Original Intervention Studies Research Articles

Effectiveness of ongoing face-to-face anti-tobacco intervention in children with asthma.

Background: Interventions to help parents quit smoking may yield important benefits for children with asthma. Children's exposure to environmental tobacco smoke can be measured by reporting of an adult in the household and testing the child's biomarker, e.g., cotinine. Objective: The aim of the study was to assess the effectiveness of "face-to-face" intervention carried out since 2016 in families with children diagnosed with asthma 3 years after beginning the anti-tobacco intervention. Methods: This study was a follow-up to an interventional study that assessed the effectiveness of direct patient education versus educational leaflets alone about parental tobacco smoking. The patients with asthma (ages 4-17 years) enrolled in our original intervention study conducted in 2016 were under the care of the allergy outpatient clinic. The active group was individually educated about the harmful effects of environmental tobacco smoke on their children. The control group included patients and parents, among whom only leaflets were distributed. After 3 years of ongoing intervention, in patients from both groups, exposure to tobacco smoking was evaluated with a questionnaire addressed to parents and/or caregivers and measurement of cotinine in children's urine. The forced expiratory volume in the first second of expiration and fractional exhaled nitric oxide levels were measured. Results: Seventy participants completed the study: 37 in the active group and 33 in the control group. In the active group, 27% of the parents quit smoking entirely compared with 9.4% of parents in the control group. In the group of active intervention, a significant decrease in the cotinine level (p < 0 .001) and the number of cigarettes smoked daily were observed (p < 0.001) 3 years after the active intervention compared with values right after the intervention. In the control group, there were no significant changes in the above-mentioned parameters. Conclusion: "Face-to-face" intervention among families with smokers were effective and lowered cotinine levels in children with asthma and the number of cigarettes smoked assessed 3 years after the intervention.

Effectiveness of Mobile Health Interventions on Diabetes and Obesity Treatment and Management: Systematic Review of Systematic Reviews.

BackgroundDiabetes and obesity have become epidemics and costly chronic diseases. The impact of mobile health (mHealth) interventions on diabetes and obesity management is promising; however, studies showed varied results in the efficacy of mHealth interventions.ObjectiveThis review aimed to evaluate the effectiveness of mHealth interventions for diabetes and obesity treatment and management on the basis of evidence reported in reviews and meta-analyses and to provide recommendations for future interventions and research.MethodsWe systematically searched the PubMed, IEEE Xplore Digital Library, and Cochrane databases for systematic reviews published between January 1, 2005, and October 1, 2019. We analyzed 17 reviews, which assessed 55,604 original intervention studies, that met the inclusion criteria. Of those, 6 reviews were included in our meta-analysis.ResultsThe reviews primarily focused on the use of mobile apps and text messaging and the self-monitoring and management function of mHealth programs in patients with diabetes and obesity. All reviews examined changes in biomarkers, and some reviews assessed treatment adherence (n=7) and health behaviors (n=9). Although the effectiveness of mHealth interventions varied widely by study, all reviews concluded that mHealth was a feasible option and had the potential for improving patient health when compared with standard care, especially for glycemic control (−0.3% to −0.5% greater reduction in hemoglobin A1c) and weight reduction (−1.0 kg to −2.4 kg body weight). Overall, the existing 6 meta-analysis studies showed pooled favorable effects of these mHealth interventions (−0.79, 95% CI −1.17 to −0.42; I2=90.5).ConclusionsmHealth interventions are promising, but there is limited evidence about their effectiveness in glycemic control and weight reduction. Future research to develop evidence-based mHealth strategies should use valid measures and rigorous study designs. To enhance the effectiveness of mHealth interventions, future studies are warranted for the optimal formats and the frequency of contacting patients, better tailoring of messages, and enhancing usability, which places a greater emphasis on maintaining effectiveness over time.

