Investing in mental health in Somalia: harnessing community mental health services through task shifting

Abstract Background The increase of mental health issues globally has been well documented and now reflected in the United Nations' Sustainable Development Goals as a matter of global health significance. At the same time, studies show the mental health situations in conflict and post-conflict settings much higher than the rest of the world, lack the financial, health services and human resource capacity to address the challenges. Methods The study used a descriptive literature review and collected data from public domain, mostly mental health data from WHO's Global Health Observatory. Since there is no primary database for Somalia's public health research, the bibliographic databases used for mental health in this study included Medline, PubMed, CINAHL, PsycINFO, and Google Scholar. Results The review of the mental health literature shows one of the biggest casualties of the civil war was loss of essential human resources in healthcare as most either fled the country or were part of the victims of the war. Conclusion In an attempt to address the human resource gap, there are calls to task-shift so that available human resource can be utilized efficiently and effectively. This policy paper discusses the case of Somalia, the impact of decade-long civil conflict on mental health and health services, the significant gap in mental health service delivery and how to strategically and evidently task-shift in closing the mental health gap in service delivery

Bis(N-isopropyl-N-methyl­dithio­carbamato-κ2 S,S′)(1,10-phenanthroline-κ2 N,N′)zinc

The ZnII atom in the title compound, [Zn(C5H10NS2)2(C12H8N2)], exists in a distorted cis-octa­hedral N2S4 donor set defined by two chelating dithio­carbamate anions as well as a 1,10-phenanthroline ligand. Each of the ligands coordinates in a symmetric mode. The crystal packing is stabilized by weak C—H⋯S, C—H⋯π(ZnS2C) and π–π [ring centroid distance between centrosymmetrically related pyridyl rings = 3.5955 (13) Å] inter­actions

Evaluation of Imprint Cytology of Endoscopic Gastric Mucosa Biopsy in the Diagnosis of Helicobacter pylori Infection

Background:Helicobacter pylori colonization of the gastric mucosa is associated with the pathogenesis of gastritis, peptic ulcer disease, and gastric malignancy. There are several methods to detect the presence of Helicobacter pylori.These tests include noninvasive method (serology, urea breath test, or stool antigen test) and invasive methods, such as, culture, histological examination, and rapid urease test. Method:This descriptive prospective cross sectional study was conducted in Gezira state in Wad Madeni from March - August 2016;it aimed to determine the sensitivity, specificity, positive (PPV), and negative predictive values (NPV) of imprint cytology in the detection of H. pylori compared with stool Ag test. H.pylori stool Ag test was done for 50 clinically suspected patients for H.pylori infection and one gastric biopsy from each patient was collected during endoscopy. Air-dried imprint smears of gastric biopsies were stained by the Diff-Quik method and examined for H.pylori. The presence of inflammation and intestinal metaplasia were documented. Results: The H. pylori prevalence was 38% by stool Ag test and 42% by imprint cytology. The sensitivity and specificity of imprint cytology in the detection of H. pylori were 89.5% and 87.1% respectively. The PPV and NPV were 80.1% and 93.1%, respectively. The accuracy of the test was 88.0%. Conclusion:This study concludes that gastric imprint smears stained with Diff-Quik method is a rapid, cheap, and reliable method for the detection of H.pylori infection.It recommends the use of Imprint cytology for detection of Helicobacter pylori inpatients undergoing upper gastrointestinal endoscopy

Is Prolonged Sitting a Risk Factor in Developing Hemorrhoids and Anal Fissures?

Background: Anal fissures and hemorrhoids are common anal conditions. They cause significant morbidity, social embarrassment, and work absenteeism. In addition, they form a significant workload on the healthcare system. Nevertheless, the etiology of these conditions is still contentious. It has been observed that hemorrhoids and anal fissures are associated with prolonged sitting. This study aims to investigate this observation.Methods: This is a case–control study. We compared 81 patients with symptomatic and endoscopically proven hemorrhoids and/or anal fissures with 162 controls with no symptoms or endoscopic evidence of perianal disease. The study was conducted at Khartoum North Teaching Hospital (KNTH) endoscopy unit between January and December 2019. Demographic data, sitting hours per day, and endoscopic findings of patients and controls were recorded in a proforma. The cases and controls were matched for age, sex, and bowel habits. Data were analyzed and compared using the SPSS version 23.Results: The mean sitting hours for cases was 5.99 (SD 3.4) whereas that for controls was 4.0 (SD 3.0) with a highly significant difference (P < 0.001). Sitting for 5 hr or more per day (exposure) was associated with an increased risk of developing hemorrhoids and/or anal fissures [odds ratio 3.68, 95% CI: 2.1–6.47].Conclusion: The study showed that sitting down for 5 hr or more per day might increase the risk of developing hemorrhoids and/or anal fissures. This finding could help in the prevention and treatment of these diseases and the reduction of recurrences

