BackgroundWith ever increasing educational expectations and demands, burnout has emerged as a major problem negatively affecting the wellbeing of different student populations. Even though the validity of the Maslach Burnout Inventory-Student Survey (MBI-SS) is widely assessed across the globe, there is a paucity of related literature in the South Asian settings. Hence, this study was aimed at assessing the factorial structure, validity, and reliability of the MBI-SS among collegiate cycle students in Sri Lanka.MethodsThe pre-tested Sinhala version of the MBI-SS was administered to a sample of 194 grade thirteen students in the Kurunegala district, Sri Lanka. The construct validity of the MBI-SS was assessed using multi-trait scaling analysis and confirmatory factor analysis (CFA), while reliability was assessed using internal consistency and test-retest reliability, which was assessed after an interval of two weeks.ResultsCFA revealed that the three-factor model of the MBI-SS fitted the data better than the one-factor and the two-factor model. Only one item (item 13) was identified as having poor psychometric properties. A modified version of the MBI-SS, with item 13 deleted, emerged as an acceptable fitting model with a combination of absolute, relative and parsimony fit indices reaching desired threshold values. All three subscales show high internal consistency with Cronbach’s α coefficient values of 0.837, 0.869, and 0.881 and test-retest reliability was high (p < 0.001).ConclusionsThe Sinhala version of the 15-item MBI-SS is a valid and a reliable instrument to assess the burnout status among collegiate cycle students in Sri Lanka. The Sinhala version of the 15-item MBI SS, due to its brevity, ease of administration, and sound psychometric properties, could be used as an effective screening tool to assess student burnout at the school level.

BackgroundAbsence of context-specific clinically validated cut-off values for assessing burnout as a dichotomous phenomenon has hindered the progress of student burnout research with regard to quantifying the magnitude of the problem. Hence, the present study was aimed at developing clinically validated cut-off values and evaluating the diagnostic accuracy of the Sinhala translation of the 15-item Maslach Burnout Inventory-Student Survey (MBI-SS) in assessing burnout among collegiate cycle students in Sri Lanka.MethodsThis prospective validation study was conducted among 194 grade thirteen students in the Kurunegala district, Sri Lanka. Clinically validated cut-off values for the subscale scores of the MBI-SS test was developed by computing ROC curves, using the clinical diagnosis made by the Consultant Psychiatrist as the reference standard. Diagnostic accuracy of the MBI-SS test results based on “exhaustion+ 1” criterion was assessed comparing with the results of the clinical diagnosis.ResultsThe clinically validated cut-off values for the exhaustion, cynicism and reduced professional efficacy subscale scores were 12.5, 7.5 and 10.5 for the respectively. The sensitivity, specificity, positive and negative predictive values of the Sinhala translation of the 15-item MBI-SS were 91.9% (95% CI = 82.5–96.5%), 93.2% (95% CI = 87.5–96.4%), 86.4% (95% CI = 76.1–92.7%) and 96.1% (95% CI = 91.2–98.3%) respectively. The positive and negative likelihood ratios were 13.48 (95% CI = 7.15–25.44) and 0.09 (95% CI = 0.04–0.20) respectively.ConclusionsBy using the clinically validated cut-off values for the subscale scores and based on the “exhaustion + 1” criterion, the Sinhala translation of the 15-item MBI-SS could be effectively used as a screening tool to assess burnout among collegiate cycle students. The study findings broaden the global evidence base pertaining to validated cut-off values of the MBI-SS.

