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[This corrects the article DOI: 10.3389/fpubh.2024.1409012.].
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Background: Alcohol imposes a significant burden on health, social and economic systems in Sri Lanka. In the present economic crisis taxes on alcohol provides necessary revenue increases. Yet, the perception of the public on alcohol policies in Sri Lanka is not well explored. Objectives: This opinion survey was conducted with the aim to understand the public's awareness on alcohol harm, alcohol industry influences, barriers and facilitators for implementing alcohol control policies in Sri Lanka, and the level of public support for alcohol policies, particularly taxes on alcohol products. Methods: A street intercept survey among 997 participants (with a ratio of 2:1 for males and females) selected through a cluster sampling method responded to an interviewer administered questionnaire. Bivariate and multivariate analyses were conducted to determine associations and a p < 0.05 was considered significant. Results: Among the respondents, 36.1% have consumed alcohol at least once in their lifetime and 29.1% have consumed alcohol during the past 12 months with a significant gender difference (females - 2.8%; males- 43.4%; p < 0.001). Significant proportions of both men (81.4%) and women (71.8%); p < 0.017 agreed that policy measures to reduce alcohol consumption would benefit the government including a significant proportion (73.8%, p < 0.008) of alcohol users. The vast majority -72.8%- agreed that increasing alcohol prices would help address the alcohol consumption problem in Sri Lanka. Moreover, only 30.8% of men and 44.3% of women agreed that the government's alcohol laws are currently strong enough to protect people from alcohol harm. The regression analysis revealed that men are 2.43 times more in agreement with the statement that "policy measures aimed at reducing alcohol consumption can benefit the public" as compared to women. However, individuals aged 50-64 years are 40% less likely to agree with this statement as compared to 18-33 years. Conclusion: The majority of the public, including people who consume alcohol, are supportive of improving alcohol related policies, including taxes, and acknowledge negative impact of alcohol consumption on the country. This presents a clear opportunity for Sri Lanka to strengthen and enforce the alcohol related policies to protect and improve public health.
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Consumo de Bebidas Alcoólicas , Opinião Pública , Impostos , Humanos , Sri Lanka , Masculino , Feminino , Adulto , Consumo de Bebidas Alcoólicas/prevenção & controle , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Pessoa de Meia-Idade , Adolescente , Inquéritos e Questionários , Adulto Jovem , Bebidas Alcoólicas/economia , Política Pública , Política de Saúde , IdosoRESUMO
The aim of the present study was to adapt and validate the ISPCAN child abuse screening tool-retrospective version (ICAST-R) in Sri Lanka with a view to investigating the experiences of physical, sexual and emotional abuse during childhood. The adaptation was performed using qualitative research methods with young adults, parents, teachers, and a multidisciplinary group of experts. The translation to Sinhala (the local Sri Lankan dialect) was carried out by a nominal group technique. A multidisciplinary team of experts assessed the Sinhala ICAST-R (SICAST-R) for its content validity. Moreover, acceptability, reliability and construct validity were determined by conducting a validation study among 200 schooling young adults. The principal component analysis (PCA) technique was used to assess the construct validity. Response rates for each item were taken as evidence of acceptability. The internal consistency was assessed by Cronbach's alpha, and test-retest reliability after two weeks was assessed using Cohen's kappa coefficient. The adaptation of ICAST-R included the introduction of an objective manner by which to measure severity of abuse and the inclusion of a set of questions regarding help-seeking behavior following physical and emotional abusive experiences. The SICAST-R showed adequate content validity and high acceptability, with response rates ranging from 90.3% to 99.5%. The minimum Cohen's kappa coefficient was 0.76, indicating good test-retest reliability. The internal consistency (Cronbach's alpha) for the total tool was 0.708, with the three constructs being 0.398, 0.844 and 0.637 for physical, sexual and emotional abuse, respectively. The PCA demonstrated good reproducibility for sexual and emotional abuse with the hypothesized structure. Overall, the SICAST-R showed adequate validity for the assessment of experiences of physical, sexual and emotional abuse during childhood among Sri Lankan young adults.
