ORCID Profile
0000-0002-5742-9866
Current Organisation
The University of Canberra
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Urban and Regional Studies (excl. Planning) | Public Policy | Social Policy | Policy and Administration
ANZSRC Socio-Economic Objective (SEO)
Social Structure and Health | Regional Planning | Electronic Information Storage and Retrieval Services |
Related Links
Publications
Traffic-related air pollution exposure is associated with allergic sensitization, asthma, and poor lung function in middle age
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.JACI.2016.05.008
Abstract: Traffic-related air pollution (TRAP) exposure is associated with allergic airway diseases and reduced lung function in children, but evidence concerning adults, especially in low-pollution settings, is scarce and inconsistent. We sought to determine whether exposure to TRAP in middle age is associated with allergic sensitization, current asthma, and reduced lung function in adults, and whether these associations are modified by variants in Glutathione S-Transferase genes. The study s le comprised the proband 2002 laboratory study of the Tasmanian Longitudinal Health Study. Mean annual residential nitrogen dioxide (NO Increased mean annual NO Even relatively low TRAP exposures confer an increased risk of adverse respiratory and allergic outcomes in genetically susceptible in iduals.
Airway closure is the predominant physiological mechanism of low ventilation seen on hyperpolarized helium-3 MRI lung scans
Publisher: American Physiological Society
Date: 03-2021
DOI: 10.1152/JAPPLPHYSIOL.00163.2020
Abstract: This study introduces a novel technique of generating high-resolution 3D ventilation maps from hyperpolarized helium-3 MRI. It is the first study to demonstrate that regions of poor or absent ventilation seen on 3 He MRI are primarily the result of airway closure.
A new bottom-up method for the standard analysis and comparison of workforce capacity in mental healthcare planning: Demonstration study in the Australian Capital Territory
Publisher: Public Library of Science (PLoS)
Date: 27-07-2021
DOI: 10.1371/JOURNAL.PONE.0255350
Abstract: The aims of this study are to evaluate and describe mental health workforce and capacity, and to describe the relationship between workforce capacity and patterns of care in local areas. We conducted a comparative demonstration study of the applicability of an internationally validated standardised service classification instrument—the Description and Evaluation of Services and Directories—DESDE-LTC) using the emerging mental health ecosystems research (MHESR) approach. Using DESDE-LTC as the framework, and drawing from international occupation classifications, the workforce was classified according to characteristics including the type of care provided and professional background. Our reference area was the Australian Capital Territory, which we compared with two other urban districts in Australia (Sydney and South East Sydney) and three benchmark international health districts (Helsinki-Uusima (Finland), Verona (Italy) and Gipuzkoa (Spain)). We also compared our data with national level data where available. The Australian and Finnish regions had a larger and more highly skilled workforce than the southern European regions. The pattern of workforce availability and profile varied, even within the same country, at the local level. We found significant differences between regional rates of identified rates of psychiatrists and psychologists, and national averages. Using a standardised classification instrument at the local level, and our occupational groupings, we were able to assess the available workforce and provide information relevant to planners about the actual capacity of the system. Data obtained at local level is critical to providing planners with reliable data to inform their decision making.
Use of Services and Cost of Agitation and Containment in Psychiatric Hospitals: a Systematic Review
Publisher: Elsevier BV
Date: 11-2014
An umbrella review of randomized control trials on the effects of physical exercise on cognition
Publisher: Springer Science and Business Media LLC
Date: 27-03-2023
Respiratory system reactance is an independent determinant of asthma control
Publisher: American Physiological Society
Date: 11-2013
DOI: 10.1152/JAPPLPHYSIOL.00093.2013
Abstract: The mechanisms underlying not well-controlled (NWC) asthma remain poorly understood, but accumulating evidence points to peripheral airway dysfunction as a key contributor. The present study tests whether our recently described respiratory system reactance (Xrs) assessment of peripheral airway dysfunction reveals insight into poor asthma control. The aim of this study was to investigate the contribution of Xrs to asthma control. In 22 subjects with asthma, we measured Xrs (forced oscillation technique), spirometry, lung volumes, and ventilation heterogeneity (inert-gas washout), before and after bronchodilator administration. The relationship between Xrs and lung volume during a deflation maneuver yielded two parameters: the volume at which Xrs abruptly decreased (closing volume) and Xrs at this volume (Xrs crit ). Lowered (more negative) Xrs crit reflects reduced apparent lung compliance at high lung volumes due, for ex le, to heterogeneous airway narrowing and unresolved airway closure or near closure above the critical lung volume. Asthma control was assessed via the 6-point Asthma Control Questionnaire (ACQ6). NWC asthma was defined as ACQ6 1.0. In 10 NWC and 12 well-controlled subjects, ACQ6 was strongly associated with postbronchodilator (post-BD) Xrs crit ( R 2 = 0.43, P 0.001), independent of all measured variables, and was a strong predictor of NWC asthma (receiver operator characteristic area = 0.94, P 0.001). By contrast, Xrs measures at lower lung volumes were not associated with ACQ6. Xrs crit itself was significantly associated with measures of gas trapping and ventilation heterogeneity, thus confirming the link between Xrs and airway closure and heterogeneity. Residual airway dysfunction at high lung volumes assessed via Xrs crit is an independent contributor to asthma control.
Adverse drug event‐related hospitalisation in persons with neurodevelopmental disorders: a state‐wide retrospective cohort study
Publisher: Wiley
Date: 04-01-2019
DOI: 10.1111/JIR.12586
Abstract: Little is known about the sociodemographic and clinical characteristics of adverse drug events (ADEs) in patients with neurodevelopmental disorders (NDD). The objective of this study was to describe and compare the demographic details of people with and without NDD hospitalised due to ADEs. The all-inclusive New South Wales Admitted Patient Data Collection from 2001 to 2014 was employed to identify ADE-related hospitalisations in patients with NDD using the International Classification of Diseases 10th revision Australian modification codes. We derived case sets specific to different clinical groups and patient characteristics and compared proportional differences between patients with and without intellectual disability using chi squared tests. A total of 2173 patients with NDD were admitted for acute care of ADEs, accounting for 0.7% of all ADE-related hospitalisations. Hospitalised ADEs among patients with NDD increased by twofold over the 14-year study period. Psychotropic medications and opioid analgesic medications were leading causes of ADE-related hospitalisations in patients with NDD. Compared with their counterparts, patients with NDD were younger, experienced more socio-economic disadvantage and less private insurance coverage, suffered with less severe but different co-morbid clinical conditions and incurred more challenges in the acute hospital care setting. Although the pattern of ADE-related hospitalisations in patients with NDD differed from that in patients without NDD, there is a lack of targeted healthcare programmes to meet their special needs. This study suggests the need for countermeasures in primary healthcare settings to reduce the burden of ADEs in this vulnerable group.
Regional evolution of psychosocial services in Australia before and after the implementation of the National Disability Insurance Scheme
Publisher: SAGE Publications
Date: 07-10-2023
DOI: 10.1177/00048674221130981
Abstract: This paper compares the evolution of the psychosocial sector in two Australian regions pre and post introduction of the National Disability Insurance Scheme – a major reform to the financing, planning and provision of disability services in Australia, intended to create greater competition and efficiency in the market, and more choice for service users. We used a standardised service classification instrument based on a health ecosystems approach to assess service availability and ersity of psychosocial services provided by non-government organisations in two Primary Health Network regions. We identified very different evolutionary pathways in the two regions. Service availability increased in Western Sydney but decreased in the Australian Capital Territory. The ersity of services available did not increase in either Primary Health Network 4 years after the reform. Many services were experiencing ongoing funding uncertainty. Assumptions of increased efficiency through organisational scaling up, and a greater ersity in range of service availability were not borne out. This study shows the urgent need for evaluation of the effects of the NDIS on the provision of psychosocial care in Australia. Four years after the implementation of the NDIS at vast expense key objectives not been met for consumers or for the system as a whole, and an environment of uncertainty has been created for providers. It demonstrates the importance of standardised service mapping to monitor the effects of major reforms on mental health care as well as the need for a focus at the local level.
A Novel Mixed Methods Approach for Integrating Not-for-Profit Service Data via Qualitative Geographic Information System to Explore Authentic Experiences of Ill-Health: A Case Study of Rural Mental Health
Publisher: SAGE Publications
Date: 21-10-2023
DOI: 10.1177/15586898221135291
Abstract: Meeting the mental health needs of rural populations is challenging internationally, with few methods and scarce data available to inform site-specific planning. We developed a mixed methods approach that integrates Not-for-profit (NFP) organization data in a Geographic Information System (GIS) to explore interrelated understandings of mental health experiences in rural places. Integrating qualitative experience data from online forums with quantitative data from service search and emergency pickup locations via GIS demonstrates how NFP health service data can be ethically sourced, reused, integrated, analyzed, and ground-truthed to explore how mental health is experienced in rural places. This article contributes to the mixed methods literature an ethical approach that utilizes NFP health service datasets to inform research in contexts of data scarcity.
What is Case Management? A Scoping and Mapping Review
Publisher: Ubiquity Press, Ltd.
Date: 19-10-2016
DOI: 10.5334/IJIC.2477
The brain injury case management taxonomy (BICM-T); a classification of community-based case management interventions for a common language
Publisher: Elsevier BV
Date: 04-2016
DOI: 10.1016/J.DHJO.2015.09.006
Abstract: Case management is a complex intervention. Complexity arises from the interaction of different components: the model (theoretical basis), implementation context (service), population and health condition, focus for the intervention (client and/or their family), case manager's actions (interventions) and the target of case management (integrated care and support, client's community participation). There is a lack of understanding and a common language. To our knowledge there is no classification (taxonomy) for community-based case management. To develop a community-based case management in brain injury taxonomy (BICM-T), as a common language and understanding of case management for use in quality analysis, policy, planning and practice. The mixed qualitative methods used multiple sources of knowledge including scoping, framing and a nominal group technique to iteratively develop the Beta version (draft) of the taxonomy. A two part developmental evaluation involving case studies and mapping to international frameworks assessed the applicability and acceptability (feasibility) before finalization of the BICM-T. The BICM-T includes a definition of community-based case management, taxonomy trees, tables and a glossary. The interventions domain tree has 9 main actions (parent category): engagement, holistic assessment, planning, education, training and skills development, emotional and motivational support, advising, coordination, monitoring 17 linked actions (children category) 8 related actions 63 relevant terms defined in the glossary. The BICM-T provides a knowledge map with the definitions and relationships between the core actions (interventions domain). Use of the taxonomy as a common language will benefit practice, quality analysis, evaluation, policy, planning and resource allocation.
BIOMED-MEROPE * project: service provision for adults with intellectual disability: a European comparison
Publisher: Wiley
Date: 12-2000
DOI: 10.1046/J.1365-2788.2000.00312.X
Abstract: The aim of the present paper is to describe and compare services for adults with intellectual disability (ID) and mental health needs in five European countries: Austria, England, Greece, Ireland and Spain. A framework and structure for collecting information about service provision was designed. This information was collected through a mixture of interviews with service providers, questionnaires and a review of the research literature within each country. Information was collected on historical context, policy, legislation, assessment, treatment and the structure of services for people with ID and mental health problems. Overall, the needs of those with additional mental health needs have not been specifically addressed at a national level with perhaps the exception of England and Ireland, although there are still gaps in services in these nations. Normalization has been adopted in each of the five countries, and there are moves toward deinstitutionalization, integration and inclusion. Families and self-advocacy groups have grown. The pace of this change varies between and even within countries. The main findings of the study include: unclear policy, trends for legislative changes, increased prevalence of mental health problems, inadequate generic service provision, a need for specialist mental health services, a need for improved interconnections of services, and a need for training developments. Policy and legislation in the five European countries under consideration tend to separate the disability aspects of people with ID from their mental health needs. Consequently, the service needs of this group remain largely invisible. This might be a direct reflection of policy clarity and legislation, or could be the result of a failure to implement existing guidelines. This has a detrimental effect on the lives of people with ID, and their families and carers.
The P15 - a multinational assessment battery for collecting data on health indicators relevant to adults with intellectual disabilities
Publisher: Wiley
Date: 02-09-2010
DOI: 10.1111/J.1365-2788.2010.01322.X
Abstract: Health disparities between adults with intellectual disabilities (ID) and the general population have been well documented but, to date, no dedicated assessment battery for measuring health disparity has been available. This paper reports on the development and testing of a multinational assessment battery for collecting data on a range of health indicators relevant to adults with ID. An assessment battery (the P15) was developed following piloting, and administered to s les of adults with ID, in 14 EU countries. S les were neither random, nor representative of the countries from which they were drawn. However, within the local health administration areas selected in each country, efforts were made to ensure s les were broadly representative of the typical living circumstances, ages and ability levels of the administrative population of adults with ID. The total s le comprised 1269 adults with ID, of whom 49% were female. The mean age was 41 years (range 19 to 90). Overall, feasibility, internal consistency and face validity of the P15 was acceptable. With some refinement the P15 could be useful for collecting data on health indicators known to be particularly important for adults with ID. It is useable in a range of countries and has the potential to highlight health inequity for adults with ID at a national or local level. Larger scale epidemiological studies are needed to exploit the potential of the P15 to address health inequity in this group.
Corrigendum to “Cost of disorders of the brain in Europe 2010” [Eur. Neuropsychopharmacol. 21 (2011) 718–779]
Publisher: Elsevier BV
Date: 03-2012
Sampling and ethical issues in a multicenter study on health of people with intellectual disabilities
Publisher: Elsevier BV
Date: 10-2010
DOI: 10.1016/J.JCLINEPI.2009.12.001
Abstract: To study health inequalities in persons with intellectual disabilities, representative and unbiased s les are needed. Little is known about s le recruitment in this vulnerable group. This study aimed to determine differences in ethical procedures and s le recruitment in a multicenter research on health of persons with intellectual disabilities. Study questions regarded the practical s ling procedure, how ethical consent was obtained in each country, and which person gave informed consent for each study participant. Exploratory, as part of a multicenter study, in 14 European countries. After developing identical guidelines for all countries, partners collected data on health indicators by orally interviewing 1,269 persons with intellectual disabilities. Subsequently, semistructured interviews were carried out with partners and researchers. Identification of sufficient study participants proved feasible. S ling frames differed from nationally estimated proportions of persons with intellectual disabilities living with families or in residential settings. Sometimes, people with intellectual disabilities were hard to trace. Consent procedures and legal representation varied broadly. Nonresponse data proved unavailable. To build representative unbiased s les of vulnerable groups with limited academic capacities, international consensus on respectful consent procedures and tailored patient information is necessary.
Cost of borderline personality disorder in Catalonia (Spain)
Publisher: Cambridge University Press (CUP)
Date: 10-2014
DOI: 10.1016/J.EURPSY.2014.07.001
Abstract: The available information on the cost of illness of Borderline Personality Disorder (BPD) is overtly insufficient for policy planning. Our aim was to estimate the costs of illness for BPD in Catalonia (Spain) for 2006. This is a multilevel cross-design synthesis study combining a qualitative nominal approach, quantitative ‘top-down’ analysis of multiple health databases, and ‘bottom-up’ data of local surveys. Both direct and indirect costs have been estimated from a governmental and societal perspective. Estimated year-prevalence of BPD was 0.7% (41,921 cases), but only 9.6% of these cases were treated in the mental health system (4033 cases). The baseline of the total cost of BPD in Catalonia was 45.6 million €, of which 15.8 million € (34.7%) were direct costs related to mental health care. The cost distribution was 0.4% in primary care 4% in outpatient mental health care 4.7% in hospitalisation 0.7% in emergency care and 24.9% in pharmacotherapy. Additionally, the cost of drug addiction treatment for persons with BPD was 11.2% costs associated with sheltered employment were 23.9% and those of crime and justice were 9.7%. Indirect costs – including temporary sick leave and premature death (suicide) – represented 20.5% of total costs. The average annual cost per patient was 11,308 €. An under-reporting of BPD was identified by the experts in all health databases and official registries. Most of the BPD costs were not related to mental health care. Amongst the direct cost categories, pharmacotherapy had the largest proportion despite the lack of specificity for BPD. This distribution of costs reinforces the idea of BPD complexity related to an inadequate and inefficient use of health resources.
Early‐life exposure to sibling modifies the relationship between CD14 polymorphisms and allergic sensitization
Publisher: Wiley
Date: 13-11-2018
DOI: 10.1111/CEA.13290
Abstract: Markers of microbial exposure are thought to be associated with risk of allergic sensitization however, the associations are inconsistent and may be related to gene-environment interactions. To examine the relationship between polymorphisms in the CD14 gene and allergic sensitization and whether sibling exposure, as a marker of microbial exposure, modified this relationship. We used data from the Tasmanian Longitudinal Health Study and the Melbourne Atopy Cohort Study. Two CD14 polymorphisms were genotyped. Allergic sensitization was defined by a positive response to a skin prick test. Sibling exposure was measured as cumulative exposure to siblings before age 6 months, 2 and 4 years. Logistic regression and multi-level mixed-effects logistic regression were used to examine the associations. Effect estimates across the cohorts were pooled using random-effects meta-analysis. CD14 SNPs were not in idually associated with allergic sensitization in either cohort. In TAHS, cumulative sibling exposure before age 6 months, 2 and 4 years was each associated with a reduced risk of allergic sensitization at age 45 years. A similar effect was observed in MACS. Meta-analysis across the two cohorts showed consistent evidence of an interaction between cumulative sibling exposure before 6 months and the rs5744455-SNP (P = 0.001) but not with the rs2569190-SNP (P = 0.60). The pooled meta-analysis showed that the odds of sensitization with increasing cumulative exposure to sibling before 6 months of age was 20.9% smaller in those with the rs5744455-C-allele than the T-allele (OR = 0.83 vs 1.05, respectively). Cumulative sibling exposure reduced the risk of sensitization from childhood to middle age in genetically susceptible in iduals.
The size and burden of mental disorders and other disorders of the brain in Europe 2010
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.EURONEURO.2011.07.018
Abstract: To provide 12-month prevalence and disability burden estimates of a broad range of mental and neurological disorders in the European Union (EU) and to compare these findings to previous estimates. Referring to our previous 2005 review, improved up-to-date data for the enlarged EU on a broader range of disorders than previously covered are needed for basic, clinical and public health research and policy decisions and to inform about the estimated number of persons affected in the EU. Stepwise multi-method approach, consisting of systematic literature reviews, reanalyses of existing data sets, national surveys and expert consultations. Studies and data from all member states of the European Union (EU-27) plus Switzerland, Iceland and Norway were included. Supplementary information about neurological disorders is provided, although methodological constraints prohibited the derivation of overall prevalence estimates for mental and neurological disorders. Disease burden was measured by disability adjusted life years (DALY). Prevalence: It is estimated that each year 38.2% of the EU population suffers from a mental disorder. Adjusted for age and comorbidity, this corresponds to 164.8million persons affected. Compared to 2005 (27.4%) this higher estimate is entirely due to the inclusion of 14 new disorders also covering childhood/adolescence as well as the elderly. The estimated higher number of persons affected (2011: 165m vs. 2005: 82m) is due to coverage of childhood and old age populations, new disorders and of new EU membership states. The most frequent disorders are anxiety disorders (14.0%), insomnia (7.0%), major depression (6.9%), somatoform (6.3%), alcohol and drug dependence (>4%), ADHD (5%) in the young, and dementia (1-30%, depending on age). Except for substance use disorders and mental retardation, there were no substantial cultural or country variations. Although many sources, including national health insurance programs, reveal increases in sick leave, early retirement and treatment rates due to mental disorders, rates in the community have not increased with a few exceptions (i.e. dementia). There were also no consistent indications of improvements with regard to low treatment rates, delayed treatment provision and grossly inadequate treatment. Disability: Disorders of the brain and mental disorders in particular, contribute 26.6% of the total all cause burden, thus a greater proportion as compared to other regions of the world. The rank order of the most disabling diseases differs markedly by gender and age group overall, the four most disabling single conditions were: depression, dementias, alcohol use disorders and stroke. In every year over a third of the total EU population suffers from mental disorders. The true size of "disorders of the brain" including neurological disorders is even considerably larger. Disorders of the brain are the largest contributor to the all cause morbidity burden as measured by DALY in the EU. No indications for increasing overall rates of mental disorders were found nor of improved care and treatment since 2005 less than one third of all cases receive any treatment, suggesting a considerable level of unmet needs. We conclude that the true size and burden of disorders of the brain in the EU was significantly underestimated in the past. Concerted priority action is needed at all levels, including substantially increased funding for basic, clinical and public health research in order to identify better strategies for improved prevention and treatment for disorders of the brain as the core health challenge of the 21st century.
Lifetime Risk Factors for Pre- and Post-Bronchodilator Lung Function Decline. A Population-based Study
Publisher: American Thoracic Society
Date: 03-2020
Depression in internal medicine inpatients at the time of hospital discharge and referral to primary care
Publisher: Elsevier BV
Date: 04-2022
Correction: Mental Fatigue Might be Not So Bad for Exercise Performance After All: A Systematic Review and Bias-Sensitive Meta-Analysis
Publisher: Ubiquity Press, Ltd.
Date: 2021
DOI: 10.5334/JOC.178
Community pharmacists’ experiences and people at risk of suicide in Canada and Australia: a thematic analysis
Publisher: Springer Science and Business Media LLC
Date: 23-06-2018
DOI: 10.1007/S00127-018-1553-7
Abstract: To explore Canadian and Australian community pharmacists' practice experiences in caring for people at risk of suicide. We conducted a thematic analysis of 176 responses to an open-ended extension question in an online survey. Four themes were identified and include referrals and triage, accessibility for confiding, emotional toll, and stigma. Subthemes included gatekeeping the medication supply, sole disclosure, planning for end of life, concerns of support people, assessing the validity of suicidality, gaps in the system, not directly asking, ill-equipped, resources in the pharmacy, relying on others to continue care, and attention seeking. Community pharmacists are caring for patients at risk of suicide frequently, and often with patients seeking the help of pharmacists directly. Pharmacists engage in activities and actions that would be considered outside of the traditional dispensing roles and provide support and intervention to people at risk of suicide through collaboration and other mechanisms. Further research to determine appropriate education and training and postvention supports is required.
Assessment of Relative Technical Efficiency of Small Mental Health Areas in Bizkaia (Basque Country, Spain)
Publisher: SCITEPRESS - Science and Technology Publications
Date: 2017
Hybrid modelling case studies
Publisher: Wiley
Date: 11-04-2014
El uso del término «cognitivo» en la terminología de salud. Una controversia latente
Publisher: Elsevier BV
Date: 10-2010
DOI: 10.1016/J.RPSM.2010.10.001
Abstract: The adjective «cognitive» has a double meaning and it is used for naming two disciplines with separate activities: Cognitive neuroscience and cognitive psychotherapy. This has an unrecognised impact on the health terminology and the classification systems. The current use of this term is reviewed in a series of key dictionaries, scientific books, databases (OldMedline and PsycINFO) and specific web searchers (Google Scholar). The history of this term and its etymology is also reviewed and compared to other alternatives (i.e. noetic) as well as its use in international classifications (e.g. the International Classification of Functioning - ICF). The modern use of the term «cognitive» in Neurosciences can be traced back to Hebb in a 1955 one year before that recorded at official version. The different meaning of this term in psychology can be traced back to the same decade. Departing from the ICF framework of mental functions, «cognitive» can be regarded as a generic term that encompasses both neurocognitive and meta-cognitive functions and should not be used for classification purposes. A hierarchy is suggested for the use of «neurocognitive» in the classification of mental functions. The polysemic use of this name reveals a latent controversy in health sciences which has implications for its use in the international classification systems. There is an need to improve the standard definition and the semantic hierarchy of the term «cognitive», «neurocognitive» and other related terms within the context of International Health Terminology Standards Development Organisation (IHTSO).
Childhood bronchitis and adult respiratory outcomes: a prospective study from age 7 to 53 years
Publisher: European Respiratory Society
Date: 07-09-2020
Framing of scientific knowledge as a new category of health care research
Publisher: Wiley
Date: 24-11-2014
DOI: 10.1111/JEP.12286
Abstract: The new area of health system research requires a revision of the taxonomy of scientific knowledge that may facilitate a better understanding and representation of complex health phenomena in research discovery, corroboration and implementation. A position paper by an expert group following and iterative approach. 'Scientific evidence' should be differentiated from 'elicited knowledge' of experts and users, and this latter typology should be described beyond the traditional qualitative framework. Within this context 'framing of scientific knowledge' (FSK) is defined as a group of studies of prior expert knowledge specifically aimed at generating formal scientific frames. To be distinguished from other unstructured frames, FSK must be explicit, standardized, based on the available evidence, agreed by a group of experts and subdued to the principles of commensurability, transparency for corroboration and transferability that characterize scientific research. A preliminary typology of scientific framing studies is presented. This typology includes, among others, health declarations, position papers, expert-based clinical guides, conceptual maps, classifications, expert-driven health atlases and expert-driven studies of costs and burden of illness. This grouping of expert-based studies constitutes a different kind of scientific knowledge and should be clearly differentiated from 'evidence' gathered from experimental and observational studies in health system research.
Unravelling the structure of the C60 and p-Bu(t)-calix[8]arene complex.
Publisher: Royal Society of Chemistry (RSC)
Date: 2015
DOI: 10.1039/C5CC03941J
Abstract: The structure of the C60 and p-Bu(t)-calix[8]arene complex has been reinvestigated, showing an unprecedented continuous layered tetragonal array of fullerenes encapsulated by calixarenes. Electron diffraction data revealed the tetragonal symmetry, with a stepped structure observed by AFM and SEM, and the thickness of the basal plane was measured by XRD, as 2 nm. The molecular simulated arrangement of fullerenes accounts for the ability to take up to ca. 11% of fullerenes C70 in place of the smaller fullerene.
eTools for the standard classification of health and social services: eDESDE-LTC
Publisher: Ubiquity Press, Ltd.
Date: 08-12-2014
DOI: 10.5334/IJIC.1954
The interpretation of beds: More bedtime stories, or maybe they’re dreaming?
Publisher: SAGE Publications
Date: 02-11-2020
Comentario. La economía de la salud mental en España. ¿Una asignatura pendiente?
Publisher: Elsevier BV
Date: 07-2007
DOI: 10.1157/13108504
Methodology for the development of a taxonomy and toolkit to evaluate health-related habits and lifestyle (eVITAL)
Publisher: Springer Science and Business Media LLC
Date: 24-03-2010
The role of geographic information system and global positioning system in dementia care and research: a scoping review
Publisher: Springer Science and Business Media LLC
Date: 04-08-2022
DOI: 10.1186/S12942-022-00308-1
Abstract: Geographic Information System (GIS) and Global Positioning System (GPS), vital tools for supporting public health research, provide a framework to collect, analyze and visualize the interaction between different levels of the health care system. The extent to which GIS and GPS applications have been used in dementia care and research is not yet investigated. This scoping review aims to elaborate on the role and types of GIS and GPS applications in dementia care and research. A scoping review was conducted based on Arksey and O’Malley’s framework. All published articles in peer-reviewed journals were searched in PubMed, Scopus, and Web of Science, subject to involving at least one GIS/GPS approach focused on dementia. Eligible studies were reviewed, grouped, and synthesized to identify GIS and GPS applications. The PRISMA standard was used to report the study. Ninety-two studies met our inclusion criteria, and their data were extracted. Six types of GIS/GPS applications had been reported in dementia literature including mapping and surveillance (n = 59), data preparation (n = 26), dementia care provision (n = 18), basic research (n = 18), contextual and risk factor analysis (n = 4), and planning (n = 1). Thematic mapping and GPS were most frequently used techniques in the dementia field. Even though the applications of GIS/GPS methodologies in dementia care and research are growing, there is limited research on GIS/GPS utilization in dementia care, risk factor analysis, and dementia policy planning. GIS and GPS are space-based systems, so they have a strong capacity for developing innovative research based on spatial analysis in the area of dementia. The existing research has been summarized in this review which could help researchers to know the GIS/GPS capabilities in dementia research.
Outcome analysis on individual health budgets in mental Health: finding from the Friuli Venezia Giulia Region, Italy
Publisher: Informa UK Limited
Date: 12-05-2023
Staging cognitive impairment and incidence of dementia
Publisher: Cambridge University Press (CUP)
Date: 15-10-2015
DOI: 10.1017/S2045796015000918
Abstract: In a background of interest in staging models in psychiatry, we tested the validity of a simple staging model of cognitive impairment to predict incident dementia. A large community s le of adults aged ≥55 years ( N = 4803) was assessed in the baseline of a longitudinal, four-wave epidemiological enquiry. A two-phase assessment was implemented in each wave, and the instruments used included the Mini-Mental Status Examination (MMSE) the History and Aetiology Schedule and the Geriatric Mental State-AGECAT. For the standardised degree of cognitive impairment Perneczky et al 's MMSE criteria were applied. A panel of psychiatrists diagnosed cases of dementia according to DSM-IV criteria, and cases and sub-cases of dementia were excluded for the follow-up waves. Competing risk regression models, adjusted by potential confounders, were used to test the hypothesised association between MMSE levels and dementia risk. Out of the 4057 participants followed up, 607 (14.9%) were classified as ‘normal’ (no cognitive impairment), 2672 (65.8%) as ‘questionable’ cognitive impairment, 732 (18.0%) had ‘mild’ cognitive impairment, 38 (0.9%) had ‘moderate’ cognitive impairment and eight (0.2%) had ‘severe’ impairment. Cognitive impairment was associated with risk of dementia, the risk increasing in parallel with the level of impairment (hazard ratio: 2.72, 4.78 and 8.38 in the ‘questionable’, ‘mild’ and ‘moderate’ level of cognitive impairment, respectively). The documented gradient of increased risk of dementia associated with the severity level of cognitive impairment supports the validity of the simple staging model based on the MMSE assessment.
Health service use and costs associated with aggressiveness or agitation and containment in adult psychiatric care: a systematic review of the evidence
Publisher: Springer Science and Business Media LLC
Date: 04-03-2015
Standardized systematic description of provision of care for multiple sclerosis at a local level
Publisher: Consortium of Multiple Sclerosis Centers
Date: 13-12-2023
DOI: 10.7224/1537-2073.2022-014
Abstract: This study evaluates and describes the pattern of services provided for people living with multiple sclerosis (MS) in a local area as a starting point for a more global assessment. A health care ecosystem approach has been followed using an internationally standardized service classification instrument–the Description and Evaluation of Services and DirectoriEs for Long Term Care (DESDE-LTC)–to identify and describe all services providing care to people with MS in the Australian Capital Territory, Australia. Available services were classified according to the target population into those specifically dedicated to people living with MS and those providing general neurologic services, both public and private, and across both social and health sectors. A limited range of services was available. There were no local facilities providing or coordinating multidisciplinary integrated care specific to people with MS. Subspecialty services specific to MS were limited in number (6 of the 28 services), and use of specialist services provided in neighboring states was frequently reported. Overall, very few services were provided outside the core health sector (4%). The provision of care to people living with MS in the Australian Capital Territory is fragmented and relies heavily on generic neurology services in the public and private sectors. More widespread use of the DESDE-LTC as a standardized method of service classification in MS will facilitate comparison with other local areas, allow monitoring of changes over time, and permit comparison with services provided for other health conditions (eg, dementia, mental disorders).
