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Epidemiology (Cambridge, Mass.) Sep 2019A common reason given for assessing interaction is to evaluate "whether the effect is larger in one group versus another". It has long been known that the answer to this... (Review)
Review
A common reason given for assessing interaction is to evaluate "whether the effect is larger in one group versus another". It has long been known that the answer to this question is scale dependent: the "effect" may be larger for one subgroup on the difference scale, but smaller on the ratio scale. In this article, we show that if the relative magnitude of effects across subgroups is of interest then there exists an "interaction continuum" that characterizes the nature of these relations. When both main effects are positive then the placement on the continuum depends on the relative magnitude of the probability of the outcome in the doubly exposed group. For high probabilities of the outcome in the doubly exposed group, the interaction may be positive-multiplicative positive-additive, the strongest form of positive interaction on the "interaction continuum". As the probability of the outcome in the doubly exposed group goes down, the form of interaction descends through ranks, of what we will refer to as the following: positive-multiplicative positive-additive, no-multiplicative positive-additive, negative-multiplicative positive-additive, negative-multiplicative zero-additive, negative-multiplicative negative-additive, single pure interaction, single qualitative interaction, single-qualitative single-pure interaction, double qualitative interaction, perfect antagonism, inverted interaction. One can thus place a particular set of outcome probabilities into one of these eleven states on the interaction continuum. Analogous results are also given when both exposures are protective, or when one is protective and one causative. The "interaction continuum" can allow for inquiries as to relative effects sizes, while also acknowledging the scale dependence of the notion of interaction itself.
Topics: Causality; Effect Modifier, Epidemiologic; Environmental Exposure; Humans; Probability; Protective Factors
PubMed: 31205287
DOI: 10.1097/EDE.0000000000001054 -
Deutsches Arzteblatt International Mar 2021
Topics: COVID-19; Complementary Therapies; Humans; Pandemics; Protective Factors; SARS-CoV-2
PubMed: 34024320
DOI: 10.3238/arztebl.m2021.0038 -
The Lancet. Psychiatry Jul 2021There is substantial variation in people's responses to adversity, with a considerable proportion of individuals displaying psychological resilience. Epigenetic... (Review)
Review
There is substantial variation in people's responses to adversity, with a considerable proportion of individuals displaying psychological resilience. Epigenetic mechanisms are hypothesised to be one molecular pathway of how adverse and traumatic events can become biologically embedded and contribute to individual differences in resilience. However, not much is known regarding the role of epigenetics in the development of psychological resilience. In this Review, we propose a new conceptual model for the different functions of epigenetic mechanisms in psychological resilience. The model considers the initial establishment of the epigenome, epigenetic modification due to adverse and protective environments, the role of protective factors in counteracting adverse influences, and genetic moderation of environmentally induced epigenetic modifications. After reviewing empirical evidence for the various components of the model, we identify research that should be prioritised and discuss practical implications of the proposed model for epigenetic research on resilience.
Topics: Adaptation, Psychological; Environment; Epigenesis, Genetic; Humans; Protective Factors; Resilience, Psychological; Stress, Psychological
PubMed: 33915083
DOI: 10.1016/S2215-0366(20)30515-0 -
Nutrients Apr 2022We are currently riding the second wave of the allergy epidemic, which is ongoing in affluent societies, but now also affecting developing countries. This increase in... (Review)
Review
We are currently riding the second wave of the allergy epidemic, which is ongoing in affluent societies, but now also affecting developing countries. This increase in the prevalence of atopy/asthma in the Western world has coincided with a rapid improvement in living conditions and radical changes in lifestyle, suggesting that this upward trend in allergic manifestations may be associated with cultural and environmental factors. Diet is a prominent environmental exposure that has undergone major changes, with a substantial increase in the consumption of processed foods, all across the globe. On this basis, the potential effects of dietary habits on atopy and asthma have been researched rigorously, but even with a considerable body of evidence, clear associations are far from established. Many factors converge to obscure the potential relationship, including methodological, pathophysiological and cultural differences. To date, the most commonly researched, and highly promising, candidate for exerting a protective effect is the so-called Mediterranean diet (MedDi). This dietary pattern has been the subject of investigation since the mid twentieth century, and the evidence regarding its beneficial health effects is overwhelming, although data on a correlation between MedDi and the incidence and severity of asthma and atopy are inconclusive. As the prevalence of asthma appears to be lower in some Mediterranean populations, it can be speculated that the MedDi dietary pattern could indeed have a place in a preventive strategy for asthma/atopy. This is a review of the current evidence of the associations between the constituents of the MedDi and asthma/atopy, with emphasis on the pathophysiological links between MedDi and disease outcomes and the research pitfalls and methodological caveats which may hinder identification of causality. MedDi, as a dietary pattern, rather than short-term supplementation or excessive focus on single nutrient effects, may be a rational option for preventive intervention against atopy and asthma.
