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Background: Brief motivational interventions (BMIs) are one of the most effective individually focused alcohol intervention strategies for college students. Despite the central theoretical role of motivation for change in BMIs, it is unclear whether BMIs increase motivation to change drinking behavior. We conducted a two‐step meta‐analysis of individual participant data (IPD) to examine whether BMIs increase motivation for change. N = 5903;59% women, 72% White) from Project INTEGRATE. The BMIs included individually delivered motivational interviewing with personalized feedback (MI + PF), stand‐alone personalized feedback (PF), and group‐based motivational interviewing (GMI). Methods: We included 15 trials of BMI (N = 5903;59% women, 72% White) from Project INTEGRATE. The BMIs included individually‐delivered motivational interviewing with personalized feedback (MI + PF), stand‐alone personalized feedback (PF), and group‐based motivational interviewing (GMI). Different measures and responses used in the original trials were harmonized. Effect size estimates were derived from a model that adjusted for baseline motivation and demographic variables for each trial (step 1) and subsequently combined in a random‐effects meta‐analysis (step 2). Results: The overall intervention effect of BMIs on motivation for change was not statistically significant (standard mean difference [SMD]: 0.026, 95% CI: [−0.001, 0.053], p = 0.06, k = 19 comparisons). Of the three subtypes of BMIs, GMI, which tended to provide motivation‐targeted content, had a statistically significant intervention effect on motivation, compared with controls (SMD: 0.055, 95% CI: [0.007, 0.103], p = 0.025, k = 5). By contrast, there was no evidence that MI + PF (SMD = 0.04, 95% CI: [−0.02, 0.10], k = 6, p = 0.20) nor PF increased motivation (SMD = 0.005, 95% CI: [−0.028, 0.039], k = 8, p = 0.75), compared with controls. Post hoc meta‐regression analysis suggested that motivation sharply decreased each month within the first 3 months postintervention (b = −0.050, z = −2.80, p = 0.005 for k = 14). Conclusions: Although BMIs provide motivational content and normative feedback and are assumed to motivate behavior change, the results do not wholly support the hypothesis that BMIs improve motivation for change. Changing motivation is difficult to assess during and following interventions, but it is still a theoretically important clinical endpoint. Further, the evidence cautiously suggests that changing motivation may be achievable, especially if motivation‐targeted content components are provided. [ABSTRACT FROM AUTHOR]

Background: : Neonatal vitamin A supplementation (NVAS) is an intervention hypothesized to reduce infant morbidity and mortality. The objective of this study was to assess the efficacy of neonatal vitamin A supplementation in reducing infant morbidity and mortality and assess potential sources of heterogeneity of the effect of NVAS.Methods: : We completed an individually randomized, double-blind, placebo-controlled trial in Tanzania. Infants were randomized within 3 days of birth to a single dose of vitamin A (50 000 IU) or placebo. We assessed infants at 1 and 3 days after supplementation, as well as 1, 3, 6 and 12 months after supplementation. We included all live births in the analysis and used relative risks (RR) and 95% confidence intervals (CI) to assess the risks of mortality and hospitalization by 12 months. We used general estimating equations to assess the incidence of morbidities during infancy.Results: : A total of 31 999 infants were enrolled in the study between August 2010 and March 2013. At 12 months, vitamin A did not reduce all-cause infant mortality (RR 1.04; 95% CI 0.92-1.16), nor affect hospitalization (RR 1.09; 95% CI 0.97-1.22) or all-cause morbidity (RR 1.00; 95% CI 0.96-1.05). Postpartum maternal vitamin A supplementation modified the effect of neonatal vitamin A supplementation on mortality at 12 months ( P -value, test for interaction = 0.04). Among infants born to women who received a mega-dose of vitamin A after delivery, NVAS appeared to increase the risk of death (RR 1.12; 95% CI 0.98-1.29), whereas the risk of death among infants born to women who did not receive a mega-dose was reduced (RR 0.86; 95% CI 0.70-1.06). We noted no modification of the effect of NVAS by infant gender, birthweight or maternal HIV status.Conclusion: : NVAS did not affect the risk of death or incidence of common childhood morbidities. However, this study sheds light on potential sources of heterogeneity of the effect of neonatal vitamin A supplementation which should be further examined in a pooled analysis of all NVAS trials. [ABSTRACT FROM AUTHOR]

Increased midsole deformation can limit exposure to high impact and vibration magnitudes while running. The aim of this study was to evaluate the effect of shoes eliciting different midsole deformation on ground reaction forces, heel impact, soft tissue vibrations and bone vibrations. Forty-eight runners performed a 5-min running task on an instrumented treadmill at a self-selected pace with four different shoes. Midsole horizontal and vertical deformations were quantified with relative displacement of seven reflective markers placed on the midsole of the shoe and tracked by eight optoelectronic cameras. Heel impacts, soft tissue and bone vibrations of lower leg muscle groups, sacrum and head were quantified with tri-axial accelerometers. Continuous wavelet transform was used to assess magnitude and frequency of the acceleration data. Linear mixed models and non-parametric one-dimensional regressions between the accelerometer data and shoe deformation were performed. Greater horizontal and vertical deformations decreased the magnitude (up to 4.6% per mm) and frequency (up to 0.6 Hz per mm) of soft tissue vibrations and bone accelerations. Accelerations of the heel, tibia, gastrocnemius medialis and vastus lateralis were more influenced than the sacrum and head. Increasing midsole deformation could therefore mitigate the risk of injury, while increasing running comfort and smoothness. [ABSTRACT FROM AUTHOR]

