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Palomar project: predicting school renouncing dropouts, using the artificial neural networks as a support for educational policy decisions.

The "Palomar" project confronts two problem situations that are partly independent and partly connected to the Italian schooling system: unstable participation in school such as drop out and educational guidance. Our concern is that of a set of phenomena which consists of ceasing compulsory education, repetition of a year at school, school "drop outs", irregular compulsory attendance and delays in the course of studies. The "Palomar" project is designed to offer educators and administrators who want to effectively intervene with these complex problems to furnish school guidance services as an instrument able to: 1. Predict: creating a system able to predict in advance (not in a "cause-effect" way but as an approximation): a) which students are at "risk" for school destabilization or failure; b) what are the prototypical characteristics of these students; c) which students among those studied are more likely to "destabilize" or fail in school; in which course of study does each student have the greatest chance of success; d) which, among the variables studied and appropriately weighted for each student, will predict the successful grade, analyzed for each possible course of studies. 2. Optimize: selecting and focusing on a student on the basis of the information given. It is possible: a) to point out which personal factors (relational, familial, student, disciplinary, economical) need to be reinforced in order to improve the school performances of each selected student, both to prevent or limit "dropping out" desertion or failure and to raise the performances in the chosen school course as much as possible; b) on the basis of what was mentioned above, to simulate the possible support measures to increase the efficacy of the considered intervention; c) to choose for each student the appropriate intervention strategy capable of obtaining the maximum result and the maximum efficacy in the given conditions. 3. Verify: when the strategy of intervention has been decided and we proceed with its implementation, it is possible to periodically verify ("follow-up"), through subsequent administration of the form, the outcome variations elapsed in the prediction of school success or failure. This makes it possible to verify in itinere the efficacy of the interventions carried out and, if necessary, to create variations and adjustments. 4. Produce scenarios: the application field of the Prediction System with Artificial Neural Networks can also be one of a group of students, of one or more organized units (for example a class, a school, or a group of schools). In this case the Prediction System ANN using the program SCHEMA (Buscema, 1996b) is able to: a) determine intervention strategies in order to optimize and to produce the maximum results of a group of students as the one of a class; b) optimize the formative route of a whole institute in order to prevent or limit the need for school guidance.

Adolescent↗

[Treatment dropout as failed utilization--development of a predictive model for inpatient psychosomatic rehabilitation].

Premature discontinuance of rehabilitative measures can be considered a revised decision by the patient concerning participation or a revised decision by the clinic concerning admittance. Such termination of therapy suggests that the individual need for rehabilitation (defined as the fit between the patient's need for rehabilitation and the treatment offered by the rehabilitation facility) is not (or no longer) present, at least at this point in time. Assuming that the individual need for rehabilitation actually existed when treatment was requested or approval for rehabilitative measures was granted, the question arises as to when and how the need changed in such a way that would prevent the treatment from continuing as planned and being concluded in a regular fashion. This question will be taken into focus in the present article by developing a model for the prediction and explanation of prematurely discontinued treatment. This model will give central significance to the intention to co-operate, which is considered a dependent variable by reference to individual symptoms and treatment related expectations. Furthermore, various factors of influence during the stay in the clinic are formulated, which, firstly, have a presumed effect on the intention to cooperate and, secondly, have an influence on whether the intention to prematurely terminate treatment develops from a specific intention to cooperate and whether this is then realized. The model is discussed with regard to its practicability and possibilities for operationalization.

Germany↗

An alternative program for methadone maintenance dropouts: description and preliminary data.

Time in drug treatment has been shown to be one of the best predictors of post-treatment success. Since as many as half of the enrollees leave methadone treatment during the first year, the project described in this article was designed to test the effectiveness of an alternative program for individuals who have recently dropped out of methadone maintenance treatment. The goals of this "Alternative Program" are to help participants re-connect with formal drug treatment and other community or medical programs, reduce their HIV risk behavior, decrease or eliminate drug use, join self-help groups, and obtain entitlements. Program components include: contacts by local outreach workers, cognitive-behavioral relapse-prevention group counseling, and individual counseling for needs assessment and referral. This paper describes the basis for development of the intervention, summarizes the methodology being used, and provides preliminary data on participation in the Alternative Program.

Adult↗

The case of the missing data: methods of dealing with dropouts and other research vagaries.

Missing data are common in most studies, especially when subjects are followed over time. This can jeopardize the validity of a study because of reduced power to detect differences, and especially because subjects who are lost to follow-up rarely represent the group as a whole. There are several approaches to handling missing data, but some may result in biased estimates of the treatment effect, and others may overestimate the significance of the statistical tests. When cross-sectional data (for example, demographic and background information and a single outcome measurement time) are missing, replacement with the group mean leads to an underestimate of the standard deviation (SD) and inflation of the Type I error rate. Using regression estimates, especially with error built into the imputed value, lessens but does not eliminate this problem. Multiple imputation preserves the estimates of both the mean and the SD, even when a significant proportion of the data are missing. With longitudinal studies, the last observation carried forward (LOCF) approach preserves the sample size, but may make unwarranted assumptions about the missing data, resulting in either underestimating or overestimating the treatment effects. Growth curve analysis makes maximal use of the existing data and makes fewer assumptions.

Clinical Trials as Topic↗

[Causes of outpatient dropouts in the dispensary care of a chest clinic (author's transl)].

An investigation was made to point out, why 397 of total 2773 patients with 5524 consultations failed the fixed next consultation. 29 patients had died meanwhile. A special invitation was necessary in 368 (= 13%) of 2744 patients. The further behaviour of these patients after suitable advice and the importance of the diagnosis of their diseases in this connection were investigated. Failing of the patients can be diminished by systematical instructions.

Adult↗