Community‐Based Mental Health and Behavioral Programs for Low‐Income Urban Youth: A Meta‐Analytic Review

A meta‐analytic review of 33 studies and 41 independent samples was conducted of the effectiveness of community‐based mental health and behavioral programs for low‐income urban youth. Findings indicated positive effects, with an overall mean effect of 0.25 at post‐test. While this is comparable to previous meta‐analytic intervention research with more diverse samples, it stands in contrast to findings of the school‐based review (0.08 at post‐test) focused on this population. The current review found type of intervention to significantly moderate effects, with effects highest for programs that were environmentally based. In fact, effect sizes for programs that did not target the environment were not significant. Findings are discussed with an emphasis on environmental influences, including the differing contexts affecting school‐ versus community‐based interventions conducted with low‐income, urban youth.     

A meta‐analysis of the effects of internet‐ and computer‐based cognitive‐behavioral treatments for anxiety

Internet‐and computer‐based cognitive‐behavioral treatments have been introduced as novel approaches to deliver standard, quality treatment that may reduce barriers to care. The purpose of this review is to quantitatively summarize the literature examining the treatment effects of Internet‐ or computer‐based treatment (ICT) on anxiety. Nineteen randomized controlled ICT trials were identified and subjected to fixed and random effects meta‐analytic techniques. Weighted mean effect sizes (Cohen's d) showed that ICT was superior to waitlist and placebo assignment across outcome measures (ds=.49–1.14). The effects of ICT also were equal to therapist‐delivered treatment across anxiety disorders. However, conclusions were limited by small sample sizes, the rare use of placebo controls, and other methodological problems. In addition, the number of available studies limited the opportunity to conduct analyses by diagnostic group; there was preliminary support for the use of ICT for panic disorder and phobia. Large, well‐designed, placebo‐controlled trials are needed to confirm and extend the results of this meta‐analysis. © 2008 Wiley Periodicals, Inc. J Clin Psychol 65: 1–21, 2009.     

EFFECTS OF AN OUT‐OF‐SCHOOL PROGRAM ON URBAN HIGH SCHOOL YOUTH'S ACADEMIC PERFORMANCE

Research strongly indicates that low‐income youth, particularly those of color who are overrepresented in poverty, have lower levels of academic performance than their higher‐income peers. It has been suggested that community‐based out‐of‐school programs can play an important role in reducing these academic differences. This study examined the effect of the YMCA High School Youth Institute on the grades, test scores, and school attendance of urban high school youth using a randomly selected matched comparison group. Those involved in the program had significantly higher English‐language art and math standardized test scores and somewhat fewer absences than the comparison group. Active program participants had significantly higher academic grade‐point averages (GPAs) and math test scores as well as somewhat higher total GPA. The findings suggest that high‐quality out‐of‐school programs can positively influence the academic performance of low‐income youth. Implications for practice are discussed.     

Detection of human papillomavirus in esophageal papillomas: systematic review and meta‐analysis

Since first suggested (in 1982), etiological role for human papillomavirus (HPV) in esophageal papillomas has aroused increasing interest. The objective of this study was to perform systematic review and formal meta‐analysis of the literature reporting on HPV detection in esophageal squamous cell papillomas (ESCP). Literature was searched through May 2012. The effect size was calculated as event rates (95% CI), with homogeneity testing using Cochran's Q and I² statistics. Meta‐regression was used to test the impact of study‐level covariates (HPV detection method, geographic origin) on effect size, and potential publication bias was estimated using funnel plot symmetry. Thirty nine studies were eligible, covering 427 ESCPs from different geographic regions. Altogether, 132 (30.9%) cases tested HPV positive; effect size 0.375 (95% CI 0.319–0.434) using the fixed‐effects (FE) model and 0.412 (95% CI 0.295–0.540) using the random‐effects model. In meta‐analysis stratified by (i) HPV detection technique and (ii) geographic study origin, the between‐study heterogeneity was not significant (p = 0.071 and p = 0.105, respectively). In meta‐regression, HPV detection method (p = 0.260) and geographic origin (p = 0.436) were not significant study‐level covariates accounting for the heterogeneity in HPV prevalence. Some evidence for publication bias was found only for PCR‐based studies, with a marginal impact on summary effect size estimates. In sensitivity analysis, all meta‐analytic results were robust to all one‐by‐one study removals. In stratified meta‐analysis and formal meta‐regression, the variability in HPV detection rates in ESCPs is not explained by the HPV detection method or geographic origin of the study.     