Factor structure, internal consistency and construct validity of the Sheehan Disability Scale in a Spanish primary care sample
Publisher: Wiley
Date: 08-07-2010
DOI: 10.1111/J.1365-2753.2009.01211.X
Abstract: The Sheehan Disability Scale (SDS) is a three-item instrument that measures disability in three inter-related domains: work, family life/home responsibilities and social/leisure activities. The main objective of the present study was to examine the factor structure, reliability and construct validity of the SDS in a wide Spanish s le of primary care (PC) patients. One phase cross-sectional survey. A total of 3815 patients, aged 18 years or older attending PC for a medical visit, were interviewed between October 2005 and March 2006. The interviews included the Structured Clinical Interview for DSM-IV Axis I Disorders for depressive and anxiety disorders, the Mini-International Neuropsychiatric Interview for the rest of mental disorders, a medical conditions checklist, the 2.0 version of the 12-item Short-Form Health Survey (SF-12) for measuring quality of life and the SDS. The principal component analysis and the subsequent confirmatory factor analysis indicated that the SDS is one-dimensional (normed fit index = 0.990, non-normed fit index = 0.987, comparative fit index = 0.991, goodness-of-fit index = 0.993, standardized root mean-square residual = 0.037, root mean-square error of approximation = 0.053). The internal consistency of the scale was good (α = 0.83) and it was significantly associated with the physical and mental component of the SF-12. Concerning discriminative validity, patients with major depression or panic disorder scored higher on the SDS than patients with chronic medical conditions or with no chronic pathology. We also found that a cut-off point of 8 in the SDS adequately discriminated between patients with and without depression (area under the curve = 0.814, sensitivity = 81.60%, specificity = 70.60%). The SDS seems a reliable, valid and useful clinical tool for measuring disability in Spanish PC patients.
Standard comparison of local mental health care systems in eight European countries
Publisher: Cambridge University Press (CUP)
Date: 18-09-2017
DOI: 10.1017/S2045796017000415
Abstract: There is a need of more quantitative standardised data to compare local Mental Health Systems (MHSs) across international jurisdictions. Problems related to terminological variability and commensurability in the evaluation of services h er like-with-like comparisons and hinder the development of work in this area. This study was aimed to provide standard assessment and comparison of MHS in selected local areas in Europe, contributing to a better understanding of MHS and related allocation of resources at local level and to lessen the scarcity in standard service comparison in Europe. This study is part of the Seventh Framework programme REFINEMENT (Research on Financing Systems’ Effect on the Quality of Mental Health Care in Europe) project. A total of eight study areas from European countries with different systems of care (Austria, England, Finland, France, Italy, Norway, Romania, Spain) were analysed using a standard open-access classification system (Description and Evaluation of Services for Long Term Care in Europe, DESDE-LTC). All publicly funded services universally accessible to adults (≥18 years) with a psychiatric disorder were coded. Care availability, ersity and capacity were compared across these eight local MHS. The comparison of MHS revealed more community-oriented delivery systems in the areas of England (H shire) and Southern European countries (Verona – Italy and Girona – Spain). Community-oriented systems with a higher proportion of hospital care were identified in Austria (Industrieviertel) and Scandinavian countries (Sør-Trøndelag in Norway and Helsinki-Uusimaa in Finland), while Loiret (France) was considered as a predominantly hospital-based system. The MHS in Suceava (Romania) was still in transition to community care. There is a significant variation in care availability and capacity across MHS of local areas in Europe. This information is relevant for understanding the process of implementation of community-oriented mental health care in local areas. Standard comparison of care provision in local areas is important for context analysis and policy planning.
Use of the terms Wellbeing and Quality of Life in health sciences: a conceptual framework
Publisher: SciELO Espana/Repisalud
Date: 03-2014
The REFINEMENT Glossary of Terms: An International Terminology for Mental Health Systems Assessment
Publisher: Springer Science and Business Media LLC
Date: 16-09-2017
DOI: 10.1007/S10488-017-0826-X
Abstract: Comparing mental health systems across countries is difficult because of the lack of an agreed upon terminology covering services and related financing issues. Within the European Union project REFINEMENT, international mental health care experts applied an innovative mixed "top-down" and "bottom-up" approach following a multistep design thinking strategy to compile a glossary on mental health systems, using local services as pilots. The final REFINEMENT glossary consisted of 432 terms related to service provision, service utilisation, quality of care and financing. The aim of this study was to describe the iterative process and methodology of developing this glossary.
Registered prevalence of borderline personality disorder in primary care databases
Publisher: Elsevier BV
Date: 03-2013
DOI: 10.1016/J.GACETA.2011.12.006
Abstract: Borderline personality disorder (BPD) is a common personality disorder, with a population prevalence of 1.4-5.9%, although the epidemiology of this disorder in primary care is insufficiently known. Our objective was to determine the registered prevalence of BPD in primary care databases and to study the demographic and clinical characteristics of these patients. We performed a cross-sectional study of the computerized databases of primary care clinical records. The target population consisted of all adults (≥ 16 years old) registered in the Catalan Health Institute (n = 4,764,729). The prevalence of recorded BPD was 0.017%, and was higher in patients with other mental disorders, particularly substance-abuse disorders (0.161%). These patients had twice as many appointments with the general practitioner as the general population (8.1 vs. 4.4). The number of diagnoses of BPD recorded in primary care is extremely low, which contrasts with the available population-based data.
The Orange Declaration on rural and remote mental health
Publisher: Wiley
Date: 12-09-2019
DOI: 10.1111/AJR.12560
Abstract: Rural mental health outcomes have been persistently poorer than those in larger cities suggesting that the prevailing investments to improve matters are not working. Mental health researchers and service providers from New South Wales, Victoria, Western Australia and the Australian Capital Territory met in Orange in October 2018 to explore issues pertaining to rural mental health and well-being. The group recognised and acknowledged that rural residents experience a series of interconnected geographical, demographic, social, economic and environmental challenges which are not addressed adequately by the current mix of services. This declaration has been endorsed by those listed below and we welcome further support. We list ten interrelated problems and ten solutions. As a group, we take this declaration as an opportunity to invite discussion about how we can collectively improve the mental health of rural residents through research, service design and delivery. We invite the reader to consider endorsing this declaration. A short summary of supporting evidence is available online at www.crrmh.com.au/.
‘Mental Retardation’ or ‘Intellectual Disability’: Time for a Conceptual Change
Publisher: S. Karger AG
Date: 18-10-2007
DOI: 10.1159/000109950
Abstract: i Background: /i The term ‘mental retardation’ (MR) is outdated and has changed to ‘intellectual disability’ (ID). Unfortunately, this decision did not follow a nosology approach. The aim of this overview is twofold: (1) to provide a conceptual background and framing on the ID/MR field to other psychiatrists, and (2) to provide a nosology-based perspective to the debate on the name and concept of MR/ID. i Method: /i This conceptual paper is based on a literature review and on an iterative process of debate within the WPA Section ‘Psychiatry of Mental Retardation’. i Results: /i ID may be regarded not as a disease or as a disability but as a syndrome grouping (metasyndrome) similar to the construct of dementia. It includes a heterogeneous group of clinical conditions, ranging from genetic to nutritional, infectious, metabolic or neurotoxic conditions. The ID metasyndrome is characterized by a deficit in cognitive functioning prior to the acquisition of skills through learning. The intensity of the deficit is such to interfere in a significant way with in idual normal functioning as expressed in limitations in activities and restriction in participation (disabilities). i Conclusions: /i The name ‘developmental cognitive impairment’ is here suggested to coexist with ID for naming the metasyndrome previously called MR following a polysemic-polynomious approach.
An ecosystems approach to mental health services research
Publisher: Royal College of Psychiatrists
Date: 22-05-2020
DOI: 10.1192/BJI.2020.24
Abstract: Mental health ecosystems research is an emerging discipline which takes a whole-systems approach to mental healthcare, facilitating analysis of the complex environment and context of mental health systems, and translation of this knowledge into policy and practice. Evidence from the local context is needed in the analysis of complex interventions and of geographic variations in the outcomes of care. Technical tools and support have been developed to gather and interpret evidence from the local context and translate it in a meaningful and relevant manner for planners and policy makers to guide their decision-making.
Consensus statement for inert gas washout measurement using multiple- and single-breath tests
Publisher: European Respiratory Society (ERS)
Date: 08-02-2013
DOI: 10.1183/09031936.00069712
Abstract: Inert gas washout tests, performed using the single- or multiple-breath washout technique, were first described over 60 years ago. As measures of ventilation distribution inhomogeneity, they offer complementary information to standard lung function tests, such as spirometry, as well as improved feasibility across wider age ranges and improved sensitivity in the detection of early lung damage. These benefits have led to a resurgence of interest in these techniques from manufacturers, clinicians and researchers, yet detailed guidelines for washout equipment specifications, test performance and analysis are lacking. This manuscript provides recommendations about these aspects, applicable to both the paediatric and adult testing environment, whilst outlining the important principles that are essential for the reader to understand. These recommendations are evidence based, where possible, but in many places represent expert opinion from a working group with a large collective experience in the techniques discussed. Finally, the important issues that remain unanswered are highlighted. By addressing these important issues and directing future research, the hope is to facilitate the incorporation of these promising tests into routine clinical practice.
Person-centred medicine and mental health
Publisher: Cambridge University Press (CUP)
Date: 02-03-2012
DOI: 10.1017/S204579601200008X
Abstract: This paper discusses an integrated approach to person-centred medicine and its role in the future of mental health care. The origins and current status of this emerging field are revised with special attention to the contributions made from psychiatry and to the implications for psychiatric diagnosis and evaluation of the three pillars of the Person-centred Integrative Diagnosis (PID) model: its conceptual domains (health status, experiences and contributors to ill and good health), the related evaluative procedures, the partnerships needed and the existing links and differences with people-centred care and personalised medicine. In spite of their striking complementarities person-centred medicine and personalised medicine do not yet have substantial bridges built between them. Knowledge transfer and coordination should be established between these two models which will cast medical evaluation and care in the upcoming future.
Patterns of mental healthcare provision in rural areas: A demonstration study in Australia and Europe
Publisher: Frontiers Media SA
Date: 06-02-2023
DOI: 10.3389/FPSYT.2023.993197
Abstract: Mental healthcare systems are primarily designed to urban populations. However, the specific characteristics of rural areas require specific strategies, resource allocation, and indicators which fit their local conditions. This planning process requires comparison with other rural areas. This demonstration study aimed to describe and compare specialized rural adult mental health services in Australia, Norway, and Spain and to demonstrate the readiness of the healthcare ecosystem approach and the DESDE-LTC mapping tool (Description and Evaluation of Services and Directories of Long Term Care) for comparing rural care between countries and across areas. The study described and classified the services using the DESDE-LTC. The analyses included context analysis, care availability, placement capacity, balance of care, and ersity of care. Additionally, readiness (Technology Readiness Levels - TRL) and impact analyses (Adoption Impact Ladder - AIL) were also assessed by two independent raters. The findings demonstrated the usability of the healthcare ecosystem approach and the DESDE-LTC to map and identify differences and similarities in the pattern of care of highly ergent rural areas. Day care had a greater weight in the European pattern of care, while it was replaced by social outpatient care in Australian areas. In contrast, care coordination was more common in Australia, pointing to a more fragmented system that requires navigation services. The share between hospital and community residential care showed no differences between the two regions, but there were differences between catchment areas. The healthcare ecosystem approach showed a TRL 8 (the tool has been demonstrated in a real-world environment and it is ready for release and general use) and an AIL of 5 (the target public agencies provided resources for its completion). Two experts evaluated the readiness of the use of DESDE-LTC in their respective regional studies. All of them were classified using the TRL. In conclusion, this study strongly supports gathering data on the provision of care in rural areas using standardized methods to inform rural service planning. It provides information on context and service availability, capacity and balance of care that may improve, directly or through subsequent analyses, the management and planning of services in rural areas.
Social distance and stigma towards persons with serious mental illness among medical students in five European Central Asia countries
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.PSYCHRES.2022.114409
Abstract: The study investigated behavioral measures of social distance (i.e., desired proximity between self and others in social contexts) as an index of stigma against those with mental illness among medical students in the Republic of North Macedonia, Turkey, Azerbaijan, Kazakhstan, and Poland, using the Reported and Intended Behavior Scale (RIBS), a standardized, self-administered behavioral measure based on the Star Social Distance Scale. The students' responses to standardized clinical vignettes on schizophrenia, and depression with suicidal ideation, were also assessed. A total of 257 North Macedonian (females, 31.5% 1-4 grades, 189 5-6 grades, 68) 268 Turkish (females, 43.3% 1-4 grades, 90 5-6 grades, 178) 450 Kazakh (females, 28.4%, 71.6% 1-4 grades, 312 5-6 grades, 138) 512 Azerbaijani (females, 24% 1-4 grades, 468 5-6 grades, 44 females, 24%), and 317 Polish (females, 59.0% 1-4 grades, 208 5-6 grades, 109) students were surveyed. The responses on the RIBS social distance behavior measures did not improve with advancing medical school grade, but students across all sites viewed schizophrenia and depression as real medical illnesses. The results support the development of enhanced range of integrated training opportunities for medical student to socially interact with persons with mental illness sharing their experiences with them.
Setting-based interventions to promote mental health at the university: a systematic review
Publisher: Springer Science and Business Media LLC
Date: 30-06-2016
DOI: 10.1007/S00038-016-0846-4
Abstract: Universities are dynamic environments. But university life presents challenges that may affect the mental health of its community. Higher education institutions provide opportunities to promote public health. Our objective is to summarise the current evidence on strategies to promote mental health at the university, following a setting-based model. We conducted a systematic literature review following standard methods. Published literature that evaluated structural and organizations strategies to promote mental health at the university was selected. 19 papers were included. The majority of the studies were targeting the students, with only four aiming to promote employees' mental health. The most promising strategies to promote mental wellbeing included changes in the way students are taught and assessed. On the other hand, social marketing strategies had not impact on mental health. There is inconclusive evidence related to the effectiveness of policies to promote mental health. Universities should invest in creating supportive physical, social and academic environments that promote student and staff mental wellbeing. However, the current body of evidence is scarce and more research is needed to recommend what are the best strategies.
Description of Agitation and Crisis Interventions in a Psychiatric Hospital in Spain: a Qualitative Study
Publisher: Elsevier BV
Date: 11-2014
The use of “cognitive” in health terminology. A latent controversy
Publisher: Elsevier BV
Date: 2010
Fair is foul, and foul is fair: reframing neurodevelopmental disorders in the neurodevelopmental perspective
Publisher: Wiley
Date: 08-2016
DOI: 10.1111/ACPS.12626
Training on intellectual disability in health sciences: the European perspective
Publisher: Informa UK Limited
Date: 06-12-2013
Risk factors and topographies for self‐injurious behaviour in a sample of adults with intellectual developmental disorders
Publisher: Wiley
Date: 04-2018
DOI: 10.1111/JIR.12487
Abstract: Self-injurious behaviour (SIB) is a prevalent form of challenging behaviour in people with intellectual developmental disorders (IDD). Existing research has yielded conflicting findings concerning the major risk factors involved, and in addition, SIB shows multiple topographies and presentations. Although presence of autism spectrum disorders (ASD) and severity of intellectual disability (ID) are known risk factors for SIB, there are no studies comparing SIB topographies by severity degrees of ID and ASD. The purpose of the present paper has been to identify risk factors and topographies for SIB in a representative, stratified and randomised s le of adults with IDD. This study was conducted on the basis of data collected by the POMONA-ESP project, in a s le of 833 adults with IDD. Data concerning demographic and health information, ASD symptoms, psychopathology and ID, have been analysed to determine the presence of risk factors for SIB among participants and to explore the occurrence and topographies of SIB across different severity levels of ID and ASD symptoms. Self-injurious behaviour prevalence in the s le was 16.2%. Younger age, oral pain, greater severity of ID, presence of dual diagnosis, psychiatric medication intake and higher scores on Childhood Autism Rating Scale were risk factors for SIB among participants, whereas number of areas with functioning limitations, place of residence, diagnosis of epilepsy and sex were not. SIB was more frequent in participants with ASD symptoms regardless of its severity level, and they displayed a higher number of different topographies of SIB. People with profound ID without co-morbid ASD symptoms showed similar results concerning SIB prevalence and topographies. Knowledge on risk factors and topographies of SIB might play a vital role in the development of prevention strategies and management of SIB in people with IDD. The mere presence of ASD symptoms, regardless of its severity level, can be a crucial factor to be taken into account in assessing SIB. Accordingly, the presence of SIB in people with ID, especially when presented with a varied number of topographies, might provide guidance on ASD differential diagnosis.
Care Staff Awareness Training on Mental Health Needs of Adults with Learning Disabilities
Publisher: SAGE Publications
Date: 09-2004
Abstract: The mental health needs of adults with learning disabilities have not been adequately addressed in many European countries. Although carers can play a significant role in identification and referral, they usually lack the expertise necessary to identify signs of mental disorders. This study evaluated a care staff training programme aiming at improving awareness on issues of dual diagnosis in a group of 36 care staff from residential and community centres in Greece. Training was based on the British Mental Health in Learning Disabilities Training Pack and the PAS–ADD Checklist. The overwhelming majority of staff were very satisfied with training. Staff from institutional work settings, with no previous training on dual diagnosis and with a lower level of education, benefited to a significant degree. Changes occurred mostly in their knowledge and attitudes rather than practice. Supervised practical training is vital to transfer, strengthen and maintain positive changes at work.
Coding long-term care services—eDESDE-LTC
Publisher: Ubiquity Press, Ltd.
Date: 22-06-2009
DOI: 10.5334/IJIC.368
Health care frames – from Virchow to Obama and beyond.
Publisher: Wiley
Date: 14-10-2014
DOI: 10.1111/JEP.12266
Abstract: Framing allows us to highlight some aspects of an issue, thereby bringing them to the forefront of our thinking, talking and acting. As a consequence, framing also distracts our attention away from other issues. Over time, health care has used various frames to explain its activities. This paper traces the emergence of various health care frames since the 1850s to better understand how we reached current ways of thinking and practicing. The succession of the most prominent frames can be summarized as: medicine as a social science the germ theory of disease health care as a battleground (or the war metaphor) managing health care resources (or the market metaphor) Health for All (the social justice model) evidence-based medicine and Obama Care. The focus of these frames is causal, instrumental, political/economic or social in nature. All remain relevant however, recycling in idual past frames in response to current problems will not achieve the outcomes we seek. Placing the in idual and his/her needs at the centre (the attractor for the health system) of our thinking, as emphasized by the World Health Organization's International Classification of Function framework and the European Society of Person Centered Health Care, may provide the frame to refocus health and health care as interdependent experiences across in idual, community and societal domains. Shifting beyond the entrenched instrumental and economic thinking will be challenging but necessary for the sake of patients, health professionals, society and the economy.
Organisational impact of the National Disability Insurance Scheme transition on mental health care providers: the experience in the Australian Capital Territory
Publisher: SAGE Publications
Date: 08-11-2018
Abstract: Concerns raised about the appropriateness of the National Disability Insurance Scheme (NDIS) in Australia for people with mental illness have not been given full weight due to a perceived lack of available evidence. In the Australian Capital Territory (ACT), one of the pilot sites of the Scheme, mental health care providers across all relevant sectors who were interviewed for a local Atlas of Mental Health Care described the impact of the scheme on their service provision. All mental health care providers from every sector in the ACT were contacted. The participation rate was 92%. We used the Description and Evaluation of Services and Directories for Long Term Care to assess all service provision at the local level. Around one-third of services interviewed lacked funding stability for longer than 12 months. Nine of the 12 services who commented on the impact of the NDIS expressed deep concern over problems in planning and other issues. The transition to NDIS has had a major impact on ACT service providers. The ACT was a best-case scenario as it was one of the NDIS pilot sites.
Mirror therapy for phantom limb pain in moderate intellectual disability. A case report
Publisher: Wiley
Date: 07-09-2021
DOI: 10.1002/EJP.1859
Abstract: Phantom limb pain (PLP) is a common problem after limb utation. There is mounting evidence supporting the use of mirror therapy (MT) in the treatment of in iduals with PLP. However, there is no research studying the effects of MT on PLP in in iduals with intellectual developmental disorders (IDD). The aim of this study was to increase our understanding of MT when used with adults with IDD and PLP through a case study approach. Here, we describe the use of MT with a 53‐year‐old female with moderate IDD and PLP, related to her left leg being utated after ulcer complications. The study followed an A‐B‐A‐B design (baseline—treatment—withdrawal of treatment—re‐introduction of treatment), lasting 2 years, which included a long‐term follow‐up. The data showed that the PLP sensation decreased after the MT treatment, with a raw change of 3.92 points and a 48% decrease in mean pain intensity ratings from pre‐ to post‐treatment. This is a unique case‐report on the use of MT with an in idual with IDD suffering from PLP. The findings show that MT helped to significantly reduce the intensity of the PLP in this patient. This is a case‐report that illustrates how mirror therapy can be applied to people with intellectual developmental disorders and phantom limb pain. The results showed that phantom limb pain decreased after the mirror therapy, with a raw change of 3,92 points and a percent change of 48%.
The new Horizon Europe programme 2021–2028: Should the gap between the burden of mental disorders and the funding of mental health research be filled?
Publisher: Elsevier BV
Date: 2020
The concept of ‘functional dependency’
Publisher: Ubiquity Press, Ltd.
Date: 22-06-2009
DOI: 10.5334/IJIC.369
Early onset of airway derecruitment assessed using the forced oscillation technique in subjects with asthma
Publisher: American Physiological Society
Date: 05-2019
DOI: 10.1152/JAPPLPHYSIOL.00534.2018
Abstract: Derecruitment of air spaces in the lung occurs when airways close during exhalation and is related to ventilation heterogeneity and symptoms in asthma. The forced oscillation technique has been used to identify surrogate measures of airway closure via the reactance (Xrs) versus lung volume relationship. This study used a new algorithm to identify derecruitment from the Xrs versus lung volume relationship from a slow vital capacity maneuver. We aimed to compare two derecruitment markers on the Xrs versus volume curve, the onset reduction of Xrs (DR1 vol ) and the onset of more rapid reduction of Xrs (DR2 vol ), between control and asthmatic subjects. We hypothesized that the onset of DR1 vol and DR2 vol occurred at higher lung volume in asthmatic subjects. DR1 vol and DR2 vol were measured in 18 subjects with asthma and 18 healthy controls, and their relationships with age and height were examined using linear regression. In the control group, DR1 vol and DR2 vol increased with age ( r 2 = 0.68, P 0.001 and r 2 = 0.71, P 0.001, respectively). DR1 vol and DR2 vol in subjects with asthma [76.58% of total lung capacity (TLC) and 56.79%TLC, respectively] were at higher lung volume compared with control subjects (46.1 and 37.69%TLC, respectively) ( P 0.001). DR2 vol correlated with predicted values of closing capacity ( r = 0.94, P 0.001). This study demonstrates that derecruitment occurs at two points along the Xrs-volume relationship. Both derecruitment points occurred at significantly higher lung volumes in subjects with asthma compared with healthy control subjects. This technique offers a novel way to measure the effects of changes in airways/lung mechanics. NEW & NOTEWORTHY This study demonstrates that the forced oscillation technique can be used to identify two lung volume points where lung derecruitment occurs: 1) where derecruitment is initiated and 2) where onset of rapid derecruitment commences. Measurements of derecruitment increase with age. The onset of rapid derecruitment was highly correlated with predicted closing capacity. Also, the initiation and rate of derecruitment are significantly altered in subjects with asthma.
Differential clinical features of late-onset panic disorder
Publisher: Elsevier BV
Date: 2000
DOI: 10.1016/S0165-0327(99)00082-8
Abstract: The aim was to analyse the sociodemographic and clinical characteristics of panic disorder (PD) in patients with a PD onset after 60 years of age, at two outpatient psychiatric clinics in Barcelona (northeastern Spain). All patients presenting with PD at two outpatient clinics over a 4-year period were assessed by the same team. Patients with PD onset at 60 or after were grouped (late-onset), and compared with the group with an earlier onset. The instruments administered to the s le were: Global Assessment of Functioning scale, Panic-Associated Symptom Scale, Hamilton's Depression and Anxiety Scales and Marks-Matthews' Fear and Phobia scale. Of 5301 patients attended over a 4-year period, 64 (1.2%) were PD patients aged 60 or above. Age at PD onset was over 60 in 27 cases (0.4% of the total population, and 6.1% of all PD patients). The mean age in the late-onset group was 67.0+/-4.9 years. Late-onset PD patients were less likely to report family history of PD. They scored lower on most scales assessing clinical severity (excepting GAF and agoraphobia scores), and they exhibited fewer and milder panic symptoms during the attacks. However, dysthymic disorder, but not major depressive disorder, was more common among late-onset PD patients (P<0.05). The most notable findings in our late-onset PD subgroup of patients were: lesser severity of the disorder, greater comorbidity with dysthymia, and less family history of PD. Prevalence rates of late-onset PD in our s le appeared to be rather high. Physical illness and less severe panic symptoms may contribute to underdiagnosing PD in this particular subpopulation.
A Realist Evaluation of Case Management Models for People with Complex Health Conditions Using Novel Methods and Tools-What Works, for Whom, and under What Circumstances?
Publisher: MDPI AG
Date: 28-02-2023
Abstract: Case management developed from a generalist model to a person-centred model aligned with the evidence-informed evolution of best practice people-centred integrated care. Case management is a multidimensional and collaborative integrated care strategy where the case manager performs a set of interventions/actions to support the person with a complex health condition to progress in their recovery pathway and participate in life roles. It is currently unknown what case management model works in real life for whom and under what circumstances. The purpose of this study was to answer these questions. The study methods used realistic evaluation framework, examined the patterns and associations between case manager actions (mechanisms), the person’s characteristics and environment (context), and recovery (outcomes) over 10 years post severe injury. There was mixed methods secondary analysis of data extracted via in-depth retrospective file reviews (n = 107). We used international frameworks and a novel approach with multi-layered analysis including machine learning and expert guidance for pattern identification. The study results confirm that when provided, a person-centred case management model contributes to and enhances the person’s recovery and progress towards participation in life roles and maintaining well-being after severe injury.Furthermore, the intensity of case management for people with traumatic brain injury, and the person-centred actions of advising, emotional and motivational support, and proactive coordination contribute to the person achieving their goals. The results provide learnings for case management services on the case management models, for quality appraisal, service planning, and informs further research on case management.
The cost-effectiveness of paliperidone extended release in Spain
Publisher: Informa Healthcare
Date: 23-10-2012
DOI: 10.3111/13696998.2012.734884
Abstract: Paliperidone Extended Release OROS (ER) is a new atypical antipsychotic for the treatment of schizophrenia. The objective is, based on a previously published model, to analyze the clinical and economic effects of Paliperidone ER in a Spanish setting compared to olanzapine oral and aripiprazole. An existing discrete event simulation model was adapted to reflect the treatment of schizophrenia in Spain in terms of costs, resource use, and treatment patterns. Inputs for the model were derived from clinical trial data, literature research, database analysis and interviews with local clinical experts. The time horizon is 5 years and Spanish discount rate was applied. Outputs include direct medical costs and Quality Adjusted Life-Years (QALYs). Extensive sensitivity analyses were carried out to assess the robustness of the results, using ordinary least squares analysis and cost-effectiveness scatter plots. The results show that the mean incremental QALYs (95% CI) compared to olanzpine is 0.033 [-0.143, 0.304] and compared to aripiprazole 0.029 [-0.107, 0.300]. The corresponding mean incremental costs and corresponding confidence intervals are -€1425 [-€10,247, €3084] and -€759 [-€10,479, €3404], respectively. The probability that paliperidone ER is cost-saving and health gaining compared to olanzapine and aripiprazole is 76% and 72%, respectively. Paliperidone ER was estimated to have 80% and 81% probability of being cost-effective compared to olanzapine at a willingness to pay of €20,000 and €30,000 and 73% and 74% compared to aripiprazole, respectively. Some of the modeled inter-relationships had to be based on expert opinion due to a lack of information. Also, foreign sources for the disutility of adverse events had been used due to a lack of Spanish data. Prolactin-related side-effects, indirect costs, and potential compliance advantages of paliperidone ER were not considered. It is unlikely that these limitations affected the conclusions. Based on differences in drug acquisition costs, side-effects, and risk of relapse, the model predicts that, in the Spanish healthcare setting, paliperidone ER dominates oral olanzapine and aripiprazole, with a probability of 76% and 72%, respectively.
Can you hear it? Stereo sound-assisted guidance in augmented reality assembly
Publisher: Springer Science and Business Media LLC
Date: 29-07-2022
Is asthma associated with exposure to smoke from a coal mine fire?
Publisher: Cold Spring Harbor Laboratory
Date: 10-05-2019
DOI: 10.1101/631317
Abstract: In 2014, a fire at the Hazelwood open cut coal mine (Victoria, Australia) burned for about 6 weeks. Residents of the adjacent town of Morwell were exposed to high levels of fine particulate matter (PM 2.5 ) during this period. Three and a half years after the event, this study aimed to investigate the long-term impact of short-term exposure to coal mine fire smoke on asthma. A cross-sectional analysis was undertaken on a group of exposed participants with asthma from Morwell (n=165) and a group of unexposed participants with asthma from the control town of Sale (n=64). Town exposure status was determined by modelled PM 2.5 data for the mine fire period. Respiratory symptoms were assessed with a validated respiratory health questionnaire and symptom severity score. Asthma control was assessed with an asthma control questionnaire. Lung function testing included spirometry, bronchodilator response, and fraction of exhaled nitric oxide. There was no evidence that exposed Morwell participants had more severe asthma symptoms, worse lung function, or more eosinophilic airway inflammation compared to unexposed Sale participants. However there was some evidence that Morwell participants had more uncontrolled than well-controlled asthma, compared to the participants from Sale (adjusted relative risk ratio 2.71 95%CI: 1.02, 7.21, p=0.046). Three and a half years after exposure, coal mine fire smoke does not appear to be associated with more severe asthma symptoms or worse lung function, but may be associated with poorer asthma control. In people with asthma, short-term coal mine fire smoke exposure does not appear to have long-term impact on severity of asthma symptoms, lung function or eosinophilic airway inflammation, but may affect asthma control.
Cost of Disorders of the Brain in Spain
Publisher: Public Library of Science (PLoS)
Date: 18-08-2014
The development of a preliminary taxonomy on case management of brain injury for a common language
Publisher: Ubiquity Press, Ltd.
Date: 08-12-2014
DOI: 10.5334/IJIC.1931
Integrating clinicians, knowledge and data: expert-based cooperative analysis in healthcare decision support
Publisher: Springer Science and Business Media LLC
Date: 30-09-2010
Impurity Tracking Enables Enhanced Control and Reproducibility of Hybrid Perovskite Vapor Deposition
Publisher: American Chemical Society (ACS)
Date: 17-07-2019
Causal Modelling for Supporting Planning and Management of Mental Health Services and Systems: A Systematic Review.
Publisher: MDPI AG
Date: 25-01-2019
Abstract: Mental health services and systems (MHSS) are characterized by their complexity. Causal modelling is a tool for decision-making based on identifying critical variables and their causal relationships. In the last two decades, great efforts have been made to provide integrated and balanced mental health care, but there is no a clear systematization of causal links among MHSS variables. This study aims to review the empirical background of causal modelling applications (Bayesian networks and structural equation modelling) for MHSS management. The study followed the PRISMA guidelines (PROSPERO: CRD42018102518). The quality of the studies was assessed by using a new checklist based on MHSS structure, target population, resources, outcomes, and methodology. Seven out of 1847 studies fulfilled the inclusion criteria. After the review, the selected papers showed very different objectives and subjects of study. This finding seems to indicate that causal modelling has potential to be relevant for decision-making. The main findings provided information about the complexity of the analyzed systems, distinguishing whether they analyzed a single MHSS or a group of MHSSs. The discriminative power of the checklist for quality assessment was evaluated, with positive results. This review identified relevant strategies for policy-making. Causal modelling can be used for better understanding the MHSS behavior, identifying service performance factors, and improving evidence-informed policy-making.
