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Du M, Liu M, Wang Y, Qin C, Liu J. Global burden of sleep disturbances among older adults and the disparities by geographical regions and pandemic periods. SSM Popul Health 2024; 25:101588. [PMID: 38225953 PMCID: PMC10788304 DOI: 10.1016/j.ssmph.2023.101588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/23/2023] [Accepted: 12/18/2023] [Indexed: 01/17/2024] Open
Abstract
Sleep disturbances are highly prevalent during the COVID-19 pandemic, especially among older adults. We aimed to evaluate sleep heath during COVID-19 pandemic and assess the differences among geographical regions and pandemic periods. We searched three databases (PubMed, Embase, Web of Science) to find articles up to March 12, 2023. We included observational studies that reported the prevalence of sleep disturbances among adults aged 60 years or older in any setting. Two researchers independently reviewed the literature and retrieved the data. We used Der Simonian-Laird random effects meta-analyses to pool the data, followed by subgroup analysis, sensitivity analysis, and meta-regression. A total of 64 studies with 181,224 older adults during the pandemic were included. The prevalence of poor sleep quality, short sleep duration, long sleep duration, and insomnia symptoms were 47.12% (95% CI: 25.97%, 68.27%), 40.81% (95% CI: 18.49%, 63.12%), 31.61% (95% CI: 24.83%, 38.38%), and 21.15% (95% CI: 15.30%, 27.00%), respectively. The prevalence of sleep problems reported by self-constructed items was 26.97% (95% CI: 20.73%, 33.22%). When compared to America (64.13%), Europe (20.23%) and the Western Pacific (21.31%) showed a lower prevalence of sleep problems (all P < 0.0001). The prevalence of worsened sleep problems was 27.88% (95% CI: 11.94%, 43.82%). Compared to 2020 (15.14%), it increased to 47.42% in 2021 (P < 0.05). Eight studies on sleep disturbances among 672 older COVID-19 patients were included. The prevalence of sleep problems and insomnia symptoms among older COVID-19 patients were 41.58% (95% CI: 21.97%, 61.20%) and 41.56% (95% CI: 28.11%, 58.02%), respectively. A significant burden related to poor sleep has been observed among older adults worldwide over the past three years, with variations across different regions and time periods. It is important to make more efforts in prevention and intervention to identify the risk factors, treatment, and rehabilitation of sleep disturbances for healthy aging.
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Affiliation(s)
- Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Yaping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Chenyuan Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
- Institute for Global Health and Development, Peking University, No.5, Yiheyuan Road, Haidian District, Beijing, 100871, China
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
- Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
- Department of Global Health and Population, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA
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Quan L, Xu S, Xu H, Chen F, Wu S, Zhu J, Liu S, Su T. Depression, anxiety, lower sleep quality and social support in square cabin hospitals during Shanghai's COVID-19 lockdown, China. Front Psychiatry 2024; 15:1339774. [PMID: 38374973 PMCID: PMC10875048 DOI: 10.3389/fpsyt.2024.1339774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024] Open
Abstract
Objectives To investigate and compare the associated factors of depression, anxiety, and other psychological differences between patients with Corona Virus Disease 2019 quarantined in square cabin hospitals (SCH) and isolation wards (IW) in China. Methods Cluster sampling method was performed during Shanghai's Two-Month Lockdown in 2022. Hospital Anxiety and Depression Scale Depression subscale (HADS-D), 7-tiem Generalized Anxiety Disorder Scale (GAD-7), Pittsburgh sleep quality index (PSQI), and Perceived Social Support Scale (PSSS) were used to investigate psychological differences. Results The HADS-D and GAD-7 scores of SCH patients were significantly higher than those in IW (p < 0.001; p = 0.0295). Sleep latency (SCH-IW = -3.76, p < 0.001), sleep duration (SCH-IW = -2.22, p < 0.05), habitual sleep efficiency (SCH-IW = -4.11, p < 0.001), sleep disturbance (SCH-IW = -3.59, p < 0.001) and use of sleep medication (SCH-IW = -5.18, p < 0.001) of SCH patients were significantly worse. Depression was the main emotional problem of quarantined patients. Patients in SCH had lower social support. Sleep disorders and the lowest oxygen saturation ≤ 93% were risk factors for depression, while social support and child status were protective factors. Myalgia and constipation were risk factors for anxiety, while marital status was the protective factor. Conclusion Patients quarantined in SCH had higher risks of depression and anxiety, lower sleep quality and social support. Somatic discomfort and sleep disorders exacerbated depression and anxiety, which could be ameliorated by social support and taken into consideration in future SCH construction.
