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3Delirium has been a recognised syndrome in the intensive care unit for some years. This systematic review reports risk factors for delirium studied in the intensive care unit. Four predisposing and 21 precipitating factors, including nine laboratory blood values and seven items relating to the use or the administration of medication, were found to influence the onset of delirium in the intensive care unit in six publications. The APACHE II score and hypertension were the only factors reported twice. Risk factors for the development of intensive care delirium were understudied and underreported in the literature.
DOCUMENT
In this study, growth trajectories (from admission until unconditional release) of crime-related dynamic risk factors were investigated in a sample of Dutch forensic patients (N = 317), using latent growth curve modeling. After testing the unconditional model, three predictors were added: first-time offender versus recidivist, age, and treatment duration. Postanalyses were chi-square difference tests, t tests, and analyses of variance (ANOVAs) to assess differences in trajectories. Overall, on scale level, a decrease of risk factors over time was found. The predictors showed no significant slope differences although age and treatment duration differed significantly at some time points. The oldest age group performed worse, especially at later time points. Treatment duration effects were found at the second time point. Our results that forensic patients show a decrease in crime-related risk factors may indicate that treatment is effective. This study also found differences in growth rates, indicating the effect of individual differences
DOCUMENT
Objectives To report (1) the injury incidence in recreational runners in preparation for a 8-km or 16-km running event and (2) which factors were associated with
an increased injury risk.
Methods Prospective cohort study in Amsterdam, the Netherlands. Participants (n=5327) received a baseline survey to determine event distance (8 km or 16 km), main sport, running experience, previous injuries, recent overuse injuries and personal characteristics. Three days after the race, they received a follow-up survey to determine duration of training period, running distance per week, training hours, injuries during preparation and use of
technology. Univariate and multivariate regression models were applied to examine potential risk factors for injuries.
Results 1304 (24.5%) participants completed both surveys. After excluding participants with current health problems, no signed informed consent, missing or incorrect data, we included 706 (13.3%) participants. In total, 142 participants (20.1%) reported an injury during preparation for the event. Univariate analyses (OR: 1.7, 95% CI 1.1 to 2.4) and multivariate analyses (OR: 1.7, 95% CI 1.1 to 2.5) showed that injury history was a significant risk factor for running injuries (Nagelkerke R-square=0.06).
Conclusion An injury incidence for recreational runners in preparation for a running event was 20%. A previous injury was the only significant risk factor for runningrelated injuries.
DOCUMENT
Previous studies have found evidence for a relationship between debt and crime, and for problems in childhood, education, work, and mental and physical health as underlying risk factors. However, insight into the interplay between these possible risk factors is limited. Therefore, a mixed methods approach was applied by both creating a quantitative Gaussian Graphical Model (GGM) and conducting qualitative analyses on 250 client files including risk assessment data from the Dutch probation service, to gain more specific insight into the interaction between potential risk factors. The results show that debt is strongly related to criminal behavior and problems in many life domains for most probation clients. Debt seems to be a direct risk factor for crime, but debt and crime also appear to be highly interrelated as part of a complex interplay of risk factors. The most frequently rated factors – limited or incomplete education, no job and related lack of income, and mental and physical health problems – are highly interwoven and increase the risk of both debt and crime. The findings stress the importance of paying attention to and using interventions focusing on strongly related crime risk factors, including debt, and their complex interplay, to supervise probation clients effectively.
DOCUMENT
Introduction Childhood-onset epilepsy during the years of transition to adulthood may affect normal social, physical, and mental development, frequently leading to psychosocial and health-related problems in the long term. Objective This study aimed to describe the main characteristics of patients in transition and to identify risk factors for poor psychosocial outcome in adolescents and young adults with epilepsy. Methods Patients with epilepsy, 15–25 years of age, who visited the Kempenhaeghe Epilepsy Transition Clinic from March 2012 to December 2014 were included ( n = 138). Predefined risk scores for medical, educational/occupational status, and independence/separation/identity were obtained, along with individual risk profile scores for poor psychosocial outcome. Multivariate linear regression analysis and discriminant analysis were used to identify variables associated with an increased risk of poor long-term psychosocial outcome. Results Demographic, epilepsy-related, and psychosocial variables associated with a high risk of poor long-term outcome were lower intelligence, higher seizure frequency, ongoing seizures, and an unsupportive and unstable family environment. Using the aforementioned factors in combination, we were able to correctly classify the majority (55.1%) of the patients regarding their risk of poor psychosocial outcome. Conclusion Our analysis may allow early identification of patients at high risk of prevention, preferably at pretransition age. The combination of a chronic refractory epilepsy and an unstable family environment constitutes a higher risk of transition problems and poor outcome in adulthood. As a consequence, early interventions should be put into place to protect youth at risk of poor transition outcome.
