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Li D, Mei Q, Li G. scQA: A dual-perspective cell type identification model for single cell transcriptome data. Comput Struct Biotechnol J 2024; 23:520-536. [PMID: 38235363 PMCID: PMC10791572 DOI: 10.1016/j.csbj.2023.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 01/19/2024] Open
Abstract
Single-cell RNA sequencing technologies have been pivotal in advancing the development of algorithms for clustering heterogeneous cell populations. Existing methods for utilizing scRNA-seq data to identify cell types tend to neglect the beneficial impact of dropout events and perform clustering focusing solely on quantitative perspective. Here, we introduce a novel method named scQA, notable for its ability to concurrently identify cell types and cell type-specific key genes from both qualitative and quantitative perspectives. In contrast to other methods, scQA not only identifies cell types but also extracts key genes associated with these cell types, enabling bidirectional clustering for scRNA-seq data. Through an iterative process, our approach aims to minimize the number of landmarks to approximately a dozen while maximizing the inclusion of quasi-trend-preserved genes with dropouts both qualitatively and quantitatively. It then clusters cells by employing an ingenious label propagation strategy, obviating the requirement for a predetermined number of cell types. Validated on 20 publicly available scRNA-seq datasets, scQA consistently outperforms other salient tools. Furthermore, we confirm the effectiveness and potential biological significance of the identified key genes through both external and internal validation. In conclusion, scQA emerges as a valuable tool for investigating cell heterogeneity due to its distinctive fusion of qualitative and quantitative facets, along with bidirectional clustering capabilities. Furthermore, it can be seamlessly integrated into border scRNA-seq analyses. The source codes are publicly available at https://github.com/LD-Lyndee/scQA.
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Affiliation(s)
- Di Li
- Research Center for Mathematics and Interdisciplinary Sciences, Shandong University, Qingdao 266237, China
| | - Qinglin Mei
- MOE Key Laboratory of Bioinformatics, BNRIST Bioinformatics Division, Department of Automation, Tsinghua University, Beijing 100084, China
| | - Guojun Li
- Research Center for Mathematics and Interdisciplinary Sciences, Shandong University, Qingdao 266237, China
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Sluijterman L, Cator E, Heskes T. How to evaluate uncertainty estimates in machine learning for regression? Neural Netw 2024; 173:106203. [PMID: 38442649 DOI: 10.1016/j.neunet.2024.106203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 12/22/2023] [Accepted: 02/20/2024] [Indexed: 03/07/2024]
Abstract
As neural networks become more popular, the need for accompanying uncertainty estimates increases. There are currently two main approaches to test the quality of these estimates. Most methods output a density. They can be compared by evaluating their loglikelihood on a test set. Other methods output a prediction interval directly. These methods are often tested by examining the fraction of test points that fall inside the corresponding prediction intervals. Intuitively, both approaches seem logical. However, we demonstrate through both theoretical arguments and simulations that both ways of evaluating the quality of uncertainty estimates have serious flaws. Firstly, both approaches cannot disentangle the separate components that jointly create the predictive uncertainty, making it difficult to evaluate the quality of the estimates of these components. Specifically, the quality of a confidence interval cannot reliably be tested by estimating the performance of a prediction interval. Secondly, the loglikelihood does not allow a comparison between methods that output a prediction interval directly and methods that output a density. A better loglikelihood also does not necessarily guarantee better prediction intervals, which is what the methods are often used for in practice. Moreover, the current approach to test prediction intervals directly has additional flaws. We show why testing a prediction or confidence interval on a single test set is fundamentally flawed. At best, marginal coverage is measured, implicitly averaging out overconfident and underconfident predictions. A much more desirable property is pointwise coverage, requiring the correct coverage for each prediction. We demonstrate through practical examples that these effects can result in favouring a method, based on the predictive uncertainty, that has undesirable behaviour of the confidence or prediction intervals. Finally, we propose a simulation-based testing approach that addresses these problems while still allowing easy comparison between different methods. This approach can be used for the development of new uncertainty quantification methods.
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Affiliation(s)
- Laurens Sluijterman
- Department of Mathematics, Radboud University, P.O. Box 9010-59, 6500 GL, Nijmegen, Netherlands.
| | - Eric Cator
- Department of Mathematics, Radboud University, Netherlands.
| | - Tom Heskes
- Institute for Computing and Information Sciences, Radboud University, Netherlands.
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Sun X, McKeaveney C, Shields J, Chan CP, Henderson M, Fitzell F, Noble H, O'Neill S. Rate and reasons for peritoneal dialysis dropout following haemodialysis to peritoneal dialysis switch: a systematic review and meta-analysis. BMC Nephrol 2024; 25:99. [PMID: 38493084 PMCID: PMC10943899 DOI: 10.1186/s12882-024-03542-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Patient experiences and survival outcomes can be influenced by the circumstances related to dialysis initiation and subsequent modality choices. This systematic review and meta-analysis aimed to explore the rate and reasons for peritoneal dialysis (PD) dropout following haemodialysis (HD) to PD switch. METHOD This systematic review conducted searches in four databases, including Medline, PubMed, Embase, and Cochrane. The protocol was registered on PROSPERO (study ID: CRD42023405718). Outcomes included factors leading to the switch from HD to PD, the rate and reasons for PD dropout and mortality difference in two groups (PD first group versus HD to PD group). The Critical Appraisal Skills Programme (CASP) checklist and the GRADE tool were used to assess quality. RESULTS 4971 papers were detected, and 13 studies were included. On meta-analysis, there was no statistically significant difference in PD dropout in the PD first group (OR: 0.81; 95%CI: 0.61, 1.09; I2 = 83%; P = 0.16), however, there was a statistically significant reduction in the rate of mortality (OR: 0.48; 95%CI: 0.25, 0.92; I2 = 73%; P = 0.03) compared to the HD to PD group. The primary reasons for HD to PD switch, included vascular access failure, patient preference, social issues, and cardiovascular disease. Causes for PD dropout differed between the two groups, but inadequate dialysis and peritonitis were the main reasons for PD dropout in both groups. CONCLUSION Compared to the PD first group, a previous HD history may not impact PD dropout rates for patients, but it could impact mortality in the HD to PD group. The reasons for PD dropout differed between the two groups, with no statistical differences. Psychosocial reasons for PD dropout are valuable to further research. Additionally, establishing a consensus on the definition of PD dropout is crucial for future studies.
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Affiliation(s)
- Xingge Sun
- School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Rd, Belfast, BT9 7BL, UK
| | - Clare McKeaveney
- School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Rd, Belfast, BT9 7BL, UK
| | - Joanne Shields
- Regional Nephrology & Transplant Unit, Belfast City Hospital, 51 Lisburn Road, Belfast, BT9 7AB, UK
| | - Chi Peng Chan
- Regional Nephrology & Transplant Unit, Belfast City Hospital, 51 Lisburn Road, Belfast, BT9 7AB, UK
| | - Matthew Henderson
- Centre for Medical Education, Queen's University Belfast, Whitla Medical Building, Belfast, BT9 7BL, UK
| | - Fiona Fitzell
- Centre for Medical Education, Queen's University Belfast, Whitla Medical Building, Belfast, BT9 7BL, UK
| | - Helen Noble
- School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Rd, Belfast, BT9 7BL, UK
| | - Stephen O'Neill
- Regional Nephrology & Transplant Unit, Belfast City Hospital, 51 Lisburn Road, Belfast, BT9 7AB, UK.
- Centre for Medical Education, Queen's University Belfast, Whitla Medical Building, Belfast, BT9 7BL, UK.
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Gong L, Cui X, Liu Y, Lin C, Gao Z. SinCWIm: An imputation method for single-cell RNA sequence dropouts using weighted alternating least squares. Comput Biol Med 2024; 171:108225. [PMID: 38442556 DOI: 10.1016/j.compbiomed.2024.108225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/28/2024] [Accepted: 02/25/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND AND OBJECTIVES Single-cell RNA sequencing (scRNA-seq) provides a powerful tool for exploring cellular heterogeneity, discovering novel or rare cell types, distinguishing between tissue-specific cellular composition, and understanding cell differentiation during development. However, due to technological limitations, dropout events in scRNA-seq can mistakenly convert some entries in the real data to zero. This is equivalent to introducing noise into the data of cell gene expression entries. The data is contaminated, which affects the performance of downstream analyses, including clustering, cell annotation, differential gene expression analysis, and so on. Therefore, it is a crucial work to accurately determine which zeros are due to dropout events and perform imputation operations on them. METHODS Considering the different confidence levels of different zeros in the gene expression matrix, this paper proposes a SinCWIm method for dropout events in scRNA-seq based on weighted alternating least squares (WALS). The method utilizes Pearson correlation coefficient and hierarchical clustering to quantify the confidence of zero entries. It is then combined with WALS for matrix decomposition. And the imputation result is made close to the actual number by outlier removal and data correction operations. RESULTS A total of eight single-cell sequencing datasets were used for comparative experiments to demonstrate the overall superiority of SinCWIm over state-of-the-art models. SinCWIm was applied to cluster the data to obtain an adjusted RAND index evaluation, and the Usoskin, Pollen and Bladder datasets scored 94.46%, 96.48% and 76.74%, respectively. In addition, significant improvements were made in the retention of differential expression genes and visualization. CONCLUSIONS SinCWIm provides a valuable imputation method for handling dropout events in single-cell sequencing data. In comparison to advanced methods, SinCWIm demonstrates excellent performance in clustering, visualization and other aspects. It is applicable to various single-cell sequencing datasets.
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Affiliation(s)
- Lejun Gong
- Jiangsu Key Lab of Big Data Security & Intelligent Processing, School of Computer Science, Nanjing University of Posts and Telecommunications, Nanjing, China.
| | - Xiong Cui
- Jiangsu Key Lab of Big Data Security & Intelligent Processing, School of Computer Science, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Yang Liu
- Jiangsu Key Lab of Big Data Security & Intelligent Processing, School of Computer Science, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Cai Lin
- Department of Burn, Wound Repair and Regenerative Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China.
| | - Zhihong Gao
- Zhejiang Engineering Research Center of Intelligent Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
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Ferede Zegeye A, Kassa Mekonnen C, Kindie H, Shetie Workneh B, Bihonegn Asmamaw D, Tarik Tamir T. Individual and community-level determinants of pentavalent vaccination dropouts among under-five children in the sub-Saharan African countries: A multilevel analysis of the recent demographic and health survey. Vaccine X 2024; 17:100465. [PMID: 38435980 PMCID: PMC10906395 DOI: 10.1016/j.jvacx.2024.100465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024] Open
Abstract
Background Globally, each year, about 3 million deaths among children are prevented by pentavalent vaccinations. However, in developing countries, particularly in Sub-Saharan Africa, pentavalent vaccination dropout rates are not well reported. Therefore, this study aimed to assess pentavalent vaccination dropout rates and their determinants among under-five children in Sub-Saharan Africa. Methods Data from the recent Demographic and Health Surveys in 33 Sub-Saharan African countries were used for analysis. The study used a total of 358,529 under-five children. The determinants of pentavalent vaccination dropout were determined using a multilevel mixed-effects logistic regression model. Significant factors associated with pentavalent vaccination dropout were declared significant at p-values < 0.05. A model with the lowest deviance and highest logliklihood ratio was selected as the best-fit model. Results In Sub-Saharan Africa, one in five under-five children had pentavalent vaccination dropout rates. Factors such as Age (AOR = 1.61, 95 % CI: 1.51, 1.72), educational level (AOR = 1.30, 95 % CI: 1.22, 1.40), place of delivery (AOR = 1.65, 95 % CI: 1.57, 1.73), ANC visits (AOR = 1.34, 95 % CI: 1.23, 1.45), postnatal check-up (AOR = 1.19, 95 % CI: 1.14, 1.25), wealth status (AOR = 1.09, 95 % CI: 1.04, 1.15), distance to health facility (AOR = 1.08, 95 % CI: 1.03, 1.13), media exposure (AOR = 1.12, 95 % 1.15), and geographical region (AOR = 1.60, 95 % CI: 1.49, 1.72) had higher odds of pentavalent vaccination dropouts. Conclusions Pentavalent vaccination dropout rates in sub-Saharan Africa among under-five children were high. Both individual and community-level variables were determinants of pentavalent vaccination dropout rates. Government and ministry of health in Sub-Saharan Africa should give attention to those mothers of under-five children who reported distance as a big problem in accessing health facilities and to women who do not utilise antenatal and postnatal check-ups while designing policies and strategies in sub-Saharan Africa.
