed by questionnaire. The data on the count event-based injuries used to fitted modified Poisson regression and negative binomial regression model. The risk factors incurring the increase of unintentional injury frequency for juvenile students was explored, so as to probe the efficiency of these two models in studying the influential factors for injury frequency. The Poisson model existed over-dispersion (P Poisson regression and negative binomial regression model, was fitted better. respectively. Both showed that male gender, younger age, father working outside of the hometown, the level of the guardian being above junior high school and smoking might be the results of higher injury frequencies. On a tendency of clustered frequency data on injury event, both the modified Poisson regression analysis and negative binomial regression analysis can be used. However, based on our data, the modified Poisson regression fitted better and this model could give a more accurate interpretation of relevant factors affecting the frequency of injury.

Risk factors in school shootings.

Science.gov (United States)

Verlinden, S; Hersen, M; Thomas, J

2000-01-01

Nine incidents of multiple-victim homicide in American secondary schools are examined and common risk factors are identified. The literature dealing with individual, family, social, societal, and situational risk factors for youth violence and aggression is reviewed along with existing risk assessment methods. Checklists of risk factors for serious youth violence and school violence are used in reviewing each school shooting case. Commonalties among the cases and implications for psychologists practicing in clinical and school settings are discussed.

Relativistic form factors for clusters with nonrelativistic wave functions

International Nuclear Information System (INIS)

Mitra, A.N.; Kumari, I.

1977-01-01

Using a simple variant of an argument employed by Licht and Pagnamenta (LP) on the effect of Lorentz contraction on the elastic form factors of clusters with nonrelativistic wave functions, it is shown how their result can be generalized to inelastic form factors so as to produce (i) a symmetrical appearance of Lorentz contraction effects in the initial and final states, and (ii) asymptotic behavior in accord with dimensional scaling theories. A comparison of this result with a closely analogous parametric form obtained by Brodsky and Chertok from a propagator chain model leads, with plausible arguments, to the conclusion of an effective mass M for the cluster, with M 2 varying as the number n of the quark constituents, instead of as n 2 . A further generalization of the LP formula is obtained for an arbitrary duality-diagram vertex, again with asymptotic behavior in conformity with dimensional scaling. The practical usefulness of this approach is emphasized as a complementary tool to those of high-energy physics for phenomenological fits to data up to moderate values of q 2

Examining Measures of Weight as Risk Factors for Sport-Related Injury in Adolescents

OpenAIRE

Richmond, Sarah A.; Nettel-Aguirre, Alberto; Doyle-Baker, Patricia K.; Macpherson, Alison; Emery, Carolyn A.

2016-01-01

Objectives. To examine body mass index (BMI) and waist circumference (WC) as risk factors for sport injury in adolescents. Design. A secondary analysis of prospectively collected data from a pilot cluster randomized controlled trial. Methods. Adolescents (n = 1,040) at the ages of 11?15 years from two Calgary junior high schools were included. BMI (kg/m2) and WC (cm) were measured from direct measures at baseline assessment. Categories (overweight/obese) were created using validated internati...

Individual and couple-level risk factors for hepatitis C infection among heterosexual drug users: a multilevel dyadic analysis.

Science.gov (United States)

McMahon, James M; Pouget, Enrique R; Tortu, Stephanie

2007-06-01

Hepatitis C virus (HCV) is the most common bloodborne pathogen in the United States and is a leading cause of liver-related morbidity and mortality. Although it is known that HCV is most commonly transmitted among injection drug users, the role of sexual transmission in the spread of HCV remains controversial because of inconsistent findings across studies involving heterosexual couples. A novel multilevel modeling technique designed to overcome the limitations of previous research was performed to assess multiple risk factors for HCV while partitioning the source of risk at the individual and couple level. The analysis was performed on risk exposure and HCV screening data obtained from 265 drug-using couples in East Harlem, New York City. In multivariable analysis, significant individual risk factors for HCV included a history of injection drug use, tattooing, and older age. At the couple level, HCV infection tended to cluster within couples, and this interdependence was accounted for by couples' drug-injection behavior. Individual and couple-level sexual behavior was not associated with HCV infection. Our results are consistent with prior research indicating that sexual contact plays little role in HCV transmission. Rather, couples' injection behavior appears to account for the clustering of HCV within heterosexual dyads.

Prevalence and Risk Factors of Dengue Infection in Khanh Hoa Province, Viet Nam: A Stratified Cluster Sampling Survey.

Science.gov (United States)

Mai, Vien Quang; Mai, Trịnh Thị Xuan; Tam, Ngo Le Minh; Nghia, Le Trung; Komada, Kenichi; Murakami, Hitoshi

2018-05-19

Dengue is a clinically important arthropod-borne viral disease with increasing global incidence. Here we aimed to estimate the prevalence of dengue infections in Khanh Hoa Province, central Viet Nam, and to identify risk factors for infection. We performed a stratified cluster sampling survey including residents of 3-60 years of age in Nha Trang City, Ninh Hoa District and Dien Khanh District, Khanh Hoa Province, in October 2011. Immunoglobulin G (IgG) and immunoglobulin M (IgM) against dengue were analyzed using a rapid test kit. Participants completed a questionnaire exploring clinical dengue incidence, socio-economic status, and individual behavior. A household checklist was used to examine environment, mosquito larvae presence, and exposure to public health interventions. IgG positivity was 20.5% (urban, 16.3%; rural, 23.0%), IgM positivity was 6.7% (urban, 6.4%; rural, 6.9%), and incidence of clinically compatible dengue during the prior 3 months was 2.8 per 1,000 persons (urban, 1.7; rural, 3.4). For IgG positivity, the adjusted odds ratio (AOR) was 2.68 (95% confidence interval [CI], 1.24-5.81) for mosquito larvae presence in water pooled in old tires and was 3.09 (95% CI, 1.75-5.46) for proximity to a densely inhabited area. For IgM positivity, the AOR was 3.06 (95% CI, 1.50-6.23) for proximity to a densely inhabited area. Our results indicated rural penetration of dengue infections. Control measures should target densely inhabited areas, and may include clean-up of discarded tires and water-collecting waste.

Common Factor Analysis Versus Principal Component Analysis: Choice for Symptom Cluster Research

Directory of Open Access Journals (Sweden)

Hee-Ju Kim, PhD, RN

2008-03-01

Conclusion: If the study purpose is to explain correlations among variables and to examine the structure of the data (this is usual for most cases in symptom cluster research, CFA provides a more accurate result. If the purpose of a study is to summarize data with a smaller number of variables, PCA is the choice. PCA can also be used as an initial step in CFA because it provides information regarding the maximum number and nature of factors. In using factor analysis for symptom cluster research, several issues need to be considered, including subjectivity of solution, sample size, symptom selection, and level of measure.

Stroke Risk Factors and Symptoms

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

Risk factors for small airway obstruction among Chinese island residents: a case-control study.

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Yu-sheng Chen

Full Text Available BACKGROUND: We investigated the prevalence of and risk factors for small airway obstruction (SAO among Chinese island residents to establish means to prevent and treat SAO. METHODS: From October 17, 2011 to November 1, 2011, a total of 2,873 residents aged >20 years who lived on the Huangqi Peninsula of Fujian were recruited by random cluster sampling. They were asked to complete a Burden of Obstructive Lung Disease (BOLD questionnaire and underwent physical examinations and lung function evaluations. SAO was defined as a forced expiratory flow at 50% of vital capacity, Vmax50%, of less than 70% of predicted. Risk factors for SAO were assessed from among demographic and anthropometric variables, blood chemistry results, and questionnaire response items. RESULTS: A total of 216 (7.52% Chinese island residents were identified as having SAO (95 males; 121 females. Their survey and test results were compared with 432 age and sex-matched healthy controls (192 males; 240 females for SAO risk factors. Among numerous factors investigated, only diabetes mellitus (p = 0.039, smoking index (SI, p600, second hand smoke (p = 0.002, and lack of regular exercise (p<0.001 were significant risk factors for SAO. CONCLUSIONS: The risk factors for SAO among Chinese island residents appeared to be similar to those among people who live in high-density urban environments and impoverished rural areas. Public health policies and medical practices directed toward improving respiratory health for island residents should be comparable to those used for urban and rural dwellers.

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

White rice consumption and CVD risk factors among Iranian population.

Science.gov (United States)

Khosravi-Boroujeni, Hossein; Sarrafzadegan, Nizal; Mohammadifard, Noushin; Sajjadi, Firouzeh; Maghroun, Maryam; Asgari, Sedigheh; Rafieian-Kopaei, Mahmoud; Azadbakht, Leila

2013-06-01

Association between white rice intake and risk factors of cardiovascular diseases remained uncertain. Most of the previous published studies have been done in western countries with different lifestyles, and scant data are available from the Middle East region, including Iran. This cross-sectional study was conducted in the structure of Isfahan Healthy Heart Program (IHHP) to assess the association between white rice consumption and risk factors of cardiovascular diseases. In the present study, 3,006 men were included from three counties of Isfahan, Najafabad, and Arak by multistage cluster random-sampling method. Dietary intake was assessed with a 49-item food frequency questionnaire (FFQ). Laboratory assessment was done in a standardized central laboratory. Outcome variables were fasting blood glucose, serum lipid levels, and anthropometric variables. Socioeconomic and demographic data, physical activity, and body mass index (BMI) were considered covariates and were adjusted in analysis. In this study, Student's t-test, chi-square test, and logistic regression were used for statistical analyses. Means of BMI among those subjects who consumed white rice less than 7 times per week and people who consumed 7-14 times per week were almost similar--24.8 +/- 4.3 vs 24.5 +/- 4.7 kg/m2. There was no significant association between white rice consumption and risk factors of cardiovascular diseases, such as fasting blood sugar arid serum lipid profiles. Although whole grain consumption has undeniable effect on preventing cardiovascular disease risk, white rice consumption was not associated with cardiovascular risks among Iranian men in the present study. Further prospective studies with a semi-quantitative FFQ or dietary record questionnaire, representing type and portion-size of rice intake as well as cooking methods and other foods consumed with rice that affect glycaemic index (GI) of rice, are required to support our finding and to illustrate the probable mechanism.

Clustering of risk-related modifiable behaviours and their association with overweight and obesity among a large sample of youth in the COMPASS study

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Rachel E. Laxer

2017-01-01

Full Text Available Abstract Background Canadian youth exhibit a number of risky behaviours, some of which are associated with overweight and obesity. The purpose of this study was to examine the prevalence of 15 modifiable risk behaviours in a large sample of Canadian youth, to identify underlying subgroups based on patterns of health behaviours, and to examine the association between identified subgroups and overweight/obesity. Methods Data from 18,587 grades 9–12 students in Year 1 (2012–13 of the COMPASS study and latent class analysis were used to identify patterns and clustering among 15 health behaviours (e.g., physical inactivity, sedentary behaviour, unhealthy eating, substance use. A logistic regression model examined the associations between these clusters and overweight/obesity status. Results Four distinct classes were identified: traditional school athletes, inactive screenagers, health conscious, and moderately active substance users. Each behavioural cluster demonstrated a distinct pattern of behaviours, some with a greater number of risk factors than others. Traditional school athletes (odds ratio (OR 1.15, 95% CI 1.03–1.29, inactive screenagers (OR 1.33; 1.19–1.48, and moderately active substance users (OR 1.27; 1.14–1.43 were all significantly more likely to be overweight/obese compared to the health conscious group. Conclusions Four distinct subpopulations of youth were identified based on their patterns of health and risk behaviours. The three clusters demonstrating poorer health behaviour were all at an increased risk of being overweight/obese compared to their somewhat healthier peers. Obesity-related public health interventions and health promotion efforts might be more effective if consideration is given to population segments with certain behavioural patterns, targeting subgroups at greatest risk of overweight or obesity.

Prevalence and risk factors of premature coronary artery disease in patients undergoing coronary angiography in Kurdistan, Iraq.

Science.gov (United States)

Mohammad, Ameen Mosa; Jehangeer, Hekmat Izzat; Shaikhow, Sabri Khalif

2015-11-18

Premature coronary artery disease (PCAD) seems to increase, particularly in developing countries. Given the lack of such studies in the country, this study examines the prevalence, associated cardiovascular risk factors, and coronary angiographic profile of the disease in Iraq. Data was collected from a total of 445 adult patients undergoing coronary angiography at Duhok Heart Center, Kurdistan in a period between March and September 2014. Patients were divided into PCAD (male 70 % compared to lesser obstruction. Premature coronary artery disease is alarming  in the country. Cardiovascular risk factors are clustered among them. But the angiographic profile and therapeutic options of PCAD are close to those reported from previous studies.

Analysis of risk factors for persistent infection of asymptomatic women with high-risk human papilloma virus.

Science.gov (United States)

Shi, Nianmin; Lu, Qiang; Zhang, Jiao; Li, Li; Zhang, Junnan; Zhang, Fanglei; Dong, Yanhong; Zhang, Xinyue; Zhang, Zheng; Gao, Wenhui

2017-06-03

This study aims to prevent persistentinfection, reduce the incidence of cervical cancer, and improve women's health by understanding the theoretical basis of the risk factors for continuous infection of asymptomatic women with high-risk human papilloma virus (HPV) strains via information collected, which includes the persistent infection rate and the most prevalent HPV strain types of high risk to asymptomatic women in the high-risk area of cervical cancer in Linfen, Shanxi Province. Based on the method of cluster sampling, locations were chosen from the industrial county and agricultural county of Linfen, Shanxi Province, namely the Xiangfen and Quwo counties. Use of the convenience sampling (CS) method enables the identification of women who have sex but without symptoms of abnormal cervix for analyzing risk factors of HPV-DNA detection and performing a retrospective questionnaire survey in these 2 counties. Firstly, cervical exfoliated cell samples were collected for thin-layer liquid-based cytology test (TCT), and simultaneously testing high-risk type HPV DNA, then samples with positive testing results were retested to identify the infected HPV types. The 6-month period of testing was done to derive the 6-month persistent infection rate. The retrospective survey included concepts addressed in the questionnaire: basic situation of the research objects, menstrual history, marital status, pregnancy history, sexual habits and other aspects. The questionnaire was divided into a case group and a comparison group, which are based on the high-risk HPV-DNA testing result to ascertain whether or not there is persistent infection. Statistical analysis employed Epidate3.1 software for date entry, SPSS17.0 for date statistical analysis. Select statistic charts, Chi-Square Analysis, single-factor analysis and multivariate Logistic regression analysis to analyze the protective factors and risk factors of high-risk HPV infection. Risk factors are predicted by using the

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....

