Os pacientes acometidos pela insuficiência renal crônica apresentam diminuição progressiva da função renal associada à redução da taxa de filtração glomerular. Possuem a resposta imune celular e humoral suprimidas e a existência de quaisquer alterações de saúde bucal pode representar focos de infecção a esses pacientes, os quais são extremamente susceptíveis a estas. A doença periodontal é uma doença inflamatória destrutiva que afeta os tecidos periodontais, e estudos têm mostrado que a prevalência desta é maior em pacientes com IRC quando comparados com a população em geral. Objetivo: Avaliar os parâmetros clínicos da doença periodontal em pacientes com doença renal crônica. Métodos: Foi realizado exame clínico periodontal de 125 indivíduos com alteração renal crônica que foram divididos em grupo controle (GC), grupo pré-diálise (GPD) e grupo hemodiálise (GHD), e os grupos foram subdivididos de acordo com a doença periodontal. Resultados: A perda de inserção clínica foi maior nos grupos GPD e GHD quando comparados ao controle (p=0,0058; p=0,0383), os demais parâmetros periodontais não apresentaram diferenças significantes. Os níveis de ácido úrico e ferritina foram estatisticamente maiores nos GPD e GHD com quando comparados ao GC (p<0,001); p=0,008; p=0,01); o nível de PCR foi maior no grupo GPD quando comparados aos grupos GC e GHD (p<0,05); e os níveis de fibrinogênio e triglicerídeos foram maiores no grupo GPD com doença periodontal quando comparados ao GC (p=0,01, p=0,008), o mesmo não ocorreu com os grupos sem doença periodontal. Conclusão: Assim sendo, conclui-se que a PIC e o número de dentes ausentes foi maior nos grupos testes quando comparados ao controle. Portanto, os profissionais de saúde devem ter uma atenção maior aos pacientes que apresentam a DRC no sentido de efetuar uma relação interdisciplinar para melhorar a condição de saúde deste. / Chronic renal failure (CRF) is a progressive and irreversible loss of renal function associated with a decline in the glomerular filtration rate. CRFs patients have a humoral and cellular immune responses suppressed and the existence of any oral complications may be outbreaks of such patients, which are extremely susceptible to these. Periodontal disease is a destructive inflammatory disease affecting periodontal tissues, and studies have shown that this is greater prevalence in patients with CRF compared to the general population. Aim: The aim of this study was to assess the clinical periodontal parameters CRFs patients. Methods: 125 CRFs patients were included in the study, and they were divided in control group (GC), foregoing dialysis group (GPD), and hemodialysis group (GHD), and the groups were subdivided in accordance with periodontitis. Results: Clinical attachment loss (CAL) was greater in GPD and GHD groups compared to the control (p = 0.0383; p = 0.0058), the other periodontal parameters did not provide significant differences. Uric acid and ferritin levels were statistically higher in GPD and GHD when compared to the GC (p<0.05); the PCR level was higher in GPD group when compared to the GC and HDG groups (p<0.05); and fibrinogen and triglycerides levels were greatest in the GPD with periodontitis than the GC (p = 0.01, p = 0.008), the same did not occur with groups without periodontitis. Conclusion: Accordingly, it is concluded that the clinical attachment loss and the number of dental lost of the tests groups were larger than the control group. Therefore, healthcare professionals must have an attention to CFRs patients to make a relationship interdisciplinary to improve the health condition.

