Search

Abstract Background Adolescence is an essential stage for the development of mental health, and suicide is among the leading cause of mortality for adolescents around the world. In India, the suicide rate among adolescents has been increasing in recent years. The scoping review was conducted to map the evidence and address gaps by examining the existing pattern, and trends, and identify the major risk factors of suicide among Indian adolescents. Methods The study was conducted as per the Arksey and O’Malley scoping review framework and the Joanna Briggs Institute Reviewers’ manual. The systematic search was performed using electronic databases such as PubMed, Google Scholar, EMBASE, and PsycINFO, by using specific keywords. After the screening, 35 articles were identified according to the inclusion criteria. Results The evidence on the trends of suicide among adolescents showed that the suicide rate has shown an alarming increase in recent years. The evidence pattern showed that hanging and poisoning were the commonly selected methods used by adolescents. The most commonly reported risk factors were mental health problems (54.28%), negative or traumatic familiar issues (34.28%), academic stress (22.85%), social/lifestyle factors (20%), violence (22.85%), economic distresses (8.75%), relationship factor (8.75%). Conclusion By synthesizing and summarising the patterns, trends, and key risk factors of suicide among Indian adolescents, this scoping review provides a broad understanding of the literature already in existence. In order to effectively tackle these issues, the finding highlights the urgent need for extensive and targeted suicide prevention measures.

Background: Adolescence is an essential stage for the development of mental health, and suicide is among the leading cause of mortality for adolescents around the world. In India, the suicide rate among adolescents has been increasing in recent years. The scoping review was conducted to map the evidence and address gaps by examining the existing pattern, and trends, and identify the major risk factors of suicide among Indian adolescents. Methods: The study was conducted as per the Arksey and O'Malley scoping review framework and the Joanna Briggs Institute Reviewers' manual. The systematic search was performed using electronic databases such as PubMed, Google Scholar, EMBASE, and PsycINFO, by using specific keywords. After the screening, 35 articles were identified according to the inclusion criteria. Results: The evidence on the trends of suicide among adolescents showed that the suicide rate has shown an alarming increase in recent years. The evidence pattern showed that hanging and poisoning were the commonly selected methods used by adolescents. The most commonly reported risk factors were mental health problems (54.28%), negative or traumatic familiar issues (34.28%), academic stress (22.85%), social/lifestyle factors (20%), violence (22.85%), economic distresses (8.75%), relationship factor (8.75%). Conclusion: By synthesizing and summarising the patterns, trends, and key risk factors of suicide among Indian adolescents, this scoping review provides a broad understanding of the literature already in existence. In order to effectively tackle these issues, the finding highlights the urgent need for extensive and targeted suicide prevention measures. [ABSTRACT FROM AUTHOR]

Objective: Universal access to personal music listening devices has attracted many adolescents to listen to music. However, risky music listening behavior can lead to music-induced hearing loss, becoming a major social and public health problem. We aimed to investigate music listening habits in three groups of adolescents based on age, learn the differences in music listening habits among the groups, if any, and assess their knowledge regarding loud music-induced hearing loss. Materials and method: A total of 300 adolescents aged 13-20 years studying in various schools and colleges of a South Indian city completed a questionnaire to understand music listening habits and knowledge regarding loud music-induced hearing loss. Based on age and education level, they were divided into three groups of 100 each [high school(HS): 13-16 years, pre-university(PU): 16-17 years, and undergraduate(UG) level: 18-20 years]. Results: Duration and frequency of music listening, usage of the device, and accessory were similar among the three groups. However, across the age, there is a difference in the loudness in music listening (younger HS and PU groups frequently used loud volume) and the awareness about the damage caused to hearing due to loud music (younger HS group was least aware). A reduced hearing was reported by 17% of the UG group as opposed to 4% of the HS group. Conclusion: With the use of earphones and loud volume, younger adolescents are at greater risk for music-induced hearing loss than older adolescents. This group, if educated, is ready to accept modifications in listening behaviors that are hearing protective. [ABSTRACT FROM AUTHOR]

Abstract Background Unhealthy snacking habits in adolescents are typically triggered by obesogenic food environments and possibly perpetuated through interactions between socio-environmental factors and personal perceptions, attitudes, and motivations to change eating behaviors. This study attempted to address the knowledge gap regarding the association of intrapersonal, socioeconomic, and food environmental characteristics with unhealthy snack consumption in Indian adolescents, presenting several targets for effective interventions. Methods A representative sample of 10–12 years old adolescents (n 712) completed a cross-sectional survey including eating habits, characteristics of school and home food environments, and perceptions related to affordability, convenience, and barriers within the food environments. The frequency of unhealthy snack consumption was assessed using a validated qualitative food frequency questionnaire. Multivariate regression analyses determined the associated factors of unhealthy snack consumption in adolescents attending private and public schools. Results The mean age of adolescents was 10.9 (1.1) years, 48.2% were girls and 53.9% attended private schools. The most frequently consumed unhealthy snacks were biscuits/ cookies (5.2d/wk) followed by wafers (3.4d/wk) and Indian fried snacks- samosa/ vada pav (2.8 d/wk). Among the public-school adolescents, the odds of unhealthy snack consumption were 0.89 times lower when meals were had frequently at the dinner table and 4.97 times higher when the perceived barriers related to the affordability of healthy snacks were greater. Maternal education (OR 0.78, 95% CI 0.66–0.82, p

