Lower Dropout Rates Research Articles

Antibiotic Clinic: Two Years' Experience in Outpatient Parenteral Antimicrobial Therapy in a Portuguese Hospital.

Outpatient antimicrobial therapy programs have been in place for more than four decades. They provide safe and effective treatment for a selected group of patients while reducing costs. In Europe in general, and in Portugal in particular, these programsare still a relatively new phenomenon. The aim of this study is to describe our center's two years' experience with such a program(Antibiotic Clinic). The cohort of treatments administered by the Antibiotic Clinic in its first two years of existence (September 12th2016 to September 11th 2018) was analyzed and data pertaining to patients, infections, infectious agents, antimicrobials and outcomes(infection resolution, adverse events and death) were characterized. The Antibiotic Clinic treated 231 patients in 250 episodes, providing a total of 2357 days of antibiotic treatment. The urinarytract was the most common site (39.2%) and Enterobacteriaceae the most common agents (63.7% of isolates). Infections were resolved in 90.8% of treatments (95.6% of patients), adverse events were few (1.2%) and direct mortality was not found. The dropoutrate was 1.6%. Infection resolution and adverse event rates were comparable to other centers. High treatment and low dropout rates pointto high physician and patient acceptance. Our experience with this program suggests it is a safe and effective alternative to inpatient admission. This is in line withcurrent literature which suggests efforts should be made to expand this treatment modality.

The Feasibility and Efficacy of Social Cognition and Interaction Training for Outpatients With Schizophrenia in Japan: A Multicenter Randomized Clinical Trial.

Background: Schizophrenia is a disabling illness. Social cognition and interaction training (SCIT) seeks to improve patients’ social functioning by alleviating deficits in social cognition. SCIT has shown promise in improving social cognition in patients with schizophrenia, but has not yet been studied in Japan. Design: An assessor-masked, randomized, parallel-group clinical trial was conducted to compare the feasibility and efficacy of SCIT with treatment as usual (TAU). Setting: Participants were recruited from outpatient clinics at the National Center of Neurology and Psychiatry and four other hospitals in Japan. Participants: Seventy-two patients diagnosed with schizophrenia or schizoaffective disorder consented to participate in the trial. Procedure: Participants were randomly allocated to either a SCIT subgroup or a TAU subgroup. SCIT is a manual-based group intervention that is delivered in 20–24-h-long weekly sessions. Groups include two to three clinicians and four to eight patients. Hypotheses: We hypothesized that SCIT would be found to be feasible and that patients who were randomized to receive SCIT would exhibit improvements in social cognition. Results: Data from 32 participants in each subgroup were entered into analyses. The persistence rate in the SCIT subgroup was 88.9%, and the average attendance rate was 87.0%. Intrinsic motivation was significantly higher in the SCIT subgroup than the TAU group during the first half of the program. Mixed effects modeling of various outcome measures revealed no significant interaction between measurement timepoint and group in any measures, including social cognition, neurocognition, symptom severity, and social functioning. In the case of the social cognition measure, significant change was observed only in the SCIT subgroup; however, the interaction between timepoint and group failed to reach significance. In an exploratory subgroup analysis, a shorter duration of illness was found to be associated with significantly better improvement on the social cognition measure in the SCIT subgroup compared with the TAU subgroup. Conclusions: In terms of the primary objective, the relatively low dropout rate observed in the present study suggests that SCIT is feasible and well tolerated by patients with schizophrenia in Japan. This view is also supported by participants’ relatively high attendance and intrinsic motivation.

Treatment of hepatitis C infection among Egyptian hemodialysis patients: the dream becomes a reality.

