The healing and preventive powers of people's health resources and self-assessed knowledge have so far been grossly underestimated in medicine. In this article, we call attention to ethical and epistemological dilemmas related to knowledge, values, communication, and autonomy embedded in the prevailing risk-oriented epidemiology, and suggest a patient-centred salutogenetic approach to promote a better balance between resources and risks in medicine. Identification and intervention upon risk factors can provide hypotheses about origins of disease and predict and sometimes (...) prevent disease at a group level. However, there are several pitfalls related to this perspective concerning causal factors, group level based possibilities, adequate end points for intervention, informed consent, and medicalization, especially in the individualized context of the clinical encounter. By introducing a salutogenic perspective, we urge to shift the attention toward resources, agency and strength, which may counteract risk of disease and empower the patient. Talk can mediate oppression as well as empowerment. A communicative key question approach, and self-assessed health resources identified through this strategy, are briefly presented as examples of empowerment through dialogue. (shrink)

_Background:_ Preterm infants are still at an increased risk for suboptimal neurodevelopmental outcomes when compared with term born infants. The development of a child born preterm can be jeopardized by suboptimal conditions during pregnancy, in addition to the suboptimal growth environment postnatally compared to the normal in utero environment. This review summarizes the literature on the role of chorioamnionitis, placental insufficiency, and maternal smoking on the developmental outcomes of preterm infants. _Methods:_ A systematic database search was performed to identify (...) all original articles published on or before September 12, 2018 that evaluated the impact of clinical or histological chorioamnionitis, abnormal prenatal fetal and placental blood flow, and prenatal smoking exposure on the neuropsychological and cognitive outcomes of preterm infants. We identified a total of 54 studies. Thirty five original articles evaluated the effects of clinical or histological chorioamnionitis; 15 studies evaluated the effects of abnormal blood flow patterns; and four studies evaluated the effects of maternal smoking during pregnancy. _Results:_ The studies on prenatal risk factors showed conflicting results about the impact on the neurodevelopment of preterm infants. The majority of the studies did not show that chorioamnionitis poses a direct risk to the development of preterm infants. The role of abnormal prenatal placental and fetal blood flow on the development of preterm infants remained inconclusive because the sample sizes were often small and methodological problems complicated the interpretation of the data. Maternal smoking during pregnancy was assessed only in one cohort which showed that maternal smoking is a risk for suboptimal cognitive and neuropsychological development in preterm infants. _Conclusions:_ This review summarizes the data on several prenatal risk factors which play a role in the developmental outcomes of preterm infants. To optimize the developmental outcomes, we need to first optimize the fetal wellbeing before birth. More research that extends from the fetal life to long-term developmental outcomes is needed. (shrink)

Determining Risk Factors and Demographic Patterns of Suicide in Tehran Suicide refers to the death of a person that is primarily achieved by self-harm. Today, it is considered one of the major public health issues. One of the important risk factors associated with attempted suicide is social relations. This study is a descriptive and analytical study that aims to identify the suicide rate, the risk factors in suicide, and the methods of suicide. The findings (...) show that there is a significant relationship between suicide and demographic variables that include age, sex, educational level, adherence to religion, and occupation. This research also shows the psychological factors that lead to suicide include depression, addiction, lack of social activities, and mental disorders caused by chronic disease. (shrink)

ObjectivesThe purpose of this study was to identify risk factors for delirium after total joint arthroplasty and provide theoretical guidance for reducing the incidence of delirium after TJA.MethodsThe protocol for this meta-analysis is registered with PROSPERO. We searched PubMed, the Cochrane Library and Embase for observational studies on risk factors for delirium after TJA. Review Manager 5.3 was used to calculate the relative risk or standard mean difference of potential risk factors related to (...) TJA. STATA 14.0 was used for quantitative publication bias evaluation.ResultsIn total, 25 studies including 3,767,761 patients from 9 countries were included. Old age has been widely recognized as a risk factor for delirium. Our results showed that the main risk factors for delirium after TJA were patient factors, comorbidities, surgical factors and drug factors.ConclusionsMultiple risk factors were associated with delirium after TJA. These results may help doctors predict the occurrence of delirium after surgery and determine the correct treatment.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42020170031. (shrink)

Background: Depressive disorder is one of the main health problems worldwide. Many risk factors have been associated with this pathology. However, while the association between risks factors and adult depression is well established, the mechanisms behind its impact remains poorly understood. A possible, yet untested explanation is the mediating impact of levels of personality functioning, i.e., impairments with regard to self and interpersonal.Method: Around 162 patients were assessed at the beginning of their therapy, with regard to (...) class='Hi'>risk factors, such as sociodemographic, physical, hereditary, and adverse childhood experiences. Depressive symptoms and personality functioning were also measured. Associations between the related variables as well as other possible covariates were examined by means of zero-order correlations and bootstrapping-based mediation analysis.Results: Of all the risk factors taken into account, level of education and physical illness were associated with depression. On the other hand, the most significant predictor of depressive symptomatology was ACE, and this relationship was mediated by personality functioning. This indicates that patients presenting adverse childhood experiences are more likely to develop deficiencies in personality functioning, which in turn increases their likelihood of developing depressive symptomatology.Conclusion: These results reaffirm the importance of incorporating risk and vulnerability factors such as personality functioning in understanding depression. (shrink)