Topics: Asthma; Diet, Mediterranean; Humans; Hypersensitivity; Hypersensitivity, Immediate; Prevalence; Protective Factors
PubMed: 35565792
DOI: 10.3390/nu14091825 -
Journal of Psychiatric Research Dec 2023We conducted an umbrella review to synthesise the evidence from systematic reviews and meta-analyses that examined the risk and protective factors for self-harm in young... (Review)
Review
We conducted an umbrella review to synthesise the evidence from systematic reviews and meta-analyses that examined the risk and protective factors for self-harm in young people. We searched six different databases and used the AMSTAR-2 checklist for quality assessment. The importance of each risk and protective factor was determined based on (1) the number of times it was identified by general reviews examining any risk or protective factor, and (2) the effect sizes from meta-analyses. There were 61 systematic reviews included in this review. The most frequently identified risk factors for self-harm in young people included childhood abuse, depression/anxiety, bullying, trauma, psychiatric illnesses, substance use/abuse, parental divorce, poor family relationships, lack of friends, and exposure to self-harm behaviour in others. The risk factors with the strongest evidence for an association with self-harm were behavioural disorders, personality disorders and depression or anxiety. There was a dearth of systematic reviews examining protective factors but good family/friend relationships were most frequently identified. There was also evidence to show that non-suicidal and suicidal self-harm shared many of the same risk factors. Clinicians and other professionals who work with young people should be particularly cognisant of the psychiatric and adverse life event risk factors as well as the substance use, education-related and individual-level (e.g. being LGB) risk factors for self-harm. Knowledge of risk factors for self-harm can potentially be used to inform the design and implementation of prevention measures and further research is needed on the protective factors for self-harm.
Topics: Humans; Adolescent; Young Adult; Child; Protective Factors; Systematic Reviews as Topic; Self-Injurious Behavior; Suicidal Ideation; Risk Factors; Substance-Related Disorders
PubMed: 37972513
DOI: 10.1016/j.jpsychires.2023.10.017 -
BMC Medicine Jan 2021The etiologies of chronic neurological diseases, which heavily contribute to global disease burden, remain far from elucidated. Despite available umbrella reviews on...
BACKGROUND
The etiologies of chronic neurological diseases, which heavily contribute to global disease burden, remain far from elucidated. Despite available umbrella reviews on single contributing factors or diseases, no study has systematically captured non-purely genetic risk and/or protective factors for chronic neurological diseases.
METHODS
We performed a systematic analysis of umbrella reviews (meta-umbrella) published until September 20th, 2018, using broad search terms in MEDLINE, SCOPUS, Web of Science, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, ProQuest Dissertations & Theses, JBI Database of Systematic Reviews and Implementation Reports, DARE, and PROSPERO. The PRISMA guidelines were followed for this study. Reference lists of the identified umbrella reviews were also screened, and the methodological details were assessed using the AMSTAR tool. For each non-purely genetic factor association, random effects summary effect size, 95% confidence and prediction intervals, and significance and heterogeneity levels facilitated the assessment of the credibility of the epidemiological evidence identified.
RESULTS
We identified 2797 potentially relevant reviews, and 14 umbrella reviews (203 unique meta-analyses) were eligible. The median number of primary studies per meta-analysis was 7 (interquartile range (IQR) 7) and that of participants was 8873 (IQR 36,394). The search yielded 115 distinctly named non-genetic risk and protective factors with a significant association, with various strengths of evidence. Mediterranean diet was associated with lower risk of dementia, Alzheimer disease (AD), cognitive impairment, stroke, and neurodegenerative diseases in general. In Parkinson disease (PD) and AD/dementia, coffee consumption, and physical activity were protective factors. Low serum uric acid levels were associated with increased risk of PD. Smoking was associated with elevated risk of multiple sclerosis and dementia but lower risk of PD, while hypertension was associated with lower risk of PD but higher risk of dementia. Chronic occupational exposure to lead was associated with higher risk of amyotrophic lateral sclerosis. Late-life depression was associated with higher risk of AD and any form of dementia.
