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1.
BackgroundCross-sectional studies have shown that children with developmental coordination disorder (DCD) are less likely to be physically active and have excess weight gain. However, longitudinal studies examining the relationship between DCD and measures of body composition (BMI and waist circumference) over time are lacking. It is not known if sex and physical activity affect the relationship between DCD and measures of body composition over time.Objective(1) To examine if BMI and waist circumference in children with and without probable DCD (pDCD) remain constant over time or change as children age, and whether this relationship varies by sex. (2) To examine if differences in physical activity between children with and without pDCD account for differences in BMI and waist circumference over time.MethodsPhysical Health Activity Study Team (PHAST) data were used for this longitudinal analysis. At baseline, a total of 2,278 (pDCD = 103) children aged 9–10 years were included in the analysis. The total follow-up period was five years. Mixed-effects modeling was used to estimate change in body composition measures in children over time.ResultsChildren with pDCD have higher BMI and waist circumference compared to typically developing children, and this difference increased over the study period. The relationship between pDCD and BMI over time also varied by sex. A similar trend was observed for waist circumference. Boys with pDCD were found to have a more rapid increase in BMI and waist circumference compared to girls with pDCD. Physical activity had neither a mediating nor a moderating effect on the relationship between pDCD and measures of body composition. However, physical activity was independently and negatively associated with measures of body composition.ConclusionspDCD is associated with higher body mass and waist circumference, both important risk factors for cardiovascular disease, type 2 diabetes, and psychological problems and other health conditions.  相似文献   

2.
It has been hypothesised that deficits in the functioning of the mirror neuron system (MNS) and internal modelling may contribute to the motor impairments associated with DCD. These processes can be explored behaviourally through motor imagery paradigms. Motor imagery proficiency of children with and without probable DCD (pDCD) was examined using a complex hand rotation task to explore whether motor imagery strategies could be used during more complex tasks. Forty-four boys aged 7–13 years participated, 22 with pDCD (mean = 9.90 years ± 1.57) and 22 controls (mean = 9.68 years ± 1.53). Participants completed the task twice: with and without motor imagery instructions. Stimuli were presented in two rotational axes – palm/back, and eight 45° rotational steps. Both groups showed evidence of following the biomechanical and postural constraints of actual movements. Responses of children with pDCD were slower and less accurate than controls, with group differences increasing alongside task complexity. A greater impact of biomechanical constraints for accuracy was observed in the DCD group. The response characteristics of children with pDCD likely reflects a reduced capacity to mentally manipulate a body schema and reduced visuo-motor processing capabilities. Behaviourally, these processes are linked to MNS and internal modelling function, suggesting deficits in these systems may contribute to the movement difficulties characteristic of DCD.  相似文献   

3.
The purpose of the present study was to examine the effect of a group-based task oriented skills training program on motor and physical ability for children with DCD. It was also investigated if there was an effect on fine motor and handwriting tasks that were not specifically practiced during the training program. Forty-one children aged 6–10 years took part in this study. Children were assigned to three groups: an experimental training group consisting of 14 children with DCD, a control non-training group consisted of 13 children with DCD and a control non-training group consisting of 14 typically developed children. The measurements included were, the Movement Assessment Battery for Children (MABC), the Modified Agility Test (MAT), the Triple Hop Distance (THD), the 5 Jump-test (5JT) and the Handwriting Performance Test. All measures were administered pre and post an 8-week training program. The results showed that 10 children of the DCD training-group improved their performance in MABC test, attaining a score above the 15th percentile after their participation in the training program. DCD training-group showed a significant improvement on all cluster scores (manual dexterity (t (13) = 5.3, p < .001), ball skills (t (13) = 2.73, p < .05) and balance (t (13) = 5.13, p < .001). Significant performance improvements were also found in MAT, THD, 5JT (t (13) = –4.55; p < .01), handwriting quality (t (12) = –2.73; p < .05) and speed (t (12) = –4.2; p < .01) after the training program. In conclusion, improvement in both practiced and non-practiced skills, in the training program, may reflect improvement in motor skill but also transfer to other skills.  相似文献   

