scholarly journals Cumulative Risk, Cumulative Outcome: A 20-Year Longitudinal Study

2021 ◽  
Author(s):  
Leslie R. Atkinson ◽  
Joseph Beitchman ◽  
Andrea Gonzalez ◽  
Arlene Young ◽  
Beth Wilson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Language Disorder ◽  
Cumulative Risk ◽  
School Dropout ◽  
Adverse Outcomes ◽  
Physical Health Outcomes ◽  
Early Risk ◽  
Cognitive Quality ◽  
Subsequent Risk

Cumulative risk (CR) models provide some of the most robust findings in the developmental literature, predicting numerous and varied outcomes. Typically, however, these outcomes are predicted one at a time, across different samples, using concurrent designs, longitudinal designs of short duration, or retrospective designs. We predicted that a single CR index, applied within a single sample, would prospectively predict diverse outcomes, i.e., depression, intelligence, school dropout, arrest, smoking, and physical disease from childhood to adulthood. Further, we predicted that number of risk factors would predict number of adverse outcomes (cumulative outcome; CO). We also predicted that early CR (assessed at age 5/6) explains variance in CO above and beyond that explained by subsequent risk (assessed at ages 12/13 and 19/20). The sample consisted of 284 individuals, 48% of whom were diagnosed with a speech/language disorder. Cumulative risk, assessed at 5/6-, 12/13-, and 19/20-years-old, predicted aforementioned outcomes at age 25/26 in every instance. Furthermore, number of risk factors was positively associated with number of negative outcomes. Finally, early risk accounted for variance beyond that explained by later risk in the prediction of CO. We discuss these findings in terms of five criteria posed by these data, positing a “mediated net of adversity” model, suggesting that CR may increase some central integrative factor, simultaneously augmenting risk across cognitive, quality of life, psychiatric and physical health outcomes.

scholarly journals Cumulative Risk, Cumulative Outcome: A 20-Year Longitudinal Study

2021 ◽  
Author(s):  
Leslie R. Atkinson ◽  
Joseph Beitchman ◽  
Andrea Gonzalez ◽  
Arlene Young ◽  
Beth Wilson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Language Disorder ◽  
Cumulative Risk ◽  
School Dropout ◽  
Adverse Outcomes ◽  
Physical Health Outcomes ◽  
Early Risk ◽  
Cognitive Quality ◽  
Subsequent Risk

Cumulative risk (CR) models provide some of the most robust findings in the developmental literature, predicting numerous and varied outcomes. Typically, however, these outcomes are predicted one at a time, across different samples, using concurrent designs, longitudinal designs of short duration, or retrospective designs. We predicted that a single CR index, applied within a single sample, would prospectively predict diverse outcomes, i.e., depression, intelligence, school dropout, arrest, smoking, and physical disease from childhood to adulthood. Further, we predicted that number of risk factors would predict number of adverse outcomes (cumulative outcome; CO). We also predicted that early CR (assessed at age 5/6) explains variance in CO above and beyond that explained by subsequent risk (assessed at ages 12/13 and 19/20). The sample consisted of 284 individuals, 48% of whom were diagnosed with a speech/language disorder. Cumulative risk, assessed at 5/6-, 12/13-, and 19/20-years-old, predicted aforementioned outcomes at age 25/26 in every instance. Furthermore, number of risk factors was positively associated with number of negative outcomes. Finally, early risk accounted for variance beyond that explained by later risk in the prediction of CO. We discuss these findings in terms of five criteria posed by these data, positing a “mediated net of adversity” model, suggesting that CR may increase some central integrative factor, simultaneously augmenting risk across cognitive, quality of life, psychiatric and physical health outcomes.

THE ROLE OF COMPREHENSIVE GERIATRIC ASSESSMENT IN THE TREATMENT OF CANCER PATIENTS IN ELDERLY AND SENILE AGE

2020 ◽  
pp. 65-73
Author(s):  
Ю. В. Алексеева ◽  
Т. Ю. Семиглазова ◽  
Б. С. Каспаров ◽  
Е. В. Ткаченко ◽  
К. И. Прощаев ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Malignant Tumors ◽  
Adverse Outcomes ◽  
Geriatric Syndromes ◽  
Complex Treatment ◽  
Increase Life Expectancy ◽  
Specialized Treatment