Hepatocellular carcinoma‐associated single‐nucleotide variants and deletions identified by the use of genome‐wide high‐throughput analysis of hepatitis B virus

This study investigated hepatitis B virus (HBV) single‐nucleotide variants (SNVs) and deletion mutations linked with hepatocellular carcinoma (HCC). Ninety‐three HCC patients and 108 non‐HCC patients were enrolled for HBV genome‐wide next‐generation sequencing (NGS) analysis. A systematic literature review and a meta‐analysis were performed to validate NGS‐defined HCC‐associated SNVs and deletions. The experimental results identified 60 NGS‐defined HCC‐associated SNVs, including 41 novel SNVs, and their pathogenic frequencies. Each SNV was specific for either genotype B (n = 24) or genotype C (n = 34), except for nt53C, which was present in both genotypes. The pathogenic frequencies of these HCC‐associated SNVs showed a distinct U‐shaped distribution pattern. According to the meta‐analysis and literature review, 167 HBV variants from 109 publications were categorized into four levels (A–D) of supporting evidence that they are associated with HCC. The proportion of NGS‐defined HCC‐associated SNVs among these HBV variants declined significantly from 75% of 12 HCC‐associated variants by meta‐analysis (Level A) to 0% of 10 HCC‐unassociated variants by meta‐analysis (Level D) (P < 0.0001). PreS deletions were significantly associated with HCC, in terms of deletion index, for both genotypes B (P = 0.030) and C (P = 0.049). For genotype C, preS deletions involving a specific fragment (nt2977–3013) were significantly associated with HCC (HCC versus non‐HCC, 6/34 versus 0/32, P = 0.025). Meta‐analysis of preS deletions showed significant association with HCC (summary odds ratio 3.0; 95% confidence interval 2.3–3.9). Transfection of Huh7 cells showed that all of the five novel NGS‐defined HCC‐associated SNVs in the small surface region influenced hepatocarcinogenesis pathways, including endoplasmic reticulum‐stress and DNA repair systems, as shown by microarray, real‐time polymerase chain reaction and western blot analysis. Their carcinogenic mechanisms are worthy of further research. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

Cognitive‐Behavioral School‐Based Interventions for Anxious and Depressed Youth: A Meta‐Analysis of Outcomes

A meta‐analysis of school‐based interventions for anxious and depressed youth using QUORUM guidelines was conducted. Studies were located by searching electronic databases, manual effort, and contact with expert researchers. Analyses examined 63 studies with 8,225 participants receiving cognitive‐behavioral therapy (CBT) and 6,986 in comparison conditions. Mean pre–post effect sizes indicate that anxiety‐focused school‐based CBT was moderately effective in reducing anxiety (Hedge's g = 0.501) and depression‐focused school‐based CBT was mildly effective in reducing depression (Hedge's g = 0.298) for youth receiving interventions as compared to those in anxiety intervention control conditions (Hedge's g = 0.193) and depression intervention controls (Hedge's g = 0.091). Predictors of outcome were explored. School‐based CBT interventions for youth anxiety and for youth depression hold considerable promise, although investigation is still needed to identify features that optimize service delivery and outcome.     

Facial phenotype in obstructive sleep apnea–hypopnea syndrome: a systematic review and meta‐analysis

This systematic review and meta‐analysis explores the association between facial phenotype and obstructive sleep apnea–hypopnea syndrome in adults. A comprehensive electronic (Medline via Ovid, Scopus, and Embase) database and reference search were undertaken in relation to imaging modalities for surface craniofacial assessments in subjects with sleep apnea. The outcome measures were surface facial dimensions, morphology and profile. The quality of studies was assessed and a meta‐analysis conducted. The studies were weighted using the inverse variance method, and the random effects model was used to analyse data. This systematic review identified eight case–control studies. In five studies (906 participants), adults with sleep apnea showed increased weighted mean differences in neck circumference by 1.26 mm (P = 0.0001) with extensive heterogeneity between studies (I² = 93%). Only two studies (467 participants) shared the following outcomes: mandible length, lower facial height, mandible width and anterior mandible height parameters. The pooled results demonstrated obstructive sleep apnea syndrome was associated with larger parameters than controls. In conclusion, the surface facial assessment was able to demonstrate some characteristic morphological features, facilitating a meta‐analysis, in adults with obstructive sleep apnea–hypopnea syndrome. The strength of these findings, however, was limited by the heterogeneity of the studies precluding the identification of a clear phenotype.     

