An ecological model of dropout intention in university students during the covid-19 pandemic

Objective: To analyse the drop out intention of university students after six months of home confinement during the covid-19 pandemic using an ecological model. Method: A non-experimental cross-sectional study with an intentional sampling of 1,011 active university students during 2020. Aged between 18 and 54 years (M = 22,6; SD = 4,8; female = 438). We evaluated them with the university dropout questionnaire for students, Depression, Anxiety and Stress Scale, Fear of covid-19 Scales, covid-19 Anxiety syndrome scale, and the Satisfaction with academic changes questionnaire. We performed a descriptive and multivariate analysis of the data. Results: The model explain 28 % of drop out intention among university students during confinement by covid-19 (sensitivity = 86,8 %). Dissatisfaction with academic changes is the main predictor of the model (OR = 0,960; IC 95 % [0,950, 0,959). Other significant predictors are positive and negative interactions (i.e., in family, social, and academic environments), negative emotional symptoms, anxiety about covid-19, being older, studying at a private university, and having a family member diagnosed with covid-19. Discussions: Macrosystem changes (i.e., home confinement and online classes) during the first six months of the covid-19 pandemic modified the students' interaction with their proximal systems and new predictors of the intention to drop out emerged (e.g., anxiety about covid-19 and having a family member diagnosed with covid-19), associated with the context of confinement.

Objetivo: Analizar la intención deserción de los estudiantes universitarios tras seis meses de confinamiento en casa durante la pandemia por covid-19 a partir de un modelo ecológico. Método: Estudio transversal no experimental con un muestreo intencional de 1011 estudiantes universitarios activos durante 2020. Con edades comprendidas entre los 18 y los 54 años (M = 22,6; DE = 4,8; mujeres = 438). Los estudiantes respondieron el cuestionario de abandono universitario para estudiantes, la Escala de Depresión, Ansiedad y Estrés, la Escala de Miedo de covid-19, la Escala de Síndrome de Ansiedad de covid-19 y el cuestionario de Satisfacción con los cambios académicos. Se realizó un análisis descriptivo y multivariante de los datos. Resultados: El modelo explica el 28 % de la varianza de la intención de deserción entre los estudiantes universitarios durante el confinamiento por covid-19 (sensibilidad = 86,8 %). La insatisfacción ante los cambios académicos es el principal predictor del modelo (OR = 0,960; IC 95 % [0,950, 0,959). Otros predictores significativos son las interacciones positivas y negativas (i.e., en el entorno familiar, social y académico), los síntomas emocionales negativos, la ansiedad ante la covid-19, ser mayor, estudiar en una universidad privada y tener un familiar diagnosticado con covid-19. Conclusiones: Los cambios en el macrosistema (i.e., el confinamiento en el hogar y las clases en línea) durante los primeros seis meses de la pandemia por covid-19 modificaron la interacción de los estudiantes con sus sistemas proximales y surgieron nuevos predictores de la intención de abandono (e.g., ansiedad ante la covid-19 y tener un familiar diagnosticado con covid-19), asociados al contexto de confinamiento.

Re-engagement and influencing factors of patients with human immunodeficiency virus infection during anti-retroviral therapy in Yunnan Province / 中华传染病杂志

Objective:To investigate the situation of patients with human immunodeficiency virus (HIV) infection who re-engaging treatment after dropping-out during anti-retroviral therapy (ART), and the influencing factors of ART re-engagement in Yunnan Province.Methods:The total dropping-out cases of ART up to December 31, 2018, including cases of lost-of-follow-up and withdrawing medications in Yunnan Province were included. The status of drop-out and demographic data were collected from survey questionnaires and the extracted medical-visiting records from the China National Free Antiretroviral Treatment Program Database of Chinese Center for Disease Control and Prevention. Chi-square test was used in statistical analysis and logistic regression was applied in analyzing factors related with re-engagement.Results:Among the total 6 075 cases with HIV infection which were recorded with the status of drop-out during ART in Yunnan Province, 5 340(87.9%) cases were confirmed drop-out, 540(8.9%) cases were false dropping-out due to belated medical visiting records, 109(1.8%) cases provided invalid answers or had no response to survey questionnaire, and 86(1.4%) cases failed to report results. Among 5 340 confirmed drop-out cases, the findings showed that 923(17.3%) cases were tracked and successfully re-initiated ART, 2 327(43.6%) cases could not be contacted, 1 443(27.0%) cases refused ART, 100(1.9%) cases died, 39(0.7%) cases came back for treatment by self-willing, 91(1.7%) cases were detained, and 417(7.8%) cases were in other situations. Tracking the dropping-out cases were through the workers based on the health facilities including ART clinics, centers for disease control and prevention and the community-based organizations. They tracked the dropping-out cases by phone, through household visiting or face-to-face communication. Statistically significant differences were found in the proportion of patients re-engagement by gender, re-engagement age, route of infection, education level and time from entry to last loss ( χ2=6.14, 21.26, 8.24, 17.69, 12.75, respectively, all P<0.050). The logistic regression suggested that the protective factors related with the re-engagement included female (adjusted odds ratio (a OR)=1.34, 95% confidence interval ( CI) 1.12 to 1.61, P=0.002), re-engagement age≤30 year-old (a OR=1.78, 95% CI 1.25 to 2.55, P<0.001), age of 31 to 60 year-old (a OR=1.33, 95% CI 1.01 to 1.76, P=0.043), education level with primary school to high school or technical secondary school (a OR=1.56, 95% CI 1.21 to 2.01, P<0.001), the period>24 months between first initiating ART and dropping-out (a OR=1.37, 95% CI 1.11 to 1.70, P=0.004). Conclusions:The program of tracking and re-engagement for ART dropping-out patients in Yunnan Province needs multi-department participation and investing large resources, but the success rate of tracking and re-engagement is not high. The protective factors related with re-engagement are female, re-engagement age≤60 year-old, education level with primary school to high school or technical secondary school, the period>24 months between first initiating ART and dropping-out.

