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Xu F, Cheng P, Xu J, Wang X, Jiang Z, Zhu H, Fan H, Wang Q, Gao Q. Influencing factors of length of stay among repeatedly hospitalized patients with mood disorders: a longitudinal study in China. Ann Gen Psychiatry 2024; 23:15. [PMID: 38664741 PMCID: PMC11046813 DOI: 10.1186/s12991-024-00497-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/02/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Patients with mood disorders usually require repeated and prolonged hospitalization, resulting in a heavy burden on healthcare resources. This study aims to identify variables associated with length of stay(LOS) of repeatedly hospitalized patients with mood disorders and to provide information for optimizing psychiatry management and healthcare resource allocation. METHODS Electronic medical records (EMRs) of repeatedly hospitalized patients with mood disorders from January 2010 to December 2018 were collected and retrospectively analyzed. Chi-square and t-test were adopted to investigate the differences in characteristics between the two groups of short LOS and long LOS. Generalized estimating equation (GEE) was conducted to investigate potential factors influencing LOS. RESULTS A total of 2,009 repeatedly hospitalized patients with mood disorders were enrolled, of which 797 (39.7%) had a long LOS and 1,212 (60.3%) had a short LOS. Adverse effects of treatment, continuous clinical manifestation, chronic onset type, suicide attempt, comorbidity and use of antidepressants were positively associated with long LOS among all repeatedly hospitalized patients with mood disorders (P < 0.050). For patients with depression, factors associated with long LOS consisted of age, monthly income, adverse effects of treatment, continuous clinical manifestation, suicide attempt and comorbidity (P < 0.050). Whereas, for patients with bipolar disorder (BD), adverse effects of treatment, four or more hospitalizations and use of antidepressants contributed to the long LOS (P < 0.050). Influencing factors of LOS also vary among patients with different effectiveness of treatment. CONCLUSION The LOS in repeatedly hospitalized patients with mood disorders was influenced by multiple factors. There were discrepancies in the factors affecting LOS in patients with different diagnoses and effectiveness of treatment, and specific factors should be addressed when evaluating the LOS.
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Affiliation(s)
- Feng Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen Wai, Beijing, 100069, China
| | - Peixia Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen Wai, Beijing, 100069, China
| | - Jiaying Xu
- Capital Medical University Affiliated Beijing Anding Hospital, Beijing, China
| | - Xiaonan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen Wai, Beijing, 100069, China
| | - Zhen Jiang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen Wai, Beijing, 100069, China
| | - Huiping Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen Wai, Beijing, 100069, China
| | - Hua Fan
- Capital Medical University Affiliated Beijing Anding Hospital, Beijing, China
| | - Qian Wang
- Capital Medical University Affiliated Beijing Anding Hospital, Beijing, China
| | - Qi Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen Wai, Beijing, 100069, China.
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Zhang Z, Měchurová K, Resch B, Amegbor P, Sabel CE. Assessing the association between overcrowding and human physiological stress response in different urban contexts: a case study in Salzburg, Austria. Int J Health Geogr 2023; 22:15. [PMID: 37344837 PMCID: PMC10286433 DOI: 10.1186/s12942-023-00334-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/26/2023] [Indexed: 06/23/2023] Open
Abstract
Overcrowding in densely populated urban areas is increasingly becoming an issue for mental health disorders. Yet, only few studies have examined the association between overcrowding in cities and physiological stress responses. Thus, this study employed wearable sensors (a wearable camera, an Empatica E4 wristband and a smartphone-based GPS) to assess the association between overcrowding and human physiological stress response in four types of urban contexts (green space, transit space, commercial space, and blue space). A case study with 26 participants was conducted in Salzburg, Austria. We used Mask R-CNN to detect elements related to overcrowding such as human crowds, sitting facilities, vehicles and bikes from first-person video data collected by wearable cameras, and calculated a change score (CS) to assess human physiological stress response based on galvanic skin response (GSR) and skin temperature from the physiological data collected by the wristband, then this study used statistical and spatial analysis to assess the association between the change score and the above elements. The results demonstrate the feasibility of using sensor-based measurement and quantitative analysis to investigate the relationship between human stress and overcrowding in relation to different urban elements. The findings of this study indicate the importance of considering human crowds, sitting facilities, vehicles and bikes to assess the impact of overcrowding on human stress at street level.
