Search results for: intervention studies

Authors: Hsin-Yu Lin, Ching-Hsia Hung

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Obstructive sleep apnea (OSA) is characterized by a complete or partial obstruction of the upper airway during sleep. The vulnerable sites of upper airway collapses are consequences of sleep state-dependent reductions in tone in specific pharyngeal dilators. Clinical examinations reveal multilevel collapses of the upper airway among the patients with OSA. Therefore, an anatomically-based oropharyngeal rehabilitation should comprise a multilevel approach, including retropalatal, retroglossal, hypopharyngeal, temporomandibular, and facial levels, all of which involve different muscle groups and contribute to multifunctional interaction and coordination, such as swallowing, breathing, and phonation. The purpose of the study was to exam the effects of this rehabilitation program with a multilevel approach. In this study, fifteen subjects with newly diagnosed moderate or severe OSA (Apnea-Hypopnea-Index≥15) were randomized into an intervention group and control group. The intervention group (N=8) underwent a 12-week-intervention of a hospital-based rehabilitation program, while the control group (N=7) was kept on the waiting list. The 12-week-intervention comprised an anatomically based multilevel approach. The primary outcome was Polysomnography (PSG) data, and the secondary outcome was oropharyngeal and respiratory muscle function. In the intervention group, Apnea-Hypopnea-Index significantly improved (46.96±19.45 versus 32.78±10.78 events/h, p=0.017) compared with control group (35.77±17.49 versus 42.96±17.32 events/h, p=0.043). While the control group remained no change, the intervention group demonstrated other PSG outcomes significantly improvement, including arousal index (46.04±18.9 versus 32.98±8.35/h, p=0.035), mean SpO2 (92.88±2.1 versus 94.13±1.46%, p=0.039). Besides, the intervention group demonstrated significant improvement in oropharyngeal and respiratory muscle function compared to the control group. This anatomically-based oropharyngeal rehabilitation with a multilevel approach can be proven as a non-invasive therapy for patients with OSA.

Keywords: obstructive sleep apnea, upper airway, oropharyngeal rehabilitation, multilevel approach

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Authors: Nazlı Üstünes Demirhan

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International norms are subject to pressures of change through contestation during the course of their lifetimes. The nature of the contestation is one of the factors that are likely to have a determinative role in the direction of this change towards a stronger or weaker norm. This paper aims to understand the relation between the legality of contestation and the direction of change in norm strength. Based on a multidimensional norm strength conceptualization, it is hypothesized that use of legal logic and rhetoric of argumentation would have a positive influence for norm strength, whereas non-legal nature of contestation would lack this and weaken the norm. In order to show this, the evolution of the human protection norm between 1999 and 2018 will be examined with reference to two major contestation periods; Kosovo intervention of 1999, which led to the development of R2P doctrine, and Libya intervention of 2011, which is followed by the demise of the norm. The comparative analysis will be conducted through process tracing method with a document analysis on the Security Council meeting minutes, resolutions, and press releases. This study aims to contribute to the norm contestation literature with the introduction of legal process analysis. It also relates to further questions in IR/IL nexus, relating to the value added of norm legality as well as the politics of legalization.

Keywords: humanitarian intervention, legality, norm contestation, norm dynamics, norm strength, responsibility to protect

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Authors: Jocelyn Solomons, Kraak

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Rhythmic movement, also referred to as “dance”, involves the execution of different motor skills as well as the integration and sequencing of actions between limbs, timing and spatial precision. The aim of this study was therefore to investigate and compare the effect of a 16-week rhythmic movement intervention on flexibility, dynamic balance, agility, power and local muscular endurance of academy rugby players in the Western Cape, according to positional groups. Players (N ¼ 54) (age 18.66 0.81 years; height 1.76 0.69 cm; weight 76.77 10.69 kg), were randomly divided into a treatment-control [TCA] (n ¼ 28) and a control-treatment [CTB] (n ¼ 26) group. In this crossover experimental design, the interaction effect of the treatment order and the treatment time between the TCA and CTB group, was determined. Results indicated a statistically significant improvement (p < 0.05) in agility2 (p ¼ 0.06), power2 (p ¼ 0.05), local muscular endurance1 (p ¼ 0.01) & 3 (p ¼ 0.01) and dynamic balance (p < 0.01). Likewise, forwards and backs also showed statistically significant improvements (p < 0.05) per positional groups. Therefore, a rhythmic movement intervention has the potential to improve rugby-specific bio-motor skills and furthermore, improve positional specific skills should it be designed with positional groups in mind. Future studies should investigate, not only the effect of rhythmic movement on improving specific rugby bio-motor skills, but the potential of its application as an alternative training method during off- season (or detraining phases) or as a recovery method.

Keywords: agility, dance, dynamic balance, flexibility, local muscular endurance, power, training

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Authors: Sushila Pareek, Divya Shekhawat

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Music has been shown as a therapeutic agent in depression, anxiety, and stress. A pilot study was carried out to see the therapeutic effects of Indian classical instrumental Raga Todi on depression, anxiety, and stress. 50 individuals diagnosed with depression, anxiety, and stress with DSM-V were taken for the study. Subjects were randomly divided into two groups: the experimental group and the control group. The experimental group received the instrumental raga Todi whereas the other control group didn't receive any intervention. DASS-21 was used on the baseline and after the intervention to measure depression, anxiety, and stress. The result indicates that anxiety, stress, and depression level was reduced after listening to the raga desi Todi. It was concluded that raga desi Todi is an effective intervention for reducing depression, anxiety, and stress.

