scholarly journals Impact of risk factor management on the sanitary condition of Norway spruce (Picea abies [L.] Karst.) pure stands in Latvia

2014 ◽  
Vol 60 (No. 5) ◽  
pp. 181-189
Author(s):  
J. Rūba ◽  
O. Miezīte ◽  
S. Luguza
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Spatial Structure ◽  
Health State ◽  
Anthropogenic Factor ◽  
Forest Stands ◽  
Risk Factor Management ◽  
Sanitary Condition ◽  
Young Forest ◽  
Empirical Material

In management of young forest stands, it is often the case in forestry that several risk factors, biotic, abiotic and anthropogenic ones, have to be dealt with. An anthropogenic factor is of great importance in management of forests, because humans, using ecosystems for their needs, still have to maintain the spatial structure of the forest and prevent the worsening of the health state. Covering all territory of Latvia, empirical material was gathered in 25 pure stands. To find out how neighbouring stands impact the young forest stands of spruce, the location in forest array was detected. In identifying the risk factors, attention should be paid to the shape of compartment and its location in forest array. A correlation between the occurrence and intensity of damage caused by cloven-hoofed game is relevant r<sub>fact </sub>= 0.988 &gt; r<sub>crit </sub>= 0.088 with 95% probability. Also the occurrence and intensity of Lophophacidium hyperboreum Lagerb., and damage by Heterobasidion spp. are relevant r<sub>fact </sub>= 0.991 &gt; r<sub>crit </sub>= 0.062 and r<sub>fact </sub>= 0.981 &gt; r<sub>crit </sub>= 0.088 with of 95% probability. &nbsp;

scholarly journals SANITARY CONDITION OF PICEA ABIES (L. ) KARST. YOUNG FOREST STANDS DEPENDING ON THE SPATIAL SPECIFICITY

AGROFOR ◽  
2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Jelena RUBA ◽  
Olga MIEZITE ◽  
Imants LIEPA
Keyword(s):  
Risk Factors ◽  
Picea Abies ◽  
Tree Height ◽  
Impact Factors ◽  
Forest Stands ◽  
Sanitary Condition ◽  
Young Forest ◽  
Young Forests ◽  
Spatial Specificity ◽  
Sanitary State

As a result of nature resources intensive use, most of ecosystems have beenconverted. Anthropogenic impact includes changes of forest stands structure andtheir spatial specificity in the forest area. Accordingly the sanitary state of Norwayspruce young forest stands can be affected by different risk impact factors ofmanagement. The aim of the research was to analyze the spruce Picea abies (L. )Karst. young forest stands sanitary condition depending on forest plots spatialspecificity and location in the forest areas. The data were collected in 4 regions ofLatvia in spruce young forest stands (1 - 40 years old). The research was conductedin young natural and artificial stands (pure – 44, mixed – 42). In total 502 sampleplots with a total area of 28250 mwere installed. The particular plot size (25, 50,100 and 200 m) were selected depending on the stand average tree height, whiletheir number depended on the forest stand area. A total area of investigated foreststands were 127. 5 hectares. Results showed that the expression of spatial specificsdepended on risk factors and their intensity, as well as the environmentalcharacteristics. Damages caused by abiotic risk factors at different forest standswere not the same regarding intensity, nature and volume, but more or less closelywere related to all site conditions. Spatial specificity of forest stands area (regularand irregular), as well as their location in the forest massif significantly affects thespruce young forests sanitary status (respectively p=0. 027 and p=0. 002). Differentrisk factors damage to forests, bordering with spruce or pine young growths,cutovers and various types of infrastructure, were identified as much moreimportant.

