The evolving evidence base for child protection in Chinese societies

Child maltreatment is a substantial public health problem worldwide. Although extensively studied in Western countries, until recently little systematic research had been published about the situation in the world's most populous nation and ethnic diaspora. In this review, we examine trends from community-based research with Chinese young people and parents in mainland China, Hong Kong SAR, Taiwan, Singapore, and Malaysia. It is clear that many Chinese adolescents experience a substantial burden from various forms of maltreatment and the psychological and behavioral correlates are similar to those found in other cultures. However, the research reveals a large gap between this reality and Chinese adults' perceptions about emotional, physical, and sexual abuse. Comprehensive awareness programs are needed to close this information gap and thereby mobilize support for prevention and care initiatives

Chinese Public Attitudes Toward Epilepsy (PATE) scale: translation and psychometric evaluation

None of the quantitative scale for public attitudes toward epilepsy was translated to Chinese language. This study aimed to translate and test the validity and reliability of a Chinese version of the Public Attitudes Toward Epilepsy (PATE) scale. Methods: The translation was performed according to standard principles and tested in 140 Chinese-speaking adults aged more than 18 years for psychometric validation. Results: The items in each domain had similar standard deviations (equal item variance), ranged from 0.85-0.95 in personal domain and 0.75-1.04 in general domain. The correlation between an item and its domain was 0.4 and above for all, and higher than the correlation with the other domain. Multitrait analysis showed the Chinese PATE had a similar variance, floor and ceiling effects, and relative relationship between the domains, as the original PATE. The Chinese PATE scale showed a similar correlation with almost all demographic variable except age. Item means were generally clustered in the factor analysis as hypothesized. The Cronbach’s α values was within acceptable range (0.773) in the personal domain and satisfactory range (0.693) in the general domain. Conclusion: The Chinese PATE scale is a validated and reliable translated version in measuring the public attitudes toward epilepsy

“Feeling Unsafe”: A Photovoice Analysis of Factors Influencing Physical Activity Behavior Among Malaysian Adolescents

Understanding the factors influencing physical activity (PA) in the Asia-Pacific region is critical, given the high prevalence of inactivity in this area. The photovoice technique explores the types of PA and factors influencing PA among adolescents in Kuching, Sarawak. A total of 160 photographs were collected from participants (adolescents, n = 22, mean age = 14.27 ± 0.7 years, and parents, n = 8, mean age = 48 ± 6.8 years). Data analysis used constant comparison methods of a grounded theory. The Analysis Grid for Environments Linked to Obesity was used to categorize PA factors. Study findings were centered on the concept of safety, facilities, parental restriction, friends, cultural traits, media, community cohesiveness, and weather. The central theme was “feeling unsafe” when being outdoors. To promote PA behavior, provision of PA facilities needs to be supported by other programs that build on peer support, crime prevention, and traffic safety, together with other educational campaigns

Business Category Classification via Indistinctive Satellite Image Analysis Using Deep Learning

Satellite image analysis has numerous useful applications in various domains. Extracting their visual information has been made easier using remote sensing and deep learning technologies that intelligently interpret clear visual cues. However, satellite information has the potential for more complex tasks, such as recommending business locations and categories based on the implicit patterns and structures of the regions of interest. Nonetheless, this task is significantly more challenging due to the absence of obvious visual cues and the highly similar appearance of each location. This study aims to analyze satellite image similarity between business class categories and investigate the capabilities of state-of-the-art deep learning models for learning non-obvious visual cues. Specifically, a satellite image dataset is constructed using business locations and annotated with the business categories for image structural similarity analysis, followed by business category classification via fine-tuning of deep learning classifiers. The models are then analyzed by visualizing the features learned to determine if they could capture hidden information for such a task. Experiments show that business locations have significantly high SSIM regardless of categories, and deep learning models only recorded a top accuracy of 60%. However, feature visualization using Grad-CAM shows that the models learn biased features and disregard highly informative details such as roads. It is concluded that typical learning models and strategies are insufficient to effectively solve this complex visual problem; thus, further research should be done to formulate solutions for such non-obvious classifications with the potential to support business recommendation applications

Physical Activity Among Adolescents in an East Malaysian Rural Indigenous Community: Exploring the Influence of Neighborhood Environmental Factors

This study explores the rural environmental factors that influence adolescents’ participation in physical activities (PA). Thirty-six indigenous adolescents, aged 13 to 17 years from rural communities of East Malaysia were involved in the photovoice procedures: photo-taking, selecting, contextualizing, and codifying themes. Despite being endowed with natural resources such as river, forest, hills, and so on, the adolescents and the community did not capitalize on these rich resources to promote and engage in PA. Poor maintenance of natural resources, the lack of pedestrian infrastructures and road safety, the lack of PA facilities, and negative perception of ancestors’ agricultural activities were among factors that constrained adolescents’ PA. Although basic amenities such as play spaces and pedestrian infrastructures are necessary to increase adolescents’ PA, any intervention should make the most of the natural resources, which are cheaper, environment friendly, and sustainable

