Reasons For Dropout Research Articles

Dropout rates and reasons for dropout among patients receiving clozapine.

The present study aimed to assess the treatment dropout rates, reasons for treatment dropout, and clozapine discontinuation rate among patients attending a tertiary care center in North India. Clozapine data bank was used to identify patients on clozapine, and their treatment records were reviewed for the period Jan 2020-March 2020. Patients who did not follow-up at least once in the last 6 months were considered to have dropped out and were contacted telephonically to understand the reasons for dropout. Treatment records of those following up regularly were reviewed to check if clozapine was discontinued and if so, the reason for the same was evaluated. Out of 671 patients on clozapine, 495 (73.8%) were still on regular follow-up and the remaining 176 (26.2%) had dropped out of treatment. Out of the 176 patients who had dropped out of treatment, 84 could be contacted. Common reasons for dropout were long distance from the hospital (n = 27), long waiting time for consultation (n = 8), no benefit with treatment (n = 17), side effects with medication (n = 10), moving away to another place (n = 6), refusal by the patient to follow-up (n = 7), patient improved and so did not feel the need to continue treatment (n = 7), and other reasons (n = 37). About one-fourth of patients who had started treatment with clozapine dropped out from the treatment. The most common reasons for dropout from treatment included long distance from the hospital and no benefit from treatment.

Characteristics of women attending a phase 3 cardiovascular rehabilitation program: is there a need for a more tailored intervention?

Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiovascular disease (CVD) remains the main reason for mortality in women, however there are well identified discrepancies between men and women attending cardiovascular rehabilitation (CR) programs. Men are usually more referred and have higher adherence to CR programs than women. Understanding the characteristics of women attending long-term CR programs might be useful to better adapt and motivate future women with CVD to adhere in a higher scale. Purpose To describe characteristics of women with CVD attending a long-term phase III CR program and to compare with men the attendance rates and chosen exercise modality preferences. Methods Patients with CVD in a phase III long-term CR program were screened for the following assessments: 1) cardiorespiratory fitness through cardiopulmonary exercise testing; 2) body mass index (BMI); 3) physical activity (accelerometery); 4) social, demographic variables (questionnaires); 5) attendance rates (sessions attended/sessions planned) and dropout. When admitted, CVD patients chose to attend either the supervised exercise phase III CR sessions in a face-to-face model or an online model, and if they wanted to attend 2x or 3x/week. Chi-square and independent-samples Mann-Whitney U test was used. Results From the 206 CVD patients assessed, 19.9% were women (n=41, mean age 61 ± 11 years, 70.7% coronary artery disease, 53.7% married, 73.2% higher education, 43.9% retired, 39% working full time). From the 41 women screened, 39 enrolled the CR program and 17.9% dropped out before 12 months of program completion (4 women dropped before 6 month of program completion). The main reason of dropout was due to work/CR sessions conciliation. When asked to select the exercise modality, 56.4% chose the 3x/week face-to-face model, 28.2% the 2x/week face-to-face model and 15.4% the online model. When compared to men, women tend to choose the online modality and the 2x/week face-to-face model more than men (x2= 9.298; df=2; p=0.010). Regarding baseline assessments, 63.4% of women completed the assessment for cardiorespiratory fitness (VO²peak=17.11 ± 3.71 ml/kg/min), 80.5% for BMI (29.17 ± 5.58 kg/m²) and 78% for physical activity (38.55 ± 23.88 min/day of moderate to vigorous physical activity). When comparing attendance at 6 months, women have significantly lower attendance rates than men (56.87 ± 2.86% vs 70.24 ± 1.63%, p=0.001). Conclusion The low sample of women, compared to men, in this CR program, their characteristics, types of session modalities chosen, and lower attendance rates suggests that changes in long-term phase III CR programs are needed to tackle this disparity. Individualized and personalized strategies should be created targeting this population according to their needs, motivations and characteristics. A women-tailored phase III long-term CR program, with different session modalities and schedules, might be the future path to undertake.

