The impact of incarceration on juvenile offenders

Increasingly, research points to the negative effects of incarcerating youth offenders, particularly in adult facilities. Literature published since 2000 suggests that incarceration fails to meet the developmental and criminogenic needs of youth offenders and is limited in its ability to provide appropriate rehabilitation. Incarceration often results in negative behavioral and mental health consequences, including ongoing engagement in offending behaviors and contact with the justice system. Although incarceration of youth offenders is often viewed as a necessary means of public protection, research indicates that it is not an effective option in terms of either cost or outcome. The severe behavioral problems of juvenile offenders are a result of complex and interactive individual and environmental factors, which elicit and maintain offending behavior. Therefore, the focus of effective treatment must be on addressing such criminogenic needs and the multiple “systems” in which the young person comes from. Recent research demonstrates that in order to achieve the best outcomes for youth offenders and the general public, community-based, empirically supported intervention practices must be adopted as an alternative to incarceration wherever possible.     

Aftercare programs for reducing recidivism among juvenile and young adult offenders: A meta-analytic review

The aim of this meta-analytic study, including 22 studies and 5764 participants, was to examine the effects of aftercare programs on recidivism in juvenile and young adult offenders released from correctional institutions. The studies had to be (quasi-)experimental, with the control group receiving ‘care as usual’ or no treatment. Recidivism was measured by re-arrests and/or reconvictions and was based on official reports. Although the overall effect size for aftercare programs was generally small (d = .12), moderator analyses indicated more substantial effects and showed that aftercare is most effective if it is well-implemented and consists of individual instead of group treatment, and if it is aimed at older and high-risk youth. Whereas the treatment duration and moment of starting the aftercare program were not related to the program's effectiveness, more intensive aftercare programs were associated with lower recidivism rates.     

Empowerment programs for parental mental health of preterm infants: A meta-analysis

ObjectiveTo assess the effectiveness of empowerment programs on mental health in parents of preterm infants.MethodsTen databases were searched for randomised controlled trials and quasi-experimental studies published from inception to March 2020, and two reviewers independently and critically assessed trial quality and extracted data.ResultsEight studies with a total of 1029 participants met the inclusion criteria. Empowerment programs significantly improved parental mental health, particularly maternal stress and depression. This meta-analysis also indicated that Creating Opportunities for Parent Empowerment (COPE) had a medium effect on maternal mental health. Both empowerment-based health education and empowerment programs conducted during the infants’ hospitalisation had large effects on maternal mental health, whereas those conducted from hospitalisation to one week after discharge showed no significant effect.ConclusionEmpowerment programs have positive effects on parental mental health, especially for mothers.Practice implicationsOur study provides objective evidence for the development of future empowerment programs.     

Pain perception in Parkinson’s disease: A systematic review and meta-analysis of experimental studies

While hyperalgesia (increased pain sensitivity) has been suggested to contribute to the increased prevalence of clinical pain in Parkinson’s disease (PD), experimental research is equivocal and mechanisms are poorly understood. We conducted a meta-analysis of studies comparing PD patients to healthy controls (HCs) in their response to experimental pain stimuli. Articles were acquired through systematic searches of major databases from inception until 10/2016. Twenty-six studies met inclusion criteria, comprising 1292 participants (PD = 739, HCs = 553). Random effects meta-analysis of standardized mean differences (SMD) revealed lower pain threshold (indicating hyperalgesia) in PD patients during unmedicated OFF states (SMD = 0.51) which was attenuated during dopamine-medicated ON states (SMD = 0.23), but unaffected by age, PD duration or PD severity. Analysis of 6 studies employing suprathreshold stimulation paradigms indicated greater pain in PD patients, just failing to reach significance (SMD = 0.30, p = 0.06). These findings (a) support the existence of hyperalgesia in PD, which could contribute to the onset/intensity of clinical pain, and (b) implicate dopamine deficiency as a potential underlying mechanism, which may present opportunities for the development of novel analgesic strategies.     

