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Kampfschulte A, Oram M, Escobar Vasco AM, Essenmacher B, Herbig A, Behere A, Leimanis-Laurens ML, Rajasekaran S. Understanding Suicide in Our Community through the Lens of the Pediatric ICU: An Epidemiological Review (2011-2017) of One Midwestern City in the US. CHILDREN-BASEL 2021; 8:children8020059. [PMID: 33498346 PMCID: PMC7909391 DOI: 10.3390/children8020059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 11/16/2022]
Abstract
Suicide frequency has tripled for some pediatric age groups over the last decade, of which, serious attempts result in pediatric intensive care unit (PICU) admissions. We paired clinical, aggregate geospatial, and temporal demographics to understand local community variables to determine if epidemiological patterns emerge that associate with risk for PICU admission. Data were extracted at an urban, high-volume, quaternary care facility from January 2011 to December 2017 via ICD 10 codes associated with suicide. Clinical, socioeconomic, geographical, and temporal variables were reviewed. In total, 1036 patients over the age of 9 were included, of which n = 161 were PICU admissions. Females represented higher proportions of all suicide-related hospital admissions (67.9%). Looking at race/ethnicity, PICU admissions were largely Caucasian (83.2%); Blacks and Hispanics had lower odds of PICU admissions (OR: 0.49; 0.17, respectively). PICU-admitted patients were older (16.0 vs. 15.5; p = 0.0001), with lower basal metabolic index (23.0 vs. 22.0; p = 0.0013), and presented in summer months (OR: 1.51, p = 0.044). Time-series decomposition showed seasonal peaks in June and August. Local regions outside the city limits identified higher numbers of PICU admissions. PICUs serve discrete geographical regions and are a source of information, when paired with clinical geospatial/seasonal analyses, highlighting clinical and societal risk factors associated with PICU admissions.
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Affiliation(s)
- Andrew Kampfschulte
- Office of Research and Education, Spectrum Health, 15 Michigan Street NE, Grand Rapids, MI 49503, USA; (A.K.); (S.R.)
| | - Matthew Oram
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Life Sciences Building, 1355 Bogue Street, East Lansing, MI 48824, USA; (M.O.); (A.M.E.V.); (A.H.); (A.B.)
| | - Alejandra M. Escobar Vasco
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Life Sciences Building, 1355 Bogue Street, East Lansing, MI 48824, USA; (M.O.); (A.M.E.V.); (A.H.); (A.B.)
| | - Brittany Essenmacher
- Pediatric Intensive Care Unit, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand 16 Rapids, MI 49503, USA;
| | - Amy Herbig
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Life Sciences Building, 1355 Bogue Street, East Lansing, MI 48824, USA; (M.O.); (A.M.E.V.); (A.H.); (A.B.)
| | - Aniruddh Behere
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Life Sciences Building, 1355 Bogue Street, East Lansing, MI 48824, USA; (M.O.); (A.M.E.V.); (A.H.); (A.B.)
- Pediatric Behavior Health, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand 14 Rapids, MI 49503, USA
| | - Mara L. Leimanis-Laurens
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Life Sciences Building, 1355 Bogue Street, East Lansing, MI 48824, USA; (M.O.); (A.M.E.V.); (A.H.); (A.B.)
- Pediatric Intensive Care Unit, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand 16 Rapids, MI 49503, USA;
- Correspondence: ; Tel.: +1-616-267-0106
| | - Surender Rajasekaran
- Office of Research and Education, Spectrum Health, 15 Michigan Street NE, Grand Rapids, MI 49503, USA; (A.K.); (S.R.)
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Life Sciences Building, 1355 Bogue Street, East Lansing, MI 48824, USA; (M.O.); (A.M.E.V.); (A.H.); (A.B.)
- Pediatric Intensive Care Unit, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand 16 Rapids, MI 49503, USA;
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Zhuang J. Estimation, diagnostics, and extensions of nonparametric Hawkes processes with kernel functions. JAPANESE JOURNAL OF STATISTICS AND DATA SCIENCE 2020. [DOI: 10.1007/s42081-019-00060-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AbstractThe Hawkes self-exciting model has become one of the most popular point-process models in many research areas in the natural and social sciences because of its capacity for investigating the clustering effect and positive interactions among individual events/particles. This article discusses a general nonparametric framework for the estimation, extensions, and post-estimation diagnostics of Hawkes models, in which we use the kernel functions as the basic smoothing tool.
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Lovasi GS, Mooney SJ, Muennig P, DiMaggio C. Cause and context: place-based approaches to investigate how environments affect mental health. Soc Psychiatry Psychiatr Epidemiol 2016; 51:1571-1579. [PMID: 27787585 PMCID: PMC5504914 DOI: 10.1007/s00127-016-1300-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 10/16/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Our surroundings affect our mood, our recovery from stress, our behavior, and, ultimately, our mental health. Understanding how our surroundings influence mental health is central to creating healthy cities. However, the traditional observational methods now dominant in the psychiatric epidemiology literature are not sufficient to advance such an understanding. In this essay we consider potential alternative strategies, such as randomizing people to places, randomizing places to change, or harnessing natural experiments that mimic randomized experiments. METHODS We discuss the strengths and weaknesses of these methodological approaches with respect to (1) defining the most relevant scale and characteristics of context, (2) disentangling the effects of context from the effects of individuals' preferences and prior health, and (3) generalizing causal effects beyond the study setting. RESULTS Promising alternative strategies include creating many small-scale randomized place-based trials, using the deployment of place-based changes over time as natural experiments, and using fluctuations in the changes in our surroundings in combination with emerging data collection technologies to better understand how surroundings influence mood, behavior, and mental health. CONCLUSIONS Improving existing research strategies will require interdisciplinary partnerships between those specialized in mental health, those advancing new methods for place effects on health, and those who seek to optimize the design of local environments.
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Affiliation(s)
- Gina S Lovasi
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Urban Health Collaborative, Drexel University, 3600 Market St, Philadelphia, PA, 19104, USA.
| | - Stephen J Mooney
- Department of Epidemiology, School of Public Health, Harborview Injury Prevention and Research Center, University of Washington, Seattle, USA
| | - Peter Muennig
- Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, USA
| | - Charles DiMaggio
- Division of Trauma, Emergency Surgery and Surgical Critical Care, New York University School of Medicine, New York, USA
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