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Affiliation(s)
- Li Quan
- Department of Cardiology, Shanghai Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China
| | - Shuyu Xu
- Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Hao Xu
- Department of Infectious Diseases, the First Affiliated Hospital (Changhai Hospital) of Naval Medical University, Shanghai, China
| | - Feng Chen
- Department of Cardiology, the First Affiliated Hospital (Changhai Hospital) of Naval Medical University, Shanghai, China
| | - Shengyong Wu
- Department of Military Health Statistics, Naval Medical University, Shanghai, China
| | - Jiaqi Zhu
- Department of Cardiology, the First Affiliated Hospital (Changhai Hospital) of Naval Medical University, Shanghai, China
| | - Suxuan Liu
- Department of Cardiology, the First Affiliated Hospital (Changhai Hospital) of Naval Medical University, Shanghai, China
| | - Tong Su
- Faculty of Psychology, Naval Medical University, Shanghai, China
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Fichten CS, Wing S, Costin G, Jorgensen M, Havel A, Wileman S, Bailes S, Creti L, Libman E. Sleep and Well-Being during the COVID-19 Remote and In-Person Periods: Experiences of College Faculty and Staff with and without Disabilities. Behav Sci (Basel) 2023; 13:844. [PMID: 37887493 PMCID: PMC10604366 DOI: 10.3390/bs13100844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
We explored the impacts of the remote and return-to-in-person work periods on sleep and well-being as reported by faculty (n = 22) and non-teaching staff (n = 21) with and without disabilities. Participants were recruited through college platforms and personal contacts. Our results show that contrary to expectations, the COVID-19 remote teaching/working period resulted in better sleep, as well as greater well-being, than the return-to-in-person work period. With respect to sleep, faculty members had slightly more negative outcomes than staff, most evident in heightened anxiety and work aspects. Faculty with disabilities had somewhat worse sleep and well-being during the remote period than faculty without disabilities. During the return to in-person work, both faculty and non-teaching staff reported more negative than positive sleep and well-being outcomes. In particular, during the in-person period, faculty members experienced slightly more negative sleep outcomes related to anxiety and work, while staff members experienced slightly more negative sleep outcomes related to the need to commute and lifestyle. Our findings show that there were benefits and disadvantages to both remote and in-person work periods, suggesting a hybrid work schedule should be considered in more detail, particularly as an optional reasonable accommodation for faculty and staff with disabilities. Our study highlights that training to keep faculty abreast of the latest technological innovations, ways to promote work-life balance, and steps to remedy classroom size and building ventilation to prevent the spread of disease all need urgent attention.
