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Sexual Abuse : a Journal of Research... Sep 2022A Five-Level Risk and Needs system has been proposed as a common language for standardizing the meaning of risk levels across risk/need tools used in corrections. Study...
A Five-Level Risk and Needs system has been proposed as a common language for standardizing the meaning of risk levels across risk/need tools used in corrections. Study 1 examined whether the Five-Levels could be applied to BARR-2002R ( = 2,390), an actuarial tool for general recidivism. Study 2 examined the construct validity of BARR-2002R risk levels in two samples of individuals with a history of sexual offending ( = 1,081). Study 1 found reasonable correspondence between BARR-2002R scores and four of the five standardized risk levels (no Level V). Study 2 found that the profiles of individuals in Levels II, III, and IV were mostly consistent with expectations; however, individuals in the lowest risk level (Level I) had more criminogenic needs than expected based on the original descriptions of the Five-Levels. The Five-Level system was mostly successful when applied to BARR-2002R. Revisions to this system, or the inclusion of putatively dynamic risk factors and protective factors, may be required to improve alignment with the information provided by certain risk tools.
Topics: Communication; Humans; Recidivism; Risk Assessment; Risk Factors; Sex Offenses
PubMed: 34670458
DOI: 10.1177/10790632211047185 -
Circulation Research Jun 2023Cardiometabolic diseases, including cardiovascular disease and diabetes, are major causes of morbidity and mortality worldwide. Despite progress in prevention and... (Review)
Review
Cardiometabolic diseases, including cardiovascular disease and diabetes, are major causes of morbidity and mortality worldwide. Despite progress in prevention and treatment, recent trends show a stalling in the reduction of cardiovascular disease morbidity and mortality, paralleled by increasing rates of cardiometabolic disease risk factors in young adults, underscoring the importance of risk assessments in this population. This review highlights the evidence for molecular biomarkers for early risk assessment in young individuals. We examine the utility of traditional biomarkers in young individuals and discuss novel, nontraditional biomarkers specific to pathways contributing to early cardiometabolic disease risk. Additionally, we explore emerging omic technologies and analytical approaches that could enhance risk assessment for cardiometabolic disease.
Topics: Young Adult; Humans; Cardiovascular Diseases; Risk Assessment; Biomarkers; Risk Factors
PubMed: 37289904
DOI: 10.1161/CIRCRESAHA.123.322000 -
The British Journal of Psychiatry : the... Oct 2016People with a history of self-harm are at a far greater risk of suicide than the general population. However, the relationship between self-harm and suicide is complex. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
People with a history of self-harm are at a far greater risk of suicide than the general population. However, the relationship between self-harm and suicide is complex.
AIMS
To undertake the first systematic review and meta-analysis of prospective studies of risk factors and risk assessment scales to predict suicide following self-harm.
METHOD
We conducted a search for prospective cohort studies of populations who had self-harmed. For the review of risk scales we also included studies examining the risk of suicide in people under specialist mental healthcare, in order to broaden the scope of the review and increase the number of studies considered. Differences in predictive accuracy between populations were examined where applicable.
RESULTS
Twelve studies on risk factors and 7 studies on risk scales were included. Four risk factors emerged from the meta-analysis, with robust effect sizes that showed little change when adjusted for important potential confounders. These included: previous episodes of self-harm (hazard ratio (HR) = 1.68, 95% CI 1.38-2.05, K = 4), suicidal intent (HR = 2.7, 95% CI 1.91-3.81, K = 3), physical health problems (HR = 1.99, 95% CI 1.16-3.43, K = 3) and male gender (HR = 2.05, 95% CI 1.70-2.46, K = 5). The included studies evaluated only three risk scales (Beck Hopelessness Scale (BHS), Suicide Intent Scale (SIS) and Scale for Suicide Ideation). Where meta-analyses were possible (BHS, SIS), the analysis was based on sparse data and a high heterogeneity was observed. The positive predictive values ranged from 1.3 to 16.7%.
CONCLUSIONS
The four risk factors that emerged, although of interest, are unlikely to be of much practical use because they are comparatively common in clinical populations. No scales have sufficient evidence to support their use. The use of these scales, or an over-reliance on the identification of risk factors in clinical practice, may provide false reassurance and is, therefore, potentially dangerous. Comprehensive psychosocial assessments of the risks and needs that are specific to the individual should be central to the management of people who have self-harmed.
Topics: Risk Assessment; Risk Factors; Suicide
PubMed: 27340111
DOI: 10.1192/bjp.bp.115.170050 -
Open Heart Nov 2022Cardiovascular risk estimation is an essential step to reduce the onset of adverse cardiovascular events. For this purpose, the Systematic Coronary Risk Evaluation...
