Effectiveness of Peer-Led Education on Knowledge and Attitude among Adolescents regarding Road Safety.

Background and Objective: Children and adolescents are the most vulnerable groups for road traffic injuries in India (39%). Hourly, forty youngsters die in road traffic crashes. Road safety education aims at reducing this burden. Peer-led education (PLE) is a credible approach influencing students to modify their behavior positively. This study aimed to evaluate the effectiveness of PLE in terms of knowledge and attitude toward road safety among adolescents. Methodology: A single-group pretest-posttest design among 113 adolescents was conducted using a two-stage sampling technique. Ten selected and trained student peers provided PLE on road safety to 103 fellow students using a teaching aid. Effectiveness of PLE on knowledge and attitude was assessed pre- and postintervention. Results: Post PLE, the mean knowledge score of subjects increased from 10.5 to 17.5 with a significant mean difference of -6.9 (P < 0.001). The mean attitude score of subjects had increased from 46.7 to 48.1. A positive statistically significant correlation (P = 0.04) between knowledge and attitude and associations between certain sociodemographic variables were noted. Conclusion: Knowledge and attitude of subjects regarding road safety improved after PLE. Innovative teaching methods can be used to promote healthy behaviors among adolescents.

Effect of Nutritional Supplementation on Illness Outcome in Adolescents with HIV on HAART: A Randomized, Double-Blind Clinical Trial.

OBJECTIVE: To assess the effect of macronutrient and micronutrient supplementation on body mass index (BMI), hemoglobin (Hb), CD4 count, triglyceride levels, and morbidity among adolescents with human immunodeficiency virus (HIV) living in India. METHODS: A prospective, randomized, double-blinded, placebo-controlled trial was conducted among 80 adolescents (10-19 y) with HIV on highly active antiretroviral therapy (HAART) for a minimum of 6 mo using simple randomization. Participants in the intervention arm received 400 kcal and 15 g protein as a powder daily and multivitamin tablets thrice weekly for 3 mo. Those in the placebo arm received a similar-appearing sachet containing 100 kcal and 2 g protein daily and a placebo tablet thrice weekly. Weight, height, BMI, Hb, CD4 count, triglycerides, and number of intercurrent illnesses were measured at 3 and 6 mo. RESULTS: At 6 mo, the intervention group showed an increase in weight from 36.4 ± 10.9 kg to 39.7 ± 8.5 kg and a significant increase in BMI from 16.6 ± 2.3 kg/m2 to 17.5 ± 2.3 kg/m2. Increase in CD4 count in the placebo arm was more than that in the intervention arm, but the difference between the arms was not statistically significant. Intervention group showed a pronounced rise in Hb from 9.7 ± 2.3 g/dL to 11.4 ± 1.6 g/dL, significant reduction in triglyceride levels from 99.2 ± 92.7 mg/dL to 81.0 ± 12.8 mg/dL and reduction in intercurrent illnesses from 32.5% to none. CONCLUSIONS: Nutritional supplementation of adolescents with HIV on HAART improves BMI, hemoglobin, and reduces triglyceride levels and intercurrent illnesses.

Clinical Profile of Adolescent Onset Anorexia Nervosa at a Tertiary Care Center.

OBJECTIVE: To study the clinical profile and outcome of adolescent onset anorexia nervosa at a tertiary care center in Southern India. METHOD: Review of hospital records of adolescents diagnosed with anorexia nervosa. Outcome was assessed for those with a follow-up of atleast one year, by outpatient visit or by a telephonic interview. FINDINGS: Data of 43 patients (28% males) with mean (SD) age at presentation of 13.4 (1.7) years were included. The mean (SD) BMI at presentation was 13.8 (3.2) kg/m2, the lowest being 8.3 kg/m2. 33 (76%) patients were hospitalized for nutritional rehabilitation. Of the 15 patients followed up 1-5 years later, one had died and 11 had achieved normal weight for age. CONCLUSIONS: As compared to other studies, this study showed a higher proportion of boys with anorexia nervosa. Further research is necessary to understand factors affecting long-term outcome.

Adolescent health in Asia: insights from India.

Adolescents living in the Indian subcontinent form a significant proportion of the general population. India is home to 236 million adolescents, who make up one-fifth of the total population of India. Adolescent health is gradually considered an important issue by the government of India. Awareness is increasing about adolescent needs. Health care professionals in particular are becoming more interested in the specific needs of adolescent age. Adolescent medicine as a subspecialty of pediatrics has also gained importance gradually over the last decade. In a hospital setting, adolescent-specific needs are met, albeit not in a uniform manner in all the health centers. After having been trained in adolescent medicine in India and abroad, I present this paper as a bird's eye view of the practice of adolescent health and medicine in India.

Eating disorders among adolescents in a tertiary care centre in India.

OBJECTIVE: To analyse the clinical profile of eating disorders (ED) among adolescent patients living in India. METHODS: This is a descriptive study of a series of seven adolescent patients presenting to a tertiary care centre with characteristic clinical features of eating disorder. RESULTS: Of the seven adolescents with ED there were 3 boys and 4 girls. Physical examination, psychiatric assessment and investigations confirmed the diagnosis of ED in all seven. Five adolescents were managed with nutritional rehabilitation and family based therapy as inpatients for about 3 wk. One was treated in the outpatient clinic and one was unwilling for treatment. Four patients who had strong family support recovered, 1 had minimal weight gain and 2 were lost to follow up. CONCLUSIONS: The characteristic form of adolescent onset ED exists among adolescents living in India. A multidisciplinary approach to treatment is essential for a good outcome. This article was written to sensitize health care professionals, pediatricians in particular about the existence of ED among adolescents living in India and the current acceptable principles of management of this potentially fatal illness.

Validation of the children's depression rating scale- revised for adolescents in primary-care pediatric use in India.

BACKGROUND: Adolescent depression needs to be identified and treated in the primary care settings. There is no clinician-rated measure validated in India for identifying depression among adolescents. AIM: We studied the diagnostic accuracy, reliability, and validity of Children's Depression Rating Scale - Revised (CDRS-R) for primary care pediatrics. SETTING AND DESIGN: Prospective study in three schools in Southern India. MATERIALS AND METHODS: Adolescents recruited were administered the CDRS-R by a pediatrician and clinical psychologist along with Beck Depression Inventory (BDI) for convergent validity. Impact of Event Scale (IES) for divergent validity and the ICD-10 clinical diagnosis of depressive disorders using modified Kiddie-SADS-Present and Lifetime Version (K-SADS-PL) interview as reference standard were administered by a psychiatrist independently. Appropriate statistical analyses for diagnostic accuracy, reliability, and validity were done. RESULTS: A cut-off score of 30 (sensitivity = 83%, specificity = 84%; AUC in ROC = 87%) in CDRS-R is suggested for diagnosing depression. The inter-rater reliability (r = 0.73) and test-retest reliability (r = 0.98) was good. In addition to the adequate face and content validity, CDRS-R had good internal consistency (α = 0.76), high convergent (r = 0.71; P = 0.001), and divergent validity (r = 0.28; P = 0.20). There was moderate concordance with the reference standard of ICD-10 diagnosis (45.5%) in identifying depression and CDRS-R discriminated 80% of the other psychiatric morbidity. The six-factor structure explained 60.6% of variance. CONCLUSION: The CDRS-R showed strong psychometric properties and is now available for use in the primary-care pediatric practice in India.