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1

Bavaasan, Enkhjargal, and Dariimaa Surenjav. "Parkinson's disease risk factors and age." Journal of the Neurological Sciences 429 (October 2021): 119464. http://dx.doi.org/10.1016/j.jns.2021.119464.

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2

Son, Ju Hyun, Zee Won Seo, Woosik Choi, Youn-Young Lee, Suk-Woong Kang, and Chang-Hyung Lee. "Etiologic Factors of Rotator Cuff Disease in Elderly: Modifiable Factors in Addition to Known Demographic Factors." International Journal of Environmental Research and Public Health 19, no. 6 (March 21, 2022): 3715. http://dx.doi.org/10.3390/ijerph19063715.

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With the aging society, musculoskeletal degenerative diseases are becoming a burden on society, and rotator cuff disease is one of these degenerative diseases. The purpose of this study was to examine the incidence of shoulder osteoarthritis and the etiologic factors of rotator cuff disease in the Korean elderly population. A total of 102 patients performing ultrasonography were recruited, and their demographic factors were analyzed. As functional factors, visual analog scale and the peak torque of external and internal rotators of the shoulder using an isokinetic dynamometer were measured. As an anatomical factor, the acromiohumeral distance in the plain radiograph of the glenohumeral anterior-posterior view was used. There were more female patients (65.7%) than male patients (34.3%). The age range with the highest number of respondents was 50–59 years old. The mean visual analogue score was 4.09 (Min 1 to Max 9). Age and dominant hand side factors appear to be the crucial etiologic factors of the presence and severity of rotator cuff disease. The lower net value of the external rotator strength is weakly related to the presence of rotator cuff disease after adjusting for age, and this is the only modifiable factor in the study.
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3

Dartigues, J. F., and C. Feart. "Risk factors for Alzheimer disease: Aging beyond age?" Neurology 77, no. 3 (July 13, 2011): 206–7. http://dx.doi.org/10.1212/wnl.0b013e31822550af.

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4

Latorre, Eva, and Lorna W. Harries. "Splicing regulatory factors, ageing and age-related disease." Ageing Research Reviews 36 (July 2017): 165–70. http://dx.doi.org/10.1016/j.arr.2017.04.004.

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5

GEOGHEGAN, J. M., J. FORBES, D. I. CLARK, C. SMITH, and R. HUBBARD. "Dupuytren’s Disease Risk Factors." Journal of Hand Surgery 29, no. 5 (October 2004): 423–26. http://dx.doi.org/10.1016/j.jhsb.2004.06.006.

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Dupuytren’s is a common problem, but little is known about its a etiology. We have undertaken a large case-control study to assess and quantify the relative contributions of diabetes and epilepsy as risk factors for Dupuytren’s in the community. Cases were patients with a diagnosis of Dupuytren’s disease and, for each, two controls were individually matched by age, sex, and general practice. Our dataset included 821 cases and 1,642 controls. Five hundred and eighty-eight (72%) of the cases were men. The mean age at diagnosis was 62 (range 24–97) years. Diabetes was a significant risk factor for Dupuytren’s disease (OR = 1.75) and there was an increased risk for medicinally treated diabetes (metformin – R = 3.56; sulphonylureas – OR = 1.75) and particularly insulin controlled (OR = 4.39) rather than diet-controlled diabetes. Epilepsy (OR = 1.12) and antiepileptic medications were not associated with Dupuytren’s disease. Ascertainment bias in previous studies may explain the reported association with epilepsy.
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6

Wanneveich, Mathilde, Hélène Jacqmin-Gadda, Jean-François Dartigues, and Pierre Joly. "Impact of intervention targeting risk factors on chronic disease burden." Statistical Methods in Medical Research 27, no. 2 (March 17, 2016): 414–27. http://dx.doi.org/10.1177/0962280216631360.

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The aging of the population is accompanied by a sharp rise of chronic disease prevalences, such as dementia. These diseases generally cannot be prevented or cured and persist over time, with a progressive deterioration of health, requiring specific care. To reduce the burden of these diseases, it is appropriate to propose interventions targeting disease risk factors, but the association between most of these risk factors and mortality makes it difficult to anticipate the potential impact of such interventions. A method was previously proposed to estimate changes in disease prevalence following an intervention targeting subjects at a given age where the incidence of the disease is supposed to be null. Here, we propose a general framework to make projections for life expectancies with and without the disease, the age at onset, and the lifelong probability of the disease, and to evaluate the consequences of preventive interventions targeting risk factors on these various measures of disease burden. The methodology takes into account the mortality trend over calendar time and age in both healthy and diseased subjects, and the change in mortality due to the intervention. The method is applied to make projections for dementia in 2030 according to several scenarios of public health interventions.
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7

Akter, Hafija, Minara Parveen, Salima Akter, and Tamima Akter. "Risk Factors Related to Gestational Trophoblastic Disease." Annals of International Medical and Dental Research 9, no. 2 (April 2023): 282–87. http://dx.doi.org/10.53339/aimdr.2023.9.38.

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Background: Gestational trophoblastic diseases (GTD) consist of a group of neoplastic disorders arising from placental trophoblastic tissue after normal or abnormal fertilization. The WHO classification of GTD includes hydatidiform mole, invasive mole, choriocarcinoma, placental site trophoblastic tumor, and miscellaneous and unclassified trophoblastic lesions. This study aimed to analyze the risk factors related to the gestational trophoblastic disease. Material Methods: This prospective study was conducted at the Department of Obstetrics Gynecology in Uttara Adhunik Medical College Hospital, Dhaka, Bangladesh for 1 year; from April 2020 to March 2021. A total of 100 subjects were included in this study. Informed written consent was taken from the study subjects. Data was collected using a pre-formed data sheet. Data processing and analysis were done by using SPSS version 17. The test statistics used to analyze the data were descriptive statistics, the McNemar Chi-square test, and Repeated Measure ANOVA statistics. All patients underwent necessary investigations. All information was kept confidential and used only for this study purpose. The ethical Clearance Certificate was obtained from Bangladesh Medical College. Results: The majority of the patients were more than of 38 years age (53, 53.0%). Out of these patients, 50 (50.0%) were para one, while 40 (40.0%) were para more than four, most of the patients (63, 63.9%) were illiterate and 5 (5.0%) were graduates, most of the subjects (73, 73.0%) belonged to the low socioeconomic group. The most common presenting symptom was bleeding per vagina (35, 35.0%) followed by pain in the lower abdomen (24, 24.0%), the passage of moles (16, 16.0%), hyperemesis gravidarum (14, 14.0%) and dyspnea in 11 (11.0%) subjects. Conclusion: The disease was common in extremes of ages, low para, and grand multiparous women. The hydatidiform mole was the commonest type of trophoblastic disease in these patients. The most common presenting complaint was bleeding per vagina followed by pain in the lower abdomen. The hydatidiform mole was diagnosed in 65 (65.0%) patients, the invasive mole in 28 subjects (28.0%), and choriocarcinoma in 7 (7.0%) patients. No patient had a placental site trophoblastic tumor.
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8

Schultz, Clyde. "Age-related Macular Degeneration—Disease, Risk Factors, and Treatments." US Ophthalmic Review 07, no. 02 (2014): 154. http://dx.doi.org/10.17925/usor.2014.07.02.154.