A Systematic Review about Educational Interventions based on the Health Belief Model (HBM) aimed to prevent and control diabetes in Iran

Background: Diabetes is one of the most common metabolic diseases in the world and a serious health problem, that requires comprehensive interventions. This systematic review was conducted to summarize educational interventions based on the Health Belief Model aimed to prevent and control diabetes. Methods: Searches were done on May 30, 2019 in PubMed, Web of Science, Google Scholar, Embase, Scopus, SID, Magiran, and IranMedex databases in English and Persian. The inclusion criteria included quantitative original interventional studies that aimed to control type 2 diabetes, and the intervention was based on the Health Belief Model. Studies done outside of Iran, interventions on other types of diabetes, non-interventional studies, and reviews were excluded. Results: Eventually, 13 studies (6 English and 7 Persian articles) entered this systematic review. The intervention durations were from 2 to 3 months. These studies fell into three broad categories: 1- Prevention of the disease 2- Improving Nutrition behaviors in patients 3-Prevention of disease complications or its progress. All of the educational interventions showed a positive effect for education on the prevention and control of diabetes. Conclusions: Interventions based on the HBM have shown an effective role in controlling and preventing diabetes.

Learning paths in synthesis writing: Which learning path contributes most to which learning outcome?

This paper presents a secondary analysis of data collected during an intervention study in which students learnt to synthesise pairs of texts presenting opposite views on controversial issues. The original intervention study included two treatments and examined the effects of two instruction conditions when instructional materials and tasks were held constant. The participants were 114 undergraduate psychology students. The object of the instruction was a guide on strategies for writing an argumentative synthesis text. However, the instruction varied between explicit strategy instruction, consisting of explaining each of the process’s four phases (exploring and identifying arguments and counterarguments, contrasting positions, drawing an integrative conclusion, and organising and revising the final draft), modelled via videos, versus self-study of the written strategy guide. After the initial instruction session, the students in both groups practiced collaboratively writing synthesis texts over two sessions with access to the strategy guide. The primary study compared the individually written pre- and posttest syntheses and found statistically significant differences favouring explicit instruction in both dependent variables: the argumentation coverage and the level of integration. The secondary analysis reported in the current paper involved scoring additional written syntheses produced during two practice sessions and then analysing the data for all time points (pretest, posttest, and the two practice sessions) using structural equation modelling (SEM) to test whether explicit instruction directly or indirectly affected the two indicators of good argumentative synthesis texts—argument coverage and integration—via the following collaborative practice. The results suggested two different learning paths for both dependent variables: explicit instruction is effective for both variables, while collaborative practice only has an additional indirect effect on argument coverage.

A Scoping Review of Interventions to Promote Health and Well-Being of Left-behind Children in Mainland China

Abstract Approximately 65 million children in mainland China are left behind in rural areas while their parents work in the cities. Research has highlighted their health needs. However, current research on interventions for this population is unknown. The purpose of this study was to systematically review existing health service interventions for left-behind children in China. The study team identified interventions for left-behind children by conducting a comprehensive search of major academic databases for Chinese and English research. Articles were retained in the study if they were original empirical intervention studies that target health and related well-being outcomes of left-behind children. A total of eighteen unique studies met inclusion criteria. The majority of them demonstrated positive outcomes using various modalities, including education, sport and nutrition guidance and nursing services. However, the shortcomings in research design and intervention limit their replication. Intervention research for left-behind children shows an enormous gap in the knowledge about this at-risk group. Of the existing programs identified, we observe considerable promise for interventions based on inter-disciplinary approaches to services. We provide additional recommendations for conducting future research and for building collaborative relationships with social workers to better serve the needs of children.

Impact of Smoking Cessation on Periodontitis: A Systematic Review and Meta-analysis of Prospective Longitudinal Observational and Interventional Studies.

This systematic review aimed to estimate the effect of tobacco smoking cessation on the risk for periodontitis compared to the risk among never-smokers and to evaluate the effect of tobacco smoking cessation on the clinical outcomes of nonsurgical periodontal treatment. Electronic searches were performed in PubMed, Scopus, and Embase. Search strategy included MeSH and free terms: periodontitis, periodontal diseases, smoking, tobacco use, tobacco, tobacco products, cigarette, pipe, and cigar. Only original prospective longitudinal observational and interventional studies that investigated the association between smoking cessation and periodontitis onset or progression were included. Meta-analyses were conducted to summarize the evidence. A total of 2743 articles were identified in electronic searches; out of which only six were included in the meta-analysis. Pooled estimates showed that the risk of periodontitis incidence or progression among those who quit smoking was not significantly different from the risk for never-smokers (risk ratio [RR] = 0.97; 95% confidence interval [CI] = 0.87% to 1.08%). Smokers had approximately 80% higher risk of periodontitis than quitters (RR = 1.79; 95% CI = 1.36% to 2.35%) and never-smokers (RR = 1.82; 95% CI = 1.43% to 2.31%). Periodontal therapy resulted in up to 0.2 mm (95% CI = -0.32% to -0.08%) higher gain in attachment level and extra 0.32 mm (95% CI = 0.07% to 0.52%) reduction in pocket depth among quitters over nonquitters after short follow-up (12-24 months). Few studies on the topic were identified. Smoking cessation reduced the risk for periodontitis onset and progression, and improved the outcomes of nonsurgical periodontal therapy. This review provides the first quantitative evidence of the impact of smoking cessation on the risk for periodontitis onset and progression. The findings have demonstrated that the risk for periodontitis becomes comparable to that of never-smokers and that nonsurgical periodontal treatment outcomes improve after smoking cessation. Dental professionals ought to consider smoking cessation interventions as a relevant component of the periodontal therapy.