Media effects of experimental presentation of the ideal physique on eating disorder symptoms: A meta-analysis of laboratory studies

Background

Older meta-analyses of the effects of the media's portrayal of the ideal physique have found small effects revealing that exposure to the ideal physique increases body image concerns. These meta-analyses also included correlational, quasi-experimental, and experimental studies, with limited examination of moderators and other relevant outcomes besides body image.

Methods

We conducted a systematic literature search and identified 33 experimental (i.e., pre and post data for both experimental and control groups) laboratory studies examining the effects of acute exposure to the media's portrayal of the ideal physique on eating disorder symptoms (i.e., body image, positive affect, negative affect, self-esteem, anger, anxiety and depression) and the mechanisms that moderate this effect.

Results

Fourteen separate meta-analyses revealed a range of small to moderate effect sizes for change in outcomes from pre to post for both experimental and control groups. Exposure to images of the ideal physique resulted in small effect sizes for increased depression and anger and decreased self-esteem and positive affect. Moderator analyses revealed moderate effect sizes for increased depression and body dissatisfaction among high-risk participants.

Conclusions

This meta-analysis makes it clear that media exposure of the ideal physique results in small changes in eating disorder symptoms, particularly with participants at high risk for developing an eating disorder. Further research is needed to examine the longitudinal effects of media exposure of eating disorder symptoms.     

Endothelial cell senescence: A machine learning-based meta-analysis of transcriptomic studies

Numerous systemic vascular dysfunction that leads to age-related diseases is highly associated with endothelial cell (EC) senescence; thus, identifying consensus features of EC senescence is crucial in understanding the mechanisms and identifying potential therapeutic targets. Here, by utilizing a total of 8 screened studies from different origins of ECs, we have successfully obtained common features in both gene and pathway level via sophisticated machine learning algorithms. A total of 400 differentially expressed genes (DEGs) were newly discovered with meta-analysis when compared to the usage of individual studies. The generated parsimonious model established 36 genes and 57 pathways features with non-zero coefficient, suggesting remarkable association of phosphoglycerate dehydrogenase and serine biosynthesis pathway with endothelial cellular senescence. For the cross-validation process to measure model performance of 36 deduced features, leave-one-study-out cross-validation (LOSOCV) was employed, resulting in an overall area under the receiver operating characteristic (AUROC) of 0.983 (95 % CI, 0.952, 1.000) showing excellent discriminative performance. Moreover, pathway-level analysis was performed by Pathifier algorithm, obtaining a total of 698 pathway deregulation scores from the 10,416 merged genes. In this process, high dimensional data was eventually narrowed down to 57 core pathways with AUROC value of 0.982 (95 % CI, 0.945, 1.000). The robust model with high performance underscores the merit of utilizing sophisticated meta-analysis in finding consensus features of endothelial cell senescence, which may lead to the development of therapeutic targets and advanced understanding of vascular dysfunction pathogenesis with further elucidation.     

Self-management programs for chronic musculoskeletal pain conditions: a systematic review and meta-analysis

Objective

To evaluate the effectiveness of self-management programs on pain and disability for chronic musculoskeletal pain conditions by systematic review.

Methods

A search of randomized controlled trials was conducted in Medline and Embase from 1970s to 2010. Two reviewers independently selected trials, conducted critical appraisal of the methodological quality, and extracted the data. Meta-analyses were performed using all time-points meta-analysis (ATM).

Results

Nineteen trials met inclusion criteria. For arthritis, the findings of this study showed that self-management programs have small to moderate effects in improving pain and disability at the long-term level, but the medium-term effect for disability is not significant. For chronic back pain, there is insufficient evidence to determine the effectiveness of self-management programs.

Conclusion

The encouraging evidence of this study indicates that it is recommended to provide self-management programs to adult patients with arthritis. Further research is needed on self-management for chronic back pain.

Practice implications

Self-management is a safe, community-based and effective way for patients with arthritis to manage pain and disability. Core skills of self-management should be delivered using multiple approaches.     

