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Tsutsumi S, Takano A, Usami T, Kumakura Y, Kanazawa Y, Takebayashi T, Sugiyama D, Matsumoto T. Risk and protective factors for early dropout from telephone monitoring for individuals with drug convictions in community mental health centers in Japan. J Subst Use Addict Treat 2024; 162:209347. [PMID: 38494050 DOI: 10.1016/j.josat.2024.209347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/27/2024] [Accepted: 02/21/2024] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Individuals involved with the criminal justice system face challenges in receiving and maintaining substance use disorder (SUD) treatment and support. Although telephone monitoring (TM) could reduce these barriers, data on TM for community-dwelling individuals involved with the criminal justice system and research on individuals who drop out of TM are scarce. We examined the factors associated with dropping out early from the Voice Bridges Project, which provides TM for individuals on probation for drug-related convictions through community mental health centers in Japan. METHODS Participants (n = 546) were individuals aged ≥20 years with methamphetamine-related convictions who were on probation. Univariate analyses examine the associations between one-year follow-up status and baseline variables, and multivariate Cox proportional hazards regression analyses identify the risk and protective factors associated with dropping out. Stratified analyses report results based on sex and halfway-house residency. RESULTS The one-year dropout rate was 43.6 % (n = 238). Multivariate analysis identified two risk factors for dropping out-halfway-house residency and suicide attempts in the past year, and two protective factors-higher education and the current use of SUD services. Sex-stratified analyses showed that halfway-house residency was a risk factor for both men and women. Attempted suicide was a risk factor for women. Conversely, higher education and current use of SUD services were protective factors for men. CONCLUSIONS Our results identify unique risk factors for women, such as a recent history of suicide attempts, and distinctive protective factors for men, including higher education and current use of SUD services, emphasizing the importance of sex-specific approaches. Furthermore, the study reveals that irrespective of sex, vulnerable individuals, such as halfway-house residents, are at a higher risk of dropping out from TM.
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Affiliation(s)
- Shiori Tsutsumi
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira-shi, Tokyo, Japan; Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa-shi, Kanagawa, Japan.
| | - Ayumi Takano
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira-shi, Tokyo, Japan.
| | - Takashi Usami
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira-shi, Tokyo, Japan; Kitakyushu Municipal Mental Health and Welfare Center, 1-7-1 Bashaku, Kokurakita Ward, Kitakyushu, Fukuoka, Japan
| | - Yousuke Kumakura
- Department of Neuropsychiatry, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Yuka Kanazawa
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, Japan
| | - Toru Takebayashi
- Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa-shi, Kanagawa, Japan; Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, Japan.
| | - Daisuke Sugiyama
- Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa-shi, Kanagawa, Japan; Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, Japan; Faculty of Nursing and Medical Care, Keio University, 4411 Endo, Fujisawa-shi, Kanagawa, Japan.
| | - Toshihiko Matsumoto
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira-shi, Tokyo, Japan.
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Emmonds S, Till K, Weaving D, Burton A, Lara-Bercial S. Youth Sport Participation Trends Across Europe: Implications for Policy and Practice. Res Q Exerc Sport 2024; 95:69-80. [PMID: 36697376 DOI: 10.1080/02701367.2022.2148623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 10/23/2022] [Indexed: 06/17/2023]
Abstract
Purpose: Despite the known health and wellbeing benefits of taking part in sport for children and adolescents, it is reported that sports participation declines during adolescence. The purpose of this study was to explore current organized youth sport participation rates across Europe for both males and females and update current understanding. Method: Sport participation registration data was collected for 18 sports from 27 countries. In total, participation data was collected from over 5 million young people from Under 8s (U8s) to Under 18s (U18s). Differences in the participation rates between age categories were investigated using a generalized linear mixed effects model. Results: Overall, males were four times more likely to participate in organised youth sport than females' participants, with this trend apparent across all age categories and across most sports. There was a significant decrease across sports in participation rates for males during adolescence from U14-U16 and U16-U18. There was a significant decrease in participation rates for females from U14-U16 for most sports except but an increase in participation rates from U16-U18 for 12 out of 18 sports. Soccer (1262%), wrestling (391%) and boxing (209%) were the sports that had greater male sport participation rates. In contrast, dance sports (86%) and volleyball (63%) had more female participants than males. This research shows male sports participation is significantly greater than female in youth sport across Europe. Conclusion: Furthermore, findings showed that for both male and female participants, participation rates increased from U8-U14 for the majority of sports followed by reduced participation rates during adolescence. Findings of this research can be used by national governing bodies and sporting organizations to inform youth sport participation initiatives.
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Huttunen-Lenz M, Raben A, Adam T, Macdonald I, Taylor MA, Stratton G, Mackintosh K, Martinez JA, Handjieva-Darlenska T, Bogdanov GA, Poppitt SD, Silvestre MP, Fogelholm M, Jalo E, Brand-Miller J, Muirhead R, Schlicht W. Socio-economic factors, mood, primary care utilization, and quality of life as predictors of intervention cessation and chronic stress in a type 2 diabetes prevention intervention (PREVIEW Study). BMC Public Health 2023; 23:1666. [PMID: 37649005 PMCID: PMC10466828 DOI: 10.1186/s12889-023-16569-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Sedentary lifestyle and unhealthy diet combined with overweight are risk factors for type 2 diabetes (T2D). Lifestyle interventions with weight-loss are effective in T2D-prevention, but unsuccessful completion and chronic stress may hinder efficacy. Determinants of chronic stress and premature cessation at the start of the 3-year PREVIEW study were examined. METHODS Baseline Quality of Life (QoL), social support, primary care utilization, and mood were examined as predictors of intervention cessation and chronic stress for participants aged 25 to 70 with prediabetes (n = 2,220). Moderating effects of sex and socio-economic status (SES) and independence of predictor variables of BMI were tested. RESULTS Participants with children, women, and higher SES quitted intervention earlier than those without children, lower SES, and men. Lower QoL, lack of family support, and primary care utilization were associated with cessation. Lower QoL and higher mood disturbances were associated with chronic stress. Predictor variables were independent (p ≤ .001) from BMI, but moderated by sex and SES. CONCLUSIONS Policy-based strategy in public health should consider how preventive interventions may better accommodate different individual states and life situations, which could influence intervention completion. Intervention designs should enable in-built flexibility in delivery enabling response to individual needs. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01777893.
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Affiliation(s)
- Maija Huttunen-Lenz
- Institute of Nursing Science, University of Education Schwäbisch Gmünd, Oberbettringerstraße 200, 73525, Schwäbisch Gmünd, Germany.