Occupational exposure to pesticides are associated with fixed airflow obstruction in middle-age
Publisher: BMJ
Date: 07-07-2017
DOI: 10.1136/THORAXJNL-2016-209665
Abstract: Population-based studies have found evidence of a relationship between occupational exposures and Chronic Obstructive Pulmonary Disease (COPD), but these studies are limited by the use of prebronchodilator spirometry. Establishing this link using postbronchodilator is critical, because occupational exposures are a modifiable risk factor for COPD. To investigate the associations between occupational exposures and fixed airflow obstruction using postbronchodilator spirometry. One thousand three hundred and thirty-five participants were included from 2002 to 2008 follow-up of the Tasmanian Longitudinal Health Study (TAHS). Spirometry was performed and lifetime work history calendars were used to collect occupational history. ALOHA plus Job Exposure Matrix was used to assign occupational exposure, and defined as ever exposed and cumulative exposure unit (EU)-years. Fixed airflow obstruction was defined by postbronchodilator FEV Ever exposure to biological dust (relative risk (RR)=1.58, 95% CI 1.01 to 2.48), pesticides (RR=1.74,95% CI 1.00 to 3.07) and herbicides (RR=2.09,95% CI 1.18 to 3.70) were associated with fixed airflow obstruction. Cumulative EU-years to all pesticides (RR=1.11,95% CI 1.00 to 1.25) and herbicides (RR=1.15,95% CI 1.00 to 1.32) were also associated with fixed airflow obstruction. In addition, all pesticides exposure was consistently associated with chronic bronchitis and symptoms that are consistent with airflow obstruction. Ever exposure to mineral dust, gases/fumes and vapours, gases, dust or fumes were only associated with fixed airflow obstruction in non-asthmatics only. Pesticides and herbicides exposures were associated with fixed airflow obstruction and chronic bronchitis. Biological dust exposure was also associated with fixed airflow obstruction in non-asthmatics. Minimising occupational exposure to these agents may help to reduce the burden of COPD.
Diferencias en la efectividad clínica y funcional, entre trastornos psiquiátricos, de un hospital de día psiquiátrico de agudos para pacientes con enfermedad mental aguda
Publisher: Elsevier BV
Date: 2021
DOI: 10.1016/J.RPSM.2019.04.001
Abstract: Intensive treatment in acute day-care psychiatric units may represent an efficient alternative to inpatient care. However, there is evidence suggesting that this clinical resource may not be equally effective for every psychiatric disorder. The primary aim of this study was to explore differences between main psychiatric diagnostic groups, in the effectiveness of an acute partial hospitalization program. And, to identify predictors of treatment response. The study was conducted at an acute psychiatric day hospital. Clinical severity was assessed using BPRS, CGI, and the HoNOS scales. Main socio-demographic variables were also recorded. Patients were clustered into 4wide diagnostic groups (i.e.: non-affective psychosis bipolar depressive and personality disorders) to facilitate statistical analyses. A total of 331 participants were recruited, 115 of whom (34.7%) were diagnosed with non-affective psychosis, 97 (28.3%) with bipolar disorder, 92 (27.8%) with affective disorder, and 27 (8.2%) with personality disorder. Patients with a diagnosis of bipolar disorder showed greater improvement in BPRS (F=5.30 P=0.001) and CGI (F=8.78 P<0.001) than those suffering from psychosis or depressive disorder. Longer length of stay in the day-hospital, and greater baseline BPRS severity, were identified as predictors of good clinical response. Thirty-day readmission rate was 3% at long-term (6 months after discharge) only 11.8% (N=39) of patients were re-admitted to a psychiatric hospitalization unit, and no differences were observed between diagnostic groups. Intensive care in an acute psychiatric day hospital is feasible and effective for patients suffering from an acute mental disorder. However, this effectiveness differs between diagnostic groups.
Childhood predictors of lung function trajectories and future COPD risk: a prospective cohort study from the first to the sixth decade of life
Publisher: Elsevier BV
Date: 07-2018
Teleconsultation Between Patients and Health Care Professionals in the Catalan Primary Care Service: Message Annotation Analysis in a Retrospective Cross-Sectional Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 06-04-2020
Abstract: ver the last decade, telemedicine services have been introduced in the public health care systems of several industrialized countries. In Catalonia, the use of eConsulta, an asynchronous teleconsultation service between primary care professionals and citizens in the public health care system, has already reached 1 million cases. Before the COVID-19 pandemic, the use of eConsulta was growing at a monthly rate of 7%, and the growth has been exponential from March 15, 2020 to the present day. Despite its widespread usage, there is little qualitative evidence describing how this tool is used. he aim of this study was to annotate a random s le of teleconsultations from eConsulta, and to evaluate the level of agreement between health care professionals with respect to the annotation. wenty general practitioners retrospectively annotated a random s le of 5382 cases managed by eConsulta according to three aspects: the type of interaction according to 6 author-proposed categories, whether the practitioners believed a face-to-face visit was avoided, and whether they believed the patient would have requested a face-to-face visit had eConsulta not been available. A total of 1217 cases were classified three times by three different professionals to assess the degree of consensus among them. he general practitioners considered that 79.60% (4284/5382) of the teleconsultations resulted in avoiding a face-to-face visit, and considered that 64.96% (3496/5382) of the time, the patient would have made a face-to-face visit in the absence of a service like eConsulta. The most frequent uses were for management of test results (26.77%, 1433/5354), management of repeat prescriptions (24.30%, 1301/5354), and medical enquiries (14.23%, 762/5354). The degree of agreement among professionals as to the annotations was mixed, with the highest consensus demonstrated for the question “Has the online consultation avoided a face-to-face visit?” (3/3 professionals agreed 67.95% of the time, 827/1217), and the lowest consensus for the type of use of the teleconsultation (3/3 professionals agreed 57.60% of the time, 701/1217). his study shows the ability of eConsulta to reduce the number of face-to-face visits for 55% (79% × 65%) to 79% of cases. In comparison to previous research, these results are slightly more pessimistic, although the rates are still high and in line with administrative data proxies, showing that 84% of patients using teleconsultations do not make an in-person appointment in the following 3 months. With respect to the type of consultation performed, our results are similar to the existing literature, thus providing robust support for eConsulta’s usage. The mixed degree of consensus among professionals implies that results derived from artificial intelligence tools such as message classification algorithms should be interpreted in light of these shortcomings.
Bridging knowledge in long-term care and support. Crossing boundaries between ageing and disability
Publisher: Ubiquity Press, Ltd.
Date: 22-06-2009
DOI: 10.5334/IJIC.385
Health indicators in intellectual developmental disorders: The key findings of the POMONA ‐ESP project
Publisher: Wiley
Date: 27-06-2018
DOI: 10.1111/JAR.12498
Abstract: The aim of this paper was to summarize the main results of the POMONA ‐ ESP project, the first study to explore health status in a large representative, randomized and stratified s le of people with intellectual developmental disorders in Spain. The POMONA ‐ ESP project collected information about the health of 953 in iduals with intellectual developmental disorders. Diseases such as urinary incontinence, oral problems, epilepsy, constipation or obesity were highly prevalent among the participants with gender‐differentiated prevalences for certain conditions, and age and intellectual disability level as risk factors for disease. Overmedication was common in the s le, and drugs were often prescribed without any clinical indication or follow‐up. The present authors also found a lack of important relevant information about the participant's health and a lack of adequate genetic counselling. Our findings may contribute to a better understanding of health status and needs of people with intellectual developmental disorders and suggest several courses of action to improve their health care.
A building blocks strategy for developing bridging and knowledge transfer between ageing and disability care and policy
Publisher: Ubiquity Press, Ltd.
Date: 23-10-2013
DOI: 10.5334/IJIC.1258
The POMONA‐ESP project methodology: Collecting data on health indicators for people with intellectual developmental disorders
Publisher: Wiley
Date: 15-07-2018
DOI: 10.1111/JAR.12497
Abstract: People with intellectual developmental disorders have significant health disparities and a lack of proper attention to their health needs. They have been underrepresented in scientific research, and very few studies have been carried out using a representative randomized s le. The aim of this study was to describe the methods used in the POMONA‐ESP project to recruit a representative and randomized s le of participants with intellectual developmental disorders. The POMONA‐ESP project is an observational cross‐sectional study. It aims to explore the health status of people with intellectual developmental disorders across Spain and the use they make of health services. The results of the POMONA‐ESP project may have a major impact on people with intellectual developmental disorders and society in general. It is the first study to obtain geographically representative epidemiological data from a large s le, information that is fundamental to improving care and healthcare planning for people with intellectual developmental disorders.
«Cognitivo»: un término en disputa. «Noético», una solución homérica
Publisher: Elsevier BV
Date: 2004
Applying an Evolutionary Algorithm for the Analysis of Mental Disorders in Macro-urban Areas: The Case of Barcelona
Publisher: Informa UK Limited
Date: 03-07-2015
Mapping case management: a realist evaluation of characteristics and patterns
Publisher: Ubiquity Press, Ltd.
Date: 26-02-2021
DOI: 10.5334/IJIC.S4128
Using accountability for mental health to drive reform summary
Publisher: AMPCo
Date: 10-2015
DOI: 10.5694/MJA15.00447
Abstract: Greatly enhanced accountability can drive mental health reform. As extant approaches are ineffective, we propose a new approach. Australia spends around $7.6 billion on mental health services annually, but is anybody getting better? Effective accountability for mental health can reduce variation in care and increase effective service provision. Despite 20 years of rhetoric, Australia's approach to accountability in mental health is overly focused on fulfilling governmental reporting requirements rather than using data to drive reform. The existing system is both fragmented and outcome blind. Australia has failed to develop useful local and regional approaches to benchmarking in mental health. New approaches must address this gap and better reflect the experience of care felt by consumers and carers, as well as by service providers. There are important social priorities in mental health that must be assessed. We provide a brief overview of the existing system and propose a new, modest but achievable set of indicators by which to monitor the progress of national mental health reform. These indicators should form part of a new, system-wide process of continuous quality improvement in mental health care and suicide prevention.
A Semiautomated Classification System for Producing Service Directories in Social and Health Care (DESDE-AND): Maturity Assessment Study
Publisher: JMIR Publications Inc.
Date: 15-03-2021
DOI: 10.2196/24930
Abstract: DESDE-LTC (Description and Evaluation of Services and DirectoriEs for Long-Term Care) is an international classification system that allows standardized coding and comparisons between different territories and care sectors, such as health and social care, in defined geographic areas. We adapted DESDE-LTC into a computer tool (DESDE-AND) for compiling a directory of care services in Andalucia, Spain. The aim of this study was to evaluate the maturity of DESDE-AND. A secondary objective of this study is to show the practicality of a new combined set of standard evaluation tools for measuring the maturity of health technology products. A system for semiautomated coding of service provision has been co-designed. A panel of 23 domain experts and a group of 68 end users participated in its maturity assessment that included its technology readiness level (TRL), usability, validity, adoption (Adoption Impact Ladder [AIL]), and overall degree of maturity [implementation maturity model [IMM]). We piloted the prototype in an urban environment (Seville, Spain). The prototype was demonstrated in an operational environment (TRL 7). Sixty-eight different care services were coded, generating fact sheets for each service and its geolocation map. The observed agreement was 90%, with moderate reliability. The tool was partially adopted by the regional government of Andalucia (Spain), reaching a level 5 in adoption (AIL) and a level 4 in maturity (IMM) and is ready for full implementation. DESDE-AND is a usable and manageable system for coding and compiling service directories and it can be used as a core module of decision support systems to guide planning in complex cross-sectoral areas such as combined social and health care.
Bridging aging and disability networks: Strategies for translating knowledge into practice
Publisher: Ubiquity Press, Ltd.
Date: 12-11-2012
DOI: 10.5334/IJIC.1107
e-Gears as new tools for enhancing eMental Health interventions in people centered integrated care
Publisher: Ubiquity Press, Ltd.
Date: 08-12-2014
DOI: 10.5334/IJIC.1900
Social functioning in schizophrenia: what is the influence of gender?
Publisher: SciELO Espana/Repisalud
Date: 09-2007
Comunicación abierta entre profesionales de la salud mental y padres de pacientes con discapacidad intelectual
Publisher: Instituto Nacional de Salud Publica
Date: 29-08-2020
DOI: 10.21149/11062
Abstract: Objetivo. Estimar los factores asociados con la comunicación abierta entre profesionales de la salud mental y padres de pacientes con discapacidad intelectual y otros trastornos del neurodesarrollo. Material y métodos. Encuesta transversal en 759 profesionales de la salud mental. Se estimó la asociación entre el patrón de comunicación abierto y los atributos de la comunicación a través de un modelo logístico, ordinal y multivariado. Resultados. La prevalencia del patrón de comunicación abierta en profesionales de la salud mental fue de 30.6% (IC95% 27.4-34.0). Los factores asociados fueron menor edad (RM=2.42, IC95% 1.57-3.75), especialidad (RM=1.56, IC95% 1.09-2.23), alto valor a la verdad (RM=4.95, IC95% 3.21-7.65), bajo paternalismo (RM=10.93, IC95% 7.22-16.52) y cursos de bioética (RM=1.45, IC95% 1.01-2.09), ajustando por variables confusoras. Conclusión. Los profesionales de la salud mental reportaron bajos niveles de comunicación abierta con los padres de personas con trastornos del neurodesarrollo, por lo que priorizar el valor a la verdad, promover un menor paternalismo y el respeto a la autonomía de los pacientes puede contribuir a cambiar estos patrones de comunicación en la práctica clínica en México.
People with disabilities and professionals’ views on access to health services in Western Sydney
Publisher: Ubiquity Press, Ltd.
Date: 08-12-2014
DOI: 10.5334/IJIC.1904
Integrated mapping of local mental health systems in Central Chile
Publisher: Pan American Health Organization
Date: 2018
Classification and diagnosis
Publisher: Cambridge University Press
Date: 31-10-2015
Patterns of service provision in child and adolescent mental health care in Australia
Publisher: SAGE Publications
Date: 20-12-2022
DOI: 10.1177/13674935221146381
Abstract: Standard description of local care provision is essential for evidence-informed planning. This study aimed to map and compare the availability and ersity of current mental health service provision for children and adolescents in Australia. We used a standardised service classification instrument, the Description and Evaluation of Services and DirectoriEs (DESDE) tool, to describe service availability in eight urban and two rural health districts in Australia. The pattern of care was compared with that available for other age groups in Australia. Outpatient care was found to be the most common type of service provision, comprising 212 (81.2%) of all services identified. Hospital care (acute and non-acute) was more available in urban than in rural areas (20 services [9.7%] vs 1 [1.8%]). The level of ersity in the types of care available for children and adolescents was lower than that for the general adult population, but slightly higher than that for older people in the same areas. Standardised comparison of the pattern of care across regions reduces ambiguity in service description and classification, enables gap analysis and can inform policy and planning.
Definición de “dependencia funcional”. Implicaciones para la política sociosanitaria
Publisher: Elsevier BV
Date: 06-2010
The Relationships between Depression Spatial Clusters and Mental Health Planning in Catalonia (Spain)
Publisher: Springer International Publishing
Date: 2014
Does mental fatigue impair physical performance? A replication study
Publisher: Informa UK Limited
Date: 30-06-2020
The exploration of physical fatigue, sleep and depression in paramedics: a pilot study
Publisher: SAGE Publications
Date: 2011
DOI: 10.33151/AJP.9.1.37
Abstract: A convenience s le of paramedics was asked to complete a number of self-reporting standardised questionnaires: The Epworth Sleepiness Scale (ESS) (8-items), Berlin Questionnaire (BQ) (10-items), Pittsburgh Sleep Quality Index (PSQI) (19-items) and the Beck Depression Inventory (BDI) (21-items). Ethics approval was granted. The study recruited 60 participants, the majority of which were male 77% (n=46), 45 years of age 31% (n=19), and having worked shift work between 5-10 years 35% (n=21). Nine out of ten (92%, n=55) of paramedics reported having experienced fatigue in the last 6 months, with 88% (n=53) believing it had affected their performance at work. The ESS reported 30% (n=18) of people had excessive daytime sleepiness, and 10% (n=6) being dangerously sleepy. Statistical significance was observed in the ESS items „chance of dozing while sitting and talking to someone‟ (p .05), and „whilst stopped in traffic for a few minutes‟ (p .05) between males and females. Almost half (48%, n=29) of paramedics answered yes to having nodded off or fallen asleep whilst driving. The PSQI found 68% (n=41) of participants suffered poor quality sleep, while 21 % (n=13) of respondents were at high risk for sleep apnoea (BQ). Depression was found to be mild among 27% (n=16) and moderate among 10% (n=6) of respondents Shift work affects health and well-being both physiologically and psychologically, which translates from work into home. Further research using a larger s le size is warranted to prevent the issues of patient safety, work-related fatigue and the cumulative effects of shift work in paramedic employees.
Pressure-sketch: a tablet-based design system in immersive VR
Publisher: Springer Science and Business Media LLC
Date: 27-01-2022
Meso-level Comparison of Mental Health Service Availability and Use in Chile and Spain
Publisher: American Psychiatric Association Publishing
Date: 04-2008
Abstract: There is a demand for international comparisons of mental health care in Latin America. The purpose of this study was to describe mental health care in catchment health areas in Chile and Spain in order to complement information reported at the macro-level (countries or regions). Availability and utilization of services for the adult population were assessed in two urban areas in Chile and in three urban areas in Spain by using the European Service Mapping Schedule (meso-level data). Indicators from a previous data envelopment analysis (DEA) model of basic community care were applied to this analysis. For the two countries, local data on beds and staff differed from data provided at the national level. In Chile meso-level data indicated more available beds and more psychologists per capita than did macro-level data. Quantitative indicators of community care were described, and the main gaps in Chile's urban areas were identified, particularly in day care and nonhospital residential care. There was nearly a tenfold difference in use of residential and day care between the benchmark area in Spain and the areas explored in Chile. In Chile's catchment areas there was no availability of nonacute hospital services, any work-related services for persons with mental disorders, or 24-hour mobile or nonmobile emergency psychiatric care. The meso-level data indicated that delivery and use of care in Chile was more similar to the pattern found in the poorer area in southern Spain than macro-level data would indicate. The European Service Mapping Schedule was useful for describing mental health care outside of Europe and allowed for an international comparison between Chile and Spain. The meso-level description gathered in this study adds to the macro-level information on the mental health care system that has been provided in other reports. The gap between mental health treatment needed and mental health treatment received in Chile may be lower than expected.
Patient‐reported impact of symptoms in schizophrenia scale (PRISS): Development and validation
Publisher: Wiley
Date: 02-03-2022
DOI: 10.1111/ACPS.13417
Abstract: We report the psychometric properties of the Patient‐Reported Impact of Symptoms in Schizophrenia Scale (PRISS), which assesses the impact of subjective experiences or qualia in outpatients with this condition. A cross‐sectional study was carried out in 162 patients diagnosed with schizophrenia in Spain. The PRISS measures the presence, frequency, concern and interference with daily life of self‐reported experiences related to the main symptoms observed in these patients. The psychometric analysis included test‐retest reliability, internal consistency and structural and convergent validity. The 28‐item PRISS showed good test‐retest reliability as 64.3% of the intraclass correlation coefficient values were between 0.40 and 0.79, which were statistically significant ( p 0.01). Analysis of the structural validity revealed a three‐factor structure, (1) productive subjective experiences, (2) affective‐negative subjective experiences and (3) excitation, which accounted for 56.11% of the variance. Of the Pearson's correlation coefficients analysed between the PRISS and the Positive and Negative Syndrome Scale (PANSS), Scale for Assessment of Negative Symptoms (SANS) and World Health Organization Disability Assessment Schedule (WHO‐DAS), 72.2% were statistically significant ( p 0.05) and ranged from 0.38–0.42, 0.32–0.42 and 0.40–0.42, respectively. Our results indicate that the PRISS appears to be a brief, reliable and valid scale to measure subjective experiences in schizophrenia and provides valuable information complementary to clinical evaluation.
Alcohol and Other Drug Service Availability, Capacity, and Diversity in Urban and Rural Australia: An Integrated Atlas
Publisher: Alcohol Research Documentation, Inc.
Date: 05-2021
Intervention to Prevent Major Depression in Primary Care
Publisher: American College of Physicians
Date: 29-03-2016
DOI: 10.7326/M14-2653
Bridging knowledge, policies and practices across the ageing and disability fields: a protocol for a scoping review to inform the development of a taxonomy
Publisher: BMJ
Date: 10-2017
DOI: 10.1136/BMJOPEN-2017-016741
Abstract: Bridging is a term used to describe activities, or tasks, used to promote collaboration and knowledge exchange across fields. This paper reports the protocol for a scoping review which aims to identify and characterise peer reviewed evidence describing bridging activities, between the ageing and disability fields. The purpose is to clarify the concepts underpinning bridging to inform the development of a taxonomy, and identify research strengths and gaps. A scoping review will be conducted. We will search Medline, Cumulative Index to Nursing and Allied Health Literature, Embase, PsycInfo, Sociological Abstracts and the Cochrane Library, to identify peer reviewed publications (reviews, experimental, observational, qualitative designs and expert commentaries) describing bridging activities. Grey literature, and articles not published in English will be excluded. Two investigators will independently complete article selection and data abstraction to minimise bias. A data extraction form will be iteratively developed and information from each publication will be extracted: (1) bibliographic, (2) methodological, (3) demographic, and (4) bridging information. Qualitative content analysis will be used to describe key concepts related to bridging. To our knowledge, this will be the first scoping review to describe bridging of ageing and disability knowledge, services and policies. The findings will inform the development of a taxonomy to define models of bridging that can be implemented and further evaluated to enable integrated care and improve systems and services for those ageing with disability. Ethics is not required because this is a scoping review of published literature. Findings will be disseminated through stakeholder meetings, conference presentations and peer reviewed publication.
The WHO construct of health-related functioning (HrF) and its implications for health policy
Publisher: Springer Science and Business Media LLC
Date: 2011
Stepped mental health care model leading Australia astray
Publisher: SAGE Publications
Date: 29-05-2020
Patterns of Mental Health Care in Remote Areas: Kimberley (Australia), Nunavik (Canada), and Lapland (Finland): Modèles de soins de santé mentale dans les régions éloignées: Kimberley (Australie), Nunavik (Canada) et Laponie (Finlande)
Publisher: SAGE Publications
Date: 28-07-2020
Abstract: Mental health (MH) care in remote areas is frequently scarce and fragmented and difficult to compare objectively with other areas even in the same country. This study aimed to analyze the adult MH service provision in 3 remote areas of Organization for Economic Cooperation and Development countries in the world. We used an internationally agreed set of systems indicators, terminology, and classification of services (Description and Evaluation of Services and DirectoriEs for Long Term Care). This instrument provided a standard description of MH care provision in the Kimberley region (Australia), Nunavik (Canada), and Lapland (Finland), areas characterized by an extremely low population density and high relative rates of Indigenous peoples. All areas showed high rates of deprivation within their national contexts. MH services were mostly provided by the public sector supplemented by nonprofit organizations. This study found a higher provision per inhabitant of community residential care in Nunavik in relation to the other areas higher provision of community outreach services in the Kimberley and a lack of day services except in Lapland. Specific cultural-based services for the Indigenous population were identified only in the Kimberley. MH care in Lapland was self-sufficient, and its care pattern was similar to other Finnish areas, while the Kimberley and Nunavik differed from the standard pattern of care in their respective countries and relied partly on services located outside their boundaries for treating severe cases. We found common challenges in these remote areas but a huge ersity in the patterns of MH care. The implementation of care interventions should be locally tailored considering both the environmental characteristics and the existing pattern of service provision.
Strategies for Implementing Occupational eMental Health Interventions: Scoping Review
Publisher: JMIR Publications Inc.
Date: 06-2022
DOI: 10.2196/34479
Abstract: The implementation of eMental health interventions, especially in the workplace, is a complex process. Therefore, learning from existing implementation strategies is imperative to ensure improvements in the adoption, development, and scalability of occupational eMental health (OeMH) interventions. However, the implementation strategies used for these interventions are often undocumented or inadequately reported and have not been systematically gathered across implementations in a way that can serve as a much-needed guide for researchers. The objective of this scoping review was to identify implementation strategies relevant to the uptake of OeMH interventions that target employees and detail the associated barriers and facilitation measures. A scoping review was conducted. The descriptive synthesis was guided by the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework and the Consolidated Framework for Implementation Research. A total of 31 of 32,916 (0.09%) publications reporting the use of the web-, smartphone-, telephone-, and email-based OeMH interventions were included. In all, 98 implementation strategies, 114 barriers, and 131 facilitators were identified. The synthesis of barriers and facilitators produced 19 facilitation measures that provide initial recommendations for improving the implementation of OeMH interventions. This scoping review represents one of the first steps in a research agenda aimed at improving the implementation of OeMH interventions by systematically selecting, shaping, evaluating, and reporting implementation strategies. There is a dire need for improved reporting of implementation strategies and combining common implementation frameworks with more technology-centric implementation frameworks to fully capture the complexities of eHealth implementation. Future research should investigate a wider range of common implementation outcomes for OeMH interventions that also focus on a wider set of common mental health problems in the workplace. This scoping review’s findings can be critically leveraged by discerning decision-makers to improve the reach, effectiveness, adoption, implementation, and maintenance of OeMH interventions.
Role of visual analytics in supporting mental healthcare systems research and policy: A systematic scoping review
Publisher: Elsevier BV
Date: 02-2020
A European classification of services for long-term care—the EU-project eDESDE-LTC
Publisher: Ubiquity Press, Ltd.
Date: 31-12-2009
DOI: 10.5334/IJIC.441
Mental health systems modelling for evidence-informed service reform in Australia
Publisher: SAGE Publications
Date: 14-05-2023
DOI: 10.1177/00048674231172113
Abstract: Australia’s Fifth National Mental Health Plan required governments to report, not only on the progress of changes to mental health service delivery, but to also plan for services that should be provided. Future population demand for treatment and care is challenging to predict and one solution involves modelling the uncertain demands on the system. Modelling can help decision-makers understand likely future changes in mental health service demand and more intelligently choose appropriate responses. It can also support greater scrutiny, accountability and transparency of these processes. Australia has an emerging national capacity for systems modelling in mental health which can enhance the next phase of mental health reform. This paper introduces concepts useful for understanding mental health modelling and identifies where modelling approaches can support health service planners to make evidence-informed decisions regarding planning and investment for the Australian population.
Intellectual developmental disorder and autism spectrum disorder in the WPA next triennium mainstream
Publisher: Wiley
Date: 11-05-2020
DOI: 10.1002/WPS.20727
Caregiver Mental Health, Parenting Practices, and Perceptions of Child Attachment in Children with Autism Spectrum Disorder
Publisher: Springer Science and Business Media LLC
Date: 02-03-2018
DOI: 10.1007/S10803-018-3517-X
Abstract: This paper investigates the role of caregiver mental health and parenting practices as predictors of attachment in children with intellectual disability/developmental delay, comparing between children with ASD (n = 29) and children with other developmental disabilities (n = 20). Parents reported that children with ASD had high levels of anxiety and stress, and attachment insecurity in children (less closeness and more conflict in attachment relationships, and more inhibited attachment behaviours) compared with children with other developmental disabilities. Children's attachment quality was associated with parenting practices and the presence of an ASD diagnosis. These results highlight the bidirectional nature of the quality of caregiving environments and attachment in children with ASD, and also provide a strong rationale for targeting children's attachment quality in early interventions.
Prevalence of electronic nicotine delivery systems and electronic non-nicotine delivery systems in children and adolescents: a systematic review and meta-analysis
Publisher: Elsevier BV
Date: 09-2021
No service is an island: towards an ecosystem approach to mental health service evaluation
Publisher: Wiley
Date: 07-05-2022
DOI: 10.1002/WPS.20963
P.4.a.013 Cost of illness of generalized anxiety disorder: a perspective from the primary health-care setting (The ANCORA study)
Publisher: Elsevier BV
Date: 10-2007
Bridging experience and evidence in mental health care reform
Publisher: Wiley
Date: 06-2008
In search of an integrative measure of functioning
Publisher: MDPI AG
Date: 26-05-2015
“Brain-Doping,” Is It a Real Threat?
Publisher: Frontiers Media SA
Date: 24-04-2019
Association of Borderline Intellectual Functioning and Adverse Childhood Experience with adult psychiatric morbidity. Findings from a British birth cohort
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S12888-019-2376-0
Abstract: To examine whether Borderline Intellectual Functioning (BIF) and Adverse Childhood Experiences independently predict adult psychiatric morbidity. We performed a secondary analysis of longitudinal data derived from the 1970 British Birth Cohort Study to examine whether BIF and Adverse Childhood Experiences independently predict adult mental distress as measured by the Malaise Inventory. Factor analysis was used to derive a proxy measure of IQ from cognitive testing at age 10 or 5. Variables that could be indicators of exposure to Adverse Childhood Experiences were identified and grouped into health related and socio-economic related adversity. Children with BIF were significantly more likely than their peers to have been exposed to Adverse Childhood Experiences (BIF mean 5.90, non-BIF mean 3.19 Mann-Whitney z = 31.74, p 0.001). As adults, participants with BIF were significantly more likely to score above the cut-off on the Malaise Inventory. We found statistically significant relationships between the number of socio-economic Adverse Childhood Experiences and poorer adult psychiatric morbidity (r range 0.104–0.141, all p 001). At all ages the indirect mediating effects of Adverse Childhood Experiences were significantly related to adult psychiatric morbidity. The relationship between BIF and adult psychiatric morbidity appears to be partially mediated by exposure to Adverse Childhood Experiences. Where possible, targeting Adverse Childhood Experiences through early detection, prevention and interventions may improve psychiatric morbidity in this population group.
Changes in socioeconomic determinants of health: comparing the effect of social and economic indicators through European welfare state regimes
Publisher: Springer Science and Business Media LLC
Date: 10-05-2014
“Intellectual developmental disorders”: reflections on the international consensus document for redefining “mental retardation-intellectual disability” in ICD-11
Publisher: Emerald
Date: 04-01-2016
DOI: 10.1108/AMHID-10-2015-0050
Abstract: – The debate as to whether intellectual disability (ID) should be conceptualized as a health condition or as a disability has intensified as the revision of World Health Organization’s (WHO’s) International Classification of Diseases (ICD) is being finalized. Defining ID as a health condition is central to retaining it in ICD, with significant implications for health policy and access to health services. The purpose of this paper is to include some reflections on the consensus document produced by the first WHO Working Group on the Classification of MR (WHO WG-MR) and on the process that was followed to realize it. The consensus report was the basis for the development of official recommendations sent to the WHO Advisory Group for ICD-11. – A mixed qualitative approach was followed in a series of meetings leading to the final consensus report submitted to the WHO Advisory group. These recommendations combined prior expert knowledge with available evidence a nominal approach was followed throughout with face-to-face conferences. – The WG recommended a synonym set (“synset”) ontological approach to the conceptualisation of this health condition underlying a clinical rationale for its diagnosis. It proposed replacing MR with Intellectual Developmental Disorders (IDD) in ICD-11, defined as “a group of developmental conditions characterized by a significant impairment of cognitive functions, which are associated with limitations of learning, adaptive behaviour and skills”. The WG further advised that IDD be included under the parent category of neurodevelopmental disorders, that current distinctions (mild, moderate, severe and profound) be continued as severity qualifiers, and that problem behaviours removed from its core classification structure and instead described as associated features. – Within the ID/IDD synset two different names combine distinct aspects under a single construct that describes its clinical as well as social, educational and policy utilities. The single construct incorporates IDD as a clinical meta-syndrome, and ID as its functioning and disability counterpart. IDD and ID are not synonymous or mirror concepts as they have different scientific, social and policy applications. New diagnostic criteria for IDD should be based on a developmental approach, which accounts for the complex causal factors known to impact the acquisition of specific cognitive abilities and adaptive behaviours. The paper focuses on a new clinical framework for the diagnosis of IDD that also includes and complements the existing social, educational and policy components inherent in ID.