4.
ObjectiveThere is very little information available about the characteristics of drivers convicted for traffic offences. The objective of this study was to perform a comparative analysis of the psychosocial characteristics of Spanish prison inmates convicted of road traffic offences (CRTOs), drivers serving a prison sentence for other types of offence (DCOOs), and drivers with no criminal record (DNCRs), in order to identify the psychosocial predictors associated with RTOs.MethodsThe study sample comprised 434 male participants divided into three groups: CRTO (n = 240); DCOO (n = 85); and DNCR (n = 105). Instruments included an interview on sociodemographic data, driving behaviour, and past offences, as well as a set of tests to evaluate personality traits (ZKPQ-50CC), driving-related aspects (MDSI-S and DAS), and alcohol dependence (AUDIT).ResultsA logistic regression analysis showed the following to be reliable predictors of RTOs: low education level (p < .05); having been involved in several road traffic accidents (p < .001); having received several fines (p < .001); a high score on the MDSI-S Risky subscale (p < .05); a low score on the MDSI-S Careful subscale (p < .05); AUDIT scores > 8 (p < .05), and repeatedly driving whilst under the influence of alcohol (p < .05).ConclusionsThe results obtained have significant practical implications for designing and implementing traffic offenders programmes.  相似文献   

5.
BackgroundIt is well established that both aerobic physical activity (PA) and resistance training are essential in the treatment and management of type 2 diabetes (T2D), but few studies have examined the determinants of both modes of PA in the same sample.PurposeThe main objective was to investigate the utility of the Protection Motivation Theory (PMT) in predicting aerobic PA and resistance training in a population sample of T2D adults.MethodsA total of 244 individuals completed self-report PMT constructs of vulnerability, severity, fear, response efficacy, self-efficacy and intention, and a 3-month follow-up that assessed aerobic PA and resistance training.ResultsPMT explained 19% (p < .001) and 20% (p < .001) of the variance respectively for aerobic PA and resistance training behaviour. Significant associations were found between self-efficacy (β = 0.45, p < .001) and gender (β = 0.15, p < .05) for aerobic PA, and self-efficacy (β = 0.48, p < .001) and age (β = 0.17, p < .05) for resistance training. PMT accounted for 43% (p < .001) and 56% (p < .001) of the variance respectively for aerobic PA and resistance training intentions. For aerobic PA, response efficacy (β = 0.14, p < .05) and self-efficacy (β = 0.59, p < .001) were significantly associated with intention, while response efficacy (β = 0.23, p < .001), self-efficacy (β = 0.64, p < .001) and age (β = 0.10, p < .05) were significantly related with resistance training intention.ConclusionsNone of the unique constructs of the PMT (i.e., perceived vulnerability, severity and fear) were significant with either aerobic and resistance training intention. These results may guide the development of effective PA interventions in people with T2D.  相似文献   

6.
This study examines how multisensory stimuli affect the performance of children with Developmental Coordination Disorder (DCD) on a choice reaction time (CRT) task. Ten children with DCD, identified using the Movement Assessment Battery for Children-2, aged 7–10 years (4F, M = 8 y 3 m, SD = 17 m) and 10 typically developing peers (TDC) (5F, M = 8 y 4 m, SD = 17 m) reached to unimodal (auditory (AO), visual (VO)) and bimodal (audiovisual (AV)) stimuli at one of three target locations. A multisensory (AV) stimulus reduced RTs for both groups (p < 0.001, η2 = 0.36). While the children with DCD had a longer RT in all conditions, the AV stimulus produced RTs in children with DCD (494 ms) that were equivalent to those produced by the TDC to the VO stimulus (493 ms). Movement Time (DCD = 486 ms; TDC = 434 ms) and Path Length (DCD = 25.6 cm; TDC = 24.2 cm) were longer in children with DCD compared to TDC as expected (p < 0.05). Only the TDC benefited from the AV information for movement control, as deceleration time of the dominant hand was seen to decrease when moving to an AV stimulus (p < 0.05). Overall, data shows children with DCD do benefit from a bimodal stimulus to plan their movement, but do not for movement control. Further research is required to understand if this is a result of impaired multisensory integration.  相似文献   