Clustering of chronic disease risk factors with tobacco smoking ...

African Journals Online (AJOL)

Methods: A cross-sectional study was derived from an initial assessment in workplaces which was part of a community-based intervention to prevent chronic disease risk ... The main items assessed socio-demographics characteristics, smoking status, eating habits, level of physical activity and alcohol use of the participants.

Prevalence and pattern of cardiovascular risk factors in a population in India.

Science.gov (United States)

Khetan, Aditya; Zullo, Melissa; Hejjaji, Vittal; Barbhaya, Dweep; Agarwal, Sushil; Gupta, Rishab; Madan Mohan, Sri Krishna; Josephson, Richard

2017-01-01

Cardiovascular disease is the leading cause of mortality in India. Since it is largely driven by risk factors such as hypertension, diabetes and smoking, it is important to study the treatment cascade for these conditions and identify areas for improvement. This is a cross-sectional study from Project SEHAT (Study to Enhance Heart Associated Treatments), an ongoing cluster randomised controlled trial testing the hypothesis that a community health worker-led intervention can improve the control of cardiovascular risk factors in a community in West Bengal, India. For the baseline data, 3556 adults, between the ages of 35 and 70, were screened for hypertension, diabetes and smoking. For hypertension and diabetes, an elevated reading was confirmed on a repeat visit. 18.3% (n=650), 9.0% (n=317) and 14.1% (n=500) of adults were diagnosed with hypertension, diabetes and smoking, respectively. Overall, 35.0% (n=1242) adults had at least one of the three risk factors. 55.1% (n=358) of participants with hypertension and 40.4% (n=128) of participants with diabetes were unaware of their respective condition. 36.6% (n=238) of those with hypertension and 58.0% (n=184) of diabetics were on treatment. 8.2% (n=53) hypertensives were controlled (blood pressure <140/90 mm Hg) while 13.6% (n=43) diabetics were controlled (defined as fasting blood sugar <126 mg/dL). Less than 1% diabetics were on insulin, and average number of medications for a patient with hypertension was 1.2. In our population in semiurban India, one in three adults have a major cardiovascular risk factor, with low control rates. There is a large burden of undiagnosed cardiovascular risk factors and a large gap between treatment and control, which may be explained by lack of treatment intensification.

Seizure clusters: characteristics and treatment.

Science.gov (United States)

Haut, Sheryl R

2015-04-01

Many patients with epilepsy experience 'clusters' or flurries of seizures, also termed acute repetitive seizures (ARS). Seizure clustering has a significant impact on health and quality of life. This review summarizes recent advances in the definition and neurophysiologic understanding of clustering, the epidemiology and risk factors for clustering and both inpatient and outpatient clinical implications. New treatments for seizure clustering/ARS are perhaps the area of greatest recent progress. Efforts have focused on creating a uniform definition of a seizure cluster. In neurophysiologic studies of refractory epilepsy, seizures within a cluster appear to be self-triggering. Clinical progress has been achieved towards a more precise prevalence of clustering, and consensus guidelines for epilepsy monitoring unit safety. The greatest recent advances are in the study of nonintravenous route of benzodiazepines as rescue medications for seizure clusters/ARS. Rectal benzodiazepines have been very effective but barriers to use exist. New data on buccal, intramuscular and intranasal preparations are anticipated to lead to a greater number of approved treatments. Progesterone may be effective for women who experience catamenial clusters. Seizure clustering is common, particularly in the setting of medically refractory epilepsy. Clustering worsens health and quality of life, and the field requires greater focus on clarifying of definition and clinical implications. Progress towards the development of nonintravenous routes of benzodiazepines has the potential to improve care in this area.

Risk moderation of a parent and student preventive alcohol intervention by adolescent and family factors: a cluster randomized trial.

Science.gov (United States)

Verdurmen, Jacqueline E E; Koning, Ina M; Vollebergh, Wilma A M; van den Eijnden, Regina J J M; Engels, Rutger C M E

2014-03-01

To examine risk moderation of an alcohol intervention targeting parents and adolescents. A cluster randomized trial including 2937 Dutch early adolescents (m=12.68years, SD=0.51) and their parents randomized over four conditions: parent intervention, student intervention, combined parent-student intervention, and control group. 152 classes of 19 high schools in The Netherlands (2006). Moderators at baseline (adolescent: gender, educational level and externalizing behavior; parent: educational level and heavy alcohol use) were used to examine the differential effects of the interventions on onset of (heavy) weekly drinking at 22-month follow-up. The combined intervention effectively delayed the onset of weekly drinking in the general population of adolescents, and was particularly effective in delaying the onset of heavy weekly drinking in a higher-risk subsample of adolescents (i.e. those attending lower levels of education and reporting higher levels of externalizing behavior). Present and previous results have established the combined intervention to be universally effective in postponing weekly alcohol use among Dutch adolescents, with an added effect on postponing heavy weekly drinking in high risk subgroups. Therefore, implementation of this intervention in the general population of schools in The Netherlands is advised. NTR649. Copyright © 2013 Elsevier Inc. All rights reserved.

Surviving a cluster collapse: risk aversion as a core value

NARCIS (Netherlands)

Schiele, Holger; Hospers, Gerrit J.; van der Zee, D.J.

2012-01-01

Purpose – This paper analyses firms, which survived in a collapsed regional cluster. The target is to analyze whether the principles for enduring success identified researching success factors of very old firms also apply in such an environment. Design/methodology/approach – The authors conduct a

Synthesizing Risk from Summary Evidence Across Multiple Risk Factors.

Science.gov (United States)

Shrier, Ian; Colditz, Graham A; Steele, Russell J

2018-07-01

Although meta-analyses provide summary effect estimates that help advise patient care, patients often want to compare their overall health to the general population. The Harvard Cancer Risk Index was published in 2004 and uses risk ratio estimates and prevalence estimates from original studies across many risk factors to provide an answer to this question. However, the published version of the formula only uses dichotomous risk factors and its derivation was not provided. The objective of this brief report was to provide the derivation of a more general form of the equation that allows the incorporation of risk factors with three or more levels.

Epidemiological evaluation of spatiotemporal and genotypic clustering of Mycobacterium tuberculosis in Ontario, Canada.

Science.gov (United States)

Tuite, A R; Guthrie, J L; Alexander, D C; Whelan, M S; Lee, B; Lam, K; Ma, J; Fisman, D N; Jamieson, F B

2013-10-01

In Canada, tuberculosis (TB) rates are at a historic low, with the remaining risk concentrated in a few vulnerable population subgroups. To describe the epidemiology of TB in the Canadian province of Ontario and to characterise risk factors associated with transmission events, identified using genetic typing techniques. Retrospective analysis of 2186 culture-positive TB cases between August 2007 and December 2011. Temporal trends and risk of spatiotemporal and genotypic clustering were evaluated using Poisson and logistic regression models. Being in a spatiotemporal cluster was associated with Aboriginal status (odds ratio [OR] 3.63, 95% confidence interval [CI] 1.23-10.71). Cases in genotypic clusters were more likely to report homelessness as a risk factor (adjusted OR [aOR] 2.92, 95%CI 1.74-4.90) or be male (aOR 1.35, 95%CI 1.09-1.68), and were less likely to be aged ≥ 65 years (aOR 0.63, 95%CI 0.49-0.82), foreign-born (aOR 0.32, 95%CI 0.24-0.43) or Aboriginal (aOR 0.40, 95%CI 0.16-0.99). The Beijing lineage had an annual rate of increase of almost 10% (P = 0.047), and was associated with genotypic clustering (aOR 2.84, 95%CI 2.19-3.67). Genotypic data suggest that disease clusters are smaller, but far more common, than would be estimated using spatiotemporal clustering.

Cluster analysis of fasciolosis in dairy cow herds in Munster province of Ireland and detection of major climatic and environmental predictors of the exposure risk.

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Selemetas, Nikolaos; Phelan, Paul; O'Kiely, Padraig; de Waal, Theo

2015-03-19

Fasciolosis caused by Fasciola hepatica is a widespread parasitic disease in cattle farms. The aim of this study was to detect clusters of fasciolosis in dairy cow herds in Munster Province, Ireland and to identify significant climatic and environmental predictors of the exposure risk. In total, 1,292 dairy herds across Munster was sampled in September 2012 providing a single bulk tank milk (BTM) sample. The analysis of samples by an in-house antibody-detection enzyme-linked immunosorbent assay (ELISA), showed that 65% of the dairy herds (n = 842) had been exposed to F. hepatica. Using the Getis-Ord Gi* statistic, 16 high-risk and 24 low-risk (P <0.01) clusters of fasciolosis were identified. The spatial distribution of high-risk clusters was more dispersed and mainly located in the northern and western regions of Munster compared to the low-risk clusters that were mostly concentrated in the southern and eastern regions. The most significant classes of variables that could reflect the difference between high-risk and low-risk clusters were the total number of wet-days and rain-days, rainfall, the normalized difference vegetation index (NDVI), temperature and soil type. There was a bigger proportion of well-drained soils among the low-risk clusters, whereas poorly drained soils were more common among the high-risk clusters. These results stress the role of precipitation, grazing, temperature and drainage on the life cycle of F. hepatica in the temperate Irish climate. The findings of this study highlight the importance of cluster analysis for identifying significant differences in climatic and environmental variables between high-risk and low-risk clusters of fasciolosis in Irish dairy herds.

Cluster analysis of fasciolosis in dairy cow herds in Munster province of Ireland and detection of major climatic and environmental predictors of the exposure risk

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Nikolaos Selemetas

2015-03-01

Full Text Available Fasciolosis caused by Fasciola hepatica is a widespread parasitic disease in cattle farms. The aim of this study was to detect clusters of fasciolosis in dairy cow herds in Munster Province, Ireland and to identify significant climatic and environmental predictors of the exposure risk. In total, 1,292 dairy herds across Munster was sampled in September 2012 providing a single bulk tank milk (BTM sample. The analysis of samples by an in-house antibody-detection enzyme-linked immunosorbent assay (ELISA, showed that 65% of the dairy herds (n = 842 had been exposed to F. hepatica. Using the Getis-Ord Gi* statistic, 16 high-risk and 24 low-risk (P <0.01 clusters of fasciolosis were identified. The spatial distribution of high-risk clusters was more dispersed and mainly located in the northern and western regions of Munster compared to the low-risk clusters that were mostly concentrated in the southern and eastern regions. The most significant classes of variables that could reflect the difference between high-risk and low-risk clusters were the total number of wet-days and rain-days, rainfall, the normalized difference vegetation index (NDVI, temperature and soil type. There was a bigger proportion of well-drained soils among the low-risk clusters, whereas poorly drained soils were more common among the high-risk clusters. These results stress the role of precipitation, grazing, temperature and drainage on the life cycle of F. hepatica in the temperate Irish climate. The findings of this study highlight the importance of cluster analysis for identifying significant differences in climatic and environmental variables between high-risk and low-risk clusters of fasciolosis in Irish dairy herds.

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

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

2014-01-01

Cardiovascular disease (CVD) has emerged as a major cause of morbidity and mortality in HIV-infected adults. Research in noninfected populations has suggested that knowledge of CVD risk factors significantly influences perceptions of risk. This cross-sectional study describes CVD risk factor knowledge and risk perception in HIV-infected adults. We recruited 130 HIV-infected adults (mean age = 48 years, 62% male, 56% current smokers, mean years since HIV diagnosis, 14.7). The mean CVD risk factor knowledge score was fairly high. However, controlling for age, CVD risk factor knowledge was not predictive of perceived risk [F(1, 117) = 0.13, p > .05]. Estimated risk and perceived risk were weakly but significantly correlated; r (126) = .24, p = .01. HIV-infected adults are at increased risk for CVD. Despite having adequate risk-factor knowledge, CVD risk perception was inaccurate. Improving risk perception and developing CVD risk reduction interventions for this population are imperative. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Generic, network schema agnostic sparse tensor factorization for single-pass clustering of heterogeneous information networks.

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Wu, Jibing; Meng, Qinggang; Deng, Su; Huang, Hongbin; Wu, Yahui; Badii, Atta

2017-01-01

Heterogeneous information networks (e.g. bibliographic networks and social media networks) that consist of multiple interconnected objects are ubiquitous. Clustering analysis is an effective method to understand the semantic information and interpretable structure of the heterogeneous information networks, and it has attracted the attention of many researchers in recent years. However, most studies assume that heterogeneous information networks usually follow some simple schemas, such as bi-typed networks or star network schema, and they can only cluster one type of object in the network each time. In this paper, a novel clustering framework is proposed based on sparse tensor factorization for heterogeneous information networks, which can cluster multiple types of objects simultaneously in a single pass without any network schema information. The types of objects and the relations between them in the heterogeneous information networks are modeled as a sparse tensor. The clustering issue is modeled as an optimization problem, which is similar to the well-known Tucker decomposition. Then, an Alternating Least Squares (ALS) algorithm and a feasible initialization method are proposed to solve the optimization problem. Based on the tensor factorization, we simultaneously partition different types of objects into different clusters. The experimental results on both synthetic and real-world datasets have demonstrated that our proposed clustering framework, STFClus, can model heterogeneous information networks efficiently and can outperform state-of-the-art clustering algorithms as a generally applicable single-pass clustering method for heterogeneous network which is network schema agnostic.

Ethical implications of excessive cluster sizes in cluster randomised trials.

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Hemming, Karla; Taljaard, Monica; Forbes, Gordon; Eldridge, Sandra M; Weijer, Charles

2018-02-20

The cluster randomised trial (CRT) is commonly used in healthcare research. It is the gold-standard study design for evaluating healthcare policy interventions. A key characteristic of this design is that as more participants are included, in a fixed number of clusters, the increase in achievable power will level off. CRTs with cluster sizes that exceed the point of levelling-off will have excessive numbers of participants, even if they do not achieve nominal levels of power. Excessively large cluster sizes may have ethical implications due to exposing trial participants unnecessarily to the burdens of both participating in the trial and the potential risks of harm associated with the intervention. We explore these issues through the use of two case studies. Where data are routinely collected, available at minimum cost and the intervention poses low risk, the ethical implications of excessively large cluster sizes are likely to be low (case study 1). However, to maximise the social benefit of the study, identification of excessive cluster sizes can allow for prespecified and fully powered secondary analyses. In the second case study, while there is no burden through trial participation (because the outcome data are routinely collected and non-identifiable), the intervention might be considered to pose some indirect risk to patients and risks to the healthcare workers. In this case study it is therefore important that the inclusion of excessively large cluster sizes is justifiable on other grounds (perhaps to show sustainability). In any randomised controlled trial, including evaluations of health policy interventions, it is important to minimise the burdens and risks to participants. Funders, researchers and research ethics committees should be aware of the ethical issues of excessively large cluster sizes in cluster trials. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is

Early risk factors for suicide in an epidemiological first episode psychosis cohort.

