Suppression of ctc promoter mutations in Bacillus subtilis

Transcription from the Bacillus subtilis ctc promoter is induced as cells enter stationary phase under conditions in which the enzymes of the tricarboxylic acid cycle are repressed. This transcription requires the presence of a secondary form of RNA polymerase, E sigma B, that is found in exponentially growing cells and in early-stationary-phase cells. Starting with a defective ctc promoter that had either a base substitution at position -15 or a base substitution at position -36, we were able to identify four independent second-site mutations within these mutated promoters that suppressed the effect of the original mutations and thereby restored function to the ctc promoter. Three of these mutated promoters had an additional base substitution(s) at positions -5, -9, or both -5 and -9 that enhanced their utilization in vivo by E sigma B, whereas one of the promoters had a single-base-pair deletion in the -15 region that placed it under a completely different form of regulation than that of the wild-type ctc promoter. In addition to mutations in the ctc promoter region, we also isolated three classes of mutants that exhibited increased ctc expression. The effects of the mutations in these strains were not allele specific, since they increased expression from both mutant and wild-type ctc promoters. One class of mutants which affected expression from the ctc promoter carried mutations that blocked the activity of the tricarboxylic acid cycle. A second class of mutations mapped near cysA and was unable to sporulate. Three-factor transformation crosses and complementation analysis indicated that one of these mutations was an allele of spo0H. The third class of mutations is closely linked to dal and may define a regulatory gene for sigB, the sigma B structural gene.

Mechanism of lithium-induced polyuria in the rat

While many studies have demonstrated a nephrogenic diabetes insipidus syndrome (NDI) with prolonged lithium (Li) treatment, experiments in the isolated rat papillary collecting duct have suggested that the defect may be due to a circulating factor that inhibits the action of arginine vasopressin (AVP). Since Li-treatment can produce a form of hyperparathyroidism and parathyroid hormone (PTH) can act as a partial agonist to AVP, in vivo and in vitro studies were performed on rats made polyuric by daily intraperitoneal (i.p.) Li (4 mmol/kg) treatment. Li-treatment for three weeks produced an increase in PTH (194 +/- 20 compared with 118 +/- 18 pg/ml in control rats; P < 0.01) as well as an increase in the plasma calcium concentration (2.38 +/- 0.05 compared with 2.25 +/- 0.04 mmol/liter; P < 0.05). Clearance studies were performed on water loaded Li-treated and control rats, and the defect in urine concentration was only observed with a low physiological concentration of AVP (10 mU/kg body wt over 5 min). Maximal urine osmolality was 328 +/- 31 compared with 613 +/- 81 mOsm/kg (P < 0.05) in controls. There was no detectable difference with a prolonged maximal physiological AVP concentration (10 mU bolus and 50 mU/kg body wt per hr) and papillary solute concentrations were unchanged. When Li-treated rats had been parathyroidectomized (PTX), a significant difference in urine concentration with the low AVP concentration could not be demonstrated when compared to non-PTX control rats. In the isolated papillary collecting duct preparation a medium was used that contained fresh plasma from Li-treated or control rats, both intact and PTX. Experiments using plasma from Li-treated intact rats produced only a 25.4 +/- 5.1% increase in diffusional water permeability with the addition of AVP (200 microU/ml) compared to 52.6 +/- 9.0% in control rats (P < 0.01). However, when plasma from Li-treated PTX rats was used, the AVP induced increase in water permeability (54.7 +/- 11.2%) was not significantly different from that observed in PTX control rats. These studies show that the NDI-like defect in Li-treatment is small and easily overcome by higher concentrations of AVP and suggests that the concentration defect is at least in part due to increased circulating levels of PTH acting as a partial agonist to AVP and thereby inhibiting its hydroosmotic action.

Reproducibility of Preschool Personnel and Guardian Reports on Energy Balance-Related Behaviors and Their Correlates in Finnish Preschool Children

Valid and reliable non-objective assessments of guardian and preschool personnel reports are necessary when estimating young children’s health behaviors. This study examines the test-retest reproducibility of (a) guardian and preschool personnel questionnaires about correlates of preschool-aged children’s energy balance-related behaviors (EBRBs), (b) a screen time diary, and (c) a food frequency questionnaire (FFQ) reported by a guardian. A sample of guardians having preschool-aged children (N = 69) and preschool personnel (N = 61) completed questionnaires twice within a five-week time interval during April–May 2018 in Finland. Intra-class correlations (ICC), kappas, and percentage agreement were calculated to test the test-retest-reproducibility. The guardian questionnaire for correlates of the children’s EBRBs demonstrated mainly moderate to good reproducibility whereas the preschool personnel questionnaire of preschool correlates for children’s EBRBs was mostly good. The reproducibility of the screen time diary was good and FFQ food items showed mostly moderate reproducibility. The reproducibility of the FFQ foods items for vegetables, fruit, and berries was slightly better for the amount consumed than for the frequency of consumption. To conclude, all the instruments are acceptable for use in future studies.

