Purpose:Several brands of anti-rabies vaccines (ARVs) are used for dog vaccination in Sri Lanka, which have shown major differences in their potency levels. This comparative study was conducted to determine humoral immune response of these ARVs using 2 different animal species. The reliability of an enzyme-linked immunosorbent assay (ELISA) antibody kit was assessed in comparison to the standard Fluorescent Antibody Virus Neutralization (FAVN) test. Materials and Methods:The laboratory animal study was conducted using 3-4 months old sero-negative New Zealand White rabbits. Nine vaccines from 7 producers were tested including 8 monovalent inactivated ARVs: Canvac R® single-dose and multi-dose, Nobivac® Rabies, Rabies Killed® Vaccine, Rabisin®, Defensor 3®, Raksharab® single-dose and multidose, and one bivalent inactivated ARV, Nobivac® RL. Second part was conducted in field dogs. Four vaccines with the highest potencies were selected for this field dog study. Animals were vaccinated subcutaneously with one dose of a selected ARV. Day 0 blood samples were collected just before the vaccination and Day 7, Day 14, and Day 30 samples from rabbits and Day 30 samples from dogs were collected post-vaccination. Results:Significant differences of humoral immune response between different vaccines brands were observed in both animal species. The coefficient of concordance between the FAVN test and the ELISA was 54.6% and 85.3% for rabbits and dogs respectively. Conclusion:The overall results showed that ARVs with proven potency can induce a robust humoral immune response following vaccination. There was a comparatively higher agreement between the FAVN test and the ELISA.

Non-communicable diseases (NCDs) are the leading cause of premature deaths globally, largely driven by modifiable behavioural risk factors such as unhealthy diet, physical inactivity, tobacco use, and alcohol consumption. Health literacy (HL) plays a vital role in modifying these behaviours. Evidence shows that Healthcare Assistants (HCAs) in Sri Lanka despite working in hospitals often demonstrate limited HL and high rates of risk behaviours. Enhancing HL among HCAs is therefore essential both for their own health and for enabling them to serve as credible health advocates in NCD prevention. This study aimed to develop and validate a Behaviour Change Intervention Package (BCIP) to improve HL related to NCD behavioural risk factors among HCAs in government hospitals in Sri Lanka. A Behaviour Change Intervention Package (BCIP) was developed using the Intervention Mapping (IM) approach, informed by the Calgary Charter HL framework. Steps included assessment of the logic model of the problem, setting objectives, intervention design, expert content validation, pilot testing, and planning for implementation and evaluation. The BCIP comprised a curriculum, facilitator guide, participant handbook, and PowerPoint presentations, for 16 two-hour sessions across eight weeks. Sessions employed lectures, role-play, group discussions, brainstorming, and m-health tools. Content validity was assessed by a 10-member expert panel, while pilot testing in selected hospitals evaluated feasibility and acceptability. Findings revealed that HL among HCAs was limited by factors at individual, family, organizational, community, and policy levels. The BCIP addressed these determinants by focusing on HL’s four domains- finding, understanding, comparing, and applying health information. Expert review confirmed high relevance and appropriateness (mean scores > 3.0), while pilot testing showed feasibility and participant satisfaction with content, delivery methods, and session duration. The validated BCIP provides a structured, theory-driven approach to improving HL and reducing NCD risk behaviours among HCAs. Pilot findings support its feasibility for integration into routine induction or in-service training. Future studies will evaluate its effectiveness, with potential adaptation for broader workplace health promotion in Sri Lanka.