Student Dropout Prediction for University with High Precision and Recall

Since a high dropout rate for university students is a significant risk to local communities and countries, a dropout prediction model using machine learning is an active research domain to prevent students from dropping out. However, it is challenging to fulfill the needs of consulting institutes and the office of academic affairs. To the consulting institute, the accuracy in the prediction is of the utmost importance; to the offices of academic affairs and other offices, the reason for dropping out is essential. This paper proposes a Student Dropout Prediction (SDP) system, a hybrid model to predict the students who are about to drop out of the university. The model tries to increase the dropout precision and the dropout recall rate in predicting the dropouts. We then analyzed the reason for dropping out by compressing the feature set with PCA and applying K-means clustering to the compressed feature set. The SDP system showed a precision value of 0.963, which is 0.093 higher than the highest-precision model of the existing works. The dropout recall and F1 scores, 0.766 and 0.808, respectively, were also better than those of gradient boosting by 0.117 and 0.011, making them the highest among the existing works; Then, we classified the reasons for dropping out into four categories: “Employed”, “Did Not Register”, “Personal Issue”, and “Admitted to Other University.” The dropout precision of “Admitted to Other University” was the highest, at 0.672. In post-verification, the SDP system increased counseling efficiency by accurately predicting dropouts with high dropout precision in the “High-Risk” group while including more dropouts in total dropouts. In addition, by predicting the reasons for dropouts and presenting guidelines to each department, the students could receive personalized counseling.

Investigating behavioral patterns of procrastinators in a Wiki-based activity.

Procrastination is one of the issues affecting more than half of the student population and is known to impact them negatively. It is also one of the major reasons for failure and dropout. Therefore, several studies have been conducted in this domain to understand when and why students procrastinate. The existing studies use self-reported procrastination scales and/or digital traces of student interactions recorded in learning environments to identify procrastination behavior. The majority of the extant studies leverage individual tasks such as assignments submission, quizzes attempted, course materials assessed by a student, etc., to study such behavior. This paper uses group-based collaborative wiki activity to explore the procrastination behavior among the students. This study will help us explore student behavior in a group activity. The results would help us investigate if the student's behavior changes when it comes to a group activity. The results would be beneficial for instructors, practitioners, and educational researchers to know if group activity could be utilized to overcome procrastination behavior.

Factors Associated with Dropout from Community Mental Health Clinic in Chandigarh during COVID-19 Pandemic

Background: Dropout of patients with mental illness is high. There is inadequate research on dropout of patient with mental illness from community mental health clinics. Aim: The aim of the study was to assess the dropout rate from three community mental health clinics and evaluate factors associated with dropout in relation to the patient, caregivers, community clinics, and COVID-19 pandemic. Methods: Patients aged 18 years and above registered in community outreach clinics (COC) from March 24, 2018, to March 23, 2020, i.e., before the lockdown, for treatment of mental illnesses including substance use disorders (SUDs) were included in the study. Responses on factors associated with dropout were collected on predesigned questionnaire telephonically after resumption of regular clinics. Results: A total of 5450 patients were registered at COCs. Neurotic and anxiety disorders, SUDs, and bipolar affective disorders were the common diagnoses. The dropout rate was 21%. Sixteen percent of patients did not perceive the need to continue treatment against 84% who felt the need for treatment. However, 87% already felt improvement with treatment. Thirty percent of patients were concerned about side effects of medicine and 52% expressed difficulty to purchase medicines from market, in case of nonavailability of free medicines. Forty-nine percent of patients reported fear of contracting COVID-19 infection as the reason for dropout postlockdown. Conclusion: Fear of contracting COVID-19, compulsory testing, and quarantine was the reasons for dropout attributable to the pandemic. Patients-related and medication-related factors were other major reasons for dropout.

A STUDY OFSOCIODEMOGRAPHIC, CULTURAL, ECONOMIC AND PSYCHOLOGICAL CHARACTERISTICSASSOCIATED WITHADOLESCENT PREGNANCYFROM TEA GARDEN COMMUNITY OF SIVASAGAR, ASSAM:CROSS-SECTIONAL SURVEY