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958, Frederiksberg, Denmark
- Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Tanja Adam
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Ian Macdonald
- MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, School of Life Sciences, Nottingham, NG7 2UH, UK
- Nestle Institute of Health Sciences, Nestle Research, Route du Jorat 57, 1000, Lausanne 26, CH, Switzerland
| | - Moira A Taylor
- University of Nottingham, School of Life Sciences, Nottingham, NG7 2UH, UK
| | - Gareth Stratton
- Sport and Exercise Sciences, Swansea University, Swansea, West Glamorgan, UK
| | - Kelly Mackintosh
- Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University, Swansea, West Glamorgan, UK
| | - J Alfredo Martinez
- Department of Medicine and Endocrinology, University of Valladolid, Valladolid, Spain
- CIBER Fisiopatología Obesidad Y Nutrición (CIBERobn), Instituto de Salud Carlos III, IMDEAfood Madrid, 28029, Madrid, Spain
| | | | - Georgi Assenov Bogdanov
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, 1000, Bulgaria
| | - Sally D Poppitt
- Department of Medicine, University of Auckland, Human Nutrition Unit, School of Biological Sciences, Auckland, 1024, New Zealand
| | - Marta P Silvestre
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, 1024, New Zealand
- Nutrition & Metabolism, CINTESIS, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, 00014, Helsinki, Finland
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, 00014, Helsinki, Finland
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Wolfgang Schlicht
- Department of Exercise and Health Sciences, University of Stuttgart, 70569, Stuttgart, Germany
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Abe T, Yamashita M, Fujiwara Y, Sasai H, Obuchi SP, Ishizaki T, Awata S, Toba K. Fluctuations in Cognitive Test Scores and Loss to Follow-Up in Community-Dwelling Older Adults: The IRIDE Cohort Study. Dement Geriatr Cogn Disord 2023; 52:296-303. [PMID: 37562370 DOI: 10.1159/000531764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/19/2023] [Indexed: 08/12/2023] Open
Abstract
INTRODUCTION We examined the relationship between previous fluctuations in Mini-Mental State Examination (MMSE) scores, future changes in MMSE scores, and attrition from follow-up surveys, which helps in a more comprehensive interpretation of repeatedly collected MMSE scores. METHODS This 4-year longitudinal study included 2,073 community-dwelling older adults aged ≥65 years in Japan. The MMSE was administered at baseline (T0), 2 years (T1), and 4 years (T2) follow-up. We performed multinomial logistic regression analysis with the dependent variable, indicating the change in MMSE score from T1 to T2 (categorized as increase, no change [reference category], and decrease) and attrition at T2. The independent variables included the change in MMSE scores from T0 to T1 and MMSE scores at T0 and T1. RESULTS The mean MMSE score was 29 across the three time points. A one-point decrease in MMSE score from T0 to T1 was associated with 79% (95% confidence interval: 1.62, 1.97) higher odds of an increase in MMSE score from T1 to T2 and 28% (1.17, 1.40) higher odds of attrition at T2. A one-point decrement in the MMSE score at T0 and T1 was also associated with an increase in the MMSE score from T1 to T2 and attrition at T2. CONCLUSION Focusing on cognitive fluctuation for 2 years, rather than cognitive function at a point in time, would have no remarkable advantage when focusing on future cognitive function and attrition. Our results emphasize the need for further studies to identify factors that distinguish between those who continue to attend follow-up surveys and show improvements in cognitive test scores and those who drop out.
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Affiliation(s)
- Takumi Abe
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Mari Yamashita
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shuichi P Obuchi
- Human Care Research Team, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Tatsuro Ishizaki
- Human Care Research Team, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shuichi Awata
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kenji Toba
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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van der Hoeven ML, Assink M, Stams GJJM, Daams JG, Lindauer RJL, Hein IM. Victims of Child Abuse Dropping Out of Trauma-Focused Treatment: A Meta-Analysis of Risk Factors. J Child Adolesc Trauma 2023; 16:269-283. [PMID: 37234839 PMCID: PMC10205941 DOI: 10.1007/s40653-022-00500-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 05/27/2023]
Abstract
A substantial number of children who experienced child maltreatment drop out of evidence-based trauma-focused treatments (TF-CBT). Identifying child, family, and treatment-related factors associated with treatment dropout is important to be able to prevent this from happening and to effectively treat children's trauma-related symptoms. Methods: A quantitative review was performed based on a systematic synthesis of the literature on potential risk factors for dropout of trauma-focused treatment in maltreated children. Results: Eight studies were included, that examined TF-CBT, reporting on 139 effects of potential risk factors for dropout. Each factor was classified into one of ten domains. Small but significant effects were found for the "Demographic and Family" risk domain (r = .121), with factors including being male, child protective services involvement or placement, and minority status, and for the "Youth Alliance" risk domain (r = .207), with factors including low therapist-child support and low youth perception of parental approval. Moderator analyses suggested that family income and parental education may better predict the risk for TF-CBT dropout than other variables in the "Demographic and Family" domain. Conclusions: Our results provide a first overview of risk factors for dropout of trauma-focused treatments (TF-CBT) after child maltreatment, and highlight the role of the therapeutic relationship in this. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-022-00500-2.
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Affiliation(s)
- Mara L. van der Hoeven
- Amsterdam UMC, Department of Child and Adolescent Psychiatry, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - Mark Assink
- Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, the Netherlands
| | - Geert-Jan J. M. Stams
- Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, the Netherlands
| | - Joost G. Daams
- Medical Library, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Ramón J. L. Lindauer
- Amsterdam UMC, Department of Child and Adolescent Psychiatry, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
- Levvel, Academic Center for Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - Irma M. Hein
- Amsterdam UMC, Department of Child and Adolescent Psychiatry, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
- Levvel, Academic Center for Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
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de Soet R, Vermeiren RRJM, Bansema CH, van Ewijk H, Nijland L, Nooteboom LA. Drop-out and ineffective treatment in youth with severe and enduring mental health problems: a systematic review. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02182-z. [PMID: 36882638 DOI: 10.1007/s00787-023-02182-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
Youth with severe and enduring mental health problems (SEMHP) tend to drop out of treatment or insufficiently profit from treatment in child and adolescent psychiatry (CAP). Knowledge about factors related to treatment failure in this group is scarce. Therefore, the aim of this systematic review was to thematically explore factors associated with dropout and ineffective treatment among youth with SEMHP. After including 36 studies, a descriptive thematic analysis was conducted. Themes were divided into three main categories: client, treatment, and organizational factors. The strongest evidence was found for the association between treatment failure and the following subthemes: type of treatment, engagement, transparency and communication, goodness of fit and, perspective of practitioner. However, most other themes showed limited evidence and little research has been done on organizational factors. To prevent treatment failure, attention should be paid to a good match between youth and both the treatment and the practitioner. Practitioners need to be aware of their own perceptions of youth's perspectives, and transparent communication with youth contributes to regaining their trust.
