Methods: Data generated by questionnaire and anthropometric indices were used to construct a logistic regression model, taking into account hierarchical relationships of risk factors to determine the odds of a child being stunted, underweight or overweight. Statistical significance was set at p < 0.05. Results: Factors ...
Children who were not sleeping under insecticide treated nets were 15 times more likely to be infected with malaria parasites compared to those who were sleeping under nets [AOR=15.27; 95%CI=4.42-. 52.82; p<0.001]. ... environmental modification, human behaviour and insecticide resistance (MOH, 2014). Although.
have resulted in significant decline of malaria incidence between 2006 and 2008 in Rwanda. (Bizimana et al., 2015). The mortality rate in children under-five years old also decreased by 61% between 2000 and 2010. The prevalence of malaria in this age group declined from 2.6% in 2007 to. 1.4% in 2010 (PMI, 2014) .
Al-Hosani, H A; Brebner, J; Bener, A B; Norman, J N
We investigated the association of biological, sociocultural and economic risk factors with child mortality in Abu Dhabi from 1 January-31 December 1997. With McNemar chi-squared test, most selected biological risk factors were statistically associated with child mortality, although maternal age older than 40 years and history of fetal death were not positively correlated with neonate, infant or age under 5 mortality. Among sociocultural and economic risk factors, maternal lack of formal education and low monthly income were significantly associated with child death. Consanguinity was significantly associated with under 5 and infant but not neonatal mortality. Gestation <37 weeks was highly associated with mortality among all ages. Strengthening health care programmes and emphasizing the need to identify high risk groups should be priorities.
Objectives: To identify risk factors associated with the development of malnutrition in the under-five-year olds in a homogeneous inner city community. Design: A community-based, case-control study. Materials and Methods: One hundred and thirty eight children (subjects and controls) aged less than five years living in the ...
Conclusions: The significant water risk factors as identified were the mode of water transportation, and the poor handling of water at the household level, including lack of or inappropriate water treatment methods. These, combined with the low education level further pre dispose the under five children to diarrhoea, thus ...
Karki, S; Fitzpatrick, A L; Shrestha, S
Pneumonia is a leading cause of mortality among children under-five years of age globally. The WHO (2014) has reported that indoor air pollution caused by cooking and heating with biomass fuel, living in crowed homes and parenting smoking are risk factors of pneumonia. The objective of the study was to identify the risk factors for pneumonia among children under-5 years of age. A case control study was carried out among the mothers having under-5 years children who were admitted in the paediatric ward of Dhulikhel Hospital in 2012/13. A convenience sampling technique was used to select 50 children with pneumonia and 150 children with non-pneumonia diseases matched on age, sex and setting. A semi-structured interview consisting of questions related to risk factors for pneumonia was used to collect data from mothers of both cases and controls. Sex of the child did not differ by case/control group whereas the children with pneumonia were slightly older with 26% cases and 15% controls older than 3 years of age. Mother's education was similar in both groups as was family income. Living in a household with a chulo with smoke increased the odds of having pneumonia significantly, with the risk almost 4 times greater if the chulo was located within the same building (OR: 3.76, 95% CI: 1.20-11.82, p=0.02). Children who had diarrhea in the past 3 months were protected from pneumonia (OR: 0.38, 95% CI: 0.18- 0.82, p=0.01). An increasing trend of pneumonia was observed among children of tobacco smoking parents with greater risk if both parents smoked; it was, however, not statically significant (OR: 2.21, 95% CI: 0.56-8.82, p=0.26). The present study suggests that two factors related to smoke, presence of a smoky chulo in a household and both parents smoking, are modifiable risk factors related to pneumonia in young children. Reliable longitudinal studies, interventions, and programs to educate parents in prevention are important for reducing mortality and morbidities related
Dennery, M.; Dupont, M.A.
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.)
Full Text Available BACKGROUND: Elucidating the role of the underlying risk factors for severe outcomes of the 2009 A/H1N1 influenza pandemic could be crucial to define priority risk groups in resource-limited settings in future pandemics. METHODS: We use individual-level clinical data on a large series of ARI (acute respiratory infection hospitalizations from a prospective surveillance system of the Mexican Social Security medical system to analyze clinical features at presentation, admission delays, selected comorbidities and receipt of seasonal vaccine on the risk of A/H1N1-related death. We considered ARI hospitalizations and inpatient-deaths, and recorded demographic, geographic, and medical information on individual patients during August-December, 2009. RESULTS: Seasonal influenza vaccination was associated with a reduced risk of death among A/H1N1 inpatients (OR = 0.43 (95% CI: 0.25, 0.74 after adjustment for age, gender, geography, antiviral treatment, admission delays, comorbidities and medical conditions. However, this result should be interpreted with caution as it could have been affected by factors not directly measured in our study. Moreover, the effect of antiviral treatment against A/H1N1 inpatient death did not reach statistical significance (OR = 0.56 (95% CI: 0.29, 1.10 probably because only 8.9% of A/H1N1 inpatients received antiviral treatment. Moreover, diabetes (OR = 1.6 and immune suppression (OR = 2.3 were statistically significant risk factors for death whereas asthmatic persons (OR = 0.3 or pregnant women (OR = 0.4 experienced a reduced fatality rate among A/H1N1 inpatients. We also observed an increased risk of death among A/H1N1 inpatients with admission delays >2 days after symptom onset (OR = 2.7. Similar associations were also observed for A/H1N1-negative inpatients. CONCLUSIONS: Geographical variation in identified medical risk factors including prevalence of diabetes and immune suppression may in part
Worthington, Catherine; Myers, Ted
Client anxiety is often associated with diagnostic testing. In this study, the authors used a grounded theory approach to examine the situational and social factors underlying anxiety associated with HIV testing, analyzing transcripts from semistructured interviews with 39 HIV test recipients in Ontario, Canada (selected based on HIV serostatus, risk experience, geographic region, gender, and number of HIV tests), then integrating emergent themes with existing research literature. Analysis revealed four themes: perceptions of risk and responsibility for health, stigma associated with HIV, the patient-provider power dynamic, and techniques used by test recipients to enhance control in their interactions with providers. Service implications include modifications to information provision during the test session, attention to privacy and anonymity, and sensitivity to patient-provider interactions.
Oloruntoba, Elizabeth Omoladun; Folarin, Taiwo Bukola; Ayede, Adejumoke Idowu
Diarrhoea diseases are among the leading causes of morbidity and mortality in under-five-children (U-5C) in Nigeria. Inadequate safe water, sanitation, and hygiene account for the disease burden. Cases of diarrhoea still occur in high proportion in the study area despite government-oriented interventions. To determine the hygiene and sanitation risk factors predisposing U-5C to diarrhoea in Ibadan, Nigeria. Two hundred and twenty pairs of children, matched on age, were recruited as cases and controls over a period of 5 months in Ibadan. Questionnaire and observation checklist were used to obtain information on hygiene practices from caregivers/mothers and sanitation conditions in the households of 30% of the consenting mothers/caregivers. Data were analysed using descriptive and inferential statistics. Caregivers/mothers' mean ages were 31.3 ±7.5 (cases) and 30.6 ±6.0(controls) years. The risk of diarrhoea was significantly higher among children whose mothers did not wash hands with soap before food preparation (OR=3.0, psanitation conditions within households were risk factors for diarrhoea. This study revealed the feasibility of developing and implementing an adequate model to establish intervention priorities in sanitation in Ibadan, Nigeria.
Full Text Available Introduction: Diarrhea is a leading cause of mortality in children in developing countries and the condition is worse in slums. In order to provide effective preventive and management strategies, it is important to identify factors associated with the disease. This study was carried out to investigate the risk factors of diarrhea in children under five years of age in urban slums. Methods: Parents of all children under five years from the urban slums of Tansen municipality, Palpa, Nepal were interviewed using a standardized pretested questionnaire and proforma. Parental variables, environmental factors, and presence of diarrhea in those children in past three months were collected by trained enumerators and the data were analyzed with statistical software SPSS-10. Results: A total of 450 under five years children were enrolled in the study. There were 216 (48% male and 234 (52% female children with F:M ratio of 1.08:1. Occurrence of diarrhea was lower if the children were breast-fed for more than six months, well-nourished, used fountain water for drinking, or used boiled or treated water. Similarly, diarrhea prevalence was lower if father had a regular job, daily income in the family was more than one US dollar, there was a toilet in the house, practice of hand washing was followed before feeding or preparing food, or there was no child suffering from diarrhea in the neighborhood. Conclusion: There are a few variables that are significantly related to diarrhea in children under five years of age. In order to decrease the diarrheal episodes in children in the slums of the developing countries, priority could be given in the improvement of those variables.
Colombara, Danny V; Hernández, Bernardo; McNellan, Claire R; Desai, Sima S; Gagnier, Marielle C; Haakenstad, Annie; Johanns, Casey; Palmisano, Erin B; Ríos-Zertuche, Diego; Schaefer, Alexandra; Zúñiga-Brenes, Paola; Zyznieuski, Nicholas; Iriarte, Emma; Mokdad, Ali H
Care practices and risk factors for diarrhea among impoverished communities across Mesoamerica are unknown. Using Salud Mesoamérica Initiative baseline data, collected 2011-2013, we assessed the prevalence of diarrhea, adherence to evidence-based treatment guidelines, and potential diarrhea correlates in poor and indigenous communities across Mesoamerica. This study surveyed 14,500 children under 5 years of age in poor areas of El Salvador, Guatemala, Mexico (Chiapas State), Nicaragua, and Panama. We compared diarrhea prevalence and treatment modalities using χ(2) tests and used multivariable Poisson regression models to calculate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) for potential correlates of diarrhea. The 2-week point prevalence of diarrhea was 13% overall, with significant differences between countries (P < 0.05). Approximately one-third of diarrheal children were given oral rehydration solution and less than 3% were given zinc. Approximately 18% were given much less to drink than usual or nothing to drink at all. Antimotility medication was given to 17% of diarrheal children, while antibiotics were inappropriately given to 36%. In a multivariable regression model, compared with children 0-5 months, those 6-23 months had a 49% increased risk for diarrhea (aRR = 1.49, 95% CI = 1.15, 1.95). Our results call for programs to examine and remedy low adherence to evidence-based treatment guidelines. © The American Society of Tropical Medicine and Hygiene.
Jiménez de Domingo, Ana; Rubio García, Elena; Marañon Pardillo, Rafael; Arias Constanti, Vanessa; Frontado Haiek, Luis Alberto; Soriano Arola, Marta; Ripoll Oliveras, Francesc; Remón García, Cristina; Estopiña Ferrer, Gloria; Lorente Romero, Jorge
To describe the epidemiological characteristics of unintentional injuries due to falls in children under one year and to analyse the risk factors associated with severe injuries. This multicentre, observational and cross-sectional study included all children less than one year treated for unintentional fall in the Emergency Departments of 8 Spanish Hospitals, belonging to the «Unintentional Paediatric Injury Workshop» of the Spanish Paediatric Emergency Society, between March 1st, 2014 and February 28th, 2015. Out of 289,887 emergency department cases, 1,022 were due to unintentional falls. The median age was 8 months and 52.5% were males. Fall injuries were more frequent among children aged 9-12 months (37.6%), and 83.5% occurred at home. The most common mechanism was fall from nursery equipment (69.4%), and 47.8% occurred from a height under 50cm. More than two-thirds (68%) of falls were witnessed, but in half of the cases (329) the caregiver was not in area. Serious injuries were seen in 12% of cases. In this study, a fall height greater than 50cm, falls in the street, from the arms of the carer, and from the stairs were identified as independent risk factors for worse outcomes. The most serious injuries occur in children 50cm, though not related to unwitnessed falls. Because the most common serious injury mechanism is the fall from the arms of the carer, from stairs, and falls in the street, these facts should be highlighted in order to avoid morbidity. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.
O'Neill, D G; Riddell, A; Church, D B; Owen, L; Brodbelt, D C; Hall, J L
To estimate prevalence and demographic risk factors for urinary incontinence in bitches under primary veterinary care in England. The study population included all bitches within the VetCompass database from September 1, 2009 to July 7, 2013. Electronic patient records were searched for urinary incontinence cases and additional demographic and clinical information was extracted. Of 100,397 bitches attending 119 clinics in England, an estimated 3108 were diagnosed with urinary incontinence. The prevalence of urinary incontinence was 3·14% (95% confidence intervals: 2·97 to 3·33). Medical therapy was prescribed to 45·6% cases. Predisposed breeds included the Irish setter (odds ratio: 8·09; 95% confidence intervals: 3·15 to 20·80; Prisk breeds including the Irish setter, Dobermann, bearded collie, rough collie and Dalmatian. These results provide an evidence base for clinicians to enhance clinical recommendations on neutering and weight control, especially in high-risk breeds. © 2017 British Small Animal Veterinary Association.
Rhee, Connie M.; Brent, Gregory A.; Kovesdy, Csaba P.; Soldin, Offie P.; Nguyen, Danh; Budoff, Matthew J.; Brunelli, Steven M.; Kalantar-Zadeh, Kamyar
Thyroid functional disease, and in particular hypothyroidism, is highly prevalent among chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients. In the general population, hypothyroidism is associated with impaired cardiac contractility, endothelial dysfunction, atherosclerosis and possibly higher cardiovascular mortality. It has been hypothesized that hypothyroidism is an under-recognized, modifiable risk factor for the enormous burden of cardiovascular disease and death in CKD and ESRD, but this has been difficult to test due to the challenge of accurate thyroid functional assessment in uremia. Low thyroid hormone levels (i.e. triiodothyronine) have been associated with adverse cardiovascular sequelae in CKD and ESRD patients, but these metrics are confounded by malnutrition, inflammation and comorbid states, and hence may signify nonthyroidal illness (i.e. thyroid functional test derangements associated with underlying ill health in the absence of thyroid pathology). Thyrotropin is considered a sensitive and specific thyroid function measure that may more accurately classify hypothyroidism, but few studies have examined the clinical significance of thyrotropin-defined hypothyroidism in CKD and ESRD. Of even greater uncertainty are the risks and benefits of thyroid hormone replacement, which bear a narrow therapeutic-to-toxic window and are frequently prescribed to CKD and ESRD patients. In this review, we discuss mechanisms by which hypothyroidism adversely affects cardiovascular health; examine the prognostic implications of hypothyroidism, thyroid hormone alterations and exogenous thyroid hormone replacement in CKD and ESRD; and identify areas of uncertainty related to the interplay between hypothyroidism, cardiovascular disease and kidney disease requiring further investigation. PMID:24574542
F. Ben Mbarka
Full Text Available Background: Vitamin K antagonists are widely used in the treatment and prevention of thromboembolic disease. However, these drugs can cause serious side effects, especially bleeding. This study aims to evaluate frequency and risk factors of both bleeding and asymptomatic overdose in North African patients undergoing Vitamin K antagonist therapy. Methods: We performed a cross-sectional study in patients undergoing Vitamin K antagonist therapy. A statistical analysis has been conducted to identify overdose and bleeding risk factors by using chi-square test (p < .05. Results: One hundred and eleven patients were included. We recorded 14 cases of bleeding and 26 cases of asymptomatic overdose. Advanced age, poor adherence, concomitant use of paracetamol and history of previous bleeding are significant risk factors of over-anticoagulation. An INR value over 6 at admission, a high therapeutic target range for INR, concomitant use of acetylsalicylic acid, lack of information on overdose signs and measures to be taken in case of bleeding were identified as risk factors for bleeding. Conclusion: Most of the risk factors identified in our study seem to be related to patients lack of information and education. These results highlight the importance of creating a therapeutic patient education program. Keywords: Vitamin K antagonist, Bleeding, Risk factor, Overdose
Berg, Carla J; Daniel, Carmen N; Vu, Milkie; Li, Jingjing; Martin, Kathleen; Le, Lana
Given increases in marijuana use and driving under the influence (DUI), it is critical to identify those at risk in order to inform intervention efforts. We used a socioecological framework to examine correlates of level of marijuana use and DUI in the past month among young adult marijuana users. We recruited 1567 participants aged 18-34 years via Facebook ads targeting tobacco and marijuana users in August 2014 to complete an online survey assessing marijuana use and DUI, as well as related multilevel factors. Analyses focused on 649 participants reporting past 30-day marijuana use. The sample was an average age of 24.48 (SD = 5.10), 43.9% female, and 76.4% White and used marijuana an average of 17.86 (SD = 11.29) days in the past month. Notably, 48.4% reported driving after marijuana use at least once in the past month, and 74.0% were passengers. Multivariable regression indicated that greater use was associated with: being older; being male; greater symptoms of dependence; residing in a state with recreational marijuana legalized; having a medical marijuana card; having parents and more friends who use; higher coping motives; lower perceived harm to health; and less concern about driving after marijuana use (adjusted R-squared = 0.294). Correlates of driving after using marijuana in the past month included: being younger; more frequent use; having more friends who use; higher enhancement motives; and less concern about driving after using (Nagelkerke R-squared = 0.442). Conclusions/Importance: Interventions and campaigns should address social norms and risk perceptions regarding marijuana use, particularly as it relates to DUI.
Bahartha, Ali S; AlEzzi, Jalil I
To assess the risk factors associated with diarrhea among children below 5-years-old in Mukalla, Yemen, and compare with other studies. We conducted a case-control study on 200 children (100 cases and 100 controls) who attended the Maternity and Child Hospital, outpatient-clinics, and the Primary Health Care Centers in Al-Mukalla, Hadhramout, Yemen between February and April 2013. We found that the significant risk factors associated with diarrhea were crowded housing (odds ratio [OR] 2.02; p=0.02; confidence interval [CI] 1.03-4.01), incomplete vaccination of the child (OR=2.02; p=0.027; CI: 1.08-3.8), and recurrent diarrheal illness during the last 3 months (OR=6.61; p=0.001; CI: 3.41-12.90). Diarrheal diseases are strongly associated with incomplete vaccination, recurrent diarrheal disease, and crowded housing.
Amar M. Taksande
Full Text Available Introduction: Acute Respiratory Infection (ARI is a major cause of morbidity and mortality in developing countries in children especially in under-fives. Every year in the world, about 13 million under-5 children dies, 95% from developing countries; one third of total deaths are due to ARI. The aim of this study was to identify the significant risk factors for ARI in children less than five years of age living in rural areas of Central India.Methods: A hospital based case control study was undertaken to determine risk factors associated with respiratory tract infections in children. Children less than 5 years admitted in a pediatric ward with diagnosis of ARI were enrolled in the study as cases (n = 300 while the same number of controls (n = 300 were selected from neighborhood and were matched for age, sex and religion. Details of risk factors in cases and controls were recorded in pre-designed proforma. Results: A significant association was found between ARI and lack of breastfeeding, nutritional status, immunization status, delayed weaning, prelactal feeding, living in overcrowded conditions, mothers’ literacy status, low birth weight and prematurity. Among the environmental variables, inadequate ventilation, improper housing condition, exposure to indoor air pollution in form of combustion from fuel used for cooking were found as significant risk factors for ARI in under-fives.Conclusions: ARIs are affected by socio-demographic and socio-cultural risk factors, which can be modified with simple interventions. The various risk factors identified in this study were lack of breastfeeding, undernutrition, delayed weaning, overcrowding and prelactal feeding.
... have been shown to reduce the risk of breast cancer in women at high risk. SERMS may cause side effects , such as hot flashes , so they are not often used for prevention of cancer. See the PDQ summary on Breast Cancer Prevention for more information. Finasteride has been ...
Hasnain, S.F.; Hashmi, S.K.
Malnutrition is a common problem, especially in developing countries. Of the 11 million children under 5 who die each year in the developing countries mainly from preventable causes, the death of about 54% are either directly or indirectly attributable to malnutrition. The objectives of this study were to assess the prevalence and associated factors for underweight in rural Sindh. Methods: A cross-sectional survey was conducted in Jhangara Town, located in District Dadu, Sindh. Eight hundred children under 5 years of age were enrolled. A questionnaire was used to elicit required information and anthropometric measurements were made. Results: The overall prevalence for underweight was 54.3% in the study population, which was higher than the prevalence reported by PDHS 1990 - 91. In multivariate analysis, various factors for underweight were consanguinity (OR=1.5, 95% CI=1.0 - 2.07), low birth weight (parents perspective) (OR=1.6, 95% CI=1.08 - 2.16) and lack of breast-feeding (OR=2.7, 95% CI=1.19 - 6.17). Conclusion: Effective strategies to discourage consanguineous marriages between first cousins are required. Promoting breast feeding is another factor that should be incorporated while designing control strategies to reduce morbidity and mortality due to malnutrition in children (<5 years). (author)
Full Text Available Abstract Background Although typhoid transmitted by food and water is a common problem in daily life, its characteristics and risk factors may differ in disaster-affected areas, which reinforces the need for rapid public health intervention. Surveys were carried out post-tsunami in Banda Aceh, post-earthquake in Yogyakarta, and under normal conditions in Bandung, Indonesia. Logistic regression analysis was used to assess the risk factors with the dependent variable of typhoid fever, with or without complications. Findings Characteristic typhoid fever with complications was found in 5 patients (11.9% affected by the tsunami in Aceh, 8 (20.5% after the earthquake in Yogyakarta, and 13 (18.6% in Bandung. After the tsunami in Aceh, clean water (OR = 0.05; 95%CI: 0.01-0.47 and drug availability (OR = 0.23; 95%CI: 0.02-2.43 are significant independent risk factors, while for the earthquake in Yogyakarta, contact with other typhoid patients (OR = 20.30; 95%CI: 1.93-213.02 and education (OR = 0.08; 95%CI: 0.01-0.98 were significant risk factors. Under normal conditions in Bandung, hand washing (OR = 0.07; 95%CI: 0.01-0.50 and education (OR = 0.08; 95%CI: 0.01-0.64 emerged as significant risk factors. Conclusion The change in risk factors for typhoid complication after the tsunami in Aceh and the earthquake in Yogyakarta emphasizes the need for rapid public health intervention in natural disasters in Indonesia.
... prevention; CVD - risk factors; Cardiovascular disease - risk factors; Coronary artery disease - risk factors; CAD - risk factors ... do smoke, quit. Controlling your cholesterol through diet, exercise, and medicines . Controlling high blood pressure through diet, ...
Isgren, Cajsa M.; Upjohn, Melissa M.; Fernandez-Fuente, Marta; Massey, Claire; Pollott, Geoff; Verheyen, Kristien L. P.; Piercy, Richard J.
Background Exertional rhabdomyolysis syndrome is recognised in many athletic horse breeds and in recent years specific forms of the syndrome have been identified. However, although Standardbred horses are used worldwide for racing, there is a paucity of information about the epidemiological and performance-related aspects of the syndrome in this breed. The objectives of this study therefore were to determine the incidence, risk factors and performance effects of exertional rhabdomyolysis syndrome in Standardbred trotters and to compare the epidemiology and genetics of the syndrome with that in other breeds. Methodology/Principal Findings A questionnaire-based case-control study (with analysis of online race records) was conducted following identification of horses that were determined susceptible to exertional rhabdomyolysis (based on serum biochemistry) from a total of 683 horses in 22 yards. Thirty six exertional rhabdomyolysis-susceptible horses were subsequently genotyped for the skeletal muscle glycogen synthase (GYS1) mutation responsible for type 1 polysaccharide storage myopathy. A total of 44 susceptible horses was reported, resulting in an annual incidence of 6.4 (95% CI 4.6–8.2%) per 100 horses. Female horses were at significantly greater risk than males (odds ratio 7.1; 95% CI 2.1–23.4; p = 0.001) and nervous horses were at a greater risk than horses with calm or average temperaments (odds ratio 7.9; 95% CI 2.3–27.0; p = 0.001). Rhabdomyolysis-susceptible cases performed better from standstill starts (p = 0.04) than controls and had a higher percentage of wins (p = 0.006). All exertional rhabdomyolysis-susceptible horses tested were negative for the R309H GYS1 mutation. Conclusions/Significance Exertional rhabdomyolysis syndrome in Standardbred horses has a similar incidence and risk factors to the syndrome in Thoroughbred horses. If the disorder has a genetic basis in Standardbreds, improved performance in susceptible animals may
Cajsa M Isgren
Full Text Available BACKGROUND: Exertional rhabdomyolysis syndrome is recognised in many athletic horse breeds and in recent years specific forms of the syndrome have been identified. However, although Standardbred horses are used worldwide for racing, there is a paucity of information about the epidemiological and performance-related aspects of the syndrome in this breed. The objectives of this study therefore were to determine the incidence, risk factors and performance effects of exertional rhabdomyolysis syndrome in Standardbred trotters and to compare the epidemiology and genetics of the syndrome with that in other breeds. METHODOLOGY/PRINCIPAL FINDINGS: A questionnaire-based case-control study (with analysis of online race records was conducted following identification of horses that were determined susceptible to exertional rhabdomyolysis (based on serum biochemistry from a total of 683 horses in 22 yards. Thirty six exertional rhabdomyolysis-susceptible horses were subsequently genotyped for the skeletal muscle glycogen synthase (GYS1 mutation responsible for type 1 polysaccharide storage myopathy. A total of 44 susceptible horses was reported, resulting in an annual incidence of 6.4 (95% CI 4.6-8.2% per 100 horses. Female horses were at significantly greater risk than males (odds ratio 7.1; 95% CI 2.1-23.4; p = 0.001 and nervous horses were at a greater risk than horses with calm or average temperaments (odds ratio 7.9; 95% CI 2.3-27.0; p = 0.001. Rhabdomyolysis-susceptible cases performed better from standstill starts (p = 0.04 than controls and had a higher percentage of wins (p = 0.006. All exertional rhabdomyolysis-susceptible horses tested were negative for the R309H GYS1 mutation. CONCLUSIONS/SIGNIFICANCE: Exertional rhabdomyolysis syndrome in Standardbred horses has a similar incidence and risk factors to the syndrome in Thoroughbred horses. If the disorder has a genetic basis in Standardbreds, improved performance in susceptible animals may be
Full Text Available Poor treatment adherence leading to risk of drug resistance, treatment failure, relapse, death and persistent infectiousness remains an impediment to the tuberculosis control programmes. The objective of the study was to identify predictors of default among new smear positive TB patients registered for treatment to suggest possible interventions to set right the problems to sustain and enhance the programme performance.Twenty districts selected from six states were assigned to six strata formed, considering the geographic, socio-cultural and demographic setup of the area. New smear positive patients registered for treatment in two consecutive quarters during III quarter 2004 to III quarter 2005 formed the retrospective study cohort. Case control analysis was done including defaulted patients as "cases" and equal number of age and sex matched patients completing treatment as "controls". The presence and degree of association between default and determinant factors was computed through univariate and multivariate logistic regression analysis. Data collection was through patient interviews using pre-tested semi structured questionnaire and review of treatment related records. Information on a wide range of socio demographic and patient related factors was obtained. Among the 687 defaulted and equal numbers of patients in completed group, 389 and 540 patients respectively were satisfactorily interviewed. In the logistic regression analysis, factors independently associated with default were alcoholism [AOR-1.72 (1.23-2.44], illiteracy [AOR-1.40 (1.03-1.92], having other commitments during treatment [AOR-3.22 (1.1-9.09], inadequate knowledge of TB [AOR-1.88(1.35-2.63], poor patient provider interaction [AOR-1.72(1.23-2.44], lack of support from health staff [AOR-1.93(1.41-2.64], having instances of missed doses [AOR-2.56(1.82-3.57], side effects to anti TB drugs [AOR-2.55 (1.87-3.47] and dissatisfaction with services provided [AOR-1.73 (1
Background Poor nutritional status of mothers has a direct and indirect consequence on their own health and that of their children. The objective of this study was to determine the relationship between nutritional status of mothers and their children and the risk factors for under-nutrition among mothers and children in rural and urban communities of Lagos State, Nigeria. Methods This was a cross sectional survey conducted using the multistage random sampling technique. A total of 300 mother-child pairs were studied, consisting of 150 each from rural and urban communities. Under-nutrition in mothers and children was determined using standard criteria. Results The prevalence of under-nutrition among mothers was significantly higher in rural than urban communities (10.7% vs. 2.7%, p = 0.014). The prevalences of underweight and stunted children were also significantly higher in rural than urban communities (19.4% vs. 9.3%, p maternal and child under nutrition differs across rural and urban communities. Conclusions The prevalence of maternal and child under-nutrition is high in both communities although higher in rural communities. Efforts at reducing the vicious cycle of under-nutrition among mothers and children should concentrate on addressing risk factors specific for each community. PMID:23880121
Torp-Pedersen, Tobias; Boyd, Heather A; Poulsen, Gry
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....
Ye, Wen-Ling; Tang, Nan; Wen, Yu-Bing; Li, Hang; Li, Min-Xi; Du, Bin; Li, Xue-Mei
Data on PCP in patients with glomerular disease are rare. The aim of this study was to assess the predictors of PCP development, the risk factors for mortality and the incidence of acute kidney injury (AKI) when high-dose trimethoprim-sulphamethoxazole (TMP-SMX) was used in patients with non-transplant glomerular disease. Forty-seven patients with PCP, as confirmed by positive results for Pneumocystis jirovecii DNA or Pneumocystis jirovecii cysts tested by a methenamine silver stain between January 1, 2003, and December 30, 2012, were retrospectively investigated. The baseline characteristics of glomerular disease, clinical findings of PCP and renal parameters after treatment were collected. Predictors for PCP development and risk factors for mortality were determined using a multivariate logistic regression analysis. All PCP patients exclusively received immunosuppressants. Baseline renal insufficiency [estimated glomerular filtration rate (eGFR) renal function to baseline values. PCP is a fatal complication in patients with glomerular disease, and the use of immunosuppressants may be a basic risk factor for this infection. Underlying renal insufficiency and high renal pathology chronicity are the key risk factors for PCP in IgA nephropathy. TMP-SMX therapy remains an ideal choice because of high treatment response and frequently reversible kidney injury.
Savi, Tadeja; Bertuzzi, Stefano; Branca, Salvatore; Tretiach, Mauro; Nardini, Andrea
Urban trees help towns to cope with climate warming by cooling both air and surfaces. The challenges imposed by the urban environment, with special reference to low water availability due to the presence of extensive pavements, result in high rates of mortality of street trees, that can be increased by climatic extremes. We investigated the water relations and xylem hydraulic safety/efficiency of Quercus ilex trees growing at urban sites with different percentages of surrounding impervious pavements. Seasonal changes of plant water potential and gas exchange, vulnerability to cavitation and embolism level, and morpho-anatomical traits were measured. We found patterns of increasing water stress and vulnerability to drought at increasing percentages of impervious pavement cover, with a consequent reduction in gas exchange rates, decreased safety margins toward embolism development, and increased vulnerability to cavitation, suggesting the occurrence of stress-induced hydraulic deterioration. The amount of impermeable surface and chronic exposure to water stress influence the site-specific risk of drought-induced dieback of urban trees under extreme drought. Besides providing directions for management of green spaces in towns, our data suggest that xylem hydraulics is key to a full understanding of the responses of urban trees to global change. © 2014 The Authors. New Phytologist © 2014 New Phytologist Trust.
To measure the contribution of individual transactions inside the total risk of a credit portfolio is a major issue in financial institutions. VaR Contributions (VaRC) and Expected Shortfall Contributions (ESC) have become two popular ways of quantifying the risks. However, the usual Monte Carlo (MC) approach is known to be a very time consuming method for computing these risk contributions. In this paper we consider the Wavelet Approximation (WA) method for Value at Risk (VaR) computation pr...
Masdemont Soler, Josep; Ortiz-Gracia, Luis
To measure the contribution of individual transactions inside the total risk of a credit portfolio is a major issue in financial institutions. VaR Contributions (VaRC) and Expected Shortfall Contributions (ESC) have become two popular ways of quantifying the risks. However, the usual Monte Carlo (MC) approach is known to be a very time consum- ing method for computing these risk contributions. In this paper we consider the Wavelet Approximation (WA) method for Value at Risk (VaR) computati...
Lu, Hongwei; Li, Jing; Ren, Lixia; Chen, Yizhong
Groundwater remediation is a complicated system with time-consuming and costly challenges, which should be carefully controlled by appropriate groundwater management. This study develops an integrated optimization method for groundwater remediation management regarding cost, contamination distribution and health risk under multiple uncertainties. The integration of health risk into groundwater remediation optimization management is capable of not only adequately considering the influence of health risk on optimal remediation strategies, but also simultaneously completing remediation optimization design and risk assessment. A fuzzy chance-constrained programming approach is presented to handle multiple uncertain properties in the process of health risk assessment. The capabilities and effectiveness of the developed method are illustrated through an application of a naphthalene contaminated case in Anhui, China. Results indicate that (a) the pump-and-treat remediation system leads to a low naphthalene contamination but high remediation cost for a short-time remediation, and natural attenuation significantly affects naphthalene removal from groundwater for a long-time remediation; (b) the weighting coefficients have significant influences on the remediation cost and the performances both for naphthalene concentrations and health risks; (c) an increased level of slope factor (sf) for naphthalene corresponds to more optimal strategies characterized by higher environmental benefits and lower economic sacrifice. The developed method could be simultaneously beneficial for public health and environmental protection. Decision makers could obtain the most appropriate remediation strategies according to their specific requirements with high flexibility of economic, environmental, and risk concerns. Copyright © 2018 Elsevier Ltd. All rights reserved.
Kayode Gbenga A
Full Text Available Abstract Background Under-5 mortality is a major public health challenge in developing countries. It is essential to identify determinants of under-five mortality (U5M childhood mortality because these will assist in formulating appropriate health programmes and policies in order to meet the United Nations MDG goal. The objective of this study was to develop a predictive model and identify maternal, child, family and other risk factors associated U5M in Nigeria. Methods Population-based cross-sectional study which explored 2008 demographic and health survey of Nigeria (NDHS with multivariable logistic regression. Likelihood Ratio Test, Hosmer-Lemeshow Goodness-of-Fit and Variance Inflation Factor were used to check the fit of the model and the predictive power of the model was assessed with Receiver Operating Curve (ROC curve. Results This study yielded an excellent predictive model which revealed that the likelihood of U5M among the children of mothers that had their first marriage at age 20-24 years and ≥ 25 years declined by 20% and 30% respectively compared to children of those that married before the age of 15 years. Also, the following factors reduced odds of U5M: health seeking behaviour, breastfeeding children for > 18 months, use of contraception, small family size, having one wife, low birth order, normal birth weight, child spacing, living in urban areas, and good sanitation. Conclusions This study has revealed that maternal, child, family and other factors were important risk factors of U5M in Nigeria. This study has identified important risk factors that will assist in formulating policies that will improve child survival.
Grabowska-Gaweł, Anna; Porzych, Katarzyna; Piskunowicz, Grazyna
Postoperative nausea and vomiting belong to fairly frequent postoperative complications, but they occupy a distant position on the list of complications, which most probably result from a general conviction that they do not pose a direct threat to patients. The objective of this work is specification of factors facilitating occurrence of postoperative nausea and vomiting, and determination of frequency of their occurrence in patients operated under general anesthesia. Questionnaire about the occurrence of postoperative nausea and vomiting (PONV), was carried out and included 253 adult sick persons (102 female and 151 male patients), in the age between 23-76 (average 42.3 +/- 6.1 years), who had undergone operative procedure in the field of abdominal and urology surgery, orthopedic, thyroid surgery and laryngological, ophthalmology and plastic surgery, under general anesthesia. The questionnaire form included preoperative characteristics of a patient (age, sex, smoking, motion sickness and migraine headaches in history, and PONV occurring earlier), type of operative procedure, used anesthetic agents, and analgesic agents applied in postoperative analgesia. The anesthesiologist administering anesthetic was not informed about the investigation carried out and did not receive any additional pieces of advice regarding the type of applied anesthetic agents or the method of conducting postoperative analgesia. Visual Analogue Scale (VAS) was used in the evaluation of nausea. Nausea and vomiting were assessed every two hours within the first postoperative 12 hours and every 4 hours for the next 24 hours. Nausea and vomiting were treated as two separate complications. Nausea itself occurred in 22.7% of patients; whereas vomiting in 13.2%. Both symptoms occurred in 14.2% of patients. Nausea occurred 4.1 +/- 0.8 hours after operation; whereas vomiting after 5.3 +/- 1.1 hours. Women suffered more often than men from (R = 0.678 p patients suffering from PONV earlier (R = 0
Full Text Available We analyzed parameters characterizing mineral balance in a body and dental state in two groups of healthy men (n = 15 in each, aged 34.7 ± 0.6 in hot and humid marine climate conditions; one group was made of people undergoing acclimatization, the second one consisted of local population. We assessed working conditions and their category, and metrological data with determining environmental thermal load (ETL-index. Both groups worked outdoors; their labor had IIb category; they had to work overtime and under increased psy-choemotional loads; their working conditions differed as per nutrition and accommodation. When people from both groups had to work beyond their permanent location, their nutrition was represented by individual rations. Labor hardness was assessed as 3.2; labor intensity, as 3.2. Daytime temperature reached 30,0 С, relative air humidity was 77.3 ± 2.6 %, wind speed was 4.3 ± 0.3 m/sec. Microclimate was assessed as having 3.1 hazard category. Overall, working conditions were assessed as hazardous (3.3 hazard category. Electrolyte balance in a body was violated and it was proved by ower contents of K, Na, and Cl in blood serum; it was more apparent in people who were undergoing acclimatization. 70.0 % of local people had Ca contents in blood serum lower than the physiological standard. Lower Ca and increased P contents in blood serum were also detected in those undergoing acclimatization which could be evidence that Ca was washed out of a body and greater risk of dental caries occurred. As per observation dynamics we detected the following processes in people undergoing acclimatization: pH saliva and its mineralizing function shifting to acidity, salivation rate, and lower enamel resistance; they proved there was a growth in dental solid tissues demineralization. These parameters corresponded to those detected in local population. It calls for primary prevention activities aimed at fighting caries of dental solid tissues.
... are here: Home For Patients Risk Factors Risk Factors for Scleroderma The cause of scleroderma is still ... Scientists are working diligently to understand what biological factors contribute to scleroderma pathogenesis. Genetic Risk Scleroderma does ...
To determine breath- holding spells (BHS) prevalence and risk factors in under 6- year- old children, we interviewed mothers of 400 children in a cross- sectional study in 5 health centers at south of Tehran in autumn 1999. 33 children (8.25%) had history of BHS (Male: 19, Female: 14 25 cases were between 2-4 years old (mean: 40±17 months). Seventy percent of cases (23) had onset of attacks after 6 months of age (mean: 10 monthis) and the commonest frequency was one spell per month...
Johnson, David C.; Corthals, Sophie L.; Walker, Brian A.; Ross, Fiona M.; Gregory, Walter M.; Dickens, Nicholas J.; Lokhorst, Henk M.; Goldschmidt, Hartmut; Davies, Faith E.; Durie, Brian G. M.; Van Ness, Brian; Child, J. Anthony; Sonneveld, Pieter; Morgan, Gareth J.
Purpose To indentify genetic variation that can modulate and predict the risk of developing thalidomide-related peripheral neuropathy (TrPN). Patients and Methods We analyzed DNA from 1,495 patients with multiple myeloma. Using a custom-built single nucleotide polymorphism (SNP) array, we tested the
Conclusion: This study has shown that SM count and CRA score were associated with new caries development in ECC children who needed to be treated under general anesthesia. The modified Cariogram used in this study is another significant tool for predicting new carries development in this particular population.
Thiam, Sokhna; Diène, Aminata N; Fuhrimann, Samuel; Winkler, Mirko S; Sy, Ibrahima; Ndione, Jacques A; Schindler, Christian; Vounatsou, Penelope; Utzinger, Jürg; Faye, Ousmane; Cissé, Guéladio
Diarrhoeal diseases remain an important cause of mortality and morbidity among children, particularly in low- and middle-income countries. In Senegal, diarrhoea is responsible for 15% of all deaths in children under the age of five and is the third leading cause of childhood deaths. For targeted planning and implementation of prevention strategies, a context-specific understanding of the determinants of diarrhoeal diseases is needed. The aim of this study was to identify risk factors of diarrhoeal diseases in children under the age of five in Mbour, Senegal. Between February and March 2014, a cross-sectional survey was conducted in four zones of Mbour to estimate the burden of diarrhoeal diseases (i.e. diarrhoea episodes in the 2 weeks preceding the survey) and associated risk factors. The zones covered urban central, peri-central, north peripheral and south peripheral areas. Overall, 596 households were surveyed by a questionnaire, yielding information on sociodemographic, environmental and hygiene behavioural factors. Univariable and multivariable logistic regression analyses were used to identify risk factors associated with the occurrence of diarrhoea. The reported prevalence of diarrhoea among children under the age of five during the 2 weeks preceding the survey was 26%. Without adjustment, the highest diarrhoea prevalence rates were observed in the peri-central (44.8%) and urban central zones (36.3%). Multivariable regression revealed significant associations between diarrhoeal diseases and unemployment of mothers (adjusted odds ratio [aOR] = 1.62, 95% confidence interval [CI]: 1.18-2.23), use of open bags for storing household waste (aOR = 1.75, 95% CI: 1.00-3.02), evacuation of household waste in public streets (aOR = 2.07, 95% CI: 1.20-3.55), no treatment of stored drinking water (aOR = 1.69, 95% CI: 1.11-2.56) and use of shared toilets (aOR = 1.69, 95% CI: 1.11-2.56). We found a high prevalence of diarrhoea in children under the age of five
Full Text Available Understanding the spatial distribution of stunting and underlying factors operating at meso-scale is of paramount importance for intervention designing and implementations. Yet, little is known about the spatial distribution of stunting and some discrepancies are documented on the relative importance of reported risk factors. Therefore, the present study aims at exploring the spatial distribution of stunting at meso- (district scale, and evaluates the effect of spatial dependency on the identification of risk factors and their relative contribution to the occurrence of stunting and severe stunting in a rural area of Ethiopia.A community based cross sectional study was conducted to measure the occurrence of stunting and severe stunting among children aged 0-59 months. Additionally, we collected relevant information on anthropometric measures, dietary habits, parent and child-related demographic and socio-economic status. Latitude and longitude of surveyed households were also recorded. Local Anselin Moran's I was calculated to investigate the spatial variation of stunting prevalence and identify potential local pockets (hotspots of high prevalence. Finally, we employed a Bayesian geo-statistical model, which accounted for spatial dependency structure in the data, to identify potential risk factors for stunting in the study area.Overall, the prevalence of stunting and severe stunting in the district was 43.7% [95%CI: 40.9, 46.4] and 21.3% [95%CI: 19.5, 23.3] respectively. We identified statistically significant clusters of high prevalence of stunting (hotspots in the eastern part of the district and clusters of low prevalence (cold spots in the western. We found out that the inclusion of spatial structure of the data into the Bayesian model has shown to improve the fit for stunting model. The Bayesian geo-statistical model indicated that the risk of stunting increased as the child's age increased (OR 4.74; 95% Bayesian credible interval [BCI]:3
Pieskä, J. (Jukka)
Abstract The aim of this thesis is to study risk factor based investing and test how well MSCI constructs their risk factor based indices. Risk factor based investing has gained a lot of media exposure in the recent years and “Smart Beta” products are becoming more popular. Blackrock estimated that there are more than 700 exchange traded products available and they have over $ 529 billion in assets under management. Risk fa...
Full Text Available To determine breath- holding spells (BHS prevalence and risk factors in under 6- year- old children, we interviewed mothers of 400 children in a cross- sectional study in 5 health centers at south of Tehran in autumn 1999. 33 children (8.25% had history of BHS (Male: 19, Female: 14 25 cases were between 2-4 years old (mean: 40±17 months. Seventy percent of cases (23 had onset of attacks after 6 months of age (mean: 10 monthis and the commonest frequency was one spell per month (78.79%. Painful experience and falling and striking the head wee the common triggering factors (79% and 76% respectively and there was significant association between BHS and history of fallin and severe striking of the head. There was no significant associations between BHS and sex, birth weight, birth order, delivery method, type of labor initiating and duration of labor.
Howard, George; Cushman, Mary; Kissela, Brett M.; Kleindorfer, Dawn O.; McClure, Leslie A.; Safford, Monika M.; Rhodes, J. David; Soliman, Elsayed Z.; Moy, Claudia S.; Judd, Suzanne E.; Howard, Virginia J.
Background and Purpose Black/white disparities in stroke incidence are well-documented, but few studies have assessed the contributions to the disparity. Here we assess the contribution of “traditional” risk factors. Methods 25,714 black and white men and women, aged 45+ and stroke-free at baseline were followed for an average of 4.4 years to detect stroke. Mediation analysis employing proportional hazards analysis assessed the contribution of “traditional” risk factors to racial disparities. Results At age 45, incident stroke risk was 2.90 (95% CI: 1.72 – 4.89) times more likely in blacks than whites, and 1.66 (95% CI: 1.34 – 2.07) times at age 65. Adjustment for risk factors attenuated these excesses by 40% and 45%, respectively, resulting in relative risks of 2.14 (95% CI: 1.25 – 3.67) and 1.35 (95% CI: 1.08 – 1.71). Approximately one-half of this mediation is attributable to systolic blood pressure. Further adjustment for socioeconomic factors resulted in total mediation of 47% and 53% to relative risks of 2.01 (95% CI: 1.16 – 3.47) and 1.30 (1.03 – 1.65) respectively. Conclusions Between ages 45 to 65 years, approximately half of the racial disparity in stroke risk is attributable to traditional risk factors (primarily systolic blood pressure) and socioeconomic factors, suggesting a critical need to understand the disparity in the development of these traditional risk factors. Because half of the excess stroke risk in blacks is not attributable to traditional risk factors and socioeconomic factors, differential racial susceptibility to risk factors, residual confounding or non-traditional risk factors may also play a role. PMID:21960581
Bonnes, Judith L; Westra, Sjoerd W; Bouwels, Leon H R; DE Boer, Menko Jan; Brouwer, Marc A; Smeets, Joep L R M
In view of the shift from routine toward no or selective defibrillation testing, optimization of the current risk stratification for inadequate defibrillation safety margins (DSMs) could improve individualized testing decisions. Given the pathophysiological differences in myocardial substrate between ischemic and nonischemic heart disease (IHD/non-IHD) and the accompanying differences in clinical characteristics, we studied inadequate DSMs and their predictors in relation to the underlying etiology. Cohort of routine defibrillation tests (n = 785) after first implantable cardioverter defibrillator (ICD)-implantations at the Radboud UMC (2005-2014). A defibrillation threshold >25 J was regarded as an inadequate DSM. In total, 4.3% of patients had an inadequate DSM; in IHD 2.5% versus 7.3% in non-IHD (P = 0.002). We identified a group of non-IHD patients at high risk (13-42% inadequate DSM); the remainder of the cohort (>70%) had a risk of only 2% (C-statistic entire cohort 0.74; C-statistic non-IHD 0.82). This was based upon two identified interaction terms: (1) non-IHD and age (aOR 0.94 [95% CI 0.91-0.97]); (2) non-IHD and the indexed left ventricular (LV) internal diastolic diameter (aOR 3.50 [95% CI 2.10-5.82]). The present study on risk stratification for an inadequate DSM not only confirms the importance of making a distinction between IHD and non-IHD, but also shows that risk factors in an entire cohort (LV dilatation, age) may only apply to a subgroup (non-IHD). Appreciation of this concept could favorably affect current risk stratification. If confirmed, our approach may be used to optimize individualized testing decisions in an upcoming era of non-routine testing. © 2016 Wiley Periodicals, Inc.
Haidar, J; Abate, G; Kogi-Makau, W; Sorensen, P
To identify the factors associated with childhood under-nutrition in North Wollo, Ethiopia. A cross-sectional study. Four purposefully selected rural villages (kebeles) in North Wollo zone of the Amhara Region, Ethiopia. One hundred-forty four sampled households with under five year old children (n=200) comprising of 96 male-headed, 24 female-headed and 24 landless with children aged between six and 59 months. Determinations of anthropometric measurements and various socio-economic factors. The overall prevalence rate of under nutrition as determined by stunting, underweight and wasting was 44.5%, 25.0% and 9.0% respectively with more preponderance among the toddlers. The proportion of under nutrition was higher in female-headed households. Shortage of farmland, lack of irrigation, dispossession of livestock, shortage of non-farm employment options, parental illiteracy, high number of children, water inadequacy, food taboos and wrong eating habits of families, poor child feeding practices, deprivation of health nutrition education as well as maternal attributes such as young motherhood, low body mass index and short stature of mothers influenced the nutritional status of the children. The prominent risk factors for undernutrition among children were dispossession of livestock, child food taboos and wrong eating habits of families, deprivation of health/nutrition education, short stature and early marriage of mothers. This study led to the conclusion that improvement of household resources through promotion of irrigation and initiation of income generating livelihood options can reverse the nutrition situation for better. Health and nutrition education focusing on appropriate child feeding, eradication of harmful traditional practices such as early marriage and inequitable intra-household food distribution, encouragement of family planning and nutrition interventions including food diversification is recommended.
Sterk, Claire E; Klein, Hugh; Elifson, Kirk W
The purposes of this study are to (1) examine the extent to which young adult Ecstasy users recently reported having had multiple sex partners and (2) identify the factors predictive of engaging in this behavior. Potential predictors included demographic characteristics, background and experiences measures, childhood maltreatment experiences, substance use variables, and measures assessing psychological/psychosocial functioning. This research is based on a sample of 283 young adult recurrent users of the drug, Ecstasy. Study participants were recruited in Atlanta, Georgia between August 2002 and August 2004 using a targeted sampling and ethnographic mapping approach. Interviews took approximately two hours to complete. Nearly one-third of the study participants had more than one sex partner during the preceding month, and sexual protection rates tended to be low. Multivariate logistic regression analysis revealed seven predictors associated with an increased likelihood of having multiple sex partners: (1) being nonwhite, (2) knowing someone who was HIV-positive, (3) younger age of first sexual experience, (4) using Ecstasy for its touch-enhancing qualities, (5) higher self-esteem, (6) handling disagreements more dysfunctionally, and (7) not being involved in a romantic relationship. The HIV prevention- and intervention-related implications of these findings are discussed.
Bhowmik, K.R.; Islam, S.
Logistic regression (LR) analysis is the most common statistical methodology to find out the determinants of childhood mortality. However, the significant predictors cannot be ranked according to their influence on the response variable. Multiple classification (MC) analysis can be applied to identify the significant predictors with a priority index which helps to rank the predictors. The main objective of the study is to find the socio-demographic determinants of childhood mortality at neonatal, post-neonatal, and post-infant period by fitting LR model as well as to rank those through MC analysis. The study is conducted using the data of Bangladesh Demographic and Health Survey 2007 where birth and death information of children were collected from their mothers. Three dichotomous response variables are constructed from children age at death to fit the LR and MC models. Socio-economic and demographic variables significantly associated with the response variables separately are considered in LR and MC analyses. Both the LR and MC models identified the same significant predictors for specific childhood mortality. For both the neonatal and child mortality, biological factors of children, regional settings, and parents socio-economic status are found as 1st, 2nd, and 3rd significant groups of predictors respectively. Mother education and household environment are detected as major significant predictors of post-neonatal mortality. This study shows that MC analysis with or without LR analysis can be applied to detect determinants with rank which help the policy makers taking initiatives on a priority basis. (author)
Randremanana, Rindra Vatosoa; Razafindratsimandresy, Richter; Andriatahina, Todisoa; Randriamanantena, Arthur; Ravelomanana, Lovaniaina; Randrianirina, Frédérique; Richard, Vincent
Diarrheal disease remains a leading cause of death in children in low-income countries. We investigated the etiology, risk factors and effects on nutritional status of severe diarrhea in children from two districts in Madagascar. We performed a matched case-control study in 2011 to 2014, on children under the age of five years from Moramanga and Antananarivo. The cases were children hospitalized for severe diarrhea and the controls were children without diarrhea selected at random from the community. Stool samples were collected from both groups. Anthropometric measurements were made during follow-up visits about one and two months after enrolment. We enrolled 199 cases and 199 controls. Rotavirus infection was the most frequently detected cause of diarrhea. It was strongly associated with severe diarrhea (OR: 58.3; 95% CI: 7.7-439.9), accounting for 42.4% (95% CI: 37.6-43.1) of severe diarrhea cases. At the household level, possession of cattle (OR = 0.3; 95% CI: 0.1-0.6) and living in a house with electricity (OR = 0.4; 95% CI: 0.2-0.8) were protective factors. The presence of garbage around the house was a risk factor for severe diarrhea (OR = 3.2; 95% CI: 1.9-5.4). We found no significant association between severe diarrhea and the nutritional status of the children at follow-up visits, but evident wasting at enrolment was associated with a higher risk of severe diarrhea (OR = 9; 95% CI: 4.5-17.9). Severe childhood diarrhea is mostly caused by rotavirus infection. An anti-rotavirus vaccine has already been introduced in Madagascar and should be promoted more widely. However, post-licensing surveillance is required. Interventions to improve the nutritional status of children, preventive measures focused on household and personal hygiene and nutritional rehabilitation during severe diarrheal disease should be reinforced.
Yang, Feng-Hua; Wang, Hua; Zhang, Jun-Mei; Liang, Hong-Yuan
Mild head trauma can cause cerebral infarction in children younger than 18 months of age, yet the pathogenesis, clinical characteristics, and risk factors are not fully understood. Data of 16 cases between August 2008 and September 2011, including clinical manifestations and imaging and laboratory findings were collected and analyzed. All patients had the history of mild head trauma. The median age of the cohort was 13.5 months (range 6 months to 18 months). All children developed neurologic symptoms and signs within 72 hours after trauma, 62.5% (10/16) within 30 minutes. The first symptoms included hemiparesis (9/16), facial paresis (4/16), and convulsion (6/16). Overall, 93.75% (15/16) of the lesions were in the basal ganglia region. Two risk factors were identified, basal ganglia calcification in 10 and cytomegalovirus infection in eight. After conservative therapy, the neurologic deficits recovered to some extent. Cerebral infarction after mild head trauma in children younger than 18 months of age may take place, especially under the circumstances of basal ganglia calcification or cytomegalovirus infection. Copyright © 2013 Elsevier Inc. All rights reserved.
Kansal, S; Chakravarty, J; Kumar, A; Malaviya, P; Boelaert, M; Hasker, E; Ostyn, B; Sundar, S
To assess the rate of default from treatment in the visceral leishmaniasis (VL) elimination programme and to identify risk factors and its underlying causes. Case-control study conducted between December 2009 and June 2012 in three primary health centres (PHCs) of Muzaffarpur district, India. Patients who defaulted from treatment from the PHCs were considered as 'cases' and those who completed their treatment as 'controls'. Two controls were included in the study for each case. Respondents' opinion and satisfaction with the services provided at the PHCs were also elicited. Logistic regression was performed to assess the contribution of sociodemographic variables on patient status, and a discriminant analysis was used (after decomposing the original data) to identify factors that can predict the patient status as defaulter or not, based on factor scores of the components as predictor variables. During the study period, 16.3% (89/544) of patients defaulted; 87 cases and 188 controls were interviewed through a semistructured questionnaire. Women tended to be more at risk for default (OR, 1.6, 95% CI (0.9 -2.9). Treatment received was miltefosine in 55.6% and sodium stibogluconate (SSG) in 44.4%. Most (86%) defaulters completed their treatment at other healthcare facilities; 70% of them preferred non-governmental institutions. Most cited reasons for default were seeking a second opinion for VL treatment and preferring to be treated in specialised VL centres. Discriminant analysis showed only one significant predictor: dissatisfaction with the medical care received in PHCs. Efforts are needed to enhance the quality of VL care at PHC level, which will be beneficial in increasing treatment completion rates. © 2017 John Wiley & Sons Ltd.