7.
IntroductionRegular physical activity (PA) practice represents a key component of obesity treatment.ObjectiveBased on self-determination theory (SDT), this cross-sectional study aimed to explore the motivational characteristics associated with PA practice among obese adolescents.MethodOne hundred and five overweight or obese adolescents (mean age = 15 years old, SD = 2.69) were questioned about their level of PA, motivational regulations toward PA and level of satisfaction of basic psychological needs.ResultsData revealed that satisfaction of autonomy and relatedness needs is positively associated with autonomous forms of motivation (e.g., for integrated regulation β = .44; and 0.35, respectively, p < .01). Otherwise, non-satisfaction of the needs of autonomy and competence is associated with the most controlled forms of motivation (e.g., for external regulation β = −.27, p < .01; and −.18, p < .05, respectively). In turn, a high level of identified regulation, a low level of external regulation and a high level of satisfaction of the need for competence are associated with weekly PA (β = .28; −.19 and .24, respectively, p < .05).ConclusionSDT appears as an interesting theoretical framework to explore motivational antecedents of PA among obese adolescents.  相似文献   

8.
The purpose of this study was to explore the relationships between preferred transition speed (PTS) and anthropometric characteristics, body composition and different human body proportions in males. In a sample of 59 male students, we collected anthropometric and body composition data and determined individual PTS using increment protocol. The relationships between PTS and other variables were determined using Pearson correlation, stepwise linear and hierarchical regression. Body ratios were formed as quotient of two variables whereby at least one significantly correlated to PTS. Circular and transversal (except bitrochanteric diameter) body dimensions did not correlate with PTS. Moderate correlations were found between longitudinal leg dimensions (foot, leg and thigh length) and PTS, while the highest correlation was found for lower leg length (r = .488, p < .01). Two parameters related to body composition showed weak correlation with PTS: body fat mass (r = −.250, p < .05) and amount of lean leg mass scaled to body weight (r = .309, p < .05). Segmental body proportions correlated more significantly with PTS, where thigh/lower leg length ratio showed the highest correlation (r = .521, p < .01). Prediction model with individual variables (lower leg and foot length) have explained just 31% of PTS variability, while model with body proportions showed almost 20% better prediction (R2 = .504). These results suggests that longitudinal leg dimensions have moderate influence on PTS and that segmental body proportions significantly more explain PTS than single anthropometric variables.  相似文献   

9.
This paper explains the effect of a motion platform for driving simulators on postural instability and head vibration exposure. The sensed head level-vehicle (visual cues) level longitudinal and lateral accelerations (ax,sensed = ax_head and ay,sensed = ay_head, ayv = ay_veh and ayv = ay_veh) were saved by using a motion tracking sensor and a simulation software respectively. Then, associated vibration dose values (VDVs) were computed at head level during the driving sessions. Furthermore, the postural instabilities of the participants were measured as longitudinal and lateral subject body centre of pressure (XCP and YCP, respectively) displacements just after each driving session via a balance platform. The results revealed that the optic-head inertial level longitudinal accelerations indicated a negative non-significant correlation (r = −.203, p = .154 > .05) for the static case, whereas the optic-head inertial longitudinal accelerations depicted a so small negative non-significant correlation (r = −.066, p = .643 > .05) that can be negligible for the dynamic condition. The XCP for the dynamic case indicated a significant higher value than the static situation (t(47), p < .0001). The VDVx for the dynamic case yielded a significant higher value than the static situation (U(47), p < .0001). The optic-head inertial lateral accelerations resulted a negative significant correlation (r = −.376, p = .007 < .05) for the static platform, whereas the optic-head inertial lateral accelerations showed a positive significant correlation (r = .418, p = .002 < .05) at dynamic platform condition. The VDVy for the static case indicated a significant higher value rather than the dynamic situation (U(47), p < .0001). The YCP for the static case yielded significantly higher than the dynamic situation (t(47), p = .001 < 0.05).  相似文献   

10.
The aim of this population-based study was to identify demographic factors for language delays at an early age. The risk analysis covered 11 biological and 8 environmental factors. The mothers’ concerns regarding language development were also examined. A total of 226 children from a Finnish cohort study were invited to participate in language assessments at 36 months. The test results for word finding and language comprehension were compared with parental questionnaires about children's vocabulary at 13 and 24 months.Regression analysis revealed that the father's social class (t = −2.79, p = 0.006) and working full time (t = −2.86, p = 0.005) significantly predicted children's language delay. In addition, language comprehension was significantly predicted by the mother's social class (t = −2.06, p = 0.041) and by gender, with an advantage to girls (t = −2.71, p = 0.008). Vocabulary at 24 months was a powerful predictor for lexical development (t = 4.58, p < 0.0001) and language comprehension (t = 4.85, p < 0.0001) at 36 months. Mothers’ concerns were correlated with children's limited lexicons as early as 24 months (r = 0.31, p < 0.0001) and poor language comprehension (r = −0.35, p < 0.0001) at 36 months. Mothers were especially concerned if the parents needed special education during school years.At the population-level, gender was the most powerful biological factor in predicting language delays. Similarly, both parents’ social status had predictive value for the child's language development. In addition, it was found that the mother's concern about her child's slow language acquisition should be taken into account when making decisions regarding special support.  相似文献   

