Trials have provided conflicting estimates of the risk of gastrointestinal illness attributable to tap water. To estimate this risk in an Iowa community with a well-run water utility with microbiologically challenged source water, the authors of this 2000-2002 study randomly assigned blinded volunteers to use externally identical devices (active device: 227 households with 646 persons; sham device: 229 households with 650 persons) for 6 months (cycle A). Each group then switched to the opposite device for 6 months (cycle B). The active device contained a 1-microm absolute ceramic filter and used ultraviolet light. Episodes of "highly credible gastrointestinal illness," a published measure of diarrhea, nausea, vomiting, and abdominal cramps, were recorded. Water usage was recorded with personal diaries and an electronic totalizer. The numbers of episodes in cycle A among the active and sham device groups were 707 and 672, respectively; in cycle B, the numbers of episodes were 516 and 476, respectively. In a log-linear generalized estimating equations model using intention-to-treat analysis, the relative rate of highly credible gastrointestinal illness (sham vs. active) for the entire trial was 0.98 (95% confidence interval: 0.86, 1.10). No reduction in gastrointestinal illness was detected after in-home use of a device designed to be highly effective in removing microorganisms from water.
We conducted a randomized, triple-blinded home drinking water intervention trial to determine if a large study could be undertaken while successfully blinding participants. Households were randomized 50:50 to use externally identical active or sham treatment devices. We measured the effectiveness of blinding of participants by using a published blinding index in which values >0.5 indicate successful blinding. The principal health outcome measured was “highly credible gastrointestinal illness” (HCGI). Participants (n=236) from 77 households were successfully blinded to their treatment assignment. At the end of the study, the blinding index was 0.64 (95% confidence interval 0.51-0.78). There were 103 episodes of HCGI during 10,790 person-days at risk in the sham group and 82 episodes during 11,380 person-days at risk in the active treatment group. The incidence rate ratio of disease (adjusted for the clustered sampling) was 1.32 (95% CI 0.75, 2.33) and the attributable risk was 0.24 (95% CI -0.33, 0.57). These data confirm that participants can be successfully blinded to treatment group assignment during a randomized trial of an in-home drinking water intervention.
Le présent article fait suite au rapport Preventing reading difficulties in young children auquel Snow et Burns ont participé. La principale conclusion de ce rapport est que l’apprentissage de l’écrit, du préscolaire à la troisième année du primaire, est déterminant pour l’avenir des enfants. Le texte présente les fondements scientifiques qui sous-tendent les recherches sur lesquelles le rapport s’est appuyé pour dégager ses conclusions et ses recommandations d’intervention. Il complète les données du rapport par une revue des recherches sur les enfants allophones et l’efficacité des mesures d’éducation préscolaire mises en place pour favoriser l’apprentissage de la langue d’enseignement et leur intégration dans le système scolaire.This article discusses the report Preventing Reading Difficulties in Young Children wherein two of the co-authors participated. The principal conclusion of the report is that learning written language from pre-school years to third grade at the primary level determines children’s future. The authors present the scientific foundations that support the research on which this report was developed in order to propose conclusions and proposals for intervention. They provide further data from a review of research studies of allophone students and the efficacy of pre-school educational techniques whose aim is the improvement of language (that used in teaching) and of their integration into the school system.El presente artículo es una continuación del informe Preventing Reading Difficulties in Young Children en el cual dos de los coautores han participado. La conclusión principal de ese informe es que el aprendizaje de la escritura, desde el nivel pre-escolar hasta el tercer año de la escuela primaria, es determinante para el futuro de los niños. Burns, Espinosa y Snow presentan los fundamentos científicos que soportan las investigaciones sobre las cuales el informe se apoyó para establecer sus conclusiones y sus recomendaciones de intervención. Asimismo, el estudio completa los datos del informe dando un panorama de las investigaciones sobre los niños cuya lengua materna no es ni el francés ni el inglés, y mostrando la eficacia de las medidas que se introdujeron en el nivel pre-escolar para favorecer el aprendidaje de la lengua de enseñanza y la integración en el sistema escolar.Der vorliegende Beitrag baut auf den Bericht Preventing Reading Difficulties in Young Children auf, an dem zwei der Autoren mitgearbeit haben. Die wichtigste Schlussfolgerung dieses Berichts ist folgende : Der Erwerb der Lesefähigkeit in der Vorschule sowie in den drei ersten Grundschuljahren ist für die Zukunft der Kinder von entscheidender Bedeutung. Die Autoren liefern dazu die wissenschaftlichen Grundlagen, auf deren Ergebnissen der Bericht basiert, um im Anschluss daran Empfehlungen und Schlussfolgerungen formulieren zu können. Der Bericht wird weiter vervollständigt durch einen Überblick über die Forschungsarbeiten zum Thema allophone Kinder und Wirksamkeit der Vorschulmethoden zum Erlernen der Unterrichtssprac...
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