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Development of Oral Healthcare Plan for Children with Congenital Anomalies 为先天性畸形儿童制定口腔保健计划
Pub Date : 2024-05-06 DOI: 10.4038/sljma.v24i2.5435
C. Gajanayake
Background: Children having birth defects denote a high-risk group for oral diseases compared to their healthy counterpart. Untreated dental caries significantly accounts for the oral disease burden of children with birth defects. A preventive oral health and restorative dental care package with close follow up could offer much benefit for such children and this poster provides some baseline information in this regard.Objective: To describe an oral health care package offered to high caries risk children with birth defects at a multi-specialty, tertiary care, and premier public dental hospital setting in Sri Lanka.Methods: A Sample of 79 children with birth defects who visited the Preventive Oral Health Unit of the National Dental Hospital (Teaching) Sri Lanka from 1st January 2017 to 29th April 2019 were included in the present analysis, by extracting data from unit’s data base. The level of corporation of a child for oral health care was assessed by child’s compliance with mouth examination and provision of simple dental treatment in a child-friendly dental setting.Results: Children with birth defects aged (mean ± SD) [6.02 ± 3.17-years], carried a high burden of untreated dental caries. The mean number (±SD) of non-cavitated decayed teeth was 2.65± 3.62, cavitated decayed teeth was 2.97±2.97 and pulp exposed teeth was 3.59 ±3.60 respectively. Children were offered a preventive oral health care package comprised of customized behavioural management, oral hygiene instructions and dietary counselling (for parental care givers), professional fluoride applications, simple restorations of carious teeth, fissure sealant applications for permanent molar teeth, referral for pulp therapy for pulp exposed symptomatic teeth under general anaesthesia to Restorative Unit B with follow up of care. 50.6% of children deemed cooperative and 8.9% were partially cooperative to receive oral health care provided by the Preventive Oral Health Unit.Conclusion: This baseline information must be utilized for effective planning of oral healthcare for children with birth defects.
背景:与健康儿童相比,有出生缺陷的儿童是口腔疾病的高危人群。未经治疗的龋齿是先天缺陷儿童口腔疾病的主要原因。本海报提供了这方面的一些基本信息:目的:描述在斯里兰卡一家多专科、三级护理和一流的公立牙科医院环境中为患有先天缺陷的高龋病风险儿童提供的口腔保健套餐:从该单位的数据库中提取数据,对 2017 年 1 月 1 日至 2019 年 4 月 29 日就诊于斯里兰卡国立牙科医院(教学医院)预防性口腔健康科的 79 名出生缺陷儿童进行了抽样分析。通过儿童在儿童友好型牙科环境中对口腔检查和简单牙科治疗的依从性来评估儿童对口腔保健的支持程度:出生缺陷儿童的年龄(平均值±标准差)[6.02 ± 3.17 岁],未治疗的龋齿率较高。非龋坏牙齿的平均数量(±SD)为 2.65±3.62 颗,龋坏牙齿的平均数量(±SD)为 2.97±2.97 颗,牙髓暴露牙齿的平均数量(±SD)为 3.59±3.60 颗。为儿童提供的预防性口腔保健套餐包括量身定制的行为管理、口腔卫生指导和饮食咨询(针对家长护理人员)、专业氟化物涂抹、龋齿的简单修复、恒磨牙的窝沟封闭剂涂抹、在全身麻醉的情况下将暴露牙髓的症状牙齿转诊至 B 修复科进行牙髓治疗,并进行后续护理。50.6%的儿童认为自己愿意接受口腔预防保健科提供的口腔保健服务,8.9%的儿童表示部分愿意:结论:必须利用这些基线信息来有效规划先天缺陷儿童的口腔保健。
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引用次数: 0
Lessons Learned from the Past Pandemic Concept Note on Proposed Reforms of Care Pathways 从过去的大流行中汲取的经验教训 关于护理途径改革建议的概念说明
Pub Date : 2024-05-06 DOI: 10.4038/sljma.v24i2.5439
N. Ranawaka, R. Nanayakkara, A. Jayatileka, K. W. R. Wimalagunarathne, S. Seralathan, K. Jeyassuthan, P. W. C. Panapitiya
No abstract available
无摘要
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引用次数: 0
Evidence of hidden leprosy diagnosed by active case finding in a highly endemic setting in Colombo district, Sri Lanka 在斯里兰卡科伦坡地区高度流行的环境中,通过主动病例调查诊断出隐性麻风病的证据
Pub Date : 2024-05-06 DOI: 10.4038/sljma.v24i2.5434
K. Kalubowila, F. Dissanayake, M. Tilakarathne, S. Withanage, S. Anujan, C. Gajanayake
Background: To achieve the elimination of leprosy by 2030, improving case detection, contact tracing and early treatment is essential. However, the extent of hidden leprosy in pockets of endemic areas remains unexplored.Objective: To determine the prevalence of hidden leprosy and its associated factors.Methods: A household survey was conducted in the Divisional Secretariat (DS) area, Moratuwa over two months from 1st September 2023 using an interviewer-administered questionnaire. The data collection and screened were done by the public health staff attached to the Medical Officer of Health office after obtaining the written informed consent.Results: The socio-demographic data were presented as frequency distributions. The prevalence was calculated and presented as proportion with its 95% confidence interval (CI). The factors associated with leprosy were calculated using bivariate and multivariate logistic regression and p<0.05 was considered statistically significant. A total of 6486 people were screened in 2059 premises. Thirteen cases were confirmed as leprosy; thus, the prevalence of hidden leprosy was 20.1 (95% CI 11-34) per 10000 population. The majority (n=10, 77.0%) were multi-bacillary type, and two patients were under 15 years of age, while three were presented with grade II disability. Age above 15 years (p=0.001) and presence of another leprosy patient in the house (p=0.001) were statistically significant with the disease.Conclusion: High number of leprosy cases were hidden in pockets in DS area Moratuwa, therefore active case findings targeting populations of age 15 years or above and contact screening of the household/d members play a substantial role.
背景:要在 2030 年之前消灭麻风病,就必须改进病例检测、接触者追踪和早期治疗。然而,在麻风病流行的小块地区,隐性麻风病的严重程度仍有待探索:确定隐性麻风病的发病率及其相关因素:自2023年9月1日起,在莫拉图瓦省秘书处(DS)地区进行了为期两个月的家庭调查,采用访谈员发放问卷的方式。在获得书面知情同意后,由隶属于卫生局医生办公室的公共卫生工作人员进行数据收集和筛选:社会人口学数据以频数分布形式呈现。流行率以比例及其 95% 的置信区间 (CI) 表示。使用二元和多元逻辑回归法计算了与麻风病相关的因素,P<0.05 为具有统计学意义。共有 6486 人在 2059 个场所接受了筛查。有 13 例被确诊为麻风病,因此,隐性麻风病的患病率为每 10000 人中有 20.1 例(95% CI 11-34)。大多数麻风病人(10 人,77.0%)属于多脓疱型麻风病,2 名病人年龄在 15 岁以下,3 名病人为二级残疾。年龄在 15 岁以上(P=0.001)和家中有其他麻风病人(P=0.001)与麻风病有显著统计学关系:结论:大量麻风病例隐藏在莫拉图瓦(Moratuwa)地区的麻风病区,因此,针对 15 岁或以上人群的积极病例调查以及对家庭成员的接触筛查发挥着重要作用。
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引用次数: 0
Comparative Analysis of the Medical Equipment Management Process in Colombo Gampaha and Kaluthara Districts 科伦坡甘帕哈区和卡卢瑟拉区医疗设备管理流程比较分析
Pub Date : 2024-05-06 DOI: 10.4038/sljma.v24i2.5433
I. D. Prathapasinghe, C. Gajanayaka, D. K. Ariyadasa, G. S. E. Perera, N. K. Rajapaksha, O. Geethananda, K. D. Jayalath
Background: Bio Medical Engineering (BME) professionals need to continuously review and improve their management strategies to keep up with enhancement in equipment technology, as well as with increasing expectations of health care organizations. In the last two decades, management strategies have evolved from the initial observation of electrical safety to flexible criteria that fit the individual institution's needs. The focus should be on the risks caused by equipment failure, rather than on equipment with highest maintenance demands.Objective: To explore the Medical Equipment Management process in the Department of Health Western Province.Methods: A retrospective cross-sectional study was conducted. Study period was from 1st January 2022 to 31st December 2022. Retrospective documentary data was obtained from the records maintained by the three Bio Medical Engineering offices in Colombo, Kaluthara and Gampaha. Data analysis was performed in an Excel sheet. Since the availability of a huge volume of equipment categories, researchers had to exclude some equipment such as blood pressure monitors due to time constraints.Results: Lowest preventive maintenance has been performed by Kaluthara BME Unit. It is confirmed that 100% Preventive maintenance has been performed by the local agent in Kaluthara District.Conclusion: Lowest performance in preventive maintenance has been performed by Kaluthara district BME unit. But in the aspect of corrective maintenance, they expressed the highest performance. Other two districts evidence showed an average performance. It is recommended to instruct BME unit Kaluthara district to start preventive maintenance. It is recommended to use their professional judgment and experience in establishing their own maintenance strategies.
背景:生物医学工程(BME)专业人员需要不断审查和改进他们的管理策略,以跟上设备技术的发展和医疗机构日益增长的期望。在过去的二十年里,管理策略已从最初的电气安全观察发展到适合各机构需求的灵活标准。重点应放在设备故障造成的风险上,而不是维护要求最高的设备上:探索西部省卫生厅的医疗设备管理流程:方法:进行回顾性横断面研究。研究时间为 2022 年 1 月 1 日至 2022 年 12 月 31 日。回顾性文献数据来自科伦坡、卡卢萨拉和甘帕哈三个生物医学工程办公室的记录。数据分析在 Excel 表格中进行。由于存在大量设备类别,研究人员不得不排除一些设备,如血压计:结果:Kaluthara BME 单位的预防性维护率最低。结论:Kaluthara BME 单位的预防性维护率最低:结论:Kaluthara 地区的 BME 单位在预防性维护方面的绩效最低。结论:Kaluthara 区的 BME 单位在预防性维护方面表现最差,但在纠正性维护方面表现最好。其他两个地区的表现一般。建议指示 Kaluthara 地区的 BME 单位开始进行预防性维护。建议利用他们的专业判断和经验制定自己的维护策略。
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引用次数: 0
Review article on Medication adherence 关于坚持用药的评论文章
Pub Date : 2024-05-06 DOI: 10.4038/sljma.v24i2.5436
C. M. Abeysekara, K. K. N. Prasanthi, K. Jeyassuthan, A. G. M. M. Dharmadasa
No abtract available
无合同
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引用次数: 0
An assessment of the vehicle operations and transport services in RDHS office Colombo 对科伦坡地区医疗卫生系统办事处的车辆运行和运输服务进行评估
Pub Date : 2024-05-06 DOI: 10.4038/sljma.v24i2.5426
T. Gandeepan, S. N. B. Premadasa, K. Rahulan, T. Kasthuri
Background: Colombo is the capital of Sri Lanka, RDHS Colombo has a large population to deliver healthcare services with their existing resources in a unique way when compared to other RDHS divisions in Sri Lanka. Vehicle Management Systems save time, money, and hassle. By optimizing the vehicle management system, we can gain a better operational view, improve patient care, eliminate inefficient vehicle use, prevent vehicle misuse and related resources and reduce downtime.Objective: To analyse the existing system and challenges in vehicle operations and transport services in RDHS office, ColomboMethods: This is a descriptive case study. The information to assess the structure and function of existing vehicle operations and transport services was gathered by interviewing key informants and desk review. Based on the assessment problems were identified and prioritized. Nominal group technique was adopted for prioritization.Results: Six major problems were identified. Lack of training and education for drivers and non-implemented disciplinary procedures was selected as the problem for further analysis based on the weightage given by the members of the nominal group. It was given higher weightage due to the rising concerns about the health hazards following accidents and vehicle repairs.Conclusion: The study reveals that frequent changes in vehicle subject clerks may lead to a lack of supervision of drivers and there are no institutional guidelines for periodic staff training.Recommendations: The study recommends preparing institutional policies on vehicle maintenance and providing training and education to drivers. In addition, it is suggested to appoint a disciplinary committee to expedite the disciplinary procedure following accidents and vehicle maintenance. It also recommended as a long-term solution to prepare a term of reference (TOR) on annual transfers of drivers for the ambulances and other vehicles based on vehicle maintenance, accident history, discipline and seniority and do periodic surveillance to ensure vehicle registration, renewing tax and insurance, maintain logbook and repair summary, and maintenance and accident summary and ensure disciplinary process.