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Dutta, Rina; Murray, Robin M; Allardyce, Judith; Jones, Peter B; Boydell, Jane

2011-03-01

Much remains unknown about whether there are early risk factors for suicide in psychosis. The aim of the study was to determine whether there are any identifiable early symptom clusters, aetiological factors or illness course markers for suicide in first episode psychosis. A total of 2132 patients with first episode psychosis presenting to secondary care services in London (1965-2004; n=1474), Nottingham (1997-1999; n=195) and Dumfries and Galloway (1979-1998; n=463) were traced after up to 40 years (mean 13 years) following first presentation. Risk factors were identified from the Operational Checklist for Psychotic Disorders rated for the first year following presentation. Overall, there were 51 suicides and 373 deaths from other causes. Male gender (RR 2.84, 95% CI 1.20-6.69, p=0.02) and a cumulative threshold effect of symptoms early in the illness (RR 6.81, 95% CI 2.33-19.85, p<0.001) were associated with a higher propensity for later completed suicide. There was also a suggestion that early manic symptoms might increase the risk of later suicide irrespective of initial diagnosis. Suicide risk was associated with a cumulative threshold effect of symptoms and manic symptoms. As suicide is a relatively rare event in psychotic disorders, general population-based prevention strategies may have more impact in this vulnerable group as well as the wider population. Copyright © 2010 Elsevier B.V. All rights reserved.

Propuesta teorica de factores que impulsan la colaboracion interempresarial en la etapa de la conformacion de los Clusters

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Rolando Porchini

2010-01-01

Full Text Available Present research intends to clarify relationship between intercompanies collaboration and cluster successful conformation. This project shows theoretical concepts about clusters, origins and how clusters evolution parallels the globalization process. The investigation also clarifies differences about concepts of intercompanies cooperation and collaboration used so far without distinction. Actual scientific literature is analyzed about early phase of cluster conformation. intercompanies collaboration (C.I. is considered key to cluster successful conformation, and highlights which key factors are most relevant in cluster conformation, its consolidation and its competitiveness. This is why this research is important regarding what theoretical framework lies behind the 7 factors recognized as the intercompanies collaboration (C.I. construct. Such factors are: i Interchange of strategic information (I.E., ii formalized and consensual rules (R.C.; iii preexistence of particular strategies (P.E.; iv Process of firms selection (P.S.; v Government roll as facilitator (R.G.; vi Expected leadership in first cluster president (L.P. and vii Expected leadership in first cluster manager (L.G.. This theoretical framework is the first part of an investigation presented here in qualitative terms and the quantitative results will be presented shortly. Finally, some recommendations are presented useful to new clusters being founded in the state as well in Mexico.

Invited commentary: genetic variants and individual- and societal-level risk factors.

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Coughlin, Steven S

2010-01-01

Over the past decade, leading epidemiologists have noted the importance of social factors in studying and understanding the distribution and determinants of disease in human populations; but to what extent are epidemiologic studies integrating genetic information and other biologic variables with information about individual-level risk factors and group-level or societal factors related to the broader residential, behavioral, or cultural context? There remains a need to consider ways to integrate genetic information with social and contextual information in epidemiologic studies, partly to combat the overemphasis on the importance of genetic factors as determinants of disease in human populations. Even in genome-wide association studies of coronary heart disease and other common complex diseases, only a small proportion of heritability is explained by the genetic variants identified to date. It is possible that familial clustering due to genetic factors has been overestimated and that important environmental or social influences (acting alone or in combination with genetic variants) have been overlooked. The accompanying article by Bressler et al. (Am J Epidemiol. 2010;171(1):14-23) highlights some of these important issues.

Postictal psychosis: presymptomatic risk factors and the need for further investigation of genetics and pharmacotherapy

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Bromfield Edward B

2006-07-01

Full Text Available Abstract Background Postictal psychosis (PIP, an episode of psychosis occurring after a cluster of seizures, is common and may be associated with profound morbidity, including chronic psychosis. Symptoms are often pleomorphic, involving a range of psychotic symptoms, including hallucinations and disorders of thought. PIP is treatable and may be averted if presymptomatic risk factors are considered in susceptible patients and treatment is initiated. Case presentation In this report, we present an illustrative case of PIP. The patient, Mr. R, presented to our emergency room with delusions and disordered thought process following a cluster of seizures. He recovered after admission, sedation and treatment with antipsychotic medication. Discussion A list of presymptomatic risk factors is established based on review of current literature. Identification of such risk factors may potentially help with prophylactic treatment; however, little empirical research exists in this area and treatment guidelines are thus far largely based on expert opinion. Further, while the neurobiology of schizophrenia is advancing at a rapid pace, largely due to advances in genetics, the pathophysiology of PIP remains largely unknown. Considering the progress in schizophrenia research in the context of the clinical features of PIP and existing studies, potential neurobiological mechanisms for PIP are herein proposed, and further genetic analyses, which may help identify those susceptible, are warranted. Conclusion While PIP is an important problem that may present first to general hospital psychiatrists, as in the case presented, this topic is under-represented in the medical psychiatry literature. As discussed in this article, further research is needed to develop presymptomatic screens and treatment pathways to help prevent morbidity.

Investigation of risk factors of psychological acceptance and burnout syndrome among nurses in China.

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Yao, Yongcheng; Yao, Wu; Wang, Wei; Li, Hong; Lan, Yajia

2013-10-01

The objectives of this study were to determine reliability of Chinese version of Acceptance and Action Questionnaire-II (AAQ-II), the relationship between psychological acceptance (PA), and burnout syndrome and their risk factors among nurses in China. The reliability of AAQ-II in Chinese was evaluated first by testing on 111 doctors and 108 nurses in China. On the number of 845 nurses selected from nine city hospitals by using stratified cluster sampling method, the Maslach Burnout Inventory-General Survey was administered to establish the presence of burnout, and the AAQ-II was used to measure their PA. Results showed that the AAQ-II in Chinese had a good test-retest reliability. PA was statistically significantly negatively correlated to the three dimensionalities of burnout among nurses in China. Male and female nurses had a significant difference in PA. Risk factors for burnout were age (25-44 years), marital status (married), gender (male), hospital department (emergency) and position (primary title) as well as PA. The findings provide insights into the risk factors of burnout in Chinese nurses and may have clinical implications in preventing burnout in Chinese nurses. © 2013 Wiley Publishing Asia Pty Ltd.

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

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

2014-01-01

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

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

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

2014-08-01

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

Ovarian Cancer Risk Factors by Histologic Subtype: An Analysis From the Ovarian Cancer Cohort Consortium.

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Wentzensen, Nicolas; Poole, Elizabeth M; Trabert, Britton; White, Emily; Arslan, Alan A; Patel, Alpa V; Setiawan, V Wendy; Visvanathan, Kala; Weiderpass, Elisabete; Adami, Hans-Olov; Black, Amanda; Bernstein, Leslie; Brinton, Louise A; Buring, Julie; Butler, Lesley M; Chamosa, Saioa; Clendenen, Tess V; Dossus, Laure; Fortner, Renee; Gapstur, Susan M; Gaudet, Mia M; Gram, Inger T; Hartge, Patricia; Hoffman-Bolton, Judith; Idahl, Annika; Jones, Michael; Kaaks, Rudolf; Kirsh, Victoria; Koh, Woon-Puay; Lacey, James V; Lee, I-Min; Lundin, Eva; Merritt, Melissa A; Onland-Moret, N Charlotte; Peters, Ulrike; Poynter, Jenny N; Rinaldi, Sabina; Robien, Kim; Rohan, Thomas; Sandler, Dale P; Schairer, Catherine; Schouten, Leo J; Sjöholm, Louise K; Sieri, Sabina; Swerdlow, Anthony; Tjonneland, Anna; Travis, Ruth; Trichopoulou, Antonia; van den Brandt, Piet A; Wilkens, Lynne; Wolk, Alicja; Yang, Hannah P; Zeleniuch-Jacquotte, Anne; Tworoger, Shelley S

2016-08-20

An understanding of the etiologic heterogeneity of ovarian cancer is important for improving prevention, early detection, and therapeutic approaches. We evaluated 14 hormonal, reproductive, and lifestyle factors by histologic subtype in the Ovarian Cancer Cohort Consortium (OC3). Among 1.3 million women from 21 studies, 5,584 invasive epithelial ovarian cancers were identified (3,378 serous, 606 endometrioid, 331 mucinous, 269 clear cell, 1,000 other). By using competing-risks Cox proportional hazards regression stratified by study and birth year and adjusted for age, parity, and oral contraceptive use, we assessed associations for all invasive cancers by histology. Heterogeneity was evaluated by likelihood ratio test. Most risk factors exhibited significant heterogeneity by histology. Higher parity was most strongly associated with endometrioid (relative risk [RR] per birth, 0.78; 95% CI, 0.74 to 0.83) and clear cell (RR, 0.68; 95% CI, 0.61 to 0.76) carcinomas (P value for heterogeneity [P-het] < .001). Similarly, age at menopause, endometriosis, and tubal ligation were only associated with endometrioid and clear cell tumors (P-het ≤ .01). Family history of breast cancer (P-het = .008) had modest heterogeneity. Smoking was associated with an increased risk of mucinous (RR per 20 pack-years, 1.26; 95% CI, 1.08 to 1.46) but a decreased risk of clear cell (RR, 0.72; 95% CI, 0.55 to 0.94) tumors (P-het = .004). Unsupervised clustering by risk factors separated endometrioid, clear cell, and low-grade serous carcinomas from high-grade serous and mucinous carcinomas. The heterogeneous associations of risk factors with ovarian cancer subtypes emphasize the importance of conducting etiologic studies by ovarian cancer subtypes. Most established risk factors were more strongly associated with nonserous carcinomas, which demonstrate challenges for risk prediction of serous cancers, the most fatal subtype. © 2016 by American Society of Clinical Oncology.

CLUSTERIZATION – A FACTOR OF EFFICIENCY IN SMALL AND MEDIUM HOSPITALITY ENTERPRISES

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Zorica Krželj-Čolović

2016-12-01

Full Text Available In the modern global economy that is constantly changing and causing constant threats and challenges, various forms of association and networking enterprises are of growing importance. Considering that small and medium enterprises are drivers of economic growth and employment, they should be the most dynamic and most efficient segment of the economy. The same is true for the hospitality industry, where small and medium hospitality enterprises are the main providers of the tourism offer. The lack of networks in clusters of small and medium hospitality enterprises in Croatia is the cause of the unsatisfactory level of competitiveness and quality of hotel facilities with negative implications for economic and social development. The beginning of clustering in Croatia could be a good way to increase the economic efficiency of Croatian small and medium hospitality enterprises. The aim of this paper is to present clustering as a factor that affects the quality of small and medium hospitality enterprises by increasing their competitiveness in the tourism market which is becoming an important element for their business efficiency. For the purposes of the research, a survey was carried out on a sample of 72 small and medium hospitality enterprises in the period from June to September 2012. The survey results have shown that clusterization is a factor of efficiency in small and medium hospitality enterprises.

Hepatitis B virus infections and risk factors among the general population in Anhui Province, China: an epidemiological study

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Li Xiaoqing

2012-04-01

Full Text Available Abstract Background Hepatitis B is one of the most common infectious diseases in China. The aim of this study was to determine the prevalence of hepatitis B surface antigen (HBsAg among the general population and the risk factors associated with HBV infection in Anhui province, China. Methods A provincial serosurvey was conducted in four cities, and selected through stratified clustering sampling. Data on demographics, immunization history, medical history, family medical history, and life history were collected, along with serum tested for HBsAg. Completed surveys were analysed from 8,875 participants. Results Overall prevalence of HBsAg was 7.44%. Using multivariate analysis, older age was a risk factor for HBsAg infection among children younger than 15 years. Among adults 15-59 years old, the risk factors were male gender, a history of surgical operations, at least one HBsAg-positive family member, and non-vaccination. For adults older than 59 years, the risk factor was a blood transfusion history. Conclusions Though Anhui province has already reached the national goal of reducing HBsAg prevalence to less than 1% among children younger than 5 years, there are still several risk factors for HBsAg infection among the older population. Immunization programs should continue to focus on adults, and interventions should be taken to reduce risk factors associated with being infected with Hepatitis B.

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

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016

DEFF Research Database (Denmark)

Moesgaard Iburg, Kim

2017-01-01

surveillance and inform policy debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs......), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR......) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated...

Analysing the spatial patterns of livestock anthrax in Kazakhstan in relation to environmental factors: a comparison of local (Gi* and morphology cluster statistics

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Ian T. Kracalik

2012-11-01

Full Text Available We compared a local clustering and a cluster morphology statistic using anthrax outbreaks in large (cattle and small (sheep and goats domestic ruminants across Kazakhstan. The Getis-Ord (Gi* statistic and a multidirectional optimal ecotope algorithm (AMOEBA were compared using 1st, 2nd and 3rd order Rook contiguity matrices. Multivariate statistical tests were used to evaluate the environmental signatures between clusters and non-clusters from the AMOEBA and Gi* tests. A logistic regression was used to define a risk surface for anthrax outbreaks and to compare agreement between clustering methodologies. Tests revealed differences in the spatial distribution of clusters as well as the total number of clusters in large ruminants for AMOEBA (n = 149 and for small ruminants (n = 9. In contrast, Gi* revealed fewer large ruminant clusters (n = 122 and more small ruminant clusters (n = 61. Significant environmental differences were found between groups using the Kruskall-Wallis and Mann- Whitney U tests. Logistic regression was used to model the presence/absence of anthrax outbreaks and define a risk surface for large ruminants to compare with cluster analyses. The model predicted 32.2% of the landscape as high risk. Approximately 75% of AMOEBA clusters corresponded to predicted high risk, compared with ~64% of Gi* clusters. In general, AMOEBA predicted more irregularly shaped clusters of outbreaks in both livestock groups, while Gi* tended to predict larger, circular clusters. Here we provide an evaluation of both tests and a discussion of the use of each to detect environmental conditions associated with anthrax outbreak clusters in domestic livestock. These findings illustrate important differences in spatial statistical methods for defining local clusters and highlight the importance of selecting appropriate levels of data aggregation.

