The purpose of this study employing meta-analysis was to assess the impact that after-school programs have on reading and mathematics outcomes. The participants in the primary studies were students in Grades K through 8; years 200 through 2009. The study utilized the theory of change as its theoretical basis. This meta-analysis used the effect size as the standard measure. It began with an overall Cohen's d of .40 for the impact that after-school programs have on reading and mathematics outcomes, and then proceeded to analyze three moderator variables: subject, time periods, and grade level.The findings of the meta-analysis, both overall and sub analyses, show that the independent variable, after-school programs, has an impact on the dependent variable, reading and mathematics. The overall results indicated that after-school programs are educationally significant in the areas of reading and mathematics combined. As for the moderator variable, the results for the areas of (a) subject (reading and mathematics), (b) time period (2000-2002, 2003-2005 and 2006-2009), and (c) grade (middle, and middle plus elementary combined), all indicated educationally significant results. The notable exception was the grade moderator, elementary.This study provides more information for researchers, practitioners and policy makers upon which to make practical research based decisions about after-school programs for the purpose of determining the applicability of such in their educational setting.

Orientadores: André Deeke Sasse, Carmen Silvia Passos Lima / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-22T03:20:05Z (GMT). No. of bitstreams: 1 Scherr_AdolfoJosedeOliveira_M.pdf: 1501111 bytes, checksum: acf22564245404a459e366435fc5790b (MD5) Previous issue date: 2013 / Resumo: Pacientes com câncer renal localmente avançado são de alto risco para recidiva após ressecção cirúrgica com intuito curativo. Muitos estudos têm sido realizados na tentativa de se descobrir alguma intervenção adjuvante capaz de reduzir este risco. No entanto, até o momento não foi observado nenhum benefício clínico nas intervenções avaliadas nos estudos. O objetivo desta revisão sistemática foi avaliar o exato papel da terapia adjuvante nos pacientes com câncer renal localmente avançado após cirurgia. Foram selecionados estudos clínicos randomizados que comparavam terapia adjuvante (quimioterapia, vacinas, imunoterapia, bioquimioterapia, hormonioterapia) versus nenhum tratamento ativo após cirurgia em pacientes com câncer renal. Os desfechos clínicos avaliados foram sobrevida global (SG), sobrevida livre de doença (SLD) e toxicidades severas. A análise dos dados extraídos foi realizada no programa estatístico Review Manager 5.0 (RevMan 5; Cochrane Collaboration Software). As diferentes estratégias de tratamento adjuvante foram avaliadas em conjunto e separadamente. Dez estudos (2609 pacientes) foram incluídos. Terapia adjuvante não mostrou benefício em termos de SG (HR 1.07; IC95% 0.89 a 1.28; P = 0.48 I2= 0%) ou SLD (HR 0,96; IC95% 0.83 a 1.10; P =0.52 I2= 36%) quando comparado a nenhum tratamento adjuvante. Nenhuma análise de subgrupo (imunoterapia,vacinas, bioquimioterapia) atingiu resultado relevante. A avaliação de toxicidades mostrou uma frequencia significativamente maior de eventos adversos graves no grupo tratado (OR 73.86; IC 95% 28,32 a 192,62; P < 0,00001 I2 = 37%). O resultado final da análise não forneceu nenhum suporte para a hipótese de que os agentes estudados forneçam qualquer benefício clínico para pacientes com câncer renal no contexto adjuvante, além de aumentarem o risco de efeitos adversos graves. Estudos clínicos randomizados que avaliam o uso de terapias-alvo no cenário adjuvante estão em andamento e podem abrir uma nova fronteira terapêutica para estes pacientes. Até que