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PubMed2005

Prevalence of selected risk and protective factors for falls in the home.

BACKGROUND: Falls are the most common cause of both fatal and nonfatal unintentional injury in the home environment. This research describes the prevalence of fall-related risk and protective factors in U.S. homes. METHODS: A random-digit-dial survey was conducted of 1003 households in the continental United States to estimate the prevalence of risk and protective factors for falls in homes. Data were weighted to reflect the national distribution of households. RESULTS: Fall hazards such as stairs with four or more steps (70%), absence of railings on stairs (34%), and use of ladders (60%) are common in many households. Use of grab bars and handrails in the bathroom was low, as was the presence of guards and locks on windows (both 25%). However, households with young children and older adults reported greater use of appropriate antifall devices. Sixty-five percent of households with children aged </=2 years reported using safety gates on stairs. Higher household income and owner-occupied (as opposed to rental) homes had an increased prevalence of fall hazards (more stairs without railings, greater use of ladders). CONCLUSIONS: Considerable opportunity exists for increased use of antifall protective devices and reduction of fall hazards.

Accidental Falls↗
PubMed2005

Immunogenetic risk and protective factors for the idiopathic inflammatory myopathies: distinct HLA-A, -B, -Cw, -DRB1 and -DQA1 allelic profiles and motifs define clinicopathologic groups in caucasians.

The idiopathic inflammatory myopathies (IIM) are systemic connective tissue diseases in which autoimmune pathology is suspected to promote chronic muscle inflammation and weakness. We have performed low to high resolution genotyping to characterize the allelic profiles of HLA-A, -B, -Cw, -DRB1, and -DQA1 loci in a large population of North American Caucasian patients with IIM representing the major clinicopathologic groups (n = 571). We confirmed that alleles of the 8.1 ancestral haplotype were important risk markers for the development of IIM, and a random forests classification analysis suggested that within this haplotype, HLA-B*0801, DRB1*0301 and/ or closely linked genes are the principal HLA risk factors. In addition, we identified several novel HLA factors associated distinctly with 1 or more clinicopathologic groups of IIM. The DQA1*0201 allele and associated peptide-binding motif (KLPLFHRL) were exclusive protective factors for the CD8+ T cell-mediated IIM forms of polymyositis (PM) and inclusion body myositis (IBM) (pc < 0.005). In contrast, HLA-A*68 alleles were significant risk factors for dermatomyositis (DM) (pc = 0.0021), a distinct clinical group thought to involve a humorally mediated immunopathology. While the DQA1*0301 allele was detected as a possible risk factor for IIM, PM, and DM patients (p < 0.05), DQA1*03 alleles were protective factors for IBM (pc = 0.0002). Myositis associated with malignancies was the most distinctive group of IIM wherein HLA Class I alleles were the only identifiable susceptibility factors and a shared HLA-Cw peptide-binding motif (AGSHTLQWM) conferred significant risk (pc = 0.019). Together, these data suggest that HLA susceptibility markers distinguish different myositis phenotypes with divergent pathogenetic mechanisms. These variations in associated HLA polymorphisms may reflect responses to unique environmental triggers resulting in the tissue pathospecificity and distinct clinicopathologic syndromes of the IIM.

Adult↗
PubMed2005

Individual, family, school, and community risk and protective factors for depressive symptoms in adolescents: a comparison of risk profiles for substance use and depressive symptoms.

This study examines the relationship between adolescent depressive symptoms and risk and protective factors identified for substance use. A questionnaire, developed to measure these factors in a young person's community, family, school, peer group, and individual characteristics for substance use, was used to assess associations with self-reported depressive symptoms. Data were provided by a representative sample of 8984 secondary school students in Victoria, Australia. The prevalence of depressive symptoms was 10.5% (95% CI 9.2,12.0) for males and 21.7% (95% CI 20.3,23.7) for females. Depressive symptoms were associated with factors in all domains, with the strongest associations in the family domain. Strong relationships were found between the number of elevated risk and protective factors and depressive symptoms, maintained after adjusting for substance use. Patterns of associations were similar for users and nonsubstance users. The findings indicate that prevention programs targeting factors for substance use have the potential to impact on depression.