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Affiliation(s)
- R de Soet
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands.
| | - R R J M Vermeiren
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
- Youz, Parnassia Group, The Hague, The Netherlands
| | - C H Bansema
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
| | - H van Ewijk
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
| | - L Nijland
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
| | - L A Nooteboom
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
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Lorentz L, Ducrocq B, Robin G, Catteau-Jonard S. [Becoming requesting couples after their registration in oocyte donation]. Gynecol Obstet Fertil Senol 2023; 51:53-9. [PMID: 36336287 DOI: 10.1016/j.gofs.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/19/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Many studies have investigated the causes of discontinuation during intraconjugal medically assisted procreation. However, there are currently very few data justifying the causes of discontinuation during the oocyte donation program. The main objective of this study is to determine the causes of discontinuation in oocyte donation and their respective frequency, excluding live births by oocyte donation in our center. METHODS This is an observational, retrospective, single-center study focused on receiving or requesting couples who stopped their oocyte donation program between January 1, 2005 and April 29, 2021. A total of 390 couples were included in the study. RESULTS Of the 390 couples included, 306 couples or nearly 80%, left our oocyte donation program without obtaining a live birth through this method. The three most frequent reasons for discontinuation were: failure of several oocyte donations (18%), desire of the couples to voluntarily discontinue their care (15%) and separation (14%). Finally, 84 couples obtained at least one live birth by oocyte donation in our center. In addition, 38 women conceived spontaneously and 33 couples benefited from an oocyte donation abroad. CONCLUSIONS The most common reason for discontinuation in oocyte donation program, excluding live births by oocyte donation in our center, is failure after several oocyte donations. However, 40% of the couples in the study obtained at least one live birth.
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Mulalint T, Seeherunwong A, Wanitkun N, Tongsai S. Determinants of continuing mental health service use among older persons diagnosed with depressive disorders in general hospitals: latent class analysis and GEE. BMC Health Serv Res 2022; 22:899. [PMID: 35818042 PMCID: PMC9275052 DOI: 10.1186/s12913-022-08250-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background Prevalence of depression in older persons was a leading cause of disability. This group has the lowest access to service and retention in care compared to other age groups. This study aimed to explore continuing mental health service use and examined the predictive power of the mental health service delivery system and individual factors on mental health service use among older persons diagnosed with depressive disorders. Methods We employed an analytic cross-sectional study design of individual and organizational variables in 12 general hospitals selected using multi-stratified sampling. There were 3 clusters comprising community hospitals, advanced and standard hospitals, and university hospitals. Participants in each group were 150 persons selected by purposive sampling. We included older persons with a first or recurring diagnosis of a depressive disorder in the last 6 to 12 months of the data collection date. Data at the individual level included socio-demographic characteristics, Charlson Comorbidity Index, Attitude toward Depression and its treatment, and perceived social support. Data at the organizational level had hospital level, nurse competency, nurse-patient ratio, and appointment reminders. Descriptive statistics, Pearson chi-square test, latent class analysis (LCA), and marginal logistic regression model using generalized estimating equation (GEE) were used to analyze the data. Results The continuing mental health service use among older persons diagnosed with depressive disorders was 54%. The latent class analysis of four variables in the mental health services delivery organization yielded distinct and interpretable findings in two groups: high and low resource organization. The marginal logistic multivariable regression model using GEE found that organizational group and attitude toward depression and its treatment were significantly associated with mental health service use (p-value = 0.046; p-value = 0.003). Conclusions The findings suggest that improving continuing mental health services use in older persons diagnosed with depressive disorders should emphasize specialty resources of the mental health services delivery system and attitude toward depression and its treatment.
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Affiliation(s)
- Thida Mulalint
- D.N.S. Candidate, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Acharaporn Seeherunwong
- Department of Mental Health and Psychiatric Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand.
| | - Napaporn Wanitkun
- Department of Surgical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Sasima Tongsai
- Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Owen KB, Foley BC, Eime R, Rose C, Reece LJ. Participation and dropout of Hockey New South Wales participants in 2017 and 2018: a longitudinal study. BMC Sports Sci Med Rehabil 2022; 14:103. [PMID: 35676741 PMCID: PMC9174916 DOI: 10.1186/s13102-022-00494-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 05/19/2022] [Indexed: 11/10/2022]
Abstract
Background Sports have a focus on increasing participation, which contributes to increasing population levels of physical activity, social cohesion and longevity of the sport. The primary aim of this study was to examine reasons for drop-out of a popular team sport in Australia, Field Hockey and identify opportunities to increase participation. Methods This longitudinal study obtained routinely collected registered player data from Hockey New South Wales over two consecutive years, and survey data from registered players who dropped out. Logistic regression models identified demographic subgroups who were more likely to drop out of sport, and the reasons for dropping out. Results In 2018, 8463 (31%) of hockey players did not return to play hockey after the previous season and 805 (10%) of these completed a survey. Specific groups who were more likely to stop playing included 5–6 years (OR: 2.1, 95% CI 1.8–2.6; reference: 12–17 years), females (OR: 1.1, 95% CI 1.0–1.2; reference: males), Indigenous (OR: 1.2, 95% CI 1.1–1.4; reference: non-Indigenous), most disadvantaged (OR: 1.1, 95% CI 1.0–1.2; reference: least disadvantaged) or regional and remote (1.1, 95% CI 1.0–1.2; reference: major cities). Top reasons for drop out were medical/age (17%), change in circumstances (16%) and high cost (13%), lack of time (13%) and lack of enjoyment (7%). Conclusions Although Hockey successfully reaches a large proportion of underrepresented groups in sport, these groups are more likely to drop out. Sports should consult these groups to develop enjoyable, flexible, and modifiable versions of the game that are appropriate to their needs.
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Affiliation(s)
- Katherine B Owen
- SPRINTER, Prevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Level 6, The Charles Perkins Centre, Camperdown, NSW, 2006, Australia.
