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Introduction: Chronic lymphoedema (CL) of lymphatic filariasis causes severe psychosocial burdens (PSB) to its victims. Currently-established scales to measure PSB of CL are not culturally adaptable to Sri Lankan patients. In this study, we developed and assessed the psychometric properties of a disease-specific questionnaire (15 item PSB-CL). Methods and Results: A detailed literature search was done to identify scales related to PSB of CL patients. Questions were developed through collected expressions from semi-structured interviews with 46 CL patients. A response scale was developed from the collected pool of possible responses, and they were scored using a visual analogue scale. Face and content validity were carried out using an initial questionnaire (31 questions). They were reduced to 27 by removing unclear, ambiguous, double-stranded ones and those with value-laden words. This new questionnaire was administrated on 92 patients by a group of doctors for item reduction by the analysis of internal consistency (Cronbach’s alpha > 0.7) and factor analysis (Principal Component Analysis; Eigenvalues > 1). After the patient survey and factor analysis, the final questionnaire PSB-CL was formed with 15 questions that had four subscales (factors), physical, social, fear and humiliation. Patients (n=92) reported quite a large percentage (42% - 69%) of problems under each dimension. Conclusion: The scale to measure the psychosocial burden of chronic lymphoedema in lymphatic filariasis patients in Sri Lanka. Further validation of the tool is needed.

Introduction: Chronic ill health due to non-communicable diseases have already posed a great threat to the well-being of older people in Sri Lanka impairing their quality of life to a greater extent. This study was aimed to examine the impact of some chronic disease conditions on quality of life (QOL) of older people in Galle, Sri Lanka. Methods: This cross-sectional study was conducted in 70 older people (male=21, female=49) aged 60 years. Validated self-reported version of World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire which measures QOL in four dimensions; physical, psychological, environmental and social was used to assess the QOL. Results: The age range of the participants was 60-90 years (mean = 70.3 years, SD = 6.2 years). Of the total, 41 subjects were living with their spouse and 22 were widowed. Visual impairment (67%), hypertension (47%) and arthritis (34%) were the most prevalent chronic diseases reported. QOL mean scores for all the four domains which measured in a 1 - 100 scale were all higher than 65 for both men and women. Further, mean scores of QOL in all the domains in both sexes were found to be low among those who were suffering from chronic conditions, although significant differences were found in physical and psychological domains between those with and without cardiovascular diseases and hypertension (p Conclusions: QOL of older people in Galle is relatively higher compared to the QOL of community dwelling older people in many other countries. Although NCDs and other chronic conditions are prevalent in this study population, cultural and environmental factors may have contributed to improve the QOL of this population group.

Introduction: Population of Sri Lanka is aging fast. Chronic diseases in the elderly have become a vital public health issue. Generativity, concern for teaching and nurturing the next generation, is identified as an important component of well-being of the elderly. This study assessed the generative concern in a sample of elders in Galle, and correlates of the construct. Methods: A cross-sectional survey was conducted using an interviewer administered questionnaire in a sample of elders, aged 60 years and above in Galle. Loyola Generative Scale (LGS) and Kesslar 10 scale was used to assess generative concern and psychological stress respectively. Results: A total of 208 elders were surveyed. The average age of the participants was 71 years (SD=7.5). The overall mean score of the LGS was 47.4 (SD=7.4). Generative concern was found to be higher among those elders whose spouse is alive (p Discussion: The average LGS score of the elders in this sample is higher than that of elders in many countries where the figure was around 40. Thus, a majority of the elders in this target population seems to have a greater generative concern. There is a possibility, therefore to improve health and well-being of the elderly in the area by developing and implementing intergenerational social and community development programmes.

Introduction: Geriatric population in Sri Lanka is a potentially vulnerable group for malnutrition. The present study was carried out to assess the nutritional status of elderly in Galle and to identify the relationships of their nutritional status with gender, age, area of residence, level of education and income. Methods : A cross sectional study was done using a sample of elders aged 60 years and above living in Galle district. An interviewer administered questionnaire was used to collect data. Mini Nutritional Assessment (MNA) tool was used to assess nutritional status. Results : A total of 396 elders participated in the study. Mean age of the participants was 69 years ( SD = 7.2) and the majority were females (n = 268, 67.7%). MNA showed that 0.5% elderly were malnourished and 30.8% were at risk of malnutrition. Older age ( p 0.05), lower monthly family income ( p p p 0.05) were found to be possible risk factors of malnutrition. Conclusions : Nutritional status is considerably poor in the elderly in Galle district. Therefore, geriatric nutritional interventions in low income older age elders in rural population segments in the area are needed.