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Affiliation(s)
- Catherine S. Fichten
- Department of Psychology, Dawson College, 3040 Sherbrooke St. W., Montreal, QC H3Z 1A4, Canada
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
| | - Samantha Wing
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- McGill Cognitive Science Program, McGill University, 845 Rue Sherbrooke O, Montréal, QC H3A 0G4, Canada
| | - Georgiana Costin
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- Department of Psychology, McGill University, 845 Rue Sherbrooke O, Montréal, QC H3A 0G4, Canada
| | - Mary Jorgensen
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
| | - Alice Havel
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- Scholars in Residence Program, Dawson College, 3040 Sherbrooke St. W., Montreal, QC H3Z 1A4, Canada
| | - Susie Wileman
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- Scholars in Residence Program, Dawson College, 3040 Sherbrooke St. W., Montreal, QC H3Z 1A4, Canada
| | - Sally Bailes
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
| | - Laura Creti
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
| | - Eva Libman
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
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AL-Musharaf S, Albedair B, Alfawaz W, Aldhwayan M, Aljuraiban GS. The Relationships between Various Factors and Sleep Status: A Cross-Sectional Study among Healthy Saudi Adults. Nutrients 2023; 15:4090. [PMID: 37764873 PMCID: PMC10536185 DOI: 10.3390/nu15184090] [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: 08/15/2023] [Revised: 09/09/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Impaired sleep can adversely affect daily life. This study assesses the association between different factors and sleep status among apparently healthy Saudi adults. In total, 478 adults were included in this study. Data on anthropometrics, body composition, stress scales, physical activity, and dietary habits were collected. Fasting blood glucose and lipid profile were measured. Sleep quality and duration were assessed using the Pittsburgh Sleep Quality Index. Larger neck circumference (NC) was associated with short sleep duration (odds ratio (OR) 1.23; 95% confidence interval (CI) [1.08, 1.41]; p = 0.002). Higher triglyceride levels were associated with poor sleep quality (OR 1.01; 95% CI [1.002, 1.02]; p = 0.019) and short sleep duration (OR 1.01; 95% CI [1.004, 1.02]; p = 0.005). Stress was a risk factor for poor sleep quality (OR 1.15; 95% CI [1.09, 1.22]; p < 0.001). Being married was significantly associated with good sleep quality (OR 2.97; 95% CI [1.32, 6.71]; p = 0.009), while being single was correlated with longer sleep duration (OR 0.46; 95% CI [0.22, 0.96]; p = 0.039). Other factors such as having a larger waist circumference and more muscle mass were protective factors against poor sleep quality and/or short sleep duration. In conclusion, a larger NC is suggested as a risk factor for short sleep duration and a higher triglyceride level for both short and poor sleep among healthy Saudis. Investigating the factors associated with sleep status may help alleviate sleep disturbances and improve overall health. Further studies are needed to confirm causality using objective sleep measures.
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Affiliation(s)
- Sara AL-Musharaf
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (B.A.); (W.A.); (M.A.); (G.S.A.)
- Center of Excellence in Biotechnology Research, King Saud University, Riyadh 11451, Saudi Arabia
| | - Basmah Albedair
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (B.A.); (W.A.); (M.A.); (G.S.A.)
| | - Waad Alfawaz
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (B.A.); (W.A.); (M.A.); (G.S.A.)
| | - Madhawi Aldhwayan
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (B.A.); (W.A.); (M.A.); (G.S.A.)
| | - Ghadeer S. Aljuraiban
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (B.A.); (W.A.); (M.A.); (G.S.A.)
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Simjanoski M, de Azevedo Cardoso T, Wollenhaupt-Aguiar B, Pfaffenseller B, De Boni RB, Balanzá-Martínez V, Frey BN, Minuzzi L, Kapczinski F. Lifestyle Behaviors, Depression, and Anxiety Among Individuals Living in Canada During the COVID-19 Pandemic. Am J Lifestyle Med 2023; 17:181-193. [PMID: 36883127 PMCID: PMC9157275 DOI: 10.1177/15598276221102097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of our study was to investigate the association between lifestyle behaviors and symptoms of depression and anxiety during the COVID-19 pandemic in Canada. A web survey was conducted between July 3-August 3, 2020, across Canada. The main outcomes considered were a positive screening for depression, as evaluated by the PHQ-2 and positive screening for anxiety, as evaluated by the GAD-7. Lifestyle behaviors were assessed using the Short Multidimensional Lifestyle Inventory Evaluation-Confinement (SMILE-C), an instrument adapted for lifestyle behaviors during the COVID-19 pandemic. The total sample size included 404 participants, of which 24.3% had a positive screen for depression, 20.5% for anxiety, and 15.5% for both. We found significant differences in SMILE-C scores between individuals with a positive and individuals with a negative screen for depression (P < .001). Likewise, there were significant differences in SMILE-C scores between individuals with a positive and individuals with a negative screen for anxiety (P < .001). We found an association between unhealthy lifestyle behaviors and symptoms of depression and anxiety during the COVID-19 lockdown in Canada. The findings highlight the importance of lifestyle medicine (LM) education and targeted lifestyle interventions to promote healthy behaviors and help reduce the burden of mental disorders.