| | - Bridget C Foley
- SPRINTER, Prevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Level 6, The Charles Perkins Centre, Camperdown, NSW, 2006, Australia
| | - Rochelle Eime
- Institute of Health and Wellbeing, Federation University, Ballarat, VIC, Australia.,Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Catriona Rose
- SPRINTER, Prevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Level 6, The Charles Perkins Centre, Camperdown, NSW, 2006, Australia
| | - Lindsey J Reece
- SPRINTER, Prevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Level 6, The Charles Perkins Centre, Camperdown, NSW, 2006, Australia
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Lucas P, Boyd S, Milloy MJ, Walsh Z. The impact of non-medical cannabis legalization and other exposures on retention in longitudinal cannabis research: a survival analysis of a prospective study of Canadian medical cannabis patients. J Cannabis Res 2021; 3:34. [PMID: 34321108 PMCID: PMC8320176 DOI: 10.1186/s42238-021-00089-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 07/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite repeated calls by medical associations to gather evidence on the harms and benefits of cannabis, there are ongoing methodological challenges to conducting observational and clinical studies on cannabis, including a high rate of patients that are lost to follow-up (LTFU). This study explores factors potentially associated with retention in a large prospective study of Canadian medical cannabis patients, with the goal of reducing the probability that patients will be lost to follow-up in future cannabis research. METHODS The Tilray Observational Patient Study (TOPS) was a multi-site, prospective study assessing the impact of medical cannabis over 6 months in a broad population of authorized Canadian cannabis patients. The study took place from 2016 to 19, and we conducted a series of exploratory analyses including a Kaplan-Meier survival analysis and logistic regressions to assess the potential association between study retention and variables including patient characteristics, cannabis and prescription drug use, quality of life, and the legalization of non-medical cannabis. RESULTS Overall, 1011 participants were included in this analysis, contributing 287 patient-years of data. Retention was 728 (72%) at 3 months, and 419 (41.4%) at 6 months. Our analyses found significantly lower adjusted odds of retention following legalization (AOR 0.28, 95% CI 0.18-0.41), and in patients that used prescription opioids at baseline (AOR 0.62, 95% CI 0.46-0.85), while increased odds of retention were found in patients with a higher baseline psychological score (AOR 1.43, 95% CI 1.08-1.90) or that used anti-seizure medications at baseline (AOR 1.91, 95% CI 1.30-2.81). DISCUSSION TOPS provided a unique opportunity to examine patient characteristics and other variables that may be associated with retention in prospective medical cannabis studies. Our findings highlight some of the challenges of conducting medical cannabis research at a time when patients have a multitude of cannabis access options, including legal adult dispensaries and a robust illicit market. High LTFU rates can impact the validity of studies, and potentially lead to misestimations of the harms and benefits of medical cannabis use. Despite being a multi-site prospective study, this was a convenience sample, thereby limiting the generalizability of these findings. Additionally, data regarding the use of cannabis was self-reported by patients, so is subject to potential recall bias. CONCLUSION We found evidence that external policy changes that affect access to cannabis such as the legalization of non-medical adult use and patient characteristics associated with patient physical/psychological capacity can impact retention in prospective medical cannabis studies. Evidence-based strategies to reduce study burden on participants, such as minimizing in-person visits by providing digitized internet-based surveys and phone or telemedicine follow-up options as well as ensuring adequate participant compensation could improve retention. Additionally, policy-related changes aimed at improving access to medical cannabis, including increased cost-coverage and community-based distribution, could encourage patients to remain in the federal medical cannabis program and thereby reduce LTFU in associated studies.
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Affiliation(s)
- Philippe Lucas
- Social Dimensions of Health, University of Victoria, 3800 Finnerty Rd, Victoria, B.C V8P 5C2 Canada
- 1100 Maughan Rd, Nanaimo, BC V9X1J2 Canada
- Canadian Institute for Substance Use Research, 2300 McKenzie Ave, Victoria, BC V8N 5M8 Canada
| | - Susan Boyd
- Faculty of Human and Social Development, School of Public Health and Social Policy, University of Victoria, 3800 Finnerty Rd, Victoria, B.C V8P 5C2 Canada
| | - M.-J. Milloy
- Faculty of Medicine, University of British Columbia, St. Paul’s Hospital, Burrard Street, Vancouver, B.C 806-1081 Canada
- British Columbia Centre On Substance Use, 400-1045 Howe St, Vancouver, B.C V6Z 2A9 Canada
| | - Zach Walsh
- Department of Psychology, University of British Columbia, 3333 University Way, OkanaganKelowna, B.C V1V 1V7 Canada
- Centre for the Advancement of Psychological Science and Law, University of British Columbia, 3333 University Way, OkanaganKelowna, BC V1V 1V7 Canada
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11
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Toga-Sato S, Tosaki T, Kondo M, Tsunekawa S, Kato Y, Nakamura J, Kamiya H. Impact of actual waiting time and perceived waiting time on treatment satisfaction in patients receiving outpatient diabetes care. Diabetol Int 2021; 12:293-300. [PMID: 34150438 DOI: 10.1007/s13340-020-00486-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
Aims We investigated the impact of actual waiting time and perceived waiting time on treatment satisfaction in patients with diabetes receiving outpatient care. Methods Three hundred and thirty-six outpatients diagnosed with diabetes mellitus or impaired glucose tolerance were selected and the time they spent in reception, blood collection, consultation, and accounting were recorded to measure the time they spent waiting in the hospital (actual waiting time). Simultaneously, we conducted a questionnaire survey that included questions on their perceptions of the waiting time (perceived waiting time) and satisfaction with treatment (DTSQ). Results No significant relationship was found between actual waiting time and DTSQ score, although associations were observed with perceived waiting time. The patients who felt the overall waiting time was long scored 23.0, those who felt it was short scored 26.0, and those who felt it was very short scored 34.0, with those who felt the waiting time was long having a significantly lower score (p = 0.004, p < 0.001, respectively) and those who felt it was short having a significantly lower score than those who felt it was very short (p = 0.008). In addition, more patients who felt the waiting time was long expressed dissatisfaction with the responses of doctors and staff than those who felt the waiting time was short. Conclusions These results suggest that in addition to reducing actual waiting times, shortening perceived waiting times by improving the responses of medical staff could help to increase patient satisfaction.
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Affiliation(s)
- Shiori Toga-Sato
- TDE Healthcare Corporation TOSAKI Clinic for Diabetes and Endocrinology, 2-1007, Motoueda, Tenpaku ward, Nagoya, Aichi 468-0009 Japan
| | - Takahiro Tosaki
- TDE Healthcare Corporation TOSAKI Clinic for Diabetes and Endocrinology, 2-1007, Motoueda, Tenpaku ward, Nagoya, Aichi 468-0009 Japan
| | - Masaki Kondo
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Shin Tsunekawa
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Yoshiro Kato
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Jiro Nakamura
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Hideki Kamiya
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195 Japan
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12
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Golay P, Ramain J, Reiff C, Solida A, Baumann PS, Conus P. Rate and predictors of disengagement in an early psychosis program with time limited intensification of treatment. J Psychiatr Res 2020; 131:33-38. [PMID: 32916376 DOI: 10.1016/j.jpsychires.2020.08.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/17/2020] [Accepted: 08/22/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Service disengagement is a frequent problem in early intervention in psychosis. The goal of this study was to evaluate the rate and variables associated with service disengagement in a three year specialized program that allows treatment intensification on a case to case basis. METHODS 328 early psychosis patients were assessed at baseline on a large set of socio-demographic and clinical variables and were followed-up over 36 months. Patients who left the program for reasons related to engagement with care were compared to patients who completed the program. RESULTS Rates of disengagement were low (6.3%). Patients with lower socio-economic status, who committed offences during the program or with a diagnosis of Schizophreniform/brief psychotic disorder were more likely to disengage from the program. CONCLUSIONS The engagement strategies implemented in the context of our early intervention programs have allowed to keep disengagements to a relatively low level. In this context, only 3 variables emerged to guide adaptation of the intervention in order to improve this already good engagement rate.