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Affiliation(s)
- Alebachew Ferede Zegeye
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences University of Gondar, Gondar, Ethiopia
| | - Chilot Kassa Mekonnen
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences University of Gondar, Gondar, Ethiopia
| | - Hailemichael Kindie
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences University of Gondar, Gondar, Ethiopia
| | - Belayneh Shetie Workneh
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Tarik Tamir
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Vancampfort D, Van Damme T, Brunner E, McGrath RL, Hemmings L, Guimaraes ME, Schuch F. Dropout From Exercise Interventions in Adults With Fibromyalgia: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2024; 105:571-579. [PMID: 37331421 DOI: 10.1016/j.apmr.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/17/2023] [Accepted: 06/08/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE To meta-analyze the prevalence and predictors of dropout rates among adults with fibromyalgia participating in exercise randomized controlled trials (RCTs). DATA SOURCES Two authors searched Embase, CINAHL, PsycARTICLES, and Medline up to 01/21/2023. STUDY SELECTION We included RCTs of exercise interventions in people with fibromyalgia that reported dropout rates. DATA EXTRACTION Dropout rates from exercise and control conditions and exerciser/participant, provider, and design/implementation related predictors. DATA SYNTHESIS A random effects meta-analysis and meta-regression were conducted. In total, 89 RCTs involving 122 exercise arms in 3.702 people with fibromyalgia were included. The trim-and-fill-adjusted prevalence of dropout across all RCTs was 19.2% (95% CI=16.9%-21.8%), which is comparable with the dropout observed in control conditions with the trim-and-fill-adjusted odds ratio being 0.31 (95% CI=0.92-1.86, P=.44). Body mass index (R2=0.16, P=.03) and higher effect of illness (R2=0.20, P=.02) predicted higher dropout. The lowest dropout was observed in exergaming, compared with other exercise types (P=.014), and in lower-intensity exercises, compared with high intensity exercise (P=.03). No differences in dropout were observed for the frequency or duration of the exercise intervention. Continuous supervision by an exercise expert (eg, physiotherapist) resulted in the lowest dropout rates (P<.001). CONCLUSIONS Exercise dropout in RCTs is comparable with control conditions, suggesting that exercise is a feasible and accepted treatment modality; however, interventions are ideally supervised by an expert (eg, physiotherapist) to minimize the risk of dropout. Experts should consider a high BMI and the effect of the illness as risk factors for dropout.
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Affiliation(s)
- Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; University Psychiatric Centre KU Leuven, Leuven, Belgium.
| | - Tine Van Damme
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; University Psychiatric Centre KU Leuven, Leuven, Belgium
| | - Emanuel Brunner
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; Department Gesundheit, Ostschweizer Fachhochschule, St. Gallen, Switzerland; Institut für Therapie und Rehabilitation, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Ryan L McGrath
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, Australia; Department of Rural Health, The University of Melbourne, Shepparton, Australia; Allied Health Education and Research Unit, Goulburn Valley Health, Shepparton, Australia
| | - Laura Hemmings
- University of Birmingham, School of Sport and Exercise Sciences, Birmingham, UK
| | - Maria Eduarda Guimaraes
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil; Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile
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Guevara SA, Donaldson A, Keegan RJ, Appaneal RN, Smyth EA, Waddington G, Mahony K, Mara JK, Drew MK. Gender and socioecological level differences in stakeholders' perceptions of athlete attrition factors in an Australian high-performance pathway system. J Sci Med Sport 2024; 27:197-203. [PMID: 37985254 DOI: 10.1016/j.jsams.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/30/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVES This study aimed to build on previous work by the authors. It examines how socioecological level and gender influence high-performance sport system (HPSS) stakeholders' perspectives of the relative importance and feasibility to address athlete attrition factors within an Australian high-performance pathway system (HPPS). DESIGN Mixed methods. METHODS Sub-analysis was conducted of rating data from 30 participants who had contributed to identifying 83 statements in 13 clusters in a previous Concept Mapping study. The 13 clusters were statistically analysed in 'R' using cumulative link mixed models (CLMMs) to determine differences in perceived importance and feasibility between 1) socioecological levels, and 2) genders. RESULTS Mean ratings for 11 and three of the 13 clusters were statistically significantly different between at least two of the five socioecological levels, for importance and feasibility, respectively. Athletes had the largest variation in mean ratings from the most (athlete health 4.59), to least (performance potential 2.83) important cluster, when compared to the other four socioecological levels. There were statistically significant differences between the ratings between genders (Men/Women) for two clusters for each rating scale: Importance: 'athlete health' (M3.33:W3.84 [p 0.012]); 'performance potential' (M3.35:W2.57; [p 0.001]), Feasibility: 'abuse and mismanagement of health' (M2.97:W3.68; [p 0.000]) and 'athlete health' (M2.54:W3.33; [p 0.000]). CONCLUSIONS This study highlights the need to implement more robust athlete attrition monitoring protocols. It also highlights the importance of listening to youth athletes' voices, and enabling equal gender representation to ensure holistically tailored environments are created to retain talented athletes in high-performance pathway programmes.
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Affiliation(s)
- Sara A Guevara
- Research Institute for Sports and Exercise Medicine, University of Canberra, Australia; New South Wales Institute of Sport, Australia; Athlete Performance Health, AIS Operations, Australian Institute of Sport, Australia.
| | - Alex Donaldson
- Centre for Sport and Social Impact, La Trobe University, Australia.
| | | | - Renee N Appaneal
- Athlete Performance Health, AIS Operations, Australian Institute of Sport, Australia
| | - Erin A Smyth
- Research Institute for Sports and Exercise Medicine, University of Canberra, Australia.
| | - Gordon Waddington
- Research Institute for Sports and Exercise Medicine, University of Canberra, Australia.
| | - Kate Mahony
- New South Wales Institute of Sport, Australia.
| | - Jocelyn K Mara
- Research Institute for Sports and Exercise Medicine, University of Canberra, Australia.
| | - Michael K Drew
- Research Institute for Sports and Exercise Medicine, University of Canberra, Australia.
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Liang Y, Niu C, Yan P, Wang G. Flipover outperforms dropout in deep learning. Vis Comput Ind Biomed Art 2024; 7:4. [PMID: 38386109 PMCID: PMC10884389 DOI: 10.1186/s42492-024-00153-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/29/2023] [Indexed: 02/23/2024] Open
Abstract
Flipover, an enhanced dropout technique, is introduced to improve the robustness of artificial neural networks. In contrast to dropout, which involves randomly removing certain neurons and their connections, flipover randomly selects neurons and reverts their outputs using a negative multiplier during training. This approach offers stronger regularization than conventional dropout, refining model performance by (1) mitigating overfitting, matching or even exceeding the efficacy of dropout; (2) amplifying robustness to noise; and (3) enhancing resilience against adversarial attacks. Extensive experiments across various neural networks affirm the effectiveness of flipover in deep learning.
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Affiliation(s)
- Yuxuan Liang
- Biomedical Imaging Center, Center for Biotechnology and Interdisciplinary Studies, Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, 12180, USA
| | - Chuang Niu
- Biomedical Imaging Center, Center for Biotechnology and Interdisciplinary Studies, Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, 12180, USA
| | - Pingkun Yan
- Biomedical Imaging Center, Center for Biotechnology and Interdisciplinary Studies, Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, 12180, USA
| | - Ge Wang
- Biomedical Imaging Center, Center for Biotechnology and Interdisciplinary Studies, Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, 12180, USA.
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Galván Núñez YC, Florez Suaza A, Sánchez Rojo LC, Lombo Lievano ÁM. [Factors associated with abandoning from the Kangaroo Mother Program between years 2019 and 2021]. Rev Esp Salud Publica 2024; 98:e202402012. [PMID: 38385555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 01/26/2024] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE The abandonment of the Kangaroo Mother Program is a public health problem that affects the health of premature infants. The objective of this study was to determine the factors associated with the abandonment of mothers or caregivers of premature infants in the first stage of the Kangaroo Mother Program of a Health Promoting Company (EPS) in the department of Antioquia (Colombia), between 2019 and 2021. METHODS An observational, cross-sectional, and analytical study was carried out, where information was collected on admissions to the program (N=1,344) between 2019 and 2021. The Chi-Square likelihood ratio test was performed with crude prevalence ratio, a generalized linear model of robust variance was applied with the adjusted prevalence ratio. RESULTS When adjusting for dropout with the independent variables, a higher probability of dropout was evidenced: with respect to the year 2020 (PR 2.44, 95% CI: 1.94-3.08, p-value=0.0001), marital status alone with support (PR 1.60, 95% CI: 0.84-3.04, p-value=0. 147), primary school completed or incomplete (PR 1.48, 95% CI 1.11-1.97, p-value=0.006), monthly income less than the current legal monthly minimum wage (CLMMW) (PR 1.26, 95% CI: 1.00-1.59, p-value=0.004) and area of residence living outside Medellin (PR 1.25, 95% CI: 1.06-1.46, p-value=0.006). CONCLUSIONS The findings of this study can be very useful to carry out interventions in families belonging to Kangaroo Programs, with the aim of intervening risk factors associated with program dropout.
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Chen Y, Markowitz JC, Blanco C, Hershman DL, Zhang JT, Hellerstein DJ. Geographical distance predicts psychiatric treatment retention for Hispanic women with comorbid major depression and breast cancer. Breast Cancer Res Treat 2024:10.1007/s10549-024-07250-9. [PMID: 38376796 DOI: 10.1007/s10549-024-07250-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 01/05/2024] [Indexed: 02/21/2024]
Abstract
PURPOSE Depression is among the most common comorbid psychiatric disorders of patients with breast cancer. Depression decreases patient quality of life and, if untreated, can adversely affect cancer treatment. We sought to identify treatment barriers for women with breast cancer receiving psychotherapy for depression. Findings may help policy makers and researchers determine funding and design of future studies involving this population, especially in communities with high rates of health disparities. METHODS We used data from a randomized trial for women with breast cancer and current DSM-IV non-psychotic unipolar major depressive disorder (MDD). Patients were randomly assigned to 12 weeks of one of three psychotherapies and attrition was assessed by whether subjects completed 12 weekly treatment sessions. We used descriptive analyses and logistic regression to identify treatment barriers. R shiny was used to determine study patient residences. RESULTS Of 134 randomized patients, 84 (62.7%) were Hispanic. Fifty-nine patients (44%) either did not start or dropped out of treatment, 49 (83.1%) of them being Hispanic. Being a Hispanic woman, less educated, and geographically distant from treatment significantly predicted attrition. Single Hispanic mothers had significantly higher attrition risk than married and/or childless women. CONCLUSION Identifying barriers to treatment is important to improve treatment adherence for patients with concurrent diagnoses of breast cancer and MDD, especially for traditionally underserved minorities. Additional support such as affordable tele-medicine, multi-language assistance, financial aid for transportation and child-care, and allocation of more funds to address some identified barriers deserve consideration to improve treatment adherence and outcomes.
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Affiliation(s)
- Ying Chen
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA.
- Columbia University Irving Medical Center (CUIMC), New York, NY, 10032, USA.
| | - John C Markowitz
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
- Columbia University Irving Medical Center (CUIMC), New York, NY, 10032, USA
| | - Carlos Blanco
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse (NIDA), Gaithersburg, MD, 20892, USA
| | - Dawn L Hershman
- Columbia University Irving Medical Center (CUIMC), New York, NY, 10032, USA
| | - Joy T Zhang
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
- University of Virginia, Charlottesville, VA, 22904, USA
| | - David J Hellerstein
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
- Columbia University Irving Medical Center (CUIMC), New York, NY, 10032, USA
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Huang H, Kuang H, Thomas TR, Wei D, Zhang H. How to minimize the dropout and crossover in an infertility trial? Fertil Steril 2024:S0015-0282(24)00075-X. [PMID: 38316206 DOI: 10.1016/j.fertnstert.2024.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/07/2024]
Abstract
Randomized controlled trials and intent-to-treat analyses are important for infertility clinical studies. Dropouts or crossovers during the study process will disrupt the randomization design and affect the intent-to-treat analysis. In this review, we have briefly introduced the occurrence of dropout and crossover from our previous Reproductive Medicine Network and other related studies and provided some experience obtained from these studies on how to minimize and reduce the occurrence of dropout and crossover for infertility randomized clinical studies.
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Affiliation(s)
- Hao Huang
- Department of Biostatistics, Yale University, New Haven, Connecticut
| | - Hongying Kuang
- The Second Department of Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, People's Republic of China
| | - Tracey R Thomas
- Women's Health Clinical Research Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Daimin Wei
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Heping Zhang
- Department of Biostatistics, Yale University, New Haven, Connecticut.
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12
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McCoy KT, Williams KA. The Williams and McCoy model of motivational spirited cognitive behavioral change communication. Arch Psychiatr Nurs 2024; 48:1-6. [PMID: 38453276 DOI: 10.1016/j.apnu.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/24/2023] [Accepted: 01/01/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE The Williams and McCoy Motivational Spirited Cognitive Behavioral Change Communication (MIS-CBC) is an innovative model combining the spirit of motivational interviewing (MI) communication, and cognitive behavioral therapy (CBT) as a patient-centered care model to improve continuity of care while enabling patients to progress during therapy. CONCLUSIONS Incorporating this model into Psychiatric Mental Health Advance Practice Nurse practice allows for provision of best practice with populations experiencing low motivation and subject to dropout. The model aims to improve patient motivation and engagement of CBT to achievement "full dose" CBT with more flexibility to significantly improve patient outcomes, particularly with patient populations subject to interruptions in psychotherapy. PRACTICE IMPLICATIONS The Williams and McCoy MIS-CBC model has implications in areas of both practice and academia addressing episodic psychotherapy in populations where interruptions and dropout frequently occur.
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Affiliation(s)
- Kathleen T McCoy
- University of South Alabama, College of Nursing, Department of Community Mental Health, Mobile, AL, USA
| | - Kimberly A Williams
- University of South Alabama, College of Nursing, Department of Community Mental Health, Mobile, AL, USA.
