PRIMARY PREVENTION OF DEMENTIA: AN EPIDEMIOLOGICAL POINT OF VIEW

2016 ◽  
pp. 1-4
Author(s):  
C. Berr
Keyword(s):  
Risk Factors ◽  
Primary Prevention ◽  
Disease Onset ◽  
Point Of View ◽  
Level Of Evidence ◽  
Life Course Approach ◽  
Important Concern ◽  
Dementia Prevention ◽  
Underlying Mechanisms ◽  
The Impact

From an epidemiological perspective, in order to increase the level of evidence, it is necessary to refer to data from longitudinal studies to validate the temporal relationship between exposure (e.g. the behavior or modifying factor) and the disease. Findings from such studies are useful for defining risk factors and laying the groundwork for proposing interventions for prevention. This step is crucial in order to define the periods (life-course approach) and groups at risk, which will then become the targets of interventions designed to modify behaviors or lifestyle. Specifying the underlying mechanisms of these risk factors is one of the objectives of etiological epidemiology which focuses on the origin of diseases but is not essential for a more pragmatic interventional approach. These questions are essential for dementia prevention and are discussed in this paper. Furthermore, timing interventions is a major problem even if we identify primary prevention pathways in dementia. Another important concern for epidemiologists is the need to make projections to estimate the number of dementia cases in the next decades considering different intervention scenarios. These models require adequate descriptive indicators of dementia, demography and mortality and precise estimations of the impact of potential interventions in terms of delaying disease onset for instance.

Assessment of The Influence of Non-Genetic Risk Factors on The Disease Onset and Progression of Androgenetic Alopecia in Egyptian Males

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Naziha Hafez Khafagy ◽  
Marwa Yassin Soltan ◽  
Ahmed Adel Ali Ali
Keyword(s):  
Risk Factors ◽  
Hair Loss ◽  
Genetic Risk ◽  
Disease Onset ◽  
Genetic Risk Factors ◽  
Androgenetic Alopecia ◽  
Major Type ◽  
Young Males ◽  
Potential Risk Factors ◽  
The Impact

Abstract Background Androgenetic alopecia (AGA) is a patterned hair loss with multifactorial background including genetic, hormonal as well as environmental and lifestyle-related risk factors. The impact of non-genetic risk factors on the onset and disease progression of androgenetic alopecia in Egyptian males. Objective To explore the potential role of non-genetic risk factors on the disease development and progression of androgenetic alopecia in Egyptian males. Patients and Methods The study included 2000 subjects with and without AGA, during the period from February 2019 to September 2019. The study protocol was approved by faculty of medicine, Ain Sham University, Research ethics committee (FWA 000017585). An informed written consent for participation in this study was obtained from patients and controls before enrollment. One thousand male patients with AGA were recruited in the study. The diagnosis was made via clinical diagnosis, dermatological findings, trichoscopic assessment. Results Our study showed that after skin examination 416 patients had acne and 344 patients had seborrhea, with statistically significant association to AGA cases. Conclusion From our study, it can be concluded that AGA became a major type of hair loss complaint among Egyptian males especially young males. Many potential risk factors were found to be associated with the disease as smoking, stress, obesity, family history, exercise, HTN and unbalanced diet. Avoidance of such risk factors may help improve the disease.

scholarly journals Où en est la situation de la violence envers les femmes dans le milieu familial, dix ans après les colloques sur la violence ?

Criminologie ◽  
2005 ◽  
Vol 23 (2) ◽  
pp. 23-45 ◽  
Author(s):  
Ginette Larouche ◽  
Louise Gagné
Keyword(s):  
Risk Factors ◽  
Public Services ◽  
Point Of View ◽  
Future Prospects ◽  
The Impact

The article presents the situation regarding violence to women for the region of Montreal. The nature and extent of the problem is examined and the risk factors are dealt with from a multidimensional point of view. The community and para-public services associated with this problem are described briefly and an account is given of the impact of past and present action. Some future prospects are also introduced.

