Attrition Rates Research Articles

The Role of Habit and Perceived Usefulness on the Continuance Intention of Subscription Video on Demand Services in Indonesia

In the midst of the rising popularity of Subscription Video On Demand (SVOD), the industry faces significant challenges. The high churn rate and the abundance of competitors in the SVOD industry necessitate that service providers develop strategies to maintain consumer interest. Consumers who significantly contribute to the high churn rate are Generation Y and Generation Z, also known as digital natives. This study aims to analyze how factors within the Expectancy Confirmation Model can influence the Continuance Intention of SVOD users. This descriptive study employs a cross- sectional design. The respondents of this study consist of 159 active SVOD users. The findings reveal that confirmation and individual mobility significantly influence perceived usefulness. Additionally, confirmation, perceived usefulness, and perceived enjoyment significantly affect satisfaction. Furthermore, satisfaction, perceived usefulness, and habit are significant predictors of continuance intention. However, the influence of individual mobility and perceived enjoyment on continuance intention is not significant. Practically, this study provides insights for SVOD service providers to develop marketing strategies that enhance consumer habit and satisfaction. Academically, this study combines two models from previous researchs making the model and variables used more comprehensive in explaining the predictors of continuance intention.

Novel Guided Self-Help for the treatment of Binge Eating Disorder: Feasibility, Acceptability, and Preliminary Efficacy.

Purpose: Binge eating disorder (BED) is a prevalent eating disorder. Many individuals with BED do not receive evidence-based care due to many barriers. This preliminary study evaluated the feasibility, acceptability, and potential efficacy of a manualized guided self-help (GSH) intervention with support in the form of a culturally adapted manual for a French-Canadian population.Method: Twenty-two women with overweight or obesity meeting the BED diagnostic criteria participated in an 8-week open trial. The GSH programme combined a self-help book and weekly support phone calls. Participants were assessed at baseline, at week 4, postintervention, and 12 weeks following its end. Feasibility was measured by attrition rates, participation, and satisfaction. Acceptability was measured by a questionnaire based on the Theoretical Framework of Acceptability. Potential efficacy outcomes were objective binge eating days, eating disorder symptomatology, depressive symptoms, and propensity to eat intuitively.Results: The GSH programme has proven feasible (4.5% attrition, 91% completion, 95.5% satisfaction) and acceptable. Potential efficacy results showed promising improvements on all outcomes (19% abstinence, 70.9% reduction in objective binge eating days).Conclusion: Although preliminary, this programme warrants further study as it may be an efficient and cost-effective way to deliver GSH for BED patients with accessibility barriers.

Caries lesions progression in adults: A prospective 2-year cohort study.

Dental caries is one of the most prevalent chronic non-communicable diseases worldwide. There is a lack of evidence, especially in adult populations, documenting caries disease progression considering lesion severity, activity and tooth surface-level characteristics. The study aimed to investigate the extent to which primary active caries lesions in adults affect caries lesions progression compared with inactive caries lesions over a 2-year follow-up period, considering their severity, surface and tooth type. A prospective study data set from a cohort of workers in a factory in Belarus were used. Participants aged 18-64 years with 20 or more natural teeth were included in the study. The participants were clinically examined twice within an interval of 2 years and completed a self-reported questionnaire. One calibrated examiner evaluated caries lesions using the International Caries Detection and Assessment System (ICDAS) and the Nyvad system. The primary outcome was caries lesions' progression. The lesion was classified as 'progressed' if it turned to a more advanced severity stage, was restored or missing/extracted due to caries. A multilevel Poisson regression was used to estimate the association between baseline caries lesions' characteristics and caries lesion progression. Out of 495 participants, 322 people completed clinical examinations at baseline and 2 years later, with an attrition rate of 35%. The prevalence of active DS1-6 and DS5-6 lesions at the baseline was 83.8% and 64.8%, respectively. In 2 years, 24% of active non-cavitated and 31% of active micro-cavitated/shadowed caries lesions progressed, while 15% of inactive caries lesions, non- or micro-cavitated/shadowed, progressed. The adjusted rate ratio (RR) for ICDAS3 + 4 caries lesions progression was 1.41 (CI 95% 1.16, 1.70) than ICDAS1 + 2 lesions. The RR for ICDAS1 + 2, active and ICDAS3 + 4, active lesions was 1.78 (CI 95%, 1.40, 2.27) and 1.97 (CI 95%, 1.53, 2.55), respectively than ICDAS1 + 2, inactive lesions. The RR for caries lesions progression on proximal surfaces and on pits and fissures was 1.57 (CI 95%, 1.30, 1.89) and 1.37 (CI 95%, 1.11, 1.67), respectively than smooth surface lesions. In caries active adults over 2 years, most non- and micro-cavitated/shadowed active and inactive caries lesions did not progress. Among caries lesions that showed progression, more severe lesions were more likely to progress than less severe lesions; active lesions were more likely to progress than inactive lesions. Pit and fissure caries lesions and proximal lesions were more likely to progress than smooth surface lesions.