Introduction: The World Health Organization (W.H.O), defines adolescence as the period of life between 10 to 19 years (1). Early marriage a hidden, yet known practice in several regions of the world has been a major public health threat where the girl experiences number of health, social, economic, and emotional problems in the form of adolescent pregnancy, synonymously termed teenage pregnancy. Methodology: A descriptive community-based cross-sectional study was conducted in a tea garden community of Sivsagar district from February 2020 to May 2020. Sample size was estimated at 282. Data was collected using pre-designed and pre-tested questionnaire. Variables like socio-demographic characteristics, income of the participant and family members, family size and school drop-out reason were analysed using descriptive statistics. Results and Discussion: In the present study, out of total of 330 eligible participants selected randomly from 12 Tea estates of Sivasagar district, 15.45 % of them were under the age group of 11-16 years and 84.55% belonged from 17-19 years. 82 % were from Other Backward Class, while rest only 18 %. The mental health status shows that out of 330 participants, 41, 91 and 8 had “extremely severe” signs of depression, anxiety and stress respectively. Conclusion: This study reflects adolescent pregnancy as a threat to society and demands a thorough exploration. Despite government schemes and legislations, it continues to be prevalent in community.

Systematic Review of the Effectiveness of Complementary and Alternative Medicine on Nausea and Vomiting in Children With Cancer.

Nausea and vomiting are distressing symptoms reported by pediatric oncology patients during cancer treatment. More than 40% of them experience these symptoms even after receiving antiemetics. Given the limitations of pharmacological interventions, this systematic review synthesized the evidence for the effectiveness of complementary and alternative medicine in controlling nausea and vomiting among pediatric oncology patients. Ten databases were searched to identify relevant randomized controlled trials. The risk of bias of selected studies was graded using the Cochrane risk-of-bias tool for randomized trials. The primary outcomes were nausea and vomiting. The secondary outcomes were intervention adherence and number of adverse events. Nineteen papers met the inclusion criteria and were included in the review. Sixteen studies showed high risk of bias. The tested interventions were acupuncture, acupressure, aromatherapy, hypnosis, massage, active cognitive distraction/relaxation techniques, creative arts therapy, psychoeducation, and combined massage and acupressure. Acupuncture, hypnosis, and massage interventions improved nausea and vomiting. Fifteen trials reported intervention adherence; only 7 monitored adverse events. The most common reason for dropout was refusal from patients and/or their guardians. A total of 34 adverse events were noted. There is insufficient evidence that complementary and alternative medicine is effective, feasible, or safe in controlling nausea and vomiting among pediatric oncology patients due to high risk of bias. Acupuncture, hypnosis, and massage appear to have therapeutic benefits. However, more robust studies are needed to address the identified methodological issues and determine the real value of these 3 interventions.

MP52-14 LONG-TERM BOTOX USE IN PATIENTS WITH NEUROGENIC LOWER URINARY TRACT DYSFUNCTION: A REAL WORLD EXPERIENCE

You have accessJournal of UrologyCME1 Apr 2023MP52-14 LONG-TERM BOTOX USE IN PATIENTS WITH NEUROGENIC LOWER URINARY TRACT DYSFUNCTION: A REAL WORLD EXPERIENCE Chris Du, Jonathan Aronov, Arshia Aalami Harandi, Zhenyue Huang, and Jason Kim Chris DuChris Du More articles by this author , Jonathan AronovJonathan Aronov More articles by this author , Arshia Aalami HarandiArshia Aalami Harandi More articles by this author , Zhenyue HuangZhenyue Huang More articles by this author , and Jason KimJason Kim More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003300.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In 2011, the United States FDA approved the use of intradetrusor OnabotulinumtoxinA (BTX-A) in patients with neurogenic lower urinary tract dysfunction (NLUTD). In these patients, BTX-A use has demonstrated improvement in episodes of urinary incontinence, total volume voided, overall quality of life, and renal preservation. However, studies on the long-term use of BTX-A in this population are limited. We sought to evaluate real-world BTX-A use in a group of patients with NLUTD over a period of several years at our institution. METHODS: Using our IRB-approved BTX-A database, we identified all NLUTD patients receiving BTX-A from 2012-2018. The clinical course of each patient was retrospectively reviewed. Demographic and clinical data for each patient was collected. Each patient was risk stratified into the appropriate category according to the new American Urological Association NLUTD guidelines. Statistical analysis was performed with SPSS v27.0. RESULTS: We identified 101 NLUTD patients that received BTX-A. 78% of patients were female and the mean age was 60.9 years. The neurologic etiologies were multiple sclerosis (23), spinal cord injury (41), distal lesion (41), and suprapontine lesion (22). 32 patients were stratified into Low, 32 Moderate, and 37 High Risk categories. At the 5-year mark, 20.8% of all patients continued BTX-A. By low, intermediate and high risk, it was 25.0%, 15.6%, and 21.6% (p=0.64). The median time to dropout was 2.2 years. Reasons for dropout include pursuing other third line therapies (33), lost to followup (30), pursuing surgical intervention (10, eg urinary diversion, suprapubic tube insertion), death (n=5). CONCLUSIONS: The compliance of all NLUTD patients utilizing BTX-A long-term over 5 years is suboptimal. The majority of patients will cease therapy in 2 years, proceeding to alternative options. Further studies are needed to delineate long-term BTX-A use in NLUTD patients, particularly those that are high risk for renal deterioration. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e707 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chris Du More articles by this author Jonathan Aronov More articles by this author Arshia Aalami Harandi More articles by this author Zhenyue Huang More articles by this author Jason Kim More articles by this author Expand All Advertisement PDF downloadLoading ...

