BackgroundThere is no specific guidance for the reporting of Cochrane systematic reviews that do not have studies eligible for inclusion. As a result, the reporting of these so-called “empty reviews” may vary across reviews. This research explores the incidence of empty systematic reviews in The Cochrane Database of Systematic Reviews (The CDSR) and describes their current characteristics.Methodology/Principal FindingsEmpty reviews within The CDSR as of 15 August 2010 were identified, extracted, and coded for analysis. Review group, original publication year, and time since last update, as well as number of studies listed as excluded, awaiting assessment, or on-going within empty reviews were examined. 376 (8.7%) active reviews in The CDSR reported no included studies. At the time of data collection, 45 (84.9%) of the Cochrane Collaboration's 53 Review Groups sustained at least one empty review, with the number of empty reviews for each of these 45 groups ranging from 1 to 35 (2.2–26.9%). Time since original publication of empty reviews ranged from 0 to 15 years with a mean of 4.2 years (SD = 3.4). Time since last assessed as up-to-date ranged from 0 to 12 years with a mean of 2.8 years (SD = 2.2). The number of excluded studies reported in these reviews ranged from 0 to 124, with an average of 9.6 per review (SD = 14.5). Eighty-eight (23.4%) empty reviews reported no excluded studies, studies awaiting assessment, or on-going studies.ConclusionsThere is a substantial number of empty reviews in The CDSR, and there is some variation in the reporting and updating of empty reviews across Cochrane Review Groups. This variation warrants further analysis, and may indicate a need to develop guidance for the reporting of empty systematic reviews in The CDSR.

IMPORTANCE Mind-body therapies (MBTs) are emerging as potential tools for addressing the opioid crisis. Knowing whether mind-body therapies may benefit patients treated with opioids for acute, procedural, and chronic pain conditions may be useful for prescribers, payers, policy makers, and patients.OBJECTIVE To evaluate the association of MBTs with pain and opioid dose reduction in a diverse adult population with clinical pain.DATA SOURCES For this systematic review and meta-analysis, the MEDLINE, Embase, Emcare, CINAHL, PsycINFO, and Cochrane Library databases were searched for English-language randomized clinical trials and systematic reviews from date of inception to March 2018. Search logic included (pain OR analgesia OR opioids) AND mind-body therapies. The gray literature, ClinicalTrials.gov, and relevant bibliographies were also searched.STUDY SELECTION Randomized clinical trials that evaluated the use of MBTs for symptom management in adults also prescribed opioids for clinical pain.DATA EXTRACTION AND SYNTHESIS Independent reviewers screened citations, extracted data, and assessed risk of bias. Meta-analyses were conducted using standardized mean differences in pain and opioid dose to obtain aggregate estimates of effect size with 95% CIs. MAIN OUTCOMES AND MEASURESThe primary outcome was pain intensity. The secondary outcomes were opioid dose, opioid misuse, opioid craving, disability, or function. RESULTS Of 4212 citations reviewed, 60 reports with 6404 participants were included in the meta-analysis. Overall, MBTs were associated with pain reduction (Cohen d = −0.51; 95% CI, −0.76 to −0.26) and reduced opioid dose (Cohen d = −0.26; 95% CI, −0.44 to −0.08). Studies tested meditation (n = 5), hypnosis (n = 25), relaxation (n = 14), guided imagery (n = 7), therapeutic suggestion (n = 6), and cognitive behavioral therapy (n = 7) interventions. Moderate to large effect size improvements in pain outcomes were found for meditation (Cohen d = −0.70), hypnosis (Cohen d = −0.54), suggestion (Cohen d = −0.68), and cognitive behavioral therapy (Cohen d = −0.43) but not for other MBTs. Although most meditation (n = 4 [80%]), cognitive-behavioral therapy (n = 4 [57%]), and hypnosis (n = 12 [63%]) studies found improved opioid-related outcomes, fewer studies of suggestion, guided imagery, and relaxation reported such improvements. Most MBT studies used active or placebo controls and were judged to be at low risk of bias. CONCLUSIONS AND RELEVANCEThe findings suggest that MBTs are associated with moderate improvements in pain and small reductions in opioid dose and may be associated with therapeutic benefits for opioid-related problems, such as opioid craving and misuse. Future studies should carefully quantify opioid dosing variables to determine the association of mind-body therapies with opioid-related outcomes.

A pressing concern with the eyewitness testimony used in many criminal cases is that jurors may be swayed by the high confidence of an eyewitness and, as a result, may disregard other factors that provide more diagnostic information. Mock jurors were surveyed using a large national sample of 1,684 laypeople, selected to be representative of the U.S. population (age, race, gender, geographic region), using mock trial videos of eyewitness testimony. To explore the relationship between courtroom confidence and other factors, we used a fractional factorial design, permitting examination of the relationships among seven factors. Among these seven factors, we found that jurors gave most weight to the confidence of eyewitnesses, especially that expressed in the courtroom, irrespective of the eyewitness's testimony about confidence (low or high) at the initial police lineup. Jurors' assessments were not sensitive to the other factors or their interactions in the experiment: crime type (burglary or sexual assault), the race of the defendant and eyewitness, or information provided in judicial instructions or by expert testimony. The disproportionate importance of the eyewitness's expressed confidence has implications for the effectiveness of legal efforts to inform jurors about factors affecting eyewitness memory.

Objectives: Services to children and adolescents with a severe emotional disturbance (SED) have long been inadequate. The wraparound approach has emerged as a promising practice that could address the needs of children with SED and their families through a strength-based, individualized, family-focused team process that emphasizes flexible service planning. This study compares the outcomes of youth receiving the wraparound approach with youth receiving traditional child welfare case management. Method: Child behavior and community integration outcomes were measured at intake and at 6 months in services. Results: Results indicated that youth receiving the wraparound approach showed significant improvement on the Child and Adolescent Functional Assessment Scale (CAFAS) when compared with youth receiving traditional child welfare services. Results also showed that youth receiving traditional child welfare services experienced significantly fewer placements. However, neither group showed significant differences on other clinical or functional outcomes. Conclusions: Results are discussed, as well as applications to social work practice, study limitations, and recommendations for additional research on wraparound.

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