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news & new scholarship from around the world 11.07.09

Meta-Analyses & Systematic Reviews / RSS feed

November 7, 2009

This review does not suggest that there are any particular volunteer tutoring models that should be recommended for immediate adoption for schools and districts across the country. Rather, we can conclude from the analysis that these programs can positively influence important reading and language sub-skills for young students. The results are substantial – approximately one-third standard deviation.

November 6, 2009

We included 12 RCTs with 306 participants. Only four had adequate allocation concealment, that is a low risk of selection bias. A large number of outcome measures were reported. Only six studies measured disability and two investigated whether the effects persisted. The overall effect (standardised mean difference) on disability had a wide confidence interval that included zero and was not statistically significant. For discharge destination there were clinically significant effects but in both directions and the confidence interval of the odds ratio included one. In contrast, cognitive rehabilitation did improve performance on some, but not all, standardised neglect tests. The number of cancellation errors made was reduced and the ability to find the midpoint of a line improved immediately and persisted at follow up. These effects appeared likely to generalise from the samples studied to the target population, but were based on a small number of studies.

November 5, 2009

The studies included in this systematic review indicate that CCTV has a modest but significant desirable effect on crime, is most effective in reducing crime in car parks, is most effective when targeted at vehicle crimes (largely a function of the successful car park schemes), and is more effective in reducing crime in the U.K. than in other countries.

November 4, 2009

Three small studies met the inclusion criteria. Two compared cognitive rehabilitation to a placebo intervention (total n=84), and the other to occupational therapy (n=33). Although cognitive rehabilitation was as acceptable as placebo and occupational therapy, with low attrition in both groups, no effects were demonstrated on measures of mental state, social behaviour, or cognitive functioning. An effect, in favour of cognitive rehabilitation, on a measure of self-esteem (Rosenberg Self-Esteem Scale, MD 6.3 CI 1.07-11.53 ) is worthy of replication in any future trials.

November 3, 2009

Although a vast majority of the selected studies . . . show noncustodial sanctions to be more beneficial in terms of re-offending than custodial sanctions, no significant difference is found in the meta-analysis based on four controlled and one natural experiments.

November 2, 2009

Two trials, involving 18 participants, were included. One study compared the effectiveness of a mnemonic strategy treatment group with a 'drill and practice' control, while the other compared the effectiveness of an imagery mnemonics programme with a 'pragmatic' memory rehabilitation control programme. Formal meta-analyses could not be performed due to a paucity of studies and lack of commonly-employed outcome measures. The results do not show any significant effect of memory rehabilitation on performance of objective memory tests, and no significant effects of treatment on subjective and observer-rated measures of memory.

November 1, 2009

Current major depression has been associated with worse clinical outcome among substance-dependent patients. The data are less clean on the prognostic implications of a past depression or elevated depressive symptoms without identification of a depressive disorder. These epidemiological data suggest that a co-occurring depressive disorder is important and warrants clinical attention.

October 31, 2009

Cognitive training can improve alertness and sustained attention but there is no evidence that it helps people to do daily activities without help after stroke. Attention problems can occur following stroke (a sudden catastrophe in the brain either because an artery to the brain blocks, or because an artery in or on the brain ruptures and bleeds). They are common in people with damage to the right side of their brain. Although there is some spontaneous recovery, some symptoms may persist for years. Cognitive rehabilitation training aims to improve attention, memory and perception. The review found that training improves alertness and sustained attention. The review found no evidence to show that cognitive rehabilitation can improve people's ability to do daily activities without help after a stroke (for example, getting dressed).

October 30, 2009

We identified 11 studies about screening accuracy, 6 depression treatment trials, but no studies that evaluated the effects of screening on depression or cardiovascular outcomes. In studies that tested depression screening instruments using a priori-defined cutoff scores, sensitivity ranged from 39% to 100% (median, 84%) and specificity ranged from 58% to 94% (median, 79%). Depression treatment with medication or cognitive behavioral therapy resulted in modest reductions in depressive symptoms (effect size, 0.20-0.38; r2, 1%-4%). There was no evidence that depression treatment improved cardiac outcomes.

October 29, 2009

Moderate effect sizes were found for the associations between cognitions and internalizing and externalizing behavior problems and self-esteem problems, negative affect and behavioral responses and internalizing behavior problems, and behavioral responses and self-esteem problems. Small to moderate effect sizes were found for the associations between cognitions and relational problems, negative affect and behavioral responses and externalizing behavior problems, and physiological reactions and internalizing and externalizing behavior problems. Effect sizes were, with 1 exception, larger for internalizing than for externalizing behavior problems. Age significantly moderated the majority of effect sizes.