The present study aimed to examine the promotive and protective role of general self-efficacy and positive self-concept in the context of the effects of early familial risk factors on children’s development of emotional problems from early to middle childhood. A total of 293, 239, and 189 children from 25 childcare centers took part in the present study. Fourteen familial risk factors were assessed at T1 using an interview and a questionnaire that were administered to children’s primary (...) caregivers. These 14 familial risk factors were used to compute a familial risk factors score. Primary caregivers also reported on their children’s emotional problems at T2 and T3 and on their children’s general self-efficacy at T2. Children reported on their positive self-concept at T2. Results showed that early familial risk factors were positively associated with emotional problems in the short and long term, although the long-term effect was small and non-significant. Further, the pattern of effect sizes of both promotive and protective effects of general self-efficacy as well as positive self-concept was found to be consistent in the short term. However, in the long term, no consistent support for either the promotive or the protective role of general self-efficacy or positive self-concept was found. These results suggest that general self-efficacy and positive self-concept might contribute to promote mental health and to protect from undesired effects of familial risk factors in the short term. Possible reasons for a lack of long-term effects are discussed along with practical implications. (shrink)

This article proposes to identify risk factors for moral distress from the literature, validate them through expert analysis and provide the basis for a new tool to assess the risk of moral distress among nurses. Moral distress is related to the psychological, emotional and physiological aspects of nursing. It arises from constraints caused by various circumstances and can lead to significant negative consequences. A scoping review and validation through expert analysis were used. The research question guiding this (...) study was as follows: What is known about risk factors for moral distress in nursing? The research was conducted using multiple sources including electronic databases and lists of references from relevant literature. The final sample consisted of 38 studies. A validation analysis was conducted by experts during December 2014 and June 2015. To exclude a risk factor item, at least 80% of the experts had to agree with the exclusion. In total, 53 risk factors for moral distress were identified, reviewed by the experts and grouped to form a new instrument that may help to identify risk for moral distress and to address its consequences. (shrink)

In current mental health care psychiatric conditions are defined as compilations of symptoms. These symptom-based disease categories have been severely criticised as contingent and boundless, facilitating the rise to epidemic proportions of such conditions as depression. In this article we look beyond symptoms and stress the role of epidemiology in explaining the current situation. By analysing the parallel development of cardiovascular disease and depression management in Finland, we argue, firstly, that current mental health care shares with the medicine of chronic (...) somatic conditions an attachment to risk factor epidemiology, which accentuates risk and prevention in disease management. However, secondly, due to the symptom-based definitions of psychiatric conditions, depression management cannot differentiate properly between symptoms, signs and risk factors such as, for example, cardiovascular medicine, but treats symptoms as signs or risk factors in contexts of treatment and prevention. Consequently, minor at-risk conditions have become difficult to separate from proper cases of depression. (shrink)

Recent research has shown that psychological risk factors play an important role in the pathogenesis of cardiovascular diseases. The so-called coronary prone behaviour pattern predominates, an important part of which is the Type A behaviour pattern. This is characterized by a marked ambition, a constant feeling of being under pressure, due to latent aggression and to a striving to dominate. For cerebrovascular diseases the so-called pressured pattern as a risk factor has been found to be typical which (...) is comparable to the Type A behaviour. Psychological risk factors and their components are not equally important for different vascular diseases. Besides the explanation of the question as to how far psychological processes really are involved in the development of vascular diseases, the research on psychological risk factors serves as a foundation for psychosomatic theories. (shrink)

The present study examined effects of sociodemographic, risk, and resilience factors on marital, parental, and financial stress early in the COVID-19 pandemic. A cross-sectional online survey was conducted among 480 married Palestinians living in Israel, using self-report questionnaires. Descriptive statistics and bivariate correlations were computed. Then, hierarchical multiple regression analyses were conducted to predict each of the three stress measures. Finally, dominance analyses were conducted to compare the contributions of sociodemographic, risk, and resilience factors. The results (...) showed considerable differences between predictors of marital and parental stress and predictors of financial stress. For marital and parental stress, resilience factors mainly family resilience were the strongest predictors, followed by risk factors and then sociodemographic characteristics. For financial stress, risk factors were the strongest predictors, followed by sociodemographic characteristics and resilience factors. These results suggest that family and individual resilience reduce marital and parental stress under difficult conditions, including the COVID-19 pandemic. Though resilience has been found to ameliorate financial stress to some extent, it appears that other measures are required to manage stress related to financial difficulties. (shrink)