Keywords: raga, anxiety, stress, depression, DASS-21, mental health

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Authors: Adela Penesova, Zofia Radikova, Boris Bajer, Andrea Havranova, Miroslav Vlcek

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Background: The aim of our study was to compare the effect of intensified lifestyle intervention on insulin resistance (HOMA-IR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and Fibroblast growth factor (FGF) 21 after 8 weeks of lifestyle intervention. Methods: A group of 43 obese patients (13M/30F; 43.0±12.4 years; BMI (body mass index) 31.2±6.3 kg/m2 participated in a weight loss interventional program (NCT02325804) following an 8-week hypocaloric diet (-30% energy expenditure) and physical activity 150 minutes/week. Insulin sensitivity was evaluated according to the homeostasis model assessment of insulin resistance (HOMA-IR) and insulin sensitivity indices according to Matsuda and Cederholm were calculated (ISImat and ISIced). Plasma ALT, AST, Fetuin-A, FGF 21, and physical fitness were measured. Results: The average reduction of body weight was 6.8±4.9 kg (0-15 kg; p=0.0006), accompanied with a significant reduction of body fat amount of fat mass (p=0.03), and waist circumference (p=0.02). Insulin sensitivity has been improved (IR HOMA 2.71±3.90 vs 1.24±0.83; p=0.01; ISIMat 6.64±4.38 vs 8.93±5.36 p ≤ 0.001). Total, LDL cholesterol, and triglycerides decreased (p=0.05, p=0.04, p=0.04, respectively). Physical fitness significantly improved after intervention (as measure VO2 max (maximal oxygen uptake) (p ≤ 0.001). ALT decreased significantly (0.44±0.26 vs post 0.33±0.18 ukat/l, p=0.004); however, AST not (pre 0.40±0.15 vs 0.35±0.09 ukat/l, p=0.07). Hepatokine Fetuin-A significantly decreased after intervention (43.1±10.8 vs 32.6±8.6 ng/ml, p < 0.001); however, FGF 21 levels tended to decrease (146±152 vs 132±164 pg/ml, p=0.07). Conclusion: 8-weeks of diet and physical activity intervention program in obese otherwise healthy subjects led to an improvement of insulin resistance parameters and liver marker profiles, as well as increased physical fitness. This study was supported by grants APVV 15-0228; VEGA 2/0161/16.

Keywords: obesity, diet, exercice, insulin sensitivity

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Authors: Esabelle Lo Yan Yam, Pheak Chhoun, Sovannary Tuot, Emily Lancsar, Siyan Yi

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Persons living with HIV (PLHIV) need lifelong antiretroviral treatment (ART) to keep their viral load suppressed to an undetectable level, maintain a healthy immune system, and reduce the risk of transmitting HIV to others. However, many factors affect PLHIV's adherence to ART, including access to antiretrovirals (ARV), stigma, lack of social support, and the burden of seeking lifelong care. Community-based care has been shown to be instrumental in the experience of PLHIV in many countries, including Cambodia. In this study based in Cambodia, a community-based ART delivery (CAD) intervention involving community action workers (CAWs) who are PLHIVs was introduced. These workers collect pre-packaged ARVs from the ART clinics and dispense them to PLHIVs in the communities. The quasi-experimental study involved approximately 2000 stable PLHIV in the intervention arm and another 2000 PLHIV in the control arm (receiving usual care). A cost-effectiveness analysis is currently conducted to complement the clinical effectiveness of the CAD intervention on the care continuum and treatment outcomes for stable PLHIV, as well as the operational effectiveness in increasing the efficiency of the ART clinics and the health system. The analysis will consider health system and societal perspectives based on primary outcomes, including retention in care, viral load suppression, and adherence to ART. Additionally, a consultation with the National Centre for HIV/AIDS, Dermatology, and STD under the Cambodia Ministry of Health will be done to discuss the conduct of a budget impact analysis that can quantify the financial impact on the government's budget when adopting the CAD intervention at the provincial and national levels. The budget impact analysis will take into consideration various scaling-up scenarios for the interventions in the country. The research will assess the cost-effectiveness of the CAD intervention to support national stakeholders in Cambodia to make an informed decision on the adoption and scaling up of the intervention in Cambodia. The results are currently being analyzed and will be available at the time of the conference.

Keywords: Cambodia, community intervention, economic evaluation, global health, HIV/AIDs, implementation research

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Authors: Abdul Rahim Razalli, Nordin Mamat, Lee Kean Low

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The objective of the study is to examine the acquisition of Bahasa Melayu hand coded and Malaysian Sign Language of hearing impaired children and the factors that influencing the acquisition of Malay language at early intervention. A qualitative research design was chosen to answer two research questions. Two sets of instruments have been used to obtain information of proficiency and factors that influence it. Five children with hearing problems, four teachers and three parents were selected as the respondents through purposive sampling technique. The findings show that pupils with hearing problems who mastered Bahasa Melayu hand coded have better acquisition of Bahasa Melayu as compared to those who acquired Malaysian Sign Language. The study also found that the parents, pupils, teachers and environmental factors have an impact on the acquisition of Bahasa Melayu hand coded. The implications of this study show that early intervention of Bahasa Melayu hand coded and the parents, pupils, teachers and environmental factors do help in the language proficiency of children with hearing problems. A more comprehensive study should be undertaken at a higher level to see the impact on an early intervention program for Malay language acquisition of hearing impaired children.

Keywords: Bahasa Melayu hand coded, Malaysian sign Language, hearing impaired children, early intervention

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Authors: Ali Babajanzade, Hossein Bozorgian

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Cognitive load plays an important role in learning in general and L2 listening comprehension in particular. This study is an attempt to investigate the effect of metacognitive strategy intervention through dialogic interaction (MSIDI) on L2 listeners’ cognitive load. A mixed-method design with 50 participants of male and female Iranian lower-intermediate learners between 20 to 25 years of age was used. An experimental group (n=25) received weekly interventions based on metacognitive strategy intervention through dialogic interaction for ten sessions. The second group, which was control (n=25), had the same listening samples with the regular procedure without a metacognitive intervention program in each session. The study used three different instruments: a) a modified version of the cognitive load questionnaire, b) digit span tests, and c) focused group interviews to investigate listeners’ level of cognitive load throughout the process. Results testified not only improvements in listening comprehension in MSIDI but a radical shift of cognitive load rate within this group. In other words, listeners experienced a lower level of cognitive load in MSIDI in comparison with their peers in the control group.