The article discusses a meta-analysis which aims to assess the impact of brief interventions (BIs) for alcohol consumption to the reduction of tobacco consumption among adolescents and young adults. Topics discussed include the eligibility criteria of participants in the study, the multi-step eligibility screening and coding process, and the selection of the standardized mean difference (SMD) to synthesize effect sizes.

Brief interventions aimed at reducing alcohol use among youth may interrupt a possible developmental progression to more serious substance use if they can also affect the use of other illicit drugs. This meta-analysis examined the findings of recent research on the effects of brief alcohol interventions for adolescents and young adults on both alcohol and illicit drug use. Eligible studies were those using randomized or controlled quasi-experimental designs to examine the effects of brief alcohol interventions on illicit drug use outcomes among youth. A comprehensive literature search identified 30 eligible study samples that, on average, included participants age 17, with 57 % male participants and 56 % White youth. Three-level random-effects meta-analyses were used to estimate mean effect sizes and explore variability in effects. Overall, brief interventions targeting both alcohol and other drugs were effective in reducing both of these substances. However, the brief interventions that targeted only alcohol had no significant secondary effects on untargeted illicit drug use. The evidence from current research, therefore, shows modest beneficial effects on outcomes that are targeted by brief interventions for youth, but does not show that those effects generalize to untargeted illicit drug use outcomes. [ABSTRACT FROM AUTHOR]

We examined the effects of CenteringPregnancy group prenatal care versus individually delivered prenatal care on gestational age, birth weight, and fetal demise. We conducted a retrospective chart review and used propensity score matching to form a sample of 6,155 women receiving prenatal care delivered in a group or individual format at five sites in Tennessee. Compared to the matched group of women receiving prenatal care in an individual format, women in CenteringPregnancy group prenatal care had longer weeks of gestation ( b = .35, 95 % CI [.29, .41]), higher birth weight in grams ( b = 28.6, 95 % CI [4.8, 52.3]), lower odds of very low birth weight (OR = .21, 95 % CI [.06, .70]), and lower odds of fetal demise (OR = .12, 95 % CI [.02, .92]). Results indicated no evidence of differences in the odds of preterm birth or low birth weight for participants in group versus individual prenatal care. CenteringPregnancy group prenatal care had statistically and clinically significant beneficial effects on very low birth weight and fetal demise outcomes relative to traditional individually delivered prenatal care. Group prenatal care had statistically significant beneficial effects on gestational age and birth weight, although the effects were relatively small in clinical magnitude. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the trends and outcomes of the national Perinatal Hepatitis B Prevention Program (PHBPP) for infants born from 1994 to 2008. METHODS: PHBPPs in state and city public health jurisdictions annually submitted program outcome reports to the Centers for Disease Control and Prevention. The annual number of births to hepatitis B surface antigen (HBsAg)-positive women was estimated and used to evaluate the percentage of PHBPP-identified HBsAg-positive pregnant women. PHBPP reports were used to assess program objectives achieved, and infant outcomes by 12 to 24 months of age. RESULTS: From 1994 to 2008, the estimated number of annual births to HBsAg-positive women increased from 19 208 to 25 600 (P < .001). The annual number of PHBPP-managed infants increased (P < 001), comprising 40.8% to 50.5% of the estimated number. On average, 94.4% of PHBPP-managed infants received hepatitis B immunoglobulin and hepatitis B vaccine within 1 day of birth. The percentage of infants who completed the vaccine series by age 12 months decreased from 86.0% to 77.7% (P = .004), but the percentage who received postvaccination testing increased from 25.1% to 56.0% (P < .001). Incidence of chronic hepatitis B virus infection among tested infants decreased from 2.1% in 1999 to 0.8% in 2008 (P= .001). CONCLUSIONS: The PHBPP achieved substantial progress in preventing perinatal hepatitis B virus infection in the United States, despite an increasing number of at-risk infants. Significant gaps remain in identifying HBsAg-positive pregnant women, and completing management and assessment of their infants to ensure prevention of perinatal hepatitis B virus transmission. [ABSTRACT FROM AUTHOR]