ANTHROPOMETRIC INDICES IN ASSOCIATION WITH CARDIOMETABOLIC RISK FACTORS: FINDINGS OF THE ISFAHAN HEALTHY HEART PROGRAM

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Nizal Sarrafzadegan

2010-11-01

Full Text Available Abstract    BACKGROUND: Obesity is increasing worldwide, but the debate about the most valid index associated with its health hazards remains unresolved. This study aimed to compare four main anthropometric indices by gender, to determine the best index in predicting cardiometabolic risk factors and to find their cutoff values in the population studied.    METHODS: This study was a cross-sectional community-based study performed on a representative sample of 12,514 adults (aged ≥19 years selected via 2-stage random cluster sampling from 3 cities in Iran. Partial correlation and ROC curve analyzes were used to determine the best anthropometric indices and their cutoff values.    RESULTS: The study population comprised 6123 males and 6391 females. In both genders, waist circumference (WC had the highest correlation with cardiometabolic risk factors (6 of 8 risk factors in men and 7 of 8 risk factors in women. ROC analyses showed that in males, the largest area under curve (AUC was obtained for waist-to-stature ration (WSR in most risk factors (6 of the 10 followed by body mass index (BMI and waist-to-height ratio (WHR with largest AUC (3 of the 10. The corresponding figure for females was obtained for WSR (9 of the 10 followed by BMI and WHR (1 of 10. Optimal cutoff values computed for combination of 3 major risk factors (including diabetes mellitus, hypertension and dyslipidemia revealed that in males and females, respectively, the cutoff values were 21.9 and 23.5 kg/m2 for BMI, 80.70 and 84.70 cm for WC, 0.85 and 0.86 for WHR and 0.47 and 0.53 for WSR.    CONCLUSION: WSR could be a valid anthropometric index for predicting cardiometabolic risk factors, and it has less variation than other indices among populations with ethnic differences in body size and fat distribution.      Keywords: Anthropometry, Cardiovascular Risk Factors, Iran, Obesity.

Factor Structure of the PTSD Checklist for DSM-5: Relationships Among Symptom Clusters, Anger, and Impulsivity.

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Armour, Cherie; Contractor, Ateka; Shea, Tracie; Elhai, Jon D; Pietrzak, Robert H

2016-02-01

Scarce data are available regarding the dimensional structure of Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) posttraumatic stress disorder (PTSD) symptoms and how factors relate to external constructs. We evaluated six competing models of DSM-5 PTSD symptoms, including Anhedonia, Externalizing Behaviors, and Hybrid models, using confirmatory factor analyses in a sample of 412 trauma-exposed college students. We then examined whether PTSD symptom clusters were differentially related to measures of anger and impulsivity using Wald chi-square tests. The seven-factor Hybrid model was deemed optimal compared with the alternatives. All symptom clusters were associated with anger; the strongest association was between externalizing behaviors and anger (r = 0.54). All symptom clusters, except re-experiencing and avoidance, were associated with impulsivity, with the strongest association between externalizing behaviors and impulsivity (r = 0.49). A seven-factor Hybrid model provides superior fit to DSM-5 PTSD symptom data, with the externalizing behaviors factor being most strongly related to anger and impulsivity.

Clusters of sirenomelia in South America.

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Orioli, Iêda M; Mastroiacovo, Pierpaolo; López-Camelo, Jorge S; Saldarriaga, Wilmar; Isaza, Carolina; Aiello, Horacio; Zarante, Ignacio; Castilla, Eduardo E

2009-02-01

One hospital in the city of Cali, Colombia, of the ECLAMC (Latin-American Collaborative Study of Congenital Malformations) network, reported the unusual occurrence of four cases of sirenomelia within a 55-day period. An ECLAMC routine for cluster evaluation (RUMOR) was followed that included: calculations of observed/expected ratios, site visits, comparison with comprehensively collected local, South American, and worldwide data, cluster analysis, and search for risk factors. All four Cali sirenomelia cases were born to mothers living in a 2 km(2) area, in neighboring communes, within the municipality of Cali. Considering the total births of the city of Cali as the denominator, and based on ECLAMC baseline birth prevalence rates (per 100,000) for sirenomelia (2.25, 95% CI: 2.66, 3.80), the cluster for this congenital abnormality was unlikely to have occurred by chance (observed/expected ratio = 5.77; 95% CI: 1.57-14.78; p = .002). No consistent common factor was identified, but vicinity to an open landfill as the cause could not be rejected. Another ECLAMC hospital in San Justo, Buenos Aires, Argentina, reported three further cases but these did not seem to constitute a nonrandom cluster. The methodology used to evaluate the two possible clusters of sirenomelia determined that the Cali sirenomelia cluster was unlikely to have occurred by chance whereas the sirenomelia cluster from San Justo seemed to be random. . (c) 2008 Wiley-Liss, Inc.

Multivariate analysis of structure and contribution per shares made by potential risk factors at malignant neoplasms in trachea, bronchial tubes and lung

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G.T. Aydinov

2017-03-01

Full Text Available The article gives the results of multivariate analysis of structure and contribution per shares made by potential risk factors at malignant neoplasms in trachea, bronchial tubes and lung. The authors used specialized databases comprising personified records on oncologic diseases in Taganrog, Rostov region, over 1986-2015 (30,684 registered cases of malignant neoplasms, including 3,480 cases of trachea cancer, bronchial tubes cancer, and lung cancer. When carrying out analytical research we applied both multivariate statistical techniques (factor analysis and hierarchical cluster correlation analysis and conventional techniques of epidemiologic analysis including etiologic fraction calculation (EF, as well as an original technique of assessing actual (epidemiologic risk. Average long-term morbidity with trachea, bronchial tubes and lung cancer over 2011-2015 amounts to 46.64 o / oooo . Over the last 15 years a stable decreasing trend has formed, annual average growth being – 1.22 %. This localization holds the 3rd rank place in oncologic morbidity structure, its specific weight being 10.02 %. We determined etiological fraction (EF for smoking as a priority risk factor causing trachea, bronchial tubes and lung cancer; this fraction amounts to 76.19 % for people aged 40 and older, and to 81.99 % for those aged 60 and older. Application of multivariate statistical techniques (factor analysis and cluster correlation analysis in this research enabled us to make factor structure more simple; namely, to highlight, interpret, give a quantitative estimate of self-descriptiveness and rank four group (latent potential risk factors causing lung cancer.

Emotional disorders: cluster 4 of the proposed meta-structure for DSM-V and ICD-11.

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Goldberg, D P; Krueger, R F; Andrews, G; Hobbs, M J

2009-12-01

The extant major psychiatric classifications DSM-IV, and ICD-10, are atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis would be greatly enhanced by an understanding of risk factors and clinical manifestations. In an effort to group mental disorders on the basis of aetiology, five clusters have been proposed. This paper considers the validity of the fourth cluster, emotional disorders, within that proposal. We reviewed the literature in relation to 11 validating criteria proposed by a Study Group of the DSM-V Task Force, as applied to the cluster of emotional disorders. An emotional cluster of disorders identified using the 11 validators is feasible. Negative affectivity is the defining feature of the emotional cluster. Although there are differences between disorders in the remaining validating criteria, there are similarities that support the feasibility of an emotional cluster. Strong intra-cluster co-morbidity may reflect the action of common risk factors and also shared higher-order symptom dimensions in these emotional disorders. Emotional disorders meet many of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster.

Risk factors for inappropriate blood requisition among hospitals in Tanzania.

Science.gov (United States)

Mauka, Wilhellmuss I; Mtuy, Tara B; Mahande, Michael J; Msuya, Sia E; Mboya, Innocent B; Juma, Abdul; Philemon, Rune N

2018-01-01

Blood is a critical aspect of treatment in life saving situations, increasing demand. Blood requisition practices greatly effect sufficient supply in blood banks. This study aimed to determine the risk factors for inappropriate blood requisition in Tanzania. This was a cross sectional study using secondary data of 14,460 patients' blood requests from 42 transfusion hospitals. Primary data were obtained by using cluster-sampling design. Data were analysed using a two-level mixed-effects Poisson regression to determine fixed-effects of individual-level factors and hospital level factors associated with inappropriate blood requests. P-value Factors significantly associated with inappropriate requisition were; reporting pulse rate and capillary refill decrease the risk (RR 0.74; 95% CI 0.64, 0.84) and (RR 0.73; 95% CI 0.63, 0.85) respectively and the following increased the risk; having surgery during hospital stay (RR 1.22; 95% CI 1.06, 1.4); being in general surgical ward (RR 3.3; 95% CI 2.7, 4.2), paediatric ward (RR 1.8; 95% CI 1.2, 2.7), obstetric ward (RR 2.5; 95% CI 2.0, 3.1), gynaecological ward (RR 2.1; 95% CI 1.5, 2.9), orthopaedics ward (RR 3.8; 95% CI 2.2, 6.7). Age of the patient, pallor and confirmation of pre-transfusion haemoglobin level were also significantly associated with inappropriate requisition. Majority of appropriate requisitions within the wards were marked in internal medicine (91.7%) and gynaecological wards (77.8%). The proportion of inappropriate blood requests was high. Blood requisition was determined by clinical and laboratory findings and the ward patients were admitted to. Adherence to transfusion guidelines is recommended to assure the best use of limited blood supply.

New risk factors for atherosclerosis and patient risk assessment

NARCIS (Netherlands)

Fruchart, Jean-Charles; Nierman, Melchior C.; Stroes, Erik S. G.; Kastelein, John J. P.; Duriez, Patrick

2004-01-01

Advances in our understanding of the ways in which the traditional cardiovascular risk factors, including standard lipid (eg, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol) and nonlipid (eg, hypertension) risk factors, interact to initiate

Bayesian Nonparametric Measurement of Factor Betas and Clustering with Application to Hedge Fund Returns

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Urbi Garay

2016-03-01

Full Text Available We define a dynamic and self-adjusting mixture of Gaussian Graphical Models to cluster financial returns, and provide a new method for extraction of nonparametric estimates of dynamic alphas (excess return and betas (to a choice set of explanatory factors in a multivariate setting. This approach, as well as the outputs, has a dynamic, nonstationary and nonparametric form, which circumvents the problem of model risk and parametric assumptions that the Kalman filter and other widely used approaches rely on. The by-product of clusters, used for shrinkage and information borrowing, can be of use to determine relationships around specific events. This approach exhibits a smaller Root Mean Squared Error than traditionally used benchmarks in financial settings, which we illustrate through simulation. As an illustration, we use hedge fund index data, and find that our estimated alphas are, on average, 0.13% per month higher (1.6% per year than alphas estimated through Ordinary Least Squares. The approach exhibits fast adaptation to abrupt changes in the parameters, as seen in our estimated alphas and betas, which exhibit high volatility, especially in periods which can be identified as times of stressful market events, a reflection of the dynamic positioning of hedge fund portfolio managers.

Human Leptospirosis and risk factors.

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Yanelis Emilia Tabío Henry

2010-09-01

Full Text Available The human leptospirosis is a zoonosis of world distribution, were risk factors exist that have favored the wild and domestic animal propagation and so man. A descpitive investigation was made with the objective of determining the behavior of risk factors in outpatients by human leptospirosis in “Camilo Cienfuegos“ University General Hospital from Sncti Spíritus In the comprised time period betwen december 1 st and 3 st , 2008.The sample of this study was conformed by 54 risk persons that keep inclusion criteria. Some variables were used:age, sex, risk factors and number of ill persons, according to the month. Some patients of masculine sex prevailed (61,9%, group of ages between 15-29 and 45-59 years (27,7%, patients treated since october to december (53,7%, the direct and indirect contact with animals (46,2 %. The risk factors cassually associated to human leptospirosis turned to be: the masculine sex, the contac with animals, the occupational exposition and the inmersion on sources of sweet water.

Critical Factors in Transnational Oil Companies Localisation Decisions - Clusters and Portfolio Optimisation

International Nuclear Information System (INIS)

Kind, Hans Jarle; Osmundsen, Petter; Tverteraas, Ragnar

2001-10-01

Enhanced understanding of the factors determining trans national companies' localisation decisions is important for regulators and other stake holders concerned about maintaining current activity levels in a petroleum producing country. This article discusses localisation decisions in the context of theories of industrial clusters and real portfolio optimisation theory (materiality), which we argue are two fruitful lines of explanation for trans national companies' behaviour. The industrial cluster literature is concerned about the level of positive externalities associated with geographic clustering of related production activities. The concept of materiality, implying that investment projects in an oil province must be of a certain minimum size in order to be interesting for oil companies, is evaluated empirically and compared to predictions of mainstream economic theory. (author)

Critical Factors in Transnational Oil Companies Localisation Decisions - Clusters and Portfolio Optimisation

Energy Technology Data Exchange (ETDEWEB)

Kind, Hans Jarle; Osmundsen, Petter; Tverteraas, Ragnar

2001-10-01

Enhanced understanding of the factors determining transnational companies' localisation decisions is important for regulators and other stakeholders concerned about maintaining current activity levels in a petroleum producing country. This article discusses localisation decisions in the context of theories of industrial clusters and real portfolio optimisation theory (materiality), which we argue are two fruitful lines of explanation for transnational companies' behaviour. The industrial cluster literature is concerned about the level of positive externalities associated with geographic clustering of related production activities. The concept of materiality, implying that investment projects in an oil province must be of a certain minimum size in order to be interesting for oil companies, is evaluated empirically and compared to predictions of mainstream economic theory. (author)

Descriptive analysis of factors that influence economical results in the furniture cluster of Bento Gonçalves

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Miguel Afonso Sellitto

2014-12-01

Full Text Available The purpose of this article is to analyze factors that can influence the competitiveness of companies in the furniture cluster of Bento Gonçalves, Rio Grande do Sul. By a literature review, we identify four factors that can influence competition in clusters: the region's productivity, innovation, relationship with suppliers, and cooperation between companies. The research method is the single case study. The research techniques are the review of specific bibliographic and documentation of the studied cluster, and interviews with experts of the cluster. The main findings are: the cluster has high productivity, mainly by hi-tech machinery employed by the main companies; innovation is permanent and motivated by the imposition to medium and short companies of business goals by the main companies; the relationship with suppliers is problematic regarding the large-scale vendors by the lack of the practice of collective purchases in the area; and cooperation between enterprises is small, by the culture of the region that don´t appreciate depending on resources available outside the companies. Such factors can contribute to produce hypotheses for further research.

