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Effect Sizes (effect + size)
Kinds of Effect Sizes Selected AbstractsConflict resolution education and antisocial behavior in U.S. schools: A meta-analysisCONFLICT RESOLUTION QUARTERLY, Issue 1 2007Wendy M. Garrard This meta-analysis examines more than twenty-five years of evidence to determine whether participation in school-based conflict resolution education (CRE) contributes to reduced antisocial behaviors among youth in kindergarten through twelfth grade in U.S. schools. Evidence from thirty-six studies, representing 4,971 students, shows improvements in antisocial behaviors in CRE participants compared to control groups (Effect Size = .26), with larger effects observed during midadolescence ( ES = .53) and early adolescence ( ES = .22) compared to middle childhood ( ES = .06). Improvements in antisocial behavior outcomes attributable to CRE are significant in both practical and statistical terms and are similar for different CRE program approaches. [source] Utilities of the P -value Distribution Associated with Effect Size in Clinical Trials,BIOMETRICAL JOURNAL, Issue 6 2003H.M. James Hung Abstract The P -value, which is widely used for assessing statistical evidence in randomized comparative clinical trials, is a function of the observed effect size of the experimental treatment relative to the control treatment. The relationship of the P -value with the observed effect size at study completion and the effect size anticipated at the design stage has potential usefulness in providing guidance for planning and interpretation of a clinical trial. The post-trial power associated with a statistically significant P -value from a completed study is also a random variable and its use may assist in planning a follow-up trial to confirm the statistically significant findings in an initial study. A measure of robustness is explored to quantify the degree of sensitivity of the observed P -value to potential bias that may be contained in the observed effect size. [source] Effects of insects on primary production in temperate herbaceous communities: a meta-analysisECOLOGICAL ENTOMOLOGY, Issue 5 2003Malcolm D. Coupe Abstract., 1. The effects of insects on primary production in temperate herbaceous communities were investigated in a meta-analysis. The following hypotheses were tested: (1) the effect of insects on primary production depends on community type, (2) the effect of insects on primary production varies as a function of productivity, (3) insects have a greater effect on primary production in communities with low species diversity, and (4) insects have a larger effect on primary production during outbreaks. 2. Data were collected from 24 studies in which insecticides were used to suppress insects in self-sown or pastoral communities. Effect sizes were calculated from sprayed and control plot standing crop or yield, expressed as the log response ratio, ln (sprayed plot phytomass/control plot phytomass). 3. There was a significant increase in primary production as a result of insect suppression. Forb-dominated communities showed a more variable response than graminoid communities. During outbreaks, insects had a greater negative impact on primary production. Effect size was unaffected by productivity or plant species richness. 4. Although insects lower primary production in a diversity of temperate herbaceous communities, the basic measures by which such communities are often described have little effect on the proportional impact that insects have on primary production. While outbreaks are significant predictors of higher negative impact on primary production, causes of outbreaks are not always related to traits of the plant community. [source] Hippocampal volume and asymmetry in mild cognitive impairment and Alzheimer's disease: Meta-analyses of MRI studiesHIPPOCAMPUS, Issue 11 2009Feng Shi Abstract Numerous studies have reported a smaller hippocampal volume in Alzheimer's disease (AD) patients than in aging controls. However, in mild cognitive impairment (MCI), the results are inconsistent. Moreover, the left-right asymmetry of the hippocampus receives less research attention. In this article, meta-analyses are designed to determine the extent of hippocampal atrophy in MCI and AD, and to evaluate the asymmetry pattern of the hippocampal volume in control, MCI, and AD groups. From 14 studies including 365 MCI patients and 382 controls, significant atrophy is found in both the left [Effect size (ES), 0.92; 95% confidence interval (CI), 0.72,1.11] and right (ES, 0.78; 95% CI, 0.57,0.98) hippocampus, which is lower than that in AD (ES, 1.60, 95% CI, 1.37,1.84, in left; ES, 1.52, 95% CI, 1.31,1.72, in right). Comparing with aging controls, the average volume reduction weighted by sample size is 12.9% and 11.1% in left and right hippocampus in MCI, and 24.2% and 23.1% in left and right hippocampus in AD, respectively. The findings show a bilateral hippocampal volume loss in MCI and the extent of atrophy is less than that in AD. By comparing the left and right hippocampal volume, a consistent left-less-than-right asymmetry pattern is found, but with different extents in control (ES, 0.39), MCI (ES, 0.56), and AD (ES, 0.30) group. © 2009 Wiley-Liss, Inc. [source] Research Review: The relationship between childhood violence exposure and juvenile antisocial behavior: a meta-analytic reviewTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 7 2009Helen W. Wilson Background:, The connection between childhood violence exposure and antisocial behavior in adolescence has received much attention and has important implications for understanding and preventing criminal behavior. However, there are a limited number of well-designed prospective studies that can suggest a causal relationship, and little is known about the magnitude of the relationship. Methods:, This meta-analysis provides a quantitative comparison of 18 studies (N = 18,245) assessing the relationship between childhood (before age 12) violence exposure and adolescent antisocial behavior. An overall effect size (Cohen's d) was calculated for each study, an average for the 18 studies, and averages for subsets of analyses within studies. Results:, Results indicated a small effect from prospective studies (d = .31) and a large effect from cross-sectional studies (d = .88). The effect for victimization (d = .61) was larger than for witnessing violence (d = .15). Conclusions:, Effect size varied across studies employing different methodologies, populations, and conceptualizations of violence exposure and antisocial behavior. These findings do not support a simple, direct link from early violence exposure to antisocial behavior but suggest that many factors influence this relationship. [source] Men's Sexual Health: Evaluating the Effectiveness of Print- and PDA-based CMETHE JOURNAL OF SEXUAL MEDICINE, Issue 9 2009Gregory A. Broderick MD ABSTRACT Introduction., Personal digital assistant (PDA)-based continuing medical education (CME) activities have become widely available. Aims., To evaluate the effectiveness of print- and PDA-based CME materials in erectile dysfunction (ED). Methods., CME materials describing links between ED and comorbid medical conditions, effects of certain lifestyle modifications on ED, and treatment of ED with phosphodiesterase 5 (PDE5) inhibitors were distributed as a print supplement and as electronic modules, viewed with PDAs. We evaluated how effectively these materials improved evidence-based clinical choices, using survey questions about case vignettes and comparing responses of CME participants (N = 85) and matched nonparticipants (N = 94). Main Outcome Measures., Effect size, measuring the difference in evidence-based clinical scores between participants and nonparticipants. Results., CME certificates were awarded to 3,557 participants (459 print, 3,098 PDA). Among survey respondents, significantly more CME participants recognized that ED was associated with greater risk for myocardial infarction (61% participants; 34% nonparticipants; P , 0.001) and was a strong marker for diabetes mellitus (37% participants; 9% nonparticipants; P , 0.001). In contrast, participants and nonparticipants both displayed a good understanding of the relationships of smoking, obesity, and sedentary lifestyle with ED and of using PDE5 inhibitors to treat ED in patients with prostate cancer or benign prostatic hyperplasia; this likely reflects a good baseline understanding of these topics. Participants and nonparticipants each displayed a poor understanding of the recommendations regarding nonarteritic anterior ischemic optic neuropathy and PDE5 inhibitor use. Patient reluctance to discuss sexual concerns was perceived as the most significant barrier to optimal ED management. Conclusions., Given patient reluctance to discuss sexual concerns, future CME activities should focus on educating health-care providers and patients that ED is a risk factor for cardiovascular disease and diabetes. Both print- and PDA-based CME on ED were effective; the large number of lesson completers suggests a trend toward on-demand, self-selected CME is positive. Broderick GA, and Abdolrasulnia M. Men's sexual health: Evaluating the effectiveness of print- and PDA-based CME. J Sex Med 2009;6:2417,2424. [source] Validity and responsiveness of the Osnabrück Hand Eczema Severity Index (OHSI): a methodological studyBRITISH JOURNAL OF DERMATOLOGY, Issue 1 2009M. Dulon Summary Background, The Osnabrück Hand Eczema Severity Index (OHSI) is a scoring system for the assessment of the severity of hand eczema (HE). Objective, To assess the clinimetric value of the OHSI and to validate the longitudinal responsiveness of the OHSI using the Manuscore as a gold standard. Methods, OHSI and Manuscore scores were compared before and after 3 weeks' inpatient treatment of 62 patients with occupational HE. Correlation coefficients and 95% limits of agreement were calculated and the ability of OHSI to identify severe HE was analysed. The responsiveness of the OHSI in monitoring skin changes over time was evaluated by calculating effect sizes. Results, High correlation was found between the OHSI and Manuscore at both scoring occasions (around rs = 0·77). Differences between both measurements were within the 95% limits of agreement for 94% of patients, with a tendency for the OHSI to underestimate the severity at very low and at very high values compared with the Manuscore. Responsiveness to change was good. Both instruments showed significant improvement between the scoring occasions. Using the OHSI values, the proportion of classification to the correct tertile of score change was 69%. Effect size from untreated to treated was 0·6 for the Manuscore and 1·1 for the OHSI, with higher effect sizes in individuals with severe HE. Conclusions, Even though the OHSI allows less differentiation than the Manuscore, it shows adequate validity and responsiveness to change. Thus the OHSI is suitable for both monitoring the severity of HE and the effects of treatment. [source] Assessing the responsiveness of measures of oral health-related quality of lifeCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 1 2004David Locker Abstract ,,, Objectives: This paper illustrates ways of assessing the responsiveness of measures of oral health-related quality of life (OHRQoL) by examining the sensitivity of the oral health impact profile (OHIP)-14 to change when used to evaluate a dental care program for the elderly. Methods: One hundred and sixteen elderly patients attending four municipally funded dental clinics completed a copy of the OHIP-14 prior to treatment and 1 month after the completion of treatment. The post-treatment questionnaire also included a global transition judgement that assessed subjects' perceptions of change in their oral health following treatment at the clinics. Change scores were calculated by subtracting post-treatment OHIP-14 scores from pre-treatment scores. The longitudinal construct validity of these change scores were assessed by means of their association with the global transition judgements. Measures of responsiveness included effect sizes for the change scores, the minimal important difference, and Guyatt's responsiveness index. An receiver operating characteristic (ROC) curve was constructed to determine the accuracy of the change scores in predicting whether patients had improved or not as a result of the treatment. Results: Based on the global transition judgements, 60.2% of subjects reported improved oral health, 33.6% reported no change, and only 6.2% reported that it was a little worse. These changes are reflected in mean pre- and post-treatment OHIP-14 scores that declined from 15.8 to 11.5 (P < 