October 28, 2009

The available evidence remains limited, but there is still no indication of any significant benefits from cognitive training. Trial reports indicate that some gains resulting from intervention may not be captured adequately by available standardized outcome measures. It is not possible at present to draw conclusions about the efficacy of individualised cognitive rehabilitation interventions for people with early-stage dementia, due to the lack of any RCTs in this area. Further, well-designed studies of cognitive training and cognitive rehabilitation are required to provide more definitive evidence.

October 27, 2009

Overall, the results showed medium effect sizes in patients with PTSD compared to controls on verbal memory across studies. Marked impairment was found in the patient groups compared to healthy controls, while modest impairment was found compared to exposed non-PTSD controls. Meta-analyses found strongest effects in war veterans compared to sexual and physical assault related PTSD. Rather unexpectedly no effect was found for the sexually abused PTSD groups compared to exposed controls. The analyses further showed that the effect was dependent on the test procedures used.

October 26, 2009

We did not find a significant difference in the subjective loudness of tinnitus, or in the associated depression. However we found a significant improvement in the quality of life (decrease of global tinnitus severity) of the participants, thus suggesting that cognitive behavioural therapy has an effect on the qualitative aspects of tinnitus and contributes positively to the management of tinnitus.

October 25, 2009

The review found only nine studies providing costs and benefits information. Six of these studies were assessed as providing a ‘valid’ or ‘comprehensive’ benefit-cost analysis, acceptable on the Benefit-Cost Validity Scale – Revised, covering a range of different sentences. Two studies of In-prison Sex Offender Treatment were found to be cost-beneficial, in addition to an Intensive Supervision program and a Youth Wilderness Program, though the two latter interventions are less well-supported by the wider research evidence. Diversion from imprisonment to drug treatment was assessed by its authors to be cost-beneficial; and imprisonment for high risk offenders was considered to be cost-beneficial, though not for less prolific offenders or for drug offenders.

October 24, 2009

To evaluate the causal effects of depression on obesity, longitudinal tests of the effect of depression on follow-up obesity status were meta-analyzed. Combining data from 16 studies the results confirmed that, after controlling for potential confounding variables, depressed compared to nondepressed people were at significantly higher risk for developing obesity. The risk among depressed people for later obesity was particularly high for adolescent females (odds ratio: 2.57, 95% CI: 2.27, 2.91). These findings highlight the importance of depression screening and treatment programs, especially among adolescents, to assist in the prevention of adult obesity.

October 23, 2009

CBT is a promising but under evaluated intervention. Currently, trial-based data supporting the wide use of CBT for people with schizophrenia or other psychotic illnesses are far from conclusive. More trials are justified, especially in comparison with a lower grade supportive approach. These trials should be designed to be both clinically meaningful and widely applicable.

October 22, 2009

The mean effect for official reports of domestic violence from experimental studies showed modest benefit whereas the mean effect for victim reported outcomes was zero. Quasi-experimental studies using a no-treatment comparison had inconsistent findings indicating an overall small harmful effect. In contrast, quasiexperimental studies using a treatment dropout design showed a large, positive mean effect on domestic violence outcomes. The latter studies suffer, we believe, from selection bias.

October 21, 2009

Biomedical risk assessment is the process of giving smokers feedback on the physical effects of smoking by physiological measurements (for example: exhaled carbon monoxide measurement or lung function tests). It was thought to be a possible way of increasing quit rates. In one study, smokers who had their lung function tested and the results explained in terms of their lung age compared to a non smoker of the same age were more likely to quit than people given the same test but without the explanation. Mixed quality evidence does not suggest that other types of biomedical risk assessment increases smoking cessation compared with standard treatments.

October 20, 2009

Main Results: Thirty-two unique research studies met our inclusion criteria. These studies reported the results from 43 independent boot-camp/comparison samples. The random effects mean odds-ratio for any form of recidivism was 1.02, indicating that the likelihood that boot camp participants recidivating was roughly equal to the likelihood of comparison participants recidivating. This overall finding was robust to the selection of the outcome measure and length of follow-up.

October 19, 2009

In this systematic review 21 studies were included. The results showed that a combined respondent-cognitive therapy and a progressive relaxation therapy alone are more effective than waiting list control for short-term pain relief. No significant differences could be detected when the various types of cognitive-behavioural treatments were compared among each other. No significant differences could be detected in short-term and long-term effectiveness when behavioural components are added to usual treatment programs for chronic low-back pain (i.e. physiotherapy, back education, or various forms of medical treatment). No significant differences were detected between behavioural treatment and exercises

October 18, 2009

Aim. This systematic review examines how specific coping strategies are associated with psychological and physical outcomes in rheumatoid arthritis. . . . Conclusions. There was generally limited evidence to suggest an association between coping strategies and outcomes but the design of studies and the lack of clarity about coping strategies were identified as problems. This study used a new framework for the conceptualisation of coping strategies, thus contributing to further examining the utility of coping strategies and contributing to their redefinition.