Background: The Child and Youth Resilience Measure-28 (CYRM-28) is one of the few measures based on a contextually and culturally embedded understanding of resilience. However, its psychometric properties have not been examined in India which is home to the largest proportion of adolescents worldwide. The present study was conducted to address this gap. Aims: This study examined the psychometric properties and factor structure of the English and Hindi translated version of the CYRM-28 in the Indian context. Additionally, it investigated the role of select sociodemographic factors on the resilience levels of Indian school-going adolescents. Method: Using convenience sampling, data were collected from 1281 adolescents (mean = 15.28 years; SD = 1.08) enrolled in private and government schools in rural and urban parts of Northern India. Three measures were used in this study: CYRM-28, Warwick-Edinburg mental well-being scale (WEMWBS) and PERMA. Descriptive statistics, confirmatory factor analysis, reliability analysis, correlation, and multivariate analysis of variance were conducted to validate the scale and to study the effect of sociodemographic factors on resilience levels of India adolescents. Results: A 16-item (English and Hindi) version of the CYRM-28, with a three factor-structure was found to be the most adequate fit for the Indian context. It demonstrated good reliability and convergent validity with the WEMWBS and PERMA. Further, the multivariate results, albeit with a small effect size, showed a significant main effect for place of residence and age, with urban and older adolescents obtaining higher resilience scores than their rural and younger counterparts. Conclusion: The present research shows that a shorter 16-item version of the CYRM with a three-factor structure is a reliable and valid tool for use among Indian adolescents. The CYRM is a robust resilience measure being used across varied cultures--its validation in the Indian context widens the scope for resilience research in the Indian adolescent population. [ABSTRACT FROM AUTHOR]

Background: Unhealthy snacking habits in adolescents are typically triggered by obesogenic food environments and possibly perpetuated through interactions between socio-environmental factors and personal perceptions, attitudes, and motivations to change eating behaviors. This study attempted to address the knowledge gap regarding the association of intrapersonal, socioeconomic, and food environmental characteristics with unhealthy snack consumption in Indian adolescents, presenting several targets for effective interventions.Methods: A representative sample of 10-12 years old adolescents (n 712) completed a cross-sectional survey including eating habits, characteristics of school and home food environments, and perceptions related to affordability, convenience, and barriers within the food environments. The frequency of unhealthy snack consumption was assessed using a validated qualitative food frequency questionnaire. Multivariate regression analyses determined the associated factors of unhealthy snack consumption in adolescents attending private and public schools.Results: The mean age of adolescents was 10.9 (1.1) years, 48.2% were girls and 53.9% attended private schools. The most frequently consumed unhealthy snacks were biscuits/ cookies (5.2d/wk) followed by wafers (3.4d/wk) and Indian fried snacks- samosa/ vada pav (2.8 d/wk). Among the public-school adolescents, the odds of unhealthy snack consumption were 0.89 times lower when meals were had frequently at the dinner table and 4.97 times higher when the perceived barriers related to the affordability of healthy snacks were greater. Maternal education (OR 0.78, 95% CI 0.66-0.82, p < 0.001), family income (OR 2.15, 95% CI 1.98-2.32, p < 0.001), availability of unhealthy snacks (OR 2.98, 95% CI 1.36-3.46, p < 0.001) and fruits (OR 0.57, 95% CI 0.49-0.69, p < 0.001) at home, having evening meals together (OR 0.71, 95% CI 0.63-0.81, p 0.031), and perceived parental control during mealtimes (OR 0.67, 95% CI 0.62-0.72, p < 0.001) were associated with unhealthy snack consumption in adolescents attending private schools.Conclusions: The results highlighted a pervasiveness of unhealthy snacks in adolescents' food environments. Improving provisions and affordability of fruits and healthy snacks at schools, encouraging family mealtimes, and limiting the availability of unhealthy snacks at home whilst addressing the perceived barriers within food environments, and inculcating self-efficacy skills can improve snacking habits in Indian adolescents, irrespective of socioeconomic backgrounds. [ABSTRACT FROM AUTHOR]

• Knowledge about HIV/AIDs among adolescents is a major determining factor for the control of the disease. • A systematic analysis of evidence around research on HIV/AIDS among adolescents will explain the research gaps, scope and policy perspective. • Present scoping review of ninety eligible studies provides the pattern of HIV/AIDS research among adolescents in India in the last 20 years. • The finding of the review shows a sparse nature of knowledge, wrong beliefs and therefore insufficient and ineffective practices towards HIV/AIDS control. • We also understand that there is significant scope for research toward improving HIV/AIDS-related health among adolescents. HIV/AIDS remains a significant global health concern among adolescents (10–19 years) with a burden of 1.65 million individuals by the year 2022; adolescents account for about 4 % of the overall HIV burden while 10 % of new adult cases are converted from the adolescent group only. In India, adolescents often lack adequate knowledge about HIV/AIDS, influenced by various factors. This scoping review aims to comprehensively synthesize and assess existing evidence on the knowledge, beliefs, and practices related to HIV/AIDS among adolescents in India. Literature searches were conducted in various databases with search limitations from January 2000 to December 2021. Ninety articles met our inclusion criteria. Data extraction was conducted, which followed a narrative summarization. A gap analysis was undertaken to highlight future research needs. A brief on government policies for creating awareness and preventing contraction among adolescents was presented for a better understanding. A total of seventy-four studies during the period of 2011–2021 were included in this analysis. More than 80% of the studies were cross-sectional (84.44%) prioritising urban settings (37.77%). Geographically, nearly one-third (26.66%) of the studies were reported from the northern region of the country. Knowledge among both the gender and the entire adolescent group was assessed by 58.9% and 15.5% of studies respectively. Key areas including knowledge regarding HIV/AIDS, sources of knowledge, attitude towards PLWH, and beliefs of adolescents regarding HIV/AIDS were prioritized. The findings indicated that males and urban adolescents exhibited higher levels of awareness about HIV/AIDS. However, several major research gaps around selected aspects of HIV/AIDS in India were identified. This scoping review provides a comprehensive overview of existing literature around attitude and beliefs among Indian adolescents regarding HIV/AIDS and emphasizes the importance and scope of further research. The study provides important perspectives for future policies and interventions. [ABSTRACT FROM AUTHOR]