Повседневность учащихся общеобразовательных школ в годы Великой Отечественной вой-ны (на примере Кабардино-Балкарии)

For the first time, based on new archival documents and other sources, a reconstruction of the schoolchildren's daily life in wartime conditions was conducted using the example of the Kabardi-no-Balkarian Republic. This article reveals the influence of a restructuring of the school education system on the daily life of students’ education. The organization of military, physical training and patriotic education of students was analyzed. This work shows the activity of schoolchildren, help-ing the front, wounded soldiers in evacuated military hospitals, participation in the partisan movement. Forms of helping rears are studied: caring for the families of front-line soldiers, or-phans, participating in the restoration of the national economy and agricultural work. The experi-ence of the state work, party bodies and educational institutions in the law’s implementation on universal compulsory education of school-age children is summarized. Problems are analyzed: the introduction of separate education, “Rules for students”, and the quality of students’ knowledge. Difficulties in covering universal education are identified as the main reasons for dropout. It is concluded that the restructuring of the school education system in the interests of the front and rear has significantly affected the daily life of students. Military and physical training, patriotic and labor education of schoolchildren allowed them to help the front and rear and overcome the difficulties of wartime.

Factors contributing to university dropout: a review

IntroductionDropout is one of the problems that the university education system has to face every year. The educational community is involved in the reasons for its trajectory as a social problem, which does not exempt any student in the world. Its study and improvement of the education system is a key element in changing the course of university dropout and alleviating its rapid growth in society.MethodologyUsing a quantitative and qualitative methodology, an attempt is made to provide answers to the objectives pursued by the research.ObjectivesTo analyze student satisfaction, to specify the causes of dropout, and to determine the most appropriate authors on dropout by means of literature and different databases.ConclusionsIt is concluded that, are five main major components would be behind university dropout: student adaptation, personality, socio-economic level, teacher–student relationship, and quality in university education. With them come certain sub-causes that must be taken into account for a better understanding of the reasons for university dropout, such as demotivation, low self-esteem, frustration, pregnancy, among others, reasons why their study is essential for their future eradication.

Implementing a physiotherapy led cancer exercise programme in a National Cancer Centre: the FIXCAS study

ObjectivesTo examine the feasibility of implementing a 10-week exercise-based cancer rehabilitation programme in a national cancer centre. DesignA single-arm prospective feasibility study. SettingAn outpatient physiotherapy department. ParticipantsForty de-conditioned cancer survivors (<1 year post completion of treatment). InterventionsA 10-week programme of twice weekly group-based supervised exercise sessions. Main outcome measuresA mixed methods approach was used. The primary outcome of the study was feasibility, evaluated in terms of recruitment, adherence, attrition and stakeholder acceptance of the programme. Secondary outcomes examined the effect of the exercise intervention on physical function and quality of life measures. ResultsForty patients (age 60 (SD 10.6) years; n = 12 breast cancer, n = 11 lung cancer, n = 7 prostate cancer, n = 5 colorectal cancer, n = 5 other) participated. In total 82% (n = 33) participants completed the post-programme assessment. Deterioration of health and concerns over COVID-19 were the most common reasons for dropout (both n = 2). Adherence to both the supervised exercise classes and home exercise programme was high (78% and 94% respectively). No adverse events were recorded during the intervention or assessments. Qualitative feedback from stakeholders highlighted the acceptability of the programme as well as many perceived benefits of the exercise programme. Improvements in three quality of life sub-scales (physical function, role function and emotional function), physical activity levels and aerobic fitness levels were found post-intervention. ConclusionIt appears feasible to offer a 10-week exercise programme to patients attending a national cancer centre, with adequate recruitment, retention and adherence rates and high acceptability among stakeholders. Contribution of the Paper•It appears feasible to integrate exercise, an established and effective treatment options for various side effects of cancer treatments, into the care of patients living with cancer.•Further trials investigating the implementation of exercise programmes into real-world, standard practice settings are needed.

