Standardized Mean Difference Effect Size Research Articles

Effectiveness of osteopathic craniosacral techniques: a meta-analysis.

Craniosacral osteopathic manipulative medicine-also known as craniosacral therapy (CST)-is a widely taught and used component of osteopathic medicine. This paper seeks to systematically review and conduct a meta-analysis of randomized controlled trials assessing the clinical effectiveness of CST compared to standard care, sham treatment, or no treatment in adults and children. A search of Embase, PubMed, and Scopus was conducted on 10/29/2023 and updated on 5/8/2024. There was no restriction placed on the date of publication. A Google Scholar search was conducted to capture grey literature. Backward citation searching was also implemented. All randomized controlled trials employing CST for any clinical outcome were included. Studies not available in English as well as studies that did not report adequate data were excluded. Multiple reviewers were used to assess for inclusions, disagreements were settled by consensus. PRISMA guidelines were followed in the reporting of this meta-analysis. Cochrane's Risk of Bias 2 tool was used to assess for risk of bias. All data were extracted by multiple independent observers. Effect sizes were calculated using a Hedge's G value (standardized mean difference) and aggregated using random effects models. The GRADE system was used to assess quality of evidence. The primary study outcome was the effectiveness of CST for selected outcomes as applied to non-healthy adults or children and measured by standardized mean difference effect size. Twenty-four RCTs were included in the final meta-analysis with a total of 1,613 participants. When subgroup analyses were performed by primary outcome only, no significant effects were found. When secondary outcomes were included in subgroup analyses, results showed that only Neonate health, structure (g = 0.66, 95% CI [0.30; 1.02], Prediction Interval [-0.73; 2.05]) and Pain, chronic somatic (g = 0.34, 95% CI [0.18; 0.50], Prediction Interval [-0.41; 1.09]) show reliable, statistically significant effect. However, these should not be interpreted as positive results as wide prediction intervals, high bias, and statistical limitations temper the real-world implications of this finding. CST demonstrated no significant effects in this meta-analysis, indicating a lack of usefulness in patient care for any of the studied indications.Pre-registration available at https://doi.org/10.17605/OSF.IO/54K6G. https://osf.io/57t4w.

Recommendations for analysing and meta-analysing small sample size software engineering experiments

ContextSoftware engineering (SE) experiments often have small sample sizes. This can result in data sets with non-normal characteristics, which poses problems as standard parametric meta-analysis, using the standardized mean difference (StdMD) effect size, assumes normally distributed sample data. Small sample sizes and non-normal data set characteristics can also lead to unreliable estimates of parametric effect sizes. Meta-analysis is even more complicated if experiments use complex experimental designs, such as two-group and four-group cross-over designs, which are popular in SE experiments.ObjectiveOur objective was to develop a validated and robust meta-analysis method that can help to address the problems of small sample sizes and complex experimental designs without relying upon data samples being normally distributed.MethodTo illustrate the challenges, we used real SE data sets. We built upon previous research and developed a robust meta-analysis method able to deal with challenges typical for SE experiments. We validated our method via simulations comparing StdMD with two robust alternatives: the probability of superiority (p^\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\hat{p}$$\\end{document}) and Cliffs’ d.ResultsWe confirmed that many SE data sets are small and that small experiments run the risk of exhibiting non-normal properties, which can cause problems for analysing families of experiments. For simulations of individual experiments and meta-analyses of families of experiments, p^\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\hat{p}$$\\end{document} and Cliff’s d consistently outperformed StdMD in terms of negligible small sample bias. They also had better power for log-normal and Laplace samples, although lower power for normal and gamma samples. Tests based on p^\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\hat{p}$$\\end{document} always had better or equal power than tests based on Cliff’s d, and across all but one simulation condition, p^\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\hat{p}$$\\end{document} Type 1 error rates were less biased.ConclusionsUsing p^\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\hat{p}$$\\end{document} is a low-risk option for analysing and meta-analysing data from small sample-size SE randomized experiments. Parametric methods are only preferable if you have prior knowledge of the data distribution.

Benefits of specialist palliative care by identifying active ingredients of service composition, structure, and delivery model: A systematic review with meta-analysis and meta-regression.

