Lower Dropout Rates Research Articles

How medical students perform academically by admission types?

Despite the importance of selecting students whom are capable for medical education and to become a good doctor, not enough studies have been done in the category. This study focused on analysing the medical students' academic performance (grade point average, GPA) differences, flunk and dropout rates by admission types. From 2004 to 2010, we gathered 369 Konyang University College of Medicine's students admission data and analyzed the differences between admission method and academic achievement, differences in failure and dropout rates. Analysis of variance (ANOVA), ordinary least square, and logistic regression were used. The rolling students showed higher academic achievement from year 1 to 3 than regular students (p < 0.01). Using admission type variable as control variable in multiple regression model similar results were shown. But unlike the results of ANOVA, GPA differences by admission types were shown not only in lower academic years but also in year 6 (p < 0.01). From the regression analysis of flunk and dropout rate by admission types, regular admission type students showed higher drop out rate than the rolling ones which demonstrates admission types gives significant effect on flunk or dropout rates in medical students (p < 0.01). The rolling admissions type students tend to show lower flunk rate and dropout rates and perform better academically. This implies selecting students primarily by Korean College Scholastic Ability Test does not guarantee their academic success in medical education. Thus we suggest a more in-depth comprehensive method of selecting students that are appropriate to individual medical school's educational goal.

Comparing Holographic Reprocessing and Prolonged Exposure for Women Veterans with Sexual Trauma: A Pilot Randomized Trial

This pilot study compares an emerging evidence-based treatment, holographic reprocessing (HR) to prolonged exposure (PE) versus a person-centered (PC) control group to treat symptoms of distress in female Veterans with sexual trauma. In contrast to PE, HR does not include exposure to a target event of trauma. Instead, HR focuses on healing the internal working model or type of attachment style that may form as a result of interpersonal trauma or maltreatment. The model reveals how people perceive themselves and others. These perceptions set in motion emotional, cognitive, and behavioral tendencies wherein people unconsciously replicate similar types of relationships that reinforce their worldview. Fifty-one female Veterans with sexual trauma were randomly assigned to one of three treatments and completed pre- and post-treatment measures of psychiatric symptoms (anxiety, depression, and PTSD) and post-traumatic cognitions. ANOVAs found significant decreases on all variables. Post-hoc comparisons revealed that HR and PE treatments demonstrated significantly greater decreases in symptoms compared to the PC control group. Chi square analyses revealed that HR produced a significantly lower dropout rate 1 (6 %) compared to PE 7 (41 %) and PC 6 (35 %). These initial results are promising and further investigation of HR is warranted.

Exploring the Association Between Erectile Rigidity and Treatment Adherence with Sildenafil

Erection hardness has been shown to correlate with increased self-confidence, sexual satisfaction, and improvement in psychosocial factors such as sexual and overall relationship. It is estimated that one-third of men using phosphodiesterase type 5 inhibitors (PDE5) cease use of medication after one prescription and one-half cease use by 6 months. This study was undertaken to explore the link between erection hardness and treatment adherence. Men presenting with erectile dysfunction (ED) who were candidates for PDE5 therapy constituted the study population. They were assessed at the baseline regarding their erectile function (EF) and rigidity using autoquestionnaires. Patients then received regular follow-up using the same assessment tools and were also asked about continued use of PDE5. The final patient assessment was conducted at a time point no sooner than 12 months after commencing PDE5. Multivariable analysis was conducted to define predictors of continued PDE5 use. Patients were assessed using the International Index of Erectile Function (IIEF) questionnaire and the Erection Hardness Score (EHS). Adherence was defined as continued use of PDE5 at least once per month. One hundred eighty-six men were analyzed. The mean age and the duration of ED were 61 ± 22 and 2.2 ± 2.9 years, respectively. Sixty-three percent were married or partnered. The mean partner age was 52 ± 8 years. Of the 186 patients, 32% had one vascular comorbidity, 34% had two vascular comorbidities, 26% had three vascular comorbidities, and 6% had ≥ 4 vascular comorbidities. All patients were treated with sildenafil and were sexually active. The mean time to end-of-treatment (EOT) interview and repeat completion of questionnaires was 17 ± 4 months. At the baseline, 26% were EHS 3 (mild ED), 42% were EHS 2 (moderate ED), and 32% were EHS 1 (severe ED). The mean baseline EF domain score was 14 ± 10, and at the EOT, it was 22 ± 5 (P < 0.01). At the follow-up interview, 4% were EHS 1, 12% were EHS 2, 28% were EHS 3, and 56% were EHS 4. Overall, 67% of the men continued to use PDE5 at follow-up. The distribution of patients continuing to use PDE5 after commencement was 15% of those achieving EHS 1, 30% for EHS 2, 66% for EHS 3, and 82% for EHS 4. Based on logistic regression analysis, the factors predictive of continued PDE5 use were being partnered, partner age, frequency of sexual activity, a shift of ≥ 2 points on the EHS, and reaching level 4 on the EHS scale. There is an excellent relationship between erection hardness and adherence to PDE5 treatment. Driving men to greater erectile rigidity appears to translate into lower dropout rates.