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Age-related macular degeneration (AMD) is a progressive disease of the posterior segment of the eye. It is has been diagnosed worldwide and primarily affects individuals over 50 years of age. The incidence of the disease increases with age and with the presence of certain genetic factors, which may indicate a disposition for disease progression. In addition to genetic factors and age, other factors may be involved in developing AMD. These include obesity and smoking, which are also linked to various cardiovascular conditions. There are two forms of AMD: wet and dry. Both forms may involve the build-up of drusen deposits in the posterior segment of the eye, but the wet form tends to be more severe due to the proliferation of blood vessels into the macula and retinal areas of the back of the eye, thus causing an individual’s vision to become ‘blocked’ or ‘shaded’ usually beginning at the center of the visual field. There are a variety of treatment options for AMD including surgery in the form of laser or photo therapy. The most current treatment options involve the injection of a biologic into the posterior segment of the eye. There are some severe adverse events with this approach but they tend to be rare.
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9

Tanna, Nita, Rakesh Srivastava, and Vilpa Tanna. "Age wise distribution of coronary artery disease risk factors." International Journal of Medical Science and Public Health 2, no. 4 (2013): 954. http://dx.doi.org/10.5455/ijmsph.2013.190720131.

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10

Jousilahti, Pekka, Erkki Vartiainen, Jaakko Tuomilehto, and Pekka Puska. "Sex, Age, Cardiovascular Risk Factors, and Coronary Heart Disease." Circulation 99, no. 9 (March 9, 1999): 1165–72. http://dx.doi.org/10.1161/01.cir.99.9.1165.

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11

Gilley, David, Brittney-Shea Herbert, Nazmul Huda, Hiromi Tanaka, and Terry Reed. "Factors impacting human telomere homeostasis and age-related disease." Mechanisms of Ageing and Development 129, no. 1-2 (January 2008): 27–34. http://dx.doi.org/10.1016/j.mad.2007.10.010.

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12

Masters, Colin L. "Major risk factors for Alzheimer's disease: age and genetics." Lancet Neurology 19, no. 6 (June 2020): 475–76. http://dx.doi.org/10.1016/s1474-4422(20)30155-1.

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13

Pauleikhoff, D., M. J. Barondes, D. Minassian, I. H. Chisholm, and A. C. Bird. "Drusen as Risk Factors in Age-Related Macular Disease." American Journal of Ophthalmology 109, no. 1 (January 1990): 38–43. http://dx.doi.org/10.1016/s0002-9394(14)75576-x.

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14

Brodzka, Sylwia, Jędrzej Baszyński, Katarzyna Rektor, Karolina Hołderna-Bona, Emilia Stanek, Natalia Kurhaluk, Halina Tkaczenko, Grażyna Malukiewicz, Alina Woźniak, and Piotr Kamiński. "Immunogenetic and Environmental Factors in Age-Related Macular Disease." International Journal of Molecular Sciences 25, no. 12 (June 14, 2024): 6567. http://dx.doi.org/10.3390/ijms25126567.

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Age-related macular degeneration (AMD) is a chronic disease, which often develops in older people, but this is not the rule. AMD pathogenesis changes include the anatomical and functional complex. As a result of damage, it occurs, in the retina and macula, among other areas. These changes may lead to partial or total loss of vision. This disease can occur in two clinical forms, i.e., dry (progression is slowly and gradually) and exudative (wet, progression is acute and severe), which usually started as dry form. A coexistence of both forms is possible. AMD etiology is not fully understood. Extensive genetic studies have shown that this disease is multifactorial and that genetic determinants, along with environmental and metabolic-functional factors, are important risk factors. This article reviews the impact of heavy metals, macro- and microelements, and genetic factors on the development of AMD. We present the current state of knowledge about the influence of environmental factors and genetic determinants on the progression of AMD in the confrontation with our own research conducted on the Polish population from Kuyavian-Pomeranian and Lubusz Regions. Our research is concentrated on showing how polluted environments of large agglomerations affects the development of AMD. In addition to confirming heavy metal accumulation, the growth of risk of acute phase factors and polymorphism in the genetic material in AMD development, it will also help in the detection of new markers of this disease. This will lead to a better understanding of the etiology of AMD and will help to establish prevention and early treatment.
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15

Burns, Alistair, Glyn Lewis, Robin Jacoby, and Raymond Levy. "Factors affecting survival in Alzheimer's disease." Psychological Medicine 21, no. 2 (May 1991): 363–70. http://dx.doi.org/10.1017/s0033291700020468.

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SYNOPSISFactors affecting survival of 178 patients diagnosed using NINCDS/ADRDA criteria for Alzheimer's disease were studied. All patients were drawn from the Camberwell Health Authority Area and so were a representative sample of subjects from a clinical old age psychiatry service. The mortality rate of the sample was 3·5 times that expected after adjustment for age. Younger subjects had a higher standardized mortality ratio than older subjects. The cumulative three-year mortality of the sample was 47%. Factors shown to be associated with a reduced survival included: increasing age, longer duration of illness, male sex, presence of physical illness, poor cognitive function, observed depression and absence of misidentification syndromes. Apraxia was a stronger predictor of early death than aphasia or dysmnesia.
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16

Tawse-Smith, Andrew. "Age and oral health: current considerations." Brazilian Oral Research 21, spe (2007): 29–33. http://dx.doi.org/10.1590/s1806-83242007000500006.

