scholarly journals The impact of the COVID-19 pandemic on hospital-treated self-harm in Sydney (Australia)

2022 ◽  
pp. 000486742110683
Author(s):  
Sandro Sperandei ◽  
Andrew Page ◽  
Piumee Bandara ◽  
Arianne Reis ◽  
Rowena Saheb ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
Suicidal Ideation ◽  
Economic Status ◽  
Interrupted Time Series ◽  
Socio Economic Status ◽  
Self Harm ◽  
Males And Females ◽  
The Impact ◽  
Sydney Australia

Objectives: This study investigated trends in hospital-treated self-harm and hospital presenting suicidal ideation in the period before and after COVID-19 public health responses by key socio-demographic groups among those presenting to hospitals in the Western Sydney (Australia) population catchment. Methods: Emergency department presentations for the period January 2016 to June 2021 were used to specify a series of interrupted time-series models to compare the observed and expected event rates of (1) hospital-treated self-harm and (2) hospital presenting suicidal ideation in the period following the onset of COVID-19 public health measures in March 2020. Rate differences between observed and expected rates in the post-implementation period were also estimated in models stratified by sex, age group, country of birth and socio-economic status. Results: There was no significant increase in hospital-treated self-harm in the period post-implementation of public health orders (March 2020) compared to the previous period, although there were lower than expected rates of emergency department presentations among non-Australian-born males, males aged 0–14 years and 25–44 years, and females aged 45–64 years. In contrast, there was a significant increase in hospital presenting suicidal ideation, particularly among women (rate difference per 100,000 = 3.91, 95% confidence interval = [1.35, 6.48]) and those aged 15–24 years (both males and females, rate differences ranging from 8.91 to 19.04), and among those residing in lower socio-economic status areas (both males and females, rate differences ranging from 0.90 to 2.33). Conclusion: There was no increase in hospital-treated self-harm rates in the 15 months post-implementation of COVID-19 public health orders in Western Sydney; however, there was a significant increase in hospital presenting suicidal ideation. The limited change in suicidal behaviour may reflect the success of social and economic supports during this period, the benefits of which may have been different for young people, and those of lower socio-economic status.

scholarly journals Interrupted time series design to evaluate ICD-9-CM to ICD-10-CM coding changes on trends in Colorado emergency department visits related to traumatic brain injury

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Lauren Alexis De Crescenzo ◽  
Barbara Alison Gabella ◽  
Jewell Johnson
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Interrupted Time Series ◽  
Emergency Department Visits ◽  
Control And Prevention ◽  
Icd 10 ◽  
Ed Visits ◽  
The Impact

Abstract Background The transition in 2015 to the Tenth Revision of the International Classification of Disease, Clinical Modification (ICD-10-CM) in the US led the Centers for Disease Control and Prevention (CDC) to propose a surveillance definition of traumatic brain injury (TBI) utilizing ICD-10-CM codes. The CDC’s proposed surveillance definition excludes “unspecified injury of the head,” previously included in the ICD-9-CM TBI surveillance definition. The study purpose was to evaluate the impact of the TBI surveillance definition change on monthly rates of TBI-related emergency department (ED) visits in Colorado from 2012 to 2017. Results The monthly rate of TBI-related ED visits was 55.6 visits per 100,000 persons in January 2012. This rate in the transition month to ICD-10-CM (October 2015) decreased by 41 visits per 100,000 persons (p-value < 0.0001), compared to September 2015, and remained low through December 2017, due to the exclusion of “unspecified injury of head” (ICD-10-CM code S09.90) in the proposed TBI definition. The average increase in the rate was 0.33 visits per month (p < 0.01) prior to October 2015, and 0.04 visits after. When S09.90 was included in the model, the monthly TBI rate in Colorado remained smooth from ICD-9-CM to ICD-10-CM and the transition was no longer significant (p = 0.97). Conclusion The reduction in the monthly TBI-related ED visit rate resulted from the CDC TBI surveillance definition excluding unspecified head injury, not necessarily the coding transition itself. Public health practitioners should be aware that the definition change could lead to a drastic reduction in the magnitude and trend of TBI-related ED visits, which could affect decisions regarding the allocation of TBI resources. This study highlights a challenge in creating a standardized set of TBI ICD-10-CM codes for public health surveillance that provides comparable yet clinically relevant estimates that span the ICD transition.

scholarly journals Prognostic evaluation of suicidality and development of risk factors in victims of physical and emotional child abuse and emotional/psychological neglect

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S273-S273
Author(s):  
Latif Miah
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Child Abuse ◽  
Depressive Symptoms ◽  
Suicidal Ideation ◽  
Child Maltreatment ◽  
Health Issue ◽  
Public Health Issue ◽  
Self Harm ◽  
The Impact

