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Ethnicity & Disease 2022Cost-related nonadherence to health maintenance behaviors is common in the general population, yet we know little about these behaviors in Middle East and North African...
OBJECTIVE
Cost-related nonadherence to health maintenance behaviors is common in the general population, yet we know little about these behaviors in Middle East and North African (MENA) Americans. We examined cost-related nonadherence (CRN) in the MENA community in SE Michigan to determine demographic predictors, and risk and protective factors.
DESIGN SETTING AND PARTICIPANTS
We used data from a cross-sectional convenience sample of MENA adults (N=398) conducted May-September 2019 to identify relevant demographic predictors, as well as the association between individual health, social, and clinical factors and the likelihood of reporting CRN.
METHODS AND MEASURES
CRN was defined by whether respondents reported any of the following: that they took less medicine, skipped doses, or delayed getting a prescription filled. Other factors included patient/provider communication and racial concordance, mental health distress, food insecurity and insurance status. We used multivariable logistic regression models to determine association of these health and social factors with CRN.
RESULTS
Those with highest incomes were least likely to report CRN. Participants with private insurance and with no coverage were more likely to report CRN compared with those with Medicaid coverage. Risk factors for CRN included food insecurity and mental health distress, though strong patient/provider communication was protective of CRN.
DISCUSSION
The risk factors for CRN in the MENA community align with risk factors in the general population. As provider communication is protective of CRN, interventions focused on improving patient/provider communication may serve as a way to protect against financially motivated medication nonadherence.
Topics: Adult; Cross-Sectional Studies; Humans; Insurance Coverage; Medication Adherence; Protective Factors; Risk Factors; United States
PubMed: 35106040
DOI: 10.18865/ed.32.1.11 -
Journal of Affective Disorders Oct 2023Suicidal behavior is strongly associated with major affective disorders, but there is a need to quantify and compare specific risk and protective factors in bipolar...
BACKGROUND
Suicidal behavior is strongly associated with major affective disorders, but there is a need to quantify and compare specific risk and protective factors in bipolar disorder (BD) and major depressive disorder (MDD).
METHODS
In 4307 extensively evaluated major affective-disorder participants with BD (n = 1425) or MDD (n = 2882) diagnosed by current international criteria, we compared characteristics among those with versus without suicidal acts from illness-onset through 8.24 years of follow-up.
RESULTS
Suicidal acts were identified in 11.4 % of participants; 25.9 % were violent and 6.92 % (0.79 % of all participants) were fatal. Associated risk factors included: diagnosis (BD > MDD), manic/psychotic features in first-episodes, family history of suicide or BD, separation/divorce, early abuse, young at illness-onset, female sex with BD, substance abuse, higher irritable, cyclothymic or dysthymic temperament ratings, greater long-term morbidity, and lower intake functional ratings. Protective factors included marriage, co-occurring anxiety disorder, higher ratings of hyperthymic temperament and depressive first episodes. Based on multivariable logistic regression, five factors remained significantly and independently associated with suicidal acts: BD diagnosis, more time depressed during prospective follow-up, younger at onset, lower functional status at intake, and women > men with BD.
LIMITATIONS
Reported findings may or may not apply consistently in other cultures and locations.
CONCLUSIONS
Suicidal acts including violent acts and suicides were more prevalent with BD than MDD. Of identified risk (n = 31) and protective factors (n = 4), several differed with diagnosis. Their clinical recognition should contribute to improved prediction and prevention of suicide in major affective disorders.
Topics: Male; Humans; Female; Depressive Disorder, Major; Prospective Studies; Suicidal Ideation; Protective Factors; Suicide; Temperament; Risk Factors; Puerperal Disorders
PubMed: 37301296
DOI: 10.1016/j.jad.2023.06.018 -
Journal of Neurodevelopmental Disorders Jul 2019Reduced executive functions (EF) are commonly associated with developmental conditions (e.g., autism spectrum disorder, ASD; attention deficit/hyperactivity disorder,... (Review)
Review
Infant regulatory function acts as a protective factor for later traits of autism spectrum disorder and attention deficit/hyperactivity disorder but not callous unemotional traits.
