http://repository.rjt.ac.lk/handle/123456789/1411 2026-04-17T10:30:48Z http://repository.rjt.ac.lk/handle/123456789/2725 Ethical Issues in Post-Disaster Clinical Interventions and Research: A Developing World Perspective. Key Findings from a Drafting and Consensus Generation Meeting of the Working Group on Disaster Research and Ethics (WGDRE) 2007 Sumathipala, A.; Jafarey, A.; De Castro, L.D.; Ahmed, A.; Marcer, D.; Srinivasan,S.; Kumar, N.; Siribaddana, Sisira; Sutaryo, S.; Bhan, A.; Waidyarathne, D.; Beneragama, S.; Jayasekara, C; Edirisinghe, S.; Siriwardane, C. Disasters, natural or man-made, can occur virtually anytime and anywhere in the world. They bring mass destruction and loss of human lives. The effects of a disaster can be amplified many times in resource poor settings, especially in developing countries. In a post-disaster period, many clinical interventions and a lot of research takes place which focuses on the disaster-affected populations. While many of these interventions and research are conducted in the hour of need, some, unfortunately, are opportunistic. While many of these activities happen in accordance with internationally accepted ethical and other regulations, many of them violate ethical norms, and disaster-affected populations end up being exploited. Also, many ethical regulations are culturally inappropriate for the setting where research is taking place. In the aftermath of the 2004 tsunami, a group of Sri Lankan and international academics and researchers observed these irregularities and formed a group to counter the exploitation of vulnerable populations, especially in developing countries. The Working Group on Disaster Research and Ethics (WGDRE) was formed in 2007 and has produced a set of ethical guidelines applicable to post-disaster research focusing on the developing world perspective. 2010-06-01T00:00:00Z http://repository.rjt.ac.lk/handle/123456789/2724 Neurobiological Stress Markers in Tsunami Survivors: A Commentary Siribaddana, Sisira; Fernando, Buddhika; Goonertne, R. Sisira Siribaddana is an Endocrinologist and Physician as well as Project Leader of the Sri Lankan Twin Registry. His research interests include diabetes, osteoporosis, bioethics, mental health and twin research. Buddhika Fernando is an Academic and a member of the Ethics committee at the Institute of Research and Development (IRD), Colombo, the leading research based institution in Sri Lanka. She is a dental surgeon, attorney at law and a chartered financial analyst. Her research interests lie primarily in the legal and ethical aspects of healthcare and healthcare delivery, health finance, and with a special focus on the role economic disparity plays on the fulfilment of healthcare needs of women in Sri Lanka. Raja Goonertne is Senior Lecturer in Law at the Open University of Sri Lanka and an attorney at law. He obtained LL.B (Hon) from University of Colombo and LL.M from Monash University, Australia. He is also a diploma holder in forensic medicine. He has a keen interest in conducting research in bioethics, human rights, law and medicine. He is also a resource person of the Institute for Research and Development. This case study was presented by Dr Nandani Kumar and discussed at the International Ethics Training Workshop organized by the Indian Council for Medical Research (ICMR) held in Chennai from 10 to 15 February 2006 and at the Research Ethics Workshop Shaukat Khanum Research Ethics Workshop Shaukat Khanum Memorial Hospital and Cancer Research Centre, Lahore, on 1 March 2009 by Dr Athula Sumathipala. The Journal of Traumatic Stress published a special section titled "The ethics of disaster research" addressing ethical issues related to conducting research after disasters and terrorist attacks, based on a meeting organised by the New York Academy of Medicine and the US National Institute of Mental health. The guidance given below is based on their recommendations. 1. Competent research participant gives informed consent 2. Capacity assessment tools should be utilised if needed 3. Disaster affected populations should not be necessarily considered vulnerable 4. Specific research proposals should be scrutinised for novel nature of research and risk benefit ratio 5. Additional research is needed in the risks and benefits in the participation in disaster-related research 6. Representatives of the community should be consulted before planning and implementation of research. 7. Informed consent procedure should clear all therapeutic misconceptions 8. Explanation about the research should be done in a safe and controlled environment 9. Confidentiality and privacy of the participants must be ensured 10. Research staff should be trained and supported 11. Participants should be informed about the research findings 12. Coordination among researchers should minimise redundant research and participant burden. 1. Liu, L.-F., P. Lynnett, H. Fernando, B.E. Jaffe, B.H. Fritz, and B. Higman, et al. (2005) Observations by the International Survey Team in Sri Lanka, Science, 308, 1595. 