Background: Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep quality tend to co-occur during adolescence. Yet, little is known about the associations of these behaviors as a cluster with adiposity indicators in Indian adolescents. This study aimed to evaluate the independent and combined influences of PA, ST, and sleep quality on body mass index (BMI) and waist to height ratio (WHtR) in 10-15 years old adolescents in Mumbai, India. A secondary aim was to explore if these influences vary between sexes.Methods: Cross-sectional study. Adolescents (n = 772, mean age 13.2 (1.4) years) reported frequency and duration of moderate to vigorous PA (MVPA) and time spent using screens on a previously validated instrument. Sleep quality was estimated using the Pittsburg Sleep Quality Index (PSQI). Weight, height, and waist circumference were measured. Mixed effect logistic regression analyses were performed to explore associations between adiposity indicators (BMI z scores > +1SD and WHtR > 0.5) and unhealthy behaviors (PA < 60 min/d, ST > 120 min/d and PSQI scores > 5), stratified by sex.Results: The combined prevalence of overweight and obesity was 38.3%. Overall, 62.0 and 85.0% reported MVPA< 60 min/d and ST > 120 min/d respectively. Girls reported higher ST (218.21 (69.01) min/d) as compared to boys (165.3 (101.22) min/d, p < 0.001). Clustering of low PA and excess ST was observed in 69.2% and of all three unhealthy behaviors in 18.8%. Among girls, MVPA < 60 min/d (OR = 1.78, 95% CI 1.54-1.92, p < 0.001) and PSQI scores > 5 (OR = 2.01, 95% CI 1.78-2.25, p < 0.001) predicted increased BMI. The odds of overweight/obesity were 2.10 times higher in boys reporting low PA and 4.13 times higher in those with low PA+ ST > 120 min/d. Clustering of all three unhealthy behaviors increased prevalence of obesity in both sexes.Conclusions: The results indicated a co-existence of multiple unhealthy lifestyle factors of obesity and that clustering of these behaviors can further aggravate obesity risk as compared to their independent effects. Integrated interventions that leverage the cumulative benefits of being active, less sedentary and sufficient sleep are warranted to facilitate greater improvements in obesity risk behaviors. [ABSTRACT FROM AUTHOR]

Victimized children's perceptions of the severity of abusive incidents have been found to be associated with their willingness to disclose. However, the relationship between perceptions, disclosure, and coping processes of abused Indian adolescents, has rarely been studied. To explore the roles of emotional reactions associated with disclosure, and potency on individuals' perception of the severity of abusive incidents, reluctance to disclose, and posttraumatic stress symptoms. A randomly selected sample, consisting of 324 adolescents (aged 12 to 16) in Kolkata, India was included. Of these, 170 adolescents disclosed incidents of abuse last year. Data were analyzed by conditional process modeling. A moderated mediation analysis (n = 170) revealed that the overall perception of the severity of abusive incidents predicted greater reluctance to disclose (B =.63, p <.0001) through heightened emotional reactions, especially with a higher potency level (B =.07, p <.05; B =.1, p <.05). Potency moderated (B = −.02, p =.01) the effect of reluctance on posttraumatic stress symptoms. When tested on the entire sample (324) the results replicated the sub-sample (170). Adolescents revealed similar results irrespective of their exposure. The reluctance to disclose abuse is discussed from an Indian cultural and societal perspective. [ABSTRACT FROM AUTHOR]

Background: Modified Dunn procedure has become popular for the treatment of severe cases of slipped capital femoral epiphysis (SCFE). We assessed the outcomes in a consecutive series of thirty Indian adolescents treated by the modified Dunn procedure. Materials and methods: All patients treated by the modified Dunn procedure by a single senior Paediatric Orthopaedic surgeon over six years were retrospectively reviewed. Only moderate and severe slips undergoing modified Dunn procedure were included. Clinical records and radiographs were reviewed to obtain demographic information; to classify the slips by duration of symptoms, severity and physeal stability; and to assess the outcomes by Harris Hip Score, radiological changes and rate of complications. Results: Thirty consecutive hips with 19 stable and 11 unstable slips were included. Mean age was 13.05 years, 25 boys and 5 girls; six were acute slips, six chronic and eighteen acute-on-chronic. There were 20 moderate and 10 severe slips. Slip angle correction was on average 43.63° ± 8.42° (p < 0.001). At a mean follow-up of 25.36 months, the slip angle averaged 9.9° ± 3.78°, and alpha angle was 33.63° ± 4.14. The average Harris Hip Score was 81.833 ± 7.12 points, with six excellent, 17 good, six fair and one poor result. Osteonecrosis occurred in two hips (6.6%). One hip had post-operative subluxation which was corrected. Conclusion: This study adds to the evidence that the modified Dunn procedure is safe, reliable and reproducible. It should be the first choice for the treatment of moderate and severe SCFE. [ABSTRACT FROM AUTHOR]

Adolescent girls are inundated with contradictory messages on sexuality. Adolescence is socially constructed as being controlled by "raging hormones" but 'good girls" are asexual, devoid of any desire or passion. Schools discipline students' bodies to prohibit any spilling over of sexuality that may pollute the educational environment. At the same time girls are also exposed through the internet to 'girl power' culture speaking of freedom, autonomy and choice in matters of sexuality. Drawing on in-depth interviews with 25 adolescent girls aged 15 to 19 years belonging to the middle class, going to reputed English medium private schools in Kolkata, a city in India, this article explores how adolescent girls speak of denial of their sexual subjectivity and disciplining of their bodies through surveillance in schools. [ABSTRACT FROM AUTHOR]