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Affiliation(s)
- Zhaoxi Zhang
- Department of Environmental Science, Aarhus University, 4000 Roskilde, Denmark
- BERTHA, The Danish Big Data Centre for Environment and Health, Aarhus University, 8000 Aarhus, Denmark
| | | | - Bernd Resch
- Department of Geoinformatics, University of Salzburg, 5020 Salzburg, Austria
- Center for Geographic Analysis, Harvard University, Cambridge, MA 02138 USA
| | - Prince Amegbor
- Department of Environmental Science, Aarhus University, 4000 Roskilde, Denmark
- School of Global Public Health, New York University, New York, 10003 USA
- BERTHA, The Danish Big Data Centre for Environment and Health, Aarhus University, 8000 Aarhus, Denmark
| | - Clive E. Sabel
- Department of Public Health, Aarhus University, 8000 Aarhus, Denmark
- BERTHA, The Danish Big Data Centre for Environment and Health, Aarhus University, 8000 Aarhus, Denmark
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Congdon P. Geographical Patterns in Drug-Related Mortality and Suicide: Investigating Commonalities in English Small Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101831. [PMID: 31126097 PMCID: PMC6572137 DOI: 10.3390/ijerph16101831] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/16/2019] [Accepted: 05/21/2019] [Indexed: 01/14/2023]
Abstract
There are increasing concerns regarding upward trends in drug-related deaths in a number of developed societies. In some countries, these have been paralleled by upward trends in suicide. Of frequent concern to public health policy are local variations in these outcomes, and the factors underlying them. In this paper, we consider the geographic pattern of drug-related deaths and suicide for 2012-2016 across 6791 small areas in England. The aim is to establish the extent of commonalities in area risk factors between the two outcomes, with a particular focus on impacts of deprivation, fragmentation and rurality.
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Affiliation(s)
- Peter Congdon
- School of Geography, Queen Mary University of London, Mile End Rd, London E1 4NS, UK.
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Jonsson F, Sebastian MS, Hammarström A, Gustafsson PE. Are neighbourhood inequalities in adult health explained by socio-economic and psychosocial determinants in adolescence and the subsequent life course in northern Sweden? A decomposition analysis. Health Place 2018; 52:127-134. [PMID: 29886129 DOI: 10.1016/j.healthplace.2018.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/03/2018] [Accepted: 05/29/2018] [Indexed: 12/13/2022]
Abstract
This study explains neighbourhood deprivation inequalities in adult health for a northern Swedish cohort by examining the contribution of socio-economic and psychosocial determinants from adolescence (age 16), young adulthood (age 21) and midlife (age 42) to the disparity. Self-reported information from 873 participants was drawn from questionnaires, with complementary neighbourhood register data. The concentration index was used to estimate the inequality while decomposition analyses were run to attribute the disparity to its underlying determinants. The results suggest that socio-economic and psychosocial factors in midlife explain a substantial part, but also that the inequality can originate from conditions in adolescence and young adulthood.
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Affiliation(s)
- Frida Jonsson
- Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, SE-90187 Umeå, Sweden.
| | - Miguel San Sebastian
- Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, SE-90187 Umeå, Sweden.
| | - Anne Hammarström
- Department of Public Health and Caring Sciences, Uppsala University, SE-751 22 Uppsala, Sweden.
| | - Per E Gustafsson
- Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, SE-90187 Umeå, Sweden.
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Fernandez A, Gillespie JA, Smith-Merry J, Feng X, Astell-Burt T, Maas C, Salvador-Carulla L. Integrated mental health atlas of the Western Sydney Local Health District: gaps and recommendations. AUST HEALTH REV 2018; 41:38-44. [PMID: 27007640 DOI: 10.1071/ah15154] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 02/01/2016] [Indexed: 11/23/2022]
Abstract
Objective Australian mental health care remains hospital centric and fragmented; it is riddled with gaps and does little to promote recovery. Reform must be built on better knowledge of the shape of existing services. Mental health atlases are an essential part of this knowledge base, enabling comparison with other regions and jurisdictions, but must be based on a rigorous classification of services. The main aim of this study is to create an integrated mental health atlas of the Western Sydney LHD in order to help decision makers to better plan informed by local evidence. Methods The standard classification system, namely the Description and Evaluation of Services and Directories in Europe for Long-term Care model, was used to describe and classify adult mental health services in the Western Sydney Local Health District (LHD). This information provided the foundation for accessibility maps and the analysis of the provision of care for people with a lived experience of mental illness in Western Sydney LHD. All this data was used to create the Integrated Mental Health Atlas of Western Sydney LHD. Results The atlas identified four major gaps in mental health care in Western Sydney LHD: (1) a lack of acute and sub-acute community residential care; (2) an absence of services providing acute day care and non-acute day care; (3) low availability of specific employment services for people with a lived experience of mental ill-health; and (4) a lack of comprehensive data on the availability of supported housing. Conclusions The integrated mental health atlas of the Western Sydney LHD provides a tool for evidence-informed planning and critical analysis of the pattern of adult mental health care. What is known about the topic? Several reports have highlighted that the Australian mental health system is hospital based and fragmented. However, this knowledge has had little effect on actually changing the system. What does this paper add? This paper provides a critical analysis of the pattern of adult mental health care provided within the boundaries of the Western Sydney LHD using a standard, internationally validated tool to describe and classify the services. This provides a good picture of the availability of adult mental health care at the local level that was hitherto lacking. What are the implications for practitioners? The data presented herein provide a better understanding of the context in which mental health practitioners work. Managers and planners of services providing care for people with a lived experience of mental illness can use the information herein for better planning informed by local evidence.