An absolute risk-guided approach to cardiovascular risk management within a chest pain clinic: the ARCPAC randomized trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.A Black ◽  
J Campbell ◽  
J Sharman ◽  
M Nelson ◽  
S Parker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Chest Pain ◽  
Smoking Status ◽  
Absolute Risk ◽  
Pain Clinic ◽  
Risk Scores ◽  
Cardiovascular Risk Management ◽  
Risk Factor Management

Abstract Background The majority of patients attending chest pain clinics are found not to have a cardiac cause of their symptoms, but have a high burden of cardiovascular risk factors that may be opportunistically addressed. Absolute risk calculators are recommended to guide risk factor management, although it is uncertain to what extent these calculations may assist with patient engagement in risk factor modification. Purpose We sought to determine the usefulness of a proactive, absolute risk-based approach, to guide opportunistic cardiovascular risk factor management within a chest pain clinic. Methods This was a prospective, open-label, blinded-endpoint study in 192 enhanced risk (estimated 5-year risk ≥8%, based on Australian Absolute Risk Calculator) patients presenting to a tertiary hospital chest pain clinic. Patients were randomized to best practice usual care, or intervention with development of a proactive cardiovascular risk management strategy framed around a discussion of the individual's absolute risk. Patients found to have a cardiac cause of symptoms were excluded as they constitute a secondary prevention population. Primary outcome was 5-year absolute cardiovascular risk score at minimum 12 months follow up. Secondary outcomes were individual modifiable risk factors (lipid profile, blood pressure, smoking status). Results 192 people entered the study; 100 in the intervention arm and 92 in usual care. There was no statistical difference between the two groups' baseline sociodemographic and clinical variables. The intervention group showed greater reduction in 5-year absolute risk scores (difference −2.77; p&lt;0.001), and more favourable individual risk factors, although only smoking status and LDL cholesterol reached statistical significance (table). Conclusion An absolute risk-guided proactive risk factor management strategy employed opportunistically in a chest pain clinic significantly improves 5-year cardiovascular risk scores. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Tasmanian Community Fund

Stroke in Pregnancy and Puerperium: Validated Incidence Trends With Risk Factor Analysis in Finland 1987–2016

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011990
Author(s):  
Liisa Karjalainen ◽  
Minna Tikkanen ◽  
Kirsi Rantanen ◽  
Karoliina Aarnio ◽  
Aino Korhonen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Postpartum Period ◽  
First Trimester ◽  
Class Iii ◽  
Hypertensive Disorders Of Pregnancy ◽  
Risk Factor Management ◽  
Incidence Trends ◽  
Hypertensive Disorders ◽  
Increased Risk

Objective:To investigate whether previously reported increasing incidence of pregnancy-associated stroke (PAS) is observed in chart-validated register data in Finland. In an exploratory analysis, we studied risk factors for PAS.Methods:We performed a retrospective population-based cohort study and nested case-control study in Finland 1987-2016. The Medical Birth Register (MBR) was linked with the Hospital Discharge Register to identify women with incident stroke (ischemic stroke, cerebral venous thrombosis, intracerebral or subarachnoid hemorrhage) during pregnancy or puerperium. Cases were verified from patient records. Incidence of PAS over the study period, in 5-year age groups and pregnancy/postpartum period were calculated per number of deliveries. Three matched controls were selected for each case from MBR to compare risk factors.Results:After chart review, 29.6% (257/868) of cases were PAS. The incidence of PAS was 14.5 (95%CI: 12.8-16.3) per 100,000 deliveries. Incidence increased from 11.1 to 25.2 per 100,000 deliveries from 1987-1991 to 2012-2016 (p<0.0001). Incidence increased by age from 9.8 to 29.9 per 100,000 deliveries from ages 20-24 to ages >40 (p<0.0001). During early postpartum period, incidence was 5-fold greater compared to the first trimester. Maternal mortality was 6.6%. In the multivariable adjusted model, smoking beyond 12 gestational weeks (odds ratio [OR] 1.8, 95%CI: 1.2-2.7), migraine (OR 16.3, 95%CI: 5.3-49.8), and hypertensive disorders of pregnancy (OR 4.0, 95%CI: 2.5-6.3) were the most important risk factors for PAS.Conclusion:PAS incidence is increasing stressing the importance of careful pregnancy surveillance and risk factor management, particularly in older expectant mothers and extending to puerperium.Classification of Evidence:This study provides Class III evidence that smoking beyond 12 gestational weeks, migraine and hypertensive disorders of pregnancy are associated with an increased risk of PAS.

