Intervention Study In Children Research Articles

Implementation processes of social network interventions for physical activity and sedentary behavior among children and adolescents: a scoping review.

The characteristics of the implementation process of interventions are essential for bridging the gap between research and practice. This scoping review aims to identify the implementation process of social network interventions (SNI) to address physical activity and sedentary behaviors in children and adolescents. The scoping review was conducted adhering to the established guidelines. The search was carried out in the ERIC, EBSCO, EMBASE, SCOPUS, and Lilacs databases in April 2023. Social network intervention studies in children and adolescents were included, addressing physical activity or sedentary behaviors. Replicability (TIDieR), applicability (PRECIS-2), and generalizability (RE-AIM) were the explored components of the implementation process. Each component was quantitatively and separately analyzed. Then, a qualitative integration was carried out using a narrative method. Most SNI were theoretically framed on the self-determination theory, used social influence as a social mechanism, and used the individual typology of network intervention. Overall, SNI had strong replicability, tended to be pragmatic, and three RE-AIM domains (reach, adoption (staff), and implementation) showed an acceptable level of the generalizability of findings. The analyzed SNI for physical activity and sedentary behaviors in adolescents tended to be reported with high replicability and were conducted pragmatically, i.e., with very similar conditions to real settings. The RE-AIM domains of reach, adoption (staff), and implementation support the generalizability of SNI. Some domains of the principles of implementation strategies of SNI had acceptable external validity (actor, action targets, temporality, dose, and theoretical justification).

Improved sleep with weighted blankets: a longitudinal intervention study in children with Attention-Deficit/Hyperactivity Disorder

Improved sleep with weighted blankets: a longitudinal intervention study in children with Attention-Deficit/Hyperactivity Disorder

Untargeted serum metabolomic profiles and breast density in young women.

Breast density is an established risk factor for breast cancer. However, little is known about metabolic influences on breast density phenotypes. We conducted untargeted serum metabolomics analyses to identify metabolic signatures associated with breast density phenotypes among young women. In a cross-sectional study of 173 young women aged 25-29 who participated in the Dietary Intervention Study in Children 2006 Follow-up Study, 449 metabolites were measured in fasting serum samples using ultra-high-performance liquid chromatography-tandem mass spectrometry. Multivariable-adjusted mixed-effects linear regression identified metabolites associated with magnetic resonance imaging measured breast density phenotypes: percent dense breast volume (%DBV), absolute dense breast volume (ADBV), and absolute non-dense breast volume (ANDBV). Metabolite results were corrected for multiple comparisons using a false discovery rate adjusted p-value (q). The amino acids valine and leucine were significantly inversely associated with %DBV. For each 1 SD increase in valine and leucine, %DBV decreased by 20.9% (q = 0.02) and 18.4% (q = 0.04), respectively. ANDBV was significantly positively associated with 16 lipid and one amino acid metabolites, whereas no metabolites were associated with ADBV. Metabolite set enrichment analysis also revealed associations of distinct metabolic signatures with %DBV, ADBV, and ANDBV; branched chain amino acids had the strongest inverse association with %DBV (p = 0.002); whereas, diacylglycerols and phospholipids were positively associated with ANDBV (p ≤ 0.002), no significant associations were observed for ADBV. Our results suggest an inverse association of branched chain amino acids with %DBV. Larger studies in diverse populations are needed.