NCDs: Risk factors and determinants

2017 ◽  
Author(s):  
Mike Rayner ◽  
Kremlin Wickramasinghe ◽  
Julianne Williams ◽  
Karen McColl ◽  
Shanthi Mendis
Keyword(s):  
Risk Factors ◽  
Primary Prevention ◽  
World Health ◽  
Global Burden ◽  
Health In All Policies ◽  
Socioecological Model ◽  
Life Course Approach ◽  
The World ◽  
Single Focus ◽  
Different Levels

This chapter introduces the main risk factors for non-communicable diseases (NCDs), using different causal webs. It uses the Global Burden of Disease data to describe the burden of these NCD risk factors. It uses the socioecological model and the World Health Organization’s conceptual framework for social determinants of health to show the different levels of influences relevant to NCDs. This chapter presents case studies to show how a life-course approach and health-in-all-policies approach could address these broad ranges of NCD risk factors. It discusses the importance of primary prevention efforts organized around multilevel interventions and shows that they are more likely to be more successful than single-focus efforts.

Increased pitch velocity and workload are common risk factors for ulnar collateral ligament injury in baseball players: a systematic review

2018 ◽  
Vol 4 (1) ◽  
pp. 41-47
Author(s):  
Ryan P Coughlin ◽  
Yung Lee ◽  
Nolan S Horner ◽  
Nicole Simunovic ◽  
Edwin R Cadet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Injury Prevention ◽  
Ulnar Collateral Ligament ◽  
Quality Data ◽  
Sufficient Evidence ◽  
Collateral Ligament ◽  
Level Of Evidence ◽  
Baseball Players ◽  
The Impact

ImportanceUlnar collateral ligament (UCL) injuries commonly occur in baseball players. Strategies for injury prevention have long been accepted without clinical data informing which risk factors lead to serious injury.ObjectiveThe objective of this study was to systematically review the impact of various pitching-related risk factors for UCL injury in baseball players from all levels of play.Evidence reviewThe electronic databases MEDLINE, EMBASE and PubMed were systematically searched until 4 March 2018, and pertinent data were abstracted by two independent reviewers. Search terms included ‘ulnar collateral ligament’, ‘medial ulnar collateral ligament’, ‘Tommy John’, ‘risk’ and ‘association’. Inclusion criteria were English-language studies, level of evidence I–IV and studies reporting risk factors for UCL injury of the elbow in baseball players. Study quality was assessed using the methodological index for non-randomised studies (MINORS) criteria. The results are presented in a narrative summary.FindingsPitching practices (workload and pitch characteristics) were reported in 9/15 studies. Specifically, three of four studies (n=1810) reported increased pitch workload as a risk factor for native UCL injury (p<0.001 to 0.02). The most common pitch characteristic reported was pitch velocity with four of five studies showing increased velocity being significantly associated with native UCL injury (p<0.01 to 0.02). Biomechanical risk factors reported were increased humeral retrotorsion (two studies; n=324), poor lower extremity and trunk balance (one study; n=42) and loss of total arc of shoulder motion (two studies; n=118), all significantly associated with UCL injury (p<0.0001 to 0.05). One of three studies assessing pitch workload as a risk factor for re-rupture of UCL reconstruction found a significant association (p<0.01).Conclusions and relevancePitching practices, reflected by increased pitch workload and velocity, were most commonly associated with UCL injury; however, the definition of workload (number of pitches per game, inning or season) was inconsistently reported. Biomechanical risk factors were less commonly reported and lack sufficient evidence to recommend preventative strategies. More quality data is needed to refine the current recommendations for injury prevention in baseball players.Level of evidenceIII.

Sex similarities and differences in risk factors for recurrence of major depression

2017 ◽  
Vol 48 (10) ◽  
pp. 1685-1693 ◽  
Author(s):  
Hanna M. van Loo ◽  
Steven H. Aggen ◽  
Charles O. Gardner ◽  
Kenneth S. Kendler
Keyword(s):  
Risk Factors ◽  
Sex Differences ◽  
Family History ◽  
Major Depression ◽  
Prediction Models ◽  
Population Sample ◽  
Disease Onset ◽  
Risk Factors For Recurrence ◽  
Males And Females ◽  
The Impact

