Differences In Dropout Rates Research Articles

Distance Learning Outcomes for Texas Tech Universityʼs Physical Therapy Program

Background and Purpose. The most significant driving force behind distance education in the physical therapy curriculum may be the ability to overcome barriers of distance and costs. In 1994, the Texas Tech University Health Sciences Center physical therapy program expanded to a 3-campus system, opening quasidistance education at campuses in Amarillo and Odessa, Tex. Expansion occurred in order to meet the needs and desires as the primary provider of health care within the geographically vast West Texas region. The campuses of Amarillo and Odessa are linked into the (main) Lubbock campus by an interactive 2-way video called HealthNet. HealthNet is a synchronous learning environment, which allows all 3 campuses to interact through video and audio technology. Regional faculty were hired not only to teach to other campuses by virtue of HealthNet, but also to provide laboratory education and facilitate interaction in conjunction with the didactic format. Subjects. This study investigated the grade point averages (GPAs) and dropout rates of master's-levelphysical therapist students between the Lubbock and regional campuses in 5 successive graduation years (1998-2002). Methods. For the GPA differences, an unpaired t test was selected and a chisquare analysis was done to determine whether a difference in dropout rates existed between the Lubbock and regional campuses. Results. The study showed no statistically significant differences in GPAs (P≤.95, critical t-test value=0.061) or dropout rates (P≤.99, X2=.00258) regardless from which campus the students graduated. Discussion and Conclusion. This study supports the program hypothesis that a quasi-distance physical therapy curriculum can effectively meet the needs of students enrolled in physical therapy programs.

Differences in Dropout Rates Among Individual, Couple, and Family Therapy Clients

The premature dropout of clients from therapy is an inefficient expenditure of mental health resources. This study examined differences in dropout rates among individual, couple, and family therapy clients. Data came from archived records at a marriage and family therapy clinic at a university in the United States. Results indicated that there were no significant differences in dropout rates, despite the use of multiple measures of dropout. Thus, from a mental health services perspective, administrators and clinicians can expect that dropout rates will remain fairly consistent across treatment modalities.

Haloperidol for agitation in dementia.

Agitation occurs in up to 70% of demented patients. Haloperidol has been used for decades to control agitation in dementia, but its effectiveness remains unclear. Previous meta-analyses examined only English language publications or compared haloperidol with other drugs rather than with placebo. To study the effectiveness of haloperidol a more widely based review was performed. To determine whether evidence supported the use of haloperidol in agitated dementia. The CDCIG Specialized Register which contains references from medical databases (MEDLINE, EMBASE, PsycInfo and CINAHL) as well as from many trials databases was searched on 26 July 2000 to identify reports of randomised controlled trials on haloperidol treatment of agitation in dementia. Randomized, placebo-controlled trials, with concealed allocation, where subjects' dementia and agitation were assessed. 1. Two reviewers extracted data from included trials 2. Data were pooled where possible, and analysed using appropriate statistical methods 3. Odds ratios of average differences were calculated 4. Only 'intention to treat' data were included 5. Analysis included haloperidol treated patients, compared with placebo The five included trials led to the following results: 1. There was no significant improvement in agitation among haloperidol treated patients, compared with controls. 2. Aggression decreased among patients with agitated dementia treated with haloperidol; other aspects of agitation were not affected significantly in treated patients, compared with controls. 3. Although two studies showed increased dropouts due to adverse effects among haloperidol patients, there was no significant difference in dropout rates, comparing all haloperidol treated patients with controls. 4. The data were insufficient to examine response to treatment in relation to length of treatment, degree of dementia, age or sex of patients, and cause of dementia. 1. Evidence suggests that haloperidol was useful in the control of aggression, but was associated with increased side effects; there was no evidence to support the routine use of this drug for other manifestations of agitated dementia. 3. Similar dropout rates among haloperidol and placebo treated patients suggested that poorly controlled symptoms, or other factors, may be important in causing treatment discontinuation. 4. Variations in degree of dementia, dosage and length of haloperidol treatment, and in ways of assessing response to treatment suggested caution in the interpretation of reported effects of haloperidol in the management of agitated dementia. 4. The present study confirmed that haloperidol should not be used routinely to treat patients with agitated dementia. Treatment of agitated dementia with haloperidol should be individualized and patients should be monitored for side effects of therapy.

Dr. Kornstein and Colleagues Reply

Dr. Kornstein and Colleagues Reply

Efficacy of Midodrine for Neurogenic Orthostatic Hypotension

To the Editor. —Orthostatic hypotension due to autonomic failure is an incapacitating condition for which treatment, despite various drug interventions (eg, yohimbine, metoclopramide, β-blockers, somatostatin analog) is not yet resolved. Therefore, the encouraging results of the study of Dr Low and colleagues 1 are potentially of great importance. Although the pharmacological efficacy of midodrine, an α1-adrenoceptor agonist, is clearly demonstrated by this trial, the therapeutic effectiveness is not documented as well and is therefore less convincing. There are several important issues. First, the number of patients included in the study should allow data analysis on an intention-to-treat basis. This approach would be preferable because of the particularly high dropout rate in the midodrine group (22 [27%] of 82 subjects) when compared with the placebo group (5 [5.6%] of 89 subjects). The difference in dropout rate during the 5 weeks of the study is significant (X 2 =14.44, P

Drug Choice in Depression

Selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors (SSRIs) are no more effective or rapid in their onset of action than tricyclic antidepressants (TCAs). Meta-analyses of comparative trials suggest that there are no significant differences between these 2 classes of drugs in overall dropout rates or those due to inefficacy alone. However, a small difference in dropout rates due to adverse effects in favour of SSRIs has been reported. It is not known if this difference exists in general practice, where most antidepressants are prescribed, or if it will be sustained during longer term treatment, during which adaptation to some adverse effects might be expected to occur. There could be differences between individual drugs in each class.