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Affiliation(s)
- Mario Simjanoski
- Neuroscience Graduate Program, McMaster University, Hamilton, Canada.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
| | | | | | - Bianca Pfaffenseller
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
| | - Raquel B De Boni
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | - Benicio N Frey
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada.,Women's Health Concerns Clinic and Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
| | - Flavio Kapczinski
- Neuroscience Graduate Program, McMaster University, Hamilton, Canada.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
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6
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Kowall SM, Sommer JL, Reynolds KA, Mota N, El-Gabalawy R. Sleep disturbance during COVID-19: Correlates and predictive ability for mental health symptomatology in a Canadian online sample. Gen Hosp Psychiatry 2023; 80:48-53. [PMID: 36638699 PMCID: PMC9816073 DOI: 10.1016/j.genhosppsych.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND Sleep disturbance is associated with mental health symptomatology, but this impact is understudied during COVID-19. The aims of this study are to: 1) examine correlates of sleep disturbance, and 2) examine the longitudinal relationship between sleep disturbance and mental health symptoms 6 months later, during the pandemic. METHODS Data were analyzed from COVID-19 Survey Canada conducted between May 2020 (T1) and November 2021 (T2) (n = 489). We examined COVID-related baseline correlates of sleep disturbance at T1, and used multivariable regressions to examine the relationship between T1 sleep disturbance and T2 post-traumatic stress (PTS), health anxiety, generalized anxiety, and depressive symptoms, controlling for baseline mental health symptoms and sociodemographics. RESULTS Females, ages 30-49, and those with an annual household income <$50,000, showed a higher prevalence of clinically significant sleep disturbance. After adjustment, compared to those without sleep disturbance at baseline, those with sleep disturbance showed a significant increase in PTS symptoms at 6 months (b = 11.80, 95% CI = [8.21-15.38], p < 0.001). LIMITATIONS Results are not nationally representative. Data may be subject to response biases due to self-report methods and we are unable to determine causality. CONCLUSION Being able to predict adverse mental health implications of sleep disturbance will help clinicians be equipped to target future impacts of the COVID-19 pandemic as well as any future potential pandemics or traumas. This study emphasizes the importance of screening individuals for sleep disturbance.
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Affiliation(s)
- Sarah M. Kowall
- Department of Psychology, Faculty of Arts, University of Winnipeg, Canada
| | - Jordana L. Sommer
- Department of Psychology, Faculty of Arts, University of Manitoba, Canada,Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba, Canada
| | | | - Natalie Mota
- Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Canada,Department of Clinical Health Psychology, Max Rady College of Medicine, University of Manitoba, Canada
| | - Renée El-Gabalawy
- Department of Psychology, Faculty of Arts, University of Manitoba, Canada; Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba, Canada; Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Canada; Department of Clinical Health Psychology, Max Rady College of Medicine, University of Manitoba, Canada.