Social, sexual and personal implications of paraplegia

Paraplegia can lead to social stigmatisation, sexual difficulties, and emotional maladjustment. The specific nature of problems experienced in these areas were investigated in an interview study of 22 male and female paraplegics. These interviews were followed up by a postal questionnaire and both qualitative and quantitative data are presented in this report. Effective counselling can only be offered on the basis of an understanding of problems as they are subjectively experienced, and with an acknowledgement of the wide differences that exist between individuals in the way that they view and react to their situation.

Predicting gender differences in liking for vegetables and preference for a variety of vegetables among 11-year-old children

We studied the factors that predict liking for vegetables and preference for a variety of vegetables among schoolchildren. Additionally, we examined if there were gender differences in the predictors that explain the hypothesized higher scores in liking vegetables and preferences among girls. The data from the PRO GREENS project included 424 Finnish children (response rate 77%) aged 11 to 12. The children completed validated measures about social and environmental factors related to their liking for vegetables and preferences both at baseline 2009 and follow-up 2010. The associations were examined with regression and mediation analyses. The strongest predictors of both girls' and boys' liking and preferences were higher levels of eating vegetables together with the family, previous vegetable intake and a lower level of perceived barriers. Liking was additionally predicted by a lower level of parental demand that their child should eat vegetables. Girls reported higher levels of liking and preferences in the follow-up. This gender difference was mainly explained by girls' lower level of perceived barriers related to vegetable intake and girls' higher previous vegetable intake. Interventions that aim to increase the low vegetable intake among boys by increasing their liking for vegetables and preference for a variety of vegetables could benefit from targeting perceived barriers, namely boys' perception and values concerning the consumption of vegetables.

Positive and negative social support in a chronic illness

A measure of social support was developed and administered to 207 patients with chronic fatigue syndrome. Positive social support was related to anxiety, and negative social support was related to both anxiety and depression.

Childcare use and overweight in Finland: cross-sectional and retrospective associations among 3- and 5-year-old children

BACKGROUND

Different types of non-parental childcare have been found to associate with childhood overweight in several, but not all studies. Studies on the matter are mainly North American.

OBJECTIVES

The objective of our study was to examine associations between childcare use and overweight in Finland.

METHODS

The cross-sectional and partly retrospective data consists of 1683 3- and 5-year-old children participating in the Child Health Monitoring Development project (LATE-project) conducted in 2007-2009 in Finland. Children were measured at health check-ups and information on child's age when entering childcare, the number of childcare places the child has had, current type of childcare (parental, informal, [group] family childcare, childcare centre) and the current amount of childcare (hours) were gathered. Parents' body mass indices, family educational level, family structure, maternal smoking during pregnancy and child's birth weight were treated as covariates.

RESULTS

Beginning childcare before age 1 (adjusted model: odds ratio [OR] 2.53, 95% confidence interval [CI] 1.41-4.52) and, for girls only, number of childcare places (adjusted model: OR 1.33, 95% CI 1.11-1.60), were associated with an increased risk of overweight. The current type of childcare or the time currently spent in childcare was not associated with overweight.

CONCLUSION

Beginning childcare before age 1, which is quite rare in Finland, and having attended several childcare places were associated with overweight even when adjusting for family socioeconomic status and other family background variables. The significance of these findings needs to be further studied.

Relationship between screen time and sleep among Finnish preschool children: results from the DAGIS study

STUDY OBJECTIVES

To examine the associations between screen time, the time spent on different screen devices, and sleep in a sample of Finnish preschool children.

METHODS

The current study analyzed cross-sectional data from the DAGIS study carried out in Finland in 2015-2016 on 736 children aged 3-6 years. Parents reported in a 7-day diary the durations the child used screen devices daily, with separate details about watching TV or DVDs, using tablets or smartphones, and using computers. In addition, parents reported children's bedtimes and wake-up times, which were further used in calculating sleep duration. Parents answered questions regarding their child's sleep consistency. Statistical analyses included adjusted general linear modeling.