0.001). Mean change scores showed a consistent gradient in the expected direction across categories of the global transition judgement, but differences between the groups were not significant. However, paired t -tests showed no significant differences in the pre- and post-treatment scores of stable subjects, but showed significant declines for subjects who reported improvement. Analysis of data from stable subjects indicated that OHIP-14 had excellent test,retest reliability with an intraclass correlation coefficient (ICC) of 0.84. Effect size based on change scores for all subjects and subgroups of subjects were small to moderate. The ROC analysis indicated that OHIP-14 change scores were not good ,diagnostic tests' of improvement. The minimal important difference for the OHIP-14 was of 5-scale points, but detecting this difference would require relatively large sample sizes. Conclusions: OHIP-14 appeared to be responsive to change. However, the magnitude of change that it detected in the context described here was modest, probably because it was designed primarily as a discriminative measure. The psychometric properties of the global transition judgements that often provide the ,gold standard' for responsiveness studies need to be established. [source] Cognitive training in Alzheimer's disease: a meta-analysis of the literatureACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2006D. I. Sitzer Objective:, To systematically review the literature and summarize the effect of cognitive training (CT) for Alzheimer's disease (AD) patients on multiple functional domains. Method:, Effect sizes (Cohen's d) were calculated for 17 controlled studies identified through a comprehensive literature review. Results:, An overall effect size of 0.47 was observed for all CT strategies across all measured outcomes. Mean effect sizes were higher for restorative (0.54) than for compensatory (0.36) strategies. Domain-specific effect sizes ranged from 2.16 (verbal and visual learning) to ,0.38 (visuospatial functioning). Data are also presented on the relative impact of restorative and compensatory strategies for each domain of functioning. Conclusion:, CT evidenced promise in the treatment of AD, with primarily medium effect sizes for learning, memory, executive functioning, activities of daily living, general cognitive problems, depression, and self-rated general functioning. Restorative strategies demonstrated the greatest overall effect on functioning. Several limitations of the published literature are discussed. [source] Cognitive performance of male adolescents is lower than controls across psychiatric disorders: a population-based studyACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2004M. Weiser Objective:, Psychiatric patients, as well as humans or experimental animals with brain lesions, often concurrently manifest behavioral deviations and subtle cognitive impairments. This study tested the hypothesis that as a group, adolescents suffering from psychiatric disorders score worse on cognitive tests compared with controls. Method:, As part of the assessment for eligibility to serve in the military, the entire, unselected population of 16,17-year old male Israelis undergo cognitive testing and screening for psychopathology by the Draft Board. We retrieved the cognitive test scores of 19 075 adolescents who were assigned any psychiatric diagnosis, and compared them with the scores of 243 507 adolescents without psychiatric diagnoses. Results:, Mean test scores of cases were significantly poorer then controls for all diagnostic groups, except for eating disorders. Effect sizes ranged from 0.3 to 1.6. Conclusion:, As group, adolescent males with psychiatric disorders manifest at least subtle impairments in cognitive functioning. [source] Psycho-educational interventions for children and young people with Type 1 diabetesDIABETIC MEDICINE, Issue 9 2006H. R. Murphy Abstract Background, A systematic review of the literature in 2000 revealed numerous methodological shortcomings in education research, but in recent years progress has been made in the quantity and quality of psycho-educational intervention studies. Summary of contents, This review focuses on diabetes education programmes developed for children, young people and their families in the past 5 years. A comprehensive review of the literature identified 27 articles describing the evaluation of 24 psycho-educational interventions. Data summary tables compare the key features of these, and comparisons are made between individual, group and family-based interventions. Effect sizes are calculated for nine of the randomized studies. Three research questions are posed: firstly has the recent literature addressed the problems highlighted in the previous review; secondly is there sufficient evidence to recommend adaptation of a particular programme; and, finally, what do we still need to do? Conclusions, Progress in the quality and quantity of educational research has not resulted in improved effectiveness of interventions. There is still insufficient evidence to recommend adaptation of a particular educational programme and no programme that has been proven effective in randomized studies for those with poor glycaemic control. To develop a range of effective educational interventions, further research involving larger sample sizes with multicentre collaboration is required. [source] Computer-delivered interventions for alcohol and tobacco use: a meta-analysisADDICTION, Issue 8 2010Sally Rooke ABSTRACT Aims To quantify the overall effectiveness of computer-delivered interventions for alcohol and tobacco use. Methods Meta-analysis of 42 effect sizes from randomized controlled trials, based on the responses of 10 632 individuals. Results The weighted average effect size (d) was 0.20, P < 0.001. While lower effect sizes were associated with studies addressing tobacco use (d = 0.14) this may well reflect differences in the types of outcome measure used. Effect sizes did not vary significantly as a function of treatment location, inclusion of entertaining elements, provision of normative feedback, availability of a discussion feature, number of treatment sessions, emphasis on relapse prevention, level of therapist involvement or follow-up period. Conclusion Findings of the meta-analysis suggest that minimal contact computer-delivered treatments that can be accessed via the internet may represent a cost-effective means of treating uncomplicated substance use and related problems. [source] Effects of insects on primary production in temperate herbaceous communities: a meta-analysisECOLOGICAL ENTOMOLOGY, Issue 5 2003Malcolm D. Coupe Abstract., 1. The effects of insects on primary production in temperate herbaceous communities were investigated in a meta-analysis. The following hypotheses were tested: (1) the effect of insects on primary production depends on community type, (2) the effect of insects on primary production varies as a function of productivity, (3) insects have a greater effect on primary production in communities with low species diversity, and (4) insects have a larger effect on primary production during outbreaks. 