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13
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Lee PK, Chung JL, Kim DR, Yoon YC, Yang S, Whang WJ, Byun YS, Hwang H, Na KS, Lee H, Chung SH, Kim EC, Cho Y, Kim HS, Hwang HS. Categorization of Meibomian Gland Dysfunction Using Lipid Layer Thickness and Meibomian Gland Dropout in Dry Eye Patients: A Retrospective Study. Korean J Ophthalmol 2024; 38:64-70. [PMID: 38148689 PMCID: PMC10869428 DOI: 10.3341/kjo.2023.0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 12/28/2023] Open
Abstract
PURPOSE In the present study, we determined the prevalence of obstructive meibomian gland dysfunction (MGD), hyposecretory MGD, grossly normal MG, and hypersecretory MGD in patients with dry eye syndrome using lipid layer thickness (LLT) and MG dropout. METHODS Eighty-eight patients with dry eye syndrome were included in the study. Patients were categorized into four groups according to the LLT and weighted total meiboscore. The proportion of patients in each group was calculated. The age, sex, Ocular Surface Disease Index, LLT, Schirmer, tear film breakup time, cornea stain, weighted total meiboscore, expressibility, and quality of meibum were compared between the four groups. RESULTS Fifteen eyes (17.0%) had obstructive MGD, two eyes (2.3%) had hyposecretory MGD, 40 eyes (45.5%) had grossly normal MG, and 17 eyes (19.3%) had hypersecretory MGD. The obstructive MGD group was younger than the grossly normal MG group. In obstructive MGD, the ratio of men to women was higher than that of the other groups. However, Ocular Surface Disease Index, Schirmer, tear film breakup time, and corneal stain did not show statistically significant differences between the four groups. The meibum expressibility of the hyposecretoy MGD group was worse than those of the other groups. The meibum expressibility of the hyposecretoy MGD group was poor than those of the obstructive and hypersecretory MGD group. CONCLUSIONS This categorization was expected to help determine the best treatment method for dry eye syndrome, according to the MG status.
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Affiliation(s)
- Phil Kyu Lee
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | | | - Da Ran Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Young Chae Yoon
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - SoonWon Yang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Woong-Joo Whang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Yong-Soo Byun
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - HyungBin Hwang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Kyung Sun Na
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - HyunSoo Lee
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - So Hyang Chung
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Eun Chul Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - YangKyung Cho
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Hyun Seung Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Ho Sik Hwang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul,
Korea
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Farrior H, Teitelbaum S, Phalin B, Janner A, Solomon L, Mathias K, Hunt J, Boissoneault J, Lewis B. Pain Predicts Dropout from Substance Use Treatment. J Stud Alcohol Drugs 2024. [PMID: 38206669 DOI: 10.15288/jsad.23-00099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION This project aimed to characterize the relationship between physical pain experienced at time of entry to residential treatment for substance use disorders (SUDs) and the frequency of treatment dropout. We hypothesized that both endorsement of recent pain and higher magnitude of endorsed pain intensity would be associated with higher dropout rates. We further hypothesized that these effects would be exacerbated among patients with opioid use disorder (OUD). METHOD Participants included 1,095 individuals in residential treatment for SUD. Data were collected within 24 hours of treatment entry. Analyses were conducted using logistic regression with dropout as the dependent variable. Dropout was operationally defined as leaving treatment against medical advice or being discharged from treatment due to use of substances. Pain (including endorsement and intensity) was the primary independent variable in all analyses. Analyses included demographic and affective covariates, and included both main effects of OUD and interaction terms between OUD and pain. RESULTS Pain endorsement was associated with greater frequency of dropout (OR=1.49, p=.04). Higher levels of pain intensity predicted increased rates of dropout (OR=1.13; p<.01). In contrast with our hypothesis, no interactions between OUD and pain were observed. CONCLUSIONS These results underscore the import of integrating pain monitoring and pain interventions as core components of treatment for substance use disorders. Our findings are highly consistent with a growing literature recognizing the impact of pain across a constellation of important treatment outcomes, and provide novel data strongly suggesting that pain predicts early cessation of treatment.
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Affiliation(s)
- Hugh Farrior
- University of Florida, Department of Psychiatry, Gainesville, FL
- University of Florida, Department of Psychology, Gainesville, FL
| | - Scott Teitelbaum
- University of Florida, Department of Psychiatry, Gainesville, FL
| | - Ben Phalin
- University of Florida, Department of Psychiatry, Gainesville, FL
| | - Amanda Janner
- University of Florida, Department of Psychiatry, Gainesville, FL
| | - Laurie Solomon
- University of Florida, Department of Psychiatry, Gainesville, FL
| | - Kent Mathias
- University of Florida, Department of Psychiatry, Gainesville, FL
| | - Jason Hunt
- University of Florida, Department of Psychiatry, Gainesville, FL
| | - Jeff Boissoneault
- University of of Minnesota, Department of Anesthesiology, Minneapolis, MN
| | - Ben Lewis
- University of Florida, Department of Psychiatry, Gainesville, FL
- University of Florida, Department of Psychology, Gainesville, FL
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15
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Kabir A. School dropout of Iranian students: A public health crisis. Child Abuse Negl 2024; 147:106589. [PMID: 38109841 DOI: 10.1016/j.chiabu.2023.106589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 12/20/2023]
Affiliation(s)
- Amir Kabir
- Independent Researcher, Washington, DC, USA
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16
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Yamaguchi T, Yabe H, Kono K, Moriyama Y, Yamada T. Differences in the purpose of exercise between hemodialysis patients who continued or dropped out of exercise programs: a multicenter cohort study. J Nephrol 2023; 36:2559-2569. [PMID: 37878181 DOI: 10.1007/s40620-023-01791-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 09/23/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Selecting suitable exercise goals is crucial for fostering adherence to, and maintenance of, exercise therapy. We aimed to evaluate the variance in exercise objectives between individuals who continued and those who dropped out of a 6-month intradialytic exercise program by analyzing an open-ended questionnaire administered to patients undergoing hemodialysis. METHODS The study consisted of outpatients (n = 541; mean age, 70 years) undergoing maintenance hemodialysis, who had been informed of an intradialytic exercise program and voluntarily agreed to participate. The primary outcome was the exercise purpose. The difference in exercise purpose was quantitatively analyzed between the exercise continuation and dropout groups. A co-occurrence network was created and concepts were constructed. The basic attributes were compared using chi-squared and independent t-tests. RESULTS Over 6 months, 154 patients (28.5%) dropped out of the intradialytic exercise program. Concepts related to the goals of the program were: (1) physical function and condition, (2) addressing limitations, (3) maintaining daily life activities, and (4) physical condition recognition. Co-occurrence network analysis showed that the exercise continuation group established their objectives based on the health benefits of exercise, and proactively set goals rooted in comprehending their current issues and problems. The dropout group tended to perceive treatment passively as an extension of daily clinical practice, rather than actively formulating exercise objectives. CONCLUSION The exercise objectives of those who continued the exercise program differed from those who dropped out. Patients in the exercise continuation group set more affirmative and specific exercise objectives, whereas those in the dropout group set more passive and abstract exercise objectives.
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Affiliation(s)
- Tomoya Yamaguchi
- Department of Rehabilitation, Hamamatsu University Hospital, Hamamatsu, Shizuoka, 431-3125, Japan.
| | - Hiroki Yabe
- Department of Physical Therapy, Seirei Christopher University. School of Rehabilitation, Hamamatsu, Shizuoka, 433-8558, Japan
| | - Kenichi Kono
- Department of Physical Therapy, School of Health Sciences at Narita, International University of Health and Welfare, Kozunomori, Narita, Chiba, 285-8686, Japan
| | - Yoshifumi Moriyama
- Department of Wellness Center, Nagoya Kyoritsu Hospital, Nagoya, Aichi, 454-0933, Japan
| | - Tetsuya Yamada
- Dialysis Division, Kaikoukai Healthcare Group, Nagoya, Aichi, 454-0933, Japan
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17
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Shayani DR, Canale CA, Sloan DM, Hayes AM. Predictors of dropout in cognitive processing therapy for PTSD: An examination of in-session treatment processes. Behav Res Ther 2023; 171:104428. [PMID: 37952284 PMCID: PMC10826797 DOI: 10.1016/j.brat.2023.104428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/20/2023] [Accepted: 11/03/2023] [Indexed: 11/14/2023]
Abstract
Dropout rates for treatments for adult posttraumatic stress disorder (PTSD) are high. Process research can reveal client factors during treatment that predict dropout. An observational coding system was used to code client processes in audio-recorded early sessions of cognitive processing therapy (CPT), a gold-standard treatment for PTSD. Data are from a randomized controlled noninferiority trial of CPT and written exposure therapy (WET), with higher rates of dropout in CPT than WET (39.7% vs. 6.4%). Participants in this study were 53 treatment-seeking adults with PTSD who were in the CPT arm of the trial and completed the CAPS-5 at pretreatment and at least one session. Of these, 15 (28.3%) dropped out of CPT early (completing ≤9 sessions) and 38 (71.7%) completed treatment. Sessions were coded with an observational coding system on a four-point scale (0 = absent to 3 = high) for maladaptive trauma-related responses (overgeneralized beliefs, ruminative processing, avoidance), affective engagement (negative emotions, physiological distress), and adaptive processing (cognitive emotional processing). Binary logistic regressions showed that more physiological distress and cognitive emotional processing predicted lower dropout, whereas more avoidance predicted higher dropout. Negative emotion, ruminative processing, and overgeneralization were not significant predictors. These findings highlight potential early indicators of treatment engagement that could be targeted to reduce dropout and perhaps facilitate further therapeutic change.
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Affiliation(s)
- Danielle R Shayani
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA.
| | - Caroline A Canale
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
| | - Denise M Sloan
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA; Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Adele M Hayes
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
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18
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Ciharova M, Cuijpers P, Amanvermez Y, Riper H, Klein AM, Bolinski F, de Wit LM, van der Heijde CM, Bruffaerts R, Struijs S, Wiers RW, Karyotaki E. Use of tailoring features and reasons for dropout in a guided internet-based transdiagnostic individually-tailored cognitive behavioral therapy for symptoms of depression and/or anxiety in college students. Internet Interv 2023; 34:100646. [PMID: 38099094 PMCID: PMC10719529 DOI: 10.1016/j.invent.2023.100646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/01/2023] [Accepted: 07/07/2023] [Indexed: 12/17/2023] Open
Abstract
Transdiagnostic individually-tailored digital interventions reduce symptoms of depression and anxiety in adults with moderate effects. However, research into these approaches for college students is scarce and contradicting. In addition, the exact reasons for intervention dropout in this target group are not well known, and the use of individually-tailored intervention features, such as optional modules, has not yet been explored. The current study aimed to (1) investigate reasons for dropout from a guided internet-based transdiagnostic individually-tailored intervention for college students assessed in a randomized controlled trial (RCT) and (2) evaluate whether participants used tailoring features intended for their baseline symptoms. A sample of college students with mild to moderate depression and/or anxiety symptoms (n = 48) in the Netherlands (partially) followed a guided internet-based transdiagnostic individually-tailored intervention. We contacted those who did not complete the entire intervention (n = 29) by phone to report the reasons for intervention dropout. Further, we descriptively explored the use of tailoring features (i.e., depression versus anxiety trajectory) and optional modules of the intervention in the whole sample. We identified a range of person- and intervention-related reasons for intervention dropout, most commonly busy schedules, needs for different kinds of help, or absence of personal contact. Furthermore, only less than half of the participants used the individually-tailoring features to address the symptoms they reported as predominant. In conclusion, digital interventions clear about the content and targeted symptoms, tested in user research could prevent dropout and create reasonable expectations of the intervention. Participants would benefit from additional guidance when using tailoring features of digital interventions, as they often do not choose the tailoring features targeting their baseline symptoms.
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Affiliation(s)
- Marketa Ciharova
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
- WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
- Faculty of Medicine, Dept. of Psychiatry, University of Turku, FI-20014 Turun yliopisto, Finland
- Babeș-Bolyai University, International Institute for Psychotherapy, No.37, Republicii Street 400015, Cluj-Napoca, Romania
| | - Yagmur Amanvermez
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
| | - Heleen Riper
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
- Faculty of Medicine, Dept. of Psychiatry, University of Turku, FI-20014 Turun yliopisto, Finland
- Research Unit for Telepsychiatry and e-Mental Health, Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19,3, 5000 Odense, Denmark
- Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands
| | - Anke M. Klein
- Developmental and Educational Psychology of the Institute of Psychology, Leiden University, Rapenburg 70, 2311 EZ Leiden, the Netherlands
- Addiction, Development, and Psychopathology Lab, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1001NK Amsterdam, the Netherlands
| | - Felix Bolinski
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
- Department of Mental Health and Prevention, Trimbos Institute, Da Costakade 45, 3521 VS Utrecht, the Netherlands
| | - Leonore M. de Wit
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
| | - Claudia M. van der Heijde
- Department of Research, Development and Prevention, Student Health Service, University of Amsterdam, Oude Turfmarkt 151, 1012 GC Amsterdam, the Netherlands
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum, Centre for Public Health Psychiatry, Katholieke Universiteit Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Sascha Struijs
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
| | - Reinout W. Wiers
- Addiction, Development, and Psychopathology Lab, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1001NK Amsterdam, the Netherlands
- Center for Urban Mental Health, Oude Turfmarkt 145-147, 1012 GC Amsterdam, the Netherlands
| | - Eirini Karyotaki
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
- WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands
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Hjarnaa L, Møller SP, Curtis AB, Becker U, Andersen O, Torvik FA, Tolstrup JS. Alcohol Intake and Academic Performance and Dropout in High School: A Prospective Cohort Study in 65,233 Adolescents. J Adolesc Health 2023; 73:1083-1092. [PMID: 37702649 DOI: 10.1016/j.jadohealth.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 06/23/2023] [Accepted: 07/03/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE During the teenage years, many adolescents start drinking alcohol, and binge drinking is prevalent. We investigated the relationship between alcohol intake and academic performance. METHODS We conducted a longitudinal cohort study by combining data from the Danish National Youth Study on 65,233 high school students aged 15-20 years, with information on dropout and grade point average. We assessed associations between alcohol intake and academic performance using multilevel Poisson regression and linear regression, accounting for dependency between students from the same school and class. RESULTS The average alcohol intake was 10 drinks per week, and 43.6% engaged in binge drinking 3+ times per month. During follow-up, 9.8% of the boys and 6.7% of the girls dropped out. The incidence rate ratio was higher in never drinkers, frequent binge drinkers, and those with a high weekly alcohol intake as compared to those with a low intake. For example, the incidence rate ratio was 1.47 (95% confidence level: 1.24, 1.76) in girls who drank 21-27 drinks per week and 1.29 (95% confidence level: 1.13, 1.48) in girls who never drank as compared to those who drank <7 drinks per week. Alcohol associated with a lower grade point average over the entire span of intake in a dose-dependent manner, and similarly so in boys and girls. Findings were consistent in strata of socioeconomy and individual academic ambition. DISCUSSION Alcohol intake has implications for academic performance and poses a threat for the prospects of the individual as well as society. Policies and interventions aimed at lowering the intake among high school students are warranted.