Adolescent↗
PubMed2005

Protective factors for youth considered at risk of criminal behaviour: does participation in extracurricular activities help?

BACKGROUND: There is a lack of research investigating the potential protective effect of participation in extracurricular activities on youth who are at risk of engaging in delinquent activity. AIM: This study examined the potential for participation in extracurricular activities to act as a protective factor for youth deemed at risk of engaging in delinquent activity. METHOD: One hundred and sixty-nine secondary students from Glasgow, Scotland completed two questionnaires (the Youth Self-Report and an additional information sheet) requesting information about their participation in extracurricular and delinquent activities as well as their possible risk factors. Activities included sports, non-sports (hobbies and games), current activities (youth clubs and other organisations) and previous involvement in activities. Risk factors included residing in a broken home, having four or more siblings, academic failure and lacking a non-parental very important person. Delinquent activities included rule-breaking and aggressive behaviours. RESULTS: Independent samples t-tests found that females participated in significantly more non-sports and previous activities than males and that males participated in significantly more rule-breaking behaviour than females. Hierarchical multiple regression analyses found that gender and participation in sports were strong predictors of rule-breaking behaviour. A significant positive correlation was found between participation in sports and involvement in aggressive behaviour. CONCLUSION: The results suggest that participation in extracurricular activities does not act as a protective factor for youth, regardless of whether or not they are considered to be at risk of engaging in delinquent activity. The significant correlation found between participation in sports and involvement in aggressive behaviour suggests that youth participation in sports may act as a risk factor.

Adolescent↗
PubMed2005

Protective factors against suicidal behavior in Latinos.

Latinos appear to be relatively protected against suicidal behavior, but the factors that mediate this effect are not known. Some protective factors may be related to cultural constructs that provide a buffer against suicidal behavior in the face of psychiatric illness. We sought to determine whether the Reasons for Living Inventory (RFLI) might capture protective factors against suicidal behavior in Latinos and non-Latinos. Patients with major depression, bipolar disorder, or schizophrenia were interviewed regarding their depressive symptomatology and lifetime history of suicidal behavior. The RFLI, which measures protective factors against suicidal acts, was also administered. Multivariate analyses were used to assess the relationship between suicide measures, ethnicity, and selected clinical and demographic variables. Although Latinos and non-Latinos did not differ significantly in attempter status (attempter/nonattempter), number of attempts, or suicide intent, Latinos reported significantly less suicidal ideation and made less lethal attempts. On the RFLI, Latinos scored significantly higher on subscales regarding survival and coping beliefs, responsibility to family, and moral objections to suicide, possibly reflective of cultural norms endorsed by Latino groups. Multivariate analyses suggested that although being Latino was independently associated with less suicidal ideation, other suicidal behaviors held a stronger relationship to moral objections to suicide and survival and coping skills than to ethnicity. Self-identification as Latino may be associated with espousing cultural constructs that mediate protective effects against suicidal behavior. Constructs identified in the RFLI may protect Latinos from acting on suicidal thoughts, affecting moral objections to suicide and survival and coping beliefs. Further studies to elucidate the impact of these factors on suicidal behavior and their relationship to specific cultural constructs would be of interest.

Adaptation, Psychological↗
PubMed1996

A fragment of staphylococcal nuclease with an OB-fold structure shows hydrogen-exchange protection factors in the range reported for "molten globules".

Hydrogen-exchange rates for an OB-fold subdomain fragment of staphylococcal nuclease have been measured at pH 4.7 and 4 degrees C, conditions close to the minimum of acid/base catalyzed exchange. The strongest protection from solvent exchange is observed for residues from a five-stranded beta-barrel in the NMR structure of the protein. Protection factors, calculated from the experimental hydrogen-exchange rates, range between 1 and 190. Similarly small protection factors have in many cases been attributed to "molten globule" conformations that are supposed to lack a specific tertiary structure. The present results suggest that marginal protection from solvent exchange does not exclude well-defined structure.