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Safiri S, Nikoofard A. Ladybug Beetle Optimization algorithm: application for real-world problems. THE JOURNAL OF SUPERCOMPUTING 2022; 79:3511-3560. [PMID: 36093388 PMCID: PMC9446635 DOI: 10.1007/s11227-022-04755-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
In this paper, a novel optimization algorithm is proposed, called the Ladybug Beetle Optimization (LBO) algorithm, which is inspired by the behavior of ladybugs in nature when they search for a warm place in winter. The new proposed algorithm consists of three main parts: (1) determine the heat value in the position of each ladybug, (2) update the position of ladybugs, and (3) ignore the annihilated ladybug(s). The main innovations of LBO are related to both updating the position of the population, which is done in two separate ways, and ignoring the worst members, which leads to an increase in the search speed. Also, LBO algorithm is performed to optimize 78 well-known benchmark functions. The proposed algorithm has reached the optimal values of 73.3% of the benchmark functions and is the only algorithm that achieved the best solution of 20.5% of them. These results prove that LBO is substantially the best algorithm among other well-known optimization methods. In addition, two fundamentally different real-world optimization problems include the Economic-Environmental Dispatch Problem (EEDP) as an engineering problem and the Covid-19 pandemic modeling problem as an estimation and forecasting problem. The EEDP results illustrate that the proposed algorithm has obtained the best values in either the cost of production or the emission or even both, and the use of LBO for Covid-19 pandemic modeling problem leads to the least error compared to others.
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Affiliation(s)
- Saadat Safiri
- Faculty of Electrical Engineering, K. N. Toosi University of Technology, Tehran, Iran
| | - Amirhossein Nikoofard
- Faculty of Electrical Engineering, K. N. Toosi University of Technology, Tehran, Iran
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Eboreime E, Shalaby R, Mao W, Owusu E, Vuong W, Surood S, Bales K, MacMaster FP, McNeil D, Rittenbach K, Ohinmaa A, Bremault-Phillips S, Hilario C, Greiner R, Knox M, Chafe J, Coulombe J, Xin-Min L, McLean C, Rathwell R, Snaterse M, Spurvey P, Taylor VH, McLean S, Urichuk L, Tzeggai B, McCabe C, Grauwiler D, Jordan S, Brown E, Fors L, Savard T, Grunau M, Kelton F, Stauffer S, Cao B, Chue P, Abba-Aji A, Silverstone P, Nwachukwu I, Greenshaw A, Agyapong VIO. Reducing readmission rates for individuals discharged from acute psychiatric care in Alberta using peer and text message support: Protocol for an innovative supportive program. BMC Health Serv Res 2022; 22:332. [PMID: 35279142 PMCID: PMC8917368 DOI: 10.1186/s12913-022-07510-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 01/13/2022] [Indexed: 12/21/2022] Open
Abstract
Background Individuals discharged from inpatient psychiatry units have the highest readmission rates of all hospitalized patients. These readmissions are often due to unmet need for mental health care compounded by limited human resources. Reducing the need for hospital admissions by providing alternative effective care will mitigate the strain on the healthcare system and for people with mental illnesses and their relatives. We propose implementation and evaluation of an innovative program which augments Mental Health Peer Support with an evidence-based supportive text messaging program developed using the principles of cognitive behavioral therapy. Methods A pragmatic stepped-wedge cluster-randomized trial, where daily supportive text messages (Text4Support) and mental health peer support are the interventions, will be employed. We anticipate recruiting 10,000 participants at the point of their discharge from 9 acute care psychiatry sites and day hospitals across four cities in Alberta. The primary outcome measure will be the number of psychiatric readmissions within 30 days of discharge. We will also evaluate implementation outcomes such as reach, acceptability, fidelity, and sustainability. Our study will be guided by the Consolidated Framework for Implementation Research, and the Reach-Effectiveness-Adoption-Implementation-Maintenance framework. Data will be extracted from administrative data, surveys, and qualitative methods. Quantitative data will be analysed using machine learning. Qualitative interviews will be transcribed and analyzed thematically using both inductive and deductive approaches. Conclusions To our knowledge, this will be the first large-scale clinical trial to assess the impact of a daily supportive text message program with and without mental health peer support for individuals discharged from acute psychiatric care. We anticipate that the interventions will generate significant cost-savings by reducing readmissions, while improving access to quality community mental healthcare and reducing demand for acute care. It is envisaged that the results will shed light on the effectiveness, as well as contextual barriers and facilitators to implementation of automated supportive text message and mental health peer support interventions to reduce the psychological treatment and support gap for patients who have been discharged from acute psychiatric care. Trial registration clinicaltrials.gov, NCT05133726. Registered 24 November 2021 Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07510-8.