Efficacy of “seeking safety” in a Dutch population of traumatized substance-use disorder outpatients: study protocol of a randomized controlled trial

BackgroundTraumatic experiences and, more specifically, posttraumatic stress disorder (PTSD) are highly prevalent among substance use disorder (SUD) patients. This comorbidity is associated with worse treatment outcomes in substance use treatment programs and more crisis interventions. International guidelines advise an integrated approach to the treatment of trauma related problems and SUD. Seeking Safety is an integrated treatment program that was developed in the United States. The aim of the current study is to test the efficacy of this program in the Netherlands in an outpatient SUD population.Methods/DesignA randomized controlled trial (RCT) will be used to test the efficacy of Seeking Safety compared to Cognitive Behavioral Therapy (CBT) in a population of SUD outpatients. Each treatment will consist of 12 group sessions. The primary outcome measure will be substance use severity. Secondary outcome measures are PTSD and trauma symptoms, coping skills, functioning, and cognitions. Questionnaires will be administered at the start of treatment, at the end of treatment (three months after the start of treatment) and at follow-up (six months after the start of treatment).DiscussionThis study protocol presents a RCT in which the efficacy of an integrated treatment for comorbid PTSD and SUD, Seeking Safety, is evaluated in a SUD outpatient population compared to CBT. It is expected that the intervention group will show significantly more improvement in substance use severity compared to the control group at end-of-treatment and at follow-up. Furthermore, a lower drop-out rate is expected for the intervention group. If the intervention proves to be effective, it can be implemented. A cost-effectiveness analysis will be conducted to evaluate the two treatments.Trial registrationThe protocol for this study is registered with the Netherlands Trial Register with number NTR3084 and approved by the local medical ethical committee (METC\\11270.haa).

From boring to scoring – a collaborative serious game for learning and practicing mathematical logic for computer science education

In this study, we address the problem of low retention and high dropout rates of computer science university students in early semesters of the studies. Complex and high abstract mathematical learning materials have been identified as one reason for the dropout rate. In order to support the understanding and practicing of core mathematical concepts, we developed a game-based multitouch learning environment in which the need for a suitable learning environment for mathematical logic was combined with the ability to train cooperation and collaboration in a learning scenario. As application domain, the field of mathematical logic had been chosen. The development process was accomplished along three steps: First, ethnographic interviews were run with 12 students of computer science revealing typical problems with mathematical logic. Second, a multitouch learning environment was developed. The game consists of multiple learning and playing modes in which teams of students can collaborate or compete against each other. Finally, a twofold evaluation of the environment was carried out (user study and cognitive walk-through). Overall, the evaluation showed that the game environment was easy to use and rated as helpful: The chosen approach of a multiplayer game supporting competition, collaboration, and cooperation is perceived as motivating and “fun.”

Factors Related to Dropout From Treatment in Two Outpatient Treatments for Borderline Personality Disorder

Patients with borderline personality disorder frequently drop out prematurely from psychotherapy. This study examined factors related to treatment attrition in 180 patients enrolled in a randomized controlled trial comparing 1 year of Dialectical Behavior Therapy (DBT) to General Psychiatric Management (GPM). Completers and dropouts were compared on a range of variables, including demographics, Axis I and Axis II disorders, anger and impulsivity, therapeutic alliance, and treatment condition. The participants were on average 30.36 years old and 86% were female. Regression analyses revealed that individuals who dropped out had higher levels of anger (p = .01), greater Axis I comorbidity (p = .03), poorer therapeutic alliance (p = .003), and a higher number of lifetime suicide attempts (p = .05). An interaction was also found between Axis I comorbidity and treatment condition, with significantly lower rates of dropout seen in individuals with high Axis I comorbidity who were assigned to GPM compared to those assigned to DBT (p < .001).