New direct-acting antiviral drugs have become the corner-stone treatment for HCV infection: they show promising results with accepted side-effects and low dropout rates. One of the available regimens is paritaprevir/ombitasvir/ritonavir (PTV/OMV/RTV). Our aim was to study the efficacy and safety of this drug regimen among HCV-positive hemodialysis patients. This prospective single-center study was performed in the Urology and Nephrology Center, Mansoura University, Egypt. Ninety-six maintenance hemodialysis patients were screened for HCV antibodies. Positive results were found in 46 patients (47.9%). HCV PCR was assessed in all HCV-antibody-positive patients; positive results were found positive for 38 (82%); all patients were HCV genotype 4. Four patients were excluded due to advanced liver cirrhosis, liver malignancy, or metastatic breast cancer. Thirty-four patients were prescribed PTV/OMV/RTV for 3months to treat HCV. Mean age was 43.2 ± 11.9years. Most patients were male (67.6%). There was a rapid response to treatment: HCV PCR became negative by 4weeks after starting treatment. By 12 and 24weeks post-DAA therapy, there was a sustained viral response (SVR 12, SVR 24) in 100% of patients with improved liver-enzyme levels. The PTV/OMV/RTV regimen was safe and effectively treated Egyptian HCV-positive genotype-4 hemodialysis patients.

Consideration of sample source for establishing reliable genetic microsatellite data from mammalian carnivore specimens held in natural history collections

AbstractSpecimens from natural history collections (NHCs) are increasingly being used for genetic studies and can provide information on extinct populations, facilitate comparisons of historical and contemporary populations, produce baseline data before environmental changes, and elucidate patterns of change. Destructive sampling for DNA may be in disagreement with NHC goals of long-term care and maintenance. Differentiating quality among sample sources can direct destructive sampling to the source predicted to yield the highest quality DNA and most reliable data, potentially reducing damage to specimens, laboratory costs, and genotyping errors. We used the kit fox (Vulpes macrotis) as a model species and evaluated the quality and reliability of genetic data obtained from carnivoran specimens via three different sample sources: cranial bones, nasal bones, and toepads. We quantified variation in microsatellite amplification success and genotyping error rates and assessed the reliability of source-specific genic data. Toepads had the highest amplification success rates and lowest genotyping error rates. Shorter loci had higher amplification success and lower allelic dropout rates than longer loci. There were substantial differences in the reliability of resulting multilocus genotypes. Toepads produced the most reliable data, required the fewest replicates, and therefore, had the lowest costs to achieve reliable data. Our results demonstrate that the quality of DNA obtained from specimens varies by sample source and can inform NHCs when evaluating requests for destructive sampling. Our results suggest that prior to large-scale specimen sampling, researchers should conduct pilot studies to differentiate among source-specific data reliability, identify high performing loci, reduce costs of analyses, and minimize destructive sampling.

High-Protein Diets for Treatment of Type 2 Diabetes Mellitus: A Systematic Review

Diet has the potential to be a powerful and cost-effective tool for treatment of type 2 diabetes mellitus (T2D). High-protein diets have shown promise for this purpose. The objective of this systematic review was to evaluate whether high-protein diets improve glycemic outcomes in people with T2D. We conducted a systematic search of literature published prior to 1 February 2018 to find clinical studies of high-protein diet patterns for treatment of T2D in human participants. A high-protein diet was defined as a diet with protein content greater than that of a typical diet in the United States (>16% of total energy as protein). Studies were excluded if weight loss >5% occurred or if no glycemic outcomes were measured. A total of 21 independent articles met our criteria and were included. Most tested diets had a protein content of around 30% of total energy. Many studies supported the use of high-protein diets for patients with T2D, but were limited by small size (n = 8-32) and short duration (1-24 wk). Randomized controlled trials tended to be larger (n = 12-419) and longer (6 wk-2 y), and had mixed results, with many trials showing no difference between a high-protein diet and control. Many randomized controlled trials were limited by low compliance and high dropout rates >15%. There were no consistent beneficial or detrimental effects of high-protein diets on renal or cardiovascular outcomes. Evidence was insufficient to recommend 1 type of protein (plant or animal) over the other. Our review suggests that interventions to improve compliance with diet change over the long term may be equally important as specific macronutrient recommendations for treatment of T2D.

Does User Choice of Device Impact the Results of Online Surveys?