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Affiliation(s)
- Philippe Golay
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Switzerland; Service of Community Psychiatry, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland.
| | - Julie Ramain
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Caroline Reiff
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Alessandra Solida
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Philipp S Baumann
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Switzerland
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Liao B, Zhang XW, Wang JY, Liu J, Liang J, He WJ, Hong B, Li Y. Analysis of factors associated with dropping-out from HIV antiretroviral therapy in Kunming City, China. BMC Infect Dis 2019; 19:1043. [PMID: 31823736 PMCID: PMC6902558 DOI: 10.1186/s12879-019-4658-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The implementation of national antiretroviral therapy (ART) and expanded ART policies results in that more and more HIV-infected patients receive ART in Kunming, Yunnan province, China. At the same time, however, the number of patients, who drop-out from ART, are also increasing. In this study, we explored the factors that may account for drop-out. METHODS Four hundred and thirty-nine HIV-infected patients, who received or used to receive ART, were recruited in this study. Their age is among 18 and 75. All patients were divided into two group: ART group (187 patients) and drop-out group (252 patients). Appropriate bio-statistics analysis, including univariate analysis and Multivariate analysis, were used to identify factors associated with drop-out. RESULTS Data from all patients were analyzed. Univariate analysis suggested that the factors associated with drop-out may include age, residential area, educational level, occupation, monthly income, the access to minimum living allowance, HIV transmission route, and living status. On the other hand, factors including area, monthly income, the access to minimum living allowance, and referral methods of follow-up institutions account for drop-out in multivariate analysis. CONCLUSIONS This study identified a number of factors associated with drop out from ART. Based on our findings,appropriate interventions should be introduced decrease drop-out.
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Affiliation(s)
- Bin Liao
- Department of AIDS and Sexually Transmitted Disease Control and Prevention, Kunming Center for Disease Control and Prevention, Kunming, Yunnan, China
| | - Xiao-Wen Zhang
- Department of AIDS and Sexually Transmitted Disease Control and Prevention, Kunming Center for Disease Control and Prevention, Kunming, Yunnan, China
| | - Jing-Ying Wang
- Department of AIDS and Sexually Transmitted Disease Control and Prevention, Kunming Center for Disease Control and Prevention, Kunming, Yunnan, China
| | - Jun Liu
- Department of AIDS and Sexually Transmitted Disease Control and Prevention, Kunming Center for Disease Control and Prevention, Kunming, Yunnan, China
| | - Jun Liang
- Department of AIDS and Sexually Transmitted Disease Control and Prevention, Kunming Center for Disease Control and Prevention, Kunming, Yunnan, China
| | - Wen-Jie He
- Department of AIDS and Sexually Transmitted Disease Control and Prevention, Kunming Center for Disease Control and Prevention, Kunming, Yunnan, China
| | - Biao Hong
- Department of AIDS Control and Prevention, Panlong District for Disease Control and Prevention, Kunming, Yunnan, China
| | - Yi Li
- Department of AIDS and Sexually Transmitted Disease Control and Prevention, Kunming Center for Disease Control and Prevention, Kunming, Yunnan, China.
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14
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Slavych BK, Zraick RI, Bursac Z, Tulunay-Ugur O, Hadden K. An Investigation of the Relationship between Adherence to Voice Therapy for Muscle Tension Dysphonia and Employment, Social Support, and Life Satisfaction. J Voice 2021; 35:386-93. [PMID: 31784257 DOI: 10.1016/j.jvoice.2019.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 10/24/2019] [Accepted: 10/25/2019] [Indexed: 01/07/2023]
Abstract
PURPOSE The purpose of this study was to investigate whether a relationship exists between employment status, perception of life quality (ie, vocal impairment, health, life satisfaction, and social support), and adherence to voice therapy for persons with muscle tension dysphonia (MTD). This study extends recent work as it evaluates investigating the impact of social support and life satisfaction on adherence to voice therapy for MTD. METHOD A cross-sectional study of 45 individuals diagnosed with MTD who participated in voice therapy between January 2014 and December 2015 at the University of Arkansas for Medical Science's Voice and Swallowing Center in Little Rock, Arkansas participated in this study. Participants provided information regarding employment status and completed the Satisfaction with Life Scale and the Quality of Relationships Inventory. RESULT Sixty percent of participants completed voice therapy. Patients who completed voice therapy were more likely to report gainful employment (P = 0.038) or less confidence in a specific and significant personal relationship (P = 0.004). CONCLUSION This study discovered a moderate effect between employment status and adherence to voice therapy for MTD as well as relationship confidence and adherence.
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15
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Dareng EO, Olaniyan Y, Adebamowo SN, Eseyin OR, Odutola MK, Obiefuna EM, Offiong RA, Pharoah PP, Adebamowo CA. Age, HIV status, and research context determined attrition in a longitudinal cohort in Nigeria. J Clin Epidemiol 2018; 100:32-43. [PMID: 29679747 PMCID: PMC8015251 DOI: 10.1016/j.jclinepi.2018.04.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/03/2018] [Accepted: 04/11/2018] [Indexed: 01/12/2023]
Abstract
OBJECTIVES We explored determinants of attrition in a longitudinal cohort study in Nigeria. STUDY DESIGN AND SETTING We enrolled 1,020 women into a prospective study. Of these, 973 were eligible to return for follow-up. We investigated the determinants of attrition among eligible women using a sequential mixed methods design. We used logistic regression models to compare the baseline characteristics of responders and nonresponders. At the end of the parent study, we conducted four focus group discussions and eight key informant interviews with nonresponders. RESULTS Of the 973 women included in the quantitative analysis, 26% were nonresponders. From quantitative analysis, older women were less likely to drop out than younger women (reference: women ≤30 years; OR 0.46; 95% confidence interval [CI] 0.30-0.70, P < 0.001 women 31-44 years; and OR 0.31; 95% CI 0.17-0.56, P < 0.001 women ≥45 years). HIV-positive women were also less likely to drop out of the study (OR 0.45; 95% CI 0.33-0.63, P < 0.001). From qualitative analysis, contextual factors that influenced attrition were high cost of participation, therapeutic misconceptions, inaccurate expectations, spousal disapproval, unpleasant side effects, challenges in maintaining contact with participants, and participant difficulties in locating the study clinic. CONCLUSION Several participant-, research-, and environment-related factors influence attrition. Retention strategies that address these barriers are important to minimize attrition.
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Affiliation(s)
- Eileen O Dareng
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Office of Strategic Information, Research and Training, Institute of Human Virology, Abuja, Nigeria
| | - Yinka Olaniyan
- Department of Obstetrics and Gynecology, National Hospital, Abuja, Nigeria
| | - Sally N Adebamowo
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA; Marlene and Stewart Greenbaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Olabimpe R Eseyin
- Office of Strategic Information, Research and Training, Institute of Human Virology, Abuja, Nigeria
| | - Michael K Odutola
- Office of Strategic Information, Research and Training, Institute of Human Virology, Abuja, Nigeria
| | - Elonna M Obiefuna
- Office of Strategic Information, Research and Training, Institute of Human Virology, Abuja, Nigeria
| | - Richard A Offiong
- Department of Obstetrics and Gynecology, University of Abuja Teaching Hospital, Abuja, Nigeria
| | - Paul P Pharoah
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Clement A Adebamowo
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA; Marlene and Stewart Greenbaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA; Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
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16
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Stowkowy J, Liu L, Cadenhead KS, Tsuang MT, Cannon TD, Cornblatt BA, McGlashan TH, Woods SW, Perkins DO, Seidman LJ, Walker EF, Bearden CE, Mathalon DH, Addington J. Exploration of clinical high-risk dropouts. Schizophr Res 2018; 195:579-580. [PMID: 28964651 PMCID: PMC8126503 DOI: 10.1016/j.schres.2017.09.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/09/2017] [Accepted: 09/13/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Jacqueline Stowkowy
- Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
| | - Lu Liu
- Mathison Centre forMental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | | | | | | | | | | | - Scott W. Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Diana O. Perkins
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA
| | - Larry J. Seidman
- Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Elaine F. Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, USA
| | - Carrie E. Bearden
- Departments of Psychology and Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA
| | | | - Jean Addington
- Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, 3280 Hospital Drive NW, T2N4Z6 Calgary, Alberta, Canada.
