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Abstract Background An unhealthy diet is a key risk factor for non-communicable diseases (NCD), which account for a significant number of premature deaths and disability-adjusted life years worldwide. Office workers are reported to have unhealthy and unbalanced diets, while being sedentary due to the nature of their work, placing them at a greater risk of NCD. This study aimed to determine dietary intake and associated factors among sedentary office workers in Southern Sri Lanka. Methods A cross-sectional study was conducted among 518 sedentary workers in 20 offices in the Galle district. Socio-demographic, health and work-related factors and dietary practices were assessed using a self-administered questionnaire. Twenty-four-hour dietary recall was used to assess dietary intake, which was converted into the number of servings from each food group. Healthy dietary intake was defined as ‘adherence to the numbers of servings recommended in Food Based Dietary Guidelines for Sri Lankans for more than three food groups including cereal and cereal-based foods, fruits, and vegetables, with the consumption of one or no unhealthy food per day’. Results Only 4.6% (n = 24) of the participants consumed a healthy diet, while a considerable proportion had the recommended intake of cereal-based foods, vegetables and fish, meat and pulses (65.3%, 65.8% and 50.8%, respectively). Intake of fruits, dairy products, nuts and seeds was low among the participants. Meal skipping and group eating were significantly associated with an overall unhealthy diet. Stratified analysis showed sex as an effect modifier for the association between group eating and unhealthy diet. In multivariate analysis, none of the factors showed a significant association with healthy dietary intake. Conclusions The dietary intake of sedentary office workers was not up to the recommendations. Meal skipping and group eating were associated with unhealthy dietary intake. This study recommends introducing interventions to improve the intake of fruits, dairy products, nuts, and seeds for sedentary office workers.

Abstract Objective This quasi-experimental study aimed to describe the outcome of a social skills intervention for adolescents with depression followed up at an outpatient Child and Adolescent Psychiatry Unit. Twenty adolescents with depression attending a tertiary care facility in Colombo, Sri Lanka were recruited, who participated in two social skills training programmes (6 months apart), in addition to pharmacological treatment. Outcome of the programme was measured by a self-administered questionnaire that assessed perceived changes in social skills, before and after the intervention. Wilcoxon Signed Rank test was used to determine the statistical significance of improvement in social skills. Results The sample consisted of 80% (n = 16) female adolescents. Median scores (inter-quartile range) for social skills before and after the first social skills programme were 31.5 (21.0–36.0) and 33.0 (28.25–40.25) respectively, indicating a significant improvement in social skills following intervention (p = 0.011, r = 0.57). A similar improvement was observed after the second programme (n = 10), reporting higher median scores for social skills after intervention (29.5 vs. 37.5, p = 0.005, r = 0.89). A significant improvement was also observed in perceived ability to cope with depressive thoughts after intervention (p = 0.032), indicating that social skills training can be a useful adjunct to pharmacological interventions, in the management of depression in adolescents.

Abstract Gestational Diabetes Mellitus (GDM) is associated with adverse maternal and perinatal outcomes and increased risk of developing diabetes in later life. Sri Lanka adopted universal GDM screening at two time points in pregnancy (before 12 weeks and between 24 and 28 weeks) in 2014 and its utilization has not been assessed. This study assessed the utilization of GDM screening services and associated factors among antenatal mothers in Southern Sri Lanka. A cross-sectional study was carried out in a consecutive sample of 420 postpartum mothers who delivered at three major hospitals in Sri Lanka. Data were collected on socio-demographics, pregnancy, availability and utilization of screening services and logistics using an interviewer-administered questionnaire and a data record sheet. Data was analysed using SPSS software. Chi-square test and binary logistic regression was used to assess the association between variables. The coverage of first and second screening tests were 91.4% and 94.5% and timeliness were 72.4% and 59.5%, respectively. The median period of amenorrhoea at the first and second screening were 10.0 (inter-quartile range: 2.5) weeks and 28.0 (inter-quartile range: 1.5) weeks. A higher utilization was associated with higher income (OR = 3.4, 95% CI: 1.1–10.5) and planned pregnancy (OR = 4.9, 95% CI: 2.2–10.7) for the first screening test. Primiparity (OR = 0.3, 95% CI: 0.1–0.9) and proximity of the nearest laboratory (OR = 3.5, 95% CI: 1.0–12.0) were positively associated with the second screening test. The timeliness of both screening tests was associated with planned pregnancy (OR = 2.1, 95% CI: 1.1-4.0 and OR = 2.3, 95% CI: 1.1–4.5) and being non-employed during the pregnancy (OR = 2.5, 95% CI: 1.4–4.3 and OR = 2.3, 95% CI: 1.3–4.1). A high utilization of GDM screening was observed. Timeliness should be ensured through improved availability and accessibility of screening facilities.

