Journal of the College of Community Physicians of Sri Lanka最新文献

{"title":"Perception of public health midwives on adolescent and youth friendly health service: Sri Lankan experience","authors":"P. Vithana, R. Nilaweera, A. Basnayaka, C. Jayasundera, H. Handagiripathira, A. Barnasuriya, B. Batugedara","doi":"10.4038/jccpsl.v27i3.8406","DOIUrl":"https://doi.org/10.4038/jccpsl.v27i3.8406","url":null,"abstract":"Introduction: One fourth of the Sri Lankan population consists of adolescents and youth. Public health midwife (PHM) is the grassroot level key health care provider in the field for adolescents. Objectives: To explore PHMs' perceptions on their role and the need of improving adolescent and youth friendly health services (AYFHS) in Sri Lanka Methods: Four focus group discussions (FGDs) were conducted among 38 PHMs in Gampaha District with 9-10 midwives for each discussion. Two experts conducted the FGDs ensuring privacy and confidentiality after obtaining informed verbal consent using FGD guide. Discussions were audio-recorded and non-verbal responses were noted down. Each session lasted 60-90 minutes. Recordings of FGDs were transcribed. Thematic analysis was conducted by coding and identifying categories and themes with constant comparison. Results were presented in a narrative form. Results: All PHMs identified the need for providing AYFHS in the field ensuring easy accessibility. However, opinion on their role on AYFHS was substandard. Domiciliary care provided by PHM was identified as a major strength. Perceived workload of PHM, inadequate training, lack of supportive supervision, insufficient facilities in centres, poor health seeking behaviours and lack of awareness on available services among adolescents were identified as challenges. Reducing of PHM workload, capacity building on AYFHS, centres with improved facilities, a better monitoring mechanism with supportive supervisions and inter-sectoral coordination were recommended. Conclusions & Recommendations: Interventions focused on supporting PHMs on AYFHS and strengthening quality AYFHS in the field with increased client demand were identified as priorities.","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129434757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving human capital through integrated primary health care","authors":"P. Chulasiri","doi":"10.4038/jccpsl.v27i3.8468","DOIUrl":"https://doi.org/10.4038/jccpsl.v27i3.8468","url":null,"abstract":"","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134370535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of paternal alcoholism on the psycho-behavioural outcomes of the offspring: a systematic review and meta-analysis","authors":"P. Mahesh, J. Leung, Sameera Senananayake, V. Kumarapeli, R. Ferdinando, W. Jayawickrama, W. Lakmini, Chiara Perera, S. Thasleem, D. McLaughlin","doi":"10.4038/jccpsl.v27i3.8398","DOIUrl":"https://doi.org/10.4038/jccpsl.v27i3.8398","url":null,"abstract":"Documented literature includes mixed interpretations of the impact of paternal alcoholism on psycho-behavioral well-being of offspring. A systematic review and a meta-analysis would facilitate the accurate establishment of this association. This review was done to evaluate the effects of paternal alcohol use disorder (AUD) or problem drinking (PD) on the psycho-behavioral well-being of the offspring at different stages of their lifecycle. This PROSPERO-registered review (CRD42018114754) was conducted by reviewing literature in MEDLINE, EMBASE and PsycINFO databases. A total of 29 articles out of 18113 were selected for data extraction after three selection rounds. Eleven were included in the meta-analyses for three numerically and one categorically assessed outcomes on internalizing behaviour, externalizing behaviour and anxiety. Heterogeneity, risk of bias and the certainty-of-evidence were assessed. Sensitivity analysis was done. Rev-Man (version 5.3) software and “GRADEproGDT” online applications were used. A narrative review was done with studies and sub-groups not included in the meta-analysis under five identified themes: depression and mood disorders, self-perceived mental health problems and personality, aggression, attention deficit hyperactive disorder and other problems. With meta-analyses, all outcomes demonstrated significant standardized mean differences or odds ratio with higher unfavourable values in the exposed group. 