Contributing factors to diaper dermatitis and NICU length of stay

Abstract Background Ever since the implementation of the EU-Turkey deal, most refugees that enter Greece via sea are confined to the island on which they arrive until their asylum claims are adjudicated, where they generally reside in camps. Some of these camps have detention-like characteristics and dire living conditions, such as Moria camp on the island of Lesbos, Greece. Aid-organizations have stated that the situation in camp Moria deteriorates the mental health of its inhabitants and there is qualitative evidence to support this. This study explores the quantitative relationship between the incidence of acute mental health crises and the length of stay in the camp. Methods A cross-sectional study was conducted using routinely collected data on 856 consultations of 634 different patients during 90 nights at an emergency clinic in Moria camp. Logistic regression analysis was used to explore whether the length of stay in the camp was predictive of the occurrence of an acute mental health crisis. Results Of the 634 patients, the majority were men (59·3%), the average age was 23·2 years [0–71], and 24·3% was < 18 years. 25·5% (n = 218) of consultations were related to mental health problems; 17·0% (n = 37) of these met the study’s case definition of an acute mental health crisis. Such crises were positively associated with the length of stay in the camp (p = 0·011); the odds ratio of a mental health crisis increases with 1·03 for every 10% increase in days of residence in the camp. This is notable when considering the average length of stay in the camp is 71 days. Conclusion This study offers quantitative support for the notion that the adverse conditions in Moria camp deteriorate the mental health of its inhabitants as suggested in qualitative research. Although this study does not provide evidence of causality, it is likely that the poor and unsafe living conditions, challenging refugee determination procedures, and a lack of mental health services in the camp are significant contributing factors. We urgently call for Europe’s policymakers to honour the ‘51 Geneva refugee convention and terminate the neglectful situation on the Greek archipelago.

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Managing agitation in critically ill patients

American Journal of Critical Care ◽

10.4037/ajcc1996.5.1.7 ◽

1996 ◽

Vol 5 (1) ◽

pp. 7-16 ◽

Cited By ~ 19

Author(s):

MA Harvey

Keyword(s):

Critical Care ◽

Length Of Stay ◽

Adverse Effects ◽

Critically Ill ◽

Critically Ill Patients ◽

Clinical Applications ◽

Contributing Factors ◽

Pharmacologic Agents

Managing agitation in critically ill patients is challenging and complex. Advances in the field of critical care impose strains on patients that can lead to disorientation and agitation, especially as more severe illnesses are treated successfully. Although the adverse effects of agitation are well-known, their impact on morbidity, mortality, length of stay, and cost are only beginning to be addressed. Meeting these challenges requires an understanding of the potential adverse effects of agitation, its causes and contributing factors, the advantages and limitations of available pharmacologic agents, and the role of nonpharmacologic interventions. This article reviews each of these issues, with a focus on clinical applications and strategies.

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Trends and Costs Associated With the Diagnosis and Treatment of Infantile Spasms: A 10-Year Multicenter Retrospective Review

The Journal of Pediatric Pharmacology and Therapeutics ◽

10.5863/1551-6776-27.1.29 ◽

2021 ◽

Vol 27 (1) ◽

pp. 29-37

Author(s):

Mindl M. Weingarten ◽

Jon A. Cokley ◽

Brady Moffett ◽

Shannon DiCarlo ◽

Sunita N. Misra

Keyword(s):

Length Of Stay ◽

Hospital Stay ◽

Average Length ◽

Infantile Spasms ◽

Diagnostic Workup ◽

Hospital Length Of Stay ◽

Care Utilization ◽

Contributing Factors ◽

Neurodevelopmental Outcomes ◽

Average Length Of Stay

OBJECTIVE Early treatment of infantile spasms (IS) may be imperative for improvement of neurodevelopmental outcomes. Existing studies have led to inconclusive recommendations with variation in treatment. Our objective was to determine the national average cost, initial diagnostic workup, treatments, and hospital length of stay for patients with IS. METHODS This retrospective cohort study was designed to review data of patients < 2 years from 43 non-profit institutions. Data obtained included patient demographics, length of stay, admission cost, and treatments used from 2004 to 2014. Cost data were collected and adjusted to 2014 dollars, the year data were analyzed. RESULTS A total of 6183 patients met study criteria (n = 3382, 55% male). Three-quarters of patients (n = 4684, 76%) had an electroencephalogram, 56.4% had brain imaging (n = 3487), and 17% (n = 1050) underwent a lumbar puncture. Medication for IS was initiated during inpatient hospital stay in two-thirds of all patients (n = 4139, 67%). Most patients were initiated on corticotropin (n = 2066, 33%) or topiramate (n = 1804, 29%). Average length of stay was 5.8 days with an average adjusted cost of $18,348. Over time there was an 86.6% increase in cost from an average $12,534.54 (2004) to $23,391.20 (2014), a significant change (p < 0.01). This correlated with an increase in average length of stay. CONCLUSIONS Variability exists in diagnostic workup and pharmacotherapy initiated for IS, which may lead to differences in the cost of hospital stay. Further studies may help determine contributing factors to increased cost and improve health care utilization for IS patients.

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Mental health consequences of long-term stays in refugee camps: Preliminary evidence from Moria

10.21203/rs.3.rs-18160/v2 ◽

2020 ◽

Author(s):

willemine van de Wiel ◽

Carla Castillo-Laborde ◽

Francisco Urzúa I. ◽

Michelle Fish ◽

Willem F. Scholte

Keyword(s):

Mental Health ◽

Length Of Stay ◽

Mental Health Problems ◽

Average Length ◽

Case Definition ◽

Living Conditions ◽

Mental Health Crisis ◽

Contributing Factors ◽

Cross Sectional ◽

Health Crisis

Abstract Background Ever since the implementation of the EU-Turkey deal, most refugees that enter Greece via sea are confined to the island on which they arrive until their asylum claims are adjudicated, where they generally reside camps. Some of these camps have detention-like characteristics and dire living conditions, such as Moria camp on the island of Lesbos, Greece. Aid-organizations have stated that the situation in camp Moria deteriorates the mental health of its inhabitants and there is qualitative evidence to support this. This study explores the quantitative relationship between the incidence of acute mental health crises and the length of stay in the camp. Methods A cross-sectional study was conducted using routinely collected data on 856 consultations of 634 different patients during 90 nights at an emergency clinic in Moria camp. Logistic regression analysis was used to explore whether the length of stay in the camp was predictive of the occurrence of an acute mental health crisis. Results Of the 634 patients, the majority were men (59·3%), the average age was 23·2 years [0–71], and 24·3% was <18 years. 25·5% (n=218) of consultations were related to mental health problems; 17·0% (n=37) of these met the study’s case definition of an acute mental health crisis. Such crises were positively associated with the length of stay in the camp (p=0011); the odds ratio of a mental health crisis increases with 1·03 for every 10% increase in days of residence in the camp. This is notable when considering the average length of stay in the camp is 71 days. Conclusion This study offers quantitative support for the notion that the adverse conditions in Moria camp deteriorate the mental health of its inhabitants as suggested in qualitative research. Although this study does not provide evidence of causality, it is likely that the poor and unsafe living conditions, challenging refugee determination procedures, and a lack of mental health services in the camp are significant contributing factors. We urgently call for Europe’s policymakers to honor the ‘51 Geneva refugee convention and terminate the neglectful situation on the Greek archipelago.

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