초등학교 ADHD아동을 위한 중재적 개입 국내 연구 동향 및 질적 지표 분석

Objectives Domestic studies related to intervention programs for children with ADHD in elementary school are reviewed, and based on this, a direction for developing and applying effective intervention programs is sought.
 Methods In order to know the research trend of interventional intervention for children with ADHD in elementary school studied in Korea, research literature was searched and papers were selected, focusing on domestic academic journals studied from 2009 to December 2022. For this purpose, 41 selected studies were analyzed according to the thesis analysis framework, and the evidence-based intervention was reviewed by analyzing the qualitative indicators of group-subject studies and single-subject studies.
 Results As a result of the research analysis, the number of students in the lower grades (1 to 3) was higher than that in the upper grades (4 to 6), and it can be seen that there are many studies targeting boys. In previous studies, there was no detailed description of the intervention site and intervention environment. As for the intervention research program, many art activity-based intervention studies were provided, and analysis according to the dependent variable involved a number of studies on the cognitive and behavioral aspects of children with ADHD. As for the qualitative indicators of group targeting intervention research programs, there was a lack of studies that satisfied performance, operator's information technology, and comparative group's teaching skills. As for the qualitative indicators of single-subject intervention research programs, there were insufficient studies that satisfied the environmental description, description of measurement validity, baseline measurement of the dependent variable, and description of the baseline period.
 Conclusions The study suggests that intervention studies of children with primary school ADHD need to be designed to increase the reliability and validity of the studies, and to clarify the description of the subjects' intervention environment. Through the results of this study, studies reflecting this should be conducted in the future by considering the evidence-based analysis of the effectiveness and qualitative indicators of interventions for children with ADHD in elementary school.

Effects of Additional Granola in Children's Breakfast on Nutritional Balance, Sleep and Defecation: An Open-Label Randomized Cross-Over Trial.

The contribution of breakfast to daily nutrient intake is low, particularly among children, at only about 20%, and it is difficult to determine whether children are receiving adequate nutrients at breakfast. Although alterations in breakfast content are considered to affect lifestyle habits such as sleep and defecation, there have been few intervention studies in children. The relationship between nutritional balance, dietary intake, and lifestyle habits in children remains unclear. We conducted an intervention study on elementary school children's breakfasts and observed the effects of improving the nutritional balance of breakfast on sleep parameters and defecation status. An intervention study was conducted with 26 elementary school students in Tokyo. The study design was an open-label randomized cross-over trial. Subjects consumed their usual breakfast during the control period and a granola snack containing soy protein in addition to their usual breakfast during the intervention period. Questionnaires regarding breakfast, sleep, and bowel movements were administered during each period. Based on the answers to these questionnaires, we compared the nutritional sufficiency of macronutrients, vitamins, and minerals (29 in total), as well as changes in sleep parameters and defecation status. The additional consumption of granola snacks increased the breakfast intake of 15 nutrients. The changes were particularly significant for iron, vitamin B1, vitamin D, and dietary fiber. During the intervention, sleep duration was decreased and wake-up time became earlier. In terms of defecation, the intervention did not change stool characteristics, but the frequency of defecations per week increased on average by 1.2 per week. These results suggest that the nutritional balance and the amount of breakfast are linked to sleep and defecation and that improving breakfast content can lead to lifestyle improvements in children.

How Memory Counts in Mathematical Development.

Memory has been well-established as a predictor of mathematics achievement in child development. Nevertheless, empirical evidence remains elusive on the unique role of the different forms of memory and their specific mechanisms as predictors of mathematics development. Therefore, in this study, the role of visuospatial short-term memory, visuospatial working memory, verbal short-term memory, and verbal long-term memory was investigated at three key stages of the development of mathematics (5-6 years, 6-7 years, 7-8 years), as well as their interactions across development. The relation between the different memory types and informal and formal mathematics was also studied. The findings of this study provide empirical support for a shift in the relation between different memory types and mathematics achievement over development with: 1) visuospatial short-term memory predicting informal mathematics achievement at the age of 5-6 years; 2) visuospatial working memory predicting informal and formal mathematics achievement at the age of 6-7 years; and 3) verbal short-term memory predicting formal mathematics achievement at the age of 7-8 years. These shifts clearly appear consistent with children's mathematics curriculum content over time and the requirements of mathematics acquisition at specific stages in development. With these findings, the unique role of various forms of memory in the development of mathematics and the timeframe in which they play a crucial part is highlighted, which should be taken into consideration for future research and possible intervention studies in children's mathematics achievement.

