Prevalence Of Modifiable Risk Factors Research Articles

Improving secondary prevention knowledge in immigrants after a heart attack: adapting and evaluating a virtual patient education resource to promote behaviour change

Abstract Funding Acknowledgements Type of funding sources: None. Background Coronary heart disease (CHD) is prevalent and recurrent (40%), whereas an estimated 75% of events could be avoided by secondary prevention of modifiable risk factors and healthy lifestyle. Structured in-person secondary prevention and patient education programs are both efficient and effective strategies; however, these programs may not meet immigrants’ care or home-based learning needs, and thus alternative educational models are needed. Purpose To adapt and evaluate the simplified Chinese version of Cardiac College, a co-designed evidence-based virtual patient education resource for heart attack, in Chinese immigrants on secondary prevention knowledge and behaviour change outcomes. Methods A prospective longitudinal pre-post study was undertaken in heart attack survivors recruited from cardiac rehabilitation programs at four metropolitan tertiary hospitals from May 2021 to November 2022. Chinese Cardiac College intervention was adapted and provided education via nine booklets and 10 pre-recorded video sessions structured and delivered to patients for four weeks following hospital discharge. Validated surveys measured health literacy, disease-related knowledge, physical activity, heart-healthy diet, and self-management behaviours at baseline and one to two weeks post-intervention. Acceptability, engagement, and satisfaction were also assessed post-intervention. Results From 81 patients assessed for eligibility, 67 were recruited, and 64 (95.5%) completed the study. The sample was aged mean 67.23 ± 8.12 years, and 81.25% were males. Participants had significant improvement in disease-related knowledge in total and in each domain, with the most improvement identified in medical, followed by exercise and psychological domains (p<0.001) (Table 1). Healthy dietary behaviour and other self-management behaviours also significantly improved (all p<0.05). All participants (100%) self-reported being engaged with the materials, rating content as highly acceptable (n=20, 31.3%) and highly satisfactory (n=30, 46.9%). In addition, most participants reported that the delivered information amount was adequate (n=44, 68.8%), and 26.6% (n=17) found it overwhelming. Conclusion A virtual patient-education intervention adapted for Chinese immigrants (Chinese Cardiac College) significantly improves secondary prevention knowledge and self-care behaviour in heart attack survivors and offers a suitable model for intervention, especially where there are limited bilingual staff or resources. Further testing of randomised controlled trials and multiple populations is required.

Cardiovascular health and potential cardiovascular risk factors in young athletes.

Cardiovascular disease remains the most common cause of death worldwide, and early manifestations are increasingly identified in childhood and adolescence. With physical inactivity being the most prevalent modifiable risk factor, the risk for cardiovascular disease is deemed low in people engaging in regular physical exercise. The aim of this study was to investigate early markers and drivers of cardiovascular disease in young athletes pursuing a career in competitive sports. One hundred and five athletes (65 males, mean age 15.7 ± 3.7 years) were characterized by measurement of body impedance to estimate body fat, blood pressure (BP), carotid femoral pulse wave velocity (PWV) to evaluate arterial elasticity, ergometry to assess peak power output, echocardiography to calculate left ventricular mass, and blood tests. Systolic BP was elevated in 12.6% and thereby more than twice as high as expected for the normal population. Similarly, structural vascular and cardiac changes represented by elevated PWV and left ventricular mass were found in 9.5% and 10.3%. Higher PWV was independently associated with higher systolic BP (β = 0.0186, p < 0.0001), which in turn was closely correlated to hemoglobin levels (β = 0.1252, p = 0.0435). In this population, increased left ventricular mass was associated with lower resting heart rate (β = -0.5187, p = 0.0052), higher metabolic equivalent hours (β = 0.1303, p = 0.0002), sport disciplines with high dynamic component (β = 17.45, p = 0.0009), and also higher systolic BP (β = 0.4715, p = 0.0354). Despite regular physical exercise and in the absence of obesity, we found an unexpected high rate of cardiovascular risk factors. The association of PWV, systolic BP, and hemoglobin suggested a possible link between training-induced raised hemoglobin levels and altered vascular properties. Our results point toward the need for thorough medical examinations in this seemingly healthy cohort of children and young adults. Long-term follow-up of individuals who started excessive physical exercise at a young age seems warranted to further explore the potential adverse effects on vascular health.