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Affiliation(s)
- Louise Hjarnaa
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Sanne Pagh Møller
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Alberte Brix Curtis
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ulrik Becker
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ove Andersen
- Department of Clinical Research, Hvidovre Hospital, Hvidovre, Denmark
| | - Fartein Ask Torvik
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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20
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Buelens F, Luyten P, Claeys H, Van Assche E, Van Daele T. Usage of unguided, guided, and blended care for depression offered in routine clinical care: Lessons learned. Internet Interv 2023; 34:100670. [PMID: 37767005 PMCID: PMC10520335 DOI: 10.1016/j.invent.2023.100670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 09/13/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction Internet-delivered psychotherapy is often considered to be a promising way to extend mental healthcare services around the world. Research findings that have emerged over the past two decades have strengthened this claim. However, very little is known about the usage of internet-delivered psychotherapy in real-life circumstances. Methods The current study explored the real-life usage of depressiehulp.be, a publicly available online platform for depression that offers pure self-help, online guided self-help, and blended treatment for depression in Flanders, Belgium, using data collected from 2656 participants between May 2018 and May 2022. Results Both duration of engagement with the online platform and number of exercises completed increased with increasing levels of therapist guidance. Findings also showed a particular pattern of engagement for each of the online treatments. Overall, participants completed most exercises during the first days of treatment. However, participants using pure online self-help showed the fastest decrease of engagement over time, with most dropping out after completing a few exercises, and more than half of all participants who enrolled in the self-help programme did not even begin the programme. In both guided and blended treatment, participants tended to show higher levels of engagement with the online platform. In each treatment modality, a relatively small but notable group of participants showed high levels of engagement. There was no relationship between severity of depression and duration of engagement. Conclusions The current study demonstrates the importance of therapist support in online interventions and offers additional insights into how, and to what extent, online platforms are used. Future research should explore clinical impact and policy implications.
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Affiliation(s)
- Fien Buelens
- Expertise Unit Psychology, Technology & Society, Thomas More University of Applied Sciences, Campus Sanderus, Molenstraat 8, 2018 Antwerp, Belgium
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102 pobox 3722, 3000 Leuven, Belgium
- Research Department of Clinical, Educational and Health Psychology, University College London, 1–19 Torrington Place, London WC1H 7BG, United Kingdom
| | - Herwig Claeys
- Project manager OnlinePsyHulp associated with Zorggroep Zin, Salvatorstraat 25, 3500 Hasselt, Belgium
| | - Eva Van Assche
- Expertise Unit Psychology, Technology & Society, Thomas More University of Applied Sciences, Campus Sanderus, Molenstraat 8, 2018 Antwerp, Belgium
| | - Tom Van Daele
- Expertise Unit Psychology, Technology & Society, Thomas More University of Applied Sciences, Campus Sanderus, Molenstraat 8, 2018 Antwerp, Belgium
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21
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Doring N, Hwang YIJ, Akpanekpo E, Gullotta M, Ton B, Knight L, Knight C, Schofield P, Butler TG. Predicting attrition of men with a history of violence from randomised clinical trials. Trials 2023; 24:740. [PMID: 37978559 PMCID: PMC10657031 DOI: 10.1186/s13063-023-07774-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
Preventing dropout (attrition) from clinical trials is vital for improving study validity. Dropout is particularly important in justice-involved populations as they can be very challenging to engage and recruit in the first instance. This study identifies factors associated with dropout in a double-blind, placebo-controlled randomised control trial of a selective serotonin reuptake inhibitor (SSRI) aimed at reducing reoffending in highly impulsive men with histories of violent offending. Age, education, social support, psychiatric history, and length of previous incarceration were identified as factors that predict attrition. These findings are consistent with previous research examining variables associated with attrition in clinical trials for community and offender populations. We also explored referral source and treatment allocation as attrition predictors. Although neither significantly predicted attrition, we identified that there are discernible differences in the median time to attrition among the referral source subgroups. Understanding factors that predict treatment completion and attrition will allow researchers to identify participants for whom additional provisions may optimise retention and inform development of targeted interventions.
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Affiliation(s)
- Natalie Doring
- School of Population Health, University of New South Wales, Sydney, NSW, Australia.
| | - Ye In Jane Hwang
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Emaediong Akpanekpo
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Mathew Gullotta
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Bianca Ton
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Lee Knight
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Crosbi Knight
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Peter Schofield
- The University of New Castle, Callaghan, NSW, Australia
- Neuropsychiatry Service, Hunter New England Mental Health, Newcastle, NSW, Australia
| | - Tony Gerard Butler
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
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Elfghi M, Jordan F, Sultan S, Tawfick W. SWAT 84: effects of same-day consent vs delayed consent on the recruitment and retention of trial participants-an observational SWAT. Trials 2023; 24:691. [PMID: 37880796 PMCID: PMC10601271 DOI: 10.1186/s13063-023-07727-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/12/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND AND AIM The recruitment process in a randomized trial can be challenging. Poor recruitment can have a negative impact on the allocated budget and estimated completion date of the study and may result in an underpowered study. We aimed to perform a Study Within A Trial (SWAT) to evaluate the impact of same-day consent or delayed consent on recruitment and retention in the host trial. METHODS This SWAT is designed as a prospective cohort design. The host trial was a randomized controlled trial evaluating the effectiveness of an intensive lifestyle modification programme in participants with peripheral arterial disease. Researchers screened the participants for inclusion and exclusion criteria. Informed consents were obtained from the participants who were willing to participate in the study on a standardized consent form. Participants were given the option to consent on the same day or to delay their consent. Following the consent, the participants were allocated to two groups (same-day consent vs. delayed consent) based on pre-determined criteria for SWAT. One hundred sixteen participants were consented to take part in the host trial. Seventy-five participants were randomized to the host trial. The primary outcome was the proportion of participants who withdrew consent at the recruitment phase. Secondary outcomes were reasons for consent withdrawal and dropout, attrition rate, and adherence with the host trial intervention. RESULTS There was a significantly lower consent-withdrawal rate in same-day consent (17.4%, n = 8/46), compared to the delayed consent group (47.1%, n = 33/70), p = 0.001. There was a significantly lower dropout rate in participants randomized following same-day consent (10.5%, n = 4/38), compared to those randomized after delayed consent (29.7%, n = 11/37), p = 0.038. Transport was the main reason mentioned for consent withdrawal and dropout. In participants randomized to the host trial intervention arm, there was a significant difference in adherence (percentage of the 12-week programme completed) between same-day consent (96.7% ± 4.9) and delayed consent participants (86.4% ± 11.2), p = 0.003, as well as number of weeks completed (mean difference = - 1.547, 95% confidence intervals (- 2.237 to - 0.85)), p = 0.02. CONCLUSION This SWAT found evidence that participants who gave consent on the same day seemed to have better adherence and fewer-withdrawal and dropout rates. SWAT REGISTRATION The SWAT was registered on the Northern Ireland Network for Trials Methodology Research, SWAT 84.
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Affiliation(s)
- M Elfghi
- School of Medicine, University of Galway, University Road, Galway, Ireland.
| | - F Jordan
- School of Medicine, University of Galway, University Road, Galway, Ireland
| | - S Sultan
- Department of Vascular and Endovascular Surgery, University College Hospital, Galway (UCHG), Newcastle Road, Galway, Ireland
| | - W Tawfick
- School of Medicine, University of Galway, University Road, Galway, Ireland
- Department of Vascular and Endovascular Surgery, University College Hospital, Galway (UCHG), Newcastle Road, Galway, Ireland
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23
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Pelizza L, Leuci E, Quattrone E, Azzali S, Pupo S, Paulillo G, Pellegrini P, Menchetti M. Rates and predictors of service disengagement in adolescents with first episode psychosis: results from the 2-year follow-up of the Pr-EP program. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02306-5. [PMID: 37812244 DOI: 10.1007/s00787-023-02306-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023]
Abstract
Service disengagement is a major concern for "Early Intervention in Psychosis" (EIP). Indeed, understanding predictors of engagement is important for the effectiveness of mental health interventions, to improve outcome and quality of life, also in adolescents with first episode psychosis (FEP). No specific European investigation on this topic in adolescence has been reported in the literature to date. The aim of this study was to investigate service disengagement rate and predictors in an Italian sample of FEP adolescents treated within an EIP program during a 2-year follow-up period. All participants were adolescents help-seekers (aged 12-18 years) enrolled in the "Parma Early Psychosis" (Pr-EP) program. At baseline, they completed the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF) scale. Univariate and multivariate Cox regression analyses were performed. 71 FEP adolescents were recruited in this research. During the 2 years of our follow-up, a 25.4% prevalence rate of service disengagement was found. Particularly robust predictors of disengagement were lower baseline acceptance of psychosocial interventions, substance abuse at entry, and lower baseline PANSS "Disorganization" factor score. Approximately, 1/4 of our FEP adolescents disengaged from the Pr-EP program during the first 2 years of treatment. A possible solution to decrease disengagement and to favor re-engagement of these young individuals might be to provide the option of low-intensity monitoring and support, also via remote technology.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum Università di Bologna, Istituto di Psichiatria "Paolo Ottonello", viale Pepoli 5, 40123, Bologna, BO, Italy.
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, largo Palli 1/a, 43100, Parma, PR, Italy.
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, largo Palli 1/a, 43100, Parma, PR, Italy
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, largo Palli 1/a, 43100, Parma, PR, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addictions, Azienda USL-IRCCS di Reggio Emilia, viale Amendola 2, 42100, Reggio Emilia, RE, Italy
| | - Simona Pupo
- Pain Therapy Service, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, viale Gramsci 14, 43100, Parma, PR, Italy
| | - Giuseppina Paulillo
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, largo Palli 1/a, 43100, Parma, PR, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, largo Palli 1/a, 43100, Parma, PR, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum Università di Bologna, Istituto di Psichiatria "Paolo Ottonello", viale Pepoli 5, 40123, Bologna, BO, Italy
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24
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Carpallo-González M, Muñoz-Navarro R, González-Blanch C, Cano-Vindel A. Symptoms of emotional disorders and sociodemographic factors as moderators of dropout in psychological treatment: A meta-review. Int J Clin Health Psychol 2023; 23:100379. [PMID: 36922928 PMCID: PMC10009192 DOI: 10.1016/j.ijchp.2023.100379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 02/08/2023] [Indexed: 03/07/2023] Open
Abstract
Objective Dropout from psychological treatment is an important problem that substantially limits treatment effectiveness. A better understanding of this phenomenon, could help to minimize it. Therefore, we performed a systematic review of meta-analyses (MA) on dropout from psychological treatments to (1) determine the estimated overall dropout rate (DR) and (2) to examine potential predictors of dropout, including clinical symptoms (anxiety and depression) and sociodemographic factors. Method A literature search of the PubMed PsycINFO, Embase, Scopus and Google Scholar databases was conducted. We identified 196 MAs on dropout from psychological treatment carried out primarily in adult patients or mixed samples (adults and children) between 1990 and 2022. Of these, 12 met all inclusion criteria. Two forest plots were created to visualize the DR and the relationship between DR and the disorder. Results The DR ranged from 15.9% to 46.8% and was significantly moderated by symptoms of emotional disorders. The highest DR were observed in younger, unmarried patients, and those with lower educational and income levels. Conclusions DR in patients undergoing psychological treatment is highly heterogeneous, but higher in individuals presenting symptoms of anxiety and/or depression, especially the latter. Given that high DR undermine the effectiveness of psychological interventions, it is clear that greater efforts are needed to reduce dropout, particularly among individuals with symptoms of emotional disorders.
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Affiliation(s)
| | | | - César González-Blanch
- Mental Health Centre, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain
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25
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Ren B, Lipsitz SR, Weiss RD, Fitzmaurice GM. Methods for handling missing binary data in substance use disorder trials. Drug Alcohol Depend 2023; 250:110897. [PMID: 37544038 PMCID: PMC10528893 DOI: 10.1016/j.drugalcdep.2023.110897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/28/2023] [Accepted: 07/09/2023] [Indexed: 08/08/2023]
Abstract
Missing data are a ubiquitous problem in longitudinal substance use disorder (SUD) clinical trials. In particular, the rates of missingness are often high and study participants often intermittently skip their scheduled outcome assessments, leading to so-called "non-monotone" missing data patterns. Moreover, when the primary outcome is a measure of substance use, study investigators often have strong prior beliefs based on their clinical experience that those participants with missing data are more likely to be using substances at those occasions, i.e., data are missing not at random (MNAR). Although approaches for handling missing data are well-developed when the missing data patterns are monotone, arising primarily from study participants withdrawing from the trial prematurely, fewer methods are available for non-monotone missingness. In this paper we review some conventional, as well as more novel, methods for handling non-monotone missingness in SUD trials when the repeatedly measured outcome variable is binary (e.g., denoting presence/absence of substance use). We compare and contrast the different approaches using data from a longitudinal clinical trial of four psychosocial treatments from the Collaborative Cocaine Treatment Study. We conclude by making some recommendations to the SUD research community concerning how more principled methods for handling missing data can be incorporated in the analysis and reporting of trial results.
