Maternal and neonatal risk factors for mental retardation: defining the ‘at-risk’ child

1998 ◽  
Vol 50 (2) ◽  
pp. 159-173 ◽  
Author(s):  
Bonnie W. Camp ◽  
Sarah H. Broman ◽  
Paul L. Nichols ◽  
Marilyn Leff
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Mental Retardation ◽  
Risk Child ◽  
Neonatal Risk Factors

scholarly journals Characterizing Pediatric Non–Malarial Fever and Identifying the At-Risk Child in Rural Malawi

2018 ◽  
Vol 5 ◽  
pp. 2333794X1775041
Author(s):  
Teresa Bleakly Kortz ◽  
Alden Blair ◽  
Ellen Scarr ◽  
Andrew Masozi Mguntha ◽  
Gama Bandawe ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Food Insecurity ◽  
Dry Season ◽  
Mobile Clinic ◽  
Logistic Regressions ◽  
Food Insecurity Access ◽  
Risk Child ◽  
Malarial Fever

Objective. To characterize children with non–malarial fever at risk of nonrecovery or worsening in rural Malawi. Methods. This is a subgroup analysis of patients ≤14 years of age from a prospective cohort study in non–malarial fever subjects (temperature ≥37.5°C, or fever within 48 hours, and malaria negative) in southern Malawi cared for at a mobile clinic during the 2016 dry (August to September) or wet (November to December) season. Data collection included chart review and questionnaires; 14-day follow-up was conducted. We conducted univariate descriptive statistics on cohort characteristics, bivariate analyses to examine associations between characteristics and outcomes, and multivariate logistic regressions to explore factors associated with nonrecovery. Results. A total of 2893 patients were screened, 401 were enrolled, 286 of these were children, and 280 children completed follow-up. Eighty-seven percent reported symptom resolution, 12.9% reported no improvement, and there were no deaths or hospitalizations. No improvement was associated with dry season presentation (42.6% vs 75.0%, P < .0003), >2 days of symptoms (51.6% vs 72.2%, P = .03), and food insecurity (62.3% vs 86.1%, P = .007). Dry season subjects had a 4.35 times greater likelihood of nonimprovement (95% confidence interval [CI] = 1.96-11.11). Household food insecurity and being >2 hours from a permanent clinic were associated with no improvement (adjusted odds ratio [AOR] = 4.61, 95% CI = 1.81-14.29; and AOR = 2.38, 95% CI = 1.11-5.36, respectively). Conclusion. Outcomes were generally excellent in this rural, outpatient pediatric cohort, though risk factors for nonrecovery included food insecurity, access to a standing clinic, and seasonality. Ideally, this study will inform clinic- and policy-level changes aimed at ameliorating the modifiable risk factors in Malawi and throughout rural Africa.

Identifying Factors of At-Risk Child Abuse Situations

1991 ◽  
Author(s):  
D. B. Bugental ◽  
◽  
J. Blue ◽  
J. Lewis
Keyword(s):  
At Risk ◽  
Child Abuse ◽  
Risk Child

The Experiences and Perspectives of African-Australian Community Service Providers Who Work with At-Risk and Justice-Involved Youth

2021 ◽  
pp. 0306624X2110226
Author(s):  
Stephane Shepherd ◽  
Aisling Bailey ◽  
Godwin Masuka
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Young People ◽  
Service Delivery ◽  
Community Service ◽  
Service Providers ◽  
Professional Staff ◽  
Youth Justice ◽  
Complex Needs ◽  
Australian Community

African-Australian young people are over-represented in custody in the state of Victoria. It has been recognized in recent government and stakeholder strategic plans that African-Australian community service providers are well placed to help address the increasing complex needs of at-risk African-Australian youth. However little is known about the capacities of such providers to effectively contend with this growing social concern. In response, this study aimed to explore the perspectives and operational (service delivery and governance) experiences of African-Australian community organizations which provide services to at-risk young people in Victoria. Through a series of in-depth interviews with the leadership of eight key African-Australian service providers, we aimed to identify their perceived strengths, obstacles faced and proposed strategies to realize key objectives. Perspectives on key risk factors for young African-Australian justice system contact were also gathered. Several themes were extracted from the interviews, specifically (i) Risk factors for African-Australian youth justice-involvement (school disengagement, peer delinquency, family breakdown, intergenerational discord, perceived social rejection), (ii) The limitations of mainstream institutions to reduce African-Australian youth justice-involvement (too compliance focused, inflexible, business rather than human-centered, disconnected from communities and families), (iii) The advantages of African-Australian community service providers when working with African-Australian youth (community credibility, client trust, flexibility, culturally responsive), (iv) The challenges faced by African-Australian service providers (lack of funding/resources, professional staff shortages, infrastructural/governance limitations), and (v) “What works” in service provision for at-risk African-Australians (client involvement in program design, African staff representation, extensive structured programming matched with client aspirations, prioritizing relationship building, persistent outreach, mental health and legal literacy for clients and families). Implications for service delivery and social policy are discussed within.

scholarly journals EULAR points to consider for conducting clinical trials and observational studies in individuals at risk of rheumatoid arthritis