The study aimed at validating the Hindi and English versions of PERMA and WEMWBS on Indian adolescent population. The data were collected from 1288 adolescents, aged 13–18 years (mean age = 15.27 years, SD = 1.08). Both the scales were an adequate fit to the data, indicating high reliability. For PERMA (α = 0.90), a set of 34 items had the best fit out of the original item pool of 49 items. For the WEMWBS (α = 0.84), original one factor model with 14 items was confirmed in the Indian adolescent population as well. Multivariate analyses revealed that males experienced greater positive emotion and engagement compared to the females. Children studying in private schools scored significantly higher on positive mental health factors, while the government school children had significantly higher scores on ill-health factors. Urban adolescents experienced more depression compared to the rural adolescents and as the age increased, adolescents experienced more depressive symptoms compared to the younger adolescents. Findings are in line with the extant literature on adolescent wellbeing in India. [ABSTRACT FROM AUTHOR]

Background: Communication with others is often a challenging task, particularly for adolescents. Some situations of their lives can leave them in despair. This study has explored the nature and dynamics of assertiveness among Indian adolescents. Method: University students from both rural and urban family background (N =29, Male =13, Female=16, age range =16-18 years) participated in the study. Findings: Four major themes were derived using thematic analysis along with various subthemes. These themes were: assertiveness is person and situation-specific, after-effects of nonassertive communication styles, lack of awareness about assertiveness, and need of change in the communication style. Conclusion: Adolescents exhibit different levels of assertiveness consequent to their culture, which plays a crucial role in determining the communication styles of adolescents. Some contexts may act as barriers resulting in difficulty in managing the stress associated with social interactions. Implications: This study will be helpful in understanding the adolescents' perspective of assertiveness in the Indian context. Moreover, the present research may help to design the intervention in terms of assertiveness training to reduce the barriers faced by adolescents and stay assertive during their social interactions. [ABSTRACT FROM AUTHOR]

The Five-Factor Model (FFM) is one of the most commonly examined constructs of personality across cultures in recent times. However, there is a lacuna of evidence for the suitability of FFM measures for Indian adolescent school students below the age of 17 years. We carried out two independent studies for the psychometric evaluation of the measures BFI-10 and NEO-FFI-3 on Indian adolescent school students. Both studies examined two socio-culturally distinct linguistic groups of secondary and senior secondary school students with a total sample of N = 1117 students. There was very limited support for a five-factor solution in both cases. Model fit was poor when applying FFM measures to our samples, whether applying confirmatory factor analysis or exploratory structural equation models. The results provide evidence against using adult personality measures with adolescents without separate psychometric validation and applying the Western age norms to Indian students without considering that the process of personality consolidation during adolescence may not be identical across cultures.

The Five-Factor Model (FFM) is one of the most commonly examined constructs of personality across cultures in recent times. However, there is a lacuna of evidence for the suitability of FFM measures for Indian adolescent school students below the age of 17 years. We carried out two independent studies for the psychometric evaluation of the measures BFI-10 and NEO-FFI-3 on Indian adolescent school students. Both studies examined two socio-culturally distinct linguistic groups of secondary and senior secondary school students with a total sample of N = 1117 students. There was very limited support for a five-factor solution in both cases. Model fit was poor when applying FFM measures to our samples, whether applying confirmatory factor analysis or exploratory structural equation models. The results provide evidence against using adult personality measures with adolescents without separate psychometric validation and applying the Western age norms to Indian students without considering that the process of personality consolidation during adolescence may not be identical across cultures. [ABSTRACT FROM AUTHOR]

The family micro-system is important in the development of any individual. Defects or deviations in its normative functioning affect the development of a child. These defects may include child maltreatment or abuse, be it physical, sexual, emotional, or neglect. Within this domain, in our view, there does not appear to be adequate development related to the understanding of, and intervention for, emotional abuse. Emotional abuse extends from explicit acts to invisible causative factors of neglect or humiliation. In this work, through quantitative and qualitative empirical evidence, we have attempted to associate family challenges with self-esteem (SE) and perceived social support. The study was carried out on a sample of early-adolescent high school students in the state of Kerala, India. We found a significant difference in SE between adolescents who reported challenges at home and those who did not. We also observed the limited role of age as a determinant in this differentiation. The current work serves to significantly supplement the understanding of causal relationships in the discourse on emotional abuse in the context of child development. [ABSTRACT FROM AUTHOR]

Background: Since the data of primary hypertension (HT) in children is scanty in India, this study attempted to evaluate HT by a multidimensional investigation of the various risk factors in children and adolescents. Materials and Methods: A total of 3906 subjects were recruited, all of whom lived in Chennai, an urban area of Tamil Nadu. The children and adolescents aged from 10 to 17 years were selected by random sampling. The children/adolescents were randomized into one control and further divided into two groups. The National High Blood Pressure Education Program fourth report (2004) and anthropometric body mass index (BMI), food frequency questionnaire (PURE) were followed in the study. Results: Out of 3906 children, 2107 were girls and 1799 boys. On screening, we found 9.5% to be hypertensive with the prevalence rate of boys and girls 8% and 10.8%, respectively. Overall obesity was 2.7%, (boys 2%, girls 3.32%); hypertensives and normotensives were 8.4% and 2.1%, respectively. We found that overweight (odds ratio [OR]: 2.06 [1.40-3.01] 95% confidence interval [CI]), obese children (OR: 1.21 [2.72-6.48] 95% CI), and those with a family history of HT (OR: 1.66 [1.20-2.30] 95% CI) had increased risk of hypertension. Females were 1.39 times (OR: 1.39 [1.11-1.72] 95% CI) more at risk of getting HT. Multivariate analysis showed that obese children/adolescent were four times more likely to have HT than children with normal BMI (OR: 4.67 [3.00-7.26] 95% CI]. Conclusion: Family history of HT, obesity, and female gender are associated with a high risk of HT. The prevalence of HT was higher among obese adolescents than among slender subjects. This may be related to their sedentary lifestyle, faulty eating habits, high fat content in the diet and little physical activity.