Healthcare Interventions for Perinatal Depression in Socially Disadvantaged Women: A Systematic Review and Meta‐Analysis

The aim of this systematic review was to identify, characterize, and analyze the effectiveness of healthcare interventions for perinatal depression in socially disadvantaged women. Prominent biomedical databases were searched in April 2013. Sixteen articles assessing 15 interventions to decrease depressive symptoms in socially disadvantaged women were selected. Most interventions were carried out in the United States (n = 11) and targeted ethnic minorities (n = 9). Approximately half of the interventions (53%) were effective in decreasing depressive symptoms, observing that culturally adapted, interpersonal therapy interventions were the most effective. Eleven interventions were included in the meta‐analysis that showed a statistically significant reduction in overall depressive symptoms (?0.44, 95% CI [?0.67, ?0.22]). Meta‐regression indicated that several characteristics increased the effectiveness of the interventions.     

SELF‐CONTROL AND ADOLESCENT INTERNALIZING AND EXTERNALIZING PROBLEMS: NEIGHBORHOOD‐BASED DIFFERENCES

Self‐control may act as a protective factor against the development of internalizing and externalizing problems among adolescents. However, little research has examined how self‐control functions within and across different types of communities. Using two cohorts from the Project on Human Development in Chicago Neighborhoods (N = 1,072; 51.40% female), we examined how self‐control and neighborhood characteristics were independently and jointly associated with these behaviors. Using latent profile analysis, we categorized neighborhoods based on several characteristics known to be associated with youth outcomes, including violence, concentrated disadvantage, and collective efficacy. Then we examined how self‐control was associated with youth internalizing and externalizing problems within and across neighborhoods. Results suggest that self‐control was a protective feature in only some types of disadvantaged and dangerous neighborhoods. We discuss findings in terms of implications for programs and policies to support youth mental health.     

Acromion morphology and prevalence of rotator cuff tear: A systematic review and meta‐analysis

The causes of degenerative rotator cuff (RTC) tears are unclear but certain acromion morphology may contribute. This study's objective was to determine using a systematic review and meta‐analysis the association of acromion type and acromial index with the prevalence of RTC tears. Six databases were searched electronically. Seventeen relevant studies between 1993 and 2017 were included in the meta‐analyses determining the association of RTC tears with acromion type (n = 11) or acromial index (n = 10). Effect sizes were calculated as an odds ratio (OR) for the studies reporting acromion type and as raw mean difference (RMD) for the studies reporting acromial index. Meta‐analysis was performed using a random‐effects model. There was a significant small‐to‐medium effect found in the meta‐analysis for acromion type (overall OR = 2.82, P = 0.000003), indicating an almost three times greater odds for a RTC tear in individuals with a type‐III acromion as compared with those with a type‐I or ‐II. A significant effect was also found for acromial index (RMD = 0.071, P < 0.0000001), indicating that a larger acromial index is associated with a greater likelihood of a RTC tear. Because of substantial heterogeneity in RMD for acromial index (Q‐df = 92, P < 0.00001; I² = 89%), subgroup analyses and meta‐regressions were performed. Interestingly, the continent where the study was conducted (i.e., Europe vs. Asia) was the only moderator variable that could explain some of the acromial index heterogeneity. Overall, the findings from our analyses indicate that individuals with either a type‐III acromion and/or a larger acromial index have a greater likelihood for non‐traumatic RTC tears. Clin. Anat. 32:122–130, 2019. © 2018 Wiley Periodicals, Inc.     

