Background Frequent presenters (FPs) define a group of individual who visit hospital emergency depart-ment (ED) frequently for urgent care. Many among the group present with main diagnosis of mental health conditions. This group of individual tend to use ED resources disproportionally and significantly affect overall healthcare outcome. No previous reviews have examined the profiles of FPs with mental health conditions. Aims This study aims to identify the key socio-demographic and clinical characteristics of patients who frequently present to ED with mental health primary diagnosis by performing systemic review from existing literature. Method PRISMA guideline was used. PubMed, PsycINFO, Scopus and Web of Science (WOS) were searched in May 2023. A manual search on reference list of included articles were conducted at same time. Covidence was used to perform extraction and screening, completed by two authors independently. Inclusion and exclusion criteria were defined. Results The abstracts of 3341 non-duplicate articles were screened with 40 full texts assessed for eligi-bility. 20 studies were included from 2004-2022 conducted in 6 countries with total patient number of 25688 (52% male, 48% female, mean age 40.7 years old). 27% were unemployed, 20% married, 41% homeless, and 17% had tertiary or above education. 44% had history of substance abuse or alcohol dependence. Top 3 diagnosis are found to be anxiety disorders (44%), depressive disorders (39%) and schizophrenia spectrum and other psychotic disorders (33%). Conclusion On average, FPs are middle aged and equally prevalent in both gender. Current data lacks rep-resentation for gender diverse group. They are significantly associated with high rate of unem-ployment, homelessness, lower than average education level, and being single. Anxiety disor-der, depressive disorder, and schizophrenia spectrum disorders are the most common clinical diagnosis associated with the group.

Quantifying the landscape pattern change can effectively demonstrate the ecological progresses and the consequences of urbanization. Based on remotely sensed land cover data in 1994, 2000, 2006 and a gradient analysis with landscape metrics at landscape- and class- level, we attempted to characterize the individual and entire landscape patterns of Shanghai metropolitan during the rapid urbanization. We highlighted that a roadscape transect approach that combined the buffer zone method and the transect-based approach was introduced to describe the urban-rural patterns of agricultural, residential, green, industrial, and public facilities land along the railway route. Our results of landscape metrics showed significant spatiotemporal patterns and gradient variations along the transect. The urban growth pattern in two time spans conform to the hypothesis for diffusion–coalescence processes, implying that the railway is adaptive as a gradient element to analyze the landscape patterns with urbanization. As the natural landscape was replaced by urban landscape gradually, the urban fringe expanded radically. The results also showed that the desakota region expanded its extent widely. Satellite towns witnessed the continual transformation from the predominantly rural landscape to peri-urban landscape. Furthermore, the gap between urban and rural areas remained large especially in public service. More reasonable urban plans and land use policies should push to make more of an effort to transition from the urban-rural separation to coordinated urban-rural development. This study is a meaningful trial in demonstrating a new form of urban–rural transects to study the landscape change of large cities from a strategic viewpoint. By combining gradient analysis with landscape metrics, we addressed the process of urbanization both spatially and temporally, and provided a more quantitative approach to urban studies.