Characterization of metabolic responses to healthy diets and association with blood pressure: application to the Optimal Macronutrient Intake Trial for Heart Health (OmniHeart), a randomized controlled study

Interindividual variation in the response to diet is common, but the underlying mechanism for such variation is unclear. The objective of this study was to use a metabolic profiling approach to identify a panel of urinary metabolites representing individuals demonstrating typical (homogeneous) metabolic responses to healthy diets, and subsequently to define the association of these metabolites with improvement of risk factors for cardiovascular diseases (CVDs). 24-h urine samples from 158 participants with pre-hypertension and stage 1 hypertension, collected at baseline and following the consumption of a carbohydrate-rich, a protein-rich, and a monounsaturated fat-rich healthy diet (6 wk/diet) in a randomized, crossover study, were analyzed by proton (1H) nuclear magnetic resonance (NMR) spectroscopy. Urinary metabolite profiles were interrogated to identify typical and variable responses to each diet. We quantified the differences in absolute excretion of metabolites, distinguishing between dietary comparisons within the typical response groups, and established their associations with CVD risk factors using linear regression. Globally all 3 diets induced a similar pattern of change in the urinary metabolic profiles for the majority of participants (60.1%). Diet-dependent metabolic variation was not significantly associated with total cholesterol or low-density lipoprotein (LDL) cholesterol concentration. However, blood pressure (BP) was found to be significantly associated with 6 urinary metabolites reflecting dietary intake [proline-betaine (inverse), carnitine (direct)], gut microbial co-metabolites [hippurate (direct), 4-cresyl sulfate (inverse), phenylacetylglutamine (inverse)], and tryptophan metabolism [N-methyl-2-pyridone-5-carboxamide (inverse)]. A dampened clinical response was observed in some individuals with variable metabolic responses, which could be attributed to nonadherence to diet (≤25.3%), variation in gut microbiome activity (7.6%), or a combination of both (7.0%). These data indicate interindividual variations in BP in response to dietary change and highlight the potential influence of the gut microbiome in mediating this relation. This approach provides a framework for stratification of individuals undergoing dietary management. The original OmniHeart intervention study and the metabolomics study were registered at www.clinicaltrials.gov as NCT00051350 and NCT03369535, respectively.

A systematic review on the adverse health effects of di-2-ethylhexyl phthalate.

Di (ethylhexyl) phthalate (DEHP) is a global environmental pollutant. This study aims to systematically review the literature on health effects of exposure to DEHP including effects on reproductive health, carcinogenesis, pregnancy outcome, and respiratory system. The literature search was done through Scopus, ISI Web of Science, Google Scholar, PubMed, Medline, and the reference lists of previous review articles to identify relevant articles published to June 2016 in each subject area. The inclusion criteria were as follows: original research, cross-sectional studies, case-control studies, cohort studies, interventional studies, and review articles. Both human and animal studies were included. The search was limited to English language papers. Conference papers, editorials, and letters were not included. The systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Overall, 152 of the 407 papers met the inclusion criteria. We provided an up-to-date comprehensive and critical assessment of both human and animal studies undertaken to explore the effects of DEHP. It revealed that in experimental studies, exposure to DEHP mainly targeted the reproductive, neurodevelopment, and respiratory systems. Human studies reported that exposure to this contaminant had carcinogenic effects and influenced neurodevelopment in early life. This systematic review underscored the adverse health effects of DEHP for pregnant women and the pediatric age group. It summarizes different response of humans and experimental animals to DEHP exposure, and some suggested underlying mechanisms.

