Psychiatric admissions in young people after expiration of criminal justice supervision in Australia: a retrospective data linkage study

BACKGROUND

Mental health services are available for young people involved with the criminal justice system. However, they have unmet mental health needs after the expiration of criminal justice supervision.

OBJECTIVE

To determine the incidence rate and identify predictors of psychiatric hospitalisations within 24 months after the expiration of criminal justice supervision among young people involved with the New South Wales (NSW) criminal justice system.

METHODS

Retrospective data from 1556 individuals aged 14-22 years who participated in four surveys of justice-involved young people in NSW were harmonised and linked to four NSW data collections. We calculated the incidence rates of psychiatric hospitalisations within 24 months postsupervision and identified predictors of these hospitalisations using a competing risks regression analysis.

RESULTS

Within 24 months postsupervision, 11.4% had a psychiatric hospitalisation compared with 3.5% during supervision. 20.7% of those admitted had a known history of mental illness and engaged with community-based and outpatient mental health services postsupervision. Predictors of psychiatric hospitalisations were: female sex (adjusted subdistribution HR (asHR) 1.84, 95% CI 1.24 to 2.73); previous incarceration (highest asHR for ≥4 episodes 1.67, 95% CI 1.01 to 2.78); head injury (asHR 1.63, 95% CI 1.20 to 2.21); personality disorder (asHR 3.66, 95% CI 2.06 to 6.48) and alcohol and substance use disorder (asHR 1.89, 95% CI 1.29 to 2.77).

CONCLUSION

Justice-involved youth have higher rates of psychiatric admissions after criminal justice supervision. Engagement with mental health services postsupervision is important in addressing emerging or persisting mental health needs.

Rate of BCG Immunization in HIV-Exposed Infants in a Selected Primary Health Centre in Southern Nigeria: Implications of No Vaccine Policy for HIV-Positive Infants

BACKGROUND

Maternal and infant HIV status influences the decision of BCG immunization of infants at birth. The objective of this study was to determine the HIV status of HIV-exposed infants (HEIs) by the first HIV DNA PCR test and the rate of BCG uptake among the HEIs who were confirmed HIV negative.

METHODS

This was a retrospective descriptive cross-sectional study involving the review of results of 99 dried blood samples (DBS) for the first HIV DNA PCR test of HEIs whose mothers were diagnosed HIV positive on presentation of the infants at first immunization visit at a Primary Health Centre from January 2018 to January 2019.

RESULTS

Of the 99 DBS examined, 86; 86.9% (95% CI 80.1-93.6) were HIV negative, 9; 9.1% (95% CI 3.3-14.8) were positive while the results of 4 (4.0%) infants were not in the register. Only 7; 7.1% (95% CI 1.9-12.2) of the 99 HEIs returned for BCG immunization at the centre. BCG immunization status of the HEIs after first PCR results was not significantly associated with sex of the infants or availability of phone number of the guardians (p = 0.70 and 0.12, respectively).

CONCLUSION

The majority of HEIs were HIV negative at first HIV DNA PCR test. Few of these HIV negative infants returned for BCG immunization. Hence, all HEIs should be given BCG immunization according to WHO GAVCS committee recommendation on BCG immunization for settings with poor HIV diagnostic and treatment facilities for mothers and infants.

Assessment of Resources for Primary Health Care: Implications for the Revitalization of Primary Health Care in Akwa Ibom, Nigeria

Context:

Primary health care (PHC) is the cornerstone of the Nigerian National Health Policy. The national policy on PHC under one roof is undergoing implementation nationwide as a means of strengthening the PHC system. Akwa Ibom State (AKS) is set to commence full implementation of the policy.

Aims:

The aim of the study was to assess the existing human resource and infrastructure in PHC facilities in AKS.

Settings and Design:

A descriptive cross-sectional study was carried out in 18 facilities selected from the three senatorial zones of AKS, Nigeria.

Subjects and Methods:

A rapid assessment of selected PHC facilities based on a checklist adapted from the minimum standards for PHC as provided by the National PHC Development Agency. The results were analyzed using Excel and presented in tables.

Results:

A total of 18 health facilities were included in the study. Human resources available were 276 full time core health workers, of which 48 (17.4%) were volunteer workers. There was inequitable distribution in district and facility type as 122(44.2%) work in Ikot Ekpene Senatorial district and 242 (87.7%) of them work in the Operational Base. Basic lifesaving equipment such as resuscitation sets was unavailable in more than 50% of the health facilities.

Conclusions:

There are absolute deficit and inequitable distribution of available human resources in AKS PHCs. Basic-lifesaving equipment is grossly inadequate. There is an urgent need for more health workers to be employed and provision of basic equipment for the PHCs.

Electrostratigraphy and hydrogeochemistry of hyporheic zone and water-bearing caches in the littoral shorefront of Akwa Ibom State University, Southern Nigeria

Ground-based electrical geophysical data calibrated with borehole information are conveniently used to delineate subsurface strata because of their inherent capability to assess the lateral and vertical variations in the pore water. In this study, joined geophysical approach of vertical electrical sounding (VES) and electrical resistivity tomography (ERT) has been steered to define the strata in the hyporheic zone and in the water bearing caches in the Akwa Ibom State University's littoral shorefront. Four ERTs with each using Wenner array with 5 m electrode spacing were conducted along four profiles at the same locations that VES were conducted. Twelve surface VES soundings were performed with maximum current electrode separations of (AB/2 = 150 m). The integration of formation resistivity with six boreholes reveals motley topsoil/dry strata with resistivity value greater than 200 Ω - m above water table; saturated clay/saline water depository with resistivity value less than 30 Ω - m below water table; fine-grained sand/brackish water depository with resistivity range spanning between 70 and 200 Ω - m below water table; medium-grained sand/freshwater depository with resistivity ranging from 500 to 800 Ω - m below water table and gravelly sand/freshwater depository with resistivity value greater 800 Ω - m below water table were inferred from top to bottom within the maximum current electrode separations. These ranges of resistivity show lithological diversity in subsurface layer. Geochemical analysis was performed for main cations (magnesium, sodium, potassium, calcium, iron and manganese), anions (bicarbonates, sulphates, chloride, and fluoride) and other physical parameters such as, pH, electrical conductivity, total dissolved solids, dissolved oxygen, biochemical oxygen demand and chemical oxygen demand. The results of the interpretation of hydrochemical species of the groundwater samples revealed that the groundwater in most locations within the study area is fresh, slightly alkaline to acidic based on the EC, pH and TDS values. The order of abundance for anions and cations is HCO₃^- > Cl^- > SO₄^2- > F^- and Na⁺ > Ca²⁺ > Mg²⁺ > K⁺ > Fe²⁺ > Mn²⁺ respectively. The observation of elevated BOD with lower DO even in the muddy area suggests anoxic condition (DO < 5 mg/L) rather than oxic condition (DO > 5 mg/L), based on the measured DO values (00.12-2.61 mg/L). The elevated ferric iron concentrations on the surface water, which later seeps into the groundwater systems, are due to excessive accumulation of dissolved organic matter (DOM) and the consequent reduction reaction within the DOM in surface water.