Background Parenting styles are broadly categorised based on two dimensions: demandingness and responsiveness. Extensive global research has examined the influence of parent–adolescent relationships on psychosocial well-being, often highlighting the benefits of authoritative (democratic) parenting. However, emerging evidence suggests that these relationships may vary across cultural and ethnic contexts. In Sri Lanka, limited research has explored this association, particularly in relation to adolescent psychological outcomes. Objectives To describe adolescents’ perceptions of maternal and paternal parenting styles and to determine their association with self-esteem and life satisfaction among school-going adolescents aged 14–15 years in Sri Lanka. Methods A cross-sectional descriptive study was conducted among 439 adolescents aged 14–15 years from randomly selected schools in the Kalutara district, Sri Lanka. Participants were selected using cluster sampling. Data were collected using a self-administered questionnaire. Descriptive statistics, including percentages and mean values, were calculated, and associations were tested using the chi-square test. Results Permissive parenting was the most commonly perceived style for both mothers (57.3%) and fathers (56.4%), followed by authoritaria n parenting. Contrary to global evidence, paternal permissive and authoritarian parenting styles were significantly associated with higher selfesteem (p=0.002) and higher life satisfaction (p=0.00) compared to authoritative parenting. The association between maternal parenting styles and psychological outcomes was less clear. Additionally, combinations of maternal and paternal parenting styles were not significantly associated with adolescent self-esteem or life satisfaction. Conclusion Authoritative parenting appears to be less prevalent among Sri Lankan parents and was not associated with optimal adolescent psychological well-being in this study. These findings highlight the importance of considering cultural context when interpreting parenting styles and their impact. Keywords: Parenting styles, self-esteem, life satisfaction, adolescents

Non-communicable diseases (NCDs) are a major public health challenge in Sri Lanka, driven by behavioural risk factors. Healthcare Assistants (HCAs) play a key role in NCD prevention, but limited health literacy (HL) reduces their effectiveness. Strengthening HL among HCAs can reduce their own NCD risk, enhance their role as health promoters, and improve patient education and hospital-based health initiatives. This study aimed to assess the effectiveness of a behaviour change intervention package (BCIP) to improve HL on behavioural risk factors of NCDs among HCAs in Colombo district. A cluster Randomized Controlled Trial (cRCT) was conducted with 240 HCAs from 20 hospitals in the Colombo district, 10 hospitals each for the control and intervention arms. The 16 sessions of the BCIP were conducted over eight weeks. The HL-NCD tool and STEPS questionnaire were administered two weeks before and after the intervention. HL score was analyzed as a continuous variable, while HL level was categorized as inadequate or adequate based on predefined HL score cutoffs. Analyses included unadjusted, cluster-level, and Generalized Estimating Equations (GEE) models to account for clustering effects. The intervention group showed significant improvements in HL score (unadjusted p < 0.001; cluster p = 0.005; GEE OR = 7.80, 95

Background and objective: Valid and cost-effective approaches are essential to assess physical activity and sedentary behaviors in individuals of all ages. This study aimed to validate a physical activity recall questionnaire (PAR-Q) and a physical activity log against the doubly labelled water (DLW) technique in 11-13-year-old Sri Lankan children. Method: Total energy expenditure (TEE) was determined using the criterion DLW technique (TEEDLW) and physical activity energy expenditure (PAEEDLW) was estimated. Subsequently, physical activity assessment methods were validated in a group of children (n=96). PAR-Q was adapted from the adolescent physical activity questionnaire and the physical activity log from the Bouchard activity diary. The youth physical activity compendium was used to calculate PAEE from both PAR-Q (PAEEPAR-Q) and activity log (PAEEPALog). Statistical analysis included Spearman’s correlation coefficient and Bland-Altman analyses. Results: Mean age of the study sample was 12.0 ± 0.8 years where the greater proportion were males (51.9%, n=41). PAEEPAR-Q and PAEEPALog were significantly correlated with the PAEEDLW (r=0.63 and r=0.49, p < 0.05). PAR-Q and activity log underestimated PAEE by 304.2 ± 1223.8 kJ/day and 375.3 ± 1087.4 kJ/day, respectively. Using Bland-Altman analysis, the majority of data points were within the limits of agreement in both PAR-Q and activity log. Conclusion: PAR-Q is a valid tool for predicting PAEE in Sri Lankan children whereas the physical activity log was not. Researchers and practitioners can confidently use the PAR-Q to assess physical activity in this population, with potential applications in various research and intervention settings.