Bullying is an international issue that is only just beginning to be researched in India and anecdotal evidence in Punjab, India, has suggested that most schools in the Punjab are in denial about bullying on campus. Our aim was to investigate the nature of bullying in this region using the PhotoStory Method. We sought to discover how young people in India perceived and experienced incidents of bullying. Three Punjabi schools were issued with ipads that students could use to email the researchers their illustrated stories about bullying. Using the Pic Collage App, 33 students aged 12-15 sent PhotoStories about experiences of victimization. Many stories described incidents of physical harassment, name calling and ‘Eve teasing’, which left students feeling sad, embarrassed, depressed and helpless. However, only four PhotoStories described incidents that met the definition of bullying i.e. that involved repetitive, hurtful behaviour perpetrated by a person or persons that could be considered more ‘powerful’ than the victim. Nonetheless, the stories, while not lengthy and overly descriptive, did indicate that physical acts of aggression between peers were common in and outside school. The findings are discussed in relation to definitional issues and the need to implement anti-violence programs in Indian schools.

Abstract Background Knowledge of normal variation and measurements on a chest radiograph is essential to interpret any abnormality. There is paucity of information about normal measurement ranges and variations in young adolescents, particularly from Indian subcontinent. The aim of this study was to analyze certain normal variations on screening chest radiographs of healthy Indian adolescents and the objectives were to measure/assess (1) degree of inspiration, (2) cardiothoracic ratio (CTR), (3) presence of gastric fundic bubble, (4) fundocupolic distance, (5) presence of splenic flexure, (6) difference in height of diaphragmatic domes and (7) effect of inspiration on the CTR. Methods Digital chest radiographs obtained during routine medical examinations for all consecutive medical graduate aspirants in the year 2016 at a medical college, were analyzed for the above mentioned parameters using DICOM viewing software. Result A total of 558 chest radiographs were analyzed. The mean age of the subjects was 18.50 (SD = 1.002) (range: 17–22 years). There were 497 (89.1%) male and 61 (10.9%) female. Degree of inspiration was at 5th, 6th, 7th and 8th ribs in 29 (5.1%), 259 (46.4%), 264 (47.3%) and 6 (1%) respectively. Mean maximum transverse cardiac diameter, internal thoracic diameter, CTR were 1153.22 ± 120.01, 2935.24 ± 224.86 and 0.39 ± 0.03 respectively. Females had slightly higher CTR (0.40 ± 0.035) as compared to the males (0.39 ± 0.032) (p = 0.009). Gastric fundic bubble was visualized in 91% subjects. Mean fundo-cupolic distance was 8.75 ± 8.00. Mean value for difference in the level of two domes of diaphragm was 15.28 ± 5.38. Conclusion The study highlights normal range of inspiration, CT ratio, fundocupolic distance and diaphragmatic dome level difference on screening chest radiographs in healthy Indian adolescents. [ABSTRACT FROM AUTHOR]

Although a growing body of quantitative research has examined the non-cognitive factors affecting the school engagement and performance of adolescents across cultures, there is relatively sparse qualitative research investigating the perceptions of adolescents regarding the factors influencing their engagement and performance in school. This focus group study comprising 32 Indian adolescents from India (mean age = 16.78 years) and 20 Indian immigrant adolescents from Canada (mean age = 17.05 years), therefore, using a self-determination theory perspective, explored the perceptions of Indian and Indian immigrant adolescents about the factors affecting their school engagement and performance in India and Canada, respectively. Thematic analysis of eight focus group discussions suggested that Indian and Indian immigrant adolescents were primarily extrinsically motivated toward school and academics. Further, both the Indian and Indian immigrant adolescents perceived their classroom teachers as controlling rather than autonomy-supportive. Implications of the findings are briefly discussed. [ABSTRACT FROM AUTHOR]

Introduction: Risk of metabolic syndrome is 2-3 times more in persons with high visceral fat. Increased accumulation of visceral fat is associated with hypertension in adults, children and adolescents. Aims: The present study was undertaken to check association of visceral fat with blood pressure in Indian adolescents of 18-19 years of age group. Methodology: Our study was conducted on 120 healthy Indian adolescents (60 males and 60 females) of 18-19 years of age group from various colleges in vicinity of Shree Krishna Hospital, Karamsad, Gujarat, India after their voluntary consent. Body visceral fat was recorded by bioelectrical impedance technique using Omron HBF-302 body fat analyzer. Systolic blood pressure (SBP) and Diastolic blood pressure (DBP) were measured by Omron T8 (HEM757A4-C1) Automatic Blood Pressure instrument by following all standard precautions. Results: All participants were divided into two groups on the basis of their visceral fat. Participants with visceral fat 0 to 9 were categorized as normal visceral fat group and participants with visceral fat ≥ 10 were categorized as high visceral fat group. In high visceral fat Indian adolescents, systolic blood pressure (SBP), diastolic blood pressure (DBP) & mean arterial pressure (MAP) were more and statistically significant than low visceral fat Indian adolescents. Conclusion: Visceral adiposity correlated with MAP, SBP and DBP in both gender with better correlation in females. [ABSTRACT FROM AUTHOR]

