scholarly journals Suicide Models and Treatment Models Are Separate Entities. What Does It Mean for Clinical Suicide Prevention?

2021 ◽  
Vol 18 (10) ◽  
pp. 5301
Author(s):  
Konrad Michel
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Suicide Risk ◽  
Psychological Treatment ◽  
Factor Models ◽  
Future Research ◽  
Factors Associated ◽  
Treatment Models ◽  
Risk Factor Models ◽  
Suicidal Crisis

Theoretical models of suicide are based on risk factors associated with suicide, such as psychiatric pathology, genetics, epigenetics, functional brain disorders, and impaired decision making. In current clinical practice, the predominant risk model is the medical model, which posits that treating suicide risk is primarily a matter of treating psychiatric disorders. However, even comprehensive risk factor models cannot overcome the basic problem that, by their nature, they cannot accommodate the suicidal person’s psychological experience of suicidality. Risk factor models do not translate into effective treatment models. Suicide risk is highly personal and fluid, and is related to individual vulnerabilities and to person-specific events triggering suicidal thoughts and actions. Clinicians need treatment models that are meaningful to suicidal patients. Understanding the single person’s suicidality requires a patient-centered approach. Therapeutic interventions that effectively reduce the risk of suicidal behavior have been developed from general principles of psychotherapy. Therapy process factors associated with effective therapies are working alliance, validation of the individual patient’s thoughts and feelings, active treatment engagement. Psychological therapies need patients who are active participants in a collaborative working relationship between therapist and patient. The goal must be to jointly develop a meaningful understanding of the suicidal crisis. In view of the limited personal resources in health care systems it is important that effective therapies are brief and effective. Future research must aim to improve our understanding of the factors involved in effective therapies in order to optimize treatments for individuals at risk. This may also include the integration of biological risk factors in psychological treatment models.

scholarly journals Opportunities and Limitations of Vascular Risk Factor Models in Studying Plasticity-Promoting and Restorative Ischemic Stroke Therapies

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Dirk M. Hermann ◽  
Thorsten R. Doeppner ◽  
Aurel Popa-Wagner
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Brain Plasticity ◽  
Experimental Studies ◽  
Vascular Risk Factor ◽  
Factor Models ◽  
Vascular Risk ◽  
Short Lifespan ◽  
Risk Factor Models

Major efforts are currently made promoting neuronal plasticity and brain remodeling in the postacute stroke phase. Experimental studies evaluating new stroke therapies are mostly performed in rodents, which compared to humans exhibit a short lifespan. These studies widely employ young, otherwise healthy, rodents that lack the vascular risk factors and comorbidities of stroke patients. These risk factors compromise postischemic neurological recovery and brain plasticity and in several contexts reduce the brain responsiveness to recovery-inducing plasticity-promoting treatments. By examining risk factor models, which have hitherto been used for studying experimentally induced ischemic stroke, this review outlines the possibilities and limitations of risk factor models in the evaluation of plasticity-promoting and restorative stroke treatments.

scholarly journals Meta-analysis of risk factors associated with suicidal ideation after stroke

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuangmei Zhang ◽  
Anrong Wang ◽  
Weifeng Zhu ◽  
Zhaoyang Qiu ◽  
Zhaoxu Zhang
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Suicidal Ideation ◽  
Sleep Disorders ◽  
Family Income ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Future Research ◽  
Factors Associated ◽  
Complications Of Stroke

Abstract Background Over the past decade, increasing attention has been paid on post stroke suicide (PSS), which is one of complications of stroke. The rates of stroke and suicide are relatively high, especially in Asian populations. Thus, a deeper understanding of the prevalence and epidemiological impact of suicide after stroke is urgently needed. Clinical diagnosis and prevention of PSS are at the incipient stage, but the risk factors responsible for the occurrence of PSS in different regions and stages of the disease remain largely unknown. The present meta-analysis aimed to determine the incidence of PSS at different stages and time courses, and to identify the underlying risk factors for PSS. Methods We systematically searched the Cochrane library, Embase, PubMed, CNKI and Web of Science databases from their inception until April 2019.The research articles reporting on the risk factor for PSS were screened and included in the meta-analysis. The data from the included studies were extracted according to the predefined criteria. Results A total of 12 studies (n = 2,693,036) were included for meta-analyses. Of these studies, 7 reporting suicide prevalence were meta-analyzed. The pooled estimate of suicidal ideation rates after stroke was 12%, which could be influenced by multiple risk factors, including sex, smoking, depression, sleep disorders, previous stroke and low household income. Studies conducted in Asia demonstrated higher suicide prevalence (approximately 15%) compared to other regions. Smoking, low family income, depression, heart disease and sleep disorders were important risk factors for PSS. When compared to PSS of more than 1 year, the incidence of suicide within 1 year after stroke was more likely to be statistically significant. It was found that 4 out of every 1000 stroke survivors tended to commit suicide. The results of this meta-analysis showed that depression (OR = 2.32; p < 0.01) was significantly associated with suicidal ideation, regardless of stroke duration. Conclusion PSS is one of the common complications of stroke. Despite some limitations, we successfully identified the risk factors associated with suicidal ideation after stroke. Notably, depression was significantly associated with suicidal ideation, regardless of stroke duration. Targeting this risk factor may be helpful to improve stroke patient care and prevent suicidal ideation after stroke. Future research will be carried out to assess whether suicidal ideation or thoughts and actual suicide attempts are strongly predictive of suicide deaths after stroke (Registration No. CRD42019128813).