AimsTo evaluate the effects of childhood maltreatment, specifically physical and emotional abuse and emotional/psychological neglect on the development of suicidal ideation, depressive symptoms and self-harm. It is hypothesised that there will be a strong causal link between the aforementioned types of maltreatment with suicidality, depression and self-harm.BackgroundChild abuse is a major public health issue with profound developmental and mental health consequences towards victims and their contributions to society as a whole. The impact of sexual abuse is well-established, however non-sexual child maltreatment and its sequelae are not as well understood or studied.MethodA literature search was carried out using the Pubmed, Cochrane, Scopus and Google Scholar databases. Articles were appraised according to set criteria and manually screened for relevance to the review.ResultThe results of this review demonstrate that there are statistically significant, potentially causal links between emotional and physical abuse, and emotional/psychological neglect with suicidal ideation, depressive symptoms and self-harm. More research is still required to elucidate the role of polyvictimisation in mental health outcomes and to further confirm these links between abuse and development.ConclusionChild maltreatment remains a large public health issue with major impact on the economy of the world. It has profound, potentially lifelong consequences on victims and is something that needs to lose its stigma so that it can be identified earlier and potential damage prevented as far as possible. The future may lie in working to remove the stigma surrounding it, standardise how it is studied and thus learn to recognise the signs earlier – ideally leading to implementation of policy to get victims to safety, preventing unncecessary harm.

Impact of 24/7 Onsite Emergency Radiology Staff Coverage on Emergency Department Workflow

2021 ◽  
pp. 084653712110238
Author(s):  
Francesco Macri ◽  
Bonnie T. Niu ◽  
Shannon Erdelyi ◽  
John R. Mayo ◽  
Faisal Khosa ◽  
...  
Keyword(s):  
Emergency Department ◽  
Major Trauma ◽  
Patient Flow ◽  
Interrupted Time Series ◽  
Trauma Patients ◽  
Linear Regression Models ◽  
High Acuity ◽  
Time Series Approach ◽  
Comparison Series ◽  
The Impact

Purpose: Assess the impact of 24/7/365 emergency trauma radiology (ETR) coverage on Emergency Department (ED) patient flow in an urban, quaternary-care teaching hospital. Methods: Patient ED visit and imaging information were extracted from the hospital patient care information system for 2008 to 2018. An interrupted time-series approach with a comparison group was used to study the impact of 24/7/365 ETR on average monthly ED length of stay (ED-LOS) and Emergency Physician to disposition time (EP-DISP). Linear regression models were fit with abrupt and permanent interrupts for 24/7/365 ETR, a coefficient for comparison series and a SARIMA error term; subgroup analyses were performed by patient arrival time, imaging type and chief complaint. Results: During the study period, there were 949,029 ED visits and 739,796 diagnostic tests. Following implementation of 24/7/365 coverage, we found a significant decrease in EP-DISP time for patients requiring only radiographs (-29 min;95%CI:-52,-6) and a significant increase in EP-DISP time for major trauma patients (46 min;95%CI:13,79). No significant change in patient throughput was observed during evening hours for any patient subgroup. For overnight patients, there was a reduction in EP-DISP for patients with symptoms consistent with stroke (-78 min;95%CI:-131,-24) and for high acuity patients who required imaging (-33 min;95%CI:-57,-10). Changes in ED-LOS followed a similar pattern. Conclusions: At our institution, 24/7/365 in-house ETR staff radiology coverage was associated with improved ED flow for patients requiring only radiographs and for overnight stroke and high acuity patients. Major trauma patients spent more time in the ED, perhaps reflecting the required multidisciplinary management.

scholarly journals Influence of Physical Activity and Socio-Economic Status on Depression and Anxiety Symptoms in Patients after Stroke

2021 ◽  
Vol 18 (15) ◽  
pp. 8058
Author(s):  
Małgorzata Paprocka-Borowicz ◽  
Mona Wiatr ◽  
Maria Ciałowicz ◽  
Wojciech Borowicz ◽  
Agnieszka Kaczmarek ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Therapy ◽  
Economic Status ◽  
Depression Scale ◽  
Post Stroke ◽  
Positive Effects ◽  
Socio Economic Status ◽  
Treatment Of Depression ◽  
Post Stroke Depression ◽  
The Impact

Stroke is a high-risk factor for depression. Neurological rehabilitation is greatly difficult and often does not include treatment of depression. The post-stroke depression plays an important role in the progress of treatment, health, and the life of the patient. The appropriate treatment of depression could improve the quality of life of the patient and their family. The study aimed to evaluate the impact of physical activity and socio-economic status of the patient on the effectiveness of recovery from depression and the severity of the symptoms of depression. The study was conducted with 40 patients after stroke aged 42–82 years, and included 10 women and 30 men who were hospitalized for two weeks. The severity of depression/anxiety (D/A) symptoms were evaluated two times; at admission and after two weeks of physical therapy. The hospital anxiety and depression scale (HADS) questionnaire was used for this purpose. Socio-economic status was evaluated by several simple questions. It was revealed that physical therapy has a positive influence on mental state. The severity of D/A symptoms after stroke is related to the financial status of the patients (2 = 11.198, p = 0.024). The state of health (2 = 20.57, p = 0.022) and physical fitness (2 = 12.95, p = 0.044) changed the severity of symptoms of anxiety and depressive disorders. The kinesiotherapy in the group of patients with post-stroke depression had positive effects; however, economic and health conditions may influence the prognosis of the disease.

