O presente estudo teve como objetivo avaliar a performance dos métodos visual, radiográfico e baseados em fluorescência quanto à detecção de lesões de cárie em dentes permanentes e decíduos, realizar meta-análise com a performance global dos métodos e investigar as possíveis fontes de heterogeneidades. Foram realizadas três revisões distintas relacionadas a cada método diagnóstico. Quatro examinadores avaliaram os trabalhos, sendo pelo menos dois por método. Estes efetuaram a busca e seleção de artigos de modo independente; um pesquisador com experiência em trabalhos de diagnóstico de cárie resolveu os casos de conflito ou dúvida. As bases de dados eletrônicas utilizadas foram MEDLINE, EMBASE e Scopus, visando reduzir o viés de publicação, também foram buscados trabalhos acadêmicos e documentos não publicados, através do OpenSigle e Anais do Congresso ORCA. Após a seleção dos estudos por critérios de inclusão e exclusão bem definidos, os dados foram coletados e anotados, de maneira independente por cada revisor. Foi realizada a avaliação da qualidade metodológica através da ferramenta Quality Assessment of Diagnostic Accuracy Studies (QUADAS) e a análise estatística através do Paired Forest Plot, Summary Receiver Operating Characteristics analysis (SROC), relative diagnostic odds ratio (RDOR), análise de sensibilidade e gráfico de funil, além da investigação e exploração das possíveis fontes de heterogeneidade. Para o método visual, 102 artigos preencheram os critérios de inclusão. Em geral, a análise demonstrou que o método visual teve uma boa acurácia para a detecção de lesões de cárie. Embora estudos laboratoriais e clínicos tenham apresentado acurácias semelhantes, os valores de especificidade obtidos clinicamente foram maiores. Observamos, também, moderada a elevada heterogeneidade e evidência de viés de publicação na maioria dos estudos. Além disso, o uso de sistemas de escores visual resultaram em valores significativamente melhores de acurácia em comparação com estudos que utilizaram os seus próprios critérios. Quanto à relevância clínica dos estudos de acurácia do método visual, 96 estudos foram incluídos. Em geral, a maioria dos estudos falha em considerar alguns aspectos clínicos relevantes: somente 1 estudo incluiu avaliação da atividade das lesões; nenhum estudo considerou o seu prognóstico; 79 estudos não consideraram um desfecho clínico relevante e apenas 1 avaliou um desfecho centrado no paciente. Quanto à qualidade metodológica, a maioria dos estudos presentes apresentou alto risco de viés na seleção da amostra. Quanto ao método radiográfico, 116 artigos foram selecionados. Os métodos radiográficos convencional e digital apresentaram desempenho semelhante, mostrando valores maiores de especificidade comparados aos de sensibilidade, além de maiores valores de AUC no limiar de lesões mais avançadas. Quanto aos métodos baseados em fluorescência, 75 estudos preencheram os critérios de inclusão. Em geral, a análise demonstrou uma tendência a valores de acurácia semelhantes para todos os tipos de dentes, superfícies ou tipos de estudo. Houve uma tendência de melhor desempenho na detecção de lesões de cárie mais avançadas. Observamos, também, moderada a alta heterogeneidade e evidência de viés de publicação. Em conclusão, o método visual de detecção de lesões de cárie tem um bom desempenho geral, mas os estudos deveriam considerar desfechos clínicos relevantes, além da acurácia. Além disso, eles deveriam ser conduzidos com maior qualidade metodológica, principalmente em relação à seleção da amostra. Ainda, a utilização de índices detalhados e validados parece melhorar a acurácia do método. O método radiográfico não apresentou diferença entre os modos de aquisição de imagem (digital ou convencional), demonstrando uma tendência a valores superiores de especificidade e melhor desempenho em lesões avançadas. Quanto aos dispositivos baseados em fluorescência, estes mostraram desempenho global semelhante; no entanto, uma melhor acurácia na detecção de lesões de cárie mais avançadas tem sido observada. / This study aimed to evaluate the performance of visual, radiographic and fluorescence-based methods in the detection of caries lesions in permanent and primary teeth, to perform meta-analysis of the overall performance of the methods and to investigate possible sources of heterogeneity. Three distinct systematic reviews related to each diagnostic method were performed. Four observers evaluated the articles, at least two per method. They performed the search and study selection independently; a researcher with experience in caries diagnostic studies solved the cases of conflict or doubt. Electronic databases used were MEDLINE, EMBASE and Scopus, to reduce publication bias, were also pursued academic papers and unpublished documents through OpenSigle and the Annals of ORCA Congress. After the selection of studies by well-defined inclusion and exclusion criteria, data were collected and recorded, independently by each reviewer. Methodological