Introduction
Child malnutrition is a major issue in conflict zones. Evidence-based interventions and their thorough evaluation could help to eliminate malnutrition. We aimed to assess the causal ...effect of a community-based multidisciplinary nutrition program for children in a chronic conflict zone near the northeastern border of Armenia on two main outcomes: stunting and anemia. We further compared the interpretations and public health relevance of the obtained effect estimates.
Methods
In 2016, the study measured hemoglobin and anthropometric measures and collected data from the children’s caregivers. We used propensity score matching analyses, inverse probability weighting, and overlap weighting methods to examine the average treatment effects among treated population (ATT), and among population with overlapping weights (ATO).
Results
The ATT for stunting among children who participated in the intervention program estimated by propensity score matching analyses (PSM-ATT) was (1.95; 95%CI 1.15–3.28). Nevertheless, children who took part in the program had a lower risk of anemia (0.28; 95%CI 0.19–0.42). The ATT, estimated by inverse probability weighting (IPTW-ATT), was slightly lower for stunting (1.82; 95%CI 1.16–2.86) while similar for anemia (0.33; 95%CI 0.23–0.46) compared to PSM-ATT. Compared to the IPTW-ATT and PSM-ATT the ATO was lower for stunting (1.75; 95%CI 1.14–2.68) and similar for anemia (0.31; 95%CI 0.22–0.43).
Discussion
Marginal models could be used in similar quasi-experimental settings to identify the causal effect of interventions in specific populations of interest. Nonetheless, these methods do not eliminate threats to internal validity. Thorough study design and accurate data collection are necessary to improve the efficiency of marginal models.
In this study, an intervention program was designed based on the instructional principles of self-regulated learning (SRL), and its effectiveness in enhancing Hong Kong secondary three students’ ...classical Chinese (CC) reading comprehension and motivation was evaluated. A pretest–posttest treatment–control group quasi-experimental design was used. During the study, 191 students between the ages of 13 and 16 years were assigned to three groups and received different treatments: in the experimental group (EG), teachers implemented all the instructional practices designed based on SRL instructional principles in the intervention package; in the control group (CG1), teachers used the traditional teacher-centered approach to teach the same instructional materials from the intervention program; and in the baseline control group (CG2), teachers adopted traditional teacher-centered, text-based instruction to teach the CC texts in students’ original textbook. Reading comprehension tests, questionnaires, and interviews were used to evaluate the effectiveness of the intervention. The findings indicated that the EG and CG1 students had significantly better CC reading comprehension performance and prior knowledge than the CG2 students. The EG students also showed positive attitudes towards the intervention program. Implications of the findings are discussed to provide insights into the potential applicability of SRL instruction in the Chinese context.
Many epidemiologic studies identify contrasts between an "always-exposed" population and a "never-exposed" population. Such "exposure effects" are perhaps most valuable in discussing individual ...lifestyle changes, or in clinical care; they may be less valuable in estimating the potential effects of realistic public health interventions. Various methods, among them population attributable fractions and generalized impact fractions, attempt to obtain more policy-relevant estimates of "population intervention" effects, but such methods remain rare in the epidemiologic literature. Here, we describe the use of the parametric g-formula as a tool for the estimation of population intervention effects in longitudinal data. Our discussion is motivated by a previous study of the effect of incident pregnancy on time to virological failure among human immunodeficiency virus-positive women initiating antiretroviral therapy in South Africa between 2004 and 2011. We show that 1) interventional estimates of effect can be estimated in longitudinal data using the parametric g-formula and 2) exposure effects and population interventional effects can have dramatically different interpretations and magnitudes in real-world data. Epidemiologists should consider estimating interventional effects in addition to exposure effects; doing so would allow the results of epidemiologic studies to be more immediately relevant to policy-makers and to implementation science efforts.