Prevalence of Modifiable Risk Factors in First-Presentation ST Elevation Myocardial Infarction Patients in Christchurch Hospital, New Zealand, Over a 5-Year Period in Māori and Non-Māori Populations

The prevalence of modifiable risk factors is known to be changing in some first-presentation ST elevation myocardial infarction cohorts worldwide. Many studies have noted an increase in patients without modifiable risk factors. This study aimed to assess the risk factors in first-presentation ST elevation myocardial infarction patients in Christchurch, New Zealand, over a 5-year period in Māori and Non-Māori populations. Data were extracted from the ANZACS-QI database from 1 January 2017 to 1 January 2023, for patients with ST elevation myocardial infarction presenting to Christchurch Hospital. Patients with prior cardiovascular disease were excluded. Prevalence of smoking, hypertension, dyslipidaemia, diabetes, and no modifiable risk factors were analysed using a two-proportion z-test. Of 1,138 patients, 66 were Māori. There was high prevalence of modifiable risk factors present with a disproportionately high rate of smoking among Māori (z=5.7; p<0.001). A total of 6.9% of the patients had no modifiable risk factors, with no significant difference found between Māori and Non-Māori (z=–0.29; p=0.2). Modifiable risk factors were still highly prevalent in this first ST elevation myocardial infarction population. Whilst risk factors such as smoking are declining in the general population, they remain highly prevalent in this group and disproportionally higher in Māori, likely contributing to health inequities. The proportion of patients who have no modifiable risk factors is relatively small.

Population attributable fraction of hypertension for dementia: global, regional, and national estimates for 186 countries.

Quantifying the proportion of dementia attributable to highly prevalent modifiable risk factors, such as hypertension, is important in informing effective dementia prevention strategies. We aim to quantify the population attributable fraction (PAF) of hypertension for dementia (the proportion of dementia cases that would not occur if hypertension was eliminated) at global, regional, and national levels. In this study, we searched international and governmental websites for global, regional, and national data reporting population hypertension (according to 10-year age categories) and dementia prevalence. MEDLINE was searched for studies reporting the risk of dementia from age at hypertension diagnosis from database inception to December 31, 2022. Longitudinal observational studies with >500 participants reporting hazard ratios by age at hypertension diagnosis for risk of future all-cause dementia were eligible for inclusion. Studies excluded had cross-sectional methodology, specific vascular dementia or 'cognitive impairment' outcomes, and no age-specific metrics of association reported. The PAF of hypertension for dementia was calculated globally and for each country and region worldwide. Data from the Global Burden of Disease, United Nations Population Prospectus, NCD Risk Factor Collaboration, UK Biobank, and Atherosclerosis Risk in Communities Study were obtained. 186 countries reported dementia and hypertension prevalence data. The global PAF of hypertension for dementia was 15.8% [95% Credible Interval (CI), 8.8%-22.7%]. Latin America and the Caribbean (18.0% [95% CI, 9.4%-26.6%]), and Europe (17.2% [95% CI, 9.6%-24.7%]) had the highest PAF of hypertension for dementia. Hypertension diagnosed between the ages of 30-44 had the highest age-specific global attributable fraction for dementia (8.4% [95% CI, 3.4%-13.5%]), followed by ages 45-54 (2.92% [ 95% CI, 0.96%-4.88%]), 55-64 (2.59% [95% CI, 1.15%-4.03%]) and 65-74 (1.82% [95% CI,-2.31%-5.96%]). The population attributable risk of hypertension for dementia is 15.8%, suggesting that optimal detection and treatment, particularly at midlife, has the potential to markedly reduce the global burden of dementia. Wellcome Trust; Health Research Board of Ireland; Alzheimer's Association.

Modifiable Risk Factors for Prevention in Dupuytren Disease: A UK Biobank Case-Control Study.

