Siriwardhana C.,Anglia Ruskin University |
Siriwardhana C.,King's College London |
Siriwardhana C.,Institute for Research and Development
Conflict and Health | Year: 2015
Abstract The month of May 2015 marked the sixth year since the end of conflict in Sri Lanka. The cause of death, destruction and displacement, three decades of conflict has had a major impact on health, especially on mental health of those affected by forced displacement. Post-conflict regions of Sri Lanka has seen improvements in many areas, including resettlement of displaced populations and rebuilding of health-related infrastructure. However, substantial gaps exist around the management of health needs among returnee populations, especially in the area of psychosocial health. Long-term mental health and resilience trajectories of those affected by prolonged displacement and experiencing return migration during post-conflict periods remain important, yet critically understudied areas. © 2015 Siriwardhana.
Sumathipala A.,King's College London |
Sumathipala A.,Institute for Research and Development
International Journal of Social Psychiatry | Year: 2014
Background: Medically unexplained symptoms (MUS) are common in primary care across cultures, accounting for high consultations with multiple providers and unnecessary investigations. Cognitive behavioural therapy (CBT) is efficacious for MUS and reduces physical symptoms, psychological distress and disability. Two intervention trials by the author and his group remain the only reported trials from the developing world. Material: A treatment package was designed by modifying a CBT model. The modifications were innovative use of locally relevant appropriate language and strategies that were simple enough while conforming to the CBT principles. The aim was to convey the principles of CBT to people using simple techniques using metaphor. These are described in the paper as generic metaphors that could be used to explain the CBT principles and specific ones for patients with MUS. Discussion: Metaphor is an effective clinical tool. The author's clinical experience and patients' feedback suggest that these metaphors are helpful in conveying the CBT principles to patients. To develop metaphors appealing to the client and effective clinically, carrying out qualitative research among patients' explanatory model is an important prerequisite. The generic and MUS-specific metaphors reported here should be tried in other cultural and clinical settings and evaluated. Further systematic work including qualitative work for consensus evaluation among CBT experts as well as opinion on user-friendliness of these techniques tested among CBT practitioners will be needed. © The Author(s) 2013.
Ekanayake S.,Health Systems and Health Equity Research Group |
Prince M.,King's College London |
Sumathipala A.,Institute for Research and Development |
Siribaddana S.,Institute for Research and Development |
Morgan C.,King's College London
World Psychiatry | Year: 2013
Natural disasters cause immense suffering among affected communities. Most occur in developing countries, which have fewer resources to respond to the resulting traumas and difficulties. As a consequence, most survivors have to rely on their own coping resources and draw from what support remains within family, social networks and the wider community to manage and deal with their losses and consequent emotional distress. Taking the 2004 Asian tsunami as an example, this article reports findings from a qualitative study designed to investigate how survivors responded in Sri Lanka, and the range of coping strategies adopted and resources mobilized. In-depth interviews were conducted with 38 survivors purposively sampled from the Matara district of southern Sri Lanka. Survivors' accounts emphasized the importance of extended supportive networks, religious faith and practices, and cultural traditions in facilitating recovery and sustaining emotional well-being. Government and external aid responses that promoted these, through contributing to the re-establishment of social, cultural, and economic life, were particularly valued by participants. Recourse to professional mental health care and Western psychological interventions was limited and survivors preferred to seek help from traditional and religious healers. Our findings tentatively suggest that long-term mental health following disaster may, in the first instance, be promoted by supporting the re-establishment of those naturally occurring resources through which communities traditionally respond to suffering.
Siriwardhana C.,King's College London |
Siriwardhana C.,Institute for Research and Development |
Adikari A.,Institute for Research and Development |
Jayaweera K.,Institute for Research and Development |
And 2 more authors.
BMC Medical Ethics | Year: 2013
Millions of people undergo displacement in the world. Internally displaced people (IDP) are especially vulnerable as they are not protected by special legislation in contrast to other migrants. Research conducted among IDPs must be correspondingly sensitive in dealing with ethical issues that may arise. Muslim IDPs in Puttalam district in the North-Western province of Sri Lanka were initially displaced from Northern Sri Lanka due to the conflict in 1991. In the backdrop of a study exploring the prevalence of common mental disorders among the IDPs, researchers encountered various ethical challenges. These included inter-related issues of autonomy, non-maleficence, beneficence, confidentiality and informed consent, and how these were tailored in a culture-specific way to a population that has increased vulnerability. This paper analyses how these ethical issues were perceived, detected and managed by the researchers, and the role of ethics review committees in mental health research concerning IDPs. The relevance of guidelines and methodologies in the context of an atypical study population and the benefit versus risk potential of research for IDPs are also discussed. The limitations that were encountered while dealing with ethical challenges during the study are discussed. The concept of post-research ethical conduct audit is suggested to be considered as a potential step to minimize the exploitation of vulnerable populations such as IDPs in mental health research. © 2013 Siriwardhana et al.; licensee BioMed Central Ltd.