In Search for Comparability: The PECUNIA Reference Unit Costs for Health and Social Care Services in Europe
Publisher: MDPI AG
Date: 16-03-2022
Abstract: Improving the efficiency of mental healthcare service delivery by learning from international best-practice ex les requires valid data, including robust unit costs, which currently often lack cross-country comparability. The European ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions (PECUNIA) aimed to harmonize the international unit cost development. This article presents the methodology and set of 36 externally validated, standardized reference unit costs (RUCs) for five health and social care services (general practitioner, dentist, help-line, day-care center, nursing home) in Austria, England, Germany, Hungary, The Netherlands, and Spain based on unambiguous service definitions using the extended DESDE PECUNIA coding framework. The resulting PECUNIA RUCs are largely comparable across countries, with any causes for deviations (e.g., country-specific scope of services) transparently documented. Even under standardized methods, notable limitations due to data-driven ergences in key costing parameters remain. Increased cross-country comparability by adopting a uniform methodology and definitions can advance the quality of evidence-based policy guidance derived from health economic evaluations. The PECUNIA RUCs are available free of charge and aim to significantly improve the quality and feasibility of future economic evaluations and their transferability across mental health systems.
Guidelines for depot antipsychotic treatment in schizophrenia
Publisher: Elsevier BV
Date: 02-1998
DOI: 10.1016/S0924-977X(97)00045-X
Abstract: These guidelines for depot antipsychotic treatment in schizophrenia were developed during a two-day consensus conference held on July 29 and 30, 1995 in Siena, Italy. Depot antipsychotic medications were developed in the 1960s as an attempt to improve the long-term treatment of schizophrenia (and potentially other disorders benefiting from long-term antipsychotic medication). Depot drugs as distinguishable from shorter acting intramuscularly administered agents can provide a therapeutic concentration of at least a seven day duration in one parenteral dose. The prevention of relapse in schizophrenia remains an enormous public health challenge worldwide and improvements in this area can have tremendous impact on morbidity, mortality and quality of life, as well as direct and indirect health care costs. Though there has been debate as to what extent depot (long-acting injectable) antipsychotics are associated with significantly fewer relapses and rehospitalizations, in our view when all of the data from in idual trials and metaanalyses are taken together, the findings are extremely compelling in favor of depot drugs. However in many countries throughout the world fewer than 20% of in iduals with schizophrenia receive these medications. The major advantage of depot antipsychotics over oral medication is facilitation of compliance in medication taking. Non-compliance is very common among patients with schizophrenia and is a frequent cause of relapse. In terms of adverse effects, there are not convincing data that depot drugs are associated with a significantly higher incidence of adverse effects than oral drugs. Therefore in our opinion any patient for whom long-term antipsychotic treatment is indicated should be considered for depot drugs. In choosing which drug the clinician should consider previous experience, personal patient preference, patients history of response (both therapeutic and adverse effects) and pharmacokinetic properties. In conclusion the use of depot antipsychotics has important advantages in facilitating relapse prevention. Certainly pharmacotherapy must be combined with other treatment modalities as needed, but the consistent administration of the former is often what enables the latter.
International experiences of the active period of COVID-19 - Mental health care
Publisher: Elsevier BV
Date: 12-2020
Cost of disorders of the brain in Europe 2010
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.EURONEURO.2011.08.008
Abstract: The spectrum of disorders of the brain is large, covering hundreds of disorders that are listed in either the mental or neurological disorder chapters of the established international diagnostic classification systems. These disorders have a high prevalence as well as short- and long-term impairments and disabilities. Therefore they are an emotional, financial and social burden to the patients, their families and their social network. In a 2005 landmark study, we estimated for the first time the annual cost of 12 major groups of disorders of the brain in Europe and gave a conservative estimate of €386 billion for the year 2004. This estimate was limited in scope and conservative due to the lack of sufficiently comprehensive epidemiological and/or economic data on several important diagnostic groups. We are now in a position to substantially improve and revise the 2004 estimates. In the present report we cover 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items. We therefore present much improved cost estimates. Our revised estimates also now include the new EU member states, and hence a population of 514 million people. To estimate the number of persons with defined disorders of the brain in Europe in 2010, the total cost per person related to each disease in terms of direct and indirect costs, and an estimate of the total cost per disorder and country. The best available estimates of the prevalence and cost per person for 19 groups of disorders of the brain (covering well over 100 specific disorders) were identified via a systematic review of the published literature. Together with the twelve disorders included in 2004, the following range of mental and neurologic groups of disorders is covered: addictive disorders, affective disorders, anxiety disorders, brain tumor, childhood and adolescent disorders (developmental disorders), dementia, eating disorders, epilepsy, mental retardation, migraine, multiple sclerosis, neuromuscular disorders, Parkinson's disease, personality disorders, psychotic disorders, sleep disorders, somatoform disorders, stroke, and traumatic brain injury. Epidemiologic panels were charged to complete the literature review for each disorder in order to estimate the 12-month prevalence, and health economic panels were charged to estimate best cost-estimates. A cost model was developed to combine the epidemiologic and economic data and estimate the total cost of each disorder in each of 30 European countries (EU27+Iceland, Norway and Switzerland). The cost model was populated with national statistics from Eurostat to adjust all costs to 2010 values, converting all local currencies to Euro, imputing costs for countries where no data were available, and aggregating country estimates to purchasing power parity adjusted estimates for the total cost of disorders of the brain in Europe 2010. The total cost of disorders of the brain was estimated at €798 billion in 2010. Direct costs constitute the majority of costs (37% direct healthcare costs and 23% direct non-medical costs) whereas the remaining 40% were indirect costs associated with patients' production losses. On average, the estimated cost per person with a disorder of the brain in Europe ranged between €285 for headache and €30,000 for neuromuscular disorders. The European per capita cost of disorders of the brain was €1550 on average but varied by country. The cost (in billion €PPP 2010) of the disorders of the brain included in this study was as follows: addiction: €65.7 anxiety disorders: €74.4 brain tumor: €5.2 child/adolescent disorders: €21.3 dementia: €105.2 eating disorders: €0.8 epilepsy: €13.8 headache: €43.5 mental retardation: €43.3 mood disorders: €113.4 multiple sclerosis: €14.6 neuromuscular disorders: €7.7 Parkinson's disease: €13.9 personality disorders: €27.3 psychotic disorders: €93.9 sleep disorders: €35.4 somatoform disorder: €21.2 stroke: €64.1 traumatic brain injury: €33.0. It should be noted that the revised estimate of those disorders included in the previous 2004 report constituted €477 billion, by and large confirming our previous study results after considering the inflation and population increase since 2004. Further, our results were consistent with administrative data on the health care expenditure in Europe, and comparable to previous studies on the cost of specific disorders in Europe. Our estimates were lower than comparable estimates from the US. This study was based on the best currently available data in Europe and our model enabled extrapolation to countries where no data could be found. Still, the scarcity of data is an important source of uncertainty in our estimates and may imply over- or underestimations in some disorders and countries. Even though this review included many disorders, diagnoses, age groups and cost items that were omitted in 2004, there are still remaining disorders that could not be included due to limitations in the available data. We therefore consider our estimate of the total cost of the disorders of the brain in Europe to be conservative. In terms of the health economic burden outlined in this report, disorders of the brain likely constitute the number one economic challenge for European health care, now and in the future. Data presented in this report should be considered by all stakeholder groups, including policy makers, industry and patient advocacy groups, to reconsider the current science, research and public health agenda and define a coordinated plan of action of various levels to address the associated challenges. Political action is required in light of the present high cost of disorders of the brain. Funding of brain research must be increased care for patients with brain disorders as well as teaching at medical schools and other health related educations must be quantitatively and qualitatively improved, including psychological treatments. The current move of the pharmaceutical industry away from brain related indications must be halted and reversed. Continued research into the cost of the many disorders not included in the present study is warranted. It is essential that not only the EU but also the national governments forcefully support these initiatives.
Exploring Health Care Professionals’ Knowledge of, Attitudes Towards, and Confidence in Caring for People at Risk of Suicide: a Systematic Review
Publisher: Informa UK Limited
Date: 22-04-2019
DOI: 10.1080/13811118.2019.1586608
Abstract: Health care professionals are paramount to the prevention and management of suicidal thoughts and behaviors. Confidence in caring for people at risk of suicidal thoughts and behaviors is influenced by knowledge of and attitudes towards suicide. This systematic review aimed to explore health care professionals' knowledge of and attitudes towards suicide, as well as, their confidence in caring for people at risk of suicidal thoughts and behaviors. A systematic search of 4 electronic databases over 10 years was conducted. Following retrieval of 1,723 abstracts, 46 primary research publications were included, involving both cross-sectional (n = 27) and intervention study designs (n = 19). Knowledge of, attitudes towards, and confidence in caring for people at risk of suicidal thoughts and behaviors were explored among primary health care professionals, specialists, and health care students. The influence of training and education, type of health care professional, country of practice, and prior experience with suicide were highlighted among included studies. Health care professionals' knowledge of, attitudes towards and confidence in caring for people at risk of suicide are complex, interrelated constructs that shape their behaviors and may impact patient outcomes. Suicide training and education is necessary within health care curricula and as part of health care professionals' continuing professional development.
Rapid response to crisis: Health system lessons from the active period of COVID-19
Publisher: Elsevier BV
Date: 12-2020
A reliability study of the Spanish version of the Social Behaviour Schedule (SBS) in a population of adults with learning disabilities
Publisher: Wiley
Date: 02-1998
DOI: 10.1046/J.1365-2788.1998.00070.X
Abstract: The reliability of the Spanish version of the Social Behaviour Schedule (SBS) was tested in a vocational setting on a s le of 64 subjects with learning disabilities. Test-retest assessment showed a good percentage of agreement (80%) and adequate kappa values for most SBS items. The overall percentage of agreement of inter-rater reliability was 85% and kappa values were moderate to nearly perfect for 52% of items. Inter-informant analyses produced poorer results, with an average agreement of 43% and inadequate kappa values on 42% of items. The intraclass correlation coefficient (ICC) was 0.64 for test-retest, 0.76 for inter-rater assessment and 0.94 for inter-informant assessment. The Spearman correlation coefficient was adequate on the test-retest and inter-rater analyses, but not on inter-informant analysis. This low inter-informant agreement could be attributed to environmental factors which alter the reliability of reports from different informants in community settings with high levels of normalization. In such environments, an interview with a key informant may not suffice, and both a careful review of the clinical record and a direct interview with subjects may enhance the reliability of the information attained.
Semiology and subtyping of panic disorders
Publisher: Wiley
Date: 04-1998
DOI: 10.1111/J.1600-0447.1998.TB09999.X
Abstract: To date, the quantitative psychopathology of panic disorder (PD) has been less well studied than that of other psychiatric conditions such as schizophrenia or major depression. The aim of the present study was to assess the frequency and factorial grouping of symptoms in a naturalistic s le of PD patients. A total of 274 consecutive cases of PD who contacted an out-patient clinic in Barcelona, Spain were assessed by two experienced interviewers. The assessment instruments included the Structured Clinical Interview for DSM-III-R Upjohn version (SCID-UP-R) and an inventory of panic attack symptoms based on DSM-III-R. Of the patients who presented at the unit during the assessment period, 8.5% presented with PD. Palpitations, shortness of breath, fear of dying and dizziness were the most frequent and intense symptoms reported by the PD patients. Principal-component analysis revealed four factors which accounted for 57% of the variance, including 'cardiorespiratory' (26.1%) and 'vestibular' (15.1%) factors, and two additional factors with mixed symptoms. The frequency of presentation of symptoms was similar to that reported in other studies. However, some discrepancies were observed that may be attributed to transcultural differences as well as to terminological problems and the range of symptoms assessed. These factors may also explain some of the differences found in factor analysis groupings in previous studies. Our findings support the symptom subtyping of PD.
Benzodiazepine-mediated overactivation of 5-HT2 behavioural responses in rodents
Publisher: Elsevier BV
Date: 06-1996
Hydrogen supply scenarios for a climate neutral energy system in Germany
Publisher: Elsevier BV
Date: 04-2022
Use of geographical information systems in multiple sclerosis research: A systematic scoping review
Publisher: Elsevier BV
Date: 06-2021
Differential impact of current diagnosis and clinical stage on attendance at a youth mental health service
Publisher: Wiley
Date: 28-01-2017
DOI: 10.1111/EIP.12319
Abstract: To examine whether clinical stage of illness and current diagnosis influence appointment behaviour in a specialized primary-level youth mental health service. Factors associated with attendance at 8697 appointments made by 828 young people (females = 497) aged 12-25 years over a 1-year period were analysed. The number of appointments made did not correlate with the rates of attendance. However, those with more severe psychiatric morbidity made significantly more appointments and missed significantly more appointments than those with less severe presentations. Impaired social functioning was the best predictor of female attendance rates, whereas age and clinical stage of illness best predicted male attendance rates. Current diagnosis rather than functional impairment appeared to influence the level of input offered by clinicians. Age, gender, severity of illness, functioning and psychological distress had differential associations with both planned treatment intensity and attendance rates. These differences are likely to have implications for service provision in this youth population.
Peripheral lung function in patients with stable and unstable asthma
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.JACI.2013.01.054
Abstract: Exacerbations of asthma are thought to be caused by airflow obstruction resulting from airway inflammation, bronchospasm, and mucus plugging. Histologic evidence suggests the small airways, including acinar air spaces, are involved however, this has not been corroborated in vivo by measurements of peripheral small-airway function. We sought to determine whether asthma severity is linked to small-airway function, particularly in patients with acute severe asthma. Eighteen subjects admitted for an asthma exacerbation underwent lung function testing, including measures of acinar ventilation heterogeneity (S(acin)) and conductive ventilation heterogeneity (S(cond)) using the multiple-breath nitrogen washout. Treatment requirement was defined according to Global Initiative for Asthma scores. Data were compared with those obtained in 19 patients with stable asthma. For the asthma exacerbation group, the median FEV1 was 59% of predicted value (95% CI, 45% to 75% of predicted value), the median S(cond) value was 185% of predicted value (95% CI, 119% to 245% of predicted value), and the median S(acin) value was 225% of predicted value (95% CI, 143% to 392% of predicted value). FEV1 (percent predicted) was correlated with S(acin) (percent predicted) values (Spearman rho = -0.67, P = .006) but not with S(cond) (percent predicted) values (P > .1). The Global Initiative for Asthma score was significantly related to S(acin) (percent predicted) (Spearman rho = 0.59, P = .016) but not to S(cond) (percent predicted) values (P > .1). The unstable group was characterized by considerably lower forced vital capacity (P < .001) and higher S(cond) (P = .001) values than the unstable group. In a subgroup of 11 unstable patients who could be reviewed after 4 weeks, FEV1, forced vital capacity, S(acin), and S(cond) values showed marked improvements. Our findings suggest that unstable asthma is characterized by a combined abnormality in the acinar and conductive lung zones, both of which are partly reversible. Functional abnormality in the acinar lung zone in particular showed a direct correlation with airflow obstruction and treatment requirement in patients with acute severe asthma.
Routine outcome assessment in mental health research
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-1999
Evaluación del impacto de un plan multisectorial de promoción de la salud y el bienestar social en Andalucía
Publisher: Elsevier BV
Date: 11-2020
DOI: 10.1016/J.GACETA.2019.01.001
Abstract: To evaluate the impact of the Plan for the promotion of personal autonomy and prevention of disability in Andalusia (2016-2020) in 13 public administrations during the first year of its implementation and to analyse the usability and feasibility of the impact assessment ladder used. The Plan addresses the promotion of personal autonomy and the prevention of disabilities and dependencies through a multisectoral approach. It is structured in strands or lines of work, objectives and actions that have been assessed through the Adoption Impact Ladder (AIL). The analysis of the face validity, feasibility and inter-rater reliability of the impact assessment ladder was carried out in 30 actions of the Plan that were rated by 20 experts from the 13 ministries and public agencies involved in the Plan, and an external rater. 176 actions and programmes were launched in 2017. Of these, 67.2% were implemented during the first year. Only one of the 16 objectives had no action initiated during the first year. Moreover, 7 out of 15 objectives implemented were fully multisectoral involving more than three Regional Ministries. The face validity, feasibility and inter-rater reliability of the AIL were good (κ: 0.72). This Plan has provided a novel framework to coordinate a broad range of proposed policies and actions within the public administration of Andalusia. For the first time, a multisectoral impact analysis has been conducted providing an effective guide for monitoring, planning and setting public priorities in health, social services, ageing and disabilities.
Hidden psychiatric morbidity in a vocational programme for people with intellectual disability
Publisher: Wiley
Date: 04-2000
DOI: 10.1046/J.1365-2788.2000.00272.X
Abstract: The aim of the present study was to assess the point-prevalence of psychiatric disorders according to DSM-III-R criteria and the hidden morbidity in in iduals with intellectual disability working in a vocational setting. The present study was carried out in a vocational centre in Southern Spain which is considered to be a model for social integration. One hundred and thirty workers with intellectual disability were interviewed by two experienced clinicians using the Assessment and Information Rating Profile, DSM-III-R criteria, and the General Assessment of Functioning and Clinical Global Impression scales. The point-prevalence of psychiatric morbidity, hidden morbidity and treatment adequacy were estimated. Morbidity was hidden (i.e. not previously diagnosed) in 50% of psychiatric cases. Forty-two (32.3%) subjects had a psychiatric diagnosis with the following distribution: schizophrenia (17.7%), other psychotic disorders (9.23%), mood disorders (4.61%), adaptive disorders (2.31%), anxiety disorders (1.54%) and other psychiatric disorders (6.15%). Treatment was judged inadequate in 30% of subjects. The point-prevalence of psychiatric problems in a vocational setting in Spain was similar to that found in other environments. Hidden morbidity was similar to that found in primary care. The present study highlights the need for standardized instruments for psychiatric assessment in non-clinical settings as well as specific training in this area.
Knowledge-in-practice in the care professions: multidisciplinary perspectives
Publisher: Ubiquity Press, Ltd.
Date: 15-09-2010
DOI: 10.5334/IJIC.569
Description and classification of mental health services: a European perspective
Publisher: Cambridge University Press (CUP)
Date: 11-1998
DOI: 10.1016/S0924-9338(99)80699-3
Abstract: Whilst steady progress has been made in the development and dissemination of valid and reliable instruments for evaluation of patient outcomes, progress in establishing standard methodologies for description and classification of mental health services has been limited. Valid and reliable methods of describing and classifying services are needed in mental health services research for purposes including i) comparison of levels of provision between catchment areas and countries ii) reaching an understanding of the relationship between socio-demographic indicators and service use iii) investigation of the degree to which one service may be substituted for another iv) evaluating programme implementation and v) understanding why different outcomes are observed from apparently similar treatment programmes. Where programmes of research encompass different countries, the need for methods of comparing the local service contexts is particularly acute. In this paper, the various contributions which have been made to the somewhat fragmented body of research in this area are reviewed, and the problems which have h ered the development of satisfactory instruments are discussed. A set of criteria for satisfactory service measurement methodologies is proposed: these include development of standard nomenclature and operational definitions of service types clear demonstration of validity and reliability comprehensiveness and applicability and similar interpretation in a range of countries.
The impact of living arrangements and deinstitutionalisation in the health status of persons with intellectual disability in Europe
Publisher: Wiley
Date: 05-07-2011
Analysis of the mental health service provision in Qatar: Progressing in community mental health in a Middle East country
Publisher: Frontiers Media SA
Date: 16-12-2022
DOI: 10.3389/FPSYT.2022.1095788
Abstract: Qatari health planning in the last decade aimed to make the transition from the traditional hospital-based psychiatric care to a community-based care, building an integrated and comprehensive mental health system. The objective of this study was to explore the mental health service provision in Qatar in 2018 and 2022. This time span coincided with two mental health plans (2013–2018 and 2019–2022) and one health plan (2018–2022). This study followed a healthcare ecosystem approach, including context analysis and the standard description and classification of mental health services. Service provision was studied applying DESDE-LTC system (Description and Evaluation of Services and DirectoriEs–Long Term Care), an internationally validated methodology to assess and describe mental health services. Service data were analyzed along with sociodemographic indicators from public statistics to know the care context. The availability of specialized mental health services increased for adults, although it remained the same for other age groups. The ersity of care and the weight of health-related care over social-related care also remained quite similar. It was noteworthy the development of new services for young adults, migrant workers, and female populations. This was the first time that this service research methodology has been applied in a Middle East country to study its mental healthcare pattern. The analysis of the mental healthcare pattern in the study time period showed the continued progress toward community-based care in Qatar in the framework of three health plans and despite the unexpected COVID-19 world pandemic.
Blended human-technology service realities in healthcare
Publisher: Emerald
Date: 04-01-2022
DOI: 10.1108/JSTP-12-2020-0285
Abstract: The healthcare sector is experiencing a major paradigm shift toward a people-centered approach. The key issue with transitioning to a people-centered approach is a lack of understanding of the ever-increasing role of technology in blended human-technology healthcare interactions and the impacts on healthcare actors' well-being. The purpose of the paper is to identify the key mechanisms and influencing factors through which blended service realities affect engaged actors' well-being in a healthcare context. This conceptual paper takes a human-centric perspective and a value co-creation lens and uses theory synthesis and adaptation to investigate blended human-technology service realities in healthcare services. The authors conceptualize three blended human-technology service realities – human-dominant, balanced and technology-dominant – and identify two key mechanisms – shared control and emotional-social and cognitive complexity – and three influencing factors – meaningful human-technology experiences, agency and DART (dialogue, access, risk, transparency) – that affect the well-being outcome of engaged actors in these blended human-technology service realities. Managerially, the framework provides a useful tool for the design and management of blended human-technology realities. The paper explains how healthcare services should pay attention to management and interventions of different services realities and their impact on engaged actors. Blended human-technology reality ex les – telehealth, virtual reality (VR) and service robots in healthcare – are used to support and contextualize the study’s conceptual work. A future research agenda is provided. This study contributes to service literature by developing a new conceptual framework that underpins the mechanisms and factors that influence the relationships between blended human-technology service realities and engaged actors' well-being.
Cost‐effectiveness of different clinical interventions for reducing the burden of schizophrenia in Spain
Publisher: Wiley
Date: 07-11-2006
DOI: 10.1111/J.1600-0447.2006.00917.X
Abstract: To estimate the cost-effectiveness of interventions for reducing the burden of schizophrenia in Spain. The study examined the cost-effectiveness of seven different types of clinical interventions at the level of Spanish population: i) current situation ii) older antipsychotics alone iii) new antipsychotics alone (risperidone) iv) older antipsychotics plus psychosocial treatment v) new antipsychotics plus psychosocial treatment vi) older antipsychotics plus case management and psychosocial treatment vii) new antipsychotics plus case management and psychosocial treatment. Interventions based on the combination of haloperidol with psychosocial treatment or psychosocial treatment plus case management proved to be the most efficient strategies. The relatively modest additional cost of concurrent psychosocial treatment has significant health gains, thereby making such a combined strategy for schizophrenia more cost-effective than pharmacology alone.
Development and validation of a prediction algorithm for the onset of common mental disorders in a working population
Publisher: SAGE Publications
Date: 12-04-2018
Abstract: Common mental disorders are the most common reason for long-term sickness absence in most developed countries. Prediction algorithms for the onset of common mental disorders may help target indicated work-based prevention interventions. We aimed to develop and validate a risk algorithm to predict the onset of common mental disorders at 12 months in a working population. We conducted a secondary analysis of the Household, Income and Labour Dynamics in Australia Survey, a longitudinal, nationally representative household panel in Australia. Data from the 6189 working participants who did not meet the criteria for a common mental disorders at baseline were non-randomly split into training and validation databases, based on state of residence. Common mental disorders were assessed with the mental component score of 36-Item Short Form Health Survey questionnaire (score ⩽45). Risk algorithms were constructed following recommendations made by the Transparent Reporting of a multivariable prediction model for Prevention Or Diagnosis statement. Different risk factors were identified among women and men for the final risk algorithms. In the training data, the model for women had a C-index of 0.73 and effect size (Hedges' g) of 0.91. In men, the C-index was 0.76 and the effect size was 1.06. In the validation data, the C-index was 0.66 for women and 0.73 for men, with positive predictive values of 0.28 and 0.26, respectively Conclusion: It is possible to develop an algorithm with good discrimination for the onset identifying overall and modifiable risks of common mental disorders among working men. Such models have the potential to change the way that prevention of common mental disorders at the workplace is conducted, but different models may be required for women.
Use of functioning-disability and dependency for case-mix and subtyping of schizophrenia
Publisher: SciELO Espana/Repisalud
Date: 03-2012
Psychometric Properties of Spanish Adaptation of the PDD-MRS Scale in Adults with Intellectual Developmental Disorders: The EVTEA-DI Scale
Publisher: Springer Science and Business Media LLC
Date: 29-11-2017
DOI: 10.1007/S10803-017-3416-6
Abstract: Strategies for the early detection of autism spectrum disorders (ASD) in people with intellectual developmental disorder (IDD) are urgently needed, but few specific tools have been developed. The present study examines the psychometric properties of the EVTEA-DI, a Spanish adaptation of the PDD-MRS, in a large randomized s le of 979 adults with IDD. Factorial solution analysis suggested a three-factor solution (stereotyped behavior, communication, and social behavior). The EVTEA-DI showed good reliability and convergent validity when compared to the Childhood Autism Rating Scale. Discriminative validity analysis resulted in an acceptable global sensitivity of 70% and a high specificity of 90%. The EVTEA-DI proved to be a valid screening tool in ASD assessment of the adult Spanish population with IDD.
International guide to prescribing psychotropic medication for the management of problem behaviours in adults with intellectual disabilities
Publisher: Wiley
Date: 10-2009
Structural modeling of tissue-specific mitochondrial alanyl-tRNA synthetase (AARS2) defects predicts differential effects on aminoacylation
Publisher: Frontiers Media SA
Date: 06-02-2015
Basic Concepts in the Taxonomy of Health-Related Behaviors, Habits and Lifestyle
Publisher: MDPI AG
Date: 13-05-2013
Magnitude of terminological bias in international health services research: a disambiguation analysis in mental health
Publisher: Cambridge University Press (CUP)
Date: 2022
DOI: 10.1017/S2045796022000403
Abstract: Health services research (HSR) is affected by a widespread problem related to service terminology including non-commensurability (using different units of analysis for comparisons) and terminological unclarity due to ambiguity and vagueness of terms. The aim of this study was to identify the magnitude of the terminological bias in health and social services research and health economics by applying an international classification system. This study, that was part of the PECUNIA project, followed an ontoterminology approach (disambiguation of technical and scientific terms using a taxonomy and a glossary of terms). A listing of 56 types of health and social services relevant for mental health was compiled from a systematic review of the literature and feedback provided by 29 experts in six European countries. The disambiguation of terms was performed using an ontology-based classification of services (Description and Evaluation of Services and DirectoriEs – DESDE), and its glossary of terms. The analysis focused on the commensurability and the clarity of definitions according to the reference classification system. Interrater reliability was analysed using κ . The disambiguation revealed that only 13 terms (23%) of the 56 services selected were accurate. Six terms (11%) were confusing as they did not correspond to services as defined in the reference classification system (non-commensurability bias), 27 (48%) did not include a clear definition of the target population for which the service was intended, and the definition of types of services was unclear in 59% of the terms: 15 were ambiguous and 11 vague. The κ analyses were significant for agreements in unit of analysis and assignment of DESDE codes and very high in definition of target population. Service terminology is a source of systematic bias in health service research, and certainly in mental healthcare. The magnitude of the problem is substantial. This finding has major implications for the international comparability of resource use in health economics, quality and equality research. The approach presented in this paper contributes to minimise differentiation between services by taking into account key features such as target population, care setting, main activities and type and number of professionals among others. This approach also contributes to support financial incentives for effective health promotion and disease prevention. A detailed analysis of services in terms of cost measurement for economic evaluations reveals the necessity and usefulness of defining services using a coding system and taxonomical criteria rather than by ‘text-based descriptions’.
From the EBM pyramid to the Greek temple
Publisher: Cambridge University Press (CUP)
Date: 14-03-2017
DOI: 10.1017/S2045796016000767
Abstract: Guideline methods to develop recommendations dedicate most effort around organising discovery and corroboration knowledge following the evidence-based medicine (EBM) framework. Guidelines typically use a single dimension of information, and generally discard contextual evidence and formal expert knowledge and consumer's experiences in the process. In recognition of the limitations of guidelines in complex cases, complex interventions and systems research, there has been significant effort to develop new tools, guides, resources and structures to use alongside EBM methods of guideline development. In addition to these advances, a new framework based on the philosophy of science is required. Guidelines should be defined as implementation decision support tools for improving the decision-making process in real-world practice and not only as a procedure to optimise the knowledge base of scientific discovery and corroboration. A shift from the model of the EBM pyramid of corroboration of evidence to the use of broader multi-domain perspective graphically depicted as ‘Greek temple’ could be considered. This model takes into account the different stages of scientific knowledge (discovery, corroboration and implementation), the sources of knowledge relevant to guideline development (experimental, observational, contextual, expert-based and experiential) their underlying inference mechanisms (deduction, induction, abduction, means-end inferences) and a more precise definition of evidence and related terms. The applicability of this broader approach is presented for the development of the Canadian Consensus Guidelines for the Primary Care of People with Developmental Disabilities.
Spain
Publisher: Emerald
Date: 2004
DOI: 10.1108/13595474200400006
Abstract: In Spain, three parallel processes have taken place during the last 20 years: decentralisation, a health reform and a mental health reform. These processes have produced an extremely complex situation in support and care for people with mental retardation. The decentralisation process was not accompanied by a clear definition of the co‐ordination mechanisms among local authorities, and as a result many different health and social care systems have emerged at different times. This makes the description of the current care organisation difficult. An important characteristic of the Spanish system is the major role of NGOs in care and policy‐making and planning in this area. A shift from institutional to community care has begun for both psychiatric patients and people with mental retardation, but compared with neighbouring countries and published standards, the provision of intermediate services and non‐hospital residential care is very low, and the situation is worst for people with mental retardation and psychiatric problems.
Adjustment disorders in primary care: prevalence, recognition and use of services
Publisher: Royal College of Psychiatrists
Date: 08-2012
DOI: 10.1192/BJP.BP.111.096305
Abstract: Within the ICD and DSM review processes there is growing debate on the future classification and status of adjustment disorders, even though evidence on this clinical entity is scant, particularly outside specialised care. To estimate the prevalence of adjustment disorders in primary care to explore whether there are differences between primary care patients with adjustment disorders and those with other mental disorders and to describe the recognition and treatment of adjustment disorders by general practitioners (GPs). Participants were drawn from a cross-sectional survey of a representative s le of 3815 patients from 77 primary healthcare centres in Catalonia. The prevalence of current adjustment disorders and subtypes were assessed face to face using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Multilevel logistic regressions were conducted to assess differences between adjustment disorders and other mental disorders. Recognition and treatment of adjustment disorders by GPs were assessed through a review of patients' computerised clinical histories. The prevalence of adjustment disorders was 2.94%. Patients with adjustment disorders had higher mental quality-of-life scores than patients with major depressive disorder but lower than patients without mental disorder. Self-perceived stress was also higher in adjustment disorders compared with those with anxiety disorders and those without mental disorder. Recognition of adjustment disorders by GPs was low: only 2 of the 110 cases identified using the SCID-I were detected by the GP. Among those with adjustment disorders, 37% had at least one psychotropic prescription. Adjustment disorder shows a distinct profile as an intermediate category between no mental disorder and affective disorders (depression and anxiety disorders).