A meta-analysis of nonrandomized effectiveness studies on outpatient cognitive behavioral therapy for adult anxiety disorders

Objective

The primary aim of this study was to assess the overall effectiveness of individual and group outpatient cognitive behavioral therapy (CBT) for adults with a primary anxiety disorder in routine clinical practice.

Method

We conducted a random effects meta-analysis of 71 nonrandomized effectiveness studies on outpatient individual and group CBT for adult anxiety disorders. Standardized mean gain effect sizes pre- to posttreatment, and posttreatment to follow-up are reported for disorder-specific symptoms, depression, and general anxiety. The mean dropout from CBT is reported.

Results

Outpatient CBT was effective in reducing disorder-specific symptoms in completer (d = 0.90–1.91) and intention-to-treat samples (d = 0.67–1.45). Moderate to large (d = 0.54–1.09) and small to large effect sizes (d = 0.42–0.97) were found for depressive and general anxiety symptoms posttreatment. Across all anxiety disorders, the weighted mean dropout rate was 15.06%. Posttreatment gains for disorder-specific anxiety were maintained 12 months after completion of therapy.

Conclusions

CBT for adult anxiety disorders is very effective and widely accepted in routine practice settings. However, the methodological and reporting quality of nonrandomized effectiveness studies must be improved.     

Effects of early prevention programs on adult criminal offending: a meta-analysis

This meta-analysis investigated the long term effects of prevention programs conducted during early and middle childhood on criminal offending during adulthood. The analyses included 3611 participants in 9 programs. The effect size for adult criminal offending was significant, but small in magnitude (OR = 1.26; 95% CI = 1.06-1.50, p = .011). The effects of the programs on positive outcomes (academic attainment and involvement in productive activity, such as being engaged in school or work) were somewhat larger and more consistent than effects on crime (OR = 1.36, 95% CI = 1.20-1.55, p < .001). Several participant and program characteristics moderated the effectiveness of (early) prevention. Children who were more at-risk and those from a lower SES benefited more. Shorter, but more intensive programs, and programs that focus on social and behavioral skills, rather than on academic skills or family support, tend to produce larger effects. Taken together, these results indicate that early prevention programs can help put children on a more positive developmental trajectory that is maintained into adulthood, but there is still no convincing evidence that they can prevent adult crime. Implications of the findings for research, policy and clinical practice are discussed.     

Problem-solving therapy for depression: A meta-analysis

Problem-Solving Therapy (PST) is a cognitive-behavioral intervention that focuses on training in adaptive problem-solving attitudes and skills. The purpose of this paper was to conduct a meta-analysis of controlled outcome studies on efficacy of PST for reducing depressive symptomatology. Based on results involving 21 independent samples, PST was found to be equally effective as other psychosocial therapies and medication treatments and significantly more effective than no treatment and support/attention control groups. Moreover, component analyses indicated that PST is more effective when the treatment program includes (a) training in a positive problem orientation (vs. problem-solving skills only), (b) training in all four major problem-solving skills (i.e., problem definition and formulation, generation of alternatives, decision making, and solution implementation and verification), and (c) training in the complete PST package (problem orientation plus the four problem-solving skills).     

The characteristics of persistent sexual offenders: a meta-analysis of recidivism studies

A meta-analysis of 82 recidivism studies (1,620 findings from 29,450 sexual offenders) identified deviant sexual preferences and antisocial orientation as the major predictors of sexual recidivism for both adult and adolescent sexual offenders. Antisocial orientation was the major predictor of violent recidivism and general (any) recidivism. The review also identified some dynamic risk factors that have the potential of being useful treatment targets (e.g., sexual preoccupations, general self-regulation problems). Many of the variables commonly addressed in sex offender treatment programs (e.g., psychological distress, denial of sex crime, victim empathy, stated motivation for treatment) had little or no relationship with sexual or violent recidivism.     

