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BMC Geriatrics Jul 2023This study aimed to investigate the prevalence of multimorbidity and its associated factors among the older population in China to propose policy recommendations for the...
BACKGROUND
This study aimed to investigate the prevalence of multimorbidity and its associated factors among the older population in China to propose policy recommendations for the management of chronic diseases in older adults.
METHODS
This study was conducted based on the 2021 Shenzhen Healthy Ageing Research (SHARE), and involved analysis of 346,760 participants aged 65 or older. Multimorbidity is defined as the presence of two or more clinically diagnosed or non self-reported chronic diseases among the eight chronic diseases surveyed in an individual. The Logistic analysis was adopted to explore the potential associated factors of multimorbidity.
RESULTS
The prevalences of obesity, hypertension, diabetes, anemia, chronic kidney disease, hyperuricemia, dyslipidemia and fatty liver disease were 10.41%, 62.09%, 24.21%, 12.78%, 6.14%, 20.52%, 44.32%, and 33.25%, respectively. The prevalence of multimorbidity was 63.46%. The mean count of chronic diseases per participant was 2.14. Logistic regression indicated that gender, age, marriage status, lifestyle (smoking status, drinking status, and physical activity), and socioeconomic status (household registration, education level, payment method of medical expenses) were the common predictors of multimorbidity for older adults, among which, being women, married, or engaged in physical activity was found to be a relative determinant as a protective factor for multimorbidity after the other covariates were controlled.
CONCLUSION
Multimorbidity is prevalent among older adults in Chinese. Guideline development, clinical management,and public intervention should target a group of diseases instead of a single condition.
Topics: Aged; Female; Humans; Male; China; Independent Living; Life Style; Multimorbidity; East Asian People
PubMed: 37430183
DOI: 10.1186/s12877-023-04128-1 -
Frontiers in Endocrinology 2023The purpose of this study is to investigate the independent influencing factors of the transition from normal population to prediabetes, and from prediabetes to...
OBJECTIVE
The purpose of this study is to investigate the independent influencing factors of the transition from normal population to prediabetes, and from prediabetes to diabetes, and to further construct clinical prediction models to provide a basis for the prevention and management of prediabetes and diabetes.
MATERIALS AND METHODS
The data for this study were based on clinical information of participants from the Health Management Center of Peking University Shenzhen Hospital. Participants were classified into normal group, prediabetes group, and diabetes group according to their functional status of glucose metabolism. Spearman's correlation coefficients were calculated for the variables, and a matrix diagram was plotted. Further, univariate and multivariate logistic regression analysis were conducted to explore the independent influencing factors. The independent influencing factors were used as predictors to construct the full-variable prediction model (Full.model) and simplified prediction model (Simplified.model).
RESULTS
This study included a total of 5310 subjects and 22 variables, among which there were 1593(30%) in the normal group, 3150(59.3%) in the prediabetes group, and 567(10.7%) in the diabetes group. The results of the multivariable logistic regression analysis showed that there were significant differences in 9 variables between the normal group and the prediabetes group, including age(Age), body mass index(BMI), systolic blood pressure(SBP), urinary glucose(U.GLU), urinary protein(PRO), total protein(TP), globulin(GLB), alanine aminotransferase(ALT), and high-density lipoprotein cholesterol(HDL-C). There were significant differences in 7 variables between the prediabetes group and the diabetes group, including Age, BMI, SBP, U.GLU, PRO, triglycerides(TG), and HDL.C. The Full.model and Simplified.model constructed based on the above influencing factors had moderate discriminative power in both the training set and the test set.
CONCLUSION
Age, BMI, SBP, U.GLU, PRO, TP, and ALT are independent risk factors, while GLB and HDL.C are independent protective factors for the development of prediabetes in the normal population. Age, BMI, SBP, U.GLU, PRO, and TG are independent risk factors, while HDL.C is an independent protective factor for the progression from prediabetes to diabetes. The Full.model and Simplified.model developed based on these influencing factors have moderate discriminative power.