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9
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Eboreime E, Ohinmaa A, Rusak B, Cassidy KL, Morrison J, McGrath P, Uher R, Meier S, Fleury MJ, Iyer SN, Rej S, Batchelor F, Levinger P, Dang C, Hopwood M, Acquah FNL, Dzator J, Tomblin Murphy G, Warford J, Wozney L, Vedel I, Gahagan J, Theou O, Koto P, Sampalli T, Kirkland S, Watters N, Agyapong VIO. The Text4HealthyAging Program: An Evidence-Based Text Messaging Innovation to Support Healthy Urban Aging in Canada and Australia. Gerontol Geriatr Med 2022; 8:23337214221081378. [PMID: 35252477 PMCID: PMC8891919 DOI: 10.1177/23337214221081378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/06/2022] [Accepted: 02/01/2022] [Indexed: 11/15/2022] Open
Abstract
Age-friendly cities are crucial to achieve the WHO goal of healthy aging. Such cities promote opportunities for health, participation, and security, thus enhancing quality of life as people age. Older people commonly experience psychosocial challenges such as anxiety, depression, substance abuse, loss of autonomy, grief, fear, and loneliness. Australian and Canadian cities continue to seek innovation to improve healthy urban aging and create more age-friendly environments for older adults. There is increasing evidence on the effectiveness and feasibility of mobile technology in health promotion and closing psychological treatment gaps. Older adults have been demonstrated to engage frequently with mobile devices, particularly text messaging. In this article, we conceptualize the Text4HealthyAging, an evidence-based text messaging innovation to support healthy urban aging in Canadian and Australian cities.
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Affiliation(s)
- Ejemai Eboreime
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Arto Ohinmaa
- School of Public Health, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Benjamin Rusak
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
- Department of Psychology & Neuroscience, Faculty of Science, Dalhousie University, Halifax, NS, Canada
| | - Keri-Leigh Cassidy
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Jason Morrison
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Patrick McGrath
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - Rudolf Uher
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Sandra Meier
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | | | | | - Soham Rej
- Department of Psychiatry, McGill UniversityMontreal, QC, Canada
| | | | - Pazit Levinger
- National Ageing Research Institute, Parkville, VIC, Australia
| | - Christa Dang
- National Ageing Research Institute, Parkville, VIC, Australia
| | - Malcolm Hopwood
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | | | - Janet Dzator
- Newcastle Business School, University of Newcastle, Australia
| | - Gail Tomblin Murphy
- Mental Health and Addictions, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Jordan Warford
- Mental Health and Addictions, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Lori Wozney
- Mental Health and Addictions, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Isabelle Vedel
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | | | - Olga Theou
- Geriatric Medicine Research, Nova Scotia Health Authority, Halifax, NS, Canada
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada
| | - Prosper Koto
- Mental Health and Addictions, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Tara Sampalli
- Mental Health and Addictions, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Susan Kirkland
- Geriatric Medicine Research, Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, NS, Canada
| | | | - Vincent I. O. Agyapong
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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10
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Obuobi-Donkor G, Eboreime E, Bond J, Phung N, Eyben S, Hayward J, Zhang Y, MacMaster F, Clelland S, Greiner R, Jones C, Cao B, Brémault-Phillips S, Wells K, Li XM, Hilario C, Greenshaw AJ, Agyapong VIO. An E-Mental Health Solution to Prevent and Manage Post-Traumatic Stress Injuries among First Responders in Alberta: Protocol for the Implementation and Evaluation of Text4PTSI and Text4Wellbeing (Preprint). JMIR Res Protoc 2021; 11:e30680. [PMID: 35468094 PMCID: PMC9086885 DOI: 10.2196/30680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 02/07/2022] [Accepted: 02/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background First responders are confronted with traumatic events in their work that has a substantial toll on their psychological health and may contribute to or result in posttraumatic stress injuries (PTSIs) for many responders. Persons with a PTSI usually seek management therapies. Evidence indicates that digital delivery of these therapies is an innovative, efficient, and effective way to improve PTSI symptoms as an