Implementing Advance Care Planning and Care Coordination in the Care for People With Parkinson Disease: A Feasibility Study.

BACKGROUND: For people with a moderate stage of Parkinson disease (PD), dedicated care coordination combined with advance care planning (ACP) is highly needed. However, evidence is lacking. The objective of this study was to assess the feasibility and acceptability of the study processes to inform a larger randomized controlled trial, aiming the effectiveness of a combined intervention on ACP and care coordination for people with PD. METHODS: Two nurse practitioners with expertise in PD followed training on a combined intervention on ACP and care coordination. Patients were invited to participate in several sessions for a period of 12 months. Feasibility of the study was surveyed covering sample recruitment, attrition rate, eligibility, intervention delivery, number of ACP sessions, type of intervention administration, and satisfaction with the intervention. RESULTS: In total, 27 patients were invited to participate, and 20 (74%) enrolled into the study, together with 11 family caregivers; 7 patients (35%) dropped out. Most patients were men (n = 20), with a mean age of 73.4 (SD 8.2) years. In total, 71 ACP sessions were held (3.6 sessions per patient on average), of which 41% of the sessions were conducted face-to-face at home, 44% at the hospital, 11% over telephone, and 4% via a videoconference call. Patients perceived the intervention not only as supportive but also as confronting. CONCLUSION: The ACP aspect of the intervention was useful and feasible to stimulate patients to think about their current care situation as well as about future care. Care coordination was less profoundly provided and discussed.

Trajectory on postpartum depression of Chinese women and the risk prediction models: A machine-learning based three-wave follow-up research

BackgroundOur study delves into postpartum depression (PPD) extending observation up to six months postpartum, addressing the gap in long-term follow-ups and uncover critical intervention points. MethodThrough a continuous three-wave cohort study involving 3174 of 10,730 invited postpartum women, we utilized machine learning to predict PPD risk, incorporating self-reported surveys and health records from October 2021 to Jan 2023. ResultsPPD prevalence slightly decreased from 30.9 % to 29.1 % over six months. The Random Forest model emerged as the most effective, identifying key predictors of PPD at different stages. The top three factors at first month were newborn's birth weight, maternal weight before delivery and before pregnancy. The EPDS scores of last time, newborn's birth weight and maternal weight before pregnancy and before delivery were main predictors for EPDS scores at third and sixth months postpartum. LimitationThe study faces limitations such as potential selection bias due to the convenience sampling method and the reliance on self-reported measures, which may introduce reporting bias. Furthermore, the high attrition rate could affect the representativeness of the sample and the generalizability of the findings. ConclusionThere is a slight decrease in PPD rates over six months, yet the prevalence remains high. This underscores the need for early and ongoing mental health support for new mothers. Our study highlights the efficacy of machine learning in enhancing PPD risk assessment and tailoring intervention strategies, paving the way for more personalized healthcare approaches in postpartum care.

Attrition rates and predictor factors for follow-up in an Ecuadorian birth cohort study: Strengthening validity in the Latin American context

Attrition rates and predictor factors for follow-up in an Ecuadorian birth cohort study: Strengthening validity in the Latin American context

Cardiovascular Pharmacogenetics: From Discovery of Genetic Association to Clinical Adoption of Derived Test.

