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Heightened Risk (heightened + risk)
Selected AbstractsAre commonly used self-report inventories suitable for screening postpartum depression and anxiety disorders?ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2000M. Muzik Objective: The utility of several self-report symptom inventories were examined for detecting postpartum depression (MDD) and anxiety disorders (AD). Method: Fifty women (3 or 6 months postpartum), at heightened risk for MDD, completed several depression and anxiety symptom checklists. Psychiatric diagnoses were obtained via SCID interview. Results: Rates of MDD (n=9) and AD (n=9) were equivalent in this sample, with minimal diagnostic overlap. While all the self-report depression inventories screened accurately for MDD, none discriminated AD sensitively and reliably. Conclusion: The frequent occurrence of AD emphasizes the need to identify appropriate screening instruments for postpartum anxiety disorders. [source] Seasonal change in offspring sex and size in Dawson's burrowing bees (Amegilla dawsoni) (Hymenoptera: Anthophorini)ECOLOGICAL ENTOMOLOGY, Issue 3 2005John Alcock Abstract., 1.,Nesting females of Dawson's burrowing bees, Amegilla dawsoni, produce a large size class of offspring, which includes daughters and major sons, and a small size class, which consists entirely of minor sons averaging half the weight of their larger siblings. Female allocation patterns change over the flight season such that the initial pattern of producing daughters shifts toward the production of both daughters and major sons in the middle of the season, and then the production of primarily minor sons in the latter part of the nesting season. 2.,In Dawson's burrowing bees, this pattern is correlated with declines in pollen and nectar availability as the nesting season progresses as well as a heightened risk of dying before the final brood cell is completed. Here, the relation between these factors and the provisioning tactics of nesting Dawson's burrowing bees is discussed. [source] Sexual orientation, substance use behaviors and substance dependence in the United StatesADDICTION, Issue 8 2009Sean Esteban McCabe ABSTRACT Aims To assess past-year prevalence rates of substance use behaviors and substance dependence across three major dimensions of sexual orientation (identity, attraction and behavior) in a large national sample of adult women and men in the United States. Design Data were collected from structured diagnostic face-to-face interviews using the Alcohol Use Disorder and Associated Disabilities Interview Schedule DSM-IV version IV (AUDADIS-IV). Setting Prevalence estimates were based on data collected from the 2004,2005 (wave 2) National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Participants A large national sample of 34 653 adults aged 20 years and older: 52% female, 71% white, 12% Hispanic, 11% African American, 4% Asian and 2% Native American. Findings Approximately 2% of the population self-identified as lesbian, gay or bisexual; 4% reported at least one life-time same-sex sexual partner and 6% reported same-sex sexual attraction. Although non-heterosexual orientation was generally associated with a higher risk of substance use and substance dependence, the majority of sexual minority respondents did not report substance use or meet criteria for DSM-IV substance dependence. There was considerable variation in substance use outcomes across sexual orientation dimensions; these variations were more pronounced among women than among men. Conclusions Results support previous research findings of heightened risk of substance use and substance dependence among some sexual minority groups and point to the need for research that examines the reasons for such differences. Results also highlight important gender differences and question previous findings indicating uniformly higher risk for substance dependence among sexual minorities. Risks appear to vary based on gender and how sexual orientation is defined. Findings have implications for more effective prevention and intervention efforts that target subgroups at greatest risk. [source] Behavioral and Psychiatric Comorbidities in Pediatric Epilepsy: Toward an Integrative ModelEPILEPSIA, Issue 9 2007Joan K. Austin Summary:, It is well recognized that children with epilepsy are at heightened risk for developing behavior problems and psychiatric disorders. Studies identifying factors associated with child behavior were reviewed and findings were placed into two broad categories for review and critique: illness-related variables and psychosocial variables. Illness-related variables were seizure frequency and seizure control, type of epilepsy, age of onset, duration of