The clinical effectiveness of different parenting programmes for children with conduct problems : a systematic review of randomised controlled trials

Background Conduct problems are common, disabling and costly. The prognosis for children with conduct problems is poor, with outcomes in adulthood including criminal behaviour, alcoholism, drug abuse, domestic violence, child abuse and a range of psychiatric disorders. There has been a rapid expansion of group based parent-training programmes for the treatment of children with conduct problems in a number of countries over the past 10 years. Existing reviews of parent training have methodological limitations such as inclusion of non-randomised studies, the absence of investigation for heterogeneity prior to meta-analysis or failure to report confidence intervals. The objective of the current study was to systematically review randomised controlled trials of parenting programmes for the treatment of children with conduct problems. Methods Standard systematic review methods were followed including duplicate inclusion decisions, data extraction and quality assessment. Twenty electronic databases from the fields of medicine, psychology, social science and education were comprehensively searched for RCTs and systematic reviews to February 2006. Inclusion criteria were: randomised controlled trial; of structured, repeatable parenting programmes; for parents/carers of children up to the age of 18 with a conduct problem; and at least one measure of child behaviour. Meta-analysis and qualitative synthesis were used to summarise included studies. Results 57 RCTs were included. Studies were small with an average group size of 21. Meta-analyses using both parent (SMD -0.67; 95% CI: -0.91, -0.42) and independent (SMD -0.44; 95% CI: -0.66, -0.23) reports of outcome showed significant differences favouring the intervention group. There was insufficient evidence to determine the relative effectiveness of different approaches to delivering parenting programmes. Conclusion Parenting programmes are an effective treatment for children with conduct problems. The relative effectiveness of different parenting programmes requires further research

Connecting Through Circles: A Playbook for Cultivating Well-Being Between Wharton Women Alumni

The Wharton Women\u27s Circles (WWC) at the University of Pennsylvania is a ground-breaking alumnae program founded in 2019 with a mandate to cultivate meaningful connections. The Circles, led by facilitators, provide working women a safe space to gather in an environment of support and encouragement. Through this process, women look to build community, confidence, inspiration, and produce desired results across personal and professional domains. Leveraging research in Positive Psychology, our team developed five facilitator-led sessions, encompassed in an adaptable ‘Playbook’ to support facilitators, engage participants, and drive discussions. The Playbook aims to accomplish three goals: (1) Amplify participant connection and well-being (2) Address survey feedback and the desire for more formal programming and structured conversations; and (3) Provide resources to enable future growth and scalability. The Playbook’s five facilitator-led sessions include: Know Your Strengths, Well-Being 101, Fostering Strong Relationships, Struggling Well, and Positive Transitions. We suggest measuring the Playbook’s efficacy through mixed qualitative and quantitative metrics

Economic evaluation of typhoid - a review.

Introduction: To evaluate the potential economic value and likely impact of a hypothetical rapid test in its early stages of development requires the use of models. The model structure and the type of model (dynamic/static) to employ are key considerations. The aim of the review was to explore the literature on typhoid economic evaluations and to explore the types of models that have been previously adopted in this setting for test-treat evaluations and to capture data on model inputs that may be useful for a de novo model. Areas covered: A systematic review was conducted to identify economic evaluations focused on typhoid in established literature databases. Eight studies were identified and included for narrative synthesis. The review has revealed that there have been relatively few economic evaluations that have focused on typhoid fever, all of which have focused on the impact of interventions at the population level (vaccination) but not the individual level (test-treat strategies). Expert commentary: Under certain circumstances, either a static model or a transmission dynamic model may be appropriate in the evaluation of an intervention for typhoid fever. Typhoid test-treat modeling represents a gray area where further work is needed

How well do health professionals interpret diagnostic information?:A systematic review