Obesity among the young is an emerging health problem with many metabolic changes including liver damage. Our objective was to investigate the association of fatty liver with serum uric acid (UA) and gamma-glutamyltransferase (GGT) in a cohort of obese children in Sri Lanka. A cross-sectional analytical study was conducted among 5-15-year-old obese children (based on WHO 2007 standards). After a 12-hour overnight fast, blood was drawn for glucose, lipid profile, alanine aminotransferase (ALT), aspartate aminotransferase (AST), insulin, UA and GGT. Height, weight, waist circumference, blood pressure and fat mass were measured. Ultrasound scan of abdomen was performed to determine fatty liver. We studied 146 obese children with a mean age (SD) 9.86 (2.1) years. The fatty liver group showed significantly elevated levels (p < 0.05) of UA, oral glucose tolerance test (OGTT), triglycerides (TG), AST, ALT, GGT, insulin resistance (HOMA-IR) and a reduced AST/ALT ratio, compared to the non-fatty liver group. Chi square test showed statistically significant associations between fatty liver and AST, ALT, AST/ALT ratio, HOMA-IR, UA and GGT. With existing cut offs, GGT (> 30 U/L) and UA (> 330 µmol/L) the sensitivity and specificity of GGT in predicting fatty liver was 26.9

Introduction: Prevalence of occupational stress (OS) among seconda ry teachers in the district of Colombo, Sri Lanka was found to be 83.4% in 2017, indicating the need for an intervention t o prevent its effects. Objectives: To evaluate the effectiveness of an intervention to reduc e OS among secondary teachers in Sinhala medium government schools in the district of Colombo Methods: A cluster randomized trial (SLCTR/2019/017) used cluster s of 10 secondary schools in Colombo District, which were assigned randomly to intervention and control arms; each ar m had 300 teachers. A package of nine-sessions of cognitive behavioural (CB) and relaxation technique-based activities designed through evidence generated in a systematic review was delivered as interactive group sessions over a period of si x months. Effectiveness of the intervention in reducing OS was assessed after four weeks using multivariate Generalized E stimating Equation analysis. Reducing psychological distress and adopting healthy lifestyles were assessed as secondary out comes of the intervention. Results: Intervention was significantly effective in reducing OS (OR=0.3; 95% CI=0.2, 0.5), psychological distress (OR=0.03; 95% CI=0.01, 0.07) and smoking (OR=0.09; 95% CI= 0.01, 0.7) among the teachers. It also significantly increased the knowledge about OS (OR=0.6; 95% CI=0.5, 0.7), hea lthiness of diet (OR=0.3; 95% CI=0.2, 0.4), level of adequate physical activity (OR=3.2; 95% CI=2.1, 4.9) and effecti ve coping of OS (OR=0.2; 95% CI=0.17, 0.3). The relative risk reduction (RRR) of OS with the intervention remained at 22.6%, the absolute risk reduction (ARR) was 19.4% and the number needed to treat (NNT) was five. Conclusions & Recommendations: The intervention package wa s highly effective to reduce OS among secondary teachers and is recommended to be incorporated to the basic training of teachers or implemented through the school health programme.

It is imperative to learn more about the distinctive Health-Risk-Behaviours (HRB) that are culturally acceptable in the lower-resource settings. Therefore, the objective of this review is to identify tools measuring HRBs among undergraduates in Sri Lankan context. A literature review was conducted both manually and electronically through Google Scholar and Hinari and PubMed databases. Self-administered Questionnaires were used in National Surveys and individual studies. Youth-Risk Behaviour-Surveillance-System was the most commonly used comprehensive HRB assessment tool. The National College Health Risk Behaviour Survey, National College Health Assessment were other widely used instruments. There are few validated tools and multiple short scales or items combined like Health-Promotion-Lifestyle[1]Profile, Health-Behaviour-Questionnaire or Inventory, DOSPERT scale, Adolescent-Health-Attitude and Behaviour[1]Survey, Healthy-Lifestyle-Scale, Health-Behaviour-Scale and Health-Behaviour-Checklist. Objective methods for assessing high-risk behaviors (HRBs) include measures of personality and aggression, which have been used to critically quantify violence and accidental injury, as well as biochemical tests for alcohol, nicotine, and other drug use, mechanical or computer sensors, and biological tests such as urinary cultures for sexual risk behaviours. These tools had focused only on specific aspects of HRBs among undergraduates in Western countries and were not comprehensive assessments of HRBs of undergraduates in lower-resource settings. It was evident that there has been a deficit of choices for the adaptation of an HRB tool for undergraduates in lower-resource-settings and a new tool to be developed for Sri Lankan context.

