880 resultados para Prevalence and risk factors


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Previously developed models for predicting absolute risk of invasive epithelial ovarian cancer have included a limited number of risk factors and have had low discriminatory power (area under the receiver operating characteristic curve (AUC) < 0.60). Because of this, we developed and internally validated a relative risk prediction model that incorporates 17 established epidemiologic risk factors and 17 genome-wide significant single nucleotide polymorphisms (SNPs) using data from 11 case-control studies in the United States (5,793 cases; 9,512 controls) from the Ovarian Cancer Association Consortium (data accrued from 1992 to 2010). We developed a hierarchical logistic regression model for predicting case-control status that included imputation of missing data. We randomly divided the data into an 80% training sample and used the remaining 20% for model evaluation. The AUC for the full model was 0.664. A reduced model without SNPs performed similarly (AUC = 0.649). Both models performed better than a baseline model that included age and study site only (AUC = 0.563). The best predictive power was obtained in the full model among women younger than 50 years of age (AUC = 0.714); however, the addition of SNPs increased the AUC the most for women older than 50 years of age (AUC = 0.638 vs. 0.616). Adapting this improved model to estimate absolute risk and evaluating it in prospective data sets is warranted.

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Objectives: To explore socioeconomic differences in four cardiovascular disease risk factors (overweight/obesity, smoking, hypertension, height) among manufacturing employees in the Republic of Ireland (ROI). Methods: Cross-sectional analysis of 850 manufacturing employees aged 18–64 years. Education and job position served as socioeconomic indicators. Group-specific differences in prevalence were assessed with the Chi-squared test. Multivariate regression models were explored if education and job position were independent predictors of the CVD risk factors. Cochran–Armitage test for trend was used to assess the presence of a social gradient. Results: A social gradient was found across educational levels for smoking and height. Employees with the highest education were less likely to smoke compared to the least educated employees (OR 0.2, [95% CI 0.1–0.4]; p b 0.001). Lower educational attainment was associated with a reduction in mean height. Non-linear differences were found in both educational level and job position for obesity/overweight. Managers were more than twice as likely to be overweight or obese relative to those employees in the lowest job position (OR 2.4 [95% CI 1.3–4.6]; p = 0.008). Conclusion: Socioeconomic inequalities in height, smoking and overweight/obesity were highlighted within a sub-section of the working population in ROI.

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The study of obesity has evolved into one of the most important public health issues in the United States (U.S.), particularly in Hispanic populations. Mexican Americans, the largest Hispanic ethnic subgroup in the U.S., have been significantly impacted by obesity and related cardiovascular diseases. Mexican Americans living in the Lower Rio Grande Valley (the Valley) in the Texas-Mexico border are one of the most disadvantaged and hard-to-reach minority groups. Demographic factors, socioeconomic status, acculturation, and physical activity behavior have been found to be important predictors of health, although research findings are mixed when establishing predictors of obesity in this population. Furthermore, while obesity has long been linked to cardiovascular disease (CVD) risk factors such as hypertension, type 2 diabetes, and dyslipidemia; information on the relationships between obesity and these CVD risk factors have been mostly from non-minority population groups. Overall, research has been mixed in establishing the association between obesity and related CVD risk factors in this population calling attention to the need for further research. Nevertheless, identifying predictors of success for weight loss in this population will be important if health disparities are to be addressed. The overall objective of the findings presented in this dissertation was to attain a more informed profile of obesity and CVD risk factors in this population. In particular, we examined predictors of obesity, measures of obesity and association with cardiovascular disease risk factors in a sample of 975 Mexican Americans participating in a health promotion program in the Valley region. Findings suggest acculturation factors to be one of the most important predictors of obesity in this population. Results also point to the need of identifying other possible risk factors for predicting CVD risk. Finally, initial body mass index is an important predictor of weight loss in this population group. Thus, indicating that this population is not only amenable to change, but that improvements in weight loss are feasible. This finding strengthens the relevance of prevention programs such as Beyond Sabor for Mexican populations at risk, in particular, food bank recipients.

