Community Resources for Forensic Mental Health Aftercare in Zimbabwe

This study sought to identify and describe existing forensic mental health aftercare facilities in Zimbabwe. A descriptive qualitative research design was applied to the study. Twenty-nine participants were purposively sampled. Semi-structured interviews were conducted. Thematic analysis of data was done. Three aftercare centers were identified. The link between special institutions where patients are discharged from and these centers is dependent on the Mental Health Review Tribunal. Models of care in these centers revolve around agro based livelihood activities. Social workers, nurses, nurse aides and volunteers from various medical background constitute care teams in the forensic mental health aftercare facilities. There is however, poor engagement within the identified aftercare facilities and also with mainstream psychiatric services.

A Pilot Study on Health Care Utilization: Outpatient Aftercare for Geriatric Patients and Their Relatives

Increasing life expectancy correlating highly with polymorbidity, frequently causes recurring inpatient stays at Geriatric hospital wards. After discharge from hospital, an offer for physical and psychological after-care seems necessary for most patients. Purpose of this project was the development, implementation and primary assessment of an out-patient after-care intervention program for elderly, multimorbid patients and their relatives. During a period of eight months an interdisciplinary team offered psychological interventions as well as medical advice, nursing care and social casework. Primary goal was the investigation of health care utilization conduct and effectiveness of this after-care service in regard to sustainable stabilization of former inpatients. Preliminary results show higher demand of psychological and psychotherapeutic groups, whereas medical questions and nursing care problems were of minor concern to the patients. Contrary to our presumptions, even geriatric patients with a diagnosis of depression or anxiety disorder, showed to be reliable and constructive participants in psychological group settings. Situation and problems of (nursing) relatives could be identified accurately, although they represented an independent target group, possibly in need of more specific interventions.

Mothers’ Level of Schooling, Monitoring of Their Pregnancy and Perinatal Prognosis at the Reference Health Centre of Commune V of the District of Bamako

Introduction: The level of schooling of mothers is a determining factor in the follow-up of pregnancy and consequently the prognosis of childbirth and the quality of the newborn. Objective: The aim was to assess the impact of the level of education on the follow-up of their pregnancy and perinatal prognosis at the Reference Health Centre of Commune V of the District of Bamako. Materials and Methods: This was a prospective, cross-sectional and analytical study aimed descriptive from August 15 to December 15, 2021. We included in this study all pregnant women who had a gestational age of at least 22 weeks of amenorrhea and who gave birth or were received in the immediate postpartum period at the maternity ward of the Reference Health Center of Commune V. Results: Out-of-school parturients accounted for 60% of cases. Among the parturients in school, 18% had a higher level. In our study, 14.3% of women in labour knew the date of the last menstrual period. In our series, 100% of mothers in higher and secondary school had completed an antenatal consultation (CPN) compared to 90.7% in the out-of-school mothers. CPN1 was performed in the first trimester of pregnancy in 21.1% among out-of-school parturients compared to 83.5% among higher-level parturients. The number of NPCs was greater than or equal to 4 in 47.9% of parturients. Conclusion: Women’s schooling has an impact on their socio-economic conditions on the one hand and on the monitoring and prognosis of pregnancies on the other.

Effectiveness of ICU Diaries: Improving “Distorted Memories” Encountered during ICU Admission