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Affiliation(s)
- Boyu Ren
- Laboratory for Psychiatric Biostatistics, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Stuart R Lipsitz
- Division of General Medicine, Brigham and Womens Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Roger D Weiss
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA, USA
| | - Garrett M Fitzmaurice
- Laboratory for Psychiatric Biostatistics, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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26
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姜 超, 胡 龙, 徐 春, 葛 芹, 赵 祥. [Imputation method for dropout in single-cell transcriptome data]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2023; 40:778-783. [PMID: 37666769 PMCID: PMC10477391 DOI: 10.7507/1001-5515.202301009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 07/27/2023] [Indexed: 09/06/2023]
Abstract
Single-cell transcriptome sequencing (scRNA-seq) can resolve the expression characteristics of cells in tissues with single-cell precision, enabling researchers to quantify cellular heterogeneity within populations with higher resolution, revealing potentially heterogeneous cell populations and the dynamics of complex tissues. However, the presence of a large number of technical zeros in scRNA-seq data will have an impact on downstream analysis of cell clustering, differential genes, cell annotation, and pseudotime, hindering the discovery of meaningful biological signals. The main idea to solve this problem is to make use of the potential correlation between cells and genes, and to impute the technical zeros through the observed data. Based on this, this paper reviewed the basic methods of imputing technical zeros in the scRNA-seq data and discussed the advantages and disadvantages of the existing methods. Finally, recommendations and perspectives on the use and development of the method were provided.
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Affiliation(s)
- 超 姜
- 东南大学 生物科学与医学工程学院 生物电子学国家重点实验室(南京 210096)State Key Laboratory of Bioelectronics, School of Biological Sciences and Medical Engineering, Southeast University, Nanjing 210096, P. R. China
- 新格元生物科技有限公司(南京 210018)Singleron BiotechCo., Ltd, Nanjing 210018, P. R. China
| | - 龙飞 胡
- 东南大学 生物科学与医学工程学院 生物电子学国家重点实验室(南京 210096)State Key Laboratory of Bioelectronics, School of Biological Sciences and Medical Engineering, Southeast University, Nanjing 210096, P. R. China
| | - 春祥 徐
- 东南大学 生物科学与医学工程学院 生物电子学国家重点实验室(南京 210096)State Key Laboratory of Bioelectronics, School of Biological Sciences and Medical Engineering, Southeast University, Nanjing 210096, P. R. China
| | - 芹玉 葛
- 东南大学 生物科学与医学工程学院 生物电子学国家重点实验室(南京 210096)State Key Laboratory of Bioelectronics, School of Biological Sciences and Medical Engineering, Southeast University, Nanjing 210096, P. R. China
| | - 祥伟 赵
- 东南大学 生物科学与医学工程学院 生物电子学国家重点实验室(南京 210096)State Key Laboratory of Bioelectronics, School of Biological Sciences and Medical Engineering, Southeast University, Nanjing 210096, P. R. China
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27
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Steuwe C, Berg M, Driessen M, Beblo T. Therapeutic alliance and dropout in patients with borderline pathology receiving residential dialectical behavior therapy. BMC Psychiatry 2023; 23:605. [PMID: 37596568 PMCID: PMC10439653 DOI: 10.1186/s12888-023-05061-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 07/28/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND This study focused on the impact of therapeutic alliance on therapy dropout in a naturalistic sample of patients with borderline pathology receiving dialectical behavior therapy (DBT) in a residential setting. We assumed that low therapeutic alliance shortly after admission would be associated with elevated dropout. METHODS 44 participants with borderline pathology (≥ 3 DSM-5 borderline personality disorder criteria) in a residential DBT program completed a quality assurance questionnaire set assessing demographic information, pretreatment psychopathology and therapeutic alliance during the first seven days of their residential stay. Predictors of dropout were investigated using binary logistic regression analyses. RESULTS The dropout rate was 34.1% (n = 15). In binary logistic regression analyses with variables covering demographic and clinical characteristics, comorbidities and childhood trauma history, only the therapeutic alliance significantly predicted dropout (z = -2.371, p = .018). CONCLUSIONS This study supports the importance of therapy process variables, here the therapeutic alliance at the beginning of treatment, as predictors of therapy dropout in borderline pathology. If this finding is replicated, it shows the potential importance of monitoring the therapeutic relationship throughout the therapeutic process. CLINICALTRIALS gov Identifier: NCT05289583, retrospectively registered on March 11, 2022.
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Affiliation(s)
- Carolin Steuwe
- Department of Psychiatry and Psychotherapy, Bielefeld University, Bielefeld, Germany.
| | - Michaela Berg
- Department of Psychiatry and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Bielefeld University, Bielefeld, Germany
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28
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Heidari M, Moattar MH, Ghaffari H. Forward propagation dropout in deep neural networks using Jensen-Shannon and random forest feature importance ranking. Neural Netw 2023; 165:238-247. [PMID: 37307667 DOI: 10.1016/j.neunet.2023.05.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 04/13/2023] [Accepted: 05/23/2023] [Indexed: 06/14/2023]
Abstract
Dropout is a mechanism to prevent deep neural networks from overfitting and improving their generalization. Random dropout is the simplest method, where nodes are randomly terminated at each step of the training phase, which may lead to network accuracy reduction. In dynamic dropout, the importance of each node and its impact on the network performance is calculated, and the important nodes do not participate in the dropout. But the problem is that the importance of the nodes is not calculated consistently. A node may be considered less important and be dropped in one training epoch and on a batch of data before entering the next epoch, in which it may be an important node. On the other hand, calculating the importance of each unit in every training step is costly. In the proposed method, using random forest and Jensen-Shannon divergence, the importance of each node is calculated once. Then, in the forward propagation steps, the importance of the nodes is propagated and used in the dropout mechanism. This method is evaluated and compared with some previously proposed dropout approaches using two different deep neural network architectures on the MNIST, NorB, CIFAR10, CIFAR100, SVHN, and ImageNet datasets. The results suggest that the proposed method has better accuracy with fewer nodes and better generalizability. Also, the evaluations show that the approach has comparable complexity with other approaches and its convergence time is low as compared with state-of-the-art methods.
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Affiliation(s)
- Mohsen Heidari
- Department of Computer Engineering, Ferdows Branch, Islamic Azad University, Ferdows, Iran.
| | | | - Hamidreza Ghaffari
- Department of Computer Engineering, Ferdows Branch, Islamic Azad University, Ferdows, Iran.
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29
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Eslamian A, Arshi M, Tahmasebi S, Alipour F, Rafiey H. Scoping Review on Interventions, Actions, and Policies Affecting Return to School and Preventing School Dropout in Primary School. Int J Prev Med 2023; 14:92. [PMID: 37854994 PMCID: PMC10580204 DOI: 10.4103/ijpvm.ijpvm_520_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 10/27/2022] [Indexed: 10/20/2023] Open
Abstract
Background Dropout is one of the most important social problems in the world and especially in low- and middle-income countries. Efforts to prevent dropouts require giving due attention to different perspectives for applying them. The present study aims to identify the policies and interventions made in previous studies because reviewing evidence-based interventions and learning from their strengths and weaknesses is likely to play an effective role in preventing students from leaving school and returning them to school. Methods This scoping review study conducted on all available studies and documents related to students' dropout. The study population includes articles searched in electronic sources that contain information related to the subject of dropout and out-of-school in primary schools. Appropriate keywords were extracted based on Mesh term and EMTREE and their synonyms and searched by a medical librarian. scientific sources and Gray literature published in Persian and English based on PRISMA standard criteria were reviewed. Results A review of studies indicated that various interventions such as student interaction with school, educational interventions on students and teachers, family and local community cooperation, free nutrition, behavioral interventions, financial aid, and free education had positive effects on reducing dropout, absenteeism and encouraging students to return to schools. effect size was not reported for school dropout intervention. Conclusions The findings have indicated that intervention with a combination of global and targeted strategies can affect dropout in developing countries. However, to confirm the effectiveness of this type of intervention, further research is required to be conducted in different countries and with different cultures.
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Affiliation(s)
- Ayoub Eslamian
- Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Maliheh Arshi
- Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Siyamak Tahmasebi
- Department of Preschool Education, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fardin Alipour
- Department of Social Welfare, Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hassan Rafiey
- Department of Social Welfare, Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Jones L, Efron N, Bandamwar K, Barnett M, Jacobs DS, Jalbert I, Pult H, Rhee MK, Sheardown H, Shovlin JP, Stahl U, Stanila A, Tan J, Tavazzi S, Ucakhan OO, Willcox MDP, Downie LE. TFOS Lifestyle: Impact of contact lenses on the ocular surface. Ocul Surf 2023; 29:175-219. [PMID: 37149139 DOI: 10.1016/j.jtos.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/10/2023] [Indexed: 05/08/2023]
Abstract
Several lifestyle choices made by contact lens wearers can have adverse consequences on ocular health. These include being non-adherent to contact lens care, sleeping in lenses, ill-advised purchasing options, not seeing an eyecare professional for regular aftercare visits, wearing lenses when feeling unwell, wearing lenses too soon after various forms of ophthalmic surgery, and wearing lenses when engaged in risky behaviors (e.g., when using tobacco, alcohol or recreational drugs). Those with a pre-existing compromised ocular surface may find that contact lens wear exacerbates ocular disease morbidity. Conversely, contact lenses may have various therapeutic benefits. The coronavirus disease-2019 (COVID-19) pandemic impinged upon the lifestyle of contact lens wearers, introducing challenges such as mask-associated dry eye, contact lens discomfort with increased use of digital devices, inadvertent exposure to hand sanitizers, and reduced use of lenses. Wearing contact lenses in challenging environments, such as in the presence of dust and noxious chemicals, or where there is the possibility of ocular trauma (e.g., sport or working with tools) can be problematic, although in some instances lenses can be protective. Contact lenses can be worn for sport, theatre, at high altitude, driving at night, in the military and in space, and special considerations are required when prescribing in such situations to ensure successful outcomes. A systematic review and meta-analysis, incorporated within the review, identified that the influence of lifestyle factors on soft contact lens dropout remains poorly understood, and is an area in need of further research. Overall, this report investigated lifestyle-related choices made by clinicians and contact lens wearers and discovered that when appropriate lifestyle choices are made, contact lens wear can enhance the quality of life of wearers.
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Affiliation(s)
- Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada.
| | - Nathan Efron
- School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Kalika Bandamwar
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Melissa Barnett
- University of California, Davis Eye Center, Sacramento, CA, USA
| | - Deborah S Jacobs
- Massachusetts Eye & Ear, Harvard Medical School, Boston, MA, USA
| | - Isabelle Jalbert
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
| | - Heiko Pult
- Dr Heiko Pult Optometry & Vision Research, Weinheim, Germany
| | | | - Heather Sheardown
- Department of Chemical Engineering, McMaster University, Hamilton, Ontario, Canada
| | | | - Ulli Stahl
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
| | | | - Jacqueline Tan
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
| | - Silvia Tavazzi
- Department of Materials Science, University of Milano-Bicocca, Milan, Italy
| | | | - Mark D P Willcox
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
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Gansaonré RJ, Moore L, Kobiané JF, Sié A, Haddad S. Birthweight, gestational age, and early school trajectory. BMC Public Health 2023; 23:1032. [PMID: 37259123 DOI: 10.1186/s12889-023-15913-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/17/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Birthweight and gestational age are important factors of not only newborn health by also child development and can contribute to delayed cognitive abilities. However, no study has analyzed the association of birthweight and gestational age with school trajectory measured simultaneously by school entry, grade repetition, and school dropout. This study aims, first, to analyze the association of birthweight or gestational age with school entry, and second, to explore the relationship between birthweight or gestational age and grade repetition and school dropout among children in Ouagadougou, Burkina Faso. METHODS This study used longitudinal data from the Ouagadougou Health and Demographic Surveillance System. Our samples consisted of children born between 2008 and 2014 who were at least three years old at the beginning of the 2017-18 school year. Samples included 13,676, 3152, and 3498 children for the analysis of the school entry, grade repetition, and dropout, respectively. A discrete-time survival model was used to examine the relationship between birthweight or gestational age and school entry, grade repetition, and dropout. The association between birthweight or gestational age and age at school entry were assessed using a Poisson regression. RESULTS The incidence rate of school entry was 18.1 per 100 people-years. The incidence of first repetition and dropout were 12.6 and 5.9, respectively. The probability of school entry decreased by 31% (HR:0.69, 95%CI: 0.56-0.85) and 8% (HR:0.92, 95%CI: 0.85-0.99) for children weighing less than 2000 g and those weighing between 2000 and 2499 g, respectively, compared to those born with a normal weight (weight ≥ 2500 g). The age at school entry of children with a birthweight less than 2000 g and between 2000 and 2499 g was 7% (IRR: 1.07, 95%CI: 1.06-1.08) and 3% (IRR: 1.03, 95%CI: 1.00-1.06) higher than children born at a normal birthweight, respectively. Gestational age was not associated with school entry or age at school entry. Similarly, birthweight and gestational age were not associated with grade repetition or dropout. CONCLUSION This study shows that low birthweight is negatively associated with school entry and age at school entry in Ouagadougou. Efforts to avoid low birthweights should be part of maternal and prenatal health care because the associated difficulties may be difficult to overcome later in the child's life. Further longitudinal studies are needed to better understand the relationship between development at birth and school trajectory.