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Bullying, frequent drunkenness, and frequent cannabis use are significant health-risk behaviours among youth. While many studies have demonstrated that bullying involvement may initiate a developmental pathway to both types of frequent substance use, there is a limited understanding of the connection between these behaviours. The presence of risk and protective factors within youths’ relationships and within their neighbourhoods may alter the associations between bullying involvement and both types of frequent substance use. A systemic approach is needed to assess the complex, social environments in which youth are embedded. The current thesis consists of two studies that examined the associations between bullying and both types of frequent substance use within the context of youths’ social environments. In Study 1, multilevel modeling was used to examine the associations between bullying and frequent substance use within the context of individual and neighbourhood risk factors. Our results indicated that the risk factors associated with both frequent drunkenness and frequent cannabis use exist at both levels, with neighbourhoods altering the association of individual risk factors. Moreover, bullying was a unique risk factor associated with both types of frequent substance use, whereas indirect associations were observed for victimization. Study 2 used a similar methodology to examine the association between bullying and both types of frequent substance use within the context of individual and neighbourhood protective factors. Once again, our results indicated that the protective factors associated with both types of frequent substance use exist at multiple levels, and that neighbourhoods altered the association of individual protective factors. Additionally, positive relationship characteristics interacted with the link between bullying and both types of frequent substance use. Together, these findings clarify the nature of the bullying-substance use link and emphasize the need to study adolescent development in context.

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A biomarker can be a substance or structure measured in body parts, fluids or products that can affect or predict disease incidence. As age-related macular degeneration (AMD) is the leading cause of blindness in the developed world, much research and effort has been invested in the identification of different biomarkers to predict disease incidence, identify at risk individuals, elucidate causative pathophysiological etiologies, guide screening, monitoring and treatment parameters, and predict disease outcomes. To date, a host of genetic, environmental, proteomic, and cellular targets have been identified as both risk factors and potential biomarkers for AMD. Despite this, their use has been confined to research settings and has not yet crossed into the clinical arena. A greater understanding of these factors and their use as potential biomarkers for AMD can guide future research and clinical practice. This article will discuss known risk factors and novel, potential biomarkers of AMD in addition to their application in both academic and clinical settings.

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Background & Aims: Certain subsets of colorectal serrated polyps (SP) have malignant potential. Weperformed a systematic review and meta-analysis to investigate the association between modifiablelifestyle factors and risk for SPs. 
Methods: We conducted a systematic search of Medline, Embase, and Web of Science, forobservational or interventional studies that contained the terms risk or risk factor, and serrated orhyperplastic, and polyps or adenomas, and colorectal (or synonymous terms), published by March2016. Titles and abstracts of identified articles were independently reviewed by at least 2 reviewers.Adjusted relative risks (RR) and 95% CIs were combined using random effects meta-analyses toassess the risk of SP, when possible. 
Results: We identified 43 studies of SP risk associated with 7 different lifestyle factors: smoking,alcohol, body fatness, diet, physical activity, medication and/or hormone replacement therapy.When we compared the highest and lowest categories of exposure, factors we found to significantlyincrease risk for SP included tobacco smoking (RR, 2.47; 95% CI, 2.12–2.87), alcohol intake (RR, 1.33;95% CI, 1.17–1.52), body mass index (RR, 1.40; 95% CI, 1.22–1.61), and high intake of fat or meat.Direct associations for smoking and alcohol, but not body fat, tended to be stronger for sessileserrated adenomas/polyps than hyperplastic polyps. In contrast, factors we found to significantlydecrease risks for SP included use of non-steroidal anti-inflammatory drugs (RR, 0.77; 95% CI, 0.65–0.92) or aspirin (RR, 0.81; 95% CI, 0.67–0.99), as well as high intake of folate, calcium, or fiber. Nosignificant associations were detected between SP risk and physical activity or hormone replacementtherapy. 
Conclusions: Several lifestyle factors, most notably smoking and alcohol, are associated with SP risk.These findings enhance our understanding of mechanisms of SP development and indicate that riskof serrated pathway colorectal neoplasms could be reduced with lifestyle changes.

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SILVEIRA, Inavan Lopes da; MARANHÃO, T. M. O.; AZEVEDO, George Dantas. Metabolic syndrome in postmenopausal women: higher prevalence in the Northeastern Region of Brazil than in other Latin American countries and the influence of obesity and socioeconomic factors. Climacteric (Carnforth), v.10, p.438-439, 2007.