Recent breakthroughs in human genetics and in information technologies have markedly expanded our understanding at the molecular level of the response to drugs, i.e., pharmacogenetics (PGx), across therapy areas. This review is restricted to PGx for cardiovascular (CV) drugs. First, we examined the PGx information in the labels approved by regulatory agencies in Europe, Japan, and North America and related recommendations from expert panels. Out of 221 marketed CV drugs, 36 had PGx information in their labels approved by one or more agencies. The level of annotations and recommendations varied markedly between agencies and expert panels. Clopidogrel is the only CV drug with consistent PGx recommendation (i.e., "actionable"). This situation prompted us to dissect the steps from discovery of a PGx association to clinical translation. We found 101 genome-wide association studies that investigated the response to CV drugs or drug classes. These studies reported significant associations for 48 PGx traits mapping to 306 genes. Six of these 306 genes are mentioned in the corresponding PGx labels or recommendations for CV drugs. Genomic analyses also highlighted the wide between-population differences in risk allele frequencies and the individual load of actionable PGx variants. Given the high attrition rate and the long road to clinical translation, additional work is warranted to identify and validate PGx variants for more CV drugs across diverse populations and to demonstrate the utility of PGx testing. To that end, pre-emptive PGx combining genomic profiling with electronic medical records opens unprecedented opportunities to improve healthcare, for CV diseases and beyond. SIGNIFICANCE STATEMENT: Despite spectacular breakthroughs in human molecular genetics and information technologies, consistent evidence supporting PGx testing in the cardiovascular area is limited to a few drugs. Additional work is warranted to discover and validate new PGx markers and demonstrate their utility. Pre-emptive PGx combining genomic profiling with electronic medical records opens unprecedented opportunities to improve healthcare, for CV diseases and beyond.

Innovations in nurse education: creating the multisensory learning approach of The WISE Room.

Nursing students often face anxiety and cognitive overload, leading to high attrition rates; meanwhile, traditional pastoral interventions have proved insufficient. A novel, digitally enhanced learning environment named The Wellbeing in Student Education (WISE) Room, was introduced as an alternative at a UK university. This study investigated the impact of The WISE Room, a 4m × 4m digital platform containing touch-interactive walls, co-created with students and academic staff, designed to promote insight through immersive experiences beyond traditional learning settings. A mixed-methods approach was adopted, collecting data from nursing students, healthcare staff and academic faculty. Data were collected at three stages, each corresponding with the iterative development of The WISE Room, including an evaluation of the intervention. Feedback from 240 participants was positive. In Phase 2 of the study, 93% of the 79 students and 21 staff who visited the room and completed a survey were satisfied with the room's suitability in three key areas: emotional wellbeing, academic readiness, and placement preparedness. The WISE Room has proved effective in supporting nursing students' wellbeing, and educational and placement preparation requirements. Its multisensory, digital and experiential nature is beneficial for students throughout their learner journey. Additional trials and content development will be required to enhance the learning and teaching experience further.

Unlocking retention: a prescriptive framework for retaining trained staff in critical care units

PurposeNurse turnover in critical care units (CCU) significantly affects patient outcomes and health systems worldwide. To safeguard patient care quality, hospitals must address the underlying reasons for turnover and strategize to retain their skilled nursing workforce. The study proposes a prescriptive framework to reduce nurse turnover in CCUs.Design/methodology/approachIn this study, the integrated methodology of Delphi-AHP-Entropy was used for the comparative prioritization of factors and subfactors that influence nursing staff turnover in CCUs.FindingsStudy findings reveal that “Organizational factors” and “Individual factors” dictate critical care nurse attrition rate. At the subfactor level, staffing policy, chronic fatigue, and perceived career are the leading concerns for the decision of nurses whether to work or leave.Research limitations/implicationsThis study is valuable for both researchers and healthcare professionals. It examines whether actions related to nurse retention align with existing theory and identifies areas requiring further theoretical or applied studies to enhance understanding in this area. This insight can bolster the field’s knowledge base and integrate theoretical and applied knowledge effectively. Additionally, for healthcare professionals, the study provides an overview of key factors conducive to retaining nursing staff in the CCU, offering valuable guidance for implementing effective strategies.Originality/valueThis study uniquely positions itself by presenting a comprehensive and prescriptive framework for critical care nurse retention in the UAE.