Objective: The present study tested the hypothesis that improvements in parental sense of competence during multisystemic therapy (MST) lead to positive changes in parenting, which in turn lead to a ...decrease of adolescent externalizing problems. Mediational models were tested separately for 3 dimensions of parenting (positive discipline, inept discipline, and relationship quality) that are targeted in MST. Each model included "3-path mediation," in which 2 mediators (i.e., changes in parental sense of competence and parenting dimension) intervene sequentially between the independent (i.e., intervention status) and dependent variable (i.e., change in externalizing problems). Method: Participants in this randomized controlled trial were 256 adolescents and their families who received either MST (n = 147) or treatment as usual (n = 109). In addition to pre- and postintervention assessments, 5 monthly within-intervention assessments took place. Results: Both preintervention-postintervention comparison, through analysis of covariance, and comparison of trajectories during intervention, through latent growth modeling, showed that MST enhanced growth in parental sense of competence and positive discipline, led to no deterioration in relationship quality, and resulted in a decrease in adolescent externalizing problems. The results supported a sequential pattern of change for positive discipline: Changes in parental sense of competence predicted changes in positive discipline, which in turn predicted decrease in adolescent externalizing problems. No support was found for mediated effects of inept discipline and relationship quality. Conclusions: The results affirm the importance of directly targeting parental sense of competence and positive discipline in future interventions aimed at decreasing adolescent problem behavior.
Abstract Purpose We tested whether effects of the Strengthening Families Program for Youth 10–14 (SFP10-14) diffused from intervention participants to their friends. We also tested which program ...effects on participants accounted for diffusion. Methods Data are from 5,449 students (51% female; mean initial age = 12.3 years) in the PROmoting School-community-university Partnerships to Enhance Resilience community intervention trial (2001–2006) who did not participate in SFP10-14 (i.e., nonparticipants). At each of five waves, students identified up to seven friends and self-reported past month drunkenness and cigarette use, substance use attitudes, parenting practices, and unsupervised time spent with friends. We computed two measures of indirect exposure to SFP10-14: total number of SFP-attending friends at each wave and cumulative proportion of SFP-attending friends averaged across the current and all previous post-intervention waves. Results Three years post-intervention, the odds of getting drunk (odds ratio = 1.4) and using cigarettes (odds ratio = 2.7) were higher among nonparticipants with zero SFP-attending friends compared with nonparticipants with three or more SFP-attending friends. Multilevel analyses also provided evidence of diffusion: nonparticipants with a higher cumulative proportion of SFP-attending friends at a given wave were less likely than their peers to use drugs at that wave. Effects from SFP10-14 primarily diffused through friendship networks by reducing the amount of unstructured socializing (unsupervised time that nonparticipants spent with friends), changing friends' substance use attitudes, and then changing nonparticipants' own substance use attitudes. Conclusions Program developers should consider and test how interventions may facilitate diffusion to extend program reach and promote program sustainability.
The effectiveness of a 10-session social problem-solving training (SPST) was evaluated in two independent studies in a juvenile justice (JJ) setting. In both studies, we aimed to examine main ...intervention effects on social problem-solving skills and recidivism, as well as differential effects as modulated by anger, anger regulation, and single nucleotide polymorphisms in the COMT gene. In Study 1, a randomized controlled trial (RCT), 289 male detainees (Mage= 14.95 years) were randomly assigned to SPST or treatment-as-usual (TAU). In Study 2, a pre-post community implementation, 187 youth (Mage = 16.03 years) on probation were assessed before and after SPST. No significant main effects of SPST on social problem solving or recidivism were shown in either study. With regard to differential effects, among youth in detention,COMT haplotypes predicted intervention effects on state anger. Moreover, independent of SPST, inward anger expression was associated with an increase in state anger from pre- to post and an increase in state anger with a decrease in social problem solving. Among youth on probation, COMT haplotypes predicted social problem-solving skills, and, in turn, an increase in social problem-solving skills decreased the odds of recidivism after SPST. The lack of main effects of SPST may be due to low program integrity in JJ settings. Juveniles' emotional and genetic characteristics might modulate the effectiveness of interventions in JJ settings. We recommend studying large samples to substantiate this observation.
This paper revisits intervention effects in Mandarin Chinese
why
-questions. I present a novel empirical generalization, in which it is shown that the ability for quantifiers to induce intervention ...hinges upon their monotonicity and their ability to be interpreted as topics. I then propose a semantic account of intervention that correlates topicality with the monotone properties of intervening operators. A crucial assumption in this account is that
why
-questions in Chinese are idiosyncratic, in that the Chinese equivalent of
why
directly merges at a high scope position that stays above a propositional argument. Combining the semantic idiosyncrasies of
why
-questions with the theory of topicality, I conclude that a wide range of intervention phenomena can be explained in terms of interpretation failure.