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Dental plaque is still considered the main etiological factor for periodontal diseases. Our understanding of periodontal disease has advanced from the previous concepts where gingivitis slowly progressed to periodontitis to a more complex scenario that correlates several risk factors in the pathogenesis of periodontal disease. Among these factors, age has been associated with increased rates of periodontal disease as the population gets older. Although the loss of alveolar bone and periodontal attachment is common in the elderly population, and there is evident age-related changes in the periodontium, severe periodontitis is not a natural consequence of ageing. The importance of identifying the risk factors that participate in the pathogenesis of periodontal disease at an early phase, both of the individual and the disease, as well as evaluating the capacity of the individual to control dental plaque will enable the implementation of an adequate preventive program, where the needs and limitations of the individual are considered to specifically tailor the oral hygiene procedures and the mouthwashes to be used.
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17

Zhidkova, Elena A., Sergey V. Shlipakov, Victoria A. Zaborova, Natella I. Krikheli, Oksana M. Drapkina, Ross T. Barnard, and Konstantin G. Gurevich. "Risk Factors for Heart Disease in Working Railwaymen." American Journal of Men's Health 16, no. 6 (November 2022): 155798832211369. http://dx.doi.org/10.1177/15579883221136983.

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Heart diseases are the most common non-communicable diseases worldwide. We examined the prevalence of risk factors for heart disease among a sub-population of working men. In total, 11,059 railway crew workers of the Russian Railways Company were included in the study. We also asked participants to answer several questions based on the WHO STEPwise approach to surveillance (STEPS) translated into Russian. Only 30% of drivers had normal body mass index (BMI), whereas 70% were overweight or obese. In 12% of subjects, total cholesterol was higher than 5 mmol/L. In 15% of participants, glucose level was higher than 5.5 mmol/L. 38% of drivers reported smoking. Physical inactivity was registered in 54% of persons. Only 29% ate according to the key principles of good diet quality. 24% of respondents had a family history of heart disease. MANOVA demonstrated that BMI was determined by age, profession, smoking, physical inactivity, and diet quality. As age increased, the number of people with normal cholesterol levels decreased. It was demonstrated that a correlation existed between glucose levels and BMI. In the total group, the correlation was 0.46 ( p < .05). The correlation between those parameters increased due to age, from 0.33 in the <30 years of age group up to 0.52 in the >50 years of age group. This study demonstrated that there is a high prevalence of risk factors for heart disease in train drivers in the Russian Federation.
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18

Konyshko, N. A., and G. S. Konyshko. "Probable gastrointestinal disease factors in postmenopausal age women receiving antihypertensive therapy." Experimental and Clinical Gastroenterology, no. 9 (January 17, 2024): 99–106. http://dx.doi.org/10.31146/1682-8658-ecg-217-9-99-106.

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The frequency of achieving control as a result of taking antihypertensive drugs in women in the age group 55-64 years reaches 78.9%, the frequency of gastrointestinal symptoms occurring during treatment of hypertension is up to 62%. The aim: to analyze the probable causes of the development of symptoms of diseases of the gastrointestinal tract in postmenopausal patients receiving antihypertensive therapy. Material and methods. A comprehensive clinical examination of out-patient and in-patient patients of health care institutions of the Smolensk region with hypertension aged 50 to 84 years, (group AG, n=160) mean age 67.4 ± 17.4 years. Results. Complex examination and observation on the basis of standard methods with high probability shows the formation of gastroesophageal reflux disease, gastritis, simple erosions of the gastric mucosa, biliary dysfunction, chronic pancreatitis steatohepatosis in the observed patients. Conclusions: In postmenopausal women receiving antihypertensive therapy, there are major gastrointestinal symptoms of varying severity, arising in conditions of irrational nutrition, psycho-emotional and physical stress on the background of irregular medication. Based on the analysis of modern scientific sources, it can be argued that complex rational antihypertensive, antiplatelet, hypolipidemic, antisecretory and eradication therapy and the correction of modifiable risk factors ensures the achievement of remission of gastrointestinal and cardiovascular disease in the optimal time, improves the quality, life expectancy of patients and improves disease prognosis.
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19

Mather, Karen A. "Genetic and Environmental Factors in Ageing and Age-Related Disease." Genes 13, no. 3 (February 23, 2022): 396. http://dx.doi.org/10.3390/genes13030396.

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20

Chen, Y., M. Bedell, and K. Zhang. "Age-related Macular Degeneration: Genetic and Environmental Factors of Disease." Molecular Interventions 10, no. 5 (October 1, 2010): 271–81. http://dx.doi.org/10.1124/mi.10.5.4.

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21

Linda, Linda. "THE RISK FACTORS OF HYPERTENSION DISEASE." Jurnal Kesehatan Prima 11, no. 2 (April 10, 2018): 150. http://dx.doi.org/10.32807/jkp.v11i2.9.

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Treatment of inappropriate hypertension will be at risk for complications such as Cerebral Vascular Accident (CVA), heart failure and others. Hypertension at puskesmas Toaya is included in the top 5 most diseases in each year. In the preliminary study found that people with hypertension routine treatment since January-July as many as 152 people. The objective of the research is to know the risk factors of hypertension disease at Community Health Center in Toaya village, Sindue distric, Donggala regency. Descriptive research method, study population is hypertension patients amounted to 152 people. Sample 34 people, sampling purposive sampling. Analysis of squaret chi data. The results showed that the age of hypertensive patients aged ≥ 50 years 20 people (58.8%), age <50 years 5 people (41.2%), male gender was 26 people (76.5%), women 8 23.5% of patients had a history of hypertension of 24 people (70.6%) there was no history of hypertension 10 people (29.4%), obese no 29 people (85.3%) obese 5 people (14, 7%), had a low risk (smoking cigarettes ≤ 10 cigarettes) amounted to 15 people (44.1%), no smoking 9 people (26.5%), low physical activity category was 23 people (67.7%) high category 1 person (2.9%). The conclusion is that the age of hypertensive patients is more ≥ 50 years old, more males, have a history of hypertension, not obesity, hypertensive patients have a lower risk of smoking cigarettes (≤ 10 cigarettes), more low category physical activity. It is suggested to Toaya Puskesmas should do counseling about risk factor and effort of prevention of hypertension and it is recommended to routinely check blood pressure.
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22

Calne, Susan, Bruce Schoenberg, Wayne Martin, Ryan J. Uitti, Peter Spencer, and D. B. Calne. "Familial Parkinson's Disease: Possible Role of Environmental Factors." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 14, no. 3 (August 1987): 303–5. http://dx.doi.org/10.1017/s0317167100026664.