Background Leptospirosis is a bacterial zoonosis. Leptospirosis incidence (LI) in Sri Lanka is high. Infected animals pass leptospires to the environment with their urine. Leprospires' survival in the environment to infect a new host depends on meteorological factors. El Nino Southern Oscillation (ENSO) and Indian Ocean Dipole (IOD) modulate the weather in Sri Lanka. Objectives The determination of interrelationship between the LI in the Hambantota District, and local meteorological parameters, ENSO and IOD. Methods We acquired notified leptospirosis cases in the Hambantota District and population data. We calculated weekly leptospirosis incidences for 2008 to 2017.Weather data from two weather stations was obtained, averaged and converted into weekly data. We plotted time series graphs and observed the correlation between seven aggregated weather parameters and LI. We estimated cross-correlations between those weather parameters and LI. As our principal analysis we determined correlation between LI and seven local weather parameters, Nino 3.4, Nino4 and Dipole Mode Index (DMI) indices using wavelet analysis. Results Our wavelet analysis results showed troughs of minimum, maximum, mean temperatures, soil temperature, the evaporation rate, the duration of sunshine were followed by peaks in LI and peaks of rainfall followed by peaks of LI, all after lag periods. Our time series graphs and cross-correlation determination results are generally in agreement with these results. However there was no significant correlation between rainfall and LI in the cross-correlation analysis. There were peaks of LI following both peaks and troughs of DMI. There was no clear correlation between both Nino indices and LI. Discussion This may be the first long-term study demonstrating soil temperature, evaporation rate and IOD are correlating with LI. The correlation pattern of LI with temperature parameters differs from similar past studies and we explain the reasons. We propose ways to control high LI we observed after periods of weather favorable for transmission of leptospirosis.

BackgroundEven though the concept of burnout has been widely explored across the globe, the evidence base on burnout among high school students in the South Asian context is scanty. Against the backdrop of ever-increasing educational demands and expectations, the present study was designed to determine the prevalence and correlates of burnout among collegiate cycle students in Sri Lanka.MethodsA school-based cross-sectional study was conducted among 872 grade thirteen students in 15 government schools in an educational zone, Kegalle district, Sri Lanka selected by a stratified cluster sampling technique. The validated Sinhala version of the 15-item Maslach Burnout Inventory-Student Survey (MBI-SS) was used to assess burnout. The adjusted prevalence of burnout was computed based on the clinically validated cut-off values using the “exhaustion + 1” criterion. Multivariable logistic regression was carried out using backward elimination method to quantify the association between burnout and selected correlates identified at bivariate analysis at p value less than 0.05.ResultsThe response rate was 91.3% (n = 796). The adjusted prevalence of burnout among grade thirteen students was 28.8% (95% CI = 25.0–32.7%). Multivariable analysis elicited a multitude of statistically significant associations with burnout when controlled for other factors included in the model (p < 0.05). Perceived satisfaction related to the school environment (classroom and library facilities), school curriculum (scope, relevance, and difficulty of the subject content), study enthusiasm (preferred subject stream), study support (support from parents to teachers), and future expectations (personal and parental expectations) emerged as statistically significant negative associations with burnout, whereas having to encounter disturbances while studying and being subjected to bullying at school emerged as statistically significant positive associations with burnout.ConclusionsThe burnout prevalence among grade thirteen students in the selected educational zone, Sri Lanka is high. Most of the significant correlates of burnout are directly related to the academic endeavours. It is recommended to strengthen the counseling services at the school level to rectify the problems related to burnout among collegiate cycle students in Sri Lanka.

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Background: With ever increasing educational expectations and demands, burnout has emerged as a major problem negatively affecting the wellbeing of different student populations. Even though the validity of the Maslach Burnout Inventory-Student Survey (MBI-SS) is widely assessed across the globe, there is a paucity of related literature in the South Asian settings. Hence, this study was aimed at assessing the factorial structure, validity, and reliability of the MBI-SS among collegiate cycle students in Sri Lanka. Methods: The pre-tested Sinhala version of the MBI-SS was administered to a sample of 194 grade thirteen students in the Kurunegala district, Sri Lanka. The construct validity of the MBI-SS was assessed using multi-trait scaling analysis and confirmatory factor analysis (CFA), while reliability was assessed using internal consistency and test-retest reliability, which was assessed after an interval of two weeks. Results: CFA revealed that the three-factor model of the MBI-SS fitted the data better than the one-factor and the two-factor model. Only one item (item 13) was identified as having poor psychometric properties. A modified version of the MBI-SS, with item 13 deleted, emerged as an acceptable fitting model with a combination of absolute, relative and parsimony fit indices reaching desired threshold values. All three subscales show high internal consistency with Cronbach's α coefficient values of 0.837, 0.869, and 0.881 and test-retest reliability was high (p < 0.001). Conclusions: The Sinhala version of the 15-item MBI-SS is a valid and a reliable instrument to assess the burnout status among collegiate cycle students in Sri Lanka. The Sinhala version of the 15-item MBI SS, due to its brevity, ease of administration, and sound psychometric properties, could be used as an effective screening tool to assess student burnout at the school level.