Современные подходы к организации диагностики и лечения больных пожилого и старческого возраста со злокачественными новообразованиями позволяют улучшать качество жизни и увеличивать продолжительность жизни. Оценка гериатрического статуса в онкологии позволяет прогнозировать осложнения в процессе комплексного лечения, в том числе лекарственного, модифицировать терапию для уменьшения факторов риска неблагоприятных исходов, осуществлять отбор пациентов на специализированное лечение с использованием стандартных схем. Таким образом, своевременная оценка гериатрических синдромов и их коррекция способна расширить показания к специализированному лечению больных пожилого и старческого возраста. Modern approaches to the organization of diagnosis and treatment of elderly and senile patients with malignant tumors allow to maintain the necessary level of health, improve the quality of life and increase life expectancy. Assessment of geriatric status in Oncology allows: to predict complications during the complex treatment, including drug treatment; to modify treatment to reduce the risk factors of adverse outcomes; to select patients for specialized treatment using standard schemes. So, timely assessment of geriatric syndromes and their correction can expand the indications for specialized treatment of elderly and senile patients.

scholarly journals Risk Factors of Going Missing in People Living With Dementia: A Scoping Review

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 643-644
Author(s):  
Noelannah Neubauer ◽  
Hector Perez ◽  
Antonio Miguel-Cruz ◽  
Christine Daum ◽  
Samantha Dawn Marshall ◽  
...  
Keyword(s):  
Risk Factors ◽  
Physical Environment ◽  
Geographical Location ◽  
Adverse Outcomes ◽  
Factors Associated ◽  
Care Partners ◽  
Scoping Reviews ◽  
Support Resources ◽  
Different Types

Abstract Critical wandering is common in persons living with dementia, it is defined as wandering that results in an individual going missing. This exposes the missing vulnerable older adult to risks and dangers. Persons with dementia who become lost and go missing and get lost can face adverse outcomes, such as injury and death, yet the amount of information available on the risk factors associated with these incidents is scarce. The aim of this study was to identify the risk factors associated with critical wandering in persons living with dementia. We used Tricco et al.’s (2018) approach for scoping reviews and searched the following databases: Medline, EMBASE, CINAHL, and Scopus. We included studies that referred to critical wandering in persons with dementia, cognitive impairment, or Alzheimer, and published since 1980. We identified 3,376 publications, which was reduced to 1641 publications after we removed duplications. A total of 78 studies met the inclusion and exclusion criteria for analysis and extraction. A rigorous process to synthesize and categorize the research evidence was followed. We identified four different types of risk factors associated with going missing: (1) personal, (2) physical environment and geographical location, (3) cultural environment, and (4) social environment and support resources. Recognition of these risk factors can help persons living with dementia and their care partners identify interventions and proactive strategies to mitigate or prevent critical wandering. This will support persons with dementia, their care partners, and community organizations to balance safety, autonomy, and independence to maximize quality of life.

Palliative Care for Family Caregivers

2020 ◽  
Vol 38 (9) ◽  
pp. 926-936 ◽  
Author(s):  
Sorayya Alam ◽  
Breffni Hannon ◽  
Camilla Zimmermann
Keyword(s):  
Risk Factors ◽  
Palliative Care ◽  
Family Caregivers ◽  
Advanced Cancer ◽  
Adverse Outcomes ◽  
Family Risk Factors ◽  
Family Risk ◽  
Early Palliative Care ◽  
Guide Care

Family caregivers provide substantial care for patients with advanced cancer, while suffering from hidden morbidity and unmet needs. The objectives of this review were to examine risk factors associated with caregiving for patients with advanced cancer, evaluate the evidence for pertinent interventions, and provide a practical framework for palliative care of caregivers in oncology settings. We reviewed studies examining the association of factors at the level of the caregiver, patient, caregiver-patient relationship, and caregiving itself, with adverse outcomes. In addition, we reviewed randomized controlled trials of interventions targeting the caregiver, the caregiver-patient dyad, or the patient and their family. Risk factors for adverse mental health outcomes included those related to the patient’s declining status, symptom distress, and poor prognostic understanding; risk factors for adverse bereavement outcomes included unfavorable circumstances of the patient’s death. Among the 16 randomized trials, the most promising results showed improvement of depression resulting from early palliative care interventions; results for quality of life were generally nonsignificant or showed an effect only on some subscales. Caregiving outcomes included burden, appraisal, and competence, among others, and showed mixed findings. Only three trials measured bereavement outcomes, with mostly nonsignificant results. On the basis of existent literature and our clinical experience, we propose the CARES framework to guide care for caregivers in oncology settings: Considering caregivers as part of the unit of care, Assessing the caregiver’s situation and needs, Referring to appropriate services and resources, Educating about practical aspects of caregiving, and Supporting caregivers through bereavement. Additional trials are needed that are powered specifically for caregiver outcomes, use measures validated for advanced cancer caregivers, and test real-world interventions.

scholarly journals Pažintinių funkcijų sutrikimai po kardiochirurginių operacijų: intraoperacinių veiksnių įtaka