illness, and antiepileptic drugs. Psychosocial variables were reviewed using a family stress framework: stressors, perceptions, adaptive resources, coping, and family adjustment. After the literature on each category is reviewed, an integrated heuristic model that includes key illness-related and psychosocial variables is presented. [source] Intimate partner violence and cardiovascular risk: is there a link?JOURNAL OF ADVANCED NURSING, Issue 10 2009Kelly Scott-Storey Abstract Title.,Intimate partner violence and cardiovascular risk: is there a link? Aim., This paper is a report of a study of the relationship between stress associated with intimate partner violence and smoking and cardiovascular risk. Background., Stress related to intimate partner violence persists after a woman leaves an abusive relationship. Persistent stress is associated with cardiovascular disease, the leading single cause of death among women. Smoking, an established risk factor for cardiovascular disease, is a coping mechanism commonly used to decrease the anxiety and stress of intimate partner violence. However, cardiovascular health is poorly understood in abused women. Method., Secondary analysis of data collected between 2004 and 2005 with a community sample of 309 women who had separated from an abusive partner 3 months to 3 years previously was conducted to create a descriptive profile of cardiovascular risk. Bivariate tests of association and logistic regression analysis were used to test relationships among variables. Results., Of the women, 44·1% were smokers; 53·2% had body mass indices classified as overweight or obese; 54·7% had blood pressures above normal range; and 50·8% reported cardiovascular symptoms. Neither severity of intimate partner violence nor smoking behaviours were statistically significant in explaining the presence of cardiovascular symptoms. Conclusion., The prevalence of hypertension, obesity and smoking suggests that survivors of intimate partner violence may be at heightened risk for cardiovascular disease and warrant clinical attention. Because cardiac symptoms develop as women get older, the mean age of 39 years in this sample may explain why intimate partner violence severity and smoking did not sufficiently explain the presence of cardiac symptoms. [source] Psychiatric disorders and family functioning in children and adolescents with functional abdominal pain syndromeJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7pt1 2008Ahmad Ghanizadeh Abstract Background and Aim:, Functional abdominal pain syndrome (FAPS) is a functional gastrointestinal disorder. There is a heightened risk when conducting potentially dangerous and unnecessary medical investigations and procedures in children with FAPS. The aim of this study was to survey the rate of the psychiatric disorders and family functioning in children and adolescents with FAPS. Methods:, The subjects were a consecutive new sample of 45 children and adolescents with FAPS, 45 with an organic abdominal pain, and 45 pain-free comparison subjects aged 5,18 years that were interviewed using the Farsi version of K-SADS. Family functioning and the severity of pain were also studied. Results:, About 51.1% of patients with FAPS suffered from at least one psychiatric disorder. Psychiatric disorders in the FAPS patients studied included general anxiety disorder (8.9%), obsessive-compulsive disorder (11.1%), attention deficit hyperactivity disorder (15.6%), separation anxiety disorder (24.4%), and major depressive disorder (15.6%). Except for generalized anxiety disorder and tic disorder, the other disorders were significantly more common in the FAPS group than in the two other control groups. Family functioning scores were not significantly different between groups. Discussion:, There is a high rate of psychiatric disorders in children and adolescents with FAPS in Iran, but our study found fewer incidences of disorders than previous reports have indicated. Family dysfunction difficulties in FAPS children are not more common than those in the control groups. [source] Preschool children with and without developmental delay: behaviour problems, parents' optimism and well-beingJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 8 2005B. L. Baker Abstract Background Children with intellectual disability are at heightened risk for behaviour problems, and these are known to increase parenting stress. This study explored the relation of behaviour problems to less child-related domains of parent well-being (depression and marital adjustment), as well as the moderating effect of a personality trait, dispositional optimism. Method Participating children (N = 214) were classified as developmentally delayed, borderline, or nondelayed. Mothers' and