DOCUMENT
The high prevalence rate of tobacco consumption among teenage school students has become a global issue with profound implications for their developmental trajectory. Research conducted at drug-abuse hot-spots as a proximal factor related to tobacco use has been limited. Therefore, the present study examined the prevalence, risk factors, and protective factors of tobacco use among adolescents at drug-abuse hot-spots in Malaysia. Through stratified random sampling, the nationwide sample comprised 3382 school-going adolescents (71.4% male; mean age = 15.35 years [SD = 2.79]). The prevalence of tobacco use was 19.0% for current use and 28.5% for lifetime use. Stepwise logistic regression analysis showed that being male, being an older adolescent, living in urban areas, living many years in the hot-spot area, parental divorce, and having a high external locus of control were significant risk factors for tobacco use. High internal locus of control and good problem-coping skills were protective factors for tobacco use. Policy implications and suggestions for future research are discussed for the prevention and intervention of tobacco use among school-going adolescents.
DOCUMENT
BACKGROUND: fear of falling (FOF) is a major health problem among the elderly living in communities, present in older people who have fallen but also in older people who have never experienced a fall. The aims of this study were 4-fold: first, to study methods to measure FOF; second, to study the prevalence of FOF among fallers and non-fallers; third, to identify factors related to FOF; and last, to investigate the relationship between FOF and possible consequences among community-dwelling older persons. METHODS: several databases were systematically searched, and selected articles were cross-checked for other relevant publications. RESULTS: a systematic review identified 28 relevant studies among the community-dwelling elderly. Due to the many different kinds of measurements used, the reported prevalence of FOF varied between 3 and 85%. The main risk factors for developing FOF are at least one fall, being female and being older. The main consequences were identified as a decline in physical and mental performance, an increased risk of falling and progressive loss of health-related quality of life. CONCLUSION: this review shows that there is great variation in the reported prevalence of FOF in older people and that there are multiple associated factors. Knowledge of risk factors of FOF may be useful in developing multidimensional strategies to decrease FOF and improve quality of life. However, the only identified modifiable risk factor of FOF is a previous fall. In order to measure the impact of interventions, a uniform measurement strategy for FOF should be adopted, and follow-up studies should be conducted.
DOCUMENT
There is an urgency and need to develop an innovative strategic approach for organizations to develop a sustainable organization for the future, in which they are able to respond resiliently to major environmental challenges and changes in the short term and adjust the management of the organization. On the same time, in this strategic approach learning and transforming accordingly in the long term is involved as well. This approach will give organizations the opportunity to operationalize their boards’ and stakeholders’ ambitions to build a responsible business, with focus on governance elements, as well as interaction with social and environmental factors, risk, and strategy from a holistic view. In education, students could work with this approach in future projects for real companies.
DOCUMENT
Aim: In-hospital prescribing errors (PEs) may result in patient harm, prolonged hospitalization and hospital (re)admission. These events are associated with pressure on healthcare services and significant healthcare costs. To develop targeted interventions to prevent or reduce in-hospital PEs, identification and understanding of facilitating and protective factors influencing in-hospital PEs in current daily practice is necessary, adopting a Safety-II perspective. The aim of this systematic review was to create an overview of all factors reported in the literature, both protective and facilitating, as influencing in-hospital PEs. Methods: PubMed, EMBASE.com and the Cochrane Library (via Wiley) were searched, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, for studies that identified factors influencing in-hospital PEs. Both qualitative and quantitative study designs were included. Results: Overall, 19 articles (6 qualitative and 13 quantitative studies) were included and 40 unique factors influencing in-hospital PEs were identified. These factors were categorized into five domains according to the Eindhoven classification (‘organization-related’, ‘prescriber-related’, ‘prescription-related’, ‘technologyrelated’ and ‘unclassified’) and visualized in an Ishikawa (Fishbone) diagram. Most of the identified factors (87.5%; n = 40) facilitated in-hospital PEs. The most frequently identified facilitating factor (39.6%; n = 19) was ‘insufficient (drug) knowledge, prescribing skills and/or experience of prescribers’. Conclusion: The findings of this review could be used to identify points of engagement for future intervention studies and help hospitals determine how to optimize prescribing. A multifaceted intervention, targeting multiple factors might help to circumvent the complex challenge of in-hospital PEs.
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