quality assessment was performed through Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS) and statistical analysis using Paired Forest Plot, Summary Receiver Operating Characteristics analysis (SROC), relative diagnostic odds ratio (RDOR), sensitivity analysis and funnel plot, in addition we explored possible sources of heterogeneity. Regarding the accuracy of visual method, 102 articles met the inclusion criteria. In general, visual analysis showed that the method had a good accuracy in the detection of caries lesions. Although laboratory and clinical studies have shown similar accuracies, clinical studies have obtained higher specificities. We also observed moderate to high heterogeneity and evidence of publication bias in most studies. In addition, the use of visual scoring systems resulted in significantly better accuracy compared to studies using their own criteria. Concerning the clinical relevance of accuracy studies of visual method, 96 studies were included. In general, most studies failed to consider some relevant clinical aspects: only 1 study included assessment of activity of the lesions; no study considered their prognosis; 79 studies did not consider a relevant clinical outcome and only 1 evaluated a patient-centered outcome. With regard to the methodological quality, most of the present studies showed a high risk of bias in the selection of the sample. With concern to the radiographic method, 116 articles were selected. Conventional and digital radiographic methods showed similar performance, showing greater specificity values compared to sensitivity, and higher AUC values at the threshold of more advanced caries lesions. Regarding fluorescence-based methods, 75 studies met the inclusion criteria. In general, the analysis demonstrated that the fluorescence-based method tend to have similar accuracy for all types of teeth, dental surfaces or settings. There was a trend of better performance of fluorescence methods in detecting more advanced caries lesions. We also observed moderate to high heterogeneity and evidenced publication bias. In conclusion, the visual method of detecting caries lesions has a good overall performance, but studies should consider relevant clinical outcomes, as well as accuracy. In addition, they should be conducted with greater methodological quality, especially in relation to sample selection. Still, the use of detailed and validated indices seems to improve the accuracy of the method. Radiographic method showed no difference between the image acquisition modes (digital or conventional), showing a tendency to higher values of specificity and performance in advanced caries lesions. Fluorescence-based devices showed similar overall performance; however, a better accuracy in detecting more advanced caries has been observed.

Introdução A prevalência de sobrepeso e obesidade em adolescentes brasileiros tem sido investigada em diferentes regiões e períodos do tempo. Estudos observacionais de base escolar apresentam baixo custo e são facilmente conduzidos, comparativamente a estudos de base populacional, que requerem maior custo e tempo. Objetivos Comparar medidas sumárias de prevalências de sobrepeso e obesidade no Brasil, obtidas em metanálise de estudos observacionais de bases escolar e populacional, realizados em amostras aleatórias. Métodos Bases de dados Medline, Embase, Lilacs, IBECS, Scielo, Adolec e Banco de Teses da Capes foram revisadas sistematicamente, buscando-se estudos de prevalência de sobrepeso e obesidade realizados no Brasil, em adolescentes, com 10 a 19 anos, entre 1990 e 2010. Estudos de prevalência, transversal ou de coorte, publicados em revistas com “peer review” e na literatura “cinza”, foram identificados por dois revisores independentemente, a partir de título e resumo, e, após comparação, um terceiro decidiu discordâncias. Dados foram extraídos por dois pesquisadores independentes utilizando protocolo padronizado, discordâncias decididas por consenso ou árbitro. A classificação de sobrepeso, obesidade e/ou excesso de peso foi definida pelos critérios utilizados em cada estudo. A análise dos dados utilizou modelo aleatório, realizada no Software 6 Comprehensive Meta-Analysis 2.0®. Resultados Entre 1939 artigos elegíveis, 138 preencheram os critérios de inclusão, 58 foram excluídos, sendo 30 exclusões pelo motivo de dados em duplicata, 17 por não utilizarem amostras aleatórias populacionais ou escolares representativas e 11 por não apresentarem os dados requeridos no protocolo da metanálise. Vinte e cinco estudos foram considerados perdas por não apresentarem a prevalência de obesidade em adolescentes, após três tentativas de contato com os autores. Dos 55 estudos incluídos na metanálise, 14 eram estudos observacionais com amostras de base populacional e 41 de base escolar. A prevalência de sobrepeso e obesidade em adolescentes encontrada em estudos de base populacional foi 16,7% (95% CI: 13,2-20,8) e 5,5% (95% CI: 4,2-7,1) e nos de base escolar foi 