scholarly journals Predictors of clinical deterioration in patients with suspected COVID-19 managed in a ‘virtual hospital’ setting: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045356
Author(s):  
Nick A Francis ◽  
Beth Stuart ◽  
Matthew Knight ◽  
Rama Vancheeswaran ◽  
Charles Oliver ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Hospital Setting ◽  
Health Problems ◽  
Clinical Deterioration ◽  
Care Services ◽  
Increased Risk ◽  
Remote Assessment ◽  
History Of

ObjectiveIdentify predictors of clinical deterioration in a virtual hospital (VH) setting for COVID-19.DesignReal-world prospective observational study.SettingVH remote assessment service in West Hertfordshire NHS Trust, UK.ParticipantsPatients with suspected COVID-19 illness enrolled directly from the community (postaccident and emergency (A&E) or medical intake assessment) or postinpatient admission.Main outcome measureDeath or (re-)admission to inpatient hospital care during VH follow-up and for 2 weeks post-VH discharge.Results900 patients with a clinical diagnosis of COVID-19 (455 referred from A&E or medical intake and 445 postinpatient) were included in the analysis. 76 (8.4%) of these experienced clinical deterioration (15 deaths in admitted patients, 3 deaths in patients not admitted and 58 additional inpatient admissions). Predictors of clinical deterioration were increase in age (OR 1.04 (95% CI 1.02 to 1.06) per year of age), history of cancer (OR 2.87 (95% CI 1.41 to 5.82)), history of mental health problems (OR 1.76 (95% CI 1.02 to 3.04)), severely impaired renal function (OR for eGFR <30=9.09 (95% CI 2.01 to 41.09)) and having a positive SARS-CoV-2 PCR result (OR 2.0 (95% CI 1.11 to 3.60)).ConclusionsThese predictors may help direct intensity of monitoring for patients with suspected or confirmed COVID-19 who are being remotely monitored by primary or secondary care services. Further research is needed to confirm our findings and identify the reasons for increased risk of clinical deterioration associated with cancer and mental health problems.

scholarly journals Predictors of adverse outcome in patients with suspected COVID-19 managed in a ‘virtual hospital’ setting: a cohort study

2020 ◽  
Author(s):  
Nick A Francis ◽  
Beth Stuart ◽  
Matthew Knight ◽  
Rama Vancheeswaran ◽  
Charles Oliver ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Adverse Outcome ◽  
Hospital Setting ◽  
Health Problems ◽  
List Type ◽  
Increased Risk ◽  
Wide Range ◽  
History Of

ABSTRACTObjectiveIdentify predictors of adverse outcome in a Virtual Hospital (VH) setting for COVID 19.DesignReal-world prospective observational study.SettingVirtual hospital remote assessment service in West Hertfordshire NHS Trust, UK.ParticipantsPatients with suspected COVID-19 illness enrolled directly from the community (post-accident and emergency (A&E) or medical intake assessment) or post-inpatient admission.Main outcome measureDeath or (re-)admission to inpatient hospital care over 28 days.Results900 patients with a clinical diagnosis of COVID-19 (455 referred from A&E or medical intake and 445 post-inpatient) were included in the analysis. 76 (8.4%) of these experienced an adverse outcome (15 deaths in admitted patients, 3 deaths in patients not admitted, and 58 additional inpatient admissions). Predictors of adverse outcome were increase in age (OR 1.04 [95%CI: 1.02, 1.06] per year of age), history of cancer (OR 2.87 [95%CI: 1.41, 5.82]), history of mental health problems (OR 1.76 [95%CI: 1.02, 3.04]), severely impaired renal function (OR for eGFR <30 = 9.09 [95%CI: 2.01, 41.09]) and having a positive SARS-CoV-2 PCR result (OR 2.0 [95% CI: 1.11, 3.60]).ConclusionsThese predictors may help direct intensity of monitoring for patients with suspected or confirmed COVID-19 who are being remotely monitored by primary or secondary care services. Further research is needed to identify the reasons for increased risk of adverse outcome associated with cancer and mental health problems.ARTICLE SUMMARYStrengths and limitations of this studyThe study uses anonymised data from all patients registered for the virtual hospital between 17/03/20 and 17/05/20, and therefore selection bias is not an issue.At the time of this study, this was the only service providing remote follow-up for patients with suspected COVID-19 in the area, and therefore our findings are likely to be relevant to primary care patients receiving remote follow-up.We were able to collect reliable data on a wide range of clinical and demographic features, and reliably follow all patients for the primary outcome for at least two weeks following their discharge from the VH.We were not able to extract detailed symptom or clinical examination data, and there were significant amounts of missing data for some variables.Our study is likely underpowered to detect all predictors, especially in the analysis of our two sub-groups

Psychological distress among Vietnamese adults attending Vietnamese-speaking general practices in South Western Sydney: prevalence and associations

