Metabolic effects of interventions to increase exercise in adults with type 2 diabetes.

AIMS/HYPOTHESIS: The aim of this meta-analysis was to integrate the results of primary research testing the effect of diabetes self-management interventions that included recommendations to increase exercise on metabolic outcomes among adults with type 2 diabetes. MATERIALS AND METHODS: Extensive literature searching strategies were used to identify published and unpublished intervention studies that measured glycated haemoglobin outcomes. Primary study results were coded. Fixed- and random-effects meta-analytic procedures included moderator analyses. RESULTS: Data were synthesised across 10,455 subjects from 103 research reports. The overall mean weighted effect size for two-group comparisons was 0.29 (higher mean for treatment than control). This effect size is consistent with a difference in HbA1c means of 0.45% (e.g. 7.38% for treatment subjects vs 7.83% for control subjects). For single-group studies, the overall mean weighted effect size was 0.32-0.34. Control group subjects experienced no improvement in metabolic control during participation in the studies. Interventions that targeted multiple health behaviours resulted in smaller effect size estimates (0.22) than interventions that focused only on exercise behaviours (0.45). Funded studies reported greater improvements in metabolic controls. Studies with a greater proportion of female subjects reported lower effect sizes. Baseline HbA1c and BMI were unrelated to metabolic outcomes. CONCLUSIONS/INTERPRETATION: These findings suggest that self-management interventions that include exercise recommendations improve metabolic control, despite considerable heterogeneity in the magnitude of the intervention effect. Interventions that emphasise exercise may be especially effective in improving metabolic control. Primary research testing interventions in randomised trials to confirm causal relationships would be constructive.

Free-response self-discrepancies across, among, and within FFM personality dimensions.

An approach for personality-based self-discrepancy (PBSD) measurement is proposed, whereby self-beliefs and incongruities among their contents are assessed with respect to five-factor model (FFM) semantic dimensions. Selves Questionnaire attributes from 191 college students were coded against L. R. Goldberg's (1990) FFM factor analysis to construct personality scores for actual, ideal, and ought self domains, as well as several PBSD indices. Multivariate analyses were conducted to test self-discrepancy and personality-structure hypotheses, and to demonstrate this strategy's operational flexibility. Profile analyses indicated that empirical self-discrepancies depend upon whether and how personality structure is incorporated. Methodological alterations influenced self-discrepancy findings negligibly. Initial evidence for PBSD construct validity and predictive specificity is presented, and the approach's implications, advantages, and extensions are discussed.

Factors influencing racial comparisons of self-esteem: a quantitative review.

Research on racial comparisons of self-esteem was examined. Early research in this area, exemplified by the doll studies of racial preference, was viewed as demonstrating that Blacks have less self-regard than Whites. However, a meta-analytic synthesis of 261 comparisons, based largely on self-esteem scales and involving more than half a million respondents, revealed higher scores for Black than for White children, adolescents, and young adults. This analysis further revealed that the direction and magnitude of racial differences are influenced by such demographic characteristics as participant age and socioeconomic status, as well as by characteristics of the measuring instruments. Many findings--for example, that the self-esteem advantage for Black respondents increases with age and is related to the sex composition of the sample--underscore the need for long-term longitudinal studies of self-esteem development in male and female members of both racial groups.