Childhood adiposity, serum metabolites and breast density in young women

BackgroundChildhood adiposity is inversely associated with young adult percent dense breast volume (%DBV) and absolute dense breast volume (ADBV), which could contribute to its protective effect for breast cancer later in life. The objective of this study was to identify metabolites in childhood serum that may mediate the inverse association between childhood adiposity and young adult breast density.MethodsLongitudinal data from 182 female participants in the Dietary Intervention Study in Children (DISC) and the DISC 2006 (DISC06) Follow-Up Study were analyzed. Childhood adiposity was assessed by anthropometry at the DISC visit with serum available that occurred closest to menarche and expressed as a body mass index (BMI) z-score. Serum metabolites were measured by untargeted metabolomics using ultra-high-performance liquid chromatography–tandem mass spectrometry. %DBV and ADBV were measured by magnetic resonance imaging at the DISC06 visit when participants were 25–29 years old. Robust mixed effects linear regression was used to identify serum metabolites associated with childhood BMI z-scores and breast density, and the R package mediation was used to quantify mediation.ResultsOf the 115 metabolites associated with BMI z-scores (FDR < 0.20), 4 were significantly associated with %DBV and 6 with ADBV before, though not after, adjustment for multiple comparisons. Mediation analysis identified 2 unnamed metabolites, X-16576 and X-24588, as potential mediators of the inverse association between childhood adiposity and dense breast volume. X-16576 mediated 14% (95% confidence interval (CI) = 0.002, 0.46; P = 0.04) of the association of childhood adiposity with %DBV and 11% (95% CI = 0.01, 0.26; P = 0.02) of its association with ADBV. X-24588 also mediated 7% (95% CI = 0.001, 0.18; P = 0.05) of the association of childhood adiposity with ADBV. None of the other metabolites examined contributed to mediation of the childhood adiposity–%DBV association, though there was some support for contributions of lysine, valine and 7-methylguanine to mediation of the inverse association of childhood adiposity with ADBV.ConclusionsAdditional large longitudinal studies are needed to identify metabolites and other biomarkers that mediate the inverse association of childhood adiposity with breast density and possibly breast cancer risk.

Core outcome set for early intervention trials to prevent obesity in childhood (COS-EPOCH): Agreement on “what” to measure

BackgroundHeterogeneity in the outcomes collected and reported in trials of interventions to prevent obesity in the first five years of life highlights the need for a core outcome set to streamline intervention evaluation and synthesis of effects. This study aimed to develop a core outcome set for use in early childhood obesity prevention intervention studies in children from birth to five years of age (COS-EPOCH).MethodsThe development of the core outcome set followed published guidelines and consisted of three stages: (1) systematic scoping review of outcomes collected and reported in early childhood obesity prevention trials; (2) e-Delphi study with stakeholders to prioritise outcomes; (3) meeting with stakeholders to reach consensus on outcomes. Stakeholders included parents/caregivers of children aged ≤ five years, policy-makers/funders, researchers, health professionals, and community and organisational stakeholders interested in obesity prevention interventions.ResultsTwenty-two outcomes from nine outcome domains (anthropometry, dietary intake, sedentary behaviour, physical activity, sleep, outcomes in parents/caregivers, environmental, emotional/cognitive functioning, economics) were included in the core outcome set: infant tummy time; child diet quality, dietary intake, fruit and vegetable intake, non-core food intake, non-core beverage intake, meal patterns, weight-based anthropometry, screentime, time spent sedentary, physical activity, sleep duration, wellbeing; parent/caregiver physical activity, sleep and nutrition parenting practices; food environment, sedentary behaviour or physical activity home environment, family meal environment, early childhood education and care environment, household food security; economic evaluation.ConclusionsThe systematic stakeholder-informed study identified the minimum outcomes recommended for collection and reporting in early childhood obesity prevention trials. Future work will investigate the recommended instruments to measure each of these outcomes. The core outcome set will standardise guidance on the measurement and reporting of outcomes from early childhood obesity prevention interventions, to better facilitate evidence comparison and synthesis, and maximise the value of data collected across studies.