Aim: To evaluate health-related quality of life of chronic hepatitis B and hepatitis B virus related cirrhosis patients and analyzed specific differences in all dimensions of HRQoL.Methods: A total of 349 patients met selection criteria were enrolled. The 36-Item Short-Form Health Survey was adopted.Results: Results showed that the physiological HRQoL of the cirrhotic group was significantly lower than that of the non-cirrhotic group, the psychological HRQoL was also lower. HRQoL was significantly negatively correlated with liver stiffness. We further evaluated the (...) risk factors associated with poor HRQoL in HBV-related cirrhosis patients. Results showed that positive HBV DNA viral load and HCC family history were independent factors associated with HRQoL in HBV-related cirrhosis. For better risk stratification of patients, multivariable analyses were conducted to explore the independent factors that affected specific physiological and psychological HRQoL. In specific physiological HRQoL, results show that marital status, positive HBV DNA viral load and antiviral drugs were independent factors associated with physiological HRQoL in cirrhosis patients. In psychological HRQoL, only HCC family history was independent risk factors associated with psychological HRQoL.Conclusion: We found that the impaired HRQoL dimensions of HBV related cirrhosis patients differ between the various subpopulations. According to our results, risk stratification, medical decision making and personalizing interventions could be made. (shrink)

Research shows that animal cruelty shares many of the aetiologial pathways and risk factors that have been shown for other aggressive behaviors. The shared aetiology not only aids understanding of the co-occurrence that has been documented between animal cruelty and other aggressive and antisocial crimes, it also highlights the dangers over and above those to animals that are lurking where animal cruelty offenders remain unidentified and their crimes remain unsanctioned. This article reviews current understandings about the development of (...) antisocial behaviors, including human aggression, and animal cruelty behaviors. Available research leads one to ask, when individuals have been found to be guilty of animal cruelty, what other aggressive behaviors might they be guilty of? For young children, one must ask, are they victims of child abuse, are they living in circumstances of domestic violence, and/or what is the aggression or violence that they may have been witness to? Animal cruelty, and most aggressive behaviors from the later childhood years onward, are indicators of non-normative development. Early detection of such behaviors can provide a valuable opportunity to engage in preventative intervention for young people or for appropriate sanctions to be applied for adults. Such interventions would be beneficial for all, humans and animals alike. (shrink)

This paper presents the results of the first phase of a longitudinal study initiated during the ‘first wave’ of the COVID-19 pandemic in Montenegro. The research aimed to examine the influence of selected risk factors on the occurrence of physical violence against women by their husbands during the pandemic. Four risk factors were assessed: the husband’s job loss, the frequency of alcohol consumption by the husband, the history of family violence, and the distribution of family responsibilities. (...) The study was conducted on a sample of 500 adult female participants, age range 20 to 49 years. Binary logistic regression analysis revealed that the husband’s job loss during the COVID-19 pandemic was significantly associated with an increased likelihood of physical violence against women. Frequent alcohol consumption by husbands, as a negative coping mechanism for stress, was found to be the strongest predictor of physical violence against women. Furthermore, a prior occurrence of domestic violence was associated with an increased likelihood of physical violence perpetrated by the husband. Findings also indicated that more equitable distribution of household responsibilities between partners correlated with a lower likelihood of physical violence against women. These results underscore the need for targeted strategies in preventing this issue. (shrink)

By examining managers’ decisions about disclosing updated assessments of firms’ risks, we present evidence that the risk factor disclosures are informative. We use the setting of cybersecurity risk factor disclosures after a data breach because data breaches, especially severe breaches, serve as a natural experiment where an exogenous shock to managers’ assessment of their firm’s cybersecurity risks occurs. We analyze the topic from the perspective of two different theoretical lenses: the economic lens of optimal risk exposure and (...) the ethical lens of stakeholder theory. Using a sample of firms experiencing data breaches, we find that firms experiencing a data breach increase the amount of cybersecurity risk factor disclosures compared to matched firms with no data breach. Further investigation reveals that the severity of data breaches affects the results; cybersecurity risk factor disclosures increase only after severe data breaches. While there is no significant market reaction if breached firms’ subsequent annual reports include increased cybersecurity risk factor disclosures, a significant negative market reaction occurs if breached firms decrease cybersecurity risk factor disclosures, regardless of the severity of the breach, implying that the market anticipates increased disclosures after data breaches. (shrink)