RESULTS

An hourly increase in total screen time was associated with 11 min later bedtime (p < 0.001) and 10 min shorter sleep duration (p < 0.001). More TV/DVD watching was associated with later bedtimes (p = 0.016) and a shorter sleep duration (p = 0.001). More smartphone/tablet use was associated with later bedtimes (p = 0.005), later wake-up times (p = 0.038), and weaker sleep consistency (p = 0.024). More computer use was associated with later bedtimes (p = 0.046). Results did not differ between genders.

CONCLUSIONS

Increased screen time was associated with later bedtimes and shorter sleep duration among preschool children. Adverse associations with sleep outcomes were found for each screen device. Attention should be paid to promoting balanced use of screens and regular sleep habits in young children.

Three-dimensional imaging for evaluation of head and neck tumors

OBJECTIVE

To determine the usefulness of three-dimensional imaging in addition to computed tomography in presurgical examination of patients with head and neck tumors.

DESIGN

Two-dimensional computed tomographic information from 31 patients with oral facial tumors was converted to three-dimensional images.

SETTING

University teaching hospital.

PATIENTS OR OTHER PARTICIPANTS

A consecutive sample of 31 patients with oral facial tumors.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Improved treatment planning with the use of three-dimensional images used in conjunction with computed tomographic scans.

RESULTS

The three-dimensional images from patients with minimal tumor invasion of bone or with massive soft-tissue tumors allowed easy appreciation of tumor dimensions, an important factor in treatment planning. In patients with small soft-tissue tumors with no evidence of bone involvement on two-dimensional scans, massive tumors with complete bone destruction, and recurrent tumors, the three-dimensional representations added little to the obvious presentation of the two-dimensional scans.

CONCLUSIONS

Three-dimensional imaging is a useful adjunct to diagnosis and treatment planning in patients with minimal tumor invasion of bone or with massive soft-tissue tumors.

The role of medial prefrontal cortex in context-specific inhibition during reversal learning of a visual discrimination

Rats with medial prefrontal cortex or sham lesions were trained on a visual discrimination task designed for the eight-arm radial maze. After reaching asymptotic performance on this task, both groups were divided into sub-groups that would experience reversal learning in the same or different context from original training. The results showed that both groups reversed in the different context had accelerated learning compared to the groups reversed in the same context. Reversal learning in rats with medial prefrontal cortex damage was faster than sham animals in the same context. These and other results from a transfer test suggest that the medial prefrontal cortex participates in the behavioral effects of a context-specific inhibitory association acquired during visual discrimination learning.

Associations between socioeconomic status, home food availability, parental role-modeling, and children's fruit and vegetable consumption: a mediation analysis

BACKGROUND

Recent literature has suggested that associations and interactions between family socioeconomic status (SES) and home food environment influence children's diet, but little is known about the mediation roles of parental role-modeling and food availability in the socioeconomic inequalities of children's diet. This study aimed to determine the associations between family SES and children's fruit and vegetable (FV) consumption and to assess the mediation roles of parental role-modeling and food availability in the above associations.

METHODS

Cross-sectional data of 574 Finnish children (aged 3 to 6) were analyzed. Parents completed an FFQ assessing their children's FV consumption frequency and a questionnaire assessing SES and home food environment. Two exposure variables: parental educational level ("low", "middle", and "high") and the relative family income tertiles of the family were used. The frequencies of parental role-modeling of FV and sugary food and drink (SFD) consumption, and the availability of FV and SFD at home were calculated. Single- and multiple-mediator models were created using IBM SPSS 27.0.

RESULTS

The positive association between high parental educational level and children's FV consumption (direct effect coefficient: 2.76, 95% CI: 0.51-4.86) was partially mediated by more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.89, 95% CI: 0.10-1.76), higher availability of FV (indirect effect coefficient: 1.00, 95% CI: 0.35-1.77), and lower availability of SFD (indirect effect coefficient: -0.30, 95% CI: -0.72 - -0.01). The relative family income was not directly associated with the outcome. However, the higher relative family income level indirectly predicted the Children's FV consumption (full mediation) through more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.91, 95% CI: 0.06-1.83) and higher availability of FV (indirect effect coefficient: 0.98, 95% CI: 0.40-1.67). Parental role-modeling on SFD consumption did not mediate any of the above associations.