This article investigates how and to what extent the data collected, the dropout rate, and the completion time in online surveys is influenced by the device used to fill out the questionnaire. To that end, an extensive online study with N=1493 was carried out. To address difficulties associated with the use of devices with smaller displays, different layout variants aimed at optimizing questionnaire usability for smartphones were developed and analyzed. Completion time, drop-out rate, and response patterns were compared across different display sizes and layout variants. Results show significantly lower completion times and drop-out rates when the questionnaire was answered on a larger display. Also, different answering patterns emerged among participants using mobile devices. Likewise, the study revealed effects of different questionnaire layouts. The authors discuss implications for the design of online questionnaire in order to obtain reliable data from online surveys.

Comparison of DBT Skills Groups with and without Animal-Assistance for Incarcerated Women with Self-Harm Histories

ABSTRACT Females are being incarcerated at a growing rate and present management and treatment challenges for correctional and security personnel. The sample included incarcerated women with self-harm histories (n = 35) who were randomly assigned to dialectical behavior therapy skills groups with or without animal-assistance. Pre- and post-test measures of self-harm and coping were obtained. There was a significant (p = .019) decrease in the instances of self-injury in the animal-assisted group. Additionally, the animal-assisted groups had significant (p < .05) decreases in three maladaptive coping strategies whereas the non-animal- assisted groups had a significant decrease (p < .05) in only one coping strategy. The animal-assisted groups also had much lower dropout rates and better attendance.

Simulation of the leaky pipeline: Gender diversity in U.S. K-graduate education

ABSTRACT What is the future trend of gender (dis)parity in the U.S. higher education and workforce populations? I take a systems approach to develop a dynamic simulation model of gender diversity in U.S. higher education. The model consists of an education pipeline for males and females and includes several mechanisms that reinforce interest in higher education or affect university admission or dropout rates. I simulated a model and examined its fidelity in replicating the historical data of U.S. higher education from 1970 to 2014. I then simulated the model to forecast future gender composition trends at different levels of education over the next two decades. The model forecasts that women will be the majority of university degree holders in the United States by 2035 (i.e., female to male ratio of 1.7 for advanced degrees) with lower dropout rates. Additionally, a discussion is provided on the study’s findings and subsequent implications.

Project-led-education experience as a partial strategy in first years of engineering courses

Recently, there has been a growing tendency to substitute or supplement teacher-centered strategies for others student-centered. These include problem-based learning or collaborative learning. In certain areas, such as engineering, project-led learning collects some of the benefits of problem-based learning and integrates others that are of interest to the formation of engineers. More recently, project-led education as an integral strategy has been demonstrated in several European universities with impressive results. Students have a lower dropout rate, a lower period of adaptation to professional practice and better soft skills. While this implementation requires a general model change, at least at the faculty level, partial strategies applied in specific courses could pick up some of the positive aspects of these methodologies. In this paper, obtained results in a second-year Unit Operations course (grade of bioengineering) by applying this type of partial strategies are discussed. The student’s acceptance was good, and both motivation and academic results improved significantly. It was observed a deeper and wider knowledge acquisition in the students. Teacher’s workload increased, although, as there was a maximum of 25 students, it was manageable. It was concluded that transition from traditional to project-led learning strategies can be done within a subject without an educational model change at faculty or university level.

Brief novel therapies for PTSD: Written Exposure Therapy.

Written Exposure Therapy (WET) is a 5-session exposure-based intervention for the treatment of posttraumatic stress disorder (PTSD). WET was developed through a series of systematic evaluations of the expressive writing procedure. It is an efficient intervention, requiring limited patient and therapist time and no between-session assignments. The treatment results in statistically and clinically significant symptom change among individuals, including veterans, with PTSD. WET has been shown to be non-inferior to Cognitive Processing Therapy (CPT), a more intensive form of PTSD treatment. Additionally, WET resulted in substantially lower rates of treatment dropout compared to CPT (6% versus 39%). Moderator analyses of the rate of symptom change during treatment indicated that WET performed equally well for participants regardless of age, gender, comorbid depression, or estimated full scale IQ. WET represents a viable option for the efficacious, brief treatment of PTSD and may have significant strengths compared to other manualized psychotherapeutic approaches.

Comparative efficacy and acceptability of disease-modifying therapies in patients with relapsing-remitting multiple sclerosis: a systematic review and network meta-analysis.

Multiple sclerosis (MS) is an autoimmune, demyelinating disease of the central nervous system. The treatment of MS has always been a focus of neurological research. To date, the US Food and Drug Administration has approved 15 medications for modifying the course of multiple sclerosis. In this study, we examined the effects of disease-modifying therapies (DMTs) on clinical outcomes. We did a systematic review and network meta-analysis based on randomized controlled trials (RCTs) comparing DMTs in patients with relapsing-remitting multiple sclerosis (RRMS). We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for RCTs published up to Oct 31, 2018. The primary outcome was efficacy (relapse rate over 24months) and acceptability (treatment discontinuation due to adverse events over 24months). We identified 23 suitable trials encompassing 14,096 participants. During the 2years of follow-up, all drugs were significantly more effective than were placebos. The risk ratios with 95% credible intervals were as follows: alemtuzumab, 0.49 (0.40, 0.59); ocrelizumab, 0.49 (0.40, 0.61); mitoxantrone, 0.47 (0.27, 0.80); natalizumab, 0.51 (0.43, 0.61); fingolimod, 0.57 (0.50, 0.65); peginterferon beta-1a, 0.63 (0.52, 0.77); dimethyl fumarate, 0.65 (0.56, 0.74); teriflunomide 14mg, 0.78 (0.66, 0.92); glatiramer acetate, 0.80 (0.72, 0.89); IFN β-1a (Rebif), 0.81 (0.72, 0.90); IFN β-1b (Betaseron), 0.81 (0.72, 0.91); teriflunomide 7mg, 0.83 (0.71, 0.98); and IFN β-1a (Avonex). 0.87 (0.77, 0.99). Risk ratios compared with placebo for discontinuation due to adverse events ranged from 1.12 for the best drug (fingolimod) to 0.10 for the worst drug (mitoxantrone); from 0.24 (alemtuzumab) to 0.89 (IFNβ-1b [Betaseron]) for sustained (3-month) disability progression; and from 0.85 (natalizumab) to 1.25 (teriflunomide 14mg) for the number of participants with serious adverse events. All DMTs were superior to placebo in reducing the relapse rate during the 2years of follow-up. As to the comparison between drugs, alemtuzumab, ocrelizumab, natalizumab and fingolimod had a relatively higher response and lower dropout rates than did the other DMTs.

Smartphone app helps improve tuberculosis treatment

Video-observed therapy (VOT) improves adherence to tuberculosis (TB) treatment, has a lower dropout rate and costs less than directly observed treatment (DOT), research has found.

Prevalence and predictors of dropout from high-intensity interval training in sedentary individuals: A meta-analysis.

Recent evidence suggests that high-intensity interval training (HIIT) is an effective method to improve fitness and various health markers. However, the tolerability and acceptability of HIIT among sedentary individuals is currently controversially discussed. Therefore, our objective was to investigate the prevalence and predictors of dropout among sedentary individuals in HIIT-based exercise interventions. MEDLINE/PubMed, SPORTDiscus, and Web of Science were searched systematically for relevant articles until 06/2018. Studies included were required to (a) be written in English, (b) include sedentary healthy adults, (c) use some form of HIIT without any complementary intervention, (d) last ≥4weeks, (e) report detailed description of the applied HIIT protocol, and (f) report data that allow calculation of a dropout rate. Fifty-five studies reporting results from 67 HIIT interventions with 1318 participants met the eligibility criteria. The trim and fill adjusted pooled dropout rate across all interventions was 17.6% (95% confidence interval 14.2-21.5%). Dropout rates were significantly lower in cycling-based interventions compared with studies using running/walking as exercise modality (P<0.001). Longer session time (β=0.02, P<0.05), higher time effort/week (β=0.005, P<0.05), and overall time effort/intervention (β=0.0003, P<0.05) predicted greater dropout. Exercise intensity was not related to dropout. Our data suggest that HIIT-based interventions are tolerable and acceptable for previously sedentary individuals, exhibiting generally lower dropout rates than commonly reported for traditional exercise programs. Given the association between HIIT volume and dropouts, future studies should further focus on identifying the minimally effective dose of practical HIIT for improving health status. Such efforts would be important to increase implementation and public health impact of HIIT.

Institutional Efficiency of Faculty of Education from the Perspective of New Taxonomy

This article, in the background of discourse on justification of the FoE, opines restructuring and strengthening the FoE with the empirical evidences and theoretical support. It begins with the problematic situation of low pass and high dropout rate in bachelor degree in Gorkha Campus and hopeful situation of research degree in Graduate School of Education Tribhuvan University and ends with the suggestion of needs of career counseling for admitting the students in higher education in colleges. Between start and end, it revolves around the theoretical model of New Taxonomy that claimslearner's cognition is highly influenced with one's meta-cognitive skills and that is guided with one's self-system as chain effect. It talks cognition, meta-cognition, and self-system of: a) undergraduate students that were already researched and one was published in article form and another was submitted as research report; and b) research degree level students with three cases. Article, with meta-synthesis method blends the poor performing learning process of undergraduate students with rich performing learning process of research degree level students to explain the learners' role in learning and institutional responsibility.

Design of a randomized superiority trial of a brief couple treatment for PTSD.

Interpersonal difficulties are common among veterans with posttraumatic stress disorder (PTSD) and are associated with poorer treatment response. Treatment outcomes for PTSD, including relationship functioning, improve when partners are included and engaged in the therapy process. Cognitive-behavioral conjoint therapy for PTSD (CBCT) is a manualized 15-session intervention designed for couples in which one partner has PTSD. CBCT was developed specifically to treat PTSD, engage a partner in treatment, and improve interpersonal functioning. However, recent research suggests that an abbreviated CBCT protocol may lead to sufficient gains in PTSD and relationship functioning, and yield lower dropout rates. Likewise, many veterans report a preference for receiving psychological treatments through clinical videoteleconferencing (CVT) rather than traditional face-to-face modalities that require travel to VA clinics. This manuscript describes the development and implementation of a novel randomized controlled trial (RCT) that examines the efficacy of an abbreviated 8-session version of CBCT (“brief CBCT,” or B-CBCT), and compares the efficacy of this intervention delivered via CVT to traditional in-person platforms. Veterans and their partners were randomized to receive B-CBCT in a traditional Veterans Affairs office-based setting (B-CBCT-Office), CBCT through CVT with the veteran and partner at home (B-CBCT-Home), or an in office-delivered, couple-based psychoeducation control condition (PTSD Family Education). This study is the first RCT designed to investigate the delivery of B-CBCT specifically to veterans with PTSD and their partners, as well as to examine the delivery of B-CBCT over a CVT modality; findings could increase access to care to veterans with PTSD and their partners.

The synergistic benefits of physical and cognitive exercise in schizophrenia: Promoting motivation to enhance community effectiveness

Emerging research highlights the potential cognitive benefits of physical exercise (PE) programs for schizophrenia (SCZ). The few recent efficacy studies that examined augmenting cognitive training (CT) with PE suggest superior effects of the combination. The next step is to consider strategies to enhance adherence in real-world settings if this type of combined treatment is going to be effective. We present the first community effectiveness data for PE and CT that included a motivationally-enhancing, self-determined approach to exercise, in lieu of participant payment. Eighty-five outpatients with schizophrenia attending an intensive outpatient program were randomized to 18 h of either (A) self-determined PE regimen with choice from a menu of different activities; (B) tablet-based neurofeedback CT focused on processing speed (PS) and working memory (WM), or (C) a time-matched combination of PE and CT. Assessments were conducted at baseline, post, and follow-up (2 mo). All groups improved in WM from baseline to post, with greatest gains in the PE only group. At follow-up, cognitive gains originally observed in the PE-only group disappeared, while the PE + CT group evidenced improvements in WM and psychotic symptoms. Notably, attrition for PE was only 7%. Our data shows that combining PE and CT leads to lasting effects that are superior to those of either intervention alone. The low PE drop-out rate suggests a self-determined approach to the exercise regimen was tolerable, and may be an important component of future community implementation efforts.