... risk factors are unique to women. These include: Menopause Use of hormonal birth control (certain types of combination pills, patches, ... risk factors are unique to women. These include: Menopause Use of hormonal birth control (certain types of combination pills, patches, ...
... Brain cells can die, causing lasting damage. Risk factors are things that increase your chance of getting ... disease or condition. This article discusses the risk factors for stroke and things you can do to ...
Full Text Available Background: Prevalence of End Stage Renal Disease (ESRD is increasing in the world. Because of clinical importance of ESRD and absence of significant data, we studied the epidemiology of end stage renal failure in patients under hemodialysis in Lorestan province. Material and methods: This descriptive cross sectional study was carried out between January 2012 and January 2013 in dialysis centers of Lorestan university of medical sciences .Subject were selected by census method and data galhered using a questionnaire. At the end, collected data were analyzed by SPSS software, descriptive statistics and Chi-square test. Results: All the patients under hemodialysis were 318 cases, 182 out of them (57.2% and 136(42.8% were male and female respectively. The mean age of the subjects was 53.2± 16.4 years. The cause of renal failure in 38.1% of the patients were hypertension, diabetes (19.2% and unknown factors (27.4%. As well as 5.97% of the patients infected by HCV, HBV or HIV . A significant statistical difference was observed between causes of chronic renal failure and different ages of the subjects (p=0.002. Conclusion: Augmentation of screening programs and especially, early referral of high risk subjects to nephrologists is recommended for prevention of end stage renal disease.
Kumari, Susavi; Prasad, Shiv; Kumaresan, Arumugam; Manimaran, Ayyasamy; Patbandha, Tapas Kumar; Pathak, Rupal; Boro, Prasanta; Mohanty, Tushar Kumar; Ravi, Sanjay Kumar
The risk factors and impact of retained fetal membranes (RFM) on productive and reproductive performance of crossbred cattle, Zebu cattle, and Murrah buffalos were evaluated using data spread over 12 years. Multivariable logistic regression model was used to identify risk factors and to quantify their odds ratio (OR). Overall incidence of RFM in crossbred cattle, Zebu cattle, and Murrah buffalos were 26, 16, and 13 %, respectively; and significant risk factors for RFM in crossbred cattle were abortion (OR = 3.9), dead calf (OR = 4.1), dystocia (OR = 4.3), pluriparity (OR = 1.5), and shorter gestation length (OR = 4.3). In Zebu cattle, abortion (OR = 4.0), dead calf (OR = 3.7), dystocia (OR = 3.9), lower birth weight of calf (OR = 1.6), and shorter gestation length (OR = 6.4) were significant risk factors for RFM. In Murrah buffalos, abortion (OR = 19.2), dead calf (OR = 4.4), dystocia (OR = 4.7), pluriparity (OR = 1.7), shorter gestation length (OR = 12.7), and calving during summer season (OR = 1.8) were the risk factors for RFM. Although the occurrence of RFM did not affect fertility parameters, a significant (P < 0.05) decrease in 305-day milk yield and total milk yield was observed in RFM-affected crossbred cattle. Taken together, it may be concluded that increased parity, abnormal calving, and short gestation length were the main risk factors for RFM in dairy bovine.
Full Text Available OBJECTIVE: The aim of this study was to evaluate whether increased crown-to-implant (C/I ratio influences implant stability or not under proper healthy control of peri-implant mucosa. The hypothesis of this study is that implant stability can be maintained despite High C/I, under appropriate plaque control. MATERIALS AND METHODS: Five male Beagle-Labrador hybrid dogs (2 years old were used. Their bilateral mandibular premolar extraction was performed. After allowing 12 weeks for bone healing, 3 types of vertical marginal bone loss were simultaneously prepared randomly. Then, 30 titanium implants were placed in the edentulous areas and defined as High C/I, Mid C/I and Low C/I groups. This time point was designated as the baseline (0 Week. Twelve weeks after implant placement, metal superstructures were cemented to the implants and an occlusal plate was set at the opposite side. At the same time, Calcein green was injected for remodeling evaluation. Implants were loaded by feeding the dogs a hard pellet diet. Tooth brushing was performed 5 days per week during the study to maintain healthy peri-implant mucosa. Twenty-four weeks following implant placement, the interface structure was evaluated clinically, radiologically, and histologically. RESULT: Implant stability quotient (ISQ increased with time in all 3 groups, without any significant correlation with the C/I value (p >0.05. Moreover, mean marginal bone loss adjacent around implants in all 3 groups ranged between 0.11 and 0.19 mm, with no significant difference (p >0.05. Many fluorescence-labeled bones are shown in the High C/I group. It is considered that high remodeling activity prevent marginal bone loss in the High C/I group and this may provide favorable implant stability under proper plaque control. CONCLUSION: These findings suggest that increased C/I may not be a risk factor for implant failure if the peri-implant mucosa is kept healthy, as was the case in this animal model.
Full Text Available We performed complex clinical and hygienic research on 234 workers suffering from occupational bronchitis; they were employed in petrochemical industry, mining, civil engineering, as well as in construction. Group of workers with occu-pational diseases comprised hose suffering from dust bronchitis and toxic-dust bronchitis. Workers employed in the exam-ined branches had to work under exposure to production aerosols with complex structure and they working conditions had 3.2–3.4 hazard degree. We showed that occupational factors exerted negative influence on workers' health as they caused occupational bronchitis development, grave complications, and frequent associated diseases evolvement. The paper dwells on the results of our research on lipid peroxidation products content in workers exposed to production aerosols. We detected increased activity of free radical oxidation caused by impacts exerted by production aerosols; here we revealed that growth in lipid peroxidation products depended on duration of work under hazardous conditions. We set a goal to detect correlation between polymorph gene types of xenobiotics transformation enzymes and occupational bronchitis evolvement via poly-merase chain reaction technique; to achieve this, we analyzed polymorphic locuses in a group of sick workers (131 people and healthy ones (156 people. We determined genetic markers which had protective significance in terms of occupational bronchitis evolvement risk. The research results prove that occupational bronchitis nature and peculiarities of its clinic pic-ture are determined both by occupational impacts and individual features of a worker' s body.
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.
Full Text Available Background: As infected children represent a large proportion of the pool from which tuberculosis (TB cases will arise and its associated risk factors that influence TB infection are basic cause for burden of TB. Aim: This study was to determine the prevalence of latent TB and associated risk factors in children less than 5 year of age in Karachi, Pakistan. Setting and Design: Cross-sectional study and it was conducted in tertiary care hospital in Karachi. Materials and Methods: In this study, children who were living in contact with individuals who had proven smear-positive pulmonary TB cases were investigated. A tuberculin skin test (TST was performed on each child. TST sizes ≥5 and 10 mm, respectively, were considered positive. Statistical Analysis: A random effects logistic regression model, which takes into account the clustering of contacts within households, was used to assess the relationship between the tuberculin response of the contact and risk factors. Results are reported as unadjusted and adjusted odds ratios and their 95% confidence intervals. The likelihood ratio test was used to assess the overall significance of risk factors, tests for trend, and tests for interaction. Results: The distribution of TST responses followed a bimodal pattern, with 135 (35% children presenting a palpable induration. The risk of positive TST response in the child increased with the geographic proximity of the child to the individual with TB within the household and with the degree of activities shared with the individual with TB. Nutritional status and presence of a bacille Calmette-Guérin (BCG scar were not independent risk factors for TST positivity in this population. On multivariate analysis, the effect of geographic proximity to the individual with TB, household size, and duration of cough in the index case persisted for TST responses ≥5 mm. Conclusions: Positive TST in a child reflects most probably TB infection rather than previous BCG
Arts, Derk L.; Visscher, Stefan; Opstelten, Wim; Korevaar, Joke C.; Abu-Hanna, Ameen; van Weert, Henk C. P. M.
To determine adequacy of antithrombotic treatment in patients with non-valvular atrial fibrillation. To determine risk factors for under- and over-treatment. Retrospective, cross-sectional study of electronic health records from 36 general practitioners in 2008. General practice in the Netherlands.
Alhaji, Nma Bida; Babalobi, Olutayo Olajide
A cross-sectional survey of 765 cattle in 125 nomadic and 375 cattle in 125 sedentary herds was conducted to investigate prevalence and risk factors for contagious bovine pleuropneumonia (CBPP) in the two production systems of Niger State in North Central Nigeria, between January and August 2013. Data on herd characteristics were collected using structured questionnaires administered on herd owners. Serological analysis was conducted using competitive enzyme linked immunosorbent assay (c-ELISA) test. Descriptive, univariate, and multivariate statistical analyses were conducted with OpenEpi version 2.3.1 software. Statistical significance was held at P production systems was 14.0 % (CI 12.1-16.1). Age and agro-ecological zones were significantly (P production. Agro-ecological zone C had the highest sero-prevalence (25.3 %, CI 20.2-31.0). No significant cattle factors were detected in sedentary production. Factors significantly associated with CBPP occurrence at herd-level were contacts with other herds during grazing (P production systems. Sero-diagnosis and risk factor identification should be institutionalized as elements of epidemio-surveillance and control strategies for CBPP, especially in resource-poor pastoralists' settlements in Nigeria.
Wright, Mona A; Wintemute, Garen J; Webster, Daniel W
While many handguns are used in crime each year in the USA, most are not. We conducted this study to identify factors present at the time of a handgun's most recent retail sale that were associated with its subsequent use in crime under circumstances suggesting that the handgun had been trafficked--purchased with the intent of diverting it to criminal use. Handguns acquired in multiple-gun purchases were of particular interest. Using data for 180,321 handguns purchased from federally licensed retailers in California in 1996, we studied attributes of the handguns, the retailers selling them, the purchasers, and the sales transactions. Our outcome measure was a handgun's recovery by a police agency, followed by a gun ownership trace, conducted by the Bureau of Alcohol, Tobacco, Firearms and Explosives, that determined (a) that the recovery had occurred within 3 years of the handgun's most recent purchase from a licensed retailer and (b) that the person who possessed the gun when it was recovered by police was not its most recent purchaser. Altogether, 722 handguns were recovered and had trace results that met the additional criteria. Handguns acquired in multiple-gun, same-day transactions were more likely to be traced than were single-purchase handguns (odds ratio [OR] 1.33, 95% confidence intervals [CI] 1.08 to 1.63). This was not the case for multiple-purchase handguns defined more broadly as multiple handguns purchased by one individual over any 30-day period as used in "one-gun-a-month" laws. Bivariate regressions indicated increased risk of a handgun being traced when it sold new for $150 or less (OR 4.28, 95% CI 3.59 to 5.11) or had been purchased by a woman (OR 2.02, 95% CI 1.62 to 2.52). Handguns sold by retailers who also had a relatively high proportion (>or=2%) of purchases denied because the prospective purchasers were prohibited from owning firearms were more likely to be traced than were those sold by other retailers (OR 4.09, 95% CI 3.39 to 4
Li, Xue; Liu, Heng; Zhao, Li; Liu, Junling; Cai, Li; Liu, Lei
Objective: To determine the adverse drug reaction (ADR) profile of non-ionic iodinated contrast media in populations with underlying diseases and risk factors and to provide guidance for more safe and rational use of iodinated contrast media (ICMs) in the clinic. Methods: Data from 120,822 cases who underwent enhanced CT examination in our hospital from January 2014 to March 2016 were collected. A standardized case report form was used for data collection and analysis. Results: The incidence of ADRs was 0.4% and 0.44% in patients with and without underlying diseases, respectively (p = 0.378). Risk factor analysis revealed that patients with asthma had the highest incidence of ADRs, followed by patients with cardiac insufficiency and patients who were aged had the lowest incidence. There was a low incidence of ADRs in patients under metformin (0.36%) and β-adrenaline receptor antagonist (0.20%) medication. The incidence was the highest in patients with previous ADRs to ICMs (7.17%) and the lowest in those with a history of ICM usage but no previous reactions (0.32%). ADRs were more common in patients at high risk at a higher injection dose (≥100 ml; p < 0.01) and speed (≥5 ml s−1; p < 0.01). Conclusion: The incidence of ADRs was extremely low in patients regardless of underlying diseases. Some high-risk factors have certain correlations with the occurrence of ADRs. Particular attention should be given to patients at high risk when performing enhanced CT examination. Advances in knowledge: The correlation between various risk factors and underlying diseases and ADRs was comprehensively analyzed in a large-scale population. PMID:27928926
Brachner, A.; Grosche, B.
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
The Volpe Center has used three sources of datathe Federal Railroad Administrations required accident reports, locomotive video, and U.S. Census datato investigate common risk factors for railroad trespassing incidents, the leading cause of ...
M. D. Patel
Full Text Available Aim: A study on surveillance of bovine brucellosis in dairy herds of peri-urban areas under intensive system of production was carried out by milk-ELISA. Various risk factors were identified having significant association with occurrence of bovine brucellosis in dairy herds of peri-urban areas. Materials and Methods: Five randomly selected peri-uban areas of six cities of Gujarat were included in the present study. Five randomly selected dairy herds under intensive system of production from each selected peri-urban area were included for further investigation. In total, 199 bulk and 582 individual milk samples were screened by milk-ELISA. Forty three different risk factors were identified and grouped into four major categories as general characteristics of farms, introduction of infection to farms, management systems of farms and exposure of disease. Further, their distribution and association with prevalence of bovine brucellosis was studied. Results: The overall herd and animal prevalence in peri-urban areas was 33.70 and 11.90%, respectively. Out of 11 risk factors on general characteristics of dairy farms, only five (herd size, type of animals, type of breed, age of owner and knowledge gained by owners showed significant (p<0.05 association with occurrence of bovine brucellosis. None of risk factors on introduction of infection to farms (n=6 and management systems of farms (n=11 was found significantly associated with occurrence of brucellosis. Among risk factors on exposure of disease (n=15, history of abortion, retention of placenta, still birth and metritis/endometritis showed significant (p<0.05 association with prevalence of bovine brucellosis. Conclusion: It was concluded that prevalence of bovine brucellosis in dairy herds under intensive system of production in peri-urban areas of Gujarat was comparatively higher than reported overall prevalence of brucellosis. Risk factors like larger herd in close confinement without adequate sheds
Full Text Available Dear Editor,We thank the authors for their interest and comments on our paper. They have raised some very valid points. This corrispondence refers to the following article:Taksande AM, Yeole M. Risk factors of Acute Respiratory Infection (ARI in under-fives in a rural hospital of Central India. J Pediatr Neonat Individual Med. 2016;5(1:e050105. doi: 10.7363/050105 br />Comments can be found in the following article:Mandal A, Sahi PK. Correspondence: risk factors of acute respiratory infection in under-fives in a rural hospital of Central India. J Pediatr Neonat Individual Med. 2016;5(2:e050207. doi: 10.7363/050207
Arnold, Robert W
In 2003, the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) published a set of risk factors for amblyopia. The intent was to promote uniformity of reporting and development in screening. Because this prevalence is not yet known, this meta-analysis is an attempt to estimate it. Major community preschool eye examination studies were reviewed and AAPOS cut-offs estimated. The approximate prevalence of anisometropia is 1.2%, hyperopia is 6%, astigmatism is 15%, myopia is 0.6%, strabismus is 2.5%, and visual acuity less than 20/40 is 6%. The mean combined prevalence is 21% ± 2% compared to a prevalence of amblyopia 20/40 and worse of 2.5%. Knowing risk factor prevalence simplifies validation efforts. Amblyopia screening with a risk factor sensitivity less than 100% is expected and desirable. Copyright 2013, SLACK Incorporated.
Kim, Hyo Jin; Lee, Joongyub; Park, Miseon; Kim, Yuri; Lee, Hajeong; Kim, Dong Ki; Joo, Kwon Wook; Kim, Yon Su; Cho, Eun Jin; Ahn, Curie; Oh, Kook-Hwan
Lower education level could be a risk factor for higher peritoneal dialysis (PD)-associated peritonitis, potentially resulting in technique failure. This study evaluated the influence of lower education level on the development of peritonitis, technique failure, and overall mortality. Patients over 18 years of age who started PD at Seoul National University Hospital between 2000 and 2012 with information on the academic background were enrolled. Patients were divided into three groups: middle school or lower (academic year≤9, n = 102), high school (912, n = 324). Outcomes were analyzed using Cox proportional hazards models and competing risk regression. A total of 655 incident PD patients (60.9% male, age 48.4±14.1 years) were analyzed. During follow-up for 41 (interquartile range, 20-65) months, 255 patients (38.9%) experienced more than one episode of peritonitis, 138 patients (21.1%) underwent technique failure, and 78 patients (11.9%) died. After adjustment, middle school or lower education group was an independent risk factor for peritonitis (adjusted hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.10-2.36; P = 0.015) and technique failure (adjusted HR, 1.87; 95% CI, 1.10-3.18; P = 0.038), compared with higher than high school education group. However, lower education was not associated with increased mortality either by as-treated (adjusted HR, 1.11; 95% CI, 0.53-2.33; P = 0.788) or intent-to-treat analysis (P = 0.726). Although lower education was a significant risk factor for peritonitis and technique failure, it was not associated with increased mortality in PD patients. Comprehensive training and multidisciplinary education may overcome the lower education level in PD.
Kandemir, Özlem; Bozlu, Murat; Efesoy, Ozan; Güntekin, Onur; Tek, Mesut; Akbay, Erdem
We evaluated the incidence and risk factors of resistant Escherichia coli infections after the prostate biopsy under flouroquinolone prophylaxis. From January 2003 to December 2012, we retrospectively evaluated the records of 2215 patients. The risk factors were described for infective complications and resistant E. coli in positive cultures was calculated. Of 2215 patients, 153 had positive urine cultures, such as 129 (84·3%) E. coli, 8 (5·2%) Enterococcus spp., 6 (3·9%) Enterobacter spp., 5 (3·2%) Pseudomonas spp., 3 (1·9%) MRCNS, and 2 (1·3%) Klebsiella spp. Of the positive urine cultures which yielded E. coli, 99 (76·7%) were evaluated for fluoroquinolone resistance. Of those, 83 (83·8%) were fluoroquinolone-resistant and composed of 51 (61·4%) extended-spectrum beta-lactamase (ESBL)-positive. Fluoroquinolone-resistant E. coli ratios were 73·4 and 95·9% before 2008 and after 2008, respectively (P = 0·002). The most sensitive antibiotics for fluoroquinolone-resistant E. coli strains were imipenem (100%), amikacin (84%) and cefoperazone (83%). The use of quinolones in the last 6 months and a history of hospitalization in the last 30 days were found to be significant risk factors. We found that resistant E. coli strains might be a common microorganism in patients with this kind of complication. The risk factors for development of infection with these resistant strains were history of the use of fluoroquinolones and hospitalization.
Full Text Available Background Nowadays, parasitic infections are a major health problem throughout the world, particularly in the developing countries. Objectives Considering the high susceptibility of children against parasitic infections, the current study aimed to determine the prevalence and associated risk factors of intestinal parasitic infections among children less than 10 years old in urban and rural areas of Hamadan district. Patients and Methods The current study was conducted on 395 children (214 males and 181 females, referred to urban and rural health centers in Hamadan district in 2013. Stool samples were examined by formalin-ether concentration technique, and trichrome and modified Ziehl-Neelsen staining methods. The results were analyzed by chi-square test. Results Of the 395 studied children, 112 (28.4% were infected with intestinal parasites. Blastocystis hominis was the most frequently detected parasite with the prevalence of 18.5%, followed by Giardia lamblia (10.9%, Entamoeba coli (2.8%, Dientamoeba fragilis (0.8%, Iodamoeba buetschlii (0.8%, Chilomastix mesnili (0.5%, Cryptosporidium spp. (0.5%, Endolimax nana (0.3% and Entamoeba hartmanni (0.3%. No cases of infection with helminth parasites were found. Conclusions The results of the study showed a high prevalence of Giardia lamblia and Blastocystis hominis in rural areas compared to urban regions. Therefore it is necessary to promote the public health awareness in the rural population, in order to reduce the frequency of parasitic infections.
Brouwers, M.M.; Feitz, W.F.J.; Roelofs, L.A.J.; Kiemeney, L.A.L.M.; Gier, R.P.E. de; Roeleveld, N.
Despite being one of the most common congenital defects in boys, the etiology of hypospadias remains largely unknown. In this case-referent study, we evaluated a wide spectrum of potential risk factors for hypospadias. Cases were identified from the hospital information system, and referents were
Full Text Available Background: Breast cancer is the most common malignancy among women worldwide. In Iran, breast cancer ranks first among cancers diagnosed in women. Nevertheless, many of women haven’t enough knowledge about breast cancer risk factors and symptoms. The main reason for this escalating mortality is lack of awareness and late diagnosis of disease. The aim of present study assessed the knowledge about risk factors and symptoms of breast cancer, also the screening method and practice (Breast self examination about it. Methods: This is a descriptive and cross-sectional study. In this study 340 red crescent volunteer women participated in a national congress were selected with convenience sampling method. The data collection instrument consisted of a three part questionnaire which included demographic factors, Knowledge level about risk factors, symptoms and screening methods of breast cancer and questions concerning practice about breast self examination (BSE.The study tool was a researcher-designed questionnaire which could evaluated a number of variables. After data collection, analysis was carried out with descriptive tests by SPSS.16 software. Results: The mean age of subjects was 23±2.1yrs. Knowledge about breast cancer risk factors was very poor, the most widely known risk factor and lowest among the participants was family history of breast cancer (30.6 % and early menarche (under 12 years (0.3% respectively. Only 47.9% respondents correctly recognized breast lump and 11.2% breast discharge as the most common symptoms of breast cancer.30% of subjects were aware of BSE. However, a lesser proportion (9.4% was done BSE regular monthly every few months. Conclusion: Regarding the low level of the women’s knowledge about breast cancer especially in young educated women, screening and interventional programs to improve awareness and practice is essential.
Wallace, Ryan M.; Pees, Anna; Blanton, Jesse B.
Ensuring the adequacy of response to rabies vaccination in dogs is important, particularly in the context of pet travel. Few studies have examined the factors associated with dogs’ failure to achieve an adequate antibody titer after vaccination (0.5 IU/ml). This study evaluated rabies antibody titers in dogs after primary vaccination. Dogs under one year of age whose serum was submitted to a reference laboratory for routine diagnostics, and which had no prior documented history of vaccination were enrolled (n = 8,011). Geometric mean titers (GMT) were calculated and univariate analysis was performed to assess factors associated with failure to achieve 0.5 IU/mL. Dogs vaccinated at >16 weeks of age had a significantly higher GMT compared to dogs vaccinated at a younger age (1.64 IU/ml, 1.57–1.72, ANOVA p vaccinated vaccinated 12–16 weeks (1.22 IU/ml and 1.21 IU/ml). The majority of dogs failed to reach an adequate titer within the first 3 days of primary vaccination; failure rates were also high if the interval from vaccination to titer check was greater than 90 days. Over 90% of dogs that failed primary vaccination were able to achieve adequate titers after booster vaccination. The ideal timing for blood draw is 8–30 days after primary vaccination. In the event of a failure, most dogs will achieve an adequate serologic response upon a repeat titer (in the absence of booster vaccination). Booster vaccination after failure provided the highest probability of an acceptable titer. PMID:28759602
Wallace, Ryan M; Pees, Anna; Blanton, Jesse B; Moore, Susan M
Ensuring the adequacy of response to rabies vaccination in dogs is important, particularly in the context of pet travel. Few studies have examined the factors associated with dogs' failure to achieve an adequate antibody titer after vaccination (0.5 IU/ml). This study evaluated rabies antibody titers in dogs after primary vaccination. Dogs under one year of age whose serum was submitted to a reference laboratory for routine diagnostics, and which had no prior documented history of vaccination were enrolled (n = 8,011). Geometric mean titers (GMT) were calculated and univariate analysis was performed to assess factors associated with failure to achieve 0.5 IU/mL. Dogs vaccinated at >16 weeks of age had a significantly higher GMT compared to dogs vaccinated at a younger age (1.64 IU/ml, 1.57-1.72, ANOVA p dogs vaccinated dogs vaccinated 12-16 weeks (1.22 IU/ml and 1.21 IU/ml). The majority of dogs failed to reach an adequate titer within the first 3 days of primary vaccination; failure rates were also high if the interval from vaccination to titer check was greater than 90 days. Over 90% of dogs that failed primary vaccination were able to achieve adequate titers after booster vaccination. The ideal timing for blood draw is 8-30 days after primary vaccination. In the event of a failure, most dogs will achieve an adequate serologic response upon a repeat titer (in the absence of booster vaccination). Booster vaccination after failure provided the highest probability of an acceptable titer.
Caffarelli, C; Stringari, G; Pajno, G B; Peroni, D G; Franceschini, F; Dello Iacono, I; Bernardini, R
Perioperative anaphylactic as well as anaphylactoid reactions can be elicited by drugs, diagnostic agents, antiseptics, disinfectants and latex. In some individuals, allergic reactions occur in the absence of any evident risk factor. Previous history of specific safe exposure to a product does not permit to exclude the risk of having a reaction. We have systematically reviewed characteristics in the patient's history or clinical parameters that affect the risk of developing reactions during anesthesia. Evidence shows that patients with previous unexplained reaction during anesthesia are at risk for perioperative allergic reactions. An allergic reaction to an agent is associated with previous reaction to a product that is related with the culprit agent. Multiple surgery procedures, professional exposure to latex and allergy to fruit are associated with an increased frequency of latex allergy. It has been shown that in some instances, allergic perioperative reactions may be more common in atopic patients and in females.
Cahlíková, Jana; Cingl, L.
Roč. 20, č. 1 (2017), s. 209-236 ISSN 1386-4157 Institutional support: RVO:67985998 Keywords : risk preferences * risk aversion * stress Subject RIV: AH - Economics OBOR OECD: Applied Economics, Econometrics Impact factor: 2.391, year: 2016
Cahlíková, Jana; Cingl, L.
Roč. 20, č. 1 (2017), s. 209-236 ISSN 1386-4157 R&D Projects: GA MŠk(CZ) SVV 265801/2012 Institutional support: Progres-Q24 Keywords : risk preferences * risk aversion * stress Subject RIV: AH - Economics OBOR OECD: Applied Economics, Econometrics Impact factor: 2.391, year: 2016
Full Text Available Abstract Background Diarrhoea and acute respiratory conditions are common medical conditions among under-five children in resource-limited and conflict situations. The present study was conducted to estimate the prevalence and associated factors for acute respiratory conditions and diarrhoea among children under the age of five years in Iraq in 2000. Methods Data for the Iraqi Multiple Indicator Cluster Survey were obtained from UNICEF. We estimated the prevalence of acute respiratory conditions and diarrhoea. Assessment of the associations between these two medical conditions on one hand and socio-demographic and environmental variables on the other was done using logistic regression analysis. Weighted analysis was conducted to account for complex survey design. Results A total of 14,676 children under the age of 5 years were reported by their mothers in the study. Of these 50.4% were males. About half (53.9% of the children had complete vaccination status. Overall, 21.3% of the children had diarrhoea, and 6.9% had acute respiratory infection (ARI in the last two weeks. In multivariate analysis, diarrhoea was associated with age of child, area of residence, maternal education, source of water, toilet facility, disposal of children' stool and disposal of dirty water. Compared to children aged 48–59 months, children in the age groups 6–11 months and 12–23 months were 2.22 (95%CI [2.02, 2.44] and 1.84 (95%CI [1.71, 2.00] times more likely, respectively, to have diarrhoea. Children whose mothers had no formal education were 11% (AOR = 1.11, 95%CI [1.04, 1.18] more likely to have diarrhoea compared to children with mothers who had attained secondary level of education. Compared to children who belonged to households with unprotected well or river as the main source of water, children who belonged to households with piped water were 32% (AOR = 1.32, 95%CI [1.17, 1.48] more likely to have diarrhoea while those who belonged to households with
Bouju, G; Grall-Bronnec, M; Landreat-Guillou, M; Venisse, J-L
In France, consumption of gambling games increased by 148% between 1960 and 2005. In 2004, gamblers lost approximately 0.9% of household income, compared to 0.4% in 1960. This represents approximately 134 Euros per year and per head. In spite of this important increase, the level remains lower than the European average (1%). However, gambling practices may continue to escalate in France in the next few years, particularly with the recent announce of the legalisation of online games and sports betting. With the spread of legalised gambling, pathological gambling rates may increase in France in the next years, in response to more widely available and more attractive gambling opportunities. In this context, there is a need for better understanding of the risk factors that are implicated in the development and maintenance of pathological gambling. This paper briefly describes the major risk factors for pathological gambling by examining the recent published literature available during the first quarter of 2008. This documentary basis was collected by Inserm for the collective expert report procedure on Gambling (contexts and addictions). Seventy-two articles focusing on risk factors for pathological gambling were considered in this review. Only 47 of them were taken into account for analysis. The selection of these 47 publications was based on the guide on literature analysis established by the French National Agency for Accreditation and Assessment in Health (ANAES, 2000). Some publications from more recent literature have also been added, mostly about Internet gambling. We identify three major types of risk factors implicated in gambling problems: some of them are related to the subject (individual factors), others are related to the object of the addiction, here the gambling activity by itself (structural factors), and the last are related to environment (contextual or situational factors). Thus, the development and maintenance of pathological gambling seems to be
Full Text Available Dementia is a complex human disease. The incidence of dementia among the elderly population is rising rapidly worldwide. In the United States, Alzheimer's disease (AD is the leading type of dementia and was the fifth and eighth leading cause of death in women and men aged ≥ 65 years, respectively, in 2003. In Taiwan and many other counties, dementia is a hidden health issue because of its underestimation in the elderly population. In Western countries, the prevalence of AD increases from 1–3% among people aged 60–64 years to 35% among those aged > 85 years. In Taiwan, the prevalence of dementia for people aged ≥ 65 years was 2–4% by 2000. Therefore, it is important to identify protective and risk factors for dementia to prevent this disease at an early stage. Several factors are related to dementia, e.g. age, ethnicity, sex, genetic factors, physical activity, smoking, drug use, education level, alcohol consumption, body mass index, comorbidity, and environmental factors. In this review, we focus on studies that have evaluated the association between these factors and the risk of dementia, especially AD and vascular dementia. We also suggest future research directions for researchers in dementia-related fields.
Deribew, Amare; Tessema, Gizachew Assefa; Deribe, Kebede; Melaku, Yohannes Adama; Lakew, Yihunie; Amare, Azmeraw T; Abera, Semaw F; Mohammed, Mesoud; Hiruye, Abiy; Teklay, Efrem; Misganaw, Awoke; Kassebaum, Nicholas
Ethiopia has made remarkable progress in reducing child mortality over the last two decades. However, the under-5 mortality rate in Ethiopia is still higher than the under-5 mortality rates of several low- and middle-income countries (LMIC). On the other hand, the patterns and causes of child mortality have not been well investigated in Ethiopia. The objective of this study was to investigate the mortality trend, causes of death, and risk factors among children under 5 in Ethiopia during 1990-2013. We used Global Burden of Disease (GBD) 2013 data. Spatiotemporal Gaussian Process Regression (GPR) was applied to generate best estimates of child mortality with 95% uncertainty intervals (UI). Causes of death by age groups, sex, and year were measured using Cause of Death Ensemble modeling (CODEm). For estimation of HIV/AIDS mortality rate, the modified UNAIDS EPP-SPECTRUM suite model was used. Between 1990 and 2013 the under-5 mortality rate declined from 203.9 deaths/1000 live births to 74.4 deaths/1000 live births with an annual rate of change of 4.6%, yielding a total reduction of 64%. Similarly, child (1-4 years), post-neonatal, and neonatal mortality rates declined by 75%, 64%, and 52%, respectively, between 1990 and 2013. Lower respiratory tract infection (LRI), diarrheal diseases, and neonatal syndromes (preterm birth complications, neonatal encephalopathy, neonatal sepsis, and other neonatal disorders) accounted for 54% of the total under-5 deaths in 2013. Under-5 mortality rates due to measles, diarrhea, malaria, protein-energy malnutrition, and iron-deficiency anemia declined by more than two-thirds between 1990 and 2013. Among the causes of under-5 deaths, neonatal syndromes such as sepsis, preterm birth complications, and birth asphyxia ranked third to fifth in 2013. Of all risk-attributable deaths in 1990, 25% of the total under-5 deaths (112,288/435,962) and 48% (112,288/232,199) of the deaths due to diarrhea, LRI, and other common infections were
Bonnes, J.L.; Westra, S.W.; Bouwels, L.H.; Boer, M.J. de; Brouwer, M.A.; Smeets, J.L.R.M.
INTRODUCTION: In view of the shift from routine toward no or selective defibrillation testing, optimization of the current risk stratification for inadequate defibrillation safety margins (DSMs) could improve individualized testing decisions. Given the pathophysiological differences in myocardial
Striegel-Moore, Ruth H.; Bulik, Cynthia M.
The authors review research on risk factors for eating disorders, restricting their focus to studies in which clear precedence of the hypothesized risk factor over onset of the disorder is established. They illustrate how studies of sociocultural risk factors and biological factors have progressed on parallel tracks and propose that major advances…
... Stay Informed Cancer Home What Are the Risk Factors for Lung Cancer? Language: English (US) Español (Spanish) ... your cell phone Research has found several risk factors that may increase your chances of getting lung ...
It is no longer reasonable to divide cancers into those that are genetic in origin and those that are environmental in origin. With rare exception, carcinogenesis involves environmental factors that directly or indirectly exert a change in the cell's genome. Virtually all causes of cancer are multifactorial, sometimes involving an inherited predisposition to the carcinogenic effects of environmental factors, which include chemicals, ionizing radiation, and oncogenic virus. Carcinogenesis is a multistep process including induction, promotion, and progression. Initiation requires an irreversible change in the cellular genome, whereas promotion is commonly associated with prolonged and reversible exposure. Tumor progression results in genotypic and phenotypic changes associated with tumor growth, invasion, and metastasis. Most information on human cancer risk is based on epidemiologic studies involving both exposed and unexposed individuals. The quality of such studies depends on their ability to assess the strength of any association of exposure and disease and careful attention to any potential bias. Few cancers are inherited in a Mendelian fashion. Several preneoplastic conditions, however, are clearly inherited and several malignancies demonstrate weak familial patterns. Environmental factors may exert their effect on DNA in a random fashion, but certain consistent changes, including specific translocations of genetic information, are often found. Currently, there is great interest in the close proximity of certain oncogenes governing growth control to the consistent chromosomal changes observed. Such changes may represent a final common pathway of action for environmental carcinogens. Sufficient laboratory and epidemiologic evidence exists to establish a causal association of several chemical agents with cancer
Kirchheiner, Kathrin, E-mail: firstname.lastname@example.org [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria); Czajka-Pepl, Agnieszka [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Ponocny-Seliger, Elisabeth [Department of Psychology, Sigmund Freud Private University Vienna, Vienna (Austria); Scharbert, Gisela; Wetzel, Léonore [Department of Anaesthesia, General Intensive Care and Pain Management, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Nout, Remi A. [Department of Clinical Oncology, Leiden University Medical Center, Leiden (Netherlands); Sturdza, Alina [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Dimopoulos, Johannes C. [Metropolitan Hospital, Athens (Greece); Dörr, Wolfgang; Pötter, Richard [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria)
Purpose: To investigate the psychological consequences of high-dose-rate brachytherapy with 2 fractions in 1 application under spinal/epidural anesthesia in the treatment of locally advanced cervical cancer. Methods and Materials: In 50 patients with locally advanced cervical cancer, validated questionnaires were used for prospective assessment of acute and posttraumatic stress disorder (ASD/PTSD) (Impact of Event Scale–Revision), anxiety/depression (Hospital Anxiety and Depression Scale), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30/Cervical Cancer 24), physical functioning (World Health Organization performance status), and pain (visual analogue scale), before and during treatment and 1 week and 3 months after treatment. Qualitative interviews were recorded in open format for content analysis. Results: Symptoms of ASD occurred in 30% of patients 1 week after treatment; and of PTSD in 41% 3 months after treatment in association with this specific brachytherapy procedure. Pretreatment predictive variables explain 82% of the variance of PTSD symptoms. Helpful experiences were the support of the treatment team, psychological support, and a positive attitude. Stressful factors were pain, organizational problems during treatment, and immobility between brachytherapy fractions. Conclusions: The specific brachytherapy procedure, as performed in the investigated mono-institutional setting with 2 fractions in 1 application under spinal/epidural anesthesia, bears a considerable risk of traumatization. The source of stress seems to be not the brachytherapy application itself but the maintenance of the applicator under epidural anesthesia in the time between fractions. Patients at risk may be identified before treatment, to offer targeted psycho-social support. The patients' open reports regarding helpful experiences are an encouraging feedback for the treatment team; the reported stressful
Kirchheiner, Kathrin; Czajka-Pepl, Agnieszka; Ponocny-Seliger, Elisabeth; Scharbert, Gisela; Wetzel, Léonore; Nout, Remi A.; Sturdza, Alina; Dimopoulos, Johannes C.; Dörr, Wolfgang; Pötter, Richard
Purpose: To investigate the psychological consequences of high-dose-rate brachytherapy with 2 fractions in 1 application under spinal/epidural anesthesia in the treatment of locally advanced cervical cancer. Methods and Materials: In 50 patients with locally advanced cervical cancer, validated questionnaires were used for prospective assessment of acute and posttraumatic stress disorder (ASD/PTSD) (Impact of Event Scale–Revision), anxiety/depression (Hospital Anxiety and Depression Scale), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30/Cervical Cancer 24), physical functioning (World Health Organization performance status), and pain (visual analogue scale), before and during treatment and 1 week and 3 months after treatment. Qualitative interviews were recorded in open format for content analysis. Results: Symptoms of ASD occurred in 30% of patients 1 week after treatment; and of PTSD in 41% 3 months after treatment in association with this specific brachytherapy procedure. Pretreatment predictive variables explain 82% of the variance of PTSD symptoms. Helpful experiences were the support of the treatment team, psychological support, and a positive attitude. Stressful factors were pain, organizational problems during treatment, and immobility between brachytherapy fractions. Conclusions: The specific brachytherapy procedure, as performed in the investigated mono-institutional setting with 2 fractions in 1 application under spinal/epidural anesthesia, bears a considerable risk of traumatization. The source of stress seems to be not the brachytherapy application itself but the maintenance of the applicator under epidural anesthesia in the time between fractions. Patients at risk may be identified before treatment, to offer targeted psycho-social support. The patients' open reports regarding helpful experiences are an encouraging feedback for the treatment team; the reported stressful
Shakoor, Sania; Zavos, Helena M.S.; McGuire, Philip; Cardno, Alastair G.; Freeman, Daniel; Ronald, Angelica
Cannabis users are more likely to have psychotic experiences (PEs). The degree to which these associations are driven by genetic or environmental influences in adolescence is unknown. This study estimated the genetic and environmental contributions to the relationship between cannabis use and PEs. Specific PEs were measured in a community-based twin sample (4830 16-year-old pairs) using self-reports and parent-reports. Adolescents reported on ever using cannabis. Multivariate liability threshold structural equation model-fitting was conducted. Cannabis use was significantly correlated with PEs. Modest heritability (37%), common environmental influences (55%) and unique environment (8%) were found for cannabis use. For PEs, modest heritability (27–54%), unique environmental influences (E=12–50%) and little common environmental influences (11–20%), with the exception of parent-rated Negative Symptoms (42%), were reported. Environmental influences explained all of the covariation between cannabis use and paranoia, cognitive disorganization and parent-rated negative symptoms (bivariate common environment=69–100%, bivariate unique environment=28–31%), whilst the relationship between cannabis use and hallucinations indicated familial influences. Cannabis use explains 2–5% of variance in positive, cognitive, and negative PEs. Cannabis use and psychotic experience co-occur due to environmental factors. Focus on specific environments may reveal why adolescent cannabis use and psychotic experiences tend to ‘travel together’. PMID:25912376
Full Text Available Abstract Background Ethiopia has made remarkable progress in reducing child mortality over the last two decades. However, the under-5 mortality rate in Ethiopia is still higher than the under-5 mortality rates of several low- and middle-income countries (LMIC. On the other hand, the patterns and causes of child mortality have not been well investigated in Ethiopia. The objective of this study was to investigate the mortality trend, causes of death, and risk factors among children under 5 in Ethiopia during 1990–2013. Methods We used Global Burden of Disease (GBD 2013 data. Spatiotemporal Gaussian Process Regression (GPR was applied to generate best estimates of child mortality with 95% uncertainty intervals (UI. Causes of death by age groups, sex, and year were measured using Cause of Death Ensemble modeling (CODEm. For estimation of HIV/AIDS mortality rate, the modified UNAIDS EPP-SPECTRUM suite model was used. Results Between 1990 and 2013 the under-5 mortality rate declined from 203.9 deaths/1000 live births to 74.4 deaths/1000 live births with an annual rate of change of 4.6%, yielding a total reduction of 64%. Similarly, child (1–4 years, post-neonatal, and neonatal mortality rates declined by 75%, 64%, and 52%, respectively, between 1990 and 2013. Lower respiratory tract infection (LRI, diarrheal diseases, and neonatal syndromes (preterm birth complications, neonatal encephalopathy, neonatal sepsis, and other neonatal disorders accounted for 54% of the total under-5 deaths in 2013. Under-5 mortality rates due to measles, diarrhea, malaria, protein-energy malnutrition, and iron-deficiency anemia declined by more than two-thirds between 1990 and 2013. Among the causes of under-5 deaths, neonatal syndromes such as sepsis, preterm birth complications, and birth asphyxia ranked third to fifth in 2013. Of all risk-attributable deaths in 1990, 25% of the total under-5 deaths (112,288/435,962 and 48% (112,288/232,199 of the deaths due to
Gülşen Tükenmez Demirc
Full Text Available Background and Design: There have been reports suggesting the involvement of environmental factors in the disease process of pemphigus. In this study, we aimed to find out the risk factors which could play role in the etiopathogenesis in our pemphigus patients.Material and method: A total of 42 patients (15 male and 27 female who were diagnosed as pemphigus with histopathological and direct immunoflurosence examinations in our clinic between the years 1998-2004, were interviewed for assessment of regarding with the subjects of the demographic properties, occupational groups, educational level, the number of pregnancies, stressfull life events, diet habits, smoking and alcohol consumption before the onset of the disease and the results were compared to 42 age and gender-matched controls with similar socioeconomic circumstances. Results: Working in agriculture and livestock, multi-parity, absence of smoking and stressfull life events were found to be statistically significant in pemphigus patients than in controls. Conclusion: Working in agriculture and livestock, multi-parity, absence of smoking and stressfull life events were assumed to play role in the etiopathogenesis and course of pemphigus.
Full Text Available Emmanuel Ademola Anigilaje,1 Ayodotun Olutola2 1Department of Paediatrics, Benue State University, Makurdi, 2Center for Clinical Care and Clinical Research, Abuja, Nigeria Background: Undernutrition is common in human immunodeficiency virus (HIV infection and it contributes significantly to its morbidity and mortality. However, as far as we are aware, few studies have described the risk factors of undernutrition among HIV-infected Nigerian children. The study reported here aimed to determine the prevalence and risk factors of undernutrition among HIV-infected, antiretroviral therapy (ART-naïve children aged under 5 years old in Makurdi, Nigeria. Methods: A retrospective, cross-sectional study was undertaken at the Federal Medical Centre, Makurdi, between June 2010 and June 2011. Logistic regression modelling was used to determine the risk factors of undernutrition. Results: Data on 182 HIV-infected children (88 males and 94 females, aged between 6 weeks and 59 months were studied. The prevalence of undernutrition was 12.1%, 33.5%, and 54.4% for underweight, wasting, and stunting, respectively. In multivariate regression analyses, being female (adjusted odds ratio [AOR] 0.292, 95% [confidence interval] CI 0.104–0.820, P=0.019, the child's caregiver being on ART (AOR 0.190, 95% CI 0.039–0.925, P=0.04, and the absence of tuberculosis in the child (AOR 0.034, 95% CI 0.003–0.357, P=0.005 were independently protective against underweight. Subjects who were exclusively breastfed in the first 6 months of life were protected from stunting (AOR 0.136, 95% CI 0.032–0.585, P=0.007. No factor impacted significantly on wasting in multivariate analyses. Conclusion: Undernutrition among HIV-infected, ART-naïve children aged under 5 years old may be reduced if programmatic interventions are guided toward early initiation of ART among eligible HIV-infected caregivers and the promotion of HIV/tuberculosis coinfection control efforts. Also, the importance
Verlinden, S; Hersen, M; Thomas, J
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.
Ambadekar, N N; Zodpey, S P
The present study was planned to identify some of the risk factors of severe acute malnutrition (SAM) in under-five children in a rural part of India. Case-control study. The study was carried out in rural areas of Yavatmal district. A total of 737 cases (under-five SAM children) and an equal number of normal controls were included in the study. Data were collected using a structured questionnaire. Binary logistic regression was used for multivariate analysis using a hierarchical model. The odds of a child being in the SAM category increased significantly if the family: was below the poverty line, have a kuccha house, have more children in the family, have less rooms in the house, have a working mother, has a mother with a lower level of education, have an unemployed father, did not use any water purification measure, did not always ensure parents washed their hands before feeding a child, did not wash hands with soap and water after defecation, have a father with any addictive habit like tobacco or alcohol consumption, have a maternal height marriage for mothers, had an institutional delivery, have the same food utilized more than once in a day, have no age-appropriate vaccination, give prelacteal feeds, have a lower frequency of breast feeding, do not use semisolid food during the weaning period, exclusively breast feed for less than four months or more than six months, had low birth weight, have five or more episodes of illness in the previous year, have ≤3 feeds per day apart from breast milk, and not initiation of breast feeding within 30 min of birth. Risk factors identified in the present study can be addressed through health system interventions. The strongest association was observed with child feeding practices; thus, more emphasis is required in nutritional education and counselling in strategies to fight undernutrition. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Pilanci, Kezban Nur; Alco, Gul; Ordu, Cetin; Sarsenov, Dauren; Celebi, Filiz; Erdogan, Zeynep; Agacayak, Filiz; Ilgun, Serkan; Tecimer, Coskun; Demir, Gokhan; Eralp, Yesim; Okkan, Sait; Ozmen, Vahit
One of the most important adverse effects of zoledronic acid (ZA) is osteonecrosis of the jaw (ONJ). In previous literature, several risk factors have been identified in the development of ONJ. In this study, we aimed to determine the role of trastuzumab, an antiangiogenic agent, as an independent risk factor for the development of this serious side effect.Our study included 97 patients (mean age: 54 ± 10 years) with breast cancer, recorded in the archives of the Istanbul Florence Nightingale Breast Study Group, who received ZA therapy due to bone metastases between March 2006 and December 2013. We recorded the patients' ages, weights, duration of treatment with ZA, number of ZA infusions, dental procedures, anticancer treatments (chemotherapy, aromatase inhibitor, trastuzumab), the presence of diabetes mellitus or renal dysfunction, and smoking habits.Thirteen patients (13.40%) had developed ONJ. Among the patients with ONJ, the mean time of exposure to ZA was 41 months (range: 13-82) and the mean number of ZA infusions was 38 (range: 15-56). The duration of treatment with ZA and the use of trastuzumab were observed to be 2 factors that influenced the development of ONJ (P = 0.049 and P = 0.028, respectively).The development of ONJ under ZA treatment may be associated solely with the duration of ZA treatment and the concurrent administration of trastuzumab. These findings show that patients who are administered trastuzumab for metastatic breast cancer while undergoing ZA treatment are prone to developing ONJ. Therefore, we recommend intense clinical observation to avoid this particular condition in patients receiving ZA and trastuzumab.
Full Text Available In this paper, an integrated approach based on Monte Carlo simulation and Six Sigma methodology is used to analyze the risk associated with a project's total cost. Monte Carlo simulation is applied to understand the variability in total cost caused by the probabilistic cost items. By Six Sigma methodology the range of variation of the project cost can be reduced by operating on the input factors with the greatest impact on total cost to cover the variation of 6 between the limits that were established in the design phase of Six Sigma.
Lava, M; Schüpbach-Regula, G; Steiner, A; Meylan, M
Ninety-one Swiss veal farms producing under a label with improved welfare standards were visited between August and December 2014 to investigate risk factors related to antimicrobial drug use and mortality. All herds consisted of own and purchased calves, with a median of 77.4% of purchased calves. The calves' mean age was 29±15days at purchasing and the fattening period lasted at average 120±28 days. The mean carcass weight was 125±12kg. A mean of 58±33 calves were fattened per farm and year, and purchased calves were bought from a mean of 20±17 farms of origin. Antimicrobial drug treatment incidence was calculated with the defined daily dose methodology. The mean treatment incidence (TIADD) was 21±15 daily doses per calf and year. The mean mortality risk was 4.1%, calves died at a mean age of 94±50 days, and the main causes of death were bovine respiratory disease (BRD, 50%) and gastro-intestinal disease (33%). Two multivariable models were constructed, for antimicrobial drug treatment incidence (53 farms) and mortality (91 farms). No quarantine, shared air space for several groups of calves, and no clinical examination upon arrival at the farm were associated with increased antimicrobial treatment incidence. Maximum group size and weight differences >100kg within a group were associated with increased mortality risk, while vaccination and beef breed were associated with decreased mortality risk. The majority of antimicrobial treatments (84.6%) were given as group treatments with oral powder fed through an automatic milk feeding system. Combination products containing chlortetracycline with tylosin and sulfadimidine or with spiramycin were used for 54.9%, and amoxicillin for 43.7% of the oral group treatments. The main indication for individual treatment was BRD (73%). The mean age at the time of treatment was 51 days, corresponding to an estimated weight of 80-100kg. Individual treatments were mainly applied through injections (88.5%), and included
Adamová, Z; Slováček, R; Sankot, J
Colonic diverticular disease is a common illness, especially in the elderly population. It may be asymptomatic and cause chronic intestinal problems, colonic diverticular bleeding or inflammatory complications with considerable morbidity and mortality. We have attempted at finding factors that would help us identify patients with a higher risk of diverticulitis recurrence as well as patients with a higher likelihood of perforated diverticulitis. This retrospective study included all patients admitted to our surgical ward for inflammatory complications of diverticular disease between 2000 and 2012: 278 patients, 88 men and 190 women. We looked up the first attack of diverticulitis in our documentation as well as the relapses, if any, their number and course, and the time from the first attack to the relapse. We analyzed the influence of age, gender, comorbidities (diabetes mellitus, overweight, ischemic heart disease, chronic renal failure, gastroduodenal disease), nicotine abuse and medication (glucocorticoids and other immunosuppressive drugs, acetylsalicylic acid) on diverticulitis recurrence and its complicated course. We compared the results of conservative and surgical therapy. Statistical analysis was performed using Fishers exact test and Man-Whitney U tests. We did not demonstrate any statistically significant dependence of diverticulitis recurrence on age or gender. Colectomy (both acute and elective surgery) clearly decreases the likelihood of recurrence (p=0.00007). Comorbidities, nicotine abuse and medication were not associated with an increased risk of recurrence. Steroid and immunosuppressive drugs use was significantly associated with higher perforation rates, without impacting on the likelihood of recurrence. Regular smoking of cigarettes had no impact on recurrence or on its severity. We did not find any reliable indicator of recurrent diverticulitis. Age, gender, comorbidities, smoking and medication are not significant. Immunocompromised
Tahmina Alam MBBS
Full Text Available Children with diarrhea hospitalized for respiratory distress often have fatal outcome in resource-limited settings, although data are lacking on risk factors for death in such children. We sought to evaluate clinical predictors for death in such children. In this prospective cohort study, we enrolled under-5 children with diarrhea admitted with severe respiratory distress to the intensive care unit of Dhaka Hospital of International Centre for Diarhoeal Disease Research, Bangladesh, from September 2014 through September 2015. We compared clinical and laboratory characteristics between study children those who died (n = 29 and those who survived (n = 62. In logistic regression analysis, after adjusting for potential confounders, the independent predictors for death in children hospitalized for diarrhea and severe respiratory distress were severe sepsis and hypoglycemia (P < .05 for all. Thus, recognition of these simple parameters may help clinicians identify children with diarrhea at risk of deaths in order to initiate prompt management for the better outcome, especially in resource-poor settings.
Jeanne M McCaffery
Full Text Available Allostatic load is a commonly used metric of health risk based on the hypothesis that recurrent exposure to environmental demands (e.g., stress engenders a progressive dysregulation of multiple physiological systems. Prominent indicators of response to environmental challenges, such as stress-related hormones, sympatho-vagal balance, or inflammatory cytokines, comprise primary allostatic mediators. Secondary mediators reflect ensuing biological alterations that accumulate over time and confer risk for clinical disease but overlap substantially with a second metric of health risk, the metabolic syndrome. Whether allostatic load mediators covary and thus warrant treatment as a unitary construct remains to be established and, in particular, the relation of allostatic load parameters to the metabolic syndrome requires elucidation. Here, we employ confirmatory factor analysis to test: 1 whether a single common factor underlies variation in physiological systems associated with allostatic load; and 2 whether allostatic load parameters continue to load on a single common factor if a second factor representing the metabolic syndrome is also modeled. Participants were 645 adults from Allegheny County, PA (30-54 years old, 82% non-Hispanic white, 52% female who were free of confounding medications. Model fitting supported a single, second-order factor underlying variance in the allostatic load components available in this study (metabolic, inflammatory and vagal measures. Further, this common factor reflecting covariation among allostatic load components persisted when a latent factor representing metabolic syndrome facets was conjointly modeled. Overall, this study provides novel evidence that the modeled allostatic load components do share common variance as hypothesized. Moreover, the common variance suggests the existence of statistical coherence above and beyond that attributable to the metabolic syndrome.
...) contribute to the racial differences in cardiovascular risk and events among women. High levels of socioeconomic stress, higher dietary fat intake and sedentary lifestyle are more prevalent among black than white women...
suggest that obstetric factors increase the risk of damage to the anal sphincter and subsequent development of AI.[4-6] These ... variations may impact on obstetric risk factors and AI prevalence. We therefore performed a study in our population, which .... Regulatory approvals. Institutional and hospital ethical approval were ...
Klinda, J.; Lieskovska, Z.