scholarly journals 798. Metronidazole Exposure Prior to Clostridiodes difficile Infection (CDI) is a Risk Factor for Severe C. difficile Disease in Cancer Patients

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S442-S443
Author(s):  
Denise Marie A Francisco ◽  
Liangliang Zhang ◽  
Ying Jiang ◽  
Adilene Olvera ◽  
Eduardo Yepez Guevara ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cancer Patients ◽  
Research Study ◽  
Research Support ◽  
Factors Associated ◽  
Patients With Cancer ◽  
Study Investigator ◽  
Severity Levels ◽  
Permutation Analysis

Abstract Background Antibiotic use is a risk factor for CDI. Few studies have correlated use of prior antibiotics with CDI severity in cancer patients. This study identified clinical and microbiology risk factors associated with severe CDI in patients with cancer. We hypothesized that previous antibiotic exposure and microbiome composition at time of CDI presentation, are risk factors for severe disease in cancer patients. Methods This non-interventional, prospective, single-center cohort study examined patients with cancer who had their first episode or first recurrence of CDI between Oct 27, 2016 and Jul 1, 2019. C. difficile was identified using nucleic acid amplification testing. Multivariate analysis was used to determine significant clinical risk factors for severe CDI as defined in the 2018 IDSA/SHEA guidelines. Alpha, and beta diversities were calculated to measure the average species diversity and the overall microbial composition. Differential abundance analysis and progressive permutation analysis were used to single out the significant microbial features that differed across CDI severity levels. Results Patient (n=200) demographics show mean age of 60 yrs., 53% female, majority White (76%) and non-Hispanic (85%). Prior 90 day metronidazole use (Odds Ratio OR 4.68 [1.47-14.91] p0.009) was a significant risk factor for severe CDI. Other factors included Horn’s Index &gt; 2 (OR 7.75 [1.05-57.35] p0.045), Leukocytosis (OR 1.29 [1.16-1.43] p&lt; 0.001), Neutropenia (OR 6.01 [1.34-26.89] p0.019) and Serum Creatinine &gt;0.95 mg/dL (OR 25.30 [8.08-79.17] p&lt; 0.001). Overall, there were no significant differences in alpha and beta diversity between severity levels. However, when identifying individual microbial features, the high presence of Bacteroides uniformis, Ruminococceae, Citrobacter koseri and Salmonella were associated with protection from severe CDI (p&lt; 0.05). Table 1 - Results of multivariate logistic regression analysis of factors associated with severe CDI Figure 1. Microbiome features identified by progressive permutation analysis as seen in a volcano plot. Conclusion A number of risk factors for severe CDI were identified among this population, including prior 90 day metronidazole use. Also, increased relative abundance of Bacteroides uniformis, Ruminococceae, Citrobacter koseri and Salmonella were linked to protection from severe CDI. Reducing metronidazole use in patients with cancer may help prevent subsequent severe CDI. Disclosures Adilene Olvera, MPH MLS (ASCP), MERK (Grant/Research Support, Scientific Research Study Investigator) Kevin W. Garey, PharmD, MS, FASHP, Merck & Co. (Grant/Research Support, Scientific Research Study Investigator) Ryan J. Dillon, MSc, Merck & Co., Inc., (Employee) Engels N. Obi, PhD, Merck & Co. (Employee)

The Contributions of Propensity, Delinquent Peers, Low Parental Supervision, and Empathy to the Emergence of Antisocial Behavior in Childhood and Adolescence: Testing Developmental Path Models Combining Psychological- and Sociological-Criminological Approaches

