scholarly journals Factors Associated With Insidious and Noninsidious Disability

2020 ◽  
Vol 75 (11) ◽  
pp. 2125-2129 ◽  
Author(s):  
Thomas M Gill ◽  
Terrence E Murphy ◽  
Evelyne A Gahbauer ◽  
Linda Leo-Summers ◽  
Ling Han
Keyword(s):  
Risk Factors ◽  
Chronic Conditions ◽  
Emergency Department Visits ◽  
Recurrent Event ◽  
Factors Associated ◽  
Shared Set ◽  
Lower Extremity Muscle ◽  
Multivariable Analyses ◽  
Restricted Activity ◽  
Hispanic White

Abstract Background Although disability is often precipitated by an illness/injury, it may arise insidiously. Our objectives were to identify the factors associated with the development of insidious and noninsidious disability and to determine whether these risk factors differ between the two types of disability. Methods We prospectively evaluated 754 community-living persons, 70+ years, from 1998 to 2016. The unit of analysis was an 18-month person-interval, with risk factors assessed at the start of each interval. Disability in four activities of daily living and exposure to intervening events, defined as illnesses/injuries leading to hospitalization, emergency department visits, or restricted activity, were assessed each month. Insidious and noninsidious disability were defined based on the absence and presence of an intervening event. Results The rate of noninsidious disability (21.7%) was twice that of insidious disability (10.8%). In multivariable recurrent-event Cox analyses, six factors were associated with both disability outcomes: non-Hispanic white race, lower extremity muscle weakness, poor manual dexterity, and (most strongly) frailty, cognitive impairment, and low functional self-efficacy. Three factors were associated with only noninsidious disability (older age, number of chronic conditions, and depressive symptoms), whereas four were associated with only insidious disability (female sex, lives with others, low SPPB score, and upper extremity weakness). The modest differences in risk factors identified for the two outcomes in multivariable analyses were less apparent in the bivariate analyses. Conclusions Although arising from different mechanisms, insidious and noninsidious disability share a similar set of risk factors. Interventions to prevent disability should prioritize this shared set of risk factors.

scholarly journals A cross sectional study to compare cardiac structure and diastolic function in adolescents and young adults with youth-onset type 1 and type 2 diabetes: The SEARCH for Diabetes in Youth Study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Amy S. Shah ◽  
Scott Isom ◽  
Dana Dabelea ◽  
Ralph D’Agostino ◽  
Lawrence M. Dolan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diastolic Function ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Factors Associated ◽  
Youth Study ◽  
Hispanic White ◽  
Diabetes In Youth

Abstract Aims To compare left ventricular structure (LV) and diastolic function in young adults with youth- onset diabetes by type, determine the prevalence of abnormal diastolic function by diabetes type using published values from age similar healthy controls, and examine the risk factors associated with diastolic function. Methods In a cross sectional analysis we compared LV structure and diastolic function from two dimensional echocardiogram in participants with type 1 (T1D) and type 2 diabetes (T2D) who participated in the SEARCH for Diabetes in Youth Study. Linear models were used to examine the risk factors associated with worse diastolic function. Results Of 479 participants studied, 258 had T1D (mean age 21.2 ± 5.2 years, 60.5% non-Hispanic white, 53.9% female) and 221 had T2D (mean age 24.8 ± 4.3 years, 24.4% non-Hispanic white, 73.8% female). Median diabetes duration was 11.6 years. Participants with T2D had greater LV mass index and worse diastolic function that persisted after adjustment for differences in risk factors compared with participants with T1D (all p < 0.05). Abnormal diastolic function, quantified using healthy controls, was pronounced in both groups but greater in those with T2D than T1D (T2D: 57.7% vs T1D: 47.2%, respectively), p < 0.05. Risk factors associated with worse diastolic function included older age at diabetes diagnosis, female sex, higher BP, heart rate and HbA1c and longer diabetes duration. Conclusions LV structure and diastolic function is worse in individuals with T2D compared to T1D. However, abnormal diastolic function in seen in both groups compared to published values from age similar healthy controls.

scholarly journals Associations Between Potentially Modifiable and Nonmodifiable Risk Factors and Gait Speed in Middle- and Older-Aged Adults: Results From the Canadian Longitudinal Study on Aging

2021 ◽  
Author(s):  
Erica Figgins ◽  
Yun-Hee Choi ◽  
Mark Speechley ◽  
Manuel Montero-Odasso
Keyword(s):  
Risk Factors ◽  
Longitudinal Study ◽  
Gait Speed ◽  
Chronic Conditions ◽  
Serum Vitamin ◽  
Lifestyle Factors ◽  
Community Dwelling ◽  
Life Course Perspective ◽  
Factors Associated ◽  
Modifiable Factors

Abstract Background Gait speed is a strong predictor of morbidity and mortality in older adults. Understanding the factors associated with gait speed and the associated adverse outcomes will inform mitigation strategies. We assessed the potentially modifiable and nonmodifiable factors associated with gait speed in a large national cohort of middle and older-aged Canadian adults. Methods We examined cross-sectional baseline data from the Canadian Longitudinal Study on Aging (CLSA) Comprehensive cohort. The study sample included 20 201 community-dwelling adults aged 45–85 years. The associations between sociodemographic and anthropometric factors, chronic conditions, and cognitive, clinical, and lifestyle factors and 4-m usual gait speed (m/s) were estimated using hierarchical multivariable linear regression. Results The coefficient of determination, R  2, of the final regression model was 19.7%, with 12.9% of gait speed variability explained by sociodemographic and anthropometric factors, and nonmodifiable chronic conditions and 6.8% explained by potentially modifiable chronic conditions, cognitive, clinical, and lifestyle factors. Potentially modifiable factors significantly associated with gait speed include cardiovascular conditions (unstandardized regression coefficient, B = −0.018; p &lt; .001), stroke (B = −0.025; p = .003), hypertension (B = −0.007; p = .026), serum Vitamin D (B = 0.004; p &lt; .001), C-reactive protein (B = −0.005; p = .005), depressive symptoms (B = −0.003; p &lt; .001), physical activity (B = 0.0001; p &lt; .001), grip strength (B = 0.003; p &lt; .001), current smoking (B = −0.026; p &lt; .001), severe obesity (B = −0.086; p &lt; .001), and chronic pain (B = −0.008; p = .018). Conclusions The correlates of gait speed in adulthood are multifactorial, with many being potentially modifiable through interventions and education. Our results provide a life-course-perspective framework for future longitudinal assessments risk factors affecting gait speed.

Factors associated with civilian and police officer injury during 10 years of officer-involved shooting incidents

2019 ◽  
Vol 26 (6) ◽  
pp. 509-515 ◽  
Author(s):  
Ellen Paddock ◽  
Katelyn Kassarjian Jetelina ◽  
Stephen A Bishopp ◽  
Kelley Pettee Gabriel ◽  
Jennifer Marie Reingle Gonzalez
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Law Enforcement ◽  
Police Officer ◽  
Police Department ◽  
Multiple Shooting ◽  
Fatal Injury ◽  
Factors Associated ◽  
Bivariate Logistic Regression ◽  
Hispanic White

BackgroundPrevious officer-involved shooting (OIS) research has focused primarily on antecedents to fatal shootings, with few studies investigating injury more broadly. Our study examined the factors associated with fatal or non-fatal injury to both civilians and officers during OIS incidents, to better understand how harm might be reduced in the most extreme law enforcement scenarios.MethodsData included 281 officers involved in 177 unique shooting incidents recorded by Dallas Police Department between 2005 and 2015. Bivariate logistic regression and multivariable generalised estimation equation analyses were used to investigate incident characteristics associated with fatal or non-fatal injury to civilians and officers.ResultsCivilian injury occurred in 61% and officer injury in 14% of unique OIS incidents. In adjusted models, multiple shooting officers increased the odds of injury to both civilians (adjusted OR (AOR): 3.22, 95% CI 1.39 to 7.50) and officers (AOR 4.73, 95% CI 1.64 to 13.65). Odds of civilian injury were also significantly higher during the daytime and among non-Hispanic white compared with non-Hispanic black and Hispanic/Latina/o civilians, although a majority of OIS incidents (79%) involved non-Hispanic black or Hispanic/Latino/a civilians. Odds of officer injury were significantly higher for detectives compared with patrol (AOR=9.32, 95% CI 1.85 to 47.03) and during off-duty versus on-duty shootings (AOR=5.23, 95% CI 1.37 to 19.99).ConclusionsBoth civilians and officers are at risk for injury during OIS incidents, though to different degrees and with unique risk factors. Additional research is needed to understand whether these results are replicated elsewhere and to further understand the mechanisms of injury.

scholarly journals Factors Associated with Anxiety and Depression among African American and White Women

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Kalycia Trishana Watson ◽  
Nehezi M. Roberts ◽  
Milda R. Saunders
Keyword(s):  
Risk Factors ◽  
Low Income ◽  
White Women ◽  
General Health Questionnaire ◽  
Significant Risk ◽  
Depression And Anxiety ◽  
Neighborhood Poverty ◽  
Factors Associated ◽  
Self Rated Health ◽  
Multivariable Analyses

Background. We examined factors associated with depression and anxiety in a cohort of low-income Baltimore women. Methods. We used Pathways to Adulthood data, a cohort of adults aged 27 to 33 who were born in Baltimore between 1960 and 1965. Our outcomes were a score of >4 on the General Health Questionnaire (GHQ-28) across the depression or anxiety domains. Linear regression clustered on census tract was used for multivariate analysis. Results. In multivariable analyses, unmarried women, White women, those with lower self-rated health, and younger mothers had higher depression scores. Only lower self-rated health and White race were associated with a higher anxiety score. Neither neighborhood poverty nor racial composition was a predictor for anxiety or depression; however, the significant risk factors cluster in disadvantaged neighborhoods. Conclusion. Our work highlights the importance of universal screening for depression or anxiety with more in-depth surveillance based on risk factors rather than on race.

scholarly journals Evaluation of compliance with early postbirth follow-up and unnecessary visits to the paediatric emergency department: a prospective observational study at the Lenval Children’s Hospital in Nice

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e056476
Author(s):  
Antoine Tran ◽  
Anne-Laure Hérissé ◽  
Marion Isoardo ◽  
Petri Valo ◽  
Anne-Marie Maillotte ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Care Pathway ◽  
Emergency Department Visits ◽  
Secondary Outcome ◽  
Medical Visit ◽  
Paediatric Emergency Department ◽  
Factors Associated ◽  
Paediatric Emergency

ObjectiveTo evaluate compliance with the French National Authority for Health’s (Haute Autorité de Santé, HAS) postbirth follow-up recommendations for newborns attending our paediatric emergency department (PED) and identify risk factors associated with non-compliance and unnecessary emergency department utilisation.DesignProspective, single centre.SettingFourth biggest PED in France in terms of attendance (CHU-Lenval).Patients280 patients of whom 249 were included in the statistical analysis.Main outcome measuresThe primary outcome of this study was the evaluation of compliance of the care pathway for newborns consulting at the PED with respect to the French postbirth follow-up recommendations. Secondary outcome was the assessment of whether the visit to the PED was justified by means of PED reception software and two postconsultation interviewsResults77.5% (193) of the newborns had non-compliant care pathways and 43% (107) of PED visits were unnecessary. Risk factors associated with a non-compliance regarding the HAS’s postbirth follow-up recommendations were: unnecessary visit to the PED (OR 2.0, 95% CI 1.1 to 3.9), precariousness (OR 2.8, 95% CI 1.4 to 6.2), birth in a public maternity hospital (OR 2.5, 95% CI 1.3 to 4.8) and no information about HAS’s postbirth follow-up recommendations on discharge from maternity ward (OR 11.4, 95% CI 5.8 to 23.3). Risk factors for unnecessary PED visits were: non-compliant care pathway (OR 2.0, 95% CI 1.1 to 3.9) and a first medical visit at a PED (OR 1.8, 95% CI 1.1 to 3.1).ConclusionPostbirth follow-up may lead to decrease unnecessary emergency department visits unnecessary emergency department visits.Trial registration numberThe study bears the clinical trial number NCT02863627.

scholarly journals Identifying Potential Intervention Points for Acute Hypoglycemic Events in Patients With Type 2 Diabetes Using Retrospective Clinical Data

2021 ◽  
Author(s):  
Mary E. Lacy ◽  
Rachel A. Whitmer ◽  
Sei J. Lee ◽  
Robert J. Rushakoff ◽  
Mark J. Pletcher
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Private Insurance ◽  
Emergency Department Visits ◽  
Hypoglycemic Event ◽  
Black Race ◽  
Factors Associated ◽  
Acute Hypoglycemia

This retrospective study examined changes in medication orders as a risk factor for future acute hypoglycemic events. The investigators identified factors associated with acute hypoglycemic events resulting in emergency department visits or inpatient admissions. Non-Hispanic Black race, chronic kidney disease, insulin at baseline, and non-private insurance were associated with higher risk of an acute hypoglycemic event, whereas age, sex, and A1C were not. After adjustment for other risk factors, changes in insulin orders after A1C measurement were associated with a 1.5 times higher risk of an acute hypoglycemia (adjusted hazard ratio 1.48, 95% CI 1.08–2.03). These results further understanding of risk factors and clinical processes relevant to predicting and preventing acute hypoglycemia.

scholarly journals Risk factors associated with the development of undifferentiated connective tissue dysplasia

2018 ◽  
Vol 17 (2) ◽  
pp. 41-48
Author(s):  
G. Yu. Kalaeva ◽  
O. I. Khokhlova ◽  
I. A. Deev ◽  
G. A. Мikheenko
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Connective Tissue ◽  
Chronic Conditions ◽  
Binary Logistic Regression ◽  
Maternity Hospital ◽  
Fetal Hypoxia ◽  
Factors Associated ◽  
Factor Combination ◽  
Connective Tissue Dysplasia

Development of the undifferentiated connective tissue dysplasia (UCTD) is influenced by various adverse factors to the fetus during intrauterine growth. There is not a clear linkage to the contribution of the separate factors to the development of the UCTD.Aims of the studyare to determine the risk factors associated with the development of the UCTD of the adolescents and to appreciate the predictive value of the examined factors related to UCTD to form the dispensary groups of the children with UCTD.Materials and methods. During the first stage of the study there was an examination of 110 adolescents at the age of 10–14 years old, the UCTD presence was established according to the scale proposed by T.I. Kadurina and V.N. Gorbunova (2009). During the second stage the data of the prenatal casework and maternity hospital records attached to the out-patient medical records were examined to detect the specialties of the antenatal life course. During the third stage 2 groups were formed: with the presence of UCTD (n = 81) and without UCTD (n = 29). The mother groups were formed accordingly with the adolescents groups.Results. The pregnancy of the mothers of the adolescents with UCTD proceeded against the anemia, threatening miscarriage, chronic fetal hypoxia, chronic fetoplacental insufficiency, toxicosis, gestosis, and concomitant chronic conditions (thyroid, kidneys, digestive apparatus, aspiration pathology) more common than the pregnancy of the mothers of the adolescents without UCTD. The binary logistic regression method allowed the predictors of the UCTD’s formation to be determined, there were: toxicosis during the gestation course (OR = 10.9; CI 95% 2.94–40.49), anemia of pregnancy (OR = 8.6; CI 95%: 2.42–30.81), gestosis (OR = 6.53; CI 95%: 1.27–33.71), chronic fetal hypoxia (OR = 4.4; CI 95%: 1.09–17.83) and pre-existing chronic conditions of the mothers (OR = 3.6; CI 95%: 0.86–15.48). Different factor combination enhances the likelihood of the delivery of a child with UCTD more than 6.5-fold: chronic conditions of the mothers and chronic fetal hypoxia (OR = 6.8; CI 95%: 1.95–48.57); anemia of pregnancy and chronic fetal hypoxia (OR = 7.2; CI 95%: 1.01–50.99), and toxicosis (OR = 10.4; CI 95%: 1.48–72.82).Conclusion. The risk factors associated to the development of UCTD in adolescents are: toxicosis during the gestation course, anemia of pregnancy, gestosis, chronic fetal hypoxia and pre-existing chronic conditions of the mothers. The use of the equation of the binary logistic regression allows the prediction of the possibility of the development of UCTD in adolescents at the level of 80.9% and to form the dispensary groups of children in order to prevent the development of dysplastic-dependent pathology

Risk factors for peripartum depression in women with multiple sclerosis

2021 ◽  
pp. 135245852110411
Author(s):  
Kristen M Krysko ◽  
Annika Anderson ◽  
Jessica Singh ◽  
Kira McPolin ◽  
Alice Rutatangwa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Sclerosis ◽  
Sleep Disturbance ◽  
Multivariable Analysis ◽  
Self Management ◽  
Birth Prevalence ◽  
Live Births ◽  
Factors Associated ◽  
Peripartum Depression ◽  
Multivariable Analyses

Background: Peripartum depression (PPD) is underexplored in multiple sclerosis (MS). Objective: To evaluate prevalence of and risk factors for PPD in women with MS. Methods: Retrospective single-center analysis of women with MS with a live birth. Prevalence of PPD was estimated with logistic regression with generalized estimating equations (GEE). GEE evaluated predictors of PPD (e.g. age, marital status, parity, pre-pregnancy depression/anxiety, antidepressant discontinuation, sleep disturbance, breastfeeding, relapses, gadolinium-enhancing lesions, and disability). Factors significant in univariable analyses were included in multivariable analysis. Results: We identified 143 live births in 111 women (mean age 33.1 ± 4.7 years). PPD was found in 18/143 pregnancies (12.6%, 95% CI = 7.3–17.8). Factors associated with PPD included older age (OR 1.16, 95% CI = 1.03–1.32 for 1-year increase), primiparity (OR 4.02, CI = 1.14–14.23), pre-pregnancy depression (OR 3.70, CI = 1.27–10.01), sleep disturbance (OR 3.23, CI = 1.17–8.91), and breastfeeding difficulty (OR 3.58, CI = 1.27–10.08). Maternal age (OR 1.17, CI = 1.02–1.34), primiparity (OR 8.10, CI = 1.38–47.40), and pre-pregnancy depression (OR 3.89, CI = 1.04–14.60) remained significant in multivariable analyses. Relapses, MRI activity, and disability were not associated with PPD. Conclusion: The prevalence of PPD in MS appeared similar to the general population, but was likely underestimated due to lack of screening. PPD can affect MS self-management and offspring development, and prospective studies are needed.

scholarly journals Neurocognitive and Behavioral Outcomes of Chinese Survivors of Childhood Lymphoblastic Leukemia

2021 ◽  
Vol 11 ◽  
Author(s):  
Liwen Peng ◽  
Lok Sum Yang ◽  
Perri Yam ◽  
Chun Sing Lam ◽  
Agnes Sui-yin Chan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Conditions ◽  
Lymphoblastic Leukemia ◽  
Behavioral Outcomes ◽  
Attention Problems ◽  
Chronic Health Conditions ◽  
Sluggish Cognitive Tempo ◽  
Health Conditions ◽  
Modifiable Risk Factors ◽  
Factors Associated

BackgroundIncreasing attention has been dedicated to investigate modifiable risk factors of late effects in survivors of childhood cancer. This study aims to evaluate neurocognitive and behavioral functioning in a relatively young cohort of survivors of childhood acute lymphoblastic leukemia (ALL) in Hong Kong, and to identify clinical and socio-environmental factors associated with these outcomes.MethodsThis analysis included 152 survivors of childhood ALL who were ≥5 years post-diagnosis (52% male, mean [SD] age 23.5[7.2] years at evaluation, 17.2[7.6] years post-diagnosis). Survivors completed performance-based neurocognitive tests, and reported their emotional and behavioral symptoms using the Child/Adult Behavior Checklist. Socio-environmental variables (living space, fatigue, physical activity, family functioning, and academic stress) were self-reported using validated questionnaires. Clinical variables and chronic health conditions were extracted from medical charts. Multivariable linear modeling was conducted to test identify factors associated with neurocognitive/behavioral outcomes, adjusting for current age, sex, age at diagnosis and cranial radiation. An exploratory mediation analysis was performed to examine the mediating effects of risk factors on neurocognitive and behavioral outcomes.ResultsAs compared to population norms, a minority of survivors developed mild-moderate impairment in motor processing speed (36.2%), memory (9.2%) and attention measures (4.0%-10.5%). Survivors also reported attention problems (12.5%), sluggish cognitive tempo (23.7%) and internalizing (depressive, anxiety and somatic symptoms) problems (17.1%). A minority of survivors developed mild-moderate treatment-related chronic conditions (n=37, 24.3%). As compared to survivors without chronic conditions, survivors with chronic conditions had more executive dysfunction (B=5.09, standard error [SE]=2.05; P=0.014) and reported more attention problems (B=5.73, SE=1.43; P&lt;0.0001). Fatigue and poor family functioning was associated with multiple measures of behavior problems (all P&lt;0.001). A lower level of physical activity was correlated with more self-reported symptoms of inattention (B= -1.12, SE=0.38, P=0.004) and sluggish cognitive tempo (B=-1.22, SE=0.41, P=0.003). Exploratory analysis showed that chronic health conditions were associated with behavioral measures through fatigue as the mediator.ConclusionThe majority of young Chinese survivors of ALL had normal cognitive and behavioral function. Regular monitoring of behavioral function should be performed on survivors who develop treatment-related chronic conditions. Health behavior and socio-environment factors may be potentially modifiable risk factors associated with health outcomes in survivors.

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