Irregular Attendance Research Articles

Planned Group Counseling: A Single-Session Intervention for Reluctant, Chemically Dependent Individuals

Planned group counseling (PGC) is a group intervention used for 20 years at an urban Veterans' Affairs medical center's methadone maintenance treatment program and substance abuse rehabilitation programs–detoxification, 28-day inpatient, and 2-year outpatient. PGC was added to these interdisciplinary programs to provide a conjoint group treatment method. The method integrates concepts and techniques found in both professional and self-help groups. It is leader centered, very directive, and based on a single-session, highly structured workshop model. PGC is intentionally designed to cope with the very reluctant behavior common to this population: lateness, irregular attendance, premature terminations, and noncompliance with therapeutic directives.

Do community‐based support services benefit bereaved children? A review of empirical evidence

To consider the evidence of effect from English language, empirically based quantitative evaluations of community-based interventions for bereaved children; community-based interventions being understood as those taking place outside a clinical setting. MedLine, PsychInfo, Applied Social Sciences Index and Sociological Abstracts were searched for documents containing the words 'child', 'bereavement' and 'program', 'group', 'intervention', 'support' or 'evaluation'. The criterion for inclusion was that studies use a control group or pre- and post-test measurements using a standardized instrument. Nine relevant studies were identified. However, empirical evidence of positive outcomes for children was limited and compromised by methodological weaknesses in the design of the studies. Small sample sizes, irregular attendance, high levels of attrition, short time scales between pre- and post-testing and difficulty in developing appropriate instrumentation, including assessment of adherence to the agreed intervention programme, all created problems. The case for universal inclusion of this group of children in such support programmes remains unproven, and further exploration of the outcomes of a range of different community interventions is required, with a specific focus on long-term and/or unwanted effects and evaluation of the basis for referral.

The reasons for the extraction of various tooth types in Scotland: a 15-year follow up

Objectives: The aim of this survey was to investigate the reasons for extraction of the various tooth types in Scotland. This study replicated one which was undertaken 15 years earlier. A further aim, therefore, was to identify any changes in the frequency of extraction of each tooth type in the 15 years between the two studies. Methods: The names of every fourth dentist on the list of the Scottish Dental Practice Board were obtained. Four hundred and twenty-five general dental practitioners were asked to record permanent tooth extractions for 1 week. Data requested for each extraction were: the patient's age, gender and dental attendance pattern, the type of tooth removed and the reason for the extraction. Results: Three hundred and fifty-two dentists participated (a response rate of 82.8%). There were 25% fewer teeth extracted per patient and 30% fewer per dentist than in the 1984 study. In 1999, more teeth of most types were extracted from regular attenders whereas, in 1984, more teeth of all types were extracted from irregular attenders. Premolars and first and second molars were the tooth types most frequently extracted in both surveys. In 1999 premolars were the teeth most commonly removed below 21 years of age, accounting for 57.5% of extractions in this age range. Molars accounted for 33.8% of extractions in this age range compared with 52% in 1984. Overall, caries was found to be the principal reason for loss of all tooth types apart from lower incisors which were extracted mainly for periodontal reasons. However, below 21 years, 84.5% of premolar extractions were performed for orthodontic purposes. Conclusions: Over the last 15 years, the overall number of extractions has reduced and the proportion of extractions from regular attenders has increased. Proportionately more premolars and fewer molars were extracted from under-21-year-olds. This observation can be explained by an increase in orthodontic extractions or a decline in extractions for caries in this age group. However, when extractions from the population as a whole are considered, caries and its sequelae remains the principal reason for loss of all tooth types other than lower incisors which are extracted mainly for periodontal reasons.

Prevalence of depersonalization and derealization experiences in a rural population.

Dissociative symptoms are common psychiatric symptoms whose prevalence in rural (agricultural) populations is unknown. The present study examines the prevalence of depersonalization and derealization experiences in a southern rural US population as well as socio-demographic and emotional factors associated with these experiences. A random sample of 1008 adults in rural eastern North Carolina completed a survey by telephone, which included questions about experiences of depersonalization or derealization in the past year. Demographic information was gathered on all respondents; for those reporting these dissociative experiences, information on their frequency, duration, and whether they occurred during conditions of danger, severe stress, upsetting memories, nervousness or depression, or for no apparent reason was also elicited. The reported prevalence rates were 19.1% for depersonalization, 14.4% for derealization, and 23.4% for either dissociative experience. Logistic regression showed that women reported a significantly higher rate of dissociative experiences (26.5%) than men (19.5%), (Odds Ratio = 1.93, 95% CI = 1.37-2.74), particularly African-American women (29.9%). Experiencing chronic pain (OR = 2.96, 95% CI = 2.05-4.28) and irregular church attendance (OR = 1.18, 95% CI = 1.07-1.31) were also associated with increased frequency of dissociation. Increasing age (OR = 0.73, 95% CI = 0.65-0.81) and being employed (OR = 0.58, 95% CI = 0.39-0.86) were associated with reduced frequency of dissociation. Pain, gender, and age were related to both depersonalization and derealization experiences. Employment and church attendance were related to depersonalization experiences, while ethnic minorities experienced more derealization. A predominantly southern rural population reported a high 1-year prevalence of depersonalization and derealization experiences. The prevalence of dissociation experiences was common in this southern sample, as was found by Ross and colleagues (1990) in an urban population in Canada. Risk factors for depersonalization and derealization experiences had considerable overlap, but differed on several variables suggesting different underlying mechanisms.

Dental fear among a young adult Saudian population

To assess the prevalence of dental fear and reasons for irregular dental attendance among young adult university students; to describe the gender distribution of the dentally anxious population according to the perceived origins or sources of fear; to identify the time of fear development and preference for anaesthesia or sedation before dental treatment. A questionnaire incorporating the Dental Fear Scale (DFS) with items related to sources of dental fear stimuli, together with the preference of anaesthesia or sedation before dental treatment and other characteristics. Approximately 500 questionnaires were distributed among Saudian undergraduate students. 368 questionnaires were completed and presented for statistical analysis. The sight and sensation of anaesthetic needles and the sight, sound and sensation of the drill were rated the most fear-eliciting stimuli. Also, females tended to be more anxious than males. Increased heart rate was the most common reported physiological response to fear resulting from dental treatment. The overall level of fear of dental work among the studied population was found to be about 39%.'Lack of time' and 'no need for treatment' were found to be the main reasons for irregular dental visits. Fear of pain and trauma were the major perceived sources of reported fear reactions and were developed mainly during childhood. About 63% of the subjects preferred to have local anaesthesia before dental treatment to prevent or ameliorate dental fear.

Slow-Release Devices for Fluoride Delivery to High-Risk Individuals

The latest fluoride research is investigating the use of slow-release devices for the long-term intra-oral provision of fluoride. 174 children aged 8 years with fluoride slow-releasing glass devices were shown to develop 67% fewer new carious teeth and 76% fewer new carious surfaces in a 2-year double-blind caries study. There were 55% fewer new occlusal fissure carious cavities showing that occlusal surfaces were also protected by the fluoride released from the devices. The fluoride devices release low levels of fluoride for at least 2 years and have great potential for use in preventing dental caries in high-caries-risk groups and irregular dental attenders in addition to a number of other applications.

Factors associated with dental anxiety and attendance in middle-aged and elderly women.

The aim of this study was to analyze the association between dental anxiety, dental attendance, health status and social factors. Our previous studies have shown that dental anxiety declines with age and is associated with poor oral health. In addition, correlations between dental anxiety, dental utilization and dental status have been revealed. However, the association of these factors with general health and social factors has not been analyzed in our previous studies. In a study of women's health in Göteborg, Sweden in 1992, 1.017 urban women aged 38 to 84 years took part in a series of investigations including clinical examinations, interviews and questionnaires. In addition to descriptive and simple inference statistics, a two-part multiple logistic regression model was utilized to investigate dental anxiety and dental utilization. Dental fear was less prevalent among older women, dentate or not, although 10% of females 62 years of age and older still reported high dental anxiety (DAS > or = 12). 94% of the younger (< or = 62 yr) and 76% of the older (> or = 70 yr) women reported regular dental attendance. When separating all women into dentate and edentulous groups, 94% of the dentate and 11% of the edentulous respondents reported regular dental care. Due to the large difference in dental attendance between dentate and edentulous women, these groups were analyzed separately. Multiple logistic regression analyses showed that the following factors were associated with irregular dental utilization among dentate women: high dental anxiety, fewer teeth and restorations, more caries, poorer chewing ability and dissatisfaction with dental esthetics. In the multiple regression for dental anxiety, high fear was shown to be associated with irregular dental care, age (younger), fewer teeth, dissatisfaction with dental esthetics and lower scores on the SF-36 mental health scale. A separate analysis showed that individuals with high fear and regular, as opposed to irregular, dental attendance had more teeth at a statistically significant level, which were less often decayed and more often restored. In spite of the group with high fear and irregular attendance having fewer teeth, their level of decay was seven times higher. Overall, the results indicate a strong association between dental fear and dental attendance. Weak associations were found among socio-economic, dental health and general health factors.

Predictable Problems in Achieving Large-Scale Change

Those who attempt to change the schools have come to accept that come with the territory, Mr. Trubowitz points out - but they are neither evidence of failure nor cause for retreat from the effort to improve schools. THE CALLS FOR school change continue, despite a history of implementation efforts marked by frustration and failure. A major reason for this record of dismal results is ignorance of the problems that inevitably appear as innovators seek to change schools. As university consultant to a project designed to convert the junior high schools of New York City to a middle school approach, I have seen these problems firsthand. I believe it can be useful to highlight some of these problems, not to discourage prospective innovators but rather to encourage a more realistic outlook. I hope to prepare others for the problems that occur whenever innovations are attempted so that shock and chagrin will not cause them to retreat from the effort to improve schools. I do not suggest that problems can be eliminated or even reduced in severity by foreknowledge, but prior awareness can help to sustain participants in the difficult and awesome task of achieving educational change. Loss of Leadership Support The Middle School Initiative, as this attempt to convert all of New York City's junior high schools to a middle school approach was called, began with a bang. Chancellor Ramon Cortines, at the urging of his deputy chancellor, opened his private residence for a reception to welcome public school and university participants in the project. Refreshments were mingled with inspirational comments as the top leadership of the district announced its support. Four years later, another meeting was held to welcome new schools and colleges into the project. The setting was a basement room in the board of education building at 110 Livingston Street in Brooklyn. The session was called to order by a new project director, the replacement for the original head of the program. The new chancellor, Rudy Crew, was occupied with other matters, and the deputy chancellor had long since departed to become superintendent of schools in Newark. Support came in the form of a letter from the chancellor, read by the new deputy. The grim, gray setting for the second reception and the absence of high-level representation symbolize a problem that inevitably arises in any large-scale project that extends over a period of time. Personnel changes in administration occur, and the new leaders, removed from the original concept and lacking the motivation that comes from feelings of ownership, provide less support to sustain the momentum. With these changes in leadership comes a dilution of interest, as shown by irregular attendance at meetings. Decisions previously shared are made by officials with different priorities. For example, it was announced that underperforming schools were to be included in the next group to participate in the initiative. This selection by the chancellor's office was to supersede a screening process that had previously been established by an advisory group. School leadership in urban areas is not characterized by lengthy service. New York City in the last decade has had a number of chancellors, none of whom held office for more than four years. District superintendents serve at the whim of what can be capricious school boards. Successful principals move to higher office or are drawn to suburban school districts by higher salaries and less onerous working conditions. In recent years retirement incentives have deprived schools of veteran leaders in growing numbers. This continuous turnover in top leadership invariably leads to a diminution of support for previously initiated change projects. The value of the ongoing interest and involvement of the top leadership ought not to be underestimated, for such administrative behavior allows project participants to believe that what they are doing will make a difference and that resources will be made available on a timely basis. …

Impact of treatment provision on the epidemiological recording of root caries.

The estimation of root caries prevalence and the identification of risk factors for decay depend upon the successful identification of carious lesions in epidemiological studies. Root surface restorations can either be placed to manage decay or cervical wear/sensitivity. The handling of data for restorations during epidemiological surveys is critical to the accurate assessment of caries prevalence. The objective of this study was to determine the relative frequency of dentists' placing root surface restorations according to their reason for placement. Data for 696 restorations were recorded from 35 dentists. Forty-five % of restorations were placed because of decay compared with 55% for cervical wear/sensitivity. There were no significant differences in proportion of placement of restoration with age of the patient or between regular and irregular attenders of different ages. Using these data a correction factor was developed for inclusion in the Root Caries Index (RCI) to make allowance for the proportion of restorations placed because of wear/sensitivity. When this correction factor was introduced into an existing data-set for root caries, the RCI was reduced for all groups. This reduction was greatest in regular attenders. When these data were analysed without making allowance for treatment effects, there was a significant difference in RCI between regular and irregular attenders. When the correction factor was applied to these data, this difference was eliminated.

School-based schistosomiasis control programmes: a comparative study on the prevalence and intensity of urinary schistosomiasis among nigerian school-age children in and out of school

A cross-sectional study was conducted in February 1998 on the prevalence and intensity of urinary schistosomiasis among school-age children in and out of school at Adim village in Nigeria to test the objective of delivering a control programme through the school system. School enrolment figures and non-attendance rate were collated from questionnaires that were self-administered by heads of families. Prevalence and intensity of infection were determined following filtration of urine and counting of carbol fuchsin-stained eggs of Schistosoma haematobium. The rates of regular school attendance, irregular attendance and non-attendance were 69·1%, 5·1%, and 25·8%, respectively. These indices were not significantly associated with the age of the schoolchildren ( P > 0·05). Boys (76·6%) were more associated with regular attendance than girls (61·4%) ( P < 0·0001) while girls had a higher rate of non-attendance (32·7%) than males (19·1%) ( P < 0·0001). Although more out-of-school children were infected (90·7%) than those in school (86·8%), the difference was not statistically significant ( P > 0·05). The same association was established in the variation of mean egg count between the 2 study populations though intensity was higher among out-of-school children. The principal reasons proffered for the high rate of non-attendance listed in their order of importance were: economic, sickness, poor performance, refusal, farming and fishing. A dual method of control that would incorporate the integration of recognized local authorities is suggested in areas with moderate school attendance rate like Adim, as lack of treatment of infected out-of-school children ensures continuous contamination and re-infection.

Deprivation associated with increased disease experience in 5-year-old children

Objective To compare the dental caries' experience and treatment received by 5-year-old children registered with a GDP. Design Retrospective case note review of all 5-year-old children registered with seven GDPs. Setting Wirral and North Cheshire in north west England in 1996/7. Subjects and materials Clinical, demographic and attendance data were collected from each practice using a common data abstraction form. Subjects were categorised according to regular/irregular attenders, and into five groups ranging from affluent to deprived using the Super Profiles geodemographic classification. The relationships between disease experience, treatment, attendance and socioeconomic status were compared using cross-tabulations, t-tests and multiple linear regression. Results The dental records of 430 5-year-old children were available for analysis. Irregular attenders had significantly higher dmft, dt and mt, and fewer filled teeth. Only 29% of disease experience of regular attenders was treated by restoration. Both socioeconomic status and visiting behaviour exerted significant independent effects on dmft, but dental attendance alone had a significant effect on ft. Conclusions Significant inequalities remain in the disease experience and service use of young children. Regularly attending children have less than a third of their diseased teeth restored. Consensus is needed across the profession on the care of the diseased deciduous dentition.

Psychological and behavioural problems in school students of Morang district

Results of structured and semi-structured interviews of 37 school teachers from 9 different schools of Morang has been presented in relation to existence of psychological/behavioural problems in their students. Data on 3911 students have been analyzed. The study shows that 1442 (36.89%) of students had some kind of problem. The list of conditions in decreasing order of incidence are: very slow to learn, irregular school attendance, suddenly degrading school performance, not able to concentrate and running away from school. The female/male ratio of students was 1:1.47.

Use of Multiplicative Commutativity by School Children and Street Sellers

We analyzed use of the commutative property for solving multiplication problems by children who learn about multiplication in schools and by street vendors who solve multiplication problems through repeated addition. Subjects were Brazilian street vendors with irregular school attendance, who had received no, or very little, school instruction on multiplication, and 1st- to 3rd-grade Brazilian school children. Results from 2 studies show that use of commutativity to solve multiplication problems is closely related to use of multiplication. Street sellers who rely exclusively on repeated addition to solve such problems may, however, use multiplicative commutativity if it represents a clear reduction in the number of computational steps needed to reach a solution. But their justifications for its use are often based on knowledge about multiplication.

Prevalence of dental caries in schoolchildren in Italy.

The caries experience and its potential risk indicators such as socioeconomic status, sweets consumption, toothbrushing habits, dental visit attendance pattern and salivary mutans streptococci (in 12 year old only), were assessed in schoolchildren raised and living in low fluoridated areas (Catanzaro, Italy). Caries-free prevalence in the 6-year-old was 52.9% in their primary dentition; the dmft and dmfs were 2.1 and 5.1, and both DMFT and DMFS were 0.1. Almost 91% of the dmft was attributable to active decay. The proportion of children with a dmft+DMFT > or = 1 and the dmft and dmfs were significantly higher in those with low socio-economic status. In the 12-year-old, 52.7% had a history of caries and the DMFT and DMFS were 1.5 and 2.6; the filled component was the dominant proportion. The more likely they visited a dentist for routine checkup, the higher socio-economic status (it was not associated with DMFT), the less frequently they had sweets, and the low level of Streptococcus mutans, the more likely they were caries-free and the less likely they were to have a high DMFT, DMFS, and DT. In the 15-year-old, 68.8% had a history of caries and the DMFT and DMFS were 2.8 and 4.8, with a higher prevalence of the F component. The children who visited a dentist for routine checkup had a significantly lower caries experience, DMFT, DMFS, and DT than the irregular attenders, and those with low socio-economic background were more likely to have a high DMFS.

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.

School Failure in Italy: explanations and strategies for intervention

SUMMARY The fight against school failure has become a priority in Italy. The seriousness of the problem emerges from an analysis of the most recent CENSIS report. In the Italian context, the concept of ‘school failure’ covers a wide range of phenomena including irregular attendance, repetition of a school year and dropping out completely. In dealing with the question of school failure in Italy, particular attention is paid to the complexity of factors in play and the presence of concomitant causes that determine current developments. This study analyses some criteria for recognizing the problem of failure and its incidence in primary, lower secondary and in upper secondary school. Some initiatives for fighting school failure, contained in current legislation and in pilot projects, are reviewed and evaluated.

Breast carcinoma stage in relation to time interval since last mammography

Breast carcinoma stage in relation to time interval since last mammography

Breast carcinoma stage in relation to time interval since last mammography

Breast carcinoma stage in relation to time interval since last mammography

Oral disadvantage among dentate adults.

Oral disadvantage can be defined as the avoidance of certain daily activities because of decrements in oral health. These decrements include oral disease and tissue damage, pain, and functional limitation. The Florida Dental Care Study (FDCS) is a longitudinal study of changes in oral health, which included at baseline 873 subjects who had at least 1 tooth, were 45 years old or older, and who participated for an interview and clinical examination. Three objectives of the FDCS are: (1) to describe selected psychometric properties of the measurement of oral disadvantage; (2) to describe oral disadvantage in a diverse sample of dentate adults; and (3) to describe the relationship between disadvantage and other aspects of oral health, such as disease/tissue damage, pain, and functional limitation. The prevalence of oral disadvantage within the previous 6 months, using eight self-reported measures, ranged from 5% to 25%, depending upon the measure. Factor analysis suggested that oral disadvantage is best described as three factors: disadvantage due to (1) oral disease/tissue damage, (2) oral pain, and (3) oral functional limitation. Irregular dental attenders, poor persons, and blacks had the highest prevalence of oral disadvantage. Clinical measures of oral disease/tissue damage, self-reported measures of oral disease/tissue damage, oral pain, and oral functional limitation were strongly associated with the presence of oral disadvantage. In multivariate analyses that accounted for differences in clinical measures of disease/tissue damage, self-reported disease/tissue damage, oral pain, and oral functional limitation, females were more likely to report disadvantage due to disease/tissue damage, and middle-aged persons and irregular dental attenders were more likely to report oral disadvantage due to pain. In these same regressions, differences in disadvantage due to race, poverty status, socioeconomic status, and rural/urban area of residence were not evident. These results have implications regarding the use of oral disadvantage to assess the long-term effectiveness of dental care.

Compliance after 17 years of breast cancer screening. Factors associated with reattendance for periodic breast screening

The motives and reasons for regular attendance, irregular attendance and drop-out were studied in women who were enrolled in a biennial breast screening programme in 1975 and who were invited to each subsequent screening round until 1992. Three compliance groups were compared: 'attended all rounds' (group A, n=79), 'missed 1 or 2 rounds' (group B, n=73) and 'missed more than 2 rounds' (group C, n=64). The groups did not differ with respect to background variables such as sociodemographic characteristics, actual health problems or preventive health orientations, but significant differences were found in general attitudes to breast screening and to the organizational aspects of screening procedures. The results suggest that during the course of a screening programme, for a substantial group of not strongly motivated women, the recurring negative aspects of mammography (pain and anxiety) are increasingly becoming a burden. 'Circumstantial factors' like waiting for one's turn, the distance to the screening centre and incidental dissatisfaction with handling by screening staff, appear to trigger the decision to skip screening rounds or to drop out of the programme. From the perspective of maintaining a regular attendance throughout the programme this is an important group. Special efforts must be made to encourage these women to stay in the programme.