scholarly journals RELATIONSHIPS BETWEEN PERSONAL NEEDS AND THE ENVIRONMENT: A STUDY OF ABUSE AND SELF-NEGLECT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S954-S954
Author(s):  
Minzhi Ye ◽  
Farida Ejaz ◽  
Miriam Rose
Keyword(s):  
Risk Factors ◽  
Network Analysis ◽  
Low Income ◽  
Emotional Abuse ◽  
Minority Groups ◽  
Functional Limitations ◽  
Face To Face ◽  
Spatial Inequalities ◽  
Risk Patients ◽  
Block Data

Abstract Estimates of self-neglect among older and/or disabled adults are much higher than the estimated 10% of older adults in the U.S. who experience physical or emotional abuse, neglect, and exploitation by others. It is not clear how the social environment affects these vulnerable adults who become self-neglecting. This study uses network analysis and a GIS approach to explore patterns of needs and environmental risks for adult healthcare patients who had risk factors for self-neglect. Sources of data included face-to-face interviews, self-neglect risk factors (e.g., depression, dependency in activities of daily living, etc.) from electronic medical records, and neighborhood information from census block data. More than two-thirds of the 480 study participants reported an average income of less than $1,360 monthly, and 89% self-identified as Hispanic or Latino. Using ArcGIS Pro, respondents’ geocoded addresses were matched to mapped neighborhood census information. The maps showed that most respondents live in Hispanic-dominated communities, in neighborhoods with crime rates above average and median household income of less than $49,066/year. These neighborhoods were probably resource-poor and had spatial inequalities. Using network analysis, the study found that the at-risk patients’ most frequently reported needs (e.g., food assistance/nutrition, functional limitations, social isolation) appear clustered together, demonstrating that people had multiple needs. The study findings suggest that practitioners and policymakers must not only provide a range of services to help disadvantaged groups, but also focus specifically on offering services in neighborhoods where low-income minority groups reside and there is a lack of community resources.

scholarly journals Factors associated with adverse childhood experiences in Scottish children: a prospective cohort study

2019 ◽  
Vol 3 (1) ◽  
pp. e000340 ◽  
Author(s):  
Louise Marryat ◽  
John Frank
Keyword(s):  
Risk Factors ◽  
Birth Cohort ◽  
Low Income ◽  
Adverse Childhood Experiences ◽  
Emotional Abuse ◽  
Urban Areas ◽  
First Year ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Physical Neglect

Background and objectivesAdverse childhood experiences (ACEs) have been associated with a range of poorer health and social outcomes throughout the life course; however, to date they have primarily been conducted retrospectively in adulthood. This paper sets out to determine the prevalence of ACEs at age 8 in a recent prospective birth cohort and examine associations between risk factors in the first year and cumulative ACEs.DesignThis study uses the Growing Up in Scotland Birth Cohort 1, in which children born in Scotland in 2004/5 were identified using Child Benefit Records and followed up for 7 years (n.3119). ACE scores and sample characteristics were calculated and described. Logistic regression models were fitted to explore associations between risk factors (sex, mother’s age and education, household income, area level deprivation and urban/rural indicator) and ACE scores.ResultsSeven ACEs (or proxies) were assessed: physical abuse, domestic violence, substance abuse, mental illness, parental separation, parental incarceration and emotional neglect. Instances of sexual abuse were too few to be reported. Emotional abuse and physical neglect could not be gathered. Around two-thirds of children had experienced one or more ACE, with 10% experiencing three or more in their lifetime. Higher ACE scores were associated with being male, having a young mother, low income and urban areas.ConclusionsUsing prospective data, the majority of children born in 2004/2005 in Scotland experienced at least one ACE by age 8, although three ACEs could not be assessed in this cohort. ACEs were highly correlated with socioeconomic disadvantage in the first year of life.

