Although early screening is critical for individuals with autism spectrum disorder (ASD) in order to receive early intervention and improve function later in life, screening is often delayed. Limitations of existing screening instruments, and the need for a culturally appropriate early screening tool in Korean children, led us to develop Behavior Development Screening for Toddlers (BeDevel). The BeDevel assessment consists of two parts: BeDevel‐Interview, a structured interview measure for parents/primary caregivers; and BeDevel‐Play, a play‐based semi‐structured observational measure in children. To examine the feasibility and validity of BeDevel, 155 children (N = 75 ASD, N = 55 typical development, N = 25 developmentally delayed) aged 18–42 months (M = 31.54 months, SD = 7.60) were examined through parent‐reported screening questionnaires, BeDevel, and standard diagnostic assessments. When BeDevel items were analyzed using Cohen's kappa statistics, most items in BeDevel‐Interview and all items in BeDevel‐Play were reasonably consistent with diagnoses. We identified primary items, which were significantly interacted with actual diagnosis in the chi‐squared test (P < 0.05, range = 0.000–0.032). Using cutoff numbers of items determined using the receiver operating characteristics curve, BeDevel showed satisfactory levels of sensitivity (83.33%–100%), specificity (81.25%–100%), positive predictive values (80.65%–100%), and negative predictive values (83.87%–100%), as well as high internal consistency (Cronbach's α = 0.866–959). The agreement between BeDevel and most other screening/diagnostic instruments was moderate (k = 0.419–1.000). These results suggest that BeDevel can be a useful instrument for early screening of ASD. Autism Res 2019, 12: 1112–1128. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary Although early screening is critical for individuals with autism spectrum disorder (ASD) in order to receive early intervention and improve function later in life, screening is often delayed. Limitations of existing screening instruments and the need for a culturally appropriate early screening tool in Korean children led us to develop Behavior Development Screening for Toddlers (BeDevel). The BeDevel assessment consists of two parts: BeDevel‐Interview, a structured interview measure for parents/primary caregivers; and BeDevel‐Play, a play‐based, semi‐structured observational measure in children. In order to test the feasibility and validity of BeDevel, we analyzed preliminary data of total 155 children aged 18–42 months, examined through parent‐reported screening questionnaires, BeDevel, and standard diagnostic assessments. When individual items were analyzed, responses of all BeDevel‐Interview items and of most BeDevel‐Play items well matched actual diagnoses, and we identified primary items, which were particularly useful in differentiating between the ASD group and the non‐ASD group. With the optimal screening criteria determined, the BeDevel was able to identify individuals...

OBJECTIVES:This study explored multidimensional factors related to obesity by dividing them into individual and environmental factors, and performed multilevel analysis to investigate community environmental effects.METHODS:Data from the 2011 and 2012 Community Health Surveys were used for the analysis. Community-level variables, constructed from various regional statistics, were included in the model as environmental factors. Respondents with body mass index (BMI)≥25 were defined as obese, and a multilevel logistic regression analysis was conducted to analyze individual and environmental factors related to obesity. Moreover, a stratified analysis was conducted to compare factors related to obesity between men and women.RESULTS:Of 337,136 samples, 82,887 (24.6%) were obese, with BMI≥25. Sociodemographic characteristics at the individual level were mostly significantly related to obesity; however, while there were more obese men subjects among those with high socioeconomic status, there were more obese women among those with low socioeconomic status. There were fewer obese respondents among those who regularly walked and more obese respondents among those who reported short sleep duration or were highly stressed. At the community level, people living in areas with high socioeconomic status, high satisfaction with safety and public transportation, and high accessibility to sports facilities in their community had lower obesity risks.CONCLUSIONS:Community-level environmental factors affected obesity, especially perceived community environment, more significant than physical environment. Thus, it is necessary to develop effective obesity prevention and management strategies by considering potential community environmental factors that affect obesity.

Improving the satisfaction with and quality of mobile screening services is important to increase compliance and achieve the aims of the NCSP. Therefore, further efforts such as quality assurance or continuous monitoring are required.

Objective This study aimed to examine the validity of the Korean version of the Autism Diagnostic Interview-Revised (K-ADI-R) and determine its efficacy in identifying individuals with autism spectrum disorder (ASD).Methods Data were pooled from several past and ongoing studies as well as clinical records acquired at Seoul National University Bundang Hospital from 2008 to 2017. The K-ADI-R were administered and scored by trained research reliable examiners. Measurements to investigate the validity of the K-ADI-R was through sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and Cohen’s kappa.Results A total of 1,271 (age 88.9±62.42 months, male=927) participants were included. The K-ADI-R yielded strong psychometric properties with high sensitivity (86.06–99.27%), specificity (84.75–99.55%), PPV (92.33–99.72%), and NPV (79.43–98.64%). There were significant differences in item scores across the K-ADI-R diagnostic algorithm regardless of age and sex (p<0.001). Agreement between the K-ADI-R and other ASD related measurements ranged between levels of good to excellent.Conclusion Despite language or cultural boundaries, the K-ADI-R demonstrated high levels of sensitivity, specificity, PPV, and NPV within a wide range of participants; hence, suggesting promising usage as a valuable diagnostic instrument for individuals with ASD.

ObjectivesThe aim of this study was to examine the composition of metabolic syndrome (MetS) components among middle-aged and older Koreans.MethodsA total of 263 participants (age 40 + years) in a lifestyle modification intervention program who met the MetS definition of National Cholesterol Education Program (NCEP) – Adult Treatment Panel (ATP) III criteria were included in the study. The frequent patterns and clustering of MetS components were investigated. Clustering of changes in individual components, through a lifestyle modification intervention, was also identified. All characteristics were stratified by and compared between sexes.ResultsApproximately 80% of the participants had three of five MetS risk factors at baseline. The prevalence of each risk differed by sex. MetS composition patterns that do not include low high-density lipoprotein (HDL) cholesterol were more noticeable in men because of the low prevalence of low HDL cholesterol. In women, with higher prevalence of low HDL cholesterol, more patterns that include low HDL cholesterol were observed. The most common combination was “elevated blood pressure + abdominal obesity + impaired fasting glucose” in both sexes. Clustering of MetS risks was also found with most of the frequent combinations of MetS components. Through the lifestyle intervention, the greatest change was observed in HDL cholesterol among men and blood pressure among women. Triglycerides and HDL cholesterol were likely to be improved with blood pressure in men and abdominal obesity in women.ConclusionDifferences in the prevalent patterns of MetS compositions were observed prior to and after the intervention, along with during-intervention changes. It is recommended that intervention strategies and guidelines for MetS management consider the MetS composition patterns for effectiveness.