Hydrogen Bonding↗
PubMed2004

Methods used to evaluate the immune protection factor of a sunscreen: advantages and disadvantages of different in vivo techniques.

Solar UV radiation (UVR) induces skin cancer in humans, a process partially mediated by UVR-induced immunosuppression. To help prevent skin cancer, sunscreens should prevent UVR-induced immunosuppression to a level that is comparable to their sun protection factor (SPF). There are no standardized protocols for determining the immune protection factor (IPF) of sunscreens or agreement on what degree of IPF is needed to fully preserve cutaneous immune function. Current in vivo approaches to this problem rely on sunscreens' ability to prevent localized UVR-induced suppression of contact hypersensitivity (CHS) and delayed-type hypersensitivity (DTH) responses, using either the induction or elicitation arms of these responses, with comprehensive controls. The induction arm of the CHS response is sensitive to a single suberythemal exposure of solar-simulated radiation (SSR), and allows for direct SPF and IPF comparisons. However, this approach requires a large number of volunteers and is extremely labor-intensive and time-consuming. The elicitation arm of the CHS or DTH response exploits prior sensitization to contact or recall antigens. Fewer volunteers are needed, but current protocols require repeat SSR exposure, which may invalidate comparison with SPF measures based on a single exposure, or erythemal doses, which may have systemic effects. Robust protocols for routinely assessing IPF are needed.

Allergens↗
PubMed1996

Obesity as a protective factor for postmenopausal osteoporosis.

BACKGROUND: Obesity is considered a protective factor for osteoporosis improving bone mass and maintaining higher levels of estrogen during menopause. OBJECTIVE: To determine the association of obesity with bone mineral density (BMD), and its relationship with sex hormone levels. DESIGN: A case-control study in Caucasian obese and non obese postmenopausal women. SUBJECTS: 113 obese and 50 non-obese postmenopausal women. MEASUREMENTS: BMD (dual-photon X-ray absorptiometry) at cervical femur. Ward's triangle, proximal radius and lumbar spine. Plasma levels of glucose, insulin, total estrogen, follicle stimulating hormone (FSH), sex hormone binding globulin (SHBG), dehydroepiandrosterone sulfate (DHA-S) and testosterone. RESULTS: Mean BMD at femoral sites were significantly higher in obese women (femoral neck: 0.849 +/- 0.124 g/cm2 vs 0.753 +/- 0.095 g/cm2, P < 0.001; Ward's triangle: 0.634 +/- 0.134 g/cm2 vs. 0.553 +/- 0.100 g/cm2, P < 0.001). Mean BMD at lumbar spine was 0.906 +/- 0.138 g/cm2 in obese women and 0.849 +/- 0.137 g/cm2 in non obese, P < 0.017. A decreased risk of osteopenia in femoral neck (Age adjusted OR = 0.36, 95%CI 0.17-0.75) and in lumbar spine (Age adjusted OR = 0.43, 95%CI 0.20-0.91) in obese women was observed. Although total estrogen were similar in both groups, in obese women, SHBG was lower (68.6 +/- 26.84 nmol/l vs. 85.1 +/- 31.18 nmol/l, P < 0.001), and postglucose load insulin levels were higher, than in non obese (77.2 +/- 50.4 Ul/ml vs. 49.4 +/- 24.1 Ul/ml, P < 0.0005). CONCLUSION: The findings confirm a higher BMD in obese women and suggest that obesity exerts protection due to a decreased SHBG thus increasing free sex steroids. Besides, hyperinsulinemia may produce a decline in the production of IGFBG-1, leading to an increase of IGF-1, that may stimulate the proliferation of osteoblasts.

Bone Density↗
PubMed1999

Sun protection factor measurement of sunscreens is dependent on minimal erythema dose.