2020 ◽  
pp. 1-14
Author(s):  
Susanne Wallner ◽  
Stemmler Mark ◽  
Jost Reinecke
Keyword(s):  
Risk Factor ◽  
Antisocial Behavior ◽  
Action Theory ◽  
Cumulative Risk ◽  
Factor Models ◽  
Individual Risk ◽  
Parental Supervision ◽  
Childhood And Adolescence ◽  
Path Models ◽  
Risk Factor Models

Psychological- and sociological-criminological research refers to, for example, cumulative risk factor models (e.g., Lösel & Bender, 2003) and Situational Action Theory (SAT; e.g., Wikström, 2006). The German longitudinal study “Chances and Risks in the Life Course“ (research project A2, Collaborative Research Center 882; e.g., Reinecke, Stemmler, & Wittenberg, 2016) focuses upon the development of antisocial behavior from a psychological and sociological point of view. Two-wave panel data of two cohorts (children and adolescents) were utilized to test the power of developmental path models investigating the development of antisocial behavior. Individual risk seems to have both direct and indirect influences on antisocial behavior, supporting the ideas of risk factor models; antisocial behavior might be the outcome of the interaction between propensity and criminogenic exposure, so there is evidence for SAT. Additionally, empathy seems to be related to both propensity and low parental supervision. Implications for the study of antisocial behavior in childhood and adolescence are discussed in line with developmental criminology.

Risk Factors for CKD Progression

2020 ◽  
pp. CJN.07830520
Author(s):  
Mary Hannan ◽  
Sajid Ansari ◽  
Natalie Meza ◽  
Amanda H. Anderson ◽  
Anand Srivastava ◽  
...  
Keyword(s):  
Risk Factors ◽  
Genome Wide Association Study ◽  
Healthy Lifestyle ◽  
Interdisciplinary Collaboration ◽  
Fibroblast Growth Factor 23 ◽  
Kidney Injury ◽  
The United States ◽  
Future Research ◽  
Ckd Progression ◽  
Factors Associated

The Chronic Renal Insufficiency Cohort (CRIC) Study is an ongoing, multicenter, longitudinal study of nearly 5500 adults with CKD in the United States. Over the past 10 years, the CRIC Study has made significant contributions to the understanding of factors associated with CKD progression. This review summarizes findings from longitudinal studies evaluating risk factors associated with CKD progression in the CRIC Study, grouped into the following six thematic categories: (1) sociodemographic and economic (sex, race/ethnicity, and nephrology care); (2) behavioral (healthy lifestyle, diet, and sleep); (3) genetic (apoL1, genome-wide association study, and renin-angiotensin-aldosterone system pathway genes); (4) cardiovascular (atrial fibrillation, hypertension, and vascular stiffness); (5) metabolic (fibroblast growth factor 23 and urinary oxalate); and (6) novel factors (AKI and biomarkers of kidney injury). Additionally, we highlight areas where future research is needed, and opportunities for interdisciplinary collaboration.

scholarly journals Ordering risk bounds in factor models

2018 ◽  
Vol 6 (1) ◽  
pp. 259-287 ◽  
Author(s):  
Jonathan Ansari ◽  
Ludger Rüschendorf
Keyword(s):  
Risk Factor ◽  
Systemic Risk ◽  
Factor Models ◽  
Worst Case ◽  
Sign Changes ◽  
Risk Factor Models ◽  
Risk Bounds ◽  
Derivatives Of ◽  
Dependence Structures

AbstractConditionally comonotonic risk vectors have been proved in [4] to yield worst case dependence structures maximizing the risk of the portfolio sum in partially specified risk factor models. In this paper we investigate the question how risk bounds depend on the specification of the pairwise copulas of the risk components Xiwith the systemic risk factor. As basic toolwe introduce a new ordering based on sign changes of the derivatives of copulas. This together with discretization by n-grids and the theory of supermodular transfers allows us to derive concrete ordering criteria for the maximal risks.