Establishment and validation of a nomogram for dropout intention in Chinese early year medical undergraduates

BackgroundThe attrition rate of Chinese medical students is high. This study utilizes a nomogram technique to develop a predictive model for dropout intention among Chinese medical undergraduates based on 19 individual and work-related characteristics.MethodA repeated cross-sectional study was conducted, enrolling 3536 medical undergraduates in T1 (August 2020-April 2021) and 969 participants in T2 (October 2022) through snowball sampling. Demographics (age, sex, study phase, income, relationship status, history of mental illness) and mental health factors (including depression, anxiety, stress, burnout, alcohol use disorder, sleepiness, quality of life, fatigue, history of suicidal attempts (SA), and somatic symptoms), as well as work-related variables (career choice regret and reasons, workplace violence experience, and overall satisfaction with the Chinese healthcare environment), were gathered via questionnaires. Data from T1 was split into a training cohort and an internal validation cohort, while T2 data served as an external validation cohort. The nomogram’s performance was evaluated for discrimination, calibration, clinical applicability, and generalization using receiver operating characteristic curves (ROC), area under the curve (AUC), calibration curves, and decision curve analysis (DCA).ResultFrom 19 individual and work-related factors, five were identified as significant predictors for the construction of the nomogram: history of SA, career choice regret, experience of workplace violence, depressive symptoms, and burnout. The AUC values for the training, internal validation, and external validation cohorts were 0.762, 0.761, and 0.817, respectively. The nomogram demonstrated reliable prediction and discrimination, with adequate calibration and generalization across both the training and validation cohorts.ConclusionThis nomogram exhibits reasonable accuracy in foreseeing dropout intentions among Chinese medical undergraduates. It could guide colleges, hospitals, and policymakers in pinpointing students at risk, thus informing targeted interventions. Addressing underlying factors such as depressive symptoms, burnout, career choice regret, and workplace violence may help reduce the attrition of medical undergraduates.Trial registrationThis is an observational study. There is no Clinical Trial Number associated with this manuscript.

Real-world treatment patterns and outcomes in relapsed/refractory multiple myeloma (1-3 prior lines): Flatiron database

AbstractIn the context of multiple myeloma (MM), early use of the immunomodulatory drug lenalidomide has led to an increased population of patients with lenalidomide-refractory MM in early-line settings, but their outcomes are not well characterized. Herein, we report treatment patterns, survival outcomes, prognostic variables, and attrition rates for patients with proteasome inhibitor–exposed, lenalidomide-refractory MM, treated with 1 to 3 prior lines of therapy (LOT). From 12 767 patients with MM in the Flatiron Health database between January 2016 and April 2022, 1455 met the inclusion criteria. The most common subsequent treatments were triplet combinations (41.6% of patients); daratumumab/pomalidomide/dexamethasone was the most common treatment regimen (13.2%). Median real-world progression-free survival (RW-PFS) and overall survival (OS) were 6.5 months and 44.4 months, respectively. RW-PFS was similar in patients with 1, 2, or 3 prior LOT. International Staging System stage III, Eastern Cooperative Oncology Group performance status of 1, hemoglobin <12 g/dL, high-risk cytogenetics, and refractoriness to anti-CD38 antibody at baseline were associated with worse RW-PFS and OS. Outcomes remained similar for patients who received National Comprehensive Cancer Network–preferred treatments and those who received treatments after 2020. In 561 patients with 1 prior LOT at inclusion, the cumulative attrition rate from LOT 2 to 5 was 85%, which included 25% patients who died and 60% with no further treatment. Patients with lenalidomide-refractory MM who have received 1 to 3 prior LOT have poor outcomes and progress rapidly through available therapies, highlighting the need for more effective treatments early in the disease course, before patients are lost to attrition.

Quantitative Analysis of Factors of Attrition in a Double-blind rTMS Study for Alzheimer Treatment.

Attrition is a particular concern in studies examining the efficacy of a treatment for Alzheimer disease. Analyzing reasons for withdrawal in Alzheimer studies is crucial to ruling out attrition bias, which can undermine a study's validity. In contrast, attrition in studies using repetitive transcranial magnetic stimulation (rTMS) has received much less attention. Our goal was to identify any commonalities between participants who withdrew for the same reasons. Three independent coders rated each response concerning the reasons for withdrawal, and frequency tables were generated to characterize the participants within each category. This study was conducted on the 28 withdrawn cases from a 7-month study investigating the short-term and long-term therapeutic effects of rTMS for Alzheimer disease among 156 participants across 3 sites of the study. Seven reasons for withdrawal were identified, with health and medical changes being the most commonly reported reason (7 participants). Personal issues involving family or caregivers were the next most common (5 participants), and the remaining 5 categories consisted of 3 participants each. Although the limited sample size prevented the use of inferential statistics, our findings highlight the need for more transparent reporting of attrition rates and withdrawal reasons by rTMS researchers.