Specialist palliative care (SPC) services address the needs of people with advanced illness. Meta-analyses to date have been challenged by heterogeneity in SPC service models and outcome measures and have failed to produce an overall effect. The best service models are unknown. We aimed to estimate the summary effect of SPC across settings on quality of life and emotional wellbeing and identify the optimum service delivery model. We conducted a systematic review with meta-analysis and meta-regression. Databases (Cochrane, MEDLINE, CINAHL, ICTRP, clinicaltrials.gov) were searched (January 1, 2000; December 28, 2023), supplemented with further hand searches (i.e., conference abstracts). Two researchers independently screened identified studies. We included randomized controlled trials (RCTs) testing SPC intervention versus usual care in adults with life-limiting disease and including patient or proxy reported outcomes as primary or secondary endpoints. The meta-analysis used, to our knowledge, novel methodology to convert outcomes into minimally clinically important difference (MID) units and the number needed to treat (NNT). Bias/quality was assessed via the Cochrane Risk of Bias 2 tool and certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. Random-effects meta-analyses and meta-regressions were used to synthesize endpoints between 2 weeks and 12 months for effect on quality of life and emotional wellbeing expressed and combined in units of MID. From 42,787 records, 39 international RCTs (n = 38 from high- and middle-income countries) were included. For quality of life (33 trials) and emotional wellbeing (22 trials), statistically and clinically significant benefit was seen from 3 months' follow-up for quality of life, standardized mean difference (SMD in MID units) effect size of 0.40 at 13 to 36 weeks, 95% confidence interval (CI) [0.21, 0.59], p < 0.001, I2 = 60%). For quality of life at 13 to 36 weeks, 13% of the SPC intervention group experienced an effect of at least 1 MID unit change (relative risk (RR) = 1.13, 95% CI [1.06, 1.20], p < 0.001, I2 = 0%). For emotional wellbeing, 16% experienced an effect of at least 1 MID unit change at 13 to 36 weeks (95% CI [1.08, 1.24], p < 0.001, I2 = 0%). For quality of life, the NNT improved from 69 to 15; for emotional wellbeing from 46 to 28, from 2 weeks and 3 months, respectively. Higher effect sizes were associated with multidisciplinary and multicomponent interventions, across settings. Sensitivity analyses using robust MID estimates showed substantial (quality of life) and moderate (emotional wellbeing) benefits, and lower number-needed-to-treat, even with shorter follow-up. As the main limitation, MID effect sizes may be biased by relying on derivation in non-palliative care samples. Using, to our knowledge, novel methods to combine different outcomes, we found clear evidence of moderate overall effect size for both quality of life and emotional wellbeing benefits from SPC, regardless of underlying condition, with multidisciplinary, multicomponent, and multi-setting models being most effective. Our data seriously challenge the current practice of referral to SPC close to death. Policy and service commissioning should drive needs-based referral at least 3 to 6 months before death as the optimal standard of care.

Using Extant Data to Improve Estimation of the Standardized Mean Difference

This article presents methods for using extant data to improve the properties of estimators of the standardized mean difference (SMD) effect size. Because samples recruited into education research studies are often more homogeneous than the populations of policy interest, the variation in educational outcomes can be smaller in these samples than is reflective of the true variation in the population. This affects effect size estimation since the sample standard deviation is used in the denominator of the SMD. We propose leveraging extant data on sample variance estimates from multiple studies, made available via clearinghouse databases such as the What Works Clearinghouse, to standardize a mean difference. This allows effect sizes to be benchmarked across a common and broad population, thus enabling better comparability across studies and interventions. We derive the new estimators of the population variance and the corresponding SMD, which pool sample variances from multiple studies using both an analysis of variance and a meta-analytic framework. We demonstrate the properties of these estimators via analytic and simulation results and offer recommendations for when these estimators are appropriate in practice.

The Effectiveness of Concept Maps on Students’ Achievement in Science: A Meta-Analysis

This study aims to evaluate the effectiveness of concept maps on science achievement among elementary and secondary education students, including low-achieving students. A systematic search located 55 studies about concept mapping in science achievement published in peer-reviewed journals and dissertations between 1980 and 2020. We extracted 58 independent standardized mean difference effect sizes from 55 eligible studies involving 5,364 students from Grade 3 to Grade 12 who used concept maps for learning in physics/earth science, chemistry, and biology that met the specified design criteria. A random-effects model meta-analysis revealed that the mean effect size was moderate for overall science (g = 0.776). The mean effect sizes varied from moderate to large based on the subject area (g = 0.671 for biology; g = 0.590 for chemistry; g = 1.040 for physics and earth science); these differences between groups were not statistically significant (p = 0.220). Concept maps were generally associated with increased science learning across several learning and teaching conditions, and methodological features (low-achieving students, higher teaching guidance, intermediate grades, low- or middle-income countries, journal publications, and late year of publication). However, we found significant heterogeneity in most subsets. Implications for future research and practice recommendations are discussed.