IntroductionLittle is known about risk factors for both Long COVID and somatic symptoms that develop in individuals without a history of COVID-19 in response to the pandemic. There is reason to assume an interplay between pathophysiological mechanisms and psychosocial factors in the etiology of symptom persistence.ObjectiveTherefore, this study investigates specific risk factors for somatic symptom deterioration in a cohort of German adults with and without prior SARS-CoV-2 infection.MethodsGerman healthcare professionals underwent SARS-CoV-2 IgG antibody testing and (...) completed self-rating questionnaires at baseline and 21 months later between April 2020 and February 2022. Differences in variables between the time points were analyzed and a regression analysis was performed to predict somatic symptom deterioration at follow-up.ResultsSeven hundred fifty-one adults completed both assessments. Until follow-up, n = 58 had contracted SARS-CoV-2 confirmed by serology. Between baseline and follow-up, signs of mental and physical strain increased significantly in the sample. Symptom expectations associated with COVID-19 and a self-reported history of COVID-19, but not serologically confirmed SARS-CoV-2 infection, significantly predicted somatic symptom deterioration at follow-up. A further predictor was baseline psychological symptom burden.ConclusionsThis study supports a disease-overarching biopsychosocial model for the development of burdensome somatic symptoms during the COVID-19 pandemic and supports research findings that symptom burden may be more related to the psychosocial effects of the pandemic than to infection itself. Future studies on Long COVID should include SARS-CoV-2 negative control groups and consider symptom burden prior to infection in order to avoid an overestimation of prevalence rates. (shrink)

Background: With the outbreak of the coronavirus disease 2019 epidemic in China, the general public but also medical staff were confronted with psychological challenges, suffering from the highly infectious and unknown characteristics of COVID-19. In this study, we surveyed psychological symptoms including anxiety, depression, and sleep disorders in medical staff.Method: A questionnaire star/WeChat link-based survey assessing the Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire-9 depression, the Insomnia Severity Index, Social Support scales in addition to lifestyle, and income level was (...) conducted and included 8,288 medical staff from 24 provinces in China. Pearson Chi-square and Mann-Whitney U-tests were used to evaluate single risk factors and significant differences in psychological symptoms before and during the outbreak of COVID-19. Binary logistic regression analyses were conducted for the risk factors of anxiety, depression, and sleep disorder symptoms.Results: Medical staff had a high incidence of psychological symptoms, which was more prominent during the COVID-19 epidemic. Comparatively, females, nurses, first-line department, never exercised, and low income were risk factors for psychological symptoms. Social support including objective support, subjective support, support utility, and regular sports over 3 times per week were protective and manageable elements that could protect from and manage the psychological symptoms of medical staff.Conclusion: The susceptibility of psychological symptoms among medical staff should be of concern to policymakers and the public in the long-term, and the aggravation of mental health problems of medical staff could be eased by providing adequate social support during and after the COVID-19 outbreak. (shrink)

Alzheimer’s Disease (AD) provides an excellent case study to investigate emerging conceptions of health, disease, pre-disease, and risk. Two scientific working groups have recently reconceptualized AD and created a new category of asymptomatic biomarker positive persons, who are either said to have preclinical AD, or to be at risk for AD. This article examines how prominent theories of health and disease would classify this condition: healthy or diseased? Next, the notion of being “at risk”—a state somewhere in-between (...) health and disease—is considered from various angles. It is concluded that medical-scientific developments urge us to let go of dichotomous ways of understanding disease, that the notion of “risk,” conceptualized as an increased chance of getting a symptomatic disease, might be a useful addition to our conceptual framework, and that we should pay more attention to the practical usefulness and implications of the ways in which we draw lines and define concepts. (shrink)

Hearing loss has been identified as a major modifiable risk factors for dementia. Adult candidates for cochlear implantation represent a population at risk of hearing loss-associated cognitive decline. This study investigated the effect of demographics, habits, and medical and psychological risk factors on cognition within such a cohort. Data from 34 consecutive adults with post-lingual deafness scheduled for CI were analyzed. Pure tone audiometry and Speech Discrimination Score were recorded. The Repeatable Battery for Assessment of (...) Neuropsychological Status for Hearing impaired individuals was used to measure cognition. Demographics, habits, and medical factors were evaluated. Depression was measured using the Hospital Anxiety and Depression Scale, and social inhibition with the Type D questionnaire. All participants suffered from severe to profound hearing loss. The mean RBANS-H total score was 83 ± 16. Participants reported a mean of years of formal education of 12 ± 5 years. The prevalence of habits and medical risk factors was: physical inactivity, body mass index >30, traumatic brain injury, hypertension, heavy alcohol consumption, smoking, and diabetes. Regarding psychological factors, the mean scores of social inhibition and depression were 10 ± 6 and 6 ± 5, respectively. The number of years of education was significantly correlated with the RBANS-H total score, and with the domains “Immediate memory”, “Visuospatial/constructional”, and “Attention”. The mean RBANS-H total score in participants who had university studies or higher level was 97 ± 9, with the remaining participants reporting a mean score of 75 ± 15. Men performed better in the “Visuospatial/constructional”. Physical inactivity was associated with lower scores in the “Delayed memory” ; hypertension correlated with lower RBANS-H total scores and “Attention”. Depression and social inhibition were negatively correlated with RBANS-H total score and with the “Immediate memory,” “Visuospatial/constructional,” and “Attention”. In adults with late-onset deafness scheduled to CI, educational level has a significant effect. Additionally, sex, physical inactivity, hypertension, and psychological traits of social inhibition and depression may also influence cognitive status. Long-term studies with more participants would enable us better understand the effects different risk factors on cognitive status. (shrink)

