This study examines the relationship between family of origin violence and dating violence. A meta-analytic approach was used to conduct a quantitative review of the relevant research literature. The results are based on data from 35 studies of dating violence. The gender of respondents, whether family of origin violence was witnessed or experienced, and whether dating violence was perpetrated or received were considered as part of the analysis. The findings suggest a weak to moderate relationship between violence in the family of origin and dating violence. Separate analysis within and between the male and female sub-samples revealed several significant differences. The findings suggest that witnessing inter-parental violence has a stronger relationship with involvement in a violent dating relationship for males, while experiencing violence as a child has a stronger relationship with involvement in a violent dating relationship for females. The findings also suggest that violence in the family of origin may have a stronger relationship with males perpetrating and females receiving violence in dating relationships. / Master of Science

Externalizing behavior problems are a common concern among youth and can be associated with significant problems. As such, the need for effective treatment is evident. While research on psychosocial interventions has been promising, the specific efficacy of youth group therapy has not been assessed in a meta-analysis. Objectives: to assess group therapy's efficacy for youth with behavioral issues and whether treatment effects are moderated by study, patient, leader, or group characteristics. Method: major databases were used to identify and screen potential articles based on inclusion criteria. Included studied were analyzed in a random effects meta-analysis, and potential moderators were assessed. Results: we analyzed 30 studies representing 2,818 youth with behavior problems. Group therapy showed a significant, small effect (g = 0.47) on externalizing behavior concerns (EBCs). There were also significant effects on several secondary outcomes including aggressive cognitions, anger, internalizing symptoms, and social skills/interpersonal functioning. The only significant moderating variables was the inclusion of a parent component to treatment, with group treatments including a parent component being less effective. Discussion: this meta-analysis provides promising evidence on the efficacy of group therapy, with outcomes being comparable to what has been reported in past meta-analyses on psychosocial treatments for behavior problems. Future research is needed to clarify discrepancies in the literature, replicate the present findings, and otherwise understand the ideal treatments.

The recent rise in maternal workforce participation has led to more research regarding the role of maternal employment for (early) childhood mental health. This systematic review with meta-analysis covers new evidence on the association of both variables. A systematic literature search was conducted. Studies had to compare children 0–7 years of age on the basis of their mothers’ employment status, working amount, employment duration, i.e., how long the mother had been back at work after birth, or timing of return to work. Child mental health was operationalized as behavior problems and prosocial behavior. Narrative and meta-analytic syntheses of evidence were conducted. Maternal employment was associated with more conduct problems but less internalizing behavior problems and anxious/depressed behavior in children; full-time employment was linked to more externalizing behavior problems and more hyperactivity/inattention. Longer employment duration was related to less (internalizing) behavior problems and more prosocial behavior but also more externalizing behavior problems. Narrative syntheses indicated early maternal return to work to be associated with more child externalizing behavior problems and less prosocial behavior. Whether maternal employment is associated with child mental health strongly depends on both variables’ operationalization. Especially part-time employment, longer employment duration, and return to work only after the first year postpartum may be beneficial for child mental health. Practical implications pertain to an expanded offer of family leave and the endorsement of maternal employment after the first year postpartum. Here, factors that may buffer the negative associations with full-time employment warrant consideration.

Bipolar disorder (BD) is a serious mental illness characterized by dramatically differing mood states and marked costs for the individual and society, making it important to find factors associated with the condition. Deficits in emotion regulation have been found across a wide range of mental health disorders and may represent an important risk factor for BD. Literature in this area has large methodological inconsistencies and many conclusions are mixed. Therefore, the current study sought to conduct a meta-analytic review of literature related to emotion regulation in BD. Results suggest that people with BD broadly report more frequent use of maladaptive emotion regulation strategies and less frequent use of adaptive emotion regulation strategies than healthy controls. Of these strategies, the largest effect sizes were found for risk-taking, rumination, impulsivity, catastrophizing, and self-blame. Comparisons to other clinical groups suggest that emotion regulation in BD is largely similar to major depressive disorder and less severely impaired than borderline personality disorder. Moderator analyses of BD samples in different mood states suggest mood state plays a limited role in emotion regulation strategy usage, although some maladaptive strategies may be more common in samples with depressive symptoms. Among emotion regulation strategies, increased positive rumination and suppression may be uniquely characteristic of BD. Findings of this review support the importance of targeting emotion regulation in assessment and treatment of BD. Notably, psychotherapeutic interventions focused on emotion regulation, such as cognitive therapies, may be a key factor in reducing BD risk and episode recurrence.