CONCLUSIONS
We identified several non-genetic risk and protective factors for various neurological diseases relevant to preventive clinical neurology, health policy, and lifestyle counseling. Our findings could offer new perspectives in secondary research (meta-research).
Topics: Biomarkers; Diet, Mediterranean; Exercise; Humans; Hypertension; Nervous System Diseases; Protective Factors; Risk Factors
PubMed: 33435977
DOI: 10.1186/s12916-020-01873-7 -
Comprehensive Psychiatry May 2023Internet gaming disorder (IGD), compulsive sexual behavior (CSB), and problematic social network usage (PSNU) are prevalent disorders among adolescents. Research...
BACKGROUND AND AIMS
Internet gaming disorder (IGD), compulsive sexual behavior (CSB), and problematic social network usage (PSNU) are prevalent disorders among adolescents. Research indicates an increase in the number of adolescents engaging in daily gaming, sex, and the use of social networks, as well as an increase in the number of adolescents diagnosed with these disorders. The current study aims to detect unique profiles of risk and protective factors and examine whether these profiles could explain the different severities of IGD, CSB, and PSNU among adolescents.
METHOD
The sample comprised 544 Jewish Israeli adolescents from the general community (age 14-18), who were asked about risk (childhood adversity, childhood trauma, depression, anxiety, stress, post-traumatic stress, self-concealment, internalized stigma) and protective (parent-adolescent communication,) factors and addictive behaviors (IGD, CSB, and PSNU).
RESULTS
Adolescents were classified into three different clusters based on their risk and protective factors: "at risk" (n = 48, 8.82%), "moderate" (n = 400, 73.53%), and "resilient" (n = 96, 17.65%). The "at risk" group had significantly greater severity of addictive behaviors (IGD, CSB, and PSNU) than did the "moderate" or "resilient" groups, and the "moderate" group had significantly greater severity of addictive behaviors than the "resilient" group.
CONCLUSIONS
The findings highlight the fact that protective and risk factor profiles are highly indicative of various addictive behaviors among adolescents. The current research expands knowledge about addictive behaviors by providing a more individualized approach to understanding addictive behaviors among adolescents.
Topics: Humans; Adolescent; Protective Factors; Behavior, Addictive; Compulsive Behavior; Anxiety; Parents; Internet; Video Games
PubMed: 37037172
DOI: 10.1016/j.comppsych.2023.152387 -
Journal of Behavioral Addictions Jun 2023The study aims to thoroughly understand the causal and precedent modifiable risk or protective factors for Internet Gaming Disorder (IGD), a newly defined and prevalent... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIMS
The study aims to thoroughly understand the causal and precedent modifiable risk or protective factors for Internet Gaming Disorder (IGD), a newly defined and prevalent mental disorder.
METHODS
We performed a systematic review on quality-designed longitudinal studies based on five online databases: MEDLINE, PsycINFO, Embase, PubMed, and Web of Science. Studies were included in the meta-analysis if they addressed IGD, adopted longitudinal, prospective, or cohort study designs, presented modifiable factors of IGD, and reported the effect sizes for correlations. Pooled Pearson's correlations were calculated using the random effects model.
RESULTS
Thirty-nine studies with 37,042 subjects were included. We identified 34 modifiable factors, including 23 intrapersonal factors (e.g., gaming time, loneliness, etc.), 10 interpersonal factors (e.g., peer relationship, social support, etc.), and 1 environmental factor (i.e., school engagement). Age, the male ratio, study region, and study years were significant moderators.
DISCUSSION AND CONCLUSIONS
Intrapersonal factors were stronger predictors than interpersonal and environmental factors. It may imply that individual-based theories are more powerful to explain the development of IGD. Longitudinal research on the environmental factors of IGD was lacking; more studies are warranted. The identified modifiable factors would help to guide effective interventions for IGD reduction and prevention.