2008 ◽  
Vol 6 (2) ◽  
pp. 0-0 ◽  
Author(s):  
Ieva Norkienė ◽  
Juozas Ivaškevičius
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Cognitive Decline ◽  
Surgical Intervention ◽  
Early Postoperative Period ◽  
Adverse Outcomes ◽  
Cerebral Hypoperfusion ◽  
Neurocognitive Outcomes ◽  
The Impact

Ieva Norkienė, Juozas IvaškevičiusVilniaus universiteto Anesteziologijos ir reanimatologijos klinika,Vilniaus greitosios pagalbos universitetinė ligoninė, Šiltnamių g. 29, LT-04130 VilniusEl paštas: [email protected] Šiuolaikinėje širdies chirurgijoje prioritetu tampa ne tik paciento gyvybės išsaugojimas, bet ir sveikatos grąžinimas. Pooperaciniu laikotarpiu pacientų sveikimą ir grįžimą prie įprastinio gyvenimo ritmo, net jei fizinė savijauta gera, dažnai sunkina rečiau ir sunkiau diagnozuojamos neuropsichologinės komplikacijos. Pažintinių (kognityvinių) funkcijų sutrikimai, arba kognityvinė disfunkcija, įvairių autorių duomenimis, gali būti nustatoma net iki 53% pacientų ankstyvuoju pooperaciniu laikotarpiu, o praėjus keleriems metams išlieka apie 20% gydytų ligonių. Ieškant efektyviausių būdų neurologinėms komplikacijoms išvengti, šiuolaikinėje medicinos literatūroje aktyviai svarstoma, kokią įtaką šiai patologinei būklei rastis turi intraoperaciniai veiksniai. Straipsnyje apžvelgiama dirbtinės kraujo apytakos, embolizacijos, hipoperfuzijos ir anestezijos sąsaja su pažintinių funkcijų pokyčiais po kardiochirurginių operacijų. Pagrindiniai žodžiai: pažintinių funkcijų sutrikimai, kardiochirurgija, rizikos veiksniai Cognitive decline after cardiac surgery: the impact of intraoperative factors Ieva Norkienė, Juozas IvaškevičiusClinic of Anesthesiology and Intensive Care of Vilnius UniversityEmergency Hospital, Šiltnamių 29, LT-04130 Vilnius, LithuaniaE-mail: [email protected] The quality of postoperative life becomes one of the most important aspects in assessing the outcomes of any surgical intervention. Recovery from the immediate effects of cardiac surgery is often complicated by less noticeable and hardly diagnosed neuropsychological complications. According to various authors, cognitive decline occurs in up to 53% of patients in the early postoperative period and persists in 20% of patients for a couple of years after surgery. Recent studies suggest that the incidence of these adverse outcomes may be closely related to intraoperative factors. In the present paper, we discuss the influence of cardiopulmonary bypass, embolisation, cerebral hypoperfusion and anesthesia on neurocognitive outcomes after cardiac surgery. Key words: cognitive decline, cardiac surgery, risk factors

The pathway to special education: The role of early risk factors in disability identification

2014 ◽  
Author(s):  
Whitney A. Leboeuf ◽  
Benjamin Brumley ◽  
John W. Fantuzzo ◽  
Cody A. Hostutler
Keyword(s):  
Risk Factors ◽  
Special Education ◽  
Early Risk ◽  
Early Risk Factors ◽  
Disability Identification

Ergonomic approaches to the organization of workplaces of teenagers at school

2020 ◽  
pp. 533-533
Author(s):  
V. A. Ablyaeva
Keyword(s):  
Risk Factors ◽  
Musculoskeletal System ◽  
Work Ability ◽  
Educational Environment ◽  
Visual Analyzer

The ergonomics of workplaces in the educational environment makes a significant effect on adolescents’ health, may create risk factors for disorders of the musculoskeletal system and the visual analyzer, which affect the work ability and quality of future life.

Clinical case of a comorbid patient with arterial hypertension

2020 ◽  
pp. 31-39
Author(s):  
Ella Polozova ◽  
Vsevolod Skvortsov ◽  
Olga Radaykina ◽  
Mariya Narvatkina ◽  
Anastasiya Seskina ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Arterial Hypertension ◽  
Clinical Picture ◽  
Clinical Case ◽  
Diagnosis And Treatment ◽  
The Moment

The widespread prevalence of comorbid pathology determines the relevance of this problem. Comorbid pathology due to the interaction of diseases, drug pathomorphism, age characteristics of the patient, significantly changes clinical picture and course of the main nosology, affects severity of complications and their nature, significantly affects quality of life and prognosis of patients. Diagnosis and treatment of many diseases is complicated in the conditions of comorbidity. The article presents a clinical case of a comorbid patient with arterial hypertension from the moment of exposure to risk factors and ending with the formation of many concomitant diseases, as an example of trans-nosological comorbidity.

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