Selection of Matching Variables in Community Health Intervention Trials

In a matched experimental design, the effectiveness of matching in reducing bias and increasing power depends on the strength of the association between the matching variable and the outcome of interest. In particular, in the design of a community health intervention trial, the effectiveness of a matched design, where communities are matched according to some community characteristic, depends on the strength of the correlation between the matching characteristic and the change in the health behavior being measured. We attempt to estimate the correlation between community characteristics and changes in health behaviors in four datasets from community intervention trials and observational studies. Community characteristics that are highly correlated with changes in health behaviors would potentially be effective matching variables in studies of health intervention programs designed to change those behaviors. Among the community characteristics considered, the urban-rural character of the community was the most highly correlated with changes in health behaviors. The correlations between Per Capita Income, Percent Low Income & Percent aged over 65 and changes in health behaviors were marginally statistically significant (p < 0.08).

Improving executive functions in 5- and 6-year-olds: Evaluation of a small group intervention in prekindergarten and kindergarten children

Research suggests a central role of executive functions for children's cognitive and social development during preschool years, especially in promoting school readiness. Interventions aiming to improve executive functions are therefore being called for. The present study examined the effect of a small group intervention implemented in kindergarten settings focusing on basic components of executive functions, i.e., working memory, interference control and cognitive flexibility. A total of 135 children enrolled in Swiss prekindergarten (5-year-olds) and kindergarten (6-year-olds) were involved. Results revealed that the small group intervention promoted gains in all three included components of executive functions: prekindergarten children substantially improved their working memory and cognitive flexibility processes, whereas significant training effects were found for the kindergarten children in interference control. Implications of these findings for early intervention programs and for tailoring preschool curricula are discussed, particularly with respect to children's school readiness. Copyright © 2011 John Wiley & Sons, Ltd.

Educational orientation regarding vocabulary and literacy access : Evaluating the impact of an intervention program designed to promote early learning at home

El estudio evalúa el impacto de un programa de promoción del desarrollo lingüístico y cognitivo para niños de 5 años implementado según dos modalidades: una que implicó acciones de alfabetización familiar en los hogares de los niños (modalidad intensiva) y otra que incluyó la participación de los niños en las salas de jardín de infantes (modalidad extensiva). La evaluación del impacto se realizó por medio de un diseño pre-test ? post-test. Se tomaron pruebas de vocabulario receptivo (VR), producción de categorías (PC) y escritura a una muestra de 214 niños participantes de la modalidad intensiva, 69 participantes de la modalidad extensiva y un grupo control de no participó del programa (49 niños). Los resultados mostraron que la participación en la modalidad intensiva implicó un mayor incremento en las habilidades infantiles de VR, PC que en la modalidad extensiva. A su vez ambas modalidades experimentales mostraron un mayor incremento en las variables examinadas respecto de las observadas en el grupo control. No se detectaron efectos de la escolaridad de la madre y la asistencia previa al jardín. Los resultados mostraron correlaciones significativas entre todas las variables analizadas y el valor predictivo de los puntajes en VR a principio de año respecto de los puntajes en VR y escritura a fin de año.

Educational orientation regarding vocabulary and literacy access : Evaluating the impact of an intervention program designed to promote early learning at home

El estudio evalúa el impacto de un programa de promoción del desarrollo lingüístico y cognitivo para niños de 5 años implementado según dos modalidades: una que implicó acciones de alfabetización familiar en los hogares de los niños (modalidad intensiva) y otra que incluyó la participación de los niños en las salas de jardín de infantes (modalidad extensiva). La evaluación del impacto se realizó por medio de un diseño pre-test ? post-test. Se tomaron pruebas de vocabulario receptivo (VR), producción de categorías (PC) y escritura a una muestra de 214 niños participantes de la modalidad intensiva, 69 participantes de la modalidad extensiva y un grupo control de no participó del programa (49 niños). Los resultados mostraron que la participación en la modalidad intensiva implicó un mayor incremento en las habilidades infantiles de VR, PC que en la modalidad extensiva. A su vez ambas modalidades experimentales mostraron un mayor incremento en las variables examinadas respecto de las observadas en el grupo control. No se detectaron efectos de la escolaridad de la madre y la asistencia previa al jardín. Los resultados mostraron correlaciones significativas entre todas las variables analizadas y el valor predictivo de los puntajes en VR a principio de año respecto de los puntajes en VR y escritura a fin de año.

