Behavioral And Psychiatric Health Problems In Iranian Students During The COVID-19 Pandemic

Background: the study of behavioral and psychiatric health problems in space and time, can help to improve health services for adolescents and children by increasing understanding of causes, development, and course of psychiatric disorders. This study aimed to examine the behavioral and psychiatric status of adolescences during the pandemic to address the effect of the pandemic and isolation on adolescent behavioral and psychiatric health.Methods: This cross-sectional study has been carried out through cluster sampling design on 322 normal students aged 12-18 attending in public high and elementary school in Esfahan, Iran. They completed study instrument that included the 110-item the Child Symptom Inventory-4 (CSI-4) and those inquiring the students’ demographic information. Results: Findings showed that 58% students met criteria for all psychiatric symptoms except of the autism and Asperger’s disorders, and 39.5% suffered from more than one comorbid categories of psychiatric disorders. The most common psychiatric disorders in boys and girls were ADHD (18.5%), ODD (15%), ADHD-C (13.5%), GAD (12.8%), ADHD: HI (11.5), and MDD (10.8%). Conclusion: Most of students suffered from more than one co-morbid category of psychiatric disorders. It is better to develop effective strategies and interventions, train students about self-protection, and establish a psychological crisis intervention team to minimize the psychological impact of the COVID-19 pandemic.

Findings from a novel and scalable community-based HIV testing approach to reduce the time required to complete point-of-care HIV testing in South Africa

Background Mobile HIV testing approaches are a key to reaching the global targets of halting the HIV epidemic by 2030. Importantly, the number of clients reached through mobile HIV testing approaches, need to remain high to maintain the cost-effectiveness of these approaches. Advances in rapid in-vitro tests such as INSTI® HIV-1/HIV-2 (INSTI) which uses flow-through technologies, offer opportunities to reduce the HIV testing time to about one minute. Using data from a routine mobile HTS programme which piloted the use of the INSTI point-of-care (POC) test, we sought to estimate the effect of using a faster test on client testing volumes and the number of people identified to be living with HIV, in comparison with standard of care HIV rapid tests. Methods In November 2019, one out of four mobile HTS teams operating in Ekurhuleni District (South Africa) was randomly selected to pilot the field use of INSTI-POC test as an HIV screening test (i.e., the intervention team). We compared the median number of clients tested for HIV and the number of HIV-positive clients by the intervention team with another mobile HTS team (matched on performance and area of operation) which used the standard of care (SOC) HIV screening test (i.e., SOC team). Results From 19 to 20 December 2019, the intervention team tested 7,403 clients, and the SOC team tested 2,426 clients. The intervention team tested a median of 442 (IQR: 288–522) clients/day; SOC team tested a median of 97 (IQR: 40–187) clients/day (p<0.0001). The intervention team tested about 180 more males/day compared to the SOC team, and the median number of adolescents and young adults tested/day by the intervention team were almost four times the number tested by the SOC team. The intervention team identified a higher number of HIV-positive clients compared to the SOC team (142 vs. 88), although the proportion of HIV-positive clients was lower in the intervention team due to the higher number of clients tested. Conclusions This pilot programme provides evidence of high performance and high reach, for men and young people through the use of faster HIV rapid tests, by trained lay counsellors in mobile HTS units.

Costs and Savings Associated With the Police Use of the interRAI Brief Mental Health Screener

Background: The police response to calls for service identified as being related to mental health continues to be highly controversial. Strategies to improve the police response include Crisis Intervention Team (CIT) training and various forms of co-response models neither of which have been subjected to comprehensive evaluations, particularly as to cost-efficiency. A new approach is the use of the interRAI Brief Mental Health Screener to enhance police officer ability to identify persons with serious mental disorders. The purpose of the current study is to evaluate the costs and cost efficiency of the police response to mental health calls using the interRAI Brief Mental Health Screener.Method: Secondary data was analyzed from the use of the screener from 2018 to 2020 by police officers in a mid-sized Canadian city. Changes were measured in the overall number of interactions police officers had with persons with mental health disorders, the number of incidents where police officers referred the person to hospital, and the time officers remained in the emergency department.Results: A total of 6,727 assessments were completed with involuntary referrals decreasing by 30%, and voluntary referrals by 34%. The overall time police officers were involved in involuntary referrals decreased from 123 min in 2018 to 113 min in 2020. The average emergency department wait time for voluntary referrals dropped from 41 min in 2018 to 27 min in 2020, while involuntary referrals decreased from 61 min in 2018 to 42 min in 2020. Each averted involuntary referral to the emergency department resulted in a savings of $81, on average during the study period.Conclusion: An analysis of the costs and costs savings associated with the use of the screener demonstrate that it is a worthwhile investment for police services. An additional benefit is its ability to collect mental health statistics that may be useful to police leaders to justify budgets. Future studies should attempt to devise some method of collecting pre-implementation data that would reveal the true costs and cost-efficiency of using the BMHS, which have been shown to be significant in the current study however, undoubtedly are under-estimated.