Physical practice, mental practice or both: a systematic review with meta-analysis

Introduction: Previous research has reached positive conclusions regarding the effects of mental practice on performance and learning of a motor skill. The purpose of this study was to use the aggregate data meta-analytic approach to assess the impact of physical practice (PP), mental practice (MP), and the combination of both on acquisition, retention, and transfer tests in motor skill performance. Methodology: Twenty-seven studies published up to 2022 were included by searching six databases. Random effects model using the standardized mean difference effect size (ES) was used to pool results. Results: A total of 42 ES, were calculated and separated into pairwise comparisons for acquisition, retention, and transfer phase. In the acquisition phase, it was found that MP was more effective than no practice (ES=0.508; n=25; CI=0.29,0.72), PP was more effective than no practice (ES=1.78; n=15; CI=0.97,2.60), CP was more effective than no practice (ES=1.16; n=12; CI=0.57,1.75), PP was more effective than MP (ES=-1.16; n=23; CI=-1.88,-0.45), PP had similar results as CP (ES=-0.01; n=16; CI=-0.31,0.28), and CP was more effective than MP (ES=0.61; n=12; CI=0.17,1.04). In the retention phase, it was found that MP was more effective than no practice (ES=1.11; n=5; CI=0.44,1.79), PP was more effective than no practice (ES=1.03; n=4; CI=0.08, 1.99), PP was more effective than MP (ES=-1.29; n=9; CI=-3.12,0.54), PP had similar results as CP (ES=0.16; n=8; CI=-0.29,0.63), CP had similar results as MP (ES=-0.06; n=3; CI=-1.22,1.09). In the transfer phase, it was found that MP was more effective than no practice (ES=1.12; n=5; CI=0.01,1.59), PP had similar results as no practice (ES=0.41; n=5; CI=-0.02,0.85), and PP was more effective than MP (ES=0.50; n=6; CI=0.12,0.87). Age, skill level, type of mental practice, total of sessions, and type of skill were considered as possible moderator variables. Conclusions: Mental practice does not replace physical practice, however, under some conditions, physical practice can be complemented with mental practice.

Effectiveness of digital health interventions to increase cardiorespiratory fitness: A systematic review and meta-analysis.

Interventions using commercial digital health tools do favorably affect health outcomes. However, the effect of digital tools on cardiorespiratory fitness, a more novel indicator cardiovascular risk, is unclear. Synthesize the digital health intervention literature and answer the following question: What is the effect of interventions using mobile health apps, wearable activity trackers, and/or text messaging on cardiorespiratory fitness? A systematic review and a meta-analysis (PROSPERO CRD42023423925) were conducted to evaluate the immediate digital health intervention effect on adult cardiorespiratory fitness. In March 2023, a search of databases Embase, MEDLINE, CINHAL, and Cochrane Library was completed. Studies were included if the intervention used a mobile health app, text messaging, and/or activity tracker. Studies were excluded if an objective measure of fitness was not used; the sample included children; the setting was hospital-based; and the digital health technology was only used for data collection or described as virtual reality. Using a random-effects model, two separate meta-analyses were completed: one for single-group studies and one for multi-group studies. Standardized mean difference effect sizes (Cohen's d) were calculated. Study quality was evaluated with the Cochrane Risk of Bias tool and ROBINS-I tool. Fifty-three studies (3657 individuals) with pre-post designs (12 single-group, 41 multi-group) were included. Most studies targeted participants with a specific chronic health condition. Digital health interventions in the single-group studies had a moderate-to-large effect size (d = 0.62, 95% confidence interval (CI) [0.41-0.84], p < 0.001), and multi-group studies had small-to-moderate effect size (d = 0.38, 95% CI 0.21-0.55, p < 0.001). Significant heterogeneity of effects was observed in both the single-group and multi-group studies. Interventions using text messaging, a mobile app, or activity tracker alone or in combination are effective in improving cardiorespiratory fitness in adults, particularly for those with a chronic health condition.

