Prevalence and Risk Factors of Depression among Adult Type 2 Diabetic Patients at Al-Jemaih Diabetic Center, Dongola, Northern State, Sudan, 2019

Background: Type 2 diabetes and depression are common diseases with bidirectional associations. Depression in diabetics leads to poor adherence to diet and medication, poor glycemic control, reduced quality of life, and increased diabetes-related healthcare expenditure. This study aimed at evaluating diabetic patients with depression to improve the quality of care delivered. Materials and Methods: An institution-based cross-sectional study was conducted among adult type 2 diabetics at Al-Jemaih Diabetic Center, Dongola, in July–December 2019A standardized pretested questionnaire was used to collect data, and the depression subscale of the Patient Health Questionnaire was used to diagnose depression. Chi-square test and logistic regression were used to analyze the data using the Statistical Package for Social Sciences version 25.0. Results: Out of the 407 participants, 282 (69.3%) were females, and more than half were aged between 40 and 59 years. The prevalence of depression among type 2 diabetic patients was 35.6%, ranging from mild (24.3%) to moderate (7.4%), moderately severe (2.2%), and severe depression (1.7%). The risk factors associated with depression in type 2 diabetes were: combining antidiabetic therapy, long duration of diabetes, family history of psychiatric illness, diabetes-related complications, poor glycemic control, and lack of regular exercise. Conclusion: More than a third of type 2 diabetics have depression. Screening diabetic patients for depression, establishing a psychiatric unit at the diabetic center, and community-based studies are recommended. Key words: diabetes mellitus, depression, Dongola, Northern Stat

Effectiveness of human mobility change in reducing the spread of COVID-19: ecological study of Kingdom of Saudi Arabia

Non-pharmacological interventions including mobility restriction have been developed to curb transmission of SARS-CoV-2. We provided precise estimates of disease burden and examined the impact of mobility restriction on reducing the COVID-19 effective reproduction number in the Kingdom of Saudi Arabia. This study involved secondary analysis of open-access COVID-19 data obtained from different sources between 2 March and 26 December 2020. The dependent and main independent variables of interest were the effective reproduction number and anonymized mobility indices, respectively. Multiple linear regression was used to investigate the relationship between the community mobility change and the effective reproduction number for COVID-19. By 26 December 2020, the total number of COVID-19 cases in Saudi Arabia reached 360,690, with a cumulative incidence rate of 105.41/10,000 population. Al Jouf, Northern Border, and Jazan regions were ≥2.5 times (OR = 2.93; 95% CI: 1.29–6.64), (OR = 2.50; 95% CI: 1.08–5.81), and (OR = 2.51; 95% CI: 1.09–5.79) more likely to have a higher case fatality rate than Riyadh, the capital. Mobility changes in public and residential areas were significant predictors of the COVID-19 effective reproduction number. This study demonstrated that community mobility restrictions effectively control transmission of the COVID-19 virus

Assessing the Level of Awareness of COVID-19 and Prevalence of General Anxiety Disorder among the Hail Community, Kingdom of Saudi Arabia

Background: The COVID-19 pandemic has caused a major public health problem around the world. Therefore, the aim of the study was to assess the awareness and prevalence of General Anxiety Disorder (GAD) with regard to COVID-19 among the Hail community, in the Kingdom of Saudi Arabia, in order to help health authorities to effectively control the pandemic. Methods: A cross-sectional online survey was completed by 412 participants living in Hail, Saudi Arabia. The questionnaire assessed demographic characteristics, knowledge, attitudes, and practices for the prevention of COVID-19, as well as psychological feelings in terms of GAD as an impact of the COVID-19 pandemic. Results: The study found that most of the respondents demonstrated good knowledge, attitudes, and practice for COVID-19 prevention. The elderly and employed demonstrated significant positive attitudes and practices (p < 0.05). Participants with a positive attitude were almost two and a half times (OR = 2.4; 95% CI: 1.54–3.99) more likely to have good practices. Additionally, the rural respondents were less likely (OR = 0.45; 95% CI: 0.21–0.96) to have a positive attitude. Married participants were more than one and a half (OR = 1.60; 95% CI: 1.04–2.44) times more likely to have a positive attitude. The prevalence of GAD was 21.8% and was significantly increased among participants with inadequate knowledge (OR = 2.01; 95% CI: 1.25–3.22), females (OR = 1.92; 95% CI: 1.19–3.09), individuals with chronic diseases (OR = 1.71; 95% CI: 1.02–2.86), and non-Saudi participants (OR = 2.44; 95% CI: 1.02–5.85). Conclusions: Ensuring a sufficient combination of relatively good levels of knowledge, positive attitudes, and desired practices serves as a good approach to preventing the spread of COVID-19. However, the increased prevalence of GAD requires the attention of policymakers. Therefore, a great emphasis should be placed on health awareness campaigns, with a focus on misconceptions and the provision of counseling