Topics: Humans; Prediabetic State; Blood Glucose; Diabetes Mellitus; Triglycerides; Risk Factors
PubMed: 37964953
DOI: 10.3389/fendo.2023.1225696 -
Journal of Youth and Adolescence Feb 2024Although both risk and protective factors are important components of etiological theories for antisocial behavior, far less is known about protective factors and their... (Meta-Analysis)
Meta-Analysis Review
Although both risk and protective factors are important components of etiological theories for antisocial behavior, far less is known about protective factors and their impact. This review summarized primary studies on the impact of different protective factors for antisocial behavior in youth. In total, 305 studies reporting on 1850 potentially protective factors were included. Each extracted factor was first classified into one of 77 mutually exclusive groups of similar factors (referred to as domains), after which a three-level meta-analysis was conducted to determine the protective effect of each domain. A significant and negative effect was found for 50 domains, which were therefore designated as being truly protective. The largest impact (r < -0.20) was found for higher levels of conservativeness, self-transcendence, life satisfaction, involvement in romantic relationships, the capacity to reflect or mentalize, peer relationships quality, prosocial peers, prosocial values, agreeableness, school self-esteem, parental control, general resilience, and social skills. Analyses revealed that the impact of some of the 77 domains was moderated by the youth's age (five domains) and gender (four domains) as well as the severity of antisocial behavior they exhibit (two domains), indicating that the impact of these domains differs across subgroups of antisocial youth. Given the substantial number of factors that were identified as being protective for antisocial behavior in youth, this study discusses implications for future directions, assessment strategies, and (preventive) interventions.
Topics: Humans; Adolescent; Antisocial Personality Disorder; Protective Factors; Peer Group; Gender Identity; Adolescent Behavior
PubMed: 37794287
DOI: 10.1007/s10964-023-01878-4 -
Journal of Affective Disorders Jul 2023The specific factors that may influence burnout levels in police officers are not yet clear. Our aim was to systematically identify the psychosocial risk and protective... (Review)
Review
BACKGROUND
The specific factors that may influence burnout levels in police officers are not yet clear. Our aim was to systematically identify the psychosocial risk and protective factors associated with burnout among police officers.
METHODS
This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). A protocol was registered in PROSPERO. A search strategy was applied to Medline via OvidSP, PsycInfo, Scopus and Web of Science. The quality assessment entailed the use of the CASP checklist for cohort studies. The data was reported through a narrative synthesis.
RESULTS
After removing studies based on the selection criteria, 41 studies were included in this review. The findings were synthesized under the following subheadings: socio-demographic factors; organisational factors; operational factors; personality variables and coping strategies. Organisational and operational factors were found to be the most predominant risk factors for burnout. Personality variables and coping strategies appeared as both risk and protective factors. Socio-demographic factors were weak in explaining burnout.
LIMITATIONS
Most studies are from high-income countries. Not all used the same burnout measurement tool. All relied on self-reported data. Since 98 % had a cross-sectional design, causal inferences could not be made.
CONCLUSIONS
Burnout, despite being strictly defined as an occupational phenomenon, is related to factors outside of this context. Future research should focus on examining the reported associations by using more robust designs. More attention must be paid to police officers' mental health by investing in developing strategies to mitigate adverse factors and maximise the effects of protective factors.
Topics: Humans; Police; Protective Factors; Cross-Sectional Studies; Burnout, Professional; Adaptation, Psychological
PubMed: 36972850
DOI: 10.1016/j.jad.2023.03.081 -
Transcultural Psychiatry Aug 2023As psychological resilience has been increasingly recognized as contextually constructed, mixed methods studies that map out local ecologies of resilience have become... (Review)
Review
As psychological resilience has been increasingly recognized as contextually constructed, mixed methods studies that map out local ecologies of resilience have become increasingly common. However, the direct adaptation of quantitative tools for cross-cultural use based on qualitative findings has been relatively lacking. The current review aims to provide an overview of existing measures of resilience used cross-culturally and to synthesize the protective and promotive factors and processes (PPFP) of resilience identified within these measures into a single resource. A January 2021 search of PubMed for studies of the development of psychological resilience measures that excluded studies of non-psychological resilience yielded 58 unique measures. These measures contain 54 unique PPFP of resilience, ranging from individual to communal-level characteristics. This review is intended to serve as a complementary tool for adapting standardized measures for stakeholders requiring an assessment tool that is attuned to their context for mental health risk assessment and intervention evaluation.
Topics: Humans; Protective Factors; Cross-Cultural Comparison; Resilience, Psychological
PubMed: 37097913
DOI: 10.1177/13634615231167661 -
Heliyon Mar 2024Self-harm (any self-injury or -poisoning regardless of intent) is highly prevalent in transgender and gender diverse (TGD) populations. It is strongly associated with... (Review)
Review
BACKGROUND
Self-harm (any self-injury or -poisoning regardless of intent) is highly prevalent in transgender and gender diverse (TGD) populations. It is strongly associated with various adverse health and wellbeing outcomes, including suicide. Despite increased risk, TGD individuals' unique self-harm pathways are not well understood. Following PRISMA guidelines we conducted the first systematic review of risk and protective factors for self-harm in TGD people to identify targets for prevention and intervention.
