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PubMed2001

In search of predictors of dropout from inpatient treatment for anorexia nervosa.

OBJECTIVE: The purpose of the present study was to investigate risk factors associated with premature dropout in the treatment of anorexia nervosa (AN). METHOD: Eighty-one women who received free inpatient treatment for AN on a clinical research unit at a university-based psychiatric facility participated in this study. Demographic, lifetime, and baseline clinical characteristics as well as self-report measures of eating disorder symptomatology and associated psychopathology were assessed upon admission. RESULTS: Results indicated that AN subtype was [corrected] modestly predictive of treatment dropout. DISCUSSION: With the exception of AN subtype [corrected], successful completion of inpatient treatment may be unrelated to the severity of eating disorder symptomatology and associated psychopathology. Continued empirical research into factors that influence treatment dropout is clearly needed.

Adolescent↗
PubMed1976

Readiness for rehabilitation.

High dropout rates of addicts in treatment have long been attributed to a lack of motivation or readiness for rehabilitation. Two groups of subjects were compared on several demographic characteristics and several variables isolated as possible predictors of readiness for rehabilitation.

Attitude to Health↗
PubMed1998

School importance and dropout among pregnant adolescents.

PURPOSE: This study examined the relationship of psychological well-being, social support, and demographic variables to school importance and school dropout among pregnant teens. METHOD: Fifty-one Caucasians and 68 African-Americans (mean age = 16.7 years, mean weeks pregnant = 23) were recruited from two Baltimore area prenatal teen clinics. The adolescents completed questionnaires measuring depression, self-esteem, mastery, parental and friend support, demographic characteristics (i.e., age, marital status, ethnicity, socioeconomic status), school importance, and status. RESULTS: Most adolescents were enrolled in school or had graduated (69.7%), were receiving at least passing grades (78.7%), and perceived finishing high school as very important (76.7%). Blacks were more likely to say school was important (p < 0.001), were less likely to drop out (p < 0.01), and received higher grades (p < 0.01) than whites. Dropouts had lower family incomes than current school attenders and graduates (p < 0.05). One measure of psychological well-being (mastery, p < 0.01) was positively correlated with school importance. Social support did not correlate with school importance or dropout. CONCLUSIONS: These findings suggest that dropping out of school among pregnant teens may be more strongly related to sociocultural factors than to individual characteristics such as emotional support and psychological well-being. Overall, this study reveals a positive picture of educational continuation and performance during pregnancy, with most adolescents recognizing the importance of education and remaining in school.

Adolescent↗
PubMed2006

Recruitment of African American women to a walking program: eligibility, ineligibility, and attrition during screening.

The purposes of this study were to identify strategies successful in the recruitment of African American (AA) women to a home-based walking program and to examine factors that contribute to attrition, eligibility, and ineligibility during the recruitment screening protocol. Of the 696 women who contacted the researchers, 281 (40.4%) women enrolled in the study, 227 (32.6%) were lost to attrition, and 188 (27%) were ineligible. Those not enrolled due to attrition during screening or ineligibility reported more family risk for cardiovascular disease (CVD) and lived in neighborhoods with higher poverty. Although our recruitment strategies may have been successful in attracting low-income AA women, we were not as successful in preventing their attrition during the screening protocol, particularly for those living in poorer neighborhoods.

Adult↗
PubMed1995

Role orientation and community pharmacists' participation in a project to improve patient care.

Community pharmacists are being assigned increased responsibility in assuring the appropriateness and effectiveness of drug therapy. This increased responsibility is reflected in recently passed legislation (OBRA '90) in the United States that requires pharmacists to counsel patients about prescriptions received and to engage in prospective drug use review for Medicaid recipients. The potential impact of this legislation is unclear due to a dearth of research evaluating the effects of community pharmacists' activities on medication use. In addition, there is little research on pharmacists' willingness to assume increased responsibility. Research that would demonstrate the effectiveness of community pharmacists in improving therapeutic outcomes is hampered by problems inherent in conducting experimentally designed research in field settings. This paper examines two issues of concern in such studies--namely, the extent to which those who agree to participate in a demonstration project differ from those who decline to participate and the extent to which differential dropout from treatment and control conditions compromise the comparability of the two groups. Specifically, this report examines pharmacist characteristics related to participation in a demonstration project to improve the care of elderly patients. Community pharmacists in Florida who had earlier been asked to participate in a demonstration project (N = 418) were sent mail questionnaires to assess their attitudinal, demographic and employment characteristics. In particular, researchers were interested in the role orientation of pharmacists in regard to patient counseling and physician consultation, satisfaction with current jobs and career choices, employment settings and treatment vs control group assignment as predictors of participation in the research project. Demographic characteristics were also examined as possible predictors of participation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2006

