COVID-19 effects on public finance and SDG priorities in developing countries : comparative evidence from Bangladesh and Sri Lanka
- Authors: Colombage, Sisira , Barua, Suborna , Nanayakkara, Madurika , Colombage, Udari
- Date: 2023
- Type: Text , Journal article
- Relation: European Journal of Development Research Vol. 35, no. 1 (2023), p. 85-111
- Full Text:
- Reviewed:
- Description: The COVID-19 pandemic, an unprecedented global health crisis, rapidly transferred into a global economic and social crisis. The pandemic has threatened the world’s commitment to achieve Sustainable Development Goals (SDGs) by 2030 as governments in developing countries have shifted their priorities from attaining SDGs, to providing urgent financial needs to save lives and prevent recession in hopes for a rapid economic recovery. The rerouting of public funding priorities has undermined the progress and achievement of SDGs. We employed a mixed-method and carried out a comparative study using pre- and post-public financial data of two developing countries in South Asia; Bangladesh and Sri Lanka. A threefold analysis was conducted to investigate the evolution of the COVID-19 pandemic in two countries, the impact of the pandemic on external and internal public finance and the effect of the pandemic in shifting the policy priorities from SDGs to economic survival. This study found that both countries are highly vulnerable to the COVID-19 pandemic and are suffering from the lack of financing from external sources through the private sector as well as an increasing foreign debt. There is mounting pressure on the fiscal balance in both countries. © 2022, The Author(s).
Experiences of pelvic floor dysfunction and treatment in women with breast cancer: a qualitative study
- Authors: Colombage, Udari , Lin, Kuan-Yin , Soh, Sze-Ee , Brennen, Robyn , Frawley, Helena
- Date: 2022
- Type: Text , Journal article
- Relation: Supportive care in cancer Vol. 30, no. 10 (2022), p. 8139-8149
- Full Text:
- Reviewed:
- Description: Purpose To explore the experiences of women with breast cancer and pelvic floor (PF) dysfunction and the perceived enablers and barriers to uptake of treatment for PF dysfunction during their recovery. Method Purposive sampling was used to recruit 30 women with a past diagnosis of breast cancer and PF dysfunction. Semi-structured interviews were conducted, and data were analysed inductively to identify new concepts in the experiences of PF dysfunction in women with breast cancer and deductively according to the capability, opportunity, motivation and behaviour (COM-B) framework to identify the enablers and barriers to the uptake of treatment for PF dysfunction in women with breast cancer. Results Participants were aged between 31 and 88 years, diagnosed with stages I–IV breast cancer and experienced either urinary incontinence ( n = 24/30, 80%), faecal incontinence ( n = 6/30, 20%) or sexual dysfunction ( n = 20/30, 67%). They were either resigned to or bothered by their PF dysfunction bother was exacerbated by embarrassment from experiencing PF symptoms in public. Barriers to accessing treatment for PF dysfunction included a lack of awareness about PF dysfunction following breast cancer treatments and health care professionals not focussing on the management of PF symptoms during cancer treatment. An enabler was their motivation to resume their normal pre-cancer lives. Conclusion Participants in this study reported that there needs to be more awareness about PF dysfunction in women undergoing treatment for breast cancer. They would like to receive information about PF dysfunction prior to starting cancer treatment, be screened for PF dysfunction during cancer treatment and be offered therapies for their PF dysfunction after primary cancer treatment. Therefore, a greater focus on managing PF symptoms by clinicians may be warranted in women with breast cancer.