This study investigates the influence of skin colour and minimal erythema dose (MED) on the in vivo determination of sunscreen sun protection factors (SPFs). The MEDs of groups of 10-20 subjects were measured on the lower back with a 1000-W solar-simulated xenon arc lamp. Five sunscreens, with commercially measured SPFs ranging from 4 to 30 + were then tested on the different groups, and their SPFs were correlated with volunteers' MEDs. We found that the sunscreens had higher SPF values when tested on subjects with lower MEDs and paler skin. The SPF values obtained with our ultraviolet (UV) source were lower than the SPF values reported with commercially used solar simulators. We conclude that while SPF tests with artificial UV sources and pale-skinned volunteers can and should be used to rank the efficacy of various sunscreens in preventing sunburn, they should not be interpreted as measures of a sunscreen's absolute level of sun protection. Factors such as the differences in skin colour and MED between subjects used for SPF testing and the general population, the spectral differences between sunlight and artificial UV, as well as the tendency of the public to apply only small amounts of sunscreen and to re-apply it infrequently, mean that laboratory and sunlight SPFs may be markedly different.

Adult↗
PubMed1999

Psychosocial risk and protective factors for adolescent tobacco use.

Knowledge of risk and protective factors for adolescent tobacco use will lead to the development of improved intervention strategies to reduce/prevent tobacco use. Theory and empirical findings demonstrate the multivariate complexity of the etiology of tobacco use. Sociocultural, social/interpersonal, and intrapersonal factors act through mediated chains of ultimate, distal, and proximal influences. Some influences moderate the effects of others. Once tobacco is used, feedback mechanisms modify prior causes that in turn alter subsequent tobacco use behavior. Most theories and cross-sectional, prospective, and causal process studies have contained major limitations: (a) most addressed only small portions of the total picture; (b) most mediational studies did not test for interactions and most moderation studies are based on limited theory (if any); and (c) most theories do not discuss how the causal processes might be different for males and females or for different ethnic groups (special cases of moderation). Furthermore, few studies focused on more distal or ultimate influences or examined multi-stream patterns, and few theories or causal process studies have specified or tested feedback loops. Determining psychosocial risk factors and how they influence tobacco use faces several major challenges, including discovering complex mediating processes, moderating variables, and overcoming limitations of surveys and theory. We offer six recommendations to advance transdisciplinary tobacco-prevention research: (a) base future studies on strong theory and aim to test one or more theories or theoretically derived hypotheses; (b) collect four or more waves of data and adopt dynamic strategies of prediction and analysis, including interactions, indirect effects, feedback loops, and transitions from one level of tobacco use to another; (c) provide evidence of generalizability to sub-populations within the study sample, such as by gender, ethnic group, and socioeconomic status; (d) use high-quality measures and multiple methodologies, including non-panel longitudinal studies, intensive interview, ethnography, experimental intervention, and small exploratory studies as well as further prospective studies; (e) include variables from multiple streams of influence to investigate interrelationships among cultural, social, and intrapersonal factors; and (f) collect data from multiple nested units (e.g., children within families, within schools, within neighborhoods) and employ multi-level analysis methods to investigate interrelationships among ultimate, distal, and proximal variables.

Adolescent↗
PubMed2001

Cholesteryl ester transfer protein as a protective factor against vascular disease in hemodialysis patients.