Background: Anxiety disorders (AD) being the most prevalent psychological problem among children and adolescents remain largely unrecognized due to their nature. If untreated, AD could lead to many adverse outcomes. The aim of this study was to assess the prevalence and correlates of anxiety disorders among children aged 13-15 years attending government Sinhala medium schools in Colombo district, Sri Lanka Methods: A school based cross-sectional study was conducted among 1524 children in Sinhala-medium government schools aged 13-15 years old selected by stratified cluster sampling. The presence of “any anxiety disorder” and its correlates were assessed using a pre-tested self-administered questionnaire that included validated Screen for Child Anxiety Related Disorders (SCARED). Multivariable analysis with binary logistic regression was carried out using backward elimination method to determine the association between anxiety disorders and selected correlates identified at bivariate analysis at p<0.05 level. Results: The adjusted prevalence of anxiety disorders was 12.3% (95% CI: 9.8% to 14.9%) Factors significantly associated with having any anxiety disorders at the multivariable analysis included being female (OR=3.0, 95% CI:2.0-4.4,p<0.001), residing away from the family (OR= 4.6, 95%:1.2-17.8, p=0.027), low to moderate self-esteem (OR=1.6, 95% CI: 1.1-2.5, p=0.022), having Stress (OR=2.3, 95%, CI: 1.5-3.6, p= <0.001), having Depression (OR= 2.5, 95% CI: 1.4-4.5, p<0.001), attending tuition classes for 5-7 days per week (OR=2.9, 95% CI: 1.9-4.3, p<0.001), non-engagement in sports activities (OR=1.6, 95%CI: 1.1-2.6, p=0.028), having a sibling/s less than one year of age ( OR=2.9, 95% CI: 1.2-6.6, p=0.015), father’s low level of education (OR=2.0, 95% CI: 1.1-3.8 p=0.044) and mother engaged in foreign employment (OR=5.3 , 95% CI: 2.0-13.9,p= 0.001), having an insecure attachment style (OR=2.7, 95% CI: 1.8-4.0, p<0.001). Conclusions: The prevalence of AD is high in this community and is associated with multiple personal, family, and educational factors. Screening for ADs need to be considered at routine mental health services.

Abstract Anxiety disorders are found to be the most prevalent psychological problems among children and adolescents. Cognitive behaviour therapy (CBT) was found to be effective at reducing anxiety. The purpose of this study was to assess the effectiveness of a universal school-based intervention for reducing anxiety among Grade 9 schoolchildren. A randomized controlled cluster trial was conducted by randomly assigning 36 schools in the Colombo district in Sri Lanka into study and control arms, each comprising 18 schools with 360 students. The levels of anxiety, self-esteem and depression status were assessed using the validated Screen for Child Anxiety Related Disorders (SCARED) tool and the Rosenberg self-esteem scale, respectively, and the Depression, Anxiety and Stress Scale 21 (DASS-21) at baseline, after intervention, and after 3 months. A CBT-based universal intervention package was administered weekly by a trained teacher for eight weeks with a one-month self-practice period to a randomly selected Grade 9 class in each school in the study arm. The control arm received routine care. Anxiety and self-esteem scores and depression status were compared between the two arms after the intervention and at 3 months of follow-up using the generalized estimation equation (GEE), controlling for confounding and clustering. The nonresponse and loss to follow-up rates were < 1%. When comparing the study arm with the control arm using GEE, anxiety levels were significantly lower [β = (-0.096), 95% CI = (-0.005) − (-0.186), p = 0.038] at follow-up but not postintervention [β = (-0.024), 95% CI = 0.006 − (-0.055), p = 0.115]. There were no significant differences in depression status after intervention (OR = 0.257, 95% CI =0.052–1.286; p = 0.098) or follow-up (OR = 0.422, 95% CI 0.177–1.008; p = 0.052), and self-esteem significantly increased after intervention (β = 0.811, 95% CI = 0.314–1.309; p = 0.001) but not at follow-up [β=0.435, 95% CI=(-0.276)-1.145, p=0.231]. This study revealed that the universal package based on CBT is effective at reducing anxiety and improving self-esteem among adolescents. The trial registration number and date were SLCTR/2018/018 and 19th of June 2018 respectively.

