scholarly journals 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?

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Miranda G. W. G. Knoops ◽  
Ilja L. Bongers ◽  
Elisabeth A. W. Janssen-de Ruijter ◽  
Chijs van Nieuwenhuizen
Keyword(s):  
Risk Factors ◽  
Residential Care ◽  
Aggressive Behaviour ◽  
Age Of Onset ◽  
Risk Profile ◽  
Disruptive Behaviour ◽  
Risk Profiles ◽  
Externalising Problems ◽  
Rule Breaking ◽  
Secure Residential Care

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.

scholarly journals One is not the other: Predicting offending after discharge from secure residential care of male adolescents with four risk profiles

2021 ◽  
Vol 72 ◽  
pp. 101758
Author(s):  
E.A.W. Janssen-de Ruijter ◽  
E.A. Mulder ◽  
I.L. Bongers ◽  
J.K. Vermunt ◽  
Ch. van Nieuwenhuizen
Keyword(s):  
Residential Care ◽  
The Other ◽  
Risk Profiles ◽  
Male Adolescents ◽  
Secure Residential Care

scholarly journals Unsupervised Discovery of Risk Profiles on Negative and Positive COVID-19 Hospitalized Patients

2021 ◽  
Author(s):  
Fahimeh Nezhadmoghadam ◽  
Jose Tamez-Peña
Keyword(s):  
Risk Factors ◽  
Respiratory Health ◽  
Treatment Decision ◽  
Viral Disease ◽  
Risk Profile ◽  
Hospitalized Patients ◽  
Stable Set ◽  
Consensus Clustering ◽  
Risk Profiles ◽  
Validation Set

AbstractCOVID-19 is a viral disease that affects people in different ways: Most people will develop mild symptoms; others will require hospitalization, and a few others will die. Hence identifying risk factors is vital to assist physicians in the treatment decision. The objective of this paper is to determine whether unsupervised analysis of risk factors of positive and negative COVID-19 subjects may be useful for the discovery of a small set of reliable and clinically relevant risk-profiles. We selected 13367 positive and 19958 negative hospitalized patients from the Mexican Open Registry. Registry patients were described by 13 risk factors, three different outcomes, and COVID-19 test results. Hence, the dataset could be described by 6144 different risk-profiles per age group. To discover the most common risk-profiles, we propose the use of unsupervised learning. The data was split into discovery (70%) and validation (30%) sets. The discovery set was analyzed using the partition around medoids (PAM) method and robust consensus clustering was used to estimate the stable set of risk-profiles. We validated the reliability of the PAM models by predicting the risk-profile of the validation set subjects. The clinical relevance of the risk-profiles was evaluated on the validation set by characterizing the prevalence of the three patient outcomes: pneumonia diagnosis, ICU, or death. The analysis discovered six positives and five negative COVID-19 risk-profiles with strong statistical differences among them. Henceforth PAM clustering with consensus mapping is a viable method for unsupervised risk-profile discovery among subjects with critical respiratory health issues.

Abstract MP04: Determinants of attaining and maintaining a low cardiovascular risk profile - the Doetinchem Cohort Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Gerben Hulsegge ◽  
Martha L Daviglus ◽  
Yvonne T van der Schouw ◽  
Henriëtte A Smit ◽  
W M Verschuren
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Risk Profile ◽  
Low Risk ◽  
Cardiovascular Risk Profile ◽  
Risk Profiles ◽  
Risk Status ◽  
Low Education ◽  
Low Cardiovascular Risk

