***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To investigate the  maternal comprehension of two different growth charts and to identify the group of mothers with poor comprehension . DESIGN An experimental prospect i ve study . SETTING A child welfare clinic at the De Soysa Hospital for Women , Colombo , Sri Lanka . SUBJECTS 932 mothers were studied regarding their interpretation of the type of growth chart their infants had been allocated . A total of 413 mothers interpreted the ‘ road-to-health ’ chart and 519 mothers interpreted the revised chart .  A vali date d scoring system was used to assess comprehension . The two groups of mothers were comparable . RESULTS 62.4 % ( 324 ) mothers who interpreted the revised chart had good comprehension . Only 20.6 % ( 85 ) mothers had similar comprehension with the road-to-health chart . Education up to or beyond grade 8 in school significantly improved comprehension . CONCLUSION The design of the growth chart has a powerful effect on maternal comprehension of growth patterns . Length of schooling rather than literacy alone is a marker of a comprehending mother . The policy implication s of these findings are that governments and agencies may need to re design parent held growth charts to achieve better comprehension by mothers Abstract Objective : To evaluate the effectiveness of a health visitor led intervention for failure to thrive in children under 2 years old . Design : Controlled trial , r and omised by primary care practice . Setting : Newcastle upon Tyne health district . Intervention : Structured health visitor management , with dietetic , paediatric , and social work input as required . Subjects : 229 children ( 120 in intervention practice s and 109 in control practice s ) were identified as failing to thrive by population screening during the first 2 years of life . Follow up was by home visit of a research nurse and review of the childrens ' records at age 3 years . Main outcome measures : Follow up weight and height and number of routinely collected weights . Results : 95 of the 97 families offered intervention completed at least the initial assessment . At follow up , 187 ( 82 % ) records were review ed , and these suggested that 15 ( 16 % ) controls were lost to follow up immediately after the screening weight was taken compared with only one child in the intervention group . In the 134 ( 58 % ) families who consented to home visits , children in the intervention group were significantly heavier and taller and were reported to have better appetites than childen in the control group , although both groups were equally satisfied by the services they had received . When the children were last weighed , 91 ( 76 % ) in the intervention group had recovered from their failure to thrive compared with 60 ( 55 % ) in the control group ( P<0.001 ) . Conclusion : In failure to thrive , health visitor intervention , with limited specialist support , can significantly improve growth compared with conventional management Reported are the results of a study that compared mothers '  underst and ing of two growth monitoring charts in Lesotho , which was carried out to assist the government in selecting a national growth chart . The study was conducted over 4 months in nine primary health care ( PHC ) clinics , where 1221 mothers were enrolled . Mothers were assigned to one of the following chart groups : " road-to-health " ( RTH ) , " growth surveillance " ( GS ) , or no chart ( controls ) . Mothers in the first two groups received instruction on their respective chart during monthly growth monitoring sessions and were tested on their knowledge of this  chart  before and after the follow-up period . The mothers in the control group were tested on the RTH and GS charts at the beginning and at the end of the study . The results indicated that mothers who received training on either chart  markedly improved their underst and ing compared with the control group and that the RTH group understood their chart better than the GS group did theirs Growth monitoring was developed as a clinic-based programme in the early 1960s , and has spread widely in many countries . The results of weighing children are usually presented in a graphic form , unintelligible to most mothers and difficult for many health workers to interpret . This study suggests that the TALC Direct Recording Scale will allow growth monitoring  to be undertaken even by illiterate mothers in the community and reports the results of a trial with a group of illiterate mothers amongst the Maasai of Kenya BACKGROUND Prolonged hospitalization of low birth weight infants increases the risk of medical and psychosocial complications . The feasibility of earlier discharge with community-based follow-up of infants of < or = 2000 g birth weight , without the use of home apnea monitors , was investigated . METHODS One hundred infants of < or = 2000 g birth weight were r and omized to either an intervention or control group . Intervention infants were discharged when readiness criteria were met . Based on assessed need , intervention group families received public health nursing and homemaker services for up to 8 weeks . Control infants were discharged to their homes at the discretion of the attending physician . All infants were assessed blindly at age 1 year with the Bayley and Home Observation for Measurement of the Environment ( HOME ) scales . RESULTS There were no group differences in baseline infants ' characteristics or in neonatal complications . Infants in the intervention group were discharged from the hospital at an earlier postconceptional age ( mean + /- SD 36.6 + /- 1.5 weeks vs 37.3 + /- 1.6 weeks ; P < .04 ) . Median length of hospital stay ( 23 days vs 31.5 days ) and mean weight at