Introduction: The quality of work life (QoWL) of the elderly worke r becomes an important concept which needs to be assessed and improved with the increase of elderly population as their engagement in the workforce is inevitable. Objectives: To assess the prevalence and associated factors of QoW L among the elderly workers in Sri Lanka Methods: A cross-sectional survey study was conducted among el derly workers selected using multi-stage cluster sampling from Gampaha District. The QoWL was assessed using newly developed and validated Quality of Work Life Scale Elderly Workers. Factors associated with good QoWL were assessed through interviewer-administered questionnaire. Using a consensus reached cutoff mark, QoWL was dichotomized into ‘good’ and ‘poor’. Data were analysed with descriptive statistics and factors associated with good QoWL were determined using bivariate analysis with Chi- squared test and multivariate analysis with multiple logistic regression. Results: The study included 835 elderly workers and the mean score for total QoWL was 119.42 (SD=12.18). Prevalence of good QoWL among the elderly workers was 32.1% (95% CI=29.0, 35.3). Good QoWL was significantly associated with multiple factors, such as personal, work related and p sychosocial factors. In the multivariate analysis, factors significantly associated with good QoWL of elder workers were earning more than LKR 30,000 per month, having properties as an income generation method, engaging in a j ob before age 60 years, job helping to have social interaction, having adequate social support and engaging in political activities. Spending on own food, having arthritis, experiencing work related accidents and occupational engagement to support the family were negatively associated with good QoWL. Conclusions & Recommendations: The QoWL of elderly worke rs was at a low level and needs improvement interventions. Employees as well as policymakers should develop a nd implement appropriate strategies to improve their QoWL.

Introduction: Various forms of Aggressive and Violence Behavior(AVB) among undergraduates have been studied and shown considerable evidence of a significant link between Emotional-Intelligence(EI). Objective: is to assess the prevalence of AVB and its association with EI among second-year undergraduatesin a lower resource setting. Method: A descriptive-cross-sectional study was carried out among 1290, second-year undergraduates using multi-stage stratified cluster sampling in four randomly selected universities in Sri Lanka. UniHRB-Inventory is a self-administered questionnaire developed, translated and validated in a local setting. The domain measures AVB with 14 items, scoring from 0 for “never” and 4 for “more than 5 times”. The minimum-threshold-score for the presence of AVB was 32. Schutte’s Self-reported-EItool was used to assess EI. Total EI score was compared between those with and without AVB using the Mann-Whitney U test . A Multiple Logistic Regression (MLR) analysis was performed to control confounders. Results: Overall response-rate for the study was 88.1% (n=1136). Prevalence of AVB was 2.6% (95%CI:1.8%-3.7%). There was a statistically significant difference between the median total EI among undergraduates with and without AVB (median 72 vs 126; p<0.0001). EI had a significant negative effect on the likelihood of AVB following MLR. When EI increases by one unit the odds of having AVB decreases by a factor of 0.93 (95%CI:0.89-0.98;p<0.05). Conclusion and Recommendation: People with better EI are less likely to have AVB. It is recommended to include EI in the routine of undergraduates’ curriculum to prevent AVB in a lower resource setting.

