Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Dropouts”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 847 records · Page 47Linked to original sources

School extracurricular activity participation as a moderator in the development of antisocial patterns.

This research involves a longitudinal study of antecedents and moderators in the development of antisocial patterns. Participants included 695 boys and girls who were interviewed annually from childhood to the end of high school and again at ages 20 and 24. Cluster analyses identified four configurations of boys and girls that were reasonably homogeneous with respect to behavior and academic performance at the beginning of the investigation. When tracked over time, the configurations differed significantly in patterns of early school dropout and criminal arrests. Boys and girls in the "multiple risk configuration" were more likely than those in other configurations to show long-term antisocial patterns. Participation in school extracurricular activities was associated with reduced rates of early dropout and criminal arrest among high-risk boys and girls. The decline in antisocial patterns was dependent on whether the individuals' social network also participated in school extracurricular activities.

Adult↗

Status of follow-up among patients with epilepsy in epilepsy clinic.

Out of 238 consecutive patients entering our epilepsy clinic from October 1988 till March 1990, the status of follow-up was evaluated in October 1990. One hundred patients (42%) could adhere to the follow-up appointment and 33 patients (14%) visited the clinic irregularly. A total of 105 patients (44%) failed to return for the follow-up at least for 2 months dated backward from October 1990. Seventy-five percent of the patients lost the follow-up within 6 months. The main reasons of the dropout were poor seizure control, seizure free, denial of epilepsy, receiving operation in other hospitals. The appropriate strategies to aid in adherence to medical care among patients with epilepsy should be formulated through the analysis of factors contributing to the dropout, which might be strongly influenced by different medical and sociocultural backgrounds all over the world.

Adolescent↗

Epilepsy rehabilitation: evaluating specialized versus general agency outcome.

This 1982 study was a retrospective comparison of vocational outcome between eight state rehabilitation agencies and the University of Washington Epilepsy Center's Vocational Unit for the years 1977-1978. Hypotheses included: (a) A significantly higher portion of those with epilepsy will find employment through a specialized (i.e., Epilepsy Center) versus a general rehabilitation program. (b) A specialized program will have a significantly lower proportion of program dropouts. (c) Those finding jobs through a specialized program will earn higher salaries and have better job retention than those employing a general agency program. On several comparisons the specialized program outperformed the general agencies--higher proportion of successful job placements and lower proportions of dropouts and those remaining in process (all chi2 tests significant at the p less than 0.001 level). Placement rates for specialized programs have traditionally approximated 50%, whereas these state agencies placed from 9 to 21%. Salary level and job retention differences were inconclusive. Data implications are discussed.

Employment↗

Psychopathology and substance abuse as predictors of program completion in a therapeutic community for drug abusers: a prospective study.

A total of 144 substance abusers entering consecutively a hierarchical therapeutic community, Phoenix House, Oslo, were followed prospectively 18 months through the entire program. Thirty percent completed the 1-year inpatient phase and 20% completed the total program. Using a structured interview and 3 self-report instruments, the Millon Clinical Multiaxial Inventory, Basic Character Inventory and Symptom Checklist-90, significant differences between dropouts and completers were found in 3 areas of pre-admission characteristics: gender, substance abuse and psychopathology. Completers were characterized by a greater percentage of females, a higher frequency of amphetamine use and a lower frequency of alcohol use and a higher frequency of histrionic and a lower frequency of schizotypal traits than dropouts. The study indicates the importance of paying closer attention to these factors during treatment.

Adult↗

Group therapy compared with individual desensitization for dental anxiety.

Effects of group therapy (GT) on extreme dental anxiety were compared with individual treatment (IT). Results by scales of dental anxiety, beliefs or trust in dentists, and fear of the next dentist after specialist treatment showed reduced dental anxiety and improved dental beliefs compared with a static control group of 45 patients. The 30 GT patients showed no significant difference in dropouts during training compared with the 68 IT patients, but for patients who completed treatment, GT (n = 24) had greater dental anxiety reduction than IT subjects (n = 60). GT patients required fewer therapist hours per patients than did either of the two IT methods, but time saved in GT did not reach significance over clinical rehearsal IT. Results at 1-yr follow-up after specialist treatment indicated that dropouts were significantly greater in group therapy. Rehearsal IT performed best for sustained dental care behavior. Group dynamics are discussed and suggestions made for effective and efficient group therapy as well as decision making about choice of treatment.

Adult↗

A peer-led AIDS prevention program for students in an alternative school.