11.
In response to persistent racial disparities in academic and behavioral outcomes between Black and White students, equitable school climate has drawn attention as a potential target for school reform. This study examined differences in Black and White students' experiences of school climate and explored whether indicators of school organizational health and staff burnout moderated differences in students' school experiences by race. Utilizing hierarchical linear modeling with a sample of 18,397 Black students (n = 6228) and White students (n = 12,169) and 2391 school staff in 53 schools, we found a consistent pattern of racial inequalities, such that Black students reported less positive experiences than White students across three indicators of school climate (caring γ =  0.08, p < .001; equity γ =  0.05, p = .007; and engagement γ =  0.05, p < .001). In addition, we found significant, positive associations between aggregated staff-report of school organizational health and student-reported school climate (e.g., staff affiliation and student-perceived equity, γ = 0.07, p < .001). Surprisingly, a number of school organizational health indicators were more strongly associated with positive perceptions of school climate among White students than Black students, translating into greater racial disparities in perceived school climate at schools with greater organizational health (e.g., supportive leadership by race on student-perceived engagement, γ =  0.03, p = .042). We also found negative associations between staff-reported burnout and students' experience of equity, such that the racial gap was smaller in schools with high ratings of burnout (γ = 0.04, p = .002). These findings have implications for educators and education researchers interested in promoting school social contexts that equitably support student engagement and success.  相似文献   

12.
Children with developmental disorders such as cerebral palsy have limited opportunities for effortful interactions with objects and tools. The goal of the study was to investigate whether children with cerebral palsy have deficits in their ability to perceive object length by dynamic touch when compared to typically developing children. Fourteen children with typical development and 12 children with cerebral palsy were asked to report the length of hand-held rods after wielding them out of sight. Multilevel regression models indicated that I1 (maximum principal moment of inertia) was a significant predictor of perceived length – LP (p < .0001). The effect of I1 on LP was significantly different among children (p = .001) and the presence of cerebral palsy (group factor) partially explained such variance (p = .002). In addition, accuracy and reliability of the length judgments made by children with cerebral palsy were significantly lower than the typically developing children (p < .05). Theoretical and clinical implications of these results were identified and discussed.  相似文献   

13.
The purpose of the present study was to explore the relationship between mechanical characteristics of hip, knee and ankle extensor and flexor muscle groups and gait transition speed. The sample included 29 physically active male adults homogenized regarding their anthropometric dimensions. Isokinetic and isometric leg muscle mechanical characteristics were assessed by an isokinetic dynamometer, while individual walk-to-run (WRT) and run-to-walk transition speeds (RWT) were determined using the standard increment protocol. The relationship between transition speeds and mechanical variables scaled to body size was determined using Pearson correlation and stepwise linear regression. The highest correlations were found for isokinetic power of ankle dorsal flexors and WRT (r = .468, p < .01) and the power of hip extensors and RWT (r = .442, p < .05). These variables were also the best predictors of WRT and RWT revealing approximately 20% of explained variance. Under the isometric conditions, the maximal force and rate of force development of hip flexors and ankle plantar flexors were moderately related with WRT and RWT (ranged from r = .340 to .427). The only knee muscle mechanical variable that correlated with WRT was low velocity knee flexor torque (r = .366, p < .05). The results generally suggest that the muscle mechanical properties, such as the power of ankle dorsal flexors and hip extensors, influence values of WRT and RWT.  相似文献   