Introduction: Increasing the proportion of adults who attain and maintain low cardiovascular risk profile is essential in the prevention of cardiovascular disease (CVD). It is unknown which factors are associated with attaining and maintaining a low risk profile. We investigate the association of 6 demographic, 4 lifestyle, 3 CVD history, and 4 psychosocial determinants with 1) attaining and 2) maintaining a low risk profile. Method: CVD risk factors and determinants were measured at baseline (1987-1991) and 5-year intervals until 2013 among 6,390 adults initially aged 20-59. Participants were categorized into low risk (i.e., ideal levels of blood pressure, cholesterol, and body mass index, not smoking and no diabetes) and medium or high risk profile. Those with low risk profile maintained or lost their low risk status, whereas those with medium/high risk profiles maintained that risk profile or attained a low risk profile during 5 years follow-up. Determinants of change in risk profiles were examined using modified Poisson regression to obtain risk ratios (RR) and 95% confidence intervals (95%CI) and generalized estimating equations to combine multiple 5-year comparisons. Results: A small proportion of participants (3%) with medium/high risk profile attained a low risk profile during the following 5 years. Compared to those who maintained a medium/high risk profile, one unit increment in Mediterranean (healthy) diet score was associated with 9% (RR: 1.09, 95%CI: 1.02-1.16) and being physically active compared to being inactive with a 104% (RR: 2.04, 95%CI: 1.05-4.00) higher likelihood to attain a low risk profile. Older age (RR: 0.66), male gender (RR: 0.46), low (RR: 0.55) and intermediate (RR: 0.77) education, low education of partner (RR: 0.70), and being a homemaker (RR: 0.73) were significantly associated with lower chance to attain low risk status. Of those having a low risk profile, 40% maintained that low risk profile over 5 years. For those with low risk profile, only older age (RR: 0.93) and low educational level (RR: 0.80) were significantly inversely associated with maintaining low risk profile. Conclusion: Low education level had an unfavorable impact on changes in risk profiles. This underscores the need to target preventive efforts at individuals with low education in the prevention of CVD. A healthy diet and physical activity were the only modifiable risk factors that were favorably associated with attaining low risk profile.

scholarly journals 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

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
E. A. W. Janssen-de Ruijter ◽  
E. A. Mulder ◽  
I. L. Bongers ◽  
L. Omlo ◽  
Ch. van Nieuwenhuizen
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Young Adults ◽  
Residential Care ◽  
Care Setting ◽  
Residential Care Setting ◽  
Secure Residential Care ◽  
Multiple Domains

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.

The Characteristics and Intervention Histories of Incarcerated and Conduct-Disordered Youth

1996 ◽  
Vol 41 (4) ◽  
pp. 211-216 ◽  
Author(s):  
Jalal Shamsie ◽  
Hayley Hamilton ◽  
Cynthia Sykes
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Age Of Onset ◽  
Antisocial Behaviour ◽  
Incarcerated Youth ◽  
Disruptive Behaviour ◽  
Factors Associated ◽  
Conduct Disordered ◽  
Disruptive Behaviour Disorders ◽  
Similar Risk

Objectives: 1) To determine if incarcerated youth and conduct-disordered youth in treatment display similar risk factors associated with chronicity of antisocial behaviour; 2) to determine if incarcerated youth had experienced high numbers of interventions by many different agencies as has been reported for conduct-disordered youth in treatment. Method: The files of 25 conduct-disordered youth in treatment and 25 incarcerated youth were examined to extract all relevant data. Results: Incarcerated youth were similar to conduct-disordered youth with regard to the number of symptoms of disruptive behaviour disorders, age of onset of behavioural problems, and family backgrounds. Both groups had high numbers of interventions and agencies in their histories. Interventions began earlier for the conduct-disordered youth. Conclusion: The distinction between conduct-disordered youth who are treated and youth who are incarcerated may be arbitrary and accidental. Given the similarity in the clinical characteristics, incarcerated youth should be offered help that is similar to that offered to conduct-disordered youth. Such help may lower the rate of recidivism.

scholarly journals Natural History and Risk Stratification of Recurrent Crohn’s Disease After Ileocolonic Resection: A Multicenter Retrospective Cohort Study