Patterns of Mental Healthcare Provision in Urban Areas: A Comparative Analysis for Informing Local Policy
Publisher: Research Square Platform LLC
Date: 21-09-2020
DOI: 10.21203/RS.3.RS-61049/V1
Abstract: ObjectiveUrbanisation presents specific challenges for the mental wellbeing of the population. An understanding of availability of existing service provision in urban areas is necessary to plan for the needs of people with mental illness in these contexts to identify gaps in care provision and inform policy and planning. This study aims to provide an analysis of the availability and ersity of mental health care in urban areas in Australia , and compare it with benchmark areas in Europe (Finland and Spain) and South America (Chile). MethodDESDE-LTC, an instrument for service classification and description of services providing long term care was used to analyse and compare service provision in Australia (Australian Capital Territory (ACT)), to other urban areas in Australia (Western Sydney, Perth North and South East Sydney) and to benchmark areas in other countries (Spain, Finland and Chile), using a standard healthcare ecosystems approach. Services from all relevant care sectors were calculated per 100,000 adults.ResultsWe identified commonalities in the pattern of mental health care in urban regions in Australia when compared to urban regions internationally, as well as gaps in care provision common to all study areas.ConclusionThese results highlight the relevance of an ecosystems approach to service planning in mental health care at the local level, and the use of a standardised instrument able to provide valid comparisons. There is a need for models of care sensitive to mental health care ecosystem indicators.
A Semiautomated Classification System for Producing Service Directories in Social and Health Care (DESDE-AND): Maturity Assessment Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 10-10-2020
Abstract: ESDE-LTC (Description and Evaluation of Services and DirectoriEs for Long-Term Care) is an international classification system that allows standardized coding and comparisons between different territories and care sectors, such as health and social care, in defined geographic areas. We adapted DESDE-LTC into a computer tool (DESDE-AND) for compiling a directory of care services in Andalucia, Spain. he aim of this study was to evaluate the maturity of DESDE-AND. A secondary objective of this study is to show the practicality of a new combined set of standard evaluation tools for measuring the maturity of health technology products. system for semiautomated coding of service provision has been co-designed. A panel of 23 domain experts and a group of 68 end users participated in its maturity assessment that included its technology readiness level (TRL), usability, validity, adoption (Adoption Impact Ladder [AIL]), and overall degree of maturity [implementation maturity model [IMM]). We piloted the prototype in an urban environment (Seville, Spain). he prototype was demonstrated in an operational environment (TRL 7). Sixty-eight different care services were coded, generating fact sheets for each service and its geolocation map. The observed agreement was 90%, with moderate reliability. The tool was partially adopted by the regional government of Andalucia (Spain), reaching a level 5 in adoption (AIL) and a level 4 in maturity (IMM) and is ready for full implementation. ESDE-AND is a usable and manageable system for coding and compiling service directories and it can be used as a core module of decision support systems to guide planning in complex cross-sectoral areas such as combined social and health care.
Mental disorders, chronic conditions and psychological factors: A path analysis model for healthcare consumption in general practice
Publisher: Informa UK Limited
Date: 02-2011
DOI: 10.3109/09540261.2010.544646
Abstract: To explore potential in idual determinants of healthcare utilization in primary care (PC) using a structural equation modelling approach. Atotal of 638 patients from five PC units were randomly selected. Mental disorders, psychological distress and other psychological factors were assessed with the 28-item General Health Questionnaire (GHQ-28) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Medical records and ICD-10 diagnosis were used to measure somatic morbidity. There is a negative relationship between the presence of mental disorders and psychological well-being (-0.74), and a negative relationship with use of health services (-0.25). Age has a positive and significant relationship with the presence of chronic diseases (0.49), which has a positive and significant relationship with limitation of daily activities (0.18). This limitation has a positive relationship with poor perception of health (0.57) and with psychological well-being (0.03). Findings confirm the existence of specific pathways in PC health use. Health service use depends on the patient's psychological well-being and on the presence of chronic medical conditions. Healthcare professionals need to pay attention to the comorbidity of mental disorders and chronic medical conditions in order to identify frequent attenders and to decrease the inappropriate use of healthcare services.
Experts' perceptions on the use of visual analytics for complex mental healthcare planning: An exploratory study
Publisher: Springer Science and Business Media LLC
Date: 07-05-2020
DOI: 10.1186/S12874-020-00986-0
Abstract: Health experts including planners and policy-makers face complex decisions in erse and constantly changing healthcare systems. Visual analytics may play a critical role in supporting analysis of complex healthcare data and decision-making. The purpose of this study was to examine the real-world experience that experts in mental healthcare planning have with visual analytics tools, investigate how well current visualisation techniques meet their needs, and suggest priorities for the future development of visual analytics tools of practical benefit to mental healthcare policy and decision-making. Health expert experience was assessed by an online exploratory survey consisting of a mix of multiple choice and open-ended questions. Health experts were s led from an international pool of policy-makers, health agency directors, and researchers with extensive and direct experience of using visual analytics tools for complex mental healthcare systems planning. We invited them to the survey, and the experts’ responses were analysed using statistical and text mining approaches. The forty respondents who took part in the study recognised the complexity of healthcare systems data, but had most experience with and preference for relatively simple and familiar visualisations such as bar charts, scatter plots, and geographical maps. Sixty-five percent rated visual analytics as important to their field for evidence-informed decision-making processes. Fifty-five percent indicated that more advanced visual analytics tools were needed for their data analysis, and 67.5% stated their willingness to learn new tools. This was reflected in text mining and qualitative synthesis of open-ended responses. This exploratory research provides readers with the first self-report insight into expert experience with visual analytics in mental healthcare systems research and policy. In spite of the awareness of their importance for complex healthcare planning, the majority of experts use simple, readily available visualisation tools. We conclude that co-creation and co-development strategies will be required to support advanced visual analytics tools and skills, which will become essential in the future of healthcare.
Working draft: Classifications of interventions in mental health care. An expert review
Publisher: Elsevier BV
Date: 10-2017
Pattern of healthcare resource utilization and direct costs associated with manic episodes in Spain
Publisher: Springer Science and Business Media LLC
Date: 28-04-2010
Mental illness and the National Disability Insurance Scheme: Lessons from Europe
Publisher: SAGE Publications
Date: 05-2014
The intellectual developmental disorders Mexico study: situational diagnosis, burden, genomics and intervention proposal
Publisher: Instituto Nacional de Salud Publica
Date: 15-12-2016
Abstract: This study aims to generate evidence on intellectual development disorders (IDD) in Mexico. IDD disease burden will be estimated with a probabilistic model, using population-based surveys. Direct and indirect costs of catastrophic expenses of families with a member with an IDD will be evaluated. Genomic characterization of IDD will include: sequencing participant exomes and performing bioinformatics analyses to identify de novo or inherited variants through trio analysis identifying genetic variants associated with IDD, and validating randomly selected variants by polymerase chain reaction (PCR) and sequencing or real-time quantitative PCR (qPCR). Delphi surveys will be done on best practices for IDD diagnosis and management. An external evaluation will employ qualitative case studies of two social and labor inclusion programs for people with IDD. The results will constitute scientific evidence for the design, promotion and evaluation of public policies, which are currently absent on IDD.
A Comparison of Mental Health Care Systems in Northern and Southern Europe: A Service Mapping Study
Publisher: MDPI AG
Date: 31-05-2018
Intellectual disability: between disability and clinical nosology
Publisher: Elsevier BV
Date: 11-2009
A decision support system for assessing management interventions in a mental health ecosystem: The case of Bizkaia (Basque Country, Spain)
Publisher: Public Library of Science (PLoS)
Date: 14-02-2019
Patterns of mental health service utilisation in Italy and Spain
Publisher: Springer Science and Business Media LLC
Date: 02-2005
DOI: 10.1007/S00127-005-0860-Y
Abstract: Methods for comparing local mental health service systems are needed to allow identification of different patterns of service provision and of inequities within and between countries. The aim of this study was to describe and compare mental health service systems in 13 catchment areas in Spain and Italy. Within each country, a range of area characteristics was represented. The European Service Mapping Schedule (ESMS) and European Socio-Demographic Schedule (ESDS) were used to describe: (i) socio-demographic and geographical area characteristics (ii) services provided and (iii) service utilisation in each area. Great differences emerged in patterns of service provision and use between and within countries. In contrast to Northern Europe, high unemployment rates were not associated with high service utilisation rates, but areas with large numbers of single-person households tended to have high service use. Most service utilisation rates were substantially below those reported from Northern European studies. Spanish centres tended to have low rates of hospital service utilisation despite limited development of community-based services. Trieste, where there has been a strong emphasis on developing innovative community services, showed a distinctive pattern with low hospital bed use and high rates of day service use and of contacts in the community. This methodology yielded useful data, which raise significant questions regarding equity and the implementation of mental health policy. The very large variations indicate that underlying local patterns of service provision must be investigated and taken into account in the interpretation of research evaluations of interventions.
Flooding and mental health: a systematic mapping review.
Publisher: Public Library of Science (PLoS)
Date: 10-04-2015
Child and Adolescent Psychiatry
Publisher: Springer International Publishing
Date: 2016
Depersonalization in panic disorder: A clinical study
Publisher: Elsevier BV
Date: 05-2000
DOI: 10.1016/S0010-440X(00)90044-0
Abstract: Panic disorder (PD) has been hypothesized to be a heterogeneous entity, with distinct clinical subgroups. The presence of depersonalization during panic attacks may distinguish a specific subgroup of PD. We sought to analyze the differential features of a subgroup of PD patients with depersonalization. A total of 274 patients with PD were assessed and ided into 2 groups according to the presence or absence of depersonalization. The Structured Clinical Interview for DSM-III-R (SCID-UP-R) was used to assess PD and comorbid disorders. The clinical scales administered included the Hamilton Anxiety and Depression Rating Scale (HARS and HDRS), the Marks and Mathews Fears and Phobia Scale, Panic-Associated Symptom Scale (PASS), and a panic attack symptoms inventory. A total of 66 patients (24.1%) exhibited depersonalization during the attacks. Patients with depersonalization appeared to be younger and had an earlier age at onset. PD was more severe in the depersonalization group (greater number of attacks, worse level of functioning, and higher scores on most self-rating scales). Also, depersonalization patients showed more comorbidity with specific phobia. Our results support the view that PD with depersonalization may be considered a distinct and more severe subcategory of PD.
The SOHO (Schizophrenia Outpatient Health Outcome) Study
Publisher: Springer Science and Business Media LLC
Date: 2006
DOI: 10.2165/00023210-200620040-00003
Abstract: The European SOHO (Schizophrenia Outpatient Health Outcome) study is an observational, naturalistic study of the outpatient treatment of schizophrenia. The patient recruitment and assessment began in September 2000 and finished in early 2005. A total of 10 972 adult patients from ten European countries who were initiating or changing antipsychotic medication for the treatment of schizophrenia within the normal course of care have been enrolled. The patients have been followed at regular intervals over the 3-year timeframe of the study. Evaluation includes clinical severity, measured with the Clinical Global Impression (CGI) scale health-related quality of life social functioning and medication tolerability. The 6- and 12-month results have been published so far and have demonstrated that the patients in whom treatment was initiated with olanzapine or clozapine or who were started on more than one antipsychotic of any class at baseline tended to have somewhat greater improvement than patients treated with other atypical or typical antipsychotics, both in terms of symptoms measured with the CGI and quality of life. Numbers of social contacts increased with the treatment, but other aspects of social functioning did not show any significant change. Atypical antipsychotics as a class were associated with a lower frequency of extrapyramidal symptoms (EPS) and anticholinergic use than typical antipsychotics. The frequency of EPS was lowest in the clozapine-, quetiapine- and olanzapine-treated patients, at around 10%. The atypical antipsychotics also conferred a lower risk for tar e dyskinesia than the typical antipsychotics. Weight gain occurred in all treatment cohorts over the first 12 months of treatment and was statistically significantly greater in the patients who started treatment with olanzapine and clozapine. Prolactin- and sexually-related adverse events were frequent at baseline assessment: amenorrhoea was present in around one- third of women, impotence in around 40% of men, and loss of libido in 50% of both male and female patients. Patients treated with olanzapine, clozapine and quetiapine were significantly less likely to have sexual/endocrine-related dysfunctions after 6 months of treatment (the 12-month results of this parameter are yet to be published) than those in the other treatment cohorts (typical antipsychotics, risperidone and amisulpride). Concomitant medication use during the study has been high, ranging from 5% to 29% for anticholinergics, 8% to 23% for antidepressants, 22% to 37% for anxiolytics and 7% to 19% for mood stabilisers, depending on the type of antipsychotic prescribed. Fewer olanzapine-, quetiapine- and clozapine-treated patients used concomitant anticholinergics or anxiolytics/hypnotics. The current results from the SOHO study indicate that differences in effectiveness and tolerability do exist between the antipsychotics. Future results from the study will be published during the coming months and years, and will allow patterns of antipsychotic use in routine clinical practice (including how often and why changes are made) to be determined. This important information is likely to impact on the future use of antipsychotics and will assist clinicians in refining the use of these drugs and improving the outcome of patients to whom they are prescribed.
Implementing mental health economic evaluation evidence: Building a bridge between theory and practice
Publisher: Informa UK Limited
Date: 2007
Adherence to Medication in Depressive Patients
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2011
The critical factor: The role of quality in the performance of supported accommodation services for complex mental illness in England
Publisher: Public Library of Science (PLoS)
Date: 17-03-2022
DOI: 10.1371/JOURNAL.PONE.0265319
Abstract: Rehabilitation services have a key role in ensuring integrated and comprehensive mental health (MH) care in the community for people suffering from long-term and severe mental disorders. MH-supported accommodation services aim to promote service users’ autonomy and independence. Given the complexity associated with MH-supported accommodation services in England, a comparative evaluation of critical performance indicators, including service provision and quality of care, seems to be necessary in designing evidence-informed policies. This study aims to explore the influence of service quality indicators on the performance of MH-supported accommodation services in England. The analysed s le includes supported accommodation services from 14 nationally representative local authorities in England from the QuEST study grouped by three main types of care: residential care homes ( ided into two subgroups: move-on and non-move-on oriented), supported housing and floating outreach. EDeS-MH (efficient decision support-mental health) was used to assess the performance indicators for the selected services by combining a Monte Carlo simulation engine, data envelopment analysis and a fuzzy inference engine for integrating expert knowledge. Depending on the type of care, six/seven quality domains were sequentially included after a baseline scenario (only technical) was analysed. Relative technical efficiency scores for the baseline scenarios revealed high performance in all the selected supported accommodation services, but the statistical variability was high. Quality domains significantly improved performance in every type of care. The inclusion of quality indicators has a positive impact on the global performance of each type of care. Remaining at the corresponding services more than expected for two years has a negative impact on performance. These findings can be considered from a planning perspective to facilitate the design of pathways of care with more realistic expectations about gaining autonomy in two years.
The Dose–Response Association between Nitrogen Dioxide Exposure and Serum Interleukin-6 Concentrations
Publisher: MDPI AG
Date: 08-05-2017
DOI: 10.3390/IJMS18051015
Life satisfaction in persons with Intellectual Disabilities
Publisher: Elsevier BV
Date: 07-2012
DOI: 10.1016/J.RIDD.2012.02.002
Abstract: We appraised life satisfaction using the Satisfaction with Life Scale (SWLS), and analysed its psychometric properties in persons with intellectual disability (ID). Ninety-nine persons with ID from four services in Spain participated. A battery of subjective assessments was used, including the SWLS, a Quality of Life measure (WHOQOL-BREF), and health status and sociodemographic information. Psychometric properties of the SWLS were investigated using standard psychometric methods. Overall, our results showed that persons with ID were satisfied with their life (SWLS score 25-29). Internal consistency (Cronbach's alpha) was .79. A factor analysis using principal components method, showed a one factor structure accounting for 55.7% of the variance. Associations, using Spearman's rho correlation coefficients, were confirmed between SWLS with the overall QoL, satisfaction with health and WHOQOL-BREF total score. Regarding 'known group' differences, persons living in residential institutions had lower life satisfaction compared to persons living in community facilities or living at home, though differences were not statistically significant. Student t-tests showed that SWLS scores significantly discriminated between healthy and unhealthy and those reporting higher satisfaction with their relationships, home environment and their jobs compared to participants with lower satisfaction levels. To our best knowledge, this study is the first to report on the psychometrics properties of the SWLS in persons with ID, both in Spain and internationally. It might be a promising tool to use, with other outcome measures, in appraising persons with ID in different services and types of care also, it might guide policymakers on the implementation of policies for persons with ID.
Perceived Discrimination and Self-Rated Health in Europe: Evidence from the European Social Survey (2010)
Publisher: Public Library of Science (PLoS)
Date: 05-09-2013
Use of the self-organising map network (SOMNet) as a decision support system for regional mental health planning
Publisher: Springer Science and Business Media LLC
Date: 25-04-2018
Standardised description of health and social care: A systematic review of use of the ESMS/DESDE (European Service Mapping Schedule/Description and Evaluation of Services and DirectoriEs)
Publisher: Cambridge University Press (CUP)
Date: 09-2019
DOI: 10.1016/J.EURPSY.2019.07.003
Abstract: Evidence-informed planning and interpretation of research results both require standardised description of local care delivery context. Such context analysis descriptions should be comparable across regions and countries to allow benchmarking and organizational learning, and for research findings to be interpreted in context. The European Service Mapping Schedule (ESMS) is a classification of adult mental health services that was later adapted for the assessment of health and social systems research (Description and Evaluation of Services and DirectoriEs - DESDE). The aim of the study was to review the diffusion and use of the ESMS/DESDE system in health and social care and its impact in health policy and decision-making. We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (1997-2018). Out of 155 papers mentioning ESMS/DESDE, 71 have used it for service research and planning. The classification has been translated into eight languages and has been used by seven international research networks. Since 2000, it has originated 11 instruments for health system research with extensive analysis of their metric properties. The ESMS/DESDE coding system has been used in 585 catchment areas in 34 countries for description of services delivery at local, regional and national levels. The ESMS/DESDE system provides a common terminology, a classification of care services, and a set of tools allowing a variety of aims to be addressed in healthcare and health systems research. It facilitates comparisons across and within countries for evidence-informed planning.
Person Centered Medicine
Publisher: Springer International Publishing
Date: 2023
Patterns of Service Provision in Older People’s Mental Health Care in Australia
Publisher: MDPI AG
Date: 17-11-2020
Abstract: Australia has a population of around 4 million people aged 65 years and over, many of whom are at risk of developing cognitive decline, mental illness, and/or psychological problems associated with physical illnesses. The aim of this study was to describe the pattern of specialised mental healthcare provision (availability, placement capacity, balance of care and ersity) for this age group in urban and rural health districts in Australia. The Description and Evaluation of Services and DirectoriEs for Long Term Care (DESDE-LTC) tool was used in nine urban and two rural health districts of the thirty-one Primary Health Networks across Australia. For the most part service provision was limited to hospital and outpatient care across all study areas. The latter was mainly restricted to health-related outpatient care, and there was a relative lack of social outpatient care. While both acute and non-acute hospital care were available in urban areas, in rural areas hospital care was limited to acute care. Limited access to comprehensive mental health care, and the uniformity in provision across areas in spite of differences in demographic, socioeconomic and health characteristics raises issues of equity in regard to psychogeriatric care in this country. Comparing patterns of mental health service provision across the age span using the same classification method allows for a better understanding of care provision and gap analysis for evidence-informed policy.
Use of geographical information systems in multiple sclerosis research: A systematic scoping review
Publisher: Research Square Platform LLC
Date: 12-02-2021
DOI: 10.21203/RS.3.RS-236908/V1
Abstract: Introduction: Geographical Information System (GIS) and spatial analysis have an emerging role in the understanding and management of health-related outcomes. However, there is a knowledge gap about the extent to which GIS has supported Multiple Sclerosis (MS) research. Therefore, this review aimed to explore the types of GIS applications and the complexity of their visualisation in MS research. Methods : A systematic scoping review was conducted based on York’s five-stage framework. PubMed, Scopus and Web of Science were searched for relevant studies published between 2000 and 2020 using a comprehensive search strategy based on the main concepts related to GIS and MS. Grounded, inductive analysis was conducted to organize studies into meaningful application areas. Further, we developed a tool to assess the visualisation complexity of the selected papers. Results: Of 3,723 identified unique citations, 42 papers met our inclusion criteria for the final review. One or more of the following types of GIS applications were reported by these studies: (a) thematic mapping (37 papers) (b) spatial cluster detection (16 papers) (c) risk factors detection (16 papers) and (d) health access and planning (two papers). In the majority of studies (88%), the score of visualisation complexity was relatively low: three or less from the range of zero to six. Conclusions: Although the number of studies using GIS techniques has dramatically increased in the last decade, the use of GIS in the areas of MS access and planning is still under-researched. Additionally, the capacity of GIS in visualising complex nature of MS care system is not yet fully investigated.
Depression at the time of hospital discharge in internal medicine inpatients
Publisher: Elsevier BV
Date: 06-2015
Ageing and health status in adults with intellectual disabilities: Results of the European POMONA II study
Publisher: Informa UK Limited
Date: 14-02-2011
DOI: 10.3109/13668250.2010.549464
Abstract: POMONA II was a European Commission public health-funded project. The research questions in this article focus on age-specific differences relating to environmental and lifestyle factors, and the 17 medical conditions measured by the POMONA Checklist of Health Indicators (P15). The P15 was completed in a cross-sectional design for a stratified s le of 1,253 adults with ID across 14 European member states. Older people (55+) were more likely to live in larger residential homes. Rates of smoking and use of alcohol were lower than in the general population but were higher with older age. More than 60% of older adults had a sedentary lifestyle. Cataract, hearing disorder, diabetes, hypertension, osteoarthritis/arthrosis, and osteoporosis were positively associated with advancing age allergies and epilepsy, negatively associated. Some evidence of health disparities was found for older people with ID, particularly in terms of underdiagnosed or inadequately managed preventable health conditions.
Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico
Publisher: Springer Science and Business Media LLC
Date: 12-2020
DOI: 10.1186/S12910-020-00566-3
Abstract: Paternalism/overprotection limits communication between healthcare professionals and patients and does not promote shared therapeutic decision-making. In the global north, communication patterns have been regulated to promote autonomy, whereas in the global south, they reflect the physician’s personal choices. The goal of this study was to contribute to knowledge on the communication patterns used in clinical practice in Mexico and to identify the determinants that favour a doctor–patient relationship characterized by low paternalism/autonomy. A self-report study on communication patterns in a s le of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were used to analyse paternalism and associated factors. A high prevalence (68.7% [95% CI 60.0–70.5]) of paternalism was observed among mental health professionals in Mexico. The main determinants of low paternalism/autonomy were medical specialty (OR 1.67 [95% CI 1.16–2.40]) and gender, with female physicians being more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11–2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomy (OR 12.13 [95% CI 7.71–19.05]). Finally, a modifying effect of age strata on the association between communication pattern or specialty and low paternalism/autonomy was observed. Among mental health professionals in Mexico, high paternalism prevailed. Gender, specialty, and a pattern of open communication were closely associated with low paternalism/autonomy. Strengthening health professionals’ competencies and promoting explicit communication could contribute to the transition towards more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.
Intellectual Disabilities
Publisher: Wiley
Date: 27-03-2009
Physical, mental, and social wellbeing and their association with death by suicide and self‐harm in older adults: a community‐based cohort study
Publisher: Wiley
Date: 20-11-2021
DOI: 10.1002/GPS.5463
Abstract: To assess associations between physical, mental, and social well‐being and suicide and self‐harm in a community‐based s le of older adults. Using a cohort design, questionnaire data from 102,880 in iduals aged 65 years or older living in New South Wales, Australia during 2006–2009 were linked to hospital and cause‐of‐death databases until 2017. Poisson regressions obtained adjusted incidence rate ratios (IRRs). One hundred nine suicides and 191 deliberate self‐harm (DSH) events occurred. Compared to those reporting excellent/good overall health, older adults reporting fair overall health had higher suicide rates (IRR = 2.8, 95% confidence interval: 1.8–4.4). Also, suffering from physical limitations was associated with higher rates of suicide. A fair versus excellent/good memory was associated with higher rates of suicide (IRR = 2.0, 1.3–3.3). Male erectile dysfunction was linked to self‐harm (IRR = 2.8, 1.0–7.7). Suicide rates were elevated with baseline Kessler‐10 scores of 20–50 versus 10–15 (IRR = 5.0, 2.9–8.9) the corresponding IRR for DSH was 2.9 (1.8–4.8). Elevated rates were observed for both self‐reported depression and anxiety. Poor versus excellent/good quality of life was associated with suicide (IRR = 4.3, 1.7–10.7) and achieving less than desired to due to emotional problems was linked to self‐harm (IRR = 1.8 1.3–2.4). Rates of suicide ande DSH were lower in those with ≥5 people to depend on versus one (suicide: IRR = 0.5, 0.3–0.9 DSH: IRR = 0.5, 0.3–0.7). Older adults experiencing health problems, including those relating to overall health or memory, and those with psychological distress had elevated rates of suicidal behavior. Rates of subsequent self‐harm and/or death by suicide were elevated in participants with small social networks.
The balance of adult mental health care: provision of core health versus other types of care in eight European countries
Publisher: Cambridge University Press (CUP)
Date: 17-10-2018
DOI: 10.1017/S2045796018000574
Abstract: Although many mental health care systems provide care interventions that are not related to direct health care, little is known about the interfaces between the latter and core health care. ‘Core health care’ refers to services whose explicit aim is direct clinical treatment which is usually provided by health professionals, i.e., physicians, nurses, psychologists. ‘Other care’ is typically provided by other staff and includes accommodation, training, promotion of independence, employment support and social skills. In such a definition, ‘other care’ does not necessarily mean being funded or governed differently. The aims of the study were: (1) using a standard classification system (Description and Evaluation of Services and Directories in Europe for Long Term Care, DESDE-LTC) to identify ‘core health’ and ‘other care’ services provided to adults with mental health problems and (2) to investigate the balance of care by analysing the types and characteristics of core health and other care services. The study was conducted in eight selected local areas in eight European countries with different mental health systems. All publicly funded mental health services, regardless of the funding agency, for people over 18 years old were identified and coded. The availability, capacity and the workforce of the local mental health services were described using their functional main activity or ‘Main Types of Care’ (MTC) as the standard for international comparison, following the DESDE-LTC system. In these European study areas, 822 MTCs were identified as providing core health care and 448 provided other types of care. Even though one-third of mental health services in the selected study areas provided interventions that were coded as ‘other care’, significant variation was found in the typology and characteristics of these services across the eight study areas. The functional distinction between core health and other care overcomes the traditional ision between ‘health’ and ‘social’ sectors based on governance and funding. The overall balance between core health and other care services varied significantly across the European sites. Mental health systems cannot be understood or planned without taking into account the availability and capacity of all services specifically available for this target population, including those outside the health sector.
Exploring the identification, validation, and categorization of costs and benefits of education in mental health: The PECUNIA project
Publisher: Cambridge University Press (CUP)
Date: 28-05-2020
DOI: 10.1017/S0266462320000203
Abstract: Mental health problems can lead to costs and benefits in other sectors (e.g. in the education sector) in addition to the healthcare sector. These related costs and benefits are known as intersectoral costs and benefits (ICBs). Although some ICBs within the education sector have been identified previously, little is known about their extensiveness and transferability, which is crucial for their inclusion in health economics research. The aim of this study was to identify ICBs in the education sector, to validate the list of ICBs in a broader European context, and to categorize the ICBs using mental health as a case study. Previously identified ICBs in the education sector were used as a basis for this study. Additional ICBs were extracted from peer-reviewed literature in PubMed and grey literature from six European countries. A comprehensive list of unique items was developed based on the identified ICBs. The list was validated by surveying an international group of educational experts. The survey results were used to finalize the list, which was categorized according to the care atom. Additional ICBs in the education sector were retrieved from ninety-six sources. Fourteen experts from six European countries assessed the list for completeness, clarity, and relevance. The final list contained twenty-four ICBs categorized into input, throughput, and output. By providing a comprehensive list of ICBs in the education sector, this study laid further foundations for the inclusion of important societal costs in health economics research in the broader European context.
Development and usefulness of an instrument for the standard description and comparison of services for disabilities (DESDE)
Publisher: Wiley
Date: 07-11-2006
DOI: 10.1111/J.1600-0447.2006.00916.X
Abstract: Mental health research has made significant progress in international comparison and instrument development. This study reports the adaptation of the European Service Mapping Schedule (ESMS) to the assessment of services for persons with disabilities. Qualitative groups were used to develop the Description and Evaluation of Services for Disabilities in Europe (DESDE). The psychometric analysis of DESDE covered: feasibility, inter-rater reliability, descriptive validity and internal validity. A demonstration study was also carried out. Compared to the original ESMS, a new main branch and several sub-branches were added. We identified 826 services for persons with disabilities, which provided 1284 main types of care. The feasibility and reliability was good for the majority of codes. Only 6% of services were not properly classified. The Boolean factor analysis supported the internal validity of DESDE. DESDE is a useful and reliable instrument for the assessment of services for persons with disabilities.
Evaluation of system efficiency using the Monte Carlo DEA: The case of small health areas
Publisher: Elsevier BV
Date: 04-2015
Service availability and capacity in rural mental health in Australia: Analysing gaps using an Integrated Mental Health Atlas
Publisher: SAGE Publications
Date: 28-06-2019
Abstract: Access to services and workforce shortages are major challenges in rural areas worldwide. In order to improve access to mental health care, it is imperative to understand what services are available, what their capacity is and where existing funds might be spent to increase availability and accessibility. The aim of this study is to investigate mental health service provision in a selection of rural and remote areas across Australia by analysing service availability, placement capacity and ersity. This research studies the health regions of Western New South Wales and Country Western Australia and their nine health areas. Service provision was analysed using the DESDE-LTC system for long-term care service description and classification that allows international comparison. Rates per 100,000 inhabitants were calculated to compare the care availability and placement capacity for children and adolescents, adults and older adults. The lowest ersity was found in northern Western Australia. Overall, Western New South Wales had a higher availability of non-acute outpatient services for adults, but hardly any acute outpatient services. In Country Western Australia, substantially fewer non-acute outpatient services were found, while acute services were much more common. Acute inpatient care services were more common in Western New South Wales, while sub-acute inpatient services and non-acute day care services were only found in Western New South Wales. The number and span of services in the two regions showed discrepancies both within and between regions, raising issues on the equity of access to mental health care in Australia. The standard description of the local pattern of rural mental health care and its comparison across jurisdictions is critical for evidence-informed policy planning and resource allocation.
Survey of Australian and Canadian Community Pharmacists’ Experiences With Patients at Risk of Suicide
Publisher: American Psychiatric Association Publishing
Date: 03-2020
DOI: 10.1176/APPI.PS.201900244
Abstract: The study's objective was to examine Canadian and Australian community pharmacists' experiences with people at risk of suicide. A survey was developed and administered online. Countries were compared by Fisher's exact and t tests. Multivariable logistic-regression analysis was used to identify variables associated with preparedness to help someone in a suicidal crisis. The survey was completed by 235 Canadian and 161 Australian pharmacists. Most (85%) interacted with someone at risk of suicide at least once, and 66% experienced voluntary patient disclosure of suicidal thoughts. More Australians than Canadians had mental health crisis training (p<0.001). Preparedness to help in a suicidal crisis was negatively associated with being Canadian, having a patient who died by suicide, lacking training and confidence, and permissive attitudes toward suicide. Several perceived barriers impede pharmacists' abilities to help patients who voluntarily disclose suicidal thoughts. Gatekeeper and related suicide prevention strategy training for community pharmacists is warranted.