Keywords: cognitive load theory, human mental functioning, metacognitive theory, listening comprehension, sociocultural theory

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Authors: Gemma Reynolds, Deborah Bailey Rodriguez, Maria Paula Valdivieso Rueda

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In recent years, the mental health of Higher Education (HE) students has been a growing concern. This has been further exacerbated by the stresses associated with the Covid-19 pandemic, placing students at even greater risk of developing mental health issues. Support available to students in HE tends to follow an established and traditional route. The demands for counselling services have grown, not only with the increase in student numbers but with the number of students seeking support for mental health issues. One way of improving well-being and mental health in HE students is through the use of brief interventions, such as expressive writing (EW). This intervention involves encouraging individuals to write continuously for at least 15-20 minutes for three to five sessions (often on consecutive days) about their deepest thoughts and feelings to explore significant personal experiences in a meaningful way. Given the brevity, simplicity and cost-effectiveness of EW, this intervention has considerable potential as an intervention for HE populations. The current study, therefore, employed a mixed-methods design to explore the effectiveness of EW in reducing anxiety, general stress, academic stress and depression in HE students while improving well-being. HE students at MDX were randomly assigned to one of three conditions: (1) The UniExp-EW group were required to write about their emotions and thoughts about any stressors they have faced that are directly relevant to their university experience (2) The NonUniExp-EW group were required to write about their emotions and thoughts about any stressors that are NOT directly relevant to their university experience, and (3) The Control group were required to write about how they spent their weekend, with no reference to thoughts or emotions, and without thinking about university. Participants were required to carry out the EW intervention for 15minutes per day for four consecutive days. Baseline mental health and wellbeing measures were taken before the intervention via a battery of standardised questionnaires. Following completion of the intervention on day four, participants were required to complete the questionnaires a second time and again one week later. Participants were also invited to attend focus groups to discuss their experience of the intervention. This will allow an in-depth investigation into students’ perceptions of EW as an effective intervention to determine whether they would choose to use this intervention in the future. The quantitative findings will be discussed at the conference as well as a discussion of the important implications of the findings. The study is fundamental because if EW is an effective intervention for improving mental health and well-being in HE students, its brevity and simplicity means it can be easily implemented and can be freely-available to students. Improving the mental health and well-being of HE students can have knock-on implications for improving academic skills and career development.

Keywords: mental health, wellbeing, higher education students, expressive writing

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Authors: Laila Khawaja

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In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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Authors: Satria B. Mahathma, Asri Hendrawati

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Background: Diabetes mellitus (DM) is a metabolic disorder syndrome characterized by chronic hyperglycemia. The number of people with diabetes rose from 108 million in 1980 to 422 million in 2014. In general, almost 90% of the prevalence of DM is type 2 DM which marked by insulin resistance and decreased receptor sensitivity. Aside from conventional antidiabetic therapy, the utilization of medicinal plants as alternative medicine has beneficial effects in diabetic patients. Flavonoid contents in radish leaves such as quercetin, pelargonidin, and kaempferol are thought to have antidiabetic activity on decreasing blood glucose levels by tricyclic nucleotide modulation of pancreatic beta cells and ameliorating insulin resistance. This study aimed to determine the effect of variant concentration of radish leaves ethanol extract on blood glucose levels in diabetic rats. Method: This study used pretest-posttest control group design by using 16 male Wistar rats which were induced type-2 diabetic by streptozotocin 60 mg/kg BW-nicotinamide 120 mg/kg BW intraperitoneally. Rats who had developed type-2 DM later divided randomly into 4 groups; negative control received placebo, positive control received glibenclamide 5 mg/kg BW/day, rats intervention I and intervention II received 100% and 50% of radish leaves ethanol extract, respectively. Treatments were administered orally for four weeks. The blood glucose levels were measured using the Enzymatic Colorimetric Test “GOD-PAP”. Data were analyzed by the dependent t-test for pretest-posttest intervention difference and one-way ANOVA followed by post hoc test to determine the significant difference of each treatment to obtain the significant data. Result: The result revealed that intervention group had lower blood glucose levels mean than control group which the lowest was intervention II group (negative control: 540,9 ± 191,7 mg/dl, positive control: 494, 97 ± 64,91 mg/dl, intervention I: 301,92 ± 165,70 mg/dl, and intervention II group: 276,1 ± 139,02 mg/dl. Intervention II group had the highest antidiabetic activity, followed by the intervention I group with the amount of decrease in blood glucose levels were -151,85 ± 77,43 mg/dl and -11,08 ± 186,62 mg/dl, however negative and positive control group didn’t have antidiabetic activity. The dependent t-test result showed there is a significant difference in decreasing blood glucose levels in the intervention II pretest-posttest intervention (p=0,03) while the other group didn’t. Data analyzed by one-way ANOVA also revealed the intervention II group significantly declined blood glucose levels compared to the negative and positive control group (p = 0,033 and p=0,032, respectively). Conclusion: There is a significant effect of radish leaves ethanol extract on blood glucose levels in streptozotocin-nicotinamide-induced diabetic rats with the optimal therapeutic effect at a concentration of 50%.

Keywords: blood glucose levels, medicinal plant, radish leaves, type-2 diabetes mellitus

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Authors: Alessandra Chiara Maraschin, Estelle Trengove

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In South Africa, only 23% of engineering students attain their degrees in the minimum time of 4 years. This begs the question: Why is the 4-year throughput rate so low? Improving the throughput rate is crucial in assisting students to the shortest possible path to completion. The Electrical Engineering programme has a fixed curriculum and students must pass all courses in order to graduate. In South Africa, as is the case in several other countries, many students rely on external funding such as bursaries from companies in industry. If students fail a course, they often lose their bursaries, and most might not be able to fund their 'repeating year' fees. It is thus important to improve the throughput rate, since for many students, graduating from university is a way out of poverty for an entire family. In Electrical Engineering, it has been found that the Software Development I course (an introduction to C++ programming) is a significant hurdle course for students and has been found to have a low pass rate. It has been well-documented that students struggle with this type of course as it introduces a number of new threshold concepts that can be challenging to grasp in a short time frame. In an attempt to mitigate this situation, a part-time night-school for Software Development I was introduced in 2015 as an intervention measure. The course includes all the course material from the Software Development I module and allows students who failed the course in first semester a second chance by repeating the course through taking the night-school course. The purpose of this study is to determine whether the introduction of this intervention course could be considered a success. The success of the intervention is assessed in two ways. The study will first look at whether the night-school course contributed to improving the pass rate of the Software Development I course. Secondly, the study will examine whether the intervention contributed to improving the overall throughput from the 2nd year to the 3rd year of study at a South African University. Second year academic results for a sample of 1216 students have been collected from 2010-2017. Preliminary results show that the lowest pass rate for Software Development I was found to be in 2017 with a pass rate of 34.9%. Since the intervention course's inception, the pass rate for Software Development I has increased each year from 2015-2017 by 13.75%, 25.53% and 25.81% respectively. To conclude, the preliminary results show that the intervention course is a success in improving the pass rate of Software Development I.