Appreciating Complexity in Adolescent Self-Harm Risk Factors: Psychological Profiling in a Longitudinal Community Sample.

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Stanford, Sarah; Jones, Michael P; Hudson, Jennifer L

2018-05-01

Past research identifies a number of risk factors for adolescent self-harm, but often fails to account for overlap between these factors. This study investigated the underlying, broader concepts by identifying different psychological profiles among adolescents. We then compared new self-harm rates over a six-month period across different psychological profiles. Australian high school students (n = 326, 68.1% female) completed a questionnaire including a broad range of psychological and socioenvironmental risk and protective factors. Non-hierarchical cluster analysis produced six groups with different psychological profiles at baseline and rate of new self-harm at follow-up. The lowest rate was 1.4% in a group that appeared psychologically healthy; the highest rate was 37.5% in a group that displayed numerous psychological difficulties. Four groups with average self-harm had varied psychological profiles including low impulsivity, anxiety, impulsivity, and poor use of positive coping strategies. Identifying multiple profiles with distinct psychological characteristics can improve detection, guide prevention, and tailor treatment.

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

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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.

Examining Measures of Weight as Risk Factors for Sport-Related Injury in Adolescents

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Sarah A. Richmond

2016-01-01

Full Text Available Objectives. To examine body mass index (BMI and waist circumference (WC as risk factors for sport injury in adolescents. Design. A secondary analysis of prospectively collected data from a pilot cluster randomized controlled trial. Methods. Adolescents (n=1,040 at the ages of 11–15 years from two Calgary junior high schools were included. BMI (kg/m2 and WC (cm were measured from direct measures at baseline assessment. Categories (overweight/obese were created using validated international (BMI and national (WC cut-off points. A Poisson regression analysis controlling for relevant covariates (sex, previous injury, sport participation, intervention group, and aerobic fitness level estimated the risk of sport injury [incidence rate ratios (IRR with 95% confidence intervals (CI]. Results. There was an increased risk of time loss injury (IRR = 2.82, 95% CI: 1.01–8.04 and knee injury (IRR = 2.07, 95% CI: 1.00–6.94 in adolescents that were overweight/obese; however, increases in injury risk for all injury and lower extremity injury were not statistically significant. Estimates suggested a greater risk of time loss injury [IRR = 1.63 (95% CI: 0.93–2.47] in adolescents with high measures of WC. Conclusions. There is an increased risk of time loss injury and knee injury in overweight/obese adolescents. Sport injury prevention training programs should include strategies that target all known risk factors for injury.

School-related risk factors for drunkenness among adolescents: risk factors differ between socio-economic groups

DEFF Research Database (Denmark)

Andersen, Anette; Holstein, Bjørn E; Due, Pernille

2006-01-01

Purpose: To examine, separately for boys and girls, whether socio-economic differences in drunkenness exist in adolescence, whether the level of exposure to school-related risk factors differ between socio-economic groups, and whether the relative contribution of school-related risk factors......) was measured by parental occupation. RESULTS: Among girls, exposures to school-related risk factors were more prevalent in lower socio-economic groups. Poor school satisfaction was associated with drunkenness among girls from high SEP, odds ratio (OR) = 2.98 (0.73-12.16). Among boys from high SEP autonomy...

Non-negative matrix factorization by maximizing correntropy for cancer clustering

KAUST Repository

Wang, Jim Jing-Yan; Wang, Xiaolei; Gao, Xin

2013-01-01

Background: Non-negative matrix factorization (NMF) has been shown to be a powerful tool for clustering gene expression data, which are widely used to classify cancers. NMF aims to find two non-negative matrices whose product closely approximates the original matrix. Traditional NMF methods minimize either the l2 norm or the Kullback-Leibler distance between the product of the two matrices and the original matrix. Correntropy was recently shown to be an effective similarity measurement due to its stability to outliers or noise.Results: We propose a maximum correntropy criterion (MCC)-based NMF method (NMF-MCC) for gene expression data-based cancer clustering. Instead of minimizing the l2 norm or the Kullback-Leibler distance, NMF-MCC maximizes the correntropy between the product of the two matrices and the original matrix. The optimization problem can be solved by an expectation conditional maximization algorithm.Conclusions: Extensive experiments on six cancer benchmark sets demonstrate that the proposed method is significantly more accurate than the state-of-the-art methods in cancer clustering. 2013 Wang et al.; licensee BioMed Central Ltd.

Non-negative matrix factorization by maximizing correntropy for cancer clustering

KAUST Repository

Wang, Jim Jing-Yan

2013-03-24

Background: Non-negative matrix factorization (NMF) has been shown to be a powerful tool for clustering gene expression data, which are widely used to classify cancers. NMF aims to find two non-negative matrices whose product closely approximates the original matrix. Traditional NMF methods minimize either the l2 norm or the Kullback-Leibler distance between the product of the two matrices and the original matrix. Correntropy was recently shown to be an effective similarity measurement due to its stability to outliers or noise.Results: We propose a maximum correntropy criterion (MCC)-based NMF method (NMF-MCC) for gene expression data-based cancer clustering. Instead of minimizing the l2 norm or the Kullback-Leibler distance, NMF-MCC maximizes the correntropy between the product of the two matrices and the original matrix. The optimization problem can be solved by an expectation conditional maximization algorithm.Conclusions: Extensive experiments on six cancer benchmark sets demonstrate that the proposed method is significantly more accurate than the state-of-the-art methods in cancer clustering. 2013 Wang et al.; licensee BioMed Central Ltd.

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...

Are religiosity and prayer use related with multiple behavioural risk factors for chronic diseases in European adults aged 50+ years?

Science.gov (United States)

Linardakis, M; Papadaki, A; Smpokos, E; Sarri, K; Vozikaki, M; Philalithis, A

2015-05-01

Behavioural risk factors for chronic diseases involve factors relating to lifestyle habits. This study examined the relationship of religious and spiritual beliefs with the adoption and presence of multiple behavioural risk factors (MBRFs) in European adults. Cross-sectional study. Data were used from 16,557 individuals, aged 50+ years, participating in the Survey of Health, Ageing and Retirement in Europe (2004/05). MBRFs clustering was defined by high body weight, smoking, physical inactivity and risky alcohol consumption, and regression estimations with religiosity and prayer use were assessed based on sampling weights. In total, 79.4% of participants had received religious education, 33.4% had used prayer '≥1 time/day' and 53.3% had clustering of 2+ MBRFs. Lower prevalence of smoking was found in males (20.6% vs. 29.4%, P prayer use (standardized beta = 0.056, P prayer use were related to the presence of fewer MBRFs in European adults aged 50+ years. These lifestyle factors should be assessed as potential determinants of MBRFs adoption when examining chronic disease development in multicultural populations. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Risk factor for febrile seizures

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Odalović Dragica

2014-01-01

Full Text Available Febrile seizures are the most frequent neurological disorder in the childhood. According to American Academy of Pediatrics (AAP, they have been defined as seizures provoked by high temperature in children aged between 6 months and 5 years, without previous history of afebrile seizures, intracranial infections and other possible causes of seizures. Seizures can be typical and atypical, according to the characteristics. Pathogenesis of this disorder has not been clarified yet, and it is believed to be a combination of genetic factors, high body temperature and brain maturation. The risk factors for recurrence of febrile seizures are: age in which seizures appeared for the first time, epilepsy in the first degree relative, febrile seizures in the first degree relative, frequent diseases with fever and low body temperature on the beginning of seizures. The frequency of recurrent seizures The risk for occurrence of epilepsy in children with simple seizures is about 1-1.5%, which is slightly higher compared to general population, while it increases to 4-15% in patients with complex seizures. However, there is no evidence that therapy prevents occurrence of epilepsy. When the prevention of recurrent seizures is considered, it is necessary to separate simple from complex seizures. The aim of this paper was to analyze the most important risk factors for febrile seizures, and to evaluate their impact on occurrence of recurrent seizures. Our study included 125 children with febrile seizures, aged from 6 months to 5 years. The presence of febrile seizures and epilepsy in the first degree relative has been noted in 22% of children. Typical febrile seizures were observed in 76% of cases, and atypical in 24%. Most patients had only one seizure (73.6%. Children, who had seizure earlier in life, had more frequent recurrences. Both risk factors were present in 25% of patients, while 68% of patients had only one risk factor. For the children with febrile disease

Detection of major climatic and environmental predictors of liver fluke exposure risk in Ireland using spatial cluster analysis.

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Selemetas, Nikolaos; de Waal, Theo

2015-04-30

Fasciolosis caused by Fasciola hepatica (liver fluke) can cause significant economic and production losses in dairy cow farms. The aim of the current study was to identify important weather and environmental predictors of the exposure risk to liver fluke by detecting clusters of fasciolosis in Ireland. During autumn 2012, bulk-tank milk samples from 4365 dairy farms were collected throughout Ireland. Using an in-house antibody-detection ELISA, the analysis of BTM samples showed that 83% (n=3602) of dairy farms had been exposed to liver fluke. The Getis-Ord Gi* statistic identified 74 high-risk and 130 low-risk significant (Pclimatic variables (monthly and seasonal mean rainfall and temperatures, total wet days and rain days) and environmental datasets (soil types, enhanced vegetation index and normalised difference vegetation index) were used to investigate dissimilarities in the exposure to liver fluke between clusters. Rainfall, total wet days and rain days, and soil type were the significant classes of climatic and environmental variables explaining the differences between significant clusters. A discriminant function analysis was used to predict the exposure risk to liver fluke using 80% of data for modelling and the remaining subset of 20% for post hoc model validation. The most significant predictors of the model risk function were total rainfall in August and September and total wet days. The risk model presented 100% sensitivity and 91% specificity and an accuracy of 95% correctly classified cases. A risk map of exposure to liver fluke was constructed with higher probability of exposure in western and north-western regions. The results of this study identified differences between clusters of fasciolosis in Ireland regarding climatic and environmental variables and detected significant predictors of the exposure risk to liver fluke. Copyright © 2015 Elsevier B.V. All rights reserved.

High prevalence of cardiovascular risk factors in Asian Indians: A community survey - Chandigarh Urban Diabetes Study (CUDS

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Rama Walia

2014-01-01

Full Text Available Background & objectives: Studies conducted to assess the prevalence of cardiovascular (CV risk factors among different regions of the country show variation in risk factors in different age groups and urban and rural population. We undertook this study to determine the prevalence of cardiovascular risk factors among urban adults in a north Indian city. Methods: In a cross-sectional survey, 2227 subjects aged ≥ 20 yr were studied from April 2008 to June 2009 in Urban Chandigarh, a north Indian city. Demographic history, anthropometry and blood pressure were assessed. Fasting, and 2 h capillary plasma glucose after 75 g glucose load, HDL-C and triglycerides were estimated. Results: The most prevalent cardiovascular risk factors in the age group of 20-29 yr was sedentary lifestyle (63%, while from fourth decade and onwards, it was overweight/obesity (59-85%. The second most common prevalent cardiovascular risk factor in the age group of 20-29 yr was overweight/obesity, in 30-49 yr sedentary lifestyle, in 50-69 yr hypertension and in subjects ≥70 yr, it was hypertriglyceridaemia. The prevalence of overweight/obesity, hypertension, dysglycaemia and smoking was almost double in subjects in the fourth decade of life, as compared to those in the third decade of life. The prevalence of CV risk factors significantly increased with age irrespective of gender and prevalence of low HDL-C was significantly more common in women as compared to men. Interpretation & conclusions: Sedentary lifestyle, obesity and low HDL-C are the most prevalent CV risk factors in subjects in the third and fourth decade of life in this north Indian population and clustering of these cardiovascular risk factors increases with advancing age. Strategies need to be formulated to target this population to prevent the epidemic of cardiovascular disease.

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

Science.gov (United States)

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

2017-01-01

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

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 Need To Know About The Hidden Risk Factors ... 2012) This year, more than 100,000 U.S. women under 65 will have a stroke. Stroke is ...

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

Science.gov (United States)

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

2015-01-01

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

Can body mass index, waist circumference, waist-hip ratio and waist-height ratio predict the presence of multiple metabolic risk factors in Chinese subjects?

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Lu Liping

2011-01-01

Full Text Available Abstract Background Obesity is associated with metabolic risk factors. Body mass index (BMI, waist circumference, waist-hip ratio (WHR and waist-height ratio (WHtR are used to predict the risk of obesity related diseases. However, it has not been examined whether these four indicators can detect the clustering of metabolic risk factors in Chinese subjects. Methods There are 772 Chinese subjects in the present study. Metabolic risk factors including high blood pressure, dyslipidemia, and glucose intolerance were identified according to the criteria from WHO. All statistical analyses were performed separately according to sex by using the SPSS 12.0. Results BMI, waist circumference and WHtR values were all significantly associated with blood pressure, glucose, triglyceride and also with the number of metabolic risk factors in both male and female subjects (all of P Conclusion The BMI, waist circumference and WHtR values can similarly predict the presence of multiple metabolic risk factors in Chinese subjects.

Down syndrome clusters in Germany after the Chernobyl accident

International Nuclear Information System (INIS)

Burkart, W.; Grosche, B.; Schoetzau, A.

1997-01-01

In two independent studies using different approaches and covering West Berlin and Bavaria, respectively, highly significant temporal clusters of Down syndrome were found. Both sharp increases occurred in areas receiving relatively low Chernobyl fallout and concomitant radiation exposures. Only for the Berlin cluster was fallout present at the time of the affected meiosis, whereas the Nuremberg cluster preceded the radioactive contamination by 1 month. Hypotheses on possible causal relationships are compared. Radiation from the Chernobyl accident is an unlikely factor, because the associated cumulative dose was so low in comparison with natural background. Microdosimetric considerations would indicate that fewer than 1 in 200 oocyte nuclei would have experienced an ionizing event from Chernobyl radioactivity. Given the lack of understanding of what causes Down syndrome, other than factors associated with increased maternal age, additional research into environmental and infectious risk factors is warranted. 23 refs., 4 figs., 2 tabs

Impact of a nurse-led intervention to improve screening for cardiovascular risk factors in people with severe mental illnesses. Phase-two cluster randomised feasibility trial of community mental health teams

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Nazareth Irwin

2010-03-01

CVD risk factor. The feasibility of the trial was confirmed in terms of CMHT recruitment and the intervention, but the response rate for outcome collection was disappointing; possibly a result of the cluster design. The trial was not large or long enough to detect changes in risk factors. Trial Registration International Standard Randomised Controlled Trial Registration Number (ISRCTRN 58625025.