Dupuytren disease is associated with significant comorbidity and mortality, and it has no existing prevention strategies. It is unclear which modifiable risk factors are most amenable for prevention. This study aimed to determine the strength of modifiable risk factors for Dupuytren disease, and to investigate associations with other diseases. Using UK Biobank data, this case-control study analyzed the association between phenotypic variables and Dupuytren disease through multivariable logistic regression. Exposures assessed were age, sex, body mass index, waist-to-hip ratio, Townsend deprivation index, smoking status, alcohol intake, diabetes mellitus, hypertension, cancer, liver disease, respiratory disease, rheumatoid arthritis, epilepsy, psoriasis, and gout. There were 4148 cases and 397,425 controls. Male sex (OR, 3.23; 95% CI, 2.90 to 3.60; P = 1.07 × 10 -100 ), increasing age (OR, 1.08; 95% CI, 1.07 to 1.08; P = 6.78 × 10 -167 ), material deprivation (OR, 1.01; 95% CI, 1.00 to 1.02; P = 0.0305), high-density lipoprotein cholesterol (OR, 1.76; 95% CI, 1.58 to 1.96; P = 3.35 × 10 -24 ), smoking exposure, and alcohol intake were all associated with increased odds of Dupuytren disease. With increasing obesity class, there was approximately 25% decreased odds (OR, 0.774; 95% CI, 0.734 to 0.816; P = 4.71 × 10 -21 ). Diabetes with microvascular or end-organ complications was associated with more than 2.5 times increased odds of Dupuytren disease (OR, 2.59; 95% CI, 1.92 to 3.44; P = 1.92 × 10 -10 ). Within this group, increasing hemoglobin A1c values by 10 mmol/mol, or 0.9%, increased the odds by 31% (OR, 1.31; 95% CI, 1.13 to 1.51; P = 2.19 × 10 -4 ). Diabetes and poor glycemic control are major risk factors for Dupuytren disease, which present an opportunity for prevention. Risk, III.

Educational interventions to promote sun-protection behaviors in adolescents in the United States: A systematic review.

The most prevalent modifiable risk factor for skin cancer is cumulative lifetime exposure to ultraviolet (UV) radiation, supporting the development of interventions promoting the early adoption of sun-protection behaviors. This systematic review summarizes behavioral interventions designed to promote sun-protection behaviors and reduce harmful UV exposure among U.S. adolescents. Ten studies describing 15 intervention arms were ultimately included in this review and comprised seven cross-sectional studies, a cohort study, a quasi-experimental study, and a randomized controlled trial. Most interventions included in this review were effective in increasing awareness of skin cancer and knowledge of the risk factors for skin cancer, but knowledge did not correlate with self-reported frequency of sun-protection behaviors in this population.

An Experimental Study to Evaluate the Effectiveness of Video Assisted Teaching on Knowledge Regarding Early Sign &amp; First aid Management of Cardiac Symptoms among General Population of Rohtas, Bihar

Introduction: Cardiovascular disease (CVD) is the leading cause of death worldwide. The prevalence of coronary artery disease (CAD), a major contributor to CVD, is related to the increasing Prevalence of modifiable risk factors, previous studies identified diabetes mellitus, hypertension, hypercholesterolemia, smoking, alcohol consumption, obesity and sedentary lifestyle as risk factors. However, certain risk factors may predominate in certain regions. Smoking is the main determinant of ischemic heart disease (IHD) amongst the East Indians of Bangalore, India and populations of certain Arab countries. India is also experiencing a large rise in chronic diseases, especially heart disease, stroke and diabetes. Cardiovascular disease will be the largest cause of death and disability by 2020 in India. It has been forecasted that 2.6 million people will die from coronary heart disease, which constitutes 54% of all cardiovascular disease deaths. AIM: To evaluate the effectiveness of video assisted teaching on knowledge regarding early sign &amp; first aid management of cardiac symptoms among general population of Rohtas, Bihar METHODOLOGY: The Experimental research is conducted using group pre-test and post-test design at Karkatpur, Akhorigola, Rohtas, Bihar from 6/02/2023 to 11/02/2023. A self-structured questionnaire tool was used to assess the knowledge regarding early sign &amp; first aid management of cardiac symptoms among 60 general population by adopting random sampling technique. Pre-test is conducted by using questionnaire tool and immediately after pre-test video assisted teaching programme was implemented. Just after the implementation of video, post-test was conducted by using same questionnaire tool. The results were analysed using descriptive and inferential statistical. RESULTS: The present study was aimed at assessing the effectiveness of video assisted teaching on knowledge regarding early sign and first aid management of cardiac symptoms among general population Akhorigola, Bihar. The relevant data was collected statistically based on objectives of the study. There are 60 participants. Before intervention in pre-test about early sign (10%) has good knowledge, (50%) has moderate knowledge and (40%) has poor knowledge. Whereas about first aid management (5%) has good knowledge, (70) has moderate knowledge and (25%) has poor knowledge. After intervention there is increase in knowledge about both early sign and first aid management. In post-test (88%) has good knowledge, (12%) has average knowledge and (0%) has poor knowledge about early sign. Whereas (66.7%) has good knowledge, (30%) has average knowledge and (3.3%) has poor knowledge regarding first aid management. CONCLUSION: At last as a researcher we concluded that there is increase in knowledge regarding early sign and first aid management of cardiac disease after video assisted teaching and there is no any correlation between both the variable early sign and first aid management. There is no association.