La contraception hormonale combinée (CHC) est la contraception la plus utilisée en France. La maladie veineuse thromboembolique (MVTE), constitue le principal effet délétère de ces CHC. Des recommandations de bonnes pratiques sont publiées pour guider les prescripteurs. La meilleure compréhension des modifications biologiques associées aux différents types de CHC, les caractéristiques cliniques des femmes ayant eu une MVTE, la place de la recherche d’antécédents familiaux de MVTE (AFVTE) et d’une thrombophilie biologique avant la prescription d’une CHC constituent des pistes de recherche qui permettrait potentiellement d’optimiser la balance bénéfice-risque des CHC. Enfin l’impact de l’utilisation d’une contraception hormonale après un 1er épisode de MVTE reste peu évalué. Ce travail de thèse a été réalisé à la fois à l’aide de données biologiques d’utilisatrices de contraceptions hormonales (Etude EDGAR) et aussi à partir des données de l’étude de cohorte française COREVE (COntraception and REcurrent Venous Event). Cette étude a inclus 3121 femmes de moins de 45 ans au moment de leur 1er épisode de MVTE. Nous nous sommes particulièrement intéressés à l’analyse des caractéristiques de ces femmes en fonction du type de contraception utilisée, à la prévalence des facteurs de risque vasculaires et notamment les AFVTE. La fréquence d’épisode de MVTE associé à une prescription inadaptée de CHC, variait ainsi de 8.8 à 25.9 %. Par ailleurs, à l’aide d’une méthodologie de type cas versus cas, l’interaction entre l’utilisation d’une CHC et la présence d’une mutation du facteur V Leiden sur le risque de MVTE diffère significativement en fonction du progestatif combiné des CHC. / Combined hormonal contraception (CHC) is the most widely used contraception in France in which venous thrombosis embolism (VTE) is the main deleterious effect. Best practice recommendations are published in order to guide prescribers.The better understanding of the biological changes associated with different types of CHC, the clinical characteristics of women with VTE, the place of family history of VTE (FHVTE) and for biological thrombophilia before prescribing a CHC constitute research paths that could potentially optimize the risk-benefit balance of CHCs. Finally, the impact of hormonal contraception use after a first episode of VTE remains rarely evaluated.This work was carried out both using biological data from hormonal contraception users (EDGAR study) and also using data from the French cohort study COREVE (COntraception and REcurrent Venous Event).This study included 3121 women under 45 at the time of their 1st episode of VTE. We were particularly interested in analyzing the characteristics of these women according to the type of contraception used, the prevalence of vascular risk factors and especially the FHVTE.The frequency of VTE episode associated with an inadequate CHC prescription varied from 8.8 to 25.9%. Moreover, using a case-only methodology, the interaction between the use of CHC and the presence of a mutation of the factor V Leiden on the risk of VTE differs significantly depending on the progestin combined of the CHCs.

The issue of energy saving building is a current topic of today. The increasing costs of operating buildings reduce economic efficiency of the organization operations. A large part of the operating cost is energy cost. An effective tool for improving the energy performance of buildings is an EPC method. The implementation of energy projects through EPC is offered by Energy Services Company. This thesis evaluates the economic efficiency of the project implemented by the EPC and analyses its risk factors. The subject of EPC project is modernisation of an energy sector of a hospital building. The economic efficiency of the project is interpreted on the basis of economic indicators Net Present Value, Internal Rate of Return and Profitability Index. There was also performed Monte Carlo simulation supported by Oracle Crystal Ball software within the analysis of risk factors for the project.

Background/Objectives: West Nile neuroinvasive disease (WNND) is a severe neurological illness that develops in approximately 1% of individuals infected with West Nile virus (WNV). Manifesting most frequently as encephalitis (WNE), meningitis (WNM), or acute flaccid paralysis (WNP), there is no cure for WNND beyond supportive care and rehabilitation, and death or permanent disability are common outcomes. As the virus arrived in North America less than 20 years ago, determinants of severe disease progression following infection are still being explored. This project is the first to examine comorbid conditions as risk factors of WNND in Ontario using a population-based study design. As prevention is the only avenue of defence against WNND, identifying comorbid risk factors of WNND would allow for public health prevention campaigns targeted to high-risk groups. The main objectives of this thesis were to explore whether pre-existing chronic diseases were associated with the development of WNND, or any of its three manifestations (i.e., encephalitis, meningitis, acute flaccid paralysis). Methods: This was a retrospective, population-based study including all Ontario residents with a confirmed diagnosis of WNV infection between January 1, 2002 and December 31, 2012. A cohort of individuals with WNV was identified from a provincial laboratory database and individually-linked to health administrative databases. In the WNV cohort, individuals with WNND and 13 comorbid conditions were identified using algorithms based on ICD-10-CA diagnostic codes. Incidence of WNND following WNV infection was then compared among individuals with and without comorbid conditions using relative risks estimated by log binomial regression. Additionally, risk ratios were calculated for associations between specific comorbid conditions and WNND neuroinvasive manifestation (i.e., encephalitis, meningitis, acute flaccid paralysis). Finally, associations between Charlson Comorbidity Index (CCI) scoring and development of WNND was examined through calculation of relative risk using log binomial regression. Results/Potential Impact: Risk factors for WNND included male sex (aRR: 1.21; 95% CI: 1.00-1.46) in addition to the combined effect of hypertension and increasing age (5-year intervals) (aRR: 1.16; 95% CI: 1.08-1.24); WNND was also associated with increasing CCI scores; individuals in low, medium, and high categories had increased risk compared to individuals with a score of zero, but the greatest risk was in the high CCI category (aRR: 3.45; 95% CI: 2.25-4.83) Male sex (aRR: 1.32; 95% CI: 1.00-1.76), increasing age (aRR: 1.02; 95% CI: 1.02-1.03), and being immunocompromised (aRR: 2.61; 95% CI: 1.23-4.53) were associated with development of WNE. No risk factors were identified for WNM and WNP. Identification of comorbid risk factors of WNND will allow public health officials to identify high-risk groups and to develop prevention strategies targeted for vulnerable individuals.

