One of the most important problems in the construction industry is variations. They occur in every construction project and the magnitude of these variations varies considerably from project to project. Hence, the variations orders bear great importance right from the inception to completion in the construction industry. Most of the road construction projects in Sri Lanka have experienced a large number of variation orders. The client had to spend more than what was initially estimated in most cases. Sometimes, disputes and unnecessary delays occur due to variations. This study attempted to reveal the possible causes of variation orders in the road construction projects in Sri Lanka. The data were collected through a literature review, a case study analysis focused on 11 road construction projects, and a questionnaire administered to professionals in the road construction industry in Sri Lanka. The study found out that the causes in the local context differ from those in the international context. According to the questionnaire survey, poor estimation was the most significant cause of variation orders. Unforeseen site conditions, political pressure during construction stage, poor investigation, and client-initiated variations occupy the 2nd to 5th places, respectively, in the ranking. This ranking was further proven through the case study analysis.
Objectives The study aimed to use Geographic Information Systems (GIS) to investigate the spatial distribution of the concentration of fluoride (F) in groundwater resources of Sri Lanka, and the geographic accessibility to an alternative water source having a low or safe F limit to mitigate dental fluorosis. Methods The study used randomly collected (6107) groundwater samples from Sri Lanka and categorized them as “dentally optimal” and “unsafe” based on their F content. The minimum distance from an identified high F source (above dentally optimal level) to a safe groundwater source was determined using geospatial analysis. Results Dentally optimal F sources (<1 and <1.5 mg/L) were identified among the high F groundwater sources (>2 mg/L), some even within a walking distance of 500 m. Results indicated that 26% of dentally unsafe groundwater sources (2.0 mg/L+ wells) had a low F source (<1.0 mg/L) available within a distance of 500 m. It was also evident that 39% of high F wells (2.0 mg/L+ wells) had a low F well (<1.5 mg/L) within a distance of 500 m, if the WHO guideline value for optimal F levels (1.5 mg/L) was assigned as the safe F limit. Conclusion The spatial approach demonstrated a reasonable access to alternative water sources with low or safe F limit in endemic fluorosis areas. Optimizing the use of accessible low F sources is highly recommended as the first‐line option to mitigate dental fluorosis in Sri Lanka since the defluoridation methods introduced in past did not provide sustainable oral health solutions for the inhabitants in high‐risk areas.
A coordinated national School Dental Service strategy is needed in response to identified areas of poor or inadequate accessibility to dental services for large parts of the child population, especially those from low socioeconomic backgrounds.
Objectives To investigate the distribution of groundwater fluoride levels in Sri Lanka in relation to its population distribution to determine the population at risk for dental caries or dental fluorosis. Methods The study used the most upgraded spatial distribution map of groundwater fluoride levels in Sri Lanka, and it was overlaid with a census of population data of the country. Results The results indicated that 12% of children aged <12 years were at risk for dental fluorosis, while 81.4% of those who lived in low‐fluoride zones were vulnerable for development of dental decay. Overall, 82.4% of the country's population lived in low‐fluoride zones and 11.2% were at risk of potential health hazards posed by ingestion of excessive fluoride. Conclusion The spatial approach provides a useful decision‐support tool for developing an oral health strategy of safe fluoride use based on predicted oral health risks in communities.
Introduction: An antenatal oral healthcare programme was introduced in Sri Lanka with the collaboration of existing Maternal and Child Health (MCH) programme in 2009. A discussion on sustenance of oral care in pregnancy will delineate the multiple and diverse factors that reflect the implications in future practice. Objectives: To describe the issues for sustainability of National Oral Healthcare Programme for Pregnant Mothers in the district of Gampaha Methodology: A qualitative study was carried out using the evaluation technique of participatory SWOT analysis. Two focus group discussions were conducted among Dental Surgeons and Medical Officers of Health (MOH) followed by two key informant interviews with the Regional Dental Surgeon and the Medical Officer -MCH care in the year 2014. The most common items identified were prioritized according to the preference of Dental Surgeons and MOHs in two separate public health forums. Results: The weaknesses pointed out by the professionals were; lack of emergency management facilities and over-crowded nature
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