This article reports on an experiment investigating the effects of featural Relativized Minimality (Friedmann et al., 2009) on the representation and processing of relative clauses in the second ...language (L2) English of Mandarin speakers. Object relatives (ORCs) are known to cause greater problems in first language (L1) acquisition and in adult processing than subject relatives (SRCs). Featural Relativized Minimality explains this in terms of intervention effects, caused by a DP (the subject of the ORC) located between the relative head and its source. Intervention effects are claimed to be reduced if the relative head and the intervenor differ in features, such as number (e.g. I know the king who the boys pushed). We hypothesize that L2 learners will show intervention effects when processing ORCs and that such effects will be reduced if the intervenor differs in number from the relative head. There were two tasks: picture identification and self-paced reading. Both manipulated relative clause type (SRC/ORC) and intervenor type (±plural). Accuracy was high in interpreting relative clauses, suggesting no representational problem. Regarding reading times, ORCs were processed slower than SRCs, supporting an intervention effect. However, faster reading times were found in ORCs when intervenor and head noun matched in number, contrary to hypothesis. We suggest that our more stringent stimuli may have resulted in the lack of an effect for mismatched ORCs, in contrast to some earlier findings for L1 acquirers.
Previous studies have reported the effect of transcranial pulsed current stimulation (tPCS) on eliminating cognitive fatigue, but there is little research on optimizing the intervention program of ...tPCS. The purpose of this study was to explore the effect of different tPCS intervention programs on the elimination of physical fatigue in college athletes. Accordingly, 40 healthy college athletes were randomly divided into two groups of 20, denoted as A and B. Both groups exercised on treadmills. There were 15 subjects in group A who met the criteria of moderate physical fatigue, and 15 subjects in group B who met the criteria of severe physical fatigue. The subjects in each group were intervened with five different intervention programs of tPCS (intervention programs I, II, III, IV and V). The heart rate variability (HRV) and concentrations of oxygenated hemoglobin (HbO2) were measured before and after each intervention to judge the elimination effects of different intervention programs on different degrees of physical fatigue; the measurement indicators of the HRV include RMSSD, SDNN, HF and LF. The results indicated that tPCS intervention can eliminate both moderate and severe physical fatigue. Programs II, III, and IV had a significant effect on eliminating the moderate physical fatigue of athletes (p < 0.05), among which program II, with a stimulation time of 30 min and a stimulation intensity of sensory intensity, had the best effect. Programs I, II, III, and IV all had significant effects on eliminating the severe physical fatigue of athletes (p < 0.05), among which program I, with a stimulation time of 30 min and a stimulation intensity of sensory intensity + 0.2 mA, had the best effect. We conclude that different tPCS intervention programs can have different effects on the elimination of physical fatigue. The effects of the five intervention programs on the elimination of physical fatigue in athletes are as follows: program II is most suitable for moderate physical fatigue, and program I is most suitable for severe physical fatigue.
The goal of the present study is to test the agrammatic comprehension of clitic left dislocation and contrastive focus in Catalan, in order to evaluate the Generalised Minimality hypothesis of Grillo ...(2009). According to this hypothesis, the comprehension deficit observed in agrammatism is the result of the underspecification of scope-discourse features giving rise to generalised intervention effects. We conducted two sentence-picture matching tasks to assess the comprehension of clitic left dislocation and contrastive focus with nine and seven Broca’s aphasic subjects, respectively, as well as control participants. The results show that the comprehension of SVO sentences and object clitics was preserved, whereas the comprehension of object dislocations and object focalisations was compromised. These findings are consistent with the analysis of the deficit as an instance of generalised intervention effects. Yet, we also examined the prediction that a relevant syntactic feature mismatch between the subject and the object would suffice to block generalised minimality effects; in particular, the number features of subject and object were controlled for. The agrammatic subjects’ performance on mismatched sentences did not differ from their performance on sentences where the subject and the object were matched in number. These findings call the hypothesis into question and stress the need for future research.
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