Associations between daily variations in summer temperatures and mental health-related emergency department visits in Ontario, Canada
Bibliographic record
Abstract
Background: According to the Intergovernmental Panel on Climate Change (IPCC), the 21 st century will be marked by an increase in the frequency, intensity, and duration of heat-related events.Several studies have assessed the effects of temperature on mental and behavioural disorders, most of which have reported increased risks.However, there is a paucity of investigations on certain mental and behavioural disorders.Moreover, a limited number of studies have investigated the impacts of apparent temperature, a metric computed using ambient temperature, relative humidity, and wind velocity.Evidence regarding effect modification is also limited and mixed.Objectives: This thesis aims to estimate associations between daily variations in ambient temperature and apparent temperature and the risk of emergency department visits for mental and behavioural disorders, as categorized by the Tenth Revision of the International Statistical Classification of Diseases (ICD-10), in Ontario, Canada.Additionally, this thesis seeks to examine how age, biological sex, material deprivation, social deprivation, tree canopy, and building density may modify the strength of these associations.Methods: A time-stratified case-crossover study was conducted using all emergency department visits for mental and behavioural disorders excluding disorders of intellectual development (ICD-10, F00-F69; F80-F99) registered in Ontario from 2004 to 2019, between June and September.Information regarding emergency department visits and demographic characteristics was derived from the National Ambulatory Care Reporting System (NACRS).Environmental and neighborhood characteristics were obtained from the Canadian Urban Environmental Health Research Consortium (CANUE).Weather data and air pollutant concentrations were extracted from Daymet and the National Air Pollution Surveillance (NAPS) program, respectively.Conditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) describing the relationships between daily variations in ambient temperature and the risk of emergency department visits for mental and behavioural disorders.Models were examined with and without adjusting for daily mean ozone (O 3 ), nitrogen dioxide (NO2), and fine particulate matter (PM2.5)concentrations, and effect modification by age, iii biological sex, material deprivation, social deprivation, tree canopy, and building density was evaluated using stratified analyses.All analyses were reproduced using apparent temperature.Results: In total, 1,107,614 emergency department visits for mental and behavioural disorders excluding disorders of intellectual development were recorded during the study period.The association between temperature and the risk of emergency department visits for mental and behavioural disorders overall was strongest for lag 0 (OR: 1.0219 per 5 °C increase in ambient temperature, 95% CI: 1.0172, 1.027) and decreased with increasing lag time.The risk of emergency department visits for mental and behavioural disorders overall was similar in males (OR: 1.021 per 5 °C increase in the 3-day mean ambient temperature, 95% CI: 1.0136, 1.029) and females (OR: 1.0173 per 5 °C increase in the 3-day mean ambient temperature, 95% CI:1.0094, 1.025).Conversely, temperature was associated with a lower risk of emergency department visits for mental and behavioural disorders overall among those aged 17 years and younger (OR: 0.9158 per 5 °C increase in the 3-day mean ambient temperature, 95% CI: 0.8987, 0.9333) and those least socially deprived (OR: 0.9948 per 5 °C increase in the 3-day mean ambient temperature, 95% CI: 0.9615, 1.029).Associations between apparent temperature and the risk of emergency department visits for mental and behavioural disorders were comparable to those described for ambient temperature.Conclusion: Overall, this thesis suggests that increases in summer temperatures are associated with an increased risk of emergency department visits for mental and behavioural disorders in adults, both overall and for most groups of conditions studied.Augustinavicius.Your valuable expertise, thoughtful feedback, and generous mentorship have been instrumental to my academic growth.I would also like to acknowledge my committee member, Dr. Eric Lavigne, for his time and guidance, my professors
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".