11,9% (95% CI: 10,3-13,3) e 5,1% (95% CI: 4,3-6,0), respectivamente. A heterogeneidade encontrada nos estudos de base populacional foi Q=8,17 (P < 0,001) para sobrepeso e Q=5,88 (P < 0,001) para obesidade, enquanto nos de base escolar foi Q=30,6 (P < 0,001) e Q=33,6 (P < 0,001), respectivamente. Apesar dos estudos com amostras de base escolar mostrarem maior inconsistência dos resultados quando comparados com os estudos de amostra de base populacional (I²=7,74 vs. 0), esses valores não são considerados altos. Conclusão Estudos com amostras de adolescentes de base populacional e escolar apresentam estimativas pontuais similares de prevalência de obesidade, porém apresentam diferenças nas prevalências pontuais de sobrepeso. / Introduction In Brazil, overweight and obesity prevalence in adolescents has been investigated in different regions and periods of time. Studies of school-based samples have low cost and are easily conducted, being widely used. Otherwise, population-based studies require greatest investments, more time and researches, besides high complexity to minimize bias. Objective To undertake meta-analysis of observational studies conducted in Brazilian adolescents to calculate pooled estimates for overweight and obesity prevalence for school-based versus population-based samplings. Methods Data sources included Medline, Embase, Bireme, and CAPES-Thesis database searching for articles and grey literature about overweight and obesity prevalence in adolescents aged 10 to 19 years, from studies conducted in Brazil from 1990 to 2010. Studies were systematically reviewed, with no language restriction, and independently extracted by two investigators using a standardized protocol. Overweight, obesity and/or overweight plus obesity were defined according to the criteria used in each study. Data analysis was performed by Comprehensive Meta-Analysis 2.0®, using random effect model. Results Among 1939 articles reviewed, 138 met the inclusion criteria, 58 were excluded, and 25 were not retrieved after three attempts to contact authors. Among 55 studies included in meta-analysis 14 were population-based and 41 school-based samples. Overweight and obesity prevalence in population-based studies was 16.7% (95% CI: 13.2-20.8) and 5.5% (95% CI: 4.2-7.1) and in school-based studies it was 11.9% (95% CI: 10.3-13.3) and 5.1% (95%CI: 4.3-6.0), respectively. The heterogeneity founded in population-based studies was Q = 8.17 (P < 0.001) for overweight and Q = 5.88 (P < 0.001) for obesity, while in school-based studies it was Q=30.6 (P < 0.001) and Q=33.6 (P < 0.001), respectively. Although school-based studies showed higher inconsistency measure in the results compared with population-based samples studies (I²=7,74 vs. 0), these values are not considered high. Conclusion School-based studies as well population-based studies conducted in adolescents provide similar point estimate of obesity prevalence, but there is a difference for point prevalence of overweight.

Orientador: Eliane Chaves Jorge / Resumo: Bissoli SFR. Mapeamento das evidências das revisões sistemáticas de oftalmologia da base de dados Cochrane. [dissertação]. Botucatu, SP: Faculdade de Medicina, Universidade Estadual Paulista; 2018. Justificativa e objetivos: A Colaboração Cochrane visa oferecer, por meio da publicação de revisões sistemáticas, informações atualizadas, objetivas e com evidências consistentes para a prática clínica e para o estabelecimento de políticas de saúde. Entretanto, verifica-se, frequentemente, uma inconsistência de evidências e incapacidade de gerar recomendações. O objetivo desse estudo foi analisar as revisões sistemáticas do Grupo Oftalmologia da Colaboração Cochrane e mapear sua utilidade para a prática clínica e para a pesquisa científica. Método: Realizou-se estudo transversal com análise de todas as revisões sistemáticas publicadas no Grupo Oftalmologia da Colaboração Cochrane até maio de 2018, verificando-se qual o tipo de recomendação para a prática clínica e para a pesquisa científica, por meio da análise das conclusões de seus autores. Além disso, computou-se o número de ensaios clínicos e meta-análises por revisão sistemática e por subespecialidade, por ano. Resultados: 202 revisões foram obtidas no período. Evidências que apoiam a intervenção, com recomendação para a realização de mais estudos ou sem recomendação para mais estudos: 36,3% [IC 95% 36,2-36,4] e 5,0% [IC 95% 4,8-5,1], respectivamente. Evidências contrárias à intervenção, com recomendação para realização de mai... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Bissoli SFR. Mapping of the evidences of systematic reviews of Ophthalmology Cochrane database. [dissertation]. Botucatu, SP: Botucatu Medical School, State University of São Paulo 2018. Rationale and objectives: The Cochrane Collaboration aims to provide, through the publication of systematic reviews, up-to-date, objective information and with consistent evidence for clinical practice and for the establishment of health policies. However, there is often an inconsistency of evidence and inability to generate recommendations. The objective of this study was to analyze the systematic reviews of the Cochrane Collaboration Ophthalmology Group and to map its usefulness to clinical practice and to scientific research. Methods: A cross-sectional study was carried out with an analysis of all the systematic reviews published in the Ophthalmology Group of the Cochrane Collaboration until May 2018, confirming the type of recommendation for clinical practice and for scientific research, through analysis of the conclusions of its authors. In addition, we counted the number of clinical trials and meta-analyzes by systematic review and by subspecialty, per year. Results: 202 revisions were obtained in the period. Evidence that supports the intervention, with recommendation for further studies: 36.3% [CI 95% 36.2-36.4] or no recommendation for further studies: 5.0% [CI 95% 4.8-5.1]. Evidence contrary to intervention, with recommendation for further studies 3.0% [CI 95% 2.8-3.1] or no recomme... (Complete abstract click electronic access below) / Mestre

No description available.

Alzheimer\'s disease (AD) is one of the main causes of dependency and disability in the elderly population. A number of investigations have been seeking its prevention and/or management. In this context, it is important to highlight the role of modifiable risk factors, such as nutrition. This study aims to conduct a systematic review and subsequent meta-analysis, to assess the effect of food and/or nutrients for the management of AD at different stages. This work was steered based on the Cochrane Handbook for systematic reviews of interventions and the PRISMA Statement. Electronic databases were searched up to 2014, in Portuguese, English or Spanish. Relevant publications were identified by title and abstract using key search terms referring to Alzheimer\'s disease, nutrition interventions and type of study. Trials\' risk of bias was appraised by applying the Cochrane\'s tool for assessing risk of bias. The main outcome measures comprise neuropsychological tests such as MMSE, ADCS-ADL, NPI and CDR-sob, biomarkers and brain imaging. Pairwise meta-analyses were performed in a random-effect model by estimating the weighted mean differences between treatment and placebo groups, with 95% confidence intervals for outcome measures by treatment. Network meta-analysis and the ranking probability of treatment for each nutrition intervention were undertaken on cognitive outcome. The strength and quality of evidence were rated according to the GRADE approach. From the whole research, 182 studies met the systematic review\'s purpose. Thirty-five clinical trials complied with eligibility criteria and risk of bias assessment. Included studies utilized: antioxidants, B-vitamin complex, carbohydrates, lipids, omega-3 fatty acids, polymeric formulas, polypeptide and vitamin D. Estimates treatment effects from pairwise meta-analyses show a significant positive effect from the supplementation with proline-rich polypeptide (WMD 12.00 [95% CI 10.20, 13.80] P < 0.00001) and B-vitamin complex (WMD 0.44 [95% CI 0.09, 0.79] P = 0.01) on cognitive function measured by the MMSE. Remaining nutrients supplementation did not show any significant effect on functional, behavioral, global performance, biomarkers or brain imaging outcomes. Isolated nutrient supplementations show no convincing evidence of providing a significant benefit on clinical manifestations or neuropathology of AD. As a treatment strategy, nutrients did not show any effect when delivered individually, probably due to their synergistic work on brain function at different domains. Nevertheless, nutrients represent a potential preventive approach and an adjuvant treatment for patients with AD at earlier stages. / A doença de Alzheimer (DA) é uma das maiores causas de dependência e incapacidade na população idosa, o que tem levado a inúmeras investigações sobre sua prevenção e ou manejo. Neste contexto, é importante destacar o papel desempenhado pelos fatores de risco modificáveis, como a nutrição. Este estudo trata de uma revisão sistemática e meta-análise, para avaliar o efeito das intervenções nutricionais no manejo da DA, em seus diferentes estágios. Este trabalho segue as propostas da Colaboração Cochrane e a declaração PRISMA. Bases de dados eletrônicas foram pesquisadas a partir do seu início até o 2014, em Português, Inglês ou Espanhol. Estudos relevantes foram identificados por título e resumo usando as palavras-chave referente à doença de Alzheimer, intervenções nutricionais e tipo de estudo. A qualidade dos estudos foi avaliada mediante a ferramenta da Cochrane para avaliação do risco de viés. As principais medidas de desfechos compreenderam os testes neuropsicológicos MEEM, AVD, NPI e CDR-sob, biomarcadores e neuroimagem. As meta-análises em pares foram realizadas em modelo de efeito aleatório pela estimativa de diferença de médias ponderadas