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Pedersen ER, Ewing BA, D'Amico EJ, Miles JNV, Haas AC, Tucker JS. Predictors of Retention in an Alcohol and Risky Sex Prevention Program for Homeless Young Adults. Prev Sci 2018; 19:459-467. [PMID: 29352399 PMCID: PMC5947862 DOI: 10.1007/s11121-018-0866-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Homeless young adults are at risk for alcohol and other drug (AOD) use and risky sexual behavior. Interventions are needed to help these young people reduce their risky behavior, but this population is often difficult to engage and retain in services. We offered a four-session AOD and risky sex reduction program to 100 participants and examined if retention in the program was predicted by a number of factors: demographics, homelessness severity, other service use, AOD behaviors, mental health symptoms, sexual risk behaviors, and readiness to change AOD and condom use. Nearly half (48%) of participants completed all sessions. In bivariate analyses, participants were significantly less likely to be retained in the program if they had slept outdoors in the past month, engaged in more alcohol and marijuana use, experienced more alcohol-related consequences, and received the program in an urban drop-in center (as opposed to a drop-in center near the beach). When controlling for all significant bivariate relationships, only sleeping outdoors and receipt of the program in the urban setting predicted fewer sessions completed. The most endorsed reasons for program non-completion were being too busy to attend and inconvenient day/time of the program. Findings can help outreach staff and researchers better prepare methods to engage higher risk homeless youth and retain them in services. Finding unique ways to help youth overcome barriers related to location of services appears especially necessary, perhaps by bringing services to youth where they temporarily reside or offering meaningful incentives for program attendance.
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Affiliation(s)
- Eric R Pedersen
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA.
| | - Brett A Ewing
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA
| | | | - Jeremy N V Miles
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA
| | - Ann C Haas
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA
| | - Joan S Tucker
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA
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Larsen T, Urke HB, Holsen I, Anvik CH, Olsen T, Waldahl RH, Antonsen KM, Johnson R, Tobro M, Brastad B, Hansen TB. COMPLETE - a school-based intervention project to increase completion of upper secondary school in Norway: study protocol for a cluster randomized controlled trial. BMC Public Health 2018. [PMID: 29523124 PMCID: PMC5845360 DOI: 10.1186/s12889-018-5241-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Drop out from upper secondary school represents a risk for the future health and wellbeing of young people. Strengthening of psychosocial aspects of the learning environment may be an effective strategy to promote completion of upper secondary school. This paper is a study protocol of a school based cluster randomized controlled trial (RCT) evaluating two school-based interventions, namely the Dream School Program (DSP) and the Mental Health Support Team (MHST). The interventions aim to improve psychosocial learning environments and subsequently school achievements and decrease drop-out and absence. METHODS/DESIGN The COMPLETE RCT is aimed at youth in upper secondary school, grade 1 (age 15-16 years), and examines the effect of the combination of the DSP and the MHST; and the DSP only, compared with a comparison group on the following primary outcomes: student completion, presence, average grade, and self-reported mental health. Seventeen upper secondary schools from four counties in Norway were randomized to one of the three arms: 1) DSP and MHST; 2) DSP; and 3) comparison (offered DSP intervention in 2018/2019). The study will evaluate the interventions based on information from two cohorts of students (cohort 1 (C1) and cohort 2 (C2)). For C1, data was collected at baseline (August 2016), and at first follow-up seven months later. Second follow-up will be collected 19 months after baseline. For C2, data was collected at baseline (August 2017), and first and second follow-up will be collected similarly to that of C2 seven and 19 months respectively after baseline. Process evaluations based on focus groups, interviews and observation will be conducted twice (first completed spring 2017). DISCUSSION The COMPLETE trial is a large study that can provide useful knowledge about what interventions might effectively improve completion of upper secondary school. Its thorough process evaluation will provide critical information about barriers and points of improvement for optimizing intervention implementation. Findings can guide school development in the perspective of improving psychosocial learning environments and subsequent completion of upper secondary schooling. TRIAL REGISTRATION The trial was retrospectively registered in the ClinicalTrials.gov register on December 22.2017: NCT03382080 .
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Affiliation(s)
- T Larsen
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - H B Urke
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway.
| | - I Holsen
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - C H Anvik
- Nordland Research Institute, Bodø, Norway
| | - T Olsen
- Nordland Research Institute, Bodø, Norway
| | | | | | - R Johnson
- Nordland Research Institute, Bodø, Norway
| | - M Tobro
- Oxford Research, Kristiansand, Norway
| | - B Brastad
- Oxford Research, Kristiansand, Norway
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Yao T, Feng D, Pan MH, Cheng YP, Li CX, Wang J, Feng YL, Shi J, Su T, Chen Q, Shi S, Wang SP. [Correlation between insufficient methadone dosage and morphine positive urine on drop out of treatment in patients with access to methadone maintenance treatment]. Zhonghua Liu Xing Bing Xue Za Zhi 2017; 38:646-50. [PMID: 28651404 DOI: 10.3760/cma.j.issn.0254-6450.2017.05.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To estimate the incidence of drop out of treatment in patients with access to methadone maintenance treatment and explore the correlation and interaction between insufficient methadone dosage and morphine positive urine on the drop out in Guangxi Zhuang Autonomous Region. Methods: Face to face interview was conducted in 1 031 patients at 3 methadone maintenance treatment clinics in Guangxi. Results: The study included 1 031 participants, 40.6% of them (419/1 031) had stopped treatment. The drop out rates in urine morphine positive group and methadone dosage<100 mg/d group were 57.6% (99/172) and 37.4% (347/929) respectively, higher than those in urine morphine negative group and methadone dosage ≥100 mg/d group (42.3%, 363/859, and 26.5%, 27/102). Orderly logistic regression analysis results showed that after adjusted factors, such as gender, age, marital status, ethnic group, patients who received a dosage less than 100 mg/day (OR=3.05, 95%CI: 1.84-5.06) and had morphine positive urine (OR=2.25, 95%CI: 1.59-3.19) were more likely to drop out of the treatment. Interaction analysis showed that dosage less than 100 mg/d and morphine positive urine during treatment had additive interaction (RERI=256.46, AP=0.87, S= 8.05) and multiplication interaction (OR=2.45, 95%CI: 1.71-3.49). Conclusion: Insufficient dosage and morphine positive urine were significantly correlated with drop out of treatment in patients with access to methadone maintenance treatment.