CONCLUSIONS

Parental educational level showed more associations with children's FV consumption than relative family income. Our findings suggest that reducing the availability of SFD is as important as increasing the availability of FV to enhance children's FV consumption. Future interventions to improve children's dietary behaviors should pay greater attention to the lower SES segments of society. Longitudinal studies and intervention studies supporting these findings are needed for making meaningful recommendations for health promotion.

Microwave endometrial ablation for menorrhagia: outcome at 2 years--experience of a district general hospital

One hundred and twenty-three women underwent microwave endometrial ablation (MEA) for the treatment of dysfunctional uterine bleeding (DUB). The mean age at treatment was 40.2 years and the average treatment time was 2 minutes 50 seconds. All patients stayed as day cases, except for two who stayed overnight, one due to pain and the other due to urinary retention. The follow-up was carried out at 6 months, 1 and 2 years, respectively. The success rate was 80%, 76% and 70% at 6 months and 1-year and 2-year follow-up. The patient satisfaction rate was 80%, 75% and 68% at 6 months, 1 year and 2 years, respectively. However, in women 45 years old and over the success rate was more than 90%, suggesting that MEA could be a preferred procedure for treatment of DUB in this age group compared to younger women, especially in those who do not benefit from the mirena intrauterine system or decline it. Approximately 70% of patients, who underwent hysterectomy due to the failure of treatment, had uterine/pelvic pathology in the form of adenomyosis, fibroid uterus or endometriosis; therefore prior to MEA, proper patient selection is vital. There were a few minor complications but no uterine perforation or emergency hysterectomies in the group studied.

Validity of self-reported out-of-school physical activity among Finnish 11-year-old children

BACKGROUND

The aim of this study is to assess the repeatability and validity of the Finnish 11-year old children's out-of-school physical activity (PA) questionnaire using accelerometer as reference method. A sub-sample of children (N = 155, 60 % participant rate) participating in the Finnish Health in Teens study was recruited in 2013. Children completed a questionnaire measuring PA two times, and wore an accelerometer for seven days. The questions and accelerometer data were transformed into average minutes of behaviors per day. Repeatability was measured by intra-class correlations. To test validity, Spearman correlations between the questions and accelerometer was checked and the Bland-Altman model was conducted. Kruskall-Wallis tests were conducted to examine the ranking capability of questionnaire.

RESULTS

The intra-class correlations between two measurement times of questionnaire had substantial agreement. The Spearman correlations between the questions and accelerometer were poor. Based on Kruskal-Wallis tests, the questionnaire was moderately able to rank children according to their levels of PA.

CONCLUSIONS

The repeatability of the questionnaire had substantial agreement among 11-years-old, whereas it moderately classifies objectively measured PA. If the aim is to measure children's duration of PA, the accelerometer might be a better measurement method to use among 11-year old children. If the aim is to classify children according to their behavior, then the used questionnaire is moderately appropriate.

Mass spectrometric measurement of end-tidal xenon concentration for clinical stable xenon/computerized tomography cerebral blood flow studies

We have demonstrated the feasibility of using a compact dedicated mass spectrometer to monitor end-tidal xenon concentration in human subjects during stable xenon computerized tomography measurements of regional cerebral blood flow. End-tidal carbon dioxide concentration is monitored simultaneously and noninvasively without degrading the dynamic response to xenon. For clinical regional cerebral blood flow studies we employed a Nuclide 3-60-G Sectorr mass spectrometer with a 3 in radius, 60 degrees magnetic sector and a variable (0-5000 V) ion accelerating potential. The required high vacuum (10(-7) Torr) was achieved and maintained by means of a turbomolecular pump. A needlemetering valve was incorporated into an anesthesia mask connector, and exhaled gases were transported to the mass spectrometer via a 6 ft length of Teflon tubing (1/16 in i.d.). Molecular flow conditions between the sample and analysis chambers were provided by use of a gold foil leak (0.0005 in. hole). At an inlet pressure of 400 m Torr (achieved by means of the needle valve), the inlet system was characterized by a gas transport lag-time of 1.3 s and a rise-time constant of 85 ms. Xenon (doubly charged ion: m/z 68) and carbon dioxide (doubly charged ion: m/z 22) were monitored alternately at 75 ms intervals. Our experience with mass spectrometry has demonstrated the feasibility of using a compact dedicated instrument for accurately and non-invasively monitoring end-tidal xenon concentration in a clinical setting.