Denna studie undersöker om periodiseringskvalitet är en prissatt riskfaktor för nordiska företag som är noterade på en reglerad marknad under perioden 2010–2019. Tidigare studier menar att periodiseringskvalitet utgör en proxy för informationsrisk, men olika författare framställer olika slutsatser i frågan huruvida periodiserings­kvalitet är en prissatt riskfaktor eller inte. Med den av McNichols (2002) modifierade Dechow &amp; Dichev modellen (2002) mäter vi periodiseringskvalitet som standard­avvikelsen av residualer från regressioner som kopplar periodiseringar till kassaflöden. Vi mäter riskpremien genom att dela in företagen i kvintiler baserad på periodiseringskvalitet och tillämpar en likaviktad portfölj som säljer företagen i de två kvintilerna med högst periodiseringskvalitet och köper företagen i kvintilerna med lägst periodiseringskvalitet. Vi finner en signifikant negativ koefficient i en två-stegs tvärsnittsregressionen som visar att periodiseringskvalitet inte utgör en prissatt riskfaktor för nordiska företag. / This study investigates if accruals quality is a priced risk factor for Nordic countries being traded on a regulated market in the Nordic countries during 2010–2019. Earlier studies argue that accruals quality is a proxy for information risk, but different authors find different results regarding whether accruals quality is a priced risk factor or not. By using the Dechow &amp; Dichev model (2002), modified by McNichols (2002), we measure accruals quality as the standard deviation of regressions that match accruals to cash flow. We measure the risk premium by dividing the entities into quintiles and use an equal-weighted portfolio that sells the stocks in the two quintiles with the highest accruals quality and buys the two quintiles with the lowest accruals quality. We find a significant negative coefficient in a two-stage cross-sectional regression which shows that accruals quality is not a priced risk factor in the Nordic countries.

The purpose of the study is to increase knowledge about leisure leaders' experiences of and opportunities to counteract exclusion and crime among young people in socially disadvantaged suburban areas, and what risk and protection factors they perceive to be important for exclusion and crime. The study is of a qualitative method based on hermeneutic theory of science. Four interviews were conducted with leisure leaders divided into three leisure centers. The correspondents consisted of three men and a woman of different ages and with varying work experience and varying ethnicities. The intention with the correspondents and the choice of a semi-structured interview guide was to gain an increased perspective on the chosen topic. The results indicate that the various systems in Bronfenbrenner's ecological system theory have a strong impact on young people in socially disadvantaged areas. The different system theories have protective and risk factors for the youth.