The focus of this study was to conduct a meta-analytic investigation to combine the results obtained in independent studies aimed at determining the effectiveness of using digital games, as opposed to traditional methods, as a strategy for improving students' performance in high school mathematics. The major question of this study is: "Does the research on the use of games in high school mathematics support the use of games as a teaching strategy for improving student achievement?" To answer this question, meta-analysis was employed. Meta-analysis synthesizes and analyzes the quantitative data collected in independent and multiple empirical studies carried out on similar topics, situations, and hypotheses in order to reach a general judgment regarding the results of these studies. To determine which studies to use, specific criteria including articles published in refereed journals, thesis, and dissertation studies with experimental and control groups, research with effect size, sample size, standard deviation, and means. Based on these criteria, it was decided to include six experimental studies in the meta-analysis. The result showed that there was no significant differences between the use of digital games and traditional methods to teach mathematics in high school. The weighting factor of the two variables, standard deviation and number of participants, may account for the lack of support for gaming over traditional method of instruction.

The purpose of this study was to determine the overall effectiveness of Turkey's technology integration initiative on teachers' attitudes and examine the moderating effects of related study characteristics. The 22 studies in this meta-analysis, carried out between the years 2010 and 2017, investigated the effects of Turkey's technology integration initiative on teachers' attitudes and met the inclusion criteria. This study followed a traditional meta-analysis research approach utilizing Hedge's g effect size to combine studies. The effect size was calculated using Comprehensive Meta-Analysis (CMA) software. The result (g = .31) indicates that Turkey's technology integration initiative had a moderate but significant influence on teacher attitudes. In addition to teacher attitudes, barriers that could contribute to some K–12 teachers' lack of integration training were identified. Based on the results it is recommended that future professional development and training for teachers include assessments of teacher technology usage by administrators, an increase in time for collaborative planning among teachers, and more just-in-time technology support for technology integration.

This dissertation consists of three studies that collectively investigate the factors influencing the consumer adoption intention towards emerging healthcare technologies. Essay 1 systematically reviews the extent literature on healthcare technology adoption and serves as the theoretical foundation of the dissertation. It investigates different models that have been previously applied to study healthcare technology acceptance. Meta-analysis method is used to quantitatively synthesize the findings from prior empirical studies. Essay 2 posits, develops, and tests a comprehensive biotechnology acceptance model from the end-user's perspective. Two new constructs, namely, perceived risk and trust in technology, are integrated into the unified theory of acceptance and use of technology. Research hypotheses are tested using survey data and partial least square – structural equation modeling (PLS-SEM). Essay 3 extends the findings from the Essay 2 and further investigates the consumer's trust initiation and its effect on behavioral adoption intention. To achieve this purpose, Essay 3 posits and develops a trust model. Survey data allows testing the model using PLS-SEM. The models developed in this dissertation reflect significant modifications specific to the healthcare context. The findings provide value for academia, practitioners, and policymakers.