AbstractBackgroundMajor depression (MD) occurs about twice as often in women as in men, but it is unclear whether sex differences subsist after disease onset. This study aims to elucidate potential sex differences in rates and risk factors for MD recurrence, in order to improve prediction of course of illness and understanding of its underlying mechanisms.MethodsWe used prospective data from a general population sample (n = 653) that experienced a recent episode of MD. A diverse set of potential risk factors for recurrence of MD was analyzed using Cox models subject to elastic net regularization for males and females separately. Accuracy of the prediction models was tested in same-sex and opposite-sex test data. Additionally, interactions between sex and each of the risk factors were investigated to identify potential sex differences.ResultsRecurrence rates and the impact of most risk factors were similar for men and women. For both sexes, prediction models were highly multifactorial including risk factors such as comorbid anxiety, early traumas, and family history. Some subtle sex differences were detected: for men, prediction models included more risk factors concerning characteristics of the depressive episode and family history of MD and generalized anxiety, whereas for women, models included more risk factors concerning early and recent adverse life events and socioeconomic problems.ConclusionsNo prominent sex differences in risk factors for recurrence of MD were found, potentially indicating similar disease maintaining mechanisms for both sexes. Course of MD is a multifactorial phenomenon for both males and females.

Preventing late-life depression: a clinical update

2010 ◽  
Vol 22 (8) ◽  
pp. 1216-1224 ◽  
Author(s):  
Robert C. Baldwin
Keyword(s):  
Risk Factors ◽  
Primary Prevention ◽  
Depressive Disorder ◽  
Functional Limitation ◽  
Late Life ◽  
Current Evidence ◽  
Secondary Outcome ◽  
Late Life Depression ◽  
Current Evidence Base ◽  
The Impact

ABSTRACTBackground: Achieving remission in late-life depressive disorder is difficult; it is far better to prevent depression. In the last ten years there have been a number of clinical studies of the feasibility of prevention.Methods: A limited literature review was undertaken of studies from 2000 specifically concerning the primary prevention of late-life depressive disorder or where primary prevention is a relevant secondary outcome.Results: Selective primary prevention (targeting individuals at risk but not expressing depression) has been shown to be effective for stroke and macular degeneration but not hip fracture. It may also prove effective for the depression associated with caregiving in dementia. Emerging evidence finds effectiveness for indicated prevention (in those identified with subthreshold depression often with other risk factors such as functional limitation). Despite a number of promising risk factors (for example, diet, exercise, vascular risk factors, homocysteine and insomnia), universal prevention of late-life depression (acting to reduce the impact of risk factors at the population level) has no current evidence base, although a population approach might mitigate suicide.Conclusion: Interventions which work in preventing late-life depression include antidepressant medication in standard doses and Problem-Solving Treatment. When integrated into a care model, such as collaborative care, prevention is feasible but more economic studies are needed.

scholarly journals The Pregnancy and EARly Life study (PEARL) - a longitudinal study to understand how gut microbes contribute to maintaining health during pregnancy and early life

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Phillips ◽  
Rachel Watt ◽  
Thomas Atkinson ◽  
George M Savva ◽  
Antonietta Hayhoe ◽  
...  
Keyword(s):  
Early Life ◽  
Disease Onset ◽  
Metagenomic Sequencing ◽  
Life Study ◽  
Host Interactions ◽  
Experimental Systems ◽  
Underlying Mechanisms ◽  
The Impact

Abstract Background The early life period represents the first step in establishing a beneficial microbial ecosystem, which in turn affects both short and longer-term health. Changes during pregnancy influence the neonatal microbiome; through transmission of maternal microbes during childbirth, and beyond, through nutritional programming. However, in-depth exploration of longitudinal maternal-infant cohorts, with sampling of multiple body sites, complemented by clinical and nutritional metadata, and use of cutting-edge experimental systems are limited. The PEARL study will increase our knowledge of; how microbes (including viruses/phages, bacteria, fungi and archaea) change in composition and functional capacity during pregnancy; transmission pathways from mother to infant; the impact of various factors on microbial communities across pregnancy and early life (e.g. diet), and how these microbes interact with other microbes and modulate host processes, including links to disease onset. Methods PEARL is a longitudinal observational prospective study of 250 pregnant women and their newborns, with stool and blood samples, questionnaires and routine clinical data collected during pregnancy, labour, birth and up to 24 months post birth. Metagenomic sequencing of samples will be used to define microbiome profiles, and allow for genus, species and strain-level taxonomic identification and corresponding functional analysis. A subset of samples will be analysed for host (immune/metabolite) molecules to identify factors that alter the host gut environment. Culturing will be used to identify new strains of health-promoting bacteria, and potential pathogens. Various in vitro and in vivo experiments will probe underlying mechanisms governing microbe-microbe and microbe-host interactions. Discussion Longitudinal studies, like PEARL, are critical if we are to define biomarkers, determine mechanisms underlying microbiome profiles in health and disease, and develop new diet- and microbe-based therapies to be tested in future studies and clinical trials. Trial registration This study is registered in the ClinicalTrials.gov Database with ID: NCT03916874.