Keywords: academic performance, electrical engineering, engineering education, intervention course, low pass rate, software development course, throughput

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Authors: Ifeoma Anozie, Teka Apalata, Dominic Abaver

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Introduction: Despite use of Anti-retroviral therapy to reduce the incidence of opportunistic infections among HIV/AIDS patients, rapid episodes of re-infection after deworming are still common occurrences because pharmaceutical intervention alone does not prevent reinfection. Unsafe water and inadequate personal hygiene and parasitic infections are widely expected to accelerate the progression of HIV infection. This is because the chronic immunosuppression of HIV infection encourages susceptibility to opportunistic (including parasitic) infections which is linked to CD4+ cell count of <200 cells/μl. Intestinal parasites such as G. intestinalis and Entamoeba spp are ubiquitous protozoa that remain infectious over a long time in an environment and show resistance to standard disinfection. To control re-infection, the social factors that underpin the prevention need to be controlled. This study aims at prevention of intestinal parasites in people living with HIV/AIDS by using a treatment, hygiene education and sanitation (THEdS) bundle approach. Methods: This study was conducted in four clinics (Ngangelizwe health centre, Tsolo gateway clinic, Idutywa health centre and Nqamakwe health centre) across the seven districts in Eastern cape, South Africa. The four clinics were divided in two: experimental and control, for the purpose of intervention. Data was collected from March 2019 to February 2020. Six hundred participants were screened for intestinal parasitic infections. Stool samples were collected and analysed twice: before (Pre-test infection screening) and after (Post-test re-infection) THEdS bundle intervention. The experimental clinics received full intervention package, which include therapeutic treatment, health education on personal hygiene and sanitation training, while the control clinics received only therapeutic treatment for those found with intestinal parasitic infections. Results: Baseline prevalence of Intestinal Parasites isolated shows 12 intestinal parasites with overall frequency of 65, with Ascaris lumbricoides having most frequency (44.6%). The intervention had a cure rate of 60%, with odd ratio of 1.42, which indicates that the intervention group is 1.42 times more likely of parasite clearing as compared to the control group. The relative risk ratio of 1.17 signifies that there is 1.17 times more likelihood to clear intestinal parasite if there no intervention. Discussion and conclusion: Infection with multiple parasites can cause health defects, especially among HIV/AIDS patients. Efficiency of some HIV vaccines in HIV/AIDS patients is affected because treatment of re-infection amplifies drug resistance, affects the efficacy of the front-line drugs, and still permits transmission. In South Africa, treatment of intestinal parasites is usually offered to clinic attending HIV/AIDS patients upon suspicion but not as a mandate for patients being initiated into Antiretroviral (ART) program. The effectiveness of THEdS bundle advocates for inclusiveness of mandatory screening for intestinal parasitic infections among attendees of HIV/Aids clinics on regular basis.

Keywords: cure rate, , HIV/AIDS patients, intestinal parasites, intervention studies, reinfection rate

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Authors: Lebeza Alemu Tenaw, Fei Wan Ngai

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Background: Postpartum depression is the most common mental health disorder that occurs after childbirth, and it is more prevalent among teenage mothers compared to adults. Although there is emerging evidence suggesting psychosocial interventions can decrease postpartum depression, there are no consistent findings regarding the effectiveness of these interventions, especially for teenage mothers. The current review aimed to investigate the effectiveness of psychosocial interventions in preventing postpartum depression among teenage mothers. Methods: The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) manual was implemented to select articles from online databases. The articles were searched using the Population, Intervention, Control, and Outcome (PICO) model. The quality of the articles was assessed using the Cochrane Collaboration Risk of Bias assessment tool. The statistical analyses were performed using Stata 17, and the effect size was estimated using the standard mean difference score of depression between the intervention and control groups. Heterogeneity between the studies was assessed through the I2 statistic and Q statistic, while the publication bias was evaluated using the asymmetry of the funnel plot and Egger's test. Results: In this systematic review, a total of nine articles were included. While psychosocial interventions demonstrated in reducing the risk of postpartum depression compared to usual maternal care, it is important to note that the mean difference score of depression was significant in only three of the included studies. The overall meta-analysis finding revealed that psychosocial interventions were effective in preventing postpartum depression, with a pooled effect size of -0.5 (95% CI: -0.95, -0.06) during the final time postpartum depression assessment. The heterogeneity level was found to be substantial, with an I2 value of 82.3%. However, no publication bias was observed. Conclusion: The review findings suggest that psychosocial interventions initiated during the late antenatal and early postnatal periods effectively prevent postpartum depression. The interventions were found to be more beneficial during the first three months of the postpartum period. However, this review also highlighted that there is a scarcity of interventional studies conducted in low-income countries, indicating the need for further studies in diverse communities.

Keywords: teenage pregnancy, postpartum depression, review

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Authors: Takudzwa C. Taruza, Carel B. Schoeman, Ilse M. Schoeman

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The proliferation of informal settlements remains one of the major planning challenges in democratic South Africa. In spite of the various local, national and international initiatives to promote the creation of sustainable human settlements, informal settlements continue to exist as spatially marginalised societies characterised by poverty, unemployment, squalor conditions and disaster risks. It is argued that, in practice, intervention is mainly directed at achieving set quantitative targets and goals rather than improving the lives of the inhabitants. The relevant planning instruments do not adequately address the integration of informal settlements into the broader planning framework. This paper is based on the analysis of the informal settlement intervention within the North West Province. Financial constraints, bureaucracy in housing delivery and lack of horizontal and vertical integration in spatial planning and programme implementation are amongst the major factors that caused stagnation in some of the upgrading programmes which in turn hindered the attainment of the target set as part of the Outcome 8 Delivery Agreement. Moreover, the absence of distinct indicators for the assessment of the qualitative progress of upgrading programmes indicates shortcomings in the intervention policies and programmes to promote the creation of sustainable human settlements. Thus, this paper seeks to proffer an assessment toolkit as well as a framework for the implementation of a Sustainable Informal Settlement Programme.