fathers' well-being and child behaviour problems were assessed at child ages 3 and 4 years. Results Parents of delayed and nondelayed preschoolers generally did not differ on depression or marital adjustment, but child behaviour problems were strongly related to scores on both measures. Optimism moderated this relationship, primarily for mothers. When child behaviour problems were high, mothers who were less optimistic reported lower scores on measures of well-being than did mothers who were more optimistic. Conclusions Interventions for parents that aim to enhance both parenting skills and psycholog- ical well-being should be available in preschool. It may be beneficial for such programmes to focus not only on behaviour management strategies aimed at child behaviour change, but also on parents' belief systems, with the aim of increasing dispositional optimism. [source] Pre-school children with and without developmental delay: behaviour problems and parenting stress over timeJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 4-5 2003B. L. Baker Abstract Background Children with intellectual disability are at heightened risk for behaviour problems and diagnosed mental disorder. Methods The present authors studied the early manifestation and continuity of problem behaviours in 205 pre-school children with and without developmental delays. Results Behaviour problems were quite stable over the year from age 36,48 months. Children with developmental delays were rated higher on behaviour problems than their non-delayed peers, and were three times as likely to score in the clinical range. Mothers and fathers showed high agreement in their rating of child problems, especially in the delayed group. Parenting stress was also higher in the delayed group, but was related to the extent of behaviour problems rather than to the child's developmental delay. Conclusions Over time, a transactional model fit the relationship between parenting stress and behaviour problems: high parenting stress contributed to a worsening in child behaviour problems over time, and high child behaviour problems contributed to a worsening in parenting stress. Findings for mothers and fathers were quite similar. [source] Cerebral Embolism of Iodized Oil (Lipiodol) after Transcatheter Arterial Chemoembolization for Hepatocellular CarcinomaJOURNAL OF NEUROIMAGING, Issue 4 2009Joon-Tae Kim MD ABSTRACT Cerebral lipiodol embolism is a rare complication of transcatheter arterial chemoembolization (TACE). Its pathological mechanism remains ambiguous despite several investigations. In Case 1, a 67-year-old man with hepatocellular carcinoma (HCC) experienced neurological deficits soon after undergoing a fourth session of TACE. Computed tomography (CT) scan showed multiple hyperdense lesions along the gyrus of frontal lobes and in the subcortical white matter. Transcranial Doppler (TCD) and transesophageal echocardiogram performed during the intravenous injection of agitated saline documented the presence of a right-to-left shunt (RLS) by demonstrating microbubbles in the left middle cerebral artery and left atrium. In Case 2, a 63-year-old woman underwent a third TACE due to a large HCC. After the procedure, her mental status deteriorated. Brain CT showed multiple hyperdense lesions on the cerebral and cerebellar cortex. TCD with agitated saline showed multiple microembolic signals shortly after the injection of agitated saline. The risk of cerebral lipiodol embolism may increase with recurrence and progression of HCC in patients who have a pre-existing RLS in the heart or lung. A test for the detection of an RLS may be necessary to identify patients with a heightened risk of cerebral embolism when multiple TACE procedures are required. TACE for HCC can cause pulmonary embolism or infarction.1,2 However, cerebral lipiodol embolism is rare after TACE. There have been several reports of cerebral embolism after TACE, but their exact mechanism has not yet been fully elucidated. We report herein 2 patients who developed cerebral lipiodol embolism after undergoing multiple TACE procedures for remnant HCC through a pre-existing RLS. [source] A Functional Polymorphism of the , -Opioid Receptor Gene (OPRM1) Influences Cue-Induced Craving for Alcohol in Male Heavy DrinkersALCOHOLISM, Issue 1 2007Esther Van Den Wildenberg Background: The , -opioid receptor gene (OPRM1) codes for the , -opioid receptor, which binds , -endorphin. The A118G polymorphism in this gene affects , -endorphin binding such that the Asp40 variant (G allele) binds , -endorphin 3 times more tightly than the more common Asn40 variant (A allele). This study investigated the influence of the A118G polymorphism on cue reactivity after exposure to an alcoholic beverage in male heavy