scholarly journals 101 - Alzheimer Disease and Dementia: diagnostic challenges and future directions in Hispanic populations

2021 ◽  
Vol 33 (S1) ◽  
pp. 2-2
Author(s):  
Jorge J Llibre Guerra ◽  
Daisy Acosta ◽  
Ivonne Z. Jiménez Velázquez ◽  
Ana Rodriguez-Salgado ◽  
Geeske Peeters ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Alzheimer Disease ◽  
Latin American ◽  
Low Cost ◽  
Assessment Tools ◽  
Preventive Strategies ◽  
Risk Factor Management ◽  
Hispanic Populations ◽  
The Impact

Alzheimer’s disease (AD) and dementia has emerged as a significant societal issue and a global priority. The prevalence of dementia is rising more rapidly in low and middle income countries (LMIC) than in high income countries. A growing body of evidence shows that prevention through risk factor management is the key to reducing the burden of dementia in the society, especially in LMIC. However, a one-size-fits all approach to health promotion is neither efficient nor effective. Latin American countries (LAC) have unique challenges related to dementia, including rapid aging population, high admixture degree and risk factors profile, which influence the prevalence and presentation of dementia. During this session, we will present findings and tools that will help tailor and personalize risk factor management in Hispanics populations. Participants will be first introduced to genetics of Alzheimer disease in Hispanic populations relative to non-Hispanics and the influence of gene by environment interactions. The second presentation will report on the epidemiology and risk factors of AD using cross countries/society comparisons (Non-Hispanics whites vs Hispanics living in US vs Hispanics living in Latin America.) The third presenter will discuss the development of a tool that visualizes how each risk factor contributes to the risk of dementia and how one may lower their risk by addressing the risk factors. The tool can be used in primary care settings in Cuba, Dominican Republic and Puerto Rico. Finally, the fourth presenter uses state-of-the-art digital assessment tools (brain health assessment), for low-cost monitoring of cognitive functioning, MCI and dementia. Such instruments are important for future evaluation of the impact of preventive strategies. At the end of the presentations, attendees will be able to identify the unique genetic and social determinants that drive AD in LAC. Recommendations will be given for preventive strategies tailored to LMIC. The findings to be shared will be essential for building evidence-based interventions tailored to reducing the burden of dementia in the Hispanic populations.Session Chair:Juan Llibre RodriguezAlzheimer Disease and genetics in Hispanic PopulationsJorge J Llibre-GuerraAlzheimer disease epidemiology and risk factors in Caribbean and non-Caribbean Hispanics populations.Ivonne Z. Jiménez VelázquezDevelopment of a tool to motivate for healthy behaviors to prevent dementia in the Caribbean.Daisy AcostaA brief digital cognitive assessment for detection of cognitive impairment in Hispanics populations.Ana Rodriguez-Salgado

scholarly journals Evaluation of a Newly Developed Smartphone App for Risk Factor Management in Young Patients With Ischemic Stroke: A Pilot Study

2022 ◽  
Vol 12 ◽  
Author(s):  
Viktoria Fruhwirth ◽  
Lisa Berger ◽  
Thomas Gattringer ◽  
Simon Fandler-Höfler ◽  
Markus Kneihsl ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Intervention Group ◽  
Smoking Behavior ◽  
Smartphone App ◽  
Younger Patients ◽  
Risk Factor Management ◽  
Post Stroke