Put Down the Tin: Chewing Tobacco Use Is Associated With Worse Outcomes After Primary Lumbar Fusion.

Retrospective study. This study evaluated the impact of chewing tobacco on both medical and spine-related complication rates after spinal lumbar fusions in comparison to both a control cohort and a smoking cohort. Smoking is a prevalent modifiable risk factor that has been demonstrated to be associated with increased complications after lumbar fusion. Although smoking rates have decreased in the United States, chewing tobacco use has not similarly reduced. Despite chewing tobacco delivering up to 4 times the dose of smoking, the impact of chewing tobacco is incompletely understood. A retrospective cohort study was conducted using the PearlDiver database. Patients who underwent lumbar spine fusion and used chewing tobacco were matched with a control cohort and a smoking cohort. Medical complications within 90 days after primary lumbar fusion were evaluated, including deep venous thrombosis, acute kidney injury, pulmonary embolism, transfusion, acute myocardial infarction, and inpatient readmission. Spine-related complications were evaluated at 2 years postoperatively, including pseudoarthrosis, incision and drainage (I&D), instrument failure, revision, and infection. After primary lumbar fusion, the chewing tobacco cohort demonstrated significantly higher rates of pseudoarthrosis [odds ratio (OR): 1.41], revision (OR: 1.57), and any spine-related complication (OR: 1.32) compared with controls. The smoking cohort demonstrated significantly higher rates of pseudoarthrosis (OR: 1.88), I&D (OR: 1.27), instrument failure (OR: 1.39), revision (OR: 1.54), infection (OR: 1.34), and any spine-related complication (OR: 1.77) compared with controls. The chewing tobacco cohort demonstrated significantly lower rates of pseudoarthrosis (OR: 0.84), I&D (OR: 0.49), infection (OR: 0.70), and any spine-related complication (OR: 0.81) compared with the smoking cohort. This study demonstrated that chewing tobacco is associated with higher rates of both spine-related and medical complications after primary lumbar fusion. However, chewing tobacco use is associated with less risk of complications compared with smoking. Level III.

VULVOVAGINAL CANDIDIASIS- PREVALENCE AND ANALYSIS OF ASSOCIATED RISK FACTORS AMONG WOMEN OF REPRODUCTIVE AGE GROUP IN VINDHYA REGION

Background: Although it can affect all groups, vaginitis remains one of the most common ambulatory problems to occur in women of reproductive age group. It accounts for 5-10 million office visits per year throughout world. In India prevalence of vaginitis is approximately 30%. Vaginitis has substantial impact on various aspects of female reproductive health, mental health, work ability and routine physical activity. It is also associated with various obstetrical and gynecological complications. Vulvovaginal candidiasis is common form of vaginitis. So, we aim to find out prevalence and analyze risk factors associated with vulvovaginal candidiasis at tertiary care hospital in Rewa, Madhya Pradesh India. Method: An observational cross-sectional study was conducted at Department of Obstetrics and Gynecology, Shyam Shah Medical College Rewa for 18 months from January 2021 to June 2022 on 1000 women of reproductive age group, visiting routine Gynae OPD of department of Obstetrics &amp; Gynecology. Results: Prevalence of vulvovaginal candidiasis in present study was found to be 12%. Various associated risk factors were OCP use, use of cloth during menses, douching/cleanliness habit, rural area of residence, middle and lower socioeconomic class and various occupations like factory workers and farmers. Conclusion: As it is evident that vaginitis will never be completely prevented, but incidence can be reduced. Much of the morbidity and complications can be reduced by identification and prevention of modifiable risk factors and interventional strategies directed mainly on high-risk behaviors in day-to-day life.

Early Administration of Vancomycin Inhibits Pulmonary Embolism by Remodeling Gut Microbiota.