Background: It is said that after ICU discharge, 40% of patients suffer from acute stress symptoms, such as anxiety and depression, caused by “distorted memories” (memory loss and delusions) due to various treatments in the ICU. This study focused on the quantitative and qualitative effects of ICU diaries on distorted memories that patients encountered during their time in the ICU. Aim: To assess improving distorted memories by providing information during ICU admission to patients to relieve the acute stress symptoms after ICU discharge. Design and Methods: This nonrandomized controlled trial included patients aged ≥20 years who had received treatment for ≥3 days in the ICU. Using ICU memory tool, the Hospital Anxiety and Depression Scale (HADS) and the Acute Stress Disorder Scale (ASDS) approximately 1 week after ICU discharge, then HADS and ASDS prior to hospital discharge, the change in mean values were compared between two groups (control and intervention) using a Wilcoxon signed-rank test. The intervention group was surveyed prior to hospital discharge using semi-structured interviews, and descriptions were analyzed by the content analysis method of Krippendorff. Results: Twenty-three participants were included in the control group, and 17 in the intervention group. When comparing subjects with distorted memories between the groups, we found reduced values for HADS anxiety (7.1 ± 3.8 to 5.7 ± 2.7, p = 0.011), HADS depression (8.6 ± 5.0 to 7.2 ± 4.3, p = 0.003), and ASDS (46.9 ± 13.8 to 43.8 ± 11.4, p = 0.012) in the intervention group. Based on the narrations, patients wanted to investigate facts in the ICU diary while having someone help them to remember these events. Conclusion: Improving distorted memories during ICU admissions may relieve acute stress symptoms. In addition, these patients needed someone to investigate facts from the ICU admission.

Self-reported sleep quality and depression in post myocardial infarction patients attending cardiology outpatient clinics in Oman

Objective: This study aimed to examine the sleep quality and prevalence of depression in post myocardial infarction patients attending cardiology outpatient clinics of selected hospitals in Oman.Methods: A descriptive cross-sectional design was used to collect data from patients (n 180) who were at least 4 weeks post myocardial infarction diagnosis and receiving follow-up care in the outpatient clinic.The Arabic version of the Pittsburgh Sleep Quality Index and Patient Health Questionnaire-9 were used to assess sleep quality and depressive symptoms,respectively.Results: The sample mean age was 62.0 ± 11.3 years.Poor sleep quality affected 61.1% of the participants.The significant predictors of poor sleep quality were gender (P ≤ 0.05),body mass index (P ≤ 0.05),and self-reported regular exercise (P ≤ 0.01).The most impacted domains of sleep quality were sleep latency,sleep duration,and sleep disturbances.The prevalence of major depression was low (5%) and the rate of re-infarction was 27.2%.The prevalence of minimal to mild major depression with a potential of transitioning into major depression overtime was very high.Self-reported regular exercise (P ≤ 0.01) was the only significant predictor of depressive symptoms.Conclusion: The sleep quality of post myocardial infarction patients was poor and the prevalence of depression was low.There was no significant relationship between sleep quality or depression with reinfarction.

Landfill Liner Failure: an Open Question for Landfill Risk Analysis

The European Union Landfill regulations (1999/31/EC) are based on the premise that technological barrier systems can fully contain all landfill leachate produced during waste degradation, and thus provide complete protection to groundwater. The long-term durability of containment systems are to date unproven as landfill liner systems have only been used for about 30 years. Many recent studies have drawn attention to some of the deficiencies associated with artificial lining systems, particularly synthetic membrane systems. Consequently, failure modes of landfill liners need to be quantified and analysed. A probabilistic approach, which is usually performed for complex technological systems such as nuclear reactors, chemical plants and spacecrafts, can be applied usefully to the evaluation of landfill liner integrity and to clarify the failure issue (reliability) of liners currently applied. This approach can be suitably included into risk analysis to manage the landfill aftercare period.

Pilot Project on in Situ Aerobisation of Old Landfills： Results from Konstanz Dorfweiher Landfill

A new in situ treatment technique was being utilized on a part of the Dorfweiher landfill in Konstanz, Germany to reduce the aftercare period. From 2010 to 2012, the landfill was aerated intermittently with low pressure. Outgoing air was treated passively in an open biofilter which covers the landfill surface. The landfill was aerated by means of 80 air injection wells arranged area-wide in a 10 m grid. An elaborate measuring process and technological controls are being utilized in the pilot scheme. The data collected offer interesting insights about the processes during aeration, allowing optimization of the aeration strategy depending on changes of the conditions in the landfill. During the three-year aeration phase, conditions have changed inside the landfill section in various ways. In numerous zones of the landfill body, the aeration caused aerobic conditions with a decline of methane production. Accelerated settlings are measured up to 11%. The effects of the aerobic stabilization on the landfill are evaluated in a two-year monitoring phase started in 2013.