14.
Resistance training has been shown to positively affect the rate of force development (RFD) whereas there is currently no data on the effect of endurance training on RFD. Subjects completed ten weeks of either resistance training (RT, n = 7) or endurance cycling (END, n = 7). Pre and post measurements included biopsies obtained from m. vastus lateralis to quantify fiber phenotype and fiber area and isokinetic dynamometer tests to quantify maximal torque (Nm) and RFD (Nm/s) at 0–30, 0–50, 0–100 and 0–200 ms during maximal isometric contraction for both knee extensors and flexors. Both groups increased the area percentage of type IIa fibers (p < .01) and decreased the area percentage of type IIx fibers (p = .05), whereas only RT increased fiber size (p < .05). RT significantly increased eccentric, concentric and isometric strength for both knee extensors and flexors, whereas END did not. RT increased 200 ms RFD (p < .01) in knee flexor RFD and a tendency towards an increase at 100 ms (p < .1), whereas tendencies towards decreases were observed for the END group at 30, 50 and 100 ms (p < .1), resulting in RT having a higher RFD than END at post (p < .01). In conclusion, resistance training may be very important for maintaining RFD, whereas endurance training may negatively impact RFD.  相似文献   

15.
The goal of this study was to test depressive symptoms as a mediator between social difficulties and hostility in young adults. Hostility is often a reaction to both intrinsic and extrinsic factors; therefore a greater understanding of contributing factors is needed, especially among emerging adults. College students (n = 608; 408 females, 200 males) self-reported on social difficulties, depression, and hostility. Via exploratory factor analyses, two latent constructs related to social difficulty were identified: social performance and social motivation. Using structural equation modeling, the direct effects found that poor social performance was significantly positively associated with BPAQ Total (β = .44, p < .01). Social motivation was not associated with BPAQ Total (β = −.07, p = .21). Further, depression scores were found to partially mediate the relationship between social performance deficits (β = .34, p < .01; 95% CI = .05–.16), but not social motivation (β = −.06, p > .05; 95% CI = −.04 to .04), and overall aggression. Results are discussed in terms of the influence of negative affect and impaired emotion regulatory processes on hostility as a consequence of social performance deficits.  相似文献   

16.
BackgroundExercise is beneficial for depression, but less is known about its impact on post-intervention physical activity and sedentary behavior. The aim of this paper was to determine the extent to which participation in light-, moderate- and vigorous-intensity exercise intervention influenced habitual physical activity and sedentary behavior patterns in depressed adults.MethodsAccelerometer data was collected pre- and post-intervention from depressed participants randomized to one of three 12-week intervention groups: light (n = 21), moderate (n = 25) and vigorous (n = 22) exercise. Mixed models examined changes in time spent sedentary and in light and moderate-to-vigorous physical activity (MVPA); time accumulated in sedentary and MVPA bouts; and, number of MVPA bouts and interruptions in sedentary time.ResultsOverall sedentary time decreased while light activity time increased across all intervention groups but not significantly so. The light exercise intervention group reduced MVPA minutes (−8.22, 95% CI: −16.44, −0.01), time in MVPA bouts (−8.44, 95% CI: −14.27, −2.62), and number of activity bouts (−0.43, 95% CI: −0.77, −0.09). The moderate exercise intervention group reduced time in MVPA bouts (−6.27, 95% CI: −11.71, −0.82) and number of sedentary interruptions (−6.07, 95% CI: −9.30, −2.84). No changes were observed for the vigorous exercise intervention group.ConclusionsThe exercise intervention led to an increase in overall light physical activity and decrease in sedentary time, though neither change was statistically significant. Participation in the light and moderate exercise intervention groups was associated with reductions of time in MVPA bouts, but this was not evident for the vigorous exercise intervention group.  相似文献   

17.
IntroductionWhile high participation rates ensure the cost-effectiveness of colorectal cancer screening programs, it is well known that postal requests do not achieve acceptable levels of participation.ObjectiveThis randomized controlled study aimed to test the impact of individualized phone counseling to prompt people aged 50 to 74 to take a colorectal cancer test.MethodTwo phone strategies were compared. The first involved computer-aided individualized counseling while the second was based on motivational interviewing. A total of 49,972 people were randomly assigned to a control group (CG) and to the individualized counseling (IC) and motivational interviewing (MI) telephone groups.ResultsA simple call doubled the participation rate per protocol (19.2% > 9.2%; p < .001; r = .131; OR = 2.374), and tripled it when the interview was conducted (30.4% > 9.2%; p < .001; r = .219; OR = 4.321). In an intention-to-treat analysis, the benefit of calling by phone remained even higher than postal requests (10% > 9.2%; p < .01; r = .014; OR = 1.103). However, there was no impact of the type of interview on participation rates.ConclusionThe results are discussed for future research.  相似文献   