BackgroundThe risk of child sexual abuse among non-forensic, non-correctional patients with Pedophilic Disorder is largely unknown.MethodsWe recruited a consecutive sample of 55 help-seeking, non-correctional adult men diagnosed with DSM-5 PD at a university-affiliated sexual medicine outpatient unit in Sweden. PD participants were compared with 57 age-matched, non-clinical control men on four literature-based dynamic risk domains and self-rated child sexual abuse risk.ResultsPD participants scored higher than controls on all tested domains ; expectedly so for pedophilic attraction : [1.91–2.89]), (...) but also for sexual preoccupation, impaired self-regulation, impaired cognitive empathy and antisocial traits, and self-rated child sexual abuse risk. When summarizing all five domains into a pre-specified composite score, PD subjects scored substantially higher than matched control men. Five PD participants self-reported any previous conviction for a contact child sexual offense and eight for possession of child sexual abuse material or non-contact sexual offending. Eighteen subjects acknowledged past week, child-related sexual behaviors.ConclusionSelf-referred, help-seeking men with PD scored higher than non-clinical control men on psychiatric measures of dynamic risk of child sexual abuse suggested in prior research with correctional samples diagnosed with PD. Our findings, including the composite risk measure, might inform clinical practice, but needs validation against actual sexual offending behavior. (shrink)

The essays on obesity in this issue frequently refer to the recent American Medical Association (AMA) declaration of obesity as a disease. In response to these essays, I describe and explore the significance of ‘risk–factor medicalization’ and how negative unintended consequences with this approach to disease modeling are exemplified in many of the essays. I also relate the essays’ content to the issue of physician hubris in the face of their own helplessness in aiding the obese patient.

BackgroundBurnout is a recognized challenge among the oncology workforce. It affects both genders with a higher frequency among women. This study examined the factors contributing to the development of burnout among female oncologists from the Middle East and North Africa.MethodsAn online cross-sectional survey was distributed to oncology professionals from different countries in the MENA region. The validated Maslach Burnout Inventory of emotional exhaustion, Depersonalization, and Personal Achievement plus questions about demography/work-related factors and attitudes toward oncology were included. Data (...) were analyzed to measure BO prevalence and related factors.ResultsBetween 10 February and 15 March 2020, 545 responses were submitted by female oncologists. The responses pre-dated the COVID-19 pandemic emergence in the region. BO prevalence was 71% among female professionals. Women aged 25% on administrative work daily. Nearly half of the respondents expressed a recurring thought of quitting oncology and 70% had no burnout support or education. Inability to deliver optimal care was reported as distressing for career development in 82%. Factors significantly influencing the BO risk were identified. Marital status, having children, academia and years in practice did not impact the risk of BO among female oncologists from MENA.ConclusionFemale oncologists from the Middle East and North Africa were found to have a high prevalence of BO. In this cohort, the majority of women oncology workers were young and in their early to mid-career stages. Burnout was linked to being younger, practicing in North African nations, having a heavy administrative load, and having persistent thoughts of quitting. Practicing a hobby and engaging in oncology communication, on the other hand, reduced the chance of BO. Burnout support and education, specifically for oncology women, is required. (shrink)

This study conducted a cross-sectional investigation of facial appearance dissatisfaction between patients before undergoing orthognathic surgery and a non-surgical sample to evaluate the potential influencing factors of facial appearance dissatisfaction. A sample of 354 participants completed a set of questionnaires concerning facial appearance dissatisfaction, interpersonal pressure, media pressure, and fear of negative appearance evaluation (112 patients, 242 controls). The patients reported higher facial appearance dissatisfaction, more media pressure, more interpersonal pressure, and a greater fear of negative appearance evaluation among (...) others than the control group. Moreover, regression analyses identified interpersonal pressure and fear of negative appearance evaluation as the main influencing factors on facial appearance dissatisfaction whether in the orthognathic patients or in the control groups. The associations between the perceptions of interpersonal pressure, fear of negative appearance evaluation, and facial appearance dissatisfaction support the possible utility of strengthening social experiences and psychological intervention in preventing and treating these appearance-concerns, especially for the orthognathic patients. (shrink)