Developing a new measure of retrospective body dissatisfaction: links to postnatal bonding and psychological well-being

ABSTRACT Background Pregnancy is a transformative time for women and their bodies, and therefore thoughts and feelings about the body understandably change during this period. While previous research has established the impact of body dissatisfaction on factors like antenatal attachment and maternal mental health, there is a notable gap in understanding its long-term effects on postnatal factors. This is often due to high attrition rates in longitudinal studies. Using retrospective measures could address this issue, however a measure of retrospective pregnant body dissatisfaction has not yet been identified. Aims This paper aimed to create a retrospective measure of pregnancy body dissatisfaction by adapting a previously validated measure. It also aimed to investigate the relationship between retrospective accounts of body dissatisfaction during pregnancy and postnatal anxiety, depression, and bonding. Method Cross-sectional online survey data was collected from women postnatally (N = 404). Findings An exploratory and confirmatory factor analysis identified a two-factor model of retrospective body dissatisfaction, adapted from the Body Understanding Measure for Pregnancy Scale, which was equivalent to two of the original subscales. Using this factor structure, linear regressions demonstrated that higher levels of retrospective pregnant body dissatisfaction were associated with elevated rates of postnatal anxiety and depression and lower bonding scores. Conclusions This study successfully established a measure for assessing retrospective pregnant body dissatisfaction, potentially aiding future research. Additionally, it has highlighted the link between pregnant body dissatisfaction and postnatal levels of depression, anxiety, and bonding. Thus, improving the pregnant bodily experience may have the potential to enhance the postnatal experience.

A digital positive psychology intervention for college student mental health and health behaviors

PurposeThe purpose of this study is to evaluate the impact of a 10-week positive psychology course on college student stress, anxiety, self-compassion, resilience and health behaviors.Design/methodology/approachThis study implemented a 10-week positive psychology program that included ten one-week modules. Each module consisted of a reading on a given positive psychology topic, a guided learning slideshow, a video to reinforce topical understanding and individual reflection or application exercises. Participants completed pre and postintervention measures, including the perceived stress scale, generalized anxiety disorder-7, self-compassion scale, brief resilience scale and wellness behavior inventory.FindingsA total of 48 students consented to participate in the study, of which 35 completed the 10-week positive psychology online intervention as well as the pre and postsurveys (27.1% attrition rate). There were no statistically significant differences between pre and postresponses for any of the outcome scales. However, there was a trend toward a decrease in perceived stress and generalized anxiety, as well as a trend toward an increase in self-compassion and health behaviors from pre to posttest.Research limitations/implicationsThe main limitation of this study was design and sample size. Although it was a pilot study, future research should consider a randomized control trial, including pre and postevaluation and blind comparison group. Finally, this intervention was only implemented in the online, asynchronous format. Future research might consider comparing face-to-face, asynchronous online and synchronous online modalities.Practical implicationsFuture implementation should include a more rigorous design, such as a comparison group with randomization as well as a larger sample size.Social implicationsGiven the previous effectiveness of positive psychological interventions on health behaviors, continued research may use direct measures of health behavior engagement throughout the intervention (Biber and Ellis, 2019). This study provides other researchers and practitioners with a model for utilization with middle, high and university students.Originality/valueThis study used open-access content that was free of charge to students to promote positive mental health and health behavior change.