Comparison of Skin Moisturizer: Consumer-Based Brand Equity (CBBE Factors in Clusters Based on Consumer Ethnocentrism

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Yossy Hanna Garlina

2014-09-01

Full Text Available This research aims to analyze relevant factors contributing to the four dimensions of consumer-based brand equity in skin moisturizer industry. It is then followed by the clustering of female consumers of skin moisturizer based on ethnocentrism and differentiating each cluster’s consumer-based brand equity dimensions towards a domestic skin moisturizer brand Mustika Ratu, skin moisturizer. Research used descriptive survey method analysis. Primary data was obtained through questionnaire distribution to 70 female respondents for factor analysis and 120 female respondents for cluster analysis and one way analysis of variance (ANOVA. This research employed factor analysis to obtain relevant factors contributing to the five dimensions of consumer-based brand equity in skin moisturizer industry. Cluster analysis and one way analysis of variance (ANOVA were to see the difference of consumer-based brand equity between highly ethnocentric consumer and low ethnocentric consumer towards the same skin moisturizer domestic brand, Mustika Ratu skin moisturizer. Research found in all individual dimension analysis, all variable means and individual means show distinct difference between the high ethnocentric consumer and the low ethnocentric consumer. The low ethnocentric consumer cluster tends to be lower in mean score of Brand Loyalty, Perceived Quality, Brand Awareness, Brand Association, and Overall Brand Equity than the high ethnocentric consumer cluster. Research concludes consumer ethnocentrism is positively correlated with preferences towards domestic products and negatively correlated with foreign-made product preference. It is, then, highly ethnocentric consumers have positive perception towards domestic product.

Quantifying urbanization as a risk factor for noncommunicable disease.

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Allender, Steven; Wickramasinghe, Kremlin; Goldacre, Michael; Matthews, David; Katulanda, Prasad

2011-10-01

The aim of this study was to investigate the poorly understood relationship between the process of urbanization and noncommunicable diseases (NCDs) in Sri Lanka using a multicomponent, quantitative measure of urbanicity. NCD prevalence data were taken from the Sri Lankan Diabetes and Cardiovascular Study, comprising a representative sample of people from seven of the nine provinces in Sri Lanka (n = 4,485/5,000; response rate = 89.7%). We constructed a measure of the urban environment for seven areas using a 7-item scale based on data from study clusters to develop an "urbanicity" scale. The items were population size, population density, and access to markets, transportation, communications/media, economic factors, environment/sanitation, health, education, and housing quality. Linear and logistic regression models were constructed to examine the relationship between urbanicity and chronic disease risk factors. Among men, urbanicity was positively associated with physical inactivity (odds ratio [OR] = 3.22; 2.27-4.57), high body mass index (OR = 2.45; 95% CI, 1.88-3.20) and diabetes mellitus (OR = 2.44; 95% CI, 1.66-3.57). Among women, too, urbanicity was positively associated with physical inactivity (OR = 2.29; 95% CI, 1.64-3.21), high body mass index (OR = 2.92; 95% CI, 2.41-3.55), and diabetes mellitus (OR = 2.10; 95% CI, 1.58 - 2.80). There is a clear relationship between urbanicity and common modifiable risk factors for chronic disease in a representative sample of Sri Lankan adults.

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

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Filipp M Filippopulos

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

Urbanicity and lifestyle risk factors for cardiometabolic diseases in rural Uganda: a cross-sectional study.

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Riha, Johanna; Karabarinde, Alex; Ssenyomo, Gerald; Allender, Steven; Asiki, Gershim; Kamali, Anatoli; Young, Elizabeth H; Sandhu, Manjinder S; Seeley, Janet

2014-07-01

Urban living is associated with unhealthy lifestyles that can increase the risk of cardiometabolic diseases. In sub-Saharan Africa (SSA), where the majority of people live in rural areas, it is still unclear if there is a corresponding increase in unhealthy lifestyles as rural areas adopt urban characteristics. This study examines the distribution of urban characteristics across rural communities in Uganda and their associations with lifestyle risk factors for chronic diseases. Using data collected in 2011, we examined cross-sectional associations between urbanicity and lifestyle risk factors in rural communities in Uganda, with 7,340 participants aged 13 y and above across 25 villages. Urbanicity was defined according to a multi-component scale, and Poisson regression models were used to examine associations between urbanicity and lifestyle risk factors by quartile of urbanicity. Despite all of the villages not having paved roads and running water, there was marked variation in levels of urbanicity across the villages, largely attributable to differences in economic activity, civil infrastructure, and availability of educational and healthcare services. In regression models, after adjustment for clustering and potential confounders including socioeconomic status, increasing urbanicity was associated with an increase in lifestyle risk factors such as physical inactivity (risk ratio [RR]: 1.19; 95% CI: 1.14, 1.24), low fruit and vegetable consumption (RR: 1.17; 95% CI: 1.10, 1.23), and high body mass index (RR: 1.48; 95% CI: 1.24, 1.77). This study indicates that even across rural communities in SSA, increasing urbanicity is associated with a higher prevalence of lifestyle risk factors for cardiometabolic diseases. This finding highlights the need to consider the health impact of urbanization in rural areas across SSA. Please see later in the article for the Editors' Summary.

Urbanicity and lifestyle risk factors for cardiometabolic diseases in rural Uganda: a cross-sectional study.

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Johanna Riha

2014-07-01

Full Text Available Urban living is associated with unhealthy lifestyles that can increase the risk of cardiometabolic diseases. In sub-Saharan Africa (SSA, where the majority of people live in rural areas, it is still unclear if there is a corresponding increase in unhealthy lifestyles as rural areas adopt urban characteristics. This study examines the distribution of urban characteristics across rural communities in Uganda and their associations with lifestyle risk factors for chronic diseases.Using data collected in 2011, we examined cross-sectional associations between urbanicity and lifestyle risk factors in rural communities in Uganda, with 7,340 participants aged 13 y and above across 25 villages. Urbanicity was defined according to a multi-component scale, and Poisson regression models were used to examine associations between urbanicity and lifestyle risk factors by quartile of urbanicity. Despite all of the villages not having paved roads and running water, there was marked variation in levels of urbanicity across the villages, largely attributable to differences in economic activity, civil infrastructure, and availability of educational and healthcare services. In regression models, after adjustment for clustering and potential confounders including socioeconomic status, increasing urbanicity was associated with an increase in lifestyle risk factors such as physical inactivity (risk ratio [RR]: 1.19; 95% CI: 1.14, 1.24, low fruit and vegetable consumption (RR: 1.17; 95% CI: 1.10, 1.23, and high body mass index (RR: 1.48; 95% CI: 1.24, 1.77.This study indicates that even across rural communities in SSA, increasing urbanicity is associated with a higher prevalence of lifestyle risk factors for cardiometabolic diseases. This finding highlights the need to consider the health impact of urbanization in rural areas across SSA. Please see later in the article for the Editors' Summary.

Clinical fracture risk evaluated by hierarchical agglomerative clustering

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Kruse, C; Eiken, P; Vestergaard, P

2017-01-01

reimbursement, primary healthcare sector use and comorbidity of female subjects were combined. Standardized variable means, Euclidean distances and Ward's D2 method of hierarchical agglomerative clustering (HAC), were used to form the clustering object. K number of clusters was selected with the lowest cluster...

The risk factor of thyroid

International Nuclear Information System (INIS)

Kusama, Tomoko

1979-01-01

For the purposes of radiation protection, the noteworthy risk of thyroid is carcinogenesis. The risk factor which ICRP presented in the publication-26 is 5 x 10 - 6 rem - 1 . This numerical value is based upon the estimated likelihood of inducing fatal thyroid cancer. On the other hand, the risk factor presented by the BEIR report is 4 x 10 - 6 yr - 1 . This value was decided after consideration of the risks of both fatal and non-fatal cancer of thyroid. The following features distinguished thyroid cancer from malignancy of other tissue from medical point of view. 1) A large difference between incidence and mortality in case of thyroid cancer is recognized, because the thyroid cancer could be successfully treated by surgical or radiological treatment. 2) The high prevalence of clinically silent tumor in thyroid gland has been reported. The incidence of thyroid cancer, therefore, is very dependent on methods of medical inspection. The prevalence of radiation induced thyroid cancer is modified by various factors such as age, sex, latency, dose and dose rate. The latent period is very important factors such as ave, sex, latency, dose and dose rate. The latent period is a very important factor in the estimation of accumulated total risk of thyroid malignancy. What is included in the risk caused by thyroid irradiation must be investigated. The risk of non-fatal cancer should be considered in the same way as that of fatal cancer. The dose-equivalent limit of thyroid in non-uniform irradiation caused by radioactive iodine is decided by the limit for non-stochastic effects. Therefore the further consideration of non-stochastic effects of thyroid is necessary. (author)

A two-stage approach to estimate spatial and spatio-temporal disease risks in the presence of local discontinuities and clusters.

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Adin, A; Lee, D; Goicoa, T; Ugarte, María Dolores

2018-01-01

Disease risk maps for areal unit data are often estimated from Poisson mixed models with local spatial smoothing, for example by incorporating random effects with a conditional autoregressive prior distribution. However, one of the limitations is that local discontinuities in the spatial pattern are not usually modelled, leading to over-smoothing of the risk maps and a masking of clusters of hot/coldspot areas. In this paper, we propose a novel two-stage approach to estimate and map disease risk in the presence of such local discontinuities and clusters. We propose approaches in both spatial and spatio-temporal domains, where for the latter the clusters can either be fixed or allowed to vary over time. In the first stage, we apply an agglomerative hierarchical clustering algorithm to training data to provide sets of potential clusters, and in the second stage, a two-level spatial or spatio-temporal model is applied to each potential cluster configuration. The superiority of the proposed approach with regard to a previous proposal is shown by simulation, and the methodology is applied to two important public health problems in Spain, namely stomach cancer mortality across Spain and brain cancer incidence in the Navarre and Basque Country regions of Spain.

A National Surveillance Survey on Noncommunicable Disease Risk Factors: Suriname Health Study Protocol

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Smits, Christel CF; Jaddoe, Vincent WV; Hofman, Albert; Toelsie, Jerry R

2015-01-01

Background Noncommunicable diseases (NCDs) are the leading cause of death in low- and middle-income countries. Therefore, the surveillance of risk factors has become an issue of major importance for planning and implementation of preventive measures. Unfortunately, in these countries data on NCDs and their risk factors are limited. This also prevails in Suriname, a middle-income country of the Caribbean, with a multiethnic/multicultural population living in diverse residential areas. For these reasons, “The Suriname Health Study” was designed. Objective The main objective of this study is to estimate the prevalence of NCD risk factors, including metabolic syndrome, hypertension, and diabetes in Suriname. Differences between specific age groups, sexes, ethnic groups, and geographical areas will be emphasized. In addition, risk groups will be identified and targeted actions will be designed and evaluated. Methods In this study, several methodologies were combined. A stratified multistage cluster sample was used to select the participants of 6 ethnic groups (Hindustani, Creole, Javanese, Maroon, Chinese, Amerindians, and mixed) divided into 5 age groups (between 15 and 65 years) who live in urban/rural areas or the hinterland. A standardized World Health Organization STEPwise approach to surveillance questionnaire was adapted and used to obtain information about demographic characteristics, lifestyle, and risk factors. Physical examinations were performed to measure blood pressure, height, weight, and waist circumference. Biochemical analysis of collected blood samples evaluated the levels of glucose, high-density-lipoprotein cholesterol, total cholesterol, and triglycerides. Statistical analysis will be used to identify the burden of modifiable and unmodifiable risk factors in the aforementioned subgroups. Subsequently, tailor-made interventions will be prepared and their effects will be evaluated. Results The data as collected allow for national inference and

Clustering of obesity and dental health with lifestyle factors among Turkish and Finnish pre-adolescents

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Cinar, Basak; Murtomaa, Heikki

2008-01-01

This study aims to assess any clustering between obesity, number of decayed, missing, and filled teeth (DMFT), television (TV) viewing, and lifestyle factors among pre-adolescents living in 2 countries with different developmental status and oral health care systems - Turkey and Finland.......This study aims to assess any clustering between obesity, number of decayed, missing, and filled teeth (DMFT), television (TV) viewing, and lifestyle factors among pre-adolescents living in 2 countries with different developmental status and oral health care systems - Turkey and Finland....

Prevalence and risk factors for trachoma in central and southern Malawi.

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Khumbo Kalua

Full Text Available BACKGROUND: Trachoma, one of the neglected tropical diseases is suspected to be endemic in Malawi. OBJECTIVES: To determine the prevalence of trachoma and associated risk factors in central and southern Malawi. METHODOLOGY/PRINCIPAL FINDINGS: A population based survey conducted in randomly selected clusters in Chikwawa district (population 438,895, southern Malawi and Mchinji district (population 456,558, central Malawi. Children aged 1-9 years and adults aged 15 and above were assessed for clinical signs of trachoma. In total, 1010 households in Chikwawa and 1016 households in Mchinji districts were enumerated within 108 clusters (54 clusters in each district. A total of 6,792 persons were examined for ocular signs of trachoma. The prevalence of trachomatous inflammation, follicular (TF among children aged 1-9 years was 13.6% (CI 11.6-15.6 in Chikwawa and 21.7% (CI 19.5-23.9 in Mchinji districts respectively. The prevalence of trachoma trichiasis (TT in women and men aged 15 years and above was 0.6% (CI 0.2-0.9 in Chikwawa and 0.3% (CI 0.04-0.6 in Mchinji respectively. The presence of a dirty face was significantly associated with trachoma follicular (TF in both Chikwawa and Mchinji districts (P10%, and warrants the trachoma SAFE control strategy to be undertaken in Chikwawa and Mchinji districts.

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

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

2017-09-01

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

Industrial risk factors for colorectal cancer

International Nuclear Information System (INIS)

Lashner, B.A.; Epstein, S.S.