Cholesteryl ester transfer protein (CETP) may promote reverse cholesterol transport. An elevated concentration of high-density lipoprotein cholesterol (HDL-C) is a protective factor against atherosclerosis. However, the effects of CETP itself and its interaction with HDL-C have not been investigated in hemodialysis patients, who are at high risk for atherosclerosis and generally considered to have decreased reverse cholesterol transport. We investigated the independent or synergistic influence of postprandial serum CETP and HDL-C concentrations on apparent atherosclerotic complications in 202 hemodialysis patients aged 40 to 80 years. Patients with vascular disease (n = 39) had significantly lower concentrations of CETP than those without vascular disease (n = 163). When all study subjects were divided into four groups according to CETP and HDL-C concentrations based on median values, we found significant differences in the prevalence of vascular disease (test for trend, P < 0.005): 28.8% in group I (HDL-C < 48 mg/dL; CETP < 2.2 microgram/mL); 25.0% in group II (HDL-C < 48 mg/dL; CETP >/= 2.2 microgram/mL); 17.8% in group III (HDL-C >/= 48 mg/dL; CETP < 2.2 microgram/mL); and 6.9% in group IV (HDL-C >/= 48 mg/dL; CETP >/= 2.2 microgram/mL). Multiple logistic regression analysis retained the interaction term between HDL-C (in milligrams per deciliter) and CETP (in micrograms per milliliter), but not HDL-C or CETP itself, as inversely associated with vascular disease in the entire patient group. In patients with HDL-C levels at the median value or greater, CETP had an independent odds ratio of 0.31 (95% confidence interval, 0.1 to 0.97; P < 0.05) after adjusting for age. These results suggest that CETP may serve as a protective factor against vascular disease in hemodialysis patients, especially those with normal or elevated HDL-C concentrations.

Adult↗
PubMed2003

Adolescent health in the Caribbean: risk and protective factors.

OBJECTIVES: This study sought to identify, among youths, factors associated with characteristics such as poor health status, substance use, and suicide risk and to explore the extent to which the risk and protective factors identified cut across health-compromising behaviors. METHODS: A survey was administered to representative samples of young people from 9 Caribbean countries. RESULTS: Physical/sexual abuse and having a friend or relative who had attempted suicide were associated with an increased prevalence of health-compromising behaviors. Connectedness with parents and school and attendance at religious services were associated with fewer health risk behaviors. CONCLUSIONS: When the identified risk and protective factors were compared with those seen among young people in the United States, similarities as well as important differences were found.

Adolescent↗
PubMed2006

Risk and protective factors for psychopathology among older versus younger adults after the 2004 Florida hurricanes.

OBJECTIVE: Previous research demonstrates increased resiliency to psychopathology after disasters among older adults. However, little is known about differences in age-based risk and protective factors for postdisaster mental illness. METHOD: The authors used random-digit dialing methodology to survey 1,130 older adults (60+ years) and 413 younger adults residing in Florida counties directly affected by the 2004 hurricanes. Assessed risk and protective factors included demographics, social support, displacement, incurred dollar losses, perceived positive outcomes, and self-rated health status. Outcome variables included symptom counts of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-defined posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). RESULTS: Older adults reported fewer symptoms of PTSD, MDD, and GAD. Explanatory risk variables accounted for large proportions of variance, but differed in meaningful ways across age groups. CONCLUSION: Although older adults are less symptomatic, their psychologic reactions appear more closely connected to economic consequences of disasters.

Adult↗
PubMed2005

Clustering of protective factors for glucose intolerance and insulin resistance: a cross-sectional study.

AIMS: A cluster of interrelated factors: a body mass index (BMI) < 25 kg/m(2), moderate exercise and alcohol intake, non-smoking and a favourable dietary pattern has been linked with markedly reduced risk of Type 2 diabetes. The aim of this study was to estimate the prevalence of a similar low-risk group in a sample of middle-aged Irish men and women, and determine whether this cluster is associated with a reduced risk of glucose intolerance (IFG and Type 2 diabetes according to ADA/WHO criteria) and insulin resistance [homeostasis model assessment (HOMA) score in upper quartile of distribution]. METHODS: A cross-sectional study involving a stratified random sample of 1018 general practice patients, aged 50-69 years. We defined a low-risk group based on the following variables: BMI < 25 kg/m(2); waist-hip ratio < 0.85 for women and 0.90 for men; never smoking status; participation in medium to high level of physical activity; light drinking (3.5-7 units of alcohol per week) and a 'prudent' dietary pattern. Valid data were available for glucose tolerance status and HOMA score and all exposure variables from 684 and 671 participants, respectively. RESULTS: A total of 7.5% of participants had none of the 'protective factors', 24.9% had one, 31.0% two, 23.3% three, 10.0% four, 3.0% five and 0.3% had six protective factors. In multivariate analyses the odds ratios for insulin resistance were 0.59, 0.48, 0.14 and 0.04 in persons with one, two, three and four or more low-risk factors, respectively, relative to those with none. Similar linear inverse trends were observed for glucose intolerance. CONCLUSIONS: The findings are consistent with an inverse linear relation between a cluster of core protective, lifestyle-related factors and the prevalence of both glucose intolerance and insulin resistance.