os resultados destes estudos sejam conhecidos e se mostrem efetivos, nenhuma terapia adjuvante pode ser recomendada para pacientes com câncer de células renais após ressecção cirúrgica curativa / Abstract: Many adjuvant trials have been undertaken in an attempt to reduce the risk of recurrence among patients who undergo surgical resection for locally advanced renal cancer. However, no clear benefit has been identified to date. This systematic review was conducted to examine the exact role of adjuvant therapy in renal cancer setting. Randomized controlled trials were searched comparing adjuvant therapy (chemotherapy, vaccine, immunotherapy, biochemotherapy, hormone therapy) versus no active treatment after surgery among renal cell cancer patients. Clinical outcomes were overall survival (OS), disease-free survival (DFS), and severe toxicities. The extracted data was performed using the statistical software Review Manager 5.0 (RevMan 5; Cochrane Collaboration Software).Different strategies of adjuvant treatment were evaluated together and separately. Ten studies (2,609 patients) were included. Adjuvant therapy provided no benefits in terms of OS (HR 1.07; 95%CI 0.89 to 1.28; P = 0.48 I2 = 0%) or DFS (HR 0,96; CI 95% 0.83 to 1.10; P =0.52 I2 = 36%) when compared to no treatment. No subgroup analysis (immunotherapy, vaccines, biochemotherapy) had relevant results. Toxicity evaluation depicted a significantly higher frequency of serious adverse events in the adjuvant group(OR 73.86; CI 95% 28,32to 192,62; P < 0,00001 I2 = 37%).The result of the analysis provided no support for the hypothesis that the agents studied provide any clinical benefit for renal cancer patients in the adjuvant setting, in addition to increasing the risk of serious adverse events. Randomized trials are underway to test targeted therapies in adjuvant setting, which might open a new therapeutic frontier for these patients. Until these trials yield results, no adjuvant therapy can be recommended for patients who undergo surgical curative resection for renal cell cancer / Mestrado / Clinica Medica / Mestre em Clinica Medica

Orientadores: Carlos Arturo Levi D'Ancona, Nelson Rodrigues Netto Júnior / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-18T11:58:20Z (GMT). No. of bitstreams: 1 Zani_EmersonLuis_D.pdf: 2437204 bytes, checksum: a73fbb0add8a13de68169511bc8b989a (MD5) Previous issue date: 2011 / Resumo: A biópsia prostática transretal (BPTR) é um procedimento bem estabelecido utilizado para a obtenção de tecido para o diagnóstico histológico do carcinoma da próstata. Apesar do fato de a BPTR ser geralmente considerada um procedimento seguro, ela pode ser acompanhada por complicações infecciosas e traumáticas. Embora as complicações infecciosas após a BPTR sejam bem conhecidas, há incerteza sobre a necessidade e a eficácia do antibiótico profilático de rotina e uma clara falta de padronização na profilaxia antibiótica para BPTR. O objetivo foi realizar uma revisão sistemática de ensaios clínicos randomizados sobre a profilaxia antibiótica em BPTR para avaliar a eficácia e os efeitos adversos do tratamento antibiótico profilático nessa situação. A pesquisa abrangeu as principais bases eletrônicas: MEDLINE, EMBASE, LILACS e Cochrane Central Register of Controlled Trials (CENTRAL). Especialistas foram consultados e referências de artigos relevantes foram obtidas. Todos os estudos randomizados e controlados (ERCs) de homens que se submeteram à BPTR e receberam antibióticos profiláticos ou placebo / nenhum tratamento foram selecionados, e também todos os ERCs avaliando um tipo de antibiótico contra outro, incluindo doses, vias de administração, freqüência de administração e duração do tratamento antibiótico. A revisão sistemática foi conduzida na Colaboração Cochrane. No geral, mais de 