Keywords: formalization of informal settlements, planning intervention, sustainable formalization indicators, sustainable human settlements

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Authors: Justina Ijeoma Ezebuwa, Catherine C. Ikewuchi, Eka B. Essien, Francis C. Anacletus

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Iron deficiency anemia (IDA) is a significant problem in Nigeria, especially in children under five. Intervention options for treating anemia in under-five children have also been the subject of research. This study aims to synthesize the evidence on dietary interventions for managing iron deficiency anemia in under-five children in Nigeria. This study uses a systematic review method to collect relevant studies to answer the research questions and a narrative synthesis to analyze and synthesize the findings of this study. Cochrane, PubMed, and ScienceDirect databases were thoroughly searched, and five (5) articles were selected for this study. The results show that dietary interventions, such as daily multi-nutrient fortified dairy-based drinks, biofortified (yellow/ white) cassava rich in pro-vitamin A, iron supplementation in foods, and ready-to-use therapeutic food (RUTF) may be relevant to the management of iron deficiency anemia in under-five children in Nigeria. The study also shows that daily multi-nutrient fortified dairy-based drinks may be more effective, feasible, and culturally acceptable for managing anemia in under-5 children in Nigeria. In addition, daily multi-nutrient fortified dairy-based drinks and ready-to-use therapeutic food (RUTF) were reported to have the potential to improve the growth, cognitive development, and overall health outcomes of under-five children with iron deficiency anemia in Nigeria. Recommendations for future studies in this research area and for public health practitioners and policymakers were provided.

Keywords: dietary intervention, iron deficiency anemia, under-five children, Nigeria

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Authors: Janice Cheong, Tan Seying

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The growing years in adolescence are often a tumultuous time for both the individual and family; this is especially so for individuals with Autism Spectrum Disorder (ASD) and Social Communication Disorder (SCD). Tea Club, which is adapted from the PEERS® for Young Adults, seeks to address some of the social challenges faced by Singaporean adolescents with ASD/SCD while navigating social situations. Tea club (hybrid) consists of face-to-face sessions and virtual sessions. These sessions work with both the adolescent and their parents to tackle the individual's difficulties with social skills, empathy, and loneliness. Prior to the group intervention, both participants and their parents scored on the Test of Adolescent Social Skills Knowledge (TASSK) and Autism Spectrum Quotient (AQ), respectively. The session was spread across four months. At the end of the group based intervention, participants’ and parents’ scores were collected again and compared. Inputs on the programme and participant’s confidence in socialization were also gathered from both participants and their parents and looked at thematically. The findings highlight some of the challenges faced by teens with ASD in Singapore and the benefits of the intervention. Parental sentiments are also examined and discussed.

Keywords: adolescence autism, group intervention, social communication disorder, social skills

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Authors: Pushpavathi M., Kavya V., Akshatha V.

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Introduction: Cleft lip and palate (CLP) is a congenital condition which hinders effectual communication due to associated speech and language difficulties. Expressive language delay (ELD) is a feature seen in this population which is influenced by factors such as type and severity of CLP, age at surgical and linguistic intervention and also the type and intensity of speech and language therapy (SLT). Since CLP is the most common congenital abnormality seen in Indian children, early intervention is a necessity which plays a critical role in enhancing their speech and language skills. The interaction between the timing of intervention and factors which contribute to effective intervention by caregivers is an area which needs to be explored. Objectives: The present study attempts to determine the effect of timing of intervention on the contributing maternal factors for effective linguistic intervention in toddlers with repaired CLP with respect to the awareness, home training patterns, speech and non-speech behaviors of the mothers. Participants: Thirty six toddlers in the age range of 1 to 4 years diagnosed as ELD secondary to repaired CLP, along with their mothers served as participants. Group I (Early Intervention Group, EIG) included 19 mother-child pairs who came to seek SLT soon after corrective surgery and group II (Delayed Intervention Group, DIG) included 16 mother-child pairs who received SLT after the age of 3 years. Further, the groups were divided into group A, and group B. Group ‘A’ received SLT for 60 sessions by Speech Language Pathologist (SLP), while Group B received SLT for 30 sessions by SLP and 30 sessions only by mother without supervision of SLP. Method: The mothers were enrolled for the Early Language Intervention Program and following this, their awareness about CLP was assessed through the Parental awareness questionnaire. The quality of home training was assessed through Mohite’s Inventory. Subsequently, the speech and non-speech behaviors of the mothers were assessed using a Mother’s behavioral checklist. Detailed counseling and orientation was done to the mothers, and SLT was initiated for toddlers. After 60 sessions of intensive SLT, the questionnaire and checklists were re-administered to find out the changes in scores between the pre- and posttest measurements. Results: The scores obtained under different domains in the awareness questionnaire, Mohite’s inventory and Mothers behavior checklist were tabulated and subjected to statistical analysis. Since the data did not follow normal distribution (i.e. p > 0.05), Mann-Whitney U test was conducted which revealed that there was no significant difference between groups I and II as well as groups A and B. Further, Wilcoxon Signed Rank test revealed that mothers had better awareness regarding issues related to CLP and improved home-training abilities post-orientation (p ≤ 0.05). A statistically significant difference was also noted for speech and non-speech behaviors of the mothers (p ≤ 0.05). Conclusions: Extensive orientation and counseling helped mothers of both EI and DI groups to improve their knowledge about CLP. Intensive SLT using focused stimulation and a parent-implemented approach enabled them to carry out the intervention in an effectual manner.

Keywords: awareness, cleft lip and palate, early language intervention program, home training, orientation, timing of intervention

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Authors: Aritra Das, Tanmay Mahapatra, Prabir Maharana, Sridhar Srikantiah

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In the absence of adequate well-equipped neonatal-care facilities serving rural Bihar, India, the practice of essential home-based newborn-care remains critically important for reduction of neonatal and infant mortality, especially among pre-term and small-for-gestational-age (Low-birth-weight) newborns. To improve the child health parameters in Bihar, ‘Very-Low-Birth-Weight (vLBW) Tracking’ intervention is being conducted by CARE India, since 2015, targeting public facility-delivered newborns weighing ≤2000g at birth, to improve their identification and provision of immediate post-natal care. To assess the effectiveness of the intervention, 200 public health facilities were randomly selected from all functional public-sector delivery points in Bihar and various outcomes were tracked among the neonates born there. Thus far, one pre-intervention (Feb-Apr’2015-born neonates) and three post-intervention (for Sep-Oct’2015, Sep-Oct’2016 and Sep-Oct’2017-born children) follow-up studies were conducted. In each round, interviews were conducted with the mothers/caregivers of successfully-tracked children to understand outcome, service-coverage and care-seeking during the neonatal period. Data from 171 matched facilities common across all rounds were analyzed using SAS-9.4. Identification of neonates with birth-weight ≤ 2000g improved from 2% at baseline to 3.3%-4% during post-intervention. All indicators pertaining to post-natal home-visits by frontline-workers (FLWs) improved. Significant improvements between baseline and post-intervention rounds were also noted regarding mothers being informed about ‘weak’ child – at the facility (R1 = 25 to R4 = 50%) and at home by FLW (R1 = 19%, to R4 = 30%). Practice of ‘Kangaroo-Mother-Care (KMC)’– an important component of essential newborn care – showed significant improvement in postintervention period compared to baseline in both facility (R1 = 15% to R4 = 31%) and home (R1 = 10% to R4=29%). Increasing trend was noted regarding detection and birth weight-recording of the extremely low-birth-weight newborns (< 1500 g) showed an increasing trend. Moreover, there was a downward trend in mortality across rounds, in each birth-weight strata (< 1500g, 1500-1799g and >= 1800g). After adjustment for the differential distribution of birth-weights, mortality was found to decline significantly from R1 (22.11%) to R4 (11.87%). Significantly declining trend was also observed for both early and late neonatal mortality and morbidities. Multiple regression analysis identified - birth during immediate post-intervention phase as well as that during the maintenance phase, birth weight > 1500g, children of low-parity mothers, receiving visit from FLW in the first week and/or receiving advice on extra care from FLW as predictors of survival during neonatal period among vLBW newborns. vLBW tracking was found to be a successful and sustainable intervention and has already been handed over to the Government.