ECP02-01 - Globalisation and the impact of economic factors on psychiatric disorders

2011 ◽  
Vol 26 (S2) ◽  
pp. 1795-1795
Author(s):  
D. Bhugra
Keyword(s):  
Mental Health ◽  
Cultural Identity ◽  
Economic Status ◽  
Psychiatric Morbidity ◽  
Economic Factors ◽  
Socio Economic Status ◽  
Level Of Economic Development ◽  
Migration Experiences ◽  
The Impact ◽  
The Relationship

IntroductionWith the process of globalisation in full flow, the movement of people and products across the globe has brought a series of difficulties. With migration the socio-economic status of the individuals may change with the likelihood that this status will be lower rather than higher, although depending upon the reasons for migration this may change too.ObjectivesLiterature shows that low socio-economic status is associated with a higher level of psychiatric morbidity.AimsWhether migration acts as a mediator needs to be investigated further.MethodsVarious studies have shown that rates of psychosis are elevated in migrants though these rates are differentially increased in different groups indicating that factors other than migration may be at play.ResultsIn this presentation the literature and link the acculturation and cultural identity with post-migration experiences will be reviewed.ConclusionA link exists between the perceptions within cultures and level of economic development of what constitutes mental health. The state of advancement of mental health services of a country will certainly have a large impact on prevalence rates. Further investigation should be carried out to examine in greater depth the relationship between social inequality and disorder prevalence, as distinct from income inequality.

scholarly journals Neighbourhood walkability, road density and socio-economic status in Sydney, Australia

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Christine T. Cowie ◽  
Ding Ding ◽  
Margaret I. Rolfe ◽  
Darren J. Mayne ◽  
Bin Jalaludin ◽  
...  
Keyword(s):  
Economic Status ◽  
Road Density ◽  
Socio Economic Status ◽  
Neighbourhood Walkability ◽  
Sydney Australia

Management of non-traumatic epistaxis in adults in the emergency department

2021 ◽  
pp. 1-6
Author(s):  
Ashley Reed ◽  
Martyn Barnes ◽  
Caroline Howard
Keyword(s):  
Emergency Department ◽  
Hospital Admissions ◽  
Interrupted Time Series ◽  
University Teaching ◽  
Attendance Rate ◽  
Interrupted Time Series Analysis ◽  
Current Management ◽  
Emergency Ambulance ◽  
Bed Days ◽  
The Impact

Background/aims Despite epistaxis being a common presentation to emergency departments there is a lack of guidelines, both nationally and internationally, for its management. The authors reviewed the current management of epistaxis and then introduced a new pathway for management to see if care could be improved. The aims were to evaluate the impact of the pathway on reduction of emergency department breaches, emergency ambulance transfers and hospital admissions. Methods The study was an interrupted time series analysis over 29 months and included 903 participants. A pathway for the management of adults with non-traumatic epistaxis was designed and implemented in a university teaching hospital with an emergency department annual attendance rate of 105 495 in 2019–20. Results The pathway led to a 14-minute longer stay in the emergency department, a 5% increase in emergency department breaches, an 8.2% reduction in admissions, a 3.6% reduction in emergency ambulance transfers, a 14.1% increase in nasal cautery and a 3.2% reduction in nasal packing. Conclusions The authors calculate that these results equate to roughly 56 hospital bed days saved, providing better care closer to home for patients, in addition to beneficial knock-on effects for other emergency department and admitted patients.

scholarly journals Is socio-economic status a determinant of HIV-related stigma attitudes in Zimbabwe? Findings from Project Accept

2016 ◽  
Author(s):  
Kudzanai Mateveke ◽  
Basant Singh ◽  
Alfred Chingono ◽  
E. Sibanda ◽  
Ian Machingura
Keyword(s):  
Social Isolation ◽  
Assessment Tool ◽  
Economic Status ◽  
Target Population ◽  
Low Ses ◽  
Voluntary Counseling And Testing ◽  
Socio Economic Status ◽  
Stigma And Discrimination ◽  
Related Stigma ◽  
The Impact

HIV related stigma and discrimination is a known barrier for HIV prevention and care. We aimed to assess the relationship between socio-economic status (SES) and HIV related stigma in Zimbabwe. This paper uses data from Project Accept, which examined the impact of community-based voluntary counseling and testing intervention on HIV incidence and stigma. Total of 2522 eligible participants responded to a psychometric assessment tool, which assessed HIV related stigma and discrimination attitudes on 4 point Likert scale. The tool measured three components of HIVrelated stigma: shame, blame and social isolation, perceived discrimination, and equity. Participants’ ownership of basic assets was used to assess the socio-economic status. Shame, blame and social isolation component of HIV related stigma was found to be significantly associated with medium [odds ratio (OR)=1.73, P<0.01] and low SES (OR=1.97, P<0.01), indicating more stigmatizing attitudes by participants belonging to medium and low SES in comparison to high SES. For HIV related stigma and discrimination programs to be effective, they should take into account the socio-economic context of target population.

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