Health benefits of cycle ergometer training for older adults over 70: a review.

As the number of older adults continues to increase worldwide, more attention is being paid to geriatric health care needs, and successful ageing is becoming an important topic in the medical literature. A preventive approach to the care of older adults is thus a priority in our aging societies. The purpose of this study was to update evidence for the health benefits of cycle ergometer training for older adults over 70. We searched online electronic databases up to September 2014 for original observational and intervention studies on the relationship between cycle ergometer training and health among older patients over 70. Twenty-five studies examined interventions aimed specifically at promoting cycling for older adults over 70. These studies reported a positive effect on the prevention of cardiovascular disease, and a significant improvement in metabolic responses. Improving functional status, muscle strength and cognitive performance are also well established. Overall, this review demonstrates a positive effect of cycle ergometer training with functional benefits and positive health outcomes for older adults over 70. Based on this evidence, clinicians can now encourage older adults to profit from the health benefits of cycle ergometer training to be able to pursue their daily activities independently.

Cost-utility analysis of an internet and computer training intervention to improve independence and mental wellbeing of older people

BackgroundGood mental health and emotional wellbeing are as important in older age as at any other time of life. This study aimed to assess the cost-effectiveness of an intervention to improve the independence and mental wellbeing of older people. MethodsCost-consequence analysis (CCA) and cost-utility analysis (CUA) were used to assess the cost-effectiveness of an internet and computer training intervention (9 h of group training over 2 weeks) versus no training. The CCA reported a range of outcomes, including reductions in loneliness and social isolation. The CUA was conducted with a decision analytical model, and populated with published data on the effect of loneliness on health outcomes such as depression, stroke, and coronary heart disease; it adopted a lifetime horizon and health service perspective. FindingsThe original intervention study (appendix) identified no statistically significant difference between groups for loneliness after 5 months, but noted increased computer use. Increased computer use has been linked to a range of positive outcomes more generally, including social network benefits and a decrease in isolation and loneliness, and this was outlined in the CCA. The increase in computer use identified in the original study corresponded to a 1·62 decrease in loneliness (UCLA Loneliness Scale), which resulted in about 2% of the population moving from moderately lonely to not lonely. Focusing only on the health outcomes that are improved by a reduction in loneliness, the internet and computer training intervention is expected to reduce depression by 0·67%, reduce the early onset of dementia by 0·14%, and increase physical activity by 1·24% (thus reducing diabetes by 0·09%, stroke by 0·1%, and coronary heart disease by 0·17%). An intervention cost of £564 per person leads to future cost savings to the health service of £224 and a quality adjusted life years gain of 0·021 per person (all present values). The incremental cost-effectiveness ratio is £15 962 (ranging from £2735 to £42 415 in the sensitivity analysis, appendix). This excludes benefits in terms of reduced mortality, as well as other gains discussed in the CCA, such as social network benefits. InterpretationAlthough this analysis was based on extrapolation from an initial study with a fairly short follow-up, the results suggest that an internet and computer training intervention is likely to be cost effective at improving the physical and mental health of older people. FundingNational Institute for Health and Care Excellence (NICE).

Longitudinal Association Between Body Mass Index and Health-Related Quality of Life.