2. Data were collected from 24 studies in which insecticides were used to suppress insects in self-sown or pastoral communities. Effect sizes were calculated from sprayed and control plot standing crop or yield, expressed as the log response ratio, ln (sprayed plot phytomass/control plot phytomass). 3. There was a significant increase in primary production as a result of insect suppression. Forb-dominated communities showed a more variable response than graminoid communities. During outbreaks, insects had a greater negative impact on primary production. Effect size was unaffected by productivity or plant species richness. 4. Although insects lower primary production in a diversity of temperate herbaceous communities, the basic measures by which such communities are often described have little effect on the proportional impact that insects have on primary production. While outbreaks are significant predictors of higher negative impact on primary production, causes of outbreaks are not always related to traits of the plant community. [source] Fitness and body size in mature odonatesECOLOGICAL ENTOMOLOGY, Issue 2 2000Natalia Sokolovska Summary The relationship between body size and fitness components in odonates was examined using a meta-analysis of 33 published studies. There was a positive and significant overall effect of body size on mating rate and lifetime mating success among males. There was also a weaker but still significant positive effect of body size on survivorship of males. The relationship between body size, mating rate, longevity, and lifetime mating success differed significantly between males of territorial and nonterritorial species. The effect of body size was significant for all fitness components in territorial species but significant only for longevity and lifetime mating success in nonterritorial species. Effect sizes appeared to be strongest on longevity in both sexes, and on male mating rate in territorial species. Other effect sizes, even when significant, were small. Despite a much smaller data set, female fitness also increased significantly with body size. Both clutch size and longevity showed a significant positive relationship with body size. These results suggest that there is a general fitness benefit to large size in odonates. Nevertheless, significant heterogeneity is apparent in this effect, which can be attributed to sex, mating system, and fitness component. Finally, these analyses point to inadequacies in the current data that need further study before the potentially rich patterns in size effects on fitness can be explored more thoroughly. [source] Results from two randomized clinical trials evaluating the impact of quarterly recovery management checkups with adult chronic substance usersADDICTION, Issue 6 2009Christy K Scott ABSTRACT Aims Post-discharge monitoring and early reintervention have become standard practice when managing numerous chronic conditions. These two experiments tested the effectiveness of recovery management checkup (RMC) protocols for adult chronic substance users. Intervention RMC included quarterly monitoring; motivational interviewing to provide personalized feedback and to resolve ambivalence about substance use; treatment linkage, engagement and retention protocols to increase the amount of treatment received. Participants and setting Recruited from sequential addiction treatment admissions, participants in the two experiments were, on average, 36 and 38 years of age, mainly female (59% versus 46%), African American (85% versus 80%) and met past-year criteria for dependence (87% versus 76%). Design Participants in both experiments were assigned randomly to the RMC or control condition and interviewed quarterly for 2 years. Measurement The Global Appraisal of Individual Needs (GAIN) was the main assessment instrument. Findings RMC participant outcomes were better than control participants in both experiments. Effect sizes were larger in the second experiment in terms of reducing days to readmission (Cohen's d = 0.41 versus d = 0.22), successive quarters in the community using substances (d = ,0.32 versus ,0.19), past-month symptoms of abuse/dependence (d = ,0.23 versus ,0.02) and increasing the days of abstinence over 2 years (d = +0.29 versus 0.04). Conclusion RMC, which provided ongoing monitoring and linkage, is feasible to conduct and is effective for adults with chronic substance dependence. [source] Mechanisms of change in motivational interviewing: a review and preliminary evaluation of the evidenceADDICTION, Issue 5 2009Timothy R. Apodaca ABSTRACT Aims Motivational interviewing (MI) is an efficacious treatment for substance use disorders. However, little is known about how MI exerts its therapeutic effects. This review is a first attempt to summarize and evaluate the evidence for purported within-session mechanisms of change. The primary question of interest was: which MI constructs and variables appear to be the most promising candidates for mechanisms of change? Methods Literature searches were conducted to identify studies delivering MI in an individual format for the treatment of substance use disorders. Our search identified a total of 152 studies for review; 19 studies met inclusion criteria by providing data on at least one link in the causal chain model under examination. Effect size estimates were calculated for every possible step in the causal model where sufficient data were provided by study authors. Results Four constructs of therapist behavior were evaluated: MI-Spirit, MI-Consistent behaviors, MI-Inconsistent behaviors and therapist use of