2021 ◽  
Author(s):  
Vincent Joustra ◽  
Marjolijn Duijvestein ◽  
Aart Mookhoek ◽  
Willem Bemelman ◽  
Christianne Buskens ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Prophylactic Treatment ◽  
Risk Profile ◽  
Postoperative Treatment ◽  
British Society ◽  
Risk Profiles ◽  
Clinical Risk ◽  
Ileocolonic Resection

Abstract Background Prediction of endoscopic postoperative recurrence (POR) and prophylactic treatment based on clinical risk profile have thus far been inconclusive. This study aimed to examine the association between clinical risk profile and the development of endoscopic POR in a Crohn’s disease population without postoperative treatment and to identify individual risk factors of endoscopic POR. Methods Medical records of 142 patients with Crohn’s disease during follow-up after ileocecal or ileocolonic resection without prophylactic treatment at 3 referral centers were reviewed. Endoscopic POR was defined as a modified Rutgeerts score ≥i2b. Clinical risk profiles were distilled from current guidelines. Both uni- and multivariate logistic regression analysis were used to assess the relationship between risk profiles and endoscopic POR. Results Endoscopic POR was observed in 68 out of 142 (47.9%) patients. Active smoking postsurgery (odds ratio [OR], 3.01; 95% confidence interval [CI], 1.24-7.34; P = 0.02), a Montreal classification of A3 (OR, 3.05; 95% CI, 1.07-8.69; P = 0.04), and previous bowel resections (OR, 2.58; 95% CI, 1.07-6.22; P = 0.03) were significantly associated with endoscopic POR. No significant association was observed between endoscopic POR and any guideline defined as a high-/low-risk profile. However, patients with a combination of any 3 or more European Crohns & Colitis Organisation– (OR, 4.87; 95% CI, 1.30-18.29; P = 0.02) or British Society of Gastroenterology–defined (OR 3.16; 95% CI, 1.05-9.49; P = 0.04) risk factors showed increased odds of developing endoscopic POR. Conclusions Our results suggest that patients with a combination of any 3 or more European Crohns & Colitis Organisation– or British Society of Gastroenterology–defined risk factors would probably benefit from immediate prophylactic treatment.

Injury risk profile of amateur Irish women soccer players and players’ opinions on risk factors and prevention strategies

2021 ◽  
Author(s):  
Tahani A. Alahmad ◽  
Audrey C. Tierney ◽  
Roisin M. Cahalan ◽  
Nassr S. Almaflehi ◽  
Amanda M. Clifford
Keyword(s):  
Risk Factors ◽  
Injury Risk ◽  
Risk Profile ◽  
Soccer Players ◽  
Prevention Strategies ◽  
Irish Women

The Risk of Seizure Recurrence After a First Unprovoked Afebrile Seizure in Childhood: An Extended Follow-up

PEDIATRICS ◽  
1996 ◽  
Vol 98 (2) ◽  
pp. 216-225 ◽  
Author(s):  
Shlomo Shinnar ◽  
Anne T. Berg ◽  
Solomon L. Moshe ◽  
Christine O'Dell ◽  
Marta Alemany ◽  
...  
Keyword(s):  
Risk Factors ◽  
Age Of Onset ◽  
Multivariable Analysis ◽  
Cumulative Risk ◽  
Febrile Seizures ◽  
Recurrence Risk ◽  
Early Recurrence ◽  
Seizure Recurrence ◽  
Unprovoked Seizure ◽  
History Of