OBJECTIVE
Cardiovascular risk estimation is an essential step to reduce the onset of adverse cardiovascular events. For this purpose, the Systematic Coronary Risk Evaluation (SCORE) risk chart method was used in Europe. In 2021, the SCORE2 algorithm was released, bringing changes in the calculation methodology. This study assessed and compared the level of cardiovascular risk in a population aged 40-65 years using the SCORE and SCORE2 methodologies.
METHODS
This cross-sectional study included a total of 85 802 patients in Hungary. Cardiovascular risk levels were determined using the SCORE and SCORE2 risk estimation methods.
RESULTS
Using SCORE, 97.7% of men aged 40-50 years were classified as low-moderate risk, which decreased to 32.4% using SCORE2. Using SCORE, 100% of women aged 40-50 years were classified as low-moderate risk, compared with 75.6% using SCORE2. Using SCORE, 36.8% of men aged 50-65 years were classified as high risk and 14.8% as very high risk, and 5.4% of women aged 50-65 years were classified as high risk and 0.5% as very high risk. In this age group, using SCORE2, 50% of men were classified as high risk and 25.8% as very high risk, and 38.8% of women were classified as high risk and 11.9% as very high risk.
CONCLUSIONS
When the SCORE2 method was used instead of SCORE 43.91% of the whole population were classified with a higher level of risk, which represents a radical increase in the number of patients with high or very high cardiovascular risk.
Topics: Male; Humans; Female; Cross-Sectional Studies; Cardiovascular Diseases; Risk Factors; Heart; Heart Disease Risk Factors
PubMed: 36442905
DOI: 10.1136/openhrt-2022-002087 -
European Journal of Heart Failure Nov 2020
Topics: Cardiology; Cardiovascular Diseases; Heart Disease Risk Factors; Heart Failure; Humans; Neoplasms; Risk Assessment; Risk Factors
PubMed: 32892435
DOI: 10.1002/ejhf.1999 -
PloS One 2022The need to evaluate suppliers from the perspective of risk analysis by purchasing companies is increasing. Such evaluation of suppliers is conducted primarily by...
The need to evaluate suppliers from the perspective of risk analysis by purchasing companies is increasing. Such evaluation of suppliers is conducted primarily by production companies with implemented quality (QMS), environmental (EMS), health and safety management systems (H&SMS), as well as Toyota Production System (TPS). This article aims to examine latent factors for suppliers' evaluation and to describe the intensity of these factors by the implemented management system. The article provides the results of empirical research conducted with the computer-assisted telephone interviewing (CATI) technique in 151 medium and large manufacturing companies operating in Poland. The risk was classified into three main groups to deepen the research process: management system risks, environment risks, and process risks. This allowed for the formulation of some original conclusions. The results showed that companies implementing standardized management systems take the issue of risk analysis and management more seriously than organizations that do not implement such systems. The research also highlighted the differences in the perception of risk caused by implementing various management systems. The study also found that the industry and business profile specificity also affect the risk assessment in cooperation with suppliers.
Topics: Poland; Risk Assessment; Risk Factors; Risk Management; Safety Management
PubMed: 35913910
DOI: 10.1371/journal.pone.0272157 -
Current HIV/AIDS Reports Aug 2021To provide the current state of the development and application of cardiovascular disease (CVD) prediction tools in people living with HIV (PLWH). (Review)
Review
PURPOSE OF REVIEW
To provide the current state of the development and application of cardiovascular disease (CVD) prediction tools in people living with HIV (PLWH).
RECENT FINDINGS
Several risk prediction models developed on the general population are available to predict CVD risk, the most notable being the US-based pooled cohort equations (PCE), the Framingham risk functions, and the Europe-based SCORE (Systematic COronary Risk Evaluation). In validation studies in cohorts of PLWH, these models generally underestimate CVD risk, especially in individuals who are younger, women, Black race, or predicted to be at low/intermediate risk. An HIV-specific CVD prediction model, the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) model, is available, but its performance is modest, especially in US-based cohorts. Enhancing CVD prediction with novel biomarkers of inflammation or coronary artery calcification is of interest but has not yet been evaluated in PLWH. Finally, studies on CVD risk prediction are lacking in diverse PLWH globally. While available risk models for CVD prediction in PLWH remain suboptimal, clinicians should remain vigilant of higher CVD risk in this population and should use any of these risk scores for risk stratification to guide preventive interventions. Focus on established traditional risk factors such as smoking remains critical in PLWH. Risk prediction functions tailored to PLWH in diverse settings will enhance clinicians' ability to deliver optimal preventive care.
Topics: Cardiovascular Diseases; Female; HIV Infections; Heart Disease Risk Factors; Humans; Risk Assessment; Risk Factors
PubMed: 34247329
DOI: 10.1007/s11904-021-00567-w -
Atherosclerosis Aug 2021An untargeted metabolomics approach allows for a better understanding and identification of new candidate metabolites involved in the etiology of vascular disease. We...