Objective: Health-related quality of life (HRQoL) is an important outcome in individuals with a high risk for cardiovascular diseases. We investigated the association of HRQoL and body mass index (BMI) as an indicator for obesity. Design: Secondary longitudinal analysis of the ORBITAL study, an intervention study which included high-risk cardiovascular primary care patients with hypercholesterolemia and an indication for statin therapy. Methods: HRQoL was determined with the generic Short Form (SF)-12 health status instrument. Body weight and height were assessed at baseline and at months 6, 12, 18, 24, 30, and 36. We used a linear and a linear mixed-effects regression model to investigate the association between BMI and SF-12 summary scores at baseline as well as between change in BMI and SF-12 summary scores over 3 years. We adjusted for age, sex, smoking status, and in the longitudinal analysis also for the study arm and its interaction term with time. Results: Of the 7640 participants who completed the baseline questionnaire, 6726 participants (mean age: 61 years) were analyzed. The baseline BMI was inversely associated with physical and mental SF-12 summary scores (b [95% CI] per 1 kg/ m: 20.36 [20.41; 20.30] and 20.05 [20.11; 20.00], respectively). A significant association between the change in BMI and physical SF-12 summary scores over time was only present in women (20.18 [20.27; 20.09]) and only in obese participants (20.19 [20.29; 20.10]). A change in BMI was directly associated with mental SF-12 summary scores (0.12 [0.06; 0.19]) in the total population. Conclusion: Increases in BMI were associated with decreases in physical HRQoL, particularly in obese individuals and in women. In contrast, the mental HRQoL seemed to increase with increasing BMI over time. Thus, body weight management with respect to the HRQoL should be evaluated differentially by sex and body weight status. Trial Registration: ClinicalTrials.gov NCT00379249 Citation: Muller-Nordhorn J, Muckelbauer R, Englert H, Grittner U, Berger H, et al. (2014) Longitudinal Association between Body Mass Index and Health-Related Quality of Life. PLoS ONE 9(3): e93071. doi:10.1371/journal.pone.0093071 Editor: Robert L. Newton, Pennington Biomedical Research Center, United States of America Received August 16, 2013; Accepted February 28, 2014; Published March 26, 2014 Copyright: 2014 Muller-Nordhorn et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: The original intervention study was supported by an unconditional grant from AstraZeneca. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The present analysis was supported exclusively by the Berlin School of Public Health, Charite University Medical Center Berlin. Competing Interests: The original intervention study was supported by an unconditional grant from AstraZeneca. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials. * E-mail: jacqueline.mueller-nordhorn@charite.de . These authors contributed equally to this work.

Health benefits of endurance training alone or combined with diet for obese patients over 60: a review.

The prevalence of obesity is rapidly increasing in older patients and it is ubiquitous in many developed countries. Obesity is related to various negative health outcomes, making it a major public health target for intervention. The aim of this study was to explore and summarise the literature that addresses endurance training alone or combined with nutrition interventions to combat obesity in obese patients over age 60. We searched online electronic databases up to September 2014 for original observational and intervention studies published between 1995 and 2014 on the relationship between endurance training alone or combined with a diet in obese patients over 60 regarding health outcomes. Twenty-six studies examined interventions aimed specifically at promoting endurance training alone or combined with diet for older obese patients over 60. These studies demonstrated a positive effect of this intervention on the primary prevention of cardiovascular disease, and a significant beneficial effect on the lipid profile. Improvement of body composition and insulin sensitivity, and a reduction in blood pressure were also well established. Overall, this review demonstrates a positive effect of endurance training alone or combined with diet on health outcomes and metabolic benefits in older adults. Clinicians can now use this evidence to formulate actions to encourage the older obese to profit from the health benefits of endurance training and diet. This will not only help reduce the dramatic increase in the number of older obese but also help prevent sarcopenic obesity, which is a complex challenge for healthcare professionals.

Association between Drug Insurance Cost Sharing Strategies and Outcomes in Patients with Chronic Diseases: A Systematic Review

BackgroundPrescription drugs are used in people with hypertension, diabetes, and cardiovascular disease to manage their illness. Patient cost sharing strategies such as copayments and deductibles are often employed to lower expenditures for prescription drug insurance plans, but the impact on health outcomes in these patients is unclear.ObjectiveTo determine the association between drug insurance and patient cost sharing strategies on medication adherence, clinical and economic outcomes in those with chronic diseases (defined herein as diabetes, hypertension, hypercholesterolemia, coronary artery disease, and cerebrovascular disease).MethodsStudies were included if they examined various cost sharing strategies including copayments, coinsurance, fixed copayments, deductibles and maximum out-of-pocket expenditures. Value-based insurance design and reference based pricing studies were excluded. Two reviewers independently identified original intervention studies (randomized controlled trials, interrupted time series, and controlled before-after designs). MEDLINE, EMBASE, Cochrane Library, CINAHL, and relevant reference lists were searched until March 2013. Two reviewers independently assessed studies for inclusion, quality, and extracted data. Eleven studies, assessing the impact of seven policy changes, were included: 2 separate reports of one randomized controlled trial, 4 interrupted time series, and 5 controlled before-after studies.FindingsOutcomes included medication adherence, clinical events (myocardial infarction, stroke, death), quality of life, healthcare utilization, or cost. The heterogeneity among the studies precluded meta-analysis. Few studies reported the impact of cost sharing strategies on mortality, clinical and economic outcomes. The association between patient copayments and medication adherence varied across studies, ranging from no difference to significantly lower adherence, depending on the amount of the copayment.ConclusionLowering cost sharing in patients with chronic diseases may improve adherence, but the impact on clinical and economic outcomes is uncertain.