The effect of mindfulness interventions on stress in medical students: A systematic review and meta-analysis.

Medical students have high levels of stress, which is associated with higher incidents of burnout, depression, and suicide compared to age-matched peers. Mindfulness practices have been shown to reduce stress among medical students. The purpose of this systematic review and meta-analysis was to examine if mindfulness interventions have an overall effect on stress outcomes in the high-stress population of medical students globally, particularly given the wide variety of interventions. Any intervention designed to promote mindfulness was included. A comprehensive literature search was completed to include multiple databases, ancestry, and hand-searching and 35 studies were included. Standardized mean difference effect sizes (ES) were synthesized across studies using a random-effects model for changes in stress levels in medical students ≥ 18. Moderator analyses were performed to explore variations in effects by participant and intervention characteristics. Mindfulness interventions significantly improved stress among medical students in both the two-arm studies (d = 0.370, k = 19, n = 2,199, 95% CI 0.239-0.501, p < .001) and one-arm pre-post studies (d = 0.291, k = 30, n = 18 (two cohorts from Dyrbye et al), 95% CI 0.127-0.455, p = 0.001). Moderator analyses found trends in less hours and less required practice resulted in better improvement in stress. This study further confirms that despite a wide variety of mindfulness interventions for medical students around the world, they produce an overall small-to-moderate effect on stress reduction. Future research looking at the most effective protocols for high-stress medical students would be beneficial.

The Effects of Strength and Conditioning Interventions on Sprinting Performance in Team Sport Athletes: A Systematic Review and Meta-Analysis.

Abstract Murphy, A, Burgess, K, Hall, AJ, Aspe, RR, and Swinton, PA. The effects of strength and conditioning interventions on sprinting performance in team sport athletes: a systematic review and meta-analysis. J Strength Cond Res 37(8): 1692–1702, 2023—Linear sprinting is a key determinant of athletic performance within team sports. The aims of the review were to quantify and compare the effectiveness of popular strength and conditioning (S&amp;C) training modes to improve sprint performance in team sport athletes, with additional focus on potential moderators and the relationships between improvements in physical factors (e.g., strength, power, and jump performance) and improvements in sprint performance. Inclusion was restricted to resistance, plyometric, sprint, and combined training interventions comprising team sport athletes. Multilevel, Bayesian’s meta-analysis and meta-regression models conducted with standardized mean difference effect sizes were used to investigate training modes and potential moderators. Weighted regression models conducted on shrunken estimates from initial Bayesian’s meta-analyses were used to quantify relationships between improvements in physical factors and sprint performance. Certainty of evidence was assessed using the grading of recommendations assessment development and evaluation (GRADE) approach. Similar improvements in sprint performance were obtained across training modes, with some evidence of the largest effects with resistance training ( = 0.55 [95% credible interval [CrI]: 0.36–0.78; very low certainty]). A strong moderating effect of training intensity was identified across all training modes with evidence of greater improvements in sprint performance with high-intensity training ( = 0.17 [95% CrI: 0.01–0.33; very low certainty]). Strong positive relationships were identified between improvements in all physical factors and sprint performance ( = 0.56 [95% CrI: 0.36–0.77; low certainty], = 0.80 [95% CrI: 0.50–1.0; low certainty], = 0.78 [95% CrI: 0.57–0.97; low certainty]). The findings indicate that focus on developing speed in team sport athletes should be placed on S&amp;C training with high intensities, including the use of resisted sprint training.

A Meta-Analysis on Behavioral Support Training and General Education Teacher Implementation

The success of teachers is tied to their effectiveness in managing student behavior. In this meta-analysis, we identified 49 single-case-design studies that evaluated the effectiveness of teacher training on their implementation of behavioral support strategies. Training was most often provided in a one-on-one format ( n = 18) and included ongoing coaching ( n = 20). Thirty-three of the 49 designs met What Works Clearinghouse standards with or without reservations. The overall between-case standardized mean difference effect size was d = 1.50. We analyzed and grouped teacher- and student-level outcomes as a result of training into five domains: (a) teacher-delivered praise ( d = 1.94), (b) teacher desirable behavior (e.g., treatment fidelity; d = 1.22), (c) teacher undesirable behavior (e.g., reprimands; d = 0.87), (d) student desirable behavior ( d = 1.88), and (e) student undesirable behavior ( d = 1.22). Across all studies, the combined nonoverlap of all pairs scores ranged from 0.37 to 1.0 ( M = 0.866). We discuss future areas of research as well as implications for teacher training in behavioral support implementation.