背景:科伦坡是斯里兰卡的首都,科伦坡区域医疗服务体系人口众多,与斯里兰卡其他区域医疗服务体系分部相比,科伦坡区域医疗服务体系以独特的方式利用现有资源提供医疗服务。车辆管理系统省时、省钱、省事。通过优化车辆管理系统,我们可以获得更好的运营视角,改善病人护理,消除车辆使用效率低下的现象,防止车辆滥用和相关资源的浪费,减少停机时间:分析科伦坡区域医疗卫生服务办事处车辆运营和运输服务的现有系统和挑战:这是一项描述性案例研究。通过访谈关键信息提供者和案头审查收集信息,以评估现有车辆运营和运输服务的结构和功能。根据评估结果,确定了存在的问题并排定了优先次序。优先排序采用了名义小组技术:结果:确定了六个主要问题。根据名义小组成员给予的权重,选择了缺乏对司机的培训和教育以及未执行纪律处分程序作为进一步分析的问题。由于人们越来越关注事故和车辆维修对健康造成的危害,这两个问题被赋予了更高的权重:研究表明,车辆科目办事员的频繁更换可能会导致对驾驶员缺乏监督,而且没有定期进行人员培训的机构指导方针:建议:研究建议制定有关车辆维修的机构政策,并为司机提供培训和教育。此外,还建议任命一个纪律委员会,以加快事故和车辆维修后的纪律处分程序。研究还建议,作为长期解决方案,根据车辆维护、事故记录、纪律和资历,制定救护车和其他车辆司机年度调任的职权范围(TOR),并进行定期监督,以确保车辆登记、续税和保险、维护日志和维修摘要、维护和事故摘要,并确保纪律程序。
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引用次数: 0
Patient adherence to Continuous Ambulatory Peritoneal Dialysis treatment in a low-resource setting: An interventional study 在资源匮乏的环境中,患者对持续性非卧床腹膜透析治疗的依从性:一项干预研究
Pub Date : 2024-05-06 DOI: 10.4038/sljma.v24i2.5418
M. S. S. Yapa, J. L. P. Chaminda, T. H. N. G. Amaraweera
Background: Continuous Ambulatory Peritoneal Dialysis (CAPD) is an affordable home-based treatment method for low-resource settings. Currently, CAPD facilities in low-resource settings are expanding in Sri Lanka. Non-adherence of patients and caregivers to the treatment is a major problem.Objective: To assess the current adherence and outcome of CAPD in low-resource settings, design an intervention to reduce the current shortcomings and evaluate the results of the intervention for improving patient adherence.Methods: This was an interventional research project with patients undergoing CAPD. Interviewer-administered questionnaires and key informant interviews during the pre and post-intervention stages were used to assess adherence. Gaps identified after analysing the results of pre-intervention were used to design the intervention. Three “one-day” workshops were conducted to improve adherence. The new system was introduced and continued for five months, after which post-intervention was assessed. McNemar’s and paired t-tests were used to measure the statistical significance.Results: Most of the participants were males, aged 50 to 59 years. Results showed that intervention proved to be effective in improving overall feelings about current health conditions (p=0.004). The number of days a patient stayed in a hospital decreased after the intervention (p=0.001). It showed a positive effect on overall personal hygiene practices (p=0.000). Further, intervention positively impacted record keeping (p=0.096).Conclusion: The intervention significantly contributed to improving patient adherence and caregivers' knowledge. Continuous assessment, training programs, and home visits for problematic patients should be implemented to improve adherence and sustainability of the CAPD.