Review of interventions to increase hearing protective device use in youth who live or work on farms

To identify and compare hearing protection interventions for youth working and living on farms. Noise-induced hearing loss represents a significant risk factor for injury, disability and death in agricultural populations due to an inability to receive sensory information that can indicate dangerous situations. Despite the availability of hearing protection devices, rates of utilisation remain low, while rates of noise-induced hearing loss are high within the agricultural youth population. Comprehensive review of the literature. Electronic database searches were conducted to identify research studies of hearing protection interventions for youth living or working on farms. Three intervention studies were identified as meeting the review criteria, with additional reanalysis studies based on the original intervention studies. The intervention studies demonstrated increased use of hearing protection devices among youth who received the interventions compared to the control groups although audiometry testing results were not improved as a result of the intervention. The findings of this review highlight the need for additional research into the effectiveness of hearing protection device use as a noise-induced hearing loss preventative measure in youth who live or work on farms and the creation of effective interventions to increase hearing protection device use and decrease Noise-induced hearing loss risk. It is recommended that nurses be educated in the areas of health promotion relevant to farming communities to be able to effectively meet their rural clients' needs in relation to noise-induced hearing loss. Working with youth, families, and schools, as well as developing community partnerships, can facilitate the dissemination of hearing protection promotion.

Cultural adaptation of an evidence-based nursing intervention to improve medication adherence among people living with HIV/AIDS (PLWHA) in China

BackgroundAdapting nursing interventions to suit the needs and culture of a new population (cultural adaptation) is an important early step in the process of implementation and dissemination. While the need for cultural adaptation is widely accepted, research-based strategies for doing so are not well articulated. Non-adherence to medications for chronic disease is a global problem and cultural adaptation of existing evidence-based interventions could be useful. ObjectivesThis paper aims to describe the cultural adaptation of an evidence-based nursing intervention to improve medication adherence among people living with HIV/AIDS and to offer recommendations for adaptation of interventions across cultures and borders. SiteThe intervention, which demonstrated efficacy in a randomized controlled trial in North America, was adapted for the cultural and social context of Hunan Province, in south central China. Sources of dataThe adaptation process was undertaken by intervention stakeholders including the original intervention study team, the proposed adaptation team, and members of a Community Advisory Board, including people living with HIV/AIDS, family members, and health care workers at the target clinical sites. ProceduresThe adaptation process was driven by quantitative and qualitative data describing the new population and context and was guided by principles for cultural adaptation drawn from prevention science research. ResultsThe primary adaptation to the intervention was the inclusion of family members in intervention activities, in response to the cultural and social importance of the family in rural China. In a pilot test of the adapted intervention, self-reported medication adherence improved significantly in the group receiving the intervention compared to the control group (p=0.01). Recommendations for cultural adaptation of nursing interventions include (1) involve stakeholders from the beginning; (2) assess the population, need, and context; (3) evaluate the intervention to be adapted with attention to details of the original studies that demonstrated efficacy; (4) compare important elements of the original intervention with those of the proposed new population and context to identify primary points for adaptation; (5) explicitly identify sources of tension between intervention fidelity and cultural adaptive needs; (6) document the process of adaptation, pilot the adapted intervention, and evaluate its effectiveness before moving to dissemination and implementation on a large scale.

Supporting Early Writing in Dual Language Head Start Classrooms

The following research-to-practice summary addresses the findings from the original intervention study and provides specific guidance for early childhood practitioners. These recommendations respond to a current and growing concern on how to implement developmental, cultural, and linguistically appropriate curricula, namely, recommendations focus on describing effective teaching practices that promote school readiness in classrooms with children who are dual language learners. In addition, the summary describes how the curriculum was implemented, using an explicit instructional design that embedded early writing and print knowledge in a developmental sequence to support learning new concepts and ideas. Additional suggestions on culturally and linguistically responsive teaching and learning practices are provided.