Mixed methods intervention studies in children and adolescents with emotional and behavioral disorders: A methodological review

BackgroundMixed methods intervention studies can improve the accuracy of interventional evaluations in the field of emotional and behavioral disorders by helping researchers gain a more nuanced understanding of how a particular intervention works. However, no studies to date have systematically examined the ways in which this type of studies have been carried out and reported. AimTo examine the methodological features and reporting practices found in mixed methods intervention studies in children and adolescents with emotional and behavioral disorders. MethodMethodological review based on a systematic search from inception to July 2021 in Embase, Medline, PsycINFO, and SCOPUS, and a hand search in seven journals. ResultsWe found 30 studies, most of them published since 2019. These studies reported several patterns of mixed methods use which illustrated the unique insights that researchers can gain by using this approach. We identified several ways that authors could more clearly report the justification for using a mixed methods approach, the description of the design used, and the evidence of integration of the quantitative and qualitative components. ConclusionWe make recommendations for improving the reporting quality of mixed methods intervention studies in the field of emotional and behavioral disorders.

Working with Families Using a Family-Centered Approach for Improved Development Outcomes in High-Risk Children

Introduction: Around the world, almost half of all deaths in children under five occur in the newborn period. Ninety-nine percent of newborn deaths are in low- and middle-income countries and prematurity, intrapartumrelated neonatal deaths (‘birth asphyxia’), sepsis and meningitis account for 75% of these1. Developmental disability is a diverse group of chronic conditions that are due to mental or physical impairments that arise before adulthood. Developmental disabilities cause individuals living with them many difficulties in certain areas of life, especially in “language, mobility, learning, self-help, and independent living”2. Aim of Study: To analyze the impact of family centered-approach on child’s development outcomes. To quantify and validate the advantages of family-centered- approach for parents and children. Method: A low-cost, family-centered intervention programme to promote child and family wellbeing is provided at an Early Intervention Centre in Latika Roy Foundation, Dehradun, India. It follows a familycentered approach of empowering families through respect, collaboration, information, training and support. The effectiveness of this methodology is evaluated in this study. Discussion: This study evaluates the effectiveness of this family-centred interventions programme, provided by early intervention Centre, for improving development outcomes of high-risk infants. This study explores, for the first time in a resource limited country, the relationship between the reduction of family stress achieved through a family empowerment programme and improvement in development outcomes of high-risk children. Families of High-risk infants enrolled at the Centre during January 2015 through July 2017, who were in NICU for 5 or &gt;5 days are partners in the study. Conclusion: The importance of family-centred care cannot be over-emphasized. Early intervention services and support to families can significantly improve quality of life of high-risk children. Intervention studies for children with disability state that the best way of improving children’s outcomes is by empowering parents through a structured learning programme. Given the scope and potential of such programs, this study quantifies and validates the advantages of the family-centred approach.

The Influence of Quantitative Intervention Dosage on Oral Language Outcomes for Children With Developmental Language Disorder: A Systematic Review and Narrative Synthesis.

Purpose The aim of this study was to examine the degree to which quantitative aspects of dosage (dose, dose frequency, and total intervention duration) have been examined in intervention studies for children with developmental language disorder (DLD). Additionally, to establish the optimal quantitative dosage characteristics for phonology, vocabulary, and morphosyntax outcomes. Method This registered review (PROSPERO ID CRD42017076663) adhered to PRISMA guidelines. Search terms were included in seven electronic databases. We included peer-reviewed quasi-experimental, randomized controlled trial or cohort analytical studies, published in any language between January 2006 and May 2020. Included articles reported on participants with DLD (M = 3-18 years); oral language interventions with phonology, vocabulary, or morphosyntax outcomes; and experimental manipulation or statistical analysis of any quantitative aspect of dosage. Studies were appraised using the Cochrane risk-of-bias tool. Results Two hundred forty-four articles reported on oral language interventions with children with DLD in the domains of interest; 13 focused on experimentally/statistically manipulating quantitative aspects of dosage. No article reported phonological outcomes, three reported vocabulary, and eight reported morphosyntax. Dose frequency was the most common characteristic manipulated. Conclusions Research is in its infancy, and significant further research is required to inform speech-language pathologists in practice. Dosage characteristics are rarely adequately controlled for their individual effects to be identified. Findings to date suggest that there is a point in vocabulary and morphosyntax interventions after which there are diminishing returns from additional dosage. If dose is high (number of learning opportunities within a session), then the literature suggests that session frequency can be reduced. Frequent, short sessions (2/3 × per week, approximately 2 min) and less frequent, long sessions (1 × per week, approximately 20 min) have yielded the best outcomes when composite language measures have been used; however, replication and further research are required before clinicians can confidently integrate these findings into clinical practice. Supplemental Material https://doi.org/10.23641/asha.13570934.

