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Silke C, Heary C, Bunting B, Devaney C, Groarke A, Major E, Durcan M, O'Brien C, Brady B. Examining the relationship between adversity and suicidality and self-harm in Irish adolescents from 2020 to 2022. J Affect Disord 2024; 349:234-243. [PMID: 38163570 DOI: 10.1016/j.jad.2023.12.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/06/2023] [Accepted: 12/24/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Research indicates that there is a strong association between childhood adversity and youth suicide and self-harm. However, there is currently a lack of understanding about the patterns of adversity most frequently experienced by youth across social settings, and whether these typologies differently predict youth engagement in suicide and self-harm. This study examines the dominant patterns of adversity experienced by adolescents across home, peer, and school contexts, and explores the relationship between youth's adversity profiles and their suicide and self-harm outcomes, across a two year period (2020-2022). METHODS Secondary analyses were performed on data collected from 10,281 (50 % male) adolescents who participated in the Irish Planet Youth questionnaire in 2020 (n = 5004) or 2022 (n = 5277). RESULTS Findings from clustered latent class analyses indicated that there are four dominant profiles of adversity experienced by adolescents. Class 1 (Multiple Adversity) was characterised by a high probability of experiencing adversity across multiple social settings. Class 2 (Parent Adversity) had a strong likelihood of experiencing adversity with parents. Class 3 (Peer Adversity) were likely to experience adversity within the peer/friend domain. Class 4 was characterised by a low probability of experiencing adversity. Findings from logistic regression models with BCH training weights indicated that there were significant differences in self-harm and suicidality across the adversity classes. In comparison to the low adversity group, adolescents in the multiple adversity group were more likely to self-harm and attempt suicide. LIMITATIONS These findings are based on cross-sectional data and rely on the use of single-item measurements, which may limit the generalisability of findings. DISCUSSION Results indicate that youth who experience adversity across home, peer and school contexts are at the greatest risk of engaging in suicide and self-harm. These findings have important implications for policy and practice, and suggest that youth experiencing adversity across multiple settings should be priority targets for intervention.
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Affiliation(s)
- Charlotte Silke
- UNESCO Child & Family Research Centre, University of Galway, Ireland.
| | | | | | - Carmel Devaney
- UNESCO Child & Family Research Centre, University of Galway, Ireland
| | | | - Emmet Major
- Western Region Drugs & Alcohol Task Force, Galway, Ireland
| | - Micheal Durcan
- Western Region Drugs & Alcohol Task Force, Galway, Ireland
| | | | - Bernadine Brady
- UNESCO Child & Family Research Centre, University of Galway, Ireland
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Li X, Mak CM, Wai Ma K, Wong HM. How the high-volume evacuation alters the flow-field and particle removal characteristics in the mock-up dental clinic. Build Environ 2021; 205:108225. [PMID: 34376905 PMCID: PMC8343392 DOI: 10.1016/j.buildenv.2021.108225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/17/2021] [Accepted: 08/02/2021] [Indexed: 05/09/2023]
Abstract
The exposure risk of droplets and aerosols emitted from the oral cavity to the dental professionals and patients has received more attention especially the ongoing outbreak of COVID-19. The aim of this study is to address the question about how the use of the high-volume evacuation (HVE) alters the risk profiles compared with the situation only personal protective equipment (PPE). The risk profiles of the different situations were analyzed in terms of droplet velocity, flow field characteristics, and particle removal efficiency. The ultrasonic scaling with suction was performed in the mock-up experimental dental clinic, and the instantaneous moment when the HVE acted on the droplets was visualized using a laser light scattering technique. From the results of the velocity profiles, the hypothesis about the moderate effect of the HVE on high-velocity small droplets near the mannequin's mouth had been firstly proven in this study. The suction can be characterized as low-threshold equipment to bring substantial benefits to reduce the area of the contaminated region. Once the cooperation of suction, the pair of vortexes that were in the face shield area of the dental professional would be eliminated, removing the high-level contaminated region near the breathing area of dental professionals. Compared with the low and medium volume evacuation, the particle removal efficiency of the HVE was more stable at 60%. The research will provide references to the HVE recommendation in the dentistry clinical practice guidelines.