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RODRIGUES, Katamara et al. Prevalence of orofacial clefts and social factors in Brazil. Brazilian oral research, v.23, n. 1, p. 38-42, 2009.Disponivel em: . Acesso em: 04 out. 2010.

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Selon la théorie de l’auto-détermination, l’autonomie est un besoin universel de base qui, lorsque soutenu, permet aux individus de mieux fonctionner et de vivre plus de bien-être psychologique (p. ex., Deci & Ryan, 2008). Le style parental des parents qui soutiennent l’autonomie de leur enfant est caractérisé par le soutien du fonctionnement autodéterminé de ce dernier. Sa définition traditionnelle inclut des pratiques telles qu’offrir des explications et des choix lors des requêtes, communiquer de l’empathie, et encourager les prises d’initiatives tout en minimisant l’utilisation d’un langage contrôlant (p. ex., Soenens et al., 2007). Les bénéfices d’un style parental qui soutient l’autonomie d’un enfant ont été bien documentés (p. ex., Grolnick, Deci, & Ryan, 1997), toutefois, peu d’études ont été effectuées auprès des bambins. Or, cette thèse visait à enrichir la littérature sur le « parentage » en explorant les pratiques soutenantes qui sont utilisées par des parents de bambins dans un contexte de socialisation (étude 1), ainsi qu’en examinant les facteurs qui peuvent brimer leur mise en pratique (étude 2). La première étude a examiné un grand nombre de pratiques de socialisation que les parents qui favorisent davantage le soutien à l’autonomie (SA) pourraient utiliser plus fréquemment lorsqu’ils font des demandes à leurs bambins. Cette étude nous a permis d’explorer comment les parents manifestent leur SA et si le SA dans ce type de contexte est associé à un plus grand niveau d’internalisation des règles. Des parents (N = 182) de bambins (M âge = 27.08 mois) ont donc été invités à rapporter la fréquence avec laquelle ils utilisent 26 pratiques potentiellement soutenantes lorsqu’ils demandent à leurs bambins de compléter des tâches importantes mais non intéressantes et de rapporter à quel point ils valorisent le SA. Huit pratiques ont été identifiées comme étant soutenantes: quatre façons de communiquer de l’empathie, donner des explications courtes, expliquer pourquoi la tâche est importante, décrire le problème de façon informative et neutre, et mettre en pratique le comportement désiré soi-même. De plus, l’ensemble des huit pratiques corrélait positivement avec le niveau d’internalisation des bambins, suggérant aussi que celles-ci représentent bien le concept du SA. Des études futures pourraient tenter de répliquer ces résultats dans des contextes potentiellement plus chargés ou ébranlants (p. ex., réagir face à des méfaits, avec des enfants souffrant de retard de développement). La deuxième étude a poursuivi l’exploration du concept du SA parental en examinant les facteurs qui influencent la fréquence d’utilisation des stratégies soutenantes dans des contextes de socialisation. Puisque la littérature suggère que le stress parental et le tempérament difficile des bambins (c.-à-d., plus haut niveau d’affectivité négative, plus faible niveau de contrôle volontaire/autorégulation, plus faible niveau de surgency) comme étant des facteurs de risque potentiels, nous avons exploré de quelle façon ces variables étaient associées à la fréquence d’utilisation des stratégies soutenantes. Les buts de l’étude étaient: (1) d’examiner comment le tempérament des bambins et le stress parental influençaient le SA parental, et (2) de vérifier si le stress parental médiait la relation possible entre le tempérament des bambins et le SA parental. Le même échantillon de parents a été utilisé. Les parents ont été invités à répondre à des questions portant sur le tempérament de leur enfant ainsi que sur leur niveau de stress. Les résultats ont démontré qu’un plus grand niveau d’affectivité négative était associé à un plus grand niveau de stress parental, qui à son tour prédisait moins de SA parental. De plus, le stress parental médiait la relation positive entre l’autorégulation du bambin et le SA parental. Des recherches futures pourraient évaluer des interventions ayant pour but d’aider les parents à préserver leur attitude soutenante durant des contextes de socialisation plus difficiles malgré certaines caractéristiques tempéramentales exigeantes des bambins, en plus du stress qu’ils pourraient vivre au quotidien.