Background: Organic acidaemias (OAs) are a biochemically heterogeneous group of inborn errors of metabolism. They are rare and infrequently reported worldwide. Most OAs are clinically apparent in the neonatal period or early infancy while some can present as a chronic progressive form or even an asymptomatic form. Objectives: To describe the clinical presentation, demographic characteristics and the incidence of OAs in Sri Lankan children. Method: A retrospective descriptive cross-sectional study was conducted over a 4-year period by reviewing records of children suspected of having OAs referred to the Department of Chemical Pathology, Lady Ridgeway Hospital. Demographic information, clinical manifestations, biochemical investigations and mutational results were recorded and analysed using descriptive statistics. Definitive diagnosis was established by gas chromatography and mass spectroscopy (GC-MS) of urine for organic acids. Results: Among the 458 patients suspected, 20 (4.3%) were confirmed to have an OA resulting in an incidence of 13/319,000 live births per year. The mean ages at onset of symptoms and diagnosis were 11.8 months (range; day 1 to 5 years) and 27.1 months (range; day 10 to 12 years) respectively. Among the 20 patients were 5 (25%) with propionic acidaemia and 4 (20%) with beta-ketothiolase deficiency. Nineteen (95%) presented acutely. Common manifestations were respiratory distress in 12 (60%) and persistent or recurrent vomiting in 10 (50%). Learning difficulty, dyskinesia and macrocephaly were some chronic manifestations. Biochemically, 15 (75%) had acidosis and 9 (45%) had ketosis. There were 13 (65%) deaths of which 6 were neonates with acute presentation. Conclusions: Propionic acidaemia and beta-ketothiolase deficiency were the common OAs identified. Common clinical presentations were respiratory distress and persistent or recurrent vomiting. Acidosis was a common biochemical finding.

Background: Anxiety disorders (AD) are the most prevalent psychological problem among adolescents. Both anxiety disorders and anxiety symptoms can lead to adverse outcomes. The aim of the study was to develop an evidence-based intervention package to reduce anxiety among school children aged 13-15 years.Methods: Design: UK Medical Research Council guidance for development of complex interventions were followed. Identification of evidence based was done by literature-search and expert opinions. Most suitable theory was identified based on level of evidence through consensus of Advisory committee (AC) consisting of experts. Subcomponents of the selected theory were mapped with associated factors of the AD. Eleven KII were conducted with school principals, teachers, parents, and students. Framework of the intervention package with suitable deliverables was designed with consensus of the AC by triangulating the findings. This was further fine-tuned with by using Modified-Delphi technique with participation of broader group of experts. These Delphi items were systematically derived from findings of the systematic reviews, expert opinion, and inputs from intervention recipients. The content development was done based on the proposed framework. Modeling process was done by conducting four consultative meetings with stakeholders with the aim of ensuring content and consensual validity followed by a consensus workshop. Feasibility study and pretesting of deliverables were done. Participants: Advisory committee [n=6] and stakeholder group [n=11] in Delphi component & four consultative meetings and a wider stakeholder group [n=23] in 1-day consensus workshop were involved.Results: Four RCTs and 12 RCTs/cRCTs were identified through literature review. Six types of intervention modalities were identified. CBT based intervention modality was shortlisted by AC considering the level of evidence. Five broad solutions, namely psycho education, realistic thinking, problem solving, graded exposure and relaxation techniques under CBT were mapped against the associated factors with consensus of the AC. Activities were developed under these broad solutions and most suitable options of these activities were selected by a stakeholder group using Modified Delphi technique. The intervention package was finalized by conducting a consensual workshop followed by feasibility study and pretesting of deliverables.Conclusions: A CBT-based universal intervention package was developed to reduce anxiety among children with ToT workshop for teachers with a field training, eight weekly 40 minutes sessions for children and one 40-minute session for parents. Teachers’ guide, Student’s workbook and leaflet for parents were deliverables. A process evaluation framework was used to monitor implementation.