Pulmonary embolism (PE) is a common and potentially fatal condition in the emergency department, and early identification of modifiable risk factors for prevention and management is highly desirable. Although gut dysbiosis is associated with a high incidence of venous thromboembolism, the role and mechanisms of the gut microbiome in the pathogenesis of venous thromboembolism, especially PE, remain unexplored. Here, we attempted to elucidate the benefits of the gut microbiome in the pathogenesis of PE using multiple antibiotics and fecal microbiota transplantation (FMT) for early intervention in a classical mouse model of PE. The results showed that early administration of various antibiotics (except ampicillin) could inhibit pulmonary thrombosis to a certain extent and reduced mortality in young and old mice with PE. Among them, vancomycin has the best inhibitory effect on PE. With the help of gut microbiota sequencing analysis, we found that antibiotic treatment can reshape the gut microbiota; especially vancomycin can significantly improve the gut microbiota structure in PE mice. Furthermore, FMT could transfer vancomycin-modified gut microbes into mice and inhibit the pathogenesis of PE, possibly due to increased intestinal colonization by Parasutterella. These data elucidate the underlying molecular mechanism by which early administration of vancomycin can remodel the gut microbiota to suppress PE, providing new clues for clinical optimization and development of PE prevention strategies.

Prevalence and correlates of modifiable risk factors for cervical cancer and HPV infection among senior high school students in Ghana: a latent class analysis

BackgroundWhile health risk behaviours are likely to co-occur, there is dearth of studies exploring the clustering of cervical cancer and HPV infection risk factors among adolescents. This study aimed to determine: 1) the prevalence of modifiable risk factors for cervical cancer and HPV infection, 2) the clustering of modifiable risk factors for cervical cancer and HPV infection, and 3) factors associated with the identified clusters.MethodsFemale students (aged 16–24 years, N = 2400) recruited from 17 randomly selected senior high schools in the Ashanti Region, Ghana completed a questionnaire assessing modifiable risk factors for cervical cancer and HPV infection including sexual experience, early sexual intercourse (< 18 years), unprotected sex, smoking, sexually transmitted infections (STIs); multiple sexual partners (MSP) and smoking. Latent class analysis explored separate classes of students according to their risk factor profiles for cervical cancer and HPV infection. Latent class regression analysis explored factors associated with latent class memberships.ResultsApproximately one in three students (34%, 95%CI: 32%-36%) reported exposure to at least one risk factor. Two separate classes emerged: high-risk and low-risk (cervical cancer: 24% and 76% of students, respectively; HPV infection: 26% and 74% of students, respectively). Compared to participants in the low-risk classes i) the cervical cancer high-risk class were more likely to report exposure to oral contraceptives; early sexual intercourse (< 18 years); STIs; MSP and smoking; and ii) the HPV infection high risk class were more likely to report exposure to sexual intercourse; unprotected sex and MSP. Participants with higher risk factor knowledge had significantly higher odds of belonging to cervical cancer and HPV infection high-risk classes. Participants with greater perceived susceptibility to cervical cancer and HPV infection were more likely to belong to the high-risk HPV infection class. Sociodemographic characteristics and greater perceived seriousness about cervical cancer and HPV infection had significantly lower odds of belonging to both high-risk classes.ConclusionsThe co-occurrence of cervical cancer and HPV infection risk factors suggests that a single school-based multi-component risk reduction intervention could concurrently target multiple risk behaviours. However, students in the high risk class may benefit from more complex risk reduction interventions.

Prevalence of modifiable risk factors in primary elective arthroplasty and their association with infections.

The aim of this study was to identify the prevalence of modifiable risk factors of surgical site infections (SSI) in patients undergoing primary elective total joint arthroplasty (TJA) receiving conventional preoperative preparation, and to explore their association with infectious outcomes. Information regarding modifiable risk factors (anemia, diabetes, obesity, nutritional status, smoking, physical activity) was prospectively gathered in patients undergoing primary TJA of hip or knee in 2018-2020 at a single institution with 6 weeks' follow-up time. 738 patients (median age 68 years [IQR 61-73], women 57%) underwent TJA (knee 64%, hip 36%). Anemia was detected in 8%, diabetes was present in 9%, an additional 2% had undiagnosed diabetes (HbA1c > 47 mmol/mol), and 8% dysglycemia (HbA1c 42-47 mmol/mol). Obesity (BMI ≥ 30) was observed in 52%. Serum albumin, total lymphocyte count, and vitamin D below normal limits was identified in 0.1%, 18%, and 16%, respectively. Current smokers were 7%. Surgical site complications occurred in 116 (16%), superficial SSI in 57 (8%), progressing to periprosthetic joint infection in 7 cases. Univariate analysis identified higher odds of superficial SSI for BMI ≥ 30 (OR 2.1, 95%CI 1.2-3.8) and HbA1c ≥ 42 mmol/mol (OR 2.2, CI 1.1-4.2), but no association was found with other factors. In a general population undergoing primary TJA an association was found between obesity (52%) and dysglycemia/diabetes (19%) and superficial SSI (8%), which progressed to PJI in 12% of cases, generating a 1% total rate of PJI. Modification of these risk factors might mitigate infectious adverse outcomes.