3500 referências foram analisadas e dezenove artigos originais com um total de 3599 pacientes foram incluídos. Nove estudos analisaram antibióticos versus placebo / nenhum tratamento, com todos os resultados favorecendo significativamente o uso de antibióticos (P <0,05 (I2=0%)), incluindo bacteriúria (risco relativo (RR) 0,25 (intervalo de confiança (IC) de 95% de 0,15 a 0,42), bacteremia (RR 0,67, IC 95% 0,49-0,92), febre (RR 0,39, IC 95% 0,23-0,64), infecção do trato urinário (RR 0,37 (IC 95% 0,22-0,62) e hospitalização (RR 0,13 (IC 95% 0,03-0,55)). Diversas classes de antibióticos foram efetivas profilaticamente para a BPTR, e a classe das quinolonas foi a melhor classe analisada, com o maior número de estudos (cinco) e de pacientes (1188). Na comparação "antibiótico versus enema", foram analisados quatro estudos com um número limitado de pacientes. As diferenças entre os grupos não foram significativas. Para "antibiótico versus antibiótico + enema", apenas o risco de bacteremia (RR 0,25, IC 95% 0,08-0,75, P = 0,01) foi reduzido no grupo "antibiótico + enema". Sete estudos relataram os efeitos de antibiótico de curta duração (um dia) versus curso de longa duração (três dias). O uso de antibióticos por longo curso foi significativamente melhor do que o tratamento de curta duração apenas para bacteriúria (RR 2,09, IC 95% 1,17-3,73, P = 0,01 (I2=34%)). Para "dose única versus múltiplas doses", houve maior risco de bacteriúria com dose única (RR 1,98, IC 95% 1,18-3,33, P <0,05 (I2%=7)). Comparando-se a administração oral versus sistêmica - injeção intramuscular (IM) ou intravenosa (IV) - dos antibióticos, não houve diferenças significativas entre os grupos para bacteriúria, febre, ITU e hospitalização. A profilaxia antibiótica é eficaz na prevenção de complicações infecciosas após BPTR. Diversas classes de antibióticos são eficazes profilaticamente para a biópsia da próstata e a classe das quinolonas foi a classe melhor analisada, com o maior número de estudos e de pacientes. Não há dados definitivos para confirmar que os cursos antibióticos de longa duração (três dias) sejam superiores aos tratamentos de curta duração (um dia), ou que o tratamento com doses múltiplas seja superior ao de uma dose única / Abstract: Transrectal prostate biopsy (TRPB) is a well established procedure used to obtain tissue for the histological diagnosis of carcinoma of the prostate. Despite the fact that TRPB is generally considered a safe procedure, it may be accompanied by traumatic and infective complications. Although infective complications after TRPB are well known, there is uncertainty about the necessity and effectiveness of routine prophylactic antibiotics and a clear lack of standardization in antibiotic prophylaxis for TRPB. The objective was to conduct a systematic review of randomized controlled trials on antibiotic prophylaxis in TRPB to evaluate the effectiveness and adverse effects of prophylactic antibiotic treatment in this situation. The search covered the principal electronic databases: MEDLINE, EMBASE, LILACS and the Cochrane Central Register of Controlled Trials (CENTRAL). Experts were consulted and references from the relevant articles were scanned. All randomized, controlled trials (RCTs) of men who underwent TRPB and received prophylactic antibiotics or placebo/no treatment were selected, and all RCTs looking at one type of antibiotic versus another, including comparable dosages, routes of administration, frequency of administration, and duration of antibiotic treatment. The systematic review was conducted in Cochrane Collaboration. Overall, more than 3500 references were considered and nineteen original reports with a total of 3599 patients were included. There were nine trials analyzing antibiotics versus placebo/no treatment, with all outcomes