Communitarianism and youth empowerment: Motivation for participation in a community‐based substance abuse prevention coalition

In recent years, collaborative efforts between universities and community‐based coalitions have helped develop prevention–intervention efforts to decrease the prevalence of drug and alcohol use among youth in low‐income, majority–minority urban areas.  One theory often employed to understand the efficacy of community member involvement is McMillian and Chavis's (1986) sense of community (SOC) model. This model posits how 4 main tenants (i.e., sense of belonging, emotional connection, needs fulfillment, and influence) lead to increased empowerment. The present study examines how individual SOC affected substance abuse coalition members’ (N = 17) motivations for serving on a coalition. Findings explore how all four tenants of McMillian and Chavis's (1986) model influenced community members’ involvement in the coalition, which have implications for prevention, policy, and further research.     

Exploring the Major Sources and Extent of Heterogeneity in a Genome‐Wide Association Meta‐Analysis

Genome‐wide association (GWA) meta‐analysis has become a popular approach for discovering genetic variants responsible for complex diseases. The between‐study heterogeneity effect is a severe issue that may complicate the interpretation of results. Aiming to improve the interpretation of meta‐analysis results, we empirically explored the extent and source of heterogeneity effect. We analyzed a previously reported GWA meta‐analysis of obesity, in which over 21,000 subjects from seven individual samples were meta‐analyzed. We first evaluated the extent and distribution of heterogeneity across the entire genome. We then studied the effects of several potentially confounding factors, including age, ethnicity, gender composition, study type, and genotype imputation on heterogeneity with a random‐effects meta‐regression model. Of the total 4,325,550 SNPs being tested, heterogeneity was moderate to very large for 25.4% of the total SNPs. Heterogeneity was more severe in SNPs with stronger association signals. Ethnicity, average age, and genotype imputation accuracy had significant effects on the heterogeneity. Exploring the effects of ethnicity can provide clues to the potential ethnic‐specific effects for two loci known to affect obesity, MC4R, and MTCH2. Our analysis can help to clarify understanding of the obesity mechanism and may provide guidance for an effective design of future GWA meta‐analysis.     

Association of IMMP2L deletions with autism spectrum disorder: A trio family study and meta‐analysis

IMMP2L, the gene encoding the inner mitochondrial membrane peptidase subunit 2‐like protein, has been reported as a candidate gene for Tourette syndrome, autism spectrum disorder (ASD) and additional neurodevelopmental disorders. Here we genotyped 100 trio families with an index proband with autism spectrum disorder in Han Chinese population and found three cases with rare exonic IMMP2L deletions. We have conducted a comprehensive meta‐analysis to quantify the association of IMMP2L deletions with ASD using 5,568 cases and 10,279 controls. While the IMMP2L deletions carried non‐recurrent breakpoints, in contrast to previous reports, our meta‐analysis found no evidence of association (P > 0.05) between IMMP2L deletions and ASD. We also observed common exonic deletions impacting IMMP2L in a separate control (5,971 samples) cohort where subjects were screened for psychiatric conditions. This is the first systematic review and meta‐analysis regarding the effect of IMMP2L deletions on ASD, but further investigations in different populations, especially Chinese population may be still needed to confirm our results.     

Birth prevalence of achondroplasia: A systematic literature review and meta‐analysis

Achondroplasia is a genetic disorder that results in disproportionate short stature. The true prevalence of achondroplasia is unknown as estimates vary widely. This systematic literature review and meta‐analysis was conducted to better estimate worldwide achondroplasia birth prevalence. PubMed, Embase, Scielo, and Google Scholar were searched, complemented by manual searching, for peer‐reviewed articles published between 1950 and 2019. Eligible articles were identified by two independent researchers using predefined selection criteria. Birth prevalence estimates were extracted for analysis, and the quality of evidence was assessed. A meta‐analysis using a quality effects approach based on the inverse variance fixed effect model was conducted. The search identified 955 unique articles, of which 52 were eligible and included. Based on the meta‐analysis, the worldwide birth prevalence of achondroplasia was estimated to be 4.6 per 100,000. Substantial regional variation was observed with a considerably higher birth prevalence reported in North Africa and the Middle East compared to other regions, particularly Europe and the Americas. Higher birth prevalence was also reported in specialized care settings. Significant heterogeneity (Higgins I² of 84.3) was present and some indication of publication bias was detected, based on visual asymmetry of the Doi plot with a Furuya‐Kanamori index of 2.73. Analysis of pooled data from the current literature yields a worldwide achondroplasia birth prevalence of approximately 4.6 per 100,000, with considerable regional variation. Careful interpretation of these findings is advised as included studies are of broadly varying methodological quality.     