The MEDEA childhood asthma study design for mitigation of desert dust health effects: implementation of novel methods for assessment of air pollution exposure and lessons learned

BackgroundDesert dust events in Mediterranean countries, originating mostly from the Sahara and Arabian deserts, have been linked to climate change and are associated with significant increase in mortality and hospital admissions from respiratory causes. The MEDEA clinical intervention study in children with asthma is funded by EU LIFE+ program to evaluate the efficacy of recommendations aiming to reduce exposure to desert dust and related health effects.MethodsThis paper describes the design, methods, and challenges of the MEDEA childhood asthma study, which is performed in two highly exposed regions of the Eastern Mediterranean: Cyprus and Greece-Crete. Eligible children are recruited using screening surveys performed at primary schools and are randomized to three parallel intervention groups: a) no intervention for desert dust events, b) interventions for outdoor exposure reduction, and c) interventions for both outdoor and indoor exposure reduction. At baseline visits, participants are enrolled on MEDena® Health-Hub, which communicates, alerts and provides exposure reduction recommendations in anticipation of desert dust events. MEDEA employs novel environmental epidemiology and telemedicine methods including wearable GPS, actigraphy, health parameters sensors as well as indoor and outdoor air pollution samplers to assess study participants’ compliance to recommendations, air pollutant exposures in homes and schools, and disease related clinical outcomes.DiscussionThe MEDEA study evaluates, for the first time, interventions aiming to reduce desert dust exposure and implement novel telemedicine methods in assessing clinical outcomes and personal compliance to recommendations. In Cyprus and Crete, during the first study period (February–May 2019), a total of 91 children participated in the trial while for the second study period (February–May 2020), another 120 children completed data collection. Recruitment for the third study period (February–May 2021) is underway. In this paper, we also present the unique challenges faced during the implementation of novel methodologies to reduce air pollution exposure in children. Engagement of families of asthmatic children, schools and local communities, is critical. Successful study completion will provide the knowledge for informed decision-making both at national and international level for mitigating the health effects of desert dust events in South-Eastern Europe.Trial registrationClinicalTrials.gov: NCT03503812, April 20, 2018.

An intervention to improve the quality of life in children of parents with serious mental illness: the Young SMILES feasibility RCT.

An intervention to improve the quality of life in children of parents with serious mental illness: the Young SMILES feasibility RCT.

Effectiveness of Occupational Therapy Sensory Interventions for Children and Adolescents: A Systematic Review

Abstract Date Presented 03/28/20 A systematic review of literature from 2010 to 2019 yielded 2,035 studies of sensory interventions for children and youth. Using established criteria, 22 qualifying studies were identified that spanned six interventions: environmental modifications, deep touch pressure, sensory integration, sensory diet, weighted vests, and stability balls. Strong evidence supported one approach, with moderate evidence in support of three approaches. The results yielded moderate evidence against two approaches. Primary Author and Speaker: Victoria Battin Additional Authors and Speakers: Julia Panzone, Marguerite Fish, Nicole Lorthioir, Justine Odierna, Andrea Dow, Alexandra Regimbald, Gabrielle Lukovich, Taylor Heitmann, Morgan Eberley

Vitamin D status and cardiometabolic risk markers in young Swedish children: a double-blind randomized clinical trial comparing different doses of vitamin D supplements