Analysis of participants drop-out in antidepressant clinical trials and related influencing factors / 四川精神卫生

ObjectiveTo analyze the drop-out rate of participants in antidepressant clinical trials and to explore the related influencing factors. MethodsA retrospective analysis was carried out on the participants of 9 antidepressant clinical trials conducted at the Affiliated Brain Hospital of Guangzhou Medical University from 2013 to 2020. A self-compiled questionnaire was used to collect the subjects' demographic data， disease characteristics and the final completion of the trial， thereafter， the participant drop-out rate and related influencing factors were discussed. ResultsA total of 157 cases were enrolled， including 120 cases completed and 37 cases dropped out the trail. The causes of drop-out were poor efficacy in 13 cases （35.14%）， presence of adverse reactions in 12 cases （32.43%）， withdrawal of informed consent in 8 cases （21.62%） and loss of follow-up in 4 cases （10.81%）. Correlation analysis showed that participant drop-out was positively correlated with the level of anxiety （r=0.224， P<0.01） and presence of adverse events （r=0.158， P<0.05）， meantime， negatively correlated with the level of education （r=-0.209， P<0.01） and overall efficacy （r=-0.545， P<0.01）. Binary Logistic regression analysis showed that education level （β=-0.611， OR=0.543， P<0.05）， number of visits （β=-1.831， OR=0.160， P<0.01） and overall efficacy （β=-2.286， OR=0.102， P<0.01） were the influencing factors of participant drop-out. ConclusionLow education level， first visit， poor outcome， high level of anxiety， and adverse events are the factors affecting participant drop-out in antidepressant clinical trials.

Adherencia o deserción de adolescentes en psicoterapia por agresiones sexuales: la perspectiva de sus terapeutas / Adherence or Drop Out of Adolescents in Psychotherapy Due to Sexual Abuse: their Therapist's Perspective

Resumen Un alto porcentaje de adolescentes que asisten a psicoterapia por haber sido víctimas de agresiones sexuales desertan de su tratamiento, afectando así su proceso de superación. Existe escasa investigación respecto a qué precipita la deserción o favorece la adherencia en estos casos. Objetivo: describir características del sistema consultante y del proceso psicoterapéutico de adolescentes que han sido víctimas de agresiones sexuales que adhieren y que desertan de la psicoterapia, desde la perspectiva de sus psicoterapeutas, explorando sus similitudes y diferencias. Método: se realizaron entrevistas semiestructuradas a psicoterapeutas que atendieron 16 casos de adolescentes que han sido víctimas de agresiones sexuales, 8 que desertaron de la psicoterapia y 8 que adhirieron hasta el alta. Se realizó un análisis narrativo temático de las entrevistas. Resultados: las principales similitudes identificadas fueron contextos sociofamiliares multiproblemáticos, recursos personales en los adolescentes y una relación psicoterapéutica positiva. Las diferencias se enfocaron en los adultos responsables, quienes en los casos de deserción mostraban bajo apoyo, una relación más conflictiva con el adolescente, escaso involucramiento en la psicoterapia y una relación frágil con el psicoterapeuta. Los adolescentes que desertaron presentaron motivos de consulta no asociados con la agresión sexual y se caracterizaron por ser socialmente poco integrados, a diferencia de los que adhirieron. Discusión: los fenómenos de adherencia y deserción a psicoterapia son complejos y multifactoriales. Junto con factores asociados al sistema consultante, se destacan elementos del proceso psicoterapéutico que propician la adherencia, y que, por tanto, pueden ser abordados tempranamente para favorecer la adherencia a la psicoterapia.

Abstract A high percentage of adolescents who attend psychotherapy due to sexual abuse drop out of treatment, affecting the overcoming. There is little research on what precipitates desertion or promotes adherence in these cases. Aim: describe features of the consulting system and the psychotherapeutic process of adolescents who have been sexually abused who adhere and drop out of psychotherapy, in order to explore similarities and differences from the perspective of their psychotherapists. Methods: Semi-structured interviews were conducted with psychotherapists who attended 16 cases of adolescent victims of sexual abuse, 8 who deserted from psychotherapy and 8 who continued until discharge. Thematic narrative analysis of the interviews was developed. Results: the main similarities described were multiproblematic social and family contexts, personal resources in the adolescents and a positive psychotherapeutic relationship. Differences were focused on caretakers, who in the drop out cases showed low support and a more conflictive relationship with the adolescent, little involvement in psychotherapy and a poor relationship with the psychotherapist. Adolescents who deserted had consultation purposes not related with sexual abuse and low social integration, unlike those who adhered. Discussion: the phenomena of adherence and dropout of psychotherapy are complex and multifactorial. Along with factors associated with the consulting system, elements of the psychotherapeutic process that support adherence stand out, which can be addressed early in the process.

Motivos de evasão na pós-graduação no Brasil: um instrumento de medida / Drop-out reasons of graduation in Brazil: a measurement tool

A quantidade de pessoas que iniciam e que concluem as pós-graduações é discrepante, mesmo considerando-se a duração do curso. O objetivo deste trabalho foi adaptar a Escala de Motivos de Evasão do Ensino Superior (M-ES) para a Pós-Graduação. Foram realizados dois estudos para tal finalidade. No primeiro, os itens da M-ES foram avaliados por juízes que indicaram a necessidade de criação de novos itens. No segundo, participaram 639 