Recruiting and retaining couples for an HIV prevention intervention: lessons learned from the PARTNERS project.

Intervening with both members of a couple has been recommended as an important strategy for human immunodeficiency virus prevention. Analyses of focus groups and in-depth interviews with project personnel involved in recruitment and retention for the Partners Against Risk-Taking: A Networking and Evaluation Research Study project identified, at the termination of the project, barriers and facilitators to recruiting couples. Barriers included logistical problems of coordinating two people's schedules, sensitivity of the topic and challenges related to recruitment efforts focused on one partner only. Strategies to overcome such barriers were to increase availability of project personnel and recruit both partners simultaneously, with recruitment teams consisting of men and women. Challenges related to recruiting and retaining couples remain significant and should be considered before undertaking couples interventions.

Adolescent↗
PubMed1979

Aspects of the patient intake process in a psychotherapy clinic.

Recent interest in psychotherapy services in the National Health Service has raised questions regarding the availability of existing psychotherapy facilities. In attempting to answer some of these questions, a study was made of aspects of the referral and assessment segments of the intake process of 180 patients referred in 1975 to the Paddington Centre for Psychotherapy Adult Out-patient Department. Of this group, 137 were referred for individual psychoanalytically oriented psychotherapy, 82 of whom were offered assessment interviews, 45 offered treatment and 40 actually began treatment during the study period. An additional seven patients originally assessed for group therapy were offered and began individual treatment. Some characteristics of the referral population, the referring agencies, the effects of a waiting list, and the phenomenon of dropouts are discussed and compared with findings from other Centres.

Hospitals, Psychiatric↗
PubMedDate not supplied

Health-compromising behavior and diabetes mismanagement among adolescents and young adults with diabetes.

PURPOSE: This study examined the relationship between health-compromising behavior, age, gender, and diabetes mismanagement. METHODS: A total of 107 adolescents and young adults, 12 to 24 years old, with type 1 diabetes were asked to complete a health-compromising behavior scale and a diabetes mismanagement scale. RESULTS: Based upon participants' responses, the study population was divided into 2 different groups: those involved in health-compromising behavior and those not involved in such behavior. A multiple regression analysis was performed using age, gender, and health-compromising behavior as predictor variables and diabetes mismanagement as the outcome variable. Variables that accounted for significant variance in diabetes mismanagement were being female and being involved in health-compromising behavior. CONCLUSIONS: Adolescents and young adults with diabetes appear to be either involved or not involved in health-compromising behavior. Being female and being involved in health-compromising behavior were associated with diabetes mismanagement.

Adolescent↗
PubMed2005

Partner aggressive women: characteristics and treatment attrition.

The topic of female partner aggression has been controversial for over 20 years, and yet we lack a coherent body of literature that describes the phenomenon. Furthermore, we know little about what treatment approaches effectively reduce partner aggression in women. Data for this study were derived from the initial evaluations of 107 domestically violent, heterosexual women referred to an anger management program. Descriptive statistics were used to expand our knowledge of the characteristics of this population. In addition, a number of variables were analyzed to determine their relevance to treatment dropout. Overall, women tended to be socioeconomically disadvantaged and undereducated, with histories of childhood attachment disruptions and victimization, mental health problems, and substance abuse. Participants that had been court mandated were more likely to complete treatment, while nonmandated women had fewer pretreatment arrests and were more likely to drop out after the initial intake. The implications for treatment are discussed, and suggestions for further investigation are offered.

Adolescent↗
PubMed2006

Histopathological changes in gastric mucosa colonized by H. pylori.