1990-01-01

Colorectal cancer is the second most common malignancy in the United States, and its incidence rates have sharply increased recently, especially in males. Industrial exposures, both occupational and environmental, are important colorectal cancer risk factors that are generally unrecognized by clinicians. Migration studies have documented that colorectal cancer is strongly associated with environmental risk factors. The causal role of occupational exposures is evidenced by a substantial literature associating specific work practices with increased colorectal cancer risks. Industrially related environmental exposures, including polluted drinking water and ionizing radiation, have also been associated with excess risks. Currently, there is a tendency to attribute colorectal cancer, largely or exclusively, to dietary and other lifestyle factors, thus neglecting these industrially related effects. Concerted efforts are needed to recognize the causal role of industrial risk factors and to encourage government and industry to reduce carcinogenic exposures. Furthermore, cost-effective screening programs for high-risk population groups are critically needed to further reduce deaths from colorectal cancer. 143 references

Environmental risk factors contributing to traffic accidents in children: a case-control study.

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Jamshidi, Ensiyeh; Moradi, Ali; Majdzadeh, Reza

2017-09-01

The aim of this study is to identify environmental risk factors related to road accidents in children of Tehran. This case-control study was performed in 2013. The cases were injured pedestrians aged 5-15 who were admitted to major hospitals supervised by Tehran University of Medical Sciences. The sample size for the cases was 273 and for the control group was 546. For the completeness of the clusters, 7 extra persons in case (total = 280) and 14 persons (total = 560) in control group were included. The interference of confounding variables assessed through forward conditional logistic regression. Result shows occurrence of traffic accidents was significantly associate with the width of the alleys or (traffic congestion (OR = 4.1, 95% CI: 2.6-6.4), traffic speed (OR = 2.1, 95% CI: 1.3-3.2) and existence of pedestrian bridges(OR = 4.2, 95% CI: 2.6-6.8). In the light of the important role of environmental factors in the occurrence of child traffic accidents, alleviating structural risk factors in addition to education and enforcement need more systematic efforts and planning by policymakers and urban planners to attain pedestrian safety goals.

Environmental risk factors and pressures

International Nuclear Information System (INIS)

Klinda, J.; Lieskovska, Z.

1998-01-01

In this chapter the physical risk factors (as radiation [air contamination, contamination of the environment components and food contamination], radon and its radioactive decay products, radioactive wastes, noise), chemical risk factors [chemical substances, xenobiotics in the food chain the ozone depletion], wastes (waste generation, waste management, municipal waste management, import, export and transit of waste) and natural an technological hazards (water quality deterioration as a result of various accidents and fire risk) in the Slovak Republic in 1997 are reviewed

Clusters as a factor for sustainable development in rural areas

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Justyna Socińska

2012-09-01

Full Text Available Sustainable development is one of the determinants of strategic thinking and current operation of modern companies. Sustainable development is a factor in other words, in which companies come to work. It is an important factor, and having far-reaching repercussions, but it is not the only one. Enterprises should therefore take in its action it into account, adapt to it and benefit from its existence, but that does not mean that this fact can and should be the only determinant of their performance. The determinant of its action should reflect the clusters, especially those operating in rural areas.

Hessian regularization based non-negative matrix factorization for gene expression data clustering.

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Liu, Xiao; Shi, Jun; Wang, Congzhi

2015-01-01

Since a key step in the analysis of gene expression data is to detect groups of genes that have similar expression patterns, clustering technique is then commonly used to analyze gene expression data. Data representation plays an important role in clustering analysis. The non-negative matrix factorization (NMF) is a widely used data representation method with great success in machine learning. Although the traditional manifold regularization method, Laplacian regularization (LR), can improve the performance of NMF, LR still suffers from the problem of its weak extrapolating power. Hessian regularization (HR) is a newly developed manifold regularization method, whose natural properties make it more extrapolating, especially for small sample data. In this work, we propose the HR-based NMF (HR-NMF) algorithm, and then apply it to represent gene expression data for further clustering task. The clustering experiments are conducted on five commonly used gene datasets, and the results indicate that the proposed HR-NMF outperforms LR-based NMM and original NMF, which suggests the potential application of HR-NMF for gene expression data.

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

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

2017-12-27

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

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

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

2009-10-01

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

Cardiovascular Risk Factors among First Year Medical Students

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Raj Krishna Dangol

2017-12-01

Full Text Available Introduction: Detection of cardiovascular risk in young age is important to motivate them to modify life styles and seek health care early to lower the chances of acquiring cardiovascular disease in later age. This study was done to assess cardiovascular risk factors among first year medical students. Methods: A cross-sectional study was conducted throughout September and October 2017 in which all first year medical students from a medical college were assessed for the presence of cardiovascular risk factors. Participants’ demography, family history of illness, anthropometric measurements, and blood reports of lipid profile and fasting glucose were acquired. Data were analyzed with Statistical Package for Social Sciences (SPSS-21. Result: There were 99 participants; 55 males and 44 females. One or more risk factors were present in 87 (87.9% participants. Moreover, 67.7% (n = 67 participants had more than one risk factors. Low HDL-cholesterol was the most common (n = 55, 55.6% risk factor followed by elevated triacylglycerol (n = 47, 47.5% and family history of hypertension (n = 45, 45.5%. There was no significant difference in presence of various risk factors between genders. Conclusion: There was higher prevalence of cardiovascular risk factors among first year medical students. Majority of them had more than one risk factors. Low HDL-cholesterol was the most common risk factor. The risk factors were comparable in males and females.

Clusters of Multidrug-Resistant Mycobacterium tuberculosis Cases, Europe

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Kremer, Kristin; Heersma, Herre; Van Soolingen, Dick

2009-01-01

Molecular surveillance of multidrug-resistant tuberculosis (MDR TB) was implemented in Europe as case reporting in 2005. For all new MDR TB cases detected from January 2003 through June 2007, countries reported case-based epidemiologic data and DNA fingerprint patterns of MDR TB strains when available. International clusters were detected and analyzed. From 2003 through mid-2007 in Europe, 2,494 cases of MDR TB were reported from 24 European countries. Epidemiologic and molecular data were linked for 593 (39%) cases, and 672 insertion sequence 6110 DNA fingerprint patterns were reported from 19 countries. Of these patterns, 288 (43%) belonged to 18 European clusters; 7 clusters (242/288 cases, 84%) were characterized by strains of the Beijing genotype family, including the largest cluster (175/288 cases, 61%). Both clustering and the Beijing genotype were associated with strains originating in eastern European countries. Molecular cluster detection contributes to identification of transmission profile, risk factors, and control measures. PMID:19624920

Non-communicable disease (NCD) risk factors and diabetes among adults living in slum areas of Dhaka, Bangladesh.

Science.gov (United States)

Rawal, Lal B; Biswas, Tuhin; Khandker, Nusrat Nausheen; Saha, Shekhar Ranjan; Bidat Chowdhury, Mohammed Mahiul; Khan, Abdullah Nurus Salam; Chowdhury, Enamul Hasib; Renzaho, Andre

2017-01-01

Despite one-third of the urban population in Bangladesh living in urban slums and at increased risk of non-communicable diseases (NCDs), little is known about the NCD risk profile of this at-risk population. The aim of the study was to identify the prevalence of the NCD risk factors and the association of NCD risk factors with socio-demographic factors among the adults of urban slums in Dhaka, Bangladesh. A cross-sectional study was conducted among adult slum dwellers (aged 25 and above) residing in three purposively selected urban slums of Dhaka for at least six months preceding the survey. The risk factors assessed were- currently smoking, fruit and vegetable intake, physical activity, hypertension and body mass index (BMI). Information on self-reported diabetes was also taken. A total of 507 participants (252 females; 49.7%) were interviewed and their physical measures were taken using the WHO NCD STEPS instrument. The overall prevalence of NCD risk factors was: 36.0% (95% CI: 31.82-40.41) for smoking; 95.60% (95% CI: 93.60-97.40) for insufficient fruit and vegetable intake; 15.30% (95% CI:12.12-18.71) for low physical activity;13.70% (95% CI: 10.71-16.92) for hypertension; 22.70% (95% CI: 19.31-26.02) for overweight or obesity; and 5.00% (95%: 3.20-7.00) for self-reported diabetes. In the logistic regression model, the clustering of three or more NCD risk factors was positively associated with younger age groups (p = 0.02), no formal education (p slum adults. These findings are important to support the formulation and implementation of NCD-related polices and plan of actions that recognize urban slum populations in Bangladesh as a priority sub-population.

[Risk factors of necrotizing enterocolitis].

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

1993-09-01

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

Late-onset neonatal sepsis, risk factors and interventions: an analysis of recurrent outbreaks of Serratia marcescens, 2006-2011.

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Samuelsson, A; Isaksson, B; Hanberger, H; Olhager, E

2014-01-01

Between 2006 and 2011, 11 patients with Serratia marcescens sepsis and 47 patients colonized due to the spread of various clones were observed. These recurrent clusters brought about interventions to reduce spread between patients. To evaluate the effect of stepwise interventions to prevent S. marcescens colonization/sepsis and to analyse risk factors for late-onset sepsis (LOS). An open retrospective observational study was performed to evaluate the interventions. A retrospective case-control study was performed to analyse the risk factors for LOS. S. marcescens sepsis and colonization decreased after the stepwise adoption of hygiene interventions. Low gestational age, low birth weight, indwelling central venous or umbilical catheter, and ventilator treatment were identified as risk factors for LOS. Compliance with basic hygiene guidelines was the only intervention monitored continuously from late 2007. Compliance increased gradually to a steady high level in early 2009. There was a decrease in S. marcescens LOS, clustering after the second quarter of 2008. After the first quarter of 2009, S. marcescens colonization decreased. It was not possible to identify the specific effects of each intervention, but it is likely that an update of the hospital's antibiotic policy affected the occurrence of S. marcescens LOS. The delayed effect of interventions on S. marcescens colonization was probably due to the time it takes for new routines to have an effect, illustrated by the gradual increase in compliance with basic hygiene guidelines. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Risk factors for unstable blood glucose level: integrative review of the risk factors related to the nursing diagnosis

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Andressa Magalhães Teixeira

Full Text Available ABSTRACT Objective: to identify evidence in the literature on the possible risk factors for the risk of unstable blood glucose diagnosis in individuals with type 2 diabetes mellitus, and to compare them with the risk factors described by NANDA International. Method: an integrative literature review guided by the question: what are the risk factors for unstable blood glucose level in people with type 2 diabetes mellitus? Primary studies were included whose outcomes were variations in glycemic levels, published in English, Portuguese or Spanish, in PubMed or CINAHL between 2010 and 2015. Results: altered levels of glycated hemoglobin, body mass index>31 kg/m2, previous history of hypoglycemia, cognitive deficit/dementia, autonomic cardiovascular neuropathy, comorbidities and weight loss corresponded to risk factors described in NANDA International. Other risk factors identified were: advanced age, black skin color, longer length of diabetes diagnosis, daytime sleepiness, macroalbuminuria, genetic polymorphisms, insulin therapy, use of oral antidiabetics, and use of metoclopramide, inadequate physical activity and low fasting glycemia. Conclusions: risk factors for the diagnosis, risk for unstable blood glucose level, for persons with type 2 diabetes mellitus were identified, and 42% of them corresponded to those of NANDA International. These findings may contribute to the practice of clinical nurses in preventing the deleterious effects of glycemic variation.

The association between distance to public amenities and cardiovascular risk factors among lower income Singaporeans

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K.K. Lim

2017-12-01

Full Text Available Existing evidence on the association between built environment and cardiovascular disease (CVD risk factors focused on the general population, which may not generalize to higher risk subgroups such as those with lower socio-economic status (SES. We examined the associations between distance to 5 public amenities from residential housing (public polyclinic, subsidized private clinic, healthier eatery, public park and train station and 12 CVD risk factors (physical inactivity, medical histories and unhealthy dietary habits among a study sample of low income Singaporeans aged ≥40years (N=1972. Using data from the Singapore Heart Foundation Health Mapping Exercise 2013–2015, we performed a series of logistic mixed effect regressions, accounting for clustering of respondents in residential blocks and multiple comparisons. Each regression analysis used the minimum distance (in km between residential housing and each public amenity as an independent continuous variable and a single risk factor as the dependent variable, controlling for demographic characteristics. Increased distance (geographical inaccessibility to a train station was significantly associated with lower odds of participation in sports whereas greater distance to a subsidized private clinic was associated with lower odds of having high cholesterol diagnosed. Increasing distance to park was positively associated with higher odds of less vegetable and fruits consumption, deep fried food and fast food consumption in the preceding week/month, high BMI at screening and history of diabetes, albeit not achieving statistical significance. Our findings highlighted potential effects of health-promoting amenities on CVD risk factors in urban low-income setting, suggesting gaps for further investigations. Keywords: Cardiovascular risk, Urban health, Socioeconomic status, Singapore, Health promotion, Primary prevention

Combined effect of educational status and cardiovascular risk factors on the incidence of coronary heart disease and stroke in European cohorts

DEFF Research Database (Denmark)

Veronesi, Giovanni; Tunstall-Pedoe, Hugh; Ferrario, Marco M

2017-01-01

Background The combined effect of social status and risk factors on the absolute risk of cardiovascular disease has been insufficiently investigated, but results provide guidance on who could benefit most through prevention. Methods We followed 77,918 cardiovascular disease-free individuals aged 35......-74 years at baseline, from 38 cohorts covering Nordic and Baltic countries, the UK and Central Europe, for a median of 12 years. Using Fine-Gray models in a competing-risks framework we estimated the effect of the interaction of education with smoking, blood pressure and body weight on the cumulative risk...... genders. Less educated men and women with a cluster of two or more risk factors had an added cardiovascular disease risk of 3.6% (+0.1%, +7.0%) and of 2.6% (-0.5%, +5.6%), respectively, compared with their more educated counterparts. Conclusions Socially disadvantaged subjects have more to gain from...

Skin Cancer: Biology, Risk Factors & Treatment

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... 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 ...

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...

Why so GLUMM? Detecting depression clusters through graphing lifestyle-environs using machine-learning methods (GLUMM).