School-based programs designed to measure health risk behavior and reduce the risk of sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV) infection have not addressed adequately the needs of adolescents outside of main-stream schools. In Florida, these youth represent a sizable proportion of the population and have been shown to be at increased risk for acquiring sexually transmitted diseases and human immunodeficiency virus. This article describes a peer-led STD/HIV intervention for students in a dropout prevention program in Dade Country, Florida. Trained peer counselor/educators (PCEs) led schoolwide activities and classroom sessions covering STD/HIV information, community health resources, communication and negotiation skills, and safer sex strategies. Teachers and students rated the PCEs effective in promoting discussion and serving as sources of information about AIDS and community health resources. Pre/post intervention questionaire results demonstrated an increase in AIDS awareness and discussion among students as well as an increase in condom use. Based on this social influences approach, peer education appears to be a promising health education strategy for students in dropout prevention programs.

Acquired Immunodeficiency Syndrome↗

Recruitment and retention in an alcohol prevention program at two inner-city middle schools.

This study examined recruitment within an alcohol prevention program at two diverse inner-city schools and retention of these students through follow-up at one month and one year. Subjects in Cohort 1 included 211 sixth grade students from one innercity, neighborhood school. Subjects in Cohort 2 included 650 sixth grade students from one neighborhood school (n = 388) and one magnet (bused) school (n = 262). Recruitment rates differed between the two Cohort 2 urban schools. However, when eligibility criteria were considered, recruitment rates were nearly identical. At one-month posttest, dropouts were more at risk for alcohol use initiation than nondropouts. At one-year follow-up, dropouts were more likely to initiate alcohol and smokeless tobacco, and had greater total risk factors for alcohol use. These findings indicate the need to establish eligibility requirements, conduct aggressive recruitment and follow-up to minimize subject attrition, and establish programming that targets students not recruited or retained when using standard protocols.

Adolescent↗

A comparative study of psychotherapy referrals.

This retrospective study examines the effects of a change in policy in the method of offering appointments for assessment to patients referred to an out-patient psychotherapy service. It was anticipated that the new system would reduce the frequency of non-attendance (DNAs) at assessment interviews, increase the proportion of attenders judged suitable for psychotherapy and reduce the proportion of early dropouts amongst those commencing therapy. Results confirmed a reduction in DNAs, but suitability for therapy was not enhanced, nor did the rate of early dropouts diminish. With the new system, proportionately fewer referrals were assessed and fewer commenced therapy, suggesting that it has created a barrier to use of the service.

Appointments and Schedules↗

Cost effectiveness of adjuvant therapy for hepatocellular carcinoma during the waiting list for liver transplantation.

BACKGROUND: Survival after liver transplantation for early hepatocellular carcinoma (HCC) is worsened by the increasing dropout rate while waiting for a donor. AIMS: To assess the cost effectiveness of adjuvant therapy while waiting for liver transplantation in HCC patients. METHOD: Using a Markov model, a hypothetical cohort of cirrhotic patients with early HCC was considered for: (1) adjuvant treatment-resection was limited to Child-Pugh's A patients with single tumours, and percutaneous treatment was considered for Child-Pugh's A and B patients with single tumours unsuitable for resection or with up to three nodules < 3 cm; and (2) standard management. Length of waiting time ranged from six to 24 months. RESULTS: Surgical resection increased the transplantation rate (>10%) and provided gains in life expectancy of 4.8-6.1 months with an acceptable cost ($40,000/ year of life gained) for waiting lists > or = 1 year whereas it was not cost effective ($74,000/life of year gained) for shorter waiting times or high dropout rate scenarios. Percutaneous treatment increased life expectancy by 5.2-6.7 months with a marginal cost of approximately $20,000/year of life gained in all cases, remaining cost effective for all waiting times. CONCLUSIONS: Adjuvant therapies for HCC while waiting for liver transplantation provide moderate gains in life expectancy and are cost effective for waiting lists of one year or more. For shorter waiting times, only percutaneous treatment confers a relevant survival advantage.

Carcinoma, Hepatocellular↗

Patient attrition in dynamically oriented treatment groups.

Clinical and empirical studies of premature terminators from dynamically oriented therapy groups are reviewed. While many studies focus on the personality characteristics of dropouts, the authors recommend conceptualizing such patients in terms of the interaction of patient, group, and therapist. On the basis of this model, the authors offer clinical recommendations for reducing the number of dropouts. Multivariate experimental designs for studying attrition in group psychotherapy are discussed, and the authors suggest possible directions for future research.

Attitude of Health Personnel↗

Stability of mood despite HIV illness progression in a group of homosexual men.