Integration of community health workers into health systems in developing countries: Opportunities and challenges

Background: Developing countries have the potential to reach vulnerable and underserved populations marginalized by the country’s health care systems by way of community health workers (CHWs). It is imperative that health care systems focus on improving access to quality continuous primary care through the use of CHWs while paying attention to the factors that impact on CHWs and their effectiveness. Objective: To explore the possible opportunities and challenges of integrating CHWs into the health care systems of developing countries. Methods: Six databases were examined for quantitative, qualitative, and mixed-methods studies that included the integration of CHWs, their motivation and supervision, and CHW policy making and implementation in developing countries. Thirty-three studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programs. Thematic coding was conducted and evidence on the main categories of contextual factors influencing integration of CHWs into the health system was synthesized. Results: CHWs are an effective and appropriate element of a health care team and can assist in addressing health disparities and social determinants of health. Important facilitators of integration of CHWs into health care teams are support from other health workers and inclusion of CHWs in case management meetings. Sustainable integration of CHWs into the health care system requires the formulation and implementation of polices that support their work, as well as financial and nonfinancial incentives, motivation, collaborative and supportive supervision, and a manageable workload. Conclusions: For sustainable integration of CHWs into health care systems, high-performing health systems with sound governance, adequate financing, well-organized service delivery, and adequate supplies and equipment are essential. Similarly, competent communities could contribute to better CHW performance through sound governance of community resources, promotion of inclusiveness and cohesion, engagement in participatory decision making, and mobilization of local resources for community welfare

Surface modification of praseodymium oxide/hematite doped into Polycaprolactone for enhanced wound management demands

Praseodymium oxide (Pr6O11), hematite (Fe2O3), graphene oxide (GO), and polycaprolactone (PCL) based polymeric nanocomposites (NCs) are fabricated, aiming their usage as bio-scaffold for medical purposes. Because of their distinctive light absorption and stability, Fe2O3 and Pr6O11 have been introduced as potential optical elements. The structure and size examination of NCs were executed by XRD, Raman, and FESEM. Pr6O11/Fe2O3/GO@PCL polymeric NC is exhibited Pr6O11, and Fe2O3 average size of 1.4, 0.4 µm, while average pores size 2.1 µm. As well, the Uv–Vis shows an absorption edge shifting along the x-axis that it begins with 3.1 eV for pure PCL, after that it declined to 1.7 eV for Pr6O11@PCL NC. Also, Pr6O11 @PCL, and Pr6O11/ Fe2O3@PCL NCs show the lowest similar contact angle with 38°. Regarding cell attachment evaluation test, the Pr6O11/Fe2O3/GO@PCL NC healing valuation is touched ∼ 80%. As a result, the structure enabled 3-dimensional the division of normal cells, so promoting wound healing

Cognitive Flexibility’s Role in Reducing Academic Stress During the COVID-19 Pandemic

Background: Cognitive flexibility (CF) in the psychological literature has been described as an individual’s ability to produce several solutions and retain control in novel situations. Recently, the COVID-19 pandemic appeared to be an ideal scenario that demanded the application of adaptive thinking by students to deal with several challenges of the pandemic. Aim: This study aimed to assess the role of CF in reducing academic stress among university students due to the sudden and strict implementation of online education during the COVID-19 pandemic. Methods: This study employed a cross-sectional survey design and data collection was completed during the 2020– 2021 academic year. The study sample comprised 328 university students from Saudi Arabia. The online survey method was used, and study tools comprises of reliable and valid psychological measures to assess CF, academic stress, the negative impact of the COVID-19 pandemic, and emotional symptoms. IBMSPSS25 was used for statistical analysis of data. Multiple regression analysis was applied to determine the role of CF in reducing academic stress after controlling for other factors such as gender, age, academic year, negative impact of COVID-19 on daily life, and unpleasant emotional experiences. Results: CF was significantly decreased the risk of experiencing academic stress (b = ‒0.196, t = ‒3.54; p Conclusion: The current findings suggest that CF could be fostered among university students as a useful mental tool to cope with academic stress during less-structured educational and social circumstances that may impact their daily lives and emotional wellness. Plain Language Summary: Cognitive Flexibility (CF), also known as the capacity for adaptive thinking, has been recognized as an important mental coping tool. The prolonged implementation of full-time online studies during the COVID-19 pandemic has been a source of academic stress among university students. This study examined the positive impact of cognitive flexibility on academic stress by collecting data from university students who underwent full-time online studies during the COVID-19 pandemic in Saudi Arabia. The study findings validated the protective role of CF, and recommended devising appropriate educational strategies that could foster adaptive thinking and enable students to cope with study-related stressors during uncertain times.</p