Dujardin J.-P.A.,Mahidol University |
Dujardin J.-P.A.,Institute for Research and Development |
Kaba D.,Institute Pierre Richet INSP |
Henry A.B.,University of Hawaii at Manoa
BMC Research Notes | Year: 2010
Background. Landmark based geometric morphometrics (GM) allows the quantitative comparison of organismal shapes. When applied to systematics, it is able to score shape changes which often are undetectable by traditional morphological studies and even by classical morphometric approaches. It has thus become a fast and low cost candidate to identify cryptic species. Due to inherent mathematical properties, shape variables derived from one set of coordinates cannot be compared with shape variables derived from another set. Raw coordinates which produce these shape variables could be used for data exchange, however they contain measurement error. The latter may represent a significant obstacle when the objective is to distinguish very similar species. Results. We show here that a single user derived dataset produces much less classification error than a multiple one. The question then becomes how to circumvent the lack of exchangeability of shape variables while preserving a single user dataset. A solution to this question could lead to the creation of a relatively fast and inexpensive systematic tool adapted for the recognition of cryptic species. Conclusions. To preserve both exchangeability of shape and a single user derived dataset, our suggestion is to create a free access bank of reference images from which one can produce raw coordinates and use them for comparison with external specimens. Thus, we propose an alternative geometric descriptive system that separates 2-D data gathering and analyzes. © 2010 Dujardin et al; licensee BioMed Central Ltd.
Da Silva N.S.,Institute for Research and Development |
Potrich J.W.,Institute for Research and Development |
Potrich J.W.,University Regional Comunitaria Of Chapeco
Photomedicine and Laser Surgery | Year: 2010
Objective: The aim of this study was to determine the influence of laser irradiation on enzyme activity. Background Data: Enzymes are catalysts of extraordinary efficiency, able to accelerate reactions by manifold. Enzyme laser light activation is currently a fast-growing field and a large number of studies have been produced. Materials and Methods: Liquid CNPG amylase and control serum (Qualitrol 1H) were used in the experiments. Laboratory analysis of α-amylase was performed on two sample groups: (i) E + S and (ii) E + S + L, in six repetitions per irradiation dose. Group 2 was irradiated with gallium-aluminum-arsenide (GaAlAs) 904 nm at doses of 0.01, 0.1, 0.5, and 1 J/cm 2. Enzyme activity was read using a spectrophotometer equipped with a thermostatic chamber capable of precise absorbance measurement at 405 nm. Results: The results were analyzed with the Student's t-test, and the percentage of enzyme activity was determined. Photomodulation of α-amylase activity by GaAlAs laser was analyzed following irradiation with different doses. Irradiation doses from 0.01 to 1 J/cm 2 led to differences in enzyme activity: 0.01 J/cm 2 (0.10%), 0.1 J/cm 2 (13.44%), 0.5 J/cm 2 (12.57%), and 1 J/cm 2 (-6.10%). Conclusion: Irradiation doses of 0.1 J/cm 2 and 0.5 J/cm 2 led to statistically significant increases in enzyme activity in comparison to the control. The similar curves of the effects of temperature and pH on enzymatic activity observed in this study suggest that laser irradiation also possess an optimum dose to modulate the enzymatic activity. That is, enzymes have an optimum laser dose (or range) at which their activity is maximal, whereas at higher or lower doses activity decreases. © Copyright 2010, Mary Ann Liebert, Inc..