The main aim of the paper is to present the results of research concerning psychological and socio-cultural risk factors for development of negative anti-health attitude toward one’s body in young Polish women. The study comprised 120 women, of 20 to 25 years of age, with similar socio-demographic status who so far in the course of their lives have not disclosed mental or somatic disturbances. The theoretical theses for the research model were the contemporary cognitive concepts, as well as (...) socio-cultural concepts. The following have been used in the study: thematic drawings, the Contour Drawing Rating Scale developed by - developed by Thompson & Gray, the Eating Disorder Inventory created by D. Garner, The Sociocultural Attitudes Towards Appearance Questionnaire 3, and questionnaire for behaviour towards the body. The results confirmed the existence of negative attitude toward one’s own body, as well as development of inclinations for compensation-generating behaviour. A group of risk factors has been identified, which may lead to the development of the above attitudes and behaviours toward one’s body in healthy women, who at the same time do not accept the image of their real bodies. (shrink)

This article presents an experimental analysis of several cybersecurity risks affecting the human attack surface of Fairmont State University, a mid-size state university. We consider two social engineering experiments: a phishing email barrage and a targeted spearphishing campaign. In the phishing experiment, a total of 4,769 students, faculty, and staff on campus were targeted by 90,000 phishing emails. Throughout these experiments, we explored the effectiveness of three types of phishing awareness training. Our results show that phishing emails that make it (...) through IT’s defenses pose a clear and present threat to large educational organizations. Moreover, we found that simple, visual, instructional guides are more effective training tools than long documents or interactive training. (shrink)

BackgroundPhysical activity has a significant health impact worldwide and has been linked to a lower risk of the common cold.ObjectiveThe aim of this study was to estimate the form of PA among Chinese adults and the correlation between PA and number of the common cold in China's eastern, central, and western areas.DesignA cross-sectional study.SettingChina's eastern, central, and western regions from 30 November 2020 to 30 March 2021.PatientsA total of 1,920 healthy participants, who aged over 18 years old, with Internet (...) access, were enrolled, and then self-reported PA behaviors and number of the common cold were collected.MeasurementsThe authors calculated preference, intensity, frequency, and duration of PA in Chinese based on gender, age, and broad occupational categories and explored the potential effect between these factors and the common cold.ResultsApproximately 20.4% of participants reported not participating in sports regularly. Except for gender, there were significant differences in PA preference and intensity among the remaining individuals. However, intensity shows a U-shaped dose-response relationship with colds, whereas the frequency and duration have an inverse dose-response relationship. High intensity combined with high frequency increased colds the most. Nevertheless, non-exercise groups always have the most colds in each comparison.LimitationsThe result may be vulnerable to recall bias.ConclusionIntensity showed that U-shape, frequency, and duration showed inverse response to the number of colds last year, but age, sex, and occupation had no significant effects. High intensity and high frequency mixed increased colds the most, regardless of duration. (shrink)

The use of social media is becoming a necessary daily activity in today’s society. Excessive and compulsive use of social media may lead to social media addiction. The main aim of this study was to investigate whether demographic factors, impulsivity, self-esteem, emotions, and attentional bias were risk factors associated with SMA. The study was conducted in a non-clinical sample of college students, ranging in age from 16 to 23 years, including 277 females and 243 males. All participants (...) completed a survey measuring impulsivity, self-esteem, anxiety, depression, social anxiety, loneliness, and attentional bias. The final hierarchical regression model indicated significant risk factors for SMA with an accuracy of 38%. The identified set of associated risk factors included female gender, impulsivity, self-esteem, anxiety, social anxiety, and negative attentional biases. Finally, a discussion of the results is presented, followed by corresponding recommendations for future studies. (shrink)

BackgroundOperation room (OR) planning is a complex process, especially in large hospitals with high rates of unplanned emergency procedures. Postponing elective surgery in order to provide capacity for emergency operations is inevitable at times. Elderly patients, residents of nursing homes, women, patients with low socioeconomic status and ethnic minorities are at risk for undertreatment in other contexts, as suggested by reports in the medical literature. We hypothesized that specific patient groups could be at higher risk for having their (...) elective surgery rescheduled for non-medical reasons.MethodsIn this single center, prospective observational trial, we analysed 2519 patients undergoing elective surgery from October 2018 to May 2019. A 14-item questionnaire was handed out to illicit patient details. Additional characteristics were collected using electronic patient records. Information on the timely performance of the scheduled surgery was obtained using the OR’s patient data management system. 6.45% of all planned procedures analysed were postponed. Association of specific variables with postponement rates were analysed using the Mann–Whitney U test and Fisher's exact test/χ2-test.ResultsSignificantly higher rates of postponing elective surgery were found in elderly patients. No significant differences in postponing rates were found for the variables gender, nationality (Germany, EU, non-EU), native language, professional medical background and level of education. Significantly lower rescheduling rates were found in patients with ties to hospital staff and in patients with a private health insurer.ConclusionsElderly patients, retirees and nursing home residents seem to be at higher risk for having their elective surgery rescheduled. However, owing to the study design, causality could not be proven. Our findings raise concern about possible undertreatment of these patient groups and provide data on short-term postponement of elective surgery.Trial registration DRKS00015836. Retrospectively registered. (shrink)

The online version of the original article can be found under doi:10.1007/s11948-007-9045-2.