Mindful Parenting in Mental Health Care: Effects on Parental and Child Psychopathology, Parental Stress, Parenting, Coparenting, and Marital Functioning

This study evaluated the acceptability and effects of a Mindful Parenting course in mental health care. Parents (n = 86) referred to secondary mental health care because of their children’s and/or their own psychopathology, or parent–child relationship problems, followed a Mindful Parenting course in a group format (10 groups). Assessments took place just before the course (pre-test), immediately after the nine-week course (post-test), and at 8-week follow-up. A waitlist assessment took place only for those parents who had to wait for a course (n = 23). Measures concerned parent report of psychopathology symptoms of their target child, as well as their own psychopathology symptoms, parental stress, parenting behaviors, coparenting, and marital functioning. Only one parent dropped out and parents evaluated the program as valuable and effective in many areas of family functioning. No improvement was reported during waitlist, except for an improvement in parental externalizing symptoms. Improvements after the course occurred in the target child’s internalizing and externalizing psychopathology symptoms, parents’ own internalizing symptoms and further improvement on their externalizing symptoms. Also, improvements occurred on parental stress, parenting, and coparenting, but not on marital functioning. Improvements were generally maintained at follow-up. In conclusion, the very low dropout rate as well as the positive evaluations, suggest that Mindful Parenting is an acceptable and feasible intervention in mental health care. Mindful Parenting appears a promising new intervention for parents in mental health care, as it seems effective on a broad range of child, parent, and family variables. Studies comparing Mindful Parenting to other effective interventions, such as Parent Management training, are needed to gain more knowledge about its relative and differential effectiveness.

The Influence of Profession and Therapy Type on the Treatment of Sexual Dysfunctions

Sexual dysfunctions are serious mental health issues that affect an estimated 1 in 3 Americans, yet many people with sexual dysfunctions do not seek treatment. Health services research on variables related to access, barriers, costs, and outcomes of treatment may help improve the quality of care. The current research is a retrospective analysis of administrative data from CIGNA that explores whether the type of profession (i.e., psychologist, social worker, marriage and family therapist, or professional counselor) or therapy modality (i.e., individual, conjoint, or mixed-mode, a combination of individual and conjoint therapy) influence the outcomes of mental health treatment. Participants included 230 men and 189 women between the ages of 18 to 101 years from all regions of the United States who received treatment for sexual disorders from 2001 to 2006. Results indicate that outcomes are similar across the different license types. Results also suggest that mixed-mode therapy has lower dropout rates and longer retention than individual or conjoint therapy. These results suggest that using a combination of relational and individual sessions may be beneficial for the treatment of sexual dysfunctions.

Obstetric and neonatal outcome after oocyte donation in 106 women with Turner syndrome: a Nordic cohort study

What are the obstetric and neonatal outcomes of deliveries after oocyte donation (OD) in women with Turner syndrome (TS)? Pregnancies among women with TS carry a substantial risk, particularly for hypertensive disorders. Potentially life-threatening complications occurred in 3.3% of pregnancies. The neonatal outcomes were generally reassuring, with similar rates of preterm birth and low birthweight (LBW) as after conventional IVF and better than previously reported in deliveries after OD in women with TS. OD pregnancies in women with TS are known to be high-risk pregnancies. This retrospective cohort study included 106 women with TS who delivered after OD (n = 122 deliveries, n = 131 newborns) in three Nordic countries (Finland, Denmark, Sweden) between 1992 and 2011. Women with TS who delivered after OD in three Nordic countries were identified (n = 110). Four women declined to participate or were lost to follow-up, thus 106 women were included in the study. The medical data from fertility clinics, antenatal clinics and the hospitals where the women had been treated and/or delivered were scrutinized. In this cohort, the karyotype was 45,X in 44% of the women with TS. Ten women (9.4%) had a known cardiac defect before pregnancy. Single embryo transfer was performed in 70.3% of the cases and the multiple birth rate was 7.4%. In total, 35.0% of the pregnancies were associated with a hypertensive disorder including pre-eclampsia in 20.5%. Potentially life-threatening complications occurred in four pregnancies (3.3%), including one woman with aortic dissection, one with mild regurgitation of the tricuspid and mitral valve, one with a mechanical heart valve who developed HELLP syndrome (haemolysis, elevated liver enzymes, low platelets) and one who underwent a post-partum hysterectomy due to severe haemorrhaging. Neonatal outcomes were reassuring, with a preterm birth rate of 8.0% and LBW rate of 8.8% in singletons. Major birth defects were found in 3.8% of the children. The perinatal mortality was 2.3% (3/131), including a set of extremely preterm twins. Although this study was performed over a period of almost 20 years in three different countries, with a low drop-out rate and little missing data, much larger series are needed to assess rare events. This study also lacks an appropriate control group. This study suggests that cardiovascular evaluation before and during pregnancy may contribute to favourable obstetric outcomes in many cases. Maternal outcomes were in agreement with the literature while neonatal outcomes were generally better than previously reported. The outcomes were consistent across the three countries, supporting generalizability to similar populations.

Academic and non-academic selection criteria in predicting medical school performance

Background: A two-step selection procedure, consisting of a non-academic and an academic step, was recently shown to select students with a 2.6 times lower risk of early dropout and a higher clerkship Grade Point Average (GPA) than lottery-admitted controls.Aim: To determine the relative contribution of the non-academic and academic steps to differences found in student performance.Method: Lottery-admitted students (n = 653) and three groups of selection procedure participants were compared on early dropout rate and clerkship GPA: (1) all participants (n = 1676), (2) participants who passed step 1, and (3) participants who passed step 2.Results: Selection procedure participation resulted in a 4.4% lower dropout rate than lottery admission and this difference increased to 5.2% after step 1 and to 8.7% after step 2. Clerkship GPA was significantly higher for participants who passed step 1 than for their lottery-admitted controls. This difference remained significant after the rejection of students on academic criteria in step 2.Conclusion: The lower dropout rate of selected students is related to both self-selection of participants before the start of the selection procedure and the academic part of the selection procedure. The higher clerkship GPA of selected students is almost exclusively related to the non-academic selection criteria.

Four-Year Follow-Up Study of Pharmacological Treatment in Pathological Gamblers

In the past decade, we have witnessed the emergence of pharmacological treatments for pathological gambling with some success but many question marks. We aimed to explore pharmacological treatments that have been previously explored with some success, with the intent of comparing their efficacy and pave the way to larger placebo-controlled trials. In this study, we allocated 78 patients to 4 different types of psychotropic medications: naltrexone, topiramate, bupropion, and escitalopram. We treated patients for more than 2 years, with additional 2-year follow-ups without medication. The sample was evaluated using the 21-item Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Global Assessment of Functioning, and the Visual Analog Scale to measure general well-being before enrollment as well as at 1 month, 6 months, 24 months, and 48 months after beginning medication treatment. During the first 2 years of treatment, 34 patients dropped out, with one more dropping out during the additional 2 years of follow-up. Significant improvement on all rating scales was seen in all groups after 2 years, except HAMD in the group that received topiramate. We found the naltrexone-treated group of patients to have a statistically significant lower dropout rate compared with other groups, statistically significant lower HAMD scores in comparison to the group treated with bupropion, statistically significant lower Hamilton Anxiety Rating Scale score compared to the groups treated with escitalopram and topiramate, and significantly higher Visual Analog Scale scores compared to the groups treated with bupropion and topiramate. Pathological gambling is essentially a biopsychological disorder that may be attenuated provided that patients adhere to medication. In our study, among 4 medications with different mechanisms of action, naltrexone was found to be the most effective. Placebo-controlled studies involving large numbers of subjects are required before naltrexone's efficacy can be established.

The Effectiveness of Educational Support to Orphans and Vulnerable Children in Tanzania and Uganda

Little evidence is available to assist policy makers and donors in deciding what kinds of programs in developing countries are more likely to be effective in supporting the entry and continuation of OVC in secondary schools. This is particularly important for females whose education has direct bearing on child mortality in the next generation. This study gathered four kinds of educational outcome measures in two East African countries ravaged by the AIDS/HIV pandemic. The goal was to determine whether direct scholarship aid to individual students versus various forms of block grants would be more effective in promoting lower rates of absenteeism, lower dropout rates, higher national examination scores, and higher pass rates for OVC of both genders. Insufficient evidence was available for recipients of scholarships, but OVC with block grant support performed as well or better than their non-OVC counterparts, and significantly better than OVC without support. Contrary to popular belief, girls had lower rates of absenteeism. There were no gender differences in dropout. However, boys consistently outperformed girls on academic tests. Insufficient data systems continue to impede more detailed analysis.