Keywords: weak newborn tracking, very low birth weight babies, newborn care, community response

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Authors: Talita Veldsman, Elzette Fritz

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Many children attending special education present with sensory integration difficulties that hamper their learning and behaviour. These learners can benefit from therapeutic interventions as part of their classroom curriculum that can address sensory development and allow for holistic development to take place. A research study was conducted by utilizing socio-drama as a therapeutic intervention in the classroom in order to develop sensory integration skills. The use of socio-drama as therapeutic intervention proved to be a successful multi-disciplinary approach where education and psychology could build a bridge of growth and integration. The paper describes how socio-drama was used in the classroom and how these sessions were designed. The research followed a qualitative approach and involved six Afrikaans-speaking children attending special secondary school in the age group 12-14 years. Data collection included observations during the session, reflective art journals, semi-structured interviews with the teacher and informal interviews with the adolescents. The analysis found improved self-confidence, better social relationships, sensory awareness and self-regulation in the participants after a period of a year.

Keywords: education, sensory integration, sociodrama, classroom intervention, psychology

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Authors: Ossama Salman

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Background and objective: Sacroiliac joint pain is a common cause for chronic axial low back pain, with up to 20% prevalence rate. To date, no effective long-term treatment intervention has been embarked on yet. The aim of our study was to compare steroid block to radiofrequency ablation for SIJ pain conditions. Methods: A randomized, blind, study was conducted in 30 patients with sacroiliac joint pain. Fifteen patients received radiofrequency denervation of L4-5 primary dorsal rami and S1-3 lateral sacral branch, and 15 patients received steroid under fluoroscopy. Those in the steroid group who did not respond to steroid injections were offered to cross over to get radiofrequency ablation. Results: At 1-, 3- and 6-months post-intervention, 73%, 60% and 53% of patients, respectively, gained ≥ 50 % pain relief in the radiofrequency (RF) ablation group. In the steroid group, at one month post intervention follow up, only 20% gained ≥ 50 % pain relief, but failed to show any improvement at 3 months and 6 months follow up. Conclusions: Radiofrequency ablation at L4 and L5 primary dorsal rami and S1-3 lateral sacral branch may provide effective and longer pain relief compared to the classic intra-articular steroid injection, in properly selected patients with suspected sacroiliac joint pain. Larger studies are called for to confirm our results and lay out the optimal patient selection and treatment parameters for this poorly comprehended disorder.

Keywords: lateral branch denervation, LBD, radio frequency, RF, sacroiliac joint, SIJ, visual analogue scale, VAS

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Authors: Jiyeon Kang, Yeon Jin Jeong, Hoon Heo

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Purpose: Bullying in nursing workplace has been a serious problem that increases the turnover of nurses. Few studies have examined the effects of communication training on workplace bullying for nurses, and all used a single-group design and a small sample size. Thus, more rigorous research has been needed to evaluate the effects properly. This research was aimed to identify the effects of the mobile type communication training of responses on bullying behaviors among nurses. Methods: A randomized controlled trial was performed. Subjects were 62 critical care nurses working in university hospitals in Busan, South Korea. We developed a mobile phone application to train nurses to deal with bullying situation. This application includes 6 common bullying situations and appropriate empathetic communication (non-violent communication) samples in the form of webtoons. The experimental group used this application for 4 weeks, and we measured interpersonal relationship, workplace bullying, symptom experience, and intention to leave before, post, and 8 weeks after the intervention from both experimental and control groups. The effect of the intervention was analyzed using repeated measures ANOVA. Results: The mobile type communication training developed in this study was effective for decreasing nurses’ intention to leave workplace (F = 5.11, p = .027). However, it had no effect on interpersonal relationship (F = 2.54, p = .116), workplace bullying (F = 2.99, p = .089) or symptom experience (F = 2.81, p = .099). The beneficial effects on intention to leave lasted at least up to 4 weeks after the training. Conclusion: The mobile type communication training can be utilized as an effective personal coping strategy for workplace bullying among nurses. Further studies on the long-term effects of the communication training are necessary.

Keywords: bullying, communication, mobile applications, nurses, training, workplace

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Authors: Hanan Algarni

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Background: Impairment of walking and balance skills has negative impact on functional independence and community participation after stroke. Gait recovery is considered a primary goal in rehabilitation by both patients and physiotherapists. Treadmill training coupled with virtual reality technology is a new emerging approach that offers patients with feedback, open and random skills practice while walking and interacting with virtual environmental scenes. Objectives: To synthesize the evidence around the effects of the VR treadmill training on gait speed and balance primarily, functional independence and community participation secondarily in stroke patients. Methods: Systematic review was conducted; search strategy included electronic data bases: MEDLINE, AMED, Cochrane, CINAHL, EMBASE, PEDro, Web of Science, and unpublished literature. Inclusion criteria: Participant: adult >18 years, stroke, ambulatory, without severe visual or cognitive impartments. Intervention: VR treadmill training alone or with physiotherapy. Comparator: any other interventions. Outcomes: gait speed, balance, function, community participation. Characteristics of included studies were extracted for analysis. Risk of bias assessment was performed using Cochrane's ROB tool. Narrative synthesis of findings was undertaken and summary of findings in each outcome was reported using GRADEpro. Results: Four studies were included involving 84 stroke participants with chronic hemiparesis. Interventions intensity ranged (6-12 sessions, 20 minutes-1 hour/session). Three studies investigated the effects on gait speed and balance. 2 studies investigated functional outcomes and one study assessed community participation. ROB assessment showed 50% unclear risk of selection bias and 25% of unclear risk of detection bias across the studies. Heterogeneity was identified in the intervention effects at post training and follow up. Outcome measures, training intensity and durations also varied across the studies, grade of evidence was low for balance, moderate for speed and function outcomes, and high for community participation. However, it is important to note that grading was done on few numbers of studies in each outcome. Conclusions: The summary of findings suggests positive and statistically significant effects (p<0.05) of VR treadmill training compared to other interventions on gait speed, dynamic balance skills, function and participation directly after training. However, the effects were not sustained at follow up in two studies (2 weeks-1 month) and other studies did not perform follow up measurements. More RCTs with larger sample sizes and higher methodological quality are required to examine the long term effects of VR treadmill effects on function independence and community participation after stroke, in order to draw conclusions and produce stronger robust evidence.