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ABSTRACT:We report here six families with Parkinson's disease in whom the onset of symptoms tended to occur at approximately the same time irrespective of the age of the patient. The mean difference in the time of onset in different generations was 4.6 years while the mean difference in age of onset in children and parents was 25.2 years. We construe this pattern of age separation within families as suggestive of an environmental rather than genetic cause. Support for this view derives from the lack of correlation between occurrence of the disease and the degree of consanguinity. We conclude that our findings are in accord with the hypothesis which attributes the cause of some cases of Parkinson's disease to early, subclinical environmental damage followed by age-related attrition of neurons within the central nervous system.
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23

Aziz, N. Ahmad, Jorien M. M. van der Burg, Sarah J. Tabrizi, and G. Bernhard Landwehrmeyer. "Overlap between age-at-onset and disease-progression determinants in Huntington disease." Neurology 90, no. 24 (May 9, 2018): e2099-e2106. http://dx.doi.org/10.1212/wnl.0000000000005690.

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ObjectiveA fundamental but still unresolved issue regarding Huntington disease (HD) pathogenesis is whether the factors that determine age at onset are the same as those that govern disease progression. Because elucidation of this issue is crucial for the development as well as optimal timing of administration of novel disease-modifying therapies, we aimed to assess the extent of overlap between age-at-onset and disease-progression determinants in HD.MethodsUsing observational data from Enroll-HD, the largest cohort of patients with HD worldwide, in this study we present, validate, and apply an intuitive method based on linear mixed-effect models to quantify the variability in the rate of disease progression in HD.ResultsA total of 3,411 patients with HD met inclusion criteria. We found that (1) about two-thirds of the rate of functional, motor, and cognitive progression in HD is determined by the same factors that also determine age at onset, with CAG repeat–dependent mechanisms having by far the largest effect; (2) although expanded HTT CAG repeat size had a large influence on average body weight, the rate of weight loss was largely independent of factors that determine age at onset in HD; and (3) about one-third of the factors that determine the rate of functional, motor, and cognitive progression are different from those that govern age at onset and need further elucidation.ConclusionOur findings imply that targeting of CAG repeat–dependent mechanisms, for example through gene-silencing approaches, is likely to affect the rate of functional, motor, and cognitive impairment, but not weight loss, in manifest HD mutation carriers.
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24

Ali, Muzaffer. "CORONARY ARTERY DISEASE IN YOUNG PAKISTANIS: RISK FACTORS AND PATTERN OF DISEASE." Pakistan Heart Journal 55, Supplement1 (November 17, 2022): S14. http://dx.doi.org/10.47144/phj.v55isupplement1.2430.

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Objectives: To determine the distribution of risk factors and pattern of coronary artery disease among young Pakistanis presenting with acute coronary artery syndrome. A cross sectional study conducted from August 2018 to October 2019 at Department of Cardiology Jinnah Hospital Lahore. Methodology: Total of 150 young patients up to 40 years of age with acute coronary syndrome (ACS) was included in this study. Risk factors were evaluated on patient’s current medication history for diabetes mellitus, hypertension, lipid lowering drugs and recent reports HbA1c, total body lipids. Data was entered and analyzed in SPSS version 21.0. Socio-demographic, clinical profile and risk factors were evaluated and presented as frequency and percentages. Cross tabulation was for ACS and risk factors. Statistical significance was assessed using Chi-square test with significant value of p < 0.05. Results: Among 150 subjects mean age was 34.20 + 4.246 with minimum age of 23 years and maximum age of 39 years. 92.0 % were male and 56.0% were having acute anterior wall STEMI, 36.0% had acute inferior Wall STEMI, 2.0% suffered from acute lateral wall STEMI, 2.7% had acute inferoposterior wall STEMI and 3.3% had NSTE-ACS. Risk factor analysis shows that 22.0% had diabetes mellitus, 20.7% had hypertension, 33.7% had a positive history of IHD in family, 71.3% were smokers, 44.0% had obesity, 66.0% had reduced HDL and 44.0 % had elevated LDL levels. Regarding pattern of coronary artery disease, 70.7% patients were having one vessel CAD, 28.0% two vessels CAD and 1.3% had three vessels CAD. Conclusion: Mean age of acute coronary syndrome is low amongst young Pakistani population with male predominance and acute anterior and inferior wall STEMI being most frequent diagnosis. Smoking, dyslipidemia particularly low HDL, positive family history of ischemic heart disease, hypertension, diabetes mellitus, obesity, was identified as important risk factors. Most of the patients had one vessel CAD.
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25

Pandey, Bandana. "Epidemiology and Risk Factors of Pelvic Inflammatory Disease." Medical Journal of Shree Birendra Hospital 13, no. 1 (July 19, 2015): 4–8. http://dx.doi.org/10.3126/mjsbh.v13i1.12992.

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Introduction: Knowledge of pelvic inflammatory disease and its epidemiology is essential to understand reproductive morbidity in women. This paper estimates the level of association between demographic factors and pelvic inflammatory disease in women in their reproductive age. Methods: A descriptive study done in Humla, Kritipur and Baudha by organizing a health camp. Women of reproductive age group and who have lower abdominal pain, pervaginal discharge, fever, and dysparunia were included in the study after taking informed verbal consent from the patient. Patients who have lower abdominal pain and pervaginal discharge were diagnosed as pelvic inflammatory disease. Results: Diagnoses of pelvic inflammatory disease were made in 30% of attendances amongst women aged between 16 to 48. Increased risk of pelvic inflammatory disease was associated with smoking (P<0.0001), age groups 31 – 40 yrs (44.6%),in rural areas(45%) and people who are illiterate (P<0.0001). Among 400, 383(95%) were reported ever using a modern contraceptive. Conclusion: The prevalence of pelvic inflammatory disease was 30% in reproductive age group and was significantly associated with smoking.doi: http://dx.doi.org/10.3126/mjsbh.v13i1.12992
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26

Matveeva, T. V., M. F. Ismagilov, and S. A. Ishmanova. "Some factors, enfluencing multiple sclerosis (MS)." Neurology Bulletin XXXIV, no. 3-4 (September 15, 2002): 16–20. http://dx.doi.org/10.17816/nb89873.