2021 ◽  
pp. annrheumdis-2021-220884
Author(s):  
Kulveer Mankia ◽  
Heidi J Siddle ◽  
Andreas Kerschbaumer ◽  
Deshire Alpizar Rodriguez ◽  
Anca Irinel Catrina ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
At Risk ◽  
Clinical Trials ◽  
Observational Studies ◽  
Task Force ◽  
Musculoskeletal Symptoms ◽  
Subclinical Inflammation ◽  
Consensus Statements ◽  
Clinical Arthritis

BackgroundDespite growing interest, there is no guidance or consensus on how to conduct clinical trials and observational studies in populations at risk of rheumatoid arthritis (RA).MethodsAn European League Against Rheumatism (EULAR) task force formulated four research questions to be addressed by systematic literature review (SLR). The SLR results informed consensus statements. One overarching principle, 10 points to consider (PTC) and a research agenda were proposed. Task force members rated their level of agreement (1–10) for each PTC.ResultsEpidemiological and demographic characteristics should be measured in all clinical trials and studies in at-risk individuals. Different at-risk populations, identified according to clinical presentation, were defined: asymptomatic, musculoskeletal symptoms without arthritis and early clinical arthritis. Study end-points should include the development of subclinical inflammation on imaging, clinical arthritis, RA and subsequent achievement of arthritis remission. Risk factors should be assessed at baseline and re-evaluated where appropriate; they include genetic markers and autoantibody profiling and additionally clinical symptoms and subclinical inflammation on imaging in those with symptoms and/or clinical arthritis. Trials should address the effect of the intervention on risk factors, as well as progression to clinical arthritis or RA. In patients with early clinical arthritis, pharmacological intervention has the potential to prevent RA development. Participants’ knowledge of their RA risk may inform their decision to participate; information should be provided using an individually tailored approach.ConclusionThese consensus statements provide data-driven guidance for rheumatologists, health professionals and investigators conducting clinical trials and observational studies in individuals at risk of RA.

scholarly journals What are the risk factors for admission to the pediatric intensive unit among pediatric patients with COVID-19?

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Susanna Esposito ◽  
Fabio Caramelli ◽  
Nicola Principi
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Ventricular Function ◽  
Early Identification ◽  
Pediatric Patients ◽  
Serum Levels ◽  
Left Ventricular ◽  
Service Planning ◽  
Children At Risk ◽  
Heart Involvement

Abstract Background Although with exceptions, evidence seems to indicate that children have lower susceptibility than adults to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. When infected, children generally remain asymptomatic or develop mild disease. A small number of pediatric cases required admission to the pediatric intensive care unit (PICU), respiratory support with a mechanical ventilation and additional life-saving interventions. Even if rarely, death can occur. Aim of this manuscript is to highlight the risk factors associated with severe outcome among pediatric patients with COVID-19. Main findings Early identification of SARS-CoV-2-infected children at risk of developing severe COVID-19 is vital for service planning, as severely affected pediatric patients require high-quality care and should be followed only where an adequately structured PICU is available. However, early identification of children who must be carefully monitored for substantial risk of severe COVID-19 remains difficult. An underlying comorbidity and heart involvement are frequently observed in severe paediatric cases. Reduced left ventricular systolic function with an ejection fraction < 60%; diastolic dysfunction; and arrhythmias, including ST segment changes, QTc prolongation, and premature atrial or ventricular beat, are the earliest manifestations of heart involvement. Inclusion of heart enzyme serum levels and evaluation of ventricular function among predictive markers could lead to a more effective evaluation of children at risk with proper selection of those to admit to the PICU and with more adequate treatment in case of more severe clinical manifestations. Conclusions To appropriately manage severe pediatric COVID-19 cases, greater attention should be paid to risk factors in children and adolescents, especially to cardiovascular alterations (e.g., heart enzyme serum levels and evaluation of ventricular function). Further studies are needed and the development of a validated score based on all the most common presumed markers of disease severity seems essential.

scholarly journals Analysis of Risk Factors for African Swine Fever in Lombardy to Identify Pig Holdings and Areas Most at Risk of Introduction in Order to Plan Preventive Measures

Pathogens ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 1077
Author(s):  
Silvia Bellini ◽  
Alessandra Scaburri ◽  
Marco Tironi ◽  
Stefania Calò
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
European Union ◽  
Preventive Measures ◽  
Descriptive Analysis ◽  
African Swine Fever ◽  
The European Union ◽  
Z Score ◽  
Pork Products ◽  
Pig Farms

In 2019, the area of the European Union (EU) affected by African swine fever (ASF) expanded progressively in a southwestern direction from Baltic and eastern countries. The disease can severely affect and disrupt regional and international trade of pigs and pork products with serious socioeconomic damages to the pig industry. Lombardy is one of the most important European pig producers and the introduction of ASF into the pig population could adversely affect the entire sector. A study was carried out to identify the farms and territories in the region most at risk of ASF introduction to plan preventive measures. The pig holdings were identified through a descriptive analysis of pig movements and Social Network Analysis (SNA), while, for the identification of the most exposed municipalities, an assessment of risk factors was carried out using the ranking of summed scores attributed to the Z-score. From the analysis, it was found that 109 municipalities and 297 pig holdings of the region were potentially more at risk, and these holdings were selected for target surveillance. This information was provided to veterinary authority to target surveillance in pig farms, in order to early detect a possible incursion of ASF and prevent its spread.

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