Building youth and family resilience for better mental health: developing and testing a hybrid model of intervention in low- and middle-income countries.

Resilience is a dynamic, multi-level, multi-systemic process of positive adaptation at the individual, family and community levels. Promoting resilience can be a cost-effective form of preventive and early intervention, offering significant health advantages for young people throughout their lives. Developing resiliency interventions for youth and their families in low- and middle-income countries (LMICs), particularly in the context of the ongoing pandemic, is especially important given a lack of services and trained specialists, and poor levels of public spend on mental health, alongside marked and clustered psychosocial disadvantages and adverse childhood experiences. We propose a 'hybrid' model targeting 10- to 17 year-old children and their families, and options to engage through communities, schools and the family unit. These options will enhance individual and family resilience, and possibly buffer against adversity. The adaptations respect cultural and health beliefs, take account of structural drivers of inequalities and are suitable for LMICs.

Inter-observer agreement in the radiographic interpretation of Demirjian's developmental stages in the mandibular second and third molars - A comparative study.

Background: The developmental stages of the teeth in the radiographs are graded on an ordinal scale. The present study was conducted using 123 digital orthopantomograms from individuals in the age group of 5 to 22 years and to analyze and evaluate the inter-observer agreement in grading the developmental stages of second and third molars. Four observers with different levels of practical experience in age estimation participated in the study. The development stages of both the molars in the lower left quadrant (3rd quadrant) were assigned based on the Demirjian's 10 stage chart. The percentage agreement and Kappa statistics were used to test the agreement between the observers. The data of the observer 1 were used as the standard for the comparison. RESULTS: There was 70.0%-75.6% agreement among the observers in staging second molar and 52%-68.3% for the third molars. There was an excellent agreement (k > 080) between observer 1 and observer 2 and a good agreement (k = 060-0.79) between observer 1 and the other two observers for both the molars. The Fleiss Kappa revealed moderate to a good overall agreement for both the molars (k = 0.51-0.66). The Freidman's test revealed a significant difference in the grading of third molars between all the raters (χ2= 25.02, df 3, P < 0.001) and for the second molar the difference was not significant (χ2= 3.89, df 3, P > 0.05). The stage-wise overall agreement was fair for Stage 3 in the second molar and Stage 9 and Stage 4 in the third molar. Conclusions: In conclusion, proper training in the radiographic interpretation of developmental stages may minimize the errors during the age estimation methods.