Moving beyond intelligence in the revision of ICD-10: specific cognitive functions in intellectual developmental disorders
Publisher: Wiley
Date: 02-2014
DOI: 10.1002/WPS.20094
Lung function in older community dwelling Australians
Publisher: European Respiratory Society
Date: 09-2016
Childhood Respiratory Risk Factor Profiles and Middle-Age Lung Function: A Prospective Cohort Study from the First to Sixth Decade
Publisher: American Thoracic Society
Date: 09-2018
«Cognitivo»: un término en disputa. «Noético», una solución homérica
Publisher: Elsevier BV
Date: 03-2004
DOI: 10.1157/13058684
The Impact of Socio-Economic Status on Self-Rated Health: Study of 29 Countries Using European Social Surveys (2002–2008)
Publisher: MDPI AG
Date: 25-02-2013
Seeing is believing: AR-assisted blind area assembly to support hand–eye coordination
Publisher: Springer Science and Business Media LLC
Date: 29-01-2022
Meeting the challenge of funding and allocating resources to mental health across Europe: developing the Mental Health Economics European Network
Publisher: Cambridge University Press (CUP)
Date: 06-2006
DOI: 10.1017/S1121189X00004310
Abstract: Aims – There is growing demand for economic analysis to support strategic decision-making for mental health but the availability of economic evidence, in particular on system performance remains limited. The Mental Health Economics European Network (MHEEN) was set up in 2002 with the broad objective of developing a base for mental health economics information and subsequent work in 17 countries. Methods – Data on financing, expenditure and costs, provision of services, workforce, employment and capacity for economic evaluation were collected through bespoke questionnaires developed iteratively by the Network. This was augmented by a literature review and analysis of international databases. Results – Findings on financing alone suggest that in many European countries mental health appears to be neglected while mechanisms for resource allocation are rarely linked to objective measure of population mental health needs. Numerous economic barriers and potential solutions were identified. Economic incentives may be one way of promoting change, although there is no one size fits all solution. Conclusions – There are significant benefits and synergies to be gained from the continuing development of networks such as MHEEN. In particular the analysis can be used to inform developments in Central and Eastern Europe. For instance there is much that can be learnt on both how the balance of care between institutional and non-institutional care has changed and on the role played by economic incentives in ensuring that resources were used to develop alternative community-based systems. Declaration of Interest: none of the authors have received any financial support that presents a conflict of interest.
Burden of chronic physical conditions and mental disorders in primary care
Publisher: Royal College of Psychiatrists
Date: 04-2010
DOI: 10.1192/BJP.BP.109.074211
Abstract: The World Health Organization (WHO) has stated that the three leading causes of burden of disease in 2030 are projected to include HIV/AIDS, unipolar depression and ischaemic heart disease. To estimate health-related quality of life (HRQoL) and quality-adjusted life-year (QALY) losses associated with mental disorders and chronic physical conditions in primary healthcare using data from the diagnosis and treatment of mental disorders in primary care (DASMAP) study, an epidemiological survey carried out with primary care patients in Catalonia (Spain). A cross-sectional survey of a representative s le of 3815 primary care patients. A preference-based measure of health was derived from the 12-item Short Form Health Survey (SF–12): the Short Form–6D (SF–6D) multi-attribute health-status classification. Each profile generated by this questionnaire has a utility (or weight) assigned. We used non-parametric quantile regressions to model the association between both mental disorders and chronic physical condition and SF–6D scores. Conditions associated with SF–6D were: mood disorders, β =−0.20 (95% CI −0.18 to −0.21) pain, β = −0.08 (95%CI −0.06 to −0.09) and anxiety, β =−0.04 (95% CI −0.03 to −0.06). The top three causes of QALY losses annually per 100 000 participants were pain (5064), mood disorders (2634) and anxiety (805). Estimation of QALY losses showed that mood disorders ranked second behind pain-related chronic medical conditions.
Vagueness and Ambiguity in Communication of Case Management: A Content Analysis in the Australian National Disability Insurance Scheme
Publisher: Ubiquity Press, Ltd.
Date: 19-03-2021
DOI: 10.5334/IJIC.5590
Developing a Set of Health Indicators for People with Intellectual Disabilities: Pomona Project
Publisher: Wiley
Date: 09-2005
DOI: 10.1111/J.1741-1130.2005.00039.X
Abstract: Abstract The European Commission's Health Monitoring Programme culminated in the development of a set of European Community Health Indicators (ECHI) for the general population. Despite evidence of marked disparities between the health of people with intellectual disabilities (ID) and their peers in the general population, the ECHI contain no significant reference to people with ID. To address this deficit, a two‐year grant from the Health Monitoring Programme was awarded to the Pomona project (a collection of researchers from 13 European countries). The project comprised exchanges of expertise a critical review of published evidence about health and ID and consultative processes in member states. The project's finding was that there was no systematic monitoring of the health of people with ID in EU member states and, as a consequence, a set of health indicators specific to people with ID was proposed that could lead to such systemic monitoring.
Development and spatial representation of synthetic indexes of outpatient mental health care in Andalusia (Spain)
Publisher: Cambridge University Press (CUP)
Date: 09-2008
DOI: 10.1017/S1121189X00001287
Abstract: Introduction – There is a need to develop composite indicators to monitor mental health care in countries such as Spain, where there is wide variability of care systems in 17 different regions. The aim of this study is to generate and to test the usability of synthetic indexes in Andalusia (Southern Spain). Method – Seven mental health indicators were selected by expert opinion from a previous list of simple indicators used to compare mental health care systems across Spain (Psicost-74). A Geographical Information Systems (GIS) was used to delineate 71 sectors based on the catchment areas of the mental health centers in Andalusia. Synthetic indexes were obtained through linear combinations of simple indicators via Principal Components Analysis (PCA), using activity data from the Mental Health Information System of Andalusia (SISMA). Maps of these indexes were drawn for 71 catchment areas. Results – Two synthetic indexes were obtained and showed high consistency in the PCA. The Care Load Index (component 1) related to population size and total outpatient care provided within the area. The Case Load Index (component 2) related to assisted morbidity in relation to the population size. The care load index was higher in populated urban areas, whereas the case load was higher in rural areas. Discussion – Care and case load indexes show a different pattern in urban and rural areas. This may be related to a different underlying model of care related to the degree of urbanisation. Geographical Information Systems (GIS) improved recognition and assessment of the spatial phenomena related to the mental health care system, and support policy decision making process in mental health. Declaration of Interest: None.
ARCoA: Using the AR-Assisted Cooperative Assembly System to Visualize Key Information about the Occluded Partner
Publisher: Informa UK Limited
Date: 22-07-2022
Integrated Care for People with Intellectual Disability
Publisher: Springer International Publishing
Date: 2017
Australia. Good intentions - reviewing 30 years of mental health policy reform
Publisher: Edward Elgar Publishing
Date: 15-11-2022
European Union. Mental health care ecosystems
Publisher: Edward Elgar Publishing
Date: 15-11-2022
WPA Working Group on Defining and Managing Autism Spectrum Disorder: spreading knowledge for the next generations of psychiatrists
Publisher: Wiley
Date: 14-01-2023
DOI: 10.1002/WPS.21051
The Global Lung Initiative 2012 reference values reflect contemporary Australasian spirometry
Publisher: Wiley
Date: 21-09-2012
DOI: 10.1111/J.1440-1843.2012.02232.X
Abstract: We aimed to ascertain the fit of the European Respiratory Society Global Lung Initiative 2012 reference ranges to contemporary Australasian spirometric data. Z-scores for spirometry from Caucasian subjects aged 4-80 years were calculated. The mean (SD) Z-scores were 0.23 (1.00) for forced expirtory volume in 1 s (FEV(1)), 0.23 (1.00) for forced vital capacity (FVC), -0.03 (0.87) for FEV(1)/FVC and 0.07 (0.95) for forced expiratory flows between 25% and 75% of FVC. These results support the use of the Global Lung Initiative 2012 reference ranges to interpret spirometry in Caucasian Australasians.
The Bronchodilator Response of In Vivo Specific Airway Compliance in Adults with Asthma
Publisher: Springer Science and Business Media LLC
Date: 24-12-2011
DOI: 10.1007/S10439-010-0206-0
Abstract: A new technique has been developed to determine in vivo airway compliance in humans that is specific to airway size and transpulmonary pressure, and can be represented as a three-dimensional surface. As yet, the ability of this technique to detect changes in specific airway compliance with disease status has not been demonstrated. The aim of this study was to assess whether this technique could determine changes in airway compliance which are thought to occur with altered smooth muscle tone in adults with asthma. Airway compliance was measured and displayed as a surface in adults with asthma before and after a reduction in smooth muscle tone by bronchodilator administration. Compliance, with respect to airway size, was calculated at three specific lung volumes functional residual capacity (FRC), total lung capacity (TLC), and midway between FRC and TLC (MID). After bronchodilator, airway compliance increased at FRC and MID in the smaller airways (<3 mm). Furthermore, airway compliance under both conditions was greater in the smaller airways compared to the larger airways. In conclusion, our method may have future utility in assessing changes in airway compliance in respiratory diseases such as asthma.
The economic cost of brain disorders in Europe
Publisher: Wiley
Date: 19-12-2011
DOI: 10.1111/J.1468-1331.2011.03590.X
Abstract: In 2005, we presented for the first time overall estimates of annual costs for brain disorders (mental and neurologic disorders) in Europe. This new report presents updated, more accurate, and comprehensive 2010 estimates for 30 European countries. One-year prevalence and annual cost per person of 19 major groups of disorders are based on 'best estimates' derived from systematic literature reviews by panels of experts in epidemiology and health economics. Our cost estimation model was populated with national statistics from Eurostat to adjust to 2010 values, converting all local currencies to Euros (€), imputing cost for countries where no data were available, and aggregating country estimates to purchasing power parity-adjusted estimates of the total cost of brain disorders in Europe in 2010. Total European 2010 cost of brain disorders was €798 billion, of which direct health care cost 37%, direct non-medical cost 23%, and indirect cost 40%. Average cost per inhabitant was €5.550. The European average cost per person with a disorder of the brain ranged between €285 for headache and €30 000 for neuromuscular disorders. Total annual cost per disorder (in billion € 2010) was as follows: addiction 65.7 anxiety disorders 74.4 brain tumor 5.2 child/adolescent disorders 21.3 dementia 105.2 eating disorders 0.8 epilepsy 13.8 headache 43.5 mental retardation 43.3 mood disorders 113.4 multiple sclerosis 14.6 neuromuscular disorders 7.7 Parkinson's disease 13.9 personality disorders 27.3 psychotic disorders 93.9 sleep disorders 35.4 somatoform disorder 21.2 stroke 64.1 and traumatic brain injury 33.0. Our cost model revealed that brain disorders overall are much more costly than previously estimated constituting a major health economic challenge for Europe. Our estimate should be regarded as conservative because many disorders or cost items could not be included because of lack of data.
Categories, Dimensions, and Narratives for Person-Centered Diagnostic Assessment
Publisher: Springer International Publishing
Date: 2016
Mental health planning at a very early stage of the COVID-19 crisis
Publisher: Springer Science and Business Media LLC
Date: 15-01-2021
DOI: 10.1186/S12888-020-03015-Y
Abstract: Mental health care systems have been dramatically affected by COVID-19. Containment measures have been imposed, with negative consequences on population mental health. Therefore, an increase in both symptomatology and mental disorder incidence is expected. This research aims to identify, describe and assess the empirical background on online strategies and recommendations developed by international organizations and governments to cope with the psychological impact of COVID-19 at a very early stage of the pandemic. The PRISMA guidelines were adapted to review online documents. A new questionnaire was developed to identify the existence of common patterns in the selected documents. Questions were classified into three domains: COVID-19 information, mental health strategies and mental health recommendations. A two-step cluster analysis was carried out to highlight underlying behaviours in the data (patterns). The results are shown as spider graphs (pattern profiles) and conceptual maps (multidimensional links between questions). Twenty-six documents were included in the review. The questionnaire analysed document complexity and identified their common key mental health characteristics (i.e., does the respondent have the tools for dealing with stress, depression and anxiety?). Cluster analysis highlighted patterns from the questionnaire domains. Strong relationships between questions were identified, such as psychological tips for maintaining good mental health and coping with COVID-19 (question n° 4), describing some psychological skills to help people cope with anxiety and worry about COVID-19 (question n° 6) and promoting social connection at home (question n° 8). When fast results are needed to develop health strategies and policies, rapid reviews associated with statistical and graphical methods are essential. The results obtained from the proposed analytical procedure can be relevant to a) classify documents according to their complexity in structuring the information provided on how to cope with the psychological impact of COVID-19, b) develop new documents according to specific objectives matching population needs, c) improve document design to face unforeseen events, and d) adapt new documents to local situations. In this framework, the relevance of adapting e-mental health procedures to community mental health care model principles was highlighted, although some problems related to the digital gap must be considered.
Health Status: From Illness to Wellbeing
Publisher: Springer International Publishing
Date: 2016
Strategies for Implementing Occupational eMental Health Interventions: Scoping Review (Preprint)
Publisher: JMIR Publications Inc.
Date: 28-10-2021
Abstract: he implementation of eMental health interventions, especially in the workplace, is a complex process. Therefore, learning from existing implementation strategies is imperative to ensure improvements in the adoption, development, and scalability of occupational eMental health (OeMH) interventions. However, the implementation strategies used for these interventions are often undocumented or inadequately reported and have not been systematically gathered across implementations in a way that can serve as a much-needed guide for researchers. he objective of this scoping review was to identify implementation strategies relevant to the uptake of OeMH interventions that target employees and detail the associated barriers and facilitation measures. scoping review was conducted. The descriptive synthesis was guided by the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework and the Consolidated Framework for Implementation Research. total of 31 of 32,916 (0.09%) publications reporting the use of the web-, smartphone-, telephone-, and email-based OeMH interventions were included. In all, 98 implementation strategies, 114 barriers, and 131 facilitators were identified. The synthesis of barriers and facilitators produced 19 facilitation measures that provide initial recommendations for improving the implementation of OeMH interventions. his scoping review represents one of the first steps in a research agenda aimed at improving the implementation of OeMH interventions by systematically selecting, shaping, evaluating, and reporting implementation strategies. There is a dire need for improved reporting of implementation strategies and combining common implementation frameworks with more technology-centric implementation frameworks to fully capture the complexities of eHealth implementation. Future research should investigate a wider range of common implementation outcomes for OeMH interventions that also focus on a wider set of common mental health problems in the workplace. This scoping review’s findings can be critically leveraged by discerning decision-makers to improve the reach, effectiveness, adoption, implementation, and maintenance of OeMH interventions.
Effect of airway smooth muscle tone on airway distensibility measured by the forced oscillation technique in adults with asthma
Publisher: American Physiological Society
Date: 05-2012
DOI: 10.1152/JAPPLPHYSIOL.01259.2011
Abstract: Airway distensibility appears to be unaffected by airway smooth muscle (ASM) tone, despite the influence of ASM tone on the airway diameter-pressure relationship. This discrepancy may be because the greatest effect of ASM tone on airway diameter-pressure behavior occurs at low transpulmonary pressures, i.e., low lung volumes, which has not been investigated. Our study aimed to determine the contribution of ASM tone to airway distensibility, as assessed via the forced oscillation technique (FOT), across all lung volumes with a specific focus on low lung volumes. We also investigated the accompanying influence of ASM tone on peripheral airway closure and heterogeneity inferred from the reactance versus lung volume relationship. Respiratory system conductance and reactance were measured using FOT across the entire lung volume range in 22 asthma subjects and 19 healthy controls before and after bronchodilator. Airway distensibility (slope of conductance vs. lung volume) was calculated at residual volume (RV), functional residual capacity (FRC), and total lung capacity. At baseline, airway distensibility was significantly lower in subjects with asthma at all lung volumes. After bronchodilator, distensibility significantly increased at RV (64.8%, P 0.001) and at FRC (61.8%, P 0.01) in subjects with asthma but not in control subjects. The increased distensibility at RV and FRC in asthma were not associated with the accompanying changes in the reactance versus lung volume relationship. Our findings demonstrate that, at low lung volumes, ASM tone reduces airway distensibility in adults with asthma, independent of changes in airway closure and heterogeneity.
The impact of built and social environmental characteristics on incidence and estimated risk of dementia
Publisher: Wiley
Date: 12-2021
DOI: 10.1002/ALZ.055380
Abstract: Dementia is a public health priority 1 and the current study designed to investigate associations between built and social environmental characteristics and dementia incidence, and the estimated future risk of dementia. Further we investigated spatial variations in dementia risk and dementia incidence to identify unmet areas for policy intervention. We used 25,511 patients (aged 65 years and older) records in Adelaide between 2011‐2015. In addition to dementia incidence, we calculated a dementia risk score based on risk and protective factors for patients not diagnosed with dementia. The following built and social environment exposures were estimated for each statistical area level 1 (SA1) 2 : social fragmentation, nitrogen dioxide (NO 2 ), public open spaces, walkability, socio‐economic status and the length of main roads. We performed multilevel regression analyses to allow for the hierarchical nature of the data and applied spatial cluster analysis to identify areas with high and low risk of dementia. We found that a one standard deviation (SD) increase in NO2 and walkability score was associated with 10% higher odds of any versus no dementia (95% confidence interval (CI): 1%, 21% for NO2 and 0%, 22% for walkability score). For estimated future risk of dementia, a 1‐SD increase in social fragmentation (mobility component) and NO2 was associated with a 1% increase in dementia risk (95% CI: 0, 1%). 1‐SD increases in public open space and socioeconomic status were associated with 3% (95% CI: 0.95, 0.98) and 1% decreases (95% CI: 0.98, 0.99) in dementia risk, respectively. There was spatial heterogeneity in the pattern of dementia incidence and dementia risk. Associations of neighbourhood NO2 level, walkability, public open space and social fragmentation with dementia incidence and estimated future risk of dementia were statistically significant, indicating the potential to reduce the risk through changes in built and social environments. Mapping the estimated future risk of dementia and diagnosed cases of dementia offers a novel approach to identifying areas of unmet need. 1. Towards a dementia plan: a WHO guide. Geneva: WHO 2018. 2. Australian Statistical Geography Standard (ASGS): Volume 1 ‐ Main Structure and Greater Capital City Statistical Areas, 2016.
Intelligence and specific cognitive functions in intellectual disability
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2018
eVITAL: A Preliminary Taxonomy and Electronic Toolkit of Health-Related Habits and Lifestyle
Publisher: Hindawi Limited
Date: 2012
DOI: 10.1100/2012/379752
Abstract: Objectives . To create a preliminary taxonomy and related toolkit of health-related habits (HrH) following a person-centered approach with a focus on primary care. Methods . From 2003–2009, a working group ( n = 6 physicians) defined the knowledge base, created a framing document, and selected evaluation tools using an iterative process. Multidisciplinary focus groups ( n = 29 health professionals) revised the document and evaluation protocol and participated in a feasibility study and review of the model based on a demonstration study with 11 adult volunteers in Antequera, Spain. Results . The preliminary taxonomy contains 6 domains of HrH and 1 domain of additional health descriptors, 3 subdomains, 43 dimensions, and 141 subdimensions. The evaluation tool was completed by the 11 volunteers. The eVITAL toolkit contains history and examination items for 4 levels of engagement: self-assessment, basic primary care, extended primary care, and specialty care. There was positive feedback from the volunteers and experts, but concern about the length of the evaluation. Conclusions . We present the first taxonomy of HrH, which may aid the development of the new models of care such as the personal contextual factors of the International Classification of Functioning (ICF) and the positive and negative components of the multilevel person-centered integrative diagnosis model.
The Barcelona declaration on bridging knowledge in long-term care and support. Barcelona (Spain), March 7, 2009
Publisher: Ubiquity Press, Ltd.
Date: 12-04-2010
DOI: 10.5334/IJIC.521
Spanish Perspective on Enlarging a Small Specialty: The National Research Network for Liaison Psychiatry and Psychosomatics
Publisher: Elsevier BV
Date: 2007
Abstract: The Spanish Research Network in Liaison Psychiatry and Psychosomatics (REPEP) comprises 11 centers (nodes), and was one of the successful applicants in a very competitive call for a networking program for the National Institute of Health "Carlos III" project. This article describes its general objectives and strategic plans. Both qualitative and quantitative results support our statement that this "perspective" should help to enlarge what is presently a small specialty. Synergies in the network have been potentiated an ambitious national study on depressive comorbidity in complex medical patients has been executed and new research and training programs have been initiated.
Advancing a research agenda for bridging ageing and disability
Publisher: Ubiquity Press, Ltd.
Date: 16-11-2012
DOI: 10.5334/IJIC.1085
Intellectual disability: an unresolved world health challenge
Publisher: FapUNIFESP (SciELO)
Date: 2008
The Toronto declaration on bridging knowledge, policy and practice in aging and disability
Publisher: Ubiquity Press, Ltd.
Date: 16-11-2012
DOI: 10.5334/IJIC.1086
Innovations and changes in the ICD‐11 classification of mental, behavioural and neurodevelopmental disorders
Publisher: Wiley
Date: 02-01-2019
DOI: 10.1002/WPS.20611
Mental health and employment: An overview of patterns and policies across Western Europe
Publisher: Informa UK Limited
Date: 2007
A framework for evidence‐based mental health care and policy
Publisher: Wiley
Date: 07-11-2006
DOI: 10.1111/J.1600-0447.2006.00914.X
Abstract: Care planning integrates a growing number of disciplines, research fields and analysis techniques. A framework of the main areas of interest with regard to evidence-based health care in mental health is provided here. The framework is based on the experience of working with data analysts and health and social decision makers at the PSICOST/RIRAG network, a Spanish research association which includes psychiatrists, health economists and health policy experts, as well as on a review of the literature. Three main areas have been identified and described here: outcomes management, knowledge discovery from data, and decision support systems. Their use in mental health care is reviewed. It is important to promote bridging strategies among these new fields in order to enhance communication and information transfer between the different parts involved in mental health decision making: i) clinicians and epidemiologists, ii) data analysts, iii) care policy makers and other end-users.
Psychosocial modifiers of drug prescription: the hidden face of pharmacology?
Publisher: Wiley
Date: 1998
DOI: 10.1002/(SICI)1099-1557(199801/02)7:1<23::AID-PDS313>3.0.CO;2-Q
Nuevas consideraciones sobre la salud de las personas con trastornos del desarrollo intelectual
Publisher: Instituto Nacional de Salud Publica
Date: 11-07-2017
DOI: 10.21149/8201
Abstract: La literatura reciente indica que las personas con trastornos del desarrollo intelectual (TDI) presentan diferencias respecto de la población general en cuanto a la prevalencia de determinadas enfermedades y a la atención sanitaria que reciben. El conocimiento actual con base en la evidencia es aún muy escaso en países no anglosajones. Los proyectos europeos POMONA-I y POMONA-II tenían el objetivo de recoger información sobre el estado de salud de las personas con TDI en Europa. Actualmente, el proyecto POMONAESP en España pretende recoger dicha información en una muestra lia y representativa de personas con TDI. También se están llevando a cabo otros estudios sobre la necesidad de contar con servicios especializados y sobre la formación que reciben los profesionales sanitarios sobre TDI. En este artículo se revisan las últimas evidencias sobre la salud de las personas con TDI y se exponen las principales actividades de investigación y asistencia sanitaria sobre este tema.
Long term impact of coal mine fire smoke on lung mechanics in exposed adults
Publisher: Cold Spring Harbor Laboratory
Date: 20-10-2020
DOI: 10.1101/2020.10.14.20213009
Abstract: In 2014, a six-week long fire at the Hazelwood open cut coal mine exposed residents in the adjacent town of Morwell to high concentrations of fine particulate matter with an aerodynamic diameter .5μm (PM 2.5 ). The long-term health consequences are being evaluated as part of the Hazelwood Health Study (HHS). Approximately 3.5 to 4 years after the mine fire, adults from Morwell (n=346) and the comparison town Sale (n=173) participated in the longitudinal Respiratory Stream of the HHS. In idual fire-related PM 2.5 exposure was retrospectively modelled. Lung mechanics were assessed using the forced oscillation technique (FOT), which utilises pressure waves to measure respiratory system resistance (Rrs) and reactance (Xrs). Multivariate linear regression was used to evaluate associations between PM 2.5 and transformed Rrs5, area under the reactance curve (AX5) and Xrs5 controlling for key confounding factors. There were clear dose-response relationships between increasing mine fire PM 2.5 and worsening lung mechanics, including a reduction in post-bronchodilator Xrs5 and an increase in AX5. A 10 μg/m 3 increase in mine fire related PM 2.5 was associated with a 0.015 (95%CI: 0.004, 0.027) reduction in exponential(Xrs5) post bronchodilator, which was comparable to 4.7 years of aging. Similarly, the effect of exposure was associated with a 0.072 (0.005, 0.138) increase in natural log(AX5) post-bronchodilator, equivalent to 3.9 years of aging. This is the first study using FOT in adults evaluating long term respiratory outcomes after a medium-term ambient PM 2.5 exposure to coal mine fire smoke. These results should inform public health policies and planning for future events.
Is it worth investing in mental health promotion and prevention of mental illness? A systematic review of the evidence from economic evaluations
Publisher: Springer Science and Business Media LLC
Date: 22-01-2008
Abstract: While evidence on the cost of mental illness is growing, little is known about the cost-effectiveness of programmes in the areas of mental health promotion (MHP) and mental disorder prevention (MDP). The paper aims at identifying and assessing economic evaluations in both these areas to support evidence based prioritisation of resource allocation. A systematic review of health and non health related bibliographic databases, complemented by a hand search of key journals and analysis of grey literature has been carried out. Study characteristics and results were qualitatively summarised. Economic evaluations of programmes that address mental health outcome parameters directly, those that address relevant risk factors of mental illness, as well as suicide prevention interventions were included, while evaluations of drug therapies were excluded. 14 studies fulfilled the inclusion criteria. They varied in terms of topic addressed, intervention used and study quality. Robust evidence on cost-effectiveness is still limited to a very small number of interventions with restricted scope for generalisability and transferability. The most favourable results are related to early childhood development programmes. Prioritisation between MHP and MDP interventions requires more country and population-specific economic evaluations. There is also scope to retrospectively add economic analyses to existing effectiveness studies. The nature of promotion and prevention suggests that innovative approaches to economic evaluation that augment this with information on the challenges of implementation and uptake of interventions need further development.
Evaluation of an integrated system for classification, assessment and comparison of services for long-term care in Europe: the eDESDE-LTC study
Publisher: Springer Science and Business Media LLC
Date: 15-06-2013
Utilisation of mental health services and costs of patients with schizophrenia in three areas of Spain
Publisher: Royal College of Psychiatrists
Date: 10-1998
Abstract: The analysis of the costs of schizophrenia and its treatment under different mental health care structures will facilitate the improved allocation of the limited resources available for the treatment of schizophrenia. The research we present compares health service use and total health care costs of three cohorts of subjects with schizophrenia which are representative of three areas of Spain (Burlada in Navarra, Cantabria and the Eix le of Barcelona). We selected first-time contacts with any psychiatric service who received a diagnosis of schizophrenia. Subjects were evaluated in the third year after onset. The mean number of out-patient visits per patient per year was 10.7 and the mean in-patient days were 9.5. The mean direct cost per patient in the third year of treatment was US$2243. Costs were higher for single subjects and for people who had a relapse. Costs of subjects with better functioning were lower than costs of subjects with a worse state. Direct costs of care in Spain were lower than the reported figures from other western European countries. Costs were greater in the two centres with greater community mental health service development. Some of the findings may be explained by service availability.
Cohort Profile: The Tasmanian Longitudinal Health STUDY (TAHS)
Publisher: Oxford University Press (OUP)
Date: 06-06-2017
DOI: 10.1093/IJE/DYW028
Assessment of service use patterns in out‐patients with schizophrenia: a Spanish study
Publisher: Wiley
Date: 07-11-2006
DOI: 10.1111/J.1600-0447.2006.00915.X
Abstract: The objective is to describe and characterize patterns of service use by out-patients with schizophrenia in Spain. A representative treated prevalence s le of cases with schizophrenia was selected from four Spanish health areas. The evaluation included health service use, clinical severity, functioning and disability. Statistical analysis was based on hierarchical clustering methods. A total of 356 patients were included in the analysis. Five patterns of health service use were defined: heavy out-patient mental health users mental health and general health service users heavy hospital service users nursing service users low users of mental health services. Patients in each group showed differences in clinical and disability status. Patterns of health service use showed consistency, but also variability, among the geographical areas. Development and organization of mental health services should take into account the combinations of services patients most frequently use.
Development of an Instrument for the Assessment of Health-Related Multi-sectoral Resource Use in Europe: The PECUNIA RUM
Publisher: Springer Science and Business Media LLC
Date: 09-01-2023
Are e‐cigarette use and vaping associated with increased respiratory symptoms and poorer lung function in a population exposed to smoke from a coal mine fire?
Publisher: Wiley
Date: 05-07-2021
DOI: 10.1111/RESP.14113
Abstract: E‐cigarette use has become increasingly prevalent, but there is some evidence demonstrating potential harms with frequent use. We aimed to identify the profiles of e‐cigarette users from a regional community in Australia and investigate the associations of e‐cigarettes with respiratory symptoms and lung function. A total of 519 participants completed a cross‐sectional study. Exposure to e‐cigarettes was collected via a validated questionnaire. Respiratory symptoms were evaluated via a self‐reported questionnaire and lung function measured with spirometry and forced oscillation technique (FOT). Linear and logistic regression models were fitted to investigate the associations between e‐cigarettes and outcomes, while controlling for confounders such as tobacco smoking. Of the 519 participants, 46 (9%) reported e‐cigarette use. Users tended to be younger (mean ± SD 45.2 ± 14.5 vs. 55.3 ± 16.0 years in non‐users), concurrently using tobacco products (63% vs. 12% in non‐users), have a mental health diagnosis (67% vs. 37% in non‐users) and have self‐reported asthma (63% vs. 42% in non‐users). After controlling for known confounders, chest tightness (OR = 2.4, 95% CI 1.2–4.9, p = 0.02) was associated with e‐cigarette use. Spirometry was not different after adjustment for confounding. However, FOT showed more negative reactance and a greater area under the reactance curve in e‐cigarette users than non‐users. E‐cigarette use was associated with increased asthma symptoms and abnormal lung mechanics in our s le, supporting a potential health risk posed by these products. Vulnerable populations such as young adults and those with mental health conditions have higher usage, while there is high concurrent tobacco smoking.
Longitudinal decline in lung function in patients with primary immunoglobulin deficiencies
Publisher: Elsevier BV
Date: 06-2011
International comparability of reference unit costs of education services: when harmonizing methodology is not enough (PECUNIA project)
Publisher: Informa UK Limited
Date: 15-12-2022
Modelling the balance of care: Impact of an evidence-informed policy on a mental health ecosystem
Publisher: Public Library of Science (PLoS)
Date: 11-01-2022
DOI: 10.1371/JOURNAL.PONE.0261621
Abstract: Major efforts worldwide have been made to provide balanced Mental Health (MH) care. Any integrated MH ecosystem includes hospital and community-based care, highlighting the role of outpatient care in reducing relapses and readmissions. This study aimed (i) to identify potential expert-based causal relationships between inpatient and outpatient care variables, (ii) to assess them by using statistical procedures, and finally (iii) to assess the potential impact of a specific policy enhancing the MH care balance on real ecosystem performance. Causal relationships (Bayesian network) between inpatient and outpatient care variables were defined by expert knowledge and confirmed by using multivariate linear regression (generalized least squares). Based on the Bayesian network and regression results, a decision support system that combines data envelopment analysis, Monte Carlo simulation and fuzzy inference was used to assess the potential impact of the designed policy. As expected, there were strong statistical relationships between outpatient and inpatient care variables, which preliminarily confirmed their potential and a priori causal nature. The global impact of the proposed policy on the ecosystem was positive in terms of efficiency assessment, stability and entropy. To the best of our knowledge, this is the first study that formalized expert-based causal relationships between inpatient and outpatient care variables. These relationships, structured by a Bayesian network, can be used for designing evidence-informed policies trying to balance MH care provision. By integrating causal models and statistical analysis, decision support systems are useful tools to support evidence-informed planning and decision making, as they allow us to predict the potential impact of specific policies on the ecosystem prior to its real application, reducing the risk and considering the population’s needs and scientific findings.