2016 ◽  
Vol 22 (4) ◽  
pp. 354 ◽  
Author(s):  
Thi Nguyen ◽  
Sarah Dennis ◽  
Huy An ◽  
Sanjyot Vagholkar ◽  
Siaw Teng Liaw
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Mental Health Problems ◽  
Past History ◽  
Health Problems ◽  
High Exposure ◽  
Increased Risk ◽  
History Of ◽  
General Practices ◽  
Exposure To Trauma

Objective The aim of the present study was to determine the prevalence of psychological distress among Vietnamese adults attending Vietnamese-speaking general practices and explore possible risk factors in this population. Methods A cross-sectional survey of Vietnamese adult patients was conducted at 25 general practices with Vietnamese-speaking general practitioners (GPs) in south-western Sydney between October 2012 and February 2013. Patients completed the Kessler (K10) scale and a demographic questionnaire, available in Vietnamese or English. Data were analysed using SPSS version 21. Results Of the 350 patients invited to participate, 247 completed surveys (response rate 71%). One-quarter (25%) of participants had a very high K10 score for psychological distress, nearly twice that reported in the NSW Health Survey. Participants with high exposure to trauma were at increased risk of psychological distress (odds ratio 5.9, 95% confidence interval 2.4–14.4; P < 0.0001) compared with those with mild or no trauma exposure. Similarly, risk was increased if there was a past history of mental health problems and a lack of personal and social support. Conclusion The high prevalence of mental health problems in adult Vietnamese people attending Vietnamese-speaking general practices is associated with exposure to trauma. This highlights the importance of personal, social and professional support in effective management. Vietnamese-speaking GPs who see Vietnamese or similar refugee groups should actively seek out a history of exposure to trauma, a past history of mental illness and the existence of support systems.

Women in Prison With Traumatic Brain Injury: Prevalence, Mechanism, and Impact on Mental Health

2017 ◽  
Vol 62 (10) ◽  
pp. 3135-3150 ◽  
Author(s):  
Rachel Woolhouse ◽  
Audrey McKinlay ◽  
Randolph C. Grace
Keyword(s):  
Mental Health ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mental Health Problems ◽  
Prison Population ◽  
Female Offenders ◽  
Health Problems ◽  
Treatment Programs ◽  
Increased Risk ◽  
History Of

Relatively little is known about the characteristics of female offenders. Here, we studied the prevalence of traumatic brain injury (TBI) and mental health issues in an exclusively female prison population in New Zealand. Participants ( N = 38) were recruited from all security levels at Christchurch Women’s Prison. Measures for depression, anxiety, and stress, sleep, and a history of TBI were administered; 94.7% (36/38) of participants presented with a history of TBI. Younger age at first injury was associated with an increased risk of mental health problems. The study concludes that TBI is highly prevalent among female offenders and may be linked to increased mental health problems. TBI should be considered as an important factor in offender pathways and treatment programs.

scholarly journals One-Year Follow-Up of Suicidal Adolescents: Parental History of Mental Health Problems and Time to Post-Hospitalization Attempt

2009 ◽  
Vol 39 (3) ◽  
pp. 219-232 ◽  
Author(s):  
Cheryl A. King ◽  
David C. R. Kerr ◽  
Michael N. Passarelli ◽  
Cynthia Ewell Foster ◽  
Christopher R. Merchant
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Health Problems ◽  
Parental History ◽  
History Of ◽  
One Year

Low Physical Activity in Adolescence is Associated with Increased Risk for Mental Health Problems

2009 ◽  
Vol 13 (2) ◽  
pp. 74-81 ◽  
Author(s):  
Karin Monshouwer ◽  
Margreet ten Have ◽  
Mireille Van Poppel ◽  
Han Kemper ◽  
Wilma Vollebergh
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Mental Health Problems ◽  
Health Problems ◽  
Increased Risk

Family Type Predicts Mental Health Problems in Young Adults: A Survey of Students at a University in Botswana

2020 ◽  
Vol 32 (2) ◽  
Author(s):  
Kennedy Amone-P'Olak ◽  
Boniface Kealeboga Ramotuana
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Mental Health Problems ◽  
Single Mother ◽  
Health Problems ◽  
Family Type ◽  
Cross Sectional ◽  
Intact Family ◽  
Increased Risk ◽  
Family Types

In Africa, the structure of the family is changing rapidly. The effects of this change on mental health remain unknown. This study investigated the extent to which different family types (intact, single-mother, and multiple) predict mental health problems in young adults in Botswana (N = 264, mean age = 21.31, SD = 2.40). In a cross-sectional design, the study sampled students registered at various faculties at the University of Botswana. The revised symptoms checklist (SCL-90-R) was used to assess symptoms of mental health problems (depression, anxiety and hostility). Binary logistic regression analyses were performed to obtain odds ratios (ORs) and 95 per cent confidence intervals (CIs) of mental health problems for mother-only and multiple family types relative to the intact family type. Compared to the intact family type, single-mother (OR = 2.34; 95% CI: 1.21, 4.51) and multiple family types (OR = 1.56; CI: 0.88, 2.78) were associated with an increased risk of depression. For anxiety, the ORs were 2.27 (CI: 1.18, 4.38) and 1.10 (CI: 0.56, 1.82) for single-mother and multiple family types respectively. For hostility, the ORs were 2.60 (CI: 1.34, 5.04), and 0.79 (CI: 0.44, 1.42) for single-mother and multiple family types, respectively. Family types predict mental health problems in young adults and therefore the interventions to mitigate the effects should consider family backgrounds and the ramifications of family types for treatment and care.