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O'Neill LD, Morcke AM, Eika B. The validity of student tutors' judgments in early detection of struggling in medical school. A prospective cohort study. Adv Health Sci Educ Theory Pract 2016; 21:1061-1079. [PMID: 27022752 DOI: 10.1007/s10459-016-9677-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 03/16/2016] [Indexed: 06/05/2023]
Abstract
Early identification and support of strugglers in medical education is generally recommended in the research literature, though very little evidence of the diagnostic qualities of early teacher judgments in medical education currently exists. The aim of this study was to examine the validity of early diagnosis of struggling in medical school based on informal teacher judgements of in-class behavior. The study design was a prospective cohort study and the outcomes/truth criteria were anatomy failure and medical school drop out. Six weeks into an anatomy course, student tutors attempted to identify medical students, who they reckoned would fail the anatomy course or drop out, based on their everyday experiences with students in a large group educational setting. In addition, they were asked to describe the indicators of struggling they observed. Sixteen student tutors evaluated 429 medical students for signs of struggling. By week six, the student tutors were able to detect approximately 1/4-1/3 of the students who eventually failed or dropped out, and for ¾ of the strugglers they identified, they were correct in their judgments. Informal student tutor's judgements showed incremental validity for both outcomes when controlling for grades obtained in preceeding exams. Lack of participation, lack of commitment, poor academic performance, poor social interactions and general signs of distress were the main indicators of struggling identified. Teachers' informal judgements of in-class behavior may be an untapped source of information in the early identification of struggling medical students with added value above and beyond formal testing.
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Affiliation(s)
- Lotte Dyhrberg O'Neill
- Centre for Health Sciences Education, INCUBA Science Park Skejby, Aarhus University, Palle Juul-Jensens Boulevard 82, building B, 8200, Århus N, Denmark.
| | - Anne Mette Morcke
- Centre for Health Sciences Education, INCUBA Science Park Skejby, Aarhus University, Palle Juul-Jensens Boulevard 82, building B, 8200, Århus N, Denmark
| | - Berit Eika
- Rector's Office, Aarhus University, Aarhus, Denmark
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Thompson TP, Greaves CJ, Ayres R, Aveyard P, Warren FC, Byng R, Taylor RS, Campbell JL, Ussher M, Michie S, West R, Taylor AH. Factors associated with study attrition in a pilot randomised controlled trial to explore the role of exercise-assisted reduction to stop (EARS) smoking in disadvantaged groups. Trials 2016; 17:524. [PMID: 27788686 PMCID: PMC5084338 DOI: 10.1186/s13063-016-1641-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 10/06/2016] [Indexed: 12/23/2022] Open
Abstract
Background Study attrition has the potential to compromise a trial’s internal and external validity. The aim of the present study was to identify factors associated with participant attrition in a pilot trial of the effectiveness of a novel behavioural support intervention focused on increasing physical activity to reduce smoking, to inform the methods to reduce attrition in a definitive trial. Methods Disadvantaged smokers who wanted to reduce but not quit were randomised (N = 99), of whom 61 (62 %) completed follow-up assessments at 16 weeks. Univariable logistic regression was conducted to determine the effects of intervention arm, method of recruitment, and participant characteristics (sociodemographic factors, and lifestyle, behavioural and attitudinal characteristics) on attrition, followed by multivariable logistic regression on those factors found to be related to attrition. Results Participants with low confidence to quit, and who were undertaking less than 150 mins of moderate and vigorous physical activity per week at baseline were less likely to complete the 16-week follow-up assessment. Exploratory analysis revealed that those who were lost to follow-up early in the trial (i.e., by 4 weeks), compared with those completing the study, were younger, had smoked for fewer years and had lower confidence to quit in the next 6 months. Participants who recorded a higher expired air carbon monoxide reading at baseline were more likely to drop out late in the study, as were those recruited via follow-up telephone calls. Multivariable analyses showed that only completing less than 150 mins of physical activity retained any confidence in predicting attrition in the presence of other variables. Conclusions The findings indicate that those who take more effort to be recruited, are younger, are heavier smokers, have less confidence to quit, and are less physically active are more likely to withdraw or be lost to follow-up.
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Affiliation(s)
- T P Thompson
- Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, UK.
| | - C J Greaves
- University of Exeter Medical School, Exeter, UK
| | - R Ayres
- Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, UK
| | - P Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - F C Warren
- University of Exeter Medical School, Exeter, UK
| | - R Byng
- Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, UK
| | - R S Taylor
- University of Exeter Medical School, Exeter, UK
| | | | - M Ussher
- Institute of Population Health Research, St George's University of London, Cranmer Terrace, London, UK
| | - S Michie
- Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, UK
| | - R West
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London, UK
| | - A H Taylor
- Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, UK
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Khazaie H, Rezaie L, Shahdipour N, Weaver P. Exploration of the reasons for dropping out of psychotherapy: A qualitative study. Eval Program Plann 2016; 56:23-30. [PMID: 27010417 DOI: 10.1016/j.evalprogplan.2016.03.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 01/14/2016] [Accepted: 03/06/2016] [Indexed: 06/05/2023]
Abstract
Elucidating the reasons for dropping out of psychotherapy can lead to the development of interventions aimed at reducing patient drop out. The present study aimed to explore patients' reasons for dropping out of psychotherapy in Kermanshah, Iran. The present qualitative study was performed using conventional content analysis. The current sample included 15 participants consisting of 7 patients who dropped out of psychotherapy and 8 psychotherapists who have previously experienced patient dropout. A semi-structured interview was used for data collection. All interviews were audio recorded and subsequently transcribed. Content analysis using constant comparisons was performed for transcribed interviews. Four main categories emerged as reasons for dropping out of psychotherapy: dissatisfaction with the quality of psychotherapy, financial problems in psychotherapy, unprepared socio-cultural context of psychotherapy, and psychotherapy as a non-user friendly treatment. Additionally, specific subcategories within each main category were documented. The results revealed distinct reasons for psychotherapy drop out in the current Iranian-based sample. These identified reasons should be considered and addressed at the onset of treatment as well as in the development of formal interventions aimed at reducing dropout. Further research investigating the antecedents leading to patient drop out is recommended.
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Affiliation(s)
- Habibolah Khazaie
- Sleep Disorders Research Center, Farabi Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Leeba Rezaie
- Sleep Disorders Research Center, Farabi Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Niloofar Shahdipour
- Psychiatry Department, Farabi Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Patrick Weaver
- Department of Psychology, Eastern Michigan University (EMU), USA.