The gender role identity is an important aspect of an individual’s personality development as it influences not only the self- concept but also has an impact on the way the individual will think, behave, feel and, in general, conduct his or her social life. A gender role is a set of societal norms dictating the types of behaviors which are generally considered acceptable, appropriate, or desirable for people based on their actual or perceived sex or sexuality. Gender roles are usually centered on conceptions of femininity and masculinity, although there are exceptions and variations. In the recent literature, however, the bipolar concept of masculinity and femininity has been questioned and replaced by addition of another type of identity namely androgynous identity. The specifics regarding the gendered expectations may vary substantially among cultures, while other characteristics may be common throughout a range of cultures. Even though, there is ongoing debate as to what extent gender roles and their variations are biologically determined, and to what extent they are socially constructed, but, in general, the phrase "gender role" is more likely to describe male/female activities that the culture defines, e.g., who should be the breadwinner, who should clean the house, who is the aggressive one. "Sex role" is more likely to describe functions that are dictated by biology, e.g., who bears the baby. It is important to assess the gender role identity in order to understand its impact on a number of psychological processes especially for the adolescents for whom the gender role identity plays a significant role in their overall development. Considering the fact that gender role prescription are culturally anchored, the gender role inventories developed in western culture may not be a very appropriate for the assessment of the gender role identity of Indian adolescents. The present study reports the development of a gender role inventory “Samajik Bhoomika Mapni’ (Social Role Scale) for Indian adolescents. The main feature of the scale is that even though the procedure for it development is based on that of the famous Bem Sex Role Inventory but the items were not drawn from the inventory but have been empirically generated in the Indian cultural context, making it a more suitable and appropriate measure of the gender role identity of the Indian adolescents. [ABSTRACT FROM AUTHOR]

This exploratory study examined the relations between approach and avoidance coping behaviors and general life satisfaction in a sample of 248 Hindu adolescents from an urban area in India. The major findings were threefold. First, gender differences were observed, with females reporting more frequent use of the strategies of seeking social support, direct problem solving, and internalizing behaviors. Second, using multiple regression analyses, the coping behaviors of problem solving and externalizing behaviors accounted for significant, unique variance in life satisfaction scores. Third, gender did not moderate the relations between any of the coping behaviors and life satisfaction. Possible implications for health promotion are discussed. [ABSTRACT FROM AUTHOR]

Background Social anxiety disorder/Social phobia is a common disorder particularly in adolescents resulting in significant impairment. This study was conducted to determine the prevalence, socio-demographic co-relates and associated impairment due to this disorder in high school children in India representing adolescent population. Method This was a cross sectional study among urban adolescent English medium school population.628 students of two schools were screened using Social Phobia Inventory (SPIN) and those screening positive were interviewed for diagnosis of Social Anxiety Disorder. Information was obtained on socio demographic variables and academic and social impairment. Results The study sample comprised of age range of respondents between 13-17 yrs with the mean age of 14.5 yrs .5.3% (n=33) of the students fulfilled the criteria for Social Phobiacomprising of 6(3.9%) males and 26(5.7%) females. No association of Social Anxiety Disorder with type of family, number of siblings, birth order and parents educational and vocational status was found. Significant association between SAD and poor academic performance and limitation in involvement in extracurricular activities and peer relationship was found. Conclusion SAD is prevalent among adolescents in India and is associated with impairment in both in academic and non academic areas. Hence, identification of SAD and timely referral of students for effective treatment is important for school health care personnel. [ABSTRACT FROM AUTHOR]

Background: Since the data of primary hypertension (HT) in children is scanty in India, this study attempted to evaluate HT by a multidimensional investigation of the various risk factors in children and adolescents. Materials and Methods: A total of 3906 subjects were recruited, all of whom lived in Chennai, an urban area of Tamil Nadu. The children and adolescents aged from 10 to 17 years were selected by random sampling. The children/adolescents were randomized into one control and further divided into two groups. The National High Blood Pressure Education Program fourth report (2004) and anthropometric body mass index (BMI), food frequency questionnaire (PURE) were followed in the study. Results: Out of 3906 children, 2107 were girls and 1799 boys. On screening, we found 9.5% to be hypertensive with the prevalence rate of boys and girls 8% and 10.8%, respectively. Overall obesity was 2.7%, (boys 2%, girls 3.32%); hypertensives and normotensives were 8.4% and 2.1%, respectively. We found that overweight (odds ratio [OR]: 2.06 [1.40-3.01] 95% confidence interval [CI]), obese children (OR: 1.21 [2.72-6.48] 95% CI), and those with a family history of HT (OR: 1.66 [1.20-2.30] 95% CI) had increased risk of hypertension. Females were 1.39 times (OR: 1.39 [1.11-1.72] 95% CI) more at risk of getting HT. Multivariate analysis showed that obese children/adolescent were four times more likely to have HT than children with normal BMI (OR: 4.67 [3.00-7.26] 95% CI]. Conclusion: Family history of HT, obesity, and female gender are associated with a high risk of HT. The prevalence of HT was higher among obese adolescents than among slender subjects. This may be related to their sedentary lifestyle, faulty eating habits, high fat content in the diet and little physical activity. [ABSTRACT FROM AUTHOR]

This study examined the relationships between academic motivation—intrinsic motivation, extrinsic motivation, amotivation—and mathematics achievement among 363 Indian adolescents in India and 355 Indian immigrant adolescents in Canada. Results of hierarchical multiple regression analyses showed that intrinsic motivation, extrinsic motivation, and amotivation were not statistically significantly related to mathematics achievement among Indian adolescents in India. In contrast, both intrinsic motivation and extrinsic motivation were statistically significantly related to mathematics achievement among Indian immigrant adolescents in Canada. While intrinsic motivation was a statistically significant positive predictor of mathematics achievement among Indian immigrant adolescents in Canada, extrinsic motivation was a statistically significant negative predictor of mathematics achievement among Indian immigrant adolescents in Canada. Amotivation was not statistically significantly related to mathematics achievement among Indian immigrant adolescents in Canada. Implications of the findings for pedagogy and practice are discussed. [ABSTRACT FROM AUTHOR]

