Rapid household food insecurity (HFI) tracking has been identified as a priority in the context of the COVID‐19 pandemic and its aftermath. We report the validation of the Latin American and ...Caribbean Food Security Scale (Escala Latinoamericana y Caribena de Seguridad Alimentaria ELCSA) among pregnant women in Sri Lanka. The eight‐item adult version of the ELCSA was translated from English to Sinhala and Tamil. Cognitive testing (on 10 pregnant women and five local experts) and psychometric validation of the self‐administered HFI tool were conducted among pregnant women (n = 269) attending the special clinics of the Rajarata Pregnancy Cohort (RaPCo) in Anuradhapura in February 2020. We assessed the psychometric properties and fit using a one parameter logistic model (Rasch model analysis) using STATA Version 14 and WINSTEP software Version 4.3.4. Concurrent validity was tested using psychological distress. The scale was internally consistent (Cronbach's alpha = 0.79) and had a good model fit (Rasch items infit statistic range: 0.85 to 1.07). Item 8 (‘did not eat for the whole day’) was removed from the model fit analysis, as it was not affirmed by respondent. Item severity scores ranged from −2.15 for ‘not eating a diverse diet’ to 4.43 for ‘not eating during the whole day’. Concurrent validity between HFI and psychological distress was confirmed (r = 0.15, p < 0.05). The self‐applied version of ELCSA‐pregnancy in Sri Lanka (ELCSA‐P‐SL) is a valid and feasible valid tool. We recommend it to track HFI among pregnant women in lower income countries during the COVID‐19 pandemic.
Background
Policing is regarded as a high-risk profession for the development of mental health disturbances owing to various critical incidents and potential traumatic events they encounter. ...Exploration of mental health problems in policing in Sri Lanka, which recently concluded a civil war expanded over three decades, is a timely, yet, a neglected issue. Hence, the present study was conducted with the aim of determining the prevalence and associated factors of depression among police officers in the Kandy police division, Sri Lanka.
Methods
A cross sectional study was conducted using a simple random sample of 750 police officers employed in the Kandy police division, Sri Lanka. A self administered questionnaire, including “Peradeniya Depression Scale” to assess depression, was used to collect data. The prevalence of depression was calculated as point prevalence with 95 % confidence intervals. Multivariable logistic regression was carried out using backward elimination method to quantify the association between depression and selected predictors identified at bivariate analysis at p < 0.10.
Results
A total of 750 Police officers were invited for the study. The response rate was 94.5 % (n = 709). The mean age of the police officers in the sample was 39.6 years (SD 9.2 years). Majority of police officers (n = 591, 83.4 %) were males. The estimated prevalence of depression in the study sample was 22.8 % (95 % CI 19.9–26.1 %). However, the adjusted prevalence of depression was 10.6 % (95 % CI 6.6–15.1 %). In the multivariable analysis, of the postulated occupational factors, satisfactory welfare facilities at work place was negatively associated with depression (adjusted OR 0.5; 95 % CI 0.3–0.7; p = 0.001). Satisfaction of the opportunity to serve the public (adjusted OR 0.2; 95 % CI 0.1–0.6; p = 0.003) and satisfaction related to social status gained in policing (adjusted OR 0.5; 95 % CI 0.3–0.8; p = 0.04) were identified as significant occupational factors that lowered the likelihood of being categorized as having depression.
Conclusions
The prevalence of depression among police officers was found to be higher in comparison to other study findings in Sri Lanka. Given the modifiable nature of the significant predictors, it is recommended to design a package of interventions and implement adaptive measures to rectify the problems related to depression among police officers.
The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the ...financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put into context the expected need for investment in pandemic preparedness.
In this analysis of global health spending between 1990 and 2021, and prediction from 2021 to 2026, we estimated four sources of health spending: development assistance for health (DAH), government spending, out-of-pocket spending, and prepaid private spending across 204 countries and territories. We used the Organisation for Economic Co-operation and Development (OECD)'s Creditor Reporting System (CRS) and the WHO Global Health Expenditure Database (GHED) to estimate spending. We estimated development assistance for general health, COVID-19 response, and pandemic preparedness and response using a keyword search. Health spending estimates were combined with estimates of resources needed for pandemic prevention and preparedness to analyse future health spending patterns, relative to need.