Objective. To assess the long-term recurrence risks after a first unprovoked seizure in childhood. Methods. In a prospective study, 407 children who presented with a first unprovoked seizure were then followed for a mean of 6.3 years from the time of first seizure. Results. One hundred seventy-one children (42%) experienced subsequent seizures. The cumulative risk of seizure recurrence was 29%,37%,42%, and 44% at 1,2,5, and 8 years, respectively. The median time to recurrence was 5.7 months, with 53% of recurrences occurring within 6 months, 69% within 1 year, and 88% within 2 years. Only 5 recurrences (3%) occurred after 5 years. On multivariable analysis, risk factors for seizure recurrence included a remote symptomatic etiology, an abnormal electroencephalogram (EEG), a seizure occurring while asleep, a history of prior febrile seizures, and Todd's paresis. In cryptogenic cases, the risk factors were an abnormal EEG and an initial seizure during sleep. In remote symptomatic cases, risk factors were a history of prior febrile seizures and age of onset younger than 3 years. Risk factors for late recurrences (after 2 years) were etiology, an abnormal EEG, and prior febrile seizures in the overall group and an abnormal EEG in the cryptogenic group. These are similar to the risk factors for early recurrence. Conclusions. The majority of children with a first unprovoked seizure will not have recurrences. Children with cryptogenic first seizures and a normal EEG whose initial seizure occurs while awake have a particularly favorable prognosis, with a 5-year recurrence risk of only 21%. Late recurrences do occur but are uncommon.

Survival and risk factors for premature mortality in patients with parkinson’s disease

2021 ◽  
Vol LIII (3) ◽  
pp. 5-10
Author(s):  
Fatima N. Aliyeva
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Survival Rate ◽  
Confidence Interval ◽  
Causes Of Death ◽  
Age Of Onset ◽  
Premature Mortality ◽  
Parkinsons Disease ◽  
Cerebrovascular Accidents ◽  
Relationship Of

Aim. To assess the survival rate and risk factors for premature mortality in patients with Parkinsons disease in Baku. Material and research methods. The observation was carried out retrospectively, information was collected on all patients (110 patients) in whom the diagnosis of Parkinsons disease was first established in 20092010. These patients are provided with drugs free of charge, which made it possible to provide them with diagnostic monitoring in polyclinics. During 20102019, 94 patients with a diagnosis of Parkinsons disease died. All medical death certificates were selected for analysis. The diagnoses in column a of these documents were accepted as direct causes of death, regardless of the presence or absence of a causal relationship of these diagnoses with Parkinsons disease. Therefore, the reported cases were interpreted not as death due to Parkinsons disease, but as the death of a patient diagnosed with Parkinsons disease. Results. Noteworthy is the prevalence of men (72.7%) and people without dementia (70.9%) among patients. Within 10 years, 85.5% of patients died from various causes. The immediate causes of death were acute cerebrovascular accidents (36.2%) and acute myocardial infarction (24.5%). The annual survival rate of the observed patients was high (94%; 95% confidence interval 51100%). The five-year survival rate is 76% (95% confidence interval 42100%). Conclusions. (1) The survival rate of patients with Parkinsons disease within 10 years after the onset of signs ranges from 0.94 to 0.41 (five-year survival rate is 0.76). (2) The immediate causes of mortality in patients with Parkinsons disease were cerebrovascular accidents (36.2%), myocardial infarction (24.5%), pulmonary embolism (11.7%), pneumonia (10.6%) and others (17%). (3) The effect of age of onset and signs of Parkinsons disease, gender, comorbidity and dementia on survival is statistically significant (p 0.05).

Results of a Survey of Cardiovascular Risk Factor Prevalence Amongst Health Care Workers

2000 ◽  
Vol 45 (3) ◽  
pp. 84-85 ◽  
Author(s):  
S.R. McEwan ◽  
N.G. Dewhurst ◽  
F. Daly ◽  
C.D. Forbes ◽  
J.J.F. Belch
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Cardiovascular Risk ◽  
Health Care Workers ◽  
Risk Profile ◽  
Royal Infirmary ◽  
Cardiovascular Risk Profile ◽  
Risk Factor Prevalence ◽  
Care Workers ◽  
High Prevalence

Summary analyses of screening data were used to ascertain the cardiovascular risk profile in a sample of health care workers in Scotland. A sample of NHS staff (298 women and 78 men) were screened during visits to Perth Royal Infirmary (PRI) in 1996 and 1997. Comparisons were made within subsets and with previous screening studies. Health care workers have been a neglected component of the workforce for receiving education about risk factors. The high prevalence of smokers found in this sample should be a cause for concern.

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