BACKGROUND
Reduced executive functions (EF) are commonly associated with developmental conditions (e.g., autism spectrum disorder, ASD; attention deficit/hyperactivity disorder, ADHD), although EF seems to be typical in children with callous unemotional (CU) traits. Regulatory function (RF) is a proposed infant precursor that maps on onto factors driving later EF. Here, we first test whether RF is specifically and negatively associated with ASD and ADHD traits, but not CU traits. Second, we test whether RF can act as a protective factor, by moderating the association between infant markers and subsequent ASD and ADHD traits.
METHODS
Participants were 79 infants at high (N = 42) and low (N = 37) familial risk for ASD. Data come from the 14-month infant visit (Autism Observational Scale for Infants; AOSI; activity level and RF from the Infant Behavior Questionnaire; IBQ) and the 7-year visit (ASD traits: Social Responsiveness Scale, SRS; ADHD traits: Conners 3, CU traits: Inventory of Callous Unemotional Traits).
RESULTS
Infant RF was negatively associated with later traits of ASD (B = - 0.5, p = 0.01) and ADHD inattention (B = - 0.24, p = 0.02) but not hyperactivity (B = - 0.25, p = 0.10) or CU traits (B = 0.02, p = 0.86). RF moderated the association between infant AOSI score and ASD traits, with a significant effect in those with low RF (B = 0.10, p = 0.006), not high RF (B = 0.01, p = 0.78). Similarly, for ADHD, infant activity level was associated with later ADHD inattention in those with low (B = 0.17, p = 0.04) but not high RF (B = 0.07, p = 0.48). For ADHD hyperactivity symptoms, activity level was predictive at both high and low levels of RF.
CONCLUSIONS
Strong RF may allow children to compensate for other atypicalities, thus attenuating the association between infant markers and later disorder traits. Whilst infant RF was associated with both ASD and ADHD inattention traits, there was no association with ADHD hyperactivity or CU traits. This suggests that any protective effect may not be universal and emphasises the need for a better understanding of the underlying moderating mechanisms.
Topics: Attention Deficit Disorder with Hyperactivity; Autism Spectrum Disorder; Child; Child, Preschool; Conduct Disorder; Executive Function; Female; Genetic Predisposition to Disease; Humans; Infant; Longitudinal Studies; Male; Protective Factors; Self-Control
PubMed: 31351456
DOI: 10.1186/s11689-019-9274-0 -
Trauma, Violence & Abuse Dec 2023This study systematically reviews and synthesizes evidence on parental risk and protective factors along with identifying differences in the presence of these factors... (Review)
Review
This study systematically reviews and synthesizes evidence on parental risk and protective factors along with identifying differences in the presence of these factors based on maltreatment type. In all, 68 quantitative, published, empirical studies were included from electronic databases for the systematic review. Quality appraisal did not exclude any studies and data were extracted from all. Results were narratively synthesized using the Risk and Resilience Ecological framework. The findings revealed more risk factors on the micro (individual and family) ecological level compared to mezzo and macro levels. At the micro level, findings mirror results of prior systematic reviews such as parental substance abuse, history of childhood maltreatment, and intimate partner violence (IPV). Social support was the most significant protective factor across all ecological levels and across all maltreatment types except child sexual abuse but differed in definition widely across studies. Physical abuse had the most risk factors unique to this type followed by neglect, and IPV was a common risk factor across all maltreatment types. Fewer studies on emotional abuse, sexual abuse, and protective factors were identified. The findings of this review delineated key parental risk and protective factors at various ecological levels along with associations between distinct factors and types of maltreatment. Interventions working with parents to reduce child maltreatment risk can use these findings to guide development of targeted programs for families based on risk and maltreatment type. For researchers, the findings can guide further investigation in under-researched areas of parental sexual and emotional abuse and protective factors.
Topics: Humans; Child; Protective Factors; Child Abuse; Child Abuse, Sexual; Physical Abuse; Parents; Risk Factors
PubMed: 36448533
DOI: 10.1177/15248380221134634 -
Frontiers in Public Health 2022Blue sky has been considered to boost outdoor physical activity and social interaction, ameliorate work pressure and life stress, and enhance people's sense of...
OBJECTIVE
Blue sky has been considered to boost outdoor physical activity and social interaction, ameliorate work pressure and life stress, and enhance people's sense of happiness. However, the direct association between blue sky exposure and cardiovascular disease (CVD) still lacks epidemiological evidence. In this study, we aimed to quantify their relationship via a nationwide prospective cohort in China.