Keywords: virtual reality, treadmill, stroke, gait rehabilitation

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Authors: Paolo Ragazzi, Olivier Peillon, Paul Fauris, Mathias Simon, Raul Navarro, Juan Carlos Martin, Oriol Casasayas, Laura Pacheco, Albert Perez-Bellmunt

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Introduction: The use of stretching techniques in the sports world is frequent and widely used for its many effects. One of the main benefits is the gain in flexibility, range of motion and facilitation of the sporting performance. Recently the use of Roller-Foam (RF) has spread in sports practice both at elite and recreational level for its benefits being similar to those observed in stretching. The objective of the following study is to compare the results of the Roller-Foam with the proprioceptive neuromuscular facilitation stretching (PNF) (one of the stretchings with more evidence) on the hamstring muscles. Study design: The design of the study is a single-blind, randomized controlled trial and the participants are 40 healthy volunteers. Intervention: The subjects are distributed randomly in one of the following groups; stretching (PNF) intervention group: 4 repetitions of PNF stretching (5seconds of contraction, 5 second of relaxation, 20 second stretch), Roller-Foam intervention group: 2 minutes of Roller-Foam was realized on the hamstring muscles. Main outcome measures: hamstring muscles flexibility was assessed at the beginning, during (30’’ of intervention) and the end of the session by using the Modified Sit and Reach test (MSR). Results: The baseline results data given in both groups are comparable to each other. The PNF group obtained an increase in flexibility of 3,1 cm at 30 seconds (first series) and of 5,1 cm at 2 minutes (the last of all series). The RF group obtained a 0,6 cm difference at 30 seconds and 2,4 cm after 2 minutes of application of roller foam. The results were statistically significant when comparing intragroups but not intergroups. Conclusions: Despite the fact that the use of roller foam is spreading in the sports and rehabilitation field, the results of the present study suggest that the gain of flexibility on the hamstrings is greater if PNF type stretches are used instead of RF. These results may be due to the fact that the use of roller foam intervened more in the fascial tissue, while the stretches intervene more in the myotendinous unit. Future studies are needed, increasing the sample number and diversifying the types of stretching.

Keywords: hamstring muscle, stretching, neuromuscular facilitation stretching, roller foam

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Authors: Eileen K. Africa, Karel J. van Deventer

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Neuro-typical children develop the motor skills necessary to play, do schoolwork and interact with others. However, this is not observed in children who have learning or behavioural problems. Children with Autism Spectrum Disorder (ASD) are often referred to as clumsy because their body parts do not work well together in a sequence. Physical Activity (PA) has shown to be beneficial to the general population, therefore, providing children with ASD opportunities to take part in PA programmes, could prove to be beneficial in many ways and should be investigated. The purpose of this study was to design a specialised group intervention programme, to attempt to improve gross motor skills of selected children diagnosed with ASD between the ages of eight and 13 years. A government school for ASD learners was recruited to take part in this study, and a sample of convenience (N=7) was selected. Children in the experimental group (n=4) participated in a 12-week group intervention programme twice per week, while the control group continued with their normal daily routine. The Movement Assessment Battery for Children-Second Edition (MABC-2), was administered pre- and post-test to determine the children’s gross motor proficiency and to determine if the group intervention programme had an effect on the gross motor skills of the experimental group. Statistically significant improvements were observed in total motor skill proficiency (p < 0.05), of the experimental group. These results demonstrate the importance of gross motor skills interventions for children diagnosed with ASD. Future research should include more participants to ensure that the results can be generalised.

Keywords: autism spectrum disorder, children, gross motor skills, group intervention programme

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Authors: Najia Zulfiqar

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Imparting moral education is the need of time, considering the obvious moral decline in society. Recent research shows the downfall of moral competence among university students. The main objective of the present study was to develop moral development intervention strategies for undergraduate students of Sports and Physical Education. Using an interpretative phenomenological approach, insight into field-specific moral issues was gained through interviews with 7 subject experts and a focus-group discussion session with 8 students. Two research assistants who were trained in qualitative interviewing collected, transcribed and analyzed data into the MAXQDA software using content and discourse analyses. The identified moral issues in Sports and Physical Education were sports gambling and betting, pay-for-play, doping, coach misconduct, tampering, cultural bias, gender equity/nepotism, bullying/discrimination, and harassment. Next, intervention modules were developed for each moral issue based on hypothetical situations, and followed by guided reflection and dilemma discussion questions. The third moral development strategy was community services that included posture screening, diet plan for different age groups, open fitness ground training, exercise camps for physical fitness, balanced diet awareness camp, gymnastic camp, shoe assessment as per health standards, and volunteering for public awareness at the playground, gymnasium, stadium, park, etc. The intervention modules were given to four subject specialists for expert validation who were from different backgrounds within Sport Sciences. Upon refinement and finalization, four students were presented with these intervention modules and questioned about accuracy, relevance, comprehension, and content organization. Iterative changes were made in the content of the intervention modules to tailor them to the moral development needs of undergraduate students. This intervention will strengthen positive moral values and foster mature decision-making about right and wrong acts. As this intervention is easy to apply as a remedial tool, academicians and policymakers can use this to promote students’ moral development.

Keywords: community service, dilemma discussion, morality, physical education, university students.