Psychometric properties of instruments for measuring elder abuse and neglect in community and institutional settings:A systematic review

Abstract Background The psychometric properties of elder abuse measurement instruments have not been well‐studied. Poor psychometric properties of elder abuse measurement instruments may contribute to the inconsistency of elder abuse prevalence estimates and uncertainty about the magnitude of the problem at the national, regional, and global levels. Objectives The present review will utilise the COSMIN taxonomy on the quality of outcome measures to identify and review the instruments used in measuring elder abuse, assess the instrument's measurement properties, and identify the definitions of elder abuse and abuse subtypes measured by the instrument. Search Methods Searches will be conducted in the following online databases: Ageline, ASSIA, CINAHL, CNKI, EMBASE, Google Scholar, LILACS, Proquest Dissertation & Theses Global, PsycINFO, PubMed, SciELO, Scopus, Sociological Abstract and WHO Index Medicus. Relevant studies will also be identified by searching the grey literature from several resources such as OpenAIRE, BASE, OISter and Age Concern NZPotential studies by searching the references of related reviews. We will contact experts who have conducted similar work or are currently conducting ongoing studies. Enquiries will also be sent to the relevant authors if any important data is missing, incomplete or unclear. Selection Criteria All quantitative, qualitative (that address face and content validity), and mixed‐method empirical studies published in peer‐reviewed journals or the grey literature will be included in this review. Studies will be included if they are primary studies that (1) evaluate one or more psychometric properties; (2) contain information on instrument development, or (3) perform content validity of the instruments designed to measure elder abuse in the community or institutional settings. Studies should describe at least one of the psychometric properties, such as reliability, validity and responsiveness. Study participants represent the population of interest, including males and females aged 60 or older in community or institutional settings (i.e., nursing homes, long‐term care facilities, assisted living, residential care institutions, and residential facilities). Data Collection and Analysis Screening of titles, abstracts, and full texts of the selected studies will be evaluated based on the preset inclusion criteria by two reviewers. Two reviewers will be assessing the quality appraisal of each study using the COSMIN Risk of Bias checklist and the overall quality of evidence of each psychometric property of the instrument against the updated criteria of good measurement properties. Any dispute between the two reviewers will be resolved through discussions or consensus with a third reviewer. The overall quality of the measurement instrument will be graded using a modified GRADE approach. Data extraction will be performed using the data extraction forms adapted from the COSMIN Guideline for Systematic Reviews of Outcome Measurement Instruments. The information includes the characteristic of included instruments (name, adaptation, language used, translation and country of origin), characteristics of the tested population, psychometric properties listed in the COSMIN criteria, including details on the instrument development, content validity, structural validity, internal consistency, cross‐cultural validity/measurement invariance, reliability, measurement error, criterion validity, hypotheses testing for construct validity, responsiveness and interoperability. We will perform a meta‐analysis to pool psychometric properties parameters (where possible) or summarise qualitatively

PROTOCOL: In‐person interventions to reduce social isolation and loneliness: An evidence and gap map

Abstract This is the protocol for an evidence and gap map. The objectives are as follows: This EGM aims to map available evidence on the effects of in‐person interventions to reduce social isolation and/or loneliness across all age groups in all settings

ISPCAN Child Abuse Screening Tools Retrospective version (ICAST-R): Delphi study and field testing in seven countries

Objectives: To gain consensus among an ethnically and linguistically diverse group of international child protection experts on the structure and content of a new survey tool for retrospective measurement of child abuse, and to determine the performance of the instrument through an international field trial with young adults. Methods: The questionnaire was developed through focus group discussions with international experts, and then subjected to a Delphi study in two waves to determine the perceived importance and translatability of items. The resultant questionnaire was translated into six languages and field tested in seven countries with convenient samples of young adults aged 18–26 years (N = 842). Results: Child maltreatment experts from 28 countries provided input to questionnaire development. Satisfactory agreement on draft item inclusion and exclusion and the translatability of items was gained. The tool includes 15 primary questions about potentially abusive physical, sexual and emotional events, with follow-up questions about perpetrator characteristics, frequency of acts and periods in childhood when the recalled abuse occurred. The field test revealed lifetime prevalence per item usually exceeded 10% (11/15 items; range 2.1–49.5%). Internal consistency (Cronbach's alpha) was moderate to high for each of three item sub-sets (between .61 and .82) and the rates of missing data were low (less than 1.5% for 14 of 15 items). The great majority of respondents nominated either peer and/or adult perpetrators (between 82.3% and 98.2% depending upon the item), and among these, child/adolescent peers and non-family adults (including teachers for emotional and physical acts) were nominated often. Conclusions: The ICAST-R is based on consensus from international experts, translates clearly and has satisfactory properties for adoption as a survey tool to estimate prevalence and describe perpetrators and other contextual aspects of child abuse. Practice implications: This tool can be utilized in a broad range of cultures and languages and may contribute to improved research practice. Although the core items are limited to just 15 acts of maltreatment, if these behaviorally specific questions are adopted as key indicators and incorporated into comprehensive local, national or regional surveys, eventually there should be greater comparability in survey estimates

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030