METHOD
We extracted the baseline data from the China Hypertension Survey (CHS), by enrolling 22,702 participants aged ≥ 35 years without self-reported medical history of CVD from 14 provinces of China between 2012 and 2015 and followed up from 2018 to 2019. A blue day was marked out with no rain, low cloud cover ≤ climatological mean at each station, and visibility at 2 pm ≥ 21.52 km. We calculated the number of blue days at baseline survey year to evaluate the chronic individual blue day exposure. Cox proportional hazards models were employed to calculate the multivariable-adjusted hazard ratio (HR). We implemented subgroup analyses as well to identify potential effect modifications.
RESULTS
A total of 1,096, 993, and 597 incident cases of all-cause mortality, fatal or nonfatal CVD, and stroke occurred during a median follow-up around 5 years, respectively. A 10-day increase in annual blue day exposure was associated with a 3% (95% confidence interval [CI]: 1-6%) and 7% (95% CI: 5-10%) decreased risk of fatal or nonfatal CVD and stroke, respectively. Compared with those exposed to the worst tertile of blue days at baseline, subjects who exposed to the best tertile had a 32% (95% CI: 19-43%) and 43% (95% CI: 29-55%) lower likelihood of developing fatal or nonfatal CVD and stroke, respectively. Negative consistent exposure-response relationships were generally observed between them in the restricted cubic spline model. In the stratified analyses, the cardioprotective effects of blue sky were stronger for females, rural residents, and individuals residing in heavily contaminated areas.
CONCLUSION
This study indicates that blue sky may serve as an independent environmental protective factor against CVD, and informs future policies on fighting air pollution and protecting the blue sky in China.
Topics: Female; Humans; Cardiovascular Diseases; Prospective Studies; Protective Factors; Air Pollution; Stroke
PubMed: 36311620
DOI: 10.3389/fpubh.2022.1016853 -
Ciencia & Saude Coletiva Oct 2020The consolidation of practices aimed at enhancing resilience corroborates the current paradigm shift within the scope of adolescent health promotion, in which the... (Review)
Review
The consolidation of practices aimed at enhancing resilience corroborates the current paradigm shift within the scope of adolescent health promotion, in which the individual's singularity is considered, as well as his/her relationship with the environment. The scope of the undertaking was to identify protective factors involved in the process of resilience among adolescents. This paper reviews indexed publications describing adolescent care models and interventions. The analysis of the texts consisted of: 1) comparing the similarities and differences between the concepts used; and 2) identifying, grouping and compiling the most cited protection factors. A total of 17 articles that strive to enhance resilience in six different practical contexts were analyzed. Based on the protection factors found, 17 actions were generated to guide the development of educational works in health. Protective factors related to "Problem solving", "Valorization of the individual" and "Ability in communication" were identified in several contexts of study on adolescence. These factors represent transversal aspects necessary to enhance resilience and should be stimulated together in order to foster the healthy development of adolescents.
Topics: Adolescent; Adolescent Health; Female; Health Promotion; Humans; Male; Protective Factors; Resilience, Psychological
PubMed: 32997025
DOI: 10.1590/1413-812320202510.22312018 -
Sao Paulo Medical Journal = Revista... 2021In a literate society, linguistic/arithmetic performance is highly valued. Based on defined risk factors, strategies for promotion of better performance can be developed.
BACKGROUND
In a literate society, linguistic/arithmetic performance is highly valued. Based on defined risk factors, strategies for promotion of better performance can be developed.
OBJECTIVE
To ascertain the risk and protective factors relating to development of language and arithmetic.
DESIGN AND SETTING
Observational comparative cross-sectional study at a public elementary school in Ribeirão Preto (SP), Brazil.
METHODS
A total of 66 children (41% females) attending first to fifth grades participated in this study. They were divided into two groups: G1, children classified as presenting language or arithmetic deficits; G2, average performance. Language (oral and written) and arithmetic skills were assessed through standardized tests. Variables relating to social skills, home environment resources and behavioral problems were assessed through standardized scales. Data on other variables (pre, peri and postnatal complications, maternal variables and others) were collected through interviews. The logistic regression technique with LASSO was used (α = 0.05).