adjunct to in-person delivery. Objective This project aims to implement and provide accessible, convenient, and economical SMS text messaging services, known as Text4PTSI and Text4Wellbeing, to first responders in Alberta, Canada; to prevent and improve the symptoms of PTSI among first responders; and to improve their overall quality of life. We will evaluate posttraumatic symptoms and the impact of Text4PTSI and Text4Wellbeing on stress, anxiety, and depression in relation to the correspondents’ demographic backgrounds. Methods First responders who subscribe to Text4PTSI or Text4Wellbeing receive daily supportive and psychoeducational SMS text messages for 6 months. The SMS text messages are preprogrammed into an online software program that delivers messages to subscribers. Baseline and follow-up data are collected through online questionnaires using validated scales at enrollment, 6 weeks, 12 weeks, and 24 weeks (end point). In-depth interviews will be conducted to assess satisfaction with the text-based intervention. Results We hypothesize that participants who enroll in this program will have improved PTSI symptoms; increased or improved quality of life; and significant reduction in associated stress, depression, and anxiety symptoms, among other psychological concerns. Improvement will be determined in comparison to established baseline parameters. Conclusions This research will be beneficial for practitioners and will inform policy-making and decision-making regarding psychological interventions for PTSI. Lessons from this study will inform the scale-up of the intervention, a cost-effective, zero contact therapeutic option to manage PTSI. International Registered Report Identifier (IRRID) PRR1-10.2196/30680
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Affiliation(s)
- Gloria Obuobi-Donkor
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Jennifer Bond
- Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB, Canada
| | - Natalie Phung
- Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB, Canada
| | - Scarlett Eyben
- Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB, Canada
| | - Jake Hayward
- Department of Emergency Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Yanbo Zhang
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Frank MacMaster
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Steven Clelland
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Russell Greiner
- Department of Computer Science, Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Chelsea Jones
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
| | - Bo Cao
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Suzette Brémault-Phillips
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
- Department of Child and Youth Care, Faculty of Health and Community Studies, MacEwan University, Edmonton, AB, Canada
| | - Kristopher Wells
- Department of Child and Youth Care, Faculty of Health and Community Studies, MacEwan University, Edmonton, AB, Canada
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Carla Hilario
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Andrew J Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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11
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Przybylko G, Morton DP, Renfrew ME. Addressing the COVID-19 Mental Health Crisis: A Perspective on Using Interdisciplinary Universal Interventions. Front Psychol 2021; 12:644337. [PMID: 33927669 PMCID: PMC8076681 DOI: 10.3389/fpsyg.2021.644337] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/12/2021] [Indexed: 12/14/2022] Open
Abstract
Mental health is reaching a crisis point due to the ramifications of COVID-19. In an attempt to curb the spread of the virus and circumvent health systems from being overwhelmed, governments have imposed regulations such as lockdown restrictions and home confinement. These restrictions, while effective for infection control, have contributed to poorer lifestyle behaviors. Currently, Positive Psychology and Lifestyle Medicine are two distinct but complimentary disciplines that offer an array of evidence-based approaches for promoting mental health and well-being across a universal population. However, these strategies for improving mental health are typically used in isolation. This perspective calls for a new paradigm shift to create and rollout well-designed interdisciplinary universal multicomponent mental health interventions that integrates the benefits of both disciplines, and uses innovative digital mental health solutions to achieve scalability and accessibility within the limitations and beyond the COVID-19 lockdown and restrictions.
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Affiliation(s)
- Geraldine Przybylko
- Lifestyle Medicine and Health Research Centre, Avondale University College, Cooranbong, NSW, Australia
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