'Low' level GRADE certainty was assigned. In sensitivity analysis, associations of similar directions were observed. Narrative review reflected other negative psycho-behavioral consequences of children associated with paternal alcoholism, falling under the five identified themes. In conclusion, robust findings of the meta-analyses and narrative review suggest that paternal AUD and PD are associated with unfavourable psycho-behavioural consequences among their offspring at many stages of the life cycle.","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115964022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, immediate consequences, associated factors and health-seeking behaviour related to falls among the elderly in Elapatha Medical Officer of Health Area, Sri Lanka","authors":"B. M. I. Gunawardana, R. Ranasinghe","doi":"10.4038/jccpsl.v27i3.8397","DOIUrl":"https://doi.org/10.4038/jccpsl.v27i3.8397","url":null,"abstract":"Introduction: Older adults are more vulnerable to falls, which are the most common cause of mortality and morbidity in the elderly. The consequences of falls and its health seeking behaviour will affect the quality of life of the elderly. Objectives: To describe the incidence, immediate consequences, associated factors and health-seeking behaviour related to falls among the elderly in Elapatha Medical Officer of Health (MOH) Area Methods: A community-based cross-sectional study was conducted in Elapatha MOH Area. Cluster sampling technique was used to select 510 elderly using probability proportional to the size of the population technique. Retrospective data on falls during the previous three months were collected using an interviewer-administrated questionnaire. Results: Cumulative incidence of falls during the past three months was 127 (95% CI=100, 159) falls per 1000 elderly. Older age (75 years and above) (adjusted odds ratio (aOR)=3.4; 95% CI=1.4, 8.4) being a female (aOR=2.1; 95% CI=1.2, 3.8) and elders who were currently employed (aOR=3.6; 95% CI=1.9, 6.9) were positively associated with falls in binary logistic regression analysis. No significant associations were observed with the level of education, living alone and the marital status. The higher proportion of falls (n=38; 59.4%) were due to Hazardous environmental conditions. Injurious falls occurred in 35.9% (n=23) of cases. Most (n=12; 41.4%) of the fall victims had received Western treatment. Conclusions & Recommendations: There was a higher reported incidence of falls among the elderly population specially among the female gender and the elders who were currently employed. Thus, there is a need for strengthening of awareness programmes on prevention of falls among elderly population and incorporation of elderly risk assessments in the available national screening programmes is a timely need.","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125932146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and associated factors of occupational stress among bus drivers of Sri Lanka Transport Board in Colombo District","authors":"D. K. Illangasinghe, M. Alagiyawanna, D. Samaranayake, N. Fernando","doi":"10.4038/jccpsl.v27i3.8424","DOIUrl":"https://doi.org/10.4038/jccpsl.v27i3.8424","url":null,"abstract":"Introduction: Occupational stress among bus drivers is on the rise in the world. It is of prime importance to detect the prevalence and to identify the associated factors of job stress for managing it among bus drivers in Sri Lanka. Objectives: To determine the prevalence of occupational stress and its associated factors among bus drivers of Sri Lanka Transport Board in Colombo District Methods: A descriptive cross-sectional study with an analytical component was carried out in Sri Lanka Transport Board depots in the district of Colombo among 631 bus drivers. The study population was selected by simple random sampling method and used the Effort Reward Imbalance-Sinhala questionnaire and other self-administered questionnaires as instruments. Associated factors with occupational stress were determined by multivariate analysis using adjusted odds ratio (aOR). Results: The prevalence of occupational stress was 52.1% (95% CI=50.66, 53.62). The factors associated with occupational stress in multivariate analysis were current use of tobacco (aOR=9.3; 95% CI=5.71, 11.2), good alertness at the end of the day (aOR=13.2; 95% CI=9.48, 15.11), work experience ten years or less (aOR=9.8; 95% CI=8.65, 11.2), working days per week six days or more (aOR=9.72; 95% CI=5.65, 12.16) and working hours per day more than 10 hours (aOR=3.1; 95% CI=2.67, 5.1). Conclusions & Recommendations: The prevalence of occupational stress was high among bus drivers. There were modifiable and non-modifiable associated factors for job