18.
ObjectivesThe present study examined the effects of motivational self-talk on self-confidence, anxiety, and task performance in young athletes.MethodsParticipants were 72 tennis players. The experiment was conducted in five sessions: baseline assessment, three training sessions, and final assessment. After the baseline assessment participants were divided and assigned randomly into experimental and control groups. The two groups followed the same training program with the experimental group practicing the use of self-talk. In the last session, the final assessment took place. A forehand drive test was used to evaluate task performance, and the Competitive Anxiety Inventory-2R was used to assess self-confidence and anxiety.ResultsA two-way mixed model MANOVA revealed that task performance improved for the experimental group (p < .01) and remained stable for the control group; self-confidence increased (p < .01) and cognitive anxiety decreased (p < .05) for the experimental group, whereas no changes were observed for the control group. Correlation analysis revealed that changes in task performance were moderately related to changes in self-confidence (p < .05).ConclusionsThe results of the study showed that self-talk can enhance self-confidence and reduce cognitive anxiety. Furthermore, it is suggested that increases in self-confidence can be regarded as a viable function explaining the facilitating effects of self-talk on performance.  相似文献   

19.
This study aimed to investigate position-specific evolution of physical and technical performance parameters in the English Premier League (EPL). Match performance observations (n = 14700) were collected using a multiple-camera computerized tracking system across seven seasons (2006–07 to 2012–13). Data were analyzed relative to five playing positions: central defenders (n = 3792), full backs (n = 3420), central midfielders (n = 3200), wide midfielders (n = 2136) and attackers (n = 2152). High-intensity running distance increased in the final season versus the first season in all playing positions (p < .05, ES: 0.9–1.3) with full backs displaying the greatest increase (∼36% higher in 2012–13). Similar trends were observed for sprint distance with full backs demonstrating the most pronounced increase across the seven seasons (36–63%, p < .001, ES: 0.8–1.3). Central players (central defenders and midfielders) illustrated the most pronounced increases in total passes and pass success rate (p < .05, ES: 0.7–0.9) whilst wide players (full backs and wide midfielders) demonstrated only small-moderate increases in total passes and pass success rate (p < .05, ES: 0.6–0.8). The data demonstrates that evolving tactics in the EPL have impacted on the physical demands of wide players and the technical requirements of central players. These findings could be used for talent identification or position-specific physical and technical training.  相似文献   

20.
《Behavior Therapy》2014,45(6):863-871
Decentering is defined as the ability to observe one’s thoughts and feelings in a detached manner. The Experiences Questionnaire (EQ) is a self-report instrument that originally assessed decentering and rumination. The purpose of this study was to evaluate the psychometric properties of the Spanish version of EQ-Decentering and to explore its clinical usefulness. The 11-item EQ-Decentering subscale was translated into Spanish and psychometric properties were examined in a sample of 921 adult individuals, 231 with psychiatric disorders and 690 without. The subsample of nonpsychiatric participants was also split according to their previous meditative experience (meditative participants, n = 341; and nonmeditative participants, n = 349). Additionally, differences among these three subgroups were explored to determine clinical validity of the scale. Finally, EQ-Decentering was administered twice in a group of borderline personality disorder, before and after a 10-week mindfulness intervention. Confirmatory factor analysis indicated acceptable model fit, sbχ2 = 243.8836 (p < .001), CFI = .939, GFI = .936, SRMR = .040, and RMSEA = .06 (.060–.077), and psychometric properties were found to be satisfactory (reliability: Cronbach’s α = .893; convergent validity: r > .46; and divergent validity: r <  .35). The scale detected changes in decentering after a 10-session intervention in mindfulness (t =  4.692, p < .00001). Differences among groups were significant (F = 134.8, p < .000001), where psychiatric participants showed the lowest scores compared to nonpsychiatric meditative and nonmeditative participants. The Spanish version of the EQ-Decentering is a valid and reliable instrument to assess decentering either in clinical and nonclinical samples. In addition, the findings show that EQ-Decentering seems an adequate outcome instrument to detect changes after mindfulness-based interventions.  相似文献   

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