entre os grupos de tratamento e placebo, com 95% de intervalo de confiança para as medidas de desfecho segundo a intervenção. A meta-análise em rede e a probabilidade da posição do tratamento para cada intervenção nutricional foi realizada para o desfecho cognitivo. A força e a qualidade da evidência foram avaliadas de acordo com o método GRADE. Da busca total inicial, 182 estudos cumpriam com o propósito desta revisão sistemática. Ainda, 35 ensaios clínicos preencheram os critérios de elegibilidade e avaliação de risco de viés. Os estudos incluídos usaram: antioxidantes, vitaminas do complexo B, carboidratos, lipídeos, ácidos graxos ômega-3, formula poliméricas, polipeptídios e vitamina D. As estimativas de efeito do tratamento das meta-análises em pares mostraram um efeito positivo significativo a partir da suplementação com um polipeptídio rico em prolina (MD 12.00 [95% IC 10.20, 13.80] P < 0.00001) e com as vitaminas do complexo B (MD 0.44 [95% IC 0.09, 0.79] P = 0.01) na função cognitiva avaliada pelo MEEM. A suplementação com os demais nutrientes não mostrou um efeito significativo na funcionalidade, comportamento, desempenho global, biomarcadores da DA, nem desfechos de imagem. A suplementação com nutrientes isolados não mostrou um efeito significativo nas manifestações clínicas ou neuropatologicas da DA. Como estratégia de tratamento, os nutrientes não demonstraram um efeito separadamente, provavelmente devido a seu trabalho sinérgico nos diferentes domínios da função cerebral. Ainda assim, os nutrientes representam uma abordagem preventiva potencial e um tratamento adjuvante nas pessoas com DA nos estágios iniciais.

The equivocal and debated findings from a 2007 meta-analysis, which viewed perfectionism as a unidimensional construct, suggested that perfectionism was unrelated to procrastination. The present meta-analysis aimed to provide a conceptual update and reanalysis of the procrastination–perfectionism association guided by both a multidimensional view of perfectionism and self-regulation theory. The random-effects meta-analyses revealed a small to medium positive average effect size (r = .23; k = 43, N = 10 000; 95% confidence interval (95% CI) [0.19, 0.27]) for trait procrastination and perfectionistic concerns and a small to medium negative average effect size (r = −.22; k = 38, N = 9544; 95% CI [−0.26, −0.18]) for procrastination and perfectionistic strivings. The average correlations remained significant after statistically accounting for the joint variance between the two perfectionism dimensions via semi-partial correlations. For perfectionistic concerns, but not perfectionistic strivings, the effects depended on the perfectionism measure used. All effects did not vary by the trait procrastination measure used or the respondent's sex. Our findings confirm that from a multidimensional perspective, trait procrastination is both positively and negatively associated with higher-order perfectionism dimensions and further highlights the value of a self-regulation perspective for understanding the cognitive, affective and behavioural dynamics that characterise these traits.

Background: Current guidelines give a class I recommendation to use of embolic protection devices (EPD) for saphenous vein graft (SVG) intervention; however, studies have shown conflicting results. The objective of this meta-analysis is to compare all-cause mortality, major adverse cardiovascular events, myocardial infarction (MI), or target vessel revascularization in SVG intervention with and without EPD. Methods and Results: Literature was searched through October 2016. Eight studies (n=52 893) comparing SVG intervention performed with EPD (n=11 506) and without EPD (n=41 387) were included. There was no significant difference in all-cause mortality (odds ratio [OR], 0.79; confidence interval [CI], 0.55–1.12; P=0.19), major adverse cardiovascular events (OR, 0.73, CI, 0.51–1.05; P=0.09), target vessel revascularization (OR, 1.0; CI, 0.95–1.05; P=0.94), periprocedural MI (OR, 1.12; CI, 0.65–1.90, P=0.69), and late MI (OR, 0.80; CI, 0.52–1.23; P=0.30) between the 2 groups. Sensitivity analysis excluding CathPCI Registry study showed no difference in periprocedural MI, late MI, and target vessel revascularization; however, it favored EPD use in all-cause mortality and major adverse cardiovascular events. Further sensitivity analysis including only observational studies revealed no difference in all-cause mortality, major adverse cardiovascular events, target vessel revascularization, and late MI. Additional analysis after excluding CathPCI Registry study revealed no difference in outcomes. Conclusions: This study including 52 893 patients suggests no apparent benefit in routine use of EPD during SVG intervention in the contemporary real-world practice. Further randomized clinical trials are needed in current era to evaluate long-term outcomes in routine use of EPD, and meanwhile, current guideline recommendations on EPD use should be revisited.