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Some factors, enfluencing multiple sclerosis development, have been studied. Connection of tire disease with living close to metallurgical plants has been confirmed, as well as with prevailing meat products in food and with craniocerebral trauma. For the first time association of multiple sclerosis with infectionous eye diseases has been revealed, as well us with soft tissue absesses, critical dental caries, with contact with birds and with age of a father (senior than 31 y.o.) at the moment of a patient birth. The factors, determining unfavourable course of MS are: craniocerebral trauma without loss of consciousness, contact with agricultural animals, prevailing meat products in nutrition of persons at the age of untill 15 y.o. and disease beginning with cerebellar symptomatology.
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Sheladia, Shyam, and P. Hemachandra Reddy. "Age-Related Chronic Diseases and Alzheimer’s Disease in Texas: A Hispanic Focused Study." Journal of Alzheimer's Disease Reports 5, no. 1 (February 24, 2021): 121–33. http://dx.doi.org/10.3233/adr-200277.

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The emergence of age-related chronic diseases within the United States has led to the direct increase of Alzheimer’s disease (AD) as well as other neurological diseases which ultimately contribute to the development of dementia within the general population. To be specific, age-related chronic diseases such as cardiovascular disease, high cholesterol, diabetes, and kidney disease contribute greatly to the advancement and rapid progression of dementia. Furthermore, unmodifiable risk factors such as advancing age and genetics as well as modifiable risk factors such as socioeconomic status, educational attainment, exercise, and diet further contribute to the development of dementia. Current statistics and research show that minority populations such as Hispanic Americans in the United States face the greatest burden of dementia due to the increase in the prevalence of overall population age, predisposing genetics, age-related chronic diseases, low socioeconomic status, as well as poor lifestyle choices and habits. Additionally, Hispanic Americans living within Texas and the rural areas of West Texas face the added challenge of finding appropriate healthcare services. This article will focus upon the research associated with AD as well as the prevalence of AD within the Hispanic American population of Texas and rural West Texas. Furthermore, this article will also discuss the prevalence of age-related chronic diseases, unmodifiable risk factors, and modifiable risk factors which lead to the progression and development of AD within the Hispanic American population of the United States, Texas, and rural West Texas.
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28

Mudassir, Mujaddid, Javed Iqbal, Muhammad Shafique Arshad, Ali Raza, and Qudsia Anjum Qureshi. "Risk Factors of Premature Coronary Artery Disease." Journal of Rawalpindi Medical College 25, no. 1 (March 30, 2021): 145–50. http://dx.doi.org/10.37939/jrmc.v25i1.1589.

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Introduction: Coronary artery disease (CAD) is one of the commonest and leading causes of death throughout the world. It is becoming common in the younger age group as well. This study was carried out to analyze the risk factors present in young patients who presented with acute Myocardial Infarction (M.I). Materials and Methods: In this descriptive cross-sectional study, we included 120 patients of age 20-35 years of age who presented with the first episode of acute M.I. Study was conducted at Pakistan Institute Of Medical Sciences, Islamabad, department of cardiology for all patients with first MI from 1st February 2016 to 31st January 2018. Twelve risk factors were studied including Gender, Hypertension, Diabetes mellitus, dyslipidemia, sedentary lifestyle, family history of premature CAD, obesity, smoking, dietary habits, profession, socioeconomic stress, drug addictions. The frequency of risk factors was calculated. Results: Results showed that some of the risk factors were present in higher proportion e.g. smoking, sedentary lifestyle, poor dietary habits, and stressful socioeconomic conditions. Most of the patients in the younger age group were drivers. The results of our study showed that male patients were higher(93.3%) in proportion to female patients (6.7%). 33% of patients were drivers, 13% plumbers, 13% shopkeepers, 10% businessmen, 8% laborers, 5% policemen, 5% students, 5% bank officers, 3% engineers, 2% teachers, 1% doctors. 68.3% of patients were smokers. 58.3% of patients were having high-stress scores. 23.3% of patients were having moderate stress score.18.3% were having a low-stress score. 56% of patients were having dyslipidemia.48% of patients were obese. Family history was present in 26.7% of patients. Conclusion: For patients presenting with premature CAD, Some of the modifiable risk factors include hypertension, sedentary lifestyle, fatty dietary habits, obesity, smoking, diabetes, dyslipidemia. The profession also affects the development of IHD as is evident from our study. So primary preventive strategies need to be implied to prevent the development of IHD, especially in individuals who are at risk.
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Wald, Nicholas J., Mark Simmonds, and Joan K. Morris. "Screening for Future Cardiovascular Disease Using Age Alone Compared with Multiple Risk Factors and Age." PLoS ONE 6, no. 5 (May 4, 2011): e18742. http://dx.doi.org/10.1371/journal.pone.0018742.

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30

Alimov, Azamat. "Primary Analysis of the Risk Factors for Severity and Mortality in COVID-19 Patients in Uzbekistan." Journal of Communicable Diseases 53, no. 03 (September 30, 2021): 104–11. http://dx.doi.org/10.24321/0019.5138.202145.

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A retrospective analysis of 561 patients with confirmed COVID-19 was performed to determine the risk factors for severity and mortality which could predict the disease outcome in early stages. Patients were divided into 4 groups in accordance with disease severity: mild, moderate, severe and critical. And initial clinical and laboratory parameters of patients at admission were studied. The age of severe and deceased patients was significantly higher than patients with mild and moderate course (р=0.003). Patiens with severe disease and fatal outcome had higher incidence of concomitant diseases compared to patients with mild and moderate course (p=0.01). The time passed from onset of first symptoms and hospital admission was shorter in patients with mild and moderate disease than patients with severe and critical disease (р=0.0001). The leukocytosis, significant lymphopenia (р=0.0001), high D-dimer and ferritin levels were associated with severe disease. Male gender, old age, presence of concomitant diseases should be considered as risk factors for severe course and death at COVID-19.
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31

Kanwar, Amrinder J., Rahul Mahajan, and Davinder Parsad. "Effect of Age at Onset on Disease Characteristics in Vitiligo." Journal of Cutaneous Medicine and Surgery 17, no. 4 (July 2013): 253–58. http://dx.doi.org/10.2310/7750.2013.12075.