Causes of academic dropout in higher education in Andalusia and proposals for its prevention at university: A systematic review

IntroductionOne of the main problems facing the university system is the high student dropout rate due to a number of variables, accentuated by the COVID-19 pandemic. This is a problem not only in Spanish universities but is prevalent worldwide. It is therefore important to understand and analyze the underlying reasons for dropout so that it can be addressed and mechanisms implemented to limit dropout in higher education to the greatest extent possible.MethodA systematic review was carried out summarizing the results of studies and reports on university dropout in Spain and specifically in the universities of the Autonomous Community of Andalusia. The review was conducted in accordance with the PRISMA statement by searching the scientific databases Scopus and Web of Science, limiting the search to articles published between 2010 and 2022.ResultsThe main publications in both Spain and the Autonomous Community of Andalusia were identified. The review included the main causes of university dropout indicated in each of the selected studies and the proposals to reduce it, including educational policies, the rise of distance education, academic failure in basic educational stages, and social, personal, psychological, and economic variables.ConclusionThere is a lack of research on university dropout, with only 25% of Spanish universities having carried out research on this subject in the last 12 years. The studies analyzed conclude that the most frequent causes of university dropout are associated with low academic performance, poor social support in the new academic environment, low socio-economic status, pessimism, and lack of motivation, together with other less significant factors such as poor relationships with teachers, lack of vocation, work incompatibility, and previous academic performance. Further research on the causes of university dropout and its prevention is needed both before university entrance, by providing meaningful information to secondary school students, and during the university stay, through institutional and teaching policies that improve family support and social roots, produce positive academic experiences, favor associationism, and encourage activities that improve planning and time management, together with cognitive learning strategies, motivational strategies and the use of advanced learning materials [such as Information and Communication Technology (ICT) tools].

Studying Vaccination Coverage and Design of Short Message Service Based Reminder to Improve Children Vaccination Coverage in Hawassa; Sidama Region; Ethiopia

A vaccine is a kind of remedy that trains the body’s protection system so that it can combat an infection. The national routine immunization coverage in Ethiopia is low. Among the main reason for defaulting children vaccinations are disremembering the appointment date, communication gap between service providers and the community, knowhow about vaccination and etc. This work is to investigate vaccination coverage in Hawassa city and main reasons of vaccination drop out, and then provide a solution for that main reason. Data was collected from 360 children whose age is between 1 to 2 years who live in Hawassa city. The data analysis result showed that only 51% of the children are fully vaccinated; and the main reason for vaccination dropout which weighs 57% was found to be disremembering the appointment date. Providing a solution to not only one of the main reasons but also for the one which weighs the most in the city of this study will improve the vaccination coverage. As the main reason is found to be disremembering the vaccination appointment date, this work provides a Short Message Service (SMS) based automatic reminding system. The design part uses database, OzekiNG network gateway and global system for mobile communication modem with active subscriber identity module. In this system the health extension workers will register the clients’ detailed information including appointment dates during the birth of baby that will be accessed periodically by the OzekiNG to send the reminder SMS to the mothers one day a head to the day of vaccination. After automatic reminding mechanism was developed and implemented, coverage of fully vaccinated children increases from 51% to 71% and the problem of forgetting appointment date decreases from 57% to 14%. The efficiency of the developed system is found to be 85%. From the above-mentioned results and the current available communication mechanisms, it can be concluded that the reminding system can be simply implemented to improve the child vaccination coverage by bridging the gap due to disremembering the vaccination appointment date.