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Affiliation(s)
- Xiujie Li
- Department of Building Services Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Cheuk Ming Mak
- Department of Building Services Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Kuen Wai Ma
- Department of Building Services Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Hai Ming Wong
- Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong Island, Hong Kong
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Losada-Espinosa N, Estévez-Moreno LX, Bautista-Fernández M, Galindo F, Salem AZM, Miranda-de la Lama GC. Cattle welfare assessment at the slaughterhouse level: Integrated risk profiles based on the animal's origin, pre-slaughter logistics, and iceberg indicators. Prev Vet Med 2021; 197:105513. [PMID: 34695650 DOI: 10.1016/j.prevetmed.2021.105513] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/10/2021] [Accepted: 10/19/2021] [Indexed: 01/18/2023]
Abstract
Detection of on farm and transport animal welfare problems at slaughterhouse level is a key issue for the meat industry; however, usually, the assessments do not include basic aspects of animal health. For that reason, it is necessary to develop an assessment method that has an integrative scope and identifies the risk profiles in animals. Therefore, the aim of the present study was to detect cattle welfare indicators that can be implemented at the slaughterhouse level and to develop integrated risk profiles based on the animal's origin, pre-slaughter logistics, and animal-based indicators. We recorded the origin, commercial category, transportation details, and horn size of 1040 cattle upon arrival at the slaughterhouse. Cattle welfare was measured based on individual scores for vocalizations, stunning shots, carcass bruises, meat pH, severe hoof injuries, and organ condemnations. To characterize operational and logistic practices from the farm to the slaughterhouse, a two-step cluster analysis was applied to the aforementioned variables (production system, cattle type, horn size, journey distance, vehicle type), which identified four clusters: small feedlot and free-range profile (C1, n = 216, 20.8 %), feedlot profile (C2, n = 193, 18.6 %), culled dairy cows profile (C3, n = 262, 25.2 %), and free-range profile (C4, n = 369, 35.5 %). The animal's diet and environmental conditions might have influenced the development of hoof disorders in C1 animals (P = 0.023), the proportion of animals that were re-shot was highest in C2 animals (P = 0.033), and C3 and C4 animals were most likely to suffer injuries such as severe bruising (P = 0.001). In addition, the number of stunning shots, meat pH, carcass bruises, severe hoof injuries, and liver condemnations, explained a significant variation in the incidence of various health and welfare consequences based on an animal's origin, which confirmed their importance as 'welfare iceberg' indicators. The study provided detailed data that can be included into assessment methods for the welfare of slaughter cattle, which can be tailored to specific production systems.
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Affiliation(s)
- N Losada-Espinosa
- Faculty of Veterinary Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - L X Estévez-Moreno
- Department of Animal Production and Food Science, Faculty of Veterinary Medicine, Agri-Food Institute of Aragon (IA2), University of Zaragoza, Zaragoza, Spain
| | - M Bautista-Fernández
- Department of Animal Production and Food Science, Faculty of Veterinary Medicine, Agri-Food Institute of Aragon (IA2), University of Zaragoza, Zaragoza, Spain
| | - F Galindo
- Faculty of Veterinary Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - A Z M Salem
- Faculty of Veterinary Medicine and Animal Science, Autonomous University of the State of Mexico (UAEM), Toluca, Mexico
| | - G C Miranda-de la Lama
- Department of Animal Production and Food Science, Faculty of Veterinary Medicine, Agri-Food Institute of Aragon (IA2), University of Zaragoza, Zaragoza, Spain.
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Knoops MGWG, Bongers IL, Janssen-de Ruijter EAW, van Nieuwenhuizen C. Do risk profiles moderate the relation between age of onset of disruptive behaviour and two types of externalising problems among adolescents admitted to secure residential care? Child Adolesc Psychiatry Ment Health 2021; 15:13. [PMID: 33637104 PMCID: PMC7908749 DOI: 10.1186/s13034-021-00364-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 02/10/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Adolescents with externalising problems in secure residential care differ in age of onset of disruptive behaviour and in cumulative risks in several domains. In order to reduce negative consequences of externalising behaviour for society and the adolescents themselves, it is important to gain more insight into the complexity and heterogeneity of disruptive behaviour in these adolescents. To look beyond the influence of single risk factors, the aim of this study is to investigate the moderator effect of co-occurring risk factors in multiple domains on the relation between age of onset of disruptive behaviour and two types of externalising problems in adolescence. METHODS Retrospectively collected data of 225 adolescents admitted to secure residential care were analysed. The four risk profiles were based on co-occurring pre-admission risk factors in four domains, which were identified in a previous study by latent class analysis. Multiple regression models were used to test whether the independent variable age of onset and dummy-coded moderator variable risk profiles had statistically significant associations with aggressive behaviour and rule-breaking behaviour of the adolescents, as reported by professional caregivers in the first months of admission. RESULTS Risk profiles moderated the relation between age of onset of disruptive behaviour and rule-breaking behaviour. Adolescents with childhood-onset disruptive behaviour within the risk profile with mainly family risks showed more rule-breaking behaviour in the first months of their admission to secure residential care than adolescents with an onset in adolescence within the same risk profile. Risk profiles, however, did not moderate the relation between age of onset of disruptive behaviour and aggressive behaviour. CONCLUSION Heterogeneity of aggressive and rule-breaking behaviour was established in this study by finding differences on these two types of externalising behaviour between the childhood- and adolescence-onset groups and between the four risk profiles. Furthermore, risk profiles moderated the effect between age of onset of disruptive behaviour and rule-breaking behaviour-not aggressive behaviour-in adolescents admitted to secure residential care. While respecting the limitations, adolescents' childhood-onset disruptive behaviour within a profile with mainly family risk factors appear to be distinctive from adolescents with adolescence-onset disruptive behaviour within the same risk profile.