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Background: Vitiligo is a multifactorial disease in which genetic, immunologic, and environmental factors play an important part. Late-onset vitiligo is a poorly defined entity. Materials and Methods: Case records of patients who attended the pigmentary clinic at our institute from January 2001 to December 2010 were reviewed. Patients with a diagnosis of vitiligo were analyzed with respect to their demographic characteristics with special reference to their age at onset. Results: Patients with disease onset after 30 years had a significantly higher association with precipitating factors such as trauma, stress, and drugs in comparison with early-onset vitiligo ( p < .004). However, the difference did not reach statistical significance when these factors were analyzed individually. There was a significantly higher association with other nonautoimmune diseases ( p = .05), a higher incidence of positive family history ( p < .0001), and a higher association with leukotrichia ( p < .002) in late-onset disease. Early-onset nonsegmental vitiligo was associated with a higher incidence of photosensitivity and pruritus compared to early-onset segmental vitiligo. Conclusion: Late-onset vitiligo has certain distinguishing features compared to early-onset vitiligo.
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32

Shadrin, O. G., R. V. Mostovenko, M. H. Horіanska, T. L. Marushko, and A. A. Kovalchuk. "Risk factors of inflammatory bowel diseases in young children." Modern pediatrics. Ukraine, no. 7(135) (November 28, 2023): 33–37. http://dx.doi.org/10.15574/sp.2023.135.33.

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In recent decades, there has been a rapid increase in the incidence of inflammatory bowel diseases in the children's population, especially in the age group under 6 years old. Risk factors significantly affect the reactive response of the child's organism and the probability of a pathology occurrence. Purpose - to analyze risk factors for the development of inflammatory bowel diseases with very early onset in children. Materials and methods. The anamnestic data of 78 examined patients with inflammatory bowel diseases - 17 patients with inflammatory bowel diseases with a very early onset and 61 children with inflammatory bowel disease that debuted over 6 years of age - were studied in detail retrospectively. Results. The anamnestic risk factors that were significantly more often observed in patients with inflammatory bowel diseases with a very early onset compared to children with inflammatory bowel diseases with an onset after 6 years of age included: spontaneous abortion in patients' mothers anamnesis, autoimmune diseases in relatives, the presence of concomitant autoimmune diseases in patients, early introduction of artificial feeding and the presence of an infectious disease just before the onset of inflammatory bowel disease. Conclusions. Taking into account the identified risk factors of inflammatory bowel diseases with a very early onset will ensure the improvement of prevention and early diagnosis of this gastrointestinal disease in young children. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the work. The informed consent of the children’s parents was obtained for the conducting the studies. No conflict of interests was declared by the authors.
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33

Vasic, Ljiljana. "Locally advanced non-small cell lung cancer, pretreatment prognostic factors: Disease stage, tumor histopathological characteristics, the patient-related factors." Archive of Oncology 15, no. 1-2 (2007): 19–23. http://dx.doi.org/10.2298/aoo0702019v.

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Background: The existing tumor-node-metastasis staging system ignores numerous clinical, therapeutic, and biological characteristics of lung cancer and psychomotor condition of a patient because it is based on the anatomic extent of disease. Therefore, there is a possibility of inadequate choice of therapy for any individual patient. Based on the disease stage, histopathological characteristics of the tumor and the patient-related factors (sex, age, Karnofsky status, accompanying diseases) the outcome of the disease can be predicted in patients with inoperable and unresectable non-small lung cancer. Methods: This report is a prospective clinical study that included patients with histopathological verified non-small cell lung cancer, followed up for a six-month period, from the beginning of the treatment. The following data were recorded: sex, age, histological cancer type, stage, Karnofsky status, and comorbid diseases. Results: The study showed planocellular carcinoma was more dominant among men than among women and that and at the diagnosis, most patients were in IIIb or IV stage. There was a decrease in psychomotor status of patients. The length of survival depended on Karnofsky index (p= 0.000), comorbidities - chronic myocardiopathy (p= 0.001), diabetes mellitus type 2 (p =0.007), myocardial infraction (p= 0.005), and the stage of the disease (p= 0.001) Conclusion: Psychomotor status of a patient, comborid diseases, and the stage of disease are the factors that determine patient?s tolerance to oncology treatment.
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34

Soto, Ileana, Mark P. Krebs, Alaina M. Reagan, and Gareth R. Howell. "Vascular Inflammation Risk Factors in Retinal Disease." Annual Review of Vision Science 5, no. 1 (September 15, 2019): 99–122. http://dx.doi.org/10.1146/annurev-vision-091517-034416.

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Inflammation of the blood vessels that serve the central nervous system has been increasingly identified as an early and possibly initiating event among neurodegenerative conditions such as Alzheimer's disease and related dementias. However, the causal relevance of vascular inflammation to major retinal degenerative diseases is unresolved. Here, we describe how genetics, aging-associated changes, and environmental factors contribute to vascular inflammation in age-related macular degeneration, diabetic retinopathy, and glaucoma. We highlight the importance of mouse models in studying the underlying mechanisms and possible treatments for these diseases. We conclude that data support vascular inflammation playing a central if not primary role in retinal degenerative diseases, and this association should be a focus of future research.
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35

Schmidt, Johanna, Kerstin Landin-Wilhelmsen, Mats Brännström, and Eva Dahlgren. "Cardiovascular Disease and Risk Factors in PCOS Women of Postmenopausal Age." Obstetrical & Gynecological Survey 67, no. 4 (April 2012): 235–36. http://dx.doi.org/10.1097/ogx.0b013e318250224e.

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36

Tershakovec, Andrew M., Abbas F. Jawad, Virginia A. Stallings, Jean A. Cortner, Babette S. Zemel, and Barbara M. Shannon. "Age-related changes in cardiovascular disease risk factors of hypercholesterolemic children." Journal of Pediatrics 132, no. 3 (March 1998): 414–20. http://dx.doi.org/10.1016/s0022-3476(98)70012-5.

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37

Golub, Yulia, Daniela Berg, Donald B. Calne, Ronald F. Pfeiffer, Ryan J. Uitti, A. Jon Stoessl, Zbigniew K. Wszolek, et al. "Genetic factors influencing age at onset in LRRK2-linked Parkinson disease." Parkinsonism & Related Disorders 15, no. 7 (August 2009): 539–41. http://dx.doi.org/10.1016/j.parkreldis.2008.10.008.

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38

Klontz, K. C., W. H. Adler, and M. Potter. "Age-dependent resistance factors in the pathogenesis of foodborne infectious disease." Aging Clinical and Experimental Research 9, no. 5 (October 1997): 320–26. http://dx.doi.org/10.1007/bf03339610.