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Affiliation(s)
- Rabi Joël Gansaonré
- Département de Médecine Sociale et Préventive, Faculté de Médecine, Université Laval, Québec, QC, Canada.
- VITAM - Centre de Recherche en Santé Durable de l'Université Laval, Québec, QC, Canada.
| | - Lynne Moore
- Département de Médecine Sociale et Préventive, Faculté de Médecine, Université Laval, Québec, QC, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé, Traumatologie-Urgence-Soins intensifs, Centre de Recherche du CHU de Québec - Université Laval (Hôpital de l'Enfant- Jésus), Université Laval, Québec, QC, Canada
| | - Jean-François Kobiané
- Institut Supérieur des Sciences de la Population, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Slim Haddad
- Direction de la Santé Publique, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Québec, QC, Canada
- VITAM - Centre de Recherche en Santé Durable de l'Université Laval, Québec, QC, Canada
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Hanevik E, Røvik FMG, Bøe T, Knapstad M, Smith ORF. Client predictors of therapy dropout in a primary care setting: a prospective cohort study. BMC Psychiatry 2023; 23:358. [PMID: 37226210 DOI: 10.1186/s12888-023-04878-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/16/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Therapy dropout poses a major challenge. Considerable research has been conducted on predictors of dropout, however none in the context of primary mental health services in Norway. The purpose of this study was to investigate which client characteristics can predict dropout from the service Prompt Mental Health Care (PMHC). METHODS We performed a secondary analysis of a Randomized Controlled Trial (RCT). Our sample consisted of 526 adult participants receiving PMHC-treatment in the municipalities of Sandnes and Kristiansand, between November 2015 to August 2017. Using logistic regression, we investigated the association between nine client characteristics and dropout. RESULTS The dropout rate was 25.3%. The adjusted analysis indicated that older clients had a lower odds ratio (OR) of dropping out compared to younger clients (OR = 0.43, [95% CI = 0.26, 0.71]). Moreover, clients with higher education had a lower odds ratio of dropping out compared to clients with lower levels of education (OR = 00.55, 95% CI [0.34, 0.88]), while clients who were unemployed were more likely to drop-out as compared the regularly employed (OR = 2.30, [95% CI = 1.18, 4.48]). Finally, clients experiencing poor social support had a higher odds ratio of dropping out compared to clients who reported good social support (OR = 1.81, [95% CI = 1.14, 2.87]). Sex, immigrant background, daily functioning, symptom severity and duration of problems did not predict dropout. CONCLUSION The predictors found in this prospective study might help PMHC-therapists identify clients at risk of dropout. Strategies for preventing dropout are discussed.
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Affiliation(s)
- Elin Hanevik
- Søndre Oslo DPS, Helga Vaneks Vei 6, 1281, Oslo, Norway
| | - Frida M G Røvik
- Rask Psykisk Helsehjelp, Bydel Ullern, Hoffsveien 48, 0377, Oslo, Norway
| | - Tormod Bøe
- Department of Psychosocial Science, The University of Bergen, Christies Gate 12, 5015, Bergen, Norway
- RKBU Vest, NORCE Norwegian Research Centre, Bergen, Norway
| | - Marit Knapstad
- Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaes Gate 7, 5015, Bergen, Norway
| | - Otto R F Smith
- Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaes Gate 7, 5015, Bergen, Norway.
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway.
- Department of Teacher Education, NLA University College, Pb 74 Sandviken, 5812, Bergen, Norway.
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Parra AG, Gonzalez-Medina G, Perez-Cabezas V, Casuso-Holgado MJ, Vinolo-Gil MJ, García-Muñoz C. Dropout Rate of Participants in Randomized Clinical Trials That Use Virtual Reality to Train Balance and Gait in Parkinson's Disease. A Systematic Review With Meta-analysis and Meta-regression. J Med Syst 2023; 47:46. [PMID: 37010723 DOI: 10.1007/s10916-023-01930-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 02/27/2023] [Indexed: 04/04/2023]
Abstract
Virtual reality is an effective system to train balance and gait in Parkinson's disease, but attrition of this intervention needs to be further examined. This study aims to review and meta-analyze the dropouts of participants in randomized clinical trials that used virtual reality for balance and gait training in people with Parkinson's disease. An electronic search was conducted in PubMed, Web of Science, Scopus and CINAHL. The PEDro scale and Revised Cochrane risk-of-bias tool for randomized trials 2.0 were employed to assess methodological quality. Proportions meta-analysis calculated dropout rate. Odds ratio meta-analysis under 1 indicated lower attrition in experimental participants. Meta-regression identified possible dropouts' moderators. A total of 18 studies were included. The pooled dropout rates were 5.6% (95% CI, 3.3%-9.3%) for all groups, 5.33% (95% CI, 3.03%-9.21%) in virtual reality, and 6.60% (95% CI, 3.84%-26.31%) in comparators. No statistical differences were found in the dropout occurred between the groups (OR 0.83; 95% CI, 0.62-1.12). Number of weeks was the unique moderator (coefficient 0.129, 95% CI 0.018- 0.239; p=0.02). Our overall pooled dropout should be considered in the sample size calculation of future studies. Adequate follow-up of the CONSORT guidelines in the loss report and their reasons could help design suitable retention strategies.
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Affiliation(s)
| | | | | | - María Jesús Casuso-Holgado
- Department of Physiotherapy, University of Seville, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | | | - Cristina García-Muñoz
- Department of Nursing and Physiotherapy, University of Cadiz, Cadiz, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
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Srifuengfung M, Srifuengfung S, Pummangura C, Pattanaseri K, Oon-Arom A, Srisurapanont M. Efficacy and acceptability of vitamin D supplements for depressed patients: A systematic review and meta-analysis of randomized controlled trials. Nutrition 2023; 108:111968. [PMID: 36716601 DOI: 10.1016/j.nut.2022.111968] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/10/2022] [Accepted: 12/31/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVES This systematic review and meta-analysis synthesized the evidence from randomized controlled trials comparing vitamin D and placebo in reducing depressive symptoms and contributing to all-cause dropout rates. METHODS Inclusion criteria were randomized controlled trials comparing reduced depression between depressed patients receiving vitamin D and those receiving placebo. We searched PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials through January 2022. RESULTS Eighteen trials (1980 participants, median age 39 y) were included in the meta-analysis. Vitamin D supplements were significantly superior to placebo in reducing depression (standardized mean difference = -0.49; 95% confidence interval [CI], -0.75 to -0.23; I2 = 81%). Depressed adults (standardized mean difference = -0.70; 95% CI, -1.09 to -0.31) responded to vitamin D significantly better than children and adolescents (standardized mean difference = 0.10; 95% CI -0.27 to 0.47). Vitamin D administered as bolus doses (oral intermittent high doses or intramuscular single high dose) appeared to be more effective than that taken daily by the oral route (P < 0.01). Patients with more severe depression tended to respond better than those with less severity (P = 0.053). We found no moderating effect of concurrent antidepressant use, presence of major depressive disorder diagnosis, physical comorbidity, sex, duration and doses of vitamin D supplement, serum 25-hydroxyvitamin D levels at baseline, and changes in serum 25-hydroxyvitamin D levels in the vitamin D group. Dropout rates were indifferent between the groups (17 trials; risk ratio = 0.84; 95% CI, 0.6-1.16; I2 = 0). CONCLUSIONS Heterogeneous data suggested that vitamin D supplements are effective and safe for depressed patients.
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Affiliation(s)
- Maytinee Srifuengfung
- Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | | | - Keerati Pattanaseri
- Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Awirut Oon-Arom
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Manit Srisurapanont
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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Eslinger J, Sprang G, Jodts J. Keeping children and youth in trauma treatment: Examination of an alliance building dropout management program. Clin Child Psychol Psychiatry 2023; 28:721-733. [PMID: 35762135 DOI: 10.1177/13591045221111849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Evidence-based treatments exist to address traumatic stress related symptoms for children, however dropout from trauma-focused treatment remains a concern. This study examined use of an alliance building dropout management program for a group of children ages 3-17 who received an evidence-based trauma-focused treatment. Logistic regression analysis was conducted to examine the relationships between child gender, race, ethnicity, age, guardianship, externalizing behaviors, participation in a dropout management program and the dose of treatment received. The final model was significant and participation in the dropout management program as well as a child's placement in foster care were significant individual correlates with full completion of treatment. Use of an Alliance Building Dropout Management program may help decrease overall dropout over and above the contribution of other variables known to impact treatment completion.
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Affiliation(s)
- Jessica Eslinger
- Department of Psychiatry, 12252University of Kentucky, Lexington, KY, USA.,Center on Trauma and Children, 4530University of Kentucky, Lexington, KY, USA
| | - Ginny Sprang
- Department of Psychiatry, 12252University of Kentucky, Lexington, KY, USA.,Center on Trauma and Children, 4530University of Kentucky, Lexington, KY, USA
| | - Jenna Jodts
- Center on Trauma and Children, 4530University of Kentucky, Lexington, KY, USA
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Ghorbani M, Hoseini FS, Yunesian M, Salehin S, Talebi SS, Keramat A. A supportive randomized clinical trial on Iranian infertile women with the history of infertility treatments dropout following unsuccessful ART cycle/s: A study protocol. Heliyon 2023; 9:e13838. [PMID: 36879964 PMCID: PMC9984792 DOI: 10.1016/j.heliyon.2023.e13838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 12/27/2022] [Accepted: 01/23/2023] [Indexed: 02/19/2023] Open
Abstract
Introduction Due to high dropout rate of infertility treatments and lack of any intervention for motivating infertile couples to continue treatments, the present study will be conducted with the aim of designing, implementing and determining the effectiveness of the proposed intervention in order to continue infertility treatments. Methods & Analysis: We will conduct this study in two stages; a review of literature and past studies will be done to identify interventions that have been performed for infertile couples, and then an appropriate intervention with the aim of continuing infertility treatments for infertile women will be designed. After that a Delphi study will be designed in accordance with collected information of previous stages and will be approved by experts. In the second stage we will implement designed intervention of a randomized clinical trial on two groups of infertile women (control and intervention) with the history of infertility treatment dropout following unsuccessful cycle. We will use descriptive statistic in first and second stage. In second stage Chi square test and independent samples T test will be used to compare variables between groups and variables in study questionnaires before and after the intervention between two groups of study. Discussion The present study will be the first study to be performed as a clinical trial on infertile women who have discontinued the treatments, with the aim of continuing treatments. Thereupon, it seems that the results of this study will be the basis for studies around the world to prevent premature cessation of infertility treatments.
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Affiliation(s)
- Maryam Ghorbani
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Fatemeh Sadat Hoseini
- Faculty Member of School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Masud Yunesian
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrbanoo Salehin
- Sexual Health and Fertility Research center. Shahroud University of Medical sciences. Shahroud. Iran
| | - Seyedeh Solmaz Talebi
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Afsaneh Keramat
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
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Rivers NJ, Maira C, Wise J, Hapner ER. The Impact of Referral Source on Voice Therapy. J Voice 2023; 37:297.e7-297.e13. [PMID: 33610441 DOI: 10.1016/j.jvoice.2020.12.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/12/2020] [Accepted: 12/15/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Adherence to voice therapy is essential in achieving successful voice outcomes. Previous studies within the field of voice therapy have suggested that shorter wait times and utilization of an interprofessional practice (IPP) model of care have a positive effect on voice therapy completion rates. While the implementation of IPP has gained popularity, especially at academic voice centers, the majority of speech-language pathologists (SLP) practice in a traditional (T) setting where they are unaffiliated with the referring otolaryngologist. PURPOSE This study aims to further examine how SLP practice models (interprofessional vs traditional) affect voice therapy initiation and completion rates. The secondary aim is to determine if voice therapy attendance rates have changed since the authors' initial investigations over 10 years ago. METHODS A retrospective chart review of 452 patients was conducted. Data was collected on patient demographics (sex, age), diagnosis, severity of dysphonia (CAPE-V), quality of life impact (V-RQOL raw score), practice setting (IPP vs T), date of referral, date of voice therapy initial evaluation, number of therapy sessions completed, and attendance to therapy sessions defined as completion or dropout. RESULTS/CONCLUSIONS Initiation of voice therapy treatment was the point in the referral process that was most impacted by practice model. Over half (53%) of referrals to voice therapy in a traditional practice model did not lead to initiation of treatment, while only 23% of the referrals taking place in an IPP model failed to initiate (P < 0.001). This study also demonstrated an improving, but continued rate of noninitiation and dropout from voice therapy when compared to data that was collected 10 years prior.
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Soerensen J, Nielsen DS, Pihl GT. It's a hard process - Nursing students' lived experiences leading to dropping out of their education; a qualitative study. Nurse Educ Today 2023; 122:105724. [PMID: 36706733 DOI: 10.1016/j.nedt.2023.105724] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 01/06/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Dropout from nursing education is a serious problem worldwide. Student nurse attrition has a profound effect not only on the nursing profession and patient care, but also on the students themselves. Dropout is recognized as a complex phenomenon that has multiple causes. A more detailed and nuanced understanding of the complexity behind dropout is needed if we are to retain more nursing students. AIM To explore the students' experiences and considerations before dropping out and their reflections after dropping out to gain a deeper understanding of the factors that prompted them to leave their nursing education. DESIGN/METHOD A qualitative explorative design inspired by Gadamer's philosophical hermeneutics was used to explore the students' lived experiences and considerations concerning dropping out. Qualitative telephone interviews were conducted on 15 nursing students. RESULTS The analysis revealed three main themes that disclosed and elucidated the nursing students' reasons for dropping out: (i) Resources to make a difference and help others; (ii) Clinical practice was more demanding than expected; (iii) The learning environment was important - the social environment was essential. CONCLUSION The students encountered a lack of support to deal with the difficult emotions that arose when witnessing serious illness and death. They expressed feeling overwhelmed by their vulnerability and called for support to develop resilience. The social environment and a sense of belonging to the nursing profession were cited by students as being essential to this support.