The road to 11th edition of the International Classification of Diseases
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2018
Use of a decision support system for benchmarking analysis and organizational improvement of regional mental health care: Efficiency, stability and entropy assessment of the mental health ecosystem of
Publisher: Public Library of Science (PLoS)
Date: 22-03-2022
DOI: 10.1371/JOURNAL.PONE.0265669
Abstract: Decision support systems are appropriate tools for guiding policymaking processes, especially in mental health (MH), where care provision should be delivered in a balanced and integrated way. This study aims to develop an analytical process for (i) assessing the performance of an MH ecosystem and (ii) identifying benchmark and target-for-improvement catchment areas. MH provision (inpatient, day and outpatient types of care) was analysed in the Mental Health Network of Gipuzkoa (Osakidetza, Basque Country, Spain) using a decision support system that integrated data envelopment analysis, Monte Carlo simulation and artificial intelligence. The unit of analysis was the 13 catchment areas defined by a reference MH centre. MH ecosystem performance was assessed by the following indicators: relative technical efficiency, stability and entropy to guide organizational interventions. Globally, the MH system of Gipuzkoa showed high efficiency scores in each main type of care (inpatient, day and outpatient), but it can be considered unstable (small changes can have relevant impacts on MH provision and performance). Both benchmark and target-for-improvement areas were identified and described. This article provides a guide for evidence-informed decision-making and policy design to improve the continuity of MH care after inpatient discharges. The findings show that it is crucial to design interventions and strategies (i) considering the characteristics of the area to be improved and (ii) assessing the potential impact on the performance of the global MH care ecosystem. For performance improvement, it is recommended to reduce admissions and readmissions for inpatient care, increase workforce capacity and utilization of day care services and increase the availability of outpatient care services.
A comprehensive survey on AR-enabled local collaboration
Publisher: Springer Science and Business Media LLC
Date: 20-08-2023
Disambiguation of psychotherapy: a search for meaning
Publisher: Royal College of Psychiatrists
Date: 04-11-2020
DOI: 10.1192/BJP.2020.196
Abstract: This analysis identifies the significant problem of ambiguity, variation and vagueness in relation to the intervention described as ‘psychotherapy’. Its purpose is to raise international awareness of this problem and alternative solutions.
The all‐age spirometry reference ranges reflect contemporary Australasian spirometry
Publisher: Wiley
Date: 25-07-2011
DOI: 10.1111/J.1440-1843.2011.01970.X
Abstract: Advances in statistical modelling have allowed the creation of smoothly changing spirometry reference ranges that apply across a wide age range and better define the lower limit of normal. The objective of this study was to assess the agreement of the Stanojevic 2009 all-age reference ranges to contemporary lung function data to verify the appropriateness of this reference for clinical use in Australia and New Zealand. Spirometry data from healthy Caucasians measured between 2000-2009 in Australia and New Zealand were collected. Z-scores were calculated for the standard spirometry outcomes based on the all-age reference ranges. Spirometry from 2066 subjects aged 4-80 years (55% male) from 14 centres were eligible. Statistically, the collated contemporary dataset differed from the all-age reference ranges, but these differences were relatively small and clinically irrelevant representing differences of approximately 3% predicted. Significant differences were also observed between some centres and equipment, potentially indicating varying influence of equipment or subject selection. Spirometry from contemporary Australasian healthy subjects fits the all-age reference ranges well. While the current study supports the use of the all-age reference ranges, the between-centre differences highlight the need for spirometry to be used in conjunction with other clinical findings.
The feasibility of applying the clinical staging paradigm to the care of people with mental disorders
Publisher: Wiley
Date: 12-06-2013
Use of an integrated Atlas of Mental Health Care for evidence informed policy in Catalonia (Spain)
Publisher: Cambridge University Press (CUP)
Date: 16-09-2014
DOI: 10.1017/S2045796014000511
Abstract: This paper aims to present the Integrated Atlas of Mental Health of Catalonia (2010) focusing on: (a) the importance of using a taxonomy-based coding and standard system of data collection when assessing health services and (b) its relevance as a tool for evidence-informed policy. This study maps all the care-related services for people with mental disorders available in Catalonia in 2010, using the ‘Description and Evaluation of Services and Directories in Europe for long-term care’ (DESDE-LTC). The unit of analysis is the Basic Stable Input of Care (BSIC), which is the minimal organisation unit composed by a set of inputs with temporal stability. We presented data on: (a) availability of BSICs and their capacity (b) the adequacy of the provision of care, taking into account availability and accessibility (c) the evolution of BSCIs from 2002 to 2010 and (d) the perceived relevance of Atlas of Mental Health as a tool for evidence-informed policy. We identified a total of 639 BSICs. A lack of Health services was detected in highly rural areas, although there was moderate availability of Social Services. Overall, more than 80% of the small mental health areas in Catalonia had an adequate core mental health service. Since 2002 the availability of mental health services has increased. Decision makers found the Atlas a useful and relevant tool for evidence informed policy. Policy makers can use Atlases to detect gaps and inequities in the provision of care for people with mental health needs.
Family burden related to clinical and functional variables of people with intellectual disability with and without a mental disorder
Publisher: Elsevier BV
Date: 05-2012
DOI: 10.1016/J.RIDD.2011.12.002
Abstract: Few studies have been found that to assess the factors that explain higher levels of family burden in adults with intellectual disability (ID) and intellectual disability and mental disorders (ID-MD). The aims of this study were to assess family burden in people with ID and ID-MD and to determine which sociodemographic, clinical and functional disability variables account for family burden. The s le is composed of pairs of 203 participants with disability and their caregivers, of which 33.5% are caregivers of people with ID and 66.5% of ID-MD. Assessments were performed using scales of clinical and functional disability as the following instruments: Weschler Adult Intelligence Scale-III (WAIS-III), Inventory for Client and Agency Planning (ICAP), Psychiatric Assessment Schedule for Adults with Development Disability (PAS-ADD checklist), Disability Assessment Schedule of the World Health Organization (WHO-DAS-II) and family burden (Subjective and Objective Family Burden Inventory - SOFBI/ECFOS-II). People with ID-MD presented higher levels of functional disability than those with ID only. Higher levels of family burden were related to higher functional disability in all the areas (p<0.006-0.001), lower intelligence quotient (p<0.001), diagnosis of ID-MD (p<0.001) and presence of organic, affective, psychotic and behavioral disorders (p<0.001). Stepwise multiple regression showed that behavioral problems, affective and psychotic disorder, disability in participation in society, disability in personal care and presence of ID-MD explained more than 61% of the variance in family burden. An integrated approach using effective multidimensional interventions is essential for both people with ID and ID-MD and their caregivers in order to reduce family burden.
A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial
Publisher: Springer Science and Business Media LLC
Date: 23-02-2018
Moving beyond the mental health care system: An exploration of the interfaces between health and non-health sectors
Publisher: Informa UK Limited
Date: 2007
Incorporating local information and prior expert knowledge to evidence‐informed mental health system research
Publisher: Wiley
Date: 12-06-2013
A method to determine in vivo, specific airway compliance, in humans
Publisher: Springer Science and Business Media LLC
Date: 09-03-2010
DOI: 10.1007/S11517-010-0576-3
Abstract: In order to understand the pathophysiology of diseases such as asthma and chronic obstructive pulmonary disease, it is essential to measure the mechanical properties of the airways. Currently, there are no methods to measure and quantify in vivo airway compliance in humans. In order to develop a method, we generated a curve-fitting algorithm that combines airway diameter measurements by high resolution computed tomography with pressure-volume curves obtained by the esophageal balloon technique. Our method allows the description of diameter-pressure curves for airways of varying size, presented as a 3D surface, from which specific airway compliance can be determined at any transpulmonary pressure. Applying this method to data from two healthy subjects, we found that small airways are more compliant than large airways and specific airway compliance was greatest at low transpulmonary pressures. In conclusion, our 3D surface is a useful tool to measure and quantify in vivo specific airway compliance in humans.
The Global Lung Function Initiative (GLI) Network: bringing the world’s respiratory reference values together
Publisher: European Respiratory Society (ERS)
Date: 09-2017
Abstract: The Global Lung Function Initiative (GLI) Network has become the largest resource for reference values for routine lung function testing ever assembled. This article addresses how the GLI Network came about, why it is important, and its current challenges and future directions. It is an extension of an article published in Breathe in 2013 [1], and summarises recent developments and the future of the GLI Network. The Global Lung Function Initiative (GLI) Network was established as a result of international collaboration, and altruism between researchers, clinicians and industry partners. The ongoing success of the GLI relies on network members continuing to work together to further improve how lung function is reported and interpreted across all age groups around the world. The GLI Network has produced standardised lung function reference values for spirometry and gas transfer tests. GLI reference equations should be adopted immediately for spirometry and gas transfer by clinicians and physiologists worldwide. The recently established GLI data repository will allow ongoing development and evaluation of reference values, and will offer opportunities for novel research. To highlight the advances made by the GLI Network during the past 5 years. To highlight the importance of using GLI reference values for routine lung function testing ( e.g. spirometry and gas transfer tests). To discuss the challenges that remain for developing and improving reference values for lung function tests.
Quality of life and living arrangements for people with intellectual disability
Publisher: Emerald
Date: 12-07-2013
DOI: 10.1108/AMHID-03-2013-0027
Abstract: Recent international experiences of community inclusion have produced a major change in residential care for people with intellectual disability (ID). Assignment and outcome assessment through new person‐centred measures are raising increasing interest however, the information on quality of life and accommodation is still limited. This paper aims to provide an overview of the application of quality of life models and the size of the provision of different living arrangements. A systematic mapping of the literature of the last decade was followed by an expert guided review of the available evidence. QoL outcomes measures of living arrangements in people with ID show conceptual and methodological challenges. The following key topics were identified: in idual level: issues related to health status, behavioural problems and other personal factors (ageing, choice and empowerment) family and peers local level: accommodation, architecture and urbanization, and economic aspects (deprivation and costs) macro level: social participation (community inclusion). The residential solutions that are currently considered of highest efficiency are small apartments in the community and “cluster centers”. The level of quality of life is very relevant in the assessment of living arrangements in people with ID although its assessment still shows significant limitations. Some accommodation typologies seem more effective than others. New conceptual models of inclusive residential care support the convenience of a wide range of accommodation alternatives that may fit the in idual needs of a highly heterogeneous population group. A unique residential alternative, albeit optimal from a community care perspective, may not be adequate for all persons with ID.
Tackling Neglect and Mental Health Reform in a Devolved System of Welfare Governance
Publisher: Cambridge University Press (CUP)
Date: 13-07-2010
DOI: 10.1017/S0047279410000553
Abstract: A system of devolved welfare governance, it is argued, increases participation in welfare services. However, limited empirical evidence has been reported on how it influences welfare reform. This paper draws upon evidence from the mental health system in Spain, where health care is devolved to the regional states (autonomous communities), to examine whether policy reform of neglected policy areas may be triggered through heightened policy awareness and better participation of interested stakeholders. We find that regional devolution has helped to scale up mental health in some of Spain's autonomous regions relative to support for other services. Evidence suggests that whilst fragmentation and certain historical legacies remain path dependent, regional devolution has indeed enhanced experimentation, reform and policy innovation in mental health care. However, the expansion of mental health care coverage has been constrained by the lack of a clear definition of public coverage, as well as the need to meet the demands of evidence-based policy in an era of cost-containment. Inequalities in access to mental health care remain they are compounded by the stigma and discrimination experienced by people with mental health problems, which is a common challenge for all health systems in Europe.
Feasibility, reliability and validity of the Spanish version of Psychiatric Assessment Schedule for Adults with Developmental Disability: a structured psychiatric interview for intellectual disability
Publisher: Wiley
Date: 03-2002
DOI: 10.1046/J.1365-2788.2002.00402.X
Abstract: Over 30% of people with intellectual disability (ID) have a comorbid psychiatric disorder. However, there are few assessment instruments available for international use and cross-cultural validation studies of these instruments are rare. The aim of the present study was to standardize the Spanish version of the Psychiatric Assessment Schedule for Adults with Developmental Disability (PAS-ADD-10), a semi-structured interview for people with ID. After a conceptual translation, feasibility (i.e. applicability, acceptability and practicality) and reliability analyses were carried out. The predictive validity of the PAS-ADD-10 CATEGO-5 codings was also examined (i.e. positive and negative predictive values). Four independent raters with wide-ranging experience in quantitative evaluation and psychiatric assessment of ID evaluated a s le of 80 subjects with ID and borderline intellectual functioning at the AFANAS occupational centre in Jerez, Southern Spain. The ICD-10 codes were used for psychiatric diagnosis. The practicality of the PAS-ADD-10 is limited because of the need for previous standardization of SCAN interviews. Nevertheless, its overall feasibility was judged adequate by raters and the PAS-ADD-10 was considered extremely useful for training. Test-retest and inter-rater reliability kappa values were moderate to high. The CATEGO coding showed limited validity because of overdiagnosis of anxiety disorders and underdiagnosis of mood and psychotic disorders (positive predictive value = 74%, negative predictive value = 76%). The PAS-ADD-10 is a useful tool for standard psychiatric assessment of people with ID however, CATEGO codings show low validity and a series of modifications should be considered before this instrument is used extensively in Spain. In this regard, a study on the clinical usefulness of the PAS-ADD-10 in patients with ID and severe mental disorders has been undertaken.
Phase 3 Randomized Study of the Efficacy and Safety of Inhaled Dry Powder Mannitol for the Symptomatic Treatment of Non-Cystic Fibrosis Bronchiectasis
Publisher: Elsevier BV
Date: 07-2013
Abstract: Inhaled dry powder mannitol enhanced mucus clearance and improved quality of life over 2 weeks in non-cystic fibrosis bronchiectasis. This study's objective was to investigate the efficacy and safety of dry powder mannitol over 12 weeks. Patients with bronchiectasis confirmed by high-resolution CT (HRCT) scan, aged 15 to 80 years, with FEV1≥50% predicted and ≥1 L participated in a randomized, placebo-controlled, double-blind study. Patients with a negative mannitol provocation test were randomized to inhale 320 mg mannitol (n=231) or placebo (n=112) bid for 12 weeks. To further assess safety, the same mannitol dose/frequency was administered to a patient subset in an open-label extension over 52 weeks. Primary end points were changes from baseline at 12 weeks in 24-h sputum weight and St. George's Respiratory Questionnaire (SGRQ) score. There was a significant difference of 4.3 g in terms of change in sputum weight over 12 weeks (95% CI, 1.64-7.00 P=.002) between mannitol and placebo however, this was largely driven by a decrease in sputum weight in the placebo group. This was associated, in turn, with more antibiotic use in the placebo group (50 of 112 [45%]) than in the inhaled mannitol group (85 of 231 [37%]). There was no statistical difference between the groups (P=.304) in total SGRQ score (mannitol, -3.4 points [95% CI, -4.81 to -1.94] vs placebo, -2.1 points [95% CI, -4.12 to -0.09]). In a subgroup study (n=82), patients receiving mannitol showed less small airway mucus plugging on HRCT scan at 12 weeks compared with patients receiving placebo (P=.048). Compliance rates were high, and mannitol was well tolerated with adverse events similar to those of placebo. Because the difference in sputum weights appears to be associated with increased antibiotic use in the placebo group, a larger controlled study is now required to investigate the long-term mannitol effect on pulmonary exacerbations and antibiotic use. ClinicalTrials.gov No.: NCT0027753 URL: www.clinicaltrials.gov.
Measures of mental, physical, and social wellbeing and their association with death by suicide and self-harm in a cohort of 266,324 persons aged 45 years and over
Publisher: Springer Science and Business Media LLC
Date: 18-08-2021
A meta-framework and conceptualisation of person and people-centred integrated health care
Publisher: Ubiquity Press, Ltd.
Date: 17-10-2017
DOI: 10.5334/IJIC.3365
Differential clinical features of early-onset panic disorder
Publisher: Elsevier BV
Date: 07-1999
DOI: 10.1016/S0165-0327(98)00148-7
Abstract: Although panic disorder (PD) begins typically in adulthood, an earlier onset is not uncommon. Recent studies on early-onset PD indicate that this subgroup of patients may display distinct clinical characteristics. To compare a subgroup of early-onset PD patients with the rest of the s le. A consecutive series of 442 patients with PD were included. Family histories were investigated, and clinical assessment employed the following instruments: Hamilton's scales, Global Functioning Scale, Marks-Mathews' Fears and Phobia Scale, and Panic-Associated Symptom Scale. The age threshold for 'early-onset' was considered at 18 years. A total of 45 patients (10.2%) exhibited early-onset PD, with a mean age at onset of 14.6. They were younger and had a longer duration of illness than later-onset patients. No differences were found in severity of panic symptoms, anxiety or depressive symptoms, and social functioning. They had more comorbidity with simple phobia, social phobia, and substance dependence. Rates of PD among first-degree relatives were higher in the early-onset group. Early-onset PD patients displayed a greater familial loading, but clinical severity of their panic-agoraphobia symptoms was not higher. Comorbidity was greater with phobic and substance-related disorders.
Lightme
Publisher: Springer Science and Business Media LLC
Date: 13-10-2020
Parallel or Cross? Effects of Two Collaborative Modes on Augmented Reality Co-located Operations
Publisher: Informa UK Limited
Date: 04-05-2023
Methodological barriers to studying the association between the economic crisis and suicide in Spain
Publisher: Springer Science and Business Media LLC
Date: 06-09-2017
Inverse Association Between Myocardial B-Type Natriuretic Peptide Release and Functional Capacity in Healthy Humans
Publisher: Elsevier BV
Date: 08-2018
Structural determinants of suicide during the global financial crisis in Spain: Integrating explanations to understand a complex public health problem
Publisher: Public Library of Science (PLoS)
Date: 03-2021
DOI: 10.1371/JOURNAL.PONE.0247759
Abstract: Suicide is a complex public health problem in contemporary societies. Macroeconomic downturns derived from the economic crisis have been found to be associated with growing suicide mortality in the United States and in Europe. The present work is aimed to assess the association between the recent economic downturns and suicide patterns using interrupted time series analysis and, particularly, adjusting this relationship by indicators of social cohesion and community values that might provide additional insights on the complex explanation of suicidal trends. We combined suicide, social and economic data extracted from the National Statistics Institute (INE) , the Eurostat database , and the World Values Survey to assess the association between the socio-economic factors and trends in suicide rates. To study the association between the financial crisis and changes in suicide rates in Spain, we used interrupted time series analysis (ITSA). Our findings confirm that suicides increased after the 2011 recession, but remained moderately constant after the 2008 economic downturn. Suicides particularly increased after the 2011 recession in the 10–14, and 45–64 years old intervals between males and females, and apparently in older groups. However, during the 2008–2011 time period suicide rates decreased during working years (specifically among 40–44, 45–49, and 55–59 years old groups). Our results highlight the importance of social protection against unemployment and, to a lesser extent, social protection in disability and family, in reducing suicides, as well as the economic prosperity of the country. This result corroborates that the economic crisis has possibly impacted the growing suicide rates of the most vulnerable groups, but exclusively during the period characterised by economic cuts after the 2011 recession. This study highlights the need to implement tailored policies that protect these collectives against suicide.
Ten-year prediction model for post-bronchodilator airflow obstruction and early detection of COPD: Development and validation in two middle-aged population-based cohorts
Publisher: BMJ
Date: 12-2021
DOI: 10.1136/BMJRESP-2021-001138
Abstract: Classifying in iduals at high chronic obstructive pulmonary disease (COPD)-risk creates opportunities for early COPD detection and active intervention. To develop and validate a statistical model to predict 10-year probabilities of COPD defined by post-bronchodilator airflow obstruction (post-BD-AO forced expiratory volume in 1 s/forced vital capacity th percentile). General Caucasian populations from Australia and Europe, 10 and 27 centres, respectively. For the development cohort, questionnaire data on respiratory symptoms, smoking, asthma, occupation and participant sex were from the Tasmanian Longitudinal Health Study (TAHS) participants at age 41–45 years (n=5729) who did not have self-reported COPD/emphysema at baseline but had post-BD spirometry and smoking status at age 51–55 years (n=2407). The validation cohort comprised participants from the European Community Respiratory Health Survey (ECRHS) II and III (n=5970), restricted to those of age 40–49 and 50–59 with complete questionnaire and spirometry/smoking data, respectively (n=1407). Risk-prediction models were developed using randomForest then externally validated. Area under the receiver operating characteristic curve (AUC ROC ) of the final model was 80.8% (95% CI 80.0% to 81.6%), sensitivity 80.3% (77.7% to 82.9%), specificity 69.1% (68.7% to 69.5%), positive predictive value (PPV) 11.1% (10.3% to 11.9%) and negative predictive value (NPV) 98.7% (98.5% to 98.9%). The external validation was fair (AUC ROC 75.6%), with the PPV increasing to 17.9% and NPV still 97.5% for adults aged 40–49 years with ≥1 respiratory symptom. To illustrate the model output using hypothetical case scenarios, a 43-year-old female unskilled worker who smoked 20 cigarettes/day for 30 years had a 27% predicted probability for post-BD-AO at age 53 if she continued to smoke. The predicted risk was 42% if she had coexistent active asthma, but only 4.5% if she had quit after age 43. This novel and validated risk-prediction model could identify adults aged in their 40s at high 10-year COPD-risk in the general population with potential to facilitate active monitoring/intervention in predicted ‘COPD cases’ at a much earlier age.
Spatial concentration of renewables in energy system optimization models
Publisher: Elsevier BV
Date: 10-2022
Spatial analysis to identify hotspots of prevalence of schizophrenia
Publisher: Springer Science and Business Media LLC
Date: 23-05-2008
DOI: 10.1007/S00127-008-0368-3
Abstract: The geographical distribution of mental health disorders is useful information for epidemiological research and health services planning. To determine the existence of geographical hotspots with a high prevalence of schizophrenia in a mental health area in Spain. The study included 774 patients with schizophrenia who were users of the community mental health care service in the area of South Granada. Spatial analysis (Kernel estimation) and Bayesian relative risks were used to locate potential hotspots. Availability and accessibility were both rated in each zone and spatial algebra was applied to identify hotspots in a particular zone. The age-corrected prevalence rate of schizophrenia was 2.86 per 1,000 population in the South Granada area. Bayesian analysis showed a relative risk varying from 0.43 to 2.33. The area analysed had a non-uniform spatial distribution of schizophrenia, with one main hotspot (zone S2). This zone had poor accessibility to and availability of mental health services. A municipality-based variation exists in the prevalence of schizophrenia and related disorders in the study area. Spatial analysis techniques are useful tools to analyse the heterogeneous distribution of a variable and to explain genetic/environmental factors in hotspots related with a lack of easy availability of and accessibility to adequate health care services.
Impact of ed-linq
Publisher: MDPI AG
Date: 27-07-2021
Abstract: Ed-LinQ is a mental health policy initiative to enhance the early detection and treatment of children with mental illness by improving the liaison between schools and health services in Queensland, Australia. We measured its impact from policy to practice to inform further program developments and public strategies. We followed a mixed quantitative/qualitative approach. The Adoption Impact Ladder (AIL) was used to analyse the adoption of this initiative by end-users (decision makers both in the health and education sectors) and the penetration of the initiative in the school sector. Survey respondents included representatives of schools (n = 186) and mental health providers (n = 78). In total, 63% of the school representative respondents were at least aware of the existence of the Ed-LinQ initiative, 74% were satisfied with the initiative and 28% of the respondent schools adopted the initiative to a significant extent. Adoption was higher in urban districts and in the health sector. The overall level of penetration in the school sector of Queensland was low (3%). The qualitative analysis indicated an improvement in the referral and communication processes between schools and the health sectors and the importance of funding in the implementation of the initiative. Mapping of existing programs is needed to assess the implementation of a new one as well as the design of different implementation strategies for urban and rural areas. Assessing the adoption of health policy strategies and their penetration in a target audience is critical to understand their proportional impacts across a defined ecosystem and constitutes a necessary preliminary step for the evaluation of their quality and efficiency.
Case Management for Children and Adolescents with Acquired Brain Injury in Community Settings: A scoping review
Publisher: Cambridge University Press (CUP)
Date: 26-04-2017
DOI: 10.1017/BRIMP.2017.3
Abstract: Background: Acquired brain injury is the leading cause of death and disability in children after infancy. Childhood brain injury has long-term consequences for children and parents, including challenges with returning to school, ongoing health and behaviour concerns, family functioning and demands on carers. Community-based case management interventions are a vital contribution to community supports. Aims: This scoping study aims to scope and map the literature on case management, to identify how case management is described in the literature for children and adolescents with acquired brain injury (0–17 years). Methods: A scoping review was completed of published articles on case management from four major databases (CINAHL, MEDLINE, PUBMed and Embase) between 2005 and 2015. Articles were selected against inclusion criteria and reviewed. Results: Eight articles of 2688 records met the inclusion criteria and were reviewed. Case management was provided by case managers and other health professionals. The case management interventions described were mapped to the International Classification of Health Interventions and the Brain Injury Case Management Taxonomy (BICM-T). Case management addressed a range of needs including return to school, family issues and ongoing medical needs. There were anecdotal reports of effectiveness of case management during the return to school process. Conclusion: This scoping study reveals a lack of information on this topic. Improved reporting of case management interventions and more research on case management is needed for children and adolescents with brain injury.
The contribution of fatigue and sleepiness to depression in patients attending the sleep laboratory for evaluation of obstructive sleep apnea
Publisher: Springer Science and Business Media LLC
Date: 06-05-2010
DOI: 10.1007/S11325-010-0355-2
Abstract: A high prevalence of depressive symptomatology has been reported amongst sufferers of obstructive sleep apnea (OSA), but it remains unclear as to whether this is due to their OSA or other factors associated with the disorder. The current study aimed to assess the incidence and aetiology of depression in a community s le of in iduals presenting to the sleep laboratory for diagnostic assessment of OSA. Forty-five consecutive in iduals who presented to the sleep laboratory were recruited of those, 34 were diagnosed with OSA, and 11 were primary snorers with no clinical or laboratory features of OSA. Nineteen control subjects were also recruited. Patients and controls completed the Beck Depression Inventory, the Profile of Mood States (POMS), and the Epworth Sleepiness Scale to assess their mood and sleepiness, prior to their polysomnography. All patients reported significantly more depressive symptoms compared with healthy controls, regardless of their degree of OSA. There were no significant differences between OSA patients and primary snorers on any of the mood and self-rated sleepiness measures. Depression scores were not significantly associated with any of the nocturnal variables. Regression analysis revealed that the POMS fatigue subscale explained the majority of the variance in subjects' depression scores. Fatigue was the primary predictor of the level of depressive symptoms in patients who attended the sleep laboratory, regardless of the level of severity of sleep-disordered breathing. When considering treatment options, practitioners should be aware of the concomitant occurrence of depressive symptoms and fatigue in patients presenting with sleep complaints, which may not be due to a sleep disorder.
In-patient costs of agitation and containment in a mental health catchment area
Publisher: Springer Science and Business Media LLC
Date: 06-06-2017
A participatory evaluation of the validity and feasibility of the Meta-framework of Person and People-centred Integrated Health Care (PPCIHC)
Publisher: Ubiquity Press, Ltd.
Date: 17-10-2017
DOI: 10.5334/IJIC.3818
Managed Care and Psychiatry
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2001
Costs of Obsessive‐Compulsive Disorder: A Review
Publisher: Wiley
Date: 15-12-2002
Financing mental health care in Europe
Publisher: Informa UK Limited
Date: 2007
Managed Care and Psychiatry
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2001
Fit for Purpose-Re-Designing Australia's Mental Health Information System
Publisher: MDPI AG
Date: 15-04-2022
Abstract: Background: Monitoring and reporting mental health is complex. Australia’s first National Mental Health Strategy in 1992 included a new national commitment to accountability and data collection in mental health. This article provides a narrative review of thirty years of experience. Materials and Methods: This review considers key documents, policies, plans and strategies in relation to the evolution of mental health data and reporting. Documents produced by the Federal and the eight state and territory governments are considered, as well as publications produced by key information agencies, statutory authorities and others. A review of this literature demonstrates both its abundance and limitations. Results: Australia’s approach to mental health reporting is characterised by duplication and a lack of clarity. The data available fail to do justice to the mental health services provided in Australia. Mental health data collection and reporting processes are centrally driven, top–down and activity-focused, largely eschewing actual health outcomes, the social determinants of mental health. There is little, if any, link to clearly identifiable service user or carer priorities. Consequently, it is difficult to link this process longitudinally to clinical or systemic quality improvement. Initial links between the focus of national reform efforts and mental health data collection were evident, but these links have weakened over time. Changes to governance and reporting, including under COVID, have made the task of delivering accountability for mental health more difficult. Conclusion: Australia’s current approach is not fit for purpose. It is at a pivotal point in mental health reform, with new capacity to use modelled data to simulate prospective mental health reform options. By drawing on these new techniques and learning the lessons of the past, Australia (and other nations) can design and implement more effective systems of planning, reporting and accountability for mental health.
The EMPOWER Occupational eMental Health (OeMH) implementation checklist. A tool for fostering eMental Health interventions in the workplace (Preprint)
Publisher: JMIR Publications Inc.
Date: 26-04-2023
Abstract: ccupational eMental Health (OeMH) interventions significantly reduce the burden of mental health conditions. However, the successful implementation of OeMH interventions is influenced by many implementation strategies, barriers and facilitators across contexts. Therefore, there is a need for practical guidance on the key implementation factors that organizations must address. Stakeholder consultations secure a valuable source of information on these key strategies, barriers and facilitators that are relevant to the successful implementation of OeMH interventions. he objective of this study was to develop a brief checklist to guide the implementation of OeMH interventions. e created a comprehensive checklist moving from a set of strategies, barriers, and facilitators relevant to the implementation of OeMH interventions that were identified in a recently published systematic review. We then relied on a two-stage stakeholder consultation process to reduce the comprehensive checklist to a brief checklist comprising key implementation factors. At the first stage, stakeholders evaluated the relevance and feasibility of items on the comprehensive checklist using a web-based survey. At the second stage, stakeholders were interviewed to elaborate on the most relevant barriers and facilitators shortlisted from the first stage. wenty-six stakeholders completed the web survey (response rate: 25%) and four stakeholders participated in in idual interviews. The EMPOWER OeMH implementation checklist comprises 28 items including 9 strategies, 8 barriers and 11 facilitators. hrough our two-stage stakeholder consultation we developed a brief implementation checklist that provides organizations with a guide for the implementation of OeMH interventions. Future research should empirically validate the effectiveness and usefulness of the checklist.
Using Geospatial Analysis to Inform Development of a Place-Based Integrated Care Initiative: The Healthy Homes and Neighbourhoods Experience
Publisher: Ubiquity Press, Ltd.
Date: 2021
DOI: 10.5334/IJIC.5430
Relative Technical Efficiency Assessment of Mental Health Services: A Systematic Review
Publisher: Springer Science and Business Media LLC
Date: 14-12-1970
DOI: 10.1007/S10488-019-00921-6
Abstract: The current prevalence of mental disorders demands improved ways of the management and planning of mental health (MH) services. Relative technical efficiency (RTE) is an appropriate and robust indicator to support decision-making in health care, but it has not been applied significantly in MH. This article systematically reviews the empirical background of RTE in MH services following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Finally, 13 studies were included, and the findings provide new standard classifications of RTE variables, efficiency determinants and strategies to improve MH management and planning.