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39

Perlstein, Michael A. "Factors Influencing Age at Referral of Children With Congenital Heart Disease." Archives of Pediatrics & Adolescent Medicine 151, no. 9 (September 1, 1997): 892. http://dx.doi.org/10.1001/archpedi.1997.02170460030005.

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40

Tate, Robert B., Jure Manfreda, and T. Edward Cuddy. "The Effect of Age on Risk Factors for Ischemic Heart Disease." Annals of Epidemiology 8, no. 7 (October 1998): 415–21. http://dx.doi.org/10.1016/s1047-2797(98)00011-8.

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41

Dermendzhiev, Svetlan, Atanaska Petrova, and Tihomir Dermendzhiev. "Age Characteristics and Concomitant Diseases in Patients with Angioedema." Open Access Macedonian Journal of Medical Sciences 7, no. 3 (February 13, 2019): 369–72. http://dx.doi.org/10.3889/oamjms.2019.121.

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BACKGROUND: Angioneurotic oedema (AE) is an unpredictable and dangerous disease directly threatening the patient's life due to a sudden onset of upper respiratory tract obstruction. The disease is associated with various causes and triggering factors, but little is known about the conditions that accompany AE. AIM: The study aims to determine the age-specificities and the spectrum of concomitant diseases in patients with AE. MATERIAL AND METHODS: The subjects of observation were 88 patients (53 women and 35 men) with angioneurotic oedema who underwent diagnostics and treatment in the Department of Occupational Diseases and Clinical Allergology of University hospital “Saint George”-Plovdiv. RESULTS: The highest level of disease prevalence was found in the age group over 50 years, both in males (45.71%) and females (54.72%). We found that the most often concomitant diseases in our patients with AE are cardiovascular (33%). On second place are the patients with other accompanying conditions outside of the target groups (27.3%). Patients with AE and autoimmune thyroiditis were 14.8%, and those with AE and skeletal-muscle disorders-10.2%. Given the role of hereditary factors in this disease, the profession of the patients is considered insignificant. CONCLUSION: Angioedema occurs in all age groups, but half of the cases are in people over 50 years of age. The most common concomitant diseases in angioedema are cardiovascular diseases.
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42

Feng, Qiqi, Yachen Li, and Zimo Zhang. "Research of Risk Factors for Alzheimer's Disease." Highlights in Science, Engineering and Technology 88 (March 29, 2024): 717–23. http://dx.doi.org/10.54097/5qwcff28.

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Alzheimer's disease (AD) is the most common type of dementia among the elderly, which has become the focus of global public health and social attention. This study is proposed to explore the relationships between 4 factors (gender, age, years of education and socioeconomic status) with AD by the use of the Binary regression model and correlation regression. It was concluded that female have a dramatic positive impact on AD significantly (p<0.01, OR = 3.517), and the years of education will have a remarkable negative impact on the Groups (p=0.011, OR =0.784). However, the Age and socioeconomic status will not have an impact on the AD (p=0.748 and p=0.622). The early prevention is feasibility and importance to delay the onset of AD and to improve patients' quality of life. Accordingly, an effort should be made to improve the professional care and formulate relevant policies for elderly care services, especially for Women with low education.
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43

Nematov, A. A. "Risk Factors for Patients Severe and Critical with Covid-19." European Journal of Medical Genetics and Clinical Biology 1, no. 1 (September 26, 2023): 155–58. http://dx.doi.org/10.61796/jmgcb.v1i1.269.

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In the fight against infectious diseases, the formation of collective immunity among the population is the main tool in the fight against diseases and the prevention of deaths. At the same time, even after vaccination, the occurrence of diseases among the population remains one of the current problems. Aim: To identify and assess risk factors for those with severe and very sever COVID-19. Materials and methods: Statistical analysis of the primary medical data of 1862 patients treated at the Republican Special Hospital for Infectious Diseases Zangiota №2, a retrospective research method was used. Results: When analyzing the patients infected with COVID-19 disease by age and gender groups, it was found that among the age groups under 20 years of age, the prevalence of the disease is almost the same among both sexes, where men are 4.88±0.2%, women are showed that 4.81±0.2%. When analyzing the patients infected with COVID-19 disease by age and gender groups, it was found that the prevalence of infection among both sexes is almost the same among the age groups under 20 years, where men are 4.88±0.2%, women are 4.81 showed that it is ±0.2%. We can explain the fact that the lifestyle and activities of these age groups in our country are almost the same, that is, they study in schools, lyceums and colleges. Among patients aged 20-49, the percentage of men is high (34.4±0.45%), while the percentage of women is slightly lower (29±0.43%). Conclusion: Factors that cause severe and very severe degree of COVID-19 include the elderly population, male sex, regular smokers, low socio economic populations, and people with chronic diseases was found to be.
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44

Shtandel, Svetlana A., Igor R. Barilyak, Vadim V. Khaziev, and Irina V. Gopkalova. "THYROID GLAND DISEASES AND FACTORS, WHICH IMPACT ON ITS POPULATION PREVALENCE." Ecological genetics 8, no. 1 (March 15, 2010): 42–49. http://dx.doi.org/10.17816/ecogen8142-49.

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As the factors which impact on the population prevalence of nodular goiter, Grave’s disease and thyroid gland cancer, iodine deficiency, remote consequences of accident on the Chernobyl atomic station, population age structure and selection in modern conditions were studied. Differential fertility indexes, diseases prevalence and population age structure official statistic data were analyzed. It has been shown, that iodine deficiency expressiveness, consequences of accident on the Chernobyl atomic station, population age structure and selection are impact on the nodular goiter, Grave’s disease and thyroid gland cancer population prevalence.
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45

Reddy, P. Hemachandra. "Role of Mitochondria in Neurodegenerative Diseases: Mitochondria as a Therapeutic Target in Alzheimer's Disease." CNS Spectrums 14, S7 (August 2009): 8–13. http://dx.doi.org/10.1017/s1092852900024901.