Educational orientation regarding vocabulary and literacy access : Evaluating the impact of an intervention program designed to promote early learning at home

El estudio evalúa el impacto de un programa de promoción del desarrollo lingüístico y cognitivo para niños de 5 años implementado según dos modalidades: una que implicó acciones de alfabetización familiar en los hogares de los niños (modalidad intensiva) y otra que incluyó la participación de los niños en las salas de jardín de infantes (modalidad extensiva). La evaluación del impacto se realizó por medio de un diseño pre-test ? post-test. Se tomaron pruebas de vocabulario receptivo (VR), producción de categorías (PC) y escritura a una muestra de 214 niños participantes de la modalidad intensiva, 69 participantes de la modalidad extensiva y un grupo control de no participó del programa (49 niños). Los resultados mostraron que la participación en la modalidad intensiva implicó un mayor incremento en las habilidades infantiles de VR, PC que en la modalidad extensiva. A su vez ambas modalidades experimentales mostraron un mayor incremento en las variables examinadas respecto de las observadas en el grupo control. No se detectaron efectos de la escolaridad de la madre y la asistencia previa al jardín. Los resultados mostraron correlaciones significativas entre todas las variables analizadas y el valor predictivo de los puntajes en VR a principio de año respecto de los puntajes en VR y escritura a fin de año.

Nutrition and physical activity programs for obesity treatment (PRONAF study). methodological approach of the project

Este trabajo aborda la metodología seguida para llevar a cabo el proyecto de investigación PRONAF (Clinical Trials Gov.: number NCT01116856.) Background: At present, scientific consensus exists on the multifactorial etiopatogenia of obesity. Both professionals and researchers agree that treatment must also have a multifactorial approach, including diet, physical activity, pharmacology and/or surgical treatment. These two last ones should be reserved for those cases of morbid obesities or in case of failure of the previous ones. The aim of the PRONAF study is to determine what type of exercise combined with caloric restriction is the most appropriate to be included in overweigth and obesity intervention programs, and the aim of this paper is to describe the design and the evaluation methods used to carry out the PRONAF study. Methods/design: One-hundred nineteen overweight (46 males) and 120 obese (61 males) subjects aged 18–50 years were randomly assigned to a strength training group, an endurance training group, a combined strength + endurance training group or a diet and physical activity recommendations group. The intervention period was 22 weeks (in all cases 3 times/wk of training for 22 weeks and 2 weeks for pre and post evaluation). All subjects followed a hypocaloric diet (25-30% less energy intake than the daily energy expenditure estimated by accelerometry). 29–34% of the total energy intake came from fat, 14–20% from protein, and 50–55% from carbohydrates. The mayor outcome variables assesed were, biochemical and inflamatory markers, body composition, energy balance, physical fitness, nutritional habits, genetic profile and quality of life. 180 (75.3%) subjects finished the study, with a dropout rate of 24.7%. Dropout reasons included: personal reasons 17 (28.8%), low adherence to exercise 3 (5.1%), low adherence to diet 6 (10.2%), job change 6 (10.2%), and lost interest 27 (45.8%). Discussion: Feasibility of the study has been proven, with a low dropout rate which corresponds to the estimated sample size. Transfer of knowledge is foreseen as a spin-off, in order that overweight and obese subjects can benefit from the results. The aim is to transfer it to sports centres. Effectiveness on individual health-related parameter in order to determine the most effective training programme will be analysed in forthcoming publications.