Between-case standardized mean differences: Flexible methods for single-case designs

Single-case designs (SCDs) are a class of research methods for evaluating the effects of academic and behavioral interventions in educational and clinical settings. Although visual analysis is typically the first and main method for analysis of data from SCDs, quantitative methods are useful for synthesizing results and drawing systematic generalizations across bodies of single-case research. Researchers who are interested in synthesizing findings across SCDs and between-group designs might consider using the between-case standardized mean difference (BC-SMD) effect size, which aims to put results from both types of studies into a common metric. Currently available BC-SMD methods are limited to treatment reversal designs with replication across participants and across-participant multiple baseline designs, yet more complex designs are sometimes used in practice. In this study, we extend available BC-SMD methods to several variations of the multiple baseline design, including the replicated multiple baseline across behaviors or settings, the clustered multiple baseline design, and the multivariate multiple baseline across participants. For each variation, we describe methods for estimating BC-SMD effect sizes and illustrate our proposed approach by re-analyzing data from a published SCD study.

Response of peer relations and social activities to treatment with viloxazine extended-release capsules (Qelbree® ): A post hoc analysis of four randomized clinical trials of children and adolescents with attention-deficit/hyperactivity disorder.

Attention-deficit/hyperactivity disorder (ADHD) is associated with impairments related to peer relations (PR) and social activities (SA). The objective of this post hoc analysis was to assess the degree to which viloxazine extended-release (viloxazine ER; viloxazine extended-release capsules; Qelbree® ) improves clinical assessments of PR and SA in children and adolescents with ADHD. Data were used from four Phase III placebo-controlled trials of 100 to 600mg/day of viloxazine ER (N=1354; 6-17 years of age). PR and SA were measured with the Peer Relations content scale of the Conners 3rdEditionParent Short Form'sPeerRelationcontentscale (C3PS-PR) and the Social Activities domain of the Weiss Functional Impairment Rating Scale-ParentReport's(WFIRS-P-SA) at baseline and end of study. ADHD symptoms were assessed weekly with the ADHD Rating Scale, 5th Edition. The analyses relied on the general linear mixed model with the subject as a random effect. Improvement in C3PS-PR (p=.0035) and WFIRS-P-SA (p=.0029) scores were significantly greater in subjects treated with viloxazine ER compared with placebo. When using measures of clinically meaningful response, the C3PS-PR responder rate was significantly higher for viloxazine ER (19.2%) compared with placebo (14.1%) and the difference was statistically significant (p=.0311); the Number Needed to Treat (NNT) was 19.6. The WFIRS-P-SA responder rate was significantly higher for viloxazine ER (43.2%) compared with placebo (28.5%) and the difference was statistically significant (p<.0001); the NNT was 6.8. The standardized mean difference effect size for both PR and SA was 0.09. Viloxazine ER significantly reduces the impairment of PR and SA in children and adolescents with ADHD. Although its effects on PR and SA are modest, many ADHD patients can be expected to achieve clinically meaningful improvements in PR and SA with viloxazine ER treatment for longer than 6 weeks.

No Meta-analytic Evidence for Risks due to Prenatal Magnetic Resonance Imaging in Animal Models