Cognitive Flexibility’s Role in Reducing Academic Stress During the COVID-19 Pandemic

Background: Cognitive flexibility (CF) in the psychological literature has been described as an individual’s ability to produce several solutions and retain control in novel situations. Recently, the COVID-19 pandemic appeared to be an ideal scenario that demanded the application of adaptive thinking by students to deal with several challenges of the pandemic. Aim: This study aimed to assess the role of CF in reducing academic stress among university students due to the sudden and strict implementation of online education during the COVID-19 pandemic. Methods: This study employed a cross-sectional survey design and data collection was completed during the 2020– 2021 academic year. The study sample comprised 328 university students from Saudi Arabia. The online survey method was used, and study tools comprises of reliable and valid psychological measures to assess CF, academic stress, the negative impact of the COVID-19 pandemic, and emotional symptoms. IBMSPSS25 was used for statistical analysis of data. Multiple regression analysis was applied to determine the role of CF in reducing academic stress after controlling for other factors such as gender, age, academic year, negative impact of COVID-19 on daily life, and unpleasant emotional experiences. Results: CF was significantly decreased the risk of experiencing academic stress (b = ‒0.196, t = ‒3.54; p Conclusion: The current findings suggest that CF could be fostered among university students as a useful mental tool to cope with academic stress during less-structured educational and social circumstances that may impact their daily lives and emotional wellness. Plain Language Summary: Cognitive Flexibility (CF), also known as the capacity for adaptive thinking, has been recognized as an important mental coping tool. The prolonged implementation of full-time online studies during the COVID-19 pandemic has been a source of academic stress among university students. This study examined the positive impact of cognitive flexibility on academic stress by collecting data from university students who underwent full-time online studies during the COVID-19 pandemic in Saudi Arabia. The study findings validated the protective role of CF, and recommended devising appropriate educational strategies that could foster adaptive thinking and enable students to cope with study-related stressors during uncertain times.</p

The Malaysian health care system: Ecology, plans, and reforms

Malaysia is on its way to achieving developed nation status in the next 4 years. Currently, Malaysia is on track for three Millennium Development Goals (MDG1, MDG4, and MDG7). The maternal mortality rate, infant mortality rate, and mortality rate of children younger than 5 years improved from 25.6% (2012) to 6.6% (2013), and 7.7% (2012) per 100,000 live births, respectively whereas immunization coverage for infants increased to an average of 90%. As of 2013 the ratio of physicians to patients improved to 1:633 while the ratio of health facilities to the population was 1:10,272. The current government administration has proposed a reform in the form of the 10th Malaysian Plan coining the term “One Care for One Malaysia” as the newly improved and reorganized health care plan, where efficiency, effectiveness, and equity are the main focus. This review illustrates Malaysia’s transition from pre-independence to the current state, and its health and socioeconomic achievement as a country. It aims to contribute knowledge through identifying the plans and reforms by the Malaysian government while highlighting the challenges faced as a nation

Structure, functions, performance and gaps of event-based surveillance (EBS) in Sudan, 2021: a cross-sectional review

Abstract Background Event-based surveillance (EBS) is an essential component of Early Warning Alert and Response (EWAR) as per the International Health Regulations (IHR), 2005. EBS was established in Sudan in 2016 as a complementary system for Indicator-based surveillance (IBS). This review will provide an overview of the current EBS structure, functions and performance in Sudan and identify the gaps and ways forward.  Methods The review followed the WHO/EMRO guidelines and tools. Structured discussions, observation and review of records and guidelines were done at national and state levels. Community volunteers were interviewed through phone calls. Directors of Health Emergency and Epidemic Control, surveillance officers and focal persons for EBS at the state level were also interviewed. SPSS software was used to perform descriptive statistical analysis for quantitative data, while qualitative data was analysed manually using thematic analysis, paying particular attention to the health system level allowing for an exploration of how and why experiences differ across levels. Written and verbal consents were obtained from all participants as appropriate. Results Sudan has a functioning EBS; however, there is an underestimation of its contribution and importance at the national and states levels. The link between the national level and states is ad hoc or is driven by the need for reports. While community event-based surveillance (CEBS) is functioning, EBS from health facilities and from non-health sectors is not currently active. The integration of EBS into overall surveillance was not addressed, and the pathway from detection to action is not clear. The use of electronic databases and platforms is generally limited. Factors that would improve performance include training, presence of a trained focal person at state level, and regular follow-up from the national level. Factors such as staff turnover, income in relation to expenses and not having a high academic qualification (Diploma or MSc) were noticed as inhibiting factors. Conclusion The review recommended revisiting the surveillance structure at national and state levels to put EBS as an essential component and to update guidelines and standard operation procedures SOPs to foster the integration between EBS components and the overall surveillance system. The need for strengthening the link with states, capacity building and re-addressing the training modalities was highlighted