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Affiliation(s)
- Miranda G. W. G. Knoops
- GGzE Centre for Child and Adolescent Psychiatry, DP 8001, PO BOX 909, 5600 AX Eindhoven, The Netherlands
| | - Ilja L. Bongers
- GGzE Centre for Child and Adolescent Psychiatry, DP 8001, PO BOX 909, 5600 AX Eindhoven, The Netherlands
- Tilburg University, Tranzo, Scientific Center for Care and Wellbeing (Tranzo), Tilburg, The Netherlands
| | - Elisabeth A. W. Janssen-de Ruijter
- GGzE Centre for Child and Adolescent Psychiatry, DP 8001, PO BOX 909, 5600 AX Eindhoven, The Netherlands
- Tilburg University, Tranzo, Scientific Center for Care and Wellbeing (Tranzo), Tilburg, The Netherlands
| | - Chijs van Nieuwenhuizen
- GGzE Centre for Child and Adolescent Psychiatry, DP 8001, PO BOX 909, 5600 AX Eindhoven, The Netherlands
- Tilburg University, Tranzo, Scientific Center for Care and Wellbeing (Tranzo), Tilburg, The Netherlands
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Xiong M, Wang L, Su L, Luo W, Li Y, Li L, Nie S, Hou FF. Acute kidney injury among hospitalized children with cancer. Pediatr Nephrol 2021; 36:171-179. [PMID: 32712760 DOI: 10.1007/s00467-020-04678-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/09/2020] [Accepted: 06/16/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Few studies to date have analyzed the epidemiology of acute kidney injury (AKI) in children with cancer in developing countries. The aim of this study was to assess the incidence, risk profile and outcomes of AKI in Chinese children hospitalized with cancer. METHODS This multi-center study analyzed Chinese children hospitalized with cancer in 2013-2015. Electronic hospital and laboratory databases were screened to select pediatric patients with malignancy who had at least two Scr results within any 7-day window during their first 30 days of hospitalization. AKI events were identified and staged according to Kidney Disease Improving Global Outcomes (KDIGO) criteria. The incidence of and risk factors for AKI were analyzed, as were mortality rate, incidence of kidney recovery, and length of hospital stay. RESULTS Of the 9828 children with cancer, 1657 (16.9%) experienced AKI events, including 549 (5.6%) community-acquired (CA-AKI) and 1108 (11.3%) hospital-acquired AKI (HA-AKI) events. The three types of cancer with the highest incidence of AKI were urinary system cancer (25.8%), hepatic cancer (19.4%), and retroperitoneal malignancies (19.1%). The risk factor profiles of CA-AKI and HA-AKI events differed, with many HA-AKI events due to treatment with nephrotoxic agents. In-hospital death rates were 5.4% (90 of 1657) in children with and 0.9% (74 of 8171) in children without AKI events. AKI events were also associated with longer hospitalization and higher daily costs. CONCLUSIONS AKI events are common among Chinese children hospitalized for cancer and are associated with adverse in-hospital outcomes.
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Affiliation(s)
- Mengqi Xiong
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Long Wang
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Licong Su
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Weihong Luo
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Yanqin Li
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Lu Li
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Sheng Nie
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China.
| | - Fan Fan Hou
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China.
