Journal/Magazine Articles
Permanent URI for this collectionhttp://repository.kln.ac.lk/handle/123456789/13
This collection contains original research articles, review articles and case reports published in local and international peer reviewed journals by the staff members of the Faculty of Medicine
Browse
7 results
Search Results
Item Evaluating the efectiveness of a community based health promotion intervention on knowledge improvement regarding low birth weight and its determinants among antenatal couples in Sri Lanka(Springer Nature, 2024) Guruge, G.N.D.; Young, S.M.; Perera, K.M.N.; Dharmaratne, S.D.; Gunathunga, M.W.BACKGROUND Improvement of the knowledge of pregnant mothers and their partners related to low birth weight (LBW) is a vital factor in preventing LBW and reducing its prevalence. OBJECTIVES Implement and evaluate the effectiveness of a community based health promotion intervention on preg nant mothers and their partners to increase knowledge on birth weight and its determinants. The second objective is to determine the difference of the birth weight after implementing the intervention. METHODS A quasi experimental study design was used, and the setting was 806 pregnant mothers, 403 each in two dis tricts. In 26 ANCs, twenty six initial training sessions were conducted as a group, with an average of three hours for each session. Three follow up sessions were conducted in each ANC over 04 months (in total 104 sessions). All sessions were conducted in groups of 10 to 20 antenatal couples. The pregnant mothers and their partners completed interviewer administered questionnaires. Pre and post data were analysed based on four major knowledge categories using statistical methods. The McNemar’s Chi Square test; Chi Square test, Fisher’s Exact test, Paired t test, Student’s independent sample t test, Wilcoxon Signed Ranks test and Mann Whitney U test methods were applied as appropriate. RESULTS Both mothers and their partners in the intervention group (IG) reached significantly higher gains in knowledge than in the comparison group (CG). The participants who got the lowest scores for knowledge, at the pre assessment, in IG, also improved more than the CG {mothers (p = 0.002) and partners (p = 0.007)}. The mean birth weight shows that the IG has significantly improved for both mothers (p < 0.001) and partners (p = 0.013) with low knowledge scores (< 50% of total). CONCLUSIONS Knowledge about birth weight and its determinants among pregnant mothers and their partners improved significantly.Item Availability of rehabilitation services for communication disorders in Sri Lanka: a cross-sectional survey(BMJ Publishing Group Ltd, 2023) Caldera, A.V.; Wickremasinghe, R.; Munasinghe, T.U.; Perera, K.M.N.; Muttiah, N.; Tilakarathne, D.; Peiris, M.K.R.R.; Thamilchelvan, E.; Sooriyaarachchi, C.; Nasma, M.N.; Manamperige, R.M.; Ariyasena, A.D.K.; Sumanasena, S.P.OBJECTIVES: To describe the rehabilitation services available for communication disorders in Sri Lanka and to estimate the adequacy of the services in provinces and districts of the country. SETTING: The study considered government and private institutions, which provide rehabilitation services for communication disorders in Sri Lanka. PARTICIPANTS: Institutions providing services of speech-language pathologists, audiologists and audiology technicians in Sri Lanka. PRIMARY AND SECONDARY OUTCOME MEASURES: We investigated the number of government hospitals and private institutions, which provide speech-language pathology and audiology services in Sri Lanka as the primary outcome measure. A number of speech-language pathologists, audiologists and audiology technicians working in the institutions were obtained from records and institution-based inquiries to identify the adequacy of the services in the country as the secondary outcome measure. RESULTS: Of the 647 government hospitals that provide free healthcare services in the country, 45 and 33 hospitals had speech and language therapy and audiology units, respectively. Government hospitals do not have audiologists but only have audiology technicians. The number of speech and language therapists and audiology technicians in the government sector per 100 000 population in the country was 0.44 and 0.18, respectively. There were wide variations in specialist to population ratio between districts. 