A meta-analysis of treatments for perinatal depression

This meta-analysis assessed efficacy of pharmacologic and psychological interventions for treatment of perinatal depression. A systematic review identified 27 studies, including open trials (n = 9), quasi-randomized trials (n = 2), and randomized controlled trials (n = 16) assessing change from pretreatment to posttreatment or comparing these interventions to a control group. Uncontrolled and controlled effect sizes were assessed in separate meta-analyses. There was significant improvement in depressive symptoms from pretreatment to posttreatment, with an uncontrolled overall effect size (Hedges' g) of 1.61 after removal of outliers and correction for publication bias. Symptom levels at posttreatment were below cutoff levels indicative of clinically significant symptoms. At posttreatment, intervention groups demonstrated significantly greater reductions in depressive symptoms compared to control groups, with an overall controlled effect size (Hedges' g) of 0.65 after removal of outliers. Individual psychotherapy was superior to group psychotherapy with regard to changes in symptoms from pretreatment to posttreatment. Interventions including an interpersonal therapy component were found to have greater effect sizes, compared to control conditions, than interventions including a cognitive-behavioral component. Implications of the findings for clinical practice and future research are discussed.     

糖尿病视网膜病变基因多态性荟萃分析新进展

糖尿病视网膜病变是成年人主要致盲的眼病之一.近年来,随着糖尿病患者的不断增加,糖尿病视网膜病变的患病率也逐年递增,国内外对于此疾病的研究也越来越多,在病因学研究中,基因多态性已成为研究的热点.将多个研究进行大样本荟萃分析可以获得更有意义的结论.本文对近几年来糖尿病视网膜病变患者的基因多态性经过荟萃分析得到的有效结果进行总结.     

Trends in meta-analysis of genetic association studies

The number of published genetic association studies (GASs) is increasing tremendously due to the availability of mapped single-nucleotide polymorphisms (SNPs) and advances in genotyping technologies. A search in HuGENet illustrates the rapid accumulation of evidence for major diseases. Recently, there has been a lot of activity regarding genome-wide association studies (GWASs), and a growing number of forthcoming studies is expected. GASs and GWASs are usually underpowered to detect significant associations, and the varying quality of reporting publications befuddles researchers. A meta-analysis can increase power and provide standards of reporting results. However, the conduct of a meta-analysis of GASs faces a major obstacle, which is the structure and diversity of stored information in databases. Similar problems are expected for GWASs, though the data are not yet publicly available. The development of a Web-based system for the detailed and structured recording of GAS or GWAS data, accompanied by an estimation of the overall genetic risk effects, would enable scientists to keep track of evidence for gene–disease associations.     

Neurostructural predictors of Alzheimer's disease: A meta-analysis of VBM studies

The identification of biological markers at early stages of Alzheimer's disease (AD) contributes to diagnostic accuracy and adds prognostic value. However, in spite of recent developments, results of neurostructural imaging studies on predicting conversion to AD are not uniform. We conducted a systematic review of voxel-based morphometry (VBM) studies about the neurostructural predictors of conversion to AD. Ten studies met inclusion criteria and nine reported baseline regional gray matter (GM) atrophy in mild cognitive impairment (MCI) or healthy subjects who progressed to AD. Using the method of Activation Likelihood Estimation, we meta-analyzed the coordinates from the six longitudinal VBM studies that enrolled subjects with amnestic MCI (aMCI) at baseline. These comprised a total of 429 aMCI subjects, of which 142 converted to AD. Meta-analysis yielded one significant cluster of GM volumetric reduction in aMCI patients who converted to AD, located in the left hippocampus and parahippocampal gyrus. In conclusion, left medial temporal lobe atrophy is the most consistent neurostructural biomarker to predict conversion from aMCI to AD.     

