Effectiveness of educational interventions on knowledge and behavioral practices of adolescents for prevention of noncommunicable diseases in low- and middle-income countries: A systematic review protocol

Introduction: The rising burden of noncommunicable diseases (NCDs) is a dominating public health crisis, globally causing 38 million of 57 million deaths annually, with 85% of these deaths occurring in low- and middle-income countries (LMICs). However, while addressing NCDs, adolescents have been largely overlooked, who have a notable share in the NCD burden globally. Adolescents are vulnerable for developing high-risk behaviors, which puts them at high risk of NCDs such as ischemic heart diseases, diabetes, and stroke. Objective: The objective of this systematic review will be to identify the effectiveness of educational interventions on the knowledge and behavioral practices of adolescents for the prevention of NCDs in LMICs. Methodology: Five electronic databases such as PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Embase, and Scopus will be utilized for generating pooled evidence. Two reviewers will individually screen the titles and abstracts for eligibility, and in case of any disagreement, the help of a third reviewer will be taken. Recognized studies will be critically appraised for methodological quality using the Cochrane risk-of-bias tool. Data will be extracted from the studies included in the review for author's name, year of study, study setting, study design, study participants and their age, sample size in the intervention group, NCD domain covered by the study intervention, intervention details, measure of outcome, etc. For data synthesis, studies will be pooled using RevMan software and effect sizes will be depicted using forest plots. The Grading of Recommendations, Assessment, Development, and Evaluation approach to grade the certainty of evidence will be followed for assessing the quality of evidence. Publication bias will also be checked using funnel plots and Egger's test. Clinical Relevance: To the best of our knowledge, this will be the first systematic review that will assess the empirical evidence and evaluate the effectiveness of educational interventions for the prevention of NCDs among adolescents of LMICs. This review will assist the public health experts and policymakers in designing effective intervention for preventing NCDs among adolescents. Results and Conclusion: The results of this systematic review will provide an in-depth insight of the existing country-specific educational policies and interventions for the prevention of NCDs among adolescents in various LMICs. This will help in the replication of such cost-effective educational models or interventions in other LMICs followed by advocacy in their school policy reforms and other related programs focusing on NCDs

Supplementary_table - A Comparison of Spastic Diplegia in Term and Preterm-Born Children

<p> Supplementary_table for A Comparison of Spastic Diplegia in Term and Preterm-Born Children by Prashant Jauhari, Pratibha Singhi, Naveen Sankhyan, Prahbhjot Malhi, Sameer Vyas, and Niranjan Khandelwal in Journal of Child Neurology </p

Development and validation of DSM-5 based diagnostic tool for children with Autism Spectrum Disorder.

Diagnostic and Statistical Manual of mental disorder-IV (DSM-IV) TR based INCLEN Diagnostic Tool for Autism Spectrum Disorder (INDT-ASD) is an established instrument for the diagnosis of ASD in Indian subcontinent and low-middle income countries (LMIC). The introduction of DSM-5 necessitated revision of existing INDT-ASD tool to incorporate the DSM-5 related changes. This study was undertaken to develop and validate the DSM-5 based All India Institute of Medical Sciences (AIIMS)-Modified-INDT-ASD Tool. The modifications were done using Delphi method and included: (a) rearrangement of questions from the previous tool; and (b) addition of new questions on sensory symptoms. The modified tool was validated against DSM-5 diagnostic criteria. In addition, receiver operating characteristic (ROC) curves were used to determine the cut-off for total score as compared to Childhood Autism Rating Scale (CARS) score to grade the severity of ASD. Two-hundred-twenty-five children (159 boys, median age = 47months) were enrolled. The modified tool demonstrated sensitivity of 98.4% and specificity of 91.7% to diagnose ASD. A score ≥14 on the tool was suggestive of severe ASD (CARS>36.5) with a sensitivity and specificity of 80% and 80.7% respectively [Area under the curve = 0.89]. AIIMS-Modified-INDT-ASD Tool is a simple and structured instrument based on DSM-5 criteria which can facilitate diagnosis of ASD with acceptable diagnostic accuracy