Browsing by Author "Gunawardena, N.S."

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    Association of attachment with parents and abusive experiences during childhood
    (Sri Lanka Medical Association, 2016) Chandraratne, N.K.; Fernando, A.D.; Gunawardena, N.S.
    INTRODUCTION: Improving parent-child attachment is considered to be an effective intervention in preventing child abuse. OBJECTIVES: This study is aimed at determining the association between parent-child attachment and experience of abuse during childhood. METHOD: A cross sectional analytical study was conducted among a representative sample of 1479 schooling young adults aged 18-20 years in Gampaha District, selected using a multi-stage cluster sampling method. Experience of abuse during childhood were determined using the self-administered locally validated tool SICAST-R. Parent-child attachment was determined using Inventory of Parent and Peer Attachment (IPPA), a self-administered tool, which measures the attachment to parents during childhood in the dimensions of communication, trust and alienation. RESULTS: The prevalence rates for abusive experience during childhood were 45.4% (95% CI=42.9–47.9), 9.1% (95% CI=7.6-10.5) and 27.9% (95% CI=25.7–30.2) for physical, sexual and emotional abuse respectively. All three dimensions that describe the attachment with the mother were significantly associated with being physically (poor trust:OR=3.71, 95% CI=1.52-9.05; poor communication: OR=1.72, 95%CI=0.89-3.35; presence of alienation: OR=2.63, 95%CI=1.72-4.00), sexually (poor trust: OR=3.62, 95%CI=1.07-12.25; poor communication :OR=2.44, 95% CI=1.01-5.92; presence of alienation: OR=3.89, 95% CI=2.22-6.81) and emotionally (poor trust: OR=6.56, 95% CI=2.88-14.91; poor communication: OR=3.19, 95% CI=1.78-5.71; presence of alienation: OR=3.32, 95% CI=2.21-4.98) abused during childhood. Similarly, aall three dimensions that describe the attachment with the father were significantly associated with being physically (poor trust: OR =3.16, 95%CI = 1.92-5.19; poor communication: OR=2.72, 95%CI=1.57-4.72; presence of alienation: OR=2.53, 95%CI=1.80-3.56), sexually (poor trust: OR=2.49, 95%CI = 1.18-5.29; poor communication: OR = 3.28, 95%CI = 2.27-4.74; presence of alienation: OR = 2.55, 95%CI = 1.54-4.22) and emotionally (poor trust: OR = 3.29, 95%C I= 2.00-5.39; poor communication:OR = 4.47, 95%CI = 2.05-9.73; presence of alienation: OR=3.21, 95%CI = 2.30-4.48) abused during childhood. CONCLUSIONS: Poor attachment with parents is associated with abusive experience during childhood. Public Health Programmes should focus on improving parent-child attachment.
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    Beyond survival: 5-year neurodevelopmental follow-up of a cohort of preterm infants in Colombo, Sri Lanka
    (Maney Publishing, 2018) Sumanasena, S.P.; Vipulaguna, D.V.; Mendis, M.M.; Gunawardena, N.S.
    BACKGROUND: There is a lack of information on long-term neurodevelopmental outcome in preterm neonates in low- and middle-income countries. OBJECTIVES: To describe the developmental attainments of preterm neonates followed up for 5 years and to identify the risk factors for impairment. METHOD: A prospective descriptive cohort study was undertaken in neonates of 34 weeks gestation born within a period of 12 months at a single tertiary maternity and neonatal unit in Colombo, Sri Lanka. Infants were assessed for neurodevelopment using the Bayley Infant and Toddler III® Assessments at 6, 12 and 24 months of corrected age and school readiness assessment at 5 years. RESULTS: Fifty-one infants were assessed at least once, 45 were assessed at 2 years and 39 had a final assessment at 5 years. Neurodevelopmental attainment deteriorated significantly in the cognitive and motor composite scores from 6 to 24 months (p < 0.05). By 5 years the number of children with delay in cognitive, language and motor domains had reduced significantly from 24 months (p < 0.05) but the cognitive skills remained most affected (10/39). At 5 years, 13 of 39 children had a confirmed diagnosis of a neurodevelopmental disorder: eight had attention deficit hyperactivity disorder, three autism spectrum disorder, one cerebral palsy and one visual impairment. Surfactant administration and retinopathy of prematurity were the most significant risks for delayed development at 5 years (p < 0.05). CONCLUSION: Deterioration of cognitive and motor composite scores over the first 24 months highlights the need for regular surveillance of premature infants. There was a discrepancy between the diagnosis of neurodevelopmental delay at 24 months and at 5 years. But the notable impact on school readiness skills requires public health initiatives to cater for the needs of these children.