Illinois annual performance report : Early Intervention Program /

The Illinois Early Intervention Services Act required the Illinois Department of Human Services (DHS) to submit to the Governor a five-fiscal year implementation plan and to annually report to the Governor and the General Assembly on the status of early intervention programs for eligible infants and toddlers and their families in Illinois.

The impact of the juvenile intervention facility on the adjudication of delinquent youth in Broward County

Considerable funds have been allocated in the area of juvenile justice in attempts to reduce and prevent the problem of juvenile delinquency. Much of these funds have been funneled to various community-level intervention programs. This dissertation reports the results of a study that examined the effects of one such program, the Juvenile Intervention Facility (JIF) in Broward County, Florida, on reducing the number of cases handled judicially by the Juvenile Court in that county. ^ Juvenile justice policy, which precipitated the creation of the JIF program, assumed that more structured and integrative efforts at the point of entry into the juvenile justice system would lead to greater diversion from the courts to much needed intervention services. By virtue of this process, the number of juveniles handled judicially by the courts was expected to decrease and future delinquent behavior would be prevented. Archival data from four fiscal years were examined, two years pre-JIF, two years post-JIF, a third-year follow-up, and a concurrent outcome measure corresponding to the first year of JIF operations. Data included all juvenile cases referred during the fiscal years defined for Broward and St. Lucie Counties, the state of Florida, and the United States. The study tested four hypotheses: (a) the JIF would reduce the number of cases handled judicially in Broward County Juvenile Court, (b) the decrease in judicially handled cases would be greater for females than for males, (c) there would be greater decreases in judicially handled cases for whites than non-whites, (d) there would be greater decreases in judicial handling for younger than older offenders. Bivariate analyses were conducted, consisting of chi square tests, to test the hypotheses. ^ Results indicate that the impact of the JIF was in the opposite direction of what was expected in that more juvenile offenders were handled judicially through juvenile court. This fact points to the possibility that the JIF has failed to provide the intended consequences of the policy. In the discussion, these “unintended” consequences are addressed in the context of juvenile justice policy creation and the competing constituencies involved in such policy development. ^

Exploring the stages of change and perceived barriers to treatment models within the context of parental adherence to an early intervention program

Parent-mediated early intervention programs depend on the willingness and ability of parents to complete prescribed activities with their children. In other contexts, internal factors, such as stages of change, and external factors, such as barriers to treatment, have been shown to correlate with adherence to service. This researcher modified the Stages of Change Questionnaire as well as the Barriers to Treatment Participation Scale (BTPS) to use with this population. Despite initial interest, twenty-three parent participants were referred to the researcher over the course of three years, with only five parents taking part in the study. A population base ten times that of the current sample would be required recruit enough participants (fifty-one) to provide sufficient power. This feasibility study discusses the results of the five parent participants. Findings suggest that the modified Stages of Change Questionnaire may not be sensitive enough for use with the current sample, while the modified BTPS may yield useful information for service providers.

Contribuindo para a formação humana dos adolescentes da FEBEM por meio da ginastica geral

Universidade Estadual de Campinas . Faculdade de Educação Física

Reflections on onset-rime and phoneme sensitivity as predictors of beginning word reading

Rival claims have been made concerning the importance of rime sensitivity as a predictor of early word reading skill. Hulme et al. (2002) suggested that phoneme sensitivity is more strongly predictive of word reading ability than is onset-rime sensitivity. An examination of two independent data sets suggests that, although onset-rime sensitivity typically predicts school entrants' later word reading skill, phoneme sensitivity does predict more variation. However, multiple regression analyses do not reveal the level of phonological sensitivity that children need in order to understand alphabetic reading instruction. This issue is crucial to the detection of children at risk for reading failure and for the design of intervention programs for these children. A different analytic strategy is described for addressing this issue. (C) 2002 Elsevier Science (USA).