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
Stewart, Jane; Benford, Penny; Wynn, Persephone; Watson, Michael Craig; Coupland, Carol; Deave, Toity; Hindmarch, Paul; Majsak-Newman, Gosia; Kendrick, Denise
To determine the relationship between a range of modifiable risk factors and medically attended scalds in children under the age of 5 years. Multicentre matched case-control study in acute hospitals, minor injury units and GP practices in four study centres in England. Cases comprised 338 children under 5 presenting with a scald, and 1438 control participants matched on age, gender, date of event and study centre. Parents/caregivers completed questionnaires on safety practices, safety equipment use, home hazards and potential confounders. Odds ratios were estimated using conditional logistic regression. Parents of cases were significantly more likely than parents of controls to have left hot drinks within reach of their child (adjusted odds ratio (AOR) 2.33, 95%CI 1.63 to 3.31; population attributable fraction (PAF) 31%). They were more likely not to have taught children rules about climbing on kitchen objects (AOR 1.66, 95%CI 1.12 to 2.47; PAF 20%); what to do or not do when parents are cooking (AOR 1.95, 95%CI 1.33 to 2.85; PAF 26%); and about hot things in the kitchen (AOR 1.89, 95%CI 1.30 to 2.75; PAF 26%). Some scald injuries may be prevented by parents keeping hot drinks out of reach of children and by teaching children rules about not climbing on objects in the kitchen, what to do or not do whilst parents are cooking using the top of the cooker and about hot objects in the kitchen. Further studies, providing a more sophisticated exploration of the immediate antecedents of scalds are required to quantify associations between other hazards and behaviours and scalds in young children. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.
Csóka, P.; Herings, P.J.J.
Risk allocation games are cooperative games that are used to attribute the risk of a financial entity to its divisions. In this paper, we extend the literature on risk allocation games by incorporating liquidity considerations. A liquidity policy specifies state-dependent liquidity requirements that
Moskwa, C A; Nicholas, J A; Goldberg, B
In brief: Many children and adolescents participate in sports that put them at risk for musculoskeletal injuries. Underlying physical conditions, or risk factors, may predispose them to particular types of sports injuries. Research shows that these risk factors fall into five categories: body type, flexibility, muscle strength, inadequate rehabilitation of a previous injury, and skeletal malalignment and anomalies. Some findings show, for example, that youthful football players who are also heavy have an increased rate of injury, sprains and strains are less common in flexible athletes, and patellar pain or subluxation may be related to a variety of malalignment factors. The authors recommend using a systematic, integrated approach to risk assessment of the athlete, both for detecting risk factors and determining their potential for con tribu ting to a sports injury.
Full Text Available Respiratory syncytial virus (RSV is the most common pathogen identified in young children with acute lower respiratory infection (ALRI as well as an important cause of hospital admission. The high incidence of RSV infection and its potential severe outcome make it important to identify and prioritise children who are at higher risk of developing RSV–associated ALRI. We aimed to identify risk factors for RSV–associated ALRI in young children. We carried out a systematic literature review across 4 databases and obtained unpublished studies from RSV Global Epidemiology Network (RSV GEN collaborators. Quality of all eligible studies was assessed according to modified GRADE criteria. We conducted meta–analyses to estimate odds ratios with 95% confidence intervals (CI for individual risk factors. We identified 20 studies (3 were unpublished data with “good quality” that investigated 18 risk factors for RSV–associated ALRI in children younger than five years old. Among them, 8 risk factors were significantly associated with RSV–associated ALRI. The meta–estimates of their odds ratio (ORs with corresponding 95% confidence intervals (CI are prematurity 1.96 (95% CI 1.44–2.67, low birth weight 1.91 (95% CI 1.45–2.53, being male 1.23 (95% CI 1.13–1.33, having siblings 1.60 (95% CI 1.32–1.95, maternal smoking 1.36 (95% CI 1.24–1.50, history of atopy 1.47 (95% CI 1.16–1.87, no breastfeeding 2.24 (95% CI 1.56–3.20 and crowding 1.94 (95% CI 1.29–2.93. Although there were insufficient studies available to generate a meta–estimate for HIV, all articles (irrespective of quality scores reported significant associations between HIV and RSV–associated ALRI. This study presents a comprehensive report of the strength of association between various socio–demographic risk factors and RSV–associated ALRI in young children. Some of these amenable risk factors are similar to those that have been identified for (all cause ALRI and
Lolli, Chiara; Marenzoni, Maria Luisa; Strona, Paolo; Lappo, Pier Giorgio; Etiang, Patrick; Diverio, Silvana
A survey was conducted to estimate the prevalence of Anaplasma, Babesia and Brucella spp. infections in cattle, goats and sheep in the Karamoja Region of Uganda and to identify possible risk factors existing in this semi-nomadic and pastoral area. Low cost laboratory tests were used to diagnose infections (Rose Bengal test for Brucella spp. antibodies and direct microscopic examination for Anaplasma and Babesia spp.). Multivariable logistic regression models were applied to identify possible risk factors linked to gender, animal species, age (only for cattle) and districts. A total of 3935 cattle, 729 goats and 306 sheep of five districts of the Karamoja Region were tested. Seroprevalence for Brucella was 9.2 % (CI, 95 %: 8.4-10), for Anaplasma 19.5 % (CI 95 %: 18.4-20.6) and for Babesia 16 % (CI 95 %: 15-17.1). Significant differences in infections prevalence were observed against risk factors associated with districts and species. Cattle were the species with higher risk of the infections. Female gender was identified as at risk only for Brucella spp. infection. Cattle more than one year old had greater likelihood to be Brucella seropositive. Co-infections of Anaplasma and Babesia spp. were statistically associated, especially in goats and sheep. Further studies to identify risk factors related to host species and geographical districts are needed. The influence on the semi-nomadic agro-pastoral system in Karamoja of animal raids and animal mixing should be further investigated. Findings were important to sensitize Karamojong undertaking measures on infection control, especially on cattle, which are their main source of food.
Gyllenborg, J; Rasmussen, S L; Borch-Johnsen, Knut
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...
Alentorn-Geli, Eduard; Myer, Gregory D; Silvers, Holly J; Samitier, Gonzalo; Romero, Daniel; Lázaro-Haro, Cristina; Cugat, Ramón
Soccer is the most commonly played sport in the world, with an estimated 265 million active soccer players by 2006. Inherent to this sport is the higher risk of injury to the anterior cruciate ligament (ACL) relative to other sports. ACL injury causes the most time lost from competition in soccer which has influenced a strong research focus to determine the risk factors for injury. This research emphasis has afforded a rapid influx of literature defining potential modifiable and non-modifiable risk factors that increase the risk of injury. The purpose of the current review is to sequence the most recent literature that reports potential mechanisms and risk factors for non-contact ACL injury in soccer players. Most ACL tears in soccer players are non-contact in nature. Common playing situations precluding a non-contact ACL injury include: change of direction or cutting maneuvers combined with deceleration, landing from a jump in or near full extension, and pivoting with knee near full extension and a planted foot. The most common non-contact ACL injury mechanism include a deceleration task with high knee internal extension torque (with or without perturbation) combined with dynamic valgus rotation with the body weight shifted over the injured leg and the plantar surface of the foot fixed flat on the playing surface. Potential extrinsic non-contact ACL injury risk factors include: dry weather and surface, and artificial surface instead of natural grass. Commonly purported intrinsic risk factors include: generalized and specific knee joint laxity, small and narrow intercondylar notch width (ratio of notch width to the diameter and cross sectional area of the ACL), pre-ovulatory phase of menstrual cycle in females not using oral contraceptives, decreased relative (to quadriceps) hamstring strength and recruitment, muscular fatigue by altering neuromuscular control, decreased "core" strength and proprioception, low trunk, hip, and knee flexion angles, and high
Gumbo, F Z; Duri, K; Kandawasvika, G Q; Kurewa, N E; Mapingure, M P; Munjoma, M W; Rusakaniko, S; Chirenje, M Z; Stray-Pedersen, B
To identify the risk factors of HIV vertical transmission in pregnant women. Observational cohort study. Between 2002 and 2003, 479 HIV-infected pregnant women in a PMTCT (prevention of the mother-to-child transmission) program were followed up with their infants at delivery, until 15 months with infant HIV testing. Of these 281 infants had a definitive HIV result by 15 months of age, and 31.7% of the infants become HIV infected. In univariate analysis the risk factor identified were presence of vaginal discharge, genital itchiness, genital ulcers, dysuria, abnormal breast and vaginal infections (Trichomonas, Bacteria vaginosis and Candida) in the mother at enrolment. In multivariate analysis vaginal infections risk ratio (RR) 1.72(1.03-2.88) and abnormal breast RR 4.36(2.89-6.58) were predictors of HIV vertical transmission. There is need to screen for vaginal infections (Trichomonas, Bacteria vaginosis and Candida) and examine pregnant women for mastitis to identify women at risk of HIV vertical transmission for prevention.
Blyth, William; Bradley, Richard; Yang, Ming; Bunn, Derek; Clarke, Charlie; Wilson, Tom
This paper describes results from a model of decision-making under uncertainty using a real options methodology, developed by the International Energy Agency (IEA). The model represents investment decisions in power generation from the perspective of a private company. The investments are subject to uncertain future climate policy, which is treated as an external risk factor over which the company has no control. The aims of this paper are to (i) quantify these regulatory risks in order to improve understanding of how policy uncertainty may affect investment behaviour by private companies and (ii) illustrate the effectiveness of the real options approach as a policy analysis tool. The study analysed firms' investment options of coal- and gas-fired power plants and carbon capture and storage (CCS) technologies. Policy uncertainty is represented as an exogenous event that creates uncertainty in the carbon price. Our findings indicate that climate policy uncertainty creates a risk premium for power generation investments. In the case of gas- and coal-fired power generation, the risk premium would lead to an increase in electricity prices of 5-10% in order to stimulate investment. In the case of CCS, the risk premium would increase the carbon price required to stimulate investment by 16-37% compared to a situation of perfect certainty. The option to retrofit CCS acts as a hedge against high future carbon prices, and could accelerate investment in coal plant. This paper concludes that to minimise investment risks in low carbon technologies, policy-makers should aim to provide some long-term regulatory certainty. (author)
Hao, Mingjie; Radfall Charitable Trust
Insurers hope to make profit through pooling policies from a large number of individuals. Unless the risk in question is similar for all potential customers, an insurer is exposed to the possibility of adverse selection by attracting only high-risk individuals. To counter this, insurers have traditionally employed underwriting principles, identifying suitable risk factors to subdivide their potential customers into homogeneous risk groups, based on which risk-related premiums can be charged. ...
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)
Full Text Available The aim of the study was to determine the correlation between risk factors and diabetic retinopathy, which is the leading cause of blindness in developed countries for patients aged 20 to 65.We compared risk factors between patients without retinopathy, with non-proliferate and with proliferate retinopathy (p< 0.05. Duration of diabetes is most important for the development of retinopathy. Hyperglycaemia and high blood pressure are important for progression. Better control of blood sugar and elevated blood pressure can reduce progression of retinopathy and riskof vision loss.
Roč. 15, 1/2 (1995), s. 203-212 ISSN 0208-5216. [Seminar on Statistics and Clinical Practice. Warsaw, 20.06.1994-23.06.1994] Keywords : risk factors * genetics * association * epidemilogy * measures of association * screening * genetics
Marti-Soler, Helena; Gubelmann, Cédric; Aeschbacher, Stefanie
OBJECTIVE: To assess the seasonality of cardiovascular risk factors (CVRF) in a large set of population-based studies. METHODS: Cross-sectional data from 24 population-based studies from 15 countries, with a total sample size of 237 979 subjects. CVRFs included Body Mass Index (BMI) and waist...
Brouwers, M.M.; Bruijne, L.M. de; Gier, R.P.E. de; Zielhuis, G.A.; Feitz, W.F.J.; Roeleveld, N.
OBJECTIVE: To contribute to the understanding of the etiology of undescended testis (UDT), by exploring a wide range of potential risk factors in a case-referent study. PATIENTS AND METHODS: Cases and referents were recruited at five hospitals and included 200 boys with surgically corrected UDT and
Sato, Hiroko; Uchida, Toshihiko; Toyota, Kentaro; Kanno, Miyako; Hashimoto, Taeko; Watanabe, Masashi; Nakamura, Tomohiro; Tamiya, Gen; Aoki, Kuraaki; Hayasaka, Kiyoshi
Breastfeeding jaundice is a well-known phenomenon, but its pathogenesis is still unclear. Increased production of bilirubin, impaired hepatic uptake and metabolism of bilirubin, and increased enterohepatic circulation of bilirubin account for most cases of pathological neonatal hyperbilirubinemia. We previously reported that 211G>A (G71R) mutation of the UGT1A1 gene is prevalent in East Asians and is associated with the development of neonatal hyperbilirubinemia. Recently, significant association of G71R mutation with hyperbilirubinemia in breast-fed neonates was reported. We enrolled 401 full-term Japanese infants, who were exclusively breast-fed without supplementation of formula before developing hyperbilirubinemia, and classified them into two groups based on the degree of maximal body weight loss during the neonatal period. We analyzed the sex, gestational age, delivery mode, body weight at birth, maximal body weight loss and genotypes of G71R and (TA)(7) polymorphic mutations of UGT1A1. Statistical analysis revealed that maximal body weight loss during the neonatal period is the only independent risk factor for the development of neonatal hyperbilirubinemia. The effect of G71R mutation on neonatal hyperbilirubinemia is significant in neonates with 5% or greater maximal body weight loss and its influence increases in parallel with the degree of maximal body weight loss. Our study indicates that G71R mutation is a risk factor for neonatal hyperbilirubinemia only in infants with inadequate breastfeeding and suggests that adequate breastfeeding may overcome the genetic predisposing factor, G71R mutation, for the development of neonatal hyperbilirubinemia.
Ali, W.; Ayub, A.; Hussain, H.
Background: The magnitude of under nutrition among children below five years of age is high in Pakistan. Undernutrition and infections are the two most important factors that affect the growth of children. This study explains the extent of undernutrition and prevalence of wasting and stunting among preschool children. Method: This cross sectional study with a sample size of 446 covered the age group 6-59 months in Jalozai Camp, District Nowshera. Height for age, weight for age and weight for height were measured as per WHO guidelines. Systematic random sampling technique was used for sample selection. Data was collected using a questionnaire. Results: According to height for age Z-score, out of 446 children studied, 8.5 percentage were stunted and 4.0 percentage were severely stunted. According to weight for age Z score, 11.4 percentage were underweight and 3.6 percentage were severely underweight. According to weight for height Z-score, 4.0 percentage were wasted and 2.7 percentage were severely wasted. Conclusion: The undernutrition in children is comparable to the national figures. Although our study found that absence of formal education, big family size, late and early weaning, absence of exclusive breast feeding and poverty were the factors associated with undernutrition in children, they could cause increase in under nutrition in future if not improved. (author)
Sun, Wei; Wu, Ming; Qu, Peng; Lu, Chunming; Wang, Lie
The HIV/AIDS epidemic in China is growing and the main transmission mode has changed from contaminated blood products to sexual contact. The aim of this study was to evaluate the levels of anxiety (SAS; Zung Self-Rating Anxiety Scale) and depression (CES-D; Center for Epidemiologic Studies Depression Scale) among people living with HIV/AIDS (PLWHA) under the new epidemic characteristics and to examine associated factors. The sample size (N=800) was calculated on the basis of the lowest prevalence of psychological disorders among PLWHA and was enlarged taking into consideration a loss of response. Participants were sampled randomly among all PLWHA registered in Liaoning Province. Questionnaires pertaining to the SAS, CES-D, and related factors were distributed between December 2010 and April 2011; 772 effective responses were received. The prevalence of anxiety (SAS ≥40) and depression (CES-D ≥16) were 49.0% and 73.1%, respectively. Multivariate logistic regression analysis revealed that SAS was associated with self-rated health, condom use at the last sexual contact, perceived social support, alcohol consumption, and transmission; CES-D was associated with self-rated health, perceived social support, job, and sex. PLWHA under the new epidemic characteristics in China suffer from serious psychological problems. To improve their psychological well-being, efforts should be focused on improving perceptions of their health condition and increasing perceived social support.
Brekke, Levi D.; Maurer, Edwin P.; Anderson, Jamie D.; Dettinger, Michael D.; Townsley, Edwin S.; Harrison, Alan; Pruitt, Tom
Risk-based planning offers a robust way to identify strategies that permit adaptive water resources management under climate change. This paper presents a flexible methodology for conducting climate change risk assessments involving reservoir operations. Decision makers can apply this methodology to their systems by selecting future periods and risk metrics relevant to their planning questions and by collectively evaluating system impacts relative to an ensemble of climate projection scenarios (weighted or not). This paper shows multiple applications of this methodology in a case study involving California's Central Valley Project and State Water Project systems. Multiple applications were conducted to show how choices made in conducting the risk assessment, choices known as analytical design decisions, can affect assessed risk. Specifically, risk was reanalyzed for every choice combination of two design decisions: (1) whether to assume climate change will influence flood-control constraints on water supply operations (and how), and (2) whether to weight climate change scenarios (and how). Results show that assessed risk would motivate different planning pathways depending on decision-maker attitudes toward risk (e.g., risk neutral versus risk averse). Results also show that assessed risk at a given risk attitude is sensitive to the analytical design choices listed above, with the choice of whether to adjust flood-control rules under climate change having considerably more influence than the choice on whether to weight climate scenarios.
Brekke, L.D.; Maurer, E.P.; Anderson, J.D.; Dettinger, M.D.; Townsley, E.S.; Harrison, A.; Pruitt, T.
Risk-based planning offers a robust way to identify strategies that permit adaptive water resources management under climate change. This paper presents a flexible methodology for conducting climate change risk assessments involving reservoir operations. Decision makers can apply this methodology to their systems by selecting future periods and risk metrics relevant to their planning questions and by collectively evaluating system impacts relative to an ensemble of climate projection scenarios (weighted or not). This paper shows multiple applications of this methodology in a case study involving California's Central Valley Project and State Water Project systems. Multiple applications were conducted to show how choices made in conducting the risk assessment, choices known as analytical design decisions, can affect assessed risk. Specifically, risk was reanalyzed for every choice combination of two design decisions: (1) whether to assume climate change will influence flood-control constraints on water supply operations (and how), and (2) whether to weight climate change scenarios (and how). Results show that assessed risk would motivate different planning pathways depending on decision-maker attitudes toward risk (e.g., risk neutral versus risk averse). Results also show that assessed risk at a given risk attitude is sensitive to the analytical design choices listed above, with the choice of whether to adjust flood-control rules under climate change having considerably more influence than the choice on whether to weight climate scenarios. Copyright 2009 by the American Geophysical Union.
Bøttcher, Louise; Dammeyer, Jesper
and psychopathology. Both a congenital hearing impairment and cerebral palsy were found to be dominating risk factors for all types of psychopathology, but no relationship was identified between degree of disability and risk of psychopathology. The higher risk cannot be explained by biological impairments alone......Empirical research has established that children with disabilities are more likely to develop psychopathology than children without disabilities. But too little is known about the association between disability and psychopathology. The aim of this article is to discuss developmental...... psychopathological models that conceptualize the connection between childhood disability and psychopathology. Empirical studies of psychopathology among children with a congenital hearing impairment and children with cerebral palsy will be reviewed, representing in-depth examples of association between disability...
Full Text Available The authors review environmental and neurodevelopmental risk factors for schizophrenic disorders, with emphasis on minor physical anomalies, particularly craniofacial anomalies and dermatoglyphic variations. The high prevalence of these anomalies among schizophrenic subjects supports the neurodevelopmental theory of the etiology of schizophrenia, since they suggest either genetically or epigenetically controlled faulty embryonic development of structures of ectodermal origin like brain and skin. This may disturb neurodevelopment that in turn may cause these subjects to be at increased risk for the development of schizophrenia and related disorders. The precise confirmation of this theory, at least in some cases, will provide further understanding of these illnesses, allowing easy and inexpensive identification of subjects at risk and providing guidelines for the development of new pharmacological interventions for early treatment and even for primary prevention of the illness.
Gyllenborg, J; Rasmussen, S L; Borch-Johnsen, Knut
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......-sectional designed study of 508 healthy males, aged 41 to 72 years. We determined total testosterone (T), sex hormone-binding globulin (SHBG), free androgen index (FAI), and estradiol (E2) and studied their relationship to body fat mass (BF), blood pressure (BP), aortic compliance, left ventricular mass (LVM...... lipids. We suggest that conflicting results of cross-sectional and intervention studies of sex hormones and lipids, in part, may be explained by interindividual differences or changes in SHBG. Thus, further studies on the potential role of SHBG in the development of ischemic heart disease (IHD) should...
This thesis presents experimental research on deviations from the standard theory of decision-making under risk. It focuses on two types of situations in which they are likely to occur. In the first part, the case of individual decision making with delayed resolution of risk is considered. It is
Aslam, Hafiz Muhammad; Saleem, Shafaq; Afzal, Rafia; Iqbal, Umair; Saleem, Sehrish Muhammad; Shaikh, Muhammad Waqas Abid; Shahid, Nazish
Birth asphyxia is an insult to the fetus or newborn due to failure to breath or breathing poorly, leads to decrease oxygen perfusion to various organs. According to WHO, 4 million neonatal deaths occurred each year due to birth asphyxia. Our goal was to evaluate antepartum, intrapartum, and fetal risk factors of birth asphyxia. It was a Retrospective Case control study, conducted at Neonatal Intensive Care Unit of pediatric ward (I, II, III) and in Gynecology wards (I, II, III) of Civil Hospital Karachi, Dow University of Health Sciences. Study was conducted from January 2011-November 2012. Neonates diagnosed with birth asphyxia were considered as "cases" while neonates born either with normal vaginal delivery or by cesarean section having no abnormality were considered as "control". Demographics of both the mother and neonate were noted and Questions regarding possible risk factors were asked from mother. Ethical issues were confirmed from Institutional review board of Civil Hospital Karachi, Dow University of Health Sciences. All data was entered and analyzed through SPSS 19. Out of total 240 neonates, 123 were "cases" and 117 were "control". Mean maternal age in "case" group was 24.22 ± 3.38 while maternal age of control group was 24.30 ± 4.04. Significant antepartum risk factors were maternal age of 20-25 (OR 0.30 CI 95% 0.07-1.21), booking status (OR 0.20 CI 95% 0.11-0.37), pre-eclampsia (OR 0.94 CI 95% 0.90-0.98) and primigravidity (OR 2.64 CI 95% 1.56-4.46). Significant Intrapartum risk factors were breech presentation (OR 2.96 CI 95% 1.25-7.02), home delivery (OR 16.16 CI 95% 3.74-69.75) and maternal fever (OR 10.01 CI95% 3.78-26.52). Significant Fetal risk factors were resuscitation of child (OR 23 CI 95% 31.27-1720.74), pre-term babies(OR 0.34 CI 95% 0.19-0.58), fetal distress (OR 0.01 CI 95% 0.00-0.11) and baby weight (OR 0.13 CI 95% 0.05-0.32). Measures should be taken to prevent neonatal mortality with great emphasis on skilled attendance at birth
Brachner, A.; Grosche, B.
The study gives a survey of the factors most frequently mentioned in the literature as factors likely to adversely affect a pregnancy. One essential aspect is the discussion of those factors that can be counted among the causes of malformations, as among others, prenatal radiation exposure. The study prepared within the framework of the research project 'Radiobiological environmental monitoring in Bavaria' is intended to serve as a basis for a retrospective and prospective evaluation of infant mortality, perinatal conditions and occurrence of malformations in Bavaria, with the principal idea of drawing up an environment - related health survey. The study therefore, in addition to ionizing radiation also takes into account other detectable risks within the ecologic context, as e.g. industrial installations, refuse incineration plants or waste dumps, or urbanity. (orig./MG) [de
Leblanc, Martine; Kellum, John A; Gibney, R T Noel; Lieberthal, Wilfred; Tumlin, James; Mehta, Ravindra
Our purpose is to discuss established risk factors in the development of acute renal failure and briefly overview clinical markers and preventive measures. Findings from the literature support the role of older age, diabetes, underlying renal insufficiency, and heart failure as predisposing factors for acute renal failure. Diabetics with baseline renal insufficiency represent the highest risk subgroup. An association between sepsis, hypovolemia, and acute renal failure is clear. Liver failure, rhabdomyolysis, and open-heart surgery (especially valve replacement) are clinical conditions potentially leading to acute renal failure. Increasing evidence shows that intraabdominal hypertension may contribute to the development of acute renal failure. Radiocontrast and antimicrobial agents are the most common causes of nephrotoxic acute renal failure. In terms of prevention, avoiding nephrotoxins when possible is certainly desirable; fluid therapy is an effective prevention measure in certain clinical circumstances. Supporting cardiac output, mean arterial pressure, and renal perfusion pressure are indicated to reduce the risk for acute renal failure. Nonionic, isoosmolar intravenous contrast should be used in high-risk patients. Although urine output and serum creatinine lack sensitivity and specificity in acute renal failure, they remain the most used parameters in clinical practice. There are identified risk factors of acute renal failure. Because acute renal failure is associated with a worsening outcome, particularly if occurring in critical illness and if severe enough to require renal replacement therapy, preventive measures should be part of appropriate management.
Vanhalst, Janne; Luyckx, Koen; Scholte, Ron H J; Engels, Rutger C M E; Goossens, Luc
Low self-esteem has been shown to relate to concurrent and later feelings of loneliness in adolescence. However, it remains unclear why low self-esteem puts adolescents at risk for experiencing loneliness. Further, longitudinal research on the direction of effects between loneliness and self-esteem is virtually non-existent. The present study aims to fill these gaps in the literature. First, the direction of effects between loneliness and self-esteem was investigated in two independent longitudinal studies: a five-wave study sampling Dutch adolescents (M age = 15.22 years at T1; 47 % female; N = 428) and a three-wave study sampling Belgian adolescents (M age = 14.95 years at T1; 63 % female; N = 882). Second, the underlying role of social acceptance was investigated in the latter sample by applying a multi-method approach that included actual (i.e., peer-reported) and perceived (i.e., self-reported) social acceptance. Results indicated that self-esteem and loneliness influenced one another in a reciprocal manner. Furthermore, the dominant path from self-esteem to loneliness was partially mediated by perceived--but not actual--social acceptance. The importance of distinguishing actual from perceived social acceptance is discussed, and suggestions for future research are outlined.
García-Martínez, Lucía; Martín-Payo, Rubén; Pelaz-García, Alejandro; Sierra-Vega, Matilde; Junquera-Gutiérrez, Luis Manuel
To evaluate the effectiveness of a health education programme on knowledge and reduction of the risk factors for bisphosphonate-related osteonecrosis of the jaw. An experimental study control group without intervention was performed with 60 subjects who had started treatment with bisphosphonates in the University Hospital of León from October to December 2014. Patients in the experimental group received a structured education intervention in two sessions. The data was collected from a heteroadministered questionnaire at the beginning and at the end of the study period for both groups. The educational intervention designed showed a significantly increased adherence to healthy behaviours related to oral hygiene such as mechanical control of plaque and the use of clorhexidine prior to invasive oral procedures. All subjects reported that they had not been advised to maintain a good level of oral health before starting treatment. After the intervention high percentages of recognition of early diagnostic measures starting from a baseline total ignorance of them were determined. No conclusive information about the use of removable dental prostheses, toxic habits or maintaining proper metabolic control in patients with diabetes mellitus was observed. Improving adherence to healthy behaviours related to oral health following the intervention, as well as their contribution to the early identification of warning signs of jaw osteonecrosis, stresses the importance of the use of health education as a tool in routine clinical practice. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Background This article explores the hypothesis that predisposing and enabling factors of households influence the vaccination status of the children under the age of five in Khartoum State, Sudan. Method The study was a cross-sectional survey among a representative sample of 410 male and female children under five ...
Full Text Available The objective of the article is to analyse and present the classification of risks actual to derivative securities. The analysis is based on classical and modern literature findings and analysis of newest statistical data. The analysis led to the conclusion, that the main risks typical for derivatives contracts and their traders are market risk, liquidity risk, credit and counterparty risk, legal risk and transactions risk. Pricing risk and systemic risk is also quite important. The analysis showed that market risk is the most important kind of risk that in many situations influences the level of remaining risks.
Phua, Chun Seng; Jayaram, Lata; Wijeratne, Tissa
Stroke is a leading cause of death and disability worldwide. While various risk factors have been identified, sleep has only been considered a risk factor more recently. Various epidemiologic studies have associated stroke with sleep such as sleep duration, and laboratory and clinical studies have proposed various underlying mechanisms. The pathophysiology is multifactorial, especially considering sleep affects many common risk factors for stroke. This review aims to provide an outline of the...
Conclusions: Hypocitraturia and hypomagnesuria were the most frequent risk factors associated with urolithiasis, followed by hypercalciuria. High PTH values were excluded. Children presented two or more risk factors for urolithiasis.
Pedersen, Jolene Masters; Lund, Rikke; Andersen, Ingelise
Background/Objectives: Metabolic deregulations and development of metabolic syndrome may be an important pathway underlying the relationship between stress and cardiovascular disease. We aim to estimate the effect of a comprehensive range of psychosocial factors on the risk of developing metabolic...... syndrome in men and women. Methods: The study population consisted of 3621 men and women from the Copenhagen City Heart Study who were free of metabolic syndrome at baseline and reexamined after 10 years. The data was analyzed by multivariable logistic regression models adjusted for age, education, income.......11) to be risk factors for developing the metabolic syndrome in women, while vital exhaustion (OR 2.09, 95% CI 0.95 to 4.59) and intake of sleep medications (OR 2.54, 95% CI 0.92 to 5.96) may play a more important role in men. Conclusions: Experiencing major life events in work and adult life and...
Konicz, Agnieszka Karolina; Pisinger, David; Weissensteiner, Alex
The paper investigates the importance of in ation-linked annuities to individuals facing in ation risk. Given the investment opportunities in nominal, real, and variable annuities, as well as cash and stocks, we investigate the consumption and investment decisions under two different objective fu...
portfolio theory that assumes Subjective Expected Utility theory; however, it provides hints to a possible solution of the under-diversification puzzle of households. I also identify conditions under which more risk or ambiguity aversion decreases the demand for coinsurance. Additionally, I show......I study the impact of ambiguity on insurance decisions and the optimality of insurance contracts. My tractable approach allows me to study the interaction between risk and ambiguity attitudes. When insurance decisions are made independently of other assets, for a given increase in wealth, both risk...... and ambiguity attitudes interact in nontrivial ways to determine the change of coinsurance demand. I derive sufficient conditions to guarantee that the optimal coinsurance demand is decreasing in wealth. When a non-traded asset is introduced, my model predicts behavior that is inconsistent with the classical...
Copeland, William; Shanahan, Lilly; Costello, E. Jane; Angold, Adrian
Background: Co-occurrence of psychosocial risk factors is commonplace, but little is known about psychiatrically-predictive configurations of psychosocial risk factors. Methods: Latent class analysis (LCA) was applied to 17 putative psychosocial risk factors in a representative population sample of 920 children ages 9 to 17. The resultant class…
Full Text Available Abstract Background In medical practice, it is generally accepted that the 'effect model' describing the relationship between baseline risk and risk under treatment is linear, i.e. 'relative risk' is constant. Absolute benefit is then proportional to a patient's baseline risk and the treatment is most effective among high-risk patients. Alternatively, the 'effect model' becomes curvilinear when 'odds ratio' is considered to be constant. However these two models are based on purely empirical considerations, and there is still no theoretical approach to support either the linear or the non-linear relation. Presentation of the hypothesis From logistic and sigmoidal Emax (Hill models, we derived a phenomenological model which includes the possibility of integrating both beneficial and harmful effects. Instead of a linear relation, our model suggests that the relationship is curvilinear i.e. the moderate-risk patients gain most from the treatment in opposition to those with low or high risk. Testing the hypothesis Two approaches can be proposed to investigate in practice such a model. The retrospective one is to perform a meta-analysis of clinical trials with subgroups of patients including a great range of baseline risks. The prospective one is to perform a large clinical trial in which patients are recruited according to several prestratified diverse and high risk groups. Implications of the hypothesis For the quantification of the treatment effect and considering such a model, the discrepancy between odds ratio and relative risk may be related not only to the level of risk under control conditions, but also to the characteristics of the dose-effect relation and the amount of dose administered. In the proposed approach, OR may be considered as constant in the whole range of Rc, and depending only on the intrinsic characteristics of the treatment. Therefore, OR should be preferred rather than RR to summarize information on treatment efficacy.
Modai, Shira; Shomron, Noam
Schizophrenia (SZ) is a complex and strongly heritable mental disorder, which is also associated with developmental-environmental triggers. As opposed to most diagnosable diseases (yet similar to other mental disorders), SZ diagnosis is commonly based on psychiatric evaluations. Recently, large-scale genetic and epigenetic approaches have been applied to SZ research with the goal of potentially improving diagnosis. Increased computational analyses and applied statistical algorithms may shed some light on the complex genetic and epigenetic pathways contributing to SZ pathogenesis. This review discusses the latest advances in molecular risk factors and diagnostics for SZ. Approaches such as these may lead to a more accurate definition of SZ and assist in creating extended and reliable clinical diagnoses with the potential for personalized treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.
Boehme, Amelia K; Esenwa, Charles; Elkind, Mitchell S V
Stroke is a heterogeneous syndrome, and determining risk factors and treatment depends on the specific pathogenesis of stroke. Risk factors for stroke can be categorized as modifiable and nonmodifiable. Age, sex, and race/ethnicity are nonmodifiable risk factors for both ischemic and hemorrhagic stroke, while hypertension, smoking, diet, and physical inactivity are among some of the more commonly reported modifiable risk factors. More recently described risk factors and triggers of stroke include inflammatory disorders, infection, pollution, and cardiac atrial disorders independent of atrial fibrillation. Single-gene disorders may cause rare, hereditary disorders for which stroke is a primary manifestation. Recent research also suggests that common and rare genetic polymorphisms can influence risk of more common causes of stroke, due to both other risk factors and specific stroke mechanisms, such as atrial fibrillation. Genetic factors, particularly those with environmental interactions, may be more modifiable than previously recognized. Stroke prevention has generally focused on modifiable risk factors. Lifestyle and behavioral modification, such as dietary changes or smoking cessation, not only reduces stroke risk, but also reduces the risk of other cardiovascular diseases. Other prevention strategies include identifying and treating medical conditions, such as hypertension and diabetes, that increase stroke risk. Recent research into risk factors and genetics of stroke has not only identified those at risk for stroke but also identified ways to target at-risk populations for stroke prevention. © 2017 American Heart Association, Inc.
Haw, Camilla; Hawton, Keith; Niedzwiedz, Claire; Platt, Steve
Suicide clusters, although uncommon, cause great concern in the communities in which they occur. We searched the world literature on suicide clusters and describe the risk factors and proposed psychological mechanisms underlying the spatio-temporal clustering of suicides (point clusters). Potential risk factors include male gender, being an…
Background: Childhood pneumonia is the foremost killer of under-fives. Indoor air pollution by smoke from cooking fuel is a major risk factor for childhood pneumonia. The knowledge of caregivers about risk factors can facilitate the practice of appropriate preventive measures. This study set out to evaluate the perception of ...
Deribew, Amare; Tessema, Gizachew Assefa; Deribe, Kebede; Melaku, Yohannes Adama; Lakew, Yihunie; Amare, Azmeraw T.; Abera, Semaw F.; Mohammed, Mesoud; Hiruye, Abiy; Teklay, Efrem; Misganaw, Awoke; Kassebaum, Nicholas
Background: Ethiopia has made remarkable progress in reducing child mortality over the last two decades. However, the under-5 mortality rate in Ethiopia is still higher than the under-5 mortality rates of several low-and middle-income countries (LMIC). On the other hand, the patterns and causes of
Mirza, N M; Caulfield, L E; Black, R E; Macharia, W M
To identify child feeding behavior and household hygiene practices that are risk factors for prolonged diarrheal illness, a longitudinal community study was conducted over a 14-month period among 920 children aged 3-37 months who lived in an urban slum settlement in Nairobi, Kenya. Morbidity surveillance was done by home visits every third day in the absence of diarrhea and daily during diarrheal illness until termination of the episode. In-home observations were made to characterize maternal hygiene, cooking, and child feeding practices. Overall, 1,496 episodes of diarrhea were detected. The average diarrheal incidence was 3.5 episodes/child-year, and the incidence of diarrhea > 14 days was 3 episodes/100 child-years. Cox regression was used to examine the independent effects of covariates on time to recovery from a diarrheal episode. Adjusted behavioral factors that were observed to influence recovery from diarrhea included: uncovered water containers (rate ratio (RR) = 0.77, 95% confidence interval (CI) 0.64-0.94); giving no fluids (as opposed to oral rehydration solutions (ORS)/sugar salt solutions (SSS)) (RR = 1.42, 95% CI 1.14-1.77); and administration of diluted cow's milk during the first 3 days of an episode (RR = 1.23, 95% CI 1.00-1.52). These associations remained significant after adjusting for diarrheal severity. The authors recommend, among other measures, improvement of water storage and promotion of continued feeding with cereal-milk mix during diarrhea.
Risk factors for mortality from acute lower respiratory infections (ALRI in children under five years of age in low and middle-income countries: a systematic review and meta-analysis of observational studies.
Full Text Available OBJECTIVE: To evaluate risk factors for death from acute lower respiratory infections (ALRI in children in low- and middle-income countries. DESIGN: Systematic review and meta-analysis. STUDY SELECTION: Observational studies reporting on risk factors for death from ALRI in children below five years in low- and middle income countries. DATA SOURCES: Medline, Embase, Global Health Library, Lilacs, and Web of Science to January 2014. RISK OF BIAS ASSESSMENT: Quality In Prognosis Studies tool with minor adaptations to assess the risk of bias; funnel plots and Egger's test to evaluate publication bias. RESULTS: Out of 10,655 papers retrieved, 77 studies from 39 countries (198,359 children met the inclusion criteria. Host and disease characteristics more strongly associated with ALRI mortality were: diagnosis of very severe pneumonia as per WHO definition (odds ratio 9.42, 95% confidence interval 6.37‒13.92; age below two months (5.22, 1.70‒16.03; diagnosis of Pneumocystis Carinii (4.79, 2.67‒8.61, chronic underlying diseases (4.76, 3.27‒6.93; HIV/AIDS (4.68, 3.72‒5.90; and severe malnutrition (OR 4.27, 3.47‒5.25. Socio-economic and environmental factors significantly associated with increased odds of death from ALRI were: young maternal age (1.84, 1.03‒3.31; low maternal education (1.43, 1.13‒1.82; low socio-economic status (1.62, 1.32‒2.00; second-hand smoke exposure (1.52, 1.20 to 1.93; indoor air pollution (3.02, 2.11‒4.31. Immunisation (0.46, 0.36‒0.58 and good antenatal practices (0.50, 0.31‒0.81 were associated with decreased odds of death. CONCLUSIONS: Host and disease characteristics as well as socio-economic and environmental determinants affect the risk of death from ALRI in children. Together with the prevention and treatment of chronic diseases, interventions to modify underlying risk factors such as poverty, lack of female education, and poor environmental conditions, should be considered among the strategies to
Chen, Zi-Li; He, Rui-Zhi; Peng, Qian; Guo, Ke-Yu; Zhang, Yu-Qiong; Yuan, Hui-Hua; Liu, Jian-Xin
Neonatal asphyxia is the third leading cause of neonatal death and main cause of long-term neurodevelopmental handicap throughout the world. Prevention is more important than treatment. Most previous reports are limited to retrospective investigations of the relationships between some prenatal risk factors and low Apgar scores. This study was designed to prospectively investigate the relationship between prenatal risk factors and neonatal asphyxia and the influence of single or multiple risk factors on the incidence of neonatal asphyxia, and examine significant risk factors for neonatal asphyxia. From April 2002 through October 2004, a total of 10 376 live-born newborns were enrolled. Forty-six prenatal risk factors were investigated. Neonatal asphyxia was diagnosed based on the following four items: 1. 1-min Apgar score asphyxia was analyzed. The significant risk factors were screened by single logistic regression analysis and forward stepwise conditional multiple logistic regression analysis, with enrolled threshold alphaor=0.10 and pasphyxia occurred in 117 cases (1.13%) out of the 8 530 cases. In the 1 846 cases without risk factors, none had asphyxia (x2=25.6, pasphyxia increased with increasing numbers of risk factors, from 0.23% in newborns with one risk factor to 14.29% in newborns who had nine risk factors (r=0.96, pasphyxia by systematically examining prenatal risk factors and giving interventions for the newborns with risk factors, especially those with the above significant risk factors or with multiple risk factors. Proper cesareon section according to indications might be helpful to decrease the incidence of birth asphyxia.
Hand, foot and mouth disease (HFMD) in children under the age of five is a major public health issue in China. Beijing–Tianjin–Hebei is the largest urban agglomeration in northern China. The present study aimed to analyze the epidemiological features of HFMD, reveal spatial clusters, and detect risk factors in this region. Reports of HFMD cases in Beijing–Tianjin–Hebei from 1 January 2013 to 31 December 2013 were collected from 211 counties or municipal districts. First, the epidemiological features were explored, and then SaTScan analysis was carried out to detect spatial clusters of HFMD. Finally, GeoDetector and spatial paneled model were used to identify potential risk factors among the socioeconomic and meteorological variables. There were a total of 90,527 HFMD cases in the year 2013. The highest rate was in individuals aged one year, with an incidence of 24.76/103. Boys (55,168) outnumbered girls (35,359). Temporally, the incidence rose rapidly from April, peaking in June (4.08/103). Temperature, relative humidity and wind speed were positively associated with the incidence rate, while precipitation and sunshine hours had a negative association. The explanatory powers of these factors were 57%, 13%, 2%, 21% and 12%, respectively. Spatially, the highest-risk regions were located in Beijing and neighboring areas, with a relative risk (RR) value of 3.04. The proportion of primary industry was negatively associated with HFMD transmission, with an explanatory power of 32%. Gross domestic product (GDP) per capita, proportion of tertiary industry, and population density were positively associated with disease incidence, with explanatory powers of 22%, 17% and 15%, respectively. These findings may be helpful in the risk assessment of HFMD transmission and for implementing effective interventions to reduce the burden of this disease. PMID:28406470
Vanhalst, J.; Luyckx, K.; Scholte, R.H.J.; Engels, R.C.M.E.; Goossens, L.
Low self-esteem has been shown to relate to concurrent and later feelings of loneliness in adolescence. However, it remains unclear why low self-esteem puts adolescents at risk for experiencing loneliness. Further, longitudinal research on the direction of effects between loneliness and self-esteem
FACTORES DE RIESGO CARDIOVASCULAR Y CALIDAD DE VIDA EN MUJERES REVASCULARIZADAS CON STENT CORONARIOS / Cardiovascular risk factors and quality of life in women who under-went revascularization with coronary stenting
José C. Castillo Núñez
Full Text Available Resumen Introducción: Los factores de riesgo cardiovascular son responsables directos de la elevada mortalidad por enfermedad coronaria aterosclerótica en la mujer. Objetivo: Describir dichos factores, la evolución clínica y la calidad de vida en las féminas tras realizarle angioplastia coronaria. Método: Estudio descriptivo, longitudinal y prospectivo en 62 mujeres revascularizadas con angioplastia e implante de stent en el período de enero a junio de 2011. Se realizó seguimiento clínico durante 180 días a través de las consultas médicas. Resultados: La edad media fue de 52,8 años y el factor de riesgo cardiovascular más frecuente, la hipertensión arterial (66,1 %, y la diabetes (24,2 %, el menos prevalente. La enfermedad coronaria aterosclerótica de un vaso fue la de mayor frecuencia (87,1 % y la de tres vasos (1,6 %, la menos representada. En 75,8 % de los pacientes se utilizó un stent, solo uno requirió de tres. El 83,9 % de ellos valoraron su calidad de vida como buena, 14,5 % la consideraron aceptable y uno la estimó como pobre. En 93,5 % de los pacientes no se evidenciaron acontecimientos cardiovasculares durante el seguimiento clínico. La diabetes y la categoría calidad de vida pobre, mostraron una asociación estadísticamente significativa con la extensión de la enfermedad coronaria aterosclerótica, el número de stents utilizados y los acontecimientos cardiovasculares. Conclusiones: Las mujeres con enfermedad coronaria aterosclerótica, revascularizadas con stents coronarios, tienen una elevada frecuencia de factores de riesgo, una evolución clínica favorable y un predominio de las percepciones positivas sobre su calidad de vida. / Abstract Introduction: Cardiovascular risk factors are directly responsible for the high mortality from atherosclerotic coronary artery disease in women. Objective: To describe these risk factors, the clinical course and quality of life in women after coronary angioplasty. Method: A
Dagrada, H; Verbanck, P; Kornreich, C
This paper aims to review current knowledge on risk factors leading to burn-out of general practitioners, who are particularly concerned by burn-out, as 50% of them are being more or less affected. This article is based on bibliographic research covering literature between 1975 and 2010, using PUB MED software, medical books and articles. 44 articles were selected as dealing well with the aspects of the burn-out reviewed here. It seems established that stress precedes burnout symptoms. Theories investigating relationships between stress and work are presented. Exogenic stress (load and organization of work, emotional interaction with the patient, constraints, lack of recognition, conflicts between private and professional life) interacts with endogenous stress (idealism, (too much) acute feeling of responsibility, mood disorder, difficulty in collaborating, character, personality). Burn-out symptoms would appear preferentially when these two stresses coexist. Despite the wealth of publications, there is still a lack of knowledge of the causes of burn-out, requiring therefore increased research efforts, in order to improve the implementation of preventive measures, beneficial to the doctors as well as to their patients.
Mathew, Mariam; Saquib, Shabnam; Rizvi, Syed G
To determine the risk factors associated with polyhydramnios, and assess the maternal and perinatal outcome in these patients. A prospective study of all deliveries complicated with polyhydramnios in Sultan Qaboos University Hospital, Sultanate of Oman between January 2005 and April 2006. Polyhydramnios was divided into mild and moderate to severe based on the amniotic fluid index values. The demographic data, antenatal complications, gestational age at delivery, mode of delivery, postpartum complications, and perinatal outcome were studied. A total of 2648 singleton deliveries occurred during the study period. Two hundred and eight (7.8%) women with polyhydramnios formed the study group, and 2440 women with normal amniotic fluid formed the control. Polyhydramnios was mild in 179 (86.1%) and moderate to severe in 29 (13.9%) cases. Sixty-eight (32.7%) of these pregnancies were complicated with diabetes as compared with 12.4% of the controls. Preterm delivery occurred in 16 (7.7%) cases. Cesarean delivery rate was 27.9% in the study group compared with 17.3% in the control. Major congenital anomalies were found in 2.8% of newborns compared with 1% among the controls. Eighteen babies were admitted to the special care baby unit. These data demonstrates a significant positive relation with maternal age, diabetes in pregnancy, and fetal macrosomia with polyhydramnios. Anemia during pregnancy, cesarean delivery rate, and congenital anomalies were significantly higher in the study group.
Prevalence, risk factors and risk perception of tuberculosis infection among medical students and healthcare workers in Johannesburg, South Africa. A van Rie, K McCarthy, L Scott, A Dow, WDF Venter, WS Stevens ...
Full Text Available Background: Leptospirosis is one of the most under diagnosed and underreported disease in both developed and developing countries including India. It is established that environmental conditions and occupational habit of the individuals put them at risk of acquiring disease, which varies from community to community. Various seroprevalence studies across the world have documented emerging situation of this neglected tropical disease, but limited have probed to identify the risk factors, especially in India. Objectives: The objective of this study was to identify the environmental and occupational risk factors associated with the disease in Udupi District. Materials and Methods: This population-based case-control study was carried out in Udupi, a District in Southern India from April 2012 until August 2012. Udupi is considered to be endemic for Leptospirosis and reported 116 confirmed cases in the year 2011. Seventy of 116 laboratory confirmed cases and 140 sex matched neighborhood healthy controls participated in the study. A predesigned, semi-structured and validated questionnaire was used for data collection through house to house visit and observations were noted about environmental conditions. Univariate analysis followed by multivariate analysis (back ward conditional logistic regression was performed by using STATA version 9.2 (StataCorp, College Station, TX, USA to identify potential risk factors. Results: Occupational factors such as outdoor activities (matched odds ratio [OR] of 3.95, 95% confidence interval [CI]: 1.19-13.0, presence of cut or wound at body parts during work (matched OR: 4.88, CI: 1.83-13.02 and environmental factors such as contact with rodents through using the food materials ate by rat (matched OR: 4.29, CI: 1.45-12.73 and contact with soil or water contaminated with urine of rat (matched OR: 4.58, CI: 1.43-14.67 were the risk factors identified to be associated with disease. Conclusion: Leptospirosis is still
Full Text Available Exposure to smoking during pregnancy is known to be one of the main modifiable risk factors, which threatens maternal and child health. Along with this factor, are not to be neglected also other risk factors belonging to lifestyle sphere, such as alcohol, sedentary, irregular daily meal serving plan, lack of knowledge.
U.S. Department of Health & Human Services — The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based system of health surveys that collects information on health risk behaviors, preventive...
About a century after Koch's discovery of the TB bacilli the tuberculosis epidemic which had appeared to be under control was again recognized as a major global health threat. The decline in the epidemic in this century had been largely through the improved living standards and, eventually, the availability and use of effective antibiotics. While tuberculosis gradually disappeared from the health agenda in the western world it remained a big killer throughout the century and in 1992 an estimated 2.7 million TB deaths occurred; 30 million will die from TB during the 1990s if current trends are not reversed. The annual number of new cases will increase from 7.5 million estimated in 1990 to more than 10 million in the year 2000. The main factors for this increase are demographic forces, population movements, the HIV epidemic and increasing drug resistance. The impact of the HIV epidemic is already felt in many sub-Saharan African countries and now threatens Asia where almost two-thirds of the world's TB infected population live and where HIV is spreading. Tuberculosis has also reemerged as a major public health problem in industrialized countries due to international migration, the breakdown of health services, including TB services etc. The control of the epidemic can only be through a concerted action to reinstate TB as priority among health concerns, reflected in national and international resources. A coalition of public and private supporters must be mobilized to support the effort to fight the disease. Governments, non-governmental organizations, the business community, refugee organizations, medical institutions, and other UN agencies are invited to join with WHO in this effort.
Ghaedrahmati, Maryam; Kazemi, Ashraf; Kheirabadi, Gholamreza; Ebrahimi, Amrollah; Bahrami, Masood
Postpartum depression is a debilitating mental disorder with a high prevalence. The aim of this study was review of the related studies. In this narrative review, we report studies that investigated risk factors of postpartum depression by searching the database, Scopus, PubMed, ScienceDirect, Uptodate, Proquest in the period 2000-2015 published articles about the factors associated with postpartum depression were assessed in Farsi and English. The search strategy included a combination of keywords include postpartum depression and risk factors or obstetrical history, social factors, or biological factors. Literature review showed that risk factors for postpartum depression in the area of economic and social factors, obstetrical history, and biological factors, lifestyle and history of mental illness detected. Data from this study can use for designing a screening tools for high-risk pregnant women and for designing a prevention programs.
... present. History of Preeclampsia/Eclampsia: Women with a history of preeclampsia/eclampsia have an increased risk of future hypertension and stroke one to 30 years after delivery. Hypertension: Women with chronic primary or secondary hypertension, ...
Abdullah M. Zakria Jaija
Full Text Available Aim. The aim of this study is to analyze the etiological factors underlying the presence of maxillary midline diastema in a sample of orthodontic patients. Materials and Methods. One hundred patients who fulfill the inclusion criteria were selected from 1355 patients seeking orthodontic treatment. The pretreatment orthodontic records were analyzed. The width of the maxillary midline diastema was measured clinically with a digital caliper at two levels: the mesioincisal angles of the central incisors and five millimeters from the incisal edge. The two measurements were averaged, and patients with diastema of more than 0.5 millimeter in width were enrolled. Results. Diastema is a multifactorial clinical finding with more than one underlying etiological cause. The interrelationship between the familial pattern of midline diastema and the microdontia, macroglossia, labial frenum, and alveolar cleft conforms was clear. The effect of a mesiodens and the upper lateral incisor whether bilaterally missing, unerupted, or peg shaped was minimal. Conclusion. Etiological factors underlying maxillary midline diastema are interconnected. Using a checklist as a guide during handling maxillary midline diastema is important in the different stages of treatment.
Soomann, Maarja; Vibo, Riina; Kõrv, Janika
Risk factor management is the key to stroke prevention. Although several studies have assessed the awareness of different risk factors in the general public, there are limited data available on how well acute stroke patients know their own risk factors. The aim of this study was to assess stroke patients' informedness of their own stroke risk factors. All consecutive eligible acute stroke and transient ischemic attack patients hospitalized at the Tartu University Hospital, Department of Neurology, during 9 months in 2010 were interviewed about different stroke risk factors within 72 hours from hospitalization. The respective information was also retrieved from medical records. Of the 341 patients admitted during the study period, 195 were eligible for the interview. Diabetes was the best known risk factor (89%) followed by hypertension (80%), atrial fibrillation (78%), previous stroke (77%), and heart failure and/or ischemic heart disease (66%). We found that acute stroke patients are best informed of their diabetes and worst informed of their ischemic heart disease and/or heart failure. There is, however, room for amelioration in the awareness of all of the studied risk factors. More attention should be addressed to explaining the risks and treatment options to patients at risk of stroke and the general population. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Pask, Andrew; Heloury, Yves; Sinclair, Andrew H.
Hypospadias results from a failure of urethral closure in the male phallus and affects 1 in 200–300 boys. It is thought to be due to a combination of genetic and environmental factors. The development of the penis progresses in 2 stages: an initial hormone-independent phase and a secondary hormone-dependent phase. Here, we review the molecular pathways that contribute to each of these stages, drawing on studies from both human and mouse models. Hypospadias can occur when normal development of the phallus is disrupted, and we provide evidence that mutations in genes underlying this developmental process are causative. Finally, we discuss the environmental factors that may contribute to hypospadias and their potential immediate and transgen erational epigenetic impacts. PMID:26613581
Piltoft, Johanne Spanggaard; Larsen, Signe Benzon; Dalton, Susanne Oksbjerg
PURPOSE: One established risk factors for testicular cancer is cryptorchidism. However, it remains unclear whether cryptorchidism is a risk factor in itself or whether the two conditions share common causes in early life (estrogen hypothesis), such as birth weight and birth order. The objective o...
Ariëns, G.A.M.; Mechelen, W. van; Bongers, P.M.; Wal, G. van der; Bouter, L.M.
To identify physical risk factors for neck pain, a systematic review of the literature was carried out. Based on methodological quality and study design, 4 levels of evidence were defined to establish the strength of evidence for the relationship between risk factors and neck pain. Altogether, 22
Apr 4, 2003 ... Objective: To review risk factors for stroke and the use of echocardiography in its diagnosis. ... therapy. Several risk factors are shared between ischaemic heart disease and ischaemic stroke and these have been well documented. Stroke has .... history, physical examination, electrocardiography or chest.
Lee, Joseph K. P.; Jackson, Henry J.; Pattison, Pip; Ward, Tony
A study involving 64 Australian sex offenders and 33 non-sex offenders found childhood emotional abuse and family dysfunction, childhood behavior problems, and childhood sexual abuse were developmental risk factors for paraphilia. Emotional abuse and family dysfunction was found to be a risk factor for pedophilia, exhibitionism, rape, or multiple…
Florian Joachim Raabe
Full Text Available Epidemiological and clinical studies have shown that children exposed to adverse experiences are at increased risk for the development of depression, anxiety disorders and PTSD. A history of child abuse and maltreatment increases the likelihood of being subsequently exposed to traumatic events or of developing PTSD as an adult. The brain is highly plastic during early life and encodes acquired information into lasting memories that normally subserve adaptation. Translational studies in rodents showed that enduring sensitization of neuronal and neuroendocrine circuits in response to early life adversity are likely risk factors of life time vulnerability to stress. Hereby, the hypothalamic-pituitary-adrenal (HPA axis integrates cognitive, behavioural and emotional responses to early-life stress and can be epigenetically programmed during sensitive windows of development. Epigenetic mechanisms, comprising reciprocal regulation of chromatin structure and DNA methylation, are important to establish and maintain sustained, yet potentially reversible, changes in gene transcription. The relevance of these findings for the development of PTSD requires further studies in humans where experience-dependent epigenetic programming can additionally depend on genetic variation in the underlying substrates which may protect from or advance disease development. Overall, identification of early-life stress associated epigenetic risk markers informing on previous stress history can help to advance early diagnosis, personalized prevention and timely therapeutic interventions, thus reducing long-term social and health costs.
