Effectiveness of Forensic Assertive Community Treatment on Forensic and Health Outcomes: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 009385482110614
Author(s):  
Marie-Hélène Goulet ◽  
Laura Dellazizzo ◽  
Clara Lessard-Deschênes ◽  
Alain Lesage ◽  
Anne G. Crocker ◽  
...  

Given the increasing literature on forensic assertive community treatment (FACT), we conducted a systematic review and meta-analysis to explore the effectiveness of FACT among justice-involved individuals with severe mental illness. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Sixteen studies were included in the systematic review, six of which were included in the meta-analyses for a total of 1,246 participants. Mixed results regarding health-related outcomes were found. The pre-post FACT analysis and comparison with control groups did not yield significant results other than increased outpatient service use. Results on forensic outcomes were more compelling. Both the narrative review and the meta-analysis highlighted that FACT programs may improve justice outcomes such as the number of days spent in jail. More high quality and multisite randomized controlled trials are needed to consolidate findings. Further research is needed to examine other psychosocial factors related to FACT program success.

2006 ◽  
Vol 37 (1) ◽  
pp. 3-14 ◽  
Author(s):  
STEPHEN KISELY ◽  
LESLIE ANNE CAMPBELL ◽  
ANITA SCOTT ◽  
NEIL J. PRESTON ◽  
JIANGUO XIAO

Background. There is limited randomized controlled trial (RCT) evidence for compulsory community treatment. Other study methods may clarify their effectiveness. We reviewed RCT and non-RCT evidence for the effect of compulsory community treatment on hospital admissions, bed-days, compliance and out-patient contacts.Method. A systematic review of RCTs, controlled before-and-after (CBA) studies, and interrupted time series (ITS) analyses. Meta-analysis of RCTs.Results. Eight papers covering five studies (two RCTs and three CBAs) met inclusion criteria (total n=1108). There was no statistical difference in 12-month admission rates between subjects on involuntary out-patient treatment and controls. Survival analyses of time to admission were equivocal. All five studies reported decreases in the number of bed-days following involuntary out-patient treatment but this only reached statistical significance in one situation; patients receiving the intervention were less likely to have admissions of over 100 days. There was no difference in treatment adherence between the intervention and control groups in either RCT or two of the CBA studies. However, the third CBA study reported a statistically significant increase of nearly five visits in the mean number of overall contacts in the involuntary out-patient treatment group.Conclusions. The evidence for involuntary out-patient treatment in reducing either admissions or bed-days is very limited. It therefore cannot be seen as a less restrictive alternative to admission. Other effects are uncertain. Evaluation of a wide range of outcomes should be included if this type of legislation is introduced.


PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3600 ◽  
Author(s):  
Julien Tripette ◽  
Haruka Murakami ◽  
Katie Rose Ryan ◽  
Yuji Ohta ◽  
Motohiko Miyachi

BackgroundWii Fitwas originally designed as a health and fitness interactive training experience for the general public. There are, however, many examples ofWii Fitbeing utilized in clinical settings. This article aims to identify the contribution ofWii Fitin the field of health promotion and rehabilitation by: (1) identifying the health-related domains for which theWii Fitseries has been tested, (2) clarifying the effect ofWii Fitin those identified health-related domains and (3) quantifying this effect.MethodA systematic literature review was undertaken. The MEDLINE database andGames for Health Journalpublished content were explored using the search term “Wii-Fit.” Occurrences resulting from manual searches on Google and material suggested by experts in the field were also considered. Included articles were required to have measurements fromWii Fitactivities for at least one relevant health indicator. The effect ofWii Fitinterventions was assessed using meta-analyses for the following outcomes: activity-specific balance confidence score, Berg balance score (BBC) and time-up-and-go test (TUG).FindingsA total of 115 articles highlighted that theWii Fithas been tested in numerous healthy and pathological populations. Out of these, only a few intervention studies have focused on the prevention of chronic diseases. A large proportion of the studies focus on balance training (N= 55). This systematic review highlights several potential benefits ofWii Fitinterventions and these positive observations are supported by meta-analyses data (N= 25). For example, the BBC and the TUG respond to a similar extend toWii Fitinterventions compared with traditional training.ConclusionWii Fithas the potential to be used as a rehabilitation tool in different clinical situations. However, the current literature includes relatively few randomized controlled trials in each population. Further research is therefore required.