Aims To illustrate a machine learning-based approach for identifying and investigating moderators of alcohol use intervention effects in aggregate-data meta-analysis. Methods We illustrated the machine learning technique of random forest modeling using data from an ongoing meta-analysis of brief substance use interventions implemented in general healthcare settings. A subset of 40 trials testing brief alcohol interventions (BAIs) was used; these trials provided 344 estimates of post-intervention effects on participants' alcohol use as well as data on 20 potential moderators of intervention effects. These candidate moderators included characteristics of trial methodology and implementation, intervention design and participant samples. Results The best-fitting random forest model identified 10 important moderators from the pool of 20 candidate moderators. Meta-regression utilizing the selected moderators found that inclusion of prescriptive advice in a BAI session significantly moderated BAI effects on alcohol use. Observed effects were also significantly moderated by several methodological characteristics of trials, including the type of comparison group used, the overall level of attrition and the strategy used to address missing data. In a meta-regression model that included all candidate moderators, fewer coefficients were found to be significant, indicating that the use of a preliminary data reduction technique to identify only important moderators for inclusion in final analyses may have yielded improved statistical power to detect moderation. Conclusions Machine learning methods can be valuable tools for clarifying the influence of trial, intervention and sample characteristics on alcohol use intervention effects, in particular when numerous candidate moderators are available. [ABSTRACT FROM AUTHOR]

Maternal nutrition plays a crucial role in influencing foetal growth and birth outcomes. The government of Indonesia provides centrally distributed food supplements (GFS) for undernourished pregnant mothers. The aim of the study was to test whether low‐cost, local food supplements (LFS) for undernourished pregnant mothers can improve maternal and birth outcomes compared with the centrally distributed GFS. This study was a two‐arm, randomised controlled trial design. The baseline data were collected at enrolment. We enrolled 60 pregnant mothers from Demak District, Central Java Province, Indonesia with mid‐upper arm circumference (MUAC) <23.5 cm who were assigned into two groups. The intervention group received LFS and multiple micronutrient supplements (MMS). The control group received the GFS and iron and folic acid supplements (IFA). LFS was a balanced energy protein food supplement made from peanuts, beans and fish. The effectiveness of these two interventions was assessed using logistic and linear regression. At baseline, the two groups had similar characteristics. After 60 days of treatment, compliance with the food and micronutrient supplements in the LFS group was 78.1% and 62.6% compared to 29.1% and 12.8% in the GFS group. After adjusting for baseline and the main covariates, mothers in the LFS group were more likely to increase MUAC (mean difference 0.60cm; 95% CI 0.27, 0.92) and to increase gestational weight (mean difference 1.02 kg; 95% CI 0.08, 1.97) than were mothers in the GFS group. For birth outcomes, the LFS group had a reduction in the risk of birthweight <3000 g (adjusted odds ratio [AOR] 0.15; 95% CI 0.02, 0.98), caesarean delivery (AOR 0.11; 95% CI 0.02, 0.60) and short birth length (AOR 0.07; 95% CI 0.01, 0.93) compared with the GFS group. Local foods and MMS supplementation can improve maternal and birth outcomes. Therefore, the provision of LFS can result in better compliance and better outcomes compared with centrally distributed GFS supplements. [ABSTRACT FROM AUTHOR]

The article focuses on a study related to relevance of high perceived social standing (PSS) for better heath prospects of Ugandan adults with HIV undergoing antiretroviral therapy. Topics discussed include health advantages possessed by individuals with high socio-economic status (SES) as compared to p;people with low SES, inverse correlation between PSS and mental and physiological health and less PSS score of HIV-infected adults getting treatment in tertiary health care center.

Background: A large volume of literature has shown negative associations between stunting and child development; however, there is limited evidence for associations with milder forms of linear growth faltering and determinants of malnutrition in developing countries.Objective: The objective of this study was to assess the association between anthropometric growth indicators across their distribution and determinants of malnutrition with development of Tanzanian children.Methods: We used the Bayley Scales of Infant Development III to assess a cohort of 1036 Tanzanian children between 18 and 36 mo of age who were previously enrolled in a neonatal vitamin A trial. Linear regression models were used to assess standardized mean differences in child development for anthropometry z scores, along with pregnancy, delivery, and early childhood factors.Results: Height-for-age z score (HAZ) was linearly associated with cognitive, communication, and motor development z scores across the observed range in this population (all P values for linear relation < 0.05). Each unit increase in HAZ was associated with +0.09 (95% CI: 0.05, 0.13), +0.10 (95% CI: 0.07, 0.14), and +0.13 (95% CI: 0.09, 0.16) higher cognitive, communication, and motor development z scores, respectively. The relation of weight-for-height z score (WHZ) was nonlinear with only wasted children (WHZ <-2) experiencing deficits (P values for nonlinear relation < 0.05). Wasted children had -0.63 (95% CI: -0.97, -0.29), -0.32 (95% CI: -0.64, 0.01), and -0.54 (95% CI: -0.86, -0.23) z score deficits in cognitive, communication, and motor development z scores, respectively, relative to nonwasted children. Maternal stature and flush toilet use were associated with higher cognitive and motor z scores, whereas being born small for gestational age (SGA) was associated with a -0.16 (95% CI: -0.30, -0.01) z score deficit in cognition.Conclusions: Mild to severe chronic malnutrition was associated with increasing developmental deficits in Tanzanian children, whereas only wasted children exhibited developmental delays during acute malnutrition. Interventions to reduce SGA, improve sanitation, and increase maternal stature may have positive effects on child development. This trial was registered with the Australian New Zealand Clinical Trials Registry as ACTRN12610000636055. [ABSTRACT FROM AUTHOR]