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PubMed1998

The association of educational achievement and school dropout with risk of alcoholism: a twenty-five-year prospective study of inner-city children.

OBJECTIVE: This prospective study is focused on the characteristics leading to alcohol use disorders in early adulthood among a cohort of black children. The principal aim of this work is to examine the impact of educational attainment, school dropout and early school adaptation on the development of alcohol abuse and dependence in adulthood. METHOD: From a population that consisted of 1,242 first graders in 1966-67, a total of 953 were interviewed at age 32-33 about their current alcohol and drug use, educational attainment, employment and family situation. RESULTS: Diagnoses of alcohol abuse and dependence were defined according to DSM-III-R criteria resulting in identification of 13.5% as having a lifetime alcohol use disorder. Early predictions of an alcohol use disorder in adulthood included early reports of underachievement in first grade by the child's teacher, dropping out of high school, whether the family set definite rules about school during adolescence, and how often the adolescent worked on homework with his/her family. CONCLUSIONS: The results suggest that educational achievement and some early adaptive behaviors in school are associated with risk for alcohol use disorders. The public health importance of the findings are discussed.

Achievement↗
PubMed2005

The law of attrition.

In an ongoing effort of this Journal to develop and further the theories, models, and best practices around eHealth research, this paper argues for the need for a "science of attrition", that is, a need to develop models for discontinuation of eHealth applications and the related phenomenon of participants dropping out of eHealth trials. What I call "law of attrition" here is the observation that in any eHealth trial a substantial proportion of users drop out before completion or stop using the application. This feature of eHealth trials is a distinct characteristic compared to, for example, drug trials. The traditional clinical trial and evidence-based medicine paradigm stipulates that high dropout rates make trials less believable. Consequently eHealth researchers tend to gloss over high dropout rates, or not to publish their study results at all, as they see their studies as failures. However, for many eHealth trials, in particular those conducted on the Internet and in particular with self-help applications, high dropout rates may be a natural and typical feature. Usage metrics and determinants of attrition should be highlighted, measured, analyzed, and discussed. This also includes analyzing and reporting the characteristics of the subpopulation for which the application eventually "works", ie, those who stay in the trial and use it. For the question of what works and what does not, such attrition measures are as important to report as pure efficacy measures from intention-to-treat (ITT) analyses. In cases of high dropout rates efficacy measures underestimate the impact of an application on a population which continues to use it. Methods of analyzing attrition curves can be drawn from survival analysis methods, eg, the Kaplan-Meier analysis and proportional hazards regression analysis (Cox model). Measures to be reported include the relative risk of dropping out or of stopping the use of an application, as well as a "usage half-life", and prediction models reporting demographic usage discontinuation in a population. Differential dropout or usage rates between two interventions could be a standard metric for the "usability efficacy" of a system. A "run-in and withdrawal" trial design is suggested as a methodological innovation for Internet-based trials with a high number of initial dropouts/nonusers and a stable group of hardcore users.

Delivery of Health Care↗
PubMed1990

A double-blind comparison of the efficacy and acceptability of Femodene and Microgynon-30.

The efficacy, cycle-control and tolerance of Microgynon-30, a widely prescribed levonorgestrel containing oral contraceptive, and Femodene, a new oral-contraceptive containing gestodene, were compared in a randomised, double-blind study involving 456 healthy women over a 6 month period. 229 women were allocated to receive Femodene and 227 received Microgynon-30. No differences between the groups in terms of obstetric and gynaecological history, previous contraceptive history, smoking habits, blood-pressure or body weight at admission were observed. No pregnancies were reported in either group, despite tablet-taking errors recorded in 6.3% of the Femodene group and 7.6% of the Microgynon-30 group. Both oral contraceptives were compared in terms of cycle length, intensity of the withdrawal bleed and side effects. Cycle-control was similar in the two groups. However, significantly fewer subjects reported breakthrough bleeding (with or without spotting) in the Femodene group (18% of patients) compared with the Microgynon-30 group (26% of patients). The incidence of absent withdrawal bleeds was 1% or less in both groups and no significant effects on body weight or blood pressure were observed.

