179 research outputs found
Cumulative Risk, Cumulative Outcome: A 20-Year Longitudinal Study
Cumulative risk (CR) models provide some of the most robust findings in the developmental
literature, predicting numerous and varied outcomes. Typically, however, these outcomes
are predicted one at a time, across different samples, using concurrent designs, longitudinal
designs of short duration, or retrospective designs. We predicted that a single CR index, applied
within a single sample, would prospectively predict diverse outcomes, i.e., depression,
intelligence, school dropout, arrest, smoking, and physical disease from childhood to adulthood.
Further, we predicted that number of risk factors would predict number of adverse outcomes
(cumulative outcome; CO). We also predicted that early CR (assessed at age 5/6)
explains variance in CO above and beyond that explained by subsequent risk (assessed at
ages 12/13 and 19/20). The sample consisted of 284 individuals, 48% of whom were diagnosed
with a speech/language disorder. Cumulative risk, assessed at 5/6-, 12/13-, and 19/
20-years-old, predicted aforementioned outcomes at age 25/26 in every instance. Furthermore,
number of risk factors was positively associated with number of negative outcomes.
Finally, early risk accounted for variance beyond that explained by later risk in the prediction
of CO. We discuss these findings in terms of five criteria posed by these data, positing a
mediated net of adversity- model, suggesting that CR may increase some central integrative
factor, simultaneously augmenting risk across cognitive, quality of life, psychiatric and
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Cumulative Risk, Cumulative Outcome
PLOS ONE | DOI:10.1371/journal.pone.0127650 June 1, 2015 13 / 16
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Regulation of peripheral blood flow in Complex Regional Pain Syndrome: clinical implication for symptomatic relief and pain management
Background. During the chronic stage of Complex Regional Pain Syndrome (CRPS), impaired microcirculation is related to increased vasoconstriction, tissue hypoxia, and metabolic tissue acidosis in the affected limb. Several mechanisms may be responsible for the ischemia and pain in chronic cold CPRS. Discussion. The diminished blood flow may be caused by either sympathetic dysfunction, hypersensitivity to circulating catecholamines, or endothelial dysfunction. The pain may be of neuropathic, inflammatory, nociceptive, or functional nature, or of mixed origin. Summary. The origin of the pain should be the basis of the symptomatic therapy. Since the difference in temperature between both hands fluctuates over time in cold CRPS, when in doubt, the clinician should prioritize the patient's report of a persistent cold extremity over clinical tests that show no difference. Future research should focus on developing easily applied methods for clinical use to differentiate between central and peripheral blood flow regulation disorders in individual patients
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