OBJECTIVE: To evaluate whether clinicians differ in how they evaluate and interpret diagnostic test information. DESIGN: Systematic review. DATA SOURCES: MEDLINE, EMBASE and PsycINFO from inception to September 2013; bibliographies of retrieved studies, experts and citation search of key included studies. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Primary studies that provided information on the accuracy of any diagnostic test (eg, sensitivity, specificity, likelihood ratios) to health professionals and that reported outcomes relating to their understanding of information on or implications of test accuracy. RESULTS: We included 24 studies. 6 assessed ability to define accuracy metrics: health professionals were less likely to identify the correct definition of likelihood ratios than of sensitivity and specificity. –25 studies assessed Bayesian reasoning. Most assessed the influence of a positive test result on the probability of disease: they generally found health professionals’ estimation of post-test probability to be poor, with a tendency to overestimation. 3 studies found that approaches based on likelihood ratios resulted in more accurate estimates of post-test probability than approaches based on estimates of sensitivity and specificity alone, while 3 found less accurate estimates. 5 studies found that presenting natural frequencies rather than probabilities improved post-test probability estimation and speed of calculations. CONCLUSIONS: Commonly used measures of test accuracy are poorly understood by health professionals. Reporting test accuracy using natural frequencies and visual aids may facilitate improved understanding and better estimation of the post-test probability of disease

CONSERVATION OF THE ORINOCO GOOSE (NEOCHEN JUBATA) IN THE MIDDLE ARAGUAIA RIVER, TOCANTINS, BRAZIL.

The Orinoco goose, (Neochen jubata) is a grazing herbivore of open habitats that was once widely distributed in tropical South America. Centuries of overhunting and habitat loss have reduced it to widely scattered remnant populations; it is categorized as Near Threatened globally. Within the Cerrado biome, the Middle Araguaia River houses the largest remnant population. In August 2017, a study was started to assess the situation of the Orinoco Goose in the regions of Araguaia National Park, Cantão State Park, and adjacent rice fields. We conducted counts from an aerial census (a 700 km transect), monthly boat censuses (40 km) and land censuses in rice plantations. The aircraft census counted 367 individuals in August 2017, while monthly monitoring of a stretch of the lower Javaés River over more than two years showed a seasonal population variation associated with the flood regime, with the species virtually disappearing during the flood period between January and April when river beaches are submerged. During this period, large flocks of about 1,000 Orinoco Geese were discovered not far away, concentrated in small stretches of rice plantation agro-systems in the region.  This behavioral seasonal concentration makes the species susceptible to poisoning and epizootic diseases. The findings suggest the need to re-categorize the Orinoco Goose population of the Middle Araguaia River as “Threatened” for the State of Tocantins due to the decline observed in the last 10 years, the maximum estimated population size, and the significant seasonal concentrations in a restricted area. At the same time, it is necessary to develop an action plan for its conservation in the surroundings of Ilha do Bananal, and throughout Brazil, where its threat status must be reviewed

Acceptability of predictive testing for ischemic heart disease in those with a family history and the impact of results on behavioural intention and behaviour change : a systematic review

Background: Tests to predict the development of chronic diseases in those with a family history of the disease are becoming increasingly available and can identify those who may benefit most from preventive interventions. It is important to understand the acceptability of these predictive approaches to inform the development of tools to support decision making. Whilst data are lacking for many diseases, data are available for ischemic heart disease (IHD). Therefore, this study investigates the willingness of those with a family history of IHD to take a predictive test, and the effect of the test results on risk-related behaviours. Method: Medline, EMBASE, PsycINFO, LILACS and grey literature were searched. Primary research, including adult participants with a family history of IHD, and assessing a predictive test were included. Qualitative and quantitative outcomes measuring willingness to take a predictive test and the effect of test results on risk-related behaviours were also included. Data concerning study aims, participants, design, predictive test, intervention and findings were extracted. Study quality was assessed using the Standard Quality Assessment Criteria for Evaluating Research Papers from a Variety of Fields and a narrative synthesis undertaken. Results: Five quantitative and two qualitative studies were included. These were conducted in the Netherlands (n = 1), Australia (n = 1), USA (n = 1) and the UK (n = 4). Methodological quality ranged from moderate to good. Three studies found that most relatives were willing to take a predictive test, reporting family history (n = 2) and general practitioner (GP) recommendation (n = 1) as determinants of interest. Studies assessing the effect of test results on behavioural intentions (n = 2) found increased intentions to engage in physical activity and smoking cessation, but not healthy eating in those at increased risk of developing IHD. In studies examining actual behaviour change (n = 2) most participants reported engaging in at least one preventive behaviour, particularly medication adherence. Conclusion: The results suggests that predictive approaches are acceptable to those with a family history of IHD and have a positive impact on health behaviours. Further studies are needed to provide a comprehensive understanding of predictive approaches in IHD and other chronic conditions