Studying Vaccination Coverage and Design of Short Message Service Based Reminder to Improve Children Vaccination Coverage in Hawassa; Sidama Region; Ethiopia

A vaccine is a kind of remedy that trains the body’s protection system so that it can combat an infection. The national routine immunization coverage in Ethiopia is low. Among the main reason for defaulting children vaccinations are disremembering the appointment date, communication gap between service providers and the community, knowhow about vaccination and etc. This work is to investigate vaccination coverage in Hawassa city and main reasons of vaccination drop out, and then provide a solution for that main reason. Data was collected from 360 children whose age is between 1 to 2 years who live in Hawassa city. The data analysis result showed that only 51% of the children are fully vaccinated; and the main reason for vaccination dropout which weighs 57% was found to be disremembering the appointment date. Providing a solution to not only one of the main reasons but also for the one which weighs the most in the city of this study will improve the vaccination coverage. As the main reason is found to be disremembering the vaccination appointment date, this work provides a Short Message Service (SMS) based automatic reminding system. The design part uses database, OzekiNG network gateway and global system for mobile communication modem with active subscriber identity module. In this system the health extension workers will register the clients’ detailed information including appointment dates during the birth of baby that will be accessed periodically by the OzekiNG to send the reminder SMS to the mothers one day a head to the day of vaccination. After automatic reminding mechanism was developed and implemented, coverage of fully vaccinated children increases from 51% to 71% and the problem of forgetting appointment date decreases from 57% to 14%. The efficiency of the developed system is found to be 85%. From the above-mentioned results and the current available communication mechanisms, it can be concluded that the reminding system can be simply implemented to improve the child vaccination coverage by bridging the gap due to disremembering the vaccination appointment date.

Determinants of School dropouts among adolescents: Evidence from a longitudinal study in India.

India has the largest adolescent population in the world. However, many unprivileged Indian adolescents are still unable to complete schooling. Hence, there is a need to understand the reasons for school dropout among this population. The present study is an attempt to understand the determinants of school dropout among adolescents and identify the factors and reasons that contribute to it. Longitudinal survey data- Understanding Adults and Young Adolescents (UDAYA) for Bihar and Uttar Pradesh has been used to identify the determinants of school dropout among adolescents aged 10-19. The first wave of the survey was conducted in 2015-2016, and the follow-up survey in 2018-2019. Descriptive statistics along with bivariate and multivariate analysis was used to observe school dropout rates and factors associated with it among adolescents. Results show that the school dropout rate was highest among married girls aged 15-19 years (84%), followed by unmarried girls (46%), and boys (38%) of the same age group. The odds of school dropout among adolescents decreased with an increase in household wealth status. School dropout was significantly less likely among adolescents whose mothers were educated as compared to mothers who had no education. Younger boys [AOR: 6.67; CI: 4.83-9.23] and girls [AOR: 2.56; CI: 1.79-3.84] who engaged in paid work were 6.67 times and 2.56 times more likely to drop out of school than those who were not. The likelihood of school dropout was 3.14 times more likely among younger boys [AOR: 3.14; CI: 2.26-4.35], and it was 89% more likely among older boys [AOR: 1.89; CI: 1.55-2.30] who consumed any substances as compared to those who did not consume any substances. Both younger [AOR: 2.05; CI: 1.37-3.05] and older girls [AOR: 1.30; CI: 1.05-1.62] who acknowledged at least one form of discriminatory practice by parents were more likely to drop out of school than their counterparts. Lack of interest in studies/education not necessary (43%) was the predominant reason among younger boys for school dropout, followed by family reasons (23%) and paid work (21%). Dropout was prevalent among lower social and economic strata. Mother's education, parental interaction, participation in sports and having role models reduce school dropout. Conversely, factors such as being engaged in paid work, substance abuse among boys, and gender discriminatory practices towards girls, are risk factors for dropout among adolescents. Lack of interest in studies and familial reasons also increase dropout. There is a need to improve the socio-economic status, delay the marital age of girls, and enhance the government incentives for education, give rightful work to girls after schooling, and provide awareness.