In 2019, at the onset of the COVID-19 pandemic, US$9·2 trillion (95% uncertainty interval UI 9·1–9·3) was spent on health worldwide. We found great disparities in the amount of resources devoted to health, with high-income countries spending $7·3 trillion (95% UI 7·2–7·4) in 2019; 293·7 times the $24·8 billion (95% UI 24·3–25·3) spent by low-income countries in 2019. That same year, $43·1 billion in development assistance was provided to maintain or improve health. The pandemic led to an unprecedented increase in development assistance targeted towards health; in 2020 and 2021, $1·8 billion in DAH contributions was provided towards pandemic preparedness in LMICs, and $37·8 billion was provided for the health-related COVID-19 response. Although the support for pandemic preparedness is 12·2% of the recommended target by the High-Level Independent Panel (HLIP), the support provided for the health-related COVID-19 response is 252·2% of the recommended target. Additionally, projected spending estimates suggest that between 2022 and 2026, governments in 17 (95% UI 11–21) of the 137 LMICs will observe an increase in national government health spending equivalent to an addition of 1% of GDP, as recommended by the HLIP.
There was an unprecedented scale-up in DAH in 2020 and 2021. We have a unique opportunity at this time to sustain funding for crucial global health functions, including pandemic preparedness. However, historical patterns of underfunding of pandemic preparedness suggest that deliberate effort must be made to ensure funding is maintained.
Bill & Melinda Gates Foundation.
Since the coronavirus disease 2019 (COVID-19) pandemic is an opportune time to introduce the value-added roles of medical students, this study assessed medical students' perceptions and willingness ...to assist in COVID-19 health sector preparedness and response via value-added roles in Sri Lanka.
A cross-sectional online survey was conducted among all medical students studying in six batches of the Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, in June 2020. A Google form in English with 10 statements about individual perceptions of medical students' roles and their willingness to assist in the COVID-19 health sector response via value-added roles was used to collect data. The responses were recorded on a five-point Likert scale. The chi-squared test for independence was used to explore the associations between the academic year and the responses to each statement.
Out of 856 (response rate 79.6%) study participants, the majority were females (n=601, 70.2%). The majority (n=804, 93.9%) reported that they have a responsibility to contribute to the country's COVID-19 health sector response. There was a statistically significant association between medical students' perceived level of clinical knowledge, having the clinical skills to assist in the COVID-19 health sector response and academic year (
<0.001). The commonly identified value-added roles were developing (n=770, 89.9%) and disseminating (n=744, 86.9%) health education messages, and field contact tracing activities (n=653, 76.3%). Other value-added roles were assisting the curative health sector in COVID-19 patient management (n=380, 44.4%) and other non-COVID-19 patient management (n=463, 54.1%).
Medical students are mostly willing to engage in preventive health sector value-added roles and, to a lesser extent, in curative health sector value-added roles during the COVID-19 outbreak. However, medical educators need to clearly define the value-added roles and provide adequate training and supervision for medical students across academic years to enable them to combine learning with making meaningful contributions to the health-care system during the COVID-19 pandemic.
Background: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the ...pattern and trend of IMIDs from 1990 to 2019. Methods: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. Interpretation: The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. Funding: The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38).
Unemployment is a huge problem around the world because a lack of job opportunities. People are unable to find the job opportunities according to their preferences and qualifications. As a solution ...for this, many countries are attempting to empower self-employment. Most of current world problems have been solved using modern technologies. Therefore, the development of self-employment also can be achieved through modern technology. The objective of our proposed platform, HIRELANCER, is empowering self-employment using modern technologies. HIRELANCER is bringing the consumers, service providers, and suppliers into the same platform. HIRELANCER will consist of innovative features that go beyond comparatively to other platforms such as an advanced mechanism to find best suitable service providers/suppliers for the service, handling the virtual front-desk, cost estimation for the services prior to contacting a service provider, and advanced facility to find a suitable career path for the people who are seeking career guidance. This research paper discusses how the innovative features of HIRELANCER will be beneficial for consumers, service providers, and suppliers and ultimately achieve our main objective, which is empowering self-employment in Sri Lanka.
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