Prevalence and correlates of psychiatric disorders in a national survey of Iranian children and adolescents

Objective: Considering the impact of rapid sociocultural, political, and economical changes on societies and families, population-based surveys of mental disorders in different communities are needed to describe the magnitude of mental health problems and their disabling effects at the individual, familial, and societal levels. Method: A population-based cross sectional survey (IRCAP project) of 30 532 children and adolescents between 6 and 18 years was conducted in all provinces of Iran using a multistage cluster sampling method. Data were collected by 250 clinical psychologists trained to use the validated Persian version of the semi-structured diagnostic interview Kiddie-Schedule for Affective Disorders and Schizophrenia-PL (K-SADS-PL). Results: In this national epidemiological survey, 6209 out of 30 532 (22.31%) were diagnosed with at least one psychiatric disorder. The anxiety disorders (14.13%) and behavioral disorders (8.3%) had the highest prevalence, while eating disorders (0.13%) and psychotic symptoms (0.26%) had the lowest. The prevalence of psychiatric disorders was significantly lower in girls (OR = 0.85; 95% CI: 0.80-0.90), in those living in the rural area (OR = 0.80; 95% CI: 0.73-0.87), in those aged 15-18 years (OR = 0.92; 95% CI: 0.86-0.99), as well as that was significantly higher in those who had a parent suffering from mental disorders (OR = 1.96; 95% CI: 1.63-2.36 for mother and OR = 1.33; 95% CI: 1.07-1.66 for father) or physical illness (OR = 1.26; 95% CI: 1.17-1.35 for mother and OR = 1.19; 95% CI: 1.10-1.28 for father). Conclusion: About one fifth of Iranian children and adolescents suffer from at least one psychiatric disorder. Therefore, we should give a greater priority to promoting mental health and public health, provide more accessible services and trainings, and reduce barriers to accessing existing services. © 2019 Tehran University of Medical Scienc

A resilience-oriented planning of energy hub by considering demand response program and energy storage systems

Energy hub systems meet the needs of customers in different forms of energy by coordinated operation of different infrastructures, thereby improving system flexibility, reducing losses and reducing operating costs. Due to the increase in the construction of energy hub systems in distribution networks, the issue of optimal design of energy hubs has attracted much attention. Therefore, this study presents a comprehensive model for hub design, in which the technical, economic and security criteria of the hub are fully considered. In the proposed model, the design problem is solved by considering all the operating constraints and seasonal variations of different loads and solar radiation are also taken into account. Uncertainties of electrical, heating and cooling loads as well as the output power of photovoltaic (PV) panels have been considered and in order to model these uncertainties, Monte Carlo simulation approach has been utilized. Besides, in order to improve the resilience of the hub in case of emergency conditions, uncertainties related to the outage of the equipment have been considered in the design problem. The design problem is modeled as a mixed-integer linear programming (MILP) optimization problem and the simulation results indicate that considering the uncertainties of equipment outages along with the load and radiation, despite a 26.51% increase in investment cost, leads to a significant improvement in hub resilience under emergency conditions. Also, the results demonstrate that the implementation of the demand response (DR) program has reduced the demand for power during peak hours, thereby reducing the installed capacity of the combined heat and power (CHP) unit

Implant-based immediate breast reconstruction in the previously augmented patient

Background: Millions of women have undergone augmentation mammaplasty with implants and breast cancer continuing to be the most common non-cutaneous malignancy in female patients. Reconstructive surgeons will inevitably encounter breast cancer patients with prior augmentation. Implant-based techniques represent the most common form of breast reconstruction overall and remains a common option among those who were previously augmented. Objective: The purpose of this study is to evaluate outcomes of implant-based reconstruction in previously augmented women. Methods: A retrospective review from September 2004 to December 2009 was performed. 38 women (63 breasts) with a history of prior augmentation (PA) who underwent implant-based reconstruction were identified and compared to a non-prior augmented (NPA) control group (77 patients; 138 breasts). Normative data, augmentation details, reconstruction method, complication rates, and revision rates were evaluated. Results: The total complication rate was significantly different between the two groups with 18 complications (28.6%) occurring in 9 PA breasts and 20 complications (14.5%) in 19 NPA breasts (p-value 0.037). When analyzed by specific complication subtypes, capsular contracture was the only complication that bordered significance between the two cohorts (p-value 0.057). Complication rates were otherwise similar regardless of augmentation or reconstruction type. Conclusion: Implant-based reconstruction is a safe option for previously augmented patients that is able to provide outcomes similar to non-augmented patients. Results are not affected by the location of previous implants or the implant-based reconstruction method. There may be a higher incidence of capsular contracture in the previously augmented patient that warrants further investigation and preoperative discussion. (C) 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved