Transparency in Cognitive Training Meta-analyses: A Meta-review.

Meta-analyses often present flexibility regarding their inclusion criteria, outcomes of interest, statistical analyses, and assessments of the primary studies. For this reason, it is necessary to transparently report all the information that could impact the results. In this meta-review, we aimed to assess the transparency of meta-analyses that examined the benefits of cognitive training, given the ongoing controversy that exists in this field. Ninety-seven meta-analytic reviews were included, which examined a wide range of populations with different clinical conditions and ages. Regarding the reporting, information about the search of the studies, screening procedure, or data collection was detailed by most reviews. However, authors usually failed to report other aspects such as the specific meta-analytic parameters, the formula used to compute the effect sizes, or the data from primary studies that were used to compute the effect sizes. Although some of these practices have improved over the years, others remained the same. Moreover, examining the eligibility criteria of the reviews revealed a great heterogeneity in aspects such as the training duration, age cut-offs, or study designs that were considered. Preregistered meta-analyses often specified poorly how they would deal with the multiplicity of data or assess publication bias in their protocols, and some contained non-disclosed deviations in their eligibility criteria or outcomes of interests. The findings shown here, although they do not question the benefits of cognitive training, illustrate important aspects that future reviews must consider.

Perfectionism and binge eating association: a systematic review and meta-analysis.

BACKGROUND: Perfectionism is considered a vulnerability factor for eating disorders. However, the role of perfectionism in binge eating needs clarification due to notably inconsistencies between studies. The purpose to this study was to conduct a systematic review and meta-analysis to estimate the perfectionism-binge eating association. METHOD: Systematic review was performed according to the PRISMA 2020 statement. Four databases (Web of Science, Scopus, PsycINFO and Psicodoc) were searched to identify studies published until September 2022. The literature search yielded 30 published articles (N = 9392) that provided 33 independent estimations of the correlation between the two variables. RESULTS: Random-effects meta-analysis revealed a small-to-moderate positive average effect size between general perfectionism and binge eating (r+ = .17) with a large heterogeneity. Perfectionistic Concerns showed a significant small-to-moderate relationship with binge eating (r+ = .27), whereas Perfectionistic Strivings presented a negligible relationship with binge eating (r+ = .07). Moderator analyses showed that the age, the type of the sample, the study design, and the tools for assessing both variables were statistically associated with the perfectionism-binge eating effect sizes. CONCLUSIONS: Our findings suggest that Perfectionism Concerns are closely associated with binge eating symptomatology. This relationship might be moderated by certain variables, especially by the clinical or non-clinical nature of the sample and the instrument employed to assess binge eating.

Perfectionism is a trait of personality comprising two facets, Perfectionistic Strivings (entails the desire to reach perfection and to pursue unrealistically high standards) and Perfectionistic Concerns (involves self-criticism, concerns over making mistakes, fears about social negative evaluation and lack of satisfaction with achievements). Perfectionist individuals have an increased risk for developing eating disorders. However, whether perfectionism or any of its facets is associated with binge eating (an episode of overeating together with a feeling of loss of control) is an unanswered question. The purpose of this systematic review and meta-analysis was to clarify this question. Our results evidenced that overall perfectionism is associated with binge eating. It means that perfectionist people are more vulnerable to developing binge eating symptomatology, although Perfectionistic Concerns entails a higher risk in comparison with Perfectionistic Strivings. Our study also provides valuable information on the aspects that might explain the variations in the results of previous studies that have analyzed the perfectionism-binge eating association.

Heterogeneity estimation in meta-analysis of standardized mean differences when the distribution of random effects departs from normal: A Monte Carlo simulation study.