significantly favoring antibiotic use (P < 0.05 (I2 = 0%)), including bacteriuria (relative risk (RR) 0.25 (95% confidence interval (CI) 0.15 to 0.42), bacteremia (RR 0.67, 95% CI 0.49 to 0.92), fever (RR 0.39, 95% CI 0.23 to 0.64), urinary tract infection (RR 0.37 (95% CI 0.22 to 0.62), and hospitalization (RR 0.13 (95% CI 0.03 to 0.55)). Several classes of antibiotics were effective prophylactically for TRPB, and the quinolones were the best analyzed class, with a higher number of studies (five) and patients (1188). For 'antibiotic versus enema', we analyzed four studies with a limited number of patients. The differences between groups were not significant. For "antibiotic versus antibiotic + enema", only the risk of bacteremia (RR 0.25, 95% CI 0.08 to 0.75, P = 0.01) was diminished in the "antibiotic + enema" group. Seven trials reported the effects of short-course (1 day) versus long-course (3 days) antibiotics. Long course was significantly better than short-course treatment only for bacteriuria (RR 2.09, 95% CI 1.17 to 3.73, P = 0.01 ( I2 = 34%)). For "single versus multiple dose", there was significantly greater risk of bacteriuria for singe-dose treatment (RR 1.98, 95% CI 1.18 to 3.33, P < 0.05 (I2 = 7%)). Comparing oral versus systemic administration - intramuscular injection (IM), or intravenous (IV) - of antibiotics, there were no significant differences in the groups for bacteriuria, fever, UTI and hospitalization. Antibiotic prophylaxis is effective in preventing infectious complications following TRPB. Several classes of antibiotics are effective prophylactically for prostate biopsy and the quinolones were the best analyzed class, with a higher number of studies and patients. There is no definitive data to confirm that antibiotics for long-course (three days) are superior to short-course treatments (one day), or that multiple-dose treatment is superior to single-dose / Doutorado / Fisiopatologia Cirúrgica / Doutor em Ciências

Orientadores: Wagner Eduardo Matheus, Ubirajara Ferreira / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T12:07:43Z (GMT). No. of bitstreams: 1 Senatore_MarcelaAndreaDuranHaun_D.pdf: 1829482 bytes, checksum: bc20dee71d7524f229d7b76160f9e38b (MD5) Previous issue date: 2014 / Resumo: Atualmente existem diferentes agentes para o tratamento do câncer renal avançado. O objetivo principal desse trabalho foi realizar revisão sistemática com meta-análise dos estudos clínicos randomizados que compararam: sorafenibe, sunitinibe, bevacizumabe, temsirolimus e everolimus ao interferon-?. Para isto foi realizada revisão sistemática da literatura em diferentes bancos de dados: EMBASE, LILACS e PUBMED, identificando estudos clínicos randomizados que compararam as terapias alvo moleculares (TAM) disponíveis versus interferon-alfa para tratamento de pacientes com câncer renal avançado. Para o tratamento de 1a linha foram encontrados 10 estudos que avaliaram as terapias com sunitinibe, sorafenibe, bevacizumabe e temsirolimus; e três estudos que avaliaram o sorafenibe e everolimus como tratamento de 2a linha. O Risco Relativo (RR) da sobrevida livre de progressão (SLP) dos estudos de 1a linha foi de 0.83, intervalo de confiança (IC) [0.78-0.87] com I2= 94% e p<0.00001. Os melhores resultados foram: o estudo do sunitinibe, 0.38, IC [0.25-0.58], do bevacizumabe com RR de 0.62, IC [0.47-0.83] e do temsirolimus, 0.78, IC [0.70-0.87]. A meta-análise não demonstrou benefício quanto à sobrevida global (SG), no tratamento de 1a linha com sunitinibe e temsirolimus. Os tratamentos de 1ª linha com sorafenibe e bevacizumabe não associaram benefícios clínicos significativos. Não foi possível realizar meta-análise nos estudos do tratamento de 2a linha, pois, as populações eram diferentes. Logo, para o tratamento de 1a linha, sunitinibe e temsirolimus