C反应蛋白诊断新生儿败血症准确性的Meta分析

目的 探讨CRP诊断新生儿败血症的诊断价值.方法 计算机检索维普中文科技期刊数据库、中国期刊全文数据库、万方数据库、中国生物医学文献数据库、Medline、EMBASE、Cochrane图书馆、PubMed等数据库（检索时间为1989年1月至2011年7月）,获得CRP诊断新生儿确诊败血症的文献.采用QUADAS工具对纳入文献进行质量评价.采用MetaDisc 1.4和RevMan 5.0软件检验各文献间的异质性,并根据异质性结果选择相应的效应模型进行加权定量合并,计算敏感度和特异度及其95%CI.绘制受试者工作特征（SROC）曲线并计算曲线下面积（AUC）,并行敏感度分析.结果 20篇文献进入Meta分析.分析结果显示：CRP诊断新生儿败血症的汇总敏感度和特异度分别为0.69（95%CI：0.65～0.72）和0.87（95%CI：0.86～0.89）,SROC AUC为0.88,Q＊指数为0.81.CRP＞8 mg·L-1诊断新生儿败血症的汇总敏感度和特异度分别为0.88（95%CI：0.82～0.92）和0.86 （95%CI：0.81～0.90）,SROC AUC为0.94,Q＊指数为0.88;CRP≥8 mg·L-1诊断新生儿败血症的汇总敏感度和特异度分别为0.54（95%CI：0.47～0.61）和0.81（95%CI：0.76～0.85）,SROC AUC为0.80,Q＊指数为0.74;两者合并诊断新生儿败血症的汇总敏感度和特异度分别为0.70（95%CI：0.65～0.74）和0.83（95%CI：0.80～0.86）,SROC AUC为0.88,Q＊指数为0.82.在纳入文献中标本来源和检测方法的差异等非阈值效应因素是产生异质性的原因.结论 CRP对新生儿败血症诊断的敏感度和特异度较高,有助于早期诊断新生儿败血症.     

An evidence base for patient-centered cancer care: A meta-analysis of studies of observed communication between cancer specialists and their patients

Objective

In the context of patients visiting cancer specialists, the objective is to test the association between both patient-centered communication (including Affective Behavior and Participation Behavior) and Instrumental Behavior and patients’ post-visit satisfaction with a variety of visit phenomena.

Methods

Meta-analysis of 25 articles representing 10 distinct data sets.

Results

Both patient-centered- and instrumental behavior are significantly, positively associated with satisfaction, with patient-centered communication having a relatively stronger association.

Conclusion

There is an evidence base for the efficacy of patient-centered care.

Practice implications

Cancer specialists need to train to improve their patient-centered communication.     

Physical activity and healthy ageing: A systematic review and meta-analysis of longitudinal cohort studies

BackgroundOlder people constitute a significant proportion of the total population and their number is projected to increase by more than half by 2030. This increasing probability of late survival comes with considerable individual, economic and social impact. Physical activity (PA) can influence the ageing process but the specific relationship with healthy ageing (HA) is unclear.MethodsWe conducted a systematic review and meta-analysis of longitudinal studies examining the associations of PA with HA. Studies were identified from a systematic search across major electronic databases from inception as January 2017. Random-effect meta-analysis was performed to calculate a pooled effect size (ES) and 95% CIs. Studies were assessed for methodological quality.ResultsOverall, 23 studies were identified including 174,114 participants (30% men) with age ranges from 20 to 87 years old. There was considerable heterogeneity in the definition and measurement of HA and PA. Most of the identified studies reported a significant positive association of PA with HA, six reported a non-significant. Meta-analysis revealed that PA is positively associated with HA (ES: 1.39, 95% CI = 1.23–1.57, n = 17) even if adjusted for publication bias (ES: 1.27, 95% CI = 1.11–1.45, n = 20).ConclusionsThere is consistent evidence from longitudinal observational studies that PA is positively associated with HA, regardless of definition and measurement. Future research should focus on the implementation of a single metric of HA, on the use of objective measures for PA assessment and on a full-range of confounding adjustment. In addition, our research indicated the limited research on ageing in low-and-middle income countries.