GENDER-RELATED DIFFERENCES IN MODIFIABLE RISK FACTORS AND ISCHEMIC STROKE SUBTYPE IN YOUNG AND MIDDLE-AGED PATIENTS – A PROSPECTIVE STUDY

Background: Male and female patients differ in their risk factors (RFs) and ischemic stroke (IS) subtype. A better understanding of the gender–related differences an important approach to successful prevention strategies for reducing the impact and burden of IS in young adults. Objective: To compare the gender–related differences in the prevalence of modifiable RFs and IS subtypes in young and middle-aged patients. Material and Methods: In the study were included 80 patients with acute IS, aged 18 – 59 years, admitted to the Neurology Clinic of UMHAT "Dr Georgi Stranski" Pleven. The following RFs were analyzed: arterial hypertension (AH), diabetes mellitus (DM), dyslipidemia, atrial fibrillation (AF), current smoking, number of cigarettes smoked per day, alcohol abuse, low physical activity, body overweight and chronic psychosocial stress. IS subtype was identified according to the Org 10172 Trial of Acute Stroke (TOAST). The statistical analysis was performed with the Statistical Package for Social Sciences, version 26.0 (SPSS). Results: Of all the 80 patients, 46 (57,5%) were males with a mean age 48,15±7,42 years, and 34 (42,5%) were females with a mean age 47,38±8,56. Male patients had higher rates of AH (80,4%), DM (47.8%), AF (4,3%), current smoking (73,9%), number of cigarettes smoked per day (60,9%), alcohol abuse (41,3%) and chronic psychosocial stress (52,2%), while the female ones showed higher rates of low physical activity (61,8%) and body overweight (38,2%). A statistical significance was found only for AH (p=0,004), DM (p=0,026), current smoking (p=0,007), number of cigarettes smoked per day (p=0,025) and alcohol abuse (p=0,031). The most common subtype of IS in males was large artery atherosclerosis (47,8%) and small vessel occlusion (28,3%). The female patients demonstrated a higher frequency of IS with other determined etiology (38,2%) and undetermined etiology (26,5%). Conclusion: Our data contribute to a better understanding of the gender–related differences of modifiable RFs and IS subtype in young and middle-aged patients with acute IS. The above findings definitely imply the necessity of developing additional specific therapeutic strategies for the effective control of modifiable RFs and lifestyle improvement in order to reduce the incidence of the most common subtypes of IS.

Sex/gender and socioeconomic differences in modifiable risk factors for dementia

Both sex/gender and socioeconomic differences have been reported in the prevalence of modifiable risk factors for dementia. However, it remains unclear whether the associations between modifiable risk factors for dementia and incident dementia differ by sex/gender or socioeconomic status. This study aimed to investigate sex/gender and socioeconomic differences in the associations of modifiable risk factors with incident dementia using a life-course perspective. We used data from the English Longitudinal Study of Ageing (2008/2009 to 2018/2019). A total of 8,941 individuals were included [mean (standard deviation) age, 66.1 ± 9.8 years; 4,935 (55.2%) were women]. No overall sex/gender difference in dementia risk was found. Dementia risk was higher among those who experienced childhood deprivation [hazard ratio (HR) = 1.51 (1.17; 1.96)], lower occupational attainment [HR low versus high = 1.60 (1.23; 2.09) and HR medium versus high = 1.53 (1.15; 2.06)], and low wealth [HR low versus high = 1.63 (1.26; 2.12)]. Though different associations were found among the subgroups, there might be a sex/gender difference in dementia risk only for low cognitive activity, suggesting a higher risk for women [HR = 2.61 (1.89; 3.60)] compared to men [HR = 1.73 (1.20; 2.49)]. No consistent socioeconomic differences in modifiable dementia risk were found. A population-based approach that tackles inequalities in dementia risk profiles directly may be more effective than individual approaches in dementia prevention.