RESULTS
Teenage pregnancy and consumption of psychoactive substances during pregnancy or complications during pregnancy were risk factors for performance regarding arithmetic and language. Higher schooling level for the mother was a protective factor in the development of arithmetic and language. Being female and having a history of otitis were risk factors for language. Altered social skills (responsibility and civility) and complaints of inattention were risk factor for arithmetic. Adequate linguistic development was a protective factor for the development of arithmetic.
CONCLUSION
The risk/protective factors included variables relating to the gestational period, mother's age when pregnant, mother's schooling, social skills, behavior and development issues.
Topics: Adolescent; Brazil; Child; Cross-Sectional Studies; Female; Humans; Language; Language Development; Male; Mathematics; Protective Factors
PubMed: 33729418
DOI: 10.1590/1516-3180.2020.0280.R1.10122020 -
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 -
American Journal of Preventive Medicine Mar 2022Nicotine and marijuana vaping among U.S. adolescents are public health priorities. Research has assessed the demographic and risk factors related to vaping, but there is...
INTRODUCTION
Nicotine and marijuana vaping among U.S. adolescents are public health priorities. Research has assessed the demographic and risk factors related to vaping, but there is a dearth of research on protective factors for vaping. On the basis of the healthy youth development perspective, the developmental assets framework is used to assess cumulative protective factors and vaping in a national sample of adolescents.
METHODS
Data came from the nationally representative Monitoring the Future study, consisting of 12th graders (n=6,982) from the 48 contiguous U.S. states (2017-2019). Past 30-day nicotine and marijuana vaping and developmental assets (low, medium, or high) were examined. Covariates included demographics and other substance use. Weighted descriptive statistics, logistic regression, postestimation analyses, and multiple imputation were used.
RESULTS
Students with higher assets were less likely to vape nicotine and marijuana, even after adjusting for covariates. The odds of nicotine vaping were lower for students with medium assets (AOR=0.65, 95% CI=0.54, 0.78) and high assets (AOR=0.22, 95% CI=0.16, 0.29) than for students with low assets. Similarly, the odds of marijuana vaping were lower for youth with medium assets (AOR=0.54, 95% CI=0.42, 0.69) and high assets (AOR=0.09, 95% CI=0.05, 0.18) than for those with low assets. Social competence and positive peer norms were strongly protective against both forms of vaping.
CONCLUSIONS
The healthy youth development perspective applies to the critical issues of nicotine and marijuana vaping among adolescents. Promoting cumulative assets may help to prevent vaping among U.S. adolescents, and increasing the specific assets of social competence and positive peer norms could be particularly fruitful.
Topics: Adolescent; Cannabis; Electronic Nicotine Delivery Systems; Humans; Nicotine; Protective Factors; Vaping
PubMed: 34924259
DOI: 10.1016/j.amepre.2021.08.022 -
Mendelian randomization analysis reveals fresh fruit intake as a protective factor for urolithiasis.Human Genomics Oct 2023Previous studies have proposed that food intakes are associated with the risk of urolithiasis. Here, we conducted a two-sample Mendelian randomization (MR) study to...
OBJECTIVE
Previous studies have proposed that food intakes are associated with the risk of urolithiasis. Here, we conducted a two-sample Mendelian randomization (MR) study to evaluate the causal effects of different food intakes on urolithiasis.
METHODS
Independent genetic variants associated with different food intakes at a genome-wide significant level were selected from summary-level statistics of genome-wide association studies from the UK Biobank. The association of these instrumental variables with urolithiasis was studied in a cohort from FinnGen Consortium.
RESULTS
Among the 15 studied food intake exposures, tea intake (odds ratio [OR] = 0.433, 95% confidence interval [CI] = 0.281-0.667, p value = 1.470 × 10) and fresh fruit intake (OR = 0.358, 95% CI = 0.185-0.694, p value = 0.002) were found to significantly reduce the risk of the calculus of kidney and ureter. The association remained consistent in the sensitivity analyses. After adjusting for the effects of vitamin D and vitamin C, fresh fruit intake remained the reverse causal association with the calculus of kidney and ureter.
CONCLUSIONS
Genetically proxied fresh fruit intake is causally associated with a reduced risk of the calculus of kidney and ureter.
Topics: Humans; Protective Factors; Mendelian Randomization Analysis; Fruit; Genome-Wide Association Study; Urolithiasis; Calculi; Polymorphism, Single Nucleotide
PubMed: 37789450
DOI: 10.1186/s40246-023-00523-2