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Dipnall, J F; Pasco, J A; Berk, M; Williams, L J; Dodd, S; Jacka, F N; Meyer, D

2017-01-01

Key lifestyle-environ risk factors are operative for depression, but it is unclear how risk factors cluster. Machine-learning (ML) algorithms exist that learn, extract, identify and map underlying patterns to identify groupings of depressed individuals without constraints. The aim of this research was to use a large epidemiological study to identify and characterise depression clusters through "Graphing lifestyle-environs using machine-learning methods" (GLUMM). Two ML algorithms were implemented: unsupervised Self-organised mapping (SOM) to create GLUMM clusters and a supervised boosted regression algorithm to describe clusters. Ninety-six "lifestyle-environ" variables were used from the National health and nutrition examination study (2009-2010). Multivariate logistic regression validated clusters and controlled for possible sociodemographic confounders. The SOM identified two GLUMM cluster solutions. These solutions contained one dominant depressed cluster (GLUMM5-1, GLUMM7-1). Equal proportions of members in each cluster rated as highly depressed (17%). Alcohol consumption and demographics validated clusters. Boosted regression identified GLUMM5-1 as more informative than GLUMM7-1. Members were more likely to: have problems sleeping; unhealthy eating; ≤2 years in their home; an old home; perceive themselves underweight; exposed to work fumes; experienced sex at ≤14 years; not perform moderate recreational activities. A positive relationship between GLUMM5-1 (OR: 7.50, Pdepression was found, with significant interactions with those married/living with partner (P=0.001). Using ML based GLUMM to form ordered depressive clusters from multitudinous lifestyle-environ variables enabled a deeper exploration of the heterogeneous data to uncover better understandings into relationships between the complex mental health factors. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

A classification of risk factors in serious juvenile offenders and the relation between patterns of risk factors and recidivism.

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Mulder, Eva; Brand, Eddy; Bullens, Ruud; Van Marle, Hjalmar

2010-02-01

There has been a lot of research on risk factors for recidivism among juvenile offenders, in general, and on individual risk factors, but less focus on subgroups of serious juvenile offenders and prediction of recidivism within these. To find an optimal classification of risk items and to test the predictive value of the resultant factors with respect to severity of recidivism among serious juvenile offenders. Seventy static and dynamic risk factors in 1154 juvenile offenders were registered with the Juvenile Forensic Profile. Recidivism data were collected on 728 of these offenders with a time at risk of at least 2 years. After factor analysis, independent sample t-tests were used to indicate differences between recidivists and non-recidivists. Logistic multiple linear regression analyses were used to test the potential predictive value of the factors for violent or serious recidivism. A nine-factor solution best accounted for the data. The factors were: antisocial behaviour during treatment, sexual problems, family problems, axis-1 psychopathology, offence characteristics, conscience and empathy, intellectual and social capacities, social network, and substance abuse. Regression analysis showed that the factors antisocial behaviour during treatment, family problems and axis-1 psychopathology were associated with seriousness of recidivism. The significance of family problems and antisocial behaviour during treatments suggest that specific attention to these factors may be important in reducing recidivism. The fact that antisocial behaviour during treatment consists mainly of dynamic risk factors is hopeful as these can be influenced by treatment. Consideration of young offenders by subgroup rather than as a homogenous population is likely to yield the best information about risk of serious re-offending and the management of that risk.

Utilizing an ANP framework for prioritizing effective criteria on industrial clusters' formation

Directory of Open Access Journals (Sweden)

Jalal Haghighat Monfared

2012-04-01

Full Text Available Clustering plays an important role on developing industries, since business units can take advantage of many existing industries for trouble shooting or sharing their experiences to increase efficiency. One of the primary concerns for developing clustering is to identify and remove important barriers. In this paper, we gather experts' feedbacks on forming clustering in Iran's industries and, using analytical network process, we prioritize the important factors and provide some necessary guidelines to develop clustering. The results of this paper indicate that the existence of a supplier network is the most important factor, followed by the existence of competition between operational units, existence of high-risk investors, existence of suitable infrastructures. There are also other less important criteria including the existence of flexibility, suitable technology and competition, governmental regularities, social background, trust, etc.

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

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Mi Jung Rho

2017-12-01

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

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

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

2017-01-01

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

Dancoff factors with partial absorption in cluster geometry by the direct method

International Nuclear Information System (INIS)

Rodrigues, Leticia Jenisch; Leite, Sergio de Queiroz Bogado; Vilhena, Marco Tullio de; Bodmann, Bardo Ernest Josef

2007-01-01

Accurate analysis of resonance absorption in heterogeneous systems is essential in problems like criticality, breeding ratios and fuel depletion calculations. In compact arrays of fuel rods, resonance absorption is strongly affected by the Dancoff factor, defined in this study as the probability that a neutron emitted from the surface of a fuel element, enters another fuel element without any collision in the moderator or cladding. In the original WIMS code, Black Dancoff factors were computed in cluster geometry by the collision probability method, for each one of the symmetrically distinct fuel pin positions in the cell. Recent improvements to the code include a new routine (PIJM) that was created to incorporate a more efficient scheme for computing the collision matrices. In that routine, each system region is considered individually, minimizing convergence problems and reducing the number of neutron track lines required in the in-plane integrations of the Bickley functions for any given accuracy. In the present work, PIJM is extended to compute Grey Dancoff factors for two-dimensional cylindrical cells in cluster geometry. The effectiveness of the method is accessed by comparing Grey Dancoff factors as calculated by PIJM, with those available in the literature by the Monte Carlo method, for the irregular geometry of the Canadian CANDU37 assembly. Dancoff factors at five symmetrically distinct fuel pin positions are found in very good agreement with the literature results (author)

Impact of Severe Obesity on Cardiovascular Risk Factors in Youth.

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Zabarsky, Gali; Beek, Cherise; Hagman, Emilia; Pierpont, Bridget; Caprio, Sonia; Weiss, Ram

2018-01-01

To compare cardiovascular risk factor clustering (CVRFC) in severely obese youth with those with lower degrees of obesity. We divided a childhood obesity clinic derived cohort into the degrees of obesity (class I, II, and III) and added a "class IV" category corresponding to >160% of the 95th centile of body mass index (BMI) for age and sex. In a cross-sectional analysis, we investigated the presence of CVRFC in 2244 participants; in 621 who were followed longitudinally, we investigated the determinants of endpoint CVRFC. Class IV obesity was associated with increased risk for CVRFC compared with overweight (OR = 17.26, P obesity (OR = 17.26, P obesity. Baseline class IV obesity was associated with increased risk compared with overweight of having CVRFC at follow-up (OR = 5.76, P = .001), to a similar extent as class III obesity (OR = 5.36, P = .001). Changes in the degree of obesity were significant predictors of CVRFC on follow-up (OR = 1.04, P obesity in childhood is conferred prior to reaching class IV obesity. An individualized risk stratification approach in children with severe obesity should be based on presence of complications rather than simple BMI cutoffs. ClinicalTrials.gov NCT01967849. Copyright © 2017 Elsevier Inc. All rights reserved.

Risk factors for venous thromboembolism during pregnancy

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Jensen, Thomas Bo; Gerds, Thomas Alexander; Grøn, Randi

2013-01-01

Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated.......Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated....

Comparison of risk factors for seropositivity to feline immunodeficiency virus and feline leukemia virus among cats: a case-case study.

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Chhetri, Bimal K; Berke, Olaf; Pearl, David L; Bienzle, Dorothee

2015-02-10

Feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) are reported to have similar risk factors and similar recommendations apply to manage infected cats. However, some contrasting evidence exists in the literature with regard to commonly reported risk factors. In this study, we investigated whether the known risk factors for FIV and FeLV infections have a stronger effect for either infection. This retrospective study included samples from 696 cats seropositive for FIV and 593 cats seropositive for FeLV from the United States and Canada. Data were collected during two cross sectional studies, where cats were tested using IDEXX FIV/FeLV ELISA kits. To compare the effect of known risk factors for FIV infection compared to FeLV, using a case-case study design, random intercept logistic regression models were fit including cats' age, sex, neuter status, outdoor exposure, health status and type of testing facility as independent variables. A random intercept for testing facility was included to account for clustering expected in testing practices at the individual clinics and shelters. In the multivariable random intercept model, the odds of FIV compared to FeLV positive ELISA results were greater for adults (OR = 2.09, CI: 1.50-2.92), intact males (OR = 3.14, CI: 1.85-3.76), neutered males (OR = 2.68, CI: 1.44- 3.14), cats with outdoor access (OR = 2.58, CI: 1.85-3.76) and lower for cats with clinical illness (OR = 0.60, 95% CI: 0.52-0.90). The variance components obtained from the model indicated clustering at the testing facility level. Risk factors that have a greater effect on FIV seropositivity include adulthood, being male (neutered or not) and having access to outdoors, while clinical illness was a stronger predictor for FeLV seropositivity. Further studies are warranted to assess the implications of these results for the management and control of these infections.

Adverse life events, area socioeconomic disadvantage, and psychopathology and resilience in young children: the importance of risk factors' accumulation and protective factors' specificity.

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Flouri, Eirini; Tzavidis, Nikos; Kallis, Constantinos

2010-06-01

Few studies on resilience in young children model risk appropriately and test theory-led hypotheses about its moderation. This study addressed both issues. Our hypothesis was that for preschool children's emotional/behavioral adjustment in the face of contextual risk protective factors should be located in the cognitive domain. Data were from the first two sweeps of the UK's Millennium Cohort Study. The final study sample was 4,748 three-year-old children clustered in 1,549 Lower layer Super Output Areas in nine strata. Contextual risk was measured at both area (with the Index of Multiple Deprivation) and family (with proximal and distal adverse life events experienced) level. Moderator variables were parenting, verbal and non-verbal ability, developmental milestones, and temperament. Multivariate multilevel models-that allowed for correlated residuals at both individual and area level-and univariate multilevel models estimated risk effects on specific and broad psychopathology. At baseline, proximal family risk, distal family risk and area risk were all associated with broad psychopathology, although the most parsimonious was the proximal family risk model. The area risk/broad psychopathology association remained significant even after family risk was controlled but not after family level socioeconomic disadvantage was controlled. The cumulative family risk was more parsimonious than the specific family risks model. Non-verbal ability moderated the effect of proximal family risk on conduct and emotional problems, and developmental milestones moderated the effect of proximal family risk on conduct problems. The findings highlight the importance of modeling contextual risk appropriately and of locating in the cognitive domain factors that buffer its effect on young children's adjustment.

Aberrant Levels of Hematopoietic/Neuronal Growth and Differentiation Factors in Euthyroid Women at Risk for Autoimmune Thyroid Disease.

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Elske T Massolt

Full Text Available Subjects at risk for major mood disorders have a higher risk to develop autoimmune thyroid disease (AITD and vice-versa, implying a shared pathogenesis. In mood disorder patients, an abnormal profile of hematopoietic/neuronal growth factors is observed, suggesting that growth/differentiation abnormalities of these cell lineages may predispose to mood disorders. The first objective of our study was to investigate whether an aberrant profile of these hematopoietic/neuronal growth factors is also detectable in subjects at risk for AITD. A second objective was to study the inter relationship of these factors with previously determined and published growth factors/cytokines in the same subjects.We studied 64 TPO-Ab-negative females with at least 1 first- or second-degree relative with AITD, 32 of whom did and 32 who did not seroconvert to TPO-Ab positivity in 5-year follow-up. Subjects were compared with 32 healthy controls (HCs. We measured serum levels of brain-derived neurotrophic factor (BDNF, Stem Cell Factor (SCF, Insulin-like Growth Factor-Binding Protein 2 (IGFBP-2, Epidermal Growth Factor (EGF and IL-7 at baseline.BDNF was significantly lower (8.2 vs 18.9 ng/ml, P<0.001, while EGF (506.9 vs 307.6 pg/ml, P = 0.003 and IGFBP-2 (388.3 vs 188.5 ng/ml, P = 0.028 were significantly higher in relatives than in HCs. Relatives who seroconverted in the next 5 years had significantly higher levels of SCF than non-seroconverters (26.5 vs 16.7 pg/ml, P = 0.017. In a cluster analysis with the previously published growth factors/cytokines SCF clustered together with IL-1β, IL-6 and CCL-3, of which high levels also preceded seroconversion.Relatives of AITD patients show aberrant serum levels of 4 hematopoietic/neuronal growth factors similar to the aberrancies found in mood disorder patients, suggesting that shared growth and differentiation defects in both the hematopoietic and neuronal system may underlie thyroid autoimmunity and mood disorders. A

Down's syndrome clusters in Germany in close temporal relationship to the Chernobyl accident

International Nuclear Information System (INIS)

Grosche, B.; Schoetzau, A.; Burkart, W.

1997-01-01

In two independent studies using different approaches and covering West Berlin and Bavaria, respectively, highly significant temporal clusters of Down's syndrome were found. Both sharp increases occurred in areas receiving relatively low Chernobyl fallout and concomitant radiation exposures. Only for the Berlin cluster was fallout present at the time of the affected meioses, whereas the Nuremberg cluster preceded the radioactive contamination for one month. Hypotheses on possible causal relationships are compared. Radiation from the Chernobyl accident is an unlikely factor, also, because the associated cumulative dose was so low in comparison with natural background. Given the lack of understanding of what causes Down's syndrome, other than factors associated with increased maternal age, additional research into environmental and infectious risk factors is warranted. (author)

Risk factors for recurrent spontaneous epistaxis.

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Abrich, Victor; Brozek, Annabelle; Boyle, Timothy R; Chyou, Po-Huang; Yale, Steven H

2014-12-01

To identify risk factors associated with spontaneous recurrent epistaxis. This was a retrospective cohort study assessing patients in the Marshfield Clinic system diagnosed as having epistaxis between January 1, 1991, and January 1, 2011. There were 461 cases with at least 2 episodes of spontaneous epistaxis within 3 years and 912 controls with only 1 episode in the same time frame. More than 50 potential risk factors were investigated, including demographic features, substance use, nasal anatomical abnormalities, nasal infectious and inflammatory processes, medical comorbidities, medications, and laboratory values. A Cox proportional hazards regression modeling approach was used to calculate hazard ratios of epistaxis recurrence. Traditional risk factors for epistaxis, including nasal perforation, nasal septum deviation, rhinitis, sinusitis, and upper respiratory tract infection, did not increase the risk of recurrence. Significant risk factors for recurrent epistaxis included congestive heart failure, diabetes mellitus, hypertension, and a history of anemia. Warfarin use increased the risk of recurrence, independent of international normalized ratio. Aspirin and clopidogrel were not found to increase the risk of recurrence. Few major adverse cardiovascular events were observed within 30 days of the first epistaxis event. Congestive heart failure is an underappreciated risk factor for recurrent epistaxis. Hypertension and diabetes mellitus may induce atherosclerotic changes in the nasal vessels, making them friable and more at risk for bleeding. Patients with recurrent epistaxis may also be more susceptible to developing anemia. Physicians should promote antiplatelet and antithrombotic medication adherence despite an increased propensity for recurrent epistaxis to prevent major adverse cardiovascular events. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.