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Authors: Nurullah Buker, Ezgi Karagoz, Yesim Salik Sengul, Sevay Alsen Guney, Gokhan Yoyler, Aylin Ozbek

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Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders with heterogeneous clinical features such as inattention, hyperactivity, and impulsivity. Many different types of exercise interventions were employed for children with ADHD. However, previous studies have usually examined the effects of non-specific exercise programs or short-term effects of exercise. The aim of this study is to investigate the effect of the Neurocognitive Exercise Program (NEP), which is a structured exercise program derived from Life Kinetik, and a relatively new for children with ADHD, on symptoms, attention, and dynamic balance in medication-naïve children with ADHD. Fourteen medication-naive children (7-12 years) with ADHD were included in the intervention group. NEP was performed once a week for ten weeks. The intervention group also performed a structured home exercise program for another six days, for ten weeks. The children in the intervention group were assessed at baseline, in the third month, in the sixth month, and in the twelfth month regarding ADHD-related symptoms, attention, and dynamic balance. Fifteen age-matched typically developing children were assessed once for establishing normative values. Hyperactivity-Impulsivity score and dynamic balance were found to improve after NEP in the ADHD group in the 3rd month (p<0.05). In addition, these results were similar for both groups after NEP and at the end of the 12th month (p>0.05). The NEP may provide beneficial effects on hyperactivity-impulsivity, oppositional defiant, and dynamic balance in children with ADHD, and the improvements may be maintained in the long term.

Keywords: ADHD, attention problems, dynamic balance, neurocognitive exercise

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Authors: Suliman Al Balawi

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Food waste is a significant problem in the Kingdom of Saudi Arabia (KSA). About SR13 billion worth of food is wasted per year in the KSA. From moral, social, and economic perspectives, it is essential to reduce the wastage of food. Although studies have identified the amount of food waste in the KSA, there is a lack of research on why people in the KSA waste food; thus, it is difficult to design efficient intervention programs to reduce food waste. This research investigates the key factors that influence the food waste behavior of the people of the KSA. A food waste behavior model is proposed in this study that has moral disengagement at the center of the model. Following a literature survey, it is hypothesised that religiosity, hedonic value, frugality, and trait cynicism are the antecedents of moral disengagement that are likely to impact the food waste behavior of the people of the KSA. The study further posits that an intervention strategy in the form of a social marketing campaign that focuses on lowering the level of moral disengagement could reduce the food waste behavior of the people of the KSA. This study will apply a pre-test/post-test experimental design (control group). A random sampling method will be used to select participants from the (employees of a chosen firm) in the KSA. The social marketing campaign will be run for six months through the Corporate Social Responsibility Department of the Company, and to analyse the experimental data, structural equation modeling (SEM) will be used. The outcomes of the study will demonstrate the effectiveness of a social marketing campaign for improving the food waste behavior of the people of the KSA and will ultimately lay the foundation for designing efficient intervention programs in the future. This study will contribute to the knowledge on food waste behavior by testing a newly proposed food waste behavior model in the KSA.

Keywords: food waste, social marketing, Saudi Arabia, moral disengagement

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Authors: Essam Amerian

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The aim of this study was to investigate the effects of improving waist-to-hip ratio (WHR) and visceral fat components on the health of shift workers in an offshore petrochemical company. A total of 100 male shift workers participated in the study, with an average age of 40.5 years and an average BMI of 28.2 kg/m². The study employed a randomized controlled trial design, with participants assigned to either an intervention group or a control group. The intervention group received a 12-week program that included dietary counseling, physical activity recommendations, and stress management techniques. The control group received no intervention. The outcomes measured were changes in WHR, visceral fat components, blood pressure, and lipid profile. The results showed that the intervention group had a statistically significant improvement in WHR (p<0.001) and visceral fat components (p<0.001) compared to the control group. Furthermore, there were statistically significant improvements in systolic blood pressure (p=0.015) and total cholesterol (p=0.034) in the intervention group compared to the control group. These findings suggest that implementing a 12-week program that includes dietary counseling, physical activity recommendations, and stress management techniques can effectively improve WHR, visceral fat components, and cardiovascular health among shift workers in an offshore petrochemical company.

Keywords: body composition, waist-hip-ratio, visceral fat, shift worker, work efficiency

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Authors: Jin Li, Jing Sun, Xiangkun Cai, Lijuanwang, Yanbin Tang, Junsheng Huo

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In order to improve the malnutrition of infants and young children in poor rural areas of China, Chinese government implement a project on improvement of children's nutrition in poor rural areas. Each infant or young child aged 6 to 23 months in selected poor rural areas of China was provided a package of Yingyangbao (YYB) per day, which is a full fat soy powder mixed with multiple micronutrient powders. A technical direction to implement this project comprehensively in poor rural areas of China will be provided by assessing the nutritional status of infants and feeding practices of caregiver. The nutritional intervention was conducted using Yingyangbao for infants aged 6 to 23 months in six poor counties of Shanxi, Yunnan and Hubei Provinces. The caregiver or parents of infants were educated on feeding knowledge and practice. A total of 1840 infants were assessed before the intervention and 1789 infants one year later. The length, weight, hemoglobin concentration of infants were measured to evaluate nutritional status before and after the intervention respectively. The questionnaires were designed to collect data for the basic demographic information and feeding practices. The average weight of infants aged 6 to 23 months increased from 9.59 ± 1.54kg to 9.73 ± 1.61kg one years later (p<0.01), and the average length from 76.0±6.0 to 77.0±6.1(p<0.01). The weight and length of infants aged 12 to 17 months had most obviously improving effect among the three age groups. Before the intervention, the hemoglobin concentration value of infants was 11.7±1.2g/L, and the anemia prevalence was 32.9%. One year later, the hemoglobin concentration value of the infants was increased to 12.0±1.1g/dL, and the anemia prevalence was decreased to 26.0%. There were both statistically significant (p <0.01). The anemia prevalence of infants aged 18 to 23 months had most obviously improving effect，which decreased from 25.0% to 17.2%(p<0.01). The proportion of infants aged 6 to 8 months who received solid, semi-solid or soft foods in time was increased from 89.4% to 91.6%, while there was no statistically significant. The proportion of 6-23 month-old infants who received minimum dietary diversity increased from 55.6% to 60.3%(p <0.01). The differences of the proportion of infants who received minimum meal frequency was no statistically significant between before and after the intervention. The nutritional intervention using Yingyangbao showed the significant effect for improving infants aged 6 to 23 months anemia status, weight and length. The feeding practices were improved through education in the process of nutritional intervention, while the effect is not significant. It is need for Chinese government to explore new publicity pattern.

Keywords: nutritional intervention, infants, nutritional status, feeding practice

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