Abstract: A sample of 15-year-olds in India took part in the Program for International Student Assessment (PISA) for the first time in 2010. The PISA reading, mathematics, and science literacy scores of Indian adolescents were considerably lower than their counterparts in most PISA participating countries. In order to explore potential reasons for this, the present study, therefore, drawing on data from the fourth cycle of PISA and employing multilevel modeling, examined the relations of student- and school-level factors to reading, mathematics, and science literacy among 4826 15-year-old students from 213 schools in India. Gender, metacognitive learning strategies, students' positive attitudes toward school, and students' positive perceptions of classroom climate were found to be significantly associated with Indian adolescents' performance on the PISA assessment. [Copyright &y& Elsevier]

The current study was conducted to determine how physical activity level and physical fitness affects the blood pressure profile of Maharashtrian adolescents to help in developing preventive strategies for the local population, as ethnic differences exist in the aetiopathogenesis of hypertension. A cross-sectional study was conducted on 485 Marathi Indian adolescent girls and boys of age group 14 -18 years. Physical activity level was assessed using Johnson Space Center/NASA Physical Activity Rating Scale and VO2max was used to assess the physical fitness. Body composition was assessed in terms of Body Mass Index, Fat Mass Index and Waist Circumference. Blood Pressure was measured by oscillometry. One-way ANOVA was used to study if any significant differences (P<0.05) existed in the blood pressure profile between the high, moderate and low physical activity groups. Pearson's correlation coefficient was determined to assess the relationship between VO2max and blood pressure profile. In girls, physical activity level did not significantly affect the blood pressure profile. In boys, systolic blood pressure and mean arterial pressure were found to be significantly higher in Moderate Physical Activity Group as compared to Low Physical Activity Group. PVO2max was found to have a significant negative correlation with systolic blood pressure, diastolic blood pressure, and mean arterial pressure in girls and a significant negative correlation with systolic blood pressure, pulse pressure and mean arterial pressure in boys. Better physical fitness rather than a higher physical activity level can keep the blood pressure in check in Indian adolescents. [ABSTRACT FROM AUTHOR]

Adolescence can be a stressful time for children, parents and also all others who work with them. School students in India have a high stress level and higher rate of deliberate self-harm. Many recent studies have found relation between stress and suicidal ideas in school children. Stress also results in increased likelihood of substance abuse among adolescents. A social and public health response in addition to mental health response is crucial to prevent suicidal behavior and creating awareness about substance abuse among adolescents. Stress also positively correlates with maladaptive strategies adopted towards schools, teachers, and parents, peers, opposite sex and also at a broader societal level. Policy planning and implementation of preventive measures for adolescent suicide is therefore, need of the hour. This review article focuses on determinants of psychological stress and suicidal behavior in Indian adolescents and various psychosocial adjustments adopted by them. [ABSTRACT FROM AUTHOR]

Background: Body weight plays a main role for the Indian adolescent college students for their physical look. Body mass index reflects health status of individual. Body mass index is associated with self esteem of students. Methodology: A cross section study was conducted on 96 students of 17-19 years of age group. Nutritional status of participants was assessed by Omron HBF-362 body fat analyzer. The body weight, body mass index, resting metabolism, metabolic age, body fat percentage and visceral fat were assessed by this instrument. Dietary questionnaire was taken from the students. Results: Body mass index (P < 0.01), resting metabolism (P < 0.0001) and visceral fat (P < 0.0001) of Indian adolescent girls were found to be significantly lower than their collegue boys. Girls are not satisfied with their body image and Indian adolescent girls are skipping their meal rather than doing physical exercise. Conclusion: We may conclude that nutritional status and awareness about nutrition play a main role for individual’s body image.

The present study examined the mediational role of academic motivation in the association between school self-concept and school achievement among 355 Indian immigrant adolescents in Canada and 363 Indian adolescents in India. Surveys were administered among Grades 9-12 students in Canada and India to assess their academic self-concepts, academic motivation, and academic achievement. Bootstrapped tests of simultaneous multiple indirect effects were conducted to determine the unique ability of each putative mediator-intrinsic motivation, extrinsic motivation, and amotivation-to account for the effect of school self-concept on overall school GPA for Indian immigrant adolescents in Canada and Indian adolescents in India. Mediational analyses revealed the mediational roles of both intrinsic and extrinsic motivation in the association between school self-concept and school achievement for Indian immigrant adolescents in Canada, while intrinsic motivation solely mediated the relations between school self-concept and school achievement for Indian adolescents in India. Amotivation was not a significant mediator for both the Indian immigrant and Indian adolescents. Implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to examine the relationships among intrinsic motivation, extrinsic motivation, and academic achievement for the Indian immigrant adolescents in Canada in comparison to their counterparts in India. Descriptive discriminant analysis indicated that the Indian immigrant adolescents in Canada had higher intrinsic motivation and academic achievement than their peers in India. By contrast, the Indian adolescents in India had higher extrinsic motivation than their counterparts in Canada. Hierarchical multiple regression analyses revealed the positive predictive effects of intrinsic motivation on academic achievement for both the Indian immigrant and Indian adolescents. While extrinsic motivation had a negative predictive effect on academic achievement for the Indian immigrant adolescents in Canada, it was not a significant predictor of academic achievement for the Indian adolescents in India. Implications of the findings for policy and practice are discussed. [ABSTRACT FROM AUTHOR]