Abstract Background Unhealthy diet is a key risk factor for Non-Communicable Diseases (NCDs) that contribute to increased morbidity and premature mortality. With increased computer literacy and mobile phone penetration, there is a high opportunity for mobile application-based interventions. The current study was conducted to develop a mobile application to monitor dietary intake and to assess its acceptability and effectiveness in diet control compared to a similar paper-based intervention. A mobile application was developed based on research evidence and opinions of local experts. The mobile application was introduced to a selected group of office workers who were in preparation, action, and maintenance stages of the Trans Theoretical Model (TTM) and a paper-based intervention was used as the comparator. Socio-demographic data were collected through a self-administered questionnaire. Participants were followed up for three months for adherence. The effectiveness of interventions was assessed at the end of three months by comparing the progressive change in the stage of change and the change from unhealthy to healthy dietary intake between two groups as primary and secondary outcomes respectively. Results Among 123 office workers who participated in the study, 19.5% preferred the mobile intervention over the paper-based intervention. Younger, unmarried office workers and those who do not have children, had a higher acceptance for the mobile intervention (p

Background: Gestational diabetes mellitus (GDM) is one of the leading causes for the future diabetes. Diet modification is an imperative part in attenuating this progression. Objectives: This study assessed energy and nutrient intakes of Sri Lankan mothers at 6 weeks after delivery, with the aim of developing specific dietary guidelines for postpartum mothers with GDM. Materials and Methods: A community-based, descriptive cross-sectional survey was conducted as a part of a quasi-experimental study. Nutrient and energy intakes were assessed among 100 mothers using 24-h dietary recall and a validated food frequency questionnaire. Energy and nutrient intakes were analyzed using NutriSurvey 2007 (EBISpro, Germany) which was modified for native food recipes and food composition tables for Sri Lanka. Results: The mean ± standard deviation intakes of total calories, carbohydrate, protein, and fat were 2817 ± 984 kcal, 445 ± 186 g, 95 ± 39 g, and 87 ± 58 g, respectively. The total calorie intake was significantly higher when compared to recommended levels based on the body mass index in both normal weight (3033 ± 1122 vs. 2300 kcal/d; P < 0.00) and overweight or obese (2759 ± 944 vs. 1800 kcal/d; P < 0.00) postpartum women. In the obese group, daily carbohydrate, fat, and protein intakes were significantly higher than the recommended values (P < 0.00). Folic acid intake was lower in both normal (23.7 vs. 400; P < 0.001) and obese or overweight (63 vs. 400; P < 0.001) groups. Conclusion: The study indicated that in majority of the mothers with GDM, the daily calorie and carbohydrate intakes were higher than the recommended. The findings suggest the need for developing a scientifically feasible and culturally acceptable dietary modification program. All macronutrients were taken more than the recommended amounts, especially in the overweight/obese group.

Background: Illicit drug use has become a significant public health problem in Sri Lanka. This study was conducted to assess characteristics and exposure to vulnerable factors for drug use among institutionalized male drug users. Methodology: A cross-sectional study was conducted among 431 institutionalized male drug users from five selected rehabilitation centers in Sri Lanka. An interviewer-administered questionnaire was used for data collection. The history of exposure to vulnerable factors was assessed using a series of questions based on existing evidence. Chi-square test was used to identify factors associated with exposure to vulnerable factors for drug use at 0.05 significance level. Results: Experimental usage, peer pressure, being unaware about harmful outcomes of drug use, ability to conceal drug use behavior from family, easy accessibility, previous use of alcohol and tobacco, history of exposure to psychoactive substance use within the usual living set up, being in a family with inadequate protection and an unsatisfactory parenting status were identified as common characteristics of people with illicit drug use disorders and drug use behavior. The age of the first drug use was positively correlated with the age of the first alcohol use (r = 0.687; P < 0.01) and first smoking (r = 0.732; P < 0.01). Ethnicity, area of residence, severity of drug use, and age of initiation of drug use had statistically significant association with exposure to vulnerable factors for drug use (P < 0.05 for all). Conclusion: Characteristics of people with illicit drug use disorders and drug use behavior were varied while the history of exposure to vulnerable factors for drug use was not uncommon in the sample. The study recommends considering these study findings during designing appropriate preventive and harm reduction strategies for illicit drug use.

Abstract Background Headache and Attention Deficit Hyperactivity Disorder (ADHD) are two relatively common, neuropsychiatric conditions seen in children. Recent studies have shown an association between these two disorders, which are otherwise distinct conditions. This study aims to assess the association between migraine and ADHD, as well as the association between screen-time and these two conditions, among children attending a Sri Lankan tertiary care facility. Possible associations will have important implications in the clinical management of these conditions. Methods This was a comparative cross-sectional study of 226 children aged 5–14 years, attending clinics at a tertiary care hospital in Galle, Sri Lanka. Of them, 141 had a diagnosis of migraine and 85 did not have migraine. The presence or absence of ADHD and the use of screen-time among the two groups was analysed. Chi-square test and Mann-Whitney U test was used to assess the associations between these variables. Results Approximately 5% of the children with migraine had clinically diagnosed ADHD, compared to 3.5% of those without migraine (p = 0.862). The median SNAP-IV scores (inter-quartile range) of the children with migraine and without migraine were 0.60 (0.27–1.00) and 0.44 (0.16–0.80) respectively (p = 0.014). There was no significant difference in screen-time hours per day between children with and without clinically diagnosed ADHD. However, a significant difference in median screen-time (hours per day) was observed between children with and without migraine (2.0 h and 1.0 h respectively; p = 0.012). Conclusions Our findings suggest that children with migraine are more likely to show features of hyperactivity/impulsivity and inattentiveness than those without migraine. While no association was found between clinically diagnosed ADHD and screen-time, migraine was associated with longer daily screen use. Screening for ADHD in children diagnosed with migraine may be of benefit. Further studies are required to understand the possible benefits of reducing screen-time in children with migraine.