Böhm, Stephan K; Kruis, Wolfgang
Diverticulosis is a very common condition. Around 20% of the carriers of diverticula are believed to suffer from diverticular disease during their lifetime. This makes diverticular disease one of the clinically and economically most significant diseases in gastroenterology. The etiopathogenesis of diverticulosis and diverticular disease is not well understood. Epidemiological studies allow defining risk factors for the development of diverticulitis and its complications. A comprehensive literature search was performed and the current knowledge about risk factors for diverticulitis and associated conditions reviewed. Besides non-controllable risk factors like age and sex, lifestyle factors like food, drinks and physical activity, drugs are described to increase or decrease the risk to develop diverticulitis or to suffer from complications. The recognition of risk factors for the development of diverticular disease or even complicated disease like lifestyle habits or medication is crucial for patient management.
Obesity is now one of the public health concerns in China. Many factors are contributing to obesity. However, the underlying mechanism is not clear. As it is hard to cure it once obesity occurs, the most effective and encouraging strategies is prevention. Risk factors should be identified in order to develop prevention strategies
Thus we propose a mixed integer programming approach to decision making and incorporate subcontracting risk . To control the risk of sub-contracting (cost) , the two popular percentile measures of risk are applied: value-at-risk and conditional value-at-risk. This model is capable of optimizing production cost of parts and ...
Sørrig, Rasmus; Klausen, Tobias W; Salomo, Morten
Several risk scores for disease progression in Smoldering Multiple Myeloma (SMM) patients have been proposed, however, all have been developed using single center registries. To examine risk factors for time to progression (TTP) to Multiple Myeloma (MM) for SMM we analyzed a nationwide population......-based cohort of 321 newly diagnosed SMM patients registered within the Danish Multiple Myeloma Registry between 2005 and 2014. Significant univariable risk factors for TTP were selected for multivariable Cox regression analyses. We found that both an M-protein ≥ 30g/l and immunoparesis significantly influenced......-high risk of transformation to MM. Using only immunoparesis and M-protein ≥ 30g/l, we created a scoring system to identify low, intermediate and high risk SMM. This first population-based study of SMM patients confirms that an M-protein ≥ 30g/l and immunoparesis remain important risk factors for progression...
Nicholson, Robert A.; Houle, Timothy T.; Rhudy, Jamie L.; Norton, Peter J.
Headache is a chronic disease that occurs with varying frequency and results in varying levels of disability. To date, the majority of research and clinical focus has been on the role of biological factors in headache and headache-related disability. However, reliance on a purely biomedical model of headache does not account for all aspects of headache and associated disability. Using a biopsychosocial framework, the current manuscript expands the view of what factors influence headache by considering the role psychological (i.e., cognitive and affective) factors have in the development, course, and consequences of headache. The manuscript initially reviews evidence showing that neural circuits responsible for cognitive–affective phenomena are highly interconnected with the circuitry responsible for headache pain. The manuscript then reviews the influence cognitions (locus of control and self-efficacy) and negative affect (depression, anxiety, and anger) have on the development of headache attacks, perception of headache pain, adherence to prescribed treatment, headache treatment outcome, and headache-related disability. The manuscript concludes with a discussion of the clinical implications of considering psychological factors when treating headache. PMID:17371358
Prostate cancer has the highest prevalence of any non-skin cancer in the human body, with similar likelihood of neoplastic foci found within the prostates of men around the world regardless of diet, occupation, lifestyle, or other factors. Essentially all men with circulating an...
Keel, Pamela K; Forney, K Jean
One goal in identifying psychosocial risk factors is to discover opportunities for intervention. The purpose of this review is to examine psychosocial risk factors for disordered eating, placing research findings in the larger context of how etiological models for eating disorders can be transformed into models for intervention. A qualitative literature review was conducted focusing on psychological and social factors that increase the risk for developing eating disorders, with an emphasis on well-replicated findings from prospective longitudinal studies. Epidemiological, cross-cultural, and longitudinal studies underscore the importance of the idealization of thinness and resulting weight concerns as psychosocial risk factors for eating disorders. Personality factors such as negative emotionality and perfectionism contribute to the development of eating disorders but may do so indirectly by increasing susceptibility to internalize the thin ideal or by influencing selection of peer environment. During adolescence, peers represent self-selected environments that influence risk. Peer context may represent a key opportunity for intervention, as peer groups represent the nexus in which individual differences in psychological risk factors shape the social environment and social environment shapes psychological risk factors. Thus, peer-based interventions that challenge internalization of the thin ideal can protect against the development of eating pathology. Copyright © 2013 Wiley Periodicals, Inc.
Crescimbene, Massimo; La Longa, Federica; Pessina, Vera; Pino, Nicola Alessandro; Peruzza, Laura
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
McMonnies, Charles W
Apart from the risk of developing glaucoma there is also the risk that it is not detected and irreversible loss of vision ensues. Some studies of methods of glaucoma diagnosis have examined the results of instrument-based examinations with great if not complete reliance on objective findings in arriving at a diagnosis. The very valuable advances in glaucoma detection instrument technologies, and apparent increasing dependence on them, may have led to reduced consideration of information available from a patient history in those studies. Dependence on objective evidence of glaucomatous pathology may reduce the possibility of detecting glaucoma suspects or patients at risk for becoming glaucoma suspects. A valid positive family history of glaucoma is very valuable information. However, negative family histories can often be unreliable due to large numbers of glaucoma cases being undiagnosed. No evidence of family history is appropriate rather than no family history. In addition the unreliability of a negative family history is increased when patients with glaucoma fail to inform their family members. A finding of no family history can only be stated as no known family history. In examining the potential diagnostic contribution from a patient history, this review considers, age, frailty, race, type and degree of refractive error, systemic hyper- and hypotension, vasospasm, migraine, pigmentary dispersion syndrome, pseudoexfoliation syndrome, obstructive sleep apnea syndrome, diabetes, medication interactions and side effects, the degree of exposure to intraocular and intracranial pressure elevations and fluctuations, smoking, and symptoms in addition to genetics and family history of the disease. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.
Yaroslava V Danilina
Full Text Available Objective to analyze the impact of economic crisis in Russia on the enterprisesrsquo access to productive resources as well as on the level of their competencies. Methods historical abstractlogical. Results the article states that despite the influence of external factors the main activities of the company are internal capabilities and resources of the firm. It is shown that under crisis a company must adapt to the limited resources i.e. change the competences of using them. Under modern conditions the competitive advantage can be based on two components ndash access to resources and internal ability of the company to use them. Therefore under the resource constraints such competencies should be generated as 1 ability to use a smaller amount of resources 2 more efficient use of available resources 3 search for the new resources development of own resources. The study determined that the acquisition of new competencies by the company will be associated with the use and improvement of its cognitive capabilities which are a function of organizational and individual knowledge possessed by the enterprise i.e. its intellectual capital. The article analyses the experience of development of new competencies under crisis by the example of reorganization of quotPrompriborquot plant and activities of quotGalogenquot JSC. Analysis of the experience of these companies which not only survived during the crisis but also acquired new competences and skills have led to the conclusion that the key role in this process was played by working with the main part of a company39s intellectual capital i.e. human capital. Thus a conclusion is made about the value of people and their common interests during the transformations within the enterprise. Scientific novelty for the first time the cognitive aspects of the enterprisesrsquo modernization system are considered from the viewpoint of the new resource and competence theory of the enterprise. Practical significance the
Janoutová, Jana; Janácková, Petra; Serý, Omar; Zeman, Tomás; Ambroz, Petr; Kovalová, Martina; Varechová, Katerina; Hosák, Ladislav; Jirík, Vitezslav; Janout, Vladimír
Schizophrenia is a severe mental disorder that affects approximately one percent of the general population. The pathogenesis of schizophrenia is influenced by many risk factors, both environmental and genetic. The environmental factors include the date of birth, place of birth and seasonal effects, infectious diseases, complications during pregnancy and delivery, substance abuse and stress. At the present time, in addition to environmental factors, genetic factors are assumed to play a role in the development of the schizophrenia. The heritability of schizo- phrenia is up to 80%. If one parent suffers from the condition, the probability that it will be passed down to the offspring is 13%. If it is present in both parents, the risk is more than 20%. The opinions are varied as to the risk factors affecting the development of schizophrenia. Knowing these factors may greatly contribute to prevention of the condition.
Montalva-Iborra, A; Alcanyis-Alberola, M; Grao-Castellote, C; Torralba-Collados, F; Giner-Pascual, M
In the last years, there has been a change in the aetiology of spinal cord injury. There has been an increase in the number of elderly patients with spinal cord injuries caused by diseases or medical procedures. The aim of this study is to investigate the frequency of the occurrence of iatrogenic spinal cord injury in our unit. The secondary aim is to study what variables can be associated with a higher risk of iatrogenesis. A retrospective, descriptive, observational study of patients with acute spinal cord injury admitted from June 2009 to May 2014 was conducted. The information collected included the patient age, aetiology, neurological level and grade of injury when admitted and when discharged, cardiovascular risk factors, a previous history of depression and any prior treatment with anticoagulant or antiplatelet drugs. We applied a logistic regression. The grade of statistical significance was established as Pinjury was the thoracic level (48%). The main aetiology of spinal cord injury caused by iatrogenesis was surgery for degenerative spine disease, in patients under the age of 30 were treated with intrathecal chemotherapy. Iatrogenic spinal cord injury is a frequent complication. A statistically significant association between a patient history of depression and iatrogenic spinal cord injury was found as well as with anticoagulant and antiplatelet drug use prior to iatrogenic spinal cord injury.
Hackett, Ruth A; Steptoe, Andrew
Type 2 diabetes is a chronic disease that is increasing in prevalence globally. Cardiovascular disease is a major cause of mortality and morbidity in diabetes, and lifestyle and clinical risk factors do not fully account for the link between the conditions. This article provides an overview of the evidence concerning the role of psychosocial stress factors in diabetes risk, as well as in cardiovascular complications in people with existing diabetes. Several types of psychosocial factors are discussed including depression, other types of emotional distress, exposure to stressful conditions, and personality traits. The potential behavioral and biological pathways linking psychosocial factors to diabetes are presented and implications for patient care are highlighted.
... among the elderly (Bernert, 2007) and, mediated by depression, are associated with suicide ideation among the elderly (Nadorff et al., 2013). ... suicidal behavior in the National Longitudinal Study of Adolescent ... (2013) 5 Nocturnal Sleep Disturbances: Risk Factors for ...
... Diseases > Lung Disease Lookup > Nontuberculosis Mycobacteria NTM Symptoms, Causes & Risk Factors The symptoms caused by NTM infection ... Low-grade fever Night sweats Weight loss What Causes NTM Lung Infections? NTM lung infections are caused ...
Jangö, Hanna; Langhoff-Roos, J; Rosthøj, Steen
Please cite this paper as: Jangö H, Langhoff-Roos J, Rosthøj S, Sakse A. Risk factors of recurrent anal sphincter ruptures: a population-based cohort study. BJOG 2012;00:000-000 DOI: 10.1111/j.1471-0528.2012.03486.x. Objective To determine the incidence and risk factors of recurrent anal sphincter...... rupture (ASR). Design Population-based retrospective cohort study. Setting Data were taken from the National Medical Birth Registry, Denmark. Population Patients with a first and a second vaginal delivery in the time period 1997-2010. Methods Univariate analysis and multivariate logistic regression...... were used to determine risk factors of recurrent ASR. Main outcome measures The incidence of recurrent ASR and odds ratios for possible risk factors of recurrent ASR: age, body mass index, grade of ASR, birthweight, head circumference, gestational age, presentation, induction of labour, oxytocin...
Ouzounian, Joseph G
Shoulder dystocia complicates ∼1% of vaginal births. Although fetal macrosomia and maternal diabetes are risk factors for shoulder dystocia, for the most part its occurrence remains largely unpredictable and unpreventable.
Heuvel, S. van den
It has been known for some time that risk factors in the workplace can have a negative effect on health. Ramazzini was one of the first scientists to identify occupational health hazards. He wrote about diseases of the musculoskeletal system caused by sudden and irregular movements and the adoption of awkward postures. Another category of work-related risk factors for musculoskeletal disorders (MSDs) includes psychosocial work characteristics, such as work demands, job control and social supp...
Orosova, Ol'ga; Gajdosova, Beata; Madarasova-Geckova, Andrea; Van Dijk, Jitse P.
The study presents the state-of-art of knowledge of risk factors of drug use as a form of risk behaviour in adolescents in individual, interpersonal, and environmental domain (family, school, society). The attention is paid to general deviation syndrome and to the construct of general tendency to
Cardiovascular disease (CVD) usually manifests itself at middle age or beyond, but it is the result of an ongoing disease process. This stresses the need for insight into changes in lifestyle and metabolic risk factors that occur throughout the life course, and their effect on CVD. We studied risk
This paper focused on the reduction of cardiovascular disease risk factors, through aerobic exercises. The central argument here is that through exercise there is the tendency for increased strength of the heart muscles. When this is the case, what follows is a reduction in body weight and ultimately less risk on the ...
Lysen, Victoria C.; Walker, Robert
Presents findings from food frequency questionnaires and surveys of 138 Midwestern eighth-grade student-parent pairs. The study examined the incidence of modifiable and nonmodifiable osteoporosis risk factors and compared gender differences. Data analysis indicated that many adolescents possessed several modifiable and nonmodifiable risk factors…
Franco, R. F.; Reitsma, P. H.
Venous thrombosis, whose main clinical presentations include deep vein thrombosis and pulmonary embolism, represents a major health problem worldwide. Numerous conditions are known to predispose to venous thrombosis and these conditions are commonly referred to as risk indicators or risk factors.
From the point of view of occupational health, the field of voice disorders is very poorly developed as compared, for instance, to the prevention and diagnostics of occupational hearing disorders. In fact, voice disorders have not even been recognized in the field of occupational medicine. Hence, it is obviously very rare in most countries that the voice disorder of a professional voice user, e.g. a teacher, a singer or an actor, is accepted as an occupational disease by insurance companies. However, occupational voice problems do not lack significance from the point of view of the patient. We also know from questionnaires and clinical studies that voice complaints are very common. Another example of job-related health problems, which has proved more successful in terms of its occupational health status, is the repetition strain injury of the elbow, i.e. the "tennis elbow". Its textbook definition could be used as such to describe an occupational voice disorder ("dysphonia professional is"). In the present paper the effects of such risk factors as vocal loading itself, background noise and room acoustics and low relative humidity of the air are discussed. Due to individual factors underlying the development of professional voice disorders, recommendations rather than regulations are called for. There are many simple and even relatively low-cost methods available for the prevention of vocal problems as well as for supporting rehabilitation.
Suarez-Munoz, Miguel Angel; Fernandez-Aguilar, Jose Luis; Sanchez-Perez, Belinda; Perez-Daga, Jose Antonio; Garcia-Albiach, Beatriz; Pulido-Roa, Ysabel; Marin-Camero, Naiara; Santoyo-Santoyo, Julio
Cholangiocarcinoma is the second most common primary malignant tumor of the liver. Perihilar cholangiocarcinoma or Klatskin tumor represents more than 50% of all biliary tract cholangiocarcinomas. A wide range of risk factors have been identified among patients with Perihilar cholangiocarcinoma including advanced age, male gender, primary sclerosing cholangitis, choledochal cysts, cholelithiasis, cholecystitis, parasitic infection (Opisthorchis viverrini and Clonorchis sinensis), inflammatory bowel disease, alcoholic cirrhosis, nonalcoholic cirrhosis, chronic pancreatitis and metabolic syndrome. Various classifications have been used to describe the pathologic and radiologic appearance of cholangiocarcinoma. The three systems most commonly used to evaluate Perihilar cholangiocarcinoma are the Bismuth-Corlette (BC) system, the Memorial Sloan-Kettering Cancer Center and the TNM classification. The BC classification provides preoperative assessment of local spread. The Memorial Sloan-Kettering cancer center proposes a staging system according to three factors related to local tumor extent: the location and extent of bile duct involvement, the presence or absence of portal venous invasion, and the presence or absence of hepatic lobar atrophy. The TNM classification, besides the usual descriptors, tumor, node and metastases, provides additional information concerning the possibility for the residual tumor (R) and the histological grade (G). Recently, in 2011, a new consensus classification for the Perihilar cholangiocarcinoma had been published. The consensus was organised by the European Hepato-Pancreato-Biliary Association which identified the need for a new staging system for this type of tumors. The classification includes information concerning biliary or vascular (portal or arterial) involvement, lymph node status or metastases, but also other essential aspects related to the surgical risk, such as remnant hepatic volume or the possibility of underlying disease.
Tsai, Jack; Rosenheck, Robert A
Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Tsai, Jack; Rosenheck, Robert A.
Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. PMID:25595171
Ul Haq, Faheem; Jalil, Fatima; Hashmi, Saman; Jumani, Maliha Iqbal; Imdad, Aamer; Jabeen, Mehnaz; Hashmi, Javad Tauseef; Irfan, Furqan Bin; Imran, Muhammad; Atiq, Mehnaz
Congenital heart disease (CHD) is associated with multiple risk factors, consanguinity may be one such significant factor. The role of consanguinity in the etiology of CHD is supported by inbreeding studies, which demonstrate an autosomal recessive pattern of inheritance of some congenital heart defects. This study was done to find out the risk factors for CHD. A case-control study was done on pediatric patients at a tertiary care hospital, Aga Khan University Hospital, located in Karachi, Pakistan. A total of 500 patients, 250 cases and 250 controls were included in the study. Amongst the 250 cases (i.e. those diagnosed with CHD), 122 patients (48.8%) were born of consanguineous marriages while in the controls (i.e. non-CHD) only 72 patients (28.9%) showed a consanguinity amongst parents. On multivariate analysis, consanguinity emerged as an independent risk factor for CHD; adjusted odds ratio 2.59 (95% C. I. 1.73 - 3.87). Other risk factors included low birth weight, maternal co-morbidities, family history of CHD and first born child. On the other hand, medications used by the mother during the index pregnancy, maternal age and gender of the child did not significantly increase the risk of developing CHD. Analyses of our results show that parental consanguinity, family history of CHD, maternal co-morbidities, first born child and low birth weight are independent risk factors for CHD
Washington, Donna L; Yano, Elizabeth M; McGuire, James; Hines, Vivian; Lee, Martin; Gelberg, Lillian
Women veterans are three to four times more likely than non-veteran women to become homeless. However, their risk factors for homelessness have not been defined. Case-control study of non-institutionalized homeless women veterans (n533) and age-matched housed women veterans (n=165). Health, health care, and factors associated with homelessness were assessed using multiple logistic regression with a Monte Carlo algorithm to estimate exact standard errors of the model coefficients and p-values. Characteristics associated with homelessness were sexual assault during military service, being unemployed, being disabled, having worse overall health, and screening positive for an anxiety disorder or post-traumatic stress disorder. Protective factors were being a college graduate or married. Efforts to assess housed women veterans' risk factors for homelessness should be integrated into clinical care programs within and outside the Veterans Administration. Programs that work to ameliorate risk factors may prevent these women's living situations from deteriorating over time.
Breithardt, G.; Ravens, U.; Kirchhof, P.; van Gelder, I. C.
The development of atrial fibrillation (AF) is closely linked to risk factors like hypertension and heart failure, diabetes mellitus, myocardial infarction and valvular heart disease. These factors partly overlap with those which determine the progression of atrial fibrillation and the incidence of
Santhiago, Marcony R; Giacomin, Natalia T; Smadja, David; Bechara, Samir J
This review outlines risk factors of post-laser in situ keratomileusis (LASIK) ectasia that can be detected preoperatively and presents a new metric to be considered in the detection of ectasia risk. Relevant factors in refractive surgery screening include the analysis of intrinsic biomechanical properties (information obtained from corneal topography/tomography and patient’s age), as well as the analysis of alterable biomechanical properties (information obtained from the amount of tissue altered by surgery and the remaining load-bearing tissue). Corneal topography patterns of placido disk seem to play a pivotal role as a surrogate of corneal strength, and abnormal corneal topography remains to be the most important identifiable risk factor for ectasia. Information derived from tomography, such as pachymetric and epithelial maps as well as computational strategies, to help in the detection of keratoconus is additional and relevant. High percentage of tissue altered (PTA) is the most robust risk factor for ectasia after LASIK in patients with normal preoperative corneal topography. Compared to specific residual stromal bed (RSB) or central corneal thickness values, percentage of tissue altered likely provides a more individualized measure of biomechanical alteration because it considers the relationship between thickness, tissue altered through ablation and flap creation, and ultimate RSB thickness. Other recognized risk factors include low RSB, thin cornea, and high myopia. Age is also a very important risk factor and still remains as one of the most overlooked ones. A comprehensive screening approach with the Ectasia Risk Score System, which evaluates multiple risk factors simultaneously, is also a helpful tool in the screening strategy. PMID:27143849
Hamlyn, Jess; Duhig, Michael; McGrath, John; Scott, James
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
Janoutová, J.; Janáčková, P.; Šerý, Omar; Zeman, T.; Ambrož, P.; Kovalová, M.; Vařechová, K.; Hosák, L.; Jiřík, V.; Janout, V.
Roč. 37, č. 1 (2016), s. 1-8 ISSN 0172-780X R&D Projects: GA MZd NT14504 Institutional support: RVO:67985904 Keywords : schizophrenia * risk factors * epidemiology Subject RIV: FQ - Public Health Care, Social Medicine Impact factor: 0.918, year: 2016
Pulido, Catarina; Vendrell, Inês; Ferreira, Arlindo R; Casimiro, Sandra; Mansinho, André; Alho, Irina; Costa, Luís
Bone is the single most frequent site for bone metastasis in breast cancer patients. Patients with bone-only metastasis have a fairly good prognosis when compared with patients with visceral disease. Nevertheless, cancer-induced bone disease carries an important risk of developing skeletal related events that impact quality of life (QoL). It is therefore particularly important to stratify patients according to their risk of developing bone metastasis. In this context, several risk factors have been studied, including demographic, clinicopathological, genetic, and metabolic factors. Most of them show conflicting or non-definitive associations and are not validated for clinical use. Nonetheless, tumour intrinsic subtype is widely accepted as a major risk factor for bone metastasis development and luminal breast cancer carries an increased risk for bone disease. Other factors such as gene signatures, expression of specific cytokines (such as bone sialoprotein and bone morphogenetic protein 7) or components of the extracellular matrix (like bone crosslinked C-telopeptide) might also influence the development of bone metastasis. Knowledge of risk factors related with bone disease is of paramount importance as it might be a prediction tool for triggering the use of targeted agents and allow for better patient selection for future clinical trials. PMID:28194227
de Groot, D; Pasterkamp, G; Hoefer, I E
Arterial lumen narrowing and vascular occlusion is the actual cause of morbidity and mortality in atherosclerotic disease. Collateral artery formation (arteriogenesis) refers to an active remodelling of non-functional vascular anastomoses to functional collateral arteries, capable to bypass the site of obstruction and preserve the tissue that is jeopardized by ischaemia. Hemodynamic forces such as shear stress and wall stress play a pivotal role in collateral artery formation, accompanied by the expression of various cytokines and invasion of circulating leucocytes. Arteriogenesis hence represents an important compensatory mechanism for atherosclerotic vessel occlusion. As arteriogenesis mostly occurs when lumen narrowing by atherosclerotic plaques takes place, presence of cardiovascular risk factors (e.g. hypertension, hypercholesterolaemia and diabetes) is highly likely. Risk factors for atherosclerotic disease affect collateral artery growth directly and indirectly by altering hemodynamic forces or influencing cellular function and proliferation. Adequate collateralization varies significantly among atherosclerotic patients, some profit from the presence of extensive collateral networks, whereas others do not. Cardiovascular risk factors could increase the risk of adverse cardiovascular events in certain patients because of the reduced protection through an alternative vascular network. Likewise, drugs primarily thought to control cardiovascular risk factors might contribute or counteract collateral artery growth. This review summarizes current knowledge on the influence of cardiovascular risk factors and the effects of cardiovascular medication on the development of collateral vessels in experimental and clinical studies.
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
Aasvang, Eske K; Gmaehle, Eliza; Hansen, Jeanette B
BACKGROUND: Persistent postherniotomy pain (PPP) affects everyday activities in 5-10% of patients. Identification of predisposing factors may help to identify the risk groups and guide anesthetic or surgical procedures in reducing risk for PPP. METHODS: A prospective study was conducted in 464...... patients undergoing open or laparoscopic transabdominal preperitoneal elective groin hernia repair. Primary outcome was identification of risk factors for substantial pain-related functional impairment at 6 months postoperatively assessed by the validated Activity Assessment Scale (AAS). Data on potential...... risk factors for PPP were collected preoperatively (pain from the groin hernia, preoperative AAS score, pain from other body regions, and psychometric assessment). Pain scores were collected on days 7 and 30 postoperatively. Sensory functions including pain response to tonic heat stimulation were...
Vilain, J; Galliot, A-M; Durand-Roger, J; Leboyer, M; Llorca, P-M; Schürhoff, F; Szöke, A
Evidence of variations in schizophrenia incidence rates has been found in genetically homogenous populations, depending on changes within time or space of certain environmental characteristics. The consideration of the impact of environmental risk factors in etiopathogenic studies has put the environment in the forefront of research regarding psychotic illnesses. Various environmental factors such as urbanicity, migration, cannabis, childhood traumas, infectious agents, obstetrical complications and psychosocial factors have been associated with the risk of developing schizophrenia. These risk factors can be biological, physical, psychological as well as social and may operate at different times in an individual's life (fetal period, childhood, adolescence and early adulthood). Whilst some of these factors act on an individual level, others act on a populational level, modulating the individual risk. These factors can have a direct action on the development of schizophrenia, or on the other hand act as markers for directly implicated factors that have not yet been identified. This article summarizes the current knowledge on this subject. An extensive literature search was conducted via the search engine Pubmed. Eight risk factors were selected and developed in the following paper: urbanicity (or living in an urban area), cannabis, migration (and ethnic density), obstetrical complications, seasonality of birth, infectious agents (and inflammatory responses), socio-demographic factors and childhood traumas. For each of these factors, we provide information on the importance of the risk, the vulnerability period, hypotheses made on the possible mechanisms behind the factors and the level of proof the current research offers (good, medium, or insufficient) according to the amount, type, quality and concordance of the studies at hand. Some factors, such as cannabis, are "unique" in their influence on the development of schizophrenia since it labels only one risk factor
Hecimovic, Karen; Barrett, Sean P; Darredeau, Christine; Stewart, Sherry H
According to the model of substance abuse of Conrod, Pihl, Stewart, and Dongier (2000), four personality factors (i.e., anxiety sensitivity [AS], introversion/hopelessness [I/H], sensation seeking [SS], and impulsivity [IMP]) are associated with elevated risk for substance use/misuse, with each personality factor being related to preference for particular drugs of abuse (e.g., AS with anxiolytics). However, cannabis use has not been consistently linked to any one of these personality factors. This may be due to the heterogeneity in cannabis use motives. The present study explored the association between these four personality risk factors and different cannabis use motives. Cannabis users completed an interview about their motives for cannabis use as well as the self-report Substance Use Risk Profile Scale (SURPS; Woicik, Conrod, Stewart, & Pihl, 2009), which measures the four personality risk factors. Results showed that AS was associated with conformity motives and I/H was associated with coping motives for cannabis use. SS was positively associated with expansion motives and IMP was associated with drug availability motives. Thus, personality risk factors in the model of Conrod et al. (2000) are associated with distinct cannabis use motives in a pattern consistent with theory. Copyright © 2013 Elsevier Ltd. All rights reserved.
Mubarak, Husin, Saiful; Oktaviati, Mutia
Some risk factors can have impacts on the cost, time, and performance. Results of previous studies indicated that the external conditions are among the factors which give effect to the contractor in the completion of the project. The analysis in the study carried out by considering the conditions of the project in the last 15 years in Aceh province, divided into military conflict phase (2000-2004), post tsunami disaster rehabilitation and reconstruction phase (2005-2009), and post-rehabilitation and reconstruction phase (2010-present). This study intended to analyze the impact of external risk factors, primarily related to the impact on project costs and to investigate the influence of the risk factors and construction phases impacted the project cost. Data was collected by using a questionnaire distributed in 15 large companies qualification contractors in Aceh province. Factors analyzed consisted of socio-political, government policies, natural disasters, and monetary conditions. Data were analyzed using statistical application of severity index to measure the level of risk impact. The analysis results presented the tendency of impact on cost can generally be classified as low. There is only one variable classified as high-impact, variable `fuel price increases', which appear on the military conflict and post tsunami disaster rehabilitation and reconstruction periods. The risk impact on costs from the factors and variables classified with high intensity needs a serious attention, especially when the high level impact is followed by the high frequency of occurrences.
Canals C, Andrea; Cavada C, Gabriel; Nazer H, Julio
The relative importance of congenital malformations as a cause of death in the first year of life is increasing along with the control of preventable causes of perinatal mortality. To identify risk factors for congenital malformations. Retrospective case-control study of births registered in the database of The Latin American Collaborative Study of Congenital Malformations (ECLAMC), in the period 2001-2010. Birth weight and gestational age were significantly lower in cases than controls, behaving as risk factors and associated with a greater severity of congenital malformations. The risk and severity of congenital malformations increased along with mother's age. Fetal growth retardation, a history of congenital malformations in the family, physical factors and acute illnesses of the mother in the first trimester of pregnancy were also significant risk factors for congenital malformations and their severity. The educational level of the mother was a protective factor for congenital malformations and their severity. Variables previously identified as risk factors for congenital malformations, were significantly related with the occurrence of congenital malformations and their severity.
Abrich, Victor; Brozek, Annabelle; Boyle, Timothy R; Chyou, Po-Huang; Yale, Steven H
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.
Full Text Available Anabel N Rodrigues,1 Glaucia R Abreu,2 Rogério S Resende,1 Washington LS Goncalves,1 Sonia Alves Gouvea21School of Medicine, University Center of Espírito Santo, Colatina, Brazil; 2Postgraduate Program in Physiological Sciences, Center for Health Sciences, Federal University of Espirito Santo, Vitória, BrazilObjectives: To correlate cardiovascular risk factors (e.g., hypertension, obesity, hypercholesterolemia, hypertriglyceridemia, hyperglycemia, sedentariness in childhood and adolescence with the occurrence of cardiovascular disease.Sources: A systematic review of books and selected articles from PubMed, SciELO and Cochrane from 1992 to 2012.Summary of findings: Risk factors for atherosclerosis are present in childhood, although cardiovascular disease arises during adulthood. This article presents the main studies that describe the importance of investigating the risk factors for cardiovascular diseases in childhood and their associations. Significant rates of hypertension, obesity, dyslipidemia, and sedentariness occur in children and adolescents. Blood pressure needs to be measured in childhood. An increase in arterial blood pressure in young people predicts hypertension in adulthood. The death rate from cardiovascular disease is lowest in children with lower cholesterol levels and in individuals who exercise regularly. In addition, there is a high prevalence of sedentariness in children and adolescents.Conclusions: Studies involving the analysis of cardiovascular risk factors should always report the prevalence of these factors and their correlations during childhood because these factors are indispensable for identifying an at-risk population. The identification of risk factors in asymptomatic children could contribute to a decrease in cardiovascular disease, preventing such diseases as hypertension, obesity, and dyslipidemia from becoming the epidemics of this century.Keywords: cardiovascular risk, children, hypertension, obesity
Gonçalves, Bruna; Ferreira, Carina; Alves, Carlos Tiago; Henriques, Mariana; Azeredo, Joana; Silva, Sónia
Vulvovaginal candidiasis (VVC) is an infection caused by Candida species that affects millions of women every year. Although Candida albicans is the main cause of VVC, the identification of non-Candida albicans Candida (NCAC) species, especially Candida glabrata, as the cause of this infection, appears to be increasing. The development of VVC is usually attributed to the disturbance of the balance between Candida vaginal colonization and host environment by physiological or nonphysiological changes. Several host-related and behavioral risk factors have been proposed as predisposing factors for VVC. Host-related factors include pregnancy, hormone replacement, uncontrolled diabetes, immunosuppression, antibiotics, glucocorticoids use and genetic predispositions. Behavioral risk factors include use of oral contraceptives, intrauterine device, spermicides and condoms and some habits of hygiene, clothing and sexual practices. Despite a growing list of recognized risk factors, much remains to be elucidated as the role of host versus microorganisms, in inducing VVC and its recurrence. Thus, this review provides information about the current state of knowledge on the risk factors that predispose to VVC, also including a revision of the epidemiology and microbiology of VVC, as well as of Candida virulence factors associated with vaginal pathogenicity.
Hilbert, Anja; Pike, Kathleen M; Goldschmidt, Andrea B; Wilfley, Denise E; Fairburn, Christopher G; Dohm, Faith-Anne; Walsh, B Timothy; Striegel Weissman, Ruth
This study sought to examine risk and onset patterns in anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Women with AN (n=71), BN (n=66), BED (n=160) and non-psychiatric controls (n=323) were compared retrospectively on risk factors, symptom onset, and diagnostic migration. Eating disorder groups reported greater risk exposure than non-psychiatric controls. AN and BED differed on premorbid personality/behavioral problems, childhood obesity, and family overeating. Risk factors for BN were shared with AN and BED. Dieting was the most common onset symptom in AN, whereas binge eating was most common in BN and BED. Migration between AN and BED was rare, but more frequent between AN and BN and between BN and BED. AN and BED have distinct risk factors and onset patterns, while BN shares similar risk factors and onset patterns with both AN and BED. Results should inform future classification schemes and prevention programs. Copyright © 2014. Published by Elsevier Ireland Ltd.
Hemphill, Sheryl A; Heerde, Jessica A; Scholes-Balog, Kirsty E
The present study aims to examine risk factors and risk-based and interactive protective factors for violent offending in a group of 437 young Australians. Participants were recruited into the study when they were in Grade 5 (10-11 years) and followed up almost annually until young adulthood (18-19 years). Measures of violent offending, risk and protective factors, and demographics were obtained through a modification of the Communities That Care youth survey. The data collected enabled identification of groups of students at-risk of violent offending according to drug use, low family socioeconomic status, and antisocial behavior. Results showed that there were very few associations between the risk factors and risk-based protective factors measured in this study (e.g., belief in the moral order, religiosity, peer recognition for prosocial involvement, attachment to parents, low commitment to school, and poor academic performance) and later self-reported violent offending. There were no statistically significant interactive protective factors. Further longitudinal analyses with large sample sizes are needed to examine risk factors and risk-based protective factors and interactive protective factors in at-risk groups. The findings support the need for multi-faceted prevention and early intervention approaches that target multiple aspects of youth's lives.
Murguía-González, Alejandrina; Hernández-Herrera, Ricardo Jorge; Nava-Bermea, Manuel
The proper prenatal care for pregnant women is crucial to quickly identify risk factors for birth trauma. To identify risk factors for neonatal birth trauma. Case-control study that included a patient in the case group for every two controls. The following risk factors were identified: cephalopelvic disproportion, macrosomia, use of forceps, precipitated or prolonged labor, malpresentation, and the most common types of birth trauma. We used descriptive statistics and odds ratios. Statistically significant risk factors for birth trauma were: maternal age or = 30 years (OR = 2.5), first pregnancy (OR = 4.0), cephalopelvic disproportion (OR = 8.3), forceps delivery (OR = 9.4), birth weight greater than 3,800 g (OR = 6.6), and non-cephalic presentation (OR = 8.3). Found birth trauma types were: ecchymosis (40.4%), caput succedaneum (25%), erosion (15.4%), clavicle fracture (5.9%), brachial plexus paralysis (4.7%), inter alia. The perinatal outcome of 79 infants with birth trauma were compared to 158 healthy newborns. Risk factors associated with birth injuries were: Maternal (age, pregnancy), newborn (weight), and birth care (presentation, instrumentation and pelvic sufficiency).
Huang, Weimin; Han, Zhiwei; Liu, Jiang; Yu, Lili; Yu, Xiuchun
Abstract Recurrent lumbar disc herniation (rLDH) is a common complication following primary discectomy. This systematic review aimed to investigate the current evidence on risk factors for rLDH. Cohort or case-control studies addressing risk factors for rLDH were identified by search in Pubmed (Medline), Embase, Web of Science, and Cochrane library from inception to June 2015. Relevant results were pooled to give overall estimates if possible. Heterogeneity among studies was examined and publication bias was also assessed. A total of 17 studies were included in this systematic review. Risk factors that had significant relation with rLDH were smoking (OR 1.99, 95% CI 1.53–2.58), disc protrusion (OR 1.79, 95% CI 1.15–2.79), and diabetes (OR 1.19, 95% CI 1.06–1.32). Gender, BMI, occupational work, level, and side of herniation did not correlate with rLDH significantly. Based on current evidence, smoking, disc protrusion, and diabetes were predictors for rLDH. Patients with these risk factors should be paid more attention for prevention of recurrence after primary surgery. More evidence provided by high-quality observational studies is still needed to further investigate risk factors for rLDH. PMID:26765413
Jae Hoon Moon
Full Text Available Cognitive impairment, including Alzheimer's disease and other kinds of dementia, is a major health problem in older adults worldwide. Although numerous investigators have attempted to develop effective treatment modalities or drugs, there is no reasonably efficacious strategy for preventing or recovering from cognitive impairment. Therefore, modifiable risk factors for cognitive impairment have received attention, and the growing literature of metabolic risk factors for cognitive impairment has expanded from epidemiology to molecular pathogenesis and therapeutic management. This review focuses on the epidemiological evidence for the association between cognitive impairment and several endocrine risk factors, including insulin resistance, dyslipidemia, thyroid dysfunction, vitamin D deficiency, and subclinical atherosclerosis. Researches suggesting possible mechanisms for this association are reviewed. The research investigating modifiable endocrine risk factors for cognitive impairment provides clues for understanding the pathogenesis of cognitive impairment and developing novel treatment modalities. However, so far, interventional studies investigating the beneficial effect of the "modification" of these "modifiable risk factors" on cognitive impairment have reported variable results. Therefore, well-designed, randomized prospective interventional studies are needed.
Exfoliated cervical cells were harvested and processed using Polymerase Chain Reaction to identify the DNAs of high-risk HPV types 16 and 18. The prevalence rate of HPV infection was 76% [(38/50) at 95% CI=61.8-86.9] with 60.5% (23/38) having co-infections with both HPV type 16 and 18. Risk factors of the infection ...
Disasters events are perfect examples of compound events. Disaster risk lies at the intersection of several independent components such as hazard, exposure and vulnerability. Understanding the weight of each component requires extensive standardisation. Here, I show how footprints of past disastrous events were generated using GIS modelling techniques and used for extracting population and economic exposures based on distribution models. Using past event losses, it was possible to identify and quantify a wide range of socio-politico-economic drivers associated with human vulnerability. The analysis was applied to about nine thousand individual past disastrous events covering earthquakes, floods and tropical cyclones. Using a multiple regression analysis on these individual events it was possible to quantify each risk component and assess how vulnerability is influenced by various hazard intensities. The results show that hazard intensity, exposure, poverty, governance as well as other underlying factors (e.g. remoteness) can explain the magnitude of past disasters. Analysis was also performed to highlight the role of future trends in population and climate change and how this may impacts exposure to tropical cyclones in the future. GIS models combined with statistical multiple regression analysis provided a powerful methodology to identify, quantify and model disaster risk taking into account its various components. The same methodology can be applied to various types of risk at local to global scale. This method was applied and developed for the Global Risk Analysis of the Global Assessment Report on Disaster Risk Reduction (GAR). It was first applied on mortality risk in GAR 2009 and GAR 2011. New models ranging from global assets exposure and global flood hazard models were also recently developed to improve the resolution of the risk analysis and applied through CAPRA software to provide probabilistic economic risk assessments such as Average Annual Losses (AAL
Rod, Naja Hulvej; Andersen, Ingelise; Prescott, Eva
Prospective studies on the role of psychosocial factors in heart failure development are virtually nonexistent. The authors aimed to address the effect of psychosocial factors on the risk of heart failure hospitalization in men and women free of cardiovascular disease. In 1991-1993, the 8......-fourth of the population reported some degree of vital exhaustion. The vital exhaustion score was associated with a higher risk of heart failure in a dose-response manner (P risk of heart failure in both men (hazard ratio = 1.93, 95% confidence...... in the population, even a modestly higher risk of heart failure associated with vital exhaustion may be of importance in the planning of future preventive strategies for heart failure....
van Viersen, Sietske; de Bree, Elise H.; Kroesbergen, Evelyn H.; Slot, Esther M.; de Jong, Peter F.
This study investigated risk and protective factors associated with dyslexia and literacy development, both at the group and individual level, to gain more insight in underlying cognitive profiles and possibilities for compensation in high-IQ children. A sample of 73 Dutch primary school children included a dyslexic group, a gifted-dyslexic group,…
Acute respiratory infections (ARIs) are the fourth major cause of morbidity and mortality among under-five children (U5-C) globally. However, essential information on mothers' belief about risk factors that could predispose U5-C to these infections is scanty in Nigeria. Therefore, this study assessed the level of knowledge and ...
In spite of the diarrhoeal disease control Programme of WHO and campaign efforts of the Nigerian government in the prevention and management ofdiarrhoea, the disease still remains a major causes of death among children under 5 years in Nigerian. Hence this study was aimed at assessing the risk factors, clinical ...
Vrijkotte, T. G.; van Doornen, L. J.; de Geus, E. J.
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
Patterns and risk factors for helminthiasis in rural children aged under 2 in Bangladesh. Soil-transmitted helminth (STH) infestation has an uneven worldwide distribution, with a peak prevalence in tropical and subtropical regions of sub-Saharan Africa, the Americas, China and East Asia.1-3 Each year about 2 billion people ...
van Viersen, Sietske; de Bree, Elise H.; Kroesbergen, Evelyn H.; Slot, Esther M.; de Jong, Peter F.
This study investigated risk and protective factors associated with dyslexia and literacy development, both at the group and individual level, to gain more insight in underlying cognitive profiles and possibilities for compensation in high-IQ children. A sample of 73 Dutch primary school children
Skaaby, Tea; Thuesen, Betina H.; Linneberg, Allan
of vitamin D effects from a cardiovascular health perspective. It focuses on vitamin D in relation to cardiovascular disease, i.e. ischemic heart disease, and stroke; the traditional cardiovascular risk factors hypertension, abnormal blood lipids, obesity; and the emerging risk factors hyperparathyroidism......, microalbuminuria, chronic obstructive pulmonary diseases, and non-alcoholic fatty liver disease. Meta-analyses of observational studies have largely found vitamin D levels to be inversely associated with cardiovascular risk and disease. However, Mendelian randomization studies and randomized, controlled trials...... (RCTs) have not been able to consistently replicate the observational findings. Several RCTs are ongoing, and the results from these are needed to clarify whether vitamin D deficiency is a causal and reversible factor to prevent cardiovascular disease....
Kessous, Roy; Danor, Daniela; Weintraub, Y Adi; Wiznitzer, Arnon; Sergienko, Ruslan; Ohel, Iris; Sheiner, Eyal
To investigate risk factors for relaparotomy after cesarean section (CS). A retrospective case-control study comparing all CS that were complicated with relaparotomy to cesarean deliveries without this complication. Relaparotomy complicated 0.23% (n=80) of CS during the study period (n=34,389). Independent risk factors for relaparotomy following CS from a multivariable logistic regression model were post partum hemorrhage, cervical tears, placenta previa, uterine rupture, placental abruption, severe preeclampsia and previous CS. Most women (51.2%) underwent relaparotomy during the first 24 h after CS. The leading causes for relaparotomy was bleeding (70%) and burst abdomen (8.8%). Hysterectomy was performed in 31.3% of the patients. Risk factors for relaparotomy after CS are previous CS, severe preeclampsia, placenta previa, uterine rupture, placental abruption, cervical tear and PPH. Experienced obstetricians should be involved in such cases and the possibility for complications including relaparotomy should be emphasized.
Full Text Available Introduction: Cerebrovascular disease is the third most common cause of death in the developed world after cancer and ischemic heart disease. In India, community surveys have shown a crude prevalence rate of 200 per 100000 population for hemiplegia. Aims and objectives: Identification of risk factors for c erebrovascular disease. Materials and Methods: Inclusion Criteria: Cases of acute stroke admitted in S.V.R.R.G.G.H, Tirupati were taken for the study. Exclusion Criteria: Head injury cases, neoplasm cases producing cerebrovascular disease were excluded. Re sults: Stroke was more common in male, 54% patients were male 46% were female. It was more common in 6 th and 7 th decade. More common risk factors were hypertension followed by smoking, diabetes mellitus. More common pathology was infarction. Conclusion: Com mon risk factors for acute stroke are hypertension, smoking, diabetes mellitus, alcoholism, obesity, cardiac disease. Stroke was confirmed by CT scan of brain.
Choudhury, A M; Nargis, S; Mollah, A H; Kabir, L M; Sarkar, R N
Pneumonia is an important cause of neonatal infection and accounts for significant morbidity and mortality in the neonatal period. The best way to reduce the high prevalence of pneumonia at this age group is through identification and elimination of its risk factors. This case-control study was conducted in the department of Pediatrics, Dhaka Medical College & Hospital during Nov 2007 to Nov 2008 with an aim to identify the risk factors of pneumonia. Data were collected from 100 neonates, 50 cases and 50 controls who met the predefined inclusion criteria. Results shows mean birth weight (pneonatal resuscitation (ppneumonia. Multivariate analysis showed inadequate antenatal care (OR 168.9), home delivery (OR 13.8), intrapartum fever (OR 225.9), obstetric problem of mother (OR 33.4), requirement of resuscitation (OR 12.5), prolonged labour (OR 15.2) as significant risk factors of neonatal pneumonia.
van Rooijen, Stefanus; Carli, Francesco; Dalton, Susanne O
in higher mortality rates and greater hospital costs. The number and severity of complications is closely related to patients' preoperative performance status. The aim of this study was to identify the most important preoperative modifiable risk factors that could be part of a multimodal prehabilitation...... program. METHODS: Prospectively collected data of a consecutive series of Dutch CRC patients undergoing colorectal surgery were analyzed. Modifiable risk factors were correlated to the Comprehensive Complication Index (CCI) and compared within two groups: none or mild complications (CCI ... complications (CCI ≥20). Multivariate logistic regression analysis was done to explore the combined effect of individual risk factors. RESULTS: In this 139 patient cohort, smoking, malnutrition, alcohol consumption, neoadjuvant therapy, higher age, and male sex, were seen more frequently in the severe...
Sakshi Singh; T K Ray; Ranjan Das; Abha Singh
Background: Gestational diabetes mellitus (GDM) has been observed to be associated with increased perinatal morbidity and mortality. GDM is becoming a public health concern globally as well as in India with fast increasing trend. It affects approximately 14% of all pregnancies. Studies on the association of food items having high glycaemic index with GDM risk are sparse. Most of the literature has focused on typical risk factors like advanced maternal age, family history of diabetes mellitus,...
Armaş, I.; Creãu, R. Z.; Stǎnciugelu, I.
Risks are mental models, which allow people to cope with dangerous phenomena (Renn, 2008; Jasanoff, 1998). The term "risk" refers to the likelihood of an adverse effect resulting from an event. The aim of the present study is to identify the psychological factors that are most predictive of risk perception in relation with age, gender, educational level and socio-economical status. Earthquake hazard was considered, because it is an emerging danger for Bucharest. 80% of the laypeople sample are waiting for this event to happen in the next three years. By integrating all the research data, it was attempted to build a risk profile of the investigated population, which could be used by institutions responsible for earthquake risk mitigation situations in Bucharest. This research appealed to the social learning Rotter (1966), auto-effectiveness Bandura (1977; 1983), and anxiety and stress theories. We used psychological variables that measured stress, personal effectiveness and the belief in personal control. The multi-modal risk perception questionnaire was structured on a 49 items sequence. The sample was composed of 1.376 participants recruited on a voluntary basis. The characteristics of risk (like probability and magnitude, time scales) are perceived differently according to psychological factors that play a role also in biases in people's ability to draw inferences from probabilistic information (like cognitive dissonance). Since the 1970's, it has been argued that those who perceive life's events as being beyond their locus of control (external locus of control) are significantly more anxious and less adapted. In this research, strongest associations and significant differences were obtained between sex, age and income categories with Stress vulnerability factor and the External Locus of Control factor. The profile of the low risk perceiver is that of a young, more educated, male individual with a higher self- efficacy level and an internal locus of control.
Full Text Available Background. Peritonitis represents a major complication of peritoneal dialysis (PD. The aim of this paper was to systematically collect data on patient-related risk factors for PD-associated peritonitis, to analyze the methodological quality of these studies, and to summarize published evidence on the particular risk factors. Methods. Studies were identified by searches of Pubmed (1990–2012 and assessed for methodological quality by using a modified form of the STROBE criteria. Results. Thirty-five methodologically acceptable studies were identified. The following nonmodifiable risk factors were considered valid and were associated with an increased risk of peritonitis: ethnicity, female gender, chronic lung disease, coronary artery disease, congestive heart failure, cardiovascular disease, hypertension, antihepatitis C virus antibody positivity, diabetes mellitus, lupus nephritis or glomerulonephritis as underlying renal disease, and no residual renal function. We also identified the following modifiable, valid risk factors for peritonitis: malnutrition, overweight, smoking, immunosuppression, no use of oral active vitamin D, psychosocial factors, low socioeconomic status, PD against patient’s choice, and haemodialysis as former modality. Discussion. Modifiable and nonmodifiable risk factors analyzed in this paper might serve as a basis to improve patient care in peritoneal dialysis.
Full Text Available Introduction: Women are very susceptible to urinary tract infections and pregnancy raises the risk of urinary tract infection. In general, little information on the risk factors of urinary tract infection in pregnancy is underway. Urinary tract infection in pregnancy is an important risk factor for pregnancy dire consequences. The purpose of this study is to find risk factors associated with urinary tract infection in pregnant women. Methods: The study was observational and retrospective analysis was carried on in the winter of which 310 pregnant women participated in 11 health centers in Shahrekord. Of these 155 cases (patients and 155 controls (healthy that were matched for age Information required from the health records of pregnant women and complete Czech list of researcher whose validity was confirmed by experts were gathered. Information needed by pregnant women health records and complete list researcher was collected. Czech list contains a number of possible risk factors for illness and demographic characteristics of the study participants was Statistical analysis software spss version 16 by using chi square tests and logistic regression and t analysis was performed. Results: Among the variables vomiting (p = 0/00 a history of urinary tract infection in a previous pregnancy (P =.001, CI = 1.508-4.408, OR = 2.578 abortion own history (P =.014, CI = 1.165 -3.847, OR = 2.117, respectively, the most important risk factors for urinary tract infection in pregnant women were determined. Conclusion: Prevention and treatment of vomiting in pregnancy prevention of urinary tract infections during pregnancy. Prevention of abortion can play an important role in the prevention of urinary tract infection and its complications in pregnancy. The study also revealed a number of factors can have an impact on urinary tract infection in pregnancy that has not been enough attention and it is necessary that more attention be placed on health programs and
Felipe Freire da Silva
Full Text Available A major cause of morbidity and mortality in the context of the antiphospholipid syndrome (APS is the occurrence of thrombotic events. Besides the pathogenic roles of antiphospholipid antibodies (aPL, other risk factors and medical conditions, which are conditions for traditional risk of an individual without the APS, can coexist in this patient, raising their risk of developing thrombosis. Therefore, the clinical and laboratory investigation of comorbidities known to increase cardiovascular risk in patients with antiphospholipid antibody syndrome is crucial for the adoption of a more complete and effective treatment. Experimental models and clinical studies show evidence of association between APS and premature formation of atherosclerotic plaques. Atherosclerosis has major traditional risk factors: hypertension, diabetes mellitus, obesity, dyslipidemia, smoking, and sedentary lifestyle that may be implicated in vascular involvement in patients with APS. The influence of nontraditional risk factors as hyperhomocysteinemia, increased lipoprotein a, and anti-oxLDL in the development of thromboembolic events in APS patients has been studied in scientific literature. Metabolic syndrome with all its components also has been recently studied in antiphospholipid syndrome and is associated with arterial events.
Harmon, K G; Roush, M B
A 20-year-old female college cross-country runner developed chest pain and dyspnea that increased with running. A chest radiograph revealed a right-side pleural effusion, and a ventilation-perfusion scan indicated a probable pulmonary embolism. The diagnosis was left-side pulmonary emboli. Testing for genetic risk factors was negative, leaving oral contraceptive use as the likely cause of the condition. The patient was treated with anticoagulant drugs and discontinuation of oral contraceptives, and was allowed to resume running gradually. Discussion covers genetic and other risk factors, anticoagulation therapy, and return to play.
Isidora de Andraca
Full Text Available OBJECTIVO: Evaluar el efecto de factores de riesgo para el desarrollo infantil en niños, de nivel socioeconómico bajo, nacidos en óptimas condiciones biológicas pero expuestos a condiciones sociales adversas. METODOLOGÍA: Lactantes de ambos sexos em número de 788, fueron exhaustivamente estudiados en términos de: alimentación, crecimiento, ambiente físico y psicosocial. Se controlaron prospectivamente hasta los 12 meses de edad, momento en que se evaluó el desarrollo mental (MDI y motor (PDI a través de la escala de Bayley. A partir de las variables medidas se identificó 18 factores de riesgo, los que fueron dicotomizados (bajo y alto riesgo. RESULTADOS: Lactancia materna, temperamento del niño, inteligencia materna y estimulación en el hogar se asocian consistentemente con MDI y PDI. Luego de ajustar por covariables, la estimulación en el hogar persiste como factor significativo en la explicación de la variabilidad del MDI y PDI, en tanto que el sexo del niño se consolida como factor condicionante del desarrollo motor. El efecto acumulado de 7 o más factores de riesgo se asocia con una disminución significativa de los puntajes de desarrollo. La combinación de categorías de riesgo de temperamento infantil, inteligencia materna, rol del padre y estimulación en el hogar alcanza mejor predicción del desarrollo infantil que otras combinaciones puestas a prueba en este estudio. CONCLUSIONE: Se concluye que, aún en niños biológicamente indemnes, el desarrollo psicomotor se afecta negativamente ante la presencia de condiciones ambientales adversas que actúan simultáneamente.OBJETIVO: Avaliar o efeito dos fatores de risco para o desenvolvimento infantil em crianças de n��vel socioeconômico baixo, nascidos em ótimas condições biológicas, mas expostos a condições sociais adversas. METODOLOGIA: Lactentes dos dois sexos, no total de 788, foram exaustivamente estudados quanto a alimentação, crescimento, ambiente f
We examine monetary policy options for a small open economy where sovereign default might occur due to intertemporal insolvency. Under interest rate policy and floating exchange rates the equilibrium is indetermined. Under a fixed exchange rate the equilibrium is uniquely determined and independent of sovereign default.