Antinuclear antibodies and recurrent miscarriage: Systematic review and meta‐analysis

Studies have investigated the relationship between antinuclear antibodies (ANA) and recurrent miscarriage (RM). The objective of this paper is to evaluate the presence of ANA as a risk factor for spontaneous abortion in patients with RM. By considering the guidelines of Preferred Reporting Items for Systematic Reviews and Meta‐Analysis, the authors performed systematic review and meta‐analysis by searching the databases of PubMed/Medline and SCOPUS. Review Manager, Version 5.3 performed the statistical analysis. Binary variables were analyzed by odds ratio (ORs) and 95% confidence interval (CI). The subgroup analysis compared the effect of different ANA titers. The authors analyzed the ANA patterns of immunofluorescence staining. Seven case‐control studies were selected. The frequency of positive ANA was statistically higher in the RM group (20.6%, 288/1400) as compared to the control group (6.7%, 72/1080). The meta‐analysis of the positive ANA showed a statistical difference between the two groups (OR 3.30, 95% CI 1.41‐7.73; I² = 87%, P = .006). Studies have revealed different frequencies of ANA patterns of immunofluorescence. This meta‐analysis suggested that positive ANA might increase the risk of RM. However, it was not possible to conclude which ANA pattern of immunofluorescence staining is more frequent in the RM group.     

Examining protective factors and risk factors in urban and rural head start Preschoolers

This study examined a comprehensive screening model within children attending Head Start programs from urban (n =232) and rural (n = 231) communities. The Devereux Early Childhood Assessment (DECA; LeBuffe & Naglieri, 1999 ) was used to measure social‐emotional protective factors (i.e., Total Protective Factors [TPF]) and risk factors (i.e., Behavior Concerns [BC]) within children that resided in two different community settings. Children from low‐income rural programs received higher scores on a subscale measuring children's relationship to adults (i.e., Attachment subscale). Additionally, children from low‐income urban programs received higher scores on children's ability to self‐regulate (i.e., Self‐Control subscale). Significant differences between children from rural and urban settings were not found on the primary scales (BC or TPF) of the DECA. Statistically significant gender differences by community‐type were not found. Findings contribute to the literature by illustrating that community characteristics might influence the development of different social‐emotional behaviors in preschool children. © 2011 Wiley Periodicals, Inc.     

No association of genetic variants in BDNF with major depression: A meta‐ and gene‐based analysis

Major depressive disorder (MDD) is a complex psychiatric condition with strong genetic predisposition. The association of MDD with genetic polymorphisms, such as Val66Met (rs6265), in the brain derived neurotrophic factor (BDNF), have been reported in many studies and the results were conflicting. In this study, we performed a systematic literature search and conducted random‐effects meta‐analysis to evaluate genetic variants in BDNF with MDD. A gene‐based analysis was also conducted to investigate the cumulative effects of genetic polymorphisms in BDNF. A total of 28 studies from 26 published articles were included in our analysis. Meta‐analysis yielded an estimated odds ratio (OR) of 0.96 (95% CI: 0.89–1.05; P = 0.402) for Val66Met (rs6265), 0.83 (95% CI: 0.67–1.04; P = 0.103) for 11757C/G, 1.16 (95% CI: 0.74–1.82; P = 0.527) for 270T/C, 1.03 (95% CI: 0.18–5.75; P = 0.974) for 712A/G and 0.98 (95% CI: 0.85–1.14; P = 0.831) for rs988748. The gene‐based analysis indicated that BDNF is not associated with MDD (P > 0.21). Our updated meta‐ and novel gene‐based analyses provide no evidence of the association of BDNF with major depression. © 2012 Wiley Periodicals, Inc.     