BACKGROUND: Advantages of meta-analysis depend on the assumptions underlying the statistical procedures used being met. One of the main assumptions that is usually taken for granted is the normality underlying the population of true effects in a random-effects model, even though the available evidence suggests that this assumption is often not met. This paper examines how 21 frequentist and 24 Bayesian methods, including several novel procedures, for computing a point estimate of the heterogeneity parameter ([Formula: see text]) perform when the distribution of random effects departs from normality compared to normal scenarios in meta-analysis of standardized mean differences. METHODS: A Monte Carlo simulation was carried out using the R software, generating data for meta-analyses using the standardized mean difference. The simulation factors were the number and average sample size of primary studies, the amount of heterogeneity, as well as the shape of the random-effects distribution. The point estimators were compared in terms of absolute bias and variance, although results regarding mean squared error were also discussed. RESULTS: Although not all the estimators were affected to the same extent, there was a general tendency to obtain lower and more variable [Formula: see text] estimates as the random-effects distribution departed from normality. However, the estimators ranking in terms of their absolute bias and variance did not change: Those estimators that obtained lower bias also showed greater variance. Finally, a large number and sample size of primary studies acted as a bias-protective factor against a lack of normality for several procedures, whereas only a high number of studies was a variance-protective factor for most of the estimators analyzed. CONCLUSIONS: Although the estimation and inference of the combined effect have proven to be sufficiently robust, our work highlights the role that the deviation from normality may be playing in the meta-analytic conclusions from the simulation results and the numerical examples included in this work. With the aim to exercise caution in the interpretation of the results obtained from random-effects models, the tau2() R function is made available for obtaining the range of [Formula: see text] values computed from the 45 estimators analyzed in this work, as well as to assess how the pooled effect, its confidence and prediction intervals vary according to the estimator chosen.

Florida Obsessive-Compulsive Inventory and Children's Florida Obsessive Compulsive Inventory: A reliability generalization meta-analysis.

BACKGROUND: The Florida Obsessive Compulsive Inventory (FOCI) and its pediatric version, the Children's Florida Obsessive Compulsive Inventory (C-FOCI), are instruments for evaluating obsessive-compulsive symptomatology. METHOD: A reliability generalization meta-analysis was conducted to estimate an average reliability of the scores and to identify study characteristics that explained the heterogeneity among scores. Using Kuder-Richardson 20 (KR-20) and Cronbach's α, a total of 23 and 20 independent samples were included in the meta-analysis for the FOCI and C-FOCI. RESULTS: We found an average KR-20 of 0.826 for the FOCI's Symptom Checklist and an α of 0.882 FOCI's Symptom Severity. An average KR-20 of 0.740 was found for the C-FOCI's Symptom Checklist, while an average α of 0.794 was found for the C-FOCI's Symptom Severity. Moderator analyses showed that the source of the coefficients (i.e., whether they were reported by the authors of the primary study or estimated by the meta-analysts) was an important variable for the FOCI Symptom Severity, and that the focus of the study (i.e., whether it was psychometric or applied) and the sample size were relevant for the C-FOCI Symptom Checklist. CONCLUSIONS: Considering that the FOCI and C-FOCI are scales characterized by their brevity and ease of use, and the reliabilities obtained here, both scales are well suited for screening purposes.

Peripheral venous catheter-related phlebitis: A meta-analysis of topical treatment.

AIM: To systematically evaluate the efficacy of different topical treatments for PVC-related phlebitis in hospital in-patients. DESIGN: A systematic review and meta-analysis. METHODS: A selection was made of experimental and quasi-experimental studies published in English or Spanish. These should provide data on the degree of phlebitis, pain and infiltration (means and standard deviations, mainly) of hospitalized patients with phlebitis secondary to peripheral venous catheter. All those studies that reflected systemic or exclusive prevention treatments were excluded. Searches were from inception to April 2020. The date of data collection was from December 2020 to May 2021. The selection criteria were based on the PICOS model. Risk of bias was assessed using the Cochrane Collaboration tool. RESULTS: Twelve studies (726 patients) met the inclusion criteria. With respect to the decrease in the degree of phlebitis, was found ichthammol glycerine, followed by heparinoids. As for degree of pain, sesame oil obtained the most marked reduction. In terms of degree of infiltration, heparinoids and ichthammol glycerine were the only products to achieve a statistically significant reduction. The most important limitations are the low quantity and quality of the trials included. Insufficient data are available to draw valid conclusions about the efficacy of any treatment.

A Meta-analytic Study on Executive Function Performancein Children/Adolescents with OCD / Un Estudio Meta-analítico sobre el Rendimiento en Funciones Ejecutivas en Niños/Adolescentes con TOC

Introducción: El objetivo general de este estudio fue llevar a cabo un estudio meta-analítico con el fin de examinar el rendimiento de las funciones ejecutivas en niños/adolescentes con trastorno obsesivo-compulsivo (TOC). Método: Se llevó a cabo una búsqueda exhaustiva de la literatura desde 1984 hasta septiembre de 2021, seleccionando un total de 20 estudios publicados que comparaban los resultados en funciones ejecutivas entre un grupo de niños y/o adolescentes con TOC y un grupo de control sano. Resultados: Los resultados mostraron que la puntuación total en la escala de calidad de los estudios osciló entre los 3 y los 8.5 puntos (en una escala de 0 a 9), con una media de 6.6. Los tamaños del efecto en las distintas funciones ejecutivas fueron: Inhibición (d+= -0.221), Flexibilidad cognitiva (d+= -0.418), toma de decisiones (d+= -0.169) y planificación (d+= -0.319), indicando un menor rendimiento en los grupos con TOC frente a los grupos de control sano. Los resultados fueron clínicamente significativos en todos los dominios excepto en Toma de decisiones. El sesgo de publicación sólo se pudo llevar a cabo en flexibilidad e inhibición de respuesta. Conclusiones: Los pacientes con TOC presentaron peor rendimiento ejecutivo que los controles sanos en todas las funciones ejecutivas, destacando flexibilidad cognitiva y planificación. No obstante, los resultados deben interpretarse con cautela debido al pequeño tamaño muestral.(AU)

Background:The main objective of this work was to carry out a meta-analytical study to examine performance in executive functions in children/adolescents with obsessive-compulsive disorder (OCD). Method:A comprehensive literature search from 1984 to September 2021 was conducted, selecting a total of 20 published studies comparing executive function outcomes among a group of children and/or adolescents with OCD and a healthy control group. Results:Results showed that the total score on the quality scale of studies ranged between 3 and 8.5 points (on a scale of 0 to 9), with a mean of 6.6. The effect sizes in the different executive functions were as follows: Inhibition (d+= -0.221), Cognitive flexibility (d+= -0.418), Decision making (d+= -0.169) and Planning (d+=-0.319), indicating a lower performance in the OCD groups compared to the healthy control groups. Results were clinically significant in all domains except decision making. Publication bias could only be carried out in flexibility and response inhibition.Conclusions: OCD patients presented worse executive performance than healthy controls in all functions, highlighting cognitive flexibility and planning. However, results should be interpreted with caution due to the small sample size.(AU)

Cognitive-Behavioral Therapy and Anxiety and Depression Level in Pediatric Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis.

BACKGROUND: Although some meta-analyses have identified potential moderators associated with treatment outcomes for pediatric obsessive-compulsive disorder (OCD), there is as yet no consensus regarding the influence of anxiety and depression symptoms on the recovery from pediatric OCD. A meta-analysis was conducted to investigate the effects of depression and anxiety symptoms and their comorbidities on the efficacy of CBT in pediatric OCD, as well as other potential moderators that may be associated with outcomes. METHOD: An exhaustive literature search from 1983 to March 2021 located 22 published articles that applied cognitive-behavioral therapy (CBT) to pediatric OCD, producing a total of 26 treatment groups. Some of the moderator variables analyzed included age, gender, comorbidity baseline in anxiety, depression and obsession, and methodological quality. RESULTS: Results showed that the psychological treatment of OCD achieves clinically significant effectiveness, both for measures of obsessions and compulsions ( d + = 2.030), and for anxiety ( d + = 0.613) and depression ( d + = 0.451). An explanatory model for the CY-BOCS effect sizes showed that three moderator variables were statistically related: the mean of the CY-BOCS (Children´s Yale Brown Obsessive Compulsive Scale) in pretest, the effect size for anxiety, and the mean age of the sample. CONCLUSIONS: CBT reduced obsessive-compulsive symptoms and, to a lesser extent, anxiety and depression symptoms. Since anxiety symptoms are reduced with the same therapy, resources would be saved compared to other treatments.

Overviews of Reviews: Concept and Development.

BACKGROUND: In the last years, overviews of systematic reviews, or umbrella reviews, have seen a dramatic increase in their use. An overview aims to provide a summary of the included reviews and will often examine research questions beyond those addressed in the systematic reviews being synthesised. The purpose of this article is to provide some recommendations on how overviews should be conducted and reported. METHOD: A literature review was performed to identify relevant papers on both methodological and applied overviews. RESULTS: The current literature recommends carrying out overviews by following similar steps to those of systematic reviews: (a) Defining the overview research question; (b) inclusion and exclusion criteria; (c) literature search; (d) data extraction; (e) assessment of risk of bias and reporting quality; (f) overview results; and (g) reporting the overview. Of special interest is how to address dependencies between the systematic reviews. CONCLUSIONS: Overviews allow evidence to be efficiently combined from multiple systematic reviews. This offers the possibility of translating and summarizing large amounts of information. As in primary studies and systematic reviews, conducting and reporting of overviews must meet appropriate quality standards.

A Reliability Generalization Meta-Analysis of the Padua Inventory-Revised (PI-R) / Meta-análisis de generalización de la fiabilidad del Padua Inventory-Revised (PI-R)

Background/Objective: The Padua Inventory-Revised (PI-R) is a widely applied instrument to measure obsessive-compulsive symptoms in clinical and nonclinical samples. We conducted a reliability generalization meta-analysis on the PI-R. Method: An exhaustive literature search yielded 118 empirical studies that had applied the PI-R, from which 30 studies (33 samples) reported an original reliability estimate. Results: Assuming a random-effects model, the average internal consistency reliability (Cronbach's alpha) was .92 (95% CI [.91, .93]) for the total scores, and ranged from .74 to .89 for the subscales. Assuming mixed-effects models, moderator analyses showed a positive statistically significant association between the standard deviation of the total scores and the reliability coefficients (p = .002; R2 = .38). Conclusions: In terms of reliability, the PI-R scale was found to be adequate for both research and clinical purposes, although exhibiting large heterogeneity across studies. Future empirical studies using the PI-R should be required to provide at least one reliability estimate based on their own data

Antecedentes/Objetivo: El Padua Inventory-Revised (PI-R) es un instrumento ampliamente utilizado para medir los síntomas obsesivo-compulsivos en muestras clínicas y no clínicas. Llevamos a cabo un meta-análisis de generalización de la fiabilidad del PI-R. Método: Una búsqueda exhaustiva de la literatura arrojó 118 estudios empíricos que habían aplicado el PI-R, de los cuales 30 estudios (33 muestras) reportaron una estimación propia de la fiabilidad. Resultados: Asumiendo un modelo de efectos aleatorios, la fiabilidad en términos de consistencia interna promedio (alfa de Cronbach) fue de 0,92 (IC del 95% [0,91, 0,93]) para las puntuaciones totales, y osciló entre 0,74 y 0,89 para las subescalas. Asumiendo modelos de efectos mixtos, los análisis de moderadores mostraron una relación positiva estadísticamente significativa entre la desviación típica de las puntuaciones totales y los coeficientes de fiabilidad (p = 0,002; R2 = 0,38). Conclusiones: En términos de fiabilidad, se encontró que el PI-R es adecuado tanto para fines clínicos como de investigación, aunque con una alta heterogeneidad entre los estudios. Es necesario que los estudios empíricos futuros que apliquen el PI-R proporcionen al menos una estimación de la fiabilidad basada en sus propios datos.

A Reliability Generalization Meta-analysis of the Padua Inventory-Revised (PI-R).

Background/Objective: The Padua Inventory-Revised (PI-R) is a widely applied instrument to measure obsessive-compulsive symptoms in clinical and nonclinical samples. We conducted a reliability generalization meta-analysis on the PI-R. Method: An exhaustive literature search yielded 118 empirical studies that had applied the PI-R, from which 30 studies (33 samples) reported an original reliability estimate. Results: Assuming a random-effects model, the average internal consistency reliability (Cronbach's alpha) was .92 (95% CI [.91, .93]) for the total scores, and ranged from .74 to .89 for the subscales. Assuming mixed-effects models, moderator analyses showed a positive statistically significant association between the standard deviation of the total scores and the reliability coefficients (p = .002; R2  = .38). Conclusions: In terms of reliability, the PI-R scale was found to be adequate for both research and clinical purposes, although exhibiting large heterogeneity across studies. Future empirical studies using the PI-R should be required to provide at least one reliability estimate based on their own data.

Antecedentes/Objetivo: El Padua Inventory-Revised (PI-R) es un instrumento ampliamente utilizado para medir los síntomas obsesivo-compulsivos en muestras clínicas y no clínicas. Llevamos a cabo un meta-análisis de generalización de la fiabilidad del PI-R. Método: Una búsqueda exhaustiva de la literatura arrojó 118 estudios empíricos que habían aplicado el PI-R, de los cuales 30 estudios (33 muestras) reportaron una estimación propia de la fiabilidad. Resultados: Asumiendo un modelo de efectos aleatorios, la fiabilidad en términos de consistencia interna promedio (alfa de Cronbach) fue de 0,92 (IC del 95% [0,91, 0,93]) para las puntuaciones totales, y osciló entre 0,74 y 0,89 para las subescalas. Asumiendo modelos de efectos mixtos, los análisis de moderadores mostraron una relación positiva estadísticamente significativa entre la desviación típica de las puntuaciones totales y los coeficientes de fiabilidad (p = 0,002; R2  = 0,38). Conclusiones: En términos de fiabilidad, se encontró que el PI-R es adecuado tanto para fines clínicos como de investigación, aunque con una alta heterogeneidad entre los estudios. Es necesario que los estudios empíricos futuros que apliquen el PI-R proporcionen al menos una estimación de la fiabilidad basada en sus propios datos.

A Meta-analysis of Gut Microbiota in Children with Autism.

Previous studies have reported dysbiosis in the gut microbiota (GM) of children with autism spectrum disorders (ASD), which may be a determining factor on child development through the microbiota-gut-brain axis. However, it is not clear if there is a specific group of dysbiotic bacteria in ASD. The aim of this study was to carry out a meta-analysis on the studies that analyze GM in children with ASD. 18 studies fulfilled our selection criteria. Our results showed a lower relative abundance of Streptococcus (SMD+ = - 0.999; 95% CI - 1.549, - 0.449) and Bifidobacterium genera (SMD+ = - 0.513; 95% CI - 0.953, - 0.073) in children with ASD. Overall, the Bifidobacterium genera is involved. However, differences found between studies are attributed to factors such as reporting bias.

A meta-review of transparency and reproducibility-related reporting practices in published meta-analyses on clinical psychological interventions (2000-2020).

Meta-analysis is a powerful and important tool to synthesize the literature about a research topic. Like other kinds of research, meta-analyses must be reproducible to be compliant with the principles of the scientific method. Furthermore, reproducible meta-analyses can be easily updated with new data and reanalysed applying new and more refined analysis techniques. We attempted to empirically assess the prevalence of transparency and reproducibility-related reporting practices in published meta-analyses from clinical psychology by examining a random sample of 100 meta-analyses. Our purpose was to identify the key points that could be improved, with the aim of providing some recommendations for carrying out reproducible meta-analyses. We conducted a meta-review of meta-analyses of psychological interventions published between 2000 and 2020. We searched PubMed, PsycInfo and Web of Science databases. A structured coding form to assess transparency indicators was created based on previous studies and existing meta-analysis guidelines. We found major issues concerning: completely reproducible search procedures report, specification of the exact method to compute effect sizes, choice of weighting factors and estimators, lack of availability of the raw statistics used to compute the effect size and of interoperability of available data, and practically total absence of analysis script code sharing. Based on our findings, we conclude with recommendations intended to improve the transparency, openness, and reproducibility-related reporting practices of meta-analyses in clinical psychology and related areas.

Overviews of Reviews: Concept and Development / Meta-Revisiones: Concepto y Desarrollo

Background: In the last years, overviews of systematic reviews, orumbrella reviews, have seen a dramatic increase in their use. An overviewaims to provide a summary of the included reviews and will often examineresearch questions beyond those addressed in the systematic reviews beingsynthesised. The purpose of this article is to provide some recommendationson how overviews should be conducted and reported. Method: A literaturereview was performed to identify relevant papers on both methodologicaland applied overviews. Results: The current literature recommendscarrying out overviews by following similar steps to those of systematicreviews: (a) Defining the overview research question; (b) inclusion andexclusion criteria; (c) literature search; (d) data extraction; (e) assessmentof risk of bias and reporting quality; (f) overview results; and (g) reportingthe overview. Of special interest is how to address dependencies betweenthe systematic reviews. Conclusions: Overviews allow evidence to beefficiently combined from multiple systematic reviews. This offers thepossibility of translating and summarizing large amounts of information.As in primary studies and systematic reviews, conducting and reporting ofoverviews must meet appropriate quality standards.

Antecedentes: en los últimosaños, las meta-revisiones, o revisiones paraguas, han incrementadoexponencialmente su uso. Una meta-revisión proporciona un resumende las revisiones incluidas y, a menudo, aborda preguntas más allá de lasplanteadas en las revisiones sistemáticas sintetizadas. El propósito de esteartículo fue proporcionar recomendaciones sobre cómo deben hacerse yreportarse las meta-revisiones. Método: se llevó a cabo una revisión dela literatura para identificar artículos relevantes sobre meta-revisiones,tanto metodológicos como aplicados. Resultados: a día de hoy la literaturasobre meta-revisiones recomienda seguir los mismos pasos que en lasrevisiones sistemáticas: (a) definición de la pregunta de investigación;(b) criterios de inclusión y exclusión; (c) búsqueda de la literatura; (d)extracción de datos; (e) valoración del riesgo de sesgo y de la calidad delreporte; (f) presentación de resultados; y (g) reporte de la meta-revisión.De especial interés es cómo abordar los problemas de dependencia entrelas revisiones sistemáticas sintetizadas. Conclusiones: las meta-revisionespermiten combinar evidencia de múltiples revisiones sistemáticas de unaforma eficiente. Esto permite transformar y resumir grandes cantidadesde información. Al igual que en los estudios primarios y las revisionessistemáticas, las meta-revisiones deben realizarse y reportarse cumpliendocon estándares mínimos de calidad.

A Reliability Generalization Meta-analysis of the Dimensional Obsessive-Compulsive Scale.

BACKGROUND: The Dimensional Obsessive-Compulsive Scale (DOCS) is a well-established tool for assessing obsessive-compulsive symptomatology. A reliability generalization meta-analysis was conducted to estimate the average reliability of DOCS scores and how reliability estimates vary according to the composition and variability of samples, to identify study characteristics that can explain its variability, and to estimate the reliability induction rate. METHOD: A literature search produced 86 studies that met the inclusion criteria. RESULTS: For the DOCS total scores, an average alpha coefficient of .925 was found (95% CI [.920,.931]), as well as mean alphas of .881, .905, .913, and .914 for Contamination, Responsibility, Unacceptable Thoughts, and Symmetry subscales, respectively. Moderator analysis showed that internal consistency fell significantly the more clinical and subclinical participants there were in the sample, and the larger the mean score in the sample for the total scores. The most important moderator variables for the subscales were the standard deviation and the mean of the scores. CONCLUSIONS: The DOCS scores exhibited excellent internal consistency reliability for both total score and subscale scores and DOCS is suitable both for research and clinical purposes.

Concentrations of bisphenol-A in adults from the general population: A systematic review and meta-analysis.

BACKGROUND: Human bisphenol-A (BPA) exposure has been linked to adverse health effects even at low doses, which may be of potential public health concern. OBJECTIVE: To summarize BPA concentrations in general human population and their variability according to sex, geographic area, and analytical method. METHODS: Systematic review and meta-analysis of studies reporting BPA concentrations in adult human populations. Separate meta-analyses of median values were carried out for BPA in serum, creatinine-adjusted urinary BPA, and unadjusted urinary BPA concentrations using a random-effects model. Cochran's Q-statistic, I2 index, 95% prediction intervals (PIs), between-studies standard deviation (τ), and forest plots were applied to verify study heterogeneity. Sensitivity and subgroup analyses and weighted ANOVAs and meta-regressions were conducted. Funnel plots and Egger's tests were used to examine publication bias. RESULTS: Fifteen studies were included in the meta-analysis, totaling 28,353 participants. BPA was detected in over 90% of participants. The pooled creatinine-adjusted urinary BPA concentration was 1.76 µg/g (95% PI: 0.79-2.73), with individual estimates ranging between 1.20 and 2.41. The pooled estimate for unadjusted urinary BPA was 1.91 µg/l (95% PI: 0-3.97), ranging between 0.81 and 3.50, while the pooled estimate for serum BPA was 1.75 µg/l (95% PI: 0-10.58), ranging between 0.34 and 3.76. No differences were found by sex, geographic area or analytical technique. Larger sample sizes were associated with lower BPA concentrations. There was large heterogeneity across studies, whereas data for urinary BPA levels suggested a publication bias affecting research in low exposed populations. CONCLUSION: This first meta-analysis of human BPA concentrations highlights a widespread population exposure to BPA. Although there was high heterogeneity across studies, the expected range of estimated human BPA concentrations suggests that potential health risks are unlikely. Further studies are warranted to better characterize the epidemiology of human BPA exposure, accounting for ethnic, geographic, individual and environmental variability.

Persistent Moderate-to-Weak Mediterranean Diet Adherence and Low Scoring for Plant-Based Foods across Several Southern European Countries: Are We Overlooking the Mediterranean Diet Recommendations?

The Mediterranean diet (MD) has been sponsored worldwide as a healthy and sustainable diet. Our aim was to update and compare MD adherence and food choices across several Southern European countries: Spain (SP), Portugal (PT), Italy (IT), Greece (GR), and Cyprus (CY) (MED, Mediterranean), and Bulgaria (BG) and the Republic of North Macedonia (NMK) (non-MED, non-Mediterranean). Participants (N = 3145, ≥18 y) completed a survey (MeDiWeB) with sociodemographic, anthropometric, and food questions (14-item Mediterranean Diet Adherence Screener, 14-MEDAS). The MED and non-MED populations showed moderate (7.08 ± 1.96) and weak (5.58 ± 1.82) MD adherence, respectively, with significant yet small differences across countries (SP > PT > GR > IT > CY > BG > NMK, p-value < 0.001). The MED participants scored higher than the non-MED ones for most of the Mediterranean-typical foods, with the greatest differences found for olive oil (OO) and white meat preference. In most countries, ≥70% of the participants reported quantities of red meat, butter, sweet drinks, and desserts below the recommended cutoff points, whereas <50% achieved the targets for plant-based foods, OO, fish, and wine. Being a woman and increasing age were associated with superior adherence (p-value < 0.001), but differences were rather small. Our results suggest that the campaigns carried out to support and reinforce the MD and to promote plant-based foods have limited success across Southern Europe, and that more hard-hitting strategies are needed.

Improving the reporting quality of reliability generalization meta-analyses: The REGEMA checklist.

Reliability generalization (RG) is a meta-analytic approach that aims to characterize how reliability estimates from the same test vary across different applications of the instrument. With this purpose RG meta-analyses typically focus on a particular test and intend to obtain an overall reliability of test scores and to investigate how the composition and variability of the samples affect reliability. Although several guidelines have been proposed in the meta-analytic literature to help authors improve the reporting quality of meta-analyses, none of them were devised for RG meta-analyses. The purpose of this investigation was to develop REGEMA (REliability GEneralization Meta-Analysis), a 30-item checklist (plus a flow chart) adapted to the specific issues that the reporting of an RG meta-analysis must take into account. Based on previous checklists and guidelines proposed in the meta-analytic arena, a first version was elaborated by applying the nominal group methodology. The resulting instrument was submitted to a list of independent meta-analysis experts and, after discussion, the final version of the REGEMA checklist was reached. In a pilot study, four pairs of coders applied REGEMA to a random sample of 40 RG meta-analyses in Psychology, and results showed satisfactory inter-coder reliability. REGEMA can be used by: (a) meta-analysts conducting or reporting an RG meta-analysis and aiming to improve its reporting quality; (b) consumers of RG meta-analyses who want to make informed critical appraisals of their reporting quality, and (c) reviewers and editors of journals who are considering submissions where an RG meta-analysis was reported for potential publication.

The heritability of insomnia: Systematic review and meta-analysis of twin studies.

Twin studies have consistently found that genetic factors explain a substantial proportion of the variance for insomnia. However, studies vary widely in their heritability estimates. Therefore, this meta-analysis aimed to: 1) Estimate the mean heritability of insomnia; 2) Assess heterogeneity among twin studies of insomnia; and 3) Search and analyse characteristics of the studies (moderator variables) that may explain heterogeneity among estimates. For this purpose, separate meta-analyses were carried out for MZ and DZ correlations and for heritability estimates by assuming random-effects models. Thirteen independent samples were included in this meta-analysis. The heterogeneity index for heritability estimates was significant in both best fitting models (I2 = 98.77, P < .0001) and full models (I2 = 97.80, P < .0001). MZ correlations were higher (0.37; 95%CI: 0.31,.43) than DZ correlations (0.15; 95%CI: 0.12,.18). A mean heritability of 0.39 (95%CI: 0.32,.44) was found for insomnia. These results highlight the role of genetic factors in explaining differences among the population on insomnia and Emphasize heterogeneity among studies. Further research is needed to identify variables that could explain this heterogeneity.