Se presenta un artículo acerca de los factores de riesgo asociados a la dermatitis atópica en niños, enfermedad con una incidencia significativa en el municipio Nuevitas. A partir de la revisión de Historias Clínicas en los Consultorios 4,5 y 6 del territorio, en el período comprendido de enero a septiembre del 2015, se constató como importantes los factores genéticos y los medioambientales en estos pacientes. Con el objetivo de disminuir los últimos se elaboró una estrategia educativa para la familia de (...) los infantes. Se aplicó una encuesta inicial y una final con una población de 60 familias y una muestra de 30 que representa el 50 % con el criterio de inclusión de tener algún o algunos de estos factores. Se concluye que la estrategia contribuyó a transformar los estilos de vida en las familias estudiadas. The article deals with risk factors associated to atopic dermatitis in children, a disease with a significant effect on Nuevitas municipality. Starting from the checking of clinical histories in doctors' offices 4, 5 and 6 in the municipality from January to September 2015, genetic and environmental factors were confirmed to be important. Aiming at lessening these risks, an educational strategy for the children's families was developed. An initial and a final survey of a population of 60 families and a sample of 30, make for a 50 % with inclusion criterion of having some or a lot of these factors. It was reached the conclusion that the strategy contributed to transforming lifestyles in the studied families. (shrink)

School principals world-wide report high levels of strain and attrition resulting in a shortage of qualified principals. It is thus, crucial to identify psychosocial risk factors that reflect principals’ occupational wellbeing. For this purpose, we used the Copenhagen Psychosocial Questionnaire (COPSOQ-II), a widely used self-report measure covering multiple psychosocial factors identified by leading occupational stress theories. We evaluated the COPSOQ-II regarding factor structure and longitudinal, discriminant, and convergent validity using latent structural equation modeling in a large sample (...) of Australian school principals (N = 2,049). Results reveal that confirmatory factor analysis produced marginally acceptable model fit. A novel approach we call set exploratory structural equation modeling (ESEM-set), where cross-loadings were only allowed within a priori defined sets of factors, fit well, and was more parsimonious than a full ESEM. Further multitrait-multimethod models based on the set-ESEM confirm the importance of a principal’s psychosocial risk factors; Stressors and depression were related to demands and ill-being, while confidence and autonomy were related to wellbeing. We also show that working in the private sector was beneficial for showing a low psychosocial risk, while other demographics have little effects. Finally, we identify five latent risk profiles (high risk to no risk) of school principals based on all psychosocial factors. Overall the research presented here closes the theory application gap of a strong multi-dimensional measure of psychosocial risk-factors. (shrink)

There is limited knowledge of the prevalence and nature of risky sexual behavior (RSB) among young adults in Hong Kong. This cross-sectional study explored the psychosocial risk factors of RSB with a sample of 1,171 Hong Kong university students (aged 18–40 years). Grounded in the theoretical propositions of several criminological theories (i.e., the theories of self-control, general strain, social learning, social control, and routine activity), engagement in three types of RSB (i.e., general, penetrative, and non-penetrative) was studied alongside (...) a range of psychosocial risk factors. Relative to female participants, male participants reported significantly higher mean levels of general, penetrative, and non-penetrative RSB. Male participants also reported significantly higher mean levels of negative temperament, use of alcohol and other drugs, and paraphilic interests than female participants, who reported significantly higher mean levels of self-control and social bonds than their male counterparts. The results of multivariate analyses (i.e., OLS regressions) revealed that, to a large extent, the male and female participants shared a similar set of psychosocial risk factors (i.e., use of alcohol and other drugs, and paraphilic interest) for their involvement in general, penetrative, and non-penetrative RSB. Furthermore, a high level of negative temperament was significantly associated with penetrative RSB for both genders, while a high level of perceived neighborhood disorganization was found to be an important factor in the participation of females in general, penetrative, and non-penetrative RSB. The findings of this study may have important implications for practice in regard to reducing, if not entirely preventing, the tendency to engage in RSB. (shrink)

The mortality and morbidity resulting from noncommunicable diseases including cancer in sub- Saharan Africa are predicted to overtake that of infectious diseases by the year 2030. Esophageal cancer is on the increase in Tanzania. This study estimates risk factors for esophageal cancer, ethical issues and the level of awareness of cancer related services among adults in rural Kilimanjaro. A cross sectional descriptive study was conducted of adults aged 18 years and above in three wards, namely, Kahe, mabogini and (...) Arusha Chini, Moshi Rural District, Kilimanjaro region. Face-to-face interviews were conducted with a total of 419 individuals. The mean age was 36.47 =13.49) years. Of those who participated, 211 were male and 60% reported to have completed primary education. A majority of participants were knowledgeable about esophageal cancer risk factors. Overall, 15% and 23% of the participants reported to have been smoking and drinking alcohol, respectively. Male respondents were almost three times more likely to be smokers as compared to female respondents. Moreover, people who were self-employed were about five times more likely to be smokers as compared to those who were unemployed.. Male respondents were almost two times more likely to be drinkers as compared to female respondents. Overall, the level of awareness of cancer related health services was about 70%. The study findings confirm that despite a good level of knowledge about risk factors for esophageal cancer, the practice of exposure to risk factors is alarmingly high. Awareness of where to seek cancer related health services was high with hospitals been mentioned by the majority though there was low understanding on modalities of treatment among adults in Rural Kilimanjaro. Intervention measures should aim at further increasing knowledge of cancer risk factors and reduce the practice of such risks. Ethical matters including truth telling, ageism and autonomy need to be addressed to improve the perception of cancer related health issues and health seeking behaviour. (shrink)

