Lifestyle interventions in the treatment of childhood overweight: a meta-analytic review of randomized controlled trials.

CONTEXT: Evaluating the efficacy of pediatric weight loss treatments is critical. OBJECTIVE: This is the first meta-analysis of the efficacy of RCTs comparing pediatric lifestyle interventions to no-treatment or information/education-only controls. DATA SOURCES: Medline, PsycINFO, and Cochrane Controlled Trials Register. STUDY SELECTION: Fourteen RCTs targetting change in weight status were eligible, yielding 19 effect sizes. DATA EXTRACTION: Standardized coding was used to extract information on design, participant characteristics, interventions, and results. DATA SYNTHESIS: For trials with no-treatment controls, the mean effect size was 0.75 (k = 9, 95% confidence interval [CI] = 0.52-0.98) at end of treatment and 0.60 (k = 4, CI = 0.27-0.94) at follow-up. For trials with information/education-only controls, the mean ES was 0.48 (k = 4, CI = 0.13-0.82) at end of treatment and 0.91 (k = 2, CI = 0.32-1.50) at follow-up. No moderator effects were identified. CONCLUSIONS: Lifestyle interventions for pediatric overweight are efficacious in the short term with some evidence for extended persistence. Future research is required to identify moderators and mediators and to determine the optimal length and intensity of treatment required to produce enduring changes in weight status.     

Emotional References in Mother-Daughter and Mother-Son Dyads' Conversations About School

The conversations of 100 mother-child (mean age4.5 years) dyads about the children's school experienceswere examined for their emotional content. Dyads variedalong the dimensions of gender of child (53 girls; 57 boys), ethnicity (31African-American, 39 Anglo-American, and 40Mexican-American), and SES (55 lower and 55 higher).When compared to mother-son dyads, mother-daughter dyadsmade more emotional references, particularly when discussing topicsrelated to interpersonal relationships and whendiscussing emotions experienced by the daughters.Higher-SES dyads made more emotional references than did lower-SES dyads. While there was no main effectof ethnicity associated with the overall tendency todiscuss emotions, relative to other dyads,African-American dyads made more emotional referenceswhen discussing noninterpersonal, nonacademic topicsthan did other dyads, Anglo-American dyads made moreemotional references during the discussing of learningtopics, and Mexican-American dyads discussed emotion more in relation to interpersonal topics thandid African-American dyads.     

A note on Lawley's formulas for standard errors in maximum likelihood factor analysis

Evidence is given to indicate that Lawley's formulas for the standard errors of maximum likelihood loading estimates do not produce exact asymptotic results. A small modification is derived which appears to eliminate this difficulty.The authors are indebted to Walter Kristof and Thomas Stroud for their helpful reviews of an earlier version of this paper and particularly to D. N. Lawley for his review, comments, and encouragement.     

Behavioral techniques in the treatment of obesity: A comparative analysis

The relative efficacy of the major techniques typically used in behavioral treatment programs for weight reduction was investigated using obese adult volunteers. Study 1 compared the effects of self-monitoring, self-control procedures, monetary rewards, aversive imagery and relaxation training. These procedures resulted in significantly greater weight reduction than either a no treatment group or subjects who graphed and recorded daily weight. Self-monitoring of daily caloric intake was as effective as the other methods, both singly and combined, over a 4 week treatment period. Study 2 compared the long-term effects of self-monitoring vs the full complement of behavioral techniques used in Study 1. The full behavior management program was significantly more effective, both during the treatment period and at 3 and 12 week follow-ups, although self-monitoring again produced substantial weight loss.     

Pausing phenomena: Influence on the quality of instruction

This report summarizes work of 7 years on the influence of a variable called “wait-time” on the development of language and logic of children taking part in elementary science programs. Analysis of over 300 classroom tape recordings showed mean pauses to be on the order of 1 sec; that is, after a teacher asked a question, students had to begin a response within an average time of 1 sec. If they did not, the teacher typically repeated, rephrased or asked a different question, or called on others. A second wait-time is involved: when a student makes a response, the teacher normally reacts or asks another question within an average time of 0.9 sec. This study investigates the consequences of manipulating both species of wait-time. When mean wait-time of 3–5 sec is achieved through training, analysis of more than 900 tapes shows changed values on eight student variables: (1) the length of response (number of words) increases, (2) the number of unsolicited but appropriate responses increases, (3) failures to respond decrease, (4) incidence of speculative responses increases, (5) incidence of student-student comparisons of data increases, (6) incidence of evidence-inference statements increases, (7) frequency of student-initiated questions increases, and (8) the variety in type of verbal moves made by students increases. Servochart plots of recordings show that students discussing science phenomena tend to speak in bursts, with intervals of as much as 3–5 sec between bursts being fairly common provided they are not interrupted. The average post-student-response wait-time of 0.9 sec apparently intervenes between bursts to prevent completion of a thought. The classroom is conceptualized as a two-player game in which the quality of inquiry will tend to improve when there is a better equity in the distribution of moves between the players. The teacher is treated as one player and the collection of students as the second player. Changes in wait-time shift the game toward a more equitable state. Over time, a classroom or instructional group on the prolonged wait-time schedule undergoes certain spontaneous changes. Two teacher variables change: (1) response flexibility scores increase, and (2) teacher questioning patterns becomes more variable. There is some indication that teacher expectations for performance of students rated as relatively slow improves.     

A second-order factor analysis of reasoning abilities

This article reports a second-order factor analysis of the 13 interpretable first-order factors of Adkins and Lyerly based on 66 variables for 200 Army men. The approach to simple structure for 6 second-order factors was unusually good. Loadings of the original 66 variables on the second-order factors were also obtained. Five of the factors are tentatively interpreted as Precision in Formation and Use of Verbal Concepts, General Verbal Fluency, Visualizing Spatial Constancy During Movement, Speed in Analysis, and Flexibility in Analysis.