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    Prediction of colorectal cancer risk among adults in a lower middle-income country
    (AME Publishing Company, 2019) Samarakoon, Y.M.; Gunawardena, N.S.; Pathirana, A.; Perera, M.N.; Hewage, S.A.
    BACKGROUND: Globally, colorectal cancer (CRC) is ranked as the third most common cancer in men and the second in women. Use of a simple, validated risk prediction tool will offer a low-cost mechanism to identify the high-risk individuals for CRC. This will increase efficient use of limited resources and early identification of patients. The aim of our study was to develop and validate a risk prediction model for developing CRC for Sri Lankan adults. METHODS: The risk predictors were based on the risk factors identified through a logistic regression model along with expert opinion. A case control design utilizing 65 CRC new cases and 65 hospital controls aged 30 years or more was used to assess the criterion validity and reliability of the model. The information was obtained using an interviewer administered questionnaire based on the risk prediction model. RESULTS: The developed model consisted of eight predictors with an area under the curve (AUC) of 0.849 (95% CI: 0.8 to 0.9, P<0.001). It has a sensitivity of 76.9%, specificity of 83.1%, positive predictive value (PPV) of 82.0%, negative predictive value (NPV) of 79.3%. Positive and negative likelihood ratios are 4.6 and 0.3. Test re-test reliability revealed a Kappa coefficient of 0.88. CONCLUSIONS: The model developed to predict the risk of CRC among adults aged 30 years and above was proven to be valid and reliable and it is an effective tool to be used as the first step to identify the high-risk population who should be referred for colonoscopy examination. © Journal of Gastrointestinal Oncology. All rights reserved.
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    Prevalence and severity of abusive experiences during childhood among a group of young adults from Gampaha District
    (Sri Lanka Medical Association, 2016) Chandraratne, N.K.; Fernando, A.D.; Gunawardena, N.S.
    INTRODUCTION: Abuse during childhood is a public health problem leading to adverse health, social and economic consequences. OBJECTIVES: The study aims to determine the prevalence and severity of physical, sexual and emotional abuse during childhood among young adults aged 18-20 years schooling in the Gampaha District. METHOD: A descriptive cross-sectional study was conducted among 1500 schooling young adults selected by multistage cluster sampling. The prevalence of physical, sexual and emotional abuse was ascertained using the validated version of ICAST-R (ISPCAN Child Abuse Screening Tool-Retrospective Version). The severity of abusive experiences was assessed using a tool developed by the researchers based on modified Delphi technique. RESULTS: Prevalence of physical abusive experiences during childhood was 45.4% (95%CI = 42.9–47.9) (males- 54.8%, 95%CI = 51.1–58.8, females- 38.3%, 95%CI = 35.0–41.3), prevalence of severe physical abuse was 0.1%.. Being 'beaten by an object' was the commonest experience among both males (45.9%, 95% CI = 42.8–49.8) and females (32.0%, 95% CI = 28.7-35.6). Prevalence of sexual abuse during childhood was 9.1% (95% CI=7.6-10.5) (males: 6.4%, 95%CI=4.6–8.3, females: 11.5%,95%CI = 9.4–13.7), prevalence of severe sexual abuse was 0.2%. ‘Someone exposing their genitals’ was the commonest act (9.1%, 95%CI = 7.1-11.1) experienced by females and ‘Someone touching the genitals’ was the commonest act (4.0%, 95%CI = 2.5-5.7) experienced by males. Prevalence of emotional abuse during childhood was 27.9% (95%CI = 25.7–30.2) (males: 33.9%, 95%CI = 30.4–37.3, females: 23.2%,95% CI = 20.3–26.1) severe emotional abuse was seen among 2.4%. Insulting or criticizing was the most common abusive act among both males (29.5%, 95%CI = 26.2-33.1) and females (20.1%, 95%CI = 17.2-22.9). CONCLUSIONS: Prevalence of physical, sexual and emotional abusive experiences during childhood were high among schooling young adults in the Gampaha District. This calls for targeted interventions.