October 17, 2009

The authors examined the mediating effects of job satisfaction and propensity to leave and their effect on the relationships between role ambiguity, role conflict, and job performance. The meta-analysis included both published and unpublished studies conducted over a period of 25 years, resulting in 113 independent samples with more than 22,000 individuals. As hypothesized, the structural model that best fit the meta-analytic estimates was the partial mediation model, in which stress is related to job performance both directly and indirectly through job satisfaction and propensity to leave and in which all path coefficients were reliably different from zero.

October 16, 2009

Aims: To describe: (i) three alternative conceptual frameworks used by economists to study addictive behaviors: rational, imperfectly rational and irrational addiction; (ii) empirical economic evidence on each framework and specific channels to explain adult smoking matched to the frameworks; and (iii) policy implications for each framework. Methods: A systematic review and appraisal of important theoretical and empirical economic studies on smoking. Results: There is some empirical support for each framework. . . . Conclusions: Much promising economic research uses the imperfectly rational addiction framework, but empirical research based on this framework is still in its infancy.

October 15, 2009

Coyne's (1976a, 1976b) interactional theory of depression predicts positive associations between excessive reassurance seeking (ERS) and both depression and interpersonal rejection. A growing body of research has supported the ERS model, but this work has yet to be systematically reviewed. A meta-analysis of 38 studies (N = 6,973) revealed an aggregate effect size (r) of .32 between ERS and concurrent depression. . . . Results support the ERS model (with several important caveats) but underscore the need for methodological diversity in future research.

October 14, 2009

We did a meta-analysis of published data and applied Hill’s criteria for causality on all available evidence to assess presence of a causal association. . . . Summary estimates were calculated for all studies combined and for sub groups stratified by type of study population, study design, and method of ascertaining circumcision status. Thirteen studies were included. Circumcised men had a reduced risk for HIV infection (adjusted RRoverall = 0.42, 95% CI 0.33−0.53; RRRCT = 0.43 95% CI 0.32−0.59, RRobservational = 0.39, 95% CI 0.27−0.56). Available evidence satisfies six of Hill’s criteria: strength of association, consistency, temporality, coherence, biological plausibility, and experiment. These results provide unequivocal evidence that circumcision plays a causal role in reducing the risk of HIV infection among men.

October 13, 2009

A meta-analysis of stereotype threat effects was conducted and an overall mean effect size of |.26| was found, but true moderator effects existed. A series of hierarchical moderator analyses evidenced differential effects of race- versus gender-based stereotypes.

October 12, 2009

A recent meta-analysis of true- and quasi-experimental writing intervention research (S. Graham & D. Perin, 2007a) addressed this issue by identifying effective instructional writing practices. The current review extends this earlier work by conducting a meta-analysis of single subject design writing intervention studies. The authors located 88 single subject design studies where it was possible to calculate an effect size. They calculated an average effect size for treatments that were tested in 4 or more studies, using a similar outcome measure in each study. This resulted in the identification of 9 writing treatments that were supported as effective.

October 11, 2009

Results: 23 studies were identified (20 epidemiological cohort, three retrospective matched case-control nested in a cohort). Meta-analyses suggest that small amounts of alcohol may be protective against dementia (random effects model, risk ratio [RR] 0.63; 95% CI 0.53–0.75) and Alzheimer's disease (RR 0.57; 0.44–0.74) but not for vascular dementia (RR 0.82; 0.50–1.35) or cognitive decline (RR 0.89; 0.67–1.17) However, studies varied, with differing lengths of follow up, measurement of alcohol intake, inclusion of true abstainers and assessment of potential confounders. Conclusions: because of the heterogeneity in the data these findings should be interpreted with caution. However, there is some evidence to suggest that limited alcohol intake in earlier adult life may be protective against incident dementia later.

October 10, 2009

Results of the search showed age that was unable to be compared because of the many variations in measurements and time periods, and there was only limited research worldwide of trends in contraception at the time of conception in relation to a termination of pregnancy. Additionally, there were no studies worldwide in the past 11 years, which specifically examined trends in the characteristics of the number of first-ever pregnancies which ended in a termination, contraception choices postoperative to a termination of pregnancy, or referral source to a termination of pregnancy provider.

October 9, 2009

Fitness to plead is a fundamental legal concept. Its determination in England and Wales rests on professional interpretation of the 'Pritchard' criteria (1836). In the United States, the determination of the analogous concept of competence to stand trial rests on professional interpretation of the 'Dusky' criteria (1960). Numerous assessment instruments have been developed in North America to help guide professional determinations of competence to stand trial, but such assessments are not routinely employed in British settings. The evidence reviewed calls into question the utility of the fitness to plead construct as currently formulated and highlights the inadequacy of the procedures employed in its determination.