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van der Toorn JE, Rueda-Ochoa OL, van der Schaft N, Vernooij MW, Ikram MA, Bos D, Kavousi M. Arterial calcification at multiple sites: sex-specific cardiovascular risk profiles and mortality risk-the Rotterdam Study. BMC Med 2020; 18:263. [PMID: 32967688 PMCID: PMC7513304 DOI: 10.1186/s12916-020-01722-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/27/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Evidence has pointed towards differences in the burden of arteriosclerosis according to its location and sex. Yet there is a scarcity of population-based data on aggregated sex-specific cardiovascular risk profiles, instead of single risk factors, and mortality risk according to the location of arteriosclerosis. We assessed sex-specific cardiovascular risk profiles and mortality risk associated with arteriosclerosis. METHODS From the population-based Rotterdam Study, 2357 participants (mean age 69 years, 53% women) underwent non-contrast computed tomography to quantify calcification, as a proxy for arteriosclerosis, in the coronary arteries (CAC), aortic arch (AAC), extracranial (ECAC) and intracranial carotid arteries (ICAC), vertebrobasilar arteries (VBAC), and aortic valve (AVC). Principal component analysis (PCA) of eight distinct cardiovascular risk factors was performed, separately for women and men, to derive risk profiles based on the shared variance between factors. We used sex-stratified multivariable logistic regression to examine the associations between PCA-derived risk profiles and severe calcification at different locations. We investigated the associations of severe calcification with mortality risk using sex-stratified multivariable Cox regression. RESULTS PCA identified three cardiovascular risk profiles in both sexes: (1) anthropometry, glucose, and HDL cholesterol; (2) blood pressure; and (3) smoking and total cholesterol. In women, the strongest associations were found for profile 2 with severe ECAC and ICAC (adjusted OR [95% CI] 1.32 [1.14-1.53]) and for profile 3 with severe at all locations, except AVC. In men, the strongest associations were found for profile 2 with VBAC (1.31 [1.12-1.52]) and profile 3 with severe AAC (1.28 [1.09-1.51]). ECAC and AVC in women and CAC in men showed the strongest, independent associations with cardiovascular mortality (HR [95% CI] 2.11 [1.22-3.66], 2.05 [1.21-3.49], 2.24 [1.21-3.78], respectively). CONCLUSIONS Our findings further underline the existence of sex- and location-specific differences in the etiology and consequences of arteriosclerosis. Future research should unravel which distinct pathological processes underlie differences in risk profiles for arteriosclerosis.
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Affiliation(s)
- Janine E van der Toorn
- Department of Epidemiology, University Medical Centre, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, University Medical Centre, Rotterdam, The Netherlands
| | - Oscar L Rueda-Ochoa
- Department of Epidemiology, University Medical Centre, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Electrocardiography Research Group, School of Medicine, Industrial University of Santander, Bucaramanga, Colombia
| | - Niels van der Schaft
- Department of Epidemiology, University Medical Centre, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, University Medical Centre, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, University Medical Centre, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, University Medical Centre, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Daniel Bos
- Department of Epidemiology, University Medical Centre, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, University Medical Centre, Rotterdam, The Netherlands.,Department of Clinical Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Maryam Kavousi
- Department of Epidemiology, University Medical Centre, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
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Janssen-de Ruijter EAW, Mulder EA, Bongers IL, Omlo L, van Nieuwenhuizen C. Looking into the crystal ball: quality of life, delinquency, and problems experienced by young male adults after discharge from a secure residential care setting in the Netherlands. Child Adolesc Psychiatry Ment Health 2019; 13:45. [PMID: 31832091 PMCID: PMC6859618 DOI: 10.1186/s13034-019-0305-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 11/07/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents in residential care are a vulnerable population with many problems in several life areas. For most of these adolescents, these problems persist after discharge and into adulthood. Since an accumulation of risk factors in multiple domains increases the likelihood of future adverse outcomes, it would be valuable to investigate whether there are differences in life after residential care between subgroups based on multiple co-occurring risk factors. AIMS AND HYPOTHESIS The aim of this exploratory follow-up study is to explore differences between young adults-classified in four risk profiles-in relation to life after discharge from a secure residential care setting. It is hypothesised that young adults with a profile with many risks in multiple domains will experience more problems after discharge, such as (persistent) delinquency, compared to young adults with a profile with lower risks. METHODS Follow-up data were collected from 46 former patients of a hospital for youth forensic psychiatry and orthopsychiatry in the Netherlands. In order to illustrate these young adults' life after discharge, self-reported outcome measures divided into five domains (i.e., quality of life, daily life, social life, problems, and delinquency) were used. Differences between four classes based on pre-admission risk factors, which were identified in a previous study by latent class analysis, were explored by three (non-)parametric statistical tests. RESULTS Life after discharge for most young adults was characterised by close friends and a high quality of life, but also by substance abuse, professional support, debts, and delinquency. Only a few significant differences between the classes were found, primarily between young adults with risk factors in the individual, family, school, and peer domains and young adults in the other three classes. CONCLUSIONS Young adults experience a high quality of life after discharge from secure residential care, despite the presence of persistent problems. Some indications have been found that young adults with risk factors in four domains are at greatest risk for persistent problems in young adulthood. Because of the high amount of persistent problems, residential treatment and aftercare should focus more on patients' long-term needs.