Modifiable risk factors among ischemic stroke patients attending Bahawal Victoria Hospital in Bahawalpur.

Objective: To identify the prevalence of modifiable risk factors of ischemic stroke. Study Design: Cross Sectional Study. Setting: Department of Medicine, Bahawal Victoria Hospital, Bahawalpur. Period: July 2019 to December 2019. Material &amp; Methods: Detailed history, clinical examination and CT scan (plain) of brain was performed and data was collected on pre-designed questionnaires. Results: Out of a total of 97 patients, there were 69.1% female and 30.1% male. Majority of the patients, 51.5% were aged more than 60 years. Hypertension was the most prevalent risk factor (56.7%) followed by ischemic heart disease (45.4%), diabetes mellitus (27.8%), dyslipidemia (26.8%) &amp; smoking (34%). Conclusion: Modifiable risk factors of ischemic stroke should be identified in general population so that this disease can be prevented.

Brazilian Adults' Hope and Spirituality in Preoperative Heart Surgery: A Cross-Sectional Study.

Given the incipience of domestic studies on hope and spirituality in cardiology, this study evaluated adult cardiac patients' hope in the preoperative period of cardiac surgery and its potential association with spirituality. This is a cross-sectional study carried out at a university hospital in the State of São Paulo (Brazil). A total of 70 patients answered the Herth Hope Scale and a sociodemographic questionnaire before undergoing surgical procedure between January and October 2018. Descriptive and inferential analyses were performed using the Spearman's rank correlation coefficient and the Mann-Whitney U test. The R-3.4.1 software and SAS System for Windows 9.2 were also used. P-value < 0.05 was considered statistically significant. Patients had a high prevalence of modifiable risk factors. Having a religion (37.53±4.57) and practicing it (38.79±4.25), regardless of its denomination and time dedicated to that religion, was associated with hope (P<0.01) in the immediate preoperative period of cardiac surgery. However, hope did not exhibit a significant correlation with factors such as age (P=0.09) and time dedicated to religious practice (P=0.07). Regardless of the religious strand and time dedicated to religious practices as an expression of spirituality, hope was associated with the participants' religion and religiosity. Considering the importance of this construct on the processes of health and disease, the whole health team should consider in their praxis a setting of conditions to make the patient's spirituality process feasible during hospitalization.

Risk factors related to early neurological deterioration in lacunar stroke and its influence on functional outcome.

To identify risk factors for early neurological deterioration (END) in acute lacunar stroke patients and its influence on functional outcome. Consecutive acute lacunar stroke patients defined by magnetic resonance imaging (MRI) between January 2018 and June 2020 were included in the study. END was defined as any persisting increase in National Institutes of Health Stroke Scale (NIHSS) score of ⩾ 2 points post admission, and favorable outcome was defined as a modified Rankin Scale (mRS) of 0-2 at discharge. Univariable and multivariable logistic regression were performed to identify risk factors related to END, as well as the influence of END on functional outcome. Among a total of 638 lacunar stroke patients (420 males (65.8%), median age 66 years (interquartile range (IQR): 56-74)), 108 (16.9%) developed END, and 94.4% (102/108) of the END occurred within 72 h post admission. Admission NIHSS score (adjusted odds ratio (aOR) 1.132, 95% confidence interval (CI) 1.046-1.225, p = 0.002), female (aOR 2.752, 95% CI 1.277-5.933, p = 0.010), admission systolic blood pressure (SBP) (160-179 mm Hg) (aOR 9.395, 95% CI 4.310-20.479, p < 0.001) and admission SBP (⩾180 mm Hg) (aOR 16.030, 95% CI 5.991-42.891, p < 0.001) were significantly associated with END. Delay time from onset to admission (aOR 0.995, 95% CI 0.990-1.000, p = 0.031), SBP dropping (⩾20 mm Hg) within 3 days or when END occurred (aOR 0.037, 95% CI 0.016-0.086, p < 0.001) and thalamic lacunar infarction (aOR 0.098, 95% CI 0.012-0.827, p = 0.033) were inversely associated with END. END (aOR 12.374, 95% CI 6.881-22.254, p < 0.001) and higher admission NIHSS score (aOR 1.488, 95% CI 1.359-1.629, p < 0.001) predicted unfavorable outcome at discharge. END in lacunar stroke patients is common and is associated with unfavorable outcome. Admission high SBP is a potentially modifiable risk factor for prevention of END, but this needs further investigation.