Newer antidepressants and panic disorder

Selective serotonin reuptake inhibitors and venlafaxine are currently considered as first-line agents for patients with panic disorder (PD). However, a systematic comparison of newer antidepressants for the treatment of PD is lacking thus far. Eligible studies focusing on PD patients treated with newer antidepressants were entered in the Cochrane Collaboration Review Manager. Our primary outcome measure was the mean change in panic symptoms from the baseline to the endpoint in patients treated with antidepressants as compared with those treated with placebo. Secondary outcome measures included the mean change in the overall anxiety scores and dropout rates. Sensitivity analyses were also carried out. Fifty studies focusing on 5236 patients were included. The following antidepressants were significantly superior to placebo for PD patients with the following increasing order of effectiveness: citalopram, sertraline, paroxetine, fluoxetine, and venlafaxine for panic symptoms and paroxetine, fluoxetine, fluvoxamine, citalopram, venlafaxine, and mirtazapine for overall anxiety symptoms. Aside from reboxetine and fluvoxamine, all drugs were associated with significantly lower dropout rates as compared with placebo. Several clinical variables moderated clinical outcomes. However, because of some inconsistencies across the studies and limited evidence for some drugs under investigation, further head-to-head comparisons are required.

Critical Challenges Of The South African School System

The emphasis in the new curriculum after 1996 in South Africa was placed on the transition from the traditional aims and objectives approach to Outcomes-based education (OBE) and Curriculum 2005. This paradigm shift was interpreted as a prerequisite for achievement of the vision of an internationally competitive country. When analysing the school system in South Africa it became clear that the education system was flawed, with poorly performing teachers, poor work ethics, lack of community and parental support, poor control by education authorities, poor support for teachers and very low levels of accountability. These factors further spilled over into the morale of learners and could be seen in the lack of discipline, brutal violence in schools, low moral values, truancy, absenteeism, late coming and high dropout rates from Grade 1 to Grade 12 and very poor performance in essential areas such as Mathematics and Literacy. Citizens in historically disadvantaged areas tend to become victims of poverty, gangs and drug abuse. These factors further blend with the evil of politics in South African schools which are furthermore plagued by various forms of corruption and socio-economic challenges. Eighteen years after the end of the apartheid dispensation, apartheid is still blamed by many for any real or imagined ills in society, but the reality is that there is no political will to enforce the law or to meet public expectations of accountability, efficiency and delivery. In the light hereof, recommendations are proposed that will address these challenges. The critical message of this article will convey that the fact of the matter is that learner enrolment is not the same as attendance and attendance does not imply learning. Therefore, teaching in South Africa must become a profession of preference and pride as opposed to the present very lackadaisical attitude.

Effect of study partner on the conduct of Alzheimer disease clinical trials

Alzheimer disease (AD) dementia clinical trials require 2 participants: a patient and a study partner. We assessed the prevalence of study partner types and how these types associate with patient-related outcome measures. Retrospective analyses of 6 Alzheimer's disease cooperative study (ADCS) randomized clinical trials were conducted. Study partners were categorized as spouse, adult child, or other. Prevalence of study partner type and associations between study partner type and trial outcomes including study completion and placebo decline on the mini-mental state examination, the Alzheimer's disease assessment scale-cognitive subscale, the clinical dementia rating scale sum of the boxes score, and the ADCS-activities of daily living were examined. More participants (67%) enrolled with spouses than adult children (26%) or other study partners (7%). Participants with spouse partners had a lower dropout rate (25%) than those with adult child (32%) or other study partners (34%); only the difference vs. others was statistically significant. Participants with adult child and other partners randomized to placebo performed worse at baseline than those with spouse partners on the ADCS-activities of daily living (p = 0.04), but were not different at 18 months. There were no differences at baseline for the mini-mental state examination, clinical dementia rating scale sum of the boxes score, or Alzheimer's disease assessment scale-cognitive subscale. In multivariate models of the rates of change over time among placebo participants, no differences among study partner groups reached statistical significance. Patients with nonspouse caregivers less frequently participate in AD dementia trials. Increased enrollment of AD patients with nonspouse caregivers may require additional recruitment and retention strategies.