With emerging westernization, there is growing concern about sexual promiscuity and changing attitudes toward sexuality. A questionnaire was administered to 182 adolescents from the city of Mumbai in the age group of 17-21 years in order to examine their knowledge about crucial aspects of sexuality and their source of sex related information. The survey also accessed attitudes regarding sex education, premarital sex and homosexuality, as well as sexual behaviors engaged in by the youth. Results showed that sexual knowledge about physiology of sexual response, conception, and pregnancy was less than other areas such as masturbation and contraception. Peers, books, and magazines were the most frequently used source of sex information. Boys reported more liberal attitudes and more frequent sexual behaviors than girls. Implications of the results in terms of access to accurate information, communication about sexual issues, and health policy reforms are discussed. [ABSTRACT FROM AUTHOR]

Victimized children's perceptions of the severity of abusive incidents have been found to be associated with their willingness to disclose. However, the relationship between perceptions, disclosure, and coping processes of abused Indian adolescents, has rarely been studied. To explore the roles of emotional reactions associated with disclosure, and potency on individuals' perception of the severity of abusive incidents, reluctance to disclose, and posttraumatic stress symptoms. A randomly selected sample, consisting of 324 adolescents (aged 12 to 16) in Kolkata, India was included. Of these, 170 adolescents disclosed incidents of abuse last year. Data were analyzed by conditional process modeling. A moderated mediation analysis ( n  = 170) revealed that the overall perception of the severity of abusive incidents predicted greater reluctance to disclose ( B  = .63, p  < .0001) through heightened emotional reactions, especially with a higher potency level ( B  = .07, p  < .05; B  = .1, p  < .05). Potency moderated ( B  = -.02, p  = .01) the effect of reluctance on posttraumatic stress symptoms. When tested on the entire sample (324) the results replicated the sub-sample (170). Adolescents revealed similar results irrespective of their exposure. The reluctance to disclose abuse is discussed from an Indian cultural and societal perspective., Competing Interests: Disclosure of InterestThe authors declare that they have no conflict of interest., (© Springer Nature Switzerland AG 2020.)

Background: Modified Dunn procedure has become popular for the treatment of severe cases of slipped capital femoral epiphysis (SCFE). We assessed the outcomes in a consecutive series of thirty Indian adolescents treated by the modified Dunn procedure., Materials and Methods: All patients treated by the modified Dunn procedure by a single senior Paediatric Orthopaedic surgeon over six years were retrospectively reviewed. Only moderate and severe slips undergoing modified Dunn procedure were included. Clinical records and radiographs were reviewed to obtain demographic information; to classify the slips by duration of symptoms, severity and physeal stability; and to assess the outcomes by Harris Hip Score, radiological changes and rate of complications., Results: Thirty consecutive hips with 19 stable and 11 unstable slips were included. Mean age was 13.05 years, 25 boys and 5 girls; six were acute slips, six chronic and eighteen acute-on-chronic. There were 20 moderate and 10 severe slips. Slip angle correction was on average 43.63° ± 8.42° ( p  < 0.001). At a mean follow-up of 25.36 months, the slip angle averaged 9.9° ± 3.78°, and alpha angle was 33.63° ± 4.14. The average Harris Hip Score was 81.833 ± 7.12 points, with six excellent, 17 good, six fair and one poor result. Osteonecrosis occurred in two hips (6.6%). One hip had post-operative subluxation which was corrected., Conclusion: This study adds to the evidence that the modified Dunn procedure is safe, reliable and reproducible. It should be the first choice for the treatment of moderate and severe SCFE., Competing Interests: Conflict of interestNone., (© Indian Orthopaedics Association 2020.)

Background & Objectives: Obesity-mediated chronic inflammatory state is primarily governed by lifestyle and food habits in adolescents and marked by alterations in the level of various inflammatory markers. This cross-sectional study was aimed to compare the inflammatory status of healthy Indian adolescents vis-à-vis their obesity profile. The inflammatory state of urban adolescents attending private and government-funded schools, and the relationship between inflammatory marker levels and anthropometric indices in the study participants from both groups were examined., Methods: A total of 4438 study participants (10-17 yr) were chosen from various schools of Delhi, India, and their anthropometric parameters were measured. Plasma adipocytokines (adiponectin, leptin and resistin) of the study participants were measured by enzyme-linked immunosorbent assay, and plasma C-reactive protein (CRP) levels were assayed by a biochemical analyzer. Metabolic syndrome-related risk factors such as waist circumference, hip circumference (HC), fasting glucose, fasting insulin, Homeostatic Model Assessment of Insulin Resistance, total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol and triglycerides of normal-weight adolescents were also evaluated., Results: The level of leptin and CRP increased with increasing adiposity, whereas adiponectin levels were found to be negatively related to obesity. All plasma cytokine levels (adiponectin, leptin and resistin) were significantly elevated in female than male adolescents. Age-based classification revealed a distinct trend of variability in the levels of all the inflammatory markers among adolescents of varying age groups. Significant differences were observed between private and government schoolgoing adolescents in terms of anthropometric and inflammatory parameters, with higher adiposity indices in the former group. The relationship of plasma adipokine and CRP levels with various adiposity indices was found to be distinctly different between private and government schoolgoing students., Interpretation & Conclusions: Inflammatory markers were significantly elevated in overweight/obese adolescents. The socio-economic condition of urban Indian schoolgoing adolescents reflecting lifestyle transition has profound effects on their adiposity indices and inflammatory states. Longitudinal studies in different regions of the country need to be done to further confirm the findings., Competing Interests: None