Objective This study aimed to assess the perceived impact of the COVID-19 pandemic on undergraduate psychiatry training in Sri Lanka and to explore several potentially associated factors. Methods An online survey was distributed among students from eight medical schools who recently faced their final exam. Their perceptions on the impact of the pandemic on the psychiatry training and exam performance were rated on a 10-point scale. Resilience was assessed using a two-item scale. Results A total of 644 students responded (69.5% female, mean age=27.5 years). Among them, 164 (25.5%) reported being quarantined; 25 (4%) reported becoming infected with COVID-19; and 170 (28.6%) reported ward closure for over a week during the clerkship. Greater impact was reported for patient availability (mean=7.08), mental status assessments (mean=6.3), developing rapport (mean=6.2), and diagnostic skills (mean=5.9), whereas the impact on peer-learning (mean=5.5) and self-study (mean=3.6) was relatively lower. Impact on clinical components of the final exam (mean=6) was rated higher than on theory components (mean=4.5). The majority (70.3%) reported that COVID-19-related stress affected their exam preparations. Higher resilience predicted lower perceived impact on all aspects of training/exam performance. Female gender and ward closure predicted greater impact on diagnostic skills, overall training, and clinical exam performance, whereas being quarantined predicted greater impact on peer-learning and self-study. Conclusion The pandemic has significantly affected the undergraduate psychiatry training in Sri Lanka, particularly its clinical components. Increasing clinical exposure to patients, managing students’ stress, and building their resilience should be key concerns for medical educators during the pandemic.

Identifying and addressing the psychosocial needs and psychological distress of primary caregivers of children and adolescents with cancers is emerging globally as a component that should be incorporated into quality cancer care. The objective of this study was to describe the psychosocial needs, psychological distress, knowledge of caregiving, and associated factors among the primary caregivers of children and adolescents with cancers attending the leading cancer treatment center in Sri Lanka. A descriptive cross-sectional study was conducted among childhood cancer caregivers in the early post-diagnosis stage using a needs and knowledge assessment questionnaire and General Health Questionnaire-30. Associations were sought between variables by bivariate analysis and further multivariate analysis. Consecutively, emotional needs, financial needs, informational needs, practical needs, and need for family and social support were at the top of the unmet needs list. All study participants had at least one item of unmet psychosocial needs. A lower education level was significantly associated with higher unmet psychosocial needs (OR=4.990; CI=1.96-12.72). Almost all the primary caregivers were psychologically distressed (97.6 %; CI = 95.3% - 99.9%) during the early post-diagnosis period. Only 18% of caregivers had a good overall knowledge of childhood cancer caregiving. Good overall knowledge of childhood cancer caregiving was associated with low distress levels (OR =2.46; 95% CI= 1.04 – 5.83). Almost all primary caregivers of children and adolescents with cancers at the early stages of diagnosis were highly distressed and had multiple unmet psychosocial needs with poor awareness of caregiving.

Background Youth violence is a significant health issue mainly in low and middle-income countries (LMICs). Violence is growing among Sri Lankan youth, yet research addressing it has been almost non-existent. Various personal and environmental factors place youth at risk of violence. The present study aimed to identify the determinants of youth violence from the perspectives of students and key informants of a Sri Lankan technical college. Methods The current study used the participatory action research (PAR) approach. The study was conducted at a technical college in Matale district, Sri Lanka with a sample of 74 students. Participants were involved in developing the focus group discussion (FGD) guide and key informant interview (KII) guide, which were the methods of data collection. Four FGDs and seven KIIs were conducted until data saturation was achieved. Thematic analysis was used in the data analysis. Participants were engaged and involved in the data collection and analysis where necessary in line with the PAR principles. Results The determinants of youth violence identified in the current study are presented under five themes: 1. individual-level determinants, 2. family-level determinants, 3. school-level determinants, 4. determinants specific to the technical college, and 5. societal-level determinants. Individual-level determinants reported by participants included poor awareness, inability to bear being defeated, frequent victimization, unemployment, psychological stress, and substance abuse. Family-level determinants reported were poor parental affection, guidance and parenting skills, distorted family connections and family disruption, pressure on education, witnessing domestic violence as a child, and discrimination within the family. School-level determinants included school dropouts, peer influences, discrimination at school, and the competitive education system. Furthermore, participants described subculture and diversity among students as determinants specific to the technical college. Societal-level determinants identified by participants included social discrimination, disadvantage, disparity and inequity, increase in the requirements and change in the goals of youth, justification, glamorization and normalization of violence, gaps in law enforcement, socio-political instabilities and the rise of inflation. Conclusions The PAR approach facilitated the identification of a variety of individual, family, school, and societal-level determinants of youth violence which may contribute to addressing violence in tertiary education institutes in Sri Lanka and other LMICs.

Background Youth violence is a global public health issue and the highest rates are reported in Low and Middle-Income Countries (LMICs). Higher rates of youth violence are reported in Sri Lanka as well. Students who fail to continue higher studies in schools or enter the universities in Sri Lanka, enroll in technical colleges and are associated with a higher number of risk factors of violence. This study aims to empower youth (15–29 years old) of a technical college in Matale district, Sri Lanka, to carry out activities among themselves to improve their knowledge, change perceptions, and violence-related behaviours. Methods The Participatory Action Research (PAR) approach will be used. The study participants will be eighty students in a technical college in Matale district, Sri Lanka. The study period will be three years. Study participants will also be collaborators and they will involve actively in all stages of the study. A health promotion intervention will be implemented to identify determinants of youth violence and to design and implement actions while monitoring the changes. The data will be collected mainly through focus group discussions and key informant interviews both before and after the health promotion intervention. Additionally, a self-administered questionnaire will be used and the principal investigator will maintain a reflective diary. The qualitative data will be analysed thematically whereas quantitative data will be analysed using descriptive statistics. Data will be triangulated to increase the rigour of the study. Discussion According to literature, PAR is not widely used in health promotion. The enabling and empowerment goals of health promotion are fulfilled in PAR. Thus, this will be a novel experience for researchers and this will stimulate discussion on the combination of PAR and health promotion. This study design itself promotes active participant involvement and it may generate effective youth-led, culturally appropriate actions to address youth violence. The findings will describe what works and why it works and will help Sri Lanka and similar LMICs to create safe environments for youth in educational institutes or training colleges.

Diagnosis of childhood cancer significantly changes the lives of those children and their family members. A family caregiver plays a significant role in providing most of the care to their ill patient, in addition to the care provided by the health staff. Identifying and addressing these psychosocial needs of primary caregivers (PCG) of children and adolescents with cancers (CAAWC) is emerging globally as a component that should be incorporated into quality cancer care.This study aimed to describe the psychosocial needs of primary caregivers of childhood cancer patients at the National Cancer Institute, Maharagama (Apeksha Hospital at present), in Sri Lanka.Method-A qualitative study through Focus Group Discussions (FGD) was conducted among primary caregivers of children and adolescents with cancer at the main Cancer treatment center in Sri Lanka. Data were transcribed verbatim, translated to English, and analyzed using thematic analysis.Results -Twenty-two PCGs participated for FGDs, and saturation point was reached by the fourth discussion. PCGs of CAAWC described their psychosocial needs at the time of the discussion and the emerged themes which could be identified during the analysis echoed the psychosocial needs already known in the literature as follows; Financial needs, Emotional needs, Informational needs, Social needs, and Practical needs. In addition, caring for the siblings emerged as a new category which is usually grouped under practical needs. Conclusion -Almost allPCGs of CAAWC in Sri Lanka, who were at the early stages of diagnosis had multiple unmet psychosocial needs, which required the early attention of health care professionals.