77 private centres provide speech therapy services in 15 out of the 25 districts; 36 private centres provide audiological evaluations in 9 districts. CONCLUSIONS: The number of specialist speech and language therapists and audiologists is not sufficient to provide adequate rehabilitation services for communications disorder for the Sri Lankan population. Not recruiting audiologists to the government sector affects the management of hearing impairment in the affected.Item REACh for the preschoolers; a developmental assessment tool for 2-5 year old children in Sri Lanka(BioMed Central, 2023) Caldera, A.V.; Wickremasinghe, A.R.; Muttiah, N.; Godamunne, P.K.S.; Jayasena, B.N.; Chathurika, L.K.E.; Perera, K.M.N.; Mendis, M.; Tilakarathne, D.; Peiris, M.K.R.R.; Wijesinghe, T.; Senarathna, N.E.; Saubhagya, W.D.L.; Chandraratne, M.; Sumanasena, S.P.BACKGROUND: Preschool children in low resource settings are at higher risk of missing developmental potential due to the lack of standardized and validated methods for the timely detection of children with developmental delays or neurodevelopmental disorders. The preschool teacher is a non-specialist resourceful link within the community to detect and offer interventions early. This paper discusses the preliminary iteration of designing and testing the psychometric properties of a developmental assessment for children aged 24 to 60 months in Sri Lanka. This assessment is designed to be conducted by preschool teachers in their preschool setting. METHODS: Three processes followed: 1. Designing and development of the Ragama Early Assessment for Children (REACh) complete preschool developmental assessment and a tool kit 2. Testing and training teachers on conducting the REACh assessment 3. Preliminary assessment of the psychometric properties including content validity, internal consistency, interrater reliability and concurrent validity. RESULTS: A literature search identified 11 assessments and 542 items representing cognitive, social-emotional and adaptive, language and motor domains. Content validity was assessed to select and adapt items. A complete assessment tool was designed to be administered in four settings within the preschool. This was further improved during pre and pilot testing and teacher training. Cronbach's alpha measuring internal consistency was > 0.70 for cognitive, language, social-emotional and adaptive domains across all three age groups in 1809 children. Interrater reliability was > 65% for age groups 36-47 and 47- 60 months. Concurrent validity using a clinical gold standard demonstrated sensitivity of more than 0.75 for all age groups with variable specificities (24-35 months: 0.71, 36- 47 months: 0.43 and 48-60 months: 0.67) assessed in 75 children. CONCLUSIONS: This culturally and linguistically adapted tool was tested nationally in Sri Lanka. The inte-rrater reliability between teachers and research assistants was higher than 65% for all domains in children more than 36 months. The preliminary iteration confirms it as an acceptable screening assessment for all age groups but with significantly lower specificity in the 36-47 month age group. Further improvement in certain domains together with intense teacher training is likely to enhance the validity and reliability of the assessment.Item A Six-step process to reduce bullying in schools; The content of a health promotion intervention to reduce bullying among early adolescents in a rural school in Sri Lanka(2021) Jayasinghe, V.P.K.K; Guruge, G.N.D.; Perera, K.M.N.ABSTRACT: Bullying is a form of aggression which has negative impacts on health. Bullying acts are reported to be common among early adolescents in rural schools in Sri Lanka. It is timely to design and implement interventions aiming to reduce bullying in schools in Sri Lanka. In this article, we aim to describe the process and the content of a health promotion intervention carried out aiming to reduce bullying among early adolescents in a rural school in Sri Lanka. The intervention is comprised of a six-step process. A logical framework developed based on Samarasinghe et al (2011) was used to guide the intervention. The content of the intervention was designed following health promotion principles. Health promotion aims for empowering people-to take collective community actions aiming to achieve desired health outcomes. The intervention for bullying was designed aiming for empowering early adolescents -to generate collective actions to reduce bullying in their school. In the intervention, adolescents not