Topics: Humans; Male; Cohort Studies; Behavior, Addictive; Prospective Studies; Protective Factors; Internet Addiction Disorder; Video Games; Internet
PubMed: 37224007
DOI: 10.1556/2006.2023.00017 -
International Journal of Environmental... Jun 2019dementia is one of the main causes of disability and dependency among the older population worldwide, producing physical, psychological, social and economic impact in... (Review)
Review
BACKGROUND
dementia is one of the main causes of disability and dependency among the older population worldwide, producing physical, psychological, social and economic impact in those affected, caregivers, families and societies. However, little is known about dementia protective factors and their potential benefits against disease decline in the diagnosed population. Cognitive stimulating activities seem to be protective factors against dementia, though there is paucity in the scientific evidence confirming this, with most publications focusing on prevention in non-diagnosed people. A scoping review was conducted to explore whether chess practice could mitigate signs, deliver benefits, or improve cognitive capacities of individuals diagnosed with dementia through the available literature, and therefore act as a protective factor.
METHODS
twenty-one articles were selected after applying inclusion and exclusion criteria.
RESULTS
the overall findings stress that chess could lead to prevention in non-diagnosed populations, while little has been shown with respect to individuals already diagnosed. However, some authors suggest its capacity as a protective factor due to its benefits, and the evidence related to the cognitive functions associated with the game.
CONCLUSION
although chess is indirectly assumed to be a protective factor due to its cognitive benefits, more studies are required to demonstrate, with strong evidence, whether chess could be a protective factor against dementia within the diagnosed population.
Topics: Dementia; Games, Recreational; Humans; Protective Factors
PubMed: 31207926
DOI: 10.3390/ijerph16122116 -
BMC Cancer May 2024Cancer is a leading global cause of death. Conventional cancer treatments like surgery, radiation, and chemotherapy have associated side effects. Ferroptosis, a... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Cancer is a leading global cause of death. Conventional cancer treatments like surgery, radiation, and chemotherapy have associated side effects. Ferroptosis, a nonapoptotic and iron-dependent cell death, has been identified and differs from other cell death types. Research has shown that ferroptosis can promote and inhibit tumor growth, which may have prognostic value. Given the unclear role of ferroptosis in cancer biology, this meta-analysis aims to investigate its impact on cancer prognosis.
METHODS
This systematic review and meta-analysis conducted searches on PubMed, Embase, and the Cochrane Library databases. Eight retrospective studies were included to compare the impact of ferroptosis inhibition and promotion on cancer patient prognosis. The primary endpoints were overall survival (OS) and progression-free survival (PFS). Studies lacking clear descriptions of hazard ratios (HR) and 95% confidence intervals for OS and PFS were excluded. Random-effects meta-analysis and meta-regression were performed on the included study data to assess prognosis differences between the experimental and control groups. Meta-analysis results included HR and 95% confidence intervals. This study has been registered with PROSPERO, CRD 42023463720 on September 27, 2023.
RESULTS
A total of 2,446 articles were screened, resulting in the inclusion of 5 articles with 938 eligible subjects. Eight studies were included in the meta-analysis after bias exclusion. The meta-analysis, after bias exclusion, demonstrated that promoting ferroptosis could increase cancer patients' overall survival (HR 0.31, 95% CI 0.21-0.44) and progression-free survival (HR 0.26, 95% CI 0.16-0.44) compared to ferroptosis inhibition. The results showed moderate heterogeneity, suggesting that biological activities promoting cancer cell ferroptosis are beneficial for cancer patient's prognosis.
CONCLUSIONS
This systematic review and meta-analysis demonstrated that the promotion of ferroptosis yields substantial benefits for cancer prognosis. These findings underscore the untapped potential of ferroptosis as an innovative anti-tumor therapeutic strategy, capable of addressing challenges related to drug resistance, limited therapeutic efficacy, and unfavorable prognosis in cancer treatment.
REGISTRATION
CRD42023463720.
Topics: Humans; Ferroptosis; Neoplasms; Prognosis; Protective Factors; Progression-Free Survival
PubMed: 38760742
DOI: 10.1186/s12885-024-12369-5