Current status of long-term follow-up system for women with a history of hypertensive disorders of pregnancy: the HDP-PPAP study (HDP-Postpartum in Aomori prefecture study)

Objective Women with a history of hypertensive disorders of pregnancy (HDP), especially those with gestational hypertension and preeclampsia, are more likely to develop hypertension, cerebrovascular disease, ischemic heart disease, diabetes mellitus, dyslipidemia, and chronic kidney disease later in life. However, the risk of lifestyle-related diseases in the immediate postpartum period among Japanese women with preexisting HDP is unclear, and a follow-up system for women with preexisting HDP has not been established in Japan. The purpose of this study was to examine the risk factors for lifestyle-related diseases in Japanese women in the immediate postpartum period and the usefulness of HDP follow-up outpatient clinics based on the situation of the HDP follow-up outpatient clinic at our hospital. Method We included 155 women with a history of HDP who visited our outpatient clinic between April 2014 and February 2020. We examined the reasons for dropout during the follow-up period. We also examined the number of new cases of lifestyle-related diseases and compared Body Mass Index(BMI), blood pressure values, and blood and urine test results at 1 and 3 years postpartum in 92 women who had been continuously followed for more than 3 years postpartum. Results The average age of our patient cohort was 34.8 ± 4.5 years. A total of 155 women with previous HDP were continuously followed for more than 1 year, of whom 23 had new pregnancies, and eight had recurrent HDP (recurrence rate 34.8%). Of the 132 patients who were not newly pregnant, 28 dropped out during follow-up, the most common reason being that the patient did not show up. The patients in this study developed hypertension, diabetes mellitus, and dyslipidemia within a short period. Both systolic and diastolic blood pressures were at normal high levels at 1-year postpartum, and BMI significantly increased at 3 years postpartum. Blood tests revealed significant deterioration in creatinine (Cre), estimated glomerular filtration rate (eGFR), and γ-glutamyl transpeptidase (γGTP) levels. Conclusion In this study, women with preexisting HDP were found to have developed hypertension, diabetes, and dyslipidemia several years postpartum. We also found a significant increase in BMI and worsening of Cre, eGFR, and γGTP levels at 1 and 3 years postpartum. Although the 3-year follow-up rate at our hospital was relatively good (78.8%), some women discontinued follow-up due to self-interruption or relocation, suggesting the need to establish a nationwide follow-up system.

A chatbot-based intervention with ELME to improve stress and health-related parameters in a stressed sample: Study protocol of a randomised controlled trial.

Stress levels in the general population had already been increasing in recent years, and have subsequently been exacerbated by the global pandemic. One approach for innovative online-based interventions are "chatbots" - computer programs that can simulate a text-based interaction with human users via a conversational interface. Research on the efficacy of chatbot-based interventions in the context of mental health is sparse. The present study is designed to investigate the effects of a three-week chatbot-based intervention with the chatbot ELME, aiming to reduce stress and to improve various health-related parameters in a stressed sample. In this multicenter, two-armed randomised controlled trial with a parallel design, a three-week chatbot-based intervention group including two daily interactive intervention sessions via smartphone (á 10-20 min.) is compared to a treatment-as-usual control group. A total of 130 adult participants with a medium to high stress levels will be recruited in Germany. Assessments will take place pre-intervention, post-intervention (after three weeks), and follow-up (after six weeks). The primary outcome is perceived stress. Secondary outcomes include self-reported interoceptive accuracy, mindfulness, anxiety, depression, personality, emotion regulation, psychological well-being, stress mindset, intervention credibility and expectancies, affinity for technology, and attitudes towards artificial intelligence. During the intervention, participants undergo ecological momentary assessments. Furthermore, satisfaction with the intervention, the usability of the chatbot, potential negative effects of the intervention, adherence, potential dropout reasons, and open feedback questions regarding the chatbot are assessed post-intervention. To the best of our knowledge, this is the first chatbot-based intervention addressing interoception, as well as in the context with the target variables stress and mindfulness. The design of the present study and the usability of the chatbot were successfully tested in a previous feasibility study. To counteract a low adherence of the chatbot-based intervention, a high guidance by the chatbot, short sessions, individual and flexible time points of the intervention units and the ecological momentary assessments, reminder messages, and the opportunity to postpone single units were implemented. The trial is registered at the WHO International Clinical Trials Registry Platform via the German Clinical Trials Register (DRKS00027560; date of registration: 06 January 2022). This is protocol version No. 1. In case of important protocol modifications, trial registration will be updated.