Adolescent↗
PubMed2001

A comparison of the characteristics of profiles produced with the AMPFlSTR SGM Plus multiplex system for both standard and low copy number (LCN) STR DNA analysis.

DNA STR profiles have been generated from 1 ng and low copy number (LCN) templates using 28 and 34 cycles of amplification, respectively. Characteristics which facilitate the interpretation of profiles, such as heterozygous balance, allelic dropout and stutter proportions have been quantified. We demonstrate that a reduction in DNA template coupled with an increase in amplification cycle number produces an increased rate of allelic dropout out which can be correlated to the peak areas of those alleles observed. In addition, the LCN conditions increase the degree of peak area asymmetry observed from heterozygotes and the size range of stutters. Analysis of the data allows us to develop sets of guidelines appropriate for interpreting both single and mixed DNA profiles.

Alleles↗
PubMed2004

A randomized study of neighborhood effects on low-income children's educational outcomes.

Experimental data from the Moving to Opportunity for Fair Housing Demonstration were used to examine (a) if moving from high- to low-poverty neighborhoods (via randomization) was associated with low-income minority children's achievement, grade retention, and suspensions/expulsions; (b) if moving minimized gender differences in these outcomes; and (c) potential mediators of observed program effects. Data on school-age children (mean age = 11.79 years, SD = 3.26) were obtained from standardized assessments and parent and adolescent interviews during the New York City site's 3-year follow-up evaluation (N = 588). Moving to low-poverty neighborhoods had positive effects on 11-18-year-old boys' achievement scores compared with those of their peers in high-poverty neighborhoods. These male adolescents' scores were comparable to females' scores, whereas male adolescents in high-poverty neighborhoods scored 10 points lower than female peers. Homework time and school safety partially accounted for program effects. From a policy perspective, the program benefited disadvantaged male adolescents at high risk for dropping out of school.

Adolescent↗
PubMed2006

The accuracy of prevalence estimations for suicide attempts. how reliably do adolescents and young adults report their suicide attempts?

This study explores the accuracy of prevalence estimations for suicide attempts. Data came from the Early Developmental Stages of Psychopathology (EDSP) Study, a prospective community study (mean follow-up period was 42 months) of 3,021 respondents aged 14 to 24 years at the outset of the study. Suicide attempters are at least 1.6 times more likely to drop out than subjects with no suicide attempts and suicidal ideas. A total of 8% of all suicide attempters answered in the negative the depression-related gate questions of all surveys. One-third of all baseline suicide attempters did not report their suicide attempt again at the four years later assessment. In particular, 80% of all nonreporters were female, and almost 60% were aged 14-17 at baseline.

Adolescent↗
PubMed1996

Medical student attrition: a 10-year survey in one medical school.

Medical student wastage leads to adverse emotional and social consequences for individual students and financial difficulties and morale problems for medical schools. This study retrospectively assessed the records of all students at Leeds School of Medicine who left the course prematurely between 1983 and 1992. The demographic data of the leavers were compared with those of all students entering the school during the 10 years studied. A-level examination choices and results of the leavers were compared with those of a control group of all students who entered the school in 1990. The attrition rate over the 10 years was 14% (283 students), with more males than females leaving. Fewer mature students than expected left the course. More leavers had A-level physics and lacked A-level biology compared with the control group. The leavers were academically less able than the controls. Fifty-three per cent of leavers were asked to withdraw from the course for academic reasons; the rest left voluntarily. Thirty per cent had personal problems, 9% had a combination of academic and personal problems and 8% had health problems (psychological difficulties were the commonest). Seventy-one per cent of leavers entered another degree course; science degrees were the most popular. Reasons for medical student wastage and possible solutions are discussed.

Attitude↗
PubMed1975

Mental health problems among university students, and their relationship to academic failure and withdrawal.