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Maus-Tratos Infantis/prevenção & controle , Programas de Rastreamento/métodos , Adolescente , Criança , Abuso Sexual na Infância/prevenção & controle , Cultura , Coleta de Dados , Diagnóstico Precoce , Feminino , Humanos , Idioma , Masculino , Pais , Abuso Físico/prevenção & controle , Psicometria , Reprodutibilidade dos Testes , Pesquisa , Estudos Retrospectivos , Mudança Social , Sri Lanka , Traduções , Adulto JovemRESUMO
Abuse during childhood is a human tragedy leading to lifelong adverse health, social, and economic consequences for survivors. This descriptive, cross-sectional study aimed to determine the prevalence of childhood physical, sexual and emotional abusive experiences among students (aged 18-19 years) in a Sri Lankan district. Multistage cluster sampling was used to select a sample of 1500 students. Experiences of physical, sexual and emotional abuse and age at abuse, perpetrators, consequences and severity were assessed using a version of ISPCAN Child Abuse Screening Tool-Retrospective Version (ICAST-R) which was culturally adapted and validated by the authors for use amongst Sinhalese students. The prevalence of the various forms of abuse during childhood was as follows: physical: 45.4% (95% CI: 42.9-7.9); sexual: 9.1% (95% CI: 7.6-10.5); emotional: 27.9% (95% CI: 25.7-30.2). The corresponding percentages of individuals categorized as having experienced severe or very severe abuse were as follows, physical: 0.3% (2/672); sexual: 4.05% (3/135); emotional: 8.8% (36/412). Experience of physical abuse was more prevalent amongst male students (54.8% vs. 38.3%) as was emotional abuse (33.9% vs. 23.2%), whereas experience of sexual abuse was more prevalent amongst female students (11.5% vs. 6.4%). Parents and teachers were the commonest perpetrators of physical and emotional abuse. Most of the sexually abusive acts were committed by neighbors or strangers. Some physically abusive acts were more frequent at earlier ages than emotional and sexual abusive acts, which were more common in late adolescence. The results indicate the necessity of targeted interventions to address this public health issue.
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Maus-Tratos Infantis/psicologia , Emoções , Abuso Físico/psicologia , Adolescente , Adulto , Criança , Maus-Tratos Infantis/estatística & dados numéricos , Abuso Sexual na Infância/psicologia , Abuso Sexual na Infância/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Programas de Rastreamento , Abuso Físico/estatística & dados numéricos , Exame Físico , Prevalência , Estudos Retrospectivos , Sri Lanka/epidemiologia , Estudantes/psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
DISCUSSION: Increased rates of multimorbidity, evident in developed and developing countries, should be addressed by health policy. The aim of this study was to compare policies and guidelines related to multimorbidity in primary healthcare in countries with different health systems, to identify initiatives, gaps and opportunities for further improvement. We conducted a content analysis of UK, Australian and Sri Lankan policy documents and guidelines published between 2006 and 2017, in electronic databases, references and government repositories, tabulating data extracted for content, implementation plans, gaps and opportunities for development. Overall, 38 of the 56 identified documents explicitly or implicitly addressed multimorbidity or its prevention. The UK had four policy documents and guidelines specifically on multimorbidity. Australia and Sri Lanka lacked specific policies on multimorbidity, but policies did address chronic conditions and non-communicable diseases. Important differences exist in how national policies seek to address multimorbidity. Policy implementation, how this affects quality of care and outcomes, and the role of primary care should be examined.
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Guias como Assunto/normas , Política de Saúde , Multimorbidade , Austrália , Doença Crônica/legislação & jurisprudência , Humanos , Sri Lanka , Reino UnidoRESUMO
SETTING: Government schools of Colombo. MAIN OUTCOME MEASURES: Premenstrual symptomatology (PMS) was determined by a modified version of Premenstrual Symptom screening tool and American College of Obstetricians and Gynecologists (ACOG) diagnostic criteria were used in categorizing study units as having PMS. Other outcome measures were demographic and reproductive factors thought to be correlates of PMS, health seeking behavior for premenstrual symptoms, and how premenstrual symptoms impact their daily life. RESULTS: Individual premenstrual symptoms were experienced by 65.7% of the population. The most common somatic symptom was fatigue (29.9%) and affective symptom was feeling sad/hopeless (29.6%). Prevalence of PMS was 8.75% (95%CI: 6.43-11.07). Multivariate analysis revealed the presence of: chronic physical illness (P = 0.001); dysmenorrhea (P < 0.0001), and regular menstrual cycles (P = 0.006) as correlates of PMS. Presence of PMS significantly disturbed "in school" activities, relationships and daily routines (P < 0.005) indicating a high negative influence on adolescents' daily life. Only 9.7% sought help from (western) medical practitioners for their premenstrual symptoms and a majority has not perceived it as a condition to report. CONCLUSION: Premenstrual syndrome is a common condition among adolescent schoolgirls with a high negative influence on their daily life. The health care seeking behavior is poor, indicating the necessity to address the subject at adolescent reproductive health programs.