drinkers. Methods: Participants were either homozygous for the A allele (n=84) or carrying at least 1 copy of the G allele (n=24). All participants took part in a cue-reactivity paradigm where they were exposed to water and beer in 3-minute trials. The dependent variables of main interest were subjective craving for alcohol, subjective arousal, and saliva production. Results: G allele carriers reported significantly more craving for alcohol than the A allele participants (as indicated by the within-subject difference in craving after beer vs after water exposure). No differences were found for subjective arousal and saliva. Both groups did not differ in family history of alcoholism. Participants with the G allele reported a significantly higher lifetime prevalence of drug use than participants homozygous for the A allele. Conclusions: A stronger urge to drink alcohol after exposure to an alcoholic beverage might contribute to a heightened risk for developing alcohol-related problems in individuals with a copy of the G allele. The G allele might also predispose to drug use in general. [source] Neurobiological Processes in Adolescent Addictive DisordersTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 1 2008Ty S. Schepis PhD The purpose of this review is to summarize the neurobiological factors involved in the etiology of adolescent addiction and present evidence implicating various mechanisms in its development. Adolescents are at heightened risk for experimentation with substances, and early experimentation is associated with higher rates of SUD in adulthood. Both normative (e.g., immature frontal-limbic connections, immature frontal lobe development) and non-normative (e.g., lowered serotonergic function, abnormal hypothalamic-pituitary-adrenal axis function) neurobiological developmental factors can predispose adolescents to a heightened risk for SUD. In addition, a normative imbalance in the adolescent neurobiological motivational system may be caused by the relative underdevelopment of suppressive mechanisms when compared to stimulatory systems. These neurobiological liabilities may correspond to neurobehavioral impairments in decision-making, affiliation with deviant peers and externalizing behavior; these and other cognitive and behavioral traits converge with neurobiological factors to increase SUD risk. The progression to SUD acts as an amplifying feedback loop, where the development of SUD results in reciprocal impairments in neurobehavioral and neurobiological processes. A clearer understanding of adolescent neurobiology is a necessary step in the development of prevention and treatment interventions for adolescent SUD. [source] Floating limb behaviors and self-biting are associated in laboratory monkeysAMERICAN JOURNAL OF PRIMATOLOGY, Issue 8 2010Kathy L. Bentson Abstract Early descriptions of floating limb behaviors in monkeys were associated with isolation rearing, a practice that ended more than two decades ago. The present authors named various forms of behaviors in which a leg is elevated for no apparent reason: "Floating Limb Suite" (FLS). Floating limb behaviors, identified in laboratory monkeys at the Washington National Primate Research Center (WaNPRC), consist of two subcategories distinguished by whether monkeys seem to react to the elevated leg or ignore it. Given the past association of isolation rearing with both self-biting (SB) and floating limb, the investigators predicted that SB and FLS would be associated in monkeys not reared in isolation. The investigators tracked, over a period of 3 years, the presence of FLS and SB in macaques (Macaca nemestrina, M. fascicularis, M. mulatta) and Papio cynocephalus at WaNPRC. SB and both subcategories of FLS occurred in mother-reared and surrogate-peer-nursery-reared monkeys. We analyzed presence of FLS, the two subcategories of FLS, and SB in 1,117 macaques monitored for up to 3 years, and 781 macaques observed for 8,min of structured data collection. The Papio sample size was insufficient for statistical analysis. Both sampling methodologies found FLS and FLS subcategories to be associated with SB. Nearly half the monkeys only engaging in seemingly harmless nonreactive forms of FLS also performed the potentially injurious behavior of self-biting. The positive association between FLS and SB suggests that monkeys exhibiting one of these behaviors are at a heightened risk for developing the other. One impediment to studying floating limb behaviors is lack of consensus on definitions. This study defined seven forms of apparently functionless elevated limb behaviors. Continued research on factors associated with floating limb behaviors across demographic groups and settings may provide insights into the etiology and treatment of self-biting. Am. J. Primatol. 