foram a terapias mais efetivas, quanto a SLP. No tratamento de 2a linha, o sorafenibe e everolimus foram relacionados à melhora da SLP. Em todos os estudos de 1a linha os pacientes não apresentaram melhora de SG e a qualidade metodológica não foram adequadas, portanto esses resultados devem ser analisados com cautela / Abstract: Currently, there are different agents for the treatment of advanced kidney cancer. The main aim of this study was to perform a systematic review and meta-analysis of randomized clinical trials that compared: sorafenib, sunitinib, bevacizumab, temsirolimus and everolimus. It was performed a systematic review of the literature in different databases: EMBASE, LILACS and PubMed, identifying randomized clinical trials that compared the available therapies target cells versus alpha-interferon for the patient treatments with advanced kidney cancer. For the treatment of first-line were found 10 studies that evaluated the therapy with sunitinib, sorafenib, bevacizumab and temsirolimus and three studies evaluating sorafenib and everolimus as a treatment second-line. The relative risk of progression free survival of first line studies was 0.83, confidence interval (CI) [0.78-0.87] with I2 = 94% and p <0.00001. The best results were: the study of sunitinib, 0.38, CI [0:25 to 0:58], bevacizumab with RR of 0.62, CI [0.47-0.83] and temsirolimus, 0.78, CI [0.70-0.87]. The meta-analysis showed no benefit on overall survival in first-line treatment with sunitinib and temsirolimus. The first-line treatment with sorafenib and bevacizumab not associated significant clinical benefits. Unable to perform meta-analysis on studies of second-line treatment, because the cohorts were different between them. For the treatment of first-line, sunitinib and temsirolimus were more effective therapies, as the progression free survival (PFS). In the second line treatment, sorafenib and everolimus was associated with improved PFS. In these studies, patients showed no improvement in overall survival (OS) and methodological quality were not adequate, so these results should be analyzed with caution / Doutorado / Fisiopatologia Cirúrgica / Doutora em Ciências

Introdução: A litíase biliar e o consumo de álcool são as etiologias mais frequentes para pancreatite aguda (PA), sendo reportadas como responsáveis por cerca de 40 e 30% dos casos respectivamente. No entanto, no Rio Grande do Sul - BR observamos uma frequência de pancreatite aguda biliar (PAB) em torno de 77% dos casos e pancreatite aguda alcoólica (PAA) em apenas 8%. Além da possibilidade de diferenças próprias da nossa população, é possível que a incidência de PAB esteja aumentando. Objetivo: Estimar as frequências globais da PAB, PAA e dos casos considerados pancreatite aguda idiopática (PAI) em estudos publicados de 2006 a 18 de outubro de 2017. Comparar as frequências de PAB, PAA e PAI entre os estudos que realizaram revisão de prontuários individuais dos pacientes ou foram prospectivos e os que utilizaram apenas os códigos de alta hospitalar para o diagnóstico etiológico. Comparar as frequências de PAB, PAA, PAI de acordo com região geográfica da população dos estudos. Métodos: Uma revisão sistemática de estudos observacionais em Inglês, Espanhol e Português, de 2006 a 18 de outubro de 2017 foi realizada. Metanálise pelo modelo de efeitos randômicos foi utilizada para calcular as frequências de PAB, PAA e PAI globais e nos subgrupos (diagnóstico por código da alta hospitalar, diagnóstico por avaliação individualizada do prontuário do paciente, estudos dos EUA, estudos da América Latina, estudos da Europa e estudos da Ásia). Resultado: Foram incluídos quarenta e seis estudos representando 2.341.007 casos de PA em 36 países. A estimativa global para a pancreatite aguda biliar (PAB) foi 41,6% (IC 95% 