Two obvious forms of student "wastage" are academic failure and withdrawal from university. In this prospective cohort study of 2,041 first-year students at Monash University, the relationship of these two events to mental health, university life-stress and other variables is examined. Four factors found to be strongly related to first-year academic failure are mental illness at university a high level of life-stress, poor secondary school academic record, and an extroverted personality. Withdrawal from university during first year is frequently preceded by poor mental health, high life-stress and loneliness. Withdrawal during second year is strongly associated with first-year academic failure and mental illness. The significance of these findings is discussed, and comparisons are made with overseas studies.

Achievement↗
PubMed1990

Recruitment and compliance in school-based FMR programs.

A study on the effectiveness of a fluoride mouthrinse program was conducted over a 20-month period among 610 children attending grade 5 in two unfluoridated communities. The results showed that the preventive agent had no significant cariostatic effect. Participation and compliance problems were investigated as possible explanations. Comparisons were made between children who refused to participate or dropped out of the program and those who completed it, to see whether group-specific characteristics could be responsible for the low reduction of caries resulting from the mouthrinse. The relationship between compliance and DMFS increment was also examined. The analysis revealed that the children who refused to participate in the study or who dropped out showed sociodemographic characteristics associated with a high caries risk. This suggests that children who need the program most might not benefit because of low participation or failure to remain in the program. Moreover, the DMFS increment over the 20-month period was lower among the children exposed to 50 rinse sessions or more.

Child↗
PubMed1983

Search for the relationship between interrupted university attendance of first year students and some psychosocial factors.

Eight hundred and seventy-four freshmen underwent a structured interview to study the relationship of some psychosocial factors to interrupted university attendance. The scores were measured using the SPSS computer package. The scores indicate negative significant relationships between interrupted university attendance and satisfactory housing, own study choice, study motivation, campus participation and irregular alcohol consumption. The results demonstrate a positive significant relationship between withdrawal and the distance from the university.

Adolescent↗
PubMedDate not supplied

Helicobacter pylori-associated gastritis and gastric carcinoma in Beijing.

A retrospective study was performed on 500 consecutive gastric biopsies obtained from patients with a diagnosis of gastritis and gastric carcinoma. Overall, Helicobacter pylori was detected in 336 cases (67.2%); it was seen in 82.4% of patients with duodenal ulcer, 80.1% of patients with gastric ulcer, 76.1% of patients with chronic atrophic gastritis, 60.3% of patients with chronic superficial gastritis, and 32.1% of patients with gastric carcinoma. The gastric epithelium colonized by Helicobacter pylori showed characteristic changes including loss of the apical mucous portion of individual cells, dropout of epithelial cells, and erosions. There is a strong suggestion that the inflammation associated with Helicobacter pylori infection plays a role in the pathogenesis of gastric carcinoma.

Adult↗
PubMed1987

Attrition in an undergraduate program in allied health education.

The present study compared the characteristics of allied health professionals who completed a bachelor's degree program in allied health education with those who failed to complete the program, in order to develop recommendations for a retention program. The data base included all graduates and dropouts for the period September 1972 to August 1986. Analyses indicated that alumni and those who dropped out were remarkedly similar with regard to demographic characteristics such as age, sex, ethnicity, and prior academic achievement. Fifty percent of the dropouts occurred within the first semester, although attrition continued to occur over a five-year period. The reasons for dropping out were varied, and few were recorded for academic reasons. It was concluded that adult allied health professionals pose difficult problems for retention because motivation and commitment variables appear more important than academic ability or social/academic integration factors. These findings were consistent with research on attrition in higher education, and with the literature on adult learning.

Achievement↗
PubMed1975

The use-effectiveness of two contraceptive methods in a Navajo population: the problem of program dropouts.

Navajo Indian intrauterine contraceptive device (IUD) and oral contraceptive users between 1966 and 1971 were followed up to estimate life table rates of complications and continuation. Because of high rates of dropping out, 41.6 per cent of 291 oral contraceptive users and 18.2 per cent of 534 IUD users, a 26 per cent sample survey of the dropout population was used to collate the dropout population data into the life table analysis. Estimates of the IUD continuation rates for one, two, and three years are similar to rates published elsewhere; however, continuation rates for the oral contraceptive are clearly lower than those for other populations, which only 33 per cent continuing after one year, 23 per cent after two years, and 12 per cent after three years. The IUD user is two to three times more successful than the oral contraceptive user in this population.