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Affiliation(s)
- Jette Soerensen
- Med in Health Promotion and Education, UCL University College, Odense, Department of Occupational Therapy and Nursing, Denmark.
| | - Dorthe Susanne Nielsen
- Migrant Health Clinic, Department of Geriatric Medicine, Odense University Hospital, University of Southern Denmark, Denmark.
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Yalew M, Molla A, Bogale GG, Birhane T, Arefaynie M, Damtie Y, Kefale B, Adane B. Spatial distribution and associated factors of dropout from health facility delivery after antenatal booking in Ethiopia: a multi-level analysis. BMC Womens Health 2023; 23:79. [PMID: 36823622 PMCID: PMC9948476 DOI: 10.1186/s12905-023-02229-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 02/14/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Nowadays, retaining women in the continuum of care throughout the lifecycle: adolescence, pregnancy, childbirth, postpartum, and childhood in reproductive health is one of the recent global concerns. Most of the previous studies focused on individual-level factors and used classical logistic regression. Furthermore, it doesn't take into account its distribution. Therefore, this study aimed to assess spatial distribution, and associated factors of dropout from health facility delivery after antenatal booking among postpartum women in Ethiopia. METHOD Cross-sectional study by secondary analysis of the Ethiopian Mini Demographic and Health Survey (EMDHS) 2019 dataset was conducted among postpartum women. A total of 2882 women who gave birth 5 years prior to the survey were included. Sampling weight was applied and the analysis was done using STATA version 16. Aeronautical Reconnaissance Coverage Geographic Information System (ArcGIS) 10.8 software was used to map the cluster and attribute of dropout from health facility delivery and Global and local Moran's Index methods were used to assess the extent of clustering. Multi-level (two-level) logistic regression analysis was used and variables with a P value less than 0.5 were considered statistical significance. Adjusted odds ratio AOR) with a 95% confidence interval was used to show the strength and direction of the association respectively. RESULTS Dropout from health facility delivery after ANC (Antenatal Care) booking in Ethiopia was 35.42%, 95% CI (33.70, 37.19), and it spatially clustered (Moran's index = 0.51, P value < 0.001). From individual-level variables: women who were primary educated [AOR = 0.70, 95% CI (0.49, 0.98)], secondary educated [AOR = 0.38, 95% CI (0.19, 0.73)], lived in the middle [AOR = 0.54, 95% CI (0.29, 0.98)], richer wealth [AOR = 0.37, 95% CI (0.18, 0.78)], richest wealth [AOR = 0.21, 95% CI (0.06, 0.74)], being counseled about pregnancy and childbirth complications [AOR = 0.52, 95% CI (0.34, 0.80)] and women who had four and above ANC visit [AOR = 0.52, 95% CI (0.38, 0.71)] were negatively associated with dropout. Whereas, second birth order [AOR = 2.62, 95% CI (1.40, 4.89)], 3-4th birth order [AOR = 4.92, 95% CI (2.82, 8.60)], above 4th birth order [AOR = 4.77, 95% CI (2.16, 10.53))] were positively associated with dropout. From community-level variables: mothers who lived in Afar [AOR = 2.61, 95% CI (1.08, 6.32)] and Oromia [AOR = 2.63, 95% CI (1.15, 6.02)] were positively associated with dropout from health facility delivery after ANC booking. CONCLUSIONS Dropout from health facility delivery after ANC booking was high as the government's effort and its spatial distribution in Ethiopia was clustered. Increased educational status of the mother, having four or more ANC visits, counseled about pregnancy and childbirth complications, and higher household wealth were negatively associated and higher birth order, and living in Oromia and Afar region were positively associated with dropout in Ethiopia. Strengthening women's education, encouraging women to complete ANC visits, being counseled them on pregnancy and childbirth complications, and improving family wealth status will be the recalled intervention areas of the government.
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Affiliation(s)
- Melaku Yalew
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
| | - Asiressie Molla
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Getahun Gebre Bogale
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tesfaye Birhane
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mastewal Arefaynie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yitayish Damtie
- Department of Reproductive Health, School of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bezawit Adane
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
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Gouse BM, Kline ER. Clinical insights: Preventing psychosis treatment disengagement. Schizophr Res 2023; 252:64-66. [PMID: 36628870 PMCID: PMC10593115 DOI: 10.1016/j.schres.2022.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/07/2022] [Accepted: 12/23/2022] [Indexed: 01/10/2023]
Abstract
Many patients with schizophrenia spectrum disorders disengage from treatment, with negative impacts on prognosis and recovery. This commentary provides an overview of common reasons underlying treatment dropout and strategies for overcoming obstacles and enhancing patient engagement. Basic clinical skills such as open-ended questions and reflective listening can be powerful tools in unmasking structural and attitudinal barriers to psychosis care.
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Affiliation(s)
- Brittany M Gouse
- Boston University School of Medicine, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, United States of America; Boston Medical Center, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, United States of America
| | - Emily R Kline
- Boston University School of Medicine, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, United States of America; Boston Medical Center, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, United States of America.
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Lucas I, Granero R, Fernández-Aranda F, Solé-Morata N, Demetrovics Z, Baenas I, Gómez-Peña M, Moragas L, Mora-Maltas B, Lara-Huallipe ML, Jiménez-Murcia S. Gambling disorder duration and cognitive behavioural therapy outcome considering gambling preference and sex. J Psychiatr Res 2023; 158:341-349. [PMID: 36638624 DOI: 10.1016/j.jpsychires.2022.12.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022]
Abstract
Gambling Disorder (GD) is a behavioural addiction that leads to high level of clinical distress and, in general, it is characterized by enduring symptomatology that presents high rates of chronicity. However, there is high variability of illness duration among patients who seek treatment for GD. Previous studies reported mixed results about the relevance of illness duration in GD treatment outcome. However, there are different profiles of patients who are diagnosed with GD. For this reason, this study aimed to evaluate the effect of illness duration in the treatment outcome of different profiles of GD patients according to their gambling preference and sex. The sample were 1699 patients diagnosed with GD. All patients received cognitive-behavioural therapy in a group format. Treatment outcome was evaluated in terms of relapsing to gambling behaviours and dropout from treatment. Results showed higher probability of poor outcome in the first years of the disorder for strategic gambling compared to non-strategic or mixed forms of gambling. Moreover, women also showed higher probability of poor outcomes than men since the first stages of the disorder. This study draws attention to the relevance of illness duration in the treatment outcome of specific profiles of GD patients. In particular, patients who presented a preference for strategic forms of gambling and women who are diagnosed with GD would have a higher risk of poor treatment outcomes since the first stages of the disorder. These results highlight the importance of an early intervention in these patients in order to prevent the chronicity of the disorder.
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Affiliation(s)
- Ignacio Lucas
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain.
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
| | - Neus Solé-Morata
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
| | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Isabel Baenas
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
| | - Mónica Gómez-Peña
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
| | - Laura Moragas
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
| | - Bernat Mora-Maltas
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
| | - Milagros Lizbeth Lara-Huallipe
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Ruelas AL, Martínez Contreras TDJ, Esparza Romero J, Díaz Zavala RG, Candia Plata MDC, Hingle M, Armenta Guirado B, Haby MM. Factors influencing adults to drop out of intensive lifestyle interventions for weight loss. Transl Behav Med 2023; 13:245-254. [PMID: 36694376 PMCID: PMC10105866 DOI: 10.1093/tbm/ibac112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Reducing ≥5% of body weight can decrease the risk of developing chronic diseases in adults with excess weight. Although Intensive Lifestyle Interventions (ILIs) that include cognitive-behavioral techniques to improve physical activity and eating habits are the best approach for losing weight, the failure to retain participants is a barrier to their successful implementation. We aimed to investigate the factors influencing adults to drop out of ILIs for weight loss at six months. We conducted retrospective multiple logistic regression analysis of 268 participants with excess weight (body mass index ≥ 25 kg/m2) from a multicenter study (n = 237, in-person ILI in five clinics, delivered by nutrition interns), and a randomized controlled trial (n = 31, one online ILI, delivered by a master's degree student). The same research team conducted both studies in Northern Mexico, using the same intervention components, and identical instruments and techniques to collect the data. We found that older participants (≥50 years) were less likely to drop out of the ILI for weight loss compared to participants <35 years old (OR = 0.34, 95% CI = 0.16-0.70). For each unit increase in the bodily pain scale of the SF-36 (less perceived pain), the risk of dropping out decreased by 2% (OR = 0.98, 95% CI = 0.97, 0.996), while a change in the interventionist during the 6-month intervention more than doubled the risk of dropping out (OR 2.25, 95% CI = 1.23-4.14). Retention in ILIs may be improved by ensuring that the same interventionist remains during the six-month intervention. In addition, ILIs may need further tailoring for younger ages and for participants with higher perceived pain.
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Affiliation(s)
- Alma L Ruelas
- Programa de Doctorado en Ciencias Químico Biológicas y de la Salud, Departamento de Ciencias Químico-Biológicas, Universidad de Sonora, Encinas y Rosales s/n Hermosillo, Sonora, 83000, México
| | - Teresita de Jesús Martínez Contreras
- Centro de Promoción de Salud Nutricional, Departamento de Ciencias Químico-Biológicas, Universidad de Sonora, Encinas y Rosales s/n Hermosillo, Sonora, 83000, México
| | - Julián Esparza Romero
- Unidad de Investigación en Diabetes, Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera Gustavo Enrique Astiazarán Rosas, No.46, C.P. 83304, Hermosillo, Sonora, México
| | - Rolando Giovanni Díaz Zavala
- Centro de Promoción de Salud Nutricional, Departamento de Ciencias Químico-Biológicas, Universidad de Sonora, Encinas y Rosales s/n Hermosillo, Sonora, 83000, México
| | - Maria Del Carmen Candia Plata
- Departamento de Medicina y Ciencias de la Salud, Universidad de Sonora, Encinas y Rosales s/n Hermosillo, Sonora, 83000, México
| | - Melanie Hingle
- Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Brianda Armenta Guirado
- Centro de Investigación en Nutrición y Salud Pública, Instituto Nacional de Salud Pública, Av. Universidad 655, col. Santa María Ahuacatitlán, Cuernavaca, Morelos, 62100, México
| | - Michelle M Haby
- Departamento de Ciencias Químico-Biológicas, Universidad de Sonora, Encinas y Rosales s/n Hermosillo, Sonora, 83000, México.,Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, 3010, Australia
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Ekkekakis P, Biddle SJH. Extraordinary claims in the literature on high-intensity interval training (HIIT): IV. Is HIIT associated with higher long-term exercise adherence? Psychol Sport Exerc 2023; 64:102295. [PMID: 37665824 DOI: 10.1016/j.psychsport.2022.102295] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 08/29/2022] [Accepted: 09/12/2022] [Indexed: 09/06/2023]
Abstract
Nonadherence to and dropout from regular exercise and physical activity are important reasons why the field of exercise science has yet to fulfill its promise of improving public health on a global scale. Researchers have claimed that High-Intensity Interval Training (HIIT) is a feasible and sustainable exercise modality that may result in higher long-term adherence than moderate-intensity continuous exercise. If true, this would be a breakthrough discovery that could unlock the potential of exercise as a health-promoting intervention. We performed a systematic search of the literature and identified eight trials comparing HIIT to moderate-intensity continuous exercise, all of which involved follow-up periods of at least 12 months (i.e., SWIFT, Small Steps for Big Changes, SAINTEX-CAD, SMARTEX-HF, Generation 100, FITR, OptimEx-Clin, HITTS). Findings from these trials demonstrate that, while unsupervised, individuals initially assigned to HIIT tend to exercise at lower-than-prescribed intensities and HIIT groups demonstrate no advantage in long-term adherence.
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Affiliation(s)
| | - Stuart J H Biddle
- Centre for Health Research, University of Southern Queensland, Australia
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44
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Yu H, Zeng W, Zhou W, Feng Y. Apolipoprotein A1 is associated with meibomian gland dropout. Ocul Surf 2023; 27:38-40. [PMID: 36535494 DOI: 10.1016/j.jtos.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/08/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Haozhe Yu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China; Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
| | - Weizhen Zeng
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Wenyan Zhou
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Yun Feng
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China; Institute of Medical Technology, Peking University Health Science Centre, Beijing, China.