72:725,733, 2010. © 2010 Wiley-Liss, Inc. [source] Psychosocial outcomes at 15 years of children with a preschool history of speech-language impairmentTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 8 2006Margaret J. Snowling Background:, Evidence suggests there is a heightened risk of psychiatric disorder in children with speech-language impairments. However, not all forms of language impairment are strongly associated with psychosocial difficulty, and some psychiatric disorders (e.g., attention deficit/hyperactivity disorder (ADHD)) are more prevalent than others in language-impaired populations. The present study assessed the psychosocial adjustment in adolescence of young people with history of speech-language impairment, and investigated specific relationships between language deficits and psychiatric disorders. Methods:, Seventy-one young people (aged 15,16 years) with a preschool history of speech-language impairment were assessed using a psychiatric interview (K-SADS) supplemented by questionnaires probing social encounters and parental reports of behaviour and attention. Their psycho-social adjustment was compared with that of a cross-sectional control group of age-matched controls. Results:, Overall the rate of psychiatric disorder was low in the clinical sample and children whose language delay had resolved by 5.5 years had a good outcome. For those whose language difficulties persisted through the school years, there was a raised incidence of attention and social difficulties. These difficulties were partially independent and associated with different language profiles. The group with attention problems showed a profile of specific expressive language difficulties; the group with social difficulties had receptive and expressive language difficulties; and the group with both attention and social difficulties was of low IQ with global language difficulties. Conclusions:, Amongst children with speech-language delays at 5.5 years, those with more severe and persistent language difficulties and low nonverbal IQ are at higher risk of psychiatric morbidity in adolescence. [source] Risky Parental Behavior and Adolescent Sexual Activity at First CoitusTHE MILBANK QUARTERLY, Issue 3 2002Esther I. Wilder In comparison with other industrialized countries, the United States has exceptionally high rates of adolescent pregnancy and abortion. In 1999, nearly half of high-school students reported having had sexual intercourse, and 6 percent said they had been pregnant or gotten someone pregnant (CDC 2000). American adolescents are especially unlikely to use birth control, and those who do practice contraception tend to rely on inefficient methods (Forrest 1990). Sexual behavior at first intercourse is of particular interest because early entry into sexual activity is associated with contraceptive nonuse and a heightened risk of pregnancy (Abma and Sonenstein 2001; Koenig and Zelnik 1982; Zabin, Kantner, and Zelnik 1979). Moreover, the timing of first intercourse may be a useful marker for risky sexual behavior and a history of sexually transmitted diseases (Greenberg, Magder, and Aral 1992). For example, age at first intercourse is inversely associated with the number of lifetime sexual partners (McGuire et al. 1992). Data from the National Longitudinal Study of Adolescent Health (Add Health) were used to examine the impact of parents' behavior on adolescents' sexual experience and contraceptive use. All else being equal, adolescents whose parents engage in risky behaviors are especially likely to be sexually active and to have had sex before age 15. These findings are only partly attributable to the link between parents' risky behaviors (smoking, drinking, driving without seatbelts) and adolescents' risky behaviors (smoking, drinking, delinquent activity, association with substance-using peers). Although parental behaviors are effective predictors of adolescents' sexual activity, they are not effective predictors of contraceptive use or of method choice at first coitus. Overall, parents with low levels of self-efficacy seem to be especially likely to have children at risk of engaging in problem behaviors. [source] Body mass and extinction risk in Australian marsupials: The ,Critical Weight Range' revisitedAUSTRAL ECOLOGY, Issue 1 2009CHRISTOPHER N. JOHNSON Abstract Australian mammals have suffered an exceptionally high rate of decline and extinction over the last two hundred years. Body mass is linked to extinction risk in Australian mammals, but the nature of this association is controversial. A widely held view is that species of intermediate body mass (between 35 and 5500 g, the ,critical weight range', CWR) have declined most severely. However, the existence