Through Barrier Diagnostics to Locate Multiple Barrier Failures in Complex Well Failure Scenario and to Enable Successful P&A

Objectives/Scope A 60-year-old well exhibited a leak at the surface and sustained annuli pressure (SAP) in all three annuli - A, B and C. The age of the well coupled with the symptoms suggested a complex multi-barrier failure scenario that needed to be diagnosed quickly and accurately so that the well could be secured safely. The paper shows how the comprehensive set of downhole diagnostics, including metal and cement barriers integrity assessment, aided in planning and execution of well intervention to secure the indicated failures. The well intervention team selected an approach to investigate the barriers status prior the rig came to the location. Surface diagnostics included evaluation of pressure trends, completion design, leak fluid composition and drilling records analysis which guided the selection of downhole survey. The input parameters for downhole through barrier diagnostics were: Downhole through barrier diagnostics targeted the evaluation of leak paths and failures in well barriers and included: This paper explores the concept, planning, execution and achieved results of the downhole diagnostics performed and how the results were implemented by Operator.

Rigless Remote Intervention: A Case Study of Combo Unit Utilization in Mahakam Offshore East Kalimantan

Mahakam block has been producing for over 40 years and now is in declining phase. Daily drilling and well intervention operations are still actively carried out to sustain and prolong the natural decline curve. Efficiency measures are taken out in each and every aspect of operations to support the diminishing values. One of them is the reduction of offshore platform sizing. Future minimalist platforms have limited top deck space which will further be reduced by the prevalence of: 1. Fixed platform equipment (generators, crane, etc.), and 2. Hazardous area requirement for Zone 0, Zone 1, and Zone 2. The future minimalist platform has a deck space area of approximately 221 m2, not yet taken into account said the reduction factors. The presence of the hazardous area and fixed equipment can reduce the free deck space availability down to 20% from the total deck space. These platforms are not originally designed with well intervention work in mind. However, the past 40 years proves that well intervention should never be left out when extending well’s lifetime is the objective. Well intervention unit, depending on the intervention type, requires top deck space from 26 m2 up to 92 m2 of free space, and an additional 3-4 m2 for lifting, means such as mast unit if the platform does not have a crane. Moreover, in a remote intervention mode, where no supporting barge is present, space requirement above the top deck became crucial as there is no alternative to back load unit to the barge incase the top deck beingover crowded. To support the continuity of remote intervention being more efficient alternative to barge-supported operation, the well intervention team initiates the feasibility study using combo unit as a replacement for conventional slickline and electric line unit. There are three types of combo unit presented in this paper, 1. Split Combo Unit, 2. Combined Drum Combo Unit, and 3. Digital Slickline Combo Unit. These types of unit can reduce the deck space requirement by 30%, reducing number of personnel needed from eight (8) to five (5) personnel in a single shift, improving operation timing efficiency, and improves the contract administration aspect. Despite the seemingly positive results, there are still issues to be resolved, both technical and non-technical, for combo unit to be an all-rounder solution for wireline work. This paper shall provide an early level observation and analysis for the feasibility of combo unit as remote well intervention unit, starting from the methodology to the corresponding results and lesson learnt.

Improving The Efficiency of Well Intervention Project Trial, Commissioning and Management Walk Through During Pandemic with Virtual Based Synergy of Engineering, Operation & Planning Division

A new and efficient practice on digitally distanced inspections & management walk through following the introduction of stringent global travel restrictions due to the COVID-19 pandemic is presented in this paper. To successfully implement this practice, Well Intervention Team identified the problem and challenge including personnel's count & travel restriction, virtual method to be used, special PPE and infrastructure to deal with COVID-19. Fishbone diagram is used to analyze many possible causes for the problem & challenge stated before. Planning, scheduling, and execution to comply with problem and challenge then is performed. The virtual commissioning is executed with minimum personnel from service provider that physically onsite to gather required data and witness the process, followed by verification of the documented data and approval of the commissioning from the Well Intervention Team. The project performed with no major safety issues during operation. Two projects (Micro Coiled Tubing and Slickline – Electricline Combo Unit) are successfully executed within projected working window due to quicker inspection & survey activities, shorter response time, and greater scheduling flexibility. Four Virtual Management Walk Through are done within period 2020. Travel and accommodation costs spent is reduced for online commissioning and Virtual Management Walk Through. Instant and greater access to many network of experts to analyze the stored data that improve the decision-making. Minimum travel activities that reduced risk in transporting personnel to site and accommodating visitors from the company and service provider at site, removed the risk of delay, and also reduced carbon footprint.

Psychofarmaca: pleidooi voor een voorzichtig beleid bij vroege psychose

Psychopharmaceuticals: a plea for cautious management in early psychosis. From the holistic approach in VRINT (Early psychosis intervention team), a psychotic episode is regarded as an existential crisis in which both biological and psychosocial factors play a role and interact with each other. Non-pharmacological treatments are indispensable and preferred. However, antipsychotics can have an important role and be even lifesaving in certain circumstances. Therefore, in this article 3 questions are explored: How long before prescribing antipsychotics? How long should they be prescribed and is medication tapering possible? Are antipsychotics neuroprotective or rather harmful? Based on the scientific literature regarding antipsychotics as well as their own experience, the authors conclude that they do have their place in treating early psychosis, but they should be prescribed with the necessary caution, since antipsychotics are not harmless products. Treatment with antipsychotics should always consist of administering the lowest possible dose with a minimum of side effects. The decision to start treatment with antipsychotics and the correct adjustment of dosage should always be done in consultation with the person in crisis and his or her family. After a first psychotic episode, medication tapering can be considered, but the tapering off must be properly supervised over a sufficiently long period of time. After all, a full long-term recovery is pursued, whereby the person with psychosis can take control of his or her own life.