stress. Mental health promotion programs need to be conducted at the recruitment of bus drivers.","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127946204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyslipidaemia in ischaemic stroke patients: results from a tertiary care teaching hospital of Pakistan","authors":"Ali Hassan Mahesar, M. Soomro, M. Magsi, A. A. Baloch, M. Soomro","doi":"10.4038/jccpsl.v27i3.8409","DOIUrl":"https://doi.org/10.4038/jccpsl.v27i3.8409","url":null,"abstract":"Introduction: Ischaemic stroke is a heterogeneous multifactorial disorder characterized by acute focal neurological deficit due to cerebrovascular disease. Considering the clinical evidence of dyslipidaemia as a risk factor for ischaemic stroke, there is a need to know the magnitude of dyslipidaemia in patients. Aim of the study was to determine the frequency of dyslipidaemia in patients of ischaemic stroke at a tertiary care teaching hospital in Larkana, Pakistan. Methods: A cross-sectional study was conducted at the Department of Medicine, Shaheed Mohtarma Benazir Bhutto Medical University Hospital Larkana, Pakistan during the period of six months (July-December 2016). All patients between 18-75 years of age of either gender suffering from ischaemic stroke were included. All patients with intracranial haemorrhage, CNS tumour, epilepsy, multiple sclerosis, familial lipid disorders, endocrine disorders, chronic diseases, and on anti-lipid medications, cocaine or alcohol addicts were excluded. The statistical analysis was conducted by using Stata Statistical Software 14. Results: Mean age of enrolled participants was 46.3 (SD=15.2) years. Of 85 enrolled participants, 73 (85.9%) were males and 12 (14.1%) were females, with male to female ratio of 6:1. The frequency of dyslipidaemia was 28 (32.9%), with mean LDL 100.7 (SD=18.4) mg/dl and HDL 42 (SD=11.7) mg/dl and total cholesterol 166.3 (SD=34.3) mg/dl. Conclusions & Recommendations: Dyslipidaemia, with low HDL 13 (15.3%) was found to be the most common risk factor we observed in our patients with stroke. The importance of preventive measures for a disease which has modifiable risk factors (diabetes and hypertension) should be emphasized to reduce the burden of stroke in the country.","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125705421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-communicable diseases, medication adherence and social support among elderly medical clinic attendees of the Teaching Hospital, Karapitiya, Sri Lanka","authors":"Sudheera Fernando, W. Uluwattage, B. Sirisena, D. Rathish","doi":"10.4038/jccpsl.v27i3.8396","DOIUrl":"https://doi.org/10.4038/jccpsl.v27i3.8396","url":null,"abstract":"Introduction: Sri Lankans 60 years and above are among the highest in South Asia and the country's population is fast ageing. This trend would increase the prevalence of non-communicable diseases (NCD). Objectives: To determine the prevalence of NCD, medication adherence and social support among elders at the medical clinics in Teaching Hospital, Karapitiya, Sri Lanka Methods: A descriptive cross-sectional study was conducted among medical clinic attendees aged 60 years and above. A self-administered questionnaire was used to collect data on demography, NCD, medication adherence and perceived social support. Data were collected from every eighth elderly patient attending the medical clinic on clinic days for a month. Binary logistic regression was performed to determine the significant association between study variables (p<0.05). Results: Data of 459 elders were included for the analysis. Hypertension (76%), diabetes mellitus (44%), ischaemic heart disease (38%), dyslipidaemia (32%), and bronchial asthma (21%) were the top five NCDs observed. High levels of medication adherence and social support were seen only in 24% and 20%, respectively. A significant association for medication adherence was found with social support (p<0.05; Spearman rho 0.09). Conclusions & Recommendations: Hypertension was the most common NCD among the elders. A significant association for medication adherence was found with social support. Hence, medication adherence among elders could be improved by enhancing perceived social support.","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115785056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Doctrinal Analysis of Food Advertisement Laws in Sri Lanka with Selected Jurisdictions","authors":"C. A. Hettiarachchi, B. Reeve, S. S. Wijesinghe","doi":"10.4038/jccpsl.v27i2.8393","DOIUrl":"https://doi.org/10.4038/jccpsl.v27i2.8393","url":null,"abstract":"Introduction: The food industry is an ever-growing industry. Food advertising is its main marketing strategy. The majority of food that advertising the children are exposed to is unhealthy products, thus promoting unhealthy food and beverages and contributing to an increase in the burden of diet-related noncommunicable diseases. Therefore, restrictions on unhealthy food advertisements via government regulations are necessary to promote public health. Objectives: To analyses the main food advertisement law in Sri Lanka and compares it to laws relevant to food advertising in other national jurisdictions Methods: A desk review of laws associated with food advertisements in Sri Lanka was conducted, followed by a comparative review of food advertisement laws in nine other national jurisdictions. Results: Sri Lanka does not have a single advertisement law, and most legal provisions on food advertising are merged into labelling regulations. When compared to other jurisdictions, Sri Lankan definition of food advertisement is narrow, and the regulatory regime does not have strict restrictions on the timing of advertising; target Sri Lankan group; type of food advertised; content of advertising; and health messages. The law also lacks a comprehensive suite of enforcement options. Conclusions & Recommendations: Sri Lankan Food Advertising Regulations contain weak restrictions on unhealthy food marketing to children when compared to other jurisdictions globally. It is recommended that the government should publish separate Food (Advertising) Regulations under the Food Act of 1980 which would include provisions on the timing of advertising; target group; type of food advertised; health messages; and enforcement measures such as penalties and warnings, while also revising the existing narrow definition of food advertisement.","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123291392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Tribute to Dr Nihal Abeyesundere - World-renowned Expert in Malaria","authors":"Editors Jccpsl","doi":"10.4038/jccpsl.v27i2.8465","DOIUrl":"https://doi.org/10.4038/jccpsl.v27i2.8465","url":null,"abstract":"","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125386525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Related Quality of Life Questionnaire for Women with Polycystic Ovary Syndrome: A Sinhala Translation and Validation Study","authors":"B. Ranasinghe, A. Balasuriya, C. Wijeyaratne, N. Fernando","doi":"10.4038/jccpsl.v27i2.8335","DOIUrl":"https://doi.org/10.4038/jccpsl.v27i2.8335","url":null,"abstract":"Introduction: Polycystic ovary syndrome (PCOS) has a negative impact on the health-related quality of life (HRQoL) of affected women. There are no studies conducted on HRQoL of women with PCOS in Sri Lanka, partly due to non-availability of a disease-specific validated tool. Objectives: To translate and evaluate the validity and reliability of the modified polycystic ovary syndrome health-related quality of life questionnaire (M - PCOSQ) among Sri Lankan women with PCOS Methods: The M-PCOSQ was translated into Sinhala language and content and consensual validity was assessed using modified Delphi process. The Short Form Health Survey (SF-36) Sinhala version and translated M-PCOSQ were completed by 94 participants attending three different clinics at a maternity hospital in Sri Lanka. Convergent validity was measured using SF-36 while divergent validity was not measured due to the absence of a suitable tool. Ethical issues were adequately addressed. Retest was done in 10% of the sample two weeks later. Results: With the modified Delphi process, items 4, 10 and 27 of M-PCOSQ Sinhala version were stated as positive statements and scoring changed accordingly. The mean age of the sample was 27.13 years and the majority (77.1% had no children). All six domains of M-PCOSQ had high intra-class correlation coefficients ranging from 0.97 to 0.99 demonstrating excellent test-retest reliability. Cronbach's alpha was 0.67 or more for four of the six domains indicating satisfactory internal consistency. Construct validity was observed by the high correlation between emotion subscale of M-PCOSQ and emotional well-being scale of SF-36 (r=0.63; p<0.01). Conclusions and Recommendations: M-PCOSQ-Sinhala version is a valid and reliable tool to measure HRQoL of PCOS women.","PeriodicalId":120205,"journal":{"name":"Journal of the College of Community Physicians of Sri Lanka","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114153410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}