Cervical insufficiency: a noteworthy disease with controversies

2020 ◽  
Vol 48 (7) ◽  
pp. 648-655
Author(s):  
Yu Han ◽  
Mengnan Li ◽  
Huijing Ma ◽  
Hailan Yang
Keyword(s):  
Risk Factors ◽  
Diagnosis And Treatment ◽  
Practical Significance ◽  
Future Research ◽  
Cervical Insufficiency ◽  
Factors Associated ◽  
The World ◽  
Potential Risk Factors ◽  
Recurrent Pregnancy Losses ◽  
Recurrent Abortions

AbstractCervical insufficiency (CI) is a mainly disease leading to recurrent abortions and preterm birth which may present in about 1% of obstetric populations. Recurrent pregnancy losses caused by CI incur serious economic burdens on society as well as huge psychological burdens to family members. However, many patients even clinicians in some areas of the world still remain confused about this disease. At the same time, the etiology of CI is still uncertain and it is still a controversial disease in diagnosis and treatment. This article summarizes the potential risk factors associated with CI, which could be worthy of attention and helpful for future research. It also reviews the methods for diagnosis and treatment of CI to better understand this noteworthy disease, as well as presents the related consensus and controversies according to the newly updated guidelines, which has practical significance for conducting more in-depth investigations in the future.

Influence of Concomitant Polypharmacy on Docetaxel-induced Febrile Neutropenia

2021 ◽  
Vol 1 (3) ◽  
pp. 135-141
Author(s):  
KATSUYA MAKIHARA ◽  
YUKA SHIMEDA ◽  
TOMOKAZU MATSUMURA
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Febrile Neutropenia ◽  
Confidence Interval ◽  
Cytochromes P450 ◽  
Cyp3a4 Activity ◽  
Factors Associated ◽  
Cyp3a4 Inhibitors ◽  
Concomitant Medications ◽  
Main Factor

Background/Aim: Docetaxel (DTX) is metabolized by liver cytochromes P450 (CYP) 3A4 (CYP3A4) and 3A5 (CYP3A5) CYP3A4 activity is considered the main factor affecting the effectiveness in DTX clearance. We, therefore, explored the association between DTX-induced febrile neutropenia (FN) and concomitant polypharmacy involving CYP3A4 inhibitors in cancer patients. Patients and Methods: Among patients who received docetaxel, we compared the number of concomitant medications between patients with and without FN, and risk factors associated with FN were identified. Results: The total number of concomitant CYP3A4 inhibitors and substrates used was significantly higher in patients with FN [mean: 2.1 (95% confidence interval (CI)=1.5-2.9)] than in those without FN [mean: 1.4 (95% CI=1.0-1.8)] (p=0.01). The only risk factor for FN was the use of ≥2 concomitant CYP3A4 inhibitors and substrates in total (OR=4.82, 95% CI=1.77-14.1; p=0.002). Conclusion: Polypharmacy involving CYP3A4 inhibitors and substrates increases the risk of DTX-induced FN.

Trail running injury risk factors: a living systematic review

2022 ◽  
pp. bjsports-2021-104858
Author(s):  
Carel Viljoen ◽  
Dina C (Christa) Janse van Rensburg ◽  
Willem van Mechelen ◽  
Evert Verhagen ◽  
Bruno Silva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Injury Risk ◽  
Previous History ◽  
Future Research ◽  
Injury Incidence ◽  
Extrinsic Factors ◽  
Factors Associated ◽  
Injury Risk Factors ◽  
Trail Running

ObjectiveTo review and frequently update the available evidence on injury risk factors and epidemiology of injury in trail running.DesignLiving systematic review. Updated searches will be done every 6 months for a minimum period of 5 years.Data sourcesEight electronic databases were searched from inception to 18 March 2021.Eligibility criteriaStudies that investigated injury risk factors and/or reported the epidemiology of injury in trail running.ResultsNineteen eligible studies were included, of which 10 studies investigated injury risk factors among 2 785 participants. Significant intrinsic factors associated with injury are: more running experience, level A runner and higher total propensity to sports accident questionnaire (PAD-22) score. Previous history of cramping and postrace biomarkers of muscle damage is associated with cramping. Younger age and low skin phototypes are associated with sunburn. Significant extrinsic factors associated with injury are neglecting warm-up, no specialised running plan, training on asphalt, double training sessions per day and physical labour occupations. A slower race finishing time is associated with cramping, while more than 3 hours of training per day, shade as the primary mode of sun protection and being single are associated with sunburn. An injury incidence range 0.7–61.2 injuries/1000 hours of running and prevalence range 1.3% to 90% were reported. The lower limb was the most reported region of injury, specifically involving blisters of the foot/toe.ConclusionLimited studies investigated injury risk factors in trail running. Our review found eight intrinsic and nine extrinsic injury risk factors. This review highlighted areas for future research that may aid in designing injury risk management strategies for safer trail running participation.PROSPERO registration numberCRD42021240832.

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