Caring for stroke survivors: experiences of family caregivers in Sri Lanka – a qualitative study

Background: Stroke is a life-changing event for both stroke survivors and their family caregivers. After receiving acute care at the hospital, family members are expected to take care of stroke survivors at home and to continue treatment and rehabilitation. The new role of “informal caregiver” is a challenge that creates many difficulties for family caregivers that are not explicit in the Sri Lankan context.

Objectives: This study aimed at exploring family caregivers’ experiences of providing informal care for dependent stroke survivors.

Methods: The sample was chosen by purposive sampling with a maximum variation by age, ethnicity, religion, educational level, relationship, and monthly income. Ten informal family caregivers to stroke survivors with hemiplegia who had been treated at the National Hospital of Sri Lanka participated in in-depth interviews analyzed using conventional content analysis.

Results: Qualitative content analysis of data resulted in an overriding theme, “Caring with love, against all odds,” along with four categories, “Life alterations,” “Lack of resources,” “Compassionate care,” and “Coping strategies.” Although the increased workload, restricted social life, physical problems, and knowledge and financial deficits were challenging for the family caregivers, self-strength and supportive social networks helped them to compassionately care for their stroke survivor.

Conclusions: The phenomenon of family caregivers providing informal care for stroke survivors was explicated as compassionate care, notwithstanding numerous difficulties. The findings motivate further research and strategies to minimize family caregivers’ burden and facilitate the positive aspects of caregiving to promote the health and well-being of both stroke survivors and their families.     

A case of endogenous candida endophthalmitis with incidental cytomegalovirus infection and optic neuropathy in a patient recovered from severe COVID-19

A 62-year-old female diabetic recovered from COVID-19 pneumonia after receiving a prolonged course of steroids. She presented with a clinical picture of left-eye panuveitis with white cotton ball chorioretinal lesions and RAPD suggesting an optic neuropathy (VA HM). Diagnostic vitrectomy was performed to take samples for infective screen and to give intravitreal voriconazole empirically. Smear, culture, and PCR for viral DNA confirmed mixed infection of endogenous Candida endophthalmitis and incidental CMV infection. With further treatment, her corrected vision improved to 6/18 with regressing fungal lesions in serial fundus photographs. Prompt diagnosis and intervention preserved her vision and prevented potential life-threatening complications.     

Permanent Deformation and Rutting Resistance of Demolition Waste Triple Blends in Unbound Pavement Applications

Virgin quarried materials are becoming increasingly scarce in our environment, and these materials are no longer a viable or economical solution for the construction industry. The construction industry is constantly seeking new markets for recycled waste in civil engineering applications. This research’s primary focus is the optimization of the usage of recycled materials such as recycled glass (RG), crushed brick (CB), and crushed concrete (CC), in pavement base/sub-base applications. Various percentages of RG, up to 40%, were blended with two types of CC in this research. The CC and CB, which were used as triple blends in this research, were utilized for the upper (100% CC) and lower sub-bases (up to 50% CB). This study sought to establish the maximum amount of RG that could be incorporated in the triple blends with CB and CC whilst maintaining an acceptable performance. Thus, a comprehensive series of fundamental and advanced geotechnical laboratory tests, including repeated load triaxial (RLT) and wheel-tracker (WT) tests, were performed to assess the engineering properties and permanent deformation characteristics of these triple blends. The particle-size distribution curve and California Bearing Ratio (CBR) values of all the blends met the minimum requirements. Results of RLT tests confirmed that all the nominated blends were found to provide the resilient modulus value required to be used as pavement materials. The WT results on the triple blend with 15% RG showed that the specimen performed exceptionally well during the test and comfortably met the requirements to be used in pavement applications. Based on the engineering properties and permanent deformation results, up to 15% RG can be suggested for incorporation as an accompanying material in unbound roadwork applications. Subject to the outcomes of future field testing, there might be potential to increase the percentage of RG added in the blends up to 30%.