merely participated but also engaged and involved in modifying the planned intervention. Different activities, brainstorming sessions, facilitated discussions, role plays, etc. were carried out in the process. In this intervention, the health promotion approach we employed enabled engagement and involvement of adolescents beyond mere participation in the intervention. KEYWORDS: adolescents, bullying, health promotion, schoolItem Validity and clinical utility of a Sinhalese version of the abnormal involuntary movement scale (AIMS)(Sri Lanka College of Psychiatrists, 2021) Baminiwatta, A.K.A.B.; Gunesekara, T.; Kuruppuarachchi, K.A.L.A.; Hapangama, A.; Harshini, M.L.; Bandara, T.R.; Perera, K.M.N.INTRODUCTION: Tardive dyskinesia (TD) is a movement disorder caused by long-term treatment with dopamine antagonists such as antipsychotics. As there is no medication universally effective for TD, prevention is important. We propose that non-medical clinicians working in psychiatry can also be trained and involved in a screening programme for TD. To facilitate such a programme, validation of a standard tool translated to Sinhala is a need. AIMS: To translate and validate the Abnormal Involuntary Movement Scale (AIMS) into Sinhala. METHODS: Translation and pilot testing followed standard guidelines. The translated version was administered by five raters (two registrars in psychiatry, a medical officer, a community psychiatry nurse (CPN) and a psychiatric social worker) amongst patients treated with antipsychotic medication for a minimum of one year. The goldstandard diagnosis was the Diagnostic and Statistical Manual (DSM)-5 criteria, applied by a psychiatrist. RESULTS: Of the 137 patients screened (53.3% male; mean age = 49 years), the percentage of patients diagnosed with TD using AIMS and DSM-5 were 33% and 34%, respectively. The sensitivity and specificity of AIMS in detection of TD were 67% and 83.4% respectively. The degree of agreement between the AIMS and DSM- 5 indicated moderate criterion validity (Cohen's kappa= 0.5). For different raters, the agreement with the psychiatrist's diagnosis (kappa) ranged from 0.41 (CPN) to 0.63 (registrar), indicating modest reliability between raters. CONCLUSIONS: Our findings provide preliminary evidence for the validity of AIMS in detecting TD among Sinhalaspeaking patients, when administered by a range of mental health professionals. KEYWORDS: Tardive dyskinesia, Abnormal involuntary movement scaleItem Knowledge and attitude towards intimate partner violence among ever-married women: A Cross-sectional study from Sri Lanka(AIJR Publisher, 2020) Reyal, H.P.; Perera, K.M.N.; Guruge, G.N.D.ABSTRACT: Effective approaches are needed to address high prevalence of intimate partner violence (IPV) against women in developing countries. Among them, addressing the attitudes of women justifying IPV is crucial. Yet, Sri Lankan studies so far have not adequately examined the community members’ knowledge and attitude toward IPV. Hence, this study aimed at i) describing knowledge and attitude towards IPV among women, ii) explore the association of socio-demographic variables with knowledge and attitude towards IPV, and iii) examine the association of knowledge and attitude with the abuse experiences. A cross-sectional survey was conducted with women (n = 600) aged 15-49 years from a selected health administrative area in Sri Lanka. Multistage cluster sampling was used to select participants and data collection was performed using an interviewer-administered questionnaire. Descriptive summaries, cross-tabulations and logistic regression analysis were performed to describe and explore the associations. Most respondents had poor knowledge (64.3%, n=386) on IPV with approximately half of them having attitudes generally justifying IPV (48.7%, n=292). Women with low levels of education and low household income were more likely to justify IPV. Further, employed women had good knowledge on IPV. Poor knowledge on IPV increased the risk of being abuse by 1.5 times and women who had justifying attitudes toward IPV had two times risk of being abuse. The necessity of interventions to be targeted on knowledge and attitudes and the contributory socio-demographic factors such as education, employment and income are emphasized. KEYWORDS: Abuse, women, socio-demographic factors, knowledge, attitudeItem The unsung heroes...(College of Community Physicians of Sri Lanka, 2018) Perera, K.M.N.