Vitamin D Receptor Gene (Fok-I) Polymorphisms in Type 1 Diabetic Children; Case Study in Zagazig University Hospitals

Background: Many meta-analyses studied the association between vitamin D receptor (VDR) gene polymorphism and type 1 diabetes (T1DM) susceptibility. Objective: This study was designed to assess the role of VDR gene (FOK-I) polymorphisms in type 1 diabetic children from Zagazig University Hospitals in Egypt. Patients and Method: In this case-control study, the genotypes of VDR gene (FOK-I) polymorphisms were assessed in 180 type 1 diabetic children and 120 healthy matched age controls by PCR-RFLP analysis. Results: A high statistical difference between patient and control regarding VDR gene (FOK-I) polymorphisms, where 44% of the patient group had heterozygous genotype (AG) compared to 8.3% in the control group. AG genotype has almost a higher risk nine times odds ratio (OR) = 8.8 than AA genotype in diabetic patients. There was a significant increase in the G allele in the patient group. Moreover, a significant association between (FOK-I) polymorphisms and T1DM complications was also observed. Conclusion: (AG) genotype of VDR gene (FOK-I) polymorphisms could be a risk factor for T1DM complications. So, VDR gene (FOK-I) polymorphisms should be performed with other genetic studies for early prediction, detection and prevention of microvascular complications of T1DM that adversely affect health-related quality of life of Egyptian children and burden the primary care units

Web based water turbidity monitoring and automated filtration system: IoT application in water management

Water supplied to residential areas is prone to contaminants due to pipe residues and silt, and therefore resulted in cloudiness, unfavorable taste, and odor in water. Turbidity, a measure of water cloudiness, is one of the important factors for assessing water quality. This paper proposes a low-cost turbidity system based on a light detection unit to measure the cloudiness in water. The automated system uses Intel Galileo 2 as the microprocessor and a server for a web-based monitoring system. The turbidity detection unit consists of a Light Dependent Resistor (LDR) and a Light Emitting Diode (LED) inside a polyvinyl chloride (PVC) pipe. Turbidity readings were recorded for two different positionings; 90° and 180° between the detector (LDR) and the incident light (LED). Once the turbidity level reached a threshold level, the system will trigger the filtration process to clean the water. The voltage output captured from the designed system versus total suspended solid (TSS) in sample water is graphed and analyzed in two different conditions; in total darkness and in the present of ambient light. This paper also discusses and compares the results from the above-mentioned conditions when the system is submerged in still and flowing water. It was found that the trends of the plotted graph decline when the total suspended solid increased for both 90° and 180° detector turbidimeter in all conditions which imitate the trends of a commercial turbidimeter. By taking the consideration of the above findings, the design can be recommended for a low-cost real-time web-based monitoring system of the water quality in an IOT environment

Progress and experiences of implementing an integrated disease surveillance and response system in Somalia; 2016–2023

IntroductionIn 2021, a regional strategy for integrated disease surveillance was adopted by member states of the World Health Organization Eastern Mediterranean Region. But before then, member states including Somalia had made progress in integration of their disease surveillance systems. We report on the progress and experiences of implementing an integrated disease surveillance and response system in Somalia between 2016 and 2023.MethodsWe reviewed 20 operational documents and identified key integrated disease surveillance and response system (IDSRS) actions/processes implemented between 2016 and 2023. We verified these through an anonymized online survey. The survey respondents also assessed Somalia’s IDSRS implementation progress using a standard IDS monitoring framework Finally, we interviewed 8 key informants to explore factors to which the current IDSRS implementation progress is attributed.ResultsBetween 2016 and 2023, 7 key IDSRS actions/processes were implemented including: establishment of high-level commitment; development of a 3-year operational plan; development of a coordination mechanism; configuring the District Health Information Software to support implementation among others. IDSRS implementation progress ranged from 15% for financing to 78% for tools. Reasons for the progress were summarized under 6 thematic areas; understanding frustrations with the current surveillance system; the opportunity occasioned by COVID-19; mainstreaming IDSRS in strategic documents; establishment of an oversight mechanism; staggering implementation of key activities over a reasonable length of time and being flexible about pre-determined timelines.DiscussionFrom 2016 to 2023, Somalia registered significant progress towards implementation of IDSRS. The 15 years of EWARN implementation in Somalia (since 2008) provided a strong foundation for IDSRS implementation. If implemented comprehensively, IDSRS will accelerate country progress toward establishment of IHR core capacities. Sustainable funding is the major challenge towards IDSRS implementation in Somalia. Government and its partners need to exploit feasible options for sustainable investment in integrated disease surveillance and response