Nocebo effect in myasthenia gravis: systematic review and meta-analysis of placebo-controlled clinical trials.

Nocebo refers to the adverse events (AEs) experienced when taking a placebo drug and is believed to be a centrally mediated process. We sought to examine the AEs following placebo administration in Randomised Controlled Trials (RCTs) for Myasthenia Gravis (MG) patients. A systematic literature search was performed on Medline and Web of Science for RCTs for MG pharmacological treatments. We assessed the number of placebo-treated patients reporting at least one AE and the number of dropouts because of AEs. Data were extracted from six RCTs fulfilling the search criteria. Four out of five placebo-treated participants (80.1%) reported at least one AE and one in 40 (2.4%) discontinued placebo treatment because of AE. All patients participating in the MG trials reported similar AEs independent of the study arm to which they belonged (placebo or active treatment). This meta-analysis demonstrates a low nocebo dropout rate in MG compared to central nervous system disorders.

Effects of Educational Fundings on Retention and Dropout of Students in Public Secondary Schools in Seme Sub-County, Kenya

Kenya government has initiated a number of education investment fundings such as Free Tuition Secondary Education, Constituency Development Fund and District Education Board Bursary in secondary schools in an attempt to promote retention and reduce dropout rate among the students. However,the national dropout rate of students in secondary schools in Kenya was 42,272 (7.8 percent) and retention rate was 419,608 (76.7 percent). In Seme Sub-County, the proportion of 16 and 17 year old without access to education was 2,257 (9.1 percent) of the total number of secondary school going age 5,883 (26.1 percent) dropped out without completing secondary school. The purpose of this study was determine retention and drop-out rate of students in public secondary schools in Seme Sub County. The study adopted descriptive survey research design. All the thirty (30) public secondary schools in the Seme Sub-County were included in the study. The study found that there was high retention rate among the students and low dropout rate because of the availability of various government education educational funding’s. Similarly, the number of students who dropped out of school due to lack of school fees between 2009 to 2013 had dropped, with most of the school principals registering less than 25% of dropout rate. Keywords: Bursary; Funding’s: Dropouts rates; Retention Rates DOI : 10.7176/JEP/10-12-12 Publication date : April 30 th 2019

Comparative Study SPOC vs. MOOC for Socio-Technical Contents from Usability and User Satisfaction

According to literature, usability and user satisfaction directly influence learning achievement. However, few studies address those elements in MOOCs (massive open online courses). Relevant questions such as “Are drop-out rates similar between SPOCs (small private open courses) and MOOCs?” and “Are there significant usability and satisfaction differences between both formats?” may help improve initiatives and dissemination policies regarding open knowledge. This study aims to upgrade guidelines for the conversion of SPOCs into MOOCs, by exploring usability and satisfaction in both formats. A quantitative research based on a questionnaire was designed, and the validated SUSE (Satisfaction and Usability of Software in Education) instrument was applied to 7 courses of each type, with the same contents, and 5,192 students. The results revealed validity and reliability, with higher satisfaction scores on the open platform. Genders, regions of residence, and age groups also provided interesting findings: students are predominantly male, young, and from diverse geographic locations. Women, the younger, and residents of economically disadvantaged regions evaluated their experiences more positively. Both formats present significantly lower dropout rates (47.50% in MOOCs and 36.94% in SPOCs) and higher completion rates (52.50% in MOOCs and 63.06% in SPOCs) compared to those generally observed in free enrollment courses.

From the Editor’s desk…: April 2019

From the Editor’s desk…: April 2019