24 h Activity Guidelines in Children and Adolescents: A Prevalence Survey in Asia-Pacific Cities.

This study aimed to examine the prevalence of adherence to 24 h activity guidelines in children and adolescents from Asia-Pacific cities. In 1139 children aged 5-18 years, moderate-to-vigorous physical activity (MVPA), screen viewing time (SVT), sleep duration, child weight, height, sex, and age were parent-reported. Descriptive statistics were used to assess the number of guidelines met, and prevalence of adherence to activity guidelines by city and child sex. Prevalence of meeting all three 24 h activity guidelines was low across all countries (1.8-10.3%) (p < 0.05). Children from Thiruvananthapuram, India had the highest [10.3% (95% CI: 6.0-17.0)], while those from Tokyo, Japan had the lowest prevalence [1.8% (95% CI: 0.5-7.0)] of meeting all three guidelines. The highest prevalence of meeting individual MVPA, SVT and sleep guidelines was found in India [67.5% (95% CI: 58.8-75.1)], Kelaniya, Sri Lanka [63.2% (95% CI: 58.7-67.4)] and Kowloon, Hong Kong [59.4% (95% CI: 51.1-65.3)], respectively. Overall, a higher prevalence of boys met all three guidelines, compared to girls [5.9% (95% CI: 4.1-8.1) vs. 4.7% (3.1-6.6), p = 0.32]. The prevalence of adhering to all three activity guidelines was low in all five participating cities, with a higher proportion of boys meeting all guidelines.

Adolescent suicide: characterizing the need and identifying the predictive factors for preventive consultation or hospitalization in a rural community setting.

BACKGROUND: Studies from India consistently document the highest suicide rates in the world, and the majority of completed suicides had been within adolescents. OBJECTIVE: To characterize the need and identify the predictive factors for preventive consultation or hospitalization for adolescent suicide in a community setting. SUBJECTS: We prospectively collected data from 500 adolescents in a rural South Indian community with independent, trained raters. METHODS: The need for suicide prevention was measured with the SAD PERSONS scale, socio-economic status with the Modified Kuppusamy Scale, depression and anxiety disorders with the Beck Depression Inventory and the Screen for Child Anxiety Related Emotional Disorders, respectively. The relationship between predictors and the need for preventive action was analyzed with univariate and multivariate regression analyses and a predictive model was built. RESULTS: Of those investigated, 2% and 0.6% required emergency consultation and hospitalization, respectively. Males needed more preventive action (p=0.04). Age (OR=3.40, p=0.07), gender (OR=3.13, p=0.05), presence of anxiety (OR=16.35, p=0.001), or depressive (OR=42.59, p=0.001) disorder independently predicted a need for protective action and, together, contributed to a parsimonious predictive model. CONCLUSIONS: The majority of adolescents in the community do not require preventive steps to address suicide risk. These predictors could identify the high-risk adolescents for suicide prevention and reduce the burden of care in the community.

Development and psychometric validation of the Brief Intellectual Disability Scale for use in low-health resource, high-burden countries.

OBJECTIVE: To develop and validate a concise, parent-completed Brief Intellectual Disability Scale (BIDS) for children in low-disability resource and high-disability care burden countries. STUDY DESIGN AND SETTING: In this prospective cross-sectional study of 124 children recruited from a facility for intellectual disability (ID), the newly developed BIDS as the measure for validation as well as for the gold standard and convergent and divergent validities was administered by independent raters. Tests for diagnostic accuracy, reproducibility, and validity were conducted at the item and scale levels. RESULTS: The BIDS scores of ≥5 (sensitivity [Sn] = 71.43%, specificity [Sp] = 80.95%) and ≥11 (Sn = 4.29%, Sp = 100%), with area under the curve of 0.79, are suggested, respectively, for screening and diagnostic use in Indian populations. The inter-rater reliability (intra-class correlation coefficient [ICC] = 0.96) and test-retest reliability at 4 weeks (ICC = 0.95) for BIDS are strong. Besides the adequate face and content validities, BIDS demonstrates good internal consistency (Cronbach α = 0.80) and item-total correlation. There is moderate convergent validity with Binet-Kamat Test of Intelligence or Gesell's Developmental Schedule (r = -0.66, P = 0.001) as well as with adaptive behavior measure of Vineland Social Maturity Scale (r =-0.52, P = 0.001) and low divergent validity with the subscales of Attention Deficit Disorder with Hyperactivity: Comprehensive Teacher Rating Scale ( r = -0.11, P = 0.7; r = 0.18, P = 0.5; r = 0.13, P = 0.6; r = 0.08, P = 0.7). An exploratory factor analysis demonstrated a three-factor structure, explaining 60% of variance. CONCLUSION: The BIDS shows promise as a psychometrically adequate, yet brief measure for identifying ID in countries with low disability care resources and high disability-related burden.