BackgroundMagnetic resonance imaging (MRI) is a powerful, noninvasive tool for both clinical practice and research. Though the safety of MRI has been endorsed by many professional societies and government bodies, some concerns have remained about potential risk from prenatal MRI. Case-control animal studies of MRI scanning during gestation and effects on offspring are the most direct test available for potential risks. We performed a meta-analysis of extant animal studies of prenatal MRI examining reproductive and offspring outcomes. MethodsRelevant articles were identified through PubMed search and citation searching of known articles and review papers. Eighteen relevant studies were identified with case-control designs of prenatal scanning conducted in vivo with mammalian species using MRI-relevant field strength. Standardized mean difference effect sizes were analyzed across k = 81 outcomes assessed across 649 unexposed dams, 622 exposed dams, 3024 unexposed offspring, and 3328 exposed offspring using a multilevel meta-analytic approach that clustered effect sizes within publications. ResultsThe meta-analysis indicated no significant evidence for a deleterious effects of prenatal MRI (standardized mean difference = 0.17, 95% CI [−0.19, 0.54], t80 = 0.94, p = .35) across outcomes. Similarly, no effects were observed when separately examining the 4 most commonly assessed outcomes: birth weight, litter size, fetal viability, and physical malformations (p > .05). ConclusionsCase-control mammalian animal studies indicate no significant known risks of prenatal MRI to reproductive outcomes or offspring development. This finding is largely mirrored in human research, though the lack of randomized case-control designs limits direct comparison. The current findings provide additional support to the prevailing consensus that prenatal MRI poses no known risk to offspring.

Nutritional rehabilitation after acute illness among older patients: A systematic review and meta-analysis

Acute illness can lead to disability and reduced quality of life in older patients. The aim of this systematic review was to evaluate the effect of nutritional rehabilitation provided during and after hospitalisation for an acute event on functional status, muscle mass, discharge destination and quality of life of older patients. The protocol for this systematic review was registered in PROSPERO (CRD42021264971). Articles were searched using Scopus, Medline, Google Scholar and Clinical. gov. For studies included in the meta-analysis, Hedges'g standardized mean difference effect size was calculated and transformed in odds ratios. We identified 7383 articles, of which 45 publications (41 trials, n=8538 participants, mean age 80.35±7.01 years.) were eligible for the systematic review. Patients were hospitalized for acute medical diseases (n=6925) and fractures (n=1063). The interventions included supplementation with a fixed amount of oral nutritional supplements (ONS, n=17 trials), individualized diet plan (n=3), combination of physical exercise with nutrition therapy (n=14 trials), combination of anabolic agents with nutrition therapy (n=5 trials). Overall nutritional rehabilitation improved functional status (Odds ratio 1.63 [1.15; 2.3], p=0.003) and muscle mass (Odds ratio 2.61 [1.22; 5.5], p=0.01), but not the quality of life or the discharge destination. Nutritional rehabilitation was found to improve functional status and muscle mass. There is a need for larger studies involving older hospitalized patients.

Physical punishment and child, adolescent, and adult outcomes in low- and middle-income countries: protocol for systematic review and meta-analysis

BackgroundPhysical punishment at home and in schools is widespread around the world. Systematic reviews and meta-analyses have synthesized evidence, mostly from high-income countries (HICs), showing that physical punishment relates to multiple detrimental individual outcomes. Yet, less work has been done to synthesize the evidence on the association between physical punishment at home and schools and child, adolescent, and adult outcomes in low- and middle-income countries (LMICs), where more than 90% of children live and physical punishment is most socially normative and prevalent. In this manuscript, we present a protocol for a systematic review and meta-analysis on the characteristics of the research, associations, and variation in associations, between physical punishment at home and in schools and child, adolescent, and adult outcomes in LMICs.MethodsWe will conduct a review of studies published in peer-reviewed journals using quantitative methods to assess the association between physical punishment in childhood and/or adolescence and individual outcomes in LMICs. We will search for studies in 10 different databases using keywords in English, Spanish, Portuguese, Arabic, and Chinese related to physical punishment. We will extract qualitative data from the studies and the statistics needed to transform all study-level effect sizes into standardized mean difference effect sizes. For the analyses, we will employ multi-level meta-analyses to use multiple effect sizes per study and leverage within-study variation as well as between study variation using moderation analysis. Besides the meta-analyses, we will also conduct a narrative synthesis of the findings.DiscussionThe proposed systematic review and meta-analysis will provide timely evidence to inform global research, policy, and practice on the links between physical punishment and lifelong individual outcomes.Systematic review registrationPROSPERO CRD42022347346

Systematic Review and Meta-Analysis of Primary Care-Based Physical Activity Interventions Among Older Adults.