OBJECTIVE: The authors investigated the association between mood status and progression of HIV illness. METHOD: In a research clinic at a university medical center, 112 HIV-positive and 52 HIV-negative homosexual men were enrolled in a 4-year prospective study with semi-annual assessments. The main study measures were psychiatric diagnoses according to the Structured Clinical Interview for DSM-III-R; level of functioning and psychiatric symptoms according to the Global Assessment of Functioning Scale (axis V, DSM-III-R), the Hamilton depression and anxiety scales, the Brief Symptom Inventory, and the Beck Hopelessness Scale; stage of HIV illness; and CD4 cell count. RESULTS: Among the HIV-positive men, there was no increase in rates of syndromal depression and anxiety over the 4 years despite substantial HIV illness progression. On all occasions, mean psychopathology symptom ratings were within the normal or not depressed range. However, compared to the HIV-negative men, the HIV-positive men had slightly more anxiety and somatic depressive symptoms throughout. The only measure that showed an increase in distress over time was orientation to the future; among the HIV-positive men, hopes for the future waned across assessments. Attrition in the group was largely attributable to the loss of men with lower CD4 cell counts and more advanced HIV illness. However, study dropouts did not differ on any psychiatric measure from subjects who remained during the first 3 years. CONCLUSIONS: In this group no significant increase in syndromal or symptomatic depression or anxiety over nine semiannual assessments was found, despite substantial HIV illness progression and some deaths. Psychopathology did not predict dropout or death.

Acquired Immunodeficiency Syndrome↗

Outcome predictors for the cognitive behavior treatment of bulimia nervosa: data from a multisite study.

OBJECTIVE: The aim of this study was to discover clinically useful predictors of attrition and outcome in the treatment of bulimia nervosa with cognitive behavior therapy. METHOD: Pretreatment, course of treatment, and outcome data were gathered on 194 women meeting the DSM-III-R criteria for bulimia nervosa who were treated with 18 sessions of manual-based cognitive behavior therapy in a three-site study. Differences between dropouts and nondropouts and between recovered and nonrecovered participants were first examined descriptively, and signal detection analyses were then used to determine clinically significant cutoff points predicting attrition and abstinence. RESULTS: The dropouts were characterized by more severe bulimic cognitions and greater impulsivity, but it was not possible to identify clinically useful predictors. The participants with treatment failures were characterized by poor social adjustment and a lower body mass index, presumably indicating greater dietary restriction. However, early progress in therapy best predicted outcome. Signal detection analyses revealed that poor outcome was predicted by a reduction in purging of less than 70% by treatment session 6, allowing identification of a substantial proportion of prospective failures. CONCLUSIONS: A cutoff point based on reduction of purging by session 6 usefully differentiates patients who will and will not respond to cognitive behavior therapy for bulimia nervosa, potentially allowing early use of a second therapy.

Adult↗

Are gender differences important for the clinical effects of antidepressants?

OBJECTIVE: Gender differences in antidepressant treatment response, side effects, dropout rates, and plasma concentrations were examined in patients with major and predominantly melancholic depression. METHOD: The study included a subgroup of 292 inpatients (96 men, 196 women) from three Danish double-blind, randomized, controlled trials. All patients completed a 5-week treatment period and fulfilled the DSM-III or DSM-III-R criteria for major depression. Clomipramine (150 mg/day) was the reference treatment, and comparable treatments were citalopram (40 mg/day), paroxetine (30 mg/day), and moclobemide (400 mg/day). Assessments were performed by using the 17-item Hamilton Depression Rating Scale and the Udvalg for Kliniske Undersøgelser Side Effect Rating Scale. In a subgroup of 110 patients, weekly measurements of clomipramine plasma concentrations were obtained. Nonparametric statistical tests and multiple linear and logistic regression models were used for statistical evaluations. RESULTS: Both genders had similar remission rates (Hamilton depression scale score <8) when treated with clomipramine and had significantly higher remission rates with clomipramine than with the comparable treatments. The plasma concentrations of clomipramine were significantly higher for female than for male patients. No gender differences were found in posttreatment Hamilton depression scale scores, nor did the therapeutic effects of treatment depend on gender. Rates of dropout and side effects were similar for men and women. No relationship between plasma concentrations, gender, and therapeutic outcome was found. CONCLUSIONS: In a group of patients with major and predominantly melancholic depression, differentiation according to gender was not important in treatment with common antidepressants. Women appeared to have higher plasma concentrations of tricyclic antidepressants than men. The consequences of this difference for clinical effects are unclear. Gender-specific recommendations for dosing of tricyclic antidepressants may be considered.

Antidepressive Agents↗

Effects of disability compensation on participation in and outcomes of vocational rehabilitation.