The construction of the Malaysian Educators Selection Inventory (MEdSI): a large scale assessment initiative / Joharry Othman...[et al.]

of a nation’s human resource is undeniable. In Malaysia, teaching has always been perceived as a financially secure and relatively easy job by many, resulting in mass application for entry into teacher education programmes. Many of those who aspire and opto to go into the teaching profession however do so regardless of their personal interests, potential, and values. Pursuing a program that does not fit a person’s personality and interest – despite initially having good academic credentials and excellent co-curricular involvement in school – may result in unsatisfactory academic performance, frustration, change of program and even withdrawal at college level. Hence, in the quest for selecting suitable teacher trainee candidates, a psychometrically sound instrument known as the Malaysian Educators Selection Inventory (MEdSI) was developed as a screening measure to filter the large number of teacher hopefuls. This paper specifically describes the theoretical basis and the constructs of the instrument developed

Frequency of significant steatosis in various chronic liver diseases: an evaluation with Transient Elastography (TE)

INTRODUCTION: TE was developed as a non-invasive method to assess liver fibrosis and steatosis using shear wave velocity. Many studies have proven its’ effectiveness as a method for evaluating liver fibrosis and steatosis.1-2 OBJECTIVE: To determine the prevalence and aetiology of steatosis in our local population. METHOD: This study was conducted as a retrospective review on all patients who had TE performed at UMMC from 1 January 2013 to 31 December 2021. Their demographics, clinical characteristics and TE findings were charted. RESULTS: A total of 3066 patients were included. 51.7% were males and 48.3% were females. The median CAP value was 271 dB/m. The median E value was 6.5kPa. 61.2% of patients had steatosis, with a staggering number of of these patients having significant steatosis (51.8%). 6.3% of patients had S2 steatosis whereas 45.5% of patients had severe (S3) steatosis. Interestingly, in those with S2 steatosis, 34.7% had chronic hepatitis B (CHB), 31.5% had non-alcoholic fatty liver disease (NAFLD), 5.2% with chronic hepatitis C (CHC) and 1% had alcoholic liver disease (ALD). In the S3 steatosis group, 66.7% had NAFLD, followed by ALD (36.6%), CHB (30.1%) and CHC (27.7%). 221 DISCUSSION: It is important to highlight that a large proportion of our patients has significant steatosis. This is likely in keeping with the global rise of obesity and sedentary lifestyle.3 NAFLD is a 4-decades old nomenclature that does not appropriately address the heterogenous pathogenicity of fatty liver disease. Our study reflects this heterogeneity, as it shows that steatosis often co-exists with other diverse aetiologies. CONCLUSION: Whilst NAFLD clearly has the greatest frequency of severe steatosis, it is also present in other aetiologies. These findings support the new terminology of metabolic associated fatty liver disease (MAFLD), which reflects the fact that NAFLD commonly co-exists with other aetiologies

A Survey of Air-to-Ground Propagation Channel Modeling for Unmanned Aerial Vehicles

In recent years, there has been a dramatic increase in the use of unmanned aerial vehicles (UAVs), particularly for small UAVs, due to their affordable prices, ease of availability, and ease of operability. Existing and future applications of UAVs include remote surveillance and monitoring, relief operations, package delivery, and communication backhaul infrastructure. Additionally, UAVs are envisioned as an important component of 5G wireless technology and beyond. The unique application scenarios for UAVs necessitate accurate air-to-ground (AG) propagation channel models for designing and evaluating UAV communication links for control/non-payload as well as payload data transmissions. These AG propagation models have not been investigated in detail when compared to terrestrial propagation models. In this paper, a comprehensive survey is provided on available AG channel measurement campaigns, large and small scale fading channel models, their limitations, and future research directions for UAV communication scenarios