The purpose of this research is to identify the effectiveness of primary care-based interventions designed to increase older adults' physical activity (PA). Primary care was defined as a patient's main source of health care. Standardized mean difference effect size (ES) was calculated related to changes in PA levels in adults' ≥65. Moderator analysis was performed to explore the relationship between participant characteristics, interventions, interventionists, and ES. Overall mean ES 0.27 (95% confidence interval [0.15, 0.39], p < .01) was calculated for 25 two-group comparisons involving 4,685 total participants with a mean age of 75.08. There was little evidence to support counseling over exercise referrals. The use of theory or a pedometer did not modify the ES. PA interventions delivered in primary care are effective and can be delivered by other health-care providers working with the primary provider. Many different behavior change strategies may be used to promote PA.

Exploring classroom practices associated with greater student engagement that may benefit low-income students in the early grades

Previous research has identified specific classroom practices that are associated with greater academic and self-regulation gains for students in prekindergarten (PreK) and kindergarten (K) classrooms. These practices include reducing time in transition, more time in sequential activities, more opportunities for associative and cooperative interactions, more math, teachers’ using higher levels of instruction, positive classroom climate, and more teacher listening to children. This cross-sectional study aims to determine whether these specific classroom practices are associated with higher student engagement. A secondary goal was to examine whether economically disadvantaged (ED) students in more engaged classrooms scored higher on measures of math, language, and literacy. Researchers collected individual student assessment data in math, language, and literacy for a sample of 407 PreK and K students and conducted day-long observations in their classrooms. In addition to collecting behavioral count data on the focal classroom practices, observers rated students’ engagement across the day. Results revealed that students who experienced more of the beneficial classroom practices also showed higher engagement. Covariate-adjusted standardized mean difference effect sizes showed the greatest differences for transition time, sequential activities, associative and cooperative interactions, teachers’ listening, the amount of instruction, behavior approvals, and teacher tone, indicating that students experiencing more of these practices were more engaged than students experiencing fewer of these practices. To address our secondary goal of exploring between-group differences on assessments, we created groups based on ED status and engagement (operationalized using a median split for student engagement). While assessment scores were higher for non-ED students than ED students, regardless of their level of engagement, based on the literature researchers expected that ED students who were more engaged would have higher scores on assessments than their less engaged counterparts. Contrary to this hypothesis, there were few differences across groups. The largest positive effect sizes were for math and vocabulary. ED students with higher engagement hadlower, not higher, scores on measures of literacy and passage comprehension. However, the magnitude of these effect sizes was small. Results provide preliminary evidence that these specific classroom practices are associated with greater student engagement.

A Meta-Analysis on the Effects of Problem-Posing in Mathematics Education on Performance and Dispositions

ABSTRACT The purpose of this meta-analysis is to examine the effect of problem-posing on students’ mathematical academic outcomes, including problem-solving skills, problem-posing skills, mathematical dispositions, and mathematics achievement. Twenty-one studies that were published between 1990 and 2019 with problem-posing as the intervention were included in the meta-analysis. A random-effects model was employed with robust variance estimation (RVE) to correct for the intercorrelation between effect sizes when necessary. The estimated average standardized mean difference effect size of problem-posing interventions (g = 0.64) demonstrated that problem-posing had a positive impact on students’ academic outcomes. Specifically, across the interventions, students’ problem-solving skills and mathematical achievement improved by engaging in problem-posing activities. The moderator analyses revealed that problem-posing interventions were more effective when structured, semi-structured, and free problem-posing tasks were all implemented, and longer-duration intervention was associated with larger improvement in students’ mathematical dispositions.

Eating-disorder psychopathology in female athletes and non-athletes: A meta-analysis.