Behavioral Emergencies and Crises

2010 ◽  
pp. 739-762
Author(s):  
Phillip M. Kleespies ◽  
Justin M. Hill
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
High Risk ◽  
Work Environment ◽  
Emotional Impact ◽  
High Risk Patients ◽  
Risk Patients ◽  
Life Threatening ◽  
Behavioral Emergencies ◽  
And Training

This chapter illustrates the mental health clinician’s relationship with behavioral emergencies. The chapter begins by distinguishing the terms behavioral emergency and behavioral crisis, and underlying themes among all behavioral emergencies are identified. Given that most clinicians will face a behavioral emergency in their careers, the importance of enhancing the process of educating and training practitioners for such situations far beyond the minimal training that currently exists is highlighted. The chapter continues by exploring various aspects of evaluating and managing high-risk patients (i.e., those who exhibit violent tendencies toward themselves or others, and those at risk for victimization). It includes a discussion of the benefits and limitations to estimating life-threatening risk factors and specific protective factors. The chapter concludes by discussing the emotional impact that working with high-risk patients has on clinicians, and an emphasis is placed on the importance of creating a supportive work environment.

A Cross-sectional Study of the Clinical Profile of Children With Cerebral Palsy in Benin, a West African Low-Income Country

2019 ◽  
Vol 34 (13) ◽  
pp. 842-850
Author(s):  
Emmanuel Segnon Sogbossi ◽  
Damienne Houekpetodji ◽  
Toussaint G. Kpadonou ◽  
Yannick Bleyenheuft
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Low Income ◽  
Classification System ◽  
West African ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Common Cause ◽  
Low Income Country ◽  
Children With Cerebral Palsy

Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries.

scholarly journals Risk Factors for Postpartum Hemorrhage in a Thai–Myanmar Border Community Hospital: A Nested Case-Control Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4633
Author(s):  
Waraporn Thepampan ◽  
Nuchsara Eungapithum ◽  
Krittai Tanasombatkul ◽  
Phichayut Phinyo
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Postpartum Hemorrhage ◽  
Minority Groups ◽  
Case Control Study ◽  
Community Hospital ◽  
Case Control ◽  
Border Community ◽  
Nested Case Control ◽  
Control Study

Postpartum hemorrhage (PPH) is a common complication of pregnancy and a global public health concern. Even though PPH risk factors were extensively studied and reported in literature, almost all studies were conducted in non-Asian countries or tertiary care centers. Our study aimed to explore relevant risk factors for PPH among pregnant women who underwent transvaginal delivery at a Thai–Myanmar border community hospital in Northern Thailand. An exploratory nested case-control study was conducted to explore risk factors for PPH. Women who delivered transvaginal births at Maesai hospital from 2014 to 2018 were included. Two PPH definitions were used, which were ≥ 500 mL and 1000 mL of estimated blood loss within 24 h after delivery. Multivariable conditional logistic regression was used to identify significant risk factors for PPH and severe PPH. Of 4774 women with vaginal births, there were 265 (5.55%) PPH cases. Eight factors were identified as independent predictors for PPH and severe PPH: elderly pregnancy, minority groups, nulliparous, previous PPH history, BMI ≥ 35 kg/m2, requiring manual removal of placenta, labor augmentation, and fetal weight > 4000 gm. Apart from clinical factors, particular attention should be given to pregnant women who were minority groups as PPH risk significantly increased in this population.

scholarly journals FRI0420 ASSOCIATION BETWEEN RED BLOOD CELLS DISTRIBUTION WIDTH AND CARDIOVASCULAR RISK IN OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 808.2-808
Author(s):  
N. Hammam ◽  
G. Salem ◽  
D. Fouad ◽  
S. Rashad
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Functional Limitations ◽  
Functional Limitation ◽  
C Reactive Protein ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Distribution Width ◽  
Reactive Protein ◽  
Lipid Panel

