Conference Papers
Permanent URI for this collectionhttp://repository.kln.ac.lk/handle/123456789/6561
This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine
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Item Risk factors for low resilience among grade 10 adolescents in the Gampaha District(Sri Lanka Medical Association, 2023) Manori, D.M.S.; Jayawardana, P.L.; Godamunne, P.INTRODUCTION: Resilience denotes the ability to withstand adversity and bounce back from difficult life events. OBJECTIVE: To determine risk factors for low resilience among Grade 10 adolescents in the District of Gampaha. METHODS: A case-control study with a computed sample size of 128 in each among cases (low resilience) and controls (high resilience) was conducted. Cases and controls were selected by applying simple random sampling to a descriptive study where the magnitude of resilience was determined. For data analysis bivariate (using chi-square test) followed by multiple logistic regression were applied. Results were expressed as adjusted odds ratios with 95% confidence intervals. RESULTS: Risk factors for low resilience were: one or both parents dead (AOR=3.4; 95% CI [1.1, 10.1]; p=0.031), mother’s educational level ≤GCE A/L (AOR=2.3; 95% CI [1.4, 3.6]; p=0.001), losing temper frequently (AOR=2.5; 95% CI [1.9, 3.4]; p<0.001), having <6 friends (AOR=1.4; 95% CI [1.03;1.9]; p<0.048), having <6 close friends (AOR=1.6; 95% CI [1.06, 2.5]; p=0.024), having conflicts with friends (AOR=2.0; 95% CI [1.03, 3.74]; p=0.040), lack of support from home (AOR=1.5; 95% CI [1.04, 2.20]; p=0.031), not seeking help when facing difficult situations (AOR=1.7; 95% CI [1.2, 2.3]; p=0.001), sleeping for <8 hours/day (AOR=1.4; 95% CI [1.2, 1.8]; p=0.007), lack of religious affiliations (AOR=2.6; 95% CI [1.2, 5.7]; p < 0.015) and non-attending Sunday school (AOR=2.1; 95% CI [1.5, 3.2]; p<0.001). CONCLUSION: Eleven risk factors were identified. Recommend conducting cognitive behavioural therapy-based interventions regularly at the school level targeting to minimize the impact of the above risk factors.Item Household expenditure on tobacco consumption in Monaragala district(Sri Lanka Medical Association, 2016) Perera, K.M.N.; Guruge, G.N.D.; Jayawardana, P.L.INTRODUCTION AND OBJECTIVES: The link between tobacco and poverty is well established. Monaragala is the poorest rural district in the southern parts of Sri Lanka and second poorest in the country. The Central Bank statistics state that 2.7% of household expenditure is spent on “liquor, drugs and tobacco”. This figure is much lower than the global estimates and findings in other countries. This study aimed to describe the expenditure on tobacco and its impact on food and education related expenditures at household level in Monaragala District. METHOD: A cross-sectional study design was used. A representative sample of 1160 households was recruited using a four-stage cluster sampling method. A simple random sampling method was used to select an individual aged between 15 to 59 years from the selected household. Data were obtained by a pre-tested, validated questionnaire was administered by trained interviewers. Recall method was used to obtain expenditure related data. RESULTS: Median monthly household income was LKR 20,000 (IQR=LKR 12,000-30,000). The median monthly expenditure on tobacco was LKR 1000 (IQR: 400-2000) with the highest spending tertile reporting a median of LKR 2700 (IQR 2000-3600). The proportionate expenditure from the monthly income ranged from 0.0% to 50% with a median of 5.0% (IQR=2.0-10.0). The poorest reported the highest mean proportionate expenditure (9.8%, SD=10) from the household income. Medium and high spenders spent significantly less on children’s education compared to others. CONCLUSION: The household expenditure on tobacco products in rural poor communities in Sri Lanka is probably greater than the current estimates.Item Risk factors for delivering a small for gestational age infant(Sri Lanka College of Obstetricians and Gynaecologists, 2004) Abeysena, C.; Jayawardana, P.L.; Seneviratne, S.R.A.OBJECTIVE: To determine the risk factors for delivering a small for gestatJonal age (SGA) infant. METHODOLOGY: A prospective study was carried out at two MOH areas in the Gampaha district, during the period of May 2001 to April 2002. Eight hundred and twenty pregnant mothers were recruited at £16 weeks of gestation and followed up until partus. Demographic, socloeconomic and obstetric data of the mothers were gathered at the time of recruitment. Trimester specific exposure statuses along with potential confounding factors were gathered on average at the 12 , 28 and 36 weeks of gestation. Physical activities were assessed by asking the duration of specific postures adopted per day by the mothers during each trimester at home for house wives and both at home and during working hours for those who were engaged in paid employment. Shift work and work related physical and chemical exposures were also assessed. Psychosocial stress was ascertained using the Modified Life Events Inventory and the General Health QuestionnaireJJO. Ultrasound scan was performed to determine the gestationai age based on foetal biparietal diameter. SGA was assessed using customized growth centile charts developed by Gardosi et al. Univariate and multivariate logistic regression analysis (sample size=504) were applied and the results are expressed in odds ratios (OR) and 95% confidence intervals (95%CI) with the probability levels (P). RESULTS: When cut off for SGA was considered as <10 centile of the customized birth weight centiles, the proportion of SGA was 16.4%. Although the univariate analysis revealed that sleeping for < 8 hours during 2" or 3 or both trimesters (OR=1.645 95% CI= 1.00-2.67; P=0.04) and work related exposures during 2 or 3 or