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45
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Sharma P, Yadav DK, Shrestha N, Ghimire P. Dropout Analysis of a National Social Health Insurance Program at Pokhara Metropolitan City, Kaski, Nepal. Int J Health Policy Manag 2022; 11:2476-2488. [PMID: 35042322 PMCID: PMC9818104 DOI: 10.34172/ijhpm.2021.171] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 12/12/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Nepal's national social health insurance (SHI) program, which started in 2016, aims to achieve universal health coverage (UHC), but it faces severe challenges in achieving adequate population coverage. By 2018, enrolment and dropout rates for the scheme were 9% and 38% respectively. Despite government's efforts, retaining the members in SHI scheme remains a significant challenge. The current study therefore aimed to assess the factors associated with SHI program dropout in Pokhara, Nepal. METHODS A cross-sectional household survey of 355 households enrolled for at least one year in the national SHI program was conducted. Face-to-face interviews with household heads were conducted using a structured questionnaire. Data was entered in Epi-Data and analysed using SPSS. The factors associated with SHI program dropout were identified using bivariate and multiple logistic regression analyses. RESULTS The findings of the study revealed a dropout prevalence of 28.2% (95% CI: 23.6%-33.2%). Households having more than five members (adjusted odds ratio [aOR]: 2.19, 95% CI: 1.22-3.94), belonging to underprivileged ethnic groups (Dalit/Janajati) (aOR: 2.36, 95% CI: 1.08-5.17), living on rented homes (aOR: 4.53, 95% CI: 1.87-10.95), absence of chronic illness in family (aOR: 1.95, 95% CI: 1.07-3.59), perceived good health status of the family (aOR: 4.21, 95% CI: 1.21-14.65), having private health facility as first contact point (aOR: 3.75, 95% CI: 1.93-7.27), poor availability of drugs (aOR: 4.75, 95% CI: 1.19-18.95) and perceived unfriendly behaviour of service providers (aOR: 3.09, 95% CI: 1.01-9.49) were statistically significant factors associated with SHI dropout. CONCLUSION In Pokhara, more than one-fourth of households have dropped out of the SHI scheme, which is a significant number. Dropping out of SHI is most commonly associated with a lack of drugs, followed by rental housing, family members' reported good health status and unfriendly service provider behaviour. Efforts to reduce SHI dropout must focus on addressing drugs availability issues and improving providers' behaviour towards scheme holders. Increasing insurance awareness, including provisions to change first contact points, may help to reduce dropouts among rented households, which make up a sizable proportion of the Pokhara metropolitan area.
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Affiliation(s)
- Prabin Sharma
- School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
| | | | - Niranjan Shrestha
- School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
| | - Prabesh Ghimire
- Central Department of Public Health, Institute of Medicine, Tribhuwan University, Kathmandu, Nepal
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Wiegel J, Seppen BF, Nurmohamed MT, Bos WH, ter Wee MM. Who stop telemonitoring disease activity and who adhere: a prospective cohort study of patients with inflammatory arthritis. BMC Rheumatol 2022; 6:73. [PMID: 36447263 PMCID: PMC9708135 DOI: 10.1186/s41927-022-00303-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/29/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The use of frequent electronic patient reported outcome measures (ePRO's) enables monitoring disease activity at a distance (telemonitoring) in patients with inflammatory arthritis. However, telemonitoring studies report declining long-term adherence to reporting ePRO's, which may oppose the benefits of telemonitoring. Therefore, the objective was to investigate what factors are associated with (non-)adherence to telemonitoring with a weekly ePRO in patients with inflammatory arthritis (IA). METHODS We performed a prospective cohort study in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) at Reade Amsterdam, The Netherlands. Patients telemonitored their disease activity weekly for 6 months with a modified Multidimensional Health Assessment Questionnaire completed in a smartphone application. The primary outcome was time to dropout, defined as ≥ 4 weeks of consecutively nonresponse. Based on literature and through expert meetings, a predefined set of 13 baseline factors were selected to assess the association with time to dropout through a multivariable Cox-regression analysis. RESULTS A total of 220 consecutive patients were included (mean age 54, SD 12; 55% females; 99 RA, 81 PsA, and 40 AS). A total of 141 patients (64%) dropped out, with a median time to dropout of 17 weeks (IQR 9-26). Women had a significant higher chance to dropout over 6 months compared to men (HR 1.58, 95% CI 1.06-2.36). CONCLUSION In the set of investigated factors, women stopped reporting the weekly ePRO sooner than men. Future focus group discussions will be performed to investigate the reasons for dropout, and in specific why women dropped out sooner. Trial registration This trials was prospectively registered at www.trialregister.nl (NL8414).
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Affiliation(s)
- J. Wiegel
- grid.418029.60000 0004 0624 3484Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, Admiraal Helfrichstraat 1, 1056 AA Amsterdam, The Netherlands ,grid.12380.380000 0004 1754 9227Rheumatology and Immunology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands ,Amsterdam Infection and Immunity, Amsterdam, The Netherlands
| | - B. F. Seppen
- grid.418029.60000 0004 0624 3484Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, Admiraal Helfrichstraat 1, 1056 AA Amsterdam, The Netherlands ,grid.12380.380000 0004 1754 9227Rheumatology and Immunology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands ,Amsterdam Infection and Immunity, Amsterdam, The Netherlands
| | - M. T. Nurmohamed
- grid.418029.60000 0004 0624 3484Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, Admiraal Helfrichstraat 1, 1056 AA Amsterdam, The Netherlands ,grid.12380.380000 0004 1754 9227Rheumatology and Immunology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands ,Amsterdam Infection and Immunity, Amsterdam, The Netherlands
| | - W. H. Bos
- grid.418029.60000 0004 0624 3484Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, Admiraal Helfrichstraat 1, 1056 AA Amsterdam, The Netherlands
| | - M. M. ter Wee
- grid.12380.380000 0004 1754 9227Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XSocietal Participation and Health, Amsterdam Public Health, Amsterdam, The Netherlands ,Amsterdam Public Health, Methodology, Amsterdam, The Netherlands
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Fu L, Sun J, Wang S, Xu M, Yao K, Zhou X. Nondestructive evaluation of Zn content in rape leaves using MSSAE and hyperspectral imaging. Spectrochim Acta A Mol Biomol Spectrosc 2022; 281:121641. [PMID: 35870430 DOI: 10.1016/j.saa.2022.121641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
Zinc (Zn) content plays a decisive role in plant growth. Accurate management of Zn fertilizer application can promote high-quality development of the oilseed rape industry. This study adopted a deep learning (DL) method to predict the Zn content of oilseed rape leaves using hyperspectral imaging (HSI). The dropout mechanism was introduced to improve the stacked sparse autoencoder (SSAE) and named modified SSAE (MSSAE). MSSAE extracted deep spectral features of samples based on pixel-level spectral information (the wavelength range of the spectrum is 431-962 nm). Subsequently, the deep spectral features were applied as the inputs for support vector regression (SVR) and least squares support vector regression (LSSVR) to predict the Zn content in oilseed rape leaves. In addition, the successive projections algorithm (SPA) and the variable iterative space shrinkage approach (VISSA) were investigated as wavelength selection algorithms for comparison. The results showed that the MSSAE-LSSVR model had the best prediction performance (the coefficient of determination (R2) and root mean square error (RMSE) of the prediction set were 0.9566 and 1.0240 mg/kg, respectively). The overall results showed that the MSSAE was able to extract the deep features of HSI data and validated the possibility of HSI combined with a DL method for nondestructive testing of Zn content in oilseed rape leaves.
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Affiliation(s)
- Lvhui Fu
- School of Electrical and Information Engineering of Jiangsu University, Zhenjiang 212013, China
| | - Jun Sun
- School of Electrical and Information Engineering of Jiangsu University, Zhenjiang 212013, China.
| | - Simin Wang
- School of Electrical and Information Engineering of Jiangsu University, Zhenjiang 212013, China
| | - Min Xu
- School of Electrical and Information Engineering of Jiangsu University, Zhenjiang 212013, China
| | - Kunshan Yao
- School of Electrical and Information Engineering of Jiangsu University, Zhenjiang 212013, China
| | - Xin Zhou
- School of Electrical and Information Engineering of Jiangsu University, Zhenjiang 212013, China
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48
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Alamu R, Roy Y, Das S. The neglect of researchers during the first COVID-19 pandemic induced national lockdown in India: inside the lives of JNU's research scholars. High Educ (Dordr) 2022; 86:1-28. [PMID: 36277660 PMCID: PMC9579556 DOI: 10.1007/s10734-022-00927-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
This p aper discusses the main findings of a study on the impact of the first COVID-19 induced nationwide lockdown and university closure in India on the research scholars (PhD and MPhil) of the Jawaharlal Nehru University (JNU). An online survey was employed using the quantitative descriptive methodology. With responses from 530 research scholars, this is one of the first quantitative studies to assess the pandemic's effect on the research work, finances, and mental health of researchers in India from March to June 2020. Given the existing social inequality in higher education, the survey reflects the researchers' dismal state of reality as reported during the first 4 months of the pandemic. Research work witnessed a standstill with large-scale disruption in travel and every other scholar encountering unreliable electricity or internet connectivity. Untimely disbursal of fellowships intensified their already existing financial hardship. Nearly 90% of scholars reported stalled fieldwork, a lack of clarity regarding extension of their research programme, and financial woes as some of the top reasons for their anxiety. Using the chi-square method, the study predicts that dropouts from research programmes are likely in the context of the pandemic, which correlates significantly with socio-economic backgrounds (caste, class and gender) of research scholars. Further, the results show that the challenges faced by terminal, mid-stage, and course-work scholars are unique, emphasizing on the need for targeted interventions beyond extended research deadlines. Non-addressal of these immediate effects of the COVID-19 pandemic will have long-term repercussions on the lives of India's researchers and academic workers. It will only deepen existing inequalities in higher education, leading to gentrification of research degrees in India. Supplementary Information The online version contains supplementary material available at 10.1007/s10734-022-00927-4.
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Affiliation(s)
- Alamu R
- Centre for Political Studies, School of Social Sciences, JNU, New Delhi, India
| | - Yangchen Roy
- Centre for Linguistics, School of Language, Literature and Cultural Studies, JNU, New Delhi, India
| | - Somashree Das
- Centre for the Study of Regional Development, School of Social Sciences, JNU, New Delhi, India
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van Dijk DA, Deen ML, van den Boogaard TM, Ruhé HG, Spijker J, Peeters FPML. Prevalence and prediction of dropout during depression treatment in routine outpatient care: an observational study. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01499-1. [PMID: 36253582 PMCID: PMC10359217 DOI: 10.1007/s00406-022-01499-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/27/2022] [Indexed: 11/24/2022]
Abstract
Efficacious treatments are available for major depressive disorder (MDD), but treatment dropout is common and decreases their effectiveness. However, knowledge about prevalence of treatment dropout and its risk factors in routine care is limited. The objective of this study was to determine the prevalence of and risk factors for dropout in a large outpatient sample. In this retrospective cohort analysis, routinely collected data from 2235 outpatients with MDD who had a diagnostic work-up between 2014 and 2016 were examined. Dropout was defined as treatment termination without achieving remission before the fourth session within six months after its start. Total and item scores on the Dutch Measure for Quantification of Treatment Resistance in Depression (DM-TRD) at baseline, and demographic variables were analyzed for their association with dropout using logistic regression and elastic net analyses. Data of 987 subjects who started routine outpatient depression treatment were included in the analyses of which 143 (14.5%) dropped out. Higher DM-TRD-scores were predictive for lower dropout odds [OR = 0.78, 95% CI = (0.70-0.86), p < 0.001]. The elastic net analysis revealed several clinical variables predictive for dropout. Higher SES, higher depression severity, comorbid personality pathology and a comorbid anxiety disorder were significantly associated with less dropout in the sample. In this observational study, treatment dropout was relatively low. The DM-TRD, an easy-to-use clinical instrument, revealed several variables associated with less dropout. When applied in daily practice and combined with demographical information, this instrument may help to reduce dropout and increase treatment effectiveness.
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Affiliation(s)
- D A van Dijk
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands. .,Department of Mood Disorders, PsyQ Haaglanden, The Hague, The Netherlands. .,Parnassia Psychiatric Institute, Monsterseweg 93, 2553 RJ, The Hague, The Netherlands.
| | - M L Deen
- Parnassia Psychiatric Institute, The Hague, The Netherlands.,Institute of Psychology, Leiden University, Leiden, The Netherlands
| | | | - H G Ruhé
- Department of Psychiatry, Radboudumc, Nijmegen, The Netherlands.,Donders Institute for Brain and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - J Spijker
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Pro Persona Mental Healthcare, Nijmegen, The Netherlands
| | - F P M L Peeters
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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50
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Schienle A, Jurinec N. Open-label placebos as adjunctive therapy for patients with depression. Contemp Clin Trials Commun 2022; 28:100948. [PMID: 35754973 PMCID: PMC9228278 DOI: 10.1016/j.conctc.2022.100948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 05/10/2022] [Accepted: 06/08/2022] [Indexed: 11/24/2022] Open
Abstract
Background Placebos prescribed as 'regular' medication can reduce symptoms of depression. However, using a placebo without patients' informed consent presents ethical issues. Therefore, the present study assessed the efficacy of an open-label placebo (OLP), which was administered concurrently with cognitive-behavioral therapy (CBT). Methods Sixty patients (mean age: 48 years) diagnosed with major depressive disorder were randomly assigned to a 4-week CBT outpatient program with or without daily OLP treatment. The patients were assessed directly before and after the program as well as three months after the therapy. Results Compared to the CBT group, the CBT + OLP group showed a greater reduction in symptoms of depression at the end of the program. Changes in categories pertaining to severity of depression did not differ between groups. All patients completed the program. Noncompliance with the follow-up appointment differed significantly between CBT + OLP (27%) and CBT (7%). Noncompliance was associated with a negative evaluation of the OLP. Conclusions The OLP intervention reduced symptoms of depression, however, these changes were not clinically meaningful. The OLP increased the risk for loss to follow-up. The high dropout rate in the present study raises questions concerning the acceptance of OLPs in the treatment of depression.
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Affiliation(s)
- Anne Schienle
- University of Graz, Department of Clinical Psychology, Graz, Austria
| | - Nina Jurinec
- University of Graz, Department of Clinical Psychology, Graz, Austria.,Community Health Center Gornja Radgona, Gornja Radgona, Slovenia
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