Adolescent↗
PubMed2005

Predictors of participation in an HIV risk reduction intervention for socially deprived Latino women: a cross sectional cohort study.

BACKGROUND: Little is known about predictors of participation and attrition in HIV prevention programs for socially deprived Latino women. OBJECTIVES: The purpose of this study was to examine factors that predict program participation and attrition among Latino women in a community-based, culturally specific HIV risk reduction intervention. DESIGN: This was a cross-sectional comparison of baseline data drawn from a randomized HIV risk reduction trial. SETTINGS: Information was drawn from study subjects residing in a predominately Latino low-income community in Chicago. PARTICIPANTS: Among 404 study subjects in the intervention group, 214 of Latino women who had attended at least 5 of 6 intervention sessions were considered participants. One hundred and twelve women who never attended and 29 of women who attended fewer than 3 sessions were considered dropouts. METHODS: The baseline data of program participants were compared to those of dropouts. The influence of the following factors on program participation was examined: sociodemographic characteristics, self-esteem, HIV knowledge, intimate partner violence, depression, and communication with partner. RESULTS: Logistic regression analysis showed that Mexican women were more likely to participate in the intervention program than Puerto Rican women (odds ratio (OR)=1.88, 95% confidence interval (CI)=1.64, 4.23). Other significant predictors of program participation included: being older (OR=1.08, 95% CI=1.03, 1.14), unemployed (OR=0.46, 95% CI=0.25, 0.83), having higher risk reduction behavior intentions score (OR=1.16, 95% CI=1.06, 1.26), and lower level of depressive symptoms (OR=0.97, 95% CI=0.95, 0.99). CONCLUSIONS: The recruitment and retention strategies should be developed by considering those important predictors of intervention participation to prevent Latino women from dropping out of the HIV prevention program.

Adolescent↗
PubMed2002

Lifetime inhalant use among alternative high school students in Texas: prevalence and characteristics of users.

This cross-sectional study describes the prevalence of lifetime inhalant use and identifies demographic, psychosocial, and other risk behavior characteristics of students reporting lifetime inhalant use. The sample consisted of 354 students attending alternative high schools (dropout prevention/recovery schools) in Texas. The prevalence of lifetime inhalant use was 27.7%. After controlling for potentially confounding factors, students reporting lifetime inhalant use were less likely to be financially supported by their parents/guardians, more likely to use alcohol/tobacco, marijuana, and cocaine, and more likely to carry weapons and consider suicide. Study results may allow school officials, parents, researchers, and health care providers to gain a better understanding of inhalant use among students at risk for dropping out of school, a group which has not been extensively studied by previous researchers.

Administration, Inhalation↗
PubMed1999

Analysis of client characteristics that may affect early discontinuation of the TCu-380A IUD.

The purpose of this study was to analyze the reasons for early discontinuation of the TCu-380A IUD in women participating in a large multicenter trial. The study relates specific characteristics of the women at the time of TCu-380A insertion with specific 1-year reasons for discontinuation. A secondary analysis was performed on data obtained from 2748 women from sites in Africa, Asia, and Latin America. By the end of the year, 321 discontinuations were observed. The gross cumulative 12-month life table rates of reasons for discontinuation were 13.3 for all reasons and 3.1, 4.5, and 4.3 for expulsion, removals for bleeding/pain, and personal reasons, respectively. Study site, age, and religion had a significant effect on early discontinuation. Women who had IUD insertions in the African centers had significantly higher expulsion rates than women from other centers. Women < 20 years old had significantly higher expulsion rates than older women. Muslim women had significantly higher rates of removal for bleeding and pain than women of other religions. This information may guide the counseling and follow-up process of women with such characteristics and result in a more satisfactory use and improved continuation rates of the TCu 380A.

Adolescent↗