Adaptation and validation of the Longer-term Unmet Needs after Stroke (LUNS) monitoring tool in Sri Lanka

The basic unmet need is 100% recovery. SOLVE THAT!

Adaptation and validation of the Longer-term Unmet Needs after Stroke (LUNS) monitoring tool in Sri Lanka

• Nalinda Tharanga Wellappuli,
• Hettiarachchige Subashini Rasanja Perera,
• Gunendrika Kasthuriratne,
• Thashi Chang &
• Nalika Sepali Gunawardena 

BMC Public Health volume 23, Article number: 1718 (2023) Cite this article

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Abstract

Background

Globally, stroke is a leading cause of mortality and morbidity. Unmet needs are defined as expressed needs that are not fulfilled by services provided and are considered an important indicator of the adequacy and quality of stroke follow-up care. This study aimed to culturally adapt, modify, translate and validate, the Longer-term Unmet Needs after Stroke (LUNS) monitoring tool, to Sri Lanka. Currently, there is no validated tool in Sri Lanka to assess unmet needs among stroke survivors and unmet needs are not systematically assessed.

Methods

A phased approach followed to culturally adapt, translate, establish its factorial validity and evaluate the convergent and divergent validity, reliability, and overall acceptability. The process of culturally adapting the tool was carried out using two rounds of the modified Delphi technique. The modified tool was translated to Sinhala and pretested among 10 stroke survivors. A descriptive cross-sectional study was conducted among 119 stroke survivors to establish the factorial validity and convergent and discriminant validity using the GHQ-12 and Barthel Index. The Socio-demographic characteristics of the study participants are presented. Communalities were assessed for 21 items and 2 items were dropped. Factor structure was confirmed with varimax and oblique rotations. The correlation coefficient was calculated to assess convergent and divergent validity. Cronbach’s alpha value was calculated to assess internal reliability.

Results

Following the modified Delphi technique, 5 items of LUNS tool were removed, and 5 items were modified. Three new items were added based on expert recommendation. One item related to driving also removed as it does not fit with the factor structure emerged. In establishing factorial validity 5 factors emerged from the exploratory factor analysis. In assessing the convergent and discriminant validity, test results revealed that both General Health Questionnaire-12 (GHQ-12) and Barthel Index significantly correlated as expected with unmet needs. The results of Cronbach’s alpha showed that all the factors were moderately high confirming the reliability of the tool.

Conclusions

The Sinhala version of the LUNS monitoring tool is a valid and reliable instrument to assess the unmet needs of stroke survivors. Assessment of unmet needs will add new insight into evaluation of the quantity, quality, and effectiveness of healthcare interventions received by stroke survivors in Sri Lanka.

National Stroke Center to be established in Mulleriyawa hospital - Sri Lanka

Time to contact them and DEMAND  that the goal of the hospital is 100% recovery for all stroke survivors. Anything less and they aren't even trying for the best interests of their stroke patients.  Dumbed down goals for the doctors and hospital are not to be tolerated. YOU have to be in charge of the goals not the self serving interests of the stroke medical professionals.
National Stroke Center to be established in Mulleriyawa hospital

Aug 23, Colombo: Sri Lanka's Minister of Health, Nutrition and Indigenous Medicine, Dr. Rajitha Senaratne has said that measures have been taken to establish the National Stroke Center in the Mulleriyawa hospital.
Minister Senaratne has disclosed this participating as the Chief Guest in an event held to launch the register of stroke patients in Sri Lanka recently at the Colombo National Hospital.
Speaking at the event, the Minister said that steps have been taken to establish stroke centers throughout the country.
The Minister of Health further said stroke has been identified as a major cause of paralysis among adults and care must be taken to eliminate the cause of strokes and the government has taken several steps.
According to the Health reports prevalence of stroke in Sri Lanka is 10 per 1000 people and is a leading cause of disability and death.
The Minister said the impact of stroke on the economy and families is very powerful, therefore, the hospital facilities have been upgraded for stroke patients.
"We must also focus on the rehabilitation of the patients after stroke. It is also important to educate the general public about the actions that need to be taken to curb the disease. That includes lifestyle changes and emergency management," the Minister said.
Director General of Health Services Dr. Jayasundera Bandara, Deputy Director General Dr. Champika Wickramasinghe, Colombo National Hospital Director Dr. Anil Jasinghe and a team of specialist doctors were present at the occasion.

Effects of white coconut oil, virgin coconut oil and grated coconut on blood glucose and serum lipids in Wistar rats

I bet this will never reach human testing.
http://repository.kln.ac.lk/jspui/handle/123456789/10641

Authors:	Samaranavake, H.A.E. Chakrewarthy, S. Karunakaran, R. Wickremasinghe, A.R.
Keywords:	serum lipids in Wistar rats
Issue Date:	2015
Publisher:	Sri lanka Medical Association
Citation:	Proceedings of the Sri Lanka Medical Association, Anniversary Academic Sessions. 2015; 128: 174
Abstract:	INTRODUCTION AND OBJECTIVES: This study investigated the effects of white coconut oil (WCO), virgin coconut oil (VCO) and grated coconut on blood glucose and serum lipids in Wistar rats. METHOD: Four groups of male Wistar rats (1-4) were maintained on four isocaloric test diets, containing WCO, VCO, WCO + grated coconut (1:1 ratio) and VCO + grated coconut (1:1 ratio) respectively. After 36 weeks of feeding blood glucose and serum lipids were assayed. Results were analysed using SPSS version 16.0. RESULTS: Compared with the baseline levels, mean blood glucose levels decreased in all four groups; -13.87, -7.22, -41.88, and -41.85 mg/dt respectively. Rats fed with mixtures of oil and grated coconut (groups 3 and 4) showed a significantly higher decrease in blood sugar (p<0.05) compared with diets containing oil only (groups 1 and 2). No significant differences (p>0.05) in blood sugar levels were observed between groups fed with diets containing oil only or between groups fed with diets containing mixtures of oii+ grated coconut. Compared with baseline levels, mean differences in serum total cholesterol (TC) were 9.05, -8.08, 6.11,1.65 mg/dl, triglycerides -31.1, -20.75, -30.5, -49.8 mg/d! and high density lipoproteins (HDL) -1.47, 8.32, 0.816, -10.82 mg/dl in groups 1-4 respectively. Although statistically not significant, lower TC and higher HDL levels were observed in rats fed with VCO containing diet. CONCLUSION: Inclusion of grated coconut in the diet results in significant hypoglyceamic action. Although statistically not significant VCO may have beneficial effects on serum lipids which warrants further investigation.
Description:	Poster Presentation Abstract (PP26), 128th Annual Scientific Sessions, Sri Lanka Medical Association, 6th-8th July 2015 Colombo, Sri Lanka
URI:	http://hdl.handle.net/123456789/10641