Nutrition and physical activity programs for obesity treatment (PRONAF study): methodological approach of the project

BackgroundAt present, scientific consensus exists on the multifactorial etiopatogenia of obesity. Both professionals and researchers agree that treatment must also have a multifactorial approach, including diet, physical activity, pharmacology and/or surgical treatment. These two last ones should be reserved for those cases of morbid obesities or in case of failure of the previous ones. The aim of the PRONAF study is to determine what type of exercise combined with caloric restriction is the most appropriate to be included in overweigth and obesity intervention programs, and the aim of this paper is to describe the design and the evaluation methods used to carry out the PRONAF study.Methods/designOne-hundred nineteen overweight (46 males) and 120 obese (61 males) subjects aged 18–50 years were randomly assigned to a strength training group, an endurance training group, a combined strength + endurance training group or a diet and physical activity recommendations group. The intervention period was 22 weeks (in all cases 3 times/wk of training for 22 weeks and 2 weeks for pre and post evaluation). All subjects followed a hypocaloric diet (25-30% less energy intake than the daily energy expenditure estimated by accelerometry). 29–34% of the total energy intake came from fat, 14–20% from protein, and 50–55% from carbohydrates. The mayor outcome variables assesed were, biochemical and inflamatory markers, body composition, energy balance, physical fitness, nutritional habits, genetic profile and quality of life. 180 (75.3%) subjects finished the study, with a dropout rate of 24.7%. Dropout reasons included: personal reasons 17 (28.8%), low adherence to exercise 3 (5.1%), low adherence to diet 6 (10.2%), job change 6 (10.2%), and lost interest 27 (45.8%).DiscussionFeasibility of the study has been proven, with a low dropout rate which corresponds to the estimated sample size. Transfer of knowledge is foreseen as a spin-off, in order that overweight and obese subjects can benefit from the results. The aim is to transfer it to sports centres. Effectiveness on individual health-related parameter in order to determine the most effective training programme will be analysed in forthcoming publications.Trial registrationClinicalTrials.gov NCT01116856

Reporting participation rates in studies of non-pharmacological interventions for patients with chronic obstructive pulmonary disease: a systematic review

BackgroundPulmonary rehabilitation (PR) and self-management (SM) support programmes are effective in the management of patients with chronic obstructive pulmonary disease (COPD), but these interventions are not widely implemented in routine care. One reason may be poor patient participation and retention. We conducted a systematic review to determine a true estimate of participation and dropout rates in research studies of these interventions.MethodsStudies were identified from eight electronic databases including MEDLINE, UK Clinical Trial Register, Cochrane library, and reference lists of identified studies. Controlled clinical trial studies of structured SM, PR and health education (HE) programmes for COPD were included. Data extraction included ‘participant flow’ data using the Consolidated Standards of Reporting Trials (CONSORT) statement and its extension to pragmatic trials. Patient ‘participation rates’ (study participation rate (SPR), study dropout rate (SDR) and intervention dropout rate (IDR)) were calculated using prior participation definitions consistent with CONSORT. Random effects logistic regression analysis was conducted to examine effects of four key study characteristics (group vs. individual treatment, year of publication, study quality and exercise vs. non-exercise) on participation rates.ResultsFifty-six quantitative studies (51 randomised controlled trials, three quasi-experimental and two before-after studies) evaluated PR (n = 31), SM (n = 21) and HE (n = 4). Reports of participant flow were generally incomplete; ‘numbers of potential participants identified’ were only available for 16%, and ‘numbers assessed for eligibility’ for only 39% of studies. Although ‘numbers eligible’ were better reported (77%), we were unable to calculate SPR for 23% of studies. Overall we found ‘participation rates’ for studies (n = 43) were higher than previous reports; only 19% of studies had less than 50% SPR and just over one-third (34%) had a SPR of 100%; SDR and IDR were less than or equal to 30% for around 93% of studies. There was no evidence of effects of study characteristics on participation rates.ConclusionUnlike previous reports, we found high participation and low dropout rates in studies of PR or SM support for COPD. Previous studies adopted different participation definitions; some reported proportions without stating definitions clearly, obscuring whether proportions referred to the study or the intervention. Clear, uniform definitions of patient participation in studies are needed to better inform the wider implementation of effective interventions.