Virtual interprofessional education for the African continent: AFRI-VIPE

This article details how multiple universities came together in 2019 during the Africa Interprofessional Education Network (AfrIPEN) conference in Nairobi, Kenya, to create an interprofessional, multi-continent, multi-university opportunity to give their students an asynchronous and synchronous virtual interprofessional experience through a programme known as VIPE (virtual interprofessional education). The programme, which was created after the conference, was entitled AFRI-VIPE (Africa virtual interprofessional education). From that conference, four AFRI-VIPE events have been implemented to date. Asynchronous material was created, and synchronous sessions were held that utilised problem-based learning to reinforce the Interprofessional Education Collaborative (IPEC) core competencies. Students’ competency attainment was assessed using the Interprofessional Collaborative Competencies Attainment Survey (ICCAS), and analysis of those data showed significant improvements across all six interprofessional subscales for students at both North American- and African-based institutions, as well as across professional groups. All data were kept anonymous. Challenges experienced during AFRI-VIPE included the difference in time zones, student attrition, connectivity and survey response rates. Through their participation in the VIPE model, students and facilitators from a variety of countries and professions appreciated the opportunity to learn with, from and about other students through exposure to authentic case studies.

Associations between readmission and patient-reported measures in acute psychiatric inpatients: a multicenter prospective longitudinal study.

This study examined whether patient-reported measures (PRMs) addressing quality of life, personal agency, functional impairment, and treatment satisfaction at hospital discharge were associated with future readmission during a 12-month follow-up period. The study also examined whether readmission influenced changes in the same measures. A multicenter prospective cohort study was conducted at 21 psychiatric hospitals in Japan. Participants completed the EuroQol-five-dimensions-five-level (EQ-5D), the Five-item Subjective Personal Agency Scale, and the Sheehan Disability Scale (SDS) at the time of index admission (T1), discharge from index admission (T2), and 6months (T3) and 12months (T4) after discharge. Inpatient treatment satisfaction was assessed at T2. Readmission and variables potentially associated with hospitalization and PRMs were evaluated using mixed-effects logistic regression models and mixed models for repeated measures. A total of 491 participants were followed for 12months (attrition rate: 19.4%), and 480 were included in the EQ-5D analysis. The most common diagnoses were schizophrenia (59%), depression (14%), and bipolar disorder (13%). No patient-reported measures were significantly associated with readmission over the follow-up period. Interaction of readmission and time did not significantly affect changes in EQ-5D. Readmission did significantly influence SDS score changes between T2 and T3 (B = 1.78, 95% CI = 0.30-3.25, p = 0.018) and between T3 and T4 (B = 1.43, 95% CI = 0.14-2.72, p = 0.029).The same influence of readmission on SDS score changes was not observed in the model which adjusted for all potential covariates. Readmission was potentially associated with changes in self-reported functional impairment. Findings highlight the potential role of intensive post-discharge services in preventing readmission, rather than relying on time-of-discharge PRMs in order to predict readmission risk. This study was registered in UMIN Clinical Trials Registry (UMIN000034220).

Attrition rate of potassium-based sorbent particle in a riser and cyclone of a circulating fluidized bed for a 10 MWe scale post-combustion CO2 capture system

A dry sorbent post-combustion CO2 capture process using a circulating fluidized bed (CFB) was developed to a 10 MWe scale. Particle attrition is a major challenge for many CFBs owing to the loss of particles and increased operating costs. Furthermore, predicting and alleviating the rate of particle attrition in an entire CFB is difficult owing to limited information on attrition in the riser and cyclone. This study experimentally investigated particle attrition in risers and cyclones and the effect of system scale-up using CO2 adsorbent particles used in a 10 MWe scale CFB. Experiments were conducted in two types of CFBs to measure the attrition rate in the riser and cyclone for 22 and 12 h for each experimental condition. To verify the scaled-up effect, internals were added to the riser to measure the effect of the surface-area-to-volume ratio. Correlations for the attrition rate of CO2 adsorbent particles in riser and cyclone were proposed, and a model for the scale-up effect was suggested. In the 10 MWe scale system, particle attrition mainly occurred in the cyclone (58.0 %) and riser (37.3 %) according to the calculation, and the calculated overall attrition rate reasonably matched the operational data.