Person-centred integrative diagnosis: conceptual bases and structural model.
Publisher: SAGE Publications
Date: 11-2010
DOI: 10.1177/070674371005501103
Abstract: To review the conceptual bases of Person-centred Integrative Diagnosis (PID) as a component and contributor to person-centred psychiatry and medicine and to outline its design and development. An analysis was conducted of the historical roots of person-centred psychiatry and medicine, tracing them back to ancient Eastern and Western civilizations, to the vicissitudes of modern medicine, to recent clinical and conceptual developments, and to emerging efforts to reprioritize medicine from disease to patient to person in collaboration with the World Medical Association, the World Health Organization, the World Organization of Family Doctors, the World Federation for Mental Health, and numerous other global health entities, and with the coordinating support of the International Network for Person-centered Medicine. One of the prominent endeavours within the broad paradigmatic health development outlined above is the design of PID. This diagnostic model articulates science and humanism to obtain a diagnosis of the person (of the totality of the person's health, both ill and positive aspects), by the person (with clinicians extending themselves as full human beings), for the person (assisting the fulfillment of the person's health aspirations and life project), and with the person (in respectful and empowering relationship with the person who consults). This broader and deeper notion of diagnosis goes beyond the more restricted concepts of nosological and differential diagnoses. The proposed PID model is defined by 3 keys: broad informational domains, covering both ill health and positive health along 3 levels: health status, experience of health, and contributors to health pluralistic descriptive procedures (categories, dimensions and narratives) and evaluative partnerships among clinicians, patients, and families. An unfolding research program is focused on the construction of a practical guide and its evaluation, followed by efforts to facilitate clinical implementation and training. PID is aimed at appraising overall health through pluralistic descriptions and evaluative partnerships, and leading through a research program to more effective, integrative, and person-centred health care.
The “PRE” scale: The assessment of the elementary passively received experiences of schizophrenia
Publisher: Elsevier BV
Date: 03-2022
Mental Fatigue Might Be Not So Bad for Exercise Performance After All: A Systematic Review and Bias-Sensitive Meta-Analysis
Publisher: Ubiquity Press, Ltd.
Date: 2020
DOI: 10.5334/JOC.126
The effects of transcranial direct current stimulation on objective and subjective indexes of exercise performance: A systematic review and meta-analysis
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.BRS.2018.12.002
Abstract: To examine the effects of transcranial direct current stimulation (tDCS) on objective and subjective indexes of exercise performance. Systematic review and meta-analysis. A systematic literature search of electronic databases (PubMed, Web of Science, Scopus, Google Scholar) and reference lists of included articles up to June 2018. Published articles in journals or in repositories with raw data available, randomized sham-controlled trial comparing anodal stimulation with a sham condition providing data on objective (e.g. time to exhaustion or time-trial performance) or subjective (e.g. rate of perceived exertion) indexes of exercise performance. The initial search provided 420 articles of which 31 were assessed for eligibility. Finally, the analysis of effect sizes comprised 24 studies with 386 participants. The analysis indicated that anodal tDCS had a small but positive effect on performance g = 0.34, 95% CI [0.12, 0.52], z = 3.24, p = .0012. Effects were not significantly moderated by type of outcome, electrode placement, muscles involved, number of sessions, or intensity and duration of the stimulation. Importantly, the funnel plot showed that, overall, effect sizes tended to be larger in studies with lower s le size and high standard error. The results suggest that tDCS may have a positive impact on exercise performance. However, the effect is probably small and most likely biased by low quality studies and the selective publication of significant results. Therefore, the current evidence does not provide strong support to the conclusion that tDCS is an effective means to improve exercise performance.
Is the performance of an Integrated Mental Health Network related to its readiness for chronicity and/or structures?
Publisher: Ubiquity Press, Ltd.
Date: 10-2014
DOI: 10.5334/IJIC.1723
The Girona declaration on borderline intellectual functioning
Publisher: Elsevier BV
Date: 03-2020
The Influence of Falling Costs for Electrolyzers on the Location Factors for Green Hydrogen Production
Publisher: Wiley
Date: 04-07-2023
Abstract: A fast and extensive build‐up of green hydrogen production is a crucial element for the global energy transition. The availability of low‐cost renewable energy at high operating hours of the electrolyzer is a central criterion in today's choice of location for green hydrogen production. It is analyzed how decreasing electrolyzer costs that are expected by many may influence this choice. The energy system optimization framework ESTRAM is used to find the optimum configuration of wind turbine, photovoltaic (PV), and electrolyzer capacity for covering a given hydrogen demand by locally produced green hydrogen in different European locations. It is found that PV is part of the cost‐optimal solution in 96% of 1372 statistical regions in Europe. Decreasing electrolyzer costs are favoring the utilization of PV in wind–solar hybrid plants. At low electrolyzer costs, pure solar hydrogen outperforms the hybrid variant in many places if hydrogen storage is available, even with few full operating hours per year. At the same time, production costs are converging significantly. The article adds a new perspective to the discussion, as it is systematically shown how further technology development may lead to a shift in locational advantages for green hydrogen production, what should be considered to avoid stranded assets when building infrastructure.
A multi-level analysis of the relationship between spatial clusters of outpatient-treated depression, risk factors and mental health service planning in Catalonia (Spain)
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.JAD.2016.04.024
Abstract: Previous research identified high/low clusters of prevalence of outpatient-treated depression at municipal level in Catalonia (Spain). This study aims to analyse potential risk factors, both socioeconomic and related to the mental health service planning, which could influence the occurrence of hot/cold spots of depressed outpatients at two geographical levels: municipalities and service catchment areas. Hot/cold spots were examined in relation to socioeconomic indicators at municipal level, such as population density, unemployment, university education, personal income, and also those related to service planning at catchment area level, such as adequacy of healthcare, urbanicity, accessibility and the availability of mental health community centres. The analysis has been carried out through multilevel logistic regression models in order to consider the two different scales. Hot spots are related to high population density, unemployment, urbanicity, the adequacy of provision of mental health services, and accessibility to mental health community centres at both study levels. On the other hand, the multilevel model weakly explains cold spots, associating them with high personal incomes. The dependent variables of the multi-level models are binary. This limits the interpretation of the results, since they cannot provide information about the variance of the dependent variables explained by the models. The results described erse risk factors at two levels which are related to a high likelihood of hot and cold spots of depression. The findings show the relevance of health planning in the distribution of diseases and the utilisation of healthcare services.
Integrating between-session homework in psychotherapy: A systematic review of immediate in-session and intermediate outcomes.
Publisher: American Psychological Association (APA)
Date: 09-2023
DOI: 10.1037/PST0000488
Treatment adequacy of anxiety and depressive disorders: Primary versus specialised care in Spain
Publisher: Elsevier BV
Date: 11-2006
DOI: 10.1016/J.JAD.2006.05.005
Abstract: Literature suggests that a high proportion of the population with mental disorders remains either untreated or poorly treated. This study aimed to describe the adequacy of treatment for Anxiety and Depressive disorders in Spain, how this differs between providers (primary versus specialised care) and which factors are associated with appropriate care. Data were derived from the Spanish s le (N=5473) of the European Study of the Epidemiology of Mental Disorders (ESEMeD), a cross sectional study in a representative s le of adults. The subs le analyzed was composed by the 133 subjects with a mental disorder in the year prior to the interview who received treatment. Treatment adequacy was evaluated in two different ways: (1) considering definitions of minimally adequate treatment evidence based guidelines and criteria used in other epidemiological studies (2) considering experts rating of treatment appropriateness based on the information contained in the case vignettes created from the CIDI answers. Generalised Estimating Equation (GEE) models and simple logistic regression were conducted to assess the correlates of adequate treatment. Similar proportions of patients in specialty and general medical treatment received a minimally adequate treatment (31.8% and 30.5%, respectively). Associated factors to appropriateness were living in a large city, having a high educational level, and having a good self rated health state. Treatment adequacy was based on simple information and criteria. Only one third of the mental health treatment in Spain met minimal adequacy criteria. More research is needed in order to find out reasons for these low rates.
Use of the European Classification of services ‘DESDE-LTC’ for integral mapping of mental health in Catalonia (Spain)
Publisher: Ubiquity Press, Ltd.
Date: 23-10-2013
DOI: 10.5334/IJIC.1289
The persistence of digital divides in the use of health information: a comparative study in 28 European countries
Publisher: Springer Science and Business Media LLC
Date: 04-2020
Identification and location of hot and cold spots of treated prevalence of depression in Catalonia (Spain)
Publisher: Springer Science and Business Media LLC
Date: 24-08-2012
Abstract: Spatial analysis is a relevant set of tools for studying the geographical distribution of diseases, although its methods and techniques for analysis may yield very different results. A new hybrid approach has been applied to the spatial analysis of treated prevalence of depression in Catalonia (Spain) according to the following descriptive hypotheses: 1) spatial clusters of treated prevalence of depression (hot and cold spots) exist and, 2) these clusters are related to the administrative isions of mental health care (catchment areas) in this region. In this ecological study, morbidity data per municipality have been extracted from the regional outpatient mental health database (CMBD-SMA) for the year 2009. The second level of analysis mapped small mental health catchment areas or groups of municipalities covered by a single mental health community centre. Spatial analysis has been performed using a Multi-Objective Evolutionary Algorithm (MOEA) which identified geographical clusters (hot spots and cold spots) of depression through the optimization of its treated prevalence. Catchment areas, where hot and cold spots are located, have been described by four domains: urbanicity, availability, accessibility and adequacy of provision of mental health care. MOEA has identified 6 hot spots and 4 cold spots of depression in Catalonia. Our results show a clear spatial pattern where one cold spot contributed to define the exact location, shape and borders of three hot spots. Analysing the corresponding domain values for the identified hot and cold spots no common pattern has been detected. MOEA has effectively identified hot/cold spots of depression in Catalonia. However these hot/cold spots comprised municipalities from different catchment areas and we could not relate them to the administrative distribution of mental care in the region. By combining the analysis of hot/cold spots, a better statistical and operational-based visual representation of the geographical distribution is obtained. This technology may be incorporated into Decision Support Systems to enhance local evidence-informed policy in health system research.
Conocimiento sobre trastornos del neurodesarrollo asociado con la aceptación del modelo de educación inclusiva en docentes de educación básica
Publisher: Instituto Nacional de Salud Publica
Date: 29-08-2020
DOI: 10.21149/11204
Abstract: Objetivo. Describir la prevalencia del conocimiento sobre trastornos del neurodesarrollo (TdN) y el nivel de aceptación de los modelos de educación inclusiva (MEI) en docentes. Material y métodos. Estudio transversal multicéntrico en México y Centroamérica. Aplicación de un instrumento de autorreporte a docentes de nivel básico sobre conocimiento en TdN y aceptación de los MEI. Resultados. Se obtuvo la respuesta de 511 docentes. La prevalencia de alta aceptación de MEI fue de 28.6%. De los 120 docentes que refirieron tener un lio conocimiento sobre discapacidad intelectual, 3.8% estuvieron en el percentil más bajo de aceptación de MEI, 19.5% en el percentil de aceptación promedio y 55.5% de ellos se encontraron en el percentil de mayor aceptación (p .001). Entre los docentes, un mayor conocimiento sobre los TdN se mostró asociado con la aceptación de MEI: trastornos del aprendizaje RM 3.76 (IC95% 2.13-6.62) trastornos por déficit de atención con hiperactividad RM 2.24 (IC95% 1.31-3.84) y discapacidad intelectual RM 3.84 (IC95% 2.46-5.99). Conclusiones. La aceptación docente de MEI puede favorecerse con una mayor y mejor capacitación de los profesionales de la educación sobre los diferentes TdN.
The Cost of Generalized Anxiety Disorder in Primary Care Settings: Results of the ANCORA Study
Publisher: Springer Science and Business Media LLC
Date: 08-04-2012
DOI: 10.1007/S10597-012-9503-4
Abstract: To assess the cost of illness of generalized anxiety disorder (GAD) in a primary healthcare setting in Spain. A cross-sectional, retrospective study was conducted. The s le comprised patients diagnosed with GAD according to ICD-10 criteria and a control group. Healthcare/non-healthcare resource utilization was recorded retrospectively for the 12 months prior to the study visit. Costs were estimated from a societal perspective. Two models have been produced to study the variables that influence the cost of the illness both, without and with controls. The study enrolled 456 patients [76.8 % women, 49.2 (17.0) years] with GAD and 74 controls without GAD [42.5 % women, 47.9 (16.7) years]. 67.8 % of subjects were on combination therapy (antidepressant + anxiolytic) 6 % were using 2 or more drugs to treat anxiety and 23.4 % were on monotherapy. Total annual average costs were higher in the GAD group (€7,739 vs. €2,609), with mean costs attributable to GAD of €5,139 (healthcare costs: €1,329, indirect costs: 75 % of total cost, approximately). Age and health status measured by Hamilton Anxiety Rating Scale and clinical global impression were related to costs. The improvements in quality of life measured by EQ-5D index are associated to lower cost. GAD treated in Spanish primary healthcare settings generated considerable healthcare costs and, particularly, loss-of-productivity costs.
Pedro Enrique Muñoz Rodríguez: un psiquiatra social en tiempos de confusión
Publisher: Elsevier BV
Date: 07-2022
Erratum: Consensus statement for inert gas washout measurement using multiple- and single-breath tests (European Respiratory Journal (2013) 41 (507-522))
Publisher: European Respiratory Society (ERS)
Date: 31-10-2013
A spatial analysis of referrals to a primary mental health programme in Western Sydney from 2012 to 2015
Publisher: PAGEPress Publications
Date: 06-11-2019
DOI: 10.4081/GH.2019.773
Abstract: Access to Allied Psychological Services is a primary mental health programme targeting hard-to-reach populations throughout Australia. This research aims to identify patterns of referrals to the programme in the Western Sydney Primary Health Network region from 2012 to 2015. The referral rates were analysed by using spatial autocorrelation indexes and spatial regression. The study area was described through the identification of the most disadvantaged areas and through consideration of three socio-economic indicators: percentage of Aboriginal and Torres Strait Islander Australians, low educational attainment and low weekly incomes. A large hot spot (identifying high referral rates) was located across the duration of the study in the south-western urban area that partially covered a disadvantaged area. The main cold spot (identifying low referral rates) was located in the south-eastern urban area, covering another disadvantaged area, however critically this association disappeared over time. Our modelling showed that the referral rates had a direct association with the percentage of Aboriginal and Torres Strait Islander peoples with low incomes, and an indirect association with low educational attainment. The results and technique are useful in monitoring and addressing inequality in health planning and policy.
Intellectual disability in Australian nursing education: Experiences in NSW and Tasmania
Publisher: Informa UK Limited
Date: 11-2017
A preliminary taxonomy and a standard knowledge base for mental-health system indicators in Spain
Publisher: Springer Science and Business Media LLC
Date: 2010
Integrated Care for People with Intellectual Disability
Publisher: Springer International Publishing
Date: 2021
The Person-Centered Health model in Intellectual Developmental Disorders/Intellectual Disability
Publisher: SciELO Espana/Repisalud
Date: 12-2015
Patterns of mental health care provision in urban areas: A comparative analysis for local policy in the ACT
Publisher: Public Library of Science (PLoS)
Date: 12-04-2023
DOI: 10.1371/JOURNAL.PONE.0284241
Abstract: Urbanisation presents specific mental health challenges, requiring a better understanding of service availability in urban areas for mental health care planning. Our objective is to analyse patterns of urban mental healthcare provision in Australia, and compare these with relevant national and international regions to inform urban mental healthcare policy and planning. Following a health ecosystems approach, we use a standardised service classification instrument, the Description and Evaluation of Services and DirectoriEs (DESDE), and Mental Health Care Atlases, to compare the availability, bed capacity and ersity of services providing specialised mental health or psychosocial care that are universally accessible (ie provided at no or low cost only in all relevant care sectors in four Australian and three international urban regions. We used a heuristics approach and an homogeneity test. Applicability to local policy was assessed using the Adoption Impact Ladder. Community care was less developed in Australia than internationally, except in the case of residential care in Australian Capital Territory, our reference area. Alternatives to hospitalisation were scarce across all regions. The Atlas was applicable to regional and local mental health planning. Differences in pattern of care between regions has implications for planning, equality of access to care and prioritisation of resources. An ecosystems approach is relevant to service planning in mental healthcare at local level.
Person-Centered Psychiatric and Mental Health Research
Publisher: Springer International Publishing
Date: 2016
Cost-effectiveness analysis of a collaborative care programme for depression in primary care
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.JAD.2014.01.021
Abstract: Collaborative care programmes lead to better outcomes in the management of depression. A programme of this nature has demonstrated its effectiveness in primary care in Spain. Our objective was to evaluate the cost-effectiveness of this programme compared to usual care. A bottom-up cost-effectiveness analysis was conducted within a randomized controlled trial (2007-2010). The intervention consisted of a collaborative care programme with clinical, educational and organizational procedures. Outcomes were monitored over a 12 months period. Primary outcomes were incremental cost-effectiveness ratios (ICER): mean differences in costs ided by quality-adjusted life years (QALY) and mean differences in costs ided by depression-free days (DFD). Analyses were performed from a healthcare system perspective (considering healthcare costs) and from a society perspective (including healthcare costs plus loss of productivity costs). Three hundred and thirty-eight adult patients with major depression were assessed at baseline. Only patients with complete data were included in the primary analysis (166 in the intervention group and 126 in the control group). From a healthcare perspective, the average incremental cost of the programme compared to usual care was €182.53 (p<0.001). Incremental effectiveness was 0.045 QALY (p=0.017) and 40.09 DFD (p=0.011). ICERs were €4,056/QALY and €4.55/DFD. These estimates and their uncertainty are graphically represented in the cost-effectiveness plane. The amount of 13.6% of patients with incomplete data may have introduced a bias. Available data about non-healthcare costs were limited, although they may represent most of the total cost of depression. The intervention yields better outcomes than usual care with a modest increase in costs, resulting in favourable ICERs. This supports the recommendation for its implementation.
Healthcare ecosystems research in mental health: a scoping review of methods to describe the context of local care delivery
Publisher: Springer Science and Business Media LLC
Date: 18-03-2019
Evidence-based medicine: Is it a bridge too far?
Publisher: Springer Science and Business Media LLC
Date: 06-11-2015
Integrated mental health atlas of the Western Sydney Local Health District: gaps and recommendations.
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/AH15154
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.
Development of the Australian neighborhood social fragmentation index and its association with spatial variation in depression across communities
Publisher: Springer Science and Business Media LLC
Date: 15-04-2019
DOI: 10.1007/S00127-019-01712-Y
Abstract: We know little about how community structures influence the risk of common mental illnesses. This study presents a new way to establish links between depression and social fragmentation, thereby identifying pathways to better target mental health services and prevention programs to the right people in the right place. A principal components analysis (PCA) was conducted to develop the proposed Australian neighborhood social fragmentation index (ANSFI). General practice clinical data were used to identify cases of diagnosed depression. The association between ANSFI and depression was explored using multilevel logistic regression. Spatial hot spots (clusters) of depression prevalence and social fragmentation at the statistical area level 1 (SA1) were examined. Two components of social fragmentation emerged, reflecting fragmentation related to family structure and mobility. In iduals treated for depression in primary care were more likely to live in neighborhoods with lower socioeconomic status and with higher social fragmentation related to family structure. A 1-SD increase in social fragmentation was associated with a 16% higher depression prevalence (95% CI 11%, 20%). However, the association attenuated with adjustment for neighborhood socio-economic status. Considerable spatial variation in social fragmentation and depression patterns across communities was observed. Developing a social fragmentation index for the first time in Australia at a small area level generates a new line of knowledge on the impact of community structures on health risks. Findings may extend our understanding of the mechanisms that drive geographical variation in the incidence of common mental disorders and mental health care.
Electronic cigarettes: A position statement from the Thoracic Society of Australia and New Zealand*
Publisher: Wiley
Date: 26-07-2020
DOI: 10.1111/RESP.13904
Teleconsultation Between Patients and Health Care Professionals in the Catalan Primary Care Service: Message Annotation Analysis in a Retrospective Cross-Sectional Study
Publisher: JMIR Publications Inc.
Date: 17-09-2020
DOI: 10.2196/19149
Abstract: Over the last decade, telemedicine services have been introduced in the public health care systems of several industrialized countries. In Catalonia, the use of eConsulta, an asynchronous teleconsultation service between primary care professionals and citizens in the public health care system, has already reached 1 million cases. Before the COVID-19 pandemic, the use of eConsulta was growing at a monthly rate of 7%, and the growth has been exponential from March 15, 2020 to the present day. Despite its widespread usage, there is little qualitative evidence describing how this tool is used. The aim of this study was to annotate a random s le of teleconsultations from eConsulta, and to evaluate the level of agreement between health care professionals with respect to the annotation. Twenty general practitioners retrospectively annotated a random s le of 5382 cases managed by eConsulta according to three aspects: the type of interaction according to 6 author-proposed categories, whether the practitioners believed a face-to-face visit was avoided, and whether they believed the patient would have requested a face-to-face visit had eConsulta not been available. A total of 1217 cases were classified three times by three different professionals to assess the degree of consensus among them. The general practitioners considered that 79.60% (4284/5382) of the teleconsultations resulted in avoiding a face-to-face visit, and considered that 64.96% (3496/5382) of the time, the patient would have made a face-to-face visit in the absence of a service like eConsulta. The most frequent uses were for management of test results (26.77%, 1433/5354), management of repeat prescriptions (24.30%, 1301/5354), and medical enquiries (14.23%, 762/5354). The degree of agreement among professionals as to the annotations was mixed, with the highest consensus demonstrated for the question “Has the online consultation avoided a face-to-face visit?” (3/3 professionals agreed 67.95% of the time, 827/1217), and the lowest consensus for the type of use of the teleconsultation (3/3 professionals agreed 57.60% of the time, 701/1217). This study shows the ability of eConsulta to reduce the number of face-to-face visits for 55% (79% × 65%) to 79% of cases. In comparison to previous research, these results are slightly more pessimistic, although the rates are still high and in line with administrative data proxies, showing that 84% of patients using teleconsultations do not make an in-person appointment in the following 3 months. With respect to the type of consultation performed, our results are similar to the existing literature, thus providing robust support for eConsulta’s usage. The mixed degree of consensus among professionals implies that results derived from artificial intelligence tools such as message classification algorithms should be interpreted in light of these shortcomings.
The impact of Covid-19 pandemic on community-oriented mental health services: The experience of Friuli Venezia Giulia region, Italy
Publisher: Elsevier BV
Date: 03-2021
Development of a new spatial analysis tool in mental health: Identification of highly autocorrelated areas (hot-spots) of schizophrenia using a Multiobjective Evolutionary Algorithm model (MOEA/HS)
Publisher: Cambridge University Press (CUP)
Date: 12-2010
DOI: 10.1017/S1121189X00000646
Abstract: Aims — This study had two objectives: 1) to design and develop a computer-based tool, called Multi-Objective Evolutionary Algorithm/Hot-Spots (MOEA/HS), to identify and geographically locate highly autocorrelated zones or hot-spots and which merges different methods, and 2) to carry out a demonstration study in a geographical area where previous information about the distribution of schizophrenia prevalence is available and which can therefore be compared. Methods — Local Indicators of Spatial Aggregation (LISA) models as well as the Bayesian Conditional Autoregressive Model (CAR) were used as objectives in a multicriteria framework when highly autocorrelated zones (hot-spots) need to be identified and geographically located. A Multi-Objective Evolutionary Algorithm (MOEA) model was designed and used to identify highly autocorrelated areas of the prevalence of schizophrenia in Andalusia. Hot-spots were statistically identified using exponential-based QQ-Plots (statistics of extremes). Results — Efficient solutions (Pareto set) from MOEA/HS were analysed statistically and one main hot-spot was identified and spatially located. Our model can be used to identify and locate geographical hot-spots of schizophrenia prevalence in a large and complicated region. Conclusions — MOEA/HS enables a compromise to be achieved between different econometric methods by highlighting very special zones in complex areas where schizophrenia shows a high autocorrelation. Declaration of Interest: This study was partly supported by the Andalusian Government, P05-TIC-00531, PAI:P06-CTS-01765, CTS-587, PI-338/2008] the Ministry of Education and Science [TIN2005–08386-C05–02] and the Ministry of Health [PI08/90752]. No additional financial sources have been received. No involvements are in conflict with this paper.
Health services use and costs in people with intellectual disability
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2016
Individual Health Budgets in Mental Health: Results of Its Implementation in the Friuli Venezia Giulia Region, Italy
Publisher: MDPI AG
Date: 13-07-2020
Abstract: Background: In idual Health Budget (IHB) is an intervention for recovery in mental health services, providing personalized care for subjects with severe disorders and complex needs. Little is known on its effectiveness and on the criteria for its delivery. Methods: A total of 67 IHB beneficiaries and 61 comparators were recruited among service users of the Mental Health Department of the Trieste Healthcare Agency, Italy. Data included sociodemographic and clinical variables, type of IHB, and Health of the Nation Outcome Scale (HoNOS) scores. Results: A comparison between groups showed significant differences in several socioeconomic and clinical characteristics. Multivariate logistic regression showed that IHB was positively associated to the 20–49 age group, single status, unemployment, low family support, cohabitation with relatives or friends, diagnosis of personality disorder, and a higher number of hospitalizations. The IHB group was at a higher risk of severe problems related to aggressive or agitated behaviors (OR = 1.4), hallucinations and delusions (OR = 1.5), and impairment in everyday life activities (OR = 2.1). Conclusions: IHB was used in patients with severe clinical and social problems. More resources, however, may be aimed at the working and social axes. More research is needed to better assess clinical and social outcomes of IHB and to adjust their intensity in a longitudinal perspective in order to enhance cost-effectiveness.
Preventing the onset of major depression based on the level and profile of risk of primary care attendees: protocol of a cluster randomised trial (the predictD-CCRT study)
Publisher: Springer Science and Business Media LLC
Date: 19-06-2013
Attachment and child behaviour and emotional problems in autism spectrum disorder with intellectual disability
Publisher: Wiley
Date: 19-11-2020
DOI: 10.1111/JAR.12689
Abstract: Behaviour and emotional problems are highly prevalent in children with autism spectrum disorder (ASD). In typically developing children, attachment quality acts as a risk rotective factor for behavioural outcomes and adjustment, warranting investigation in children with ASD. We investigated the relationship between attachment and child behaviour and emotional problems in children with ASD and comorbid intellectual disability. Data were collected from parent-child dyads where children were diagnosed with ASD and ID (n = 28) or other developmental disabilities (n = 20). Children with ASD had higher levels of behaviour and emotional problems and more attachment difficulties than children with other developmental disabilities. Poorer attachment quality contributed uniquely to the variance in child behaviour and emotional problems. Interventions targeting behaviour and emotional problems in children with ASD may benefit from an attachment model which addresses the child's difficulty in using caregivers as a coregulatory agent of emotions.
Degree of cognitive impairment and mortality: a 17-year follow-up in a community study
Publisher: Cambridge University Press (CUP)
Date: 06-06-2014
DOI: 10.1017/S2045796014000390
Abstract: To test the hypothesis that cognitive impairment in older adults is associated with all-cause mortality risk and the risk increases when the degree of cognitive impairment augments and then, if this association is confirmed, to report the population-attributable fraction (PAF) of mortality due to cognitive impairment. A representative random community s le of in iduals aged over 55 was interviewed, and 4557 subjects remaining alive at the end of the first year of follow-up were included in the analysis. Instruments used in the assessment included the Mini-Mental Status Examination (MMSE), the History and Aetiology Schedule (HAS) and the Geriatric Mental State (GMS)-AGECAT. For the standardised degree of cognitive impairment Perneczky et al 's MMSE criteria were applied. Mortality information was obtained from the official population registry. Multivariate Cox proportional hazard models were used to test the association between MMSE degrees of cognitive impairment and mortality risk. We also estimated the PAF of mortality due to specific MMSE stages. Cognitive impairment was associated with mortality risk, the risk increasing in parallel with the degree of cognitive impairment (Hazard ratio, HR: 1.18 in the ‘mild’ degree of impairment HR: 1.29 in the ‘moderate’ degree and HR: 2.08 in the ‘severe’ degree). The PAF of mortality due to severe cognitive impairment was 3.49%. A gradient of increased mortality-risk associated with severity of cognitive impairment was observed. The results support the claim that routine assessment of cognitive function in older adults should be considered in clinical practice.
Official ERS technical standards: Global Lung Function Initiative reference values for the carbon monoxide transfer factor for Caucasians
Publisher: European Respiratory Society (ERS)
Date: 09-2017
DOI: 10.1183/13993003.00010-2017
Abstract: There are numerous reference equations available for the single-breath transfer factor of the lung for carbon monoxide (
Occupational exposure to solvents and lung function decline: A population based study
Publisher: BMJ
Date: 26-04-2019
DOI: 10.1136/THORAXJNL-2018-212267
Abstract: While cross-sectional studies have shown associations between certain occupational exposures and lower levels of lung function, there was little evidence from population-based studies with repeated lung function measurements. We aimed to investigate the associations between occupational exposures and longitudinal lung function decline in the population-based Tasmanian Longitudinal Health Study. Lung function decline between ages 45 years and 50 years was assessed using data from 767 participants. Using lifetime work history calendars completed at age 45 years, exposures were assigned according to the ALOHA plus Job Exposure Matrix. Occupational exposures were defined as ever exposed and cumulative exposure -unit- years. We investigated effect modification by sex, smoking and asthma status. Compared with those without exposure, ever exposures to aromatic solvents and metals were associated with a greater decline in FEV 1 (aromatic solvents 15.5 mL/year (95% CI −24.8 to 6.3) metals 11.3 mL/year (95% CI −21.9 to – 0.7)) and FVC (aromatic solvents 14.1 mL/year 95% CI −28.8 to – 0.7 metals 17.5 mL/year (95% CI –34.3 to – 0.8)). Cumulative exposure (unit years) to aromatic solvents was also associated with greater decline in FEV 1 and FVC. Women had lower cumulative exposure years to aromatic solvents than men (mean (SD) 9.6 (15.5) vs 16.6 (14.6)), but greater lung function decline than men. We also found association between ever exposures to gases/fumes or mineral dust and greater decline in lung function. Exposures to aromatic solvents and metals were associated with greater lung function decline. The effect of aromatic solvents was strongest in women. Preventive strategies should be implemented to reduce these exposures in the workplace.
Ordinal classification of depression spatial hot-spots of prevalence
Publisher: IEEE
Date: 11-2011
Economic context analysis in mental health care. Usability of health financing and cost of illness studies for international comparisons
Publisher: Cambridge University Press (CUP)
Date: 03-2011
DOI: 10.1017/S2045796011000072
Abstract: This paper discusses an integrated approach to mental health studies on Financing of Illness (FoI) and health accounting, Cost of Illness (CoI) and Burden of Disease (BoD). In order to expand the mental health policies, the following are suggested: (a) an international consensus on the standard scope, methods to collect and to analyse mental health data, as well as to report comparative information (b) mathematical models are also to be validated and tested in an integrated approach, (c) a better knowledge transfer between clinicians and knowledge engineers, and between researchers and policy makers to translate economic analysis into practice and health planning.
Hemodynamic determinants of the abnormal cardiopulmonary exercise response in heart failure with preserved left ventricular ejection fraction
Publisher: Elsevier BV
Date: 09-2012
Related Organisations
Ministerio De Sanidad, Servicios Sociales E Igualdad
Location: No location found
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End Date: 2017
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Start Date: 05-2020
End Date: 12-2021
Amount: $580,000.00
Funder: Australian Research Council
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