背景:连续不卧床腹膜透析(CAPD)是一种在低资源环境下经济实惠的家庭治疗方法。目前,斯里兰卡正在扩大低资源环境中的 CAPD 设施。患者和护理人员不坚持治疗是一个主要问题:评估目前在低资源环境中坚持 CAPD 治疗的情况和结果,设计一种干预措施以减少目前的不足之处,并评估干预措施对提高患者坚持治疗的效果:这是一项针对接受 CAPD 患者的干预性研究项目。方法:这是一项以接受 CAPD 的患者为对象的干预性研究项目,在干预前和干预后阶段采用访谈者发放的调查问卷和关键信息提供者访谈来评估患者的依从性。在分析干预前的结果后发现的不足之处被用于设计干预措施。举办了三期 "为期一天 "的讲习班,以提高坚持率。新系统投入使用并持续了五个月,之后对干预后的情况进行了评估。采用 McNemar 检验和配对 t 检验来衡量统计学意义:大多数参与者为男性,年龄在 50 至 59 岁之间。结果表明,干预对改善对当前健康状况的总体感受有效(P=0.004)。干预后,患者住院天数减少(p=0.001)。干预对整体个人卫生习惯有积极影响(p=0.000)。此外,干预还对记录保存产生了积极影响(p=0.096):干预对改善患者的依从性和护理人员的知识水平有很大的帮助。应针对有问题的患者实施持续评估、培训计划和家访,以提高患者对 CAPD 的依从性和持续性。
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引用次数: 0
Effectiveness of waste management interventions at the new District General Hospital, Hambantota 汉班托塔新区综合医院废物管理干预措施的效果
Pub Date : 2024-05-06 DOI: 10.4038/sljma.v24i2.5425
V. G. S. C. Ubeysekara, S. Dolamulla, D. K. Lokuhewagama, H. Karawita
Background: Healthcare waste management is a critical global issue and an effective waste management is essential to maintain a safe and hygienic healthcare environment. District General Hospital, Hambantota serves a significant population in the region and the hospital generates substantial medical waste including general non-hazardous waste, hazardous waste, infectious waste and recyclable waste.Objective: To assess the effectiveness of waste management interventions at the hospital and to provide recommendations for improving waste handling and disposal strategies.Methods: A comprehensive approach was adopted, involving a combination of quantitative and qualitative methods. Surveys and direct observations assessed current practices and infrastructure, while interviews with healthcare professionals provided in-depth insights. Compliance with waste management regulations and guidelines was evaluated through document analysis.Results: Following the intervention, waste production per bed per day was significantly reduced from 2.03kg to 1.27kg, and most waste types showed a decrease in quantity.Conclusion: Following the intervention, waste production per bed per day was significantly reduced from 2.03kg to 1.27kg, and most waste types showed a decrease in quantity.