2. Sumathipala, A., S.H. Siribaddana, and C. Perera (2006) Management of dead bodies as a component of psychosocial interventions after the Tsunami: a view from Sri Lanka, International Review in Psychiatry, 18, 249-53. 3. Yamada, S., R.P. Gunatilake, T.M. Roytman, S. Gunatilake, T. Fernando, and L. Fernando (2006) The Sri Lanka tsunami experience. Disaster Manag Response, 4, 38-48. 4. Liu et al., 2005; Inoue, S., A.C. Wijewickrema, H. Matsumoto, H. Miura, P. Gunaratna, M. Madurapperuma, and T. Sekiguchi (2007) Field Survey of Tsunami Effects in Sri Lanka due to the Sumatra-Andaman Earthquake of December 26, 2004, Pure appl. geophys, 164, 395-411. 5. Sumathipala et al., 2006 6. Soejima, M., H. Kimura, and Y. Koda (2004) Two novel FUT3 alleles responsible for Lewisnull phenotypes in Sri Lanka Transfusion, 44, 1534-5. 7. Collogan, K.L., F. Tuma, R. Donald-Sewell, S. Borja, and R. Fleischman (2004) Ethical issues pertaining to research in the aftermath of the disaster, Journal of Traumatic Stress, 17, 363-72. Available at http://www.globalizationandhealth.eom/content/1/1/16 2010-06-01T00:00:00Z http://repository.rjt.ac.lk/handle/123456789/2723 Aetiology of fatigue in Sri Lanka and its overlap with depression Ball, H.; Sumathipala, A.; Siribaddana, Sisira; Kovas, Y.; Glozier, N.; Guffin P, M.C.; Hotopf, M. Background Fatigue is a common symptom in Western high-income countries but is often medically unexplained and little is known about its presentation in other populations. Aims To explore the epidemiology and aetiology of fatigue in Sri Lanka, and of its overlap with depression. Method A total of 4024 randomly selected twins from a population-based register in Sri Lanka (Colombo district) completed home interviews including the Chalder Fatigue Questionnaire. Results The prevalence of fatigue was similar to that in other countries, although prolonged fatigue may be less common. There was substantial comorbidity with a screen for lifetime depression. Non-shared environmental factors made the largest contributions, although genetic/family factors also contributed. The aetiology appeared consistent across the spectrum of severity. Conclusions The aetiology of fatigue is broadly similar in Sri Lanka and Western high-income countries. Abnormal experiences of fatigue appear to be the extreme form of more common fatigue, rather than representing independent entities with different genetic or environmental risk factors. 2010-08-01T00:00:00Z http://repository.rjt.ac.lk/handle/123456789/2722 Understanding of research: a Sri Lankan perspective Sumathipala, A.; Siribaddana, Sisira; Hewage, S.N.; Lekmawattege, M.; Athukorala; Siriwardane, C.; Munasingha, K.; Murray, J.; Prince, M. Lack of proper understanding on the part of researchers about public understanding of research and informed consent will increase the potential for malpractice. As a part of a larger study on ethics and informed consent in Sri Lanka, this study aimed to ascertain the level of understanding of 'research' by exploring the views of the public and professionals. Methods Convenience sampling and snow ball technique were used for recruitment with an emphasis on balanced age and gender representation, diverse educational, socio-cultural and professional backgrounds, and previous research experience, either as researchers or participants. Content analysis of the data was carried out. Results 66 persons (37 males, 29 females) participated. Although fundamentally a qualitative study, themes were also quantitatively analysed for informative results. Most participants thought that the word 'research' meant searching, looking, inquiring while some others thought it meant gathering information, gaining knowledge and learning. A third of participants did not offer an alternative word for research. Others suggested the words survey, exploration, search, experiment, discovery, invention and study as being synonymous. Doctors, health professionals, health institutions, scientists, professionals, businessmen, pharmaceutical companies, students, teachers were identified as people who conduct research. Participants indicated that crucial information on deciding to participate in research included objectives of the research, project importance and relevance, potential benefits to individuals and society, credibility & legitimacy of researchers, what is expected of participant, reason for selection, expected outcome, confidentiality and ability to withdraw at any time. A majority (89%) expressed their willingness to participate in future research. Conclusions The results show that with or without prior experience in research, participants in this study had a reasonable understanding of research. The findings show that a decision about taking part in research is dependent on knowledge, education and also on social networks. The results demonstrate that the majority were supportive of health research and believe that research is beneficial to the welfare of society. 0004-01-01T00:00:00Z