There is ongoing discussion about whether sports participation is a risk or protective factor for eating disorders (EDs). Research is mixed, with some studies suggesting that athletes have higher mean levels of ED psychopathology compared to nonathletes, while other studies suggest the opposite effect or no differences. The purpose of the current meta-analysis was to identify whether female athletes reported higher mean levels of ED psychopathology compared to nonathletes. Following PRISMA guidelines, we identified 56 studies that reported ED psychopathology for female athletes and nonathletes. A three-level random-effects model of between- and within-study variance was completed for the following outcome variables: overall ED psychopathology, body dissatisfaction, drive for thinness, restricting, and loss-of-control eating. Athletes reported lower levels of body dissatisfaction compared to nonathletes (g=-.21, p < .0001). Athletes and nonathletes reported similar levels of overall ED psychopathology, drive for thinness, restricting, and loss-of-control eating on average. Sport type significantly moderated standardized mean difference effect sizes of ED psychopathology in athletes versus nonathletes. Effect sizes comparing levels of drive for thinness, restricting, and loss-of-control eating in athletes versus nonathletes were larger for studies with athletes participating in aesthetic/lean sports compared to nonaesthetic/nonlean sports. Findings from this meta-analysis could inform future ED prevention and treatment in female athletes by providing further evidence that athletes in aesthetic/lean sports may report higher levels of ED psychopathology. Participating in nonaesthetic/nonlean sports may be a protective factor for experiencing less body dissatisfaction. The current meta-analysis summarized findings from 56 studies that assessed levels of disordered eating, body dissatisfaction, dietary restricting, and loss-of-control eating in female athletes and nonathletes. Athletes reported lower levels of body dissatisfaction compared to nonathletes, highlighting that participation in sport could have some protective factors. Athletes participating in sports that require weight categories (e.g., judo) and sports that emphasize thinness/leanness (e.g., gymnastics and distance running) had higher levels of disordered eating relative to athletes participating in other types of sports that do not emphasize thinness/leanness (e.g., volleyball and basketball).

Online interventions for reducing hate speech and cyberhate: A systematic review.

The unique feature of the Internet is that individual negative attitudes toward minoritized and racialized groups and more extreme, hateful ideologies can find their way onto specific platforms and instantly connect people sharing similar prejudices. The enormous frequency of hate speech/cyberhate within online environments creates a sense of normalcy about hatred and the potential for acts of intergroup violence or political radicalization. While there is some evidence of effective interventions to counter hate speech through television, radio, youth conferences, and text messaging campaigns, interventions for online hate speech have only recently emerged. This review aimed to assess the effects of online interventions to reduce online hate speech/cyberhate. We systematically searched 2 database aggregators, 36 individual databases, 6 individual journals, and 34 websites, as well as bibliographies of published reviews of related literature, and scrutiny of annotated bibliographies of related literature. We included randomized and rigorous quasi-experimental studies of online hate speech/cyberhate interventions that measured the creation and/or consumption of hateful content online and included a control group. Eligible populations included youth (10-17 years) and adult (18+ years) participants of any racial/ethnic background, religious affiliation, gender identity, sexual orientation, nationality, or citizenship status. The systematic search covered January 1, 1990 to December 31, 2020, with searches conducted between August 19, 2020 and December 31, 2020, and supplementary searches undertaken between March 17 and 24, 2022. We coded characteristics of the intervention, sample, outcomes, and research methods. We extracted quantitative findings in the form of a standardized mean difference effect size. We computed a meta-analysis on two independent effect sizes. Two studies were included in the meta-analysis, one of which had three treatment arms. For the purposes of the meta-analysis we chose the treatment arm from the Álvarez-Benjumea and Winter (2018) study that most closely aligned with the treatment condition in the Bodine-Baron et al. (2020) study. However, we also present additional single effect sizes for the other treatment arms from the Álvarez-Benjumea and Winter (2018) study. Both studies evaluated the effectiveness of an online intervention for reducing online hate speech/cyberhate. The Bodine-Baron et al. (2020) study had a sample size of 1570 subjects, while the Álvarez-Benjumea and Winter (2018) study had a sample size of 1469 tweets (nested in 180 subjects). The mean effect was small (g = -0.134, 95% confidence interval [-0.321, -0.054]). Each study was assessed for risk of bias on the following domains: randomization process, deviations from intended interventions, missing outcome data, measurement of the outcome, and selection of the reported results. Both studies were rated as "low risk" on the randomization process, deviations from intended interventions, and measurement of the outcome domains. We assessed the Bodine-Baron et al. (2020) study as "some" risk of bias regarding missing outcome data and "high risk" for selective outcome reporting bias. The Álvarez-Benjumea and Winter (2018) study was rated as "some concern" for the selective outcome reporting bias domain. The evidence is insufficient to determine the effectiveness of online hate speech/cyberhate interventions for reducing the creation and/or consumption of hateful content online. Gaps in the evaluation literature include the lack of experimental (random assignment) and quasi-experimental evaluations of online hate speech/cyberhate interventions, addressing the creation and/or consumption of hate speech as opposed to the accuracy of detection/classification software, and assessing heterogeneity among subjects by including both extremist and non-extremist individuals in future intervention studies. We provide suggestions for how future research on online hate speech/cyberhate interventions can fill these gaps moving forward.