Introduction Chronic kidney disease of unknown aetiology (CKDu) is prevalent in the North Central Province (NCP) of Sri Lanka and ingestion of dug well water is considered a potential causative factor. Three CKDu prevalent villages were selected from the NCP based on the number of CKDu patients in the locality.

Background and Objective: Assertiveness is a crucial skill in the nursing profession to reinforce interprofessional relationships, prevent workplace violence, reduce work stress, improve professional efficacy, develop leadership skills, autonomy and job satisfaction. Assertiveness when inculcated among nursing students will immensely contribute to their professional development and a sustainable career. Since no standard tools are available to measure assertiveness among Sinhala speaking students, this study is aimed to cross-culturally adapt the Sinhala version of Begley and Glacken's Assertiveness Scale among nursing students in Sri Lanka.Methods: Permission to translate, cross-culturally adapt and use the 28-item Begley and Glackens' Assertiveness Scale were obtained from its developers. The content and consensual validity of translated version was assessed with a two round Delphi process using five experts and a consensus evaluation. If 70% or more of the ratings for an item are in categories 0-3 the item was removed or reworded. The process was repeated for the reworded items and those were retained if 70% or more of the ratings were in categories 4-6 and /or 7-9. Subsequently, Content Validity Index (CVI) was evaluated using I-CVI, Universal Agreement (S-CVI/UA) and Average CVI (S-CVI/Ave). Finally, the scale's reliability was evaluated using Cronbach's alpha in a randomized sample of 140 nursing undergraduates from the University of Colombo.Results: All the items in category 4-6 and 7-9 were retained. Sinhala version of the assertiveness scale showed maximum CVI of all individual items (I-CVI=1.0) and maximum overall CVI (S-CVI/UA = 1.0; S-CVI/Ave = 1.0). The reliability analysis indicated Cronbach's alpha of 0.753. Conclusions:The Sinhalese version of the Begley and Glacken's assertiveness scale is a culturally adapted, valid and reliable instrument to measure assertiveness among nursing students.

BackgroundIschaemic Heart Disease (IHD) is a major constituent of cardiovascular disease in the world at present and has become the leading cause of death in Sri Lanka. Poor adherence to medication in IHD is related to increased re-hospitalisation and mortality. Therefore, continuous assessment of medication adherence is extremely important among these patients. The Morisky Green Levine Medication Adherence Scale (MGLS) is a widely used instrument to evaluate medication adherence in the clinical setting. The study aimed to translate the MGLS into Sinhala and cross-culturally adapt it to the Sri Lankan setting. Methods A Delphi process was conducted with a panel of experts where content and consensual validity of the scale was assessed after translation, back translation and pre-testing of the original scale. The ratings received from the first round of the Delphi process were noted and the amended translation re-sent for a second round. The re-ratings were evaluated for the degree of consensus and Items for the MGLS Sinhala version were chosen based on the following criteria: (i) the item was reworded or removed if 70% or more of the re-ratings were in category 0-3. If reworded, the Delphi Process was repeated for that item, (ii) the item was kept with no change if 70% or more of the re-ratings were in categories of 4-6 and 7-9. Results No items were removed from the original scale. Some items were reworded according to the experts' suggestions to retain the conceptual meaning when translated into Sinhala. The Sinhala version of the MGLS exhibited adequate content and consensual validity. ConclusionThe Sinhala version of the MGLS can be used in research, medication adherence evaluations and IHD prevention programmes in Sri Lanka.

This article discusses some novel approaches that can be implemented in Sri Lanka to upgrade its nursing education to meet global challenges. Globally, employers look for nursing professionals who possess competencies compatible with the new demands of the global healthcare system. Therefore, it has become necessary to upgrade nursing education to broaden its scope, and provide more exceptional patient care and job satisfaction. The relevant literature for the article was gathered from the Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed and Google Scholar. The search was restricted to the English language and 2020 as the year of publication. Health professionals in the field were also interviewed for their opinion on improving the Sri Lankan nursing curriculum. Enhancing nursing education is one of the best investments a country can make towards a quality healthcare system. Training is crucial. The implementation of new approaches to nursing education will standardize and develop the quality of nursing professionalism in Sri Lanka.

Justification for the selection of water sources for the study Questionnaire based study was performed in two Medical Officer of Health (MOH) areas in North Central Province (NCP) namely, Dimbulagala and Medirigiriya in order to select suitable water sources. Previous investigations carried out by health authorities using dipstick method revealed that high microalbuminuria and these areas were identified as CKDu prevalent. Other causative factors such as diabetes mellitus, high blood pressure etc. were excluded in these investigations. Each MOH area comprised of Public Health Inspectors areas of New Town Medirigiriya (NTM) and Bisobandaragama (BB) from Medirigiriya and Divuldamana (DD) from Dimbulagala. People were questioned in order to identify whether they have CKDu patients in their families identified by health authorities, their regular water source, depth of their wells and number of years of consumption of water and boiled and unboiled water and nature of consumed water. One hundred and thirty nine families were recruited to the study and according to the questionnaire based study, 23 families were identified as affected and of them, 9 families were from New Town Medirigiriya and 9 families from Bisobandaragama Medirigiriya whilst 5 families were from Divuldamana, Dimbulagala [1]. Wells were selected considering number of CKDu patients in the locality or close proximity to the locality in the selected villages [2]. According to questionnaire based study there was a significant association between number of years of consumption of water and development of CKDu [2]. Water from Colombo was used as a control from a low CKDu disease prevalence area based on scientific evidence. A previous study by Gunarathne et al among This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.