METHODS
We searched five electronic databases (PubMed, PsychInfo, Scopus, MEDLINE, and Web of Science) published from database inception to November 2023 for primary and secondary studies of risk and/or protective factors for self-harm thoughts and behaviours in TGD people. Data was extracted and study quality assessed using Newcastle-Ottawa Scales.
FINDINGS
Overall, 78 studies published between 2007 and 2023 from 16 countries (N = 322,144) were eligible for inclusion. Narrative analysis identified six key risk factors for self-harm in TGD people (aged 7-98years) were identified. These are younger age, being assigned female at birth, illicit drug and alcohol use, sexual and physical assault, gender minority stressors (especially discrimination and victimisation), and depression or depressive symptomology. Three important protective factors were identified: social support, connectedness, and school safety. Other possible unique TGD protective factors against self-harm included: chosen name use, gender-identity concordant documentation, and protective state policies. Some evidence of publication bias regarding sample size, non-responders, and confounding variables was identified.
INTERPRETATION
This systematic review indicates TGD people may experience a unique self-harm pathway. Importantly, the risk and protective factors we identified provide meaningful targets for intervention. TGD youth and those assigned female at birth are at increased risk. Encouraging TGD people to utilise and foster existing support networks, family/parent and peer support groups, and creating safe, supportive school environments may be critical for self-harm and suicide prevention strategies. Efforts to reduce drug and alcohol use and experiences of gender-based victimisation and discrimination are recommended to reduce self-harm in this high-risk group. Addressing depressive symptoms may reduce gender dysphoria and self-harm. The new evidence presented in this systematic review also indicates TGD people may experience unique pathways to self-harm related to the lack of social acceptance of their gender identity. However, robust longitudinal research which examines gender-specific factors is now necessary to establish this pathway.
PubMed: 38468947
DOI: 10.1016/j.heliyon.2024.e26074 -
International Journal of Molecular... Nov 2023Fabry disease is a lysosomal disease characterized by globotriaosylceramide (Gb3) accumulation. It may coexist with diabetes mellitus and both cause potentially lethal...
Fabry disease is a lysosomal disease characterized by globotriaosylceramide (Gb3) accumulation. It may coexist with diabetes mellitus and both cause potentially lethal kidney end-organ damage. However, there is little information on their interaction with kidney disease. We have addressed the interaction between Fabry disease and diabetes in data mining of human kidney transcriptomics databases and in Fabry (-/-) and wild type mice with or without streptozotocin-induced diabetes. Data mining was consistent with differential expression of genes encoding enzymes from the Gb3 metabolic pathway in human diabetic kidney disease, including upregulation of , the gene encoding the upstream and rate-limiting enzyme glucosyl ceramide synthase. Diabetic Fabry mice displayed the most severe kidney infiltration by F4/80+ macrophages, and a lower kidney expression of kidney protective genes ( and ) than diabetic wild type mice, without a further increase in kidney fibrosis. Moreover, only diabetic Fabry mice developed kidney insufficiency and these mice with kidney insufficiency had a high expression of . In conclusion, we found evidence of interaction between diabetes and Fabry disease that may increase the severity of the kidney phenotype through modulation of the Gb3 synthesis pathway and downregulation of kidney protective genes.
Topics: Humans; Mice; Animals; Fabry Disease; Protective Factors; Kidney; Kidney Diseases; Renal Insufficiency; Diabetes Mellitus; Trihexosylceramides; alpha-Galactosidase
PubMed: 37958836
DOI: 10.3390/ijms242115853 -
Blood Cancer Journal Dec 2023Patients with multiple myeloma (MM), an age-dependent neoplasm of antibody-producing plasma cells, have compromised immune systems and might be at increased risk for...
Sample average treatment effect on the treated (SATT) analysis using counterfactual explanation identifies BMT and SARS-CoV-2 vaccination as protective risk factors associated with COVID-19 severity and survival in patients with multiple myeloma.