Effect of time-limited psychotherapy on patient dropout rates

The authors conducted an archival study of 149 new clinic patients at a large community mental health center. The dropout rate for patients in brief psychotherapy in which the length of therapy was specified at the outset of treatment (time-limited psychotherapy) (32%) was about one-half the dropout rate for patients in brief (67%) and long-term (61%) individual psychotherapy. The difference in dropout rates could not be explained by patient demographic or diagnostic variables or by therapist characteristics measured in the study. The results suggest that setting a specific time limit on individual psychotherapy at the outset of treatment can reduce the patient dropout rate in a public mental health clinic.

Dropping out among Hispanic youth

This paper examines the nature and extent of the dropout problem among Hispanics, compared to non-Hispanic whites and blacks, using data from the sophomore cohort of “High School and beyond,” a national longitudinal study of high school students initiated in 1980. We predict dropping out with measures of scholastic achievement, socioeconomic background, and demographic characteristics for separate race and gender groups. For Hispanics, we also explore the effects of language factors and nativity on dropping out. With the exception of socioeconomic status, the results show similar patterns of effects across groups. Socioeconomic status is a more important deterrent to dropping out among non-Hispanic whites than among Hispanics and non-Hispanic blacks. Simulations of droupout rates based on these analyses reveal that much of the difference in dropout rates observed between Hispanics and non-Hispanic whites is due to variations in average background characteristics.

Effect of Ketanserin in the Treatment of Patients with Intermittent Claudication

The effect of ketanserin on intermittent claudication was assessed in 13 placebo-controlled parallel group studies following basically the same protocol. After a single-blind placebo run-in period of 1-2 months, the patients randomly received either ketanserin (n = 152) or placebo (n = 158) for 3-6 months. Data on walking distance, assessed on the treadmill, were available in 12 centers (239 patients). Walking distance significantly increased in seven centers with ketanserin and in two centers with placebo. In two centers, the intergroup comparison between ketanserin and placebo was significantly in favor of ketanserin; in one center, it was in favor of placebo. A pooled analysis of all data on walking distance showed that ketanserin significantly increased walking distance by 65%, whereas placebo significantly increased it by 25%. However, the intergroup comparison does not show significant differences. Comparison of individual responses, on the other hand, showed that more patients experienced a doubling of walking distance on ketanserin than on placebo (25 versus 13%), and fewer patients deteriorated on ketanserin than on placebo (23 versus 32%); this difference in response rate is significant (p less than 0.05). In these studies there was a striking difference in drop-out rate between ketanserin and placebo. In total, 25 patients dropped out during placebo treatment versus 14 during ketanserin treatment. Nine of the 25 dropouts on placebo suffered severe "cardiovascular events," whereas no such events were observed in the ketanserin group. This difference is highly significant and suggests that ketanserin may have a vascular protective effect in patients with intermittent claudication. This possibility is being investigated in a prospective trial (PACK trial).

Dropping Out Among Language Minority Youth

Dropping out of high school among language minority youngsters, a group characterized by an extremely high dropout rate, has seldom been examined. In this review, direct and indirect evidence concerning school-leaving among language minority youth is discussed. Generally speaking, it appears that the combination of socioeconomic disadvantage and early academic failure—a combination known to be predictive of dropping out—contributes to the higher dropout rate of language minority youngsters. Interestingly, however, although the evidence is by no means unequivocal, studies conducted to date suggest that dropping out is more prevalent among language minority youngsters from Hispanic backgrounds than among other non-English-speaking youngsters. Four hypotheses concerning the higher dropout rate of language minority Hispanics are discussed: (a) It is a socioeconomic artifact; (b) there exist ethnic group differences in the pressure parents place on youngsters to learn and use English; (c) school personnel interact more negatively with Spanish-speaking youngsters than with other language minority youth; and (d) differences in dropout rates are attributable to differences in the circumstances surrounding youngsters’ immigration to the United States.

Dropping Out of High School: The Influence of Race, Sex, and Family Background

This paper examines the extent of the high school dropout problem in 1979 and investigates both the stated reasons students leave school and some of the underlying factors influencing their decision. Particular attention is focused on differences by sex, race, and family background. Data for this research come from a new, national sample of youth who were 14 to 21 years of age in 1979. A multivariate model is developed to estimate the effects of family background and other factors on the decision to drop out of school. Several results emerge from the study: The reasons students cite for leaving school vary widely, with women more likely to leave because of pregnancy or marriage and men more likely to leave to go to work; family background strongly influences the propensity to drop out of school and accounts for virtually all the racial differences in dropout rates; various other factors, including ability and aspirations, also influence this decision.

Fresh symptom emergence after intensive behaviour therapy.

The outcome of a standard four-day intensive symptomatic treatment programme with 39 agoraphobics is examined in relation to the incidence of fresh symptom emergence. Twenty-six patients suffered fresh symptom emergence during follow-up, and there was a significant association of fresh symptom emergence with poorer outcome at one-year follow-up. About 18 percent of patients were adversely affected by the treatment programme, as judged on a wide range of symptoms and measures of inter- and intra-personal adjustment. Sixteen individually treated patients are then compared with the 39 group-treated patients and differences in drop-out rate are discussed.