Modelo de avaliação do programa comunitário de intervenção precoce da CERCI Lisboa

Mestrado em Intervenção Socio-Organizacional na Saúde - Área de especialização: Políticas de Administração e Gestão de Serviços de Saúde.

Qualidade de vida relacionada com o exercício em indivíduos com asma: revisão sistemática

Background: A asma condiciona o dia-a-dia do indivíduo asmático do ponto de vista clínico e emocional demonstrando-se muitas vezes como um subtractivo da qualidade de vida (QV). Alguns estudos, com particular incidência nos últimos dez anos, para além de demonstrarem os benefícios da actividade física na componente clínica da doença, têm analisado o seu efeito na QV dos asmáticos. Objectivo: Analisar os efeitos da actividade física na QV de indivíduos com asma tendo por base uma revisão da literatura actual. Métodos: Foi conduzida uma pesquisa dos randomized controlled trials (RCT) compreendidos entre Janeiro de 2000 e Agosto de 2010, bem como as citações e as referências bibliográficas de cada estudo nas principais bases de dados de ciências da saúde (Academic Search Complete, DOAJ, Elsevier – Science Direct, Highwire Press, PubMed, Scielo Global, Scirus, Scopus, SpringerLink, Taylor & Francis e Wiley Interscience) com as palavras-chave: asthma, quality of life, QoL, physical activity, exercise, breathing, training e programme em todas as combinações possíveis. Os estudos foram analisados independentemente por dois revisores quanto aos critérios de inclusão e qualidade dos estudos. Resultados: Dos 1075 estudos identificados apenas onze foram incluídos. Destes, seis apresentaram um score 5/10, três 6/10 e dois 7/10 segundo a escala PEDro. Cinco destes estudos foram realizados em crianças entre os 7 e os 15 anos e os restantes em adultos. Os programas de intervenção dividiram-se em programas de treino aeróbio e programas de exercícios respiratórios. Todos programas de treino aeróbio apresentaram melhorias na QV demonstrando uma influência positiva do treino aeróbio na asma. Principais conclusões: Há uma tendência notória do benefício dos programas de treino aeróbio na QV dos indivíduos asmáticos. Os programas de exercícios respiratórios foram poucos e heterogéneos impossibilitando uma conclusão positiva quanto à sua recomendação para a melhoria da QV nesta patologia. Há uma grande necessidade de mais RCT com rigor metodológico.

Occupational exposure to poultry dust and effects on the respiratory system in workers

Farmers are occupationally exposed to many respiratory hazards at work and display higher rates of asthma and respiratory symptoms than other workers. Dust is one of the components present in poultry production that increases risk of adverse respiratory disease occurrence. Dust originates from poultry residues, molds, and feathers and is biologically active as it contains microorganisms. Exposure to dust is known to produce a variety of clinical responses, including asthma, chronic bronchitis, chronic airways obstructive disease (COPD), allergic alveolitis, and organic dust toxic syndrome (ODTS). A study was developed to determine particle contamination in seven poultry farms and correlate this with prevalence rate of respiratory defects and record by means of a questionnaire the presence of clinical symptoms associated with asthma and other allergy diseases by European Community Respiratory Health Survey. Poultry farm dust contamination was found to contain higher concentrations of particulate matter (PM) PM5 and PM10. Prevalence rate of obstructive pulmonary disorders was higher in individuals with longer exposure regardless of smoking status. In addition, a high prevalence for asthmatic (42.5%) and nasal (51.1%) symptoms was noted in poultry workers. Data thus show that poultry farm workers are more prone to suffer from respiratory ailments and this may be attributed to higher concentrations of PM found in the dust. Intervention programs aimed at reducing exposure to dust will ameliorate occupational working conditions and enhance the health of workers.

Relatório de estágio em reabilitação neurológica

Mestrado em Fisioterapia.