Background: Efficient treatment of modifiable vascular risk factors decreases reoccurrence of ischemic stroke, which is of uttermost importance in younger patients. In this longitudinal pilot study, we thus assessed the effect of a newly developed smartphone app for risk factor management in such a cohort.Methods: The app conveys key facts about stroke, provides motivational support for a healthy lifestyle, and a reminder function for medication intake and blood pressure measurement. Between January 2019 and February 2020, we consecutively invited patients with ischemic stroke aged between 18 and 55 years to participate. Patients in the intervention group used the app between hospital discharge and 3-month follow-up. The control group received standard clinical care. Modifiable risk factors (physical activity, nutrition, alcohol consumption, smoking behavior, obesity, and hypertension) were assessed during the initial hospital stay and at a dedicated stroke outpatient department three months post-stroke.Results: The study cohort comprised 21 patients in the app intervention group (62% male; age = 41 ± 11 years; education = 12 ± 3 years) and 21 sex-, age- and education-matched control patients with a comparable stroke risk factor profile. Baseline stroke severity was comparable between groups (intervention: median NIHSS = 3; control: median NIHSS = 4; p = 0.604). Three months post-stroke, patients in the intervention group reported to be physically almost twice as active (13 ± 9 h/week) compared to controls (7 ± 5 h/week; p = 0.022). More intense app usage was strongly associated with higher physical activity (r = 0.60, p = 0.005) and lower consumption of unhealthy food (r = −0.51, p = 0.023). Smoking behavior (p = 0.001) and hypertension (p = 0.003) improved in all patients. Patients in the intervention group described better self-reported health-related quality of life three months post-stroke (p = 0.003).Conclusions: Specifically designed app interventions can be an easily to implement and cost-efficient approach to promote a healthier lifestyle in younger patients with a stroke.

ICARUSS: An effective model for risk factor management in stroke survivors

2019 ◽  
Vol 15 (4) ◽  
pp. 438-453 ◽  
Author(s):  
Jacques Joubert ◽  
Stephen M Davis ◽  
Geoffrey A Donnan ◽  
Christopher Levi ◽  
Graeme Gonzales ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Risk Factor ◽  
Primary Care Physicians ◽  
Best Practice ◽  
Intervention Group ◽  
Control Group ◽  
Stroke Survivors ◽  
Risk Factor Management ◽  
Practice Recommendations

Background and purpose After an initial stroke, the risk of recurrent stroke is high. Models that implement best-practice recommendations for risk factor management in stroke survivors to prevent stroke recurrence remain elusive. We examined a model which focuses on vascular risk factor management to prevent stroke recurrence in survivors returning to their primary care physicians. This model is coordinated from the stroke unit, integrates specialist stroke services with primary care physicians, and directly involves patients and carers in risk factor management. It is underpinned by the shared care principle in which there is joint participation of specialists as well as primary care physicians in a planned, integrated delivery of care with ongoing involvement of patients and carers, a structure which encourages implementation of best-practice recommendations as well as transferability and sustainability. We hypothesized that an integrated, multimodal intervention based on a shared-care model which supports joint participation of stroke specialists and primary care physicians would improve the implementation of best-practice recommendations for risk factor management in stroke survivors returning to the community. Methods We undertook a double-blind randomized controlled trial, testing the model in three Australian cities using stroke survivors admitted to stroke units and discharged from hospital to return to their primary care physicians. The model was a shared care, multifaceted integrated program which included bidirectional feedback between general practitioner and specialist unit, education, and engagement of patient and carer in self-management with ongoing input from a multidisciplinary team. The primary endpoint was improvement or abolition of risk factors such as raised blood pressure, diabetes, hyperlipidemia, the modification of adverse life-style factors such as lack of exercise, smoking and alcohol abuse and adherence to preventive medication at one year. Intermediate measurement points were scheduled at three monthly intervals. Analysis was by intention to treat, evaluated by covariance or a linear model adjusting for confounding factors or variance of base-line risk factors. The study was registered as ACTRN = 1261100026498. Results The study population was as follows: intervention ( n = 112), control ( n = 137). At baseline, there was no statistical difference between the groups for any variable. At the 12-month evaluation, there was a significant decrease in systolic blood pressure from baseline in the intervention group of 5.2 mmHg ( p < 0.01). This change was not observed in the control group ( p = 0.29). Moreover, at 12 months the mean systolic blood pressure in the intervention group was 129.4 mmHg (SD 14.7), a result which was not obtained in controls. Fasting total cholesterol as well as triglycerides was reduced significantly in the intervention group (both p < 0.01) but this was not the case in the control group ( p = 0.11 and p = 0.27, respectively). At 12 months, there was no change in BMI in the intervention group but there was a significant increase in BMI ( p = 0.02) in the control group. At 12 months in the intervention group, the mean distance walked with ease compared to the baseline measurements was increased by a mean distance of 600 m while in the control group the distance walked with ease was reduced compared to that measured at baseline. At 12 months, the Barthel index in the intervention group demonstrated improved function ( p = 0.01), but no change was observed in controls. At 12 months in the intervention group, there was a significant decrease in number of standard alcoholic drinks consumed per week compared to the baseline ( p = 0.04). This was not observed in the control group ( p = 0.34). Conclusion In stroke survivors, the ICARUSS (Integrated Care for the Reduction of Secondary Stroke) model is superior to usual care with respect to best-practice recommendations for traditional risk factors as well as behavioral and functional outcomes.