S112 Estimating Participation Rates of COPD Patients in Pulmonary Rehabilitation and Self-Management Programmes: The Importance of Defining Participation

Introduction and ObjectivesDelivery of pulmonary rehabilitation (PR) and self-management (SM) support programmes to patients living with chronic obstructive pulmonary disease (COPD) is emphasised in national guidelines, but these interventions are...

Therapeutic communities for drug addicts in Israel: comparing addicts born in the Former Soviet Union and in Israel

PurposeThe purpose of this paper is to focus on comparing background characteristics, self‐efficacy, and family support of immigrants from the Former Soviet Union (FSU) and of veteran Israelis who join therapeutic communities in Israel, and their adjustment to these communities. The aim of this research was to examine whether therapeutic communities are an appropriate rehabilitative setting for immigrants who come from a different cultural background.Design/methodology/approachThe study sample consisted of 213 people with addictions, who were being treated in therapeutic communities in Israel: 110 were Israeli‐born and 103 were immigrants from the FSU. The data in the present study are based on questionnaires, which the participants completed upon their arrival into the communities: socio‐demographic data; perceived self‐efficacy in resisting the temptation of drugs; and family support. The dropout rates from the therapeutic communities were also examined.FindingsThe findings indicate that the addicts who immigrated from the FSU had lower self‐efficacy in resisting high‐risk drug situations as well as lower levels of family support, whereas the dropout rate from the treatment program was considerably higher among the Israeli‐born participants.Originality/valueThe findings suggest that the therapeutic community is an appropriate setting for addicts from the FSU, and that they had a lower dropout rate than did the Israeli‐born addicts. Thus, the main value of this research is that it suggests that the communities are an appropriate rehabilitative setting for the immigrants.

The implementation of a community-based aerobic walking program for mild to moderate knee osteoarthritis (OA): a knowledge translation (KT) randomized controlled trial (RCT): Part I: The Uptake of the Ottawa Panel clinical practice guidelines (CPGs)

BackgroundThe implementation of evidence based clinical practice guidelines on self-management interventions to patients with chronic diseases is a complex process. A multifaceted strategy may offer an effective knowledge translation (KT) intervention to promote knowledge uptake and improve adherence in an effective walking program based on the Ottawa Panel Evidence Based Clinical Practice Guidelines among individuals with moderate osteoarthritis (OA).MethodsA single-blind, randomized control trial was conducted. Patients with mild to moderate (OA) of the knee (n=222) were randomized to one of three KT groups: 1) Walking and Behavioural intervention (WB) (18 males, 57 females) which included the supervised community-based aerobic walking program combined with a behavioural intervention and an educational pamphlet on the benefits of walking for OA; 2) Walking intervention (W) (24 males, 57 females) wherein participants only received the supervised community-based aerobic walking program intervention and the educational pamphlet; 3) Self-directed control (C) (32 males, 52 females) wherein participants only received the educational pamphlet. One-way analyses of variance were used to test for differences in quality of life, adherence, confidence, and clinical outcomes among the study groups at each 3 month assessment during the 12-month intervention period and 6-month follow-up period.ResultsShort-term program adherence was greater in WB compared to C (p<0.012) after 3 months. No statistical significance (p> 0.05) was observed for long-term adherence (6 to 12 months), and total adherence between the three groups. The three knowledge translation strategies demonstrated equivalent long-term results for the implementation of a walking program for older individuals with moderate OA. Lower dropout rates as well as higher retention rates were observed for WB at 12 and 18 months.ConclusionThe additional knowledge translation behavioural component facilitated the implementation of clinical practice guidelines on walking over a short-term period. More studies are needed to improve the long-term walking adherence or longer guidelines uptake on walking among participants with OA. Particular attention should be taken into account related to patient’s characteristic and preference. OA can be managed through the implementation of a walking program based on clinical practice guidelines in existing community-based walking clubs as well as at home with the minimal support of an exercise therapist or a trained volunteer.Trial RegistrationCurrent Controlled Trials IRSCTNO9193542