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Affiliation(s)
- Ana Fernandez
- The Mental Health Policy Unit, Brain and Mind Centre, The University of Sydney, 100 Mallett Street, Camperdown, NSW 2050, Australia
| | - James A Gillespie
- Menzies Centre for Health Policy and Sydney School of Public Health, The University of Sydney, City Road, Edward Ford Building A27, NSW 2006, Australia. Email
| | - Jennifer Smith-Merry
- Centre for Disability Research and Policy, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia.
| | - Xiaoqi Feng
- Menzies Centre for Health Policy and Sydney School of Public Health, The University of Sydney, City Road, Edward Ford Building A27, NSW 2006, Australia. Email
| | - Thomas Astell-Burt
- School of Health and Society, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
| | - Cailin Maas
- The Mental Health Policy Unit, Brain and Mind Centre, The University of Sydney, 100 Mallett Street, Camperdown, NSW 2050, Australia
| | - Luis Salvador-Carulla
- The Mental Health Policy Unit, Brain and Mind Centre, The University of Sydney, 100 Mallett Street, Camperdown, NSW 2050, Australia
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Astell-Burt T, Feng X, Kolt GS. Large-scale investment in green space as an intervention for physical activity, mental and cardiometabolic health: study protocol for a quasi-experimental evaluation of a natural experiment. BMJ Open 2016; 6:e009803. [PMID: 27053266 PMCID: PMC4823445 DOI: 10.1136/bmjopen-2015-009803] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION 'Green spaces' such as public parks are regarded as determinants of health, but evidence from tends to be based on cross-sectional designs. This protocol describes a study that will evaluate a large-scale investment in approximately 5280 hectares of green space stretching 27 km north to south in Western Sydney, Australia. METHODS AND ANALYSIS A Geographic Information System was used to identify 7272 participants in the 45 and Up Study baseline data (2006-2008) living within 5 km of the Western Sydney Parklands and some of the features that have been constructed since 2009, such as public access points, advertising billboards, walking and cycle tracks, BBQ stations, and children's playgrounds. These data were linked to information on a range of health and behavioural outcomes, with the second wave of data collection initiated by the Sax Institute in 2012 and expected to be completed by 2015. Multilevel models will be used to analyse potential change in physical activity, weight status, social contacts, mental and cardiometabolic health within a closed sample of residentially stable participants. Comparisons between persons with contrasting proximities to different areas of the Parklands will provide 'treatment' and 'control' groups within a 'quasi-experimental' study design. In line with expectations, baseline results prior to the enhancement of the Western Sydney Parklands indicated virtually no significant differences in the distribution of any of the outcomes with respect to proximity to green space preintervention. ETHICS AND DISSEMINATION Ethical approval was obtained for the 45 and Up Study from the University of New South Wales Human Research Ethics Committee. Ethics approval for this study was obtained from the University of Western Sydney Ethics Committee. Findings will be disseminated through partner organisations (the Western Sydney Parklands and the National Heart Foundation of Australia), as well as to policymakers in parallel with scientific papers and conference presentations.
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Affiliation(s)
- Thomas Astell-Burt
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- Early Start Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Xiaoqi Feng
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- Early Start Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Gregory S Kolt
- School of Science and Health, Western Sydney University, Penrith, NSW, Australia
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Silva ATCD, Menezes PR. Depression and violent crime: is there a relationship? EVIDENCE-BASED MENTAL HEALTH 2015; 18:114. [PMID: 26449535 PMCID: PMC11234586 DOI: 10.1136/eb-2015-102104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 09/23/2015] [Accepted: 09/24/2015] [Indexed: 11/03/2022]
Affiliation(s)
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, University of São Paulo, São Paulo, Brazil
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