2020 ◽  
Vol 3 ◽  
pp. 1-15
Author(s):  
Laura McCosker ◽  
Robert Ware ◽  
Martin J. Downes

Background: In comparison to the general population, people who are homeless have poorer health and health-related outcomes, including for vaccine-preventable diseases. Vaccination is safe, effective and cost-effective, and many vaccination guidelines specifically recommend vaccination in people who are homeless. This systematic review will identify interventions which are effective in delivering vaccination to, and/or at improving vaccination rates in, people who are homeless. Methods/Design: This systematic review is presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches will be undertaken on eight electronic databases, using combinations of search terms and subject headings or index terms. Citation chaining will also be undertaken. Literature will be screened for relevance against inclusion/exclusion criteria firstly by title/abstract and secondly by full text. The selected studies will be assessed for quality using an evidence-based tool appropriate to their methods. Data relevant to the topic will be extracted and examined using meta-analysis and narrative synthesis. Discussion: This systematic review will address an important gap in the literature about vaccination in people who are homeless. The review’s findings are particularly relevant considering the current coronavirus disease (COVID-19) pandemic, which is likely to be managed through vaccination.


2021 ◽  
Vol 12 ◽  
Author(s):  
Ana Filipa Silva ◽  
Rodrigo Ramirez-Campillo ◽  
Hugo Sarmento ◽  
José Afonso ◽  
Filipe Manuel Clemente

BackgroundThe use of dedicated training programs for improving decision-making (DM) in team sports players has grown in the last several years. Approaches such as imagery training, video-based training, or game-based drills are some of the interventions used in youth players in order to improve DM. However, no systematic reviews or meta-analyses have been conducted to summarize the main evidence regarding the effects of these programs on the players and identify the magnitude of the effects compared to control groups.ObjectiveThis systematic review (with meta-analysis) was conducted to assess the effects of training programs on the DM of youth team sports players.Data SourcesThe data sources utilized were PubMed, PsycINFO, Scopus, SPORTDiscus, and Web of Science.Study eligibility criteriaThe criteria included the following: (i) youth (≤ 18 years old) team sports players with no restriction on sex or competitive level; (ii) players subjected to training programs to develop DM; (iii) control groups; (iv) pre–post outcomes related to tactical behavior, technical execution, reaction, and decision time; and (v) controlled trials.ResultsThe database search initially identified 2497 titles. From these, six articles were eligible for the systematic review and meta-analysis. The results showed a significant beneficial effect of DM interventions on tactical behavior (ES = 1.12; p = 0.035; I2 = 80.0%; Egger’s test p = 0.066), whereas no significant effect of DM interventions on technical execution was found (ES = 0.74; p = 0.180; I2 = 69.1%; Egger’s test p = 0.873).ConclusionThe DM interventions were significantly effective in improving tactical behavior in youth team sports players independently from the number of sessions to which players were exposed. In addition, DM interventions were significantly effective in improving technical execution. However, the results should be carefully interpreted due to the heterogeneity of the articles’ overall methodological quality. Future DM interventions should consider using combined approaches that allow players to develop both tactical behavior and technical execution.


Sports ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. 88 ◽  
Author(s):  
Håvard Lorås

Appropriate levels of motor competence are an integrated part of individuals’ health-related fitness, and physical education is proposed as an important context for developing a broad range of motor skills. The aim of the current study was to apply meta-analyses to assess the effectiveness of curriculum-based physical education on the development of the overall motor competence of children and adolescents. Studies were located by searching seven databases and included according to predefined criteria. Random effects models using the standardized effect size (Hedges’ g) were used to aggregate results, including an examination of heterogeneity and inconsistency. The meta-analysis included 20 studies, and a total of 38 effect sizes were calculated. A statistically significant improvement in motor competence following curriculum-based physical education compared to active control groups was observed in children and adolescents (g = −0.69, 95% CI −0.91 to −0.46, n = 23). Participants’ ages, total time for physical education intervention, and type of motor competence assessment did not appear to be statistically significant moderators of effect size. Physical education with various curricula can, therefore, increase overall motor competence in children and adolescents.


2021 ◽  
Author(s):  
Thomas Munder ◽  
Alessia Geisshüsler ◽  
Tobias Krieger ◽  
Johannes Zimmermann ◽  
Markus Wolf ◽  
...  