Patients with multiple myeloma (MM), an age-dependent neoplasm of antibody-producing plasma cells, have compromised immune systems and might be at increased risk for severe COVID-19 outcomes. This study characterizes risk factors associated with clinical indicators of COVID-19 severity and all-cause mortality in myeloma patients utilizing NCATS' National COVID Cohort Collaborative (N3C) database. The N3C consortium is a large, centralized data resource representing the largest multi-center cohort of COVID-19 cases and controls nationwide (>16 million total patients, and >6 million confirmed COVID-19+ cases to date). Our cohort included myeloma patients (both inpatients and outpatients) within the N3C consortium who have been diagnosed with COVID-19 based on positive PCR or antigen tests or ICD-10-CM diagnosis code. The outcomes of interest include all-cause mortality (including discharge to hospice) during the index encounter and clinical indicators of severity (i.e., hospitalization/emergency department/ED visit, use of mechanical ventilation, or extracorporeal membrane oxygenation (ECMO)). Finally, causal inference analysis was performed using the Coarsened Exact Matching (CEM) and Propensity Score Matching (PSM) methods. As of 05/16/2022, the N3C consortium included 1,061,748 cancer patients, out of which 26,064 were MM patients (8,588 were COVID-19 positive). The mean age at COVID-19 diagnosis was 65.89 years, 46.8% were females, and 20.2% were of black race. 4.47% of patients died within 30 days of COVID-19 hospitalization. Overall, the survival probability was 90.7% across the course of the study. Multivariate logistic regression analysis showed histories of pulmonary and renal disease, dexamethasone, proteasome inhibitor/PI, immunomodulatory/IMiD therapies, and severe Charlson Comorbidity Index/CCI were significantly associated with higher risks of severe COVID-19 outcomes. Protective associations were observed with blood-or-marrow transplant/BMT and COVID-19 vaccination. Further, multivariate Cox proportional hazard analysis showed that high and moderate CCI levels, International Staging System (ISS) moderate or severe stage, and PI therapy were associated with worse survival, while BMT and COVID-19 vaccination were associated with lower risk of death. Finally, matched sample average treatment effect on the treated (SATT) confirmed the causal effect of BMT and vaccination status as top protective factors associated with COVID-19 risk among US patients suffering from multiple myeloma. To the best of our knowledge, this is the largest nationwide study on myeloma patients with COVID-19.
Topics: Female; Humans; Male; COVID-19; SARS-CoV-2; COVID-19 Vaccines; Multiple Myeloma; Protective Factors; COVID-19 Testing; Risk Factors; Vaccination
PubMed: 38057320
DOI: 10.1038/s41408-023-00901-y -
Journal of Obstetrics and Gynaecology :... Dec 2024Many risk factors in uterine fibroid development have been identified, but women and their physicians are less aware of the influence of lifestyle on uterine fibroid... (Review)
Review
BACKGROUND
Many risk factors in uterine fibroid development have been identified, but women and their physicians are less aware of the influence of lifestyle on uterine fibroid development. The objective of this systematic review is to investigate and summarize modifiable prognostic factors associated with uterine fibroid development.
METHODS
Pubmed and Embase were searched for relevant articles according to PRISMA guidelines. References from included articles were screened and when relevant also included. Human in vivo studies on modifiable factors in fibroid development were included. Studies on non-modifiable factors and treatment, in vitro studies and animal studies were excluded. 607 articles were screened and 33 articles were included. Two independent investigators collected data from the report.
RESULTS
The strongest risk factor for fibroid development was a high BMI, while the strongest protective factors were a high fruit and vegetable intake and high vitamin D intake.
CONCLUSION
More high-quality studies are necessary to better understand the impact of the abovementioned factors as well as the role they play in the growth of already existing fibroids.
Topics: Animals; Female; Humans; Uterine Neoplasms; Prognosis; Leiomyoma; Risk Factors
PubMed: 38102975
DOI: 10.1080/01443615.2023.2288225 -
Behavioral Sciences (Basel, Switzerland) Oct 2023Depression is one of the most common psychological problems in adolescence. Familial and school-related factors are closely related to adolescents' depression, but their...
Depression is one of the most common psychological problems in adolescence. Familial and school-related factors are closely related to adolescents' depression, but their combined effects need further examination. The purpose of this study was to explore the combined effects of risk/protective factors of depression in family and school domains using a sample of Chinese adolescents differing in gender, age group and left-behind status. A total of 2455 Chinese students in primary and secondary school participated in the cross-sectional survey and reported multiple risk/protective factors in family and school environments and depressive symptoms. Association rule mining, a machine learning method, was used in the data analyses to identify the correlation between risk/protective factor combinations and depression. We found that (1) Family cohesion, family conflict, peer support, and teacher support emerged as the strongest factors associated with adolescent depression; (2) The combination of these aforementioned factors further strengthened their association with depression; (3) Female gender, middle school students, and family socioeconomic disadvantages attenuated the protective effects of positive relational factors while exacerbating the deleterious effects of negative relational factors; (4) For individuals at risk, lack of mental health education resources at school intensified the negative impact; (5) The risk and protective factors of depression varied according to gender, age stage and left-behind status. In conclusion, the findings shed light on the identification of high-risk adolescents for depression and underscore the importance of tailored programs targeting specific subgroups based on gender, age, or left-behind status.
PubMed: 37998640
DOI: 10.3390/bs13110893