both trimesters (OR=2.42,95% GUI.19-4.93; P=0.01) were significantly associated with SGA, none of these factors became significant on multivariate logistic regression analysis. When the cut off was considered as <5 centile of the customised birth weight centiles, the proportion of SGA was 8.8%. Sleeping <8 hours during 2 or 3 or both trimesters (OR=2.34,95% CI=1.18-4.61; P=0.01), work related exposures during 2" or 3' or both trimesters (OR=2.91, 95% CM.27-6.65; P=0.01) and alcohol consumption during the 3' trimester {OR=4.33, 95% CI=1.11-16.94; P=0.03) had statistically significant association with SGA in the univariate analysis. Multivariate logistic regression also revealed that sleeping for <8 hours during 2" or 3 or both trimesters (OR=2.14, 95% 01=1.06-4.32; P=0.03), and walking for < 2.5 hours per day (OR=2.40> 95% CM.05-5-51; P=0.04) and alcohol consumption during the 3' trimester (OR=8.01,95% CM.31-49.02; P=0.02) were risk factors. CONCLUSIONS: Risk factors for being SGA when SGA is defined as <5 centile of the customised birth weight centiles are, sleeping for <8 hours during 2 or 3 or both trimesters, walking < 2.5 hours per day and alcohol consumption during 3 trimester. It is recommended that the importance of sleeping >8 hours and walking > 2.5 hours per day and avoidance of alcohol be emphasised to pregnant mothers.Item Public health midwives’ perception on breast cancer early detection services provided through well woman clinics in the Gampaha District, Sri Lanka(College of the Community Physicians of Sri Lanka, 2013) Vithana, P.V.S.C.; Hemachandra, D.K.N.N.; Ariyarathne, M.A.Y.; Jayawardana, P.L.INTRODUCTION: Being most common cancer diagnosed in Sri Lanka, breast cancer accounts for 27% of female cancer-mortality. Early-detection of breast cancer is conducted using clinical breast examination (CBE) and increasing awareness on breast self-examination through well woman clinics (WWCs). OBJECTIVE: To identify Public health midwives' (PHMs') perception on the importance and deficiencies of the breast cancer early-detection services provided through WWCs, and their suggestions on improving the breast cancer early-detection services. METHODS: A qualitative study using four focus group discussions (FGDs) consisting of 8-10 participants per each FGD were conducted among 38 PHMs in the Gampaha District during July to September 2008. FGD guide included discussion points on availability of guidelines and protocols, training received, time for clinic-sessions, adequacy of resources, support from other sectors, and reasons for low-participation and their recommendations for improving utilization of services. Two experts conducted FGDs as moderator and data recorder. FGDs were audio-recorded, transcribed and analyzed using constant comparison and identifying themes and categories. Results were presented in narrative form. RESULTS: All the PHMs had a firm realization on the need of breast cancer early-detection. FGDs revealed non-availability of guidelines, lack of training, lack of skills and material to provide health education, inability to provide privacy during CBE, shortage of stationery and lack of community awareness and motivation. The suggestions for the improvements identified in FGDs were capacity building of PHMs, making availability of guidelines, rescheduling clinics, improving the supervision, strengthening the monitoring, improving coordination between clinical and preventive sectors, and improving community awareness. CONCLUSIONS AND RECOMMENDATIONS: The components to be improved in breast cancer early-detection services were identified. Study recommends training programmes at basic and post basic levels on a regular basis and supervision for the sustenance of the program.Item Developing and validating a tool to assess empowerment for tobacco control(Sri lanka Medical Association, 2015) Perera, K.M.N.; Guruge, G.N.D.; Jayawardana, P.L.INTRODUCTION AND OBJECTIVES: Empowerment is defined as the mechanism by which individuals, organizations and communities gain mastery over their lives. Many tobacco control interventions aim to empower individuals but measuring empowerment is a challenge. Study aim was to develop a tool to assess empowerment for tobacco controf at individual level in the Moneragala District. METHOD: indicators were operationalized based on Zimmerman's psychological empowerment definition. Initial interviewer-administered tool was subjected to modified Delphi technique to determine content and consensual validity and a scoring system. Cognitive interviews were conducted to assess applicability to local context. Pre testing (n=30) and validation (n=200) were conducted in the Badulla District. Exploratory factor analysis was performed to assess construct validity. Based on communalities, Scree test and Eigenvalues derived from latter, Delphi technique was used to determine the factor structure which improved interpretability. Internal consistency and test-retest reliability were assessed using Cronbach's alpha and Cohen's kappa coefficient respectively. RESULTS: Components extracted using principle component analysis showed high communalities (0.914 to 0.996). Eigenvalue cut-off taken was 0.3 and six constructs based on the Scree plot converged in 14 iterations in Varimax rotation. Final tool comprised 27 items under seven factors named "Perceived awareness"; "Motivation to involve and perceived mastery"; "Awareness and mobilization of resources"; "Perceived efficacy"; "Perceived competence in society", “perceived competence within network” and “community involvement” for tobacco control. Cronbach’s alpha was 0.91 demonstrating good internal consistency. Cohen’s kappa coefficient was 0.63 indiicating substancial agreement .CONCLUSION: Developed tool can be used in similar contexts to measure empowerment for tobacco control.