Introdução: A Estimulação Transcraniana por Corrente Contínua (ETCC) é uma intervenção não farmacológica com resultados discordantes quanto à sua eficácia para o tratamento do Episódio Depressivo Maior (EDM). Possivelmente devido a heterogeneidade dos estudos, as três meta-análises publicadas até agora sobre o assunto apontam para uma pequena vantagem a favor da técnica, dependendo da variável de desfecho analisada (melhora de depressão ou resposta). Todas essas meta-análises utilizaram dados agregados. Focamo-nos, no presente estudo, na realização de uma revisão sistemática da literatura e de uma meta-análise baseada em dados individuais de pacientes (MA-DIP) com Depressão Maior (DM) submetidos à ETCC na fase aguda. Este tipo de análise é mais preciso na avaliação da eficácia de uma intervenção e na obtenção dos preditores de respostas de tratamento, já que as características individuais de cada sujeito são consideradas ao invés das médias e frequências, como nas meta-análises de dados agregados. Objetivos: (1) avaliar a eficácia da ETCC na fase aguda da DM, (2) identificar preditores de resposta, remissão e melhora da depressão específicos e (3) avaliar a aceitabilidade da intervenção. Resultados: Os dados foram colecionados de 6 ensaios clínicos randomizados placebo controlados, totalizando 289 sujeitos. A ETCC ativa foi estatisticamente superior à estimulação simulada em relação à resposta (34% vs. 19%, respectivamente; RC=2,44, IC 95% = 1,38-4,32, NNT=7), remissão (23,1% vs. 12,7%, respectivamente; RC= 2,38, IC 95% = 1,22 - 4,64, NNT=9) e melhora da depressão (coeficiente = 0,35, IC 95% =0,12 0,57). Demonstrou-se que após ajustes para outros preditores e confundidores, depressão resistente a tratamento e doses mais altas de ETCC foram, respectivamente, inversa e diretamente associadas com a eficácia da ETCC. Conclusões: O tamanho de efeito do tratamento com ETCC foi comparável àqueles reportados, em outros estudos, para a Estimulação Magnética Transcraniana repetitiva (EMTr) e para o tratamento farmacológico (com antidepressivos tricíclicos e inibidores seletivos de recaptação de serotonina) na atenção primária para depressão. Os parâmetros mais importantes para otimização em ensaios clínicos futuros são a refratariedade da depressão e a dose da ETCC / Introduction: Transcranial direct current stimulation (tDCS) is a nonpharmacological intervention for depression. Randomised, sham-controlled clinical trials (RCTs) conducted hitherto have presented mixed results regarding its efficacy. Although recent meta-analyses suggest some efficacy when measuring depression symptoms using a continuous outcome, these meta-analyses were limited in their results as they used an aggregate data approach. We aimed therefore to perform an individual patient data (IPD) meta-analysis. In contrast to an aggregate data meta-analysis, an IPD approach uses the raw data of each participant within a study. IPD is more accurate in estimating the efficacy of an intervention since aggregate data meta-analyses present only summary estimates of efficacy. IPD meta-analysis is also superior to the aggregate data approach for obtaining predictors of treatment outcome, as the characteristics of each patient are assessed instead of the mean and frequency values obtained in the traditional aggregate data meta-analysis. Objectives (a) To provide precise estimates of tDCS efficacy based on continuous (depression improvement) and categorical (response and remission rates) outcomes, (b) to identify variables associated with tDCS efficacy and (c) to estimate the treatment acceptability. Results: Data were gathered from six randomised sham-controlled trials, enrolling 289 patients. Active tDCS was significantly superior to sham for response (34% v. 19%, respectively, odds ratio (OR) = 2.44, 95% CI 1.384.32, number needed to treat (NNT) = 7), remission (23.1% v. 12.7%, respectively, OR = 2.38, 95% CI 1.224.64, NNT = 9) and depression improvement ( coefficient 0.35, 95% CI 0.120.57). Mixed effects models showed that, after adjustment for other predictors and confounders, treatment-resistant depression and higher tDCS doses were, respectively, negatively and positively associated with tDCS efficacy. Conclusions: The effect size of tDCS treatment was comparable with those reported for repetitive transcranial magnetic stimulation (rTMS) and antidepressant drug treatment in primary care. The most important parameters for optimisation in future trials are depression refractoriness and tDCS dose

Les cancers des voies aérodigestives supérieures (VADS) représentent la 5e cause de cancer en France. Ils sont fréquemment découverts à un stade avancé, et leur mauvais pronostic a conduit à l’élaboration de traitements intensifiés. De nombreux essais randomisés ont évalué l’apport de la chimiothérapie et de modifications du fractionnement de la radiothérapie. Leurs résultats ont été synthétisés dans deux méta-analyses sur données individuelles coordonnées par l’Institut Gustave Roussy. Cependant ces méta-analyses génèrent des questions cliniques et méthodologiques, qui constituent le socle de cette thèse. Ainsi nous avons exploré par différents moyens l’étude de l’interaction entre des covariables de niveau individuel, le site tumoral, et l’effet du traitement. Nous avons adapté la méthodologie des méta-analyses en réseau pour les données de survie afin réaliser une analyse globale de l’ensemble de ces essais randomisés et classer les traitements selon leur efficacité sur la survie. Certains de ces traitements n’avaient pas fait l’objet de comparaison directe, et nos résultats se sont vérifiés dans des essais publiés ultérieurement. Nous avons passé en revue les avantages et les limites de la méta-analyse en réseau. Nous avons enfin engagé la mise à jour de ce corpus de méta-analyses pour produire des résultats en accord avec les pratiques actuelles, avec un suivi long, et en explorant des problématiques variées, telles que l’efficacité, la toxicité et l’adhérence au protocole thérapeutique. Les résultats finaux de la méta-analyse sur la chimiothérapie d’induction avec taxanes sont présentés dans cette thèse. / Head and neck cancers represent the fifth cause of death from cancer in France. They are often diagnosed at an advanced stage. The poor prognosis of these diseases has led to the introduction of intensified treatments. Numerous randomized trials have evaluated the benefits of the addition of chemotherapy to locoregional treatment and of the modification of radiotherapy fractionation. The results of these trials have been synthesized in two individual patient data meta-analyses coordinated by the Meta-Analysis Unit of Gustave Roussy Cancer Center. However these meta-analyses bring up clinical and methodological questions, some of which are dealt with in this thesis. First we have studied by different means the interaction between patient level covariate, tumor site and treatment effect. We have also adapted the methodology of network meta-analyses to survival data to perform a global analysis of the entire meta-analysis database, and to rank treatments according to their efficacy, including some treatments that had not been directly compared. Some of these results were eventually confirmed by subsequently published randomized trials. We have reviewed the advantages and limits of network meta-analysis. We have also launched the update of all these meta-analyses in order to produce results consistent with actual clinical practice, update patient follow-up, and collect additional data regarding treatment efficacy, toxicity and compliance. The final results of the taxane induction meta-analysis are presented in this manuscript.