Helicobacter pylori (H. pylori), infection has been linked to acute and chronic gastritis, non-ulcer-dyspepsia, peptic ulcer, gastric adenocarcinoma and gastric non-Hodgkin's lymphoma of mucosa-associated lymphoid tissue (MALT). The epithelial changes in H. pylori colonized gastric mucosa are easy to recognize in routine Haematoxylin & Eosin stained sections and are so distinctive that they can serve as a helpful histological indicator for the presence of H. pylori in gastric biopsies. The histopathology of seventy-five gastric biopsies showing colonization by H. pylori was studied. Histologically, the H. pylori colonized gastric epithelium showed characteristic changes that were topographically related to the bacteria. These changes included irregular surface, epithelial pits, individual cell dropout and microerosion, which were specific for H. pylori colonization. These were absent in areas not colonized by H. pylori and in 20 consecutive H. pylori negative gastric biopsies seen during the same study period. As specific treatment for H. pylori infection is available, identification of H. pylori colonization in gastric biopsies should be attempted in all cases of gastritis, peptic ulcers and non-ulcer-dyspepsia.

Adult↗
PubMed1997

The peer relations of dropouts: a comparative study of at-risk and not at-risk youths.

Little research has been devoted to exploring the relationship between high school disengagement and friendship network changes. In this study, the characteristics of friends, the environments of the friendship network and the nature of peer relations of students at-risk and not at-risk of dropping out of high school were compared. A questionnaire was given to 191 high school students (109 males, 82 females) from a middle class environment at the beginning and end of the school year. Results indicated that at-risk students had more dropout friends, more working friends, fewer school friends and fewer same-sex friends. Sex differences were discovered in several areas. Findings are discussed in relation to research and theories pertaining to dropouts and adolescent development.

Adolescent↗
PubMed1992

Acceptability and efficacy of two associations of paracetamol with a central analgesic (dextropropoxyphene or codeine): comparison in osteoarthritis.

A double-blind randomized parallel group trial was undertaken to compare the acceptability and efficacy of 2 forms of analgesic treatment, DI-Antalvic (Houde Laboratories, Puteaux, France) (30 mg dextropropoxyphene and 400 mg paracetamol per capsule) and Efferalgan-Codeine (UPSA Laboratories, Rueil Malmaison, France) (30 mg codeine and 500 mg paracetamol per tablet) prescribed for 1 week at doses of 6 capsules/day and 6 tablets/day, respectively, in 141 outpatients with active osteoarthritis of the knee or hip. The principal aim of the trial was concerned with acceptability, with efficacy as its secondary aim. The principal trial criterion was defined as overall assessment of acceptability by the patient at the end of the trial (success or failure) or by treatment dropouts because of an adverse effect (failure). Comparability of the groups was confirmed before any treatment regarding the physical characteristics of the patients, characteristics of osteoarthritis, and the initial level of pain and functional consequences of pain. Results show that the analgesic efficacy of the treatment was similar, but that the acceptability of Efferalgan-Codeine was significantly worse than that of DI-Antalvic: 53% failure with Efferalgan-Codeine versus 29% failure with DI-Antalvic (P = .005). Other trials of the same type would seem necessary (comparison of lower doses, other types of pain) before being able to generally extrapolate such findings.

Acetaminophen↗
PubMed2002

Early drop-outs, late drop-outs and completers: differences in the continuation phase of a clinical trial.