Abstract 357: Comparison of Comorbidities Between Patients Admitted With Index Myocardial Infarction and Recurrent Myocardial Infarction

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Raunak Nair ◽  
Michael Johnson ◽  
Kathleen A Kravitz ◽  
Moses Anabila ◽  
Jeevanantham Rajeswaran ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Risk Factor ◽  
Medical Center ◽  
Modifiable Risk Factors ◽  
Risk Factor Management ◽  
Recurrent Myocardial Infarction ◽  
Artery Disease ◽  
The Relationship ◽  
Risk Factor Burden

Background: Several comorbidities are known to increase the risk of coronary artery disease. However, the relationship between modifiable risk factors and recurrent Myocardial Infarction (MI) has not been clearly defined. The purpose of our study was to assess if there were certain comorbidities that increase the risk of recurrent myocardial infarction. Methods: We reviewed 6,626 cases of MI at a single quaternary care medical center from January 1 st , 2010 to January 1 st , 2017 (29% STEMI, 71% NSTEMI), and we identified all cases of readmission with a recurrent MI within 90 days after index MI. All patients with index MI were screened for accompanying comorbidities and compared with patients with recurrent MI. Results: There were a total of 2051 readmissions (31%) within 90-days of index MI, of which 168 readmissions were for recurrent MI. Hypertension and Dyslipidemia appeared to be the most prominent modifiable risk factors in patients with index MI and recurrent MI (86%, 94% for HTN & 81%, 93% for DLP). All comorbidities were substantially more prevalent in patients with recurrent MI than in patients with index MI. Conclusion: Patients with recurrent MI have a higher risk factor burden than the general population with MI. This highlights the importance of risk factor management in patients with acute Myocardial infarction.

Diabetes and schizophrenia 2005: are we any closer to understanding the link?

2005 ◽  
Vol 19 (6_suppl) ◽  
pp. 56-65 ◽  
Author(s):  
Richard I. G. Holt ◽  
Chris Bushe ◽  
Leslie Citrome
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
Risk Factor ◽  
Attributable Risk ◽  
Antipsychotic Medications ◽  
Risk Factor Management ◽  
International Group ◽  
Traditional Risk Factors ◽  
Glucose Abnormalities

The association between schizophrenia and diabetes has been recognized for well over a century, but the underlying reasons for this association are unclear. In October 2003, an international group of diabetologists and psychiatrists met to review the literature relating to the association, and to create pragmatic guidelines for the management of diabetic risk in patients with severe mental illness. Since that meeting, over 100 additional papers have been published on the association between glucose abnormalities and schizophrenia, and this is a clear reflection of the level of interest in this clinically important area. Diabetes is highly prevalent among the schizophrenia population, but most sufferers remain undiagnosed in the community. The reasons why individuals with schizophrenia are more prone to developing diabetes than the general population are poorly defined, but likely to be multifactorial. The role of antipsychotic medications in the development of diabetes and other pre-diabetic states remains controversial, but it appears that the attributable risk is low. Traditional risk factors most probably account for much of the diabetes seen in schizophrenia populations, suggesting that routine screening and aggressive risk factor management are especially important in this patient group.