Nagendra H.,Ashoka Trust for Research in Ecology and the Environment Atree |
Nagendra H.,Indiana University |
Rocchini D.,University of Siena |
Ghate R.,Institute for Research and Development
Biological Conservation | Year: 2010
Parks represent spatially and socially heterogeneous conservation units, yet are often assessed and managed using spatially homogeneous approaches. This paper represents an effort to focus on the larger social-ecological landscapes within which protected areas are embedded, to understand why conservation succeeds and fails in different parts of the landscape. In a wildlife sanctuary in the central plains of India (Tadoba Andhari Tiger Reserve), we address: (i) how people living within and immediately outside a park differentially impact its resources and (ii) how the park differentially impacts communities living within. Using forest plots, satellite imagery and interviews, we evaluate park conservation by assessing plant diversity, land cover change, forest fragmentation, and attitudes of local communities towards conservation. We find that interior villages have a negative impact on regeneration, but there is a decline in tree species diversity, and increased forest cover change and fragmentation at the park periphery. Interior villages suffer greatly from crop and livestock depredations by wildlife and consider park rules to be unfairly devised. Yet, they affirm the importance of the park for conservation, and are willing to work with park authorities for stricter protection. Park authorities largely focus on resettlement of interior villages, when they should also pay attention to protecting the peripheral areas of the park from severe degradation by surrounding villages. In summary, we find that different parts of the park landscape face different conservation challenges. Taking into account spatial variations in the factors influencing conservation can greatly benefit the management of protected areas. © Elsevier Ltd.
Siribaddana N.,Institute for Research and Development
Indian journal of medical ethics | Year: 2012
Medicine is one of the most sought after professions in the world. However, opportunities for students to realise this dream are few, particularly due to the competitive nature of university entrance examinations. This essay discusses the establishment of private medical schools in Sri Lanka and the expanded opportunities now available for medical students. There are differing perspectives on these developments, among medical professionals as well as the public. We give a background to the controversy followed by opposing views from the first and second author on the regulatory framework in Sri Lanka and providers' commercial agenda.
Kulbicki M.,Institute for Research and Development
Marine Ecology Progress Series | Year: 2012
Lionfish (Pterois volitans and P. miles) have become a major concern in the western Atlantic and Caribbean since their introduction in the 1980s. Invasive lionfish can reach very high population densities on coral reefs in their invaded range, yet there are few data from their native range in the Indo-Pacific for comparison. We compiled data on the geographical distribution and density of Indo-Pacific lionfishes in their native ranges from published and unpublished under-water visual censuses and field collections. We found that lionfish in their native Indo-Pacific range are unevenly distributed, with higher densities in the Indian Ocean than in the Pacific. Lionfish densities increase significantly with increasing latitude, and are significantly higher in continental areas than around islands. In the Indo-Pacific, lionfishes are found not only on reefs but also on soft bottoms and in nearshore habitats such as seagrass beds and mangroves, and near estuaries. Native lionfish can be found at depths greater than 75 m. Because lionfish can be cryptic and secretive, we estimate that only ∼1/8 of Indo-Pacific lionfishes are detected during general underwater visual censuses. In the Pacific Ocean, the relative abundance of lionfish in the catch of reef-fish larvae is of the same order of magnitude as the relative abundance of adult lionfish within reef fish assemblages. Overall the observed densities of lionfishes in the Indo-Pacific are much lower (max. 26.3 fish ha -1) than the densities reported in their invaded Atlantic range (max. 400 fish ha -1). We found no effects of fishing or pollution on the densities of lionfishes. © 2012 Inter-Research.
Radovic V.,Institute for Research and Development
Journal of Medical Biochemistry | Year: 2010
The serum immunoglobulin free light chain assay measures levels of free κ and λ immunoglobulin light chains. There are three major indications for the free light chain assay in the evaluation and management of multiple myeloma and related plasma cell disorders. In the context of screening, the serum free light chain assay in combination with serum protein electrophoresis and immunofixation yields high sensitivity, and negates the need for 24-hour urine studies for diagnoses other than light chain amyloidosis. Second, the baseline free light chains measurement is of major prognostic value in virtually every plasma cell disorder. Third, the free light chain assay allows for quantitative monitoring of patients with oligosecretory plasma cell disorders, including AL, oligosecretory myeloma, and nearly twothirds of patients who had previously been deemed to have non-secretory myeloma. In AL patients, serial free light chains measurements outperform protein electrophoresis and immunofixation. In oligosecretory myeloma patients, although not formally validated, serial free light chains measurements reduce the need for frequent bone marrow biopsies. In contrast, there are no data to support using free light chain assay in place of 24-hour urine electrophoresis for monitoring or for serial measurements in plasma cell disorders with measurable disease by serum or urine electrophoresis.