Sickness absence in student nursing assistants following a preventive intervention programme

We have previously shown that a multidimensional programme combining physical training, patient transfer techniques and stress management significantly reduced sickness absence rates in student nurse assistants (NAs) after 14 months of follow-up. At follow-up, the control group had reduced SF-36 scores for general health perception [general health (GH)], psychological well-being [mental health (MH)] and energy/fatigue [vitality (VT)] compared with the intervention group, which remained at the baseline level for all three measures. To ascertain whether this effect remained after a further 36 months of follow-up and to analyse the association of GH, MH and VT scores with sickness absence. This was a cluster randomized prospective study. The original study involved assessment at baseline and follow-up at 14 months (the duration of the student NA course). Of 568 subjects from the original intervention study, 306 (54%) completed a postal questionnaire at 36 months. Sickness absence increased in both groups between the first and second follow-up. At the second follow-up, the intervention group had a mean of 18 days of sickness absence compared with 25 in the control group but this was not significant. GH at 14 months follow-up was found to predict sickness absence levels after 3 years. MH and VT scores showed an inverse association with sickness absence but the results were not significant. The results suggest that the initial intervention did not have a sustained effect on sickness absence 36 months after initial follow-up of the study group.

Recent Evidence of the Effectiveness of Educational Interventions for Improving Complementary Feeding Practices in Developing Countries

Inappropriate complementary feeding practices have been identified as the major causes of malnutrition in young children in developing countries. This article reviewed literature on complementary feeding educational interventions from 1998 onwards. The purpose of this study was to provide evidence from published studies in the past decade on the effectiveness of educational intervention programs on improving complementary feeding practices in the developing world. The literature search was performed through PubMed/Medline database with the following key words: infant feeding, weaning and intervention, and identified a total of 15 original educational intervention studies. Evidence from these studies supports that educational intervention can effectively improve complementary feeding practices and child nutrition and growth. The intervention should be culturally sensitive, accessible and integrated with local resources.

Theoretical models for pedometer use in physical activity interventions

Background: Research shows that pedometers help to increase daily physical activity. However, much less is known about why pedometers work, specifically as it relates to the theoretical grounding of pedometer-based interventions.Objectives: To complete a full review of the literature regarding the use of theory and specific skills/tools used in pedometer-based interventions as it relates to changes in behaviour across time.Methods: Thirty-one original theoretically-based intervention studies were identified to inform this review of theoretical constructs, intervention strategies, and pedometer contributions that influence walking behaviour.Results: Studies suggest that Social Cognitive Theory (SCT), specifically the behaviours of self-monitoring, feedback, and goal-setting are critical elements for an intervention. While the Theory of Planned Behaviour (TBP) successfully increases motivation, there is less evidence that changing motivation alone translates into behaviour change. However, adding the Implementation Intention (II) Theory appears to hold promise. Using behavioural techniques guided by the Transtheoretical Model (TTM) appear to provide benefit when considering population, the environment, and overcoming environmental barriers. Other and new integrated models are also emerging in this area, such as the small changes model (SCM).Conclusions: While the field of pedometer-based interventions holds significant potential to address the physical inactivity crisis, interventionists should use theory to guide intervention, consistent description of the theory, skills and tools used in an intervention, and reported step counts to compare interventions in order to advance the impact of this important area of research.

Phonological awareness and language intervention in preschoolers from low socio‐economic backgrounds: A longitudinal investigation

This study examines the literacy outcomes for children from socially disadvantaged backgrounds who had received specific whole-class phonological awareness (PA) and language intervention in preschool. The participants were 57 children who had been involved in the original intervention study. Their PA skills, letter-sound knowledge, real word and non-word spelling and reading comprehension were assessed in Grade 2. The results indicated that children who had received intervention in preschool performed similarly to the children who had not received intervention. The gains made in PA and language skills post intervention had failed to augment further literacy development. A post hoc examination of individual student profiles, however, revealed that a subgroup of children who had received intervention had maintained their enhanced performance and that the intervention cohort had similar scores on tests of PA ability to their age-matched peers in the population. It was concluded that whole-class, teacher-delivered, PA and language intervention, while effective in the short term, does not lead to a generalized improvement in literacy skills in Grade 2. Possible reasons for the failure of the program to produce medium term gains are discussed.