ABSTRACTBackgroundObservational studies have linked low vitamin D status to unfavorable cardiometabolic risk markers, but double-blinded vitamin D intervention studies in children are scarce.ObjectivesThe aim was to evaluate the effect of different doses of a vitamin D supplement on cardiometabolic risk markers in young healthy Swedish children with fair and dark skin.MethodsCardiometabolic risk markers were analyzed as secondary outcomes of a double-blind, randomized, milk-based vitamin D intervention trial conducted during late fall and winter in 2 areas of Sweden (latitude 63°N and 55°N, respectively) in both fair- and dark-skinned 5- to 7-y-old children. During the 3-mo intervention, 206 children were randomly assigned to a daily milk-based vitamin D3 supplement of either 10 or 25 µg or placebo (2 µg; only at 55°N). Anthropometric measures, blood pressure, serum 25-hydroxyvitamin D [25(OH)D], total cholesterol, HDL cholesterol, apoA-I, apoB, and C-reactive protein (CRP) were analyzed and non–HDL cholesterol calculated at baseline and after the intervention.ResultsAt baseline, serum 25(OH)D was negatively associated with systolic and diastolic blood pressure (β = −0.194; 95% CI: −0.153, −0.013; and β = −0.187; 95% CI: −0.150, −0.011, respectively). At follow-up, there was no statistically significant difference in any of the cardiometabolic markers between groups.ConclusionsWe could not confirm any effect of vitamin D supplementation on serum lipids, blood pressure, or CRP in healthy 5- to 7-y-old children. The study was registered at clinicaltrials.gov (NCT01741324).

Sleep disturbance as a predictor of anxiety in children with Fetal Alcohol Spectrum Disorders and typically developing children

BackgroundHigh levels of anxiety and sleep problems are common features of Fetal Alcohol Spectrum Disorders (FASD). The strong association between sleep and anxiety has been documented in typically developing (TD) populations and is thought to be bidirectional. The association between sleep and anxiety in children with FASD has not yet been examined. MethodsCaregivers of children with FASD (n = 91) and TD children (n = 103) aged 6–16 completed the Children’s Sleep Habits Questionnaire (CSHQ), Spence Children’s Anxiety Scale (SCAS), and a background questionnaire. Hierarchical multiple regression analyses, group comparisons and ANCOVA interaction models were used to test the associations between sleep and anxiety within and between the two groups. ResultsSleep disturbances and anxiety were at clinical levels for the majority of the FASD group, and significantly higher in the FASD group than the TD group. After controlling for age and sex, 27 % of the variance in anxiety scores in TD children was attributable to sleep problems, and 33 % in children with FASD. ConclusionThis study highlights associations between parent-reported sleep and anxiety in FASD. Sleep disturbances were significant predictors of anxiety in both children with FASD and in TD children. Given the importance of sleep to healthy neurodevelopment, there is a pressing need for sleep intervention studies in children with FASD. Early identification and intervention for sleep problems in this condition should be a therapeutic priority.

Vascular Structure and Function in Children and Adolescents: What Impact Do Physical Activity, Health-Related Physical Fitness, and Exercise Have?

A physically active lifestyle can prevent cardiovascular disease. Exercise intervention studies in children and adolescents that aim to increase physical activity have resulted in reduced vascular wall thickening and improve cardiovascular function. Here we review the literature that explores the correlations between physical activity, health-related physical fitness, and exercise interventions with various measures of vascular structure and function in children and adolescents. While several of these studies identified improvements in vascular structure in response to physical activity, these associations were limited to studies that relied on questionnaires. Of concern, these findings were not replicated in studies featuring quantitative assessment of physical activity with accelerometers. Half of the studies reviewed reported improved vascular function with increased physical activity, with the type of vascular measurement and the way physical activity was assessed having an influence on the reported relationships. Similary, most of the studies identified in the literature report a beneficial association of health-related physical fitness with vascular structure and function. Overall, it was difficult to compare the results of these studies to one another as different methodologies were used to measure both, health-related physical fitness and vascular function. Likewise, exercise interventions may reduce both arterial wall thickness and increased vascular stiffness in pediatric populations at risk, but the impact clearly depends on the duration of the intervention and varies depending on the target groups. We identified only one study that examined vascular structure and function in young athletes, a group of particular interest with respect to understanding of cardiovascular adaptation to exercise. In conclusion, future studies will be needed that address the use of wall:diameter or wall:lumen-ratio as part of the evaluation of arterial wall thickness. Furthermore, it will be critical to introduce specific and quantitative measurements of physical activity, as intensity and duration of participation likely influence the effectiveness of exercise interventions.