Assessing infant sleep practices and other risk factors of SIDS in Zambia: a cross-sectional survey of mothers in Lusaka, Zambia

BackgroundHaving infants sleep with their parents and sleeping face down or on their sides are the two most proximate and modifiable risk factors for sudden infant death syndrome (SIDS). Little is known about the burden of SIDS or the prevalence of these risk factors in Africa. Our primary objective was to determine the prevalence of modifiable risk factors of SIDS in Lusaka, Zambia.MethodsWe conducted cross-sectional surveys with recent mothers of infants aged < 1 year across two busy urban clinic sites in Lusaka, Zambia. We used log-binomial regression analysis to identify factors predictive of bedsharing and prone sleeping.ResultsSurveys were conducted with 478 mothers between April-May 2021. The sleep-related risk factors, bedsharing and side sleeping, were widely prevalent. 89.5% of respondents indicated that they share a bed with the infant during sleep, 73.0% preferred putting their baby on its side, and 19.9% preferred the prone position. Only 6.7% of respondents described using the safer, supine position. Age of infant was the only factor which was predictive of prone sleeping. Infants > 2 months old were twice as likely to be put to sleep in a prone position compared to infants aged less than 2 months old. Mothers reported that they rarely (24.1%) received advice from medical caregivers to use the supine position. Maternal use of alcohol (12.0%) and tobacco (0.8%) during pregnancy were uncommon.ConclusionsBedsharing and placing the infant to sleep on the side were commonly reported among the mothers we interviewed. Whether this represents an opportunity to reduce SIDS in Zambia is unclear since accurate data on the burden of SIDS in Zambia is not available. There is a need for increased awareness of SIDS and more prospective data collection on its burden and related risk factors in these African populations.

Abstract 11767: Alarmingly Rising Trends in Cardiovascular Disease Risk Factors and Atrial Fibrillation in Young [18-44 Years] Asian Patients: A Nationwide Analysis Between 2016 and 2019

Background: Traditional cardiovascular disease (CVD) risk factors can increase the risk of Atrial Fibrillation (AF) even in young adults. With rising trends in CVD in the Asian population, we aimed to assess the prevalence and disparities of major modifiable risk factors for CVD and AF in the young Asians hospitalized in the US. Methods: The National Inpatient Sample (2016-2019) was used to estimate the temporal trends in modifiable CVD risk factors among young (18-44 years) Asian hospitalizations and evaluated disparities by sex. Also, we assessed the prevalence of AF in young Asians hospitalized with vs. without atleast one CVD risk factor. Results: From 2016 through 2019, a total of 1,324,259 young Asian admissions (Male 85%, age 18-44 years) were analyzed, the highest increase was noted for Obesity (1.8%) followed by Diabetes (1.3%). Males demonstrated the most prominent prevalence of Obesity (2.1%) and Hypertension (1.7%) as compared to the female population (1.7% and 0.4%), respectively. The incidence of AF in patients with at least one CVD risk factor increased by 0.4% (males 0.9% vs females 0.15%), (OR 2.80, 95%CI 2.44-3.21, p&lt;0.001). Conclusion: The prevalence of modifiable risk factors for CVD are increasing at a steady pace in the young Asian population. There is a need for urgent preventive and curative strategies to decrease the overall burden of CVD in this population.

Relationship between Early Childhood Caries and Prolonged Coughing Episodes in a Cohort of Cambodian Children.

Studies have shown an association between Early Childhood Caries (ECC) and respiratory infections; however, most have been cross-sectional, and all have been in high-income countries. Inverse probability treatment weighting (IPTW) was applied to longitudinal data from the Cambodia Health and Nutrition Monitoring Study. An analytical sample of 1703 Cambodian children between 1- and 4-years old was used to examine the effect of caries incidence (ECC Activity) on the odds of a child subsequently experiencing an episode of prolonged coughing (>14 days) over the subsequent 18 m. ECC activity occurred among 523 children (30.7%) while prolonged coughing was observed among 235 children (13.8%). ECC activity increased the risk of prolonged coughing (RR 1.23; 95% CI 0.95, 1.58; Average treatment effect = 3%). Follow-up investigations are justified in order to examine whether ECC may be a modifiable risk factor for prevention of respiratory illness among young children.