The objective is to assess the prevalence and association of Dismissive-Attitude-towards-Violence(DAV) among second-year undergraduates in a lower-resource-setting. A descriptive-cross-sectional-study was carried out among 1290, second-year undergraduates in Sri Lanka using multi-stage-stratified cluster-sampling. Four universities were randomly selected from ten. Undergraduates from foreign-countries, those following external-degrees, distance-learning, clergymen, undergraduates of medical and allied-health were excluded. The cluster size was 30 and 43 clusters were allocated proportionately to the total second-year undergraduate population in each university and faculty. In each faculty, clusters were proportionately allocated to general-degree programmes with more than 100 students. DAV was measured using three items locally validated, scoring from 0 for “more than 5 times” and 4 for “never” and provided a minimum score of 0 to a maximum possible score of 12. The minimum threshold score for the presence of DAV was seven. Response-rate for the study was 88.1% (n = 1136). The prevalence of DAV was 82.2% (95%CI:79.9%–84.4%) which was significantly associated with poor relationships with teachers, friends, lecturers, batchmates and seniors, having peers with high-delinquency-behaviour, participating in ragging and involving in politics. DAV is negatively associated with emotional-intelligence. Accepting violent behaviour is a huge problem among undergraduates, which was influenced by many university and relationship-related factors. Therefore, creating healthy relationships in various levels, improving emotional intelligence and introducing other ways to recognize seniority among students should be supported and institutionalized to end campus violence.

This study aimed to develop a regression equation to predict physical activity energy expenditure (PAEE) using accelerometry. Children aged 11–13 years were recruited and randomly assigned to validation (n = 54) and cross-validation (n = 25) groups. The doubly labelled water (DLW) technique was used to assess energy expenditure and accelerometers were worn by participants across the same period. A preliminary equation was developed using stepwise multiple regression analysis with sex, height, weight, body mass index, fat-free mass, fat mass and counts per minute (CPM) as independent variables. Goodness-of-fit statistics were used to select the best prediction variables. The PRESS (predicted residual error sum of squares) statistical method was used to validate the final prediction equation. The preliminary equation was cross-validated on an independent group and no significant (p > 0.05) difference was observed in the PAEE estimated from the two methods. Independent variables of the final prediction equation (PAEE = [0.001CPM] − 0.112) accounted for 70.6% of the variance. The new equation developed to predict PAEE from accelerometry was found to be valid for use in Sri Lankan children.

Introduction: Nomophobia is becoming an increasing concern as a result of inappropriate use of electronic communication devices.Objectives: To describe the pattern of use of electronic communication devices and the prevalence of nomophobia among General Certificate of Education (GCE) Advanced Level (A/L) students in Colombo Educational Zone.Method: This descriptive cross-sectional study was carried out from January to March 2020 in six of the randomly selected government and government approved private schools within the Colombo Education Zone. A self-administered questionnaire including a culturally adapted nomophobia-questionnaire was used. Data were analysed using SPSS-20.Results: Of 337 students, 336 (99.7%) were regularly using a device for communication, the most preferred (n=319) being mobile phone; 213 owned a mobile phone; 60.4% were spending ≥2 hours/day with these devices, 10.1% spending >5 hours/day. Common uses of devices were listening to music (96.7%), taking photos (85.4%), sending text messages (84.8%) and academic activities (84.5%). Prevalence of moderate and severe nomophobia was 49.8% and 34.2% respectively. Prevalence of severe nomophobia was significantly higher in females (p<0.001) and those studying in grade 13 (p=0.036), government schools (p=0.002), Sinhala-medium (p=0.017) and Science stream (p=0.024).Conclusions: Among GCE A/L students in Colombo, Sri Lanka, 99.7% were regularly using a device for communication. Prevalence of moderate and severe nomophobia was 49.8% and 34.2% respectively.