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Sisira Siribaddana

Publications and source records attributed to Sisira Siribaddana.

10 recordsLinked to original sources
PubMed2004

Under-representation of developing countries in the research literature: ethical issues arising from a survey of five leading medical journals.

BACKGROUND: It is widely acknowledged that there is a global divide on health care and health research known as the 10/90 divide. METHODS: A retrospective survey of articles published in the BMJ, Lancet, NEJM, Annals of Internal Medicine & JAMA in a calendar year to examine the contribution of the developing world to medical literature. We categorized countries into four regions: UK, USA, Other Euro-American countries (OEAC) and (RoW). OEAC were European countries other than the UK but including Australia, New Zealand and Canada. RoW comprised all other countries. RESULTS: The average contribution of the RoW to the research literature in the five journals was 6.5%. In the two British journals 7.6% of the articles were from the RoW; in the three American journals 4.8% of articles were from RoW. The highest proportion of papers from the RoW was in the Lancet (12%). An analysis of the authorship of 151 articles from RoW showed that 104 (68.9%) involved authorship with developed countries in Europe or North America. There were 15 original papers in these journals with data from RoW but without any authors from RoW. CONCLUSIONS: There is a marked under-representation of countries in high-impact general medical journals. The ethical implications of this inequity and ways of reducing it are discussed.

Africa↗
PubMed2004

Do patients volunteer their life weariness and suicidal ideations? A Sri Lankan study.

OBJECTIVES: Sri Lanka has a high suicide rate. The importance of suicidal ideations and their relationship to the common mental disorders (CMD) have not been adequately explored. This study examined whether patients harboring suicidal thoughts or life weariness would volunteer them. It also examined the relationship between life weariness, suicidal ideations, and the probability of underlying CMD. METHOD: A case control study was nested within a cross-sectional survey of attendees to the outpatients department in a general hospital. The index group consisted of patients presenting with multiple complaints and repeated visits, the control group was 100 patients randomly selected from a total of 5,767 between 16 and 65 years of age, not fulfilling criteria for the index group. Presence of underlying CMD was assessed by the General Health Questionnaire 30 (GHQ-30). The two groups were compared for symptoms volunteered, response to questions from GHQ-30 on suicidal ideations, and hopelessness. RESULTS: Somatic symptoms were the most common in both groups. Eighty-one patients (81%) in the index group and 34 patients (34%) in the control group had probable CMD. No patient in either group volunteered suicidal ideation as a symptom. However, 59% of index patients and 26% of controls admitted life weariness, and 51/59 index patients and 15/26 controls who had life weariness also had underlying CMD as defined by GHQ scores. CONCLUSION: Patients who have suicidal thoughts do not volunteer them unless directly asked. There is a strong relationship between suicidal ideation and the probability of underlying CMD.

Adolescent↗
PubMed2004

Revisiting "freely given informed consent" in relation to the developing world: role of an ombudsman.

BACKGROUND: Establishment of Sri Lankan Twin Registry demanded development of ethical guidelines, as an effective ethical framework was not available in Sri Lanka. DESIGN: Objectives were to find out whether the ombudsman concept exists in current informed consent practices and to investigate opinion about ombudsmen. We searched Pub Med, conducted a postal survey, and monitored Internet discussion. RESULTS: The responses were categorized into current practices and existing models in informed consent process, reservations expressed about current practices, arguments supporting the concept, concerns and issues, alternatives, and how to implement the proposal. The concept of a third person is not entirely novel. How to find a truly independent person, the financial implication, confidentiality, obligations, and liabilities of ombudsmen, also emerged. CONCLUSIONS: The concept of an ombudsman is conceptually and ethically sound and acceptable but the challenges posed by this very same solution to creating a better process of informed consent will have to be faced.

Confidentiality↗
PubMed2004

Osteoporosis in Sri Lanka.

In Sri Lanka the median age, which was 25 in year 1991, is expected to rise to 45 by the year 2041 and half of the population will be over 45 years and vulnerable to osteoporosis. We describe 2 large epidemiological studies done in Sri Lanka. The first one, Galle Prospective Osteoporosis Survey, in its initial phase recruited 350 women randomly from the current voters registers. 42.4% of women in the entire sample and 61.5% in women over 50 years were found to have osteoporosis. The second study was to assess the prevalence of stiffness index with heel ultrasound and calcium intake in a suburban population close to Colombo. We randomised 1250 from electoral register numbers and 986 people consented to participate. Stiffness index start decreasing after the age of 50, which is the average age of age of menopause. In men stiffness decreases after age of 70.

Adult↗
PubMed2002

Sri Lankan Twin Registry.

Sri Lanka is an island with genetic diversity between the five main population groups. Our twin registry is the first in the developing world. Initially, we established a volunteer cohort of 4600 twin pairs through a competition advertised in the media. In addition, we have volunteer cohorts, birth registration-based cohorts through hospitals, and community-based cohorts. There is also a nationwide population-based younger twin cohort (1992-1997) traced through the Department of Birth and Death Registration. Additionally, we have adapted a Zygosity determination questionnaire and validated it. Establishing ethical guidelines for twin research was a priority because the field of bio-ethics is at an early stage of development in Sri Lanka. These guidelines were from a developing world perspective. A sister organization, the Multiple Birth Foundation, was formed to cater to twins and their special needs and to represent their interests, and several branches have been formed. We intend to build capacity by establishing a genetic lab and through crosscultural collaboration. Our vision is to establish a multidisciplinary research foundation. Based on our research findings, we plan to build services to cater to needs of twins by working with professionals, statutory services and government policy makers.

Birth Certificates↗