Background Dengue fever is a common mosquito borne viral infection. Severe dengue fever associated severe hepatitis carries high mortality. Based on the beneficial effect of N-acetylcysteine (NAC) in paracetamol poisoning and non-acetaminophen induced liver failure, it is used in dengue fever associated hepatitis in clinical practice. We aim to study the reversal of liver enzymes with NAC in the setting of severe hepatitis due to severe dengue infection. Methods A retrospective analysis was conducted on hospitalized 30 adults with severe dengue fever with severe hepatitis. These 30 patients had aspartate transaminase (AST) and alanine transaminases (ALT) more than 500 U/L and/or PT INR (prothrombin time and international normalized ratio) more than 1.5. They were treated with NAC infusion of 100 mg/h for 3 to 5 days. Results The mean age of the group was 49.9 ± 11.46 years and 18 (60%) patients were males. Nineteen patients (63%) developed dengue shock. Of them 12 patients (40%) developed hepatic encephalopathy. Median AST on the day of administration of NAC was 1125 U/L interquartile range (IQR) 1653.25 while median ALT was 752 (IQR 459.25). There was a statistically significant reduction of both ALT (p = 0.034) and AST (p = 0.049) from day 1 to 4 after NAC infusion. Rise of platelet count between day 1 and day 4 also showed statistically significant difference (p = 0.011) but the reduction of prothrombin time and international normalized ratio (PT/INR) from 1 to day 4 did not show statistical significance difference. Mean duration of treatment with NAC was 3.61 ± 0.75 days while mean length of hospital stay was 6.2 ± 1.27 days. Only one patient died (3.3%). None of the patients reported adverse drug reaction due to NAC. Conclusion Majority of patients demonstrated marked clinical and biochemical improvements and they recovered fully. We observed faster and significant recovery of liver enzymes following administration of NAC. Based on the above findings, this study provides preliminary evidence for the beneficial effect of NAC in severe hepatitis in dengue infection with greater survival benefits.

ObjectiveThe present study was aimed at assessing the validity and the reliability of the Sinhala version of the Utrecht Work Engagement Scale-Student Version (UWES-S) among collegiate cycle students in Sri Lanka.ResultsThe 17-item UWES-S was translated to Sinhala and the judgmental validity was assessed by a multi-disciplinary panel of experts. Construct validity of the UWES-S was appraised by using multi-trait scaling analysis and exploratory factor analysis (EFA) on data obtained from a sample of 194 grade thirteen students in the Kurunegala district, Sri Lanka. Reliability of the UWES-S was assessed by using internal consistency and test–retest reliability. Except for item 13, all other items showed good psychometric properties in judgemental validity, item-convergent validity and item-discriminant validity. EFA using principal component analysis with Oblimin rotation, suggested a three-factor solution (including vigor, dedication and absorption subscales) explaining 65.4% of the total variance for the 16-item UWES-S (with item 13 deleted). All three subscales show high internal consistency with Cronbach’s α coefficient values of 0.867, 0.819, and 0.903 and test–retest reliability was high (p < 0.001). Hence, the Sinhala version of the 16-item UWES-S is a valid and a reliable instrument to assess work engagement among collegiate cycle students in Sri Lanka.