Objective Genetic factors play an important role in modulating the vulnerability to body mass index (BMI). The purpose of this study is to identify novel genetic variants for BMI using genome-wide association (GWA) meta-analysis. Methods PLINK software was used to perform meta-analysis of two GWA studies (the FUSION and Marshfield samples) of 5218 Caucasian individuals with BMI. A replication study was conducted using the SAGE sample with 762 individuals. Results Through meta-analysis we identified 33 SNPs associated with BMI with p < 10− 4. The most significant association was observed with rs2967951 (p = 1.19 × 10− 6) at 5p15.2 within ROPN1L gene. Two additional SNPs within ROPN1L and 5 SNPs within MARCH6 (the top SNP was rs2607292 with 4.27 × 10− 6) further supported the association with BMI on 5p15.2 (p < 1.8 × 10− 5). Conditional analysis on 5p15.2 could not distinguish the effects of ROPN1L and MARCH6. Several SNPs within MARCH6 and ROPN1L were replicated in the SAGE sample (p < 0.05). Conclusion We identified a novel locus for BMI. These findings offer the potential for new insights into the pathogenesis of BMI and obesity and will serve as a resource for replication in other populations to elucidate the potential role of these genetic variants in BMI and obesity.

abstract: Knowledge advancement occurs when the creation of new and useful knowledge encompasses and supersedes earlier knowledge. A rapidly growing number of scholars with state-of-the-art research tools has led to the growth of knowledge exploration in almost every field. It, however, has been observed that the findings of new studies frequently differ from previously established evidence and even disagree with one another. Conflicting and contradictory results prevail in the literature. This phenomenon has puzzled many people with respect to which findings are reliable and which should be considered as valid. Inconclusive results in the literature inhibit, rather than facilitate, knowledge advancement in sciences. Meta-analysis, which is referred to as the analysis of analyses, designed to synthesize findings from a large collection of quantitative analyses that produce inconsistent results has become a major research method in the fields of medicine, education, and psychology; however, the method has been slow to penetrate research in nonprofit and public management (NPM). This study, therefore, discusses how meta-analysis contributes to knowledge advancement in the fields of nonprofit and public management by using nonprofit commercialization as an example to examine its impact on nonprofit capacity and donations, respectively. The attention of this discussion is directed toward how the use of meta-regression models is able to offer new and useful knowledge that encompasses and supersedes earlier knowledge in the literature with evidence-based results. Moreover, this study examines whether the use of SEM-based meta-analysis produces equivalent results when compared with results from traditional meta-regression models. The comparison results suggest that the use of SEM-based meta-analysis is able to produce equivalent results even when missing data are present. Overall, this study makes at least two contributions. First, it introduces a newly-developed method for conducting meta-analysis to the field of NPM. This method is especially useful when there are missing data in data sets. Second and most importantly, this study demonstrates how knowledge advancement in NPM can be achieved by conducting meta-analysis. / Dissertation/Thesis / Doctoral Dissertation Community Resources and Development 2019

Using the results of 65 reports, this study examined the effect of marriage and relationship education (MRE) on couples' communication, and accounted for various moderators of this effect, including method of assessment and unit of analysis. This study is part of a comprehensive meta-analysis of MRE evaluation research conducted since 1975 (k = 124 codable reports). Overall, MRE produced modest but reliable effects on couples' communication. These effects were maintained at follow-up assessments and were not affected significantly by publication bias. No differences in effect were found for gender. Observational assessments did produce larger effects than self-report assessments. MRE produced the largest effect on positive conflict resolution outcomes. These results have important implications for research, intervention, and policy.