Improving remote lifestyle intervention studies in children: Participant and caregiver feedback of the smart heart study

ObjectivesWe sought to describe and analyze the quantitative and qualitative feedback obtained from participants and their caregivers of the Smart Heart study, a successful 12-month lifestyle intervention for children with overweight or obesity and congenital heart disease that provided remote lifestyle counseling, to improve future lifestyle interventions in children. MethodsThirty-six participants and caregivers were polled using a standard program evaluation questionnaire at the end of the intervention. Feedback was compiled into themes, and facilitators and barriers to program success were identified. ResultsThere was a high level of satisfaction with the intervention and staff interactions as well as a low perceived burden of participation. There were also specific concerns, including mixed impressions regarding technology usage and a less impressive indication of actual impactful behavior change. ConclusionsThe study identified five themes, and corresponding facilitators and barriers to participant compliance, from the Smart Heart intervention feedback and offered suggestions for improving future lifestyle behavioral intervention study designs in children. Practice implicationsRemote smartphone counseling is effective and efficient. It is recommended that the counseling messages are specific, the counseling schedule is patient-centric, patient burden is limited, methods with immediate patient feedback are used and family is included when feasible.

Evaluation of Bug Club: a randomised control trial of a whole school primary aged reading programme

Literacy levels for children leaving primary school, internationally, remain a cause for concern. There is a limited evidence base for whole school reading programmes and resources in the first two years of primary school compared to studies of interventions for children with reading difficulties. This study used a longitudinal randomised control trial (RCT) design to evaluate the efficacy of Bug Club; a whole school reading programme. Data from1273 pupils in Years 1 and 2 from 30 schools in the United Kingdom were analysed. A new cohort of 1425 Year 1 pupils was recruited in the second year. Over two terms, the experimental group made 1.75 more standardised points progress in reading compared to the control group, a small but significant effect. A replication study in the second year did not elicit the same significant gains. Over five terms, experimental pupils were 11 months ahead on age equivalent reading scores, relative to their chronological age. This study is the first of its type to evaluate the efficacy of a whole school reading programme in the United Kingdom. The findings contribute to an emerging understanding of what pupil progress might be expected as a result of a whole school reading programme.

Parental Knowledge of Appropriate Placement of Child Restraint Systems Before and After Educational Intervention in a Pediatric Emergency Department

This study aimed to determine caregiver's knowledge of appropriate car restraint systems (CRSs) use and compare this with the actual use among children presenting to the pediatric emergency department (PED), and to determine the efficacy of PED-based intervention on improving knowledge. We conducted a prospective, intervention study of children (<8 years old) during a 12-month period in the PED. Based on their height and weight, children were assigned to group 1 (rear facing), group 2 (forward facing), or group 3 (booster). Caregivers were surveyed in their baseline CRS knowledge. Certified child passenger safety technicians evaluated each CRS and gave caregivers one-on-one education. Participants were called back to answer a posttest to determine if the information given was retained. Of the 170 children enrolled, 64 (37.6%) were assigned to group 1, 68 (40%) to group 2, and 38 (22.3%) to group 3. Of these, 63% were not aware of the state law regarding CRS use. Among those without a CRS, 18% belonged to group 1, 36% to group 2, and 46% to group 3. Even among those who reportedly had CRS, 13% of children did not have one-on-on inspection. After inspection, 84% of group 1, 71% of group 2, and 70% of group 3 were in the appropriate one. Nearly 45% were not compliant with American Academy of Pediatrics guidelines of children riding in rear-facing CRS until 2 years of age. A significant proportion of children visiting the PED are not in appropriate CRS, and caretaker knowledge about correct CRS types and installation is poor. Future educational efforts should focus on rear-facing and booster seat age-group children.