Background: Treatment as usual (TAU) is the most frequently used control group in randomised trials of psychotherapy for depression and meta-analyses that summarise these trials. Concerns have been raised over imprecise and biased efficacy estimates because of substantial variability in the treatments provided in TAU. We set out to investigate the impact of the control group intensity (i.e., quantitative and qualitative aspects of treatments in control groups) on results of trials of psychotherapy for depression and confounding due to systematic differences in this intensity in trials of face-to-face (F2F) and internet-based (INT) psychotherapy.Methods: We conducted a pre-registered systematic review and meta-analysis. We searched PsycINFO for systematic reviews of psychotherapy for depression from Jan 1, 2015 to Jan 3, 2020 and retrieved all references of trials included in these systematic reviews. We searched Cochrane’s Central Register of Controlled Trials and PsycINFO for randomised trials from Jan 1, 2018 to Jan 3, 2020. We included trials that compared (individual or group) F2F or (self-guided or guided) INT with TAU or waiting list (WL) in the acute treatment of patients with symptoms of unipolar depression. We excluded trials published before 2000. All information was extracted by two independent researchers. Six dichotomous indicators were used to create a score that expressed the intensity of TAU and WL. Primary outcome: Standardised mean differences (SMD) of treatment and control groups in depressive symptoms at treatment termination. SMDs were extracted from trial reports. A protocol was pre-registered with the Center for Open Science (www.osf.io/4mzyd).Findings: We included 89 eligible trials that randomised 14,474 patients to 113 eligible psychotherapy arms (8,284 patients) and 89 control arms (6,190 patients). TAU was used as control group in 42 trials (47.19%) and WL in 47 trials (52.81%). F2F was investigated in 37 trials (42.05%) and INT in 51 trials (57.95%). Intensity of control groups did not differ between F2F trials (M = 0.86, SD = 1.42) and INT trials (M = 0.39, SD = 0.63, p = .255). Intensity of control group was a significant predictor of trial results in the main analysis (one-sided p = .042), in pre-registered sensitivity analyses, and in all further exploratory analyses. Heterogeneity estimates were high (I2 = 69.30% to 95.37%). The final analysis found psychotherapy effects to be SMD = -0.287 (95% confidence interval [CI] -0.483 to -0.091, one-sided p = .002, I2 = 76.13%) smaller in 24 trials with higher intensity TAU compared to 16 trials with lower intensity TAU. Interpretation: Our findings suggest that the variability of treatments in TAU influences the results of trials on psychotherapy for depression and is likely to introduce imprecision into meta-analyses of these trials. Source of funding: None


Author(s):  
Ava Oliaei

Introduction: Obesity is associated with multiple health-related complications, which together can decrease quality of life, disability-adjusted life years and life expectancy.1 Systematic reviews and meta-analyses have demonstrated that sex can influence the association between obesity and health complications, such as rheumatoid arthritis and many types of cancer.2-4 However, no systematic review or meta-analysis has been conducted to review the effect of sex on the association between obesity and hypertension, thus far. Knowing whether or not sex influences this relationship can help tailor the prevention, prediction, and care of this condition towards each sex.    Objectives: To evaluate current studies on the association between sex, obesity, and hypertension, so as to obtain an overall estimate of the effect of sex on the prevalence of hypertension in obese individuals.     Methods: A systematic search of EMBASE, MEDLINE, and PubMed was conducted. Search terms, such as “obesity,” “sex differences,” and “hypertension,” were used to filter results. After reviewing 406 articles, eight articles were included.    Results: Four articles showed that obese women were at a greater risk of developing hypertension than obese men.5-8 Conversely, the results of two studies found that obese men are at a greater risk of developing hypertension.9,10 The remaining two studies showed that the difference between the sexes was insignificant.11,12     Discussion/Limitations: Stronger evidence shows that obese women are at a greater risk of developing hypertension than obese men. The two studies that had contradictory conclusions had small sample sizes relative to the other studies. Additionally, the two studies that concluded that both sexes are at a similar risk highlighted that most other studies have determined that obese women are at a greater risk and that their limitations may have caused this discrepancy. Limitations of this review include the limited ethnicity of participants and the use of BMI to classify obesity, which can sometimes lead to misclassification due to varying muscle to fat ratios. These factors limit the generalizability of the results.     Conclusion: Obese women are seemingly at a greater risk of developing hypertension than obese men. However, this conclusion remains statistically inconclusive. Therefore, it would be beneficial to complete a meta-analysis in order to conclusively determine which sex is statistically more at risk of developing hypertension, when obese.  


Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1899
Author(s):  
Alessandro Rizzo ◽  
Margherita Nannini ◽  
Annalisa Astolfi ◽  
Valentina Indio ◽  
Pierandrea De Iaco ◽  
...  

Background: Although the use of adjuvant chemotherapy (AC) appears to be increasing over the past few years, several clinical trials and previous meta-analyses failed to determine whether AC could improve clinical outcomes in uterine leiomyosarcoma (uLMS). The aim of this systematic review and meta-analysis was to compare AC (with or without radiotherapy) versus observation (obs) after primary surgery in early stage uLMS. Materials and Methods: Randomized controlled (RCTs) and non-randomized studies (NRSs) were retrieved. Outcomes of interest were as follows: distant recurrence rate, locoregional recurrence rate and overall recurrence rate. Results about distant recurrence rate, locoregional recurrence rate and overall recurrence rate were compared by calculating odds ratios (ORs) with 95% confidence intervals (CIs); ORs were combined with Mantel–Haenszel method. Results: Nine studies were included in the analysis, involving 545 patients (AC: 252, obs: 293). Compared with obs, AC did not reduce locoregional and distant recurrence rate, with a pooled OR of 1.36 and 0.63, respectively. Similarly, administration of AC did not decrease overall recurrence rate in comparison to obs. Conclusion: According to our results, AC (with or without radiotherapy) did not decrease recurrence rate in early stage uLMS; thus, the role of AC in this setting remains unclear.


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