of the CWR has been disputed. In this paper we clarify the relationship of decline status and body mass in Australian marsupials. We show that the form of this relationship differs for ground-living versus arboreal species, and for species from low versus high rainfall areas. Among ground-living species and those from low-rainfall areas, declines were strongly size-selective and concentrated on species within the CWR. For the remaining species, decline was only weakly related to body mass with no evidence of heightened risk for species of intermediate size. We conclude that for terrestrial species in low rainfall areas, species within the CWR are most at risk of decline and extinction. [source] Apgar score and dental caries risk in the primary dentition of five year oldsAUSTRALIAN DENTAL JOURNAL, Issue 3 2010AE Sanders Abstract Background:, Conditions in utero and early life underlie risk for several childhood disorders. This study tested the hypothesis that the Apgar score predicted dental caries in the primary dentition. Methods:, A retrospective cohort study conducted in 2003 examined associations between conditions at birth and early life with dental caries experience at five years. Dental examination data for a random sample of five-year-old South Australian children were obtained from School Dental Service electronic records. A questionnaire mailed to the parents obtained information about neonatal status at delivery (five-minute Apgar score, birthweight, plurality, gestational age) and details about birth order, weaning, and behavioural, familial and sociodemographic characteristics. Results:, Of the 1398 sampled children with a completed questionnaire (response rate = 64.6%), 1058 were singleton term deliveries among whom prevalence of dental caries was 40.1%. In weighted log-binomial regression analysis, children with an Apgar score of <=8 relative to a score of 9,10 had greater probability of dental caries in the primary dentition after adjusting for sociodemographic and behavioural covariates and water fluoridation concentration (adjusted PR = 1.47, 95% CI = 1.11, 1.95). Conclusions:, Readily accessible markers of early life, such as the Apgar score, may guide clinicians in identifying children at potentially heightened risk for dental caries and aid decision-making in allocating preventive services. [source] Strategies for improving melanoma education and screening for men age , 50 yearsCANCER, Issue 7 2002Findings from the American Academy of Dermatology National Skin Cancer Screening Program Abstract BACKGROUND Recently, the Institute of Medicine (2000) and the Third United States Preventive Services Task Force (2001) called for studies to help clinicians identify patients, especially elderly patients, who are at high risk for melanoma. In the current study, the authors sought to identify factors associated with a high yield in skin cancer screening and to explore strategies for improving mass screenings for melanoma. METHODS The authors analyzed the data base of the 242,374 skin cancer screenings conducted on more than 206,000 Americans who attended the American Academy of Dermatology National Skin Cancer Screening Programs during the period 1992,1994. RESULTS Ninety-six percent of 3476 screenees with a presumptive diagnosis of melanoma or possible melanoma were contacted, and follow-up records were obtained for 73% of screenees. Of these, 363 screenees had histologically proven melanoma. Middle-aged and older men (age , 50 years) comprised only 25% of screenees but comprised 44% of those with a confirmed diagnosis of melanoma. The overall yield of melanoma (the number of confirmed diagnoses per the number of screenees) was 1.5 per 1000 screenings (363 diagnoses of 242,374 screenees) compared with a yield of 2.6 per 1000 screenings among men age , 50 years. The yield was improved further for men age , 50 years who reported either a changing mole (4.6 per 1000 screenings) or skin types I and II (3.8 per 1000 screenings). The predictive value of a screening diagnosis of melanoma was more than twice as high for men age , 50 years with either a changing mole or skin types I and II compared with all other participants. CONCLUSIONS The yield of mass screening for melanoma would be improved by outreach to middle-aged and older men, with particular focus on men with changing moles or with skin types I and II. Primary care physicians should be attuned to the risk factors among all of their patients but should be alerted in particular to the heightened risk of melanoma for men age , 50 years. Formal assessment of the impact of targeted screening on mortality warrants further study. Cancer 2002;95:1554,61. © 2002 American Cancer Society. DOI 10.1002/cncr.10855 [source] | |||||||||||||