Probiotics for prevention of atopic diseases in infants: systematic review and meta‐analysis

Growing evidence underlines the pivotal role of infant gut colonization in the development of the immune system. The possibility to modify gut colonization through probiotic supplementation in childhood might prevent atopic diseases. The aim of the present systematic review and meta‐analysis was to evaluate the effect of probiotic supplementation during pregnancy and early infancy in preventing atopic diseases. PubMed, Embase and Cochrane Library were searched for randomized controlled trials evaluating the use of probiotics during pregnancy or early infancy for prevention of allergic diseases. Fixed‐effect models were used, and random‐effects models where significant heterogeneity was present. Results were expressed as risk ratio (RR) with 95% confidence interval (CI). Seventeen studies, reporting data from 4755 children (2381 in the probiotic group and 2374 in the control group), were included in the meta‐analysis. Infants treated with probiotics had a significantly lower RR for eczema compared to controls (RR 0.78 [95% CI: 0.69–0.89], P = 0.0003), especially those supplemented with a mixture of probiotics (RR 0.54 [95% CI: 0.43–0.68], P < 0.00001). No significant difference in terms of prevention of asthma (RR 0.99 [95% CI: 0.77–1.27], P = 0.95), wheezing (RR 1.02 [95% CI: 0.89–1.17], P = 0.76) or rhinoconjunctivitis (RR 0.91 [95% CI: 0.67–1.23], P = 0.53) was documented. The results of the present meta‐analysis show that probiotic supplementation prevents infantile eczema, thus suggesting a new potential indication for probiotic use in pregnancy and infancy.     

Effectiveness of mite‐impermeable covers: a hypothesis‐generating meta‐analysis

Asthma is a heterogeneous disease. The subject of mite allergen control has evolved into a debate dominated by a Cochrane review by Gøtzsche and Johansen (Cochrane Database of Systematic Reviews, 2008, Art. No: CD001187). A not well‐discussed aspect of that study is the selection by those authors of a univariate meta‐analysis including various interventions. This study extends the meta‐analysis by Gøtzsche and Johansen and aims to generate hypotheses on the effectiveness of various bedding interventions, including the coverage of all bedding elements. Trials were selected based on environmental criteria. The interventions were classified according to the number of barriers used. Standardized mean differences yielded the mite load, three physiological outcomes and asthma symptom scores. The influence of covariates was examined with a mixed‐effect model using the metafor package for meta‐analysis in R. Twelve trials included 1187 observations. The interventions included one barrier or product (six trials), two barriers or partial control (four trials) and three barriers or integral control (two trials). The exposure data showed considerable heterogeneity (I² = 93%). The risk of bias significantly (P = 0.04) influenced the final load, the square root of the interaction between the baseline load and the type of intervention as well (95% CI: ?0.66 to ?0.07 μg/g; P = 0.02). Changes in load showed similar tendencies. Health outcomes showed moderate to considerable heterogeneity (physiological outcomes I² = 44–94%; symptom score I² = 93%). A meta‐regression of bedding interventions indicates that integral control most significantly reduced mite load when the load was high at baseline. The number of trials was too small to allow an appropriate examination of health outcomes. Future studies are suggested to test the hypothesis that allergic patients benefit from integral control when the baseline mite load is high.     

Patterns of place‐based self‐regulation and associated mental health of urban adolescents

Efforts to simultaneously address adolescent self‐regulation, activity space (routine locations), and mental health represent a promising social ecological approach aimed at understanding the lives and development of urban youth. This type of examination of contextual influences on self‐regulation is considered an important area of developmental research, yet one that is understudied (McCabe, Cunnington, & Brooks‐Gunn, 2004 ). Little is known about the self‐regulatory experiences that might link specific types of locations with mental health problems, particularly with urban youth who live in areas characterized by chronic and severe stressors such as personal violence, criminal activity, and poverty. Recent research has demonstrated the “power of context” (Tolan, Gorman‐Smith, Henry, Chung, & Hunt, 2002 ) to influence coping styles and has demonstrated that without detailed and specified knowledge of the social ecology of urban youth, measurement of critical variables and interpretation of results are likely to be misinformed (Tolan & Grant, 2009 ). Given the importance of understanding youth through an interactive and contextual framework (Bronfenbrenner, 1979 ; Szapocznik & Coatsworth, 1999 ), the present study examined self‐regulatory experiences, specified favorite locations, and mental health with urban adolescents residing in low‐resource and high‐risk environments. © 2010 Wiley Periodicals, Inc.