Pressure ulcers (PUs) present intrinsic risk factors that are not consistently identified by clinical assessments. The objective of this project was to develop a clinical practice guideline (CPG) to provide nurses with guidance in identifying and differentiating how intrinsic and extrinsic risk factors are associated with populations at risk for developing avoidable and unavoidable PUs. CPG development followed a systematic method to search the literature, organize findings, and assess the strength of the resulting evidence and its applicability to the CPG. Quality of the CPG was assessed by a panel of 8 health care professionals using the Appraisal of Guidelines for Research & Evaluation II instrument. Findings of the assessment indicated a high overall quality of the CPG; its immediate use was recommended and systematic evaluation was suggested to promote usage in a wider array of health care contexts. The quality domains with the highest scores were scope, purpose, applicability, editorial independence (all 100%), rigor of development (99.7%), and clarity of presentation (99.3%). The stakeholder involvement domain demonstrated the lowest--yet still robust--score (94.4%). The CPG can be used to emphasize appropriate and specific nursing competencies for making informed decisions when identifying and describing patients at risk for developing PUs. Further research and evaluation of the use of this CPG will be useful to demonstrate how CPGs can help to decrease the incidence of avoidable PUs. The potential for positive social change relative to the prevention of PUs is high. Decreased incidence of preventable PUs will eliminate unnecessary health care costs and improve overall health outcomes of patients at all levels of socioeconomic status.

No description available.

Med längre bostadsköer och ökande hemlöshet vill vi med denna studie rikta fokus mot ungdomar och unga vuxna som till följd av hemlöshet står inför ökade risker. Syftet med denna scoping review är att identifiera och sammanställa risker som ungdomar och unga vuxna står inför till följd av hemlöshet samt identifiera kunskapsluckor. Denna scoping review handlar om riskfaktorer i främst USA men även Storbritannien, Kanada och Frankrike, däremot inte i Sverige. I denna studie granskas 15 vetenskapliga artiklar från 2015 till 2023 för att identifiera och sammanställa riskerna till följden av hemlöshet. Ungdomar med erfarenhet av hemlöshet löper ökad risk för att missbruka alkohol och droger. Hemlösa ungdomar har även sämre psykisk hälsa i relation till ungdomar utan erfarenhet av hemlöshet.Hemlösa ungdomar löper högre risk att utsätta deras sexuella hälsa. Risken för brott ökar för hemlösa ungdomar ju längre de varit hemlösa. Hemlösa ungdomar löper även högre risk att själva bli brottsoffer. Hemlösa ungdomar riskerar att hoppa av skolan innan 16 årsåldern och utsättas för mobbing i skolan. / With longer housing queues and rising homelessness, we are in this study aiming to focus on adolescents and young adults who due to homelessness are facing higher risks. The aim of this study is to identify and compile risks adolescents and young adults are facing due to homelessness and identify knowledge gaps. This scoping review is about risk factors in USA, Great Britain, Canada and France, but not in Sweden. This study contains a review of 15 scientific articles from 2015 to 2023 to identify and compile risk due to homelessness. The risk for substance or alcohol abuse rises due to homelessness for adolescents. In comparison to adolescents with housing homeless adolescents mental health is at higher risk. Homeless adolescentshave higher risk to develop a sexual riskbehaviour. The risk of committingoffences rises the longer the adolescent has been homeless. Homeless adolescents are at higher risk of victimization. Homeless adolescents are also at higher risk of dropping out of school before the age of 16.

The objective of this study was to examine how a child's attachment is influenced by having an alcohol- or drug-abusing mother. The importance of secure attachment for a child's positive development, made exploring the issues surrounding substance abuse, and its impact on the child's essential attachment, of great interest. A systematic literature review was conducted to analyze the published research on the topic. The results provide valuable insights into attachment, maternal substance abuse, and related risks and protective factors.  Furthermore, the findings shed light on the increased vulnerability of children whose mothers have engaged in substance abuse before, during, and after pregnancy, indicating a higher likelihood of developing insecure attachment patterns. However, it is important to note that there is no consensus among researchers. Some results suggest that children growing up with substance-abusing mothers do not necessarily exhibit insecure attachment or develop problems later in life due to the substance abuse. The gathered empirical evidence, however, supports the effectiveness of interventions targeting substance-abusing mothers in promoting security in the child's attachment. Nevertheless, it is crucial not to solely focus on interventions for mothers, but also to consider the measures that can be offered to children in unfavorable home environments, with the best interests of the child as a central principle in social work.