Face, content, criterion and construct validity assessment of a newly developed tool to assess and classify work-related stress (TAWS- 16).

INTRODUCTION: As work-stress, is associated with Non Communicable Diseases, and decreased work productivity, health and economic benefits are expected from periodic work-stress screening among employees using valid and reliable tools. Tool to Assess and classify Work Stress (TAWS- 16) was developed to overcome limitations in existing work-stress assessment tools in India. This study aims to test face, content, criterion and construct validity of TAWS- 16 in a sample of managerial-supervisory employees. METHODS: Nine domain experts rated face and content validity of TAWS- 16. Content validity was measured by Content Validity Indices (I-CVI, S-CVI) and Modified Kappa statistics. Empirical validity was tested by analysing data reported from 356 Information Technology (IT) professionals wherein Exploratory Factor Analysis was conducted for the assessment of Construct Validity. Self-reported data was collected in an unlinked and anonymous manner using a web-link, which was emailed to the study subjects, after initial introductory telephone or personal conversation. Criterion Validity was tested against stress sub-scale of DASS- 21. This study was approved by NIMHANS ethics committee. RESULTS: Findings revealed that TAWS- 16 has good face validity. The content validity is acceptable (CVI = 0.829). Construct Validity is appropriate as 60.8% of the total variance was explained by the factors identified in our study. Criterion Validity was moderate (Kappa Value 0.208) due to inappropriate work-stress instrument for comparison with TAWS- 16. CONCLUSIONS: Overall, TAWS- 16 demonstrated good face, content and construct validity. It measures work-stressors, coping abilities and psycho-somatic symptoms associated with work-stress. We recommend use of TAWS- 16 for periodic screening and classification of work-stress among employees.

Profile of two hundred children with Autism Spectrum Disorder from a tertiary child and adolescent psychiatry centre.

BACKGROUND: There is a recent trend of increase in diagnosis of Autism Spectrum Disorder in India. Till date, there are few retrospective and prospective Indian studies with limited sample sizes ranging from 16 to 94 children. With this background, we planned a retrospective chart review of all new cases of Autism Spectrum Disorder for a period of 1 year in our tertiary care child psychiatry centre. METHODOLOGY: Objectives of this study were to compare the sociodemographic and clinical profile of children below and above 3 years of age and between those who were self-referred versus those referred by professionals. RESULTS: Out of a total of 1957 case records, 201 children (10.3%) were diagnosed with Autism Spectrum Disorder. Male to female ratio was 4:1.2. Mean age of consultation was significantly higher in males. Seventy six percent had a comorbid disorder with Intellectual disability, Attention Deficit Hyperactivity Disorder and Epilepsy being the most common comorbidities. Most caregivers (92.5%) recognized symptoms by 3 years of age. Presenting complaint of poor social response was more prevalent in children <3 years and co-morbidities in children above 3 years. Presenting complaint of speech delay was more common in children who were referred by professionals when compared with those who were self-referred. DISCUSSION: There is a need to sensitize parents and professionals for early intervention and to standardize protocols for assessment and intervention.

Chronic diseases and injuries in India.

Chronic diseases (eg, cardiovascular diseases, mental health disorders, diabetes, and cancer) and injuries are the leading causes of death and disability in India, and we project pronounced increases in their contribution to the burden of disease during the next 25 years. Most chronic diseases are equally prevalent in poor and rural populations and often occur together. Although a wide range of cost-effective primary and secondary prevention strategies are available, their coverage is generally low, especially in poor and rural populations. Much of the care for chronic diseases and injuries is provided in the private sector and can be very expensive. Sufficient evidence exists to warrant immediate action to scale up interventions for chronic diseases and injuries through private and public sectors; improved public health and primary health-care systems are essential for the implementation of cost-effective interventions. We strongly advocate the need to strengthen social and policy frameworks to enable the implementation of interventions such as taxation on bidis (small hand-rolled cigarettes), smokeless tobacco, and locally brewed alcohols. We also advocate the integration of national programmes for various chronic diseases and injuries with one another and with national health agendas. India has already passed the early stages of a chronic disease and injury epidemic; in view of the implications for future disease burden and the demographic transition that is in progress in India, the rate at which effective prevention and control is implemented should be substantially increased. The emerging agenda of chronic diseases and injuries should be a political priority and central to national consciousness, if universal health care is to be achieved.