OBJECTIVE: The purpose of this study was to assess the differences between early and late drop-outs and completers in the continuation phase of a clinical trial. METHODS: The authors studied 119 outpatients who were treatment responders in an 8-week open trial with fluoxetine 20 mg/day, and who were then enrolled in a 26-week clinical trial comparing the efficacy of fluoxetine versus fluoxetine and cognitive behavior therapy (CBT). Patients were assessed using the Structured Clinical Interview for DSM-III-R--Axis I (SCID-Patient Edition), Hamilton Depression Rating Scale (HAMD-17) and the following self-rated scales: Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), Anxiety Sensitivity Index (ASI) and the Symptom Questionnaire (SQ) prior to starting the 26-week continuation phase. We defined "early drop-outs" (EDs) as patients who dropped out either at or prior to Visit 2 (which was at 2 months into the 6-month continuation phase); those dropping out at Visit 3 or later were defined as "late drop-outs" (LDs) (ED < or = 2 months; LD >2 months). The Kruskal-Wallis and the Mann-Whitney U tests were used for data analysis. RESULTS: Of the 119 patients, 83 were completers (mean age: 42.1+/-9.0 years; 46 [55%] women; age of onset of major depressive disorder [MDD] = 24.3+/-12.5 years), II were EDs (mean age: 38.1 + 13.0 years: 4 [36%] women; age of onset of MDD = 22.0+/-11.1 years) and 25 were LDs (mean age: 35.2+/-10.4 years; 12 [48%] women; age of onset of MDD = 24.6+/-11.6 years). LDs were significantly younger than completers (P<.01). There was no significant difference in age between EDs and LDs, nor between EDs and completers. EDs were more likely to have been depressed for a longer period of time compared to LDs (P< .05). EDs completers were depressed for a longer period of time compared to LDs (P< .05). CONCLUSIONS: Our data suggest that late drop-outs are significantly younger than completers, although age is not a predictor between early drop-outs and late drop-outs. Further, early drop-outs are depressed for a longer duration compared to late drop-outs completers are depressed for a longer duration than late dropouts, and Early drop-outs have significantly more social impairment compared to completers. Our study identified some patient characteristics significantly associated with dropping out of a long-term clinical trial.

Adolescent↗
PubMed1998

Intergenerational transfer of psychosocial risk in women with childhood histories of aggression, withdrawal, or aggression and withdrawal.

Intergenerational transfer of risk between mothers and children, based on mothers' childhood aggression and social withdrawal, was examined in an inner-city sample. Each of the 3 studies reported involved a subset of the 909 female participants in the Concordia Longitudinal Risk Project, initiated when the participants were of school age. Using medical records, Study 1 (n = 853) focused on prediction of teen motherhood, delivery complications during childbirth, multiparity, and close spacing of births. Study 2 (n = 428) examined pathways to school dropout and teen parenthood. Study 3 (n = 89) involved prediction of observed parent and child behavior from mothers' childhood characteristics. Mothers' childhood aggression was consistently predictive of negative outcomes in each area of intergenerational risk, especially when combined with social withdrawal and low levels of academic achievement. Education was protective: Mothers' years of schooling predicted positive outcomes.

Achievement↗
PubMed1987

Long-term treatment of alcoholic liver disease with propylthiouracil.

Propylthiouracil has been shown experimentally to protect against alcohol-induced hepatocellular necrosis in hypoxic conditions. An earlier, short-term study of patients with alcoholism and liver disease indicated clinical improvement with propylthiouracil, but the effect on mortality could not be assessed. In the present study, we investigated the effect of propylthiouracil on mortality in patients with alcoholic liver disease in a long-term, double-blind, randomized clinical trial involving 310 compliant patients who received propylthiouracil (n = 157) or placebo (n = 153) for a maximum of two years. There were no differences between the two groups in demographic and clinical characteristics and biopsy-confirmed diagnoses at randomization, or in daily urinary alcohol levels during the study. The cumulative dropout rate over two years was not significantly different (propylthiouracil group, 0.68; placebo group, 0.60). The group receiving propylthiouracil (300 mg per day) had a cumulative mortality rate half that in the group receiving placebo (0.13 vs. 0.25 [P less than 0.05] in the total sample, and 0.25 vs. 0.55 [P less than 0.03] in a subgroup of severely ill patients [propylthiouracil group, n = 56; placebo group, n = 41]). Proportional-hazards stepwise regression analyses indicated that only propylthiouracil treatment, prothrombin time, hemoglobin levels, and mean daily urinary alcohol levels significantly affected mortality. The hazards ratio for the complete group indicated that mortality in the propylthiouracil group was 0.38 (95 percent confidence interval, 0.20 to 0.83) that of the placebo group. Protection by propylthiouracil was not observed in patients with high morning urinary alcohol levels. No clinically important side effects of propylthiouracil were observed at the dose used. We conclude that the administration of propylthiouracil can reduce mortality due to alcoholic liver disease.

Alcohol Drinking↗