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Affiliation(s)
- E. A. W. Janssen-de Ruijter
- GGzE Centre for Child & Adolescent Psychiatry, PO BOX 909 (DP 8001), 5600 AX Eindhoven, The Netherlands ,0000 0001 0943 3265grid.12295.3dTilburg University, Scientific Center for Care & Wellbeing (Tranzo), Tilburg, The Netherlands
| | - E. A. Mulder
- 0000000089452978grid.10419.3dLeiden University Medical Center, Leiden, The Netherlands ,Intermetzo-Pluryn, Nijmegen, The Netherlands
| | - I. L. Bongers
- GGzE Centre for Child & Adolescent Psychiatry, PO BOX 909 (DP 8001), 5600 AX Eindhoven, The Netherlands ,0000 0001 0943 3265grid.12295.3dTilburg University, Scientific Center for Care & Wellbeing (Tranzo), Tilburg, The Netherlands
| | - L. Omlo
- GGzE Centre for Child & Adolescent Psychiatry, PO BOX 909 (DP 8001), 5600 AX Eindhoven, The Netherlands
| | - Ch. van Nieuwenhuizen
- GGzE Centre for Child & Adolescent Psychiatry, PO BOX 909 (DP 8001), 5600 AX Eindhoven, The Netherlands ,0000 0001 0943 3265grid.12295.3dTilburg University, Scientific Center for Care & Wellbeing (Tranzo), Tilburg, The Netherlands
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Humphries H, Osman F, Knight L, Abdool Karim Q. Who is sexually active? Using a multi-component sexual activity profile (MSAP) to explore, identify and describe sexually-active high-school students in rural KwaZulu-Natal, South Africa. BMC Public Health 2019; 19:317. [PMID: 30885161 PMCID: PMC6423781 DOI: 10.1186/s12889-019-6602-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 02/27/2019] [Indexed: 11/18/2022] Open
Abstract
Background Understanding sexual activity is necessary to prevent sexually transmitted infections. Evidence from Sub-Saharan Africa suggests that 10–20% of youth aged 15–24 are sexually active before reaching 15 years, yet estimating sexual activity remains challenging. This study explored the use of multiple sexual health outcomes to identify sexually-active young women in rural KwaZulu-Natal, South Africa. Methods Using a multi-component sexual activity profile (MSAP), we aimed to identify sexually active students. Based on data from 2675 grade 9 and 10 students attending 14 high schools) in rural KwaZulu-Natal, we constructed a descriptive diagram identifying students who were sexually active by self-report vs MSAP profile. T-tests for two independent samples was performed to compare by sex and ecological variables that characterise students newly-identified as sexually active. Results Using self-report only, 40.3% self-reported as sexually active, whilst the MSAP identified 48.7% (223 additional students). More females were identified than males. Younger adolescents were more likely to underreport sexual activity but were identified using MSAP. Newly-identified as sexually active were more likely to be female (p = < 0.000), 15 years old or younger (p = 0.008), less likely to perceive being at risk (p = 0.037) or have ever used alcohol (p = < 0.000). At a relational level, they were less likely to report having ever had a boyfriend/girlfriend (p = 0.000) or to have felt pressured to have sex by their peers (p = < 0.000) or partners (p = 0.008). At a familial level they more likely to be of medium socioeconomic (SES) status (p = 0.037) whilst at a school and community level they were less likely to have repeated a grade (p = 0.024) and were more likely to be engaged in social activities (p = 0.032). Conclusions The MSAP profile identified more potentially sexually active students, and gave insight into the characteristics of students who may be unwilling to self-report sexual activity Future work should investigate how this approach could enhance and describe sexually-active adolescents for research and healthcare provision.