specific techniques. Five constructs of client behavior were evaluated: change talk/intention, readiness to change, involvement/engagement, resistance and the client's experience of discrepancy. The absence of experimental and full mediation studies of mechanisms of change was notable. Effect sizes were generally mixed. Conclusions The most consistent evidence was found for three constructs: client change talk/intention (related to better outcomes); client experience of discrepancy (related to better outcomes); and therapist MI-Inconsistent behavior (related to worse outcomes). Regarding therapist use of specific techniques, use of a decisional balance exercise showed the strongest association to better outcomes. [source] Do the Transtheoretical Model processes of change, decisional balance and temptation predict stage movement?ADDICTION, Issue 5 2009Evidence from smoking cessation in adolescents ABSTRACT Aims To examine the effects of processes of change (POC) on forward stage movement directly, indirectly through decisional balance and temptation, and total effects as a test of the key hypothesis of the Transtheoretical Model (TTM). Design Prospective cohort study. Setting United Kingdom. Participants A total of 1160 adolescents aged 13,14 years who were current or former smokers at baseline. Measurements Stage was assessed with the standard algorithm three times, once every 3 months. On each occasion the POC, decisional balance and temptation were measured with the standard questionnaires. Path analysis was used to examine the direct, indirectly mediated and total contribution of POC and the other constructs to stage movement 3 months later. Findings Four of the 24 analyses showed evidence that the theoretically appropriate POC predicted stage transition, with statistically significant total effects. Effect sizes were small. When the POC were summarized to experiential and behavioural process means, one transition from pre-contemplation was predicted by experiential processes and, contrary to the TTM, one transition predicted by behavioural processes. There was slightly more evidence that decisional balance (attitudes towards smoking) and temptation (ability to resist the urge to smoke) was associated with stage transition. Conclusions POC use was not associated generally with stage transition and evidence that effects, if missed, must be modest, giving no support to the central tenet of the TTM. [source] Outcome of psychological treatments of pathological gambling: a review and meta-analysisADDICTION, Issue 10 2005Ståle Pallesen ABSTRACT Aims To investigate the short- and long-term effect of psychological treatments of pathological gambling and factors relating to treatment outcome. Design and setting This study provides a quantitative meta-analytical review of psychotherapeutic treatments of pathological gambling. Studies were identified by computer search in the PsycINFO and Medline databases covering the period from 1966 to 2004, as well as from relevant reference lists. Inclusion criteria The target problem was pathological gambling, the treatment was psychological, the study was published in English and outcomes directly pertaining to gambling were employed. Single case studies, studies where elimination of gambling not was the priority and studies with insufficient statistical information were excluded from the present meta-analysis. Participants A total of 37 outcome studies, published or reported between 1968 and 2004, were identified. Of these 15 were excluded, thus 22 studies were included, involving 1434 subjects. The grand mean age was 40.1 years. The overall proportion of men was 71.5%. Measurements The included studies were coded for outcome measures of pathological gambling. For each condition, means and standard deviations for gambling-related outcome measures, all based upon self-reports or therapist ratings, were compiled at three points in time: baseline, post-treatment and the last follow-up reported. Findings Effect sizes represent the difference between the mean score in a treatment condition and a control condition or the difference between mean scores at separated points in time for one group, expressed in terms of standard deviation units. At post-treatment the analysis indicated that psychological treatments were more effective than no treatment, yielding an overall effect size of 2.01 (P < 0.01). At follow-up (averaging 17.0 months) the corresponding effect size was 1.59 (P < 0.01). A multiple regression analysis showed that the magnitude of effect sizes at post-treatment were lower in studies including patients with a formal diagnosis of pathological gambling only, compared to studies not employing such inclusion criteria. Effect sizes were also higher in randomized controlled trials compared to not randomized controlled trials, higher in within subjects designs compared to between subjects designs and also positively related to number of therapy sessions. No mediator variables were significantly related to the magnitude of the effect sizes at follow-up. Conclusion Psychological interventions for pathological gamble seem to be yield very favourable short- and long-term outcomes. [source] How can we increase the involvement of primary health care in the treatment of tobacco dependence?ADDICTION, Issue 3 2004A meta-analysis ABSTRACT Aims A systematic review of studies testing the effectiveness of educational and practice base strategies to increase the involvement of primary health-care practitioners in the treatment of tobacco dependence. Data sources MEDLINE, EMBASE, CINAHL and the Cochrane Library (1966,2001). Selection criteria included studies that used randomized or controlled clinical designs, controlled before and after trials and interrupted time-series designs and that presented objective and interpretable measures of practitioners' behaviour and biochemically verified patient quit rates. Review methods A meta-analysis, using a random effects model, of 24 programmes identified in 19 trials. Effect sizes were adjusted by inverse variance weights to control for studies' sample sizes. Findings Analyses to explain the heterogeneity of effect sizes found that interventions were equally effective in changing practitioners' screening and advice-giving rates and their patients' quit rates. Absolute increases for the intervention above the comparison groups were 