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A growing body of evidence suggests that mitochondrial abnormalities are involved in aging and in age-related neurodegenerative diseases as well as cancer, diabetes, and several other diseases known to be affected by mitochondria. Causal factors for most age-related neurodegenerative diseases—including Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis (ALS), and Friedrich ataxia (FRDA)—are largely unknown. Genetic defects are reported to cause a small number of neurodegenerative diseases (Slide 1), but cellular, molecular, and pathological mechanisms of disease progression and selective neuronal cell death are not understood fully in these diseases. However, based on several cellular, molecular, and animal model studies of Alzheimer's disease, Parkinson's disease, ALS, FRDA, cancer, and diabetes, aging may play a large role in cell death in these diseases. Age-dependent, mitochondrially-generated reactive oxygen species (ROS) have been identified as important factors responsible for disease progression and cell death, particularly in late-onset diseases, in which genetic mutations are not causal factors.
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46

Tanner, Caroline M., Biao Chen, Wen-Zhi Wang, Man-Ling Peng, Zho-Lin Liu, Xue-Ling Liang, Li Chiung Kao, David W. Gilley, and Bruce S. Schoenberg. "Environmental Factors in the Etiology of Parkinson's Disease." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 14, S3 (August 1987): 419–23. http://dx.doi.org/10.1017/s0317167100037835.

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ABSTRACT:Parkinson's disease (PD) has been proposed to result from the interaction of aging and environment in susceptible individuals. Defective metabolism of debrisoquine, inherited as an autosomal recessive, has been associated with this susceptibility. In 35 PD patients and 19 age-matched controls, no significant differences in debrisoquine metabolism were found, although a trend to impaired metabolism was noted in patients with disease onset ≤40. Foci of PD patients were associated with rural living and well water drinking, or rural living coupled with market gardening or wood pulp mills. In a questionnaire survey, patients with PD onset ≤age 47 were significantly more likely to have lived in rural areas and to have drunk well water than those with onset ≥age 54 (p≤0.01). Because of population mobility in North America, a case-control study designed to test environmental, occupational, dietary and other proposed risk factors for PD was conducted in China, where the population is more stationary and the environment more stable. No significant differences in incidences of head trauma, smoking or childhood measles were found between patients and controls.
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47

Soulissa, Abdul Gani. "A Review of the Factors Associated with Periodontal Disease in the Elderly." Journal of Indonesian Dental Association 3, no. 1 (February 20, 2020): 47. http://dx.doi.org/10.32793/jida.v3i1.448.

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The world’s elderly population is growing faster than other age groups. The World Health Organization states that in 2020, Indonesia’s elderly population will reach 11.34% of the total population, or around 28.8 million people. The increasing number of elderly people can be a challenge for clinicians due to the degenerative changes caused by chronic diseases, treatment of chronic diseases, systemic conditions, and oral health care accessibility. The purpose of this study was to analyze the factors that increase the risk of periodontal disease in the elderly. Over the last few years, a lot of research has focused on identifying the relationship between periodontal disease and systemic disease as well as the link between periodontal disease and aging. Increased age relates directly and proportionally with increased prevalence and severity of periodontal disease. Furthermore, an increase in age causes a decrease in motoric function and an increase in comorbidities and their treatments in the elderly. The aging process causes cementum surface irregularities, inhibition of osteoblast activity, and reduction in the number of fibroblasts. Loss of attachment and alveolar bone resorption was affected by frequent exposure to other risk factors. The risk factors that influence the development of periodontal disease in the elderly include systemic diseases, such as diabetes mellitus and osteoporosis, systemic conditions, such as obesity, metabolic syndrome, and stress, treatment of systemic diseases, and limited access to oral health care. Although the potential link between periodontal disease and systemic disease has been established, the extent of this relationship has not yet been clearly explained. Understanding the factors that influence periodontal disease in the elderly is important because it may provide a better understanding of the treatment. The multiple risk factors that cause periodontal disease in elderly patients require special attention involving multidisciplinary teams.
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48

Hadzi-Pesic, Marina, Jelisaveta Todorovic, and Kristina Brajovic-Car. "Psychological factors and coronary heart disease." Psihologija 40, no. 3 (2007): 463–76. http://dx.doi.org/10.2298/psi0703461h.

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Coronary heart disease (CAD) results from an interaction of different somatic, environmental and behavioral risk factors. Commonly, development of CAD is associated with arterial hypertension, dyslipidemia, diabetes mellitus, smoking, sedentary life style and the like. Psychological factors in their own sake or in combination with other risk factors are also important for genesis of CAD. In this study, 170 people that were diagnosed with CAD and 170 healthy controls of corresponding sex and age were compared for anxiety, aggressiveness and Eysenck's two personality dimension. The data indicate that patients with CAD have very low level of anxiety and aggressiveness and very high level of neuroticism relative to the controls. .
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Bisciglia, Andrea, Vincenzo Pasceri, Diego Irini, Antonio Varveri, and Giulio Speciale. "Risk Factors for Ischemic Heart Disease." Reviews on Recent Clinical Trials 14, no. 2 (May 31, 2019): 86–94. http://dx.doi.org/10.2174/1574887114666190328125153.

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Background: Several risk factors have been empirically linked to an increased risk of cardiovascular disease. Some of them are therapeutically amenable to modification; while others are not. Modifiable risk factors include physical inactivity, tobacco use, diet, “bad fats” in the blood, hypertension, and being overweight; while non-modifiable risk factors include the patient’s family history, the presence versus absence of diabetes mellitus, and demographic characteristics like age, gender, ethnicity, and socio-economic status. Methods: In this article, we review those risk factors that are both clinically important and amenable to change. Conclusion: To prevent cardiovascular disease, it is important to minimize modifiable risk factors, like LDL cholesterol.
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Shakoori, Irfan Sharif, Fauzia Aslam, Gohar Ashraf, and Hammad Akram. "Understanding chronic disease risk factors and multimorbidity." International Journal Of Community Medicine And Public Health 7, no. 5 (April 24, 2020): 1990. http://dx.doi.org/10.18203/2394-6040.ijcmph20201556.

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Chronic diseases and multimorbidity are becoming an alarming public health problem of this century. Multimorbidity is defined as “having two or more chronic diseases at one time in a person” and a result of complex biological, psychological and social phenomenon. The risks of multimorbidity can be divided into modifiable (behavioral factors) and non-modifiable (age, genetics) factors. Socioeconomic disadvantage and environmental factors can also influence on causation of it. Strategies aligned with primary, secondary and tertiary stages of prevention can help in the prevention of multimorbidity and reduction in complications among diseased. Multimorbidity requires multidimensional programs implemented through multiple stakeholder and policymaker’s collaboration.
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