the time of discharge ( 2200 + /- 288 g vs 2275 + /- 301 g ) were lower , but not significantly , for infants in the intervention group . A secondary analysis by birth weight strata ( < or = 1500 g and 1501 through 2000 g ) revealed that the most significant reductions in hospital stay and weight at discharge were realized in infants of 1501 through 2000 g birth weight . The persistence of apneic episodes and need for electronic monitoring prevented earlier discharge of infants of < or = 1500 g birth weight . Postdischarge services to the intervention group included 185 public health nurse home visits ( 3.8 + /- 0.91 ) , 410 phone contacts ( 8.4 + /- 5 ) , and 2298 homemaker hours ( 46 + /- 78 ) of service . At 1 year , there were no deaths and no group differences in rehospitalization rates , use of ambulatory services , or Bayley scores . Intervention families had significantly higher 1-year HOME scores . Minimum cost of hospital care was $ 873 per day , while the total cost of community-based services averaged $ 626 per infant . CONCLUSIONS A significant reduction in average length of hospital stay was achieved for infants of 1501 through 2000 g birth weight . Earlier discharge of infants weighing < or = 1500 g at birth was hampered by persistent apneic episodes and feeding difficulties . A community-based program design ed to provide individualized support and education for families of low birth weight infants was cost-effective and had a positive influence on the home environment OBJECTIVE To evaluate the efficacy of a home-based intervention on the growth and development of children with nonorganic failure to thrive ( NOFTT ) . DESIGN R and omized clinical trial . PARTICIPANTS The NOFTT sample included 130 children ( mean age , 12.7 months ; SD , 6.4 ) recruited from urban pediatric primary care clinics serving low income families . All children were younger than 25 months with weight for age below the fifth percentile . Eligibility criteria included gestational age of at least 36 weeks , birth weight appropriate for gestational age , and no significant history of perinatal complications , congenital disorders , chronic illnesses , or developmental disabilities . Children were r and omized into two groups : clinic plus home intervention ( HI ) ( n = 64 ) or clinic only ( n = 66 ) . There were no group differences in children 's age , gender , race , or growth parameters , or on any of the family background variables . Most children were raised by single , African-American mothers who received public assistance . Eighty-nine percent of the families ( 116 of 130 ) completed the 1-year evaluation . INTERVENTIONS All children received services in a multidisciplinary growth and nutrition clinic . A community-based agency provided the home intervention . Families in the HI group were scheduled to receive weekly home visits for 1 year by lay home visitors , supervised by a community health nurse . The intervention provided maternal support and promoted parenting , child development , use of informal and formal re sources , and parent advocacy . MEASUREMENTS Growth was measured by st and ard procedures and converted to z scores for weight for height and height for age to assess wasting and stunting . Cognitive and motor development were measured with the Bayley Scales of Infant Development , and language development was measured by the Receptive/Expressive Emergent Language Scale . Both scales were administered at recruitment and at the 12-month follow-up . Parent-child interaction was measured by observing mothers and children during feeding at recruitment and at the 12-month follow-up , and the quality of the home was measured by the Home Observation Measure of the Environment 18 months after recruitment . ANALYSES Repeated- measures multivariate analyses of covariance were used to examine changes in children 's growth and development and parent-child interaction . Analyses of covariance were used to examine the quality of the home . Independent variables were intervention status and age at recruitment ( 1.0 to 12.0 vs 12.1 to 24.9 months ) . Maternal education was a covariate in all analyses . When changes in developmental status and parent-child interaction were examined , weight for height and height for age at recruitment were included as covariates . RESULTS Children 's weight for age , weight for height , and height for age improved significantly during the 12-month study period , regardless of intervention status . Children in the HI group had better receptive language over time and more child-oriented home environments than children in the clinic-only group . The impact of intervention status on cognitive development varied as a function of children 's ages at recruitment , with younger children showing beneficial effects of home intervention . There were no changes in motor development associated with intervention status . During the study period , children gained skills in interactive competence during feeding , and their parents became more controlling during feeding , but differences were not associated with intervention status . CONCLUSIONS Findings support a cautious optimism regarding home intervention during the first year of life provided by trained lay home visitors . Early home intervention can promote a nurturant home environment effectively and can reduce the developmental delays often experienced by low income , urban infants with NOFTT : Subsequent investigations of home intervention should consider alternative options for toddlers with NOFTT 
    Output:
    
It showed small numerical differences in test scores .
DISCUSSION AND IMPLICATION S Current policies appear to be based on the opinion that investment in the activity has worthwhile health benefits , and does no harm .