39,2-44,1), seguido por PA alcoólica (PAA) com 20,5% (IC 95% 3 16,6-24,6) e PA idiopática (PAI) em 18,3% (IC 95% 15.1 - 21,7). Em estudos com diagnóstico etiológico por código de alta a PAI foi a mais frequente com 37,9% dos casos (IC 95% 35,1 - 40,8). Nos estudos que revisaram os prontuários dos pacientes a PAB foi a mais frequente com 46% (IC 95% 42,3 - 49,8). Nos EUA a PAI foi a mais frequente com 34,7% (IC 95% 32,3 - 37,2). Na América Latina a estimativa de PAB foi de 68,5% (IC de 95% 57,8 - 78,3). Na Europa, na Ásia e em 1 estudo Australiano, a etiologia mais frequente foi a PAB em 41,3% (IC 95% 37,9 - 44,7), 42% (IC 95% 28,8 - 55,8) e 40% (IC 95% 36,8 - 43,2), respectivamente. Na África do Sul 1 artigo apresentou frequência de 70,2% (IC de 95% 64,5 - 75,4) para PAA. Conclusão: A PAB é a etiologia mais prevalente da PA, sendo 2 vezes mais frequente que o segundo lugar. A América Latina apresenta uma frequência para PAB muito maior do que o resto do mundo. Grandes estudos populacionais que utilizam diagnósticos codificados e estudos americanos apresentam elevadas taxas de PA sem classificação. A importância do diagnóstico etiológico consiste no tratamento da causa para prevenção da recorrência. / Background: Gallstones and alcohol are the most common etiology of acute pancreatitis (AP) and is reported to account for about 40% and 30% of cases respectively. However, in Rio Grande do Sul - BR, we observed a frequency of acute biliary pancreatitis (ABP) around 77% of cases and alcoholic acute pancreatitis (AAP) in only 8%. Besides the possibility of differences of our own population, it is possible that the incidence of PAB is increasing. Objective: estimate the global frequency of ABP, AAP and the cases considered idiopathic pancreatitis (IAP) in published studies from 2006 to October 18 2017. Compare the frequencies for ABP, AAP and AIP among studies that performed review of individual records of patients or collected data prospectively and those using only the hospital discharge diagnostic codes for etiologic diagnosis. Compare the frequency of ABP, AAP and IAP by geographic region. Methods: A systematic review of observational studies in English, Spanish and Portuguese, from 2006 to October 18, 2017 was done. Random-effects metaanalysis was used to assess the frequency of biliary, alcoholic and idiopathic AP worldwide and to perform the analysis of 6 subgroups (hospital discharge coded diagnosis, individual patient chart review, studies from US, Latin America, Europe and studies from Asia). Results: Forty-six studies were included representing 2.341.007 cases of PA in 36 countries. The overall estimate for ABP was 41.6% (95% CI 39.2 to 44.1), followed by AAP with 20.5% (95% CI 16.6 to 24 6) and IAP with 18.3% (95% CI 15.1 - 21.7). In studies with hospital discharge coded diagnosis IAP was the most frequent with 37.9% (95% CI 35.1 to 40.8). In studies with individual patient chart review PAB 5 was more frequent with 46% (95% CI 42.3 to 49.8). In US studies IAP was he most frequent etiology with 34.7% (95% CI 32.3 to 37.2). In Latin America PAB was estimated 68.5% of the cases (95% CI 57.8 to 78.3). In Europe, Asia and one Australian study, the most frequent cause was the ABP in 41.3% (95% CI 37.9 to 44.7), 42% (95% CI 28.8 to 55.8) and 40% (95% CI 36.8 to 43.2) of the cases respectively. One study from South Africa had AAP in 70.2% (95% CI 64.5 to 75.4) of the cases. Conclusion: Gallstones are the main etiology of AP globally, twice as frequent as the second one. Latin America has a frequency for ABP much higher than the rest of the world. Large population studies using coded diagnoses and American studies show high rates IAP. The importance of the etiological diagnosis resides in treating the cause in order to prevent recurrence.

No description available.