Aged↗
PubMed1993

[HLA DR7 as a protective factor against gold salt toxicity in rheumatoid arthritis].

We performed a study of antigens HLA type I and II (specificity DR) in 90 patients with diagnosis of Rheumatoid Arthritis (RA) treated with Sodium Aurothiomalate (SATM) in order to detect the presence of an antigen HLA which could act as a protective factor against toxicity by SATM. Our results demonstrated a decrease in the frequency of the antigen DR7 in patients with toxicity by SATM, which suggests a protective factor of this antigen against the development of toxic reactions due to gold salts.

Adult↗
PubMed2002

Basic fibroblast growth factor protects cardiac myocytes from iNOS-mediated apoptosis.

Basic fibroblast growth factor (bFGF) is an important angiogenic factor produced by hearts subjected to ischemia. However, the direct effects of bFGF on myocardial cells are unknown. Primary cultured cardiac myocytes from neonatal rats were stimulated with lipopolysaccharide (LPS), a potent inducer of inducible nitric oxide synthase (iNOS), in the presence or the absence of bFGF. LPS induced the expression of iNOS in cardiac myocytes, demonstrated at both mRNA and protein levels. We showed that LPS activated the apoptotic pathway, evidenced by TUNEL staining, DNA ladder formation, and morphologic features. LPS-induced apoptosis was blocked by the administration of L-NAME, an inhibitor of NOS. This indicates that LPS induces apoptosis via an iNOS-dependent pathway. Administration of bFGF completely inhibited myocardial cell apoptosis induced by hydrogen peroxide or acidic medium as well as LPS. To determine signaling pathways for this inhibitory effect, we utilized PD098059, an MEK-1-specific inhibitor. PD098059 blocked bFGF-induced activation of ERK (extracellularly responsive kinase)-1/2 and neutralized the apoptotic inhibitory effect of bFGF. These findings demonstrate that LPS induces myocardial cell apoptosis in an iNOS-dependent manner. The results also suggest that bFGF is a protective factor against myocardial cell apoptosis and that this protection requires the MEK-1-ERK pathway.

Animals↗
PubMed2003

Risk and protective factors for juvenile eating disorders.

Eating disorders are prevalent and complicated disorders which are difficult to treat. Unicausal and main effects models are not likely to do justice to the complexity of psychopathology encountered, as one considers etiology and pathogenesis. Risk and protection can arise out of several domains: biological, psychological and social. Risk and protective factors aggregate in specific developmental phases and interact to produce adverse outcomes. Temperamental factors, eating dysregulation, attachment, deficient self regulation and sociocultural ideals of health and beauty all contribute to pathogenesis. Applying the insights of developmental psychopathology to these disorders has considerable potential to lead to early and preventive interventions. Reviewing the current literature from this perspective and updating a similar discussion from 8 years ago, we witness a continued accumulation of quality empirical data. Compared to previous reviews, the field's attention has shifted to psychosocial/cultural domains relevant to eating, away from biological risk. In the aggregate, these data make possible the increasing differentiation of eating disorders from other psychopathology, and the specific pathways in which anorexia and bulimia may develop. Understanding of risk and vulnerability still outweighs our knowledge of protective factors and resilience. While an ideal study would be longitudinal, such studies are still extremely difficult to conduct and costly, thus, forcing us to further our understanding from lagged designs, cross-sectional data and case control studies. While these have many limitations, they do seem to produce an increasingly coherent account of the development of these disorders and prepare us for more targeted and longitudinal study of high risk populations.

Adolescent↗