A study of the interaction of catecholamines and antidiuretic hormone on water permeability and the cyclic AMP system in isolated papillae of the rat

The diffusional water permeability of collecting ducts in vitro and the cyclic A.M.P. content of isolated papillae were measured after exposure to different concentrations of antidiuretic hormone, isoproterenol and noradrenalin. Antidiuretic hormone 25 mu units/ml. caused a 25% increase in diffusional water permeability. This response was not affected by isoproterenol (10(-6) M) or noradrenalin (2 x 10(-6) M). Antidiuretic hormone 100 mu unit ml-1 caused a 50% increase in diffusional water permeability which likewise was not altered by isoproterenol or noradrenalin. Isoproterenol (10(-6) M) and noradrenalin (2 x 10(-6) M) had no significant effect on basal levels of diffusional water permeability. Isoproterenol had no significant effect on the tissue concentration of cyclic A.M.P. concentration induced by antidiuretic hormone. Noradrenalin (2 x 10(-6) and 10(-4)) had no significant effect on basal cyclic A.M.P. concentration. However, noradrenalin inhibited the stimulation of cyclic A.M.P. induced by antidiuretic hormone. This effect was inhibited by phentolamine. This study suggests that catecholamines do not alter water handling by a direct action on the water permeability of the kidney but probably exert their action through an effect of A.D.H. release.

Association of screen time with long-term stress and temperament in preschoolers: results from the DAGIS study

Screen time is increasing rapidly in young children. The aim of this study was to examine associations of long-term stress and temperament with screen time in Finnish preschool children and the moderating role of socioeconomic status. Cross-sectional DAGIS data were utilized. Long-term stress was assessed using hair cortisol concentration, indicating values of the past 2 months. Temperament was reported by the parents using the Children's Behavior Questionnaire (the Very Short Form), and three broad temperament dimensions were constructed: surgency, negative affectivity, and effortful control. Screen time was reported by the parents over 7 days. The highest education level in the household was used as an indicator of socioeconomic status. In total, 779 children (mean age, 4.7 ± 0.9 years, 52% boys) were included in the study. Of the temperament dimensions, a higher effortful control was associated with less screen time (B = - 6.70, p = 0.002). There was no evidence for an association between hair cortisol concentration and screen time nor a moderating role of socioeconomic status in the associations (p > 0.05).Conclusion: Our findings indicate that preschool children with a higher score in effortful control had less screen time. Because effortful control reflects general self-regulatory abilities, promoting these skills may be effective in reducing screen time in young children. What is Known: • Screen time has increased rapidly during the last decades, and higher screen time has been linked with numerous adverse health consequences in children. • There are no previous studies investigating associations of long-term stress and temperament with screen time in young children. What is New: • Of the temperament dimensions, effortful control was associated with higher screen time in preschool children, but there was no association found between long-term stress and screen time. • Since effortful control reflects general self-regulatory abilities, promoting these skills may be effective in reducing screen time in young children.

Nurses' perceptions of early breast cancer and mastectomy, and their psychological implications, and of the role of health professionals in providing support

The literature on the psychological precursors and outcomes of cancer and the role of the surgeon and nurse in the psychological management of early breast cancer, is briefly reviewed. A questionnaire study tapped nurses' perceptions of the disease and its treatment, patients' problems and the provision of psychological support. Their responses indicated mixed attitudes toward treatment outcomes, but a general enthusiasm for health education. Mastectomy itself was seen as posing serious social problems by half the sample, and serious sexual problems by more than three-quarters, and many felt that the support currently provided for patients is inadequate. While nurses saw themselves as having a key role in giving comfort, they were less likely to see themselves in the role of counsellor. Many of the sample felt that they had not been trained to provide psychological care at this level. Here, the skills of a specialist nurse were looked for, in the case of counselling the patient herself, or the authority of the doctor, when counselling husbands.