La méta-analyse (MA) en réseau, en généralisant la MA conventionnelle, permet d'évaluer toutes les comparaisons deux à deux possibles entre interventions. Les biais de publication ont reçu peu d’attention dans ce contexte. Nous avons évalué l’impact des biais de publication en utilisant un réseau de 74 essais randomisés évaluant 12 antidépresseurs contre placebo enregistrés à la FDA et un réseau de 51 essais parmi les 74 dont les résultats étaient publiés. Nous avons montré comment les biais de publication biaisaient les quantités d'effet estimées et le classement des traitements. L'effet du biais de publication peut différer entre MA en réseau et MA conventionnelle en ce que les biais affectant un traitement peuvent affecter le classement de tous les traitements. Nous avons ensuite généralisé un test de détection des biais à la MA en réseau. Il est basé sur la comparaison entre les nombres attendu et observé d’essais avec résultats statistiquement significatifs sur l’ensemble du réseau. Nous avons montré par des études de simulation que le test proposé avait une puissance correcte après ajustement sur l’erreur de type I, excepté lorsque la variance inter-essais était élevée. Par ailleurs, le test indiquait un signal significatif de biais sur le réseau d’essais d’antidépresseurs publiés. Enfin, nous avons introduit deux modèles d’analyse de sensibilité des résultats d'une MA en réseau aux biais de publication: un modèle de méta-régression qui relie la quantité d’effet estimée à son erreur standard, et un modèle de sélection dans lequel on estime la propension d’un essai à être publié puis l’on redresse le poids des essais en fonction de cette propension. Nous les avons appliqués aux réseaux d’essais d’antidépresseurs. Ce test et ces modèles d'ajustement tirent leur force de tous les essais du réseau, sous l’hypothèse qu'un biais moyen commun opère sur toutes les branches du réseau. / Network meta-analysis (NMA), a generalization of conventional MA, allows for assessing all possible pairwise comparisons between multiple treatments. Reporting bias, a major threat to the validity of MA, has received little attention in the context of NMA. We assessed the impact of reporting bias empirically using data from 74 FDA-registered placebo-controlled trials of 12 antidepressants and their 51 matching publications. We showed how reporting bias biased NMA-based estimates of treatments efficacy and modified ranking. The effect of reporting bias in NMAs may differ from that in classical meta-analyses in that reporting bias affecting only one drug may affect the ranking of all drugs. Then, we extended a test to detect reporting bias in network of trials. It compares the number of expected trials with statistically significant results to the observed number of trials with significant p-values across the network. We showed through simulation studies that the test was fairly powerful after adjustment for size, except when between-trial variance was substantial. Besides, it showed evidence of bias in the network of published antidepressant trials. Finally, we introduced two methods of sensitivity analysis for reporting bias in NMA: a meta-regression model that allows the effect size to depend on its standard error and a selection model that estimates the propensity of trial results being published and in which trials with lower propensity are weighted up in the NMA model. We illustrated their use on the antidepressant datasets. The proposed test and adjustment models borrow strength from all trials across the network, under the assumption that conventional MAs in the network share a common mean bias mechanism.