Studying Vaccination Coverage and Design of Short Message Service Based Reminder to Improve Children Vaccination Coverage in Hawassa; Sidama Region; Ethiopia

A vaccine is a kind of remedy that trains the body’s protection system so that it can combat an infection. The national routine immunization coverage in Ethiopia is low. Among the main reason for defaulting children vaccinations are disremembering the appointment date, communication gap between service providers and the community, knowhow about vaccination and etc. This work is to investigate vaccination coverage in Hawassa city and main reasons of vaccination drop out, and then provide a solution for that main reason. Data was collected from 360 children whose age is between 1 to 2 years who live in Hawassa city. The data analysis result showed that only 51% of the children are fully vaccinated; and the main reason for vaccination dropout which weighs 57% was found to be disremembering the appointment date. Providing a solution to not only one of the main reasons but also for the one which weighs the most in the city of this study will improve the vaccination coverage. As the main reason is found to be disremembering the vaccination appointment date, this work provides a Short Message Service (SMS) based automatic reminding system. The design part uses database, OzekiNG network gateway and global system for mobile communication modem with active subscriber identity module. In this system the health extension workers will register the clients’ detailed information including appointment dates during the birth of baby that will be accessed periodically by the OzekiNG to send the reminder SMS to the mothers one day a head to the day of vaccination. After automatic reminding mechanism was developed and implemented, coverage of fully vaccinated children increases from 51% to 71% and the problem of forgetting appointment date decreases from 57% to 14%. The efficiency of the developed system is found to be 85%. From the above mentioned results and the current available communication mechanisms, it can be concluded that the reminding system can be simply implemented to improve the child vaccination coverage by bridging the gap due to disremembering the vaccination appointment date.

Identifying and Categorizing Adverse Events in Trials of Digital Mental Health Interventions: Narrative Scoping Review of Trials in the International Standard Randomized Controlled Trial Number Registry.

To contextualize the benefits of an intervention, it is important that adverse events (AEs) are reported. This is potentially difficult in trials of digital mental health interventions, where delivery may be remote and the mechanisms of actions less understood. We aimed to explore the reporting of AEs in randomized controlled trials of digital mental health interventions. The International Standard Randomized Controlled Trial Number database was searched for trials registered before May 2022. Using advanced search filters, we identified 2546 trials in the category of mental and behavioral disorders. These trials were independently reviewed by 2 researchers against the eligibility criteria. Trials were included where digital mental health interventions for participants with a mental health disorder were evaluated through a completed randomized controlled trial (protocol and primary results publication published). Published protocols and primary results publications were then retrieved. Data were extracted independently by 3 researchers, with discussion to reach consensus when required. Twenty-three trials met the eligibility criteria, of which 16 (69%) included a statement on AEs within a publication, but only 6 (26%) reported AEs within their primary results publication. Seriousness was referred to by 6 trials, relatedness by 4, and expectedness by 2. More interventions delivered with human support (9/11, 82%) than those with only remote or no support (6/12, 50%) included a statement on AEs, but they did not report more AEs. Several reasons for participant dropout were identified by trials that did not report AEs, of which some were identifiable or related to AEs, including serious AEs. There is significant variation in the reporting of AEs in trials of digital mental health interventions. This variation may reflect limited reporting processes and difficulty recognizing AEs related to digital mental health interventions. There is a need to develop guidelines specifically for these trials to improve future reporting.

An Empirical Study of the Reasons for Client Dropouts from Contributory Pension Schemes of Sri Lanka Social Security Board

The study attempts to explore the causes of client dropouts of the said pension schemes in the Sri Lanka Social Security Board (SLSSB) to identify the mechanisms to overcome the weaknesses in providing a successful pension scheme. The study employed the embedded mixed method from nine Grama Niladhari Divisions in Gampaha, Badulla, and Matale Districts. A purposive sampling method was used and primary data were gathered using simple observation, key-informant interviews, survey with questionnaires and in-depth interview methods; secondary data, using government reports and relevant literature; SPSS package, used in analyzing quantitative data; content analysis, used in analyzing qualitative data. The findings revealed that socio-economic factors such as gender, occupation, income, expenditure and the number of dependents significantly affect the client dropping out of the pension schemes. Furthermore, lack of proper awareness among both active and inactive members regarding the contributory pension and social security benefit schemes of SLSSB was also a key contributory factor to client dropouts; in terms of institutional inefficiency of SLSSB, lack of a proper follow-up process, incompetent record-keeping, misinformed recruitments, having inadequate staff also seen as contributing factors. The lack of proper awareness and information dissemination about the institution and its program to the general public has created a distance between the SLSSB and the contributors. Enhancing the quality of customer service and taking proper measures will reduce this distance minimizing dropouts and developing an effective pension scheme.