Mechanisms of recovery from mechanical injury of cultured rat hepatocytes

The mechanism(s) whereby hepatocytes restore denuded areas remains unknown. We therefore studied the recovery of denuded areas made in monolayers of primary cultures of rat hepatocytes. Minimal recovery occurred in cells plated on plastic. Plating on Matrigel produced modest recovery (25% at 24 h), whereas plating on a type I collagen substrate resulted in > 70% recovery at 24 h. The rate of recovery on collagen could be attenuated by a monoclonal antibody directed against the extracellular domain of the beta 1-integrin subunit. Monoclonal antibodies directed against CD44 (the hyaluron receptor) and E-cadherin did not influence the rate of recovery. Recovery could be stimulated, in a dose-dependent fashion, by epidermal and hepatocyte growth factors. The effects of epidermal and hepatocyte growth factors to promote recovery occurred in the absence of 5-bromo-2'-deoxyuridine uptake, suggesting a proliferation-independent mechanism. Transforming growth factor-beta 1 inhibited recovery. Exposure to selected cytokines (interleukins 1 and 2), an adenine nucleotide [adenosine 5'-O-(3-thiotriphosphate)], adenosine, pertussis toxin, and selected agents that bind to fibronectin and other matrix component adhesive sites (heparin and the RGD peptide) did not influence the rate of recovery of hepatocytes. However, the peptide DGEA, which can bind to collagen adhesive sites, attenuated recovery. These studies demonstrate that primary cultures of rat hepatocytes require a particular type of extracellular matrix to renew denuded areas and that the beta 1-integrin subunit may be involved in this recovery process. Hepatocyte recovery of denuded areas can be modulated by growth factors in both a stimulatory (epidermal and hepatocyte growth factors) and an inhibitory (transforming growth factor-beta 1) fashion.

The effect of prostaglandin E2 and ADH on diffusional water permeability in collecting duct of an isolated rat papilla

The effect of prostaglandin on diffusional water permeability has been studied in collecting ducts in an isolated rat papilla. PGE2 increased water permeability. The effect was significant at a concentration of 10(-8) mol 1(-1) and was maximal with a concentration of 10(-6) mol 1(-1). The maximal increment of 0.94 +/- 0.10 (SEM) micron s-1 was approximately half that produced by maximal stimulation with antidiuretic hormone (2.18 +/- 0.12 micron s-1). A concentration of 10(-8) mol 1(-1) produced an increase in basal water permeability and 24 mu unit ml-1 ADH, which without PGE2 present gave a similar increase, had no incremental effect. ADH 100 mu unit ml-1 increased permeability to a value similar to that observed in the absence of PGE2. Thus PGE2 and ADH both increase water permeability but the increments are not additive. Indomethacin in a concentration that inhibited prostaglandin production altered the response of the collecting duct to ADH. The dose response curve was shifted to the left and the maximal increase in water permeability and the lowest dose at which a response occurred took place at concentrations less than 1/2 those required in its absence. Prostaglandins influence the action of ADH and it is likely that in life they regulate and modulate the change in water permeability induced by anti-diuretic hormone.

Development of the DAGIS intervention study: a preschool-based family-involving study promoting preschoolers' energy balance-related behaviours and self-regulation skills

Background

Preschoolers’ energy balance-related behaviours (EBRBs) and self-regulation skills are important for their later health. Few preschool-based interventions aiming to promote preschoolers’ EBRBs and self-regulation skills, simultaneously reducing differences in EBRBs, due to children’s socio-economic status (SES) background, have been conducted. This study will present the Increased Health and Wellbeing in Preschools (DAGIS) intervention development process applying the Intervention Mapping (IM) framework.

Methods

The development of the DAGIS intervention study, a preschool level clustered randomized controlled trial (RCT), was based on the IM framework. The protocol in IM guides the development process of an intervention through six steps: needs assessment and logic model of the problem, programme outcomes and objectives, design of the programme, production, implementation plan, and evaluation plan.

Results

The needs assessment, part of the step 1 in IM, yielded the base for the DAGIS logic model of change. The model includes objectives related to changes in children’s EBRBs, self-regulation skills, and in psychosocial and physical environment that is determined by parents and early educators. A 22-week programme was developed, and materials for preschools and families were produced. A feasibility study of the recruitment processes, acceptability of the materials and methods, and implementation was conducted. The DAGIS intervention study was conducted September 2017–May 2018 as a clustered RCT including a comprehensive effectiveness and process evaluation. The process evaluation was run throughout the intervention targeting preschools and families.

Conclusion

A preschool-based family-involving programme was developed in the DAGIS intervention study by applying the IM protocol. It was a time- and resource-consuming process. However, the systematic planning, development, and running of the programme have reinforced a comprehensive evaluation, which is a strength in the intervention. The results from the evaluation will enhance the knowledge of how to promote EBRBs and self-regulation skills among preschoolers, and diminish SES differences in them.

Trial registration

ISRCTN57165350 (Prospectively registered January the 8th, 2015).