Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Policy implementation and recommended actions to create healthy food environments using the healthy food environment policy index (Food-EPI): a comparative analysis in South Asia(Elsevier Ltd, 2024) Pineda, E.; Atanasova, P.; Wellappuli, N.T.; Kusuma, D.; Herath, H.; Segal, A.B.; Vandevijvere, S.; Anjana, R.M.; Shamim, A.A.; Afzal, S.; Akter, F.; Aziz, F.; Gupta, A.; Hanif, A.A.; Hasan, M.; Jayatissa, R.; Jha, S.; Jha, V.; Katulanda, P.; Khawaja, K.I.; Kumarendran, B.; Loomba, M.; Mahmood, S.; Mridha, M.K.; Pradeepa, R.; Aarthi, G.R.; Tyagi, A.; Kasturiratne, A.; Sassi, F.; Miraldo, M.BACKGROUND The increasing prevalence of diet-related non-communicable diseases (NCDs) in South Asia is concerning, with type 2 diabetes projected to rise to 68%, compared to the global increase of 44%. Encouraging healthy diets requires stronger policies for healthier food environments.METHODS This study reviewed and assessed food environment policies in Bangladesh, India, Pakistan, and Sri Lanka from 2020 to 2022 using the Healthy Food Environment Policy Index (Food-EPI) and compared them with global best practices. Seven policy domains and six infrastructure support domains were considered, employing 47 good practice indicators to prevent NCDs. Stakeholders from government and non-governmental sectors in South Asia (n = 148) were invited to assess policy and infrastructure support implementation using the Delphi method.FINDINGS Implementation of food environment policies and infrastructure support in these countries was predominantly weak. Labelling, monitoring, and leadership policies received a moderate rating, with a focus on food safety, hygiene, and quality rather than obesity prevention. Key policy gaps prioritized for attention included front-of-pack labelling, healthy food subsidies, unhealthy food taxation, restrictions on unhealthy food promotion, and improvements in school nutrition standards to combat NCDs.INTERPRETATION Urgent action is required to expand food policies beyond hygiene and food security measures. Comprehensive strategies targeting NCD prevention are crucial to combat the escalating burden of NCDs in the region.Item Cardiovascular risk stratification in primary prevention of non-communicable diseases(Ceylon College of Physicians, 2022) Mettananda, C.No abstract availableItem Identifying influential determinants for non-communicable diseases among school children using Health Promotion approach(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Thilokshika, R.M.S.; Guruge, G.N.D.Introduction: World Health Organisation (WHO) estimates for deaths attributed to non- communicable Diseases (NCD) in Sri Lanka have increased up to 75% of total deaths. NCD cause more than three quarters of all deaths and nearly 1 in 5 people die prematurely from NCD. According to the views of school children and staff and observations, NCD risk was high in Wallisinghe Harishchandra Maha Vidyalaya in Anuradapura District. Objective: To empower school children to identify influential determinants for non- communicable disease through the health promotion approach. Methods: A community-based study was conducted with a group of school children (n =15) who are in the age range 12-15 years. Interactive discussions were facilitated with school children about current NCD risk among children and identified most influential structural determinants to address to reduce NCD risk. Observation of behavioural patterns, measuring BMI of school children also helped to identify influential determinants. Results: Eighteen determinants were identified through discussion including peer influence, lack of experience, media influence, poor awareness of parents and children, food preparation methods of children. Five determinants were identified through observation including availability of packed foods in shops, junk food consumption among children, fixable price of junk foods. Six determinants were prioritized by them according to the criteria like importance, changeability, magnitude, majority view and easiness to address. Those included poor awareness of parents and children, peer influence and media influence. Conclusions: School children were successfully able to identify influential determinants for non- communicable diseases. Health promotion approach is effective in enabling school children to identify the determinants of non-communicable diseases.Item Selected non-communicable diseases and risk conditions among fishermen in Divisional Secretariat Division of Kalpitiya(College of Community Physicians of Sri Lanka, 2016) Harshani, S.R.A.P.; Abeysena, C.Introduction: Fishermen are special group of people who are more vulnerable to non-communicable diseases due to occupation specific conditions. Objective: To determine the prevalence of accidental injuries, hypertension, malnutrition, smoking and alcohol consumption among fishermen in Divisional Secretariat Division of Kalpitiya. Methodology: This was a descriptive cross-sectional study, conducted during the period of August to October 2011. The sample consisted of 465 fishermen with ≥6 months experience in fishing and selected by applying the cluster sampling technique. The study instruments were the interviewer-administered questionnaire and the record sheet. Prevalence of the above conditions and diseases with 95% confidence intervals (CI) were calculated. Results: The prevalence of accidental injuries was 19.6%(95%CI:16%-23.2%). The prevalence of hypertension was 24.3%(95% CI:20.4%-28.2%) and it was significantly higher among those who have >10 years of service experience in the fishing sector (p<0.01) and history of smoking >10 years duration (p<0.001). The prevalence of underweight, overweight and obesity were 6.2%(95%CI:4%-8.4%), 20.6%(95%CI:16.9%-24.3%) and 2.6%(95%CI:1.2%-4%) respectively. The prevalence of current smokers and current alcohol consumers were 54.6%(95% CI: 50.2%-59%) and 60.2%(95% CI: 55.8%-64.6%) respectively. Conclusion: The prevalence of hypertension, smoking and alcohol consumption were higher and obesity was lower among fishermen than general population. Improve the knowledge on prevention and screening are recommended.