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.     

Post-experimentalist pragmatism

Rorty's neopragmatism is an attempt to retrofit Dewey's experimentalism for the post-modern situation. Specifically, he substitutes "language" for "experience" and "culture" for "science", to arrive at a philosophy "no closer to science than to art". I argue that the first move results from misunderstanding of the role experience plays in the context of verification in Dewey's experimental logic. The second move leaves Rorty without any alternative method even for approaching the very problems which Dewey proposed to solve with his experimentalism.     

Long Term Outcomes to Family Caregiver Empowerment

The Vanderbilt Caregiver Empowerment Project evaluated a training program designed to enhance empowerment of caregiver and their subsequent involvement in the mental health treatment of their children. The intervention utilized a multi-component parent training curriculum that was designed to enhance: (a) knowledge of the service system; (b) skills needed to interact with the mental health system; and (c) the caregiver' s mental health services self-efficacy designed to improve caregivers beliefs in their ability to collaborate with service providers. The resulting increased empowerment was hypothesized to increase caretaker involvement, which should affect service use and ultimately the mental health status of the child. A randomized design was used to test the effectiveness of this model with caregivers of children receiving mental health services. The results one-year after the training replicated the intermediate outcomes of the project conducted 3-months after the training. The initial training continued to significantly influence the parent's knowledge and mental health services self-efficacy. However, the intervention had no effect on caregiver involvement in treatment, service use or the mental health status of the children.     

Visual inertia of rotating 3-D objects

Five experiments were designed to determine whether a rotating, transparent 3-D cloud of dots (simulated sphere) could influence the perceived direction of rotation of a subsequent sphere. Experiment 1 established conditions under which the direction of rotation of a virtual sphere was perceived unambiguously. When a near-far luminance difference and perspective depth cues were present, observers consistently saw the sphere rotate in the intended direction. In Experiment 2, a near-far luminance difference was used to create an unambiguous rotation sequence that was followed by a directionally ambiguous rotation sequence that lacked both the near-far luminance cue and the perspective cue. Observers consistently saw the second sequence as rotating in the same direction as the first, indicating the presence of 3-D visual inertia. Experiment 3 showed that 3-D visual inertia was sufficiently powerful to bias the perceived direction of a rotation sequence made unambiguous by a near-far luminance cue. Experiment 5 showed that 3-D visual inertia could be obtained using an occlusion depth cue to create an unambiguous inertia-inducing sequence. Finally, Experiments 2, 4, and 5 all revealed a fast-decay phase of inertia that lasted for approximately 800 msec, followed by an asymptotic phase that lasted for periods as long as 1,600 msec. The implications of these findings are examined with respect to motion mechanisms of 3-D visual inertia.     

GENERALITY AND SIDE EFFECTS OF OVERCORRECTION1

The effects and side effects of overcorrection for self-stimulatory behaviors of two children in a specialized day-care program were evaluated. For one child, a “hand” overcorrection procedure involving arm and hand exercises was introduced contingent upon inappropriate hand movements and later contingent upon inappropriate foot movements. After “hand” overcorrection was withdrawn for inappropriate foot movements, a “foot” overcorrection procedure involving foot and leg exercises was introduced contingent upon inappropriate foot movements. For a second child, the “hand” overcorrection procedure was introduced contingent upon inappropriate hand movements during a free-play period, and later contingent upon inappropriate vocalizations at naptime. “Hand” overcorrection was withdrawn and then re-introduced sequentially for both behaviors. Several concurrent behaviors were measured to assess multiple effects of treatment. Results for both children indicated the “hand” overcorrection procedure suppressed inappropriate hand movements and inappropriate behaviors that were topographically dissimilar. In addition, inverse relationships were observed between the second child's inappropriate hand movements and appropriate toy usage during free play and between his inappropriate vocalizations and inappropriate foot movements during naptime. Results suggest that overcorrection procedures that are effective for one behavior can be used to reduce the frequency of topographically different behaviors. This finding is discussed in terms of its practical implications for therapists.     

Authoritarianism and job preference

The hypothesis tested was that authoritarian personalities prefer the natural sciences (specifically biology and chemistry) and nonauthoritarian personalities choose the social sciences and humanities (specifically, psychology and philosophy). The results strongly supported the hypothesis. Since the study was conducted on freshmen students in Israel who select their department at the time they apply for admission to the university, the results were interpreted as indicating that authoritarians choose professions different from nonauthoritarians.     

The role of nonlinguistic stimuli and semantic relations in children's acquisition of grammatical utterances

Eighteen children, randomly assigned to one of six conditions, were trained in the use of two-word subject-verb (e.g. “mommy go”) utterances. The groups differed in (1) the number of different semantic relations theoretically underlying the subject-verb utterances on which the children were trained, and (2) the extent to which these semantic relations were associated with nonlinguistic events. The results indicated that the children acquired the subject-verb utterance forms more readily when they were also exposed to the events to which the utterances actually referred. Provided that the subject-verb utterances were related to ongoing events, the number of relations “underlying” these utterances did not appear critical. These results suggest that the child's acquisition of novel and grammatical utterances describing nonlinguistic stimuli highly similar to those in his natural environment are amenable to experimental control.