Systematic review is a type of review that identifies, assesses, and combines all the published empirical evidence on a specific topic by using explicit, systematic methods. This type of reviews often includes a meta-analysis, a statistical tool used to combine the collected data into a quantitative summary estimate. Guidance documents such as the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) were developed to improve the reporting of systematic reviews of randomized controlled trials. Systematic reviews are commonly used in the field of healthcare research and are increasingly being employed in the field of environmental epidemiology. Environmental epidemiology studies examine exposures in populations and their associations with health outcomes. This field contains several unique considerations that require a careful and critical assessment to ensure the validity of results and to make the data or information more useful for the readers. However, to our knowledge, there is currently no guidance document for conducting systematic reviews that comprehensively addresses the specific issues in this field. Therefore, the objectives of this proposal are twofold: (1) to conduct a systematic review of the currently published epidemiology systematic reviews on a specific topic (mercury exposure and children autism spectrum disorder) to identify analytical issues encountered, and (2) use the experience and other potential solution identified in the literature to develop a guidance or recommendation document for conducting systematic reviews of environmental epidemiology studies. Akin to reporting guidelines for randomized controlled trials, a reporting guideline for environmental epidemiology is anticipated to increase the clarity and transparency of publications and enhance the usefulness of systematic reviews for knowledge synthesis.

京都大学 / 0048 / 新制・課程博士 / 博士(社会健康医学) / 甲第18648号 / 社医博第60号 / 新制||社医||8(附属図書館) / 31562 / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 村井 俊哉, 教授 佐藤 俊哉, 教授 福原 俊一 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

The relative importance of deterministic processes versus chance is one of the most important questions in science. We analyze the success of variance partitioning methods used to explain variation in β-diversity and partition it into environmental, spatial, and spatially structured environmental components. We test the hypotheses that 1) the number of environmental descriptors in a study would be positively correlated with the percentage of β-diversity explained by the environment, and that the environment would explain more variation in β-diversity than spatial or shared factors in VP analyses, 2) increasing the complexity of environmental descriptors would help account for more of the total variation in β-diversity, and 3) studies based on functional groups would account for more of the total variation in β-diversity than studies based on taxonomic data. Results show that the amount of unexplained β-diversity is on average 65.6%. There was no evidence showing that the number of environmental descriptors, increased complexity of environmental descriptors, or utilizing functional diversity allowed researchers to account for more variation in β-diversity. We review the characteristics of studies that account for a large percentage of variation in β-diversity as well as explanations for studies that accounted for little variation in β-diversity.

Objective: The aims of this systematic review and meta-analysis were to examine the overall prevalence of dropout from psychological treatments for problem gambling and gambling disorder and to examine how study, client, and treatment variables influenced dropout rates. Method: A systematic search was conducted to identify studies of cognitive and/or behavioral therapies and motivational interventions for problem gambling and gambling disorder. Meta-analysis was used to calculate an overall weighted dropout rate. Random effect meta-regressions were used to examine covariates of dropout rates. Mixed-effect subgroup analyses were used to examine moderators of dropout rates. Results: The systematic search identified 24 studies (31 dropout rates) comprising 2,791 participants. Using a random-effects model, the overall weighted dropout rate was 39.1%, 95% CI [33.0%, 45.6%]. Increases in the percentage of married participants were significantly associated with lower dropout rates. Dropout rates were significantly higher when dropout was defined as attending all sessions of a treatment protocol compared to when defined as attending a prespecified number of sessions different from the total in the protocol and when defined as study therapists judging participants to be dropouts. Insufficient reporting of some gambling-related variables and other psychological symptom variables prevented a thorough examination of covariates and moderators. Conclusions: A large proportion of individuals drop out of treatment for problem gambling and gambling disorder. Future research should examine the reasons for dropout across marital statuses and should adopt dropout definitions that consider session-by-session symptom change. (PsycInfo Database Record (c) 2021 APA, all rights reserved) This review suggests that a significant proportion of individuals drop out of psychological treatments for problem gambling and gambling disorder. This review also recommends that the field adopt symptom-based dropout definitions to determine the adequate dosage of psychological treatment for problem gambling and gambling disorder. (PsycInfo Database Record (c) 2021 APA, all rights reserved)