I argue that ductal carcinoma in situ (DCIS), the tumor most commonly diagnosed by breast mammography, cannot be confidently classified as cancer, that is, as pathological. This is because there may not be dysfunction present in DCIS—as I argue based on its high prevalence and the small amount of risk it conveys—and thus DCIS may not count as a disease by dysfunction-requiring approaches, such as Boorse’s biostatistical theory and Wakefield’s harmful dysfunction account. Patients should decide about treatment for DCIS (...) based on the risks it poses and the risks and benefits of treatment, not on its disease status. (shrink)

Healthcare workers who are on the front line of coronavirus disease 2019 and are also undergoing shift schedules face long work hours with few pauses, experience desynchronization of their circadian rhythm, and an imbalance between work hours effort and reward in saving lives, resulting in an impact on work capacity, aggravated by the lack of personal protective equipment, few resources and precarious infrastructure, and fear of contracting the virus and contaminating family members. Some consequences are sleep deprivation, chronic insomnia, stress-related (...) sleep disorders, and post-traumatic stress disorder. These sleep alterations critically affect mental health, precipitating or perpetuating anxiety, stress, and depression, resulting in the inability to regulate positive and negative emotions. Pre-existing sleep disorders are an important risk factor for the development and maintenance of PSTD when individuals are exposed to an important stressor such as a COVID-19 pandemic. At the same time, how an individual regulates the emotion associated with worries during daytime functioning impacts nighttime sleep, precipitating and perpetuating difficulties in sleeping. All of these changes in sleep and emotional regulation also alter the immune system. Sleep deprivation is commonly associated with chronic inflammatory diseases, due to the desynchronizations in circadian rhythms, causing possible psychophysiological disorders and impaired neuroimmune-endocrine homeostasis. From this perspective, we clarify in this article how sleep disorders affect the immune system and emotional regulation, explaining their phenomenological and neurobiological mechanisms, and discussing elements of cognitive and behavioral coping for health professionals to adopt and manage a healthier sleep pattern in the COVID-19 outbreak. (shrink)

ObjectivesDuring their lifetimes, a majority of musicians experience playing-related musculoskeletal disorders. PRMD prevalence is tied to instrument choice, yet most studies examine heterogeneous groups of musicians, leaving some high-risk groups such as oboists understudied. This paper aims to ascertain the prevalence and nature of PRMDs in oboists, determine relevant risk factors, and evaluate the efficacy of treatment methods in preventing and remedying injuries in oboe players.MethodsA 10-question online questionnaire on PRMDs and their treatments was completed by 223 (...) oboists. PRMDs were compared across gender, weekly playing hours, career level, age, and years of playing experience.ResultsOf all respondents, 74.9% reported having had at least one PRMD in their lifetime. A majority of these injuries were of moderate to extreme severity. Females reported significantly more severe injuries than males. No significant effects of career level, age, or years of playing experience were observed. We found significant non-linear relationships between weekly playing hours and PRMD prevalence and severity. Injuries were most commonly on the right side of the body, with the right thumb, wrist, hand, and forearm being most affected in frequency and severity. Of those injuries for which recovery information was provided, only 26.1% of injuries were “completely recovered.” The perceived effectiveness of a few treatments tended to be ranked more highly than others.ConclusionThe oboists in this study experienced high rates of PRMD, particularly in the right upper extremities. Females and those playing 7-9 and 16-18 h per week reported a significantly higher severity of injuries than other groups. (shrink)

Are risk behaviours in adolescence differentiated according to same-sex vs opposite-sex interest? For all respondents a five-point scale of interest in each sex used information from both of the first two in-home waves of the National Longitudinal Study of Adolescent Health (Add Health). Logistic regression predicted the probability of experiencing each risk behaviour from the same-sex and opposite-sex interest scores. Same-sex interests have more effect on emotional risk, and opposite-sex interests have more effect on substance use. Nevertheless, (...) all risk variables except boys’ depression are responsive to both same-sex and opposite-sex interest. The same-sex interest component of risk is attributed to the emotional strain of living with an anomalous sex interest in a heterosexual society. (shrink)