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Jiandani D, Wharton S, Rotondi MA, Ardern CI, Kuk JL. Predictors of early attrition and successful weight loss in patients attending an obesity management program. BMC Obes 2016; 3:14. [PMID: 26966544 PMCID: PMC4784380 DOI: 10.1186/s40608-016-0098-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 03/04/2016] [Indexed: 11/10/2022]
Abstract
Background Our objective was to identify factors that are independently associated with early attrition and successful weight loss (WL) in an obesity-management program. Methods Participants were 9,498 patients enrolled in treatment at the Wharton Weight Management Clinic for at least 6 months. Predictors of early attrition (<6 months) and successful WL (≥5 %) were analyzed using relative risk (RR) in men and women separately. Pearson’s correlation was used to determine the relationship between WL and treatment time Weight loss and attrition analysis was restricted to patients who had more than two visits (n = 5415). Results Older individuals had lower early attrition (RR Range:0.74–0.92, P < 0.05) and greater WL success (RR Range:1.40–1.65, P < 0.05) than younger individuals. Males with hypertension and females with depression had greater early attrition (RR Range:1.09–1.20, P < 0.05) and lower WL success (RR Range:0.48–0.57, P < 0.05) than those without these health conditions. Males with lower education had greater early attrition (RR = 1.11[1.03–1.19]) than males with higher education, but did not differ in WL. Females who smoked had greater early attrition (RR = 1.06[1.01–1.11]) than females who did not smoke, but did not differ in WL. Ethnicity was not related to early attrition, however, females of Black and Other ethnicities had lower WL success compared to White females (RR Range:0.58–0.74, P < 0.05). After adjusting for treatment time, all above associations were no longer significant and treatment time remained as the only independent predictor of WL success (P < 0.0001). Conclusion As WL is positively and independently related with treatment time, individuals at risk for early attrition may need alternative treatment options, in order to improve patient retention and improve WL success.
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Affiliation(s)
- Dishay Jiandani
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Sean Wharton
- School of Kinesiology and Health Science, York University, Toronto, Canada ; The Wharton Weight Management Clinic, Toronto, Canada
| | - Michael A Rotondi
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Chris I Ardern
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Jennifer L Kuk
- School of Kinesiology and Health Science, York University, Toronto, Canada ; Room 2002B, Sherman Health Science Research Centre, York University, 4700 Keele St., Toronto, ON M3J 1P3 Canada
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Nichols EB, Loper AB, Meyer JP. Promoting Educational Resiliency in Youth with Incarcerated Parents: The Impact of Parental Incarceration, School Characteristics, and Connectedness on School Outcomes. J Youth Adolesc 2016; 45:1090-109. [PMID: 26259843 DOI: 10.1007/s10964-015-0337-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 07/29/2015] [Indexed: 10/23/2022]
Abstract
The United States has the highest incarceration rate in the world, and as a result, one of the largest populations of incarcerated parents. Growing evidence suggests that the incarceration of a parent may be associated with a number of risk factors in adolescence, including school drop out. Taking a developmental ecological approach, this study used multilevel modeling to examine the association of parental incarceration on truancy, academic achievement, and lifetime educational attainment using the National Longitudinal Survey of Adolescent Health (48.3 % female; 46 % minority status). Individual characteristics, such as school and family connectedness, and school characteristics, such as school size and mental health services, were examined to determine whether they significantly reduced the risk associated with parental incarceration. Our results revealed small but significant risks associated with parental incarceration for all outcomes, above and beyond individual and school level characteristics. Family and school connectedness were identified as potential compensatory factors, regardless of parental incarceration history, for academic achievement and truancy. School connectedness did not reduce the risk associated with parental incarceration when examining highest level of education. This study describes the school related risks associated with parental incarceration, while revealing potential areas for school-based prevention and intervention for adolescents.
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Kulkarni G, Mohanty NC, Mohanty IR, Jadhav P, Boricha BG. Survey of reasons for discontinuation from in vitro fertilization treatment among couples attending infertility clinic. J Hum Reprod Sci 2015; 7:249-54. [PMID: 25624660 PMCID: PMC4296398 DOI: 10.4103/0974-1208.147491] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 09/10/2014] [Accepted: 10/22/2014] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND With the increase in infertility burden, more and more couples are opting for in vitro fertilization (IVF). Despite the availability of various treatment options, the major concern that needs to be addressed is the reasons why such couples, initially motivated so strongly, drop out in fairly high numbers from IVF cycles. With this point of view the study was designed. AIM The objective of this study was to explore the reasons why couples discontinue fertility treatment. SETTINGS AND DESIGN This retrospective study was carried out among couples in the age group of 20-40 years who opted for IVF at Tertiary care hospital and a private infertility center. MATERIALS AND METHODS Medical records for 3 years (2009-2012) were taken out and included in the study for analysis. Socio-demographic details along with indication for IVF and reasons for drop-separate IVF therapy were recorded on case record form and were analyzed. RESULTS Twenty-one percent of the patients had tubal pathology, thus making it the commonest female related factor for indication of IVF. Oligoasthenospermia (13%) was the commonest cause of male related infertility factor. Financial burden was the primary cause for terminating treatment in majority of the IVF cases. CONCLUSIONS Financial burden (62.5%) was the commonest reason for drop out among couples from IVF cycle.
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Affiliation(s)
- Grishma Kulkarni
- Department of Pharmacology, Mahatma Gandhi Mission Medical College, Kamothe, Navi Mumbai, Maharashtra, India
| | - Nimain C Mohanty
- Department of Pediatrics, Mahatma Gandhi Mission Medical College Hospital for Women and Children, Kalamboli, Navi Mumbai, Maharashtra, India
| | - Ipseeta Ray Mohanty
- Department of Pharmacology, Mahatma Gandhi Mission Medical College, Kamothe, Navi Mumbai, Maharashtra, India
| | - Pradeep Jadhav
- Department of Pharmacology, Mahatma Gandhi Mission Medical College, Kamothe, Navi Mumbai, Maharashtra, India
| | - B G Boricha
- Department of Obstetrics and Gynecology, Mahatma Gandhi Mission Medical College Hospital for Women and Children, Kalamboli, Navi Mumbai, Maharashtra, India
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Abstract
The role of liver transplant for treatment of early hepatocellular cancer (HCC) is no longer contested. However, its benefit relative to other therapies for patients with very early (<2 cm) HCC is still a matter of debate. Twenty years after the establishment of the Milan criteria, we are beginning to realize that the number and size of tumors may not be the best metric by which to prognosticate outcomes and allocate organs. A better assessment of tumor aggressiveness is clearly needed.
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Abstract
Current methods of power and sample size calculations for the design of longitudinal studies to evaluate mediation effects are mostly based on simulation studies and do not provide closed-form formulae. A further challenge due to the longitudinal study design is the consideration of missing data, which almost always occur in longitudinal studies due to staggered entry or drop out. In this article, we consider the product of coefficients as a measure for the longitudinal mediation effect and evaluate three methods for testing the hypothesis on the longitudinal mediation effect: the joint significant test, the normal approximation and the test of b methods. Formulae for power and sample size calculations are provided under each method while taking into account missing data. Performance of the three methods under limited sample size are examined using simulation studies. An example from the Einstein aging study is provided to illustrate the methods.
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Affiliation(s)
- Cuiling Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine of Yeshiva University, New York, USA
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine of Yeshiva University, New York, USA
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