The feasibility of pelvic floor training to treat urinary incontinence in women with breast cancer : a telehealth intervention trial
- Authors: Colombage, Udari , Soh, Sze , Lin, Kuan-Yin , Kruger, Jennifer , Frawley, Helena
- Date: 2023
- Type: Text , Journal article
- Relation: Breast Cancer Vol. 30, no. 1 (2023), p. 121-130
- Full Text:
- Reviewed:
- Description: Purpose: To investigate the feasibility of recruiting into a pelvic floor muscle training (PFMT) program delivered via telehealth to treat urinary incontinence (UI) in women with breast cancer on aromatase inhibitors. Methods: We conducted a pre-post single cohort clinical trial with 54 women with breast cancer. Participants underwent a 12-week PFMT program using an intra-vaginal pressure biofeedback device: femfit®. The intervention included eight supervised individual PFMT sessions over Zoom™ and a 12-week home exercise program. The primary outcome of this study was feasibility, specifically consent rate. Secondary outcomes which included prevalence and burden of UI measured using the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF), and pelvic floor muscle (PFM) strength measured as intravaginal squeeze pressure were compared using McNemar’s and paired t tests. Results: The mean age of participants was 50 years (SD ± 7.3). All women who were eligible to participate in this study consented (n = 55/55, 100%). All participants reported that the program was beneficial and tailored to their needs. The results showed a statistically significant decline in the prevalence (percentage difference 42%, 95% CI 28, 57%) and burden (ICIQ-UI SF score mean change 9.4, 95% CI 8.5, 10.4) of UI post intervention. A significant increase in PFM strength was observed post-intervention (mean change 4.8 mmHg, 95% CI 3.9, 5.5). Conclusion: This study indicated that PFMT delivered via telehealth may be feasible and potentially beneficial in treating stress UI in women with breast cancer. Further studies such as randomized controlled trials are required to confirm these results. © 2022, The Author(s).
Factors associated with pelvic floor dysfunction in women with breast cancer
- Authors: Colombage, Udari , Soh, Sze-Ee , Lin, Kuan-Yin , Vincent, Amanda , White, Michelle , Fox, Jane , Frawley, Helena
- Date: 2022
- Type: Text , Journal article
- Relation: Continence Vol. 2, no. (2022), p.
- Full Text:
- Reviewed:
- Description: Purpose: To determine the prevalence of pelvic floor (PF) dysfunction according to breast cancer characteristics and examine the association between breast cancer characteristics and the prevalence, distress and impact of PF dysfunction in women with breast cancer. Outcome measures: The Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire were used to quantify the prevalence, distress and impact of PF dysfunction. Results: Data from 120 women with breast cancer were included in this analysis. Women who underwent chemotherapy experienced the highest rates of UI (n=23/29; 79%) and FI (n=7/29; 24%). The associations between breast cancer characteristics and the presence of pelvic floor dysfunction were not statistically significant. Being older (
Pelvic floor muscle function in women with and without breast cancer : a cross-sectional study
- Authors: Colombage, Udari , Soh, Sze-Ee , Lin, Kuan-Yin , Frawley, Helena
- Date: 2023
- Type: Text , Journal article
- Relation: Continence Vol. 5, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Introduction: The aim of this study was to quantify PF muscle function in women with and without breast cancer using pressure manometry, digital palpation and transperineal ultrasound. Methods: This cross-sectional study included women with and without breast cancer. The primary outcome was PF muscle strength measured as maximal squeeze pressure (cmH2O). Differences between groups were analysed using independent t-tests or chi-square tests. Results: The group with breast cancer was older (mean age: 54 years) than the group without breast cancer (mean age: 38 years, p<0.0001). Participants with breast cancer had significantly weaker PF muscles as measured by maximal squeeze pressure (breast cancer group: mean 18 cmH2O, 95% CI 15, 21; control group: mean 29 cmH2O, 95% CI 27, 32; p<0.0001) and digital examination (strength rated as weak: 30% in participants with breast cancer compared to 9% in control group, p=0.0167). Relaxation ability was poorer in participants with breast cancer than control group participants (p=0.0039). Conclusion: Our cohort of women with breast cancer demonstrated reduced PF muscle strength and poorer relaxation ability compared to those without breast cancer. This finding suggests that therapies such as PF muscle training or relaxation techniques may be therapeutic targets to improve PF muscle function. © 2023 The Author(s)