Real-world treatment sequencing and effectiveness of second- and third-generation ALK tyrosine kinase inhibitors for ALK-positive advanced non-small cell lung cancer

IntroductionWith multiple targeted therapies approved for anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC), it is increasingly important to understand outcomes with various sequences of next-generation ALK tyrosine kinase inhibitors (TKIs). We describe contemporary sequencing patterns and treatment effectiveness of first-line (1L) and second-line (2L) treatments in patients who received second-generation ALK TKIs in the 1L treatment of ALK-positive NSCLC in the United States. MethodsA cohort of adults with ALK-positive advanced NSCLC who initiated treatment with 1L alectinib or brigatinib between June 2017 and April 2021 in the Flatiron Health electronic health record–derived de-identified database were followed through April 2023. Time to treatment discontinuation (TTD) in 1L and 2L, TTD on 1L plus 2L sequential therapy (TTD2), and total time on sequential ALK TKI therapy (including beyond 2L) were evaluated. ResultsPatients (N=273) were followed up for a median duration of 28.9 months. Among patients who discontinued 1L therapy, 22% died after 1L discontinuation (median time from discontinuation to death, 4.0 months) without receiving 2L therapy. Median (95% confidence interval [CI]) TTD was 21.9 (15.2–25.8) and 7.3 (5.3–10.2) months in 1L and 2L, respectively. Median (95% CI) TTD2 was 29.4 (25.1–36.1) months and total time on sequential ALK TKI treatment was 28.0 (23.6–32.9) months. ConclusionsIn this large real-world study, TTD2 and the total time on sequential ALK TKIs was approximately 2.5 years. The high attrition rate from 1L to 2L and the longest clinical benefit observed with 1L therapy support using the drug with the longest 1L effectiveness up front in patients with ALK-positive advanced NSCLC.

A Pilot Feasibility Trial of Mind–Body Tactical Training for Firefighters: Evaluation of a Yoga-Based Transdiagnostic Program

ObjectivesFirefighters are at heightened risk for chronic occupational stress and exposure to potentially traumatic events. Experiencing potentially traumatic events is a risk factor for various psychiatric symptoms among firefighters, notably posttraumatic stress disorder (PTSD), depression, and anxiety. This study evaluated the feasibility and preliminary effectiveness of yoga to reduce PTSD symptoms, negative affect, and trait anxiety in firefighters.MethodsA total of 108 trauma-exposed career firefighters (99% male; Mage = 34.55, SD = 8.37) were enrolled in a single-arm 8-week yoga intervention, termed Mind–Body Tactical Training (MBTT). Feasibility was assessed in five domains. Self-report measures were used to evaluate the MBTT intervention’s effectiveness in reducing symptoms of PTSD, negative affect, and trait anxiety. The Intervention Appropriateness Measure was employed to assess acceptability. Attrition, attendance, and intervention costs were used to determine demand, implementation, and practicality, respectively.ResultsTotal PTSD (p < 0.001, d = 0.426), negative affect (p = 0.029, d = 0.242), and trait anxiety (p < 0.001, d = 0.327) decreased from pre- to post-intervention. Improvements in trait anxiety were also observed from pre-intervention to follow-up (p = 0.032). The intervention was generally acceptable to participants, had a 6.48% attrition rate, and had an 80.73 ± 18.96% class attendance. The cost of instructors and equipment totaled US$6636.78, equating to a cost per participant per attended class of US$4.76.ConclusionsThe current study provides initial evidence for the feasibility and effectiveness of yoga as a transdiagnostic treatment for firefighters.PreregistrationThis study is not preregistered.

Modeling gender differences in the job promotion process: Replication and extension of Martell et al. (1996).

Differences in employee evaluations due to gender bias may be small in any given rating cycle, but they may accumulate to produce large disparities in the number of women and men promoted to the top of an organization. A highly cited simulation by Martell et al. (1996) demonstrates this cumulative advantage process in a multilevel organization. We replicated this simulation to uncover important details about its operating assumptions, and we extended the simulation to examine a range of variables that may impact the cumulative effects of gender bias. The replication revealed that the male cumulative advantage in the Martell et al. simulation requires (a) decades of typical promotion cycles to produce, (b) constant mean differences in the performance ratings of women and men but equal within-group variances, and (c) attrition that occurs randomly at a low and constant rate. Our extended simulation demonstrates that (a) cumulative effects of gender bias are higher when the attrition rate is lower, (b) gender biases are mitigated when attrition is more strongly associated with good or poor performance, and (c) the cumulative effects of mean gender differences in performance ratings can often be smaller than the cumulative effects of variance differences between gender subgroups. Results suggest that talent development and recognition of high performers might have a greater positive impact on female representation at top levels of a firm than programs aimed at reducing bias in employee evaluations. We encourage additional simulation work that further explores the dynamics of cumulative advantage in employment settings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).