Familial risk factors are known to play an important role in colorectal cancer (CRC) risk, particularly when the relatives are affected by early-onset cancer. Part of this familial aggregation can be accounted for by inherited forms of colorectal cancer, i.e. familial adenomatous polyposis (less than 1% of all CRC) and hereditary nonpolyposis colorectal cancer (about 3%). Other genetic factors may be involved in the development of adenoma or in the transformation of adenoma into carcinoma. That the existence of polymorphisms of the adenomatous polyposis coli gene increase susceptibility to both adenomas and cancer favours this hypothesis. Interactions between environmental factors, and most of all dietary factors, and polymorphisms of carcinogen-metabolizing enzymes may also be involved. Better knowledge of these mechanisms will substantially widen the scope of colorectal cancer prevention.
E. A. Epanchintseva
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
Kröger, K; Buss, C; Goyen, M; Renzing-Köhler, K; Rudofsky, G
Risk factors and especially the combination of multiple risk factors are associated with the development of atherosclerosis. Therefore, patients with an early manifestation of atherosclerotic disease are likely to show an extraordinary risk profile. We analysed the frequencies and severity of risk factors in young patients with manifest peripheral arterial occlusive disease as compared to old patients. We analysed the risk profiles in 303 patients who were sent for interventional treatment of a symptomatic peripheral arterial occlusive disease. The risk profiles were described for different age groups (54 patients under 50 years of age, 194 patients from 51 to 74 years, 55 patients over 75 years). Multiple linear regression analysis and analysis of variance were performed to look for age-dependent effects. Elevated total cholesterol, and triglyceride levels and nicotine abuse were more frequent in patients younger than 50 years. Diabetes mellitus and hypertension were more frequent in patients older than 75 years. The different frequencies for smoking, diabetes mellitus and hypertension were age-related (phematocrit and uric acid. The coincidence with clinically manifest myocardial infarction was 11.15% in the patients under 50 years compared to 20.6% in those aged 51-74 years and 16.4% in those over 75 years, for cerebral stroke it was 5.6%, 17.5% and 14.5%, respectively. Patients under 50 years with peripheral arterial occlusive disease and a history of myocardial infarction were characterised by high levels of total cholesterol, triglyceride and lipoprotein(a). Excluding patients with prior myocardial infarction patients did not show any difference in risk profile between the three age groups. In a population suffering from manifest peripheral arterial occlusive disease the risk profile in patients under 50 years is not different from that in older patients. In contrast an additional myocardial infarction in such a population is associated with pathological
A study was done to identify social, economic, and childhood characteristics of high and low achieving children living in adverse environmental conditions, and to test the association between achievement and specific risk and protective factors. In addition, the study identified the most powerful model for predicting achievement by comparing…
Ghaedrahmati, Maryam; Kazemi, Ashraf; Kheirabadi, Gholamreza; Ebrahimi, Amrollah; Bahrami, Masood
Postpartum depression is a debilitating mental disorder with a high prevalence. The aim of this study was review of the related studies. In this narrative review, we report studies that investigated risk factors of postpartum depression by searching the database, Scopus, PubMed, ScienceDirect, Uptodate, Proquest in the period 2000-2015 published articles about the factors associated with postpartum depression were assessed in Farsi and English. The search strategy included a combination of ke...
Uppal, H; Chandran, S; Potluri, R
Down syndrome is a genetic condition that contributes to a significantly shorter life expectancy compared with the general population. We investigated the most common comorbidities in a population of acute hospital patients with Down syndrome and further explored what the most common risk factors for mortality are within this population. From our database of one million patients admitted to National Health Service (NHS) Trusts in northern England, we identified 558 people who had Down syndrome. We compared this group with an age- and gender-matched control group of 5580 people. The most prevalent comorbid diseases within the Down's population were hypothyroidism (22.9%) and epilepsy (20.3%). However, the conditions that had the highest relative risks (RRs) in the Down's population were septal defects and dementia. Respiratory failure, dementia and pneumonia were the most significantly related comorbidities to mortality in the Down syndrome population. In the control population, respiratory failure, dementia and renal failure were the most significant disease contributors. When these contributors were analysed using multivariate analysis, heart failure, respiratory failure, pneumonia and epilepsy were the identified risk factors for in-hospital mortality in the Down syndrome population. Respiratory failure was the sole risk factor for mortality in the Down syndrome population [RR = 9.791 (1.6-59.9) P ≤ 0.05], when compared with the risk factors for mortality in the control population. There is significant medical morbidity in Down syndrome. This morbidity contributes to the lower life expectancy. Respiratory failure is a risk factor for mortality in Down syndrome. We need to thoroughly investigate people with Down syndrome to ensure any treatable illnesses are well managed. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Psychological risk factors and personality disorders comorbidities are more frequent than psychological risk factors only or personality disorders only in outpatient cardiology setting without cardiovascular diseases.
Chen, Yangbo; Zhou, Haolan; Zhang, Hui; Du, Guoming; Zhou, Jinhui
In the past decades, China has observed rapid urbanization, the nation's urban population reached 50% in 2000, and is still in steady increase. Rapid urbanization in China has an adverse impact on urban hydrological processes, particularly in increasing the urban flood risks and causing serious urban flooding losses. Urban flooding also increases health risks such as causing epidemic disease break out, polluting drinking water and damaging the living environment. In the highly urbanized area, non-engineering measurement is the main way for managing urban flood risk, such as flood risk warning. There is no mature method and pilot study for urban flood risk warning, the purpose of this study is to propose the urban flood risk warning method for the rapidly urbanized Chinese cities. This paper first presented an urban flood forecasting model, which produces urban flood inundation index for urban flood risk warning. The model has 5 modules. The drainage system and grid dividing module divides the whole city terrain into drainage systems according to its first-order river system, and delineates the drainage system into grids based on the spatial structure with irregular gridding technique; the precipitation assimilation module assimilates precipitation for every grids which is used as the model input, which could either be the radar based precipitation estimation or interpolated one from rain gauges; runoff production module classifies the surface into pervious and impervious surface, and employs different methods to calculate the runoff respectively; surface runoff routing module routes the surface runoff and determines the inundation index. The routing on surface grid is calculated according to the two dimensional shallow water unsteady flow algorithm, the routing on land channel and special channel is calculated according to the one dimensional unsteady flow algorithm. This paper then proposed the urban flood risk warning method that is called DPSIR model based
Full Text Available Fred A English,1 Louise C Kenny,1 Fergus P McCarthy1,2 1Irish Centre for Fetal and Neonatal Translational Research (INFANT, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland; 2Women’s Health Academic Centre, King's Health Partners, St Thomas' Hospital, London, UK Abstract: Preeclampsia, a hypertensive disorder of pregnancy is estimated to complicate 2%–8% of pregnancies and remains a principal cause of maternal and fetal morbidity and mortality. Preeclampsia may present at any gestation but is more commonly encountered in the third trimester. Multiple risk factors have been documented, including: family history, nulliparity, egg donation, diabetes, and obesity. Significant progress has been made in developing tests to predict risk of preeclampsia in pregnancy, but these remain confined to clinical trial settings and center around measuring angiogenic profiles, including placental growth factor or newer tests involving metabolomics. Less progress has been made in developing new treatments and therapeutic targets, and aspirin remains one of the few agents shown to consistently reduce the risk of developing preeclampsia. This review serves to discuss recent advances in risk factor identification, prediction techniques, and management of preeclampsia in antenatal, intrapartum, and postnatal patients. Keywords: pregnancy, treatment, risk reduction, prediction
Alexander J. Ambinder
Full Text Available Follicular lymphoma (FL is an indolent malignancy of germinal center B cells with varied incidence across racial groups and geographic regions. Improvements in the classification of non-Hodgkin lymphoma subtypes provide an opportunity to explore associations between environmental exposures and FL incidence. Our paper found that aspects of Western lifestyle including sedentary lifestyle, obesity, and diets high in meat and milk are associated with an increased risk of FL. Diets rich in fruits and vegetables, polyunsaturated fatty acids, vitamin D, and certain antioxidants are inversely associated with FL risk. A medical history of Sjogren's syndrome, influenza vaccination, and heart disease may be associated with FL incidence. Associations between FL and exposure to pesticides, industrial solvents, hair dyes, and alcohol/tobacco were inconsistent. Genetic risk factors include variants at the 6p21.32 region of the MHC II locus, polymorphisms of the DNA repair gene XRCC3, and UV exposure in individuals with certain polymorphisms of the vitamin D receptor. Increasing our understanding of risk factors for FL must involve integrating epidemiological studies of genetics and exposures to allow for the examination of risk factors and interactions between genes and environment.
Pelsser, A.A.J.; Laeven, R.J.A.
In this paper we develop a framework for optimal investment decisions for insurance companies in the presence of (partially) unhedgeable risk. The perspective that we choose is from an insurance company that maximises the stream of dividends paid to its shareholders. The policy instruments that the
Full Text Available Abstract Background Understanding the factors which determine a household's or individual's risk of malaria infection is important for targeting control interventions at all intensities of transmission. Malaria ecology in Tanzania appears to have reduced over recent years. This study investigated potential risk factors and clustering in face of changing infection dynamics. Methods Household survey data were collected in villages of rural Muheza district. Children aged between six months and thirteen years were tested for presence of malaria parasites using microscopy. A multivariable logistic regression model was constructed to identify significant risk factors for children. Geographical information systems combined with global positioning data and spatial scan statistic analysis were used to identify clusters of malaria. Results Using an insecticide-treated mosquito net of any type proved to be highly protective against malaria (OR 0.75, 95% CI 0.59-0.96. Children aged five to thirteen years were at higher risk of having malaria than those aged under five years (OR 1.71, 95% CI 1.01-2.91. The odds of malaria were less for females when compared to males (OR 0.62, 95% CI 0.39-0.98. Two spatial clusters of significantly increased malaria risk were identified in two out of five villages. Conclusions This study provides evidence that recent declines in malaria transmission and prevalence may shift the age groups at risk of malaria infection to older children. Risk factor analysis provides support for universal coverage and targeting of long-lasting insecticide-treated nets (LLINs to all age groups. Clustering of cases indicates heterogeneity of risk. Improved targeting of LLINs or additional supplementary control interventions to high risk clusters may improve outcomes and efficiency as malaria transmission continues to fall under intensified control.
Brouwers, M.M.; Zanden, L.F.M. van der; Gier, R.P.E. de; Barten, E.J.; Zielhuis, G.A.; Feitz, W.F.J.; Roeleveld, N.
OBJECTIVE: To obtain more insight into the origin of hypospadias by exploring a wide range of potential risk factors in a case-referent study in which a distinction was made between different phenotypes. PATIENTS AND METHODS: Cases and referents were 305 boys with hypospadias and 629 boys with
Breast Cancer Risk and Environmental Factors For millions of women whose lives have been affected by breast cancer, the 1994 discovery of the first breast ... gene by researchers from the National Institute of Environmental Health Sciences (NIEHS) and their collaborators, was a ...
MacPhee, Angela R.; Andrews, Jac J. W.
The purpose of this study was to identify salient risk factors for depression in early adolescence from a group of common predictors. The following nine predictors were examined: (1) perceived quality of peer relationships, (2) perceived parental nurturance, (3) perceived parental rejection, (4) self-esteem, (5) body image, (6) pubertal status,…
Sol-de Rijk, B.G.M.
Summary The aim of this thesis was to provide insight into the potential of a self-management approach in treatment of vascular risk factors and to develop a self-management intervention. Furthermore to examine if this intervention, based on self-efficacy promoting theory, is effective in reducing
Garassini, M E; Pulgar, Y; Alvarado, M; Garassini, M A
To establish the risk factors to hepatitis C virus (HCV) infection, we studied 120 patients divided in 2 groups: A first group of 40 patients with HCV infection, 24 (60%) with past medical history of blood transfusion, 14 (35%) of them also had hemodialysis and 3 Kidney transplant. 10 patients (25%) had mayor surgery without transfusion, 3 had frequent visits to the dentist and 3 month baby whose mother was HCV positive. In 4 patients we found no risk factors. A second group of 80 patients who visit our clinic for the first time, 2 were found positive for HCV (1.6%). 13 of them had blood transfusion, one was HCV+ (OR: 5.5, P = 0.73). 41 had history of mayor surgery, one HCV+ (OR: 0.95, P = 1.000). The risk factors related to HCV infection in our population were blood transfusion, hemodialysis and mayor surgery. The use of EV drugs, tatoos, sexual behavior, interfamiliar or vertical transmission were not risk factor in our population.
The chapters of Part I of the thesis describe the development of techniques that can be used in the assessment of risk factors for the development of diabetes mellitus (DM) in cats. The hyperglycemic glucose clamp (HGC) was developed for use in conscious cats, equipped with arterial catheters for
Lee, Shawna J.; Guterman, Neil B.; Lee, Yookyong
Objective: This study uses the developmental-ecological framework to examine a comprehensive set of paternal factors hypothesized to be linked to risk for paternal child abuse (PCA) among a diverse sample of fathers. Attention was given to fathers' marital status and their race/ethnicity (White, African American, and Hispanic). Methods: Interviews…
Evidence is accumulating that lifestyle factors influence the incidence of fatal and non-fatal cardiovascular diseases (CVD). A healthy diet, being physically active, moderate alcohol consumption and not smoking are associated with a lower CVD risk. In
Frederiksen, Thomas Winther; Ramlau-Hansen, Cecilia Høst; Stokholm, Zara Ann
The objective of this study was to evaluate the influence of atherogenic risk factors on hearing thresholds. In a cross-sectional study we analyzed data from a Danish survey in 2009-2010 on physical and psychological working conditions. The study included 576 white- and blue-collar workers from c...
Kuehl, L.K.; Penninx, B.W.J.H.; Otte, C.
Major depression is an independent risk factor for the development of cardiovascular disease. In patients with existing cardiovascular disease, major depression has a large impact on the quality of life and is associated with a poor course and prognosis. Potential mechanisms responsible for this
East and Central African Journal of Surgery ... Genetics, obesity, smoking, and alcohol consumption are among the known risk factors for this deadly cancer. ... Methods: A case-control study where volunteer adult patients aged 18 and above with diagnosis of oesophageal cancer (cases) and non-esophageal cancer ...
Heuvel, S. van den
It has been known for some time that risk factors in the workplace can have a negative effect on health. Ramazzini was one of the first scientists to identify occupational health hazards. He wrote about diseases of the musculoskeletal system caused by sudden and irregular movements and the adoption
Abstract This study has been conducted to determine the possible risk factors of autism. This case control study was conducted at pediatric hospital, Ain Shams University on, 100 autistic patients who were subjected to the followings tools: Confirmation of diagnosis using DSM-IV-TR criteria,. IQ assessment using ...
Villa-Manzano, Alberto Iram; Robles-Romero, Miguel Angel; Gutiérrez-Román, Elsa Armida; Martínez-Arriaga, María Guadalupe; Valadez-Toscano, Francisco Javier; Cabrera-Pivaral, Carlos E
A better understanding of risk factors for suicide in general population is crucial for the design of suicide prevention programs. Our objective was to identify personal and family risk factors in suicide attempters. Case-control design. We searched in patients with an acute intoxication, those subjects with and intoxication attributable to suicide attempt. These patients were matched with controls by gender and the date of intoxication. We use a structured questionnaire to identify personal characteristics, family features and network support. Odds ratio (OR) and 95 % confidence interval were obtained. 25 cases and 25 controls were evaluated. The risk factors associated with suicide attempt adjusted by age, were being a student and smoking habits. Family violence background showed OR = 3.8 (IC 95 % = 1.1-13), family disintegration a OR = 8.5 (IC 95 % = 2.1-35), critical events background OR = 8.8 (IC 95 % = 2.1-36), poor self-esteem OR = 8.2 (IC 95 % 2-35), depression OR = 22 (IC 95 % = 3-190), anxiety OR = 9 (IC 95 % = 2-47), family dysfunction OR = 25 (IC 95 % = 4-151). The principal risk factor for suicide attempt was family dysfunction and psychological traits.
Ni Luh Putu Maharani
Full Text Available Background An estimated 6 of 1,000 children with live births suffer from permanent hearing loss at birth or the neonatal period. At least 90% of cases occur in developing countries. Hearing loss should be diagnosed as early as possible so that intervention can be done before the age of 6 months. Objective To determine risk factors for hearing loss in neonates. Methods We performed a case-control study involving 100 neonates with and without hearing loss who were born at Sanglah Hospital, Denpasar from November 2012 to February 2013. Subjects were consisted of 2 groups, those with hearing loss (case group of 50 subjects and without hearing loss (control group of 50 subjects. The groups were matched for gender and birth weight. We assessed the following risk factors for hearing loss: severe neonatal asphyxia, hyperbilirubinemia, meningitis, history of aminoglycoside therapy, and mechanical ventilation by Chi-square analysis. The results were presented as odds ratio and its corresponding 95% confidence intervals. Results Seventy percent of neonates with hearing loss had history of aminoglycoside therapy. Multivariable analysis revealed that aminoglycoside therapy of 14 days or more was a significant risk factor for hearing loss (OR 2.7; 95%CI 1.1 to 6.8; P=0.040. There were no statistically significant associations between hearing loss and severe asphyxia, hyperbilirubinemia, meningitis, or mechanical ventilation. Conclusion Aminoglycoside therapy for >=14 days was identified as a risk factor for hearing loss in neonates.
Lagerlund, Magdalena; Hvidberg, Line; Hajdarevic, Senada
was generally seen with increasing age in both countries, but deviating patterns were seen for alcohol intake, red/processed meat, obesity and age 70+. Conclusions: This study supports findings from other European studies that generally demonstrate modest public awareness of many established cancer risk factors...
Boelens, C.; Hekman, E. E. G.; Verkerke, G. J.
OBJECTIVE: Fall prevention is a major issue in the ageing society. This study provides an overview of all risk factors for falls of older citizens. METHOD: A literature search was conducted to retrieve studies of the past 25 years. All participants from the studies lived in the community or
... having TS. The causes of TS and other tic disorders are not well understood. Although the risk factors ... Psychiatry. 2017; 74(7): 740-746. Related Links Attention-Deficit/Hyperactivity Disorder (ADHD) Child Development Positive Parenting Tips A-Z ...
Chung, Sung Suk; Joung, Kyoung Hwa
Many students in Korea begin to use tobacco and develop a regular smoking habit before they reach adulthood. Yet, little is known about various signs contributing to the transition of the student smoking behaviors. This study used a national sample to explore and compare risk factors for smoking behaviors. Three types of smoking behaviors were…
van Wijk, N. Ph. L.; de Bruijn, J. G. M.
One out of three people (25% of men, 38% of women) in Curacao have experienced some form of domestic violence at some point in their adult lives. The most significant risk factors for domestic violence in Curacao are the female gender, a young age, low education, and experiencing domestic violence victimization in childhood. Divorce, single…
Stice, Eric; Ng, Janet; Shaw, Heather
Prospective studies have identified factors that increase risk for eating pathology onset, including perceived pressure for thinness, thin-ideal internalization, body dissatisfaction, dietary restraint, and negative affect. Research also suggests that body dissatisfaction and dietary restraint may constitute prodromal stages of the development of…
Background Evidence is accumulating that lifestyle factors influence the incidence of fatal and non-fatal cardiovascular diseases (CVD). A healthy diet, being physically active, moderate alcohol consumption and not smoking are associated with a lower CVD risk. In addition to
infant weighing 4 000 g or more in a black population. Identifiable maternal risk factors included a ... of the high perinatal mortality and morbidity rates, as well as maternal morbidity, are discussed. S Afr Med J 1995; 85: 43-46. Little attention has been paid to fetal macrosomia in black. African populations, despite the fact that ...
and Gram-positive bacteria. KEY WORDS: Antenatal women, antibiotic resistance, asymptomatic bacteriuria, prevalence, risk factors. INTRODUCTION. Urinary tract infection (UTI) during pregnancy is classified as either symptomatic or asymptomatic. Symptomatic UTI are divided into lower tract (acute cystitis) and upper ...
Iribarren B, Osvaldo; Aranda T, Jacquelin; Dorn H, Lilian; Ferrada M, Mónica; Ugarte E, Héctor; Koscina M, Vinka; López R, Daniel; Morel F, Mauro
to identify lethality and mortality rates and, mortality risk factors in ventilator associated pneumonia (VAP) on 114 patients treated between 2000 and 2007. Twenty five risk factors were analyzed, emphasizing age, gender, APACHE score, associated diseases, hypotension at intake, coma, hospitalization time, length of time of ventilation, emergency intubation, reintubation, previous antibiotics, and resistant microrganisms. Lethality was 25.4 %, and mortality was 2.4 %. Association between lethality, and APACHE score was found (p: 0.04). Critical APACHE value was 22. Also, in early pneumonia, association between lethality and nasogastric tube (p: 0.01, I.C. 95 % 1.39 - 6.35) was found. No association with late pneumonia was found among mortality and clinical practices. Death's RR (relative risk) increase in following values with: previous neurological disease 2.7 (p: 0.15, IC 95 % 1.15 - 6.5), neurological comaRR 2 (p: 0.2, IC 95 % 0.54 - 7.53). Nevertheless, at multivariate analysis no mortality risk factors were identified. Fair association with time in ICU (p: 0.051 IC 95 % 0.99 - 1.17) and, male sex (p: 0.051, IC 95 % 0.99 - 6.72) was found. We observed multiple factors associated to mortality in VAP: use of nasogastric catheter, longer stay in ICU and male sex.
Risk factors associated with oesophageal malignancy among Ethiopian patients: a case control study. ... The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like more information about how to print, save, ...
Jul 26, 2016 ... Abstract Background: Osteoporosis is a bone disease that combines both a decrease in bone den- sity and its internal architecture changes. Nutrition is one of the major determinants of osteoporo- sis. Aim: The purpose of our study was to identify nutritional risk factors of osteoporosis of two groups of ...
Background: Osteoporosis is a bone disease that combines both a decrease in bone density and its internal architecture changes. Nutrition is one of the major determinants of osteoporosis. Aim: The purpose of our study was to identify nutritional risk factors of osteoporosis of two groups of osteoporotic women and ...
Apr 4, 2003 ... Objective: To review risk factors for stroke and the use of echocardiography in its diagnosis. ... embolism(5,18). Intra-cardiac thrombosis: This occurs in the setting of post myocardial infarction particularly in the anterior cardiac area (19). AC with INR .... of left ventricular thrombi in patients with acute anterior.
David, A.; Kipp, J.M.
This paper reports that with the increasing internationalization of the petroleum industry, lenders to the industry must understand and overcome several new credit risk factors. As a result, new financial products are now available to reserve-based borrowers. Traditional project financing now also may include futures hedging, swaps, and collar elements
van Wijk, N.Ph.L.; de Bruijn, J.G.M.
One out of three people (25% of men, 38% of women) in Curacao have experienced some form of domestic violence at some point in their adult lives. The most significant risk factors for domestic violence in Curacao are the female gender, a young age, low education, and experiencing domestic violence
Allan, G Michael; Nouri, Faeze; Korownyk, Christina; Kolber, Michael R; Vandermeer, Ben; McCormack, James
Risk estimates for the same patient can vary substantially among cardiovascular risk calculators and the reasons are not fully explained. We compared the relative risk increases for consistent risk factors changes across different cardiovascular risk calculators. Five clinicians independently selected 16 calculators providing absolute risk estimations. Hypothetical patients were generated using a combination of seven risk factors [age, gender, smoking, blood pressure, high-density lipoprotein (HDL), total cholesterol and diabetes] dichotomized to high and low risk, generating 2(7) patients (128 total). Relative risk increases due to specific risk factors were determined and compared. The 16 selected calculators were from six countries, used 5- and 10-year predictions, and estimated CVD or coronary heart disease risk. Across the different calculators for non-diabetic patients, changing age from 50 to 70 produced average relative risk increases from 82 to 395%, gender (female to male) 35-225%, smoking status 31-118%, systolic blood pressure (120-160 mmHg) 16-124%, total cholesterol (4-7 mmol/L) 51-302% and HDL (1.3-0.8 mmol/L) 27-133%. Similar results were found among diabetic patients. Some calculators appeared to have consistently higher relative risk increases over multiple risk factors. Cardiovascular risk calculators weigh the same risk factors differently. For each risk factor, the relative risk increase from the calculator with the highest increase was generally three to eight times greater than the relative risk increase from the calculator with lowest increase. This likely contributes to some of the inconsistency in risk calculator estimation. It also limits the use of risk calculators in estimating the benefits of therapy.
Xu, Ling-Fan; Liang, Chao-Zhao; Lipianskaya, Julia; Chen, Xian-Guo; Fan, Song; Zhang, Li; Zhou, Jun; Tai, Sheng; Jiang, Chang-Qin
This case-controlled study was designed to evaluate the association between various baseline parental factors and the risk of hypospadias in China. Patients were selected from tertiary referral hospitals in Anhui, a province in mid-eastern China. A questionnaire was given to the parents of each patient. The final database included 193 cases and 835 controls. The incidence of additional coexistent anomalies was 13.0%, primarily cryptorchidism (9.8%). Ten patients (5.1%) were from families with genital anomaly, including five families (2.6%) with hypospadias. The risks of hypospadias was higher for children of mothers > 35 (odds ratio [OR] =1.47) and hypospadias was also higher when mothers (OR = 1.68) and fathers (OR = 1.74) were engaged in agriculture. Other factors assessed were not associated with the risk of hypospadias. PMID:24875823
Østerlund, Anna H; Lander, Flemming; Nielsen, Kent
2.7, 95% CI 1.9-3.9), being distracted by someone (OR 3.1, 95% CI 2.3-4.1), non-routine task (OR 8.2, 95% CI 5.3-12.5), altered surroundings (OR 20.9, 95% CI 12.2-35.8), and broken machinery or materials (OR 20.6, 95% CI 13.5-31.7). The risk of occupational injury did not vary substantially....... In particular, equipment (broken machinery or materials) and work-practice-related factors (non-routine task and altered surroundings) increased the risk of an occupational injury. Elaboration of results in relation to hazard period and information bias is warranted....... risk factors (time pressure, disagreement with someone, feeling sick, being distracted by someone, non-routine task, altered surroundings, and broken machinery and materials) for occupational injuries. In the study, 1693 patients with occupational injuries were recruited from a total of 4002...
Skaaby, Tea; Thuesen, Betina H.; Linneberg, Allan
Observational studies have suggested a possible protective role of vitamin D on the cardiovascular system. The available evidence does not support either cardiovascular benefits or harms of vitamin D supplementation. This chapter provides an overview and discussion of the current knowledge...... of vitamin D effects from a cardiovascular health perspective. It focuses on vitamin D in relation to cardiovascular disease, i.e. ischemic heart disease, and stroke; the traditional cardiovascular risk factors hypertension, abnormal blood lipids, obesity; and the emerging risk factors hyperparathyroidism......, microalbuminuria, chronic obstructive pulmonary diseases, and non-alcoholic fatty liver disease. Meta-analyses of observational studies have largely found vitamin D levels to be inversely associated with cardiovascular risk and disease. However, Mendelian randomization studies and randomized, controlled trials...
Xiong, Y; Xia, H X; Wang, Y S; Lin, X L; Zhu, T T; Zhao, Y; Li, X T
Objective: To explore the high risk factors of stillbirth. Methods: 176 cases of stillbirth were collected in the Obstetrics and Gynecology Hospital of Fudan University from January 1(st), 2010 to December 31(st), 2016. All cases were analyzed retrospectively, including general profile, high risk factors of stillbirth in different years and pregnancy periods. Results: (1) The incidence of stillbirth was 0.178%(176/98 785). Stillbirth occured mostly at 28-28(+6) gestational weeks (10.8%,19/176), and the second peak was 29-29(+6) weeks(10.2%,18/176), while the third common period was 37-37(+6) weeks (9.1%,16/176). After 39 weeks, it maintained at a low level. (2) The top 5 high risk factors of stillbirth were infection (18.2%,32/176), unexplained (13.6%,24/176), hypertention disorders in pregnancy (13.1%, 23/176), umbilical cord torsion (12.5%, 22/176) and fetal malformations (10.2%, 18/176). (3) From 2010 to 2012, the top 3 high risk factors were unexplained, the umbilical cord torsion and infection, while hypertention in pregnancy, infection and fetal malformation became the top 3 high risk factors after 2013. (4) Early stillbirth (20-27(+6) weeks) accounted for 21.6%(38/176); and unexplained (47.4%, 18/38), fetal edema (13.2%, 5/38),infection (13.2%, 5/38), umbilical cord torsion (5.3%, 2/38) were the top 4 high risk factors. Late stillbirth (≥28 weeks) accounted for 78.4%(138/176), with infection (19.6%,27/138), hypertention in pregnancy (15.9%,22/138), umbilical cord torsion (14.5%,20/138) and fetal malformation(12.3%,17/138)being the top 4 high risk factors. Conclusions: More attention should be paid to maternal complications, especially infection and hypertension in pregnancy. Antenatal fetal monitoring, timely termination of pregnancy, standard management of stillbirth and looking for the causes may help reduce the incidence of stillbirth.
Christina A Brook
Full Text Available Christina A Brook, Louis A SchmidtDepartment of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, CanadaAbstract: Social anxiety disorder (SAD is a debilitating and chronic illness characterized by persistent fear of one or more social or performance situations, with a relatively high lifetime prevalence of 7% to 13% in the general population. Although the last two decades have witnessed enormous growth in the study of biological and dispositional factors underlying SAD, comparatively little attention has been directed towards environmental factors in SAD, even though there has been much ongoing work in the area. In this paper, we provide a recent review and critique of proposed environmental risk factors for SAD, focusing on traditional as well as some understudied and overlooked environmental risk factors: parenting and family environment, adverse life events, cultural and societal factors, and gender roles. We also discuss the need for research design improvements and considerations for future directions.
Gawde, Nilesh Chandrakant; Kurlikar, Prashika R
Non-communicable diseases have emerged as a global health issue. Role of occupation in pathogenesis of non-communicable diseases has not been explored much especially in the hospitality industry. Objectives of this study include finding risk factor prevalence among hotel workers and studying relationship between occupational group and chronic disease risk factors chiefly high body mass index. A cross-sectional study was conducted among non-managerial employees from classified hotels in India. The study participants self-administered pre-designed pilot-tested questionnaires. The risk factor prevalence rates were expressed as percentages. Chi-square test was used for bi-variate analysis. Overweight was chosen as 'outcome' variable of interest and binary multi-logistic regression analysis was used to identify determinants. The prevalence rates of tobacco use, alcohol use, inadequate physical activity and inadequate intake of fruits and vegetables were 32%, 49%, 24% and 92% respectively among hotel employees. Tobacco use was significantly common among those in food preparation and service, alcohol use among those in food service and security and leisure time physical activity among front office workers. More than two-fifths (42.7%) were overweight. Among the hotel workers, those employed in food preparation and security had higher odds of 1.650 (CI: 1.025 - 2.655) and 3.245 (CI: 1.296 - 8.129) respectively of being overweight. Prevalence of chronic disease risk factors is high among hotel workers. Risk of overweight is significantly high in food preparation and security departments and workplace interventions are necessary to address these risks.
Gawde, Nilesh Chandrakant; Kurlikar, Prashika R.
Context: Non-communicable diseases have emerged as a global health issue. Role of occupation in pathogenesis of non-communicable diseases has not been explored much especially in the hospitality industry. Aims: Objectives of this study include finding risk factor prevalence among hotel workers and studying relationship between occupational group and chronic disease risk factors chiefly high body mass index. Settings and Design: A cross-sectional study was conducted among non-managerial employees from classified hotels in India. Materials and Methods: The study participants self-administered pre-designed pilot-tested questionnaires. Statistical analysis used: The risk factor prevalence rates were expressed as percentages. Chi-square test was used for bi-variate analysis. Overweight was chosen as ‘outcome’ variable of interest and binary multi-logistic regression analysis was used to identify determinants. Results: The prevalence rates of tobacco use, alcohol use, inadequate physical activity and inadequate intake of fruits and vegetables were 32%, 49%, 24% and 92% respectively among hotel employees. Tobacco use was significantly common among those in food preparation and service, alcohol use among those in food service and security and leisure time physical activity among front office workers. More than two-fifths (42.7%) were overweight. Among the hotel workers, those employed in food preparation and security had higher odds of 1.650 (CI: 1.025 – 2.655) and 3.245 (CI: 1.296 – 8.129) respectively of being overweight. Conclusions: Prevalence of chronic disease risk factors is high among hotel workers. Risk of overweight is significantly high in food preparation and security departments and workplace interventions are necessary to address these risks PMID:27390474
Elshatarat, Rami Azmi; Burgel, Barbara J
In the United States (U.S.), cardiovascular disease (CVD) is a major leading cause of death. Despite the high mortality rate related to CVD, little is known about CVD risk factors among urban taxi drivers in the U.S. A cross-sectional design was used to identify the predictors of high cardiovascular risk factors among taxi drivers. Convenience sampling method was used to recruit 130 taxi drivers. A structured questionnaire was used to obtain the data. The sample was male (94 %), age mean (45 ± 10.75) years, married (54 %), born outside of the USA (55 %), had some college or below (61.5 %), night drivers (50.8 %), and driving on average 9.7 years and 41 h/week. About 79 % of them were eligible for CVD prevention, and 35.4 % had high CVD risk factors (4-9 risk factors). A CVD high-risk profile had a significant relationship with the subjects who were ≥55 years old; had hypertension, diabetes, or hyperlipidemia; were drinking alcohol ≥2 times/week; and had insufficient physical activity. Subjects who worked as a taxi driver for more than 10 years (OR 4.37; 95 % CI 1.82, 10.50) and had mental exertion from cab driving >5 out of 10 (OR 2.63; 95 % CI 1.05, 6.57) were more likely to have a CVD high-risk profile. As a conclusion, system-level or worksite interventions include offering healthy food at taxi dispatching locations, creating a work culture of frequent walking breaks, and interventions focusing on smoking, physical activity, and weight management. Improving health insurance coverage for this group of workers is recommended.
Babar, Tariq Farooq; Zaman, Mir; Khan, Mohammad Naeem; Khan, Mohammad Daud
To estimate the frequency and major risk factors of preseptal and orbital cellulitis. A cross-sectional analytical study. The Khyber Institute of Ophthalmic Medical Sciences, Hayatabad Medical Complex, Peshawar from July 2003 to December 2006. All consecutive patients between ages 6 and 40 years, admitted to the institute with the diagnosis of preseptal and orbital cellulitis were included in the study. The patients were divided into two groups. Group I included patients with ages 6-16 years and group II with ages 17-40 years. The clinical features, diagnosis and risk factors were entered on a specially-designed proforma. The risk factors included were trauma, insect bite, localized or systemic infection and postsurgical. Odd ratio and p-values were calculated for potential risk factors. The frequency of orbital cellulitis was 0.1% of total admission. Out of 26 patients, 42.30% patients were in group I and 57 in group II. In group I, insect bite was the most common risk factor identified in 40% of patients with preseptal cellulitis and trauma as a common cause in 50% with orbital cellulitis. In group II, trauma was the leading cause in 50% of patients with preseptal cellulitis and sinusitis as a common cause in 18.1% with those of orbital cellulitis. In both groups the p-values were found insignificant (p>0.5). Complications included cicatricial ectropion in 44.4% and orbital abscess in 41.1%. For preseptal cellulitis, insect bite was the most common cause in group I and trauma was the leading cause in group II. For orbital cellulitis, trauma was important cause in group I and sinusitis in group II.
G. Carson, Charlotte
for developing AD at 3 years of age. Our data suggested a strong heredity of AD and confirmed the risk associated with the non-functional FLG allele mutations after adjustments for confounders. Besides this mother's dermatitis and father's allergic rhinitis were found to increase the risk of AD. Perinatal...... exposure to dog was the only environmental exposure that significantly reduced the disease manifestation, suggesting other, yet unknown environmental factors affecting the increasing prevalence of AD in children. Length at birth was shown to be inversely associated with the risk of later developing AD......-up period (HR 1.44, 95% CI 1.05-1.99, p=0.024). The increased risk was still significant after confounder adjustment for mother's education, AD and smoking habits during the 3rd trimester. There was no association between alcohol intake during pregnancy and other atopic endpoints (wheeze episodes, asthma...
G. Carson, Charlotte
-up period (HR 1.44, 95% CI 1.05-1.99, p=0.024). The increased risk was still significant after confounder adjustment for mother's education, AD and smoking habits during the 3rd trimester. There was no association between alcohol intake during pregnancy and other atopic endpoints (wheeze episodes, asthma......The aim of this thesis was to investigate possible risk factors affecting the development of AD. AD is a frequent disease among children and has a substantial impact on the lives of both the child and its family. A better understanding of the disease would enable better treatment, prevention...... for developing AD at 3 years of age. Our data suggested a strong heredity of AD and confirmed the risk associated with the non-functional FLG allele mutations after adjustments for confounders. Besides this mother's dermatitis and father's allergic rhinitis were found to increase the risk of AD. Perinatal...
Thomsen, Christoffer; Starkopf, Liis; Hastrup, Lene Halling
PURPOSE: Reducing the use of coercion among patients with mental disorders has long been a political priority. However, risk factors for coercive measures have primarily been investigated in smaller studies. To reduce the use of coercion, it is crucial to identify people at risk which we aim to do...... in this first large-scale study. METHODS: A cohort study was conducted among all psychiatric inpatients in Denmark, following 112,233 individuals during 1999-2014. Data from Danish registers were analysed using logistic regression for repeated measures. RESULTS: 24,594 inpatients were exposed to a coercive...... measure (21.9%). Clinical characteristics were the foremost predictors of coercion and patients with organic mental disorder had the highest increased risk of being subjected to a coercive measure (OR = 5.56; 95% CI = 5.04, 6.14). The risk of coercion was the highest in the first admission and decreased...
Pasian, M. S.
Full Text Available Studies on young people who live in restricted areas under liberty deprivation are relevant to improve educational measures and put them into effect, once education is a way of achieving a positive reintegration of young institutionalized people into society. This paper starts describing and discussing national articles, selected from SciELO and LILACS databases, focusing on education inside restricted areas with liberty deprivation, specifically addressing young population. Then, the paper discusses child abuse, learning disabilities and behavior problems, all issues related to risk factors that may lead to children and adolescent’s conduct impairment, being, many times, the cause and/or reinforcement of violent behavior and delinquency. This research found that there is a considerable shortage of articles on education of young people living under liberty deprivation in Brazil. The analyzed national publications reflect, as well as authors from other countries, that many young offenders have experienced abuse and/or parental neglect during their childhood, have exhibited behavior problems and/or learning disabilities. Estudos sobre os jovens em espaços de restrição e privação de liberdade são relevantes para que medidas educacionais sejam efetivadas e aprimoradas, sendo que a educação é um meio de acesso à reintegração do jovem institucionalizado na sociedade de forma positiva. O presente trabalho primeiramente descreve e discute, através de uma busca nas bases de dados SciELO e LILACS, artigos nacionais produzidos no campo da educação em espaços de restrição e privação de liberdade, especificamente referente à população jovem. Em um segundo momento o artigo discute sobre maus-tratos infantis, dificuldades de aprendizagem e problemas de comportamento, os quais são temas relacionados a fatores de risco que podem levar ao comprometimento da conduta da criança e do adolescente, sendo, por vezes, causadores e/ou refor
Full Text Available As for the research into this subject, we find, therefore, that one of the most important indicators that quantify the international competitiveness is the exchange rate, together with other fundamental macroeconomic variables such as the size of the potential GDP, the equilibrium real exchange rate, gives a certain insight into the functioning of the fundamental macroeconomic mechanisms and their regulation. Commercial and financial operations imply relationships between partners from different currency countries or areas that involve conversion operations, of replacement of a currency to another. Exchange rate fluctuations of one currency create currency risk, to the extent that it is used to carry out international transactions. These operations are subjected to currency risk as exchange rates change frequently from one period to another and, on the other hand, speculations in the forex market influence the exchange rate by the interventions of those who perform them.
In a context of concurrence and emergence of energy markets, the production of electricity is affected by the new sources of risks which are the price variations on the energy markets. These new sources of risks generate a new risk: the market risk. In this research, the author explores the possibility of introducing constraints, expressed by measurements of risk, into the process of optimization of electricity production when financial contracts are signed on the energy market. The author makes the distinction between the engineering approach (taking the risk into account by risk measurements) and the economist approach (taking the risk into account by utility functions). After an overview of these both approaches in a static framework, he gives an economical formulation (a Maccheroni type one) for a static optimization problem under a risk constraint when the risk measurement is written under the form of an expected infimum like the variance, the 'conditional value at risk', and so on. The obtained results are then extended to a dynamic optimization framework under risk constraints. A numerical application of this approach is presented to solve a problem of electricity production management under a constraint of 'conditional value at risk' on a middle term
Full Text Available The article identifies the risks of the economic activity of a factoring company. The identified risks are divided into internal (fraud risk, credit risk, liquidity, nonpayment, staff, supplier's failure to meet the terms of the supply / factoring contract and external (legal, inflation, currency, interest, industry risks, country risk. The cause-effect relationships of the identified risks have been established. The content of information requests of the leading part of the factoring company, as well as the management subsystems (accounting, economic analysis, control and planning, and the direction of information flows between them (to manage the company's internal risks is determined. These proposals contribute to the improvement of accounting and analytical support for risk management of the factoring business, the choice of alternative risk management methods, the impact on their possible consequences, minimizing the negative impact of risks on the financial condition of the company, and establishing the effectiveness of factoring operations under risk.
O'Toole, Timothy E; Conklin, Daniel J; Bhatnagar, Aruni
In this review, we discuss current evidence linking environmental pollutants to cardiovascular disease (CVD). Extensive evidence indicates that environmental factors contribute to CVD risk, incidence, and severity. Migrant studies show that changes in the environment could substantially alter CVD risk in a genetically stable population. Additionally, CVD risk is affected by changes in nutritional and lifestyle choices. Recent studies in the field of environmental cardiology suggest that environmental toxins also influence CVD. Exposure to tobacco smoke is paradigmatic of such environmental risk and is strongly and positively associated with increased cardiovascular morbidity and mortality. In animal models of exposure, tobacco smoke induces endothelial dysfunction and prothrombotic responses and exacerbates atherogenesis and myocardial ischemic injury. Similar mechanism may be engaged by other pollutants or food constituents. Several large population-based studies indicate that exposure to fine or ultrafine particulate air pollution increases CVD morbidity and mortality, and the plausibility of this association is supported by data from animal studies. Exposure to other chemicals such as polyaromatic hydrocarbons, aldehydes, and metals has also been reported to elevate CVD risk by affecting atherogenesis, thrombosis, or blood pressure regulation. Maternal exposure to drugs, toxins, and infection has been linked with cardiac birth defects and premature CVD in later life. Collectively, the data support the notion that chronic environmental stress is an important determinant of CVD risk. Further work is required to assess the magnitude of this risk fully and to delineate specific mechanisms by which environmental toxins affect CVD.
Clark, Alice Jessie; Salo, Paula; Lange, Theis
STUDY OBJECTIVES: Impaired sleep has been linked to increased risk of cardiovascular disease (CVD), but the underlying mechanisms are still unsettled. We sought to determine how onset of impaired sleep affects the risk of established physiological CVD risk factors (i.e., hypertension, diabetes...... of medication for hypertension, diabetes, and dyslipidemia was derived from electronic medical records within 8 years of follow-up. Data on 45,647 participants was structured as two data-cycles to examine the effect of change in sleep (between two waves) on incident CVD events. We applied strict inclusion......, and dyslipidemia). METHODS: In a longitudinal cohort study with 3 survey waves (2000, 2004, 2008) from the Finnish Public Sector study we used repeated information on sleep duration and disturbances to determine onset of impaired sleep. Information on development of CVD risk factors, as indicated by initiation...
Fazel, Seena; Sjöstedt, Gabrielle; Långström, Niklas; Grann, Martin
Sexual offenders constitute a substantial proportion of the older male prison population. Recent research findings, with potential consequences for risk management, indicate that recidivism risk might be lower in older sexual offenders. We followed up all adult male sexual offenders released from prison in Sweden during 1993-1997 (N=1,303) for criminal reconviction for an average of 8.9 years. We studied rates of repeat offending (sexual and any violent) by four age bands (<25, 25-39, 40-54, and 55+years), and examined whether risk factors for recidivism remained stable across age groups. Results showed that recidivism rates decreased significantly in older age bands. In addition, the effect of certain risk factors varied by age band. These findings on recidivism rates in older sexual offenders concur with studies from the United Kingdom, United States, and Canada and may suggest some generalizability in Western settings. Further research is needed to address underlying mechanisms.
Bright, Fiona; Gilbert, John D; Winskog, Calle; Byard, Roger W
An 86-year-old woman was found dead lying on her back on the floor of an unkempt kitchen. She had last been seen four days before. Her dress was pulled up and she was not wearing underpants. The house was noted to be in "disarray" with papers covering most surfaces and the floor. Rubbish was piled up against one of the doors. At autopsy the major findings were of a fractured left neck of femur, fresh pressure areas over her right buttock, Wischnewski spots of the stomach and foci of pancreatic necrosis, in keeping with hypothermia. No significant underlying organic diseases were identified and there was no other evidence of trauma. Death was due to hypothermia complicating immobility from a fractured neck of femur. This case confirms the vulnerability of frail, elderly and socially-isolated individuals to death from hypothermia if a significant illness or injury occurs. Additional risk factors for hypothermia are also illustrated in this case that involve inadequate housing construction with absent insulation and window double glazing. The approach to hypothermic deaths should, therefore, include checking for these features as well as measuring room and environmental temperatures, evaluating the type and quality of heating and the nature of the floor and its coverings, Given the ageing population in many Western countries, increasing social isolation of the elderly, cost of fuel and electricity, and lack of energy efficient housing, this type of death may become an increasingly witnessed occurrence during the colder months of the year. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Fuzzy sets and interval analysis tools to make computations and solve optimisation problems are presented. Fuzzy and interval extensions of Decision Theory criteria for decision-making under parametric uncertainty of prior information (probabilities, payoffs) are developed. An interval probability approach to the mean-value criterion is proposed. (author)
Oral contraceptives (OCs) have been distributed through a community-based distribution (CBD) program in Matamaros, Mexico under the auspices of the Centro pro Orientacion Familiar (COFAC). Family Health International (FHI) has provided technical assistance enabling COFAC to conduct a Reproductive Risk Factors Survey to determine if any substantial group of women were placed at a greater risk of death or serious health damage because of this program than if the program had not existed, and, if so, how might such women be protected. The health of CBD acceptors was compared with that of women accepting OC from other sources and women who had never taken OC, using parameters ranging from anemia to cardiovascular disorders. The objective was to investigate the behavior of women who may have serious contraindications to OC and/or pregnancy. About 500 women were interviewed in their homes by specially trained nurses with a questionnaire supplemented by some simple, objective measurements. For validation, a complete medical history was taken and physical examination given for a subsample in the COFAC clinic. Some 40 separate reproductive health indicators were developed from this data. Findings indicated that the CBD program in Matamoros did not introduce any new source of danger to women of reproductive age. As a generality across the 40 indicators, CBD acceptors were as healthy as acceptors from other sources and were somewhat more likely to have consulted a physician. Current OC users were healthier than never users, after controlling for age and parity. The fact of regular contact with neighborhood promotoras (promoters), backed up by the COFAC medical center, represented an additional source of safety not previously available. The promoters were responsible for promotion of family planning, including sale at a subsidized price of OCs and contraceptive foam, and were trained in the use of a checklist for possible contraindications to OC. The CBD program introduced an
Okuda, Mayumi; Liu, Weiwei; Cisewski, Jodi A; Segura, Luis; Storr, Carla L; Martins, Silvia S
Previous studies demonstrate disparities in health and health services including gambling disorders (GD) among ethnic and racial minority groups. In this review, we summarize studies examining the prevalence of GD across different ethnic and racial minorities. We describe the sociodemographic subgroup variations at heightened risk for GD and factors associated with GD in racial and ethnic minority groups including gambling availability, comorbid substance use, psychiatric conditions, stress, acculturation, and differences in cultural values and cognitions. We found that research of GD among minority groups is scant, and the prevalence of GD among these groups is at a magnitude of concern. Racial and ethnic minority status in it of itself is not a risk factor for GD but may be a proxy for underlying potential risk factors. The need for prevention and treatment programs for different cultural group remains unmet.
Lundbo, Lene Fogt; Benfield, Thomas
Bacterial meningitis is a significant burden of disease and mortality in all age groups worldwide despite the development of effective conjugated vaccines. The pathogenesis of bacterial meningitis is based on complex and incompletely understood host-pathogen interactions. Some of these are pathogen-specific, while some are shared between different bacteria. We searched the database PubMed to identify host risk factors for bacterial meningitis caused by the pathogens Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b, because they are three most common causative bacteria beyond the neonatal period. We describe a number of risk factors; including socioeconomic factors, age, genetic variation of the host and underlying medical conditions associated with increased susceptibility to invasive bacterial infections in both children and adults. As conjugated vaccines are available for these infections, it is of utmost importance to identify high risk patients to be able to prevent invasive disease.
Sallé, G; Cortet, J; Bois, I; Dubès, C; Guyot-Sionest, Q; Larrieu, C; Landrin, V; Majorel, G; Wittreck, S; Woringer, E; Couroucé, A; Guillot, J; Jacquiet, P; Guégnard, F; Blanchard, A; Leblond, A
Intestinal strongyles are the most problematic endoparasites of equids as a result of their wide distribution and the spread of resistant isolates throughout the world. While abundant literature can be found on the extent of anthelmintic resistance across continents, empirical knowledge about associated risk factors is missing. This study brought together results from anthelmintic efficacy testing and risk factor analysis to provide evidence-based guidelines in the field. It involved 688 horses from 39 French horse farms and riding schools to both estimate Faecal Egg Count Reduction (FECR) after anthelmintic treatment and to interview farm and riding school managers about their practices. Risk factors associated with reduced anthelmintic efficacy in equine strongyles were estimated across drugs using a marginal modelling approach. Results demonstrated ivermectin efficacy (96.3% ± 14.5% FECR), the inefficacy of fenbendazole (42.8% ± 33.4% FECR) and an intermediate profile for pyrantel (90.3% ± 19.6% FECR). Risk factor analysis provided support to advocate for FEC-based treatment regimens combined with individual anthelmintic dosage and the enforcement of tighter biosecurity around horse introduction. The combination of these measures resulted in a decreased risk of drug resistance (relative risk of 0.57, p = 0.02). Premises falling under this typology also relied more on their veterinarians suggesting practitionners play an important role in the sustainability of anthelmintic usage. Similarly, drug resistance risk was halved in premises with frequent pasture rotation and with stocking rate below five horses/ha (relative risk of 0.53, p risk factor analysis for anthelmintic resistance in equids. Our findings should guide the implementation of more sustained strongyle management in the field. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Full Text Available Intestinal strongyles are the most problematic endoparasites of equids as a result of their wide distribution and the spread of resistant isolates throughout the world. While abundant literature can be found on the extent of anthelmintic resistance across continents, empirical knowledge about associated risk factors is missing. This study brought together results from anthelmintic efficacy testing and risk factor analysis to provide evidence-based guidelines in the field. It involved 688 horses from 39 French horse farms and riding schools to both estimate Faecal Egg Count Reduction (FECR after anthelmintic treatment and to interview farm and riding school managers about their practices. Risk factors associated with reduced anthelmintic efficacy in equine strongyles were estimated across drugs using a marginal modelling approach. Results demonstrated ivermectin efficacy (96.3%Â Â±Â 14.5% FECR, the inefficacy of fenbendazole (42.8%Â Â±Â 33.4% FECR and an intermediate profile for pyrantel (90.3%Â Â±Â 19.6% FECR. Risk factor analysis provided support to advocate for FEC-based treatment regimens combined with individual anthelmintic dosage and the enforcement of tighter biosecurity around horse introduction. The combination of these measures resulted in a decreased risk of drug resistance (relative risk of 0.57, pÂ =Â 0.02. Premises falling under this typology also relied more on their veterinarians suggesting practitionners play an important role in the sustainability of anthelmintic usage. Similarly, drug resistance risk was halved in premises with frequent pasture rotation and with stocking rate below five horses/ha (relative risk of 0.53, pÂ <Â 0.01. This is the first empirical risk factor analysis for anthelmintic resistance in equids. Our findings should guide the implementation of more sustained strongyle management in the field. Keywords: Horse, Nematode, Anthelmintic resistance, Strongyle, Cyathostomin
Ronco, P.; Zennaro, F.; Torresan, S.; Critto, A.; Santini, M.; Trabucco, A.; Zollo, A. L.; Galluccio, G.; Marcomini, A.
In several regions, but especially in semi-arid areas, raising frequency, duration and intensity of drought events, mainly driven by climate change dynamics, are expected to dramatically reduce the current stocks of freshwater resources, limiting crop development and yield especially where agriculture largely depends on irrigation. The achievement of an affordable and sustainable equilibrium between available water resources and irrigation demand is essentially related to the planning and implementation of evidence-based adaptation strategies and actions. The present study proposed a state-of-the art conceptual framework and computational methodology to assess the potential water scarcity risk, due to changes in climate trends and variability, on irrigated croplands. The model has been tested over the irrigated agriculture of Puglia Region, a semi-arid territory with the largest agricultural production in Southern Italy. The methodology, based on the Regional Risk Assessment (RRA) approach, has been applied within a scenario-based hazard framework. Regional climate projections, under alternative greenhouse gas concentration scenarios (RCP4.5 and RCP8.5) and for two different timeframes, 2021-2050 and 2041-2070 compared to the baseline 1976-2005 period, have been used to drive hydrological simulations of river inflow to the most important reservoirs serving irrigation purposes in Puglia. The novelty of the proposed RRA-based approach does not simply rely on the concept of risk as combination of hazard, exposure and vulnerability, but rather elaborates detailed (scientific and conceptual) framing and computational description of these factors, to produce risk spatial pattern maps and related statistics distinguishing the most critical areas (risk hot spots).. The application supported the identification of the most affected areas (i.e. Capitanata Reclamation Consortia under RCP8.5 2041-2070 scenario), crops (fruit trees and vineyards), and, finally, the vulnerability
Connell, Paul P
Age-related maculopathy (ARM) is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age-related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715\\/HTRA1, demonstrating that environmental and genetic factors are important for the development of ARM suggesting that gene-environment interaction plays an important role in the pathogenesis of this condition.