OBJECTIVE: The authors sought to determine the relationship between receipt of disability compensation and participants' success in a vocational rehabilitation program. METHODS: Administrative data for 22,515 individuals who participated in the Veterans Health Administration compensated work therapy program between 1993 and 1998 were analyzed. Six dependent variables were compared between participants who were receiving disability compensation and those who were not: duration of participation in compensated work therapy, number of hours worked per week, mean hourly earnings, total income from compensated work therapy, dropout rate, and competitive employment status at discharge. Regression equations were determined for each dependent variable to assess associations with the degree of disability, the amount of disability compensation, and the type of compensation program. RESULTS: Participants who were receiving disability benefits worked fewer hours in compensated work therapy each week, earned less income, had a higher dropout rate, and were less likely to be competitively employed at discharge. The amount of compensation and the type of program were modestly but significantly associated with participation in compensated work therapy and with outcome. CONCLUSIONS: Unintended effects of disability compensation programs discourage full participation in vocational rehabilitation and result in poorer rehabilitation outcomes.

Adult↗

Treatment of depression among impoverished primary care patients from ethnic minority groups.

OBJECTIVE: The aim of this study was to determine whether supplementing traditional cognitive-behavioral therapy for depression with clinical case management would reduce the rate of dropout from care and improve outcomes for ethnically diverse, impoverished medical outpatients. METHODS: The study was a randomized trial that compared cognitive-behavioral group psychotherapy alone (N=103) with the same therapy supplemented by clinical case management (N=96). RESULTS: The patients who received supplemental case management had lower dropout rates than those who received cognitive-behavioral group therapy alone. Supplemental case management was associated with greater improvement in symptoms and functioning than cognitive-behavioral therapy alone for patients whose first language was Spanish (N=77) but was less effective for those whose first language was English (N=122). CONCLUSIONS: Supplemental case management improves retention in traditional mental health outpatient care and can improve outcomes for Spanish-speaking patients.

Adult↗

Substance abuse relapse and factors associated with relapse in an inner-city sample of patients with dual diagnoses.

OBJECTIVE: This study documented rates of substance abuse relapse and explored factors associated with sustained remission among consumers with severe mental illness in a large, urban clinical sample. METHODS: Existing clinical records of consumers with severe mental illness and co-occurring substance use disorders who had achieved remission and who were interviewed at two or more subsequent follow-up points (12 months after remission) were reviewed. Consumers who relapsed within 12 months after remission were compared with those who maintained remission on demographic, clinical, and functional indicators. RESULTS: Of the 133 consumers who achieved remission, 91 (68 percent) had maintained remission at six-month follow-up, and 69 (52 percent) had maintained remission at 12-month follow-up. The strongest factors associated with maintenance of remission at 12 months were older age and living in Thresholds residential programs. Multivariate analysis showed that consumers who were older, held jobs, and lived in Thresholds residential programs at initial remission had a higher likelihood of maintaining remission at 12 months. To explore the potential impact of program dropout on the results, supplemental analyses using a third group without 12-month follow-up data were conducted. These analyses indicated that program dropouts were younger and less likely to live in Thresholds residential programs at initial remission. CONCLUSIONS: Age, therapeutic residential programming, and, to a lesser degree, employment appear to be potential factors to consider in the development of relapse prevention models.

Demography↗

Variation in neurophysiological function and evidence of quantitative electroencephalogram discordance: predicting cocaine-dependent treatment attrition.

Cocaine treatment trials suffer from a high rate of attrition. We examined pretreatment neurophysiological factors to identify participants at greatest risk. Twenty-five participants were divided into concordant and discordant groups following electroencephalogram (EEG) measures recorded prior to a double-blind, placebo-controlled treatment trial. Three possible outcomes were examined: successful completion, dropout, and removal. Concordant (high perfusion correlate) participants had an 85% rate of successful completion, while discordant participants had a 15% rate of successful completion. Twenty-five percent of dropouts and 50% of participants removed were discordant (low perfusion correlate), while only 25% of those who completed were discordant. Failure to complete the trial was not explained by depression, craving, benzoylecgonine levels or quantitative electroencephalogram (QEEG) power; thus cordance may help identify attrition risk.

Adult↗

Locating drug addicts who have dropped out of treatment.

Staff at a VA-sponsored drug treatment center followed up dropouts one year after they left the program; they were able to locate 80 per cent of those clients. The staff found several contacts useful in locating the difficult-to-find population, including the addicts' mothers, other drug programs, prisons, and the department of motor vehicles. To make it easier for researchers to tract down dropouts, the author suggests that when patients enter a program they should be required to give names, addresses, and telephone numbers of at least two friends or relatives who would know where they were. Staff should emphasize to patients that the information is for research purposes and that confidentiality will be preserved.

Chicago↗