BACKGROUND AND AIMS
An untargeted metabolomics approach allows for a better understanding and identification of new candidate metabolites involved in the etiology of vascular disease. We aimed to investigate the associations of cardiovascular (CV) risk factors with the metabolic fingerprint and macro- and microvascular health in an untargeted metabolomic approach in predefined CV risk groups of aged individuals.
METHODS
The metabolic fingerprint and the macro- and microvascular health from 155 well-characterized aged (50-80 years) individuals, based on the EXAMIN AGE study, were analysed. Nuclear magnetic resonance spectroscopy was used to analyse the metabolic fingerprint. Carotid-femoral pulse wave velocity and retinal vessel diameters were assessed to quantify macro- and microvascular health.
RESULTS
The metabolic fingerprint became more heterogeneous with an increasing number of risk factors. There was strong evidence for higher levels of glutamine [estimate (95% CI): -14.54 (-17.81 to -11.27), p < 0.001], glycine [-5.84 (-7.88 to -3.79), p < 0.001], histidine [-0.73 (-0.96 to -0.50), p < 0.001], and acetate [-1.68 (-2.91 to -0.46), p = 0.007] to be associated with a lower CV risk profile. Tryptophan, however, was positively associated with higher CV risk [0.31 (0.06-0.56), p = 0.015]. The combination of a priori defined CV risk factors explained up to 45.4% of the metabolic variation. The metabolic fingerprint explained 20% of macro- and 23% of microvascular variation.
CONCLUSIONS
Metabolic profiling has the potential to improve CV risk stratification by identifying new underlying metabolic pathways associated with atherosclerotic disease development, from cardiovascular risk to metabolites, to vascular end organ damage.
Topics: Cardiovascular Diseases; Heart Disease Risk Factors; Humans; Metabolomics; Pulse Wave Analysis; Risk Factors
PubMed: 34344526
DOI: 10.1016/j.atherosclerosis.2021.07.005 -
Psychological Medicine Jun 2020A multitude of risk/protective factors for anxiety and obsessive-compulsive disorders have been proposed. We conducted an umbrella review to summarize the evidence of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
A multitude of risk/protective factors for anxiety and obsessive-compulsive disorders have been proposed. We conducted an umbrella review to summarize the evidence of the associations between risk/protective factors and each of the following disorders: specific phobia, social anxiety disorder, generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder, and to assess the strength of this evidence whilst controlling for several biases.
METHODS
Publication databases were searched for systematic reviews and meta-analyses examining associations between potential risk/protective factors and each of the disorders investigated. The evidence of the association between each factor and disorder was graded into convincing, highly suggestive, suggestive, weak, or non-significant according to a standardized classification based on: number of cases (>1000), random-effects p-values, 95% prediction intervals, confidence interval of the largest study, heterogeneity between studies, study effects, and excess of significance.
RESULTS
Nineteen systematic reviews and meta-analyses were included, corresponding to 216 individual studies covering 427 potential risk/protective factors. Only one factor association (early physical trauma as a risk factor for social anxiety disorder, OR 2.59, 95% CI 2.17-3.1) met all the criteria for convincing evidence. When excluding the requirement for more than 1000 cases, five factor associations met the other criteria for convincing evidence and 22 met the remaining criteria for highly suggestive evidence.
CONCLUSIONS
Although the amount and quality of the evidence for most risk/protective factors for anxiety and obsessive-compulsive disorders is limited, a number of factors significantly increase the risk for these disorders, may have potential prognostic ability and inform prevention.
Topics: Anxiety Disorders; Humans; Obsessive-Compulsive Disorder; Protective Factors; Risk Factors
PubMed: 31172897
DOI: 10.1017/S0033291719001247 -
Health Security 2017In the decades to come, advanced bioweapons could threaten human existence. Although the probability of human extinction from bioweapons may be low, the expected value...
In the decades to come, advanced bioweapons could threaten human existence. Although the probability of human extinction from bioweapons may be low, the expected value of reducing the risk could still be large, since such risks jeopardize the existence of all future generations. We provide an overview of biotechnological extinction risk, make some rough initial estimates for how severe the risks might be, and compare the cost-effectiveness of reducing these extinction-level risks with existing biosecurity work. We find that reducing human extinction risk can be more cost-effective than reducing smaller-scale risks, even when using conservative estimates. This suggests that the risks are not low enough to ignore and that more ought to be done to prevent the worst-case scenarios.
Topics: Cost-Benefit Analysis; Existentialism; Humans; Models, Economic; Probability; Quality-Adjusted Life Years; Risk; Risk Assessment; Risk Factors
PubMed: 28806130
DOI: 10.1089/hs.2017.0028