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Affiliation(s)
- Hilton Humphries
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
| | - Farzana Osman
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Lucia Knight
- School of Public Health, University of the Western Cape, Bellville, South Africa
| | - Quarraisha Abdool Karim
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, USA
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Gaalema DE, Leventhal AM, Priest JS, Higgins ST. Understanding individual differences in vulnerability to cigarette smoking is enhanced by attention to the intersection of common risk factors. Prev Med 2018; 117:38-42. [PMID: 30222998 PMCID: PMC6234036 DOI: 10.1016/j.ypmed.2018.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 07/27/2018] [Accepted: 09/11/2018] [Indexed: 02/04/2023]
Abstract
While smoking prevalence in the U.S. and other industrialized countries has decreased substantially, this change has been unevenly distributed, with dramatic decreases in certain subpopulations but little change or even increases in others. Accordingly, considerable attention has been fruitfully devoted to identifying important risk factors for smoking (e.g., mental illness, other substance use disorders). However, there has been little research on the intersection of these risk factors. As risk factors rarely occur in isolation, it is important to examine risk-factor profiles as is commonly done in studying other chronic conditions (e.g., cardiovascular disease). The purpose of this Commentary is to encourage greater interest in the intersection of multiple risk factors using cigarette smoking as an exemplar. We focus on the intersection of eight well-established risk factors for smoking (age, gender, race/ethnicity, educational attainment, poverty, drug abuse/dependence, alcohol abuse/dependence, mental illness). Studying the intersection of risk factors is likely to require use of innovative data-analytic methods. We illustrate, using years 2011-2016 of the US National Household Survey on Drug Use and Health, how Classification and Regression Tree (CART) analysis can be an effective tool for identifying risk profiles for smoking. Examination of the intersection of these risk factors elucidates a series of risk profiles with associated, orderly gradations in vulnerability to current smoking, including the striking and reliable strength of a college education as a stand-alone profile predicting low risk for current smoking, and illustrating the potentially increasing importance of drug abuse/dependence as a risk factor.
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Affiliation(s)
- Diann E Gaalema
- Vermont Center on Tobacco Regulatory Science, University of Vermont, Burlington, VT, United States of America; Department of Psychiatry, University of Vermont, Burlington, VT, United States of America; Department of Psychology, University of Vermont, Burlington, VT, United States of America.
| | - Adam M Leventhal
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, United States of America
| | - Jeffrey S Priest
- Medical Biostatistics, University of Vermont, Burlington, VT, United States of America
| | - Stephen T Higgins
- Vermont Center on Tobacco Regulatory Science, University of Vermont, Burlington, VT, United States of America; Department of Psychiatry, University of Vermont, Burlington, VT, United States of America; Department of Psychology, University of Vermont, Burlington, VT, United States of America
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Abstract
PURPOSE OF THE REVIEW This review article synthesizes recent research findings on the psychological context of Type D personality and the mechanisms through which Type D affects disease progression and prognosis among patients with coronary heart disease (CHD). RECENT FINDINGS One in four patients with CHD has a Distressed (Type D) personality, which is characterized by two stable traits: social inhibition and negative affectivity. Type D personality predicts increased mortality and morbidity burden, and poorer health-related quality of life. Type D is part of a family of psychosocial risk factors that affect CHD prognosis. The pattern of co-occurrence of these psychosocial factors and intra-individual differences in psychosocial profiles may affect risk prediction accuracy. Multiple biological and behavioral processes have been associated with Type D personality. Identifying pathways explaining the observed associations between Type D personality and CHD is important to improve etiological and pathophysiological knowledge and to design personalized interventions, and targeting specific risk-associated pathways.