With decreasing fertility and mortality rates, the population of Sri Lanka is rapidly aging, and this issue will become one of the greatest challenges the government has to face in the near future.Aconsiderable proportion of elders in Sri Lanka depends on their children or relatives for food, shelter and safely.Although caring for elders is an integral and important cultural norm in the country, factors such as urbanization, migration and westernization have meant that many elders today experience poor health and living conditions. In this context, social support and social security of elders are important issues and need urgent attention of the government, non-governmental organizations and general public. Social support and social security systems available today for elders in Sri Lanka need to be investigated thoroughly to identify mechanisms and strategies that are effective and sustainable. Further, unmet needs of elders with respect to social support and social security need to be assessed. Based on such investigations, specific plans of actions should be formulated to reduce future social support and social security problems of elders in Sri Lanka. Key words : Aging; social support; social security DOI: http://dx.doi.org/10.4038/gmj.v16i2.3748 GMJ 2011; 16(2): 20-23

Having sex is one of the most pleasurable experiences a person can have if done in a proper behavior and a healthy way. Unfortunately, unhealthy sexual behavior is common in many communities across the world today, and they are a great threat to the health of the people (1-3). Globally, curable sexually transmitted infections (STIs) accounts for 340 million new cases each year which cause unnecessary ill health and deaths which could be avoided by better education, earlier diagnosis and treatment (4).An estimated 20 million unsafe abortions took place in the year 2003, 98% of them in developing countries with restrictive abortion laws (5).Worldwide, approximately 15% to 25% of women and 5% to 15% ofmenwere sexually abused when they were children (4-6). Not only the victims of these ill-health conditions suffer, but, each of these problems carries with it the potential for lifelong consequences for families, communities, and the nations as a whole. Sexual health is a fundamental part of human life and a core component of personality and it requires a positive and respectful approach to sexuality and sexual relationships. The WHO affirms that to attain and maintain sexual health, the sexual rights of all persons must be protected, respected and fulfilled (2,7). However, there are serious disparities among the populations affected by sexual health problems. The economically disadvantaged, racial and ethnic minorities, persons with different sexual identities, and adolescents often bear the heaviest burden.

Introduction: Psychological problems pose a significant threat to health and well-being of medical undergraduates in many countries. Less is known about psychological health issues of medical undergraduates in Sri Lanka. This study assesses and compares the prevalence of depressive symptoms between first year medical and non-medical undergraduates in a southern university in Sri Lanka. In addition, the predictors of depressive symptoms in this target population were explored. Methods: A self-report, anonymous questionnaire that contained the Center for Epidemiological Studies- Depression Scale (CES-D) was administered to a sample of 392 first year undergraduates from the faculties of Agriculture, Medicine, Business Administration and Science. Results: The mean score of the CES-D scale was 21.2 (SD = 11.0), higher when compared to similar studies conducted in other countries. About 76% of medical and 60% of non-medical undergraduates reported elevated depressive symptoms (p Conclusions: Depressive symptoms appear to be more prevalent among first year medical students when compared to their non-medical peers. Physically and socially active lifestyles may reduce the chances of developing depressive symptoms in undergraduates. More research is needed to understand the behavioral and social factors associated with these elevated levels of distress and the behaviors and other strategies employed by these undergraduates to manage it. SD Key words: Depressive symptoms, Behavior, Undergraduates, Sri Lanka DOI: 10.4038/gmj.v16i1.2901 Galle Medical Journal , Vol 16: No. 1, March 2011 pp.1-5

Introduction: Sexual behavior and reproductive health of adolescents in Sri Lanka is getting increasing attention. Factors associated with sexual behavior among adolescents are not adequately understood. Objectives: To investigate the prevalence of sexual experiences among school age adolescents and assess demographic and behavioral correlates of sexual experience. Methods: A study was conducted among late adolescents in public sector schools in southern Sri Lanka. A self-administered questionnaire was used to obtain relevant information. Results: Data from a total of 2385 subjects (1104 males and 1281 females) were analyzed. Among these, 15.5% of males and 7.9% of females reported some sexual experience with another person ( Conclusion: A considerable proportion of late adolescents in the Southern Province have been sexually active. There is a need to address sexual health issues of this group through student education and parent education. Improving sexual life skills of students is an important component in sex education programs. DOI: 10.4038/gmj.v14i1.1172 Galle Medical Journal Vol.14(1) 2009 39-44

Objectives: To present the rationale and design of the Southern Province A-level School Health Survey, to identify health status and health behaviour patterns, and to examine gender differences in these factors, among late adolescent school children in Southern Sri Lanka. Methods: A self-administered, anonymous questionnaire was used to obtain information on demographics, perceived health status, psychological well-being, substance use, physical activity, school violence, and sexual health. A two-stage cluster sampling method was used to select students from the three districts in the Southern Province. Results: A total of 908 females and 903 males participated in the study. The majority (about 98%) was aged 18 years and 99% were Sinhalese. Over 80% of both male and female participants reported self-perceived physical and ment~l h-11th r"very pcd" or ' ' ~n? l . ' ' Ncnrly 50% of both male and female respondents had experienced severe or moderate psychological distress in the 30-day period preceding the survey. Males were more likely to report substance use than females (Alcohol use: 10.5% verses 1.8%; Smoking: 5.1 % verses < I % ; Illegal drug use: 1.5% verses