背景:医疗废物管理是一个重要的全球性问题,有效的废物管理对于维持安全、卫生的医疗环境至关重要。汉班托塔地区综合医院为该地区大量人口提供服务,医院产生大量医疗废物,包括一般无害废物、有害废物、传染性废物和可回收废物:评估医院废物管理干预措施的有效性,并就改进废物处理和处置策略提出建议:方法:采用定量和定性相结合的综合方法。调查和直接观察评估了当前的做法和基础设施,而对医护人员的访谈则提供了深入的见解。通过文件分析,对废物管理条例和指南的遵守情况进行了评估:干预措施实施后,每张病床每天产生的废物量从 2.03 千克大幅减少到 1.27 千克,大多数废物类型的数量也有所减少:结论:干预措施实施后,每张病床每天产生的废物量从 2.03 千克大幅减少到 1.27 千克,大多数废物的数量也有所减少。
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引用次数: 0
SWASTHA: Revolutionizing Medical Supply Management in Sri Lankan Healthcare SWASTHA:斯里兰卡医疗供应管理的革命性变革
Pub Date : 2024-05-06 DOI: 10.4038/sljma.v24i2.5437
H. Attanayake, I. W. Y. K. C. Rambukwelle
No abstract available
无摘要
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引用次数: 0
Case study on Provincial Specific Development Grant allocation for Regional Directorate of Health Services, in Western Province, Sri Lanka 斯里兰卡西部省地区卫生服务局省级专项发展补助金分配案例研究
Pub Date : 2024-05-06 DOI: 10.4038/sljma.v24i2.5428
K. Rahulan, T. Sathiyamoorthy, G. P. Roshan, T. Seralathan, S. Mathurahan, S. De Alwis
Background: The case study delves into the Provincial Specific Development Grant (PSDG) allocation for the Regional Directorate of Health Services (RDHS) in the Western Province of Sri Lanka. The Western Province, being the smallest and most densely populated, comprises three RDHS divisions: Colombo, Gampaha, and Kalutara. This study assesses the methodology used for PSDG apportionment, considering factors such as demography, epidemiology, health status, and annual regional performance.Objective: To assess the methodology used for the apportionment of PSDG to RDHS regions of Colombo, Gampaha and Kalutara by PDHS, WP.Methods: Examining health sector expenditure, demographic and health status indicators, and regional performance, the study highlights the need for a clear system to generate, collect, and interpret performance data.Results: The study identifies "Annual Regional Performance" as the prioritized problem. Lack of a clear system for data management, inadequate performance information, and traditional monitoring practices contribute to this issue. The study recommends implementing Result-Based Management (RBM) approaches at the provincial level, to conduct workshops on RBM to build awareness among regional officers, to develop Key Performance Indicators (KPI) for measuring medium-term results and ensure fair PSDG allocation through scientific criteria and a scoring system.Conclusion: This study underscores the importance of a systematic and scientific approach to PSDG allocation, aiming for efficient and equitable distribution to address the unique needs of each RDHS region.
背景:本案例研究深入探讨了斯里兰卡西部省地区卫生服务局(RDHS)的省级专项发展补助金(PSDG)分配情况。西部省是面积最小、人口最稠密的省份,由三个地区卫生服务局组成:科伦坡、甘帕哈和卡卢塔拉。本研究考虑到人口、流行病学、健康状况和年度地区绩效等因素,对用于分配 PSDG 的方法进行了评估:评估科伦坡、甘帕哈和卡卢塔拉地区人口与健康调查(PDHS,WP)用于分摊 PSDG 的方法:方法:研究卫生部门的支出、人口和健康状况指标以及地区绩效,强调需要一个明确的系统来生成、收集和解释绩效数据:研究将 "年度地区绩效 "确定为优先问题。缺乏明确的数据管理系统、绩效信息不足以及传统的监测做法都是造成这一问题的原因。研究建议在省一级实施成果管理制 (RBM) 方法,举办成果管理制讲习班以提高地区官员的认识,制定衡量中期成果的关键绩效指标 (KPI),并通过科学的标准和评分系统确保公平分配私营部门发展援助金:本研究强调了系统、科学地分配私营部门发展补助金的重要性,其目的是高效、公平地分配补助金,以满足每个地区人口与健康调查地区的独特需求。
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引用次数: 0
期刊
Sri Lankan Journal of Medical Administration
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