Six-year follow-up study of combined type ADHD from childhood to young adulthood: Predictors of functional impairment and comorbid symptoms

2016 ◽  
Vol 35 ◽  
pp. 47-54 ◽  
Author(s):  
T Cadman ◽  
J. Findon ◽  
H. Eklund ◽  
H. Hayward ◽  
D. Howley ◽  
...  
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Drug Use ◽  
Mental Health Problems ◽  
The United States ◽  
Health Problems ◽  
Population Norms ◽  
Police Contact ◽  
Dsm Iv

AbstractBackgroundADHD in childhood is associated with development of negative psychosocial and behavioural outcomes in adults. Yet, relatively little is known about which childhood and adulthood factors are predictive of these outcomes and could be targets for effective interventions. To date follow-up studies have largely used clinical samples from the United States with children ascertained at baseline using broad criteria for ADHD including all clinical subtypes or the use of DSM III criteria.AimsTo identify child and adult predictors of comorbid and psychosocial comorbid outcomes in ADHD in a UK sample of children with DSM-IV combined type ADHD.MethodOne hundred and eighteen adolescents and young adults diagnosed with DSM-IV combined type ADHD in childhood were followed for an average of 6 years. Comorbid mental health problems, drug and alcohol use and police contact were compared for those with persistent ADHD, sub-threshold ADHD and population norms taken from the Adult Psychiatric Morbidity Study 2007. Predictors included ADHD symptomology and gender.ResultsPersistent ADHD was associated with greater levels of anger, fatigue, sleep problems and anxiety compared to sub-threshold ADHD. Comorbid mental health problems were predicted by current symptoms of hyperactivity-impulsivity, but not by childhood ADHD severity. Both persistent and sub-threshold ADHD was associated with higher levels of drug use and police contact compared to population norms.ConclusionsYoung adults with a childhood diagnosis of ADHD showed increased rates of comorbid mental health problems, which were predicted by current levels of ADHD symptoms. This suggests the importance of the continuing treatment of ADHD throughout the transitional years and into adulthood. Drug use and police contact were more common in ADHD but were not predicted by ADHD severity in this sample.

scholarly journals MyHealthPA: Development and Pilot Testing of a Mobile-Based Monitoring Tool to Reduce Cardio-Vascular Disease Risk in People with Mental Health Problems (Preprint)

2018 ◽  
Author(s):  
Louise Thornton ◽  
Frances Kay-Lambkin ◽  
Bree Tebbutt ◽  
Tanya L Hanstock ◽  
Amanda L Baker
Keyword(s):  
Mental Health ◽  
Young People ◽  
Mental Health Problems ◽  
Pilot Trial ◽  
Health Problems ◽  
Treatment Assessment ◽  
End Of Treatment ◽  
Cardio Vascular Disease ◽  
Cardio Vascular

BACKGROUND Background: People with mental health disorders live on average 20 years less than those without, often due to poor physical health including cardio-vascular disease (CVD). Evidence-based interventions are required to reduce this lifespan gap. OBJECTIVE Objective: This study aimed to develop, trial, and evaluate a mobile-based lifestyle program (MyHealthPA) to help people with mental health problems improve key health risk behaviors and reduce their risk of CVD. METHODS Methods: The development of MyHealthPA occurred in three stages: (1) a review of the literature; (2) a scoping survey (n=251) among people with and without experience of mental health problems; and (3) program development informed by stages (1) and (2). A small pilot trial among young people with and without mental health (MH) disorders was also conducted. Participants completed a baseline assessment and given access to the MyHealthPA program for a period of eight weeks. They were then asked to complete an end-of-treatment assessment and a follow-up assessment one month later. RESULTS Results: Twenty-eight young people aged 19 to 25 years were recruited to the pilot trial. Of these, 12 (43%) had been previously diagnosed with a MI. Twelve participants (43%) completed the end-of-treatment assessment and six (21%) completed the follow-up assessment. Small improvements in fruit and vegetable consumption, level of physical activity, alcohol use, and mood were found between baseline and end-of-treatment and follow-up, particularly among people with experience of MH issues. Most participants (57-60%) reported the program had above average usability, however only 29-40% of participants reported that they would like to use the program frequently and would recommend it to other young people. Participants also identified a number of ways in which the program could be improved. CONCLUSIONS Conclusions: This article describes the formative research and process of planning that formed the development of MyHealthPA and the evidence base underpinning the approach. The MyHealthPA program represents an innovative approach to CVD risk reduction among people with mental health problems. MyHealthPA appears to be an acceptable, easy to use, and potentially effective mHealth intervention to assist young people with mental illness to monitor risk factors for CVD. However, ways in which the program could be improved for future testing and dissemination were identified and are discussed.

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