15% (95% CI = 7,22) for screening rates, 13% (95% CI = 9,18) for advice-giving rates and 4.7% (95% CI = 2.5,6.9) for biochemically verified patient quit rates. Practitioners in training programmes were effective in changing their patients' quit rates but not their own screening rates; educational interventions were more effective than practice-based interventions. For established practitioners, programmes were effective in changing their screening and advice-giving rates, but not their patients' quit rates; a combination of practice-based and educational interventions were more effective. Conclusions Primary health-care practitioners can be engaged in the treatment of tobacco dependence to increase equally their screening and advice-giving rates and their patients' quit rates with outcomes of considerable public health and clinical significance. The provision of educational interventions for practitioners in training in combination with systematic outreach practice-based support for established practitioners is likely to be an effective strategy to increase smoking quit rates throughout primary health care. [source] A cross-national meta-analysis of alcohol and injury: data from the Emergency Room Collaborative Alcohol Analysis Project (ERCAAP)ADDICTION, Issue 9 2003Cheryl J. Cherpitel ABSTRACT Aims, To examine the relationship of acute alcohol consumption with an injury compared to a non-injury event in the emergency room across ERs in five countries. Design, Meta-analysis was used to evaluate the consistency and magnitude of the association of a positive blood alcohol concentration (BAC) at the time of arrival in the ER and self-reported consumption within 6 hours prior to the event with admission to the ER for an injury compared to a non-injury, and the extent to which contextual (socio-cultural and organizational) variables explain effect sizes. Findings, When controlling for age, gender and drinking five or more drinks on an occasion at least monthly, pooled effect size was significant and of a similar magnitude for both BAC and self-reported consumption, with those positive on either measure over half as likely again to be admitted to the ER with an injury compared to a medical problem. Effect sizes were found to be homogeneous across ERs for BAC, but not for self-report. Trauma center status and legal level of intoxication were positively predictive of self-reported consumption effect size on injury. Conclusions, These data suggest a moderate, but robust association of a positive BAC and self-report with admission to the ER with an injury, and that contextual variables also appear to play a role in the alcohol,injury nexus. [source] Stability and prediction of parenting stressINFANT AND CHILD DEVELOPMENT, Issue 2 2007Monica Östberg Abstract The study focused on stability and prediction of parenting stress experiences over a 6-year period. Mothers (N=93) who had received a clinical intervention for feeding or sleeping problems during infancy (Time 1; T 1) were followed-up when the children were 5,10 years old (Time 2; T 2). An age- and sex-of-child matched normal group was used for comparison of stress levels at T 2. Parenting stress was measured by the Swedish Parenthood Stress Questionnaire, which consists of a general parenting stress scale and sub-scales tapping different aspects of parenting stress experiences. T 1 predictors were clinical assessments of child problem load, maternal unresponsiveness, and family psychosocial problems. T 2 predictors were mother-reported concurrent child problem load and psychosocial problems. The individual stability in stress experiences was moderate. Effect sizes indicated that mothers with early clinical contacts had reduced their stress to levels close to those in the normal sample. Parenting stress at T 2 could be predicted from early and from concurrent child and family problems. The results point to the relevance of early clinical assessments and to the importance of a sub-area approach in parenting stress research, as there were differences between stress sub-areas regarding both prediction and stability. Copyright © 2007 John Wiley & Sons, Ltd. [source] Executive functioning deficits in relation to symptoms of ADHD and/or ODD in preschool childrenINFANT AND CHILD DEVELOPMENT, Issue 5 2006Lisa B. Thorell Abstract The present study investigated the relation between executive functioning and symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) in children aged 4,6. A population-based sample (n=201) was used and laboratory measures of inhibition, working memory and verbal fluency and teacher ratings of disruptive behaviour problems were collected. Both group differences and linear relations were studied and comorbidity was controlled for dimensionally. In both categorical and dimensional analyses, executive functioning was associated with symptoms of ADHD, but not with symptoms of ODD when controlling for comorbidity, and no significant interactive effects of ADHD and ODD symptoms were found. Effect sizes for significant effects were generally in the medium range. Regarding sex differences, the control for comorbid ODD symptoms appeared to affect the relation between ADHD symptoms and executive functioning somewhat more for girls compared with boys. In conclusion, poor executive functioning in preschool appears to be primarily related to symptoms of ADHD, whereas the relation to symptoms of ODD can be attributed to the large overlap between these two disruptive disorders. Copyright © 2006 John Wiley & Sons, Ltd. [source] Meta-analysis of the effectiveness of psychological and pharmacological treatments for binge eating disorderINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2010Silja Vocks PhD Abstract Objective: The aim of this study was to compute and compare mean effects of various treatments for binge eating disorder. Method: A total of 38 studies with 1973 participants fulfilled the defined inclusion criteria. Effect sizes, odds ratios, and simple rates were integrated in fixed and random (mixed) effects categorical models. Results: From randomized controlled trials, psychotherapy and structured self-help, both based on cognitive behavioral interventions, were found to have large effects on the reduction of binge eating. Regarding pharmacotherapy, mainly comprising antidepressants, randomized controlled trials revealed medium effects for the reduction of binge eating. Uncontrolled studies on weight-loss treatments demonstrated moderate reductions of binge eating. Combination treatments did not result in higher effects compared with single-treatment regimens. Except for weight-loss treatment, none of the interventions resulted in a considerable weight reduction. Discussion: Psychotherapy and structured self-help, both based on cognitive-behavioral interventions, should be recommended as the first-line treatments. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2010 [source] A meta-analytic examination of the relationship between child sexual abuse and eating disordersINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 2 2002Linda Smolak Abstract Objective This study had two goals. The first was to assess the magnitude and consistency of the relationship between child sexual abuse (CSA) and eating disorders (ED). The second was to examine methodological factors contributing to the heterogeneity of this relationship. Method Meta-analysis was used to examine both questions. Fifty-three studies were included in the analysis. Results A small, significant positive relationship between CSA and ED emerged. The relationship was marked by heterogeneity. Effect sizes were largest when CSA was the grouping variable, the Eating Disorders Inventory (EDI) or the Eating Attitudes Test (EAT) was used as the measure of eating disorders, and nonclinical groups were compared with clinical samples. Discussion Models of CSA and ED need to more clearly specify what aspects of ED (e.g., body image or binge eating) are most influenced by which types of CSA. These specific relationships then need to be examined empirically. © 2002 by Wiley Periodicals, Inc. Int J Eat Disord 31: 136,150, 2002; DOI 10.1002/eat.10008 [source] Dementia, cognitive impairment and mortality in persons aged 65 and over living in the community: a systematic review of the literatureINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2001Michael E. Dewey Abstract Background No recent attempt has been made to synthesise information on mortality and dementia despite the theoretical and practical interest in the topic. Our objective was to estimate the influence on mortality of cognitive impairment and dementia. Methods Data sources were Medline, Embase, personal files and colleagues' records. Studies were considered if they included a majority of persons aged 65 and over at baseline either drawn from a total community sample or drawn from a random sample from the community. Samples from health care facilities were excluded. The search located 68 community studies. Effect sizes were extracted from the studies and if they were not included in the published studies, effect sizes were calculated where possible: this was possible for 23 studies of cognitive impairment and 32 of dementia. No attempt was made to contact authors for missing data. Results For the studies of cognitive impairment Fisher's method (a vote counting method), gave a p -value (from eight studies) of 0.00001. For studies of dementia, age-adjusted confidence intervals (CI) were pooled (odds ratio (OR) 2.63 with 95% CI 2.17 to 3.21 from six studies). Conclusions Levels of cognitive impairment commonly found in community studies give rise to an increased risk of mortality, and this appears to be true even for quite mild levels of impairment. The analysis confirms the increased risk of mortality for dementia, but reveals a dearth of information on the causes of the excess mortality and on possible effect modification by age, dementia subtype or other variables. Copyright © 2001 John Wiley & Sons, Ltd. [source] Depression, depressive symptoms and mortality in persons aged 65 and over living in the community: a systematic review of the literatureINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 6 2001Pedro Saz Abstract Background No recent attempt has been made to synthesize information on mortality and depression despite the theoretical and practical interest in the topic. Our objective was to estimate in the older population the influence on mortality of depression and depressive symptoms. Methods Data sources were: Medline, Embase, personal files and colleagues' records. Studies were considered if they included a majority of persons aged ,,65 years at baseline either drawn from a total community sample or drawn from a random sample from the community. Samples from healthcare facilities were excluded. Effect sizes were extracted from the papers; if they were not included in the published papers, effect sizes were calculated if possible. No attempt was made to contact authors for missing data. Results We found 21 reports on 23 cohorts using depression diagnosis. For 15 of these, odds ratios were pooled using the Greenland method based on confidence intervals (CIs), giving an estimated odds ratio for mortality with depression of 1.73 (95% CI 1.53 to 1.95). A fixed effects meta-regression of these studies suggested that longer follow-up predicted smaller effect sizes (log odds ratios ,0.096 per year (95% CI ,0.179 to ,0.014)). There is a weak suggestion of a reduced effect of depression on mortality for women. We were unable to pool effect sizes from the 17 studies using symptom totals and scales, or from eight studies of specific symptoms. Conclusions The studies show that diagnosed depression in community-resident older people is associated with increased mortality. The picture for sex differences is still unclear. Copyright © 2001 John Wiley & Sons, Ltd. [source] Is the Child Oral Health Quality of Life Questionnaire Sensitive to Change in the Context of Orthodontic Treatment?JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2008A Brief Communication Abstract Objective: This study aimed to assess the ability of the Child Oral Health Quality of Life Questionnaire (COHQoL) to detect change following provision of orthodontic treatment. Methods: Children were recruited from an orthodontic clinic just prior to starting orthodontic treatment. They completed a copy of the Child Perception Questionnaire, while their parents completed a copy of the Parents Perception Questionnaire and the Family Impact Scale. Normative outcomes were assessed using the Dental Aesthetic Index (DAI) and the Peer Assessment Rating (PAR) index. Change scores and effect sizes were calculated for all scales. Results: Complete data were collected for 45 children and 26 parents. The mean age was 12.6 years (standard deviation = 1.4). There were significant pre-/posttreatment changes in DAI and PAR scores and significant changes in scores on all three questionnaires (P < 0.05). Effect sizes for the latter were moderate. Global transition judgments also confirmed pre-/posttreatment improvements in oral health and well-being. Conclusion: The results provide preliminary evidence of the sensitivity to change of the COHQoL questionnaires when used with children receiving orthodontic treatment. However, the study needs to be repeated in different treatment settings and with a larger sample size in order to confirm the utility of the measure. [source] Long-term effects of a psycholinguistic treatment for dyslexiaJOURNAL OF RESEARCH IN READING, Issue 2 2003Jurgen Tijms Short and long-term effects of a treatment for dyslexia are evaluated. The treatment is based on psycholinguistic theory and assumes that dyslexia is due to poor lexico-phonological processing of words. The treatment is computer-based and focuses on learning to recognise and to make use of the phonological and morphological structure of Dutch words. The results of the treatment were clear improvements in reading words, reading text and spelling. Effect sizes of standardised treatment gains were large (Cohen's d>0.80 for all variables). Following the treatment, participants attained an average level of text-reading and spelling. The attained level of reading words and reading text was found to be stable over a four-year follow-up period. Spelling showed a slight decline one year after the treatment, but remained stable thereafter.1 [source] Problem-based learning: why curricula are likely to show little effect on knowledge and clinical skillsMEDICAL EDUCATION, Issue 9 2000Mark Albanese Objectives A recent review of problem-based learning's effect on knowledge and clinical skills updated findings reported in 1993. The author argues that effect sizes (ES) seen with PBL have not lived up to expectations (0.8,1.0) and the theoretical basis for PBL, contextual learning theory, is weak. The purposes of this study were to analyse what constitutes reasonable ES in terms of the impacts on individuals and published reports, and to elaborate upon various theories pertaining to PBL. Design Normal theory is used to demonstrate what various ESs would mean for individual change and a large meta-analysis of over 10 000 studies is referred to in identifying typical ESs. Additional theories bearing upon PBL are presented. Results Effect sizes of 0.8,1.0 would require some students to move from the bottom quartile to the top half of the class or more. The average ES reported in the literature was 0.50 and many commonly used and accepted medical procedures and therapies are based upon studies with ESs below 0.50. Conclusions Effect sizes of 0.8,1.0 are an unreasonable expectation from PBL because, firstly, the degree of changes that would be required of individuals would be excessive, secondly, leading up to medical school, students are groomed and selected for success in a traditional curriculum, expecting them to do better in a PBL curriculum than a traditional curriculum is an unreasonable expectation, and, thirdly, the average study reported in the literature and many commonly used and accepted medical procedures and therapies are based upon studies having lesser ESs. Information-processing theory, Cooperative learning, Self-determination theory and Control theory are suggested as providing better theoretical support for PBL than Contextual learning theory. Even if knowledge acquisition and clinical skills are not improved by PBL, the enhanced work environment for students and faculty that has been consistently found with PBL is a worthwhile goal. [source] The responsiveness of the OAB-q among OAB patient subgroups,NEUROUROLOGY AND URODYNAMICS, Issue 2 2007Karin S. Coyne Abstract Aims Although the majority of patients with overactive bladder (OAB) are continent, most patient-reported outcome measures for OAB were designed for patients with urinary incontinence. The overactive bladder questionnaire (OAB-q) was developed to assess symptom bother and HRQL among both continent and incontinent OAB patients; however, the responsiveness of the OAB-q among continent patients has not been evaluated. The purpose of this analysis was to assess the responsiveness of the OAB-q among OAB patient subgroups with a focus on continent patients. Methods Post-hoc analyses were conducted from two 12-week trials of tolterodine for the treatment of OAB. Patients completed the OAB-q and daily bladder diaries (assessing frequency, urgency, and incontinence episodes) at baseline, 4 weeks, and 12 weeks. Three patient subgroups were identified on the basis of continence status at all three timepoints: (1) continent; (2) incontinent; and (3) incontinent at baseline and continent by Week 12 (ITC). General linear models were used to compare changes from baseline, and Spearman correlations assessed the association between OAB-q changes and bladder diary changes. Effect sizes were computed separately for each group. Results A total of 262 continent, 552 incontinent, and 397 ITC patients were included in this analysis. Continent patients tended to be younger than incontinent patients, and patients were predominantly female, although continent patients had the highest percentage of male patients in both studies. Compared with continent patients, patients who were incontinent at baseline tended to have greater symptom bother and lower HRQL at baseline. All OAB-q change scores were consistently greatest for the ITC group (12.1,33.9), and greater for continent patients (10.8,28.6) than for incontinent patients (7.6,20.1). All three groups of patients experienced reductions in frequency and urgency episodes, and these changes were significantly correlated with changes in the OAB-q scales. Among all three groups, effect sizes were in the moderate-to-large range for all OAB-q subscales except Social Interaction. Conclusions The OAB-q is highly responsive to change between continent and incontinent patients with OAB, and is a valid tool for measuring treatment outcomes among continent OAB patients. Neurourol. Urodynam. 26:196,203, 2007. © 2006 Wiley-Liss, Inc. [source] | |||||||||||||||||||||||||||||||||||||||||||