Contribution of Nursing to Risk Factor Management as Perceived by Patients with Established Coronary Heart Disease

2002 ◽  
Vol 1 (2) ◽  
pp. 87-94 ◽  
Author(s):  
Wilma J.M. Scholte op Reimer ◽  
Chris H. Jansen ◽  
Esther A.M. de Swart ◽  
Eric Boersma ◽  
Maarten L. Simoons ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Patient Education ◽  
Hospital Admission ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Risk Factor Management

Background: Guidelines stress the importance of risk factor management in patients with coronary heart disease (CHD). Aims: To evaluate whether guidelines on patient education in risk factor management are followed in clinical practice and to assess the contribution of nursing to risk factor management as perceived by patients with established CHD. Methods: Within three Dutch hospitals consecutive patients were identified after a first coronary–artery bypass graft, a first percutaneous transluminal coronary angioplasty or hospital admission for acute myocardial infarction or ischaemia ( n=357). Data were collected through patient interviews at least 6 months after hospital admission. Results: Among smokers, overweight patients, patients with hypertension, high cholesterol, and sedentary lifestyle, respectively 75, 36, 67, 61 and 49% reported that information on presence or management of these risk factors was provided. The proportion of patients informed by nurses ranged from 14% (lowering cholesterol) to 23% (increasing physical activity), while 55% (lowering cholesterol) to 71% (stop smoking) were informed by physicians. Conclusion: Many patients with established CHD and cardiovascular risk factors do not remember ever having received information about management of their risk factors. Clearly, there is a substantial potential to improve professionals’ compliance to guidelines on risk factor management, including those on patient education. The perceived contribution of nurses to risk factor management is small compared to that of physicians and other caregivers. If risk factor management is felt to be a main responsibility of nurses, current nursing activities in this area should be reconsidered within an improved organisational structure.

scholarly journals Determinants of coronary artery disease risk factor management across three world regions

Heart Asia ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. e011112
Author(s):  
Min Zhao ◽  
Ian Graham ◽  
Marie Therese Cooney ◽  
Diederick E Grobbee ◽  
Ilonca Vaartjes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Middle East ◽  
Cardiac Rehabilitation ◽  
Cardiovascular Health ◽  
Disease Risk ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Risk Factor Management ◽  
Logistic Regression Models

BackgroundThe SUrvey of Risk Factors (SURF) indicated poor control of risk factors in subjects with established coronary heart disease (CHD). The present study aimed to investigate determinants of risk factor management in patients with CHD.Methods and resultsSURF recruited 9987 consecutive patients with CHD from Europe, Asia and the Middle East between 2012 and 2013. Risk factor management was summarised as a Cardiovascular Health Index Score (CHIS) based on six risk factor targets (non-smoker/ex-smoker, body mass index <30, adequate exercise, controlled blood pressure, controlled low-density lipoprotein and controlled glucose). Logistic regression models assessed the associations between determinants (age, sex, family history, cardiac rehabilitation, previous hospital admission and diabetes) and achievement of moderate CHIS (≥3 risk factors controlled). The results are presented as OR with corresponding 95% CI. A moderate CHIS was less likely to be reached by women (OR 0.90, 95% CI 0.69 to 1.00), those aged <55 years old (OR 0.62, 95% CI 0.53 to 0.76) and those with diabetes (OR 0.41, 95% CI 0.37 to 0.46). Attendance in cardiac rehabilitation was associated with better CHIS achievements (OR 1.62, 95% CI 1.42 to 1.87). Younger Asian and European patients had poorer risk factor management, whereas for patients from the Middle East age was not significantly associated with risk factor management. The availability and applicability of cardiac rehabilitation varied by region.ConclusionsOverall, risk factor management was poorer in women, those younger than 55 years old, those with diabetes and those who did not participate in a cardiac rehabilitation. Determinants of cardiovascular risk factor management differed by region.

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