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Krittayaphong R, Winijkul A, Methavigul K, Wongtheptien W, Wongvipaporn C, Wisaratapong T, Kunjara-Na-Ayudhya R, Boonyaratvej S, Komoltri C, Kaewcomdee P, Yindeengam A, Sritara P. Risk profiles and pattern of antithrombotic use in patients with non-valvular atrial fibrillation in Thailand: a multicenter study. BMC Cardiovasc Disord 2018; 18:174. [PMID: 30144802 PMCID: PMC6109333 DOI: 10.1186/s12872-018-0911-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 08/20/2018] [Indexed: 02/08/2023] Open
Abstract
Background Anticoagulation therapy is a standard treatment for stroke prevention in patients with non-valvular atrial fibrillation (NVAF) that have risk factors for stroke. However, anticoagulant increases the risk of bleeding, especially in Asians. We aimed to investigate the risk profiles and pattern of antithrombotic use in patients with NVAF in Thailand, and to study the reasons for not using warfarin in this patient population. Methods A nationwide multicenter registry of patients with NVAF was created that included data from 24 hospitals located across Thailand. Demographic data, atrial fibrillation-related data, comorbid conditions, use of antithrombotic drugs, and reasons for not using warfarin were collected. Data were recorded in a case record form and then transferred into a web-based system. Results A total of 3218 patients were included. Average age was 67.3 ± 11.3 years, and 58.2% were male. Average CHADS2, CHA2DS2-VASc, and HAS-BLED score was 1.8 ± 1.3, 3.0 ± 1.7, and 1.5 ± 1.0, respectively. Antiplatelet was used in 26.5% of patients, whereas anticoagulant was used in 75.3%. The main reasons for not using warfarin in those with CHA2DS2-VASc ≥2 included already taking antiplatelet (26.6%), patient preference (23.1%), and using non-vitamin K antagonist oral anticoagulants (NOACs) (22.7%). Anticoagulant was used in 32.3% of CHA2DS2-VASc 0, 56.8% of CHA2DS2-VASc 1, and 81.6% of CHA2DS2-VASc ≥2. The use of NOACs increased from 1.9% in 2014 to 25.6% in 2017. Conclusions Anticoagulation therapy was prescribed in 75.3% of patients with NVAF. Among those receiving anticoagulant, 90.9% used warfarin and 9.1% used NOACs. The use of NOACs increased over time. Electronic supplementary material The online version of this article (10.1186/s12872-018-0911-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rungroj Krittayaphong
- Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.
| | - Arjbordin Winijkul
- Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | - Komsing Methavigul
- Department of Cardiology, Central Chest Institute of Thailand, Nonthaburi, Thailand
| | | | | | | | | | | | - Chulalak Komoltri
- Department of Research Promotion, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pontawee Kaewcomdee
- Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | - Ahthit Yindeengam
- Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | - Piyamitr Sritara
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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12
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Dong B, Branas CC, Richmond TS, Morrison CN, Wiebe DJ. Youth's Daily Activities and Situational Triggers of Gunshot Assault in Urban Environments. J Adolesc Health 2017; 61:779-785. [PMID: 28947347 PMCID: PMC5701826 DOI: 10.1016/j.jadohealth.2017.06.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 06/27/2017] [Accepted: 06/28/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Although previous research has made progress in identifying individuals predicted to face an elevated risk of being shot, it is not clear how that risk varies within individuals based on the contexts they encounter as they navigate daily life. The current study examines how the convergence of individual risk activity and neighborhood disadvantage and disorder triggers the risk of being shot. METHODS Using a novel geographic information system application, 123 male gunshot assault victims between 10 and 24 years old in Philadelphia, Pennsylvania, described their minute-by-minute movements over the course of the day of the gunshot assault. Through latent class analysis, the primary exposure was real-life circumstance where nine theoretically informed risk factors converged, compared with two other circumstances. Case-crossover analyses of subjects' 10-minute segments of full-day activities compared gunshot assault victims at the time of assault with themselves earlier in the day. RESULTS Compared to when individuals were exposed to minimal situational risk or were mainly exposed to neighborhood disadvantage and disorder, the concurrence of risk activity and neighborhood disadvantage and disorder was associated with a 9.90 (95% CI: 2.72-36.14) and 6.06 (95% CI: 2.78-13.22) times higher risk of being shot. Importantly, the likelihood of being in the high-risk circumstance increased systematically over the course of the day leading up to the time when young individuals were shot. CONCLUSIONS After controlled individual's propensity to be shot (e.g., inherent traits), the concurrence of situational risks emerged as significant triggers of gunshot assault. The findings suggest potential for community-based gunshot violence interventions.