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    Risk prediction models for colorectal cancer: A Scoping review
    (Postgraduate Institute of Medicine University of Colombo, 2017) Samarakoon, Y.M.; Pathmeswaran, A.; Gunawardena, N.S.
    BACKGROUND AND OBJECTIVES: Many risk prediction models have been developed globally to identify specific populations at high risk for colorectal cancer in specific settings. Documentation of available evidence from existing studies will serve as a useful information base. We performed a scoping review, to review and analyse published risk prediction models for colorectal cancer the world over. METHODS: A scoping review was undertaken to address the following question ‘what are the existing risk prediction models to identify the risk of developing colorectal cancer among individuals in different countries and settings?’ using the framework developed by Arksey and O’Malley for scoping reviews. Forty-one articles were included in this review from database searches and from additional searches. The titles and abstracts were reviewed using predetermined screening criteria. We limited our search to existing literature in English language and included both observational and interventional studies. RESULTS: Out of the 58 risk prediction models identified, most were developed for colorectal cancer followed by advanced colorectal cancer. Most of the articles reviewed were cross sectional studies or cohort studies. Statistical methods such as multiple logistic regression was used by a majority, while few have incorporated non-statistical methods such as consensus method and extracting data from published literature. The authors of the 58 risk prediction models have considered 77 different risk factors excluding the genetic variants. CONCLUSIONS: This comprehensive scoping review demonstrates the capacity of the existing risk models to stratify the general population into risk categories, detailing the studies conducted, location, study design, outcome, overview of the methods, data source and the identified risk predictors. While striving to build on existing knowledge, the review also identifies the research gaps and the need for further improvement.
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    Uncovering the ancient cultural interactions and ties between nāgarjunakoṇḍa and sri lanka
    (The Library, University of Kelaniya, Sri Lanka, 2023) Gunawardena, N.S.
    This research focuses into the historical and cultural relations between Nāgarjunakoṇḍa and Sri Lanka during ancient times. The primary objective of this study is to elucidate the depth and significance of these cultural interactions, exploring their influence on art, architecture, religion, trade, and language. To achieve this objective, a comprehensive examination of historical records, archaeological findings, and scholarly literature has been conducted. Methodologically, this research relies on a multidisciplinary approach, integrating data from diverse sources to provide a holistic understanding of the ancient ties between Nāgarjunakoṇḍa and Sri Lanka. The research draws from ancient texts, inscriptions, archaeological excavations, and comparative analyses of art and architecture. The key findings of this study reveal that there was a cultural exchange between Nāgarjunakoṇḍa and Sri Lanka. Buddhism played a central role in facilitating these exchanges, leading to the transmission of religious teachings, texts, and artifacts. Architectural styles, artistic motifs, and trade connections were shared, leaving a lasting imprint on both regions. In conclusion, the cultural relations between Nāgarjunakoṇḍa and Sri Lanka during ancient times were profound and enduring. The findings underscore the importance of such historical interactions in shaping the cultural and religious landscapes of both regions. The lessons learned from these ancient ties can inform contemporary intercultural relations and cooperation. This research offers insights into the interconnectedness of societies in the past and highlights the value of preserving and studying our shared cultural heritage.
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