scholarly journals RELATION BETWEEN IMPACT FACTOR IN ORTHOPEDIC JOURNALS AND LEVEL OF EVIDENCE

2018 ◽  
Vol 26 (4) ◽  
pp. 275-277
Author(s):  
Mauricio Pandini Monteiro de Barros ◽  
Fabio Teruo Matsunaga ◽  
Marcel Jun Sugawara Tamaoki
Keyword(s):  
Impact Factor ◽  
Orthopedic Surgery ◽  
Randomized Clinical Trials ◽  
Point Of View ◽  
Impact Factors ◽  
Level Of Evidence ◽  
High Level ◽  
The Impact ◽  
Source Of Information

ABSTRACT Objective: This study aims to assess the quality of articles published in the leading orthopedic surgery journals, by measuring the relation between the impact factor and the number studies with a high level of evidence. Methods: A literature review was performed of articles published in four previously selected journals. A score of journal evidence (RER - Relation between Randomized clinical trials and Systematic reviews) was calculated, considering the number of RCTs and SR published and the total number of full-text articles. Results: The selected journals were JBJS-Am, ASMJ, BJJ-Br and Arthroscopy, with Impact factors of 5.280, 4.362, 3.309 and 3.206 respectively in 2015. In the study, the RER Scores, in the same order, were 9.408, 6.153, 7.456 and 7.779. Conclusion: The journal JBJS-Am is the best available source of information on orthopedic surgery from this point of view. It has the highest Impact Factor and clearly the highest RER Score. On the other hand, we could conclude that the number of published RCT and good quality SR is very low, with less than 10% of all the articles. Level of evidence III, Analyses based on limited alternatives and costs, and poor estimates.

Abstract P321: Pregnancy Loss is Associated With Subclinical Cardiovascular Disease in Mexican Women

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Sandra A Hartasanchez ◽  
Mario Flores ◽  
Adriana Monge ◽  
Elsa Yunes ◽  
Carlos Cantu-Brito ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Pregnancy Loss ◽  
Carotid Atherosclerosis ◽  
Intima Media Thickness ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Underlying Mechanisms ◽  
The Impact

Introduction: Cardiovascular disease (CVD) in women often develops in the absence of conventional risk factors. Prenatal loss, a common pregnancy outcome, may result in physiologic changes that could affect future risk of myocardial infarction. Little is known about the impact of pregnancy loss on early markers of CVD risk. Hypothesis: Pregnancy loss affects carotid artery intima-media thickness (CIMT). Methods: We conducted a cross-sectional analysis among 1,769 disease-free women from the Mexican Teachers’ Cohort who had been pregnant to evaluate the relation between pregnancy loss and CIMT. In 2008 participants answered a baseline questionnaire on reproductive history, risk factors for chronic disease and medical conditions that was updated in 2011. We defined pregnancy loss as abortion and/or stillbirth. Between 2012 and 2016, CIMT was measured by trained neurologists using ultrasound in three clinical sites. We log-transformed CIMT and defined carotid atherosclerosis as CIMT ≥0.8mm or plaque. We used multivariable linear and logistic regression models to assess the relation between pregnancy loss, CIMT and carotid atherosclerosis. Results: Mean age of participants was 49.8 (SD ± 5.1) years. The prevalence of pregnancy loss was 22% (394 of 1769) , while we observed carotid atherosclerosis in 23% (405 of 1769) of participants. Comparing participants who reported a pregnancy loss to those who did not, the multivariable-adjusted odds ratio for carotid atherosclerosis was 1.52 (95% CI 1.12, 2.06). Women who experienced a stillbirth had 2.32 higher odds (95% CI 1.03, 5.21) of carotid atherosclerosis than those who did not. Mean CIMT appeared to be higher in women who reported a pregnancy loss relative to those who did not, however, in multivariable analyses, pregnancy loss and stillbirth were not significantly associated with CIMT. Conclusions: Abortion and stillbirth may be associated with a higher risk of CVD. Additional investigation on potential underlying mechanisms for this association is required.

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