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Affiliation(s)
- Beidi Dong
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
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O'Connor M, Hanlon A, Mauer E, Meghani S, Masterson-Creber R, Marcantonio S, Coburn K, Van Cleave J, Davitt J, Riegel B, Bowles KH, Keim S, Greenberg SA, Sefcik JS, Topaz M, Kong D, Naylor M. Identifying distinct risk profiles to predict adverse events among community-dwelling older adults. Geriatr Nurs 2017; 38:510-519. [PMID: 28479081 PMCID: PMC5991797 DOI: 10.1016/j.gerinurse.2017.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 03/06/2017] [Accepted: 03/13/2017] [Indexed: 12/17/2022]
Abstract
Preventing adverse events among chronically ill older adults living in the community is a national health priority. The purpose of this study was to generate distinct risk profiles and compare these profiles in time to: hospitalization, emergency department (ED) visit or death in 371 community-dwelling older adults enrolled in a Medicare demonstration project. Guided by the Behavioral Model of Health Service Use, a secondary analysis was conducted using Latent Class Analysis to generate the risk profiles with Kaplan Meier methodology and log rank statistics to compare risk profiles. The Vuong-Lo-Mendell-Rubin Likelihood Ratio Test demonstrated optimal fit for three risk profiles (High, Medium, and Low Risk). The High Risk profile had significantly shorter time to hospitalization, ED visit, and death (p < 0.001 for each). These findings provide a road map for generating risk profiles that could enable more effective targeting of interventions and be instrumental in reducing health care costs for subgroups of chronically ill community-dwelling older adults.
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Affiliation(s)
- Melissa O'Connor
- NewCourtland Center for Transitions in Health, University of Pennsylvania School of Nursing, USA; Villanova University, College of Nursing, USA.
| | - Alexandra Hanlon
- NewCourtland Center for Transitions in Health, University of Pennsylvania School of Nursing, USA
| | - Elizabeth Mauer
- Department of Healthcare Policy & Research, Weill Cornell Medicine, USA
| | - Salimah Meghani
- NewCourtland Center for Transitions in Health, University of Pennsylvania School of Nursing, USA
| | | | | | | | - Janet Van Cleave
- NewCourtland Center for Transitions in Health, University of Pennsylvania School of Nursing, USA; New York University, College of Nursing, USA
| | - Joan Davitt
- NewCourtland Center for Transitions in Health, University of Pennsylvania School of Nursing, USA; University of Maryland, School of Social Work, USA
| | - Barbara Riegel
- NewCourtland Center for Transitions in Health, University of Pennsylvania School of Nursing, USA
| | - Kathryn H Bowles
- NewCourtland Center for Transitions in Health, University of Pennsylvania School of Nursing, USA; Center for Home Care Research and Policy, Visiting Nurse Service of New York, USA
| | - Susan Keim
- NewCourtland Center for Transitions in Health, University of Pennsylvania School of Nursing, USA
| | - Sherry A Greenberg
- NewCourtland Center for Transitions in Health, University of Pennsylvania School of Nursing, USA; New York University, College of Nursing, USA
| | - Justine S Sefcik
- NewCourtland Center for Transitions in Health, University of Pennsylvania School of Nursing, USA
| | | | - Dexia Kong
- NewCourtland Center for Transitions in Health, University of Pennsylvania School of Nursing, USA
| | - Mary Naylor
- NewCourtland Center for Transitions in Health, University of Pennsylvania School of Nursing, USA
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Kara E, Xiromerisiou G, Spanaki C, Bozi M, Koutsis G, Panas M, Dardiotis E, Ralli S, Bras J, Letson C, Edsall C, Pliner H, Arepalli S, Kalinderi K, Fidani L, Bostantjopoulou S, Keller MF, Wood NW, Hardy J, Houlden H, Stefanis L, Plaitakis A, Hernandez D, Hadjigeorgiou GM, Nalls MA, Singleton AB. Assessment of Parkinson's disease risk loci in Greece. Neurobiol Aging 2014; 35:442.e9-442.e16. [PMID: 24080174 DOI: 10.1016/j.neurobiolaging.2013.07.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 07/15/2013] [Indexed: 12/14/2022]
Abstract
Genome-wide association studies (GWAS) have been shown to be a powerful approach to identify risk loci for neurodegenerative diseases. Recent GWAS in Parkinson's disease (PD) have been successful in identifying numerous risk variants pointing to novel pathways potentially implicated in the pathogenesis of PD. Contributing to these GWAS efforts, we performed genotyping of previously identified risk alleles in PD patients and control subjects from Greece. We showed that previously published risk profiles for Northern European and American populations are also applicable to the Greek population. In addition, although our study was largely underpowered to detect individual associations, we replicated 5 of 32 previously published risk variants with nominal p values <0.05. Genome-wide complex trait analysis revealed that known risk loci explain disease risk in 1.27% of Greek PD patients. Collectively, these results indicate that there is likely a substantial genetic component to PD in Greece, similarly to other worldwide populations, that remains to be discovered.
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