Soltaninejad, Abdollah; Fathi-Ashtiani, Ali; Ahmadi, Khodabakhsh; Mirsharafoddini, Hediye Sadat; Nikmorad, Alireza; Pilevarzadeh, Motahare
Suicidal behavior is one the most significant mental health problems in the military. Militaries are closed systems that operate in particular situations. Military service is associated with certain stressful conditions. On this basis, there is likely of trauma in the military environment. Measures of suicidal behavior are pathologically complex. A range of biological, psychological, social, and institutional factors are involved in the incidence and prevalence of these behaviors. One of the underlying factors in suicidal behavior is individuals' personality. The study population comprised of the Iranian Armed Forces. To recruit the sample of the research, 1659 soldiers were selected by multistage sampling. Data were collected using the Beck Scale for Suicide Ideation (BSSI) and NEO-Five Factor Inventory. There was a significant positive correlation (r = 0.323) between neuroticism and suicide ideation; however, significant negative correlations existed between three other personality traits --extraversion [r = -0.306], agreeableness [r = -0.227], and conscientiousness [r = -0.271] and suicidal ideation. Unlike neuroticism, extraversion and conscientiousness personality factors could reduce significantly (as much 14% as are predicted) levels of suicidal ideation. Based on these results, neuroticism might increase suicide, but extraversion and conscientiousness personality traits are associated with a reduced risk of suicide.
a counterexample to a classical result in insurance economics where an insurance contract with straight deductible is dominated by a coinsurance contract. Finally, I find that a modified Borch rule characterizes the optimal insurance contract with bilateral risk and ambiguity attitudes and heterogeneity in beliefs....... and ambiguity attitudes interact in nontrivial ways to determine the change of coinsurance demand. I derive sufficient conditions to guarantee that the optimal coinsurance demand is decreasing in wealth. When a non-traded asset is introduced, my model predicts behavior that is inconsistent with the classical...
Broeders, M. J. M.; Verbeek, A. L. M.
Breast cancer is the most common malignancy among women in the Western society. Over the past decades it has become apparent that breast cancer incidence rates are increasing steadily, whereas the mortality rates for breast cancer have remained relatively constant. Information through the media on this rising number of cases has increased breast health awareness but has also introduced anxiety in the female population. This combination of factors has made the need for prevention of breast cancer an urgent matter. Breast cancer does not seem to be a single disease entity. A specific etiologic factor may therefore have more influence on one form may therefore have more influence on one form of breast cancer than another. So far though, as shown in their summary of current knowledge on established and dubious risk factors, no risk factors have been identified that can explain a major part of the incidence. Efforts to identify other ways for primary prevention have also been discouraging, even though breast cancer is one of the most investigated tumours world-wide. Thus, at this point i time, the most important strategy to reduce breast cancer mortality is early detection through individual counselling and organised breast screening programs. The recent isolation of breast cancer susceptibility genes may introduce new ways to reduce the risk of breast cancer in a small subset of women
Davies, Eryl A; Jones, Alyson C
To quantify the incidence of child sexual abuse allegations referred to a forensic examination centre; to identify possible risk factors predisposing children to sexual abuse by measuring their prevalence among the complainant population. The records of children involved in sexual abuse allegations presenting over a 12 month period were reviewed retrospectively. Demographic data such as nature of case, sex, ethnicity, number of previous allegations, assailant relationship, month of presentation, and age were compiled. Potential risk factors such as alcohol or drug use, being 'looked after', physical disability, learning disability, previous consensual sexual intercourse, past psychiatric history, and history of psychiatric support were compiled. Descriptive statistics were calculated. 138 cases were recorded, of which the majority were acute. Epidemiological data demonstrated a higher incidence in females and most complainants were of White British origin. Most of the cases were of first allegations and the assailant relationship was most frequently an acquaintance. The incidence was highest in January. The modal age was 15 years and age distribution was positively skewed. Of the potential risk factors studied, alcohol and drug use was the most prevalent. Prevalence increased with age for the majority of factors studied. Alcohol and drug use may be an area in which preventative strategies would be beneficial. Ethnic minorities may hold a large amount of unreported cases. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Kehlet, Henrik; Jensen, Troels Staehelin; Woolf, Clifford J.
therapy for postoperative pain should be investigated, since the intensity of acute postoperative pain correlates with the risk of developing a persistent pain state. Finally, the role of genetic factors should be studied, since only a proportion of patients with intraoperative nerve damage develop...... chronic pain. Based on information about the molecular mechanisms that affect changes to the peripheral and central nervous system in neuropathic pain, several opportunities exist for multimodal pharmacological intervention. Here, we outline strategies for identification of patients at risk...... and for prevention and possible treatment of this important entity of chronic pain....
M. M. Vysotsky
Full Text Available The review of the literature on the problems of sporadic ovarian cancer details the present views of its disputable risk factors, such as dietary habits, body weight, contraception, and labor, and age of commencing a sexual activity. It discusses the dietary and sexual behavior model that has changed since the Neolithic, as well as the number of menses and ovulations throughout the reproductive peri- od. The works by authors dealing with the impact of smoking and alcohol consumption on the risk of ovarian cancer are analyzed.
Gurewitsch Allen, Edith D
A prior history of delivery complicated by shoulder dystocia confers a 6-fold to nearly 30-fold increased risk of shoulder dystocia recurrence in a subsequent vaginal delivery, with most reported rates between 12% and 17%. Whereas prevention of shoulder dystocia in the general population is neither feasible nor cost-effective, directing intervention efforts at the particular subgroup of women with a prior history of shoulder dystocia has merit. Potentially modifiable risk factors and individualized management strategies that may reduce shoulder dystocia recurrence and its associated significant morbidities are reviewed.
Fatores de risco para internamento por diarréia aguda em menores de dois anos: estudo de caso-controle Risk factors for hospitalization due to acute diarrhea in children under two years old: a case-control study
Lygia Carmen de Moraes Vanderlei
Full Text Available O objetivo deste estudo foi investigar a associação entre determinantes sócio-econômico-demográficos e biológicos e hospitalização por diarréia aguda (DA em menores de dois anos. Utilizou-se estudo tipo caso-controle de base hospitalar no período de maio a outubro de 1997, em hospital pediátrico de nível terciário em Recife, Pernambuco. Os casos (n = 185 foram crianças internadas por DA e os controles (n = 185 foram crianças com doenças ambulatoriais, exceto diarréia, que tinham apresentado a doença nos últimos 15 dias, atendidas no mesmo local e período. Utilizaram-se os programas Epi Info e Stata para a análise dos dados. Foram calculados o odds ratio e os intervalos de confiança de 95% por meio da técnica de regressão logística múltipla, para o controle dos fatores de confusão, considerando um modelo hierarquizado dos fatores de risco. A investigação mediante o modelo proposto mostrou existência de associação entre internamento por DA e piso de terra ou tábua, paridade das mães igual a cinco ou mais filhos, criança menor de seis meses e gravidade dos episódios, que depende da interação entre condições sócio-econômicas desfavoráveis, baixa idade das crianças e episódio diarréico grave.The aim of this study was to investigate the socioeconomic, demographic, and biological determinants of hospitalization due to acute diarrhea (AD in children under two years old. The hospital-based, case-control study was conducted from May to October 1997 in a pediatric hospital in Recife, Pernambuco, Brazil. Cases (n = 185 were children hospitalized due to AD, and controls (n = 185 were children with various diseases (except AD presenting in the previous 15 days in the same area and time period. Data analysis used the Epi Info and Stata software. Odds ratios and 95% confidence intervals were calculated by multiple logistic regression to control confounding factors, considering a hierarchical risk factor model
Brian C. Peach MSN
Full Text Available Objective: To identify factors that predispose older adults to urosepsis and urosepsis-related mortality. Method: A systematic search using PubMed and CINAHL databases. Articles that met inclusion criteria were assessed using the Strengthening the Reporting of OBservational studies in Epidemiology (STROBE criteria and were scored on a 4-point Likert-type scale. Results: A total of 180 articles were identified, and six met inclusion criteria. The presence of an internal urinary catheter was associated with the development of urosepsis and septic shock. Although a number of factors were examined, functional dependency, number of comorbidities, and low serum albumin were associated with mortality across multiple studies included in this review. Discussion: Little scientific evidence is available on urosepsis, its associated risk factors, and those factors associated with urosepsis-related mortality in older adults. More research is warranted to better understand urosepsis in this vulnerable population in an effort to improve the quality of patient care.
Full Text Available Caroline Ingre,1 Per M Roos,2 Fredrik Piehl,1 Freya Kamel,3 Fang Fang4 1Department of Clinical Neuroscience, 2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; 3Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA; 4Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Abstract: Amyotrophic lateral sclerosis (ALS is the most common motor neuron disease. It is typically fatal within 2–5 years of symptom onset. The incidence of ALS is largely uniform across most parts of the world, but an increasing ALS incidence during the last decades has been suggested. Although recent genetic studies have substantially improved our understanding of the causes of ALS, especially familial ALS, an important role of non-genetic factors in ALS is recognized and needs further study. In this review, we briefly discuss several major genetic contributors to ALS identified to date, followed by a more focused discussion on the most commonly examined non-genetic risk factors for ALS. We first review factors related to lifestyle choices, including smoking, intake of antioxidants, physical fitness, body mass index, and physical exercise, followed by factors related to occupational and environmental exposures, including electromagnetic fields, metals, pesticides, β-methylamino-L-alanine, and viral infection. Potential links between ALS and other medical conditions, including head trauma, metabolic diseases, cancer, and inflammatory diseases, are also discussed. Finally, we outline several future directions aiming to more efficiently examine the role of non-genetic risk factors in ALS. Keywords: amyotrophic lateral sclerosis, risk factors, genetics, lifestyle, environment
Bijelic, Radojka; Milicevic, Snjezana; Balaban, Jagoda
Scientific studies show that many factors related to lifestyles affect the reduction of bone mineral density and osteoporosis in postmenopausal women. The goal of this study was to determine whether smoking, drinking coffee and alcohol in menopausal women contribute to the reduction of bone mass and osteoporosis, as well as the impact of physical activity on bone mass. The study was carried out as case study and matched controls. The group of cases consisted of 100 females in postmenopausal age, in which by the DEXA method was newly diagnosed osteoporosis at the Clinic of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center of RS during 2015-2016, while the control group consisted of 100 females in a postmenopausal age without diagnosed osteoporosis. The groups were matched by age (±2 years). In order to collect demographic data and information on risk factors for osteoporosis and lifestyle of patients was used the questionnaire Bone Mineral Density Questionnaire- Female of the Irish Association for osteoporosis. Testing the significance of differences in terms of smoking showed that the studied groups are statistically significantly different in terms of smoking (χ 2 =24.025, p=0.000). In terms of consumption of coffee, a statistically significant difference was found between the group of cases and control group (χ 2 =0.615, p=0.735). When observing the obtained information about the consumption of alcohol, we find that this preventable risk factor in the present study did not show as significant for osteoporosis in postmenopausal women (χ 2 =4.35, p=0.114). Statistical analysis shows that there are significant differences between the group of cases and control group in terms of physical activity (χ 2 =7.30, p=0.026). Analysis of the data of our study by univariate logistic regressions showed that smoking (p=0.000) was statistically significantly associated with osteoporosis, while physical activity is a protective factor for bone mass (p
Linares Fernandez, Tomasa Maria; Correa Lozano, Zoila; Ibarra Fernandez de la Vega, Enrique Jose; Bonet Gorbea Mariano
To identify the relative contribution of different occupational risk factors associated with the occurrence of skin cancer in the provinces of Havana City and Havana, Cuba , in 2006-2007. It was designed a case-control study of hospital base that included 112 cases of non-melanoma skin cancer and 448 witnesses, following the inclusion-exclusion criteria preset. We considered the totality of patients diagnosed with basal cell carcinoma and squamous cell histological study of skin biopsy or surgical excision. Risk factors with possible association with the disease were studied, such as sun exposure, ionizing and non-ionizing radiations and a wide range of chemical and biological substances potentially carcinogenic
Hudson, Stephen M; Wales, David S; Bakker, Leon; Ward, Tony
Risk assessment is an essential part of clinical practice. Each of the three aspects of risk (static, stable, and acute dynamic) are important at various points of contact between the man and the systems that are responsible for providing service. Dynamic factors, the typical treatment and supervision targets, have received less research attention than static factors. This paper examined the extent to which pretreatment, posttreatment and change scores were associated with reoffending among men incarcerated for sexually molesting. The results were generally supportive of change in prooffending attitudes as the key to not reoffending and suggested that the perspective-taking component of empathy and the use of fantasy may be important mechanisms. Affect scales generally failed to show any relationship with reoffending, outside decreases in trait and suppressed anger. Moreover, these data suggest that we could improve our assessments and treatment through increased sensitivity to offense pathways.
Full Text Available Intimate partner violence has kept being one of the major societal issues in our country over the past year. It is absolutely necessary to intervene in this substantially psychological issue multi-directionally. In order to intervene in the problem from psychological aspect, it is important to estimate and interpret the risk factors for intimate partner violence. Therefore in the current study, ‘I-cube theory’ which is about the risk factors for intimate partner violence has been explained first. Afterwards, the findings of content analysis which was obtained from newspaper reports about femicide in 2013 have been shown and these findings have been discussed within the context of I-cube theory, respectively. Finally, solutions to prevent this violence has been suggested.
Jensen, Peter; Thyssen, Jacob P; Zachariae, Claus
Background Epidemiological data have established an association between cardiovascular disease and psoriasis. Only one general population study has so far compared prevalences of cardiovascular risk factors among subjects with psoriasis and control subjects. We aimed to determine the prevalence...... of cardiovascular risk factors in subjects with and without psoriasis in the general population. Methods During 2006-2008, a cross-sectional study was performed in the general population in Copenhagen, Denmark. A total of 3471 subjects participated in a general health examination that included assessment of current...... smoking status, weight, height, waist and hip circumferences, systolic and diastolic blood pressures, resting heart rate, and plasma lipids, hemoglobin A1c, fasting glucose, and insulin levels. Results Physician-diagnosed psoriasis was reported by 238 (7.1%) of 3374 participants. There were no differences...
Holm, Jakob Præst; Hyldstrup, Lars; Jensen, Jens-Erik Beck
The aim of this article was to identify prevalent osteoporosis risk factors, medications and comorbidities associated with bone mineral density (BMD). Furthermore to evaluate changes in risk factor profiles over 12 years. 6285 women consecutively referred to an osteoporosis specialist clinic were...... was established in a real-life setting. The prevalence of osteoporosis and proportion of patient's having comorbidity's associated with osteoporosis were increasing during the inclusion period (start 23.8 %, end 29.7 %). Increasing age (OR = 1.05), current smoking (OR = 1.18), estrogen deficiency (OR = 1.......7), hyperthyroidism (OR = 1.5), previous major osteoporotic fracture (OR = 1.7), former osteoporosis treatment (OR = 3.5), higher BMI (OR = 0.87), use of calcium supplementation (OR = 1.2), high exercise level (OR = 0.7), and use of thiazide diuretics (OR = 0.7) were identified as predictors of osteoporosis by DXA...
The chapters of Part I of the thesis describe the development of techniques that can be used in the assessment of risk factors for the development of diabetes mellitus (DM) in cats. The hyperglycemic glucose clamp (HGC) was developed for use in conscious cats, equipped with arterial catheters for plasma glucose measurements. The glucose disposal rate measured during HGC was lower in normal glucose-tolerant cats than in normal glucose-tolerant humans, apparently related to the cat’s lower insu...
Lígia da Silva Leroy; Adélia Lúcio; Maria Helena Baena de Moraes Lopes
Abstract OBJECTIVE: To investigate the risk factors for postpartum urinary incontinence (UI) and its characteristics. METHOD: This was a case-control study with 344 puerperal women (77 cases and 267 controls) with up to 90 days postpartum. In a single session, participants were given a questionnaire with sociodemographic and clinical data and two others that assessed urine leakage, leakage situations, and type of UI. RESULTS: Stress UI was present in 45.5% of the women, incidents of urine...
The main aim of this lecture is focus on different aspects of occurerence of depression in Adolescence, especially with focus on risk factors. I introduced epidemiology of depression : causes, treatment, and prevention (Abela & Hankin,2008). The special part of the lecture was focus on etiology of depression. Adolescence is characterized by positive gains in cognitive maturity, better interpersonal skills, new experiences, increased autonomy, and hormonal changes (Feldman & Elliot, 1990). Alt...
Kelly Vasconcelos Chaves Martins; Marília Fontenele e Silva Câmara
Objective: To identify risk factors related to sensorineural hearing loss in elderly. Methods: The sample consisted of 60 selected elderly, divided into two groups: the Case Group, composed by 30 individuals, 21 females and 9 males, aged at least 60 years, presenting sensorineural hearing loss, and the Control Group, composed by 30 individuals matched on gender and age, with normal hearing. The patients were submitted to audiological anamnesis and tonal audiometry. The hearing impairment ...
Postolache, Teodor T.; Komarow, Hirsh; Tonelli, Leonardo H.
The rates of depression, anxiety, and sleep disturbance (suicide risk factors) are greater in patients with allergic rhinitis than in the general population. The rate of allergy is also greater in patients with depression. Preliminary data suggest that patients with a history of allergy may have an increased rate of suicide. Clinicians should actively inquire to diagnose allergy in patients with depression and depression in patients with allergy.
This thesis explores the epidemiology and risk factors of eating disorders. It focuses on the impact of the political and cultural changes that occured in the Czech Republic in the early 1990s. The term eating disorders includes mental illnesses characterized by disturbances in eating behaviour: anorexia nervosa, bulimia nervosa and various eating disorders not otherwise specifieed. It appears that the incidence of anorexia nervosa was increasing until 1970s and remains stable since. The inci...
Anne F Peery
Full Text Available Constipation, a low fiber diet, sedentary lifestyle and gravidity are commonly assumed to increase the risk of hemorrhoids. However, evidence regarding these factors is limited. We examined the association between commonly cited risk factors and the prevalence of hemorrhoids.We performed a cross sectional study of participants who underwent a colonoscopy in a colorectal adenoma prevention trial and who had a detailed assessment of bowel habits, diet and activity. The presence of hemorrhoids was extracted from the subjects' colonoscopy reports. We used logistic regression to estimate odds ratios and 95% confidence intervals while adjusting for age and sex.The study included 2,813 participants. Of these, 1,074 had hemorrhoids recorded. Constipation was associated with an increased prevalence of hemorrhoids (OR 1.43, 95% CI 1.11, 1.86. Of the fiber subtypes, high grain fiber intake was associated with a reduced risk (OR for quartile 4 versus quartile 1 = 0.78, 95% CI 0.62, 0.98. We found no association when comparing gravid and nulligravida women (OR 0.93, 95% CI 0.62-1.40. Sedentary behavior was associated with a reduced risk (OR 0.80, 95% CI 0.65-0.98, but not physical activity (OR 0.83, 95% CI 0.66-1.03. Neither being overweight nor obese was associated with the presence of hemorrhoids (OR 0.89, 95% CI 0.72-1.09 and OR 0.86, 95% CI 0.70-1.06.Constipation is associated with an increased risk of hemorrhoids. Gravidity and physical activity do not appear to be associated. High grain fiber intake and sedentary behavior are associated with a decreased risk of hemorrhoids.
Full Text Available This case-controlled study was designed to evaluate the association between various baseline parental factors and the risk of hypospadias in China. Patients were selected from tertiary referral hospitals in Anhui, a province in mid-eastern China. A questionnaire was given to the parents of each patient. The final database included 193 cases and 835 controls. The incidence of additional coexistent anomalies was 13.0%, primarily cryptorchidism (9.8%. Ten patients (5.1% were from families with genital anomaly, including five families (2.6% with hypospadias. The risks of hypospadias was higher for children of mothers > 35 (odds ratio [OR] =1.47 and < 18 (OR = 2.95 years of age, and in mothers who had consumed alcohol (OR = 2.67, used drugs (OR = 1.53 and had an infection (OR = 1.87 during pregnancy. The risk of hypospadias was also higher when mothers (OR = 1.68 and fathers (OR = 1.74 were engaged in agriculture. Other factors assessed were not associated with the risk of hypospadias.
Gray, P; Hildebrand, K
Parkinson's disease (PD) is a neurodegenerative disorder characterized by tremor, rigidity, bradykinesia, gait disturbance, and postural instability. Patients with PD suffer frequent falls, yet little research has been done to identify risks specific to PD patients. The objective of this study was to identify the risk factors associated with falls for PD patients through the collection of demographic, environmental, and medical information as well as fall diaries completed during a 3-month period. Patients with a diagnosis of idiopathic PD, with and without falls, were included in the study provided they could stand and walk and had no other condition that could predispose them to falls. Of the 118 participants, 59% reported one or more falls. A total of 237 falls were reported. Duration and severity of PD symptoms, particularly freezing, involuntary movements, and walking and postural difficulties, were significantly associated with an increased risk of falls. Other factors associated with falls were postural hypotension and daily intake of alcohol. Forty percent of falls resulted in injury, but serious injury was rare. The findings have implications for reducing the risk of falls through patient education.
Oliveira, C S F; Hogeveen, H; Botelho, A M; Maia, P V; Coelho, S G; Haddad, J P A
Information related to mastitis risk factors is useful for the design and implementation of clinical mastitis (CM) control programs. The first objective of our study was to model the risk of CM under Brazilian conditions, using cow-specific risk factors. Our second objective was to explore which
Önder, Akın; Kapan, Murat; Ülger, Burak Veli; Oğuz, Abdullah; Türkoğlu, Ahmet; Uslukaya, Ömer
As a serious complication of cholelithiasis, gangrenous cholecystitis presents greater mortality than noncomplicated cholecystitis. The aim of this study was to specify the risk factors on mortality. 107 consecutive patients who underwent surgery due to gangrenous cholecystitis between January 1997 and October 2011 were investigated retrospectively. The study included 60 (56.1%) females and 47 (43.9%) males, with a mean age of 60.7 ± 16.4 (21-88) years. Cardiovascular diseases were the most frequently accompanying medical issues (24.3%). Thirty-six complications (33.6%) developed in 29 patients, and surgical site infection was proven as the most common. Longer delay time prior to hospital admission, low white blood cell count, presence of diabetes mellitus, higher blood levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and total bilirubin, pericholecystic fluid in abdominal ultrasonography, and conversion from laparoscopic surgery to open surgery were identified as risk factors affecting mortality (P < 0.001, P = 0.001, P = 0.044, P = 0.005, P = 0.049, P = 0.009, P = 0.022, P = 0.011, and P = 0.004, respectively). Longer delay time prior to hospital admission and low white blood cell count were determined as independent risk factors affecting mortality.
Full Text Available Background: Migraine is a chronic daily headache which interfere a quality of life. The purpose of this research is to obtain the prevalence, risk factors, and comorbidity of migraine. Methods: A cross sectional study involving 4771 subjects in 5 villages in the district of Central Bogor, Bogor City 2011–2012. Data collection was performed using WHO STEPS (interview, measurement, physical examination, and laboratory test. Results: In this study, the migraine prevalence was 22.43%, with significant risk factors were sex, age, and stress (p < 0.05. Comorbidity of migraine was coronary heart diseases (p < 0.05. There was no significant correlation between migraine with marital status, level of education, smoking, hypertension, obesity, total cholesterol, LDL, HDL, trigliseride level, and diabetes mellitus (p > 0.05. Conclusions: Risk factors which have significant association with migraine are sex, age, and stress, whereas coronary heart disease existed as a comorbidity with migraine.
Arica, Emrah; Strandhagen, Jan Ola; Hvolby, Hans-Henrik
This paper gives indications to important factors that must be considered for effectiveness of the production control systems under uncertainty. Five key factors have been identified by the literature study. Production schedule generation and execution approach under uncertainty, information...... and communication technology, coordination and feedback, human factors and decision making, and measurement are the identified factors to be taken into account. Industrial interviews with three case companies, that are participating to the research program called The Norwegian Manufacturing Future (SFI NORMAN...
Akre, Olof; Boyd, Heather A.; Ahlgren, Martin; Wilbrand, Kerstin; Westergaard, Tine; Hjalgrim, Henrik; Nordenskjöld, Agneta; Ekbom, Anders; Melbye, Mads
Background An increase in the prevalence of hypospadias has been reported, but the environmental causes remain virtually unknown. Objectives Our goal was to assess the association between risk of hypospadias and indicators of placental function and endogenous hormone levels, exposure to exogenous hormones, maternal diet during pregnancy, and other environmental factors. Methods We conducted a case–control study in Sweden and Denmark from 2000 through 2005 using self-administered questionnaires completed by mothers of hypospadias cases and matched controls. The response rate was 88% and 81% among mothers of cases and controls, respectively. The analyses included 292 cases and 427 controls. Results A diet during pregnancy lacking both fish and meat was associated with a more than 4-fold increased risk of hypospadias [odds ratio (OR) = 4.6; 95% confidence interval (CI), 1.6–13.3]. Boys born to obese [body mass index (BMI) ≥ 30] women had a more than 2-fold increased risk of hypospadias (OR = 2.6; 95% CI, 1.2–5.7) compared with boys born to mothers with a normal weight (BMI = 20–24). Maternal hypertension during pregnancy and absence of maternal nausea increased a boy’s risk of hypospadias 2.0-fold (95% CI, 1.1–3.7) and 1.8-fold (95% CI, 1.2–2.8), respectively. Nausea in late pregnancy also appeared to be positively associated with hypospadias risk (OR = 7.6; 95% CI, 1.1–53). Conclusions A pregnancy diet lacking meat and fish appears to increase the risk of hypospadias in the offspring. Other risk associations were compatible with a role for placental insufficiency in the etiology of hypospadias. PMID:18709149
Koutroubakis, I; Manousos, O N; Meuwissen, S G; Pena, A S
Besides a genetic predisposition, a causal role of various environmental factors have been taken into consideration in the etiology of inflammatory bowel disease (IBD). The most consistent association of environmental factors so far identified is the association between non smoking and ulcerative colitis (UC) as well a between smoking and Crohn's disease (CD). Other factors such as oral contraceptives, refined sugar, perinatal events, childhood infections, microbial agents, and domestic hygiene have been found to be associated with ulcerative colitis and Crohn's disease but further evaluation is required to confirm the consistency and to define the strength of the association. Recent data also suggest that measles virus may persist in intestinal tissue and early exposure to the virus may be a risk factor for development of CD. The further investigation of environmental factors on IBD and the explanation of their role is expected to open new avenues for basic scientific research and may lead to the development of a more rational approach to the prevention and treatment of IBD. The available data suggest that UC and CD are heterogeneous disorders of multifactorial etiology in which hereditary and environmental factors interact to produce the disease.
I F Dementieva
Full Text Available The article considers the most significant risk factors for the development of childhood under the contemporary conditions of the Russian family functioning. The specifics of the Russian society is determined by the implementation of fundamental social and economic reforms in the country in the last decades. The article provides a comprehensive analysis of key risk factors and defines possible negative consequences of their impact on the children personal development. Based on statistics and international legislation the article examines the issue of children protection from various forms of domestic violence. The demographic risk factors are considered from the perspective of raising a child in a one-child family, in the situation of childbirth out of wedlock and after the divorce, or the child’s health problems and the lack of conditions for its improvement. The author believes that the low quality of life is an important factor for the childhood risks development for it limits cognitive and physiological needs of the child. The article also points to the connection of the parents’ authority with their professional occupation and unemployment. Thus, the author comes to the following conclusions: childhood development is inevitably linked with the acquisition of life experience of overcoming risk situations; the family strategy to protection the child from all dangerous contacts is pedagogically unjustified and hinders the socialization process. In order to achieve positive results in overcoming the childhood risks, it is necessary to increase the educational competence of parents in the prevention of possible risks. The task of the family is not to isolate the child from the risks, but to teach the child to overcome them.
Maynard, Scott; Keijzers, Guido; Hansen, A-M
To examine associations of DNA damage, cardiovascular risk factors and physical performance with vitality, in middle-aged men. We also sought to elucidate underlying factors of physical performance by comparing physical performance parameters to DNA damage parameters and cardiovascular risk factors....
Tint, Derrick; Kubala, Stephanie; Toskala, Elina
Chronic rhinosinusitis (CRS) is a heterogeneous disorder that creates a significant burden on the healthcare system. It is caused by a combination of inflammatory, environmental, and host factors; however, the precise mechanism of how each factor leads to CRS continues to be a source of debate. Previous data regarding this topic is often inconsistent or of lower quality. In this article, we review the recent literature on the risk factors and comorbidities in CRS. Large population-based studies have helped establish smoking as a significant risk factor for CRS. The focus has now shifted towards smoking and its effect on long-term outcomes after endoscopic sinus surgery (ESS). Ciliary dyskinesia, both primary and secondary, can affect both the sinonasal cavity and lower airways simultaneously by decreasing the beat frequency of cilia and inducing mucostasis. The effects of secondary dyskinesia may be reversible and there is some evidence to suggest the use of topical mucolytics in patients with CRS. Allergy and variants of sinonasal anatomy have been hypothesized to increase the risk of developing CRS by inducing chronic inflammation and obstructing the sinus ostia. Nevertheless, emerging data regarding these topics continue to produce inconclusive results. Inflammation of the upper and lower airways can occur simultaneously as seen in patients with asthma and aspirin sensitivity. The connection between these pro-inflammatory disease states has been known for many years. Newer evidence include large population-based studies and studies that correlate objective tests, such as computer tomography scans to pulmonary function tests. However, the treatment of CRS and its effects on obstructive airway disease continues to be a topic of debate. More large prospective studies are needed in order to continue refining our knowledge of the disease processes in CRS.
Full Text Available Introduction. In current era of widespread use of percutaneous coronary interventions (PCI, it is debatable whether coronary artery by-pass graft (CABG patients are at higher risk. Objective. The aim of the study was to evaluate trends in risk profile of isolated CABG patients. Methods. By analysing the EuroSCORE and its risk factors, we reviewed a consecutive group of 4675 isolated CABG patients, operated on during the last 8 years (2001-2008 at our Clinic. The number of PCI patients was compared to the number of CABG patients. For statistical analyses, Pearson’s chi-square and ANOVA tests were used. Results. The number of PCI increased from 159 to 1595 (p<0.001, and the number of CABG from 557 to 656 (p<0.001. The mean EuroSCORE increased from 2.74 to 2.92 (p=0.06. The frequency of the following risk factors did not change over years: female gender, previous cardiac surgery, serum creatinine >200μmol/l, left ventricular dysfunction and postinfarct ventricular septal rupture. Chronic pulmonary disease, neurological dysfunction, and unstable pectoral angina declined significantly (p<0.001. Critical preoperative care declined from 3.1% in 2001 to 0.5 % in 2005, than increased and during the last 3 years did not change (2.3%. The mean age increased from 56.8 to 60.7 (p<0.001 and extracardiac arteriopathy increased from 9.2% to 22.9% (p<0.001. Recent preoperative myocardial infarction increased from 11% to 15.1% (p=0.021, while emergency operations increased from 0.9% to 4.0% (p=0.001. Conclusion. The number of CABG increases despite the enlargement of PCI. The risk for isolated CABG given by EuroSCORE increases over years. The risk factors, significantly contributing to higher EuroSCORE are: older age, extracardiac arteriopathy, recent myocardial infarction and emergency operation.
van Drongelen, Alwin; Boot, Cécile R L; Hlobil, Hynek; Smid, Tjabe; van der Beek, Allard J
The objective of this study is to determine risk factors for fatigue among airline pilots, taking into account person-, work-, health-, sleep-, and lifestyle-related characteristics. The study population consisted of 502 pilots who participated in the MORE Energy study. Included risk factors were either measured through an online questionnaire or provided by the company. The outcome of this study, fatigue, was assessed using the Checklist Individual Strength (CIS), and was defined as scoring more than 76 points on this questionnaire. The association of the risk factors with fatigue was determined using univariate and multivariate logistic regression analyses. Of the participating pilots, 29.5 % scored more than 76 points on the CIS and were classified as being fatigued. The fully adjusted regression model showed that person-, work-, health-, and lifestyle-related characteristics were associated with fatigue. Pilots who were aged 31 to 40 (OR 3.36, 95 % CI 1.32-8.53) or 41 to 50 (OR 4.19, 95 % CI 1.40-12.47), an evening type (OR 2.40, 95 % CI 1.38-4.16), scored higher on work-life balance disturbance (OR 1.22, 95 % CI 1.10-1.36), scored higher on need for recovery (OR 1.02, 95 % CI 1.01-1.04), scored lower on general health perception (OR 0.31, 95 % CI 0.20-0.47), were less physically active (OR 0.77, 95 % CI 0.66-0.89), and had a moderate alcohol consumption (OR 3.88, 95 % CI 1.21-12.43), were at higher risk for fatigue. Higher age, being an evening type, disturbance of the work-life balance, more need for recovery, a lower perceived health, less physical activity, and moderate alcohol consumption were shown to be risk factors for fatigue. Further longitudinal research is needed to elucidate the direction of the associations found and to evaluate the effects of possible countermeasures in airline pilots.
de Araújo Nobre, Miguel; Mano Azul, António; Rocha, Evangelista; Maló, Paulo
This study aimed to identify risk factors for the incidence of peri-implant pathology. One-thousand, two-hundred and seventy-fifty patients (255 cases and 1020 controls), rehabilitated with dental implants, were included. Peri-implant pathology was defined as the presence of peri-implant pockets ≥ 5 mm, bleeding on probing, vertical bone loss, and loss of attachment ≥ 2 mm. Cases and controls were matched for age, gender, and duration of follow-up. A logistic regression model was used, with estimation of the OR for each variable and interaction, with a level of significance of 5%. The risk factors for peri-implant pathology were: history of periodontitis (OR = 19), bacterial plaque (OR = 3.6), bleeding (OR = 2.9), bone level on the medium third of the implant (OR = 13.9), lack of prosthetic fit or non-optimal screw joint (OR = 5.9), metal-ceramic restorations (OR = 3.9), and the interaction between bacterial plaque and the proximity of other teeth or implants (PROXI) (OR = 4.3). PROXI (OR = 0.44) exerted a protective effect when independent. Based on the results, peri-implant pathology represents a group of multifactorial situations with interaction of biological and biomechanical components in its pathogenesis. It was possible to model the condition and to assess, with high precision, the risk profile of each patient. © 2015 Eur J Oral Sci.
Tikkanen, J; Heinonen, O P
To investigate possible associations between cardiovascular malformations and maternal occupational exposure to various factors during the first trimester of pregnancy, 406 cases and 756 controls were studied retrospectively. The cases were taken from all infants diagnosed with cardiovascular malformations born in Finland during 1982 and 1983. The controls were randomly selected from all normal births in the country during the same period. All mothers were interviewed approximately 3 months after delivery by a midwife, using a structured questionnaire. Maternal overall exposure to chemicals at work was more prevalent among the case group (35.8%) than the control group (26.2%, P less than 0.01). Among the specific chemical groups, maternal exposure to dyes, lacquers, or paints was significantly associated with the risk of congenital heart disease. Exposure to organic solvents during the first trimester seemed to increase to risk of ventricular septal defect (P less than 0.05). Work at video display terminals was slightly more prevalent among the case group (6.3%) than among the control group (5.0%). The mothers' education level, regular exposure to passive smoking at work, or temperature at the workplace were not risk factors for congenital heart disease in the offspring, neither was maternal exposure to microwave ovens, disinfectants, pesticides, or anesthetic gases. It is concluded that many maternal exposures at work seem not to have a teratogenic effect on the fetal heart, although the limited power of this investigation needs to be borne in mind.
Full Text Available The aim of this study was to investigate the risk factors for osteoporotic vertebral fractures in postmenopausal women. 44 postmenopausal women whose L 2-L4 T scores were £ -2.5 SD with a mean age of 66.38+ 6.47 years were included in this study. Age, postmenopausal years, body mass index, milk consumption (before and after age 50, family history of osteoporosis and osteoporotic fracture, patient’s previous fracture history, tobacco use, number of pregnancies, surgical menopause were questioned in all patients. DEXA was used to evaluate bone mineral density . Kleerekoper method was used to evaluate the fractures between T4 and L5 vertebra on lateral thoracal and lumbar X rays. When 25 patient with vertebral fractures compared with 19 patients without fracture ,only patient’s age showed statistically significant difference between groups ( p=0.035. Of the 5 risk factors chosen (age, L2-L4 BMD, L2-L4 T score, body weight <57 kg, milk consumption before age 50 only patient’s age was found to be statistically important in estimating vertebral fracture risk (p=0.032.There was statistically significant positive correlation between vertebral deformity score (evaluated according to Kleerekoper method and patient’s age and postmenopausal years (respectively p=0.001, p=0.006.
Machado, V; Troncoso, S; Mejías, L; Idoate, M Á; San-Julián, M
To evaluate the clinical, radiological and histological factors that can predict local recurrence of fibromatosis. A retrospective study was conducted on 51 patients diagnosed with fibromatosis in this hospital from 1983 to 2014. The mean follow-up was 83 months. A study was made of the clinical parameters, location, depth, size, surgical margins, and proliferation index (Ki-67). An evaluation was also made of the risk of recurrence depending on the adjuvant treatment and the relationship between treatment and patient functionality. Tumour location and depth were identified as risk factors for local recurrence, showing statistically significant differences (P<.001 and P=.003, respectively). There were no statistically significant differences in age, gender, size, surgical margins, or adjuvant treatments, or in the Musculoskeletal Tumour Society Score according to the treatment received. The mean Ki-67 was 1.9% (range 1-4), and its value was not associated with the risk of recurrence. Deep fibromatosis fascia tumours, and those located in extremities are more aggressive than superficial tumours and those located in trunk. The Ki-67 has no predictive value in local recurrence of fibromatosis. Radiotherapy, chemotherapy, or other adjuvant treatments such as tamoxifen have not been effective in local control of the disease. Given the high recurrence rate, even with adequate margins, a wait and see attitude should be considered in asymptomatic patients and/or stable disease. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.
Mehta, Shobha H; Sokol, Robert J
Shoulder dystocia remains an unpredictable obstetric emergency, striking fear in the hearts of obstetricians both novice and experienced. While outcomes that lead to permanent injury are rare, almost all obstetricians with enough years of practice have participated in a birth with a severe shoulder dystocia and are at least aware of cases that have resulted in significant neurologic injury or even neonatal death. This is despite many years of research trying to understand the risk factors associated with it, all in an attempt primarily to characterize when the risk is high enough to avoid vaginal delivery altogether and prevent a shoulder dystocia, whose attendant morbidities are estimated to be at a rate as high as 16-48%. The study of shoulder dystocia remains challenging due to its generally retrospective nature, as well as dependence on proper identification and documentation. As a result, the prediction of shoulder dystocia remains elusive, and the cost of trying to prevent one by performing a cesarean delivery remains high. While ultimately it is the injury that is the key concern, rather than the shoulder dystocia itself, it is in the presence of an identified shoulder dystocia that occurrence of injury is most common. The majority of shoulder dystocia cases occur without major risk factors. Moreover, even the best antenatal predictors have a low positive predictive value. Shoulder dystocia therefore cannot be reliably predicted, and the only preventative measure is cesarean delivery. Copyright © 2014 Elsevier Inc. All rights reserved.
Borgomeo, Edoardo; Mortazavi-Naeini, Mohammad; Hall, Jim W.; Guillod, Benoit P.
Risk-based water resources planning is based on the premise that water managers should invest up to the point where the marginal benefit of risk reduction equals the marginal cost of achieving that benefit. However, this cost-benefit approach may not guarantee robustness under uncertain future conditions, for instance under climatic changes. In this paper, we expand risk-based decision analysis to explore possible ways of enhancing robustness in engineered water resources systems under different risk attitudes. Risk is measured as the expected annual cost of water use restrictions, while robustness is interpreted in the decision-theoretic sense as the ability of a water resource system to maintain performance—expressed as a tolerable risk of water use restrictions—under a wide range of possible future conditions. Linking risk attitudes with robustness allows stakeholders to explicitly trade-off incremental increases in robustness with investment costs for a given level of risk. We illustrate the framework through a case study of London's water supply system using state-of-the -art regional climate simulations to inform the estimation of risk and robustness.
Glazer, Clara Helene; Bonde, Jens Peter; Giwercman, Aleksander
problem. WHAT IS KNOWN ALREADY: Previous cross-sectional studies have shown an increased prevalence of comorbidities among infertile men when compared to controls. STUDY DESIGN, SIZE, DURATION: In this prospective cohort study, 39 516 men who had since 1994 undergone fertility treatment with their female...... partner were identified from the Danish national IVF register, which includes data on assumed cause of couple infertility (male/female factor, mixed and unexplained infertility) and type of fertility treatment. With a median follow-up time of 5.6 years, each man was followed for diabetes occurrence from......STUDY QUESTION: Is male factor infertility associated with an increased risk of developing diabetes? SUMMARY ANSWER: The study provides evidence that male factor infertility may predict later occurrence of diabetes mellitus with the risk being related to the severity of the underlying fertility...
Lobo Pereira, J. A.; Ferreira, Maria Cristina; Oliveira, Teresa
Multivariate statistical analysis is indispensable to assess the associations and interactions between different factors and the risk of periodontitis. Among others, regression analysis is a statistical technique widely used in healthcare to investigate and model the relationship between variables. In our work we study the impact of socio-demographic, medical and behavioral factors on periodontal health. Using regression, linear and logistic models, we can assess the relevance, as risk factors for periodontitis disease, of the following independent variables (IVs): Age, Gender, Diabetic Status, Education, Smoking status and Plaque Index. The multiple linear regression analysis model was built to evaluate the influence of IVs on mean Attachment Loss (AL). Thus, the regression coefficients along with respective p-values will be obtained as well as the respective p-values from the significance tests. The classification of a case (individual) adopted in the logistic model was the extent of the destruction of periodontal tissues defined by an Attachment Loss greater than or equal to 4 mm in 25% (AL≥4mm/≥25%) of sites surveyed. The association measures include the Odds Ratios together with the correspondent 95% confidence intervals.
Liu, Wei-Xiao; Lang, Jun-Feng; Zhang, Qin-Feng
To investigate the risk factors for anorexia in children, and to reduce the prevalence of anorexia in children. A questionnaire survey and a case-control study were used to collect the general information of 150 children with anorexia (case group) and 150 normal children (control group). Univariate analysis and multivariate logistic stepwise regression analysis were performed to identify the risk factors for anorexia in children. The results of the univariate analysis showed significant differences between the case and control groups in the age in months when supplementary food were added, feeding pattern, whether they liked meat, vegetables and salty food, whether they often took snacks and beverages, whether they liked to play while eating, and whether their parents asked them to eat food on time (Panorexia in children. Liking of meat (OR=0.093) and vegetables (OR=0.272) and eating on time required by parents (OR=0.079) were protective factors against anorexia in children. Timely addition of supplementary food, a proper diet, and development of children's proper eating and living habits can reduce the incidence of anorexia in children.
Carballo, José L; Marín-Vila, María; Espada, José P; Orgilés, Mireia; Piqueras, José A
Empirical evidence has revealed various factors that contribute to the development and maintenance of Internet abuse. The aim of this paper was to analyze, on a sample of Spanish adolescents, the relationship between Internet abuse and: (1) Personal and interpersonal risk factors, including social skills in both virtual and real-life contexts; (2) Drug use. A total of 814 high school students aged between 13 and 17 participated in this study, and were divided into two groups: Internet Abusers (IA = 173) and Non-Internet Abusers (NIA = 641). Questionnaires were used to analyze Internet and drug use/abuse, as well as social skills, in virtual and real contexts. Various interpersonal risk factors (family and group of friends) were also assessed. IA showed a more severe pattern of Internet and drug use, as well as poorer social skills in both contexts. Moreover, their groups of friends appeared more likely to become involved in risky situations related to Internet and drug abuse. Both IA and NIA showed more adaptive social skills in the virtual context than in the real one. There is a need for further research to build on these findings, with a view to designing specific preventive programs that promote responsible Internet use.
Gul Mert, Gulen; Herguner, Mihriban Ozlem; Incecik, Faruk; Altunbasak, Sakir; Sahan, Duygu; Unal, Ilker
To assess risk factors that affect epilepsy prognosis and neurodevelopmental outcome and response to treatment in patients diagnosed with infantile spasm. In this study, demographics, treatment modalities, etiologies, risk factors affecting neurodevelopmental outcome and epilepsy prognosis were assessed retrospectively at the end of a minimum 24-months follow-up of 104 patients diagnosed with infantile spasm from May 2012 to October 2015. Neonatal seizure during neonatal period, abnormal head circumference, young age at the time of presentation and early gestational age, symptomatic etiology, abnormal initial examination and abnormal development test at the time of diagnosis, consanguinity, the medical center where treatment was started in the second center or beyond and magnetic resonance imaging finding were found to be statistically significant for poor prognosis in terms of neurodevelopment (p Infantile spasm is an age-related epileptic encephalopathy, and it was observed that it is still catastrophic, and that the most important factor affecting prognosis of epilepsy is etiology, age at the time of presentation and the medical center where treatment was started in the second center or beyond.
Background: Asthma exacerbations are caused by a variety of risk factors. Reducing exposure to these risk factors improves the control of asthma and reduces medication needs. Knowledge of the particular risk factors is essential in formulating controlling and treatment protocols. This study set out to determine the risk ...
Full Text Available Operational risk is one of the core risks of every insurance company in accordance to the solvency capital requirement under the Solvency II regime. The target of the research is to investigate the improvement possibilities of the operational risk measurement under Solvency II regime. The authors have prepared the algorithm of the operational risk measurement under Solvency II framework that helps improve the understanding of the operational risk capital requirements. Moreover, the authors have prepared the case study about a practical usage of the suggested algorithm through the example of one non-life insurance company. The authors use, in order to perform the research, such corresponding methods as theoretical and methodological analysis of scientific literature, analytical, statistical and mathematical methods.
van Wijk, N Ph L; de Bruijn, J G M
One out of three people (25% of men, 38% of women) in Curacao have experienced some form of domestic violence at some point in their adult lives. The most significant risk factors for domestic violence in Curacao are the female gender, a young age, low education, and experiencing domestic violence victimization in childhood. Divorce, single parenthood, and unemployment increase the risk for women, but not for men. These findings are consistent with current literature on the subject. Further research on the context, nature, and severity of domestic violence in the Caribbean is necessary. Studies should preferably combine the strengths of national crime surveys and family conflict studies: nationally representative samples (including men and women) and questionnaires that include all possible experiences of psychological, physical, and sexual assaults by current and former partners, family, and friends.
Smith, Andrew; Smith, Hugo
Research has identified a number of risk factors for road traffic accidents. Some of these require education of drivers and a first step in this process is to assess perceptions of these risk factors to determine the current level of awareness. An online survey examined risk perception with the focus being on driver behavior, risk taking and fatigue. The results showed that drivers’ perceptions of the risk from being fatigued was lower than the perceived risk from the other factors.
Garipagaoglu, Muazzez; Budak, Nurten; Süt, Necdet; Akdikmen, Oznur; Oner, Naci; Bundak, Rüveyde
On the basis of the knowledge that the prevalence of obesity in children has increased steadily in recent years, this study aimed to assess the association between obesity and certain risk factors in a group of 6- to 14-year-old children living in Istanbul. The study was carried out at the Istanbul University School of Medicine Hospital. Data were collected from 592 children aged between 6 and 14 years who were examined in general pediatrics clinics. Weight and height measurements were performed on the children and their parents. The children were classified as obese and nonobese in accordance with the body mass index reference values for Turkish children. Energy intake of children was estimated with a 3-day food consumption recording form. A structured questionnaire was used to collect the information from the parents on possible risk factors causing obesity. The physical activity state of the children was assessed. A logistic regression model was developed to examine the relationships between obesity and possible risk factors. Almost 32% (n = 184) and 69% (n = 408) of children were assessed as obese and nonobese, respectively. Although there was no difference in daily energy intakes of obese and nonobese children, 13.6% of obese and 40.9% of nonobese children were reported to do physical activity regularly. Obesity was strongly associated with parental obesity. Furthermore, energy intake; having regular physical activity; presence of obesity in the mother, the father, and the mother's family; and having a mother working out of home were also significantly associated with obesity. Creating awareness in mothers on the importance of a healthy nutrition and encouraging families to participate in physical activities are important points in the prevention of childhood obesity.
Zhang, Jixiang; Song, Jianwei; Wang, Jing
This study aims to define the characteristics of adolescents who have engaged in self-harm behavior and ascertain the risk factors. From January 2013 to January 2014, 4,176 adolescents from senior middle schools in Linyi, China, were administered four questionnaire surveys to ascertain the following: incidence of self-harm behavior regarding the frequency of different self-harm behaviors by group (never/one to five times/greater than five times in the last 6 months) and then comparing the self-harm behavior of the different subgroups; symptom self-check, comparing the differences between the adolescents with self-harm behavior and without in nine subscales (somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, fear, paranoid, and psychosis); Adolescent Self-Rating Life Events Check List scores; and Egna Minnenav Barndoms Uppfostran (EMBU) scores. Multivariate logistic regression analysis was used to determine the risk factors of self-harm in adolescents. The incidence of adolescent self-harm was 27.60%; the occurrence of adolescent self-harm was closely related to their mental health status, stressful life events, and EMBU. Being female, an urban student, or an only child; having poor school performance or experiences of stressful life events, harsh parenting styles, or excessive interference; and poor mental health were the risk factors for adolescent self-harm. The incidence of adolescent self-harm was high, and their mental health status, stressful life events, and EMBU affected the occurrence of adolescent self-harm, which is an issue that needs greater attention. © 2016 John Wiley & Sons Australia, Ltd.
Stenager, E N; Koch-Henriksen, N; Stenager, E
BACKGROUND: The purpose of the present study was to identify risk factors for suicide in patients with multiple sclerosis (MS). METHODS: The study is based on available information about MS patients identified in the Danish MS Registry (DMSR) with onset in the period 1950-1985. We compared the MS...... suicides with the 1950-1985 onset cohort patients in the DSMR as to distribution of age at onset, presenting symptoms, and time from onset to diagnosis. We reviewed sociodemographic data, age of onset, the course of the disease, recent deterioration, type of deterioration, Kurtzke Disability Status Scale...
Ondrusova, M.; Ondrus, D.
Testicular cancer is a rare malignancy, that affects 1-2 % of male population. Trends of testicular cancer mortality are stable for a long period of time, even that incidence shows a rapid growth. This paper deals with national trends in testicular cancer incidence and mortality in Slovakia from 1968 to 2007 by using the join-point regression analysis to propose potential changes in health care. The authors noted a statistically significant increase in the values of incidence and improvement in mortality after 1975. Paper also deals with the etiology and risk factors of this malignancy. (author)
Full Text Available Bercin Tarlan,1 Hayyam Kiratli21Department of Ophthalmology, Kozluk State Hospital, Batman, Turkey; 2Ocular Oncology Service, Hacettepe University Schoolof Medicine, Ankara, TurkeyAbstract: Subconjunctival hemorrhage is a benign disorder that is a common cause of acute ocular redness. The major risk factors include trauma and contact lens usage in younger patients, whereas among the elderly, systemic vascular diseases such as hypertension, diabetes, and arteriosclerosis are more common. In patients in whom subconjunctival hemorrhage is recurrent or persistent, further evaluation, including workup for systemic hypertension, bleeding disorders, systemic and ocular malignancies, and drug side effects, is warranted.Keywords: subconjunctival hemorrhage, contact lens, hypertension, red eye
G. K. Taitubayeva
Full Text Available Purpose. To identify risk factors for the development of acute cerebral circulatory impairments (ACCI in pregnant women.Materials and methods. The material for the study was the medical history of 31 pregnant women with diagnosis ACCI. The average age was 29,5 ± 5,1 years. The comparison group consisted of pregnant women with physiological pregnancy (n = 30 with different gestation periods, the mean age was 29,1 ± 6,7 years. In this study, a comparative analysis of risk factors for stroke was carried out: gynecological and allergic history, smoking and taking contraceptives, the presence of chronic diseases, indicators of the hemostasis and lipid spectrum, polymorphism of thrombophilia genes.Results. The prevalence of ischemic stroke over hemorrhagic stroke was found, which was 77.4% and 22.6%, respectively. In 93.5% of cases, a stroke occurred during pregnancy, in 79.3% of them in the third trimester of gestation. The number of recuperated women was 67.7%. As a result of statistical treatment, a significant difference in study and comparison groups was obtained (p < 0.05 as a result of a burdened obstetric-gynecological history. Among the women taking contraceptives, 11 (35.5% women were in the study group, and 3 (10% women were found in the comparison group (p < 0.05. At the analysis of smoking in the history the number of women in the study group prevailed comparing to the comparison group (35.5–13.3%, p < 0.05. Changes in the lipid spectrum system and hemostasis were detected, but there were no significant differences between the study group and the comparison group (p> 0.05. Various forms of mutations were identified in the group with ischemic stroke in 14 (58.3% women, in 2 (28.5% women in the group with hemorrhagic stroke.Conclusion. Of all the data analyzed in pregnant women with stroke, statistically significant risk factors are: smoking, taking contraceptives, the presence of chronic diseases, including an obstructed obstetric
Albers, Willem/Wim; Kallenberg, W.C.M.; Lukocius, V.
Methods for computing risk measures, such as stop-loss premiums, tacitly assume independence of the underlying individual risks. This can lead to huge errors even when only small dependencies occur. In the present paper, a general model is developed which covers what happens in practice in a
The proximal risk factors are male gender, age < 2 years, 2nd birth order and positive family nd history. The social status of families is a distal risk factor. The second year of life and 2 birth order are the strongest predisposing factors to the development of FC. Key words: Febrile convulsions, Risk factors, Benin City, Nigeria ...
Tabbara, Khalid F; Kotb, Amgad A
To establish a grading system that helps identify high-risk individuals who may experience corneal ectasia after LASIK. Retrospective, comparative, interventional case series. One hundred forty-eight consecutive patients (148 eyes) were included in this study. Thirty-seven patients who underwent LASIK at other refractive centers experienced corneal ectasia in 1 eye after LASIK. One hundred eleven eyes of 111 patients who underwent successful LASIK during the same period were age and gender matched and served as controls. All patients underwent preoperative and postoperative topographic analysis of the cornea. The follow-up period in both groups of patients ranged from 2 to 5 years, with a mean follow-up of 3.6 years. All patients underwent LASIK for myopia (spherical equivalent, -4.00 to -8.00 diopters). Corneal keratometry, oblique cylinder, pachymetry, posterior surface elevation, difference between the inferior and superior corneal diopteric power, and posterior best sphere fit (BSF) over anterior BSF were given a grade of 1 to 3 each. An ectasia grading system was established, and the cumulative risk score was assessed. Patients who had a grade of 7 or less showed no evidence of corneal ectasia, whereas 16 (59%) of 27 patients who had a grade of 8 to 12 had corneal ectasia. Twenty-one (100%) of 21 patients with a grade of more than 12 had corneal ectasia after LASIK (P<0.0001). A risk score may help in the prediction of patients who are at risk of experiencing corneal ectasia after LASIK. A prospective clinical study is needed to assess the validity of these risk factors.
Full Text Available Background and aims :Prevalence of musculoskeletal disorders (MSDs is high among office workers. Long time seated posture, working with computer, repetitive movements and inappropriate environmental conditions may have causal effects in these disorders. High prevalence rate of MSDs makes ergonomics assessment and working conditions improvement necessary. Designing an assessment checklist and calculating ergonomics indices can be useful in this evaluation. This study was conducted with the objectives of determination of prevalence rate, ergonomics assessment of working conditions and determination of factors associated with MSDs among office workers. Methods:In this study 400 randomly selected office workers participated. Nordic musculoskeletal disorders questionnaire was applied to determine prevalence rate of MSDs. Working conditions were assessed by the designed ergonomics checklist and ergonomic risk factors were identified. Data were analyzed using statistical tests including t-test, Chi-square and test of proportion by SPSS software (Version 12.0. Results:The highest prevalence rates of MSDs were reported in lower back and neck regions (49% and 47%, respectively. Statistical analysis revealed that there were significant association between occurrence of MSDs and calculated ergonomics indices (P<0.05. The mean of ergonomics index among those suffered from MSDs were less than other healthy workers indicating inappropriate ergonomics conditions. Calculation of OR also revealed that ergonomics conditions was associated with MSDs occurrence among workers (P<0.05. Totally, 53.3% of the office workers studied had poor working conditions. Awkward working posture and inappropriate workstation design were recognized as the main risk factors in the office workplace. Conclusion:Most ergonomics problems were originated from bad postures and inappropriate design of workstation. Any interventional program for working conditions improvement should
Full Text Available The article analyses the effect of two ambient scents (peppermint and vanilla and their intensiveness on risk related behaviour that is expressed through selected decision making heuristics. Purpose of the article: The purpose of this article is to identify the relationship of ambient scent type and intensiveness with risk related behaviour that is expressed through selected decision making heuristics. Methodology/methods: 2×2 factorial experiment with control group was run. Ambient scent type (vanilla vs. peppermint and intensiveness (8 (1mg vs. 16 sprays (2mg of scent concentrate in the same room were manipulated as between subject variables. Risk aversion, effect of anchoring heuristic on bidding, and affect (risk and benefit heuristics were tracked as dependent variables. Scientific aim: To identify whether ambient scent type and intensiveness have effect on risk related behaviour. Findings: Evidence suggests that there are effects of ambient scent on risk related behaviour, thus fulfilling the missing gap to relate ambient environment to decision making heuristics when risks are involved. However, not all heuristics were affected by experimental conditions. Subjects were bidding significantly higher amounts under low anchor conditions, when peppermint scent was around (if compared to vanilla group. Affect risk was perceived as lower in peppermint ambient scent conditions, if compared to the control group. Intensity of ambient scent also had influence on affect risk: subjects perceived less risk under high scent intensity conditions. Conclusions: By manipulating ambient scent, marketers may reduce or increase consumers risk perception and behaviour and as a consequence influence their purchase decisions. Marketers could use peppermint scent in high intensiveness in the situations where they want consumers to undertake higher risks (expensive purchases, gambling, insurance, since stakes were higher under peppermint ambient scent condition
Gbenga A Kayode
Full Text Available Low birth weight (LBW remains to be a leading cause of neonatal death and a major contributor to infant and under-five mortality. Its prevalence has not declined in the last decade in sub-Saharan Africa (SSA and Asia. Some individual level factors have been identified as risk factors for LBW but knowledge is limited on contextual risk factors for LBW especially in SSA.Contextual risk factors for LBW in Ghana were identified by performing multivariable multilevel logistic regression analysis of 6,900 mothers dwelling in 412 communities that participated in the 2003 and 2008 Demographic and Health Surveys in Ghana.Contextual-level factors were significantly associated with LBW: Being a rural dweller increased the likelihood of having a LBW infant by 43% (OR 1.43; 95% CI 1.01-2.01; P-value <0.05 while living in poverty-concentrated communities increased the risk of having a LBW infant twofold (OR 2.16; 95% CI 1.29-3.61; P-value <0.01. In neighbourhoods with a high coverage of safe water supply the odds of having a LBW infant reduced by 28% (OR 0.74; 95% CI 0.57-0.96; P-value <0.05.This study showed contextual risk factors to have independent effects on the prevalence of LBW infants. Being a rural dweller, living in a community with a high concentration of poverty and a low coverage of safe water supply were found to increase the prevalence of LBW infants. Implementing appropriate community-based intervention programmes will likely reduce the occurrence of LBW infants.
Full Text Available The increasing in the life span of patients with major thalassemia should be followed by increased quality of life. There are factors which can affect growth retardation in these patients. The aim of this study was to find out the risk factors for growth retardation in patients with major thalassemia. An analytical study with cross-sectional design was conducted at Pediatric Thalassemia Clinics of Dr.Hasan Sadikin Hospital, Bandung, in June to July 2006. The subjects of this study were patients with major thalassemia. Inclusion criteria’s were age under 14 years old, had no chronic diseases like tuberculosis, cerebral palsy with complete medical records. Risk factors were the timing of diagnosis, initial and dose of deferoxamine, volume of transfused blood, mean pretransfusion hemoglobin level, family income, and age. Antropometric measurement indices were used to assess the growth which expressed in Z score. Growth evaluated based on height/age (H/A and growth retardation if H/A <-2 SD. Risk factors for growth retardation were analyzed separately using chi-square test and odds ratio (OR with 95% confidence interval (CI. Then they were analyzed simultaneously with logistic regression method. Subjects consisted of 152 patients with major thalassemia. Seventy three thalassemia patients were stunted. Analysis showed that age (OR: 5.42, 95% CI:2.32–12.65, p <0.001, dosage of deferoxamine (OR: 4.0, 95% CI: 1.29–12.41, p: 0.016, and family income (OR: 2.32, 95% CI: 1.06–5.06, p: 0.036 were risks factors for growth retardation. Conclusion, risk factors for growth retardation in major thalassemia are age, dosage of deferoxamine, and family income.
de Araújo Nobre, Miguel; Mano Azul, António; Rocha, Evangelista; Maló, Paulo; Salvado, Francisco
This study aimed to estimate the impact of risk factors for peri-implant pathology, to identify potentially modifiable factors, and to evaluate the accuracy of the risk algorithm, risk scores and risk stratification. This retrospective case-control study with 1275 patients (255 cases; 1020 controls) retrieved a model according to the predictors: history of Periodontitis, bacterial plaque, bleeding, bone level, lack of passive fit or non-optimal screw joint, metal-ceramic restoration, proximity to other implants/teeth, and smoking habits. Outcome measures were the attributable fraction; the positive and negative likelihood ratios at different disease cut-off points illustrated by the area under the curve statistic. Six predictors may be modified or controlled directly by either the patient or the clinician, accounting for a reduction in up to 95% of the peri-implant pathology cases. The positive and negative likelihood ratios were 9.69 and 0.13, respectively; the area under the curve was 0.96; a risk score was developed, making the complex statistical model useful to clinicians. Based on the results, six predictors for the incidence of peri-implant pathology can be modified to significantly improve the outcome. It was possible to stratify patients per risk category according to the risk score, providing a tool for clinicians to support their decision-making process. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Normal ageing and Alzheimer's disease (AD) have many features in common and, in many respects, both conditions only differ by quantitative criteria. A variety of genetic, medical and environmental factors modulate the ageing-related processes leading the brain into the devastation of AD. In accordance with the concept that AD is a metabolic disease, these risk factors deteriorate the homeostasis of the Ca(2+)-energy-redox triangle and disrupt the cerebral reserve capacity under metabolic stress. The major genetic risk factors (APP and presenilin mutations, Down's syndrome, apolipoprotein E4) are associated with a compromise of the homeostatic triangle. The pathophysiological processes leading to this vulnerability remain elusive at present, while mitochondrial mutations can be plausibly integrated into the metabolic scenario. The metabolic leitmotif is particularly evident with medical risk factors which are associated with an impaired cerebral perfusion, such as cerebrovascular diseases including stroke, cardiovascular diseases, hypo- and hypertension. Traumatic brain injury represents another example due to the persistent metabolic stress following the acute event. Thyroid diseases have detrimental sequela for cerebral metabolism as well. Furthermore, major depression and presumably chronic stress endanger susceptible brain areas mediated by a host of hormonal imbalances, particularly the HPA-axis dysregulation. Sociocultural and lifestyle factors like education, physical activity, diet and smoking may also modulate the individual risk affecting both reserve capacity and vulnerability. The pathophysiological relevance of trace metals, including aluminum and iron, is highly controversial; at any rate, they may adversely affect cellular defences, antioxidant competence in particular. The relative contribution of these factors, however, is as individual as the pattern of the factors. In familial AD, the genetic factors clearly drive the sequence of events. A strong
Full Text Available In this study, we investigate the new and standardized European system of supervisory called Solvency II. In essence, asymmetric distribution of information between policyholder and insurer triggered this new regulation which aims at better protecting policyholders. Its three-pillar model is about to challenge both, insurers as well as policyholders. The first pillar includes quantitative aspects, the second pillar contains qualitative aspects and the third pillar comprises market transparency and reporting obligations. Underwriting risks, the default risk of a bank and market risks can be identified for the dynamic hybrid. Solvency II covers all these risks in the first pillar and insurers shall deposit sufficient risk-bearing capital. In our analysis, we first identify the dynamic hybrid specific risks under the Solvency II regime und then develop product modifications to reduce this risk.
Sanchez, J.A.; Retamar, J.A.; Blazquez, J.; Castano, J.C.
The was to study the natural course of pneumothorax produced after aspiration biopsy in the attempt to differentiate those cases that will resolve spontaneously from those that will require drainage, and to assess the possible risk factors associated with the development of this entity. Eighty-nine CT-guided aspiration biopsies were performed in 80 patients. Control CT was done immediately after the procedure and 24 hours later. When pneumothorax persisted, CT was repeated at 48 h, 72 h, day 5 and day 7 or until a drainage tube was introduced. The cases of pneumothorax were classified as minimal, anterior or anterolateral. Seven variables were assessed as possible risk factors for its occurrence. Pneumothorax developed on 29 occasions (32.5%), requiring drainage in 12 cases (13.5%). In 20 patients (22%), pneumothorax occurred immediately, while in the remaining 9 (10%) it was detected in the 24 h CT scan. When studied according to type, drainage was required in 3 of the 19 cases of minimal or anterior pneumothorax (15%) and in 9 or the 10 cases of anterolateral location (90%) (p<0.0005). The mean thickness of the parenchyma punctured was 3.4 cm +- 2.2. cm when pneumothorax developed and 1.3 cm+- 2 cm when it did not (p<0.0001). There is a statistically significant association between the development of anterolateral pneumothorax and the need for chest drainage. The thickness of the punctured parenchyma is associated with the production of pneumothorax. 16 refs
Cinthia Tomasa Mercado Contreras
Full Text Available The advance of the technology in communications has led to social networking sites fulfill an important role in society. Among the most used and known is Facebook, that social network allows to make public certain information and provides the opportunity to hold private conversations. This new trend of talks, and the natural desire to explore sexuality has led young people interested at phenomenon known as sexting. This phenomenon, from some of the negative consequences became public, has attracted the interest from parents, teachers, researchers and health workers, however, have not been universally well defined. This lack of unanimous conceptualization has led to confusion within the psychological, social and legal area. That is why in the present article presents results of a systematic review of articles that speak about sexting. The select articles were those that were published from 2009 to 2014, in which work was focused to adolescents and speak about risk factors and consequences of the phenomenon. The articles were analyzed by looking at the similarities and differences in their definition of sexting and their results, identifying risk factors and consequences related considered. With the analysis was possible to categorize their limitations and finally offer a possible definition of sexting.
Frías López, Ma del C; Tárraga López, P J; Rodríguez Montes, J A; Solera Albero, J; Celada Rodríguez, A; López Cara, M A; Gálvez, A
To determine the prevalence of subclinical hypothyroidism in the general population of an urban health center and describe the clinical characteristics and cardiovascular risk factors in patients with subclinical hypothyroidism. An observational study, retrospective, reviewing the medical histories of patients sampled from June 2005 until July 2007. We analyzed the following variables; facts: age and sex. Family history thyroid disease and other diseases. Personal History: cardiovascular pulmonary autoimmune, alterations gynecology obstetric diabetes, hypertension (HT) dislipemia, obesity, psychiatric alterations and haematological. Laboratory data: novel TSH, free T4, antiperoxidase antibodies, total cholesterol and its fractions. The prevalence of the sample of 100 patients collected over 8 months was 3.8% in the general population over 14 years, of which 79 were women and 21 were men. 13% were type 2 diabetics, 23% had HT and 40% had dyslipidemia. Overweight and obesity were present in 26%. The average level of TSH was 6.92 ± 2.29 μU/ml and the average level of free T4 was 1.16 ± 0.16 ng/ml. Prevalence subclinical hypothyroidism was 3.8%. especially in women with a mean age of 46. The incidence of cardiovascular risk factors in the subjects studied is higher in DM (13%), similar to general population in terms of dyslipidemia (40%) and obesity (23%) and lowest in hypertension (23%). In our study we observed a common pattern in the management of subclinical hypothyroidism, requiring the implementation and promotion of practice guidelines in primary care.
Full Text Available The study of the adolescent pregnancy has been historically centered in the mother, the preponderant focus has been considers the maternity in this stage of the vital cycle as a factor of risk. Nowadays, have begun some studies that focus the problem of the adolescent pregnancy being centered in the father’s figure to appear and proposing a healthy focus, starting from the introduction of such concepts like Resilience. The present article, is a theoretical work, it is carried out to leave of secondary data. The objective is the compilation of studies and information on the subject of adolescent fatherhood from a less explored focus, considering the factors of risk and resilience. Different studies are raised with Latin American youths. Also are analyzed the access possibilities to the sanitary system from the youths, the knowledge of birth-control methods and the participation in programs of reproductive health. It outlines the importance of including the males in the whole process of procreation and the boy’s upbringing.
Silvia Di Legge
Full Text Available Prevention plays a crucial role in counteracting morbidity and mortality related to ischemic stroke. It has been estimated that 50% of stroke are preventable through control of modifiable risk factors and lifestyle changes. Antihypertensive treatment is recommended for both prevention of recurrent stroke and other vascular events. The use of antiplatelets and statins has been shown to reduce the risk of recurrent stroke and other vascular events. Angiotensin-converting enzyme inhibitors (ACEIs and angiotensin II receptor blockers (ARBs are indicated in stroke prevention because they also promote vascular health. Effective secondary-prevention strategies for selected patients include carotid revascularization for high-grade carotid stenosis and vitamin K antagonist treatment for atrial fibrillation. The results of recent clinical trials investigating new anticoagulants (factor Xa inhibitors and direct thrombin inhibitors clearly indicate alternative strategies in stroke prevention for patients with atrial fibrillation. This paper describes the current landscape and developments in stroke prevention with special reference to medical treatment in secondary prevention of ischemic stroke.
Estrella de la Caridad Armenteros Espino
Full Text Available Background: cervix cancer constitutes the second cause of death worldwide, with new diagnosis each year. Objective: to determine the risk factors of cervical intraepithelial neoplasia in the municipality of Cruces. Methods: it was developed an analytical research with case and control design from November 2013 to November 2014. The group of cases was formed of the 34 women with this diagnosis. There were selected 64 females from the same environment with the same age for the control group. The data obtained by surveys and clinical records reviews were presented in absolute numbers and percentages. It was used Chi-squared test and odd ratio. Results: 52 % of women with neoplasia were less than 25 years old. Significant differences were found which associate neoplasia with early sexual intercourse, sexually transmitted infections by Papilloma virus, Plane genital condyloma, and the use of oral contraceptive pills. Multiple sex partner was a frequent antecedent. Conclusion: risk factors associated to cervical intraepithelial neoplasia in the group of women studied in the Cruces municipality were early sexual intercourse, mainly before 15 years old, multiple sex partner, sexually communicated diseases and the use of oral contraceptive pills for more than 5 years.
Tuggy, M L; Ong, R
We performed a population survey of telemark skiers over two ski seasons to determine specific risk factors for injury. The survey inquired about the skier's sex, experience, equipment used, injuries, and number of days skied in each season. The respondents completed the surveys whether or not they were injured while skiing. We received 677 responses from telemark skiing clubs, with 19,962 skier-days of data. The number of self-reported injuries was 178, for an overall self-reported injury rate of 8.9 per 1000 skier-days. Knee injuries (N = 48) were the most common injury (27%), followed by thumb (N = 32, 18%) and shoulder (N = 21, 12%) injuries. Specific risk factors for injury were identified with multivariate regression and survival analysis. The skill level of the skier had a significant injury-sparing effect, as did the use of plastic telemark boots. The protective effect of the plastic boots was likely due to the increased stability they provided compared with traditional leather boots. There were fewer knee injuries with the recently available releasable bindings for telemark skis. Sex and age had no significant impact on injury rates in this study population. As all reported deaths associated with telemark sking were due to environmental hazards, skiers must continue to pay close attention to these hazards in the backcountry.
Kelly Vasconcelos Chaves Martins
Full Text Available Objective: To identify risk factors related to sensorineural hearing loss in elderly. Methods: The sample consisted of 60 selected elderly, divided into two groups: the Case Group, composed by 30 individuals, 21 females and 9 males, aged at least 60 years, presenting sensorineural hearing loss, and the Control Group, composed by 30 individuals matched on gender and age, with normal hearing. The patients were submitted to audiological anamnesis and tonal audiometry. The hearing impairment was defined according to average threshold greater than 35dBNA, in the frequencies of 1,000; 2,000 and 4,000 Hz, in the best ear. Results: Statistically significant odds ratios were: a to audiological history: noise exposure and family history of deafness; b to situations involving hearing difficulty: television, church, telephone, silent environment, spatial location of sound, difficulty with voices and noisy environment; c to otologic history: tinnitus, otorrhea and nausea; and d to medical history: visual problems, smoke, alcohol, thyroid problems and kidney disease. Conclusion: The findings of this study highlighted, for sensorineural hearing loss, risk factors related to audiologic, otologic and medical history, and to situations involving hearing difficulty.
Thapa, Shyam; Neupane, Shailes
To examine the incidence of and risk factors for repeat abortion in Nepal. Data were analyzed from a survey of 1172 women who had surgical abortions between December 2009 and March 2010 in 2 clinics in Kathmandu, Nepal. Bivariate and multivariate logistic regressions were performed to estimate odds ratios for the risk factors. Among the respondents, 32.3% (95% confidence interval, 29.6-34.9) had repeat abortions. This incidence rose sharply with age and parity, and was higher among those with no intention of having a future child, those attaining primary or secondary level education, and those attending the non-governmental sector clinic. Women with repeat abortion were similar to those with 1 abortion in terms of contraceptive practice. Among women not using contraceptives at the time of the unintended pregnancy, the 3 most commonly cited reasons were ill health, non-compliance with the method intended for use, and dislike of the method. Women with repeat abortion showed a pattern of contraceptive acceptance immediately after the procedure similar to that of women who had 1 abortion. Repeat abortion is emerging as a major public health issue in Nepal, with implications for counseling and provision of abortion, and for family planning services. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Full Text Available Weather and climate risk factors for tourism are surveyed and illustrated with regard to the expected climate changes in Hungary. These changes are not at all advantageous and which affect the business in question both directly and indirectly. These are the summer resort tourism (characterised by bioclimatic indices. Green tourism is the next one to characterise, including skiing, mountain climbing and eco-tourism, as well. Here both day-to-day weather extremes and long-lasting effects on the biota (e.g. drought, or inundation for plain-area eco-tourism. Last, but not least the urban (cultural- and shopping- tourism is presented, since the large towns exhibit their special climate and different risks. The paper intends to specify these meteorological factors and effects also in terms of the different types of touristic activities. The general statements on the effect of weather and climate on tourism are illustrated by a few individual parameters and also by the so called Physiologically Equivalent Temperature. Annual and diurnal course of this parameter are presented, together with various trends in this variable at different sites and in different (hot and cold extremities of the occurring values. Other examples, helping the tourism industry are presented in various climate conditions of the country. They include high precipitation and high relative humidity information. The paper also lists the possible adaptation measures to extreme events and also their likely changes in time.
Full Text Available AbstractObjectives: to assess nurses' perceptions of risk factors for the development of phlebitis, with a special focus on the perception of phlebitic potentials of some infusion medications and solutions.Method: a cross-sectional questionnaire study, which included a sample of 102 nurses.Results: Nurses recognized some factors that may reduce the incidence of phlebitis; however, more than half of the nurses were unaware that the material and diameter of the cannula can affect the incidence rate of phlebitis. Furthermore,underlying disease and high pH of medications or solutions were identified as potential risk factors, whereas low pH and low osmolality were not. Nurses identified Vancomycin and Benzylpenicillin antibiotics with the strongest phlebitic potential. Among other medications and intravenous fluids, Aminophylline, Amiodaronehydrochloride and Potassium chloride 7.4% were identified as potentially causing phlebitis.Conclusion: predisposing factors for phlebitis relating to patients and administered therapy were identified by nurses, while some cannula related risk factors, in particular its physicochemical properties and the time for cannula replacement, were not fully perceived.
Majeed, R.; Rajar, U.D.M.
To identify the risk factors associated with childhood asthma, in children attending Isra University Hospital, Hyderabad. The study included 398 age-matched children (200 asthmatic and 198 non-asthmatic). Information was collected concerning their familial history of atopy, birth weight, environment, breastfeeding, disease and treatment history. Odds ratio was calculated for determining the risk. The children were aged between 12 months and 8 years and 60% were male. The asthmatic children were hospitalized more frequently than the non-asthmatic children (p < 0.0001). Most of the asthmatic children lived in the urban areas of Hyderabad (odd ratio (OR) 16.7, 95% CI = 3.1-14.6, p < 0.0001), had a parental history of asthma (OR 26.8, 95% CI = 10.8-68.2, p < 0.0001) or allergic rhinitis (OR 4, 95% CI 1.2-13.4, p= 0.01), 38.5% had at least one person who smoked, and were weaned earlier than the non-asthmatic children (OR =12.4, 95% CI 1.3-4.4, p < 0.01). Childhood asthma was strongly associated with a family history of asthma and allergic rhinitis, the urban place of residence, having smokers as parents and early weaning from maternal breast milk. The results highlight the need to educate the parents about the risk of smoking and early weaning in the development of asthma. (author)
Angra Larissa Durans Costa
Full Text Available ABSTRACT Introduction: Climacteric women are susceptible to a number of changes, among them osteoporosis. Osteoporosis is a disease characterized by low bone mass and susceptibility to fracture. Currently, this disease is a public health issue, being necessary to recognize its risk factors. Objectives: Identify risk factors related to osteoporosis in women attending Propis/Proex/UFMA, tracing a socio-demographic characterization and considering community lifestyles. Material and methods: This is a transversal retrospective clinical with a quantitative approach study conducted between March and June 2013 in São Luís (MA with 107 women treated at the Programa de Práticas de Integralidade em Saúde (Propis - Integrality Health Practice Program. The study was approved by the University Hospital Ethics Committee of UFMA under opinion no. 362/07. Data were tabulated and analyzed in the epidemiological Epi-Info® software, version 3.4.1. Results: The brown color was predominant, consensual relationships proved to be a protective factor and low education was a risk factor. The average age of the group with menopause was 54.1 years and without menopause was 31.3 years (p < 0.0001. The average age of menopause was 43.7 years. The irregular menstrual cycle was a protective factor. The average number of pregnancies was 4.56 for the group with menopause and 2.45 for the group without menopause, with most births occurring normally (p < 0.0001. Smoking, physical inactivity and caffeine intake were risk factors, while the absence of alcoholism and of soda intake were protective factors for the disease. Conclusion: The patients followed the socioeconomic and demographic profile of Maranhão. Most had menarche and menopause in appropriate periods, showed no positive family history of osteoporosis, did not usually drink alcohol, were sedentary and the caffeine intake was high.
Costa, Angra Larissa Durans; da Silva, Marcos Antonio Custódio Neto; Brito, Luciane Maria Oliveira; Nascimento, Anna Cyntia Brandão; do Carmo Lacerda Barbosa, Maria; Batista, José Eduardo; de Barros Bezerra, Geusa Felipa; De Castro Viana, Graça Maria; Filho, Walbert Edson Muniz; Vidal, Flávia Castello Branco; Nascimento, Maria do Desterro Soares Brandão
Climacteric women are susceptible to a number of changes, among them osteoporosis. Osteoporosis is a disease characterized by low bone mass and susceptibility to fracture. Currently, this disease is a public health issue, being necessary to recognize its risk factors. Identify risk factors related to osteoporosis in women attending PROPIS/PROEX/UFMA, tracing a socio-demographic characterization and considering community lifestyles. This is a transversal retrospective clinical with a quantitative approach study conducted between March and June 2013 in São Luís-MA with 107 women treated at the Programa de Práticas de Integralidade em Saúde (PROPIS - Integrality Health Practice Program). The study was approved by the University Hospital Ethics Committee of UFMA under opinion no. 362/07. Data were tabulated and analyzed in the epidemiological Epi-Info(®) software, version 3.4.1. The brown color was predominant, consensual relationships proved to be a protective factor and low education was a risk factor. The average age of the group with menopause was 54.1 years and without menopause was 31.3 years (p<0.0001). The average age of menopause was 43.7 years. The irregular menstrual cycle was a protective factor. The average number of pregnancies was 4.56 for the group with menopause and 2.45 for the group without menopause, with most births occurring normally (p<0.0001). Smoking, physical inactivity and caffeine intake were risk factors, while the absence of alcoholism and of soda intake were protective factors for the disease. The patients followed the socioeconomic and demographic profile of Maranhão. Most had menarche and menopause in appropriate periods, showed no positive family history of osteoporosis, did not usually drink alcohol, were sedentary and the caffeine intake was high. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.
Full Text Available Background: Gestational diabetes mellitus (GDM has been observed to be associated with increased perinatal morbidity and mortality. GDM is becoming a public health concern globally as well as in India with fast increasing trend. It affects approximately 14% of all pregnancies. Studies on the association of food items having high glycaemic index with GDM risk are sparse. Most of the literature has focused on typical risk factors like advanced maternal age, family history of diabetes mellitus, history of abortions, previous history of GDM. Objective: To assess the risk of developing GDM in pregnant women consuming food items with high glycemic index. Material and Methods: A hospital based case control study was conducted in Lady Hardinge Medical College and associated hospital with a sample size of 104 (52 cases & 52 controls. For dietary history a validated quantitative food frequency questionnaire was used. The usual pattern of eating during days, weeks and months were asked. The data was compiled and analysed in SPSS version 12. Results: Total 30.8% cases and 13.5% controls gave history of consuming food items having high glycaemic index more frequently (at least once daily. The odds ratio of developing GDM was 2.86(CI -1.06-7.70 among the cases who were taking high glycaemic foods more frequently in comparison to those who were taking occasionally. Conclusions: Risk of developing GDM in high glycemic foods consumers is high. Simple measures like changing dietary patterns, consuming food items with low glycaemic load can contribute significantly in prevention of GDM.
Mtibaa, L; Fakhfakh, N; Kallel, A; Belhadj, S; Belhaj Salah, N; Bada, N; Kallel, K
To determine epidemiological, clinical and mycological characteristics of vulvovaginal candidiasis (VVC) in Tunisian population and to evaluate predisposing factors. In this retrospective study, 2160 vaginal swabs were performed over 2 years (January 2014-December 2015). It was carried out at the laboratory of Parasitology and Mycology, Rabta Hospital in Tunisia. After swab collecting, direct examination and culture on Sabouraud Chloramphenicol and Sabouraud Chloramphenicol Actidione media were implemented to research yeasts. Then identifying of yeast species was through chlamydosporulation test and auxanogram. For each patient, a questionnaire was filled noting age, medical and surgical history, symptoms and risk factors. Statistical analysis of data was performed on SPSS 16 using Khi 2 test, P<0.05 was considered significant. Direct examination was positive showed spore and/or pseudohypha in 24.72%. Candida albicans was isolated most frequently (76.61%) followed by Candida glabrata (17.18%). The maximum frequency of Candida-positive cultures was in 25-34 years old age group. Leucorrhea was the most common symptom (72.25%) followed by vulvar prurits (63.23%), dyspareunia (32.25%) and urinary burning (24.92%). Only pregnancy was correlated positively with VVC. It appears from our study that VVC is relatively common in Tunisia. His diagnosis results from confrontation of anamnestic, clinical and mycological data. The knowledge of risk factors and their correction would be necessary to prevent the occurrence of VVC, especially in its recurrent form. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Lígia da Silva Leroy
Full Text Available Abstract OBJECTIVE: To investigate the risk factors for postpartum urinary incontinence (UI and its characteristics. METHOD: This was a case-control study with 344 puerperal women (77 cases and 267 controls with up to 90 days postpartum. In a single session, participants were given a questionnaire with sociodemographic and clinical data and two others that assessed urine leakage, leakage situations, and type of UI. RESULTS: Stress UI was present in 45.5% of the women, incidents of urine leakage several times a day in 44.2%, of which 71.4% were in small amounts and 57.1% when coughing or sneezing. In 70.1% of cases, UI began during pregnancy and remained through the postpartum period. After running a binary logistic regression model, the following factors remained in the final model: UI during pregnancy (OR 12.82, CI 95% 6.94 - 23.81, p<0.0001, multiparity (OR 2.26, CI 95% 1.22 - 4.19, p=0.009, gestational age at birth greater or equal to 37 weeks (OR 2.52, CI 95% 1.16 - 5.46, p=0.02 and constipation (OR 1.94, CI 95% 1.05 - 5.46, p=0.035. CONCLUSION: Most often, UI first appeared during pregnancy and remained through the postpartum period. Urinary incontinence during pregnancy, multiparity, gestational age at birth greater or equal to 37 weeks, and constipation were presented as risk factors. In the studied group, stress UI was more frequent.
Li, Fawen; Wang, Liping; Zhao, Yong
Land use pattern contains a large amount of information about the flood hazard-formative environments, which is the most sensitive factor in hazard-formative environments. In this paper, based on the land use pattern in 2008 (the base year) and in 2020 (the planning year), the comparative analysis of flood disaster risk changes in Haihe basin were studied by the spatial analysis function of ARCGIS and the analytic hierarchy process (AHP). The results showed the flood disaster risk in Haihe basin had an obvious zonality in the space, among which low risk was located in the northwest regions, and high risk was located in the southeast regions. Flood disaster risk in planning year was lower than in the base year. The risk value of 2020 in the mountain decreases from 0.445 to 0.430, while the risk value of the plain increases from 0.562 to 0.564. For the plain, high-risk area in 2020 is increased by 13.2%, which is the biggest change in risk grades. For the mountain, low-risk area and low risk area in 2020 are increased, and the low-risk area is the biggest increase, up to 37.7%. Meanwhile, high-risk area, high risk area, and medium risk area all tend to decrease, and the high-risk area is the biggest decrease, up to 32.6%. Overall, land use planning pattern under low-carbon mode is conducive to the Haihe basin flood control. The research can provide scientific foundations for basin land use planning and flood disaster risk management.
I. A. Kiseleva
Full Text Available One of the most important components in today's market is a party decision-making under risk and uncertainty. The first step in making such decisions - to adequately process the information for estimating the future value of assets and the interests of investors probabilities of each particular scenario. The next step is to choose the alternative that has the greatest utility for the investor. Each of these steps is associated with numerous difficulties, the roots of which stem from the specificity of human psychology. The article notes that an integral part of professional risk management is to identify the nature of the object of management in the sphere of economy. Since the domestic theory of risk management is being formed-tion, the problem of a clear comprehensive definition of “risk” becomes now particularly relevant-ness. The article deals with along with economic forecasts of the risks and the human factor in decision-tions solutions. Along with economic forecasts, the report focuses on psychological problems and attempts to take into account the human factor in decision-making at the forecast of risks arising in the company. The important parameters are the status and position of the person in the society, as well as its social well-being. Analysis Meto-ing risk assessment concluded that the need to develop new models and methods of risk management, taking into account the four-lovecheskogo factor. Economic psychology and its applications have developed into a special branch of economic knowledge - the so-called behavioral economics, which surely develops a wide range of economic issues - from the actual theory of individual behavior to the problems of public choice and the financial economy. The most interesting item is the fact that the concept of “risk” is considered from different points of view - as the economist-mathematician with the position, and a psychologist.
Full Text Available In the article some historical aspects of insurance, domestic trends in insurance risk management with aspects of international experience, the modern role of insurance and insurance companies in a market economy, factors of risk management system and the nature of the insurance portfolio are analyzed. Factors of risk events in insurance, the spectrum of risks, imbalance of the insurance market in crisis conditions are outlined; expert’s estimations of the insurance market in recent years are examined. Problems of insurance business perform are determined, especially insurance risk management. The ability to use the provisions of European insurance regulation on internal domestic insurance market is analyzed, and also the aspects of integration of Ukrainian insurance market are determined.
Sandra Cristina Dias dos Santos
Full Text Available Background: Crohn's disease is an inflammatory disease that can reach any part of the gastrointestinal tract. This disease has been associated with an increased neoplastic risk, including colorectal carcinoma. Objective: The objective of this work is to describe the mechanisms present in two diseases, and that are responsible for the increased risk in Crohn's disease. Methods: A bibliographic research was conducted in PubMed database. In addition to the articles obtained with an inserted query in Pubmed, other references relevant to the topic in question were included. Results: Colorectal cancer risk varies according to the presence of certain factors, and an example of this is Crohn's disease. Chronic inflammation seems to be an important contribution to carcinogenesis, since it creates a microenvironment suitable for the onset and progression of the disease. There are molecular changes that are common to two conditions, thus justifying the fact of Crohn's disease being a risk factor for colorectal carcinoma. The disease control with an appropriate therapy and with surveillance are two ways to control this risk. Conclusions: A proinflammatory state is the cornerstone in the association between Crohn's disease and colorectal carcinoma. The implementation of surveillance strategies allowed a decrease in morbidity and mortality associated with this cancer. Resumo: Introdução: A doença de Crohn é uma doença inflamatória que pode atingir todo o trato gastrointestinal. Esta patologia tem sido associada a um risco neoplásico aumentado, nomeadamente de carcinoma colorretal. Objetivo: O objetivo deste trabalho é descrever os mecanismos responsáveis pelo aumento do risco de carcinoma colorretal na doença de Crohn. Métodos: A pesquisa bibliográfica foi realizada na base de dados Pubmed. Para além dos artigos obtidos com a query inserida na Pubmed, foram também incluídas outras referências com relevância para o tema em questão. Resultados
Financial or corporate risk management is a part of the firm risk management with which deal with the financial risks, such as market risk, liquidity risk and credit risk. In the context of international financial crisis, a variety of factors are influencing the development of corporate risk management: the increased volatility and deregulation of financial markets; developments in information and communications technology; the complexity of financial products and so on. The objective of risk...
Okroglic, S.; Widmann, C.N.; Urbach, H.; Scheltens, P.; Heneka, M.T.
Objective: Although the clinical manifestation and risk factors of cerebral microangiopathy (CM) remain unclear, the number of diagnoses is increasing. Hence, patterns of association among lesion topography and severity, clinical symptoms and demographic and disease risk factors were investigated
Ostergaard, Lars; Børrestad, Line A B; Tarp, Jakob
To investigate whether bicycling to school improves cardiometabolic risk factor profile and cardiorespiratory fitness among children.......To investigate whether bicycling to school improves cardiometabolic risk factor profile and cardiorespiratory fitness among children....
Conclusions: skipping breakfast is associated with increased risk of MetS and other cardiometabooic factors in children and adolescents. Promoting the benefit of eating breakfast could be a simple and important implication to prevent these risk factors.
... Risk Factors for Bone Loss Bed Rest and Immobilization: Risk Factors for Bone Loss Like muscle, bone ... complications of pregnancy; and those who are experiencing immobilization of some part of the body because of ...
Iversen, Louise Bagger; Strandberg-Larsen, Katrine; Prescott, Eva
on average gained 2 kg of weight and 8% became obese during follow-up. The experience of major life events in childhood, work life and adult life was associated with weight gain and obesity in women, but not in men. Vital exhaustion was associated with weight gain in a dose-response manner in men (P = 0......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...
Mohamed Shameem P. M
Full Text Available INTRODUCTION Diabetic foot ulcers vary in their clinical presentation and nature of severity and therefore create a challenging problem to the treating surgeon regarding the prediction of the clinical course and the end result of the treatment. Clinical studies have shown that there are certain risk factors for the progression of foot ulcers in diabetics and it may therefore be possible to predict the course of an ulcer foot at presentation itself, thus instituting proper therapy without delay. Spoken otherwise clinical scoring may tell that this particular ulcer is having highest chance of amputation, then one may be able to take an early decision for the same and avoid the septic complications, inconvenience to the patient, long hospital stay and cost of treatments. AIM OF THE STUDY Aim of the study is to evaluate the above-mentioned scoring system in predicting the course the diabetic foot ulcers. MATERIALS AND METHODS 50 patients with Diabetic Foot attending the OPD of Department of Surgery of Government Hospital attached to Calicut Medical College are included in the present study. After thorough history taking and clinical examination, six risk factors like Age, pedal vessels, renal function, neuropathy, radiological findings and ulcers were observed in the patients by giving certain scoring points to each of them. The total number of points scored by the patients at the time of admission or OPD treatment was correlated with the final outcome in these patients, whether leading to amputation or conservative management. All the data was analysed using standard statistical methods. OBSERVATIONS AND RESULTS There were 12 females and 38 males with a female to male ratio 1:3.1. All were aged above 30 years. Twenty-four (48% of them were between 30-60 years and twenty six (52% were above 60 years. 10 patients were treated conservatively with risk score range: 10 to 35. Six had single toe loss with risk score: 25 to 35. Six had multiple toe loss
Full Text Available This paper present review and analysis of risk factors, which could affect successful implementation of ERP system, for project performed in project oriented organizations. Presented risk breakdown structure and the list of common risk factors, are well-suited for ERP implementation projects. Considered risk categories allow for complex risk analysis. Additionally, mapping of risk importance for particular implementation phases is presented. Making presented model an important input for project risk management process, especially for the beginning phases which require identification of risk factors.
Full Text Available Dengue hemorrhagic fever is an infectious disease resulting spectrum of clinical manifestations that vary from the lightest, dengue fever, hemorrhagic fever and dengue fever are accompanied by shock or dengue shock syndrome. Its caused by dengue virus, transmitted by Aedes mosquitoes. The case is spread in the tropics, especially in Southeast Asia, Central America, America and the Caribbean, many causes of death in children 90% of them attacking children under 15 years old. Until now pathogenesis is unclear. There are two theories or hypotheses immuno-patogenesis DHF and DSS is still controversial which secondary infections (secondary heterologus infection and antibody-dependent enhancement. Risk factors for dengue transmission are rapid urban population growth, mobilization of the population because of improved transportation facilities and disrupted or weakened so that population control. Another risk factor is poverty which result in people not has the ability to provide a decent home and healthy, drinking water supply and proper waste disposal.
Full Text Available Michael C Kew Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa Abstract: Hepatocellular carcinoma is one of the major malignant tumors in the world today. The number of new cases of the tumor increases year by year, and hepatocellular carcinoma almost always runs a fulminant course and carries an especially grave prognosis. It has a low resectability rate and a high recurrence rate after surgical intervention, and responds poorly to anticancer drugs and radiotherapy. Hepatocellular carcinoma does not have a uniform geographical distribution: rather, very high incidences occur in Eastern and Southeastern Asia and in sub-Saharan Black Africans. In these regions and populations, the tumor shows a distinct shift in age distribution toward the younger ages, seen to greatest extent in sub-Saharan Black Africans. In all populations, males are more commonly affected. The most common risk factors for hepatocellular carcinoma in resource-poor populations with a high incidence of the tumor are chronic hepatitis B virus infection and dietary exposure to the fungal hepatocarcinogen aflatoxin B1. These two causative agents act either singly or synergistically. Both the viral infection and exposure to the fungus occur from early childhood, and the tumor typically presents at an early age. Chronic hepatitis C virus infection is an important cause of hepatocellular carcinoma in resource-rich countries with a low incidence of the tumor. The infection is acquired in adulthood and hepatocellular carcinoma occurs later than it does with hepatitis B virus-induced tumors. In recent years, obesity and the metabolic syndrome have increased markedly in incidence and importance as a cause of hepatocellular carcinoma in some resource-rich regions. Chronic alcohol abuse remains an important risk factor for malignant transformation of hepatocytes, frequently in association with alcohol-induced cirrhosis. Excessive iron
Full Text Available Introduction: Ectopic pregnancy is a pregnancy with extrauterine implantation. This situation is gynecologic emergency that contributes to maternal mortality. Therefore, early recognition, based on identification of the causes of ectopic pregnancy risk factors, is needed. Methods: The design descriptive observational. The samples were pregnant women who had ectopic pregnancy at Maternity Room, Emergency Unit, Dr. Soetomo Hospital, Surabaya, from 1 July 2008 to 1 July 2010. Sampling technique was total sampling using medical records. Result: Patients with ectopic pregnancy were 99 individuals out of 2090 pregnant women who searched for treatment in Dr. Soetomo Hospital. However, only 29 patients were accompanied with traceable risk factors. Discussion:. Most ectopic pregnancies were in the age group of 26-30 years, comprising 32 patients (32.32%, then in age groups of 31–35 years as many as 25 patients (25.25%, 18 patients in age group 21–25 years (18.18%, 17 patients in age group 36–40 years (17.17%, 4 patients in age group 41 years and more (4.04%, and the least was in age group of 16–20 years with 3 patients (3.03%. A total of 12 patients with ectopic pregnancy (41.38% had experience of abortion and 6 patients (20.69% each in groups of patients with ectopic pregnancy who used family planning, in those who used family planning as well as ectopic pregnancy patients with history of surgery. There were 2 patients (6.90% of the group of patients ectopic pregnancy who had history of surgery and history of abortion. The incidence rate of ectopic pregnancy was 4.73%, mostly in the second gravidity (34.34%, whereas the nulliparous have the highest prevalence of 39.39%. Acquired risk factors, i.e. history of operations was 10.34%, patients with family planning 20.69%, patients with history of abortion 41.38%, patients with history of abortion and operation 6.90% patients with family and history of abortion was 20.69%.
Наталья Витальевна Батырева
Full Text Available The aim of the research – assess risk factors for very preterm delivery in the Omsk region. Materials and methods. The main group comprised women with very preterm delivery (n = 64; сomparison group – pregnant women with a threat of interruption in terms of 22-27 weeks and successful preserving therapy (n = 63; control group – pregnant women in whom this pregnancy was taking place without the threat of interruption (n = 62. Results. Risk factors for very preterm delivery were bacterial vaginosis, specific vaginitis, kidney disease and the threat of interruption. There was a significant lead in streptococci (32.3 ± 5.8 %, especially group B (19.0 ± 4.9 % in the main group. The risk factor for very preterm delivery was infectious viral diseases transferred during pregnancy, observed in 12.7 ± 4.2 % of women in the main group, in 7.8 ± 3.3 % in the comparison group (p < 0.01 and in 4.8 ± 2,7 % – control (p < 0,001. In the main group, placental insufficiency was 2 times more common than in the comparison group and 13 times than in the control group. Every sixth pregnant of the main group had manifestations of gestosis. Such complications of gestation as the premature detachment of the normally inserted placenta (7.8 ± 3.3 % and inborn malformations of a fruit (1.6 ± 1.6 % were observed only in the main group. Conclusion. The results of the research and literature data showed that the significant influence on the level of very early premature births is due to: the age of the parents, the abuse of nicotine, alcohol, drugs, abortion, preterm birth, urinary tract and genital tract infections, severe somatic diseases, multiple pregnancies. In the structure of complications of gestation during miscarriages, placental insufficiency predominates, the threat of abortion, fetal growth retardation, and polyhydramnios.
Ramesh Kota; Ramesh Lingala
BACKGROUND Incisional hernia is a common surgical problem with which a patient presents to the surgical OPD. There are certain modifiable risk factors, which if corrected can prevent incisional hernia. Among these risk factors, obesity is a major risk factor. Present study aims to prove that obesity is a major risk factor for incisional hernia. MATERIALS AND METHODS It is a prospective observational study conducted at a tertiary care centre from December 2014 to December 2017...
Sumanth Mallikarjuna Majgi
Full Text Available Purpose: Prevalence of type 2 diabetes is increasing in India. Rural area constitutes 80% of India. Hence it is essential to understand the epidemiology for appropriate interventions. Objectives: to identify risk factors of type 2 diabetes mellitus in rural Puducherry. Methodology: Cross sectional study in two villages of Puducherry, India. 1403 subjects above 25 years from 2 villages. Study measured demographic variables, Body Mass Index (BMI, physical activity, family history of Diabetes Mellitus, smoking and alcohol consumption. Fasting blood glucose was measured for study subjects. Further, those with >126 mg/dl were subjected for Oral Glucose Tolerance Test. Univariate and multivariate analysis was done. Receiver Operating characteristic Curve was plotted to find out cut off for Diabetic Risk Score. Findings: The prevalence of type 2 Diabetes Mellitus (DM was 5.8%. The response rate was (88%. In univariate analysis age, occupation, Socio Economic Status, BMI, physical activity, family history were significant for DM. In multivariate analysis age, BMI, family history of diabetes and occupation were significant for type 2 DM. The ‘diabetes risk score’ generated by the study using age, BMI and family history of DM, had specificity, sensitivity and accuracy of 54%, 77% and 76.2% respectively. The area under curve for scoring system was 0.784 (<0.05. Conclusions: Identified risk factors are useful for early diagnosis by using ‘diabetes risk score’ – thus uncovering the iceberg of disease.
Full Text Available Dams and reservoirs are useful systems in water conservancy projects; however, they also pose a high-risk potential for large downstream areas. Flood, as the driving force of dam overtopping, is the main cause of dam failure. Dam floods and their risks are of interest to researchers and managers. In hydraulic engineering, there is a growing tendency to evaluate dam flood risk based on statistical and probabilistic methods that are unsuitable for the situations with rare historical data or low flood probability, so a more reasonable dam flood risk analysis method with fewer application restrictions is needed. Therefore, different from previous studies, this study develops a flood risk analysis method for large dams based on the concept of total risk factor (TRF used initially in dam seismic risk analysis. The proposed method is not affected by the adequacy of historical data or the low probability of flood and is capable of analyzing the dam structure influence, the flood vulnerability of the dam site, and downstream risk as well as estimating the TRF of each dam and assigning corresponding risk classes to each dam. Application to large dams in the Dadu River Basin, Southwestern China, demonstrates that the proposed method provides quick risk estimation and comparison, which can help local management officials perform more detailed dam safety evaluations for useful risk management information.
Chu, L W; Pei, C K; Chiu, A; Liu, K; Chu, M M; Wong, S; Wong, A
The incidence of falls among older hospitalized patients is higher than that of community-dwelling older persons. Prevention is important, but factors associated with these falls are less well studied than falls occurring in the community or nursing homes. This study was conducted in an acute-care general hospital in Hong Kong. During November 1995 to March 1997, all older inpatients who fell during hospitalization were assessed by a geriatrician, a physiotherapist, and an occupational therapist. A standardized protocol to study the clinical and performance-oriented functional factors was employed. A sex- and age-matched hospital control was recruited for each case. In total, 51 cases and controls (mean ages 77.8 +/- 7.3 years and 77.5 +/- 7.0 years, respectively) were studied. Among the multiple clinical and functional risk factors for falls identified, lower limb weakness (i.e., power less than MRC grade 4 in one or both lower limbs) and poor tandem walk ability emerged as two significant predictive factors for falls in the hospital. The overall classification accuracy of fallers and nonfallers was 79%. The sensitivity was 84% and specificity was 75%. Clinical factors were the underlying causes for the lower limb weakness and poor tandem walk performance. Among clinical and functional risk factors for falls in the older medical patient, lower limb weakness and poor tandem walk ability were most predictive. Falls prevention programs in hospitals should employ these two tests as screening instruments.
Deswal B S
Full Text Available Research question: What is the extent of low weight babies born in hospitals and its association with some maternal factors? Objectives: 1. To find an overall prevalence of low birth weight babies amongst hospital births in Meerut city. 2. To identify and quantify the effects of some risk factors for low birth weight. Setting: District women Hospital of Meerut city of western U.P. Study Design: Hospital based matched case-control study. Sample size: 491 low birth weight babies as â€˜casesâ€ and an equal number of babies of normal birth weight in â€˜controlâ€ group matched for maternal age, sex of baby, birth order and institution of delivery. Study variables: Socio-economic Status: maternal biological factors including obstetric history: antenatal factors: nutritional factors: history of abortion: toxaemia of pregnancy etc. Results: Overall proportion of low birth weight babies was found to be 21.8% amongst hospital live births and 30.9% born to mothers aged below 30 years of age. Low maternal weight, under nutrition, lack of antenatal care, short inter-pregnancy interval, toxacmia of pregnancy were independent factors increasing the risk of low birth weight significantly. Conclusions: The study suggested that a substantial proportion of low birth weight babies can be averted by improving maternal nutritional status including anemic condition, birth spacing and proper antenatal care.
Introduction: Osteoradionecrosis (ORN) of the jaws is defined as exposed irradiated bone that fails to heal over a period of 3 months without the evidence of a persisting or recurrent tumor. In the previous decades, numerous factors were associated with the risk of ORN development and severity. Aims: The purposes of this study were to present the data of the patients that were treated for ORN in the Department of Oral and Maxillofacial Surgery in Munich (LMU), to detect factors that contributed to the onset of ORN, to identify risk factors associated with the severity of ORN and finally, to delineate and correlate these factors with the personal, health and treatment characteristics of the patients. Material and Methods: A retrospective study was conducted during the period from January 2003 until December 2012 that included all ORN cases having been treated in the Department of Oral and Maxillofacial Surgery in Munich (LMU). The total sample was categorized in three groups according to stage and several variables were evaluated in an attempt to identify possible correlations between them and the necrosis severity. Results: One hundred and fifty three cases of ORN were documented. Among them, 23 (15.1%) cases were stage I, 31 (20.2%) were stage II and 99 (64.7%) were stage III and all localised in the mandible. There was a predominance of the disease in the posterior region when compared to the anterior region. The majority of cases was addicted to alcohol and tobacco abuse and was suffering from Diabetes Mellitus (DM). All cases were treated with RT and 80.4% of them with concomitant chemotherapy. The initial tumor was predominantly located in the floor of the mouth, the tongue and the pharynx. Approximately two thirds of the cases occured either after dental treatment or due to a local pathological condition. Logistic regression analysis identified Diabetes Mellitus (OR: 4.955, 95% Cl: 1.965-12.495), active smoking (OR: 13.542, 95% Cl: 2.085-87.947), excessive
Introduction: Osteoradionecrosis (ORN) of the jaws is defined as exposed irradiated bone that fails to heal over a period of 3 months without the evidence of a persisting or recurrent tumor. In the previous decades, numerous factors were associated with the risk of ORN development and severity. Aims: The purposes of this study were to present the data of the patients that were treated for ORN in the Department of Oral and Maxillofacial Surgery in Munich (LMU), to detect factors that contributed to the onset of ORN, to identify risk factors associated with the severity of ORN and finally, to delineate and correlate these factors with the personal, health and treatment characteristics of the patients. Material and Methods: A retrospective study was conducted during the period from January 2003 until December 2012 that included all ORN cases having been treated in the Department of Oral and Maxillofacial Surgery in Munich (LMU). The total sample was categorized in three groups according to stage and several variables were evaluated in an attempt to identify possible correlations between them and the necrosis severity. Results: One hundred and fifty three cases of ORN were documented. Among them, 23 (15.1%) cases were stage I, 31 (20.2%) were stage II and 99 (64.7%) were stage III and all localised in the mandible. There was a predominance of the disease in the posterior region when compared to the anterior region. The majority of cases was addicted to alcohol and tobacco abuse and was suffering from Diabetes Mellitus (DM). All cases were treated with RT and 80.4% of them with concomitant chemotherapy. The initial tumor was predominantly located in the floor of the mouth, the tongue and the pharynx. Approximately two thirds of the cases occured either after dental treatment or due to a local pathological condition. Logistic regression analysis identified Diabetes Mellitus (OR: 4.955, 95% Cl: 1.965-12.495), active smoking (OR: 13.542, 95% Cl: 2.085-87.947), excessive
Tran, Dieu-My T; Zimmerman, Lani M; Kupzyk, Kevin A; Shurmur, Scott W; Pullen, Carol H; Yates, Bernice C
To assess college students' knowledge and perception of cardiovascular risk factors and to screen for their cardiovascular risks. The final sample that responded to recruitment consisted of 158 college students from a midwestern university. A cross-sectional, descriptive study was performed using convenience sampling. College students were knowledgeable about cardiovascular risk factors but did not perceive themselves at risk for cardiovascular disease (CVD). Knowledge of cardiovascular risk factors was correlated with the lifetime risk estimates (ρ = .17, p = .048), and perception of cardiovascular risk was positively associated with 30-year CVD risk estimates (ρ = .16, p = .048). More than 50% of the participants had 1 or more cardiovascular risk factors. High knowledge level of cardiovascular risk factors was not sufficient to lower cardiovascular risks within this study population, but changing perception of cardiovascular risk factors may play a bigger role in reducing long-term cardiovascular risks.
Søborg, Bolette; Andersen, Aase Bengaard; Melbye, Mads
To examine the risk factors for Mycobacterium tuberculosis infection (MTI) among Greenlandic children for the purpose of identifying those at highest risk of infection.......To examine the risk factors for Mycobacterium tuberculosis infection (MTI) among Greenlandic children for the purpose of identifying those at highest risk of infection....
Introduction: cardiovascular risk factors are prevalent in HIV-positive patients which places them at increased risk for cardiovascular disease (CVD). We aimed to determine the risk factors and risk assessment for CVD in HIV-positive patients with and without antiretroviral therapy. Methods: this was a cross-sectional study of ...
Xie, Zhixin; Page, Lionel; Hardy, Ben
There is a significant gender imbalance on financial trading floors. This motivated us to investigate gender differences in financial risk taking under pressure. We used a well-established approach from behavior economics to analyze a series of risky monetary choices by male and female participants with and without time pressure. We also used second to fourth digit ratio (2D:4D) and face width-to-height ratio (fWHR) as correlates of pre-natal exposure to testosterone. We constructed a structural model and estimated the participants' risk attitudes and probability perceptions via maximum likelihood estimation under both expected utility (EU) and rank-dependent utility (RDU) models. In line with existing research, we found that male participants are less risk averse and that the gender gap in risk attitudes increases under moderate time pressure. We found that female participants with lower 2D:4D ratios and higher fWHR are less risk averse in RDU estimates. Males with lower 2D:4D ratios were less risk averse in EU estimations, but more risk averse using RDU estimates. We also observe that men whose ratios indicate a greater prenatal exposure to testosterone exhibit a greater optimism and overestimation of small probabilities of success.
Full Text Available There is a significant gender imbalance on financial trading floors. This motivated us to investigate gender differences in financial risk taking under pressure. We used a well-established approach from behavior economics to analyze a series of risky monetary choices by male and female participants with and without time pressure. We also used second to fourth digit ratio (2D:4D and face width-to-height ratio (fWHR as correlates of pre-natal exposure to testosterone. We constructed a structural model and estimated the participants' risk attitudes and probability perceptions via maximum likelihood estimation under both expected utility (EU and rank-dependent utility (RDU models. In line with existing research, we found that male participants are less risk averse and that the gender gap in risk attitudes increases under moderate time pressure. We found that female participants with lower 2D:4D ratios and higher fWHR are less risk averse in RDU estimates. Males with lower 2D:4D ratios were less risk averse in EU estimations, but more risk averse using RDU estimates. We also observe that men whose ratios indicate a greater prenatal exposure to testosterone exhibit a greater optimism and overestimation of small probabilities of success.
Oct 13, 2011 ... risk factor and 104(76%) recognized history of previous benign breast lump as a risk factor . Other risk factors .... nurses in Nigeria where 89% would agree to have mastectomy should they develop breast cancer . ... Only seventy five percent carried out the procedure at least once every month. A lower.
Abstract. Background: Asthma exacerbations are caused by a variety of risk factors. Reducing exposure to these risk factors improves the control of asthma and reduces medication needs. Knowledge of the particular risk factors is essential in formulating controlling and treatment protocols. This study set out to determine the ...
de Borst, Martin H.; de Boer, Rudolf A.; Stolk, Ronald P.; Slaets, Joris P. J.; Wolffenbuttel, Bruce H. R.; Navis, Gerjan
In the Western world, the majority of morbidity and mortality are caused by multifactorial diseases. Some risk factors are related to more than one type of disease. These so-called universal risk factors are highly relevant to the population, as reduction of universal risk factors may reduce the
Vascular access complications and risk factors in hemodialysis patients: A single center study. ... Stenosis was the most common risk factor for vascular failure as it occurred in (29%) of patients. ... Other risk factors for dialysis CRBSI include older age, low serum albumin, high BUN and decreasing the duration of dialysis.
Tarek A. Ghonemy
Aug 18, 2015 ... Diabetes was the second common risk factor for vascular failure as it occurred in (17%) of patients. Conclusion: Stenosis and infection are the most common complications of the vascular access. DM is an important risk factor for the incidence of infection. Other risk factors for dialysis CRBSI include older ...
Aim: This study was aimed to determine the prevalence of modifiable risk factors of hypertension in ... Ibekwe: Correlation between modifiable risk factors of hypertension and socio‑demographic profile in Oghara, Delta State. 72. Annals of ..... non‑communicable disease risk factors among older adults in South Africa.
There was a statistically significant association between presence of hypertension and impaired fasting glucose and risk factor for type 2 DM. Conclusion: The significant risk factors identified in this study were prehypertension/hypertension and impaired fasting blood glucose. Key words: Adolescence, Risk factors, Type 2 ...
Conclusion: DCM and cardiac sarcoidosis were identified as risk factors for amiodarone-induced hyperthyroidism. Risk factors for amiodarone-induced hypothyroidism included higher baseline TSH level and lower baseline free T4 level, suggesting that subclinical hypothyroidism may be a potential risk factor for the development of amiodarone-induced hypothyroidism.
Wang, Chun-Hao; Lee, Sai-Cheong; Huang, Shie-Shian; Kao, Yu-Chin; See, Lai-Chu; Yang, Shih-Hsien
Scabies is a global problem. Transmission of scabies is usually due to direct or indirect contact. Delay in diagnosis may result in the spread of the scabies mite. Prompt diagnosis and treatment are important. In this study, we collected data from 52 scabies patients and analyzed the risk factors for scabies with the case-control method. Our study has revealed that the patients who were bedridden [odds ratio (OR) 6.72, p scabies infection. To prevent scabies, proper management of the nursing home setting, including adequate cleaning of the contaminated clothing, bedding and equipment, in combination with treating all suspected scabies patients, and contact isolation are important and necessary. Copyright © 2012. Published by Elsevier B.V.
Girbovan, Anamaria; Sur, Genel; Samasca, Gabriel; Lupan, Iulia
Celiac disease remains one of the most challenging pathologies of the small intestine. It involves multiple pathogenic pathways and there are no disease-changing pharmacological agents available against it yet. The term microbiota refers to the community of microorganisms that inhabit a particular region of the body. Normal gut microbiota has a vital role in maintaining the intestinal homeostasis and promoting health. Celiac disease is associated with microbiota alteration, especially with an increase in the number of Gram-negative bacteria and a decrease in the number of Gram-positive bacteria. There is a strong relationship between intestinal dysbiosis and celiac disease, and recent studies are aimed at determining whether the celiac disease is a risk factor for dysbiosis or dysbiosis is for celiac disease. Therefore, the aim of this review was to assess the latest findings regarding the gut microbiota and its impact on the celiac disease, including therapeutic aspects.
Stenager, E N; Koch-Henriksen, N; Stenager, E
suicides with the 1950-1985 onset cohort patients in the DSMR as to distribution of age at onset, presenting symptoms, and time from onset to diagnosis. We reviewed sociodemographic data, age of onset, the course of the disease, recent deterioration, type of deterioration, Kurtzke Disability Status Scale...... (DSS) score, previous mental disorder, type of mental disorder, previous suicide attempts, expression of suicidal intentions, circumstances at suicide, and suicide method for all MS patients who had committed suicide. In order to characterize MS suicides with respect to risk factors, comparisons were...... made for male and female suicides and for various groups of MS suicides according to disability status. RESULTS: The male suicide patients were characterized by a tendency to commit suicide in the age interval 40-49 years, by the use of a violent suicide method, by previous suicidal behaviour...
Full Text Available 150 cases of retinal detachment comprising 50 patients each of bilateral retinal detachment, unilateral retinal detachment without any retinal lesions in the fellow eve and unilateral retinal detachment with retinal lesions in the fellow eye were studied and the various associated risk factors were statistically analysed. The findings are discussed in relation to their aetiological and prognostic significance in the different types of retinal detachment. Based on these observations certain guidelines are offered which may be of value in decision making, in prophylactic detachment surgery. Tractional breaks in the superior temporal quadrant especially when symptomatic. mandate prophylactic treatment. Urgency is enhanced it′ the patient is aphakic. Associated myopia adds to the urgency. The higher incidence of initial right e′ e involvement in all groups suggests a vascular original possibly ischaemic.
Cervical carcinoma is caused by human papillomavirus (HPV). Among the risk factors for HPV infection are having multiple sex partners and sex partners who themselves had multiple sex partners. Women married to relatives are more likely to become infected with HPV and develop cervical carcinoma. Consanguineous spouses have a mild sexual aversion to each other that leads to sex avoidance and increases likelihood of satisfying sexual desire outside the marriage. Sexual aversion develops as a result of spouses growing together in early childhood, which triggers biological imprinting of Westermarck. Westermarck's effect prevents incest in nuclear family. In consanguineous family, it extends to spouses, producing mild sexual antipathy. Because of high prevalence of consanguinity worldwide, it is important to test this hypothesis.
Folgori, Laura; Bernaschi, Paola; Piga, Simone; Carletti, Michaela; Cunha, Filippe Pirrone; Lara, Paulo Henrique Rodriguez; de Castro Peixoto, Nicholas Cafieiro; Alves Guimarães, Bárbara Gomes; Sharland, Mike; Araujo da Silva, André Ricardo; Ciofi Degli Atti, Marta
OBJECTIVES To describe trends in the epidemiology of healthcare-associated Infections (HAIs) in pediatric/neonatal intensive care units (ICUs) and to evaluate risk factors and impact of multidrug resistance in children admitted to ICUs. DESIGN Multicenter, retrospective, cohort study with a nested case-control study conducted from January 1, 2010, through December 31, 2014. SETTING Three tertiary care pediatric hospitals in Italy and Brazil with a total of 103 ICU beds. PATIENTS Inclusion criteria were admission to ICU during the study period, age at onset less than 18 years, and microbiologically confirmed HAI. RESULTS A total of 538 HAIs in 454 children were included; 93.3% of patients had comorbidities. Bloodstream infections were the leading pattern (45.4%). The cumulative incidence of HAI was 3.6/100 ICU admissions and the crude 30-day fatality rate was 5.7/1,000 admissions. The most frequently isolated pathogens were Enterobacteriaceae, followed by Pseudomonas aeruginosa and Staphylococcus aureus. Forty-four percent of isolates were multidrug-resistant (MDR). Two multivariate logistic regressions were performed. Factors independently associated with an MDR-HAI were country, previous antibiotics, transplantation, major surgery, and colonization by an MDR strain. Factors independently associated with 30-day case fatality were country, previous transplantation, fungal infection, bloodstream infection, lower respiratory tract infection, and infection caused by MDR strains. CONCLUSIONS Infection control and prevention can limit the spread of MDR strains and improve outcomes. Targeted surveillance programs collecting neonatal and pediatric HAI/bloodstream infection data and outcomes would allow global benchmarking. The next step is to identify methods to monitor key HAIs and integrate these into affordable intervention programs. Infect Control Hosp Epidemiol 2016;1-8.
Kelmanson, Igor A.
Relationship between major risk factors of sudden infant death syndrome (SIDS) and sleep disorders in the infants is the subject of review and discussion. Improper micro-environmental characteristics (especially poor environmental organisation and lack of developmental stimulation), pre-term delivery and/or infant low birth weight, prone sleep…
Monma, Takafumi; Ando, Akira; Asanuma, Tohru; Yoshitake, Yutaka; Yoshida, Goichiro; Miyazawa, Taiki; Ebine, Naoyuki; Takeda, Satoko; Omi, Naomi; Satoh, Makoto; Tokuyama, Kumpei; Takeda, Fumi
To clarify sleep disorder risk factors among student athletes, this study examined the relationship between lifestyle habits, competition activities, psychological distress, and sleep disorders. Student athletes (N = 906; male: 70.1%; average age: 19.1 ± 0.8 years) in five university sports departments from four Japanese regions were targeted for analysis. Survey items were attributes (age, gender, and body mass index), sleep disorders (recorded through the Pittsburgh Sleep Quality Index), lifestyle habits (bedtime, wake-up time, smoking, drinking alcohol, meals, part-time jobs, and use of electronics after lights out), competition activities (activity contents and competition stressors), and psychological distress (recorded through the K6 scale). The relation between lifestyle habits, competition activities, psychological distress, and sleep disorders was explored using logistic regression analysis. Results of multivariate logistic regression analysis with attributes as adjustment variables showed that "bedtime," "wake-up time," "psychological distress," "part-time jobs," "smartphone/cellphone use after lights out," "morning practices," and "motivation loss stressors," were risk factors that were independently related to sleep disorders. Sleep disorders among student athletes are related to lifestyle habits such as late bedtime, early wake-up time, late night part-time jobs, and use of smartphones/cellphones after lights out; psychological distress; and competition activities such as morning practices and motivation loss stressors related to competition. Therefore, this study suggests the importance of improving these lifestyle habits, mental health, and competition activities. Copyright © 2017 Elsevier B.V. All rights reserved.
Jahromi, Alireza Hamidian; Roozbeh, Jamshid; Raiss-Jalali, Ghanbar Ali; Dabaghmanesh, Alireza; Jalaeian, Hamed; Bahador, Ali; Nikeghbalian, Saman; Salehipour, Mehdi; Salahi, Heshmat; Malek-Hosseini, Ali
It is well recognized that patients with end stage renal diseases (ESRD) have hyper-plastic parathyroid glands. In most patients, a decrease in parathyroid hormone (PTH) occurs by about 1 year after renal transplantation. However, some renal transplant recipients continue to have elevated level of PTH. We prospectively evaluated 121 patients undergoing renal transplantation between August 2000 and 2002. The duration of dialysis, calcium (Ca), phosphorus (P), albumin, creatinine and iPTH levels were recorded prior to transplantation and three months and one year after transplantation. These 121 patients were on dialysis for an average period of 17.4 months prior to transplantation. An increase in the serum Ca and a decrease in serum P and iPTH level was seen in the patients after transplantation (P< 0.001). Hyperparathyroidism was in 12 (9.9%) and 7 (5.7%) patients three months and one year after transplantation respectively. Elderly patients and patients with longer duration on dialysis had an increased risk of developing post transplant hyperparathyroidism and hypercalcemia in the first year post transplant (P< 0.05). In conclusion age and duration on dialysis before transplantation seems to be important risk factors for post transplant hyperparathyroidism. (author)
Full Text Available Objectives. To investigate a prevalence of caries, filled permanentand extracted permanent teeth, as well as caries risk factors inschool children aged 7, 9 and 11.Methods. The survey included 800 children (296 children aged7; 254 children aged 9 and 250 children aged 11 from the MostarMunicipality, 400 of them living in both rural and urban areas.A dental mirror and standard light of dental chair were used forexamination. The DMF index (Dental Caries, Missing Teeth andFilled Teeth was determined, as well as failure in keeping teethhygiene, sugar intake with food, and incidence of oral cavity infection.Results. The dental state of permanent teeth in children aged 7and 9 has shown significant difference between the children fromrural and urban areas (p < 0,001. Out of 2,698 and 2,790 permanentteeth in children aged 11 from rural and urban areas, 1,086(40,25 % and 884 (31.68 % had caries, respectively (p < 0.01.The difference between these groups of children has been foundin relation to the index of oral hygiene too (p < 0.05.Conclusion. An identification of risk groups for getting caries wasvery important and could help health and social structures to maintaintheir programs in order to improve oral health.
Information on nutritional status of children under five years is an indicator of the nutritional situation in society. Identification of core factors influencing nutrition of this population supports plans to alleviate child malnutrition and its consequences. This study sought to determine the nutritional status of children under five ...
Full Text Available Besides clinical medicine, which is in the process of constant and fast development, the focus is increasingly on public health services, which should be well prepared for reducing or keeping under control the dangers induced by the growing social burden of disease. Continuous risk management is represented by these services that are specially designed to prevent diseases and health damages. The grounds for the planning and implementation of public health services are constituted by risk factor management and assessment by means of adopting a unified approach.
Conclusion: It was found that a history of relapse, a refractory state of underlying disease, and high C-reactive protein concentrations at the beginning of fever were significant risk factors for mortality after developing sepsis. Survival rate of patients with risk factors raised in this study might be improved by early introduction of vancomycin.
Brevers, Damien; Cleeremans, Axel; Goudriaan, Anna E.; Bechara, Antoine; Kornreich, Charles; Verbanck, Paul; Noël, Xavier
The aim of the present study was to examine the relationship between problem gambling severity and decision-making situations that vary in two degrees of uncertainty (probability of outcome is known: decision-making under risk; probability of outcome is unknown: decision-making under ambiguity). For
Beyene, Kebede; Aspden, Trudi; McNeill, Rob; Sheridan, Janie
Prescription medicine sharing has been defined as giving one's own medicine to someone else (lending) or taking someone else's medicine (borrowing). Medicines can be shared for non-medical purposes (recreational sharing or drug abuse) or for their intended therapeutic benefits (non-recreational sharing, e.g. sharing antibiotics to self-treat); the latter is the focus of this research. Limited research evidence is available about modifiable risk factors for non-recreational medicine sharing and addressing this issue was the main aim of this research. An online, cross-sectional survey design was used. The study population comprised a convenience sample of 233 adults, who were primarily recruited through patient support groups across New Zealand. Principal component analysis was used to develop scales assessing attitudes toward medicine lending and borrowing. Logistic regression was used to examine the relationship between explanatory (demographics, medical conditions, and attitudes towards medicine sharing) and outcome (medicine sharing behaviours) variables. Half of the study participants reported ever borrowing/lending medicines, and approximately a third of participants reported borrowing/lending in the past year. Modifiable risk factors associated with an increased risk of medicine borrowing behaviour were having more difficulty with accessing medicine ('access-related issue'), stronger 'emotional beliefs about borrowing', and greater 'concern about missing doses.' Greater 'concern for the wellbeing of others' and stronger 'beliefs about the benefits and safety of lending' were associated with an increased risk of medicine lending behaviour. Those with a higher 'perceived risk of harm' were less likely to borrow or lend medicines. This research expands the current knowledge of medicine sharing by examining underlying behavioural factors which predict sharing behaviours and that can be modified by interventions. This research suggests using multifaceted
Full Text Available Over the last two decades, the amount of evidence corroborating an association between dental plaque bacteria and coronary diseases that develop as a result of atherosclerosis has increased. These findings have brought a new aspect to the etiology of the disease. There are several mechanisms by which dental plaque bacteria may initiate or worsen atherosclerotic processes: activation of innate immunity, bacteremia related to dental treatment, and direct involvement of mediators activated by dental plaque and involvement of cytokines and heat shock proteins from dental plaque bacteria. There are common predisposing factors which influence both periodontitis and atherosclerosis. Both diseases can be initiated in early childhood, although the first symptoms may not appear until adulthood. The formation of lipid stripes has been reported in 10-year-old children and the increased prevalence of obesity in children and adolescents is a risk factor contributing to lipid stripes development. Endothelium damage caused by the formation of lipid stripes in early childhood may lead to bacteria penetrating into blood circulation after oral cavity procedures for children as well as for patients with aggressive and chronic periodontitis.
Sonia Irshad Mari
Full Text Available Sustainable supply chain network design is a rich area for academic research that is still in its infancy and has potential to affect supply chain performance. Increasing regulations for carbon and waste management are forcing firms to consider their supply chains from ecological and social objectives, but in reality, however, facilities and the links connecting them are disrupted from time to time, due to poor weather, natural or manmade disasters or a combination of any other factors. Supply chain systems drop their sustainability objectives while coping with these unexpected disruptions. Hence, the new challenges for supply chain managers are to design an efficient and effective supply chain network that will be resilient enough to bounce back from any disruption and that also should have sufficient vigilance to offer same sustainability under a disruption state. This paper focuses on ecological sustainability, because an environmental focus in a supply chain system is more important and also links with other pillars of sustainability, as the products need to be produced, packed and transported in an ethical way, which should not harm social balance and the environment. Owing to importance of the considered issue, this paper attempts to introduce a network optimization model for a sustainable and resilient supply chain network by incorporating (1 sustainability via carbon emissions and embodied carbon footprints and (2 resilience by incorporating location-specific risks. The proposed goal programming (GP model optimizes the total cost, while considering the resilience and sustainability of the supply chain network.
Full Text Available Portfolio optimization with respect to different risk measures is of interest to both practitioners and academics. For there to be a well-defined optimal portfolio, it is important that the risk measure be coherent and quasiconvex with respect to the proportion invested in risky assets. In this paper we investigate one such measure—conditional capital at risk—and find the optimal strategies under this measure, in the Black-Scholes continuous time setting, with time dependent coefficients.
Egorova, Yu E.; Yazenin, A. V.
In this paper, we investigate a minimum risk portfolio model under hybrid uncertainty when the profitability of financial assets is described by fuzzy random variables. According to Feng, the variance of a portfolio is defined as a crisp value. To aggregate fuzzy information the weakest (drastic) t-norm is used. We construct an equivalent stochastic problem of the minimum risk portfolio model and specify the stochastic penalty method for solving it.
Tsur, Yacov; Zemel, Amos
Under risk of catastrophic climate change, the occurrence hazard is added to the social discount rate. As a result, the social discount rate (i) increases and (ii) turns endogenous to the global warming policy. The second effect bears profound policy implications that are magnifed by economic growth. In particular, it implies that green- house gases (GHG) emission should gradually be brought to a halt. Due to the public bad nature of the catastrophic risk, the second effect is ignored in a co...
Sánchez-Rodríguez, Martha A; Zacarías-Flores, Mariano; Arronte-Rosales, Alicia; Correa-Muñoz, Elsa; Mendoza-Núñez, Víctor Manuel
The aim of this study was to determine the influence of menopause (hypoestrogenism) as a risk factor for oxidative stress. We carried out a cross-sectional study with 187 perimenopausal women from Mexico City, including 94 premenopausal (mean ± SD age, 44.9 ± 4.0 y; estrogen, 95.8 ± 65.7 pg/mL; follicle-stimulating hormone, 13.6 ± 16.9 mIU/mL) and 93 postmenopausal (mean ± SD age, 52.5 ± 3.3 y; estrogen, 12.8 ± 6.8 pg/mL; follicle-stimulating hormone, 51.4 ± 26.9 mIU/mL) women. We measured lipoperoxides using a thiobarbituric acid-reacting substance assay, erythrocyte superoxide dismutase and glutathione peroxidase activities, and the total antioxidant status with the Randox kit. An alternative cutoff value for lipoperoxide level of 0.320 μmol/L or higher was defined on the basis of the 90th percentile of young healthy participants. All women answered the Menopause Rating Scale, the Athens Insomnia Scale, and a structured questionnaire about pro-oxidant factors, that is, smoking, consumption of caffeinated and alcoholic beverages, and physical activity. Finally, we measured weight and height and calculated body mass index. The lipoperoxide levels were significantly higher in the postmenopausal group than in the premenopausal group (0.357 ± 0.05 vs 0.331 ± 0.05 μmol/L, P = 0.001). Using logistic regression to control pro-oxidant variables, we found that menopause was the main risk factor for oxidative stress (odds ratio, 2.62; 95% CI, 1.35-5.11; P menopause rating score, insomnia score, and lipoperoxides, and this relationship was most evident in the postmenopausal group (menopause scale, r = 0.327 [P = 0.001]; insomnia scale, r = 0.209 [P < 0.05]). Our findings suggest that the depletion of estrogen in postmenopause could cause oxidative stress in addition to the known symptoms.
Korn, Gustavo Polacow; Augusto de Lima Pontes, Antonio; Abranches, Denise; Augusto de Lima Pontes, Paulo
To characterize the presence of hoarseness and the risk factors in male and female university teachers in private institutions in the city of São Paulo, Brazil. Cross-sectional survey. Voice self-evaluation forms prepared by the Brazilian Ministry of Labor were administered to 846 university teachers in a private institution in the city of São Paulo, Brazil. Prevalence of hoarseness in the sample is 39.6%. Percentage of hoarseness is higher in females (51.8%) than in males (32.6%). Comparing hoarseness and time of teaching, it was observed that the percentage of hoarseness is lower in a time shorter or equal to 1 year, and it is higher in a time between 10 and 20 years. Percentage of hoarseness is lower in the maximum workload of one to three class hours per day compared with the other workloads. Percentage of hoarseness is lower when the maximum number of students per classroom is less than 30 than when it is between 101 and 150 students. Other factors like in terms of noise and sound competition, air pollution, and in terms of causing stress and anxiety, besides habits and style/quality of life are related to the presence of hoarseness. University teachers show high percentage of hoarseness. Factors, such as time of teaching, females, work organization, workplace, in terms of noise and sound competition, air pollution, and in terms of causing stress and anxiety, besides habits and style/quality of life, are related to the presence of hoarseness in this group. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
Fakhfakh, R; Jaidane, I; Hsairi, M; Ben Hamida, A M
Since smoking is a major public health problem among Tunisian teenagers, it is important to identify the underlying risk and protective factors associated with initiation of this behavior. A cross-sectional, school-based survey of students was conducted by the Tunisian Ministry of Health among a nationally representative sample of 4172 adolescents aged between 12 and 20 years attending public, private, and professional secondary schools across Tunisia who participated in the Survey of the Health of Tunisian adolescents in 2000. For data analysis, we first calculated crude odds ratios (OR) followed by calculating adjusted OR after using multivariate logistic regression models. Almost one-third of respondents had already started smoking at an average age of 13 years, 6.4% among them smoked daily. Demographic vulnerabilities to smoking behavior were gender (boys more than girls), age and residence in urban areas and particularly in Greater Tunis and the North East. Familial and school factors were parental divorce, poor relationship with parents, poor integration into the peer group, and poor school investment. Psychological and behavioral factors were low self-esteem level and the occurrence of stressful life events, risk taking and alcohol consumption when there was no association with the depression, anxiety and body image. Protective factors against the experimental cigarettes were mainly sports and reading. There are many factors associated with smoking behavior among adolescents. All of these predictors need to be considered in smoking prevention among Tunisian teenagers. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Wilke, Thomas; Mueller, Sabrina; Groth, Antje
BACKGROUND: The aim of this study was to analyse which factors predict the real-world macro-/microvascular event, hospitalisation and death risk in patients with type 2 diabetes mellitus. Furthermore, we aimed to investigate whether there exists both an under- and over-treatment risk of these pat...
van Viersen, Sietske; de Bree, Elise H; Kroesbergen, Evelyn H; Slot, Esther M; de Jong, Peter F
This study investigated risk and protective factors associated with dyslexia and literacy development, both at the group and individual level, to gain more insight in underlying cognitive profiles and possibilities for compensation in high-IQ children. A sample of 73 Dutch primary school children included a dyslexic group, a gifted-dyslexic group, and a borderline-dyslexic group (i.e., gifted children with relative literacy problems). Children were assessed on literacy, phonology, language, and working memory. Competing hypotheses were formulated, comparing the core-deficit view to the twice-exceptionality view on compensation with giftedness-related strengths. The results showed no indication of compensation of dyslexia-related deficits by giftedness-related strengths in gifted children with dyslexia. The higher literacy levels of borderline children compared to gifted children with dyslexia seemed the result of both fewer combinations of risk factors and less severe phonological deficits in this group. There was no evidence for compensation by specific strengths more relevant to literacy development in the borderline group. Accordingly, the findings largely supported the core-deficit view, whereas no evidence for the twice-exceptionality view was found. Besides practical implications, the findings also add to knowledge about the different manifestations of dyslexia and associated underlying cognitive factors at the higher end of the intelligence spectrum.
Khorrami, Zahra; Etemad, Koorosh; Yarahmadi, Shahin; Khodakarim, Soheila; Kameli, Mohammadesmail; Hezaveh, Alireza Mahdavi; Rahimi, Ebrahim
This study was conducted to examine the relationship between urbanization and risk factors of noncommunicable diseases (NCDs) according to the World Health Organization stepwise approach to surveillance of NCDs. This study is part of a NCD risk factor surveillance of 10 069 individuals in all provinces of the Islamic Republic of Iran, aged over 20 years, during 2011. By utilizing 2011 census data, urbanization levels were determined in all provinces and logistics regression was used to examine the relationship between urbanization and risk factors. Among males, urbanization had a positive correlation with low physical activity (OR=1.7; 95% CI: 1.42-2.09), low fruit and vegetable consumption (OR=1.8; 95% CI: 1.09-2.96), and high BMI (OR=1.4; 95% CI: 1.20-1.70). Among females there was a positive and significant correlation with low physical activity (OR=1.2; 95% CI: 1.08-1.49), low fruit and vegetable consumption (OR=1.22; 95% CI: 0.78-1.91) and high BMI (OR=1.3; 95% CI: 1.14-1.53). Thus, urbanization has a significant correlation with increases in NCD factors in the Islamic Republic of Iran.
Grace Vincent-Onabajo; Taritei Moses
Background. Knowledge of stroke risk factors is expected to reduce the incidence of stroke?whether first-ever or recurrent. This study examined knowledge of stroke risk factors and its determinants among stroke survivors. Methods. A cross-sectional survey of consenting stroke survivors at two physiotherapy facilities in Nigeria was carried out. Sociodemographic and clinical data were obtained and knowledge of stroke risk factors (defined as the ability to mention at least one correct risk fac...
Arun Prasanna; Gandhibabu; Asok Kumar
BACKGROUND: Alcohol dependence is a potent risk factor for completed suicide but data are limited on factors that distinguish risk within this high risk population. AIM: To study the risk factors for suicide attempts among male alcohol dependents. METHODS: This was a case control study conducted from January to July in the Year 2014. Cases and controls were recruited from Department of Psychiatry, Rajah Muthiah Medical College, using various tools such as semi structured p...
Grantz, Katherine L.; Hinkle, Stefanie N.; Mendola, Pauline; Sjaarda, Lindsey A.; Leishear, Kira; Albert, Paul S.
Risk factors for preterm delivery have been described, but whether risk factors differ in the context of prior preterm delivery history is less understood. We assessed whether known risk factors were different in women with versus without prior preterm delivery using medical records of the first and second singleton deliveries in 25,820 Utah women (2002–2010). Longitudinal transition models with modified Poisson regression calculated adjusted relative risks and 95% confidence intervals, with ...
Full Text Available Patrick Olivieri,1 Bruce Solitar,2,* Michel Dubois3,*1NYU School of Medicine, New York, NY, USA; 2Department of Rheumatology, 3Department of Pain Management, New York University Langone Medical Center, New York, NY, USA*These authors contributed equally to this workBackground: Fibromyalgia is a disease process without an obvious etiology. While some evidence suggests that adverse experiences in childhood contribute to its development, specific evidence has been equivocal.Methods: A total of 36 patients with fibromyalgia from the greater New York area were recruited and surveyed using the Centers for Disease Control's Behavioral Risk Factor Surveillance System survey, and questions from the section on adverse childhood experiences were administered. The results were compared to those obtained from over 400,000 people surveyed by the Centers for Disease control each year, and were monitored for statistically significant differences.Results: A statistically significant difference was noted among the control group, suggesting that individuals reported growing up with someone who was depressed when the respondents were between the ages of 0 and 18 years old. Moreover, respondents reported that they were hit by their parents in some way, were insulted or cursed at by their parents, and had been forced to have sex with someone at least 5 years older than them or with an adult. No correlation was found with the following variables and the development of fibromyalgia: growing up with divorced or separated parents; growing up with someone sentenced to serve time in jail; or having parents that abused each other. Additionally, statistically significant differences were found for the following categories: lack of emotional support; life dissatisfaction; fair or poor health; physical, mental or emotional disability; and being divorced or not married.Discussion: Using this well-validated survey, it became clear that at least six specific adverse childhood
Schoonderwoerd, Bas A.; Smit, Marcelle D.; Pen, Lucas; Van Gelder, Isabelle C.
Atrial fibrillation (AF) is a prevalent arrhythmia in patients with cardiovascular disease. The classical risk factors for developing AF include hypertension, valvular disease, (ischaemic) cardiomyopathy, diabetes mellitus, and thyroid disease. In some patients with AF, no underlying
Full Text Available Introduction: The analysis of new cardiovascular risk factors is under an extensive debate in the cardiology and metabolic research fields. Objective: To determine the main factors that contribute to the classification of individuals with higher coronary risk in the adult population from Maracaibo, Venezuela. Methods: A descriptive, cross-sectional study with multistage random sampling in 1379 individuals belonging to the Maracaibo City Metabolic Syndrome Prevalence Study (MMSPS was performed. They were classified according to the coronary risk by Framingham-Wilson equation adapted to our population. The association between various risk factors was evaluated by ordinal logistic regression models. Results: 1,379 subjects (females 55.9%; nÂ =Â 771 were evaluated, 66.2% (nÂ =Â 913 were classified with low coronary risk. In univariate (Ï2Â =Â 112.35; pÂ <Â 0.00001 and multivariate analysis [OR: 3.98 (2.39-6.63; pÂ <Â 0.01], the main factors associated to be classified as the highest risk category were hypertriglyceridemia. Conclusion: There are several factors that should be included in predictive models use worldwide. The most important in our population were dyslipidemia such as hypertriglyceridemia, hyperlipoproteinemia (a and insulin resistance. Resumen: IntroducciÃ³n: El anÃ¡lisis de nuevos factores de riesgo cardiovascular constituye un tema de amplio debate en la investigaciÃ³n cardio-metabÃ³lica. Objetivo: Determinar los principales factores que contribuyen a la clasificaciÃ³n de sujetos en las categorÃas de mayor riesgo coronario en individuos adultos de la ciudad de Maracaibo, Venezuela. MÃ©todos: Estudio descriptivo, trasversal con muestreo aleatorio multietapas en 1.379 individuos pertenecientes al Estudio de Prevalencia de SÃndrome MetabÃ³lico de la Ciudad de Maracaibo (EPSMM. Estos fueron clasificaron de acuerdo con el riesgo coronario mediante la fÃ³rmula Framingham-Wilson adaptada para
Raj Krishna Dangol
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.
Barreiro-López, Bienvenido; Tricas, Josep Maria; Mauri, Elisabeth; Quintana, Salvador; Garau, Javier
Nosocomial pneumonia (NP) is the second most frequent cause of hospital-acquired infection and is associated with elevated morbidity and mortality rates, particularly in intensive care units (ICU). The objectives of this study were to determine the incidence, risk factors and prognostic factors of NP acquired outside the ICU. A prospective case-control study was performed. All NP cases were acquired outside the ICU, and each case was paired with a control subject matched for gender, age, date of admission and hospitalization area. Epidemiological, clinical and microbiological data were obtained from cases and controls, and the risk factors and prognostic factors for NP were established. During the study period a total of 67 cases of NP outside the ICU were diagnosed. Estimated incidence was 3.35 cases/1,000 admissions. Mean age of the patients was 70 +/- 13 years and 48 of them were men. On multivariate analysis adjusted for confounding factors, bronchoaspiration, previous surgery and steroids were significantly associated with the development of NP. Mortality attributable to NP was 27%. The existence of an ultimately or rapidly fatal underlying condition and the presence of leukocytosis or leukopenia were associated with poor prognosis. The incidence of NP outside the ICU setting is low. Measures to reduce bronchoaspiration and judicial steroid use are necessary to decrease the risk of acquiring NP and to improve the prognosis.
The paper considers the manifoild factors of environmental pollution effect upon living organisms and their possible response manifested in additivity, synergism and anthogonism. Consideration is also given to the possible practical measures for improving ecological situation and decreasing the risk of anthropogenesis negative after-effects
The HFM panel has decided to install an Exploratory Team, ET-078, which should advise whether or not a Technical Group (TG) should be established on the subject of risk management of exposure to chemicals under operational conditions. This paper described the context and approach of ET-078.
Juan F Navas
Full Text Available The negative consequences of energy dense foods are well known, yet people increasingly make unhealthy food choices leading to obesity (i.e., risky decisions. The aims of this study were:  to compare performance in decision-making tasks under risk and under ambiguity between individuals with obesity, overweight and normal weight;  to examine the associations between body mass index (BMI and decision-making, and the degree to which these associations are modulated by reward sensitivity.Seventy-nine adults were recruited and classified in three groups according to their BMI: obesity, overweight and normal-weight. Groups were similar in terms of age, education and socio-economic status, and were screened for comorbid medical and mental health conditions. Decision-making under risk was measured via the Wheel of Fortune Task (WoFT and decision-making under ambiguity via the Iowa Gambling Task (IGT. Reward sensitivity was indicated by the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ.Individuals with obesity made riskier choices in the WoFT, specifically in choices with an expected value close to zero and in the propensity to risk index. No differences were found in IGT performance or SPSRQ scores. BMI was associated with risk-taking (WoFT performance, independently of reward sensitivity.Obesity is linked to a propensity to make risky decisions in experimental conditions analogous to everyday food choices.
Losecaat Vermeer, A.B.; Boksem, M.A.S.; Sanfey, A.G.
Studies of risky decision-making have demonstrated that humans typically prefer risky options after incurring a financial loss, while generally preferring safer options after a monetary gain. Here, we examined the neural processes underlying these inconsistent risk preferences by investigating the
The study measures farm credit risk by using farm records collected by Farm Business Farm Management (FBFM) during the period 1995-2004. The study addresses the following questions: (1) whether farm's financial position is fully described by the structure model, (2) what are the determinants of farm capital structure under the structure model, (3)…
Kari Hyytiainen; Robert G. Haight
We evaluate the economic efficiency of even- and uneven-aged management systems under risk of wildfire. The management problems are formulated for a mixed-conifer stand and approximations of the optimal solutions are obtained using simulation optimization. The Northern Idaho variant of the Forest Vegetation Simulator and its Fire and Fuels Extension is used to predict...
Zhang, Long; Dong, Yi; Ji, Yifu; Zhu, Chunyan; Yu, Fengqiong; Ma, Huijuan; Chen, Xingui; Wang, Kai
Evidence in the literature suggests that executive dysfunction is regarded as an endophenotype candidate for obsessive-compulsive disorder (OCD). Decision making is an important domain of executive function. However, few studies that have investigated whether decision making is a potential endophenotype for OCD have produced inconsistent results. Differences in the findings across these studies may be attributed to several factors: different study materials, comorbidity, medication, etc. There are at least two types of decision making that differ mainly in the degree of uncertainty and how much useful information about consequences and their probabilities are provided to the decision maker: decision making under ambiguity and decision making under risk. The aim of the present study was to simultaneously examine decision making under ambiguity as assessed by the Iowa Gambling Task (IGT) and decision making under risk as measured by the Game of Dice Task (GDT) in OCD patients and their unaffected first-degree relative (UFDR) for the first time. The study analyzed 55 medication-naïve, non-depressed OCD patient probands, 55 UFDRs of the OCD patients and 55 healthy matched comparison subjects (CS) without a family history of OCD with the IGT, the GDT and a neuropsychological test battery. While the OCD patients and the UFDRs performed worse than the CS on the IGT, they were unimpaired on the GDT. Our study supports the claim that decision making under ambiguity differs from decision making under risk and suggests that dissociation of decision making under ambiguity and decision making under risk may qualify to be a neurocognitive endophenotypes for OCD. Copyright © 2014 Elsevier Inc. All rights reserved.
Jo, Yong Suk; Lee, Yeon Joo; Park, Jong Sun; Yoon, Ho Il; Lee, Jae Ho; Lee, Choon-Taek; Cho, Young-Jae
The objectives of this study were to find factors related to medical intensive care unit (ICU) readmission and to develop a prediction index for determining patients who are likely to be readmitted to medical ICUs. We performed a retrospective cohort study of 343 consecutive patients who were admitted to the medical ICU of a single medical center from January 1, 2008 to December 31, 2012. We analyzed a broad range of patients' characteristics on the day of admission, extubation, and discharge from the ICU. Of the 343 patients discharged from the ICU alive, 33 (9.6%) were readmitted to the ICU unexpectedly. Using logistic regression analysis, the verified factors associated with increased risk of ICU readmission were male sex [odds ratio (OR) 3.17, 95% confidence interval (CI) 1.29-8.48], history of diabetes mellitus (OR 3.03, 95% CI 1.29-7.09), application of continuous renal replacement therapy during ICU stay (OR 2.78, 95% CI 0.85-9.09), white blood cell count on the day of extubation (OR 1.13, 95% CI 1.07-1.21), and heart rate just before ICU discharge (OR 1.03, 95% CI 1.01-1.06). We established a prediction index for ICU readmission using the five verified risk factors (area under the curve, 0.76, 95% CI 0.66-0.86). By using specific risk factors associated with increased readmission to the ICU, a numerical index could be established as an estimation tool to predict the risk of ICU readmission.
Patricia Angélica A Marques
Full Text Available The oregano is a plant, rich in essential oil and very used as spice in the preparation of foods. The objective of this paper was to analyze the viability of irrigation for oregano in Presidente Prudente, São Paulo state, Brazil, including economic risk factors, their effect on irrigation total cost, as well as the different pumping kinds. The Monte Carlo simulation was utilized to study the economic factors: fixed cost, labor, maintenance, pumping and water. The use of irrigation for the oregano in the region of Presidente Prudente is indicated because of its economic feasibility and the reduced risks. The average values of the benefit/cost for all water depths tested were higher than 1, indicating viability. The use of irrigation promoted lower risks compared to the non irrigated crop. The micro irrigation system presented greater sensitivity to changes of prices of the equipment associated to the variation of the useful life of the system. The oregano selling price was the most important factor involved in annual net profit. The water cost was the factor of lesser influence on the total cost. Due to the characteristic of high drip irrigation frequency there was no difference between the tariffs based in use hour of electric energy classified as green and blue, which are characterized by applying different rates on the energy consumption and demand according to the hours of day and times of the year. For the studied region it was recommended drip irrigation water management of oregano with the daily application of 100% of pan evaporation Class A using electric motor with tariffs blue or green.O orégano é planta rica em óleo essencial, muito usada como tempero na preparação de alimentos. O objetivo deste trabalho foi a análise da viabilidade econômica do uso da irrigação em orégano para a região de Presidente Prudente (SP, com a inclusão do risco econômico e a análise do efeito dos fatores econômicos sobre o custo total da
Nimnuan, Chaichana; Asawavichienjinda, Thanin; Srikiatkhachorn, Anan
Psychiatric comorbidities are common among patients with headache. These can compromise the quality of life of patients and may affect the result of treatment. No available systematic study concerning this problem has been conducted in Thailand. The study aimed to determine the prevalence and risk factors of psychiatric disorders in patients with headache in tertiary care facility. The study was conducted at the Headache Clinic, King Chulalongkorn Memorial Hospital in Bangkok, Thailand. One hundred and thirteen patients were enrolled. Diagnosis of headache was made based on International Classification of Headache Disorders II system. Mental disorders were assessed using Primary Care Evaluation of Mental Disorders. Other possible risk factors were extracted using significant physical symptoms count and accumulated risk for mental disorder. Of the 113 samples analyzed, the prevalence of depression, anxiety, and somatoform disorder was found to be 29.2%, 9.7%, and 27.4%, respectively. No definite relationship between headache types and mental disorders was observed. High number of significant physical complaints and health concerns significantly increased the risk for depression (OR = 4.6, 95% CI = 1.6 to 13.5) while the level of possible risk for mental disorder was associated with an increased risk for somatoform disorder (OR = 1.6, 95% CI = 1.2 to 2.2). The study confirmed high prevalence of psychiatric comorbidities in patients with headache. The results of this study will raise the awareness of physicians to possible underlying mental disorders in patients with headache and facilitate appropriate treatment or psychiatric referral. © 2011 American Headache Society.
Elflein, H M
Amblyopia is the main cause for mostly monocular, impaired vision in childhood. Treatment and prevention of amblyopia is only effective during childhood. Ophthalmological screening of children does not yet exist in Germany. The prevalence of amblyopia in Germany is 5.6%, which is higher than in reports from studies in Australia; however, the prevalence of amblyopia is not comparable in these studies due to different definitions of amblyopia and the inclusion/exclusion criteria of the study cohorts. At present it is unknown at what age ophthalmological screening should be carried out to prevent amblyopia and the appropriate frequency of screening examinations. Amblyopia is a disorder of the visual cortex that is due to suppression and deprivation of one eye leading to unilateral visual impairment. Approximately 50% of cases of amblyopia are caused by anisometropia, 25% by strabismus and in every sixth person by a combination of both. Other causes, such as unilateral congenital cataracts are relatively rare. A variety of factors, such as ocular pathologies, premature birth, familial disposition and general diseases are associated with an increased risk for amblyopia.
Zaleska, Martyna; Trojacka, Ewelina; Savitskyi, Stepan; Terlikowska-Brzósko, Agnieszka; Galus, Ryszard
Atopic dermatitis (AD) is a chronic, inflammatory skin disease characterized by severe itching and eczematic skin lesions. In Poland from 1.5 to 2.5 million people suffer from AD. The pathophysiologic complexity and the wide spectrum of clinical phenotypes cause diagnostic and therapeutic problems and this is the basis for the division of the disease into subtypes. Heterogeneity of the disease is also confirmed in the study of the genotype of the disease. In relation with AZS more than 1000 loci in chromosomes were demonstrated. The roles of certain genes and the pathophysiology of lesions caused by their polymorphism were described. Wide spectrums of AD risk factors are: cigarette smoking, alcohol consumption during pregnancy, obesity and high and low birth weight. The quality of life in patients with AD is impaired, the disease disrupts family and professional relationships. Biological medical products are an example of an individual approach to the treatment of AD. It seems, individual approach to disease and treatment can be a successive solution to the problem.
Conclusion: Stunting levels were higher in the boys than in the girls in mid to late childhood in a rural setting in South Africa, while the girls had a higher prevalence of overweight and obesity than the boys. Pre-hypertension prevalence in the boys and girls was high. Other metabolic risk factors, i.e. impaired FG and lipids, ...
Objective: This study assessed the perception of risk of cervical cancer and existence of risk factors for cervical cancer based on five known risk factors among women attending the Tamale Teaching Hospital in Tamale, Ghana. Methods: A consecutive sample of 300 women was interviewed using a semi structured ...
Maarel-Wierink, C.D. van der; Putten, G.J. van der; Visschere, L.M. De; Bronkhorst, E.M.; Baat, C. de; Schols, J.M.
Pneumonia is a prevalent cause of death in care home residents. Dysphagia is a significant risk factor of aspiration pneumonia. The purpose of the current study was to screen for risk of aspiration in care home residents in the Netherlands and assess potential risk factors of aspiration. Five
Leroy, Lígia da Silva; Lúcio, Adélia; Lopes, Maria Helena Baena de Moraes
To investigate the risk factors for postpartum urinary incontinence (UI) and its characteristics. This was a case-control study with 344 puerperal women (77 cases and 267 controls) with up to 90 days postpartum. In a single session, participants were given a questionnaire with sociodemographic and clinical data and two others that assessed urine leakage, leakage situations, and type of UI. Stress UI was present in 45.5% of the women, incidents of urine leakage several times a day in 44.2%, of which 71.4% were in small amounts and 57.1% when coughing or sneezing. In 70.1% of cases, UI began during pregnancy and remained through the postpartum period. After running a binary logistic regression model, the following factors remained in the final model: UI during pregnancy (OR 12.82, CI 95% 6.94 - 23.81, ppregnancy and remained through the postpartum period. Urinary incontinence during pregnancy, multiparity, gestational age at birth greater or equal to 37 weeks, and constipation were presented as risk factors. In the studied group, stress UI was more frequent. Investigar os fatores de risco para a incontinência urinária (IU) no puerpério e as suas características. Trata-se de estudo caso-controle com 344 puérperas (77 casos e 267 controles), com até 90 dias pós-parto. Foi aplicado, em um único momento, um questionário para os dados sociodemográficos e clínicos, e dois outros para avaliar a perda urinária, situações de perda e o tipo de IU. Apresentaram IU de esforço 45,5%, perda urinária diversas vezes ao dia 44,2%, sendo 71,4% em pequena quantidade e 57,1% ao tossir ou espirrar. Em 70,1% dos casos a IU iniciou-se na gestação e permaneceu no puerpério. Ao ajustar-se um modelo de regressão logística binária, apenas IU na gestação (OR 12,82, IC 95% 6,94 - 23,81, p<0,0001), multiparidade (OR 2,26, IC 95% 1,22 - 4,19, p=0,009), idade gestacional no parto maior ou igual a 37 semanas (OR 2,52, IC 95% 1,16 - 5,46, p=0,02) e constipação (OR 1,94, IC
Background. Impaired fasting or glucose tolerance and/or diabetes can occur with hypertension, which theoretically predicts a worse cardiovascular risk profile, and consequently requires intensive cardiovasular risk management. Objectives. To characterise the frequency of the occurence of conventional cardiovascular risk ...
Yang, Chunxue; Kong, Alice Pik Shan; Cai, Zongwei; Chung, Arthur C K
The rising prevalence of obesity and diabetes cannot be fully explained by known risk factors, such as unhealthy diet, a sedentary lifestyle, and family history. This review summarizes the available studies linking persistent organic pollutants (POPs) to obesity and diabetes and discusses plausible underlying mechanisms. Increasing evidence suggest that POPs may act as obesogens and diabetogens to promote the development of obesity and diabetes and induce metabolic dysfunction. POPs are synthesized chemicals and are used widely in our daily life. These chemicals are resistant to degradation in chemical or biological processes, which enable them to exist in the environment persistently and to be bio-accumulated in animal and human tissue through the food chain. Increasingly, epidemiologic studies suggest a positive association between POPs and risk of developing diabetes. Understanding the relationship of POPs with obesity and diabetes may shed light on preventive strategies for obesity and diabetes.
Nielsen, Karoline Kragelund; Damm, Peter; Kapur, Anil
. Objective: The aims of this observational study were to examine the role of potential risk factors for HIP, and to investigate whether any single or accumulated risk factor(s) could be used to predict HIP among women attending GDM screening at three centres in urban, semi-urban and rural Tamil Nadu, India...... and a risk factor scoring variable was constructed. Results: HIP was prevalent in 18.9% of the study population (16.3% GDM; 2.6% DIP). Increasing age and BMI as well as having a mother only or both parents with diabetes were significant independent risk factors for HIP. Among women attending the rural health...
Sunjoo Boo, RN, PhD
Conclusion: Modifiable cardiovascular risk factors are highly prevalent in Korean women, and the combination of risk factors is common. Development and implementation of multifaceted nursing interventions are required to confront the current epidemic rise of CHD in Korean women.
Epidemiological studies have identified several modifiable risk factors for colorectal neoplasms in the general population. However, associations between modifiable risk factors, including body mass index (BMI), smoking, alcohol consumption and dietary patterns, and colorectal neoplasms in two
Rod, Naja Hulvej; Hansen, Ase Marie; Nielsen, Jens
Obesity, alcohol consumption, physical inactivity and postmenopausal hormone use are known modifiable risk factors for breast cancer. We aim to measure incidence rates of breast cancer for women with favorable levels on all 4 risk factors (BMI......Obesity, alcohol consumption, physical inactivity and postmenopausal hormone use are known modifiable risk factors for breast cancer. We aim to measure incidence rates of breast cancer for women with favorable levels on all 4 risk factors (BMI...
Koegl, Christopher J.; Farrington, David P.; Augimeri, Leena K.
We asked 176 mental health clinicians to list factors that place a child at risk for engaging in future antisocial behavior. Participants were randomly assigned to do this in relationship to boys and girls. Listed factors were then coded into broad item categories using the Early Assessment Risk Lists (EARL). Of the 1,695 factors listed, 1,476…
Background: Factors associated with the development of hypertension can be categorized into modifiable and non‑modifiable risk factors. The modifiable risk factors include obesity, physical inactivity, high salt diet, smoking alcohol consumption and others. Aim: This study was aimed to determine the prevalence of ...
Shevlin, Mark; McElroy, Eoin; Christoffersen, Mogens Nygaard
psychosis and a broad range of familial (advanced paternal age, family dissolution, parental psychosis), environmental (urbanicity,deprivation) and psychological factors (childhood adversity). Findings indicated that all types of risk factors were significantly associated with psychosis. In conclusion......, large scale cohort studies using the Danish registry system is a powerful way of assessing the relative impact ofdifferent risk factors for psychosis....
Khan, M.N.S.; Naqvi, A.H.; Irshad, K.; Chaudhary, A.R.
Objective: To find out the frequency of abdominal wound dehiscence (AWD) in a tertiary care hospital and the assessment of associated risk factors. Subjects and Methods: This study was carried out on 406 patients who underwent laparotomy for intra peritoneal procedure and complied with inclusion criteria. Demographic features were recorded and any complications documented. Results: Out of a total of 406 patients, 32 showed wound dehiscence giving an over all frequency of 7.8%. The male to female ratio was 2.8:1. The frequency was greater in males than in females. Majority patients suffered from an underlying malignancy. Malignant intestinal obstruction was the leading cause of wound dehiscence. Forty three patients had hypoalbuminemia(serum albumin <35 gm/l) and 09 of them had AWD. Emergency surgery showed a higher frequency of AWD(12.5%), as compared to elective surgery (18/143 and 14/263 respectively). Wound infection was a major contributor to AWD as out of 406, 76 patients developed infection and then 21 manifested AWD. Older age was also associated with greater frequency. The overall mortality of AWD in this study was 28.1 %. Conclusion: AWD still continues to be major post operative complication, with a high morbidity and mortality. The significant risk factors in this study were age more than 55 years, male gender, underlying malignancy, wound infection, jaundice, use of steroids, emergency surgery, uraemia and technique of closure. (author)
Tin Tin, Sandar; Woodward, Alistair; Ameratunga, Shanthi
Background Regular cycling plays an important role in increasing physical activity levels but raises safety concerns for many people. While cyclists bear a higher risk of injury than most other types of road users, the risk differs geographically. Auckland, New Zealand’s largest urban region, has a higher injury risk than the rest of the country. This paper identified underlying factors at individual, neighbourhood and environmental levels and assessed their relative contribution to this risk...
Cleopas Martin Rumende
Diabetes mellitus has been a well-known risk factor for TB in the past. The global convergence of the accelerating type 2 DM pandemic, high TB prevalence and drug-resistant TB during the past couple of decades has become a serious challenge to clinicians worldwide. Over the past few years, some studies have shown that the treatment failure rate is higher in TB patients with DM as comorbidity. Moreover, there is significant association between DM an MDR-TB. There is higher chance of TB bacilli persistence to be present in sputum of pulmonary TB patient with DM than TB-only patient after 5 months treatment, and this persistence made it necessary for more longer treatment. Presence of DM in TB patients cause a longer period for sputum conversion, therefore it may become a major cause of poor treatment outcome in TB patients. Previous studies showed that a major mechanism for the emergence of drugs resistance in TB bacilli is random mutation in the bacterial genome and the pressure of selection by anti-TB drugs. Pulmonary TB in diabetic patients usually show higher mycobacterial loads at the initiation of treatment, hence they may have higher chance of bacillary mutation and the emergence of MDR-TB with the presenting of higher bacterial loads, longer treatment is needed to clear the bacteria. Therefore, it is not suprising that a higher chance of MDR-TB patients could be find in those patients. A pharmacokinetic study noted that plasma levels of rifampicin were 53% lower in TB patients with diabetes, which might affect treatment outcomes. Inadequate immune respons of the host may also be important in this negative effect of diabetes. Depressed production of IFN-γ in diabetic patients is related to decreasing immune response to TB infection. Reduction of IL-12 response to mycobacterial stimulation in leukocytes from TB with diabetic patients suggest a compromise of innate immune response.
Full Text Available Introduction: Methicillin resistant Staphylococcus aureus (MRSA has emerged as a nosocomial pathogen of major worldwide importance and is an increasingly frequent cause of community-acquired infections. In this study, different risk factors and MRSA resistance pattern were investigated. Methods: In a 24 months period, all of the patients who were confined to bed in the surgery ward were included in the study. Then they were assessed to find out as if they had MRSA infection when hospitalized and once when they were discharged. Almost 48 h after admission, when patients were discharged, social and medical histories were acquired. Acquired samples were examined. Results: During the present study of 475 patients, 108 patients (22.8% had S. aureus. About frequency of antibiotic resistance among collected S. aureus colonies, erythromycin resistance, was the most frequent antibiotic resistance, also resistance to vancomycin was 0.4% that was the least. Only hospitalization duration had statistically significant correlation with antibiotic resistance, also resistance to erythromycin had statistically significant relation with history of surgery and alcohol consumption. Of all 34 MRSA species, 22 (64.7% samples were resistant to erythromycin, 17 (50.0% resistant to cefoxitin, 5 (14.7% resistant to mupirocin, 1 (2.9% resistant to vancomycin and 1 (2.9% resistant to linezolid. Conclusion: The results of the current study show that among hospitalized patients, there is resistance against methicillin. Since based on results of the study there is resistance against oxacillin and erythromycin in most cases, administering appropriate antibiotics have an important role in minimizing the resistance burden among bacterial species.
Nilsson, Sandra Feodor; Andersen, Per Kragh; Strandberg-Larsen, K
OBJECTIVE: To identify modifiable risk factors for miscarriage and to estimate the preventable proportion of miscarriages that could be attributed to these. DESIGN: Nationwide observational follow-up study. SETTING: Denmark. POPULATION: Ninety-one thousand four hundred and twenty seven pregnancies...... consumption, lifting of >20 kg daily, and night work. We estimated that 25.2% of the miscarriages might be prevented by reduction of all these risk factors to low risk levels. Modification of risk factors acting before and during pregnancy could lead to prevention of 14.7 and 12.5%, respectively......, of the miscarriages. Maternal age at conception and alcohol consumption were the most important risk factors. CONCLUSIONS: Miscarriage risk is increased by multiple potentially modifiable risk factors and a considerable proportion of miscarriages may be preventable....
) in order to determine occupational risk ... KEYWORDS: HIV, Traditional birth attendants, occupational risk factors, Zambia. [Afr J Health Sci. 2010; 17:5-9] ... + 5% and a confidence level of 95%, the required minimum sample would have been ...