Background:Osteoarthritis (OA) is the most common joint disease that results in patient’s morbidity and disabilities. There is strong evidence that OA is a significant risk factor for cardiovascular disease (CVD). Red cell distribution width (RDW) blood test is a measure of the variation in red blood cell volume and size. Elevated RDW has recently been found to correlate with CVD risk in patients with and without heart disease and autoimmune diseases. RDW may be a marker for factors driving CVS risk.Objectives:: To investigate whether RDW can serve as a potential parameter for indicating cardiovascular risk in OA patients.Methods:A subsample of 819 OA patients was extracted from 2003-2006 National Health & Nutrition Examination Survey in a cross-sectional study. 63.7% of them were females. Their mean age was 66.4 ± 14.1 yrs. Demographic, medical data, inflammatory markers & lipid panel were obtained. Only patients with Haemoglobin>12 mg/dl were included. Functional limitations were assessed using a physical function questionnaire.Results:Elevated levels of RDW were associated with CVD risk factors in OA patients. 532 (65.8%) OA patients had functional limitations, while 78 (9.5%) and 63 (7.6%) known to have heart attacks or stroke ever. Mean RDW was 12.9±1.1fL. There was a positive significant correlation between RDW & CVD risk factors including body mass index (r=0.17, p<0.001), C-reactive protein (r=0.29, p<0.001), serum uric acid (r=0.12, p<0.001), and functional limitation (0.16, p<0.001). No significant association between RDW & lipid panel was found. In multiple regression analysis controlling for age, sex as covariates, body mass index (β =0.02, 95%CI: 0.01, 0.03, p=0.002), C-reactive protein (β =0.35, 95%CI: 0.26, 0.45, p<0.001), and functional limitation (β =0.18, 95%CI: 0.13, 0.35, p=0.03).Conclusion:In addition to known CVD risk in OA patients, elevated RDW levels should prompt physicians to aggressively screen and treat their patients for modifiable CVS risk factors, in addition to OA.Disclosure of Interests:None declared

scholarly journals Risk Factors for Oral Health in Anorexia Nervosa: Comparison of a Self-Report Questionnaire and a Face-to-Face Interview

2021 ◽  
Vol 18 (8) ◽  
pp. 4212
Author(s):  
Hélène Rangé ◽  
Alice Pallier ◽  
Aminata Ali ◽  
Caroline Huas ◽  
Pierre Colon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anorexia Nervosa ◽  
Oral Health ◽  
Statistical Tests ◽  
The Self ◽  
Self Report ◽  
Short Version ◽  
Oral Diseases ◽  
Face To Face ◽  
Local Risk

Behavioral, nutritional, and local risk factors for oral health are frequent in people with anorexia nervosa. However no self-report questionnaire is available for screening in clinical practice or for research purposes. The objective of this study was to design a questionnaire to identify risk factors and symptoms of oral diseases and to test its reliability as a self-report form among people with anorexia nervosa. A 26-item questionnaire was designed based on a sound literature review performed by a group of dentists, psychiatrists, and epidemiologists specialized in the field of eating disorders. Sixty-nine anorexia nervosa inpatients (mean age 18.72 ± 5.1) were included from four specialized units. The questionnaire was first self-reported by the patients, then the same questionnaire was administrated by a dentist during a structured face-to-face interview as the gold standard. The concordance between the two forms was evaluated globally and item per item using Cohen’s kappa statistical tests. The overall concordance between the self-report questionnaire and the face-to-face structured interview was 55%. Of the 26 items, 19 showed significant concordance. Items relating to water intake, extracted teeth, gingival status, and oral hygiene had the best concordance (all kappa coefficients > 0.4). A questionnaire that identifies risk factors and symptoms of oral diseases in anorexia nervosa was developed and tested. The 26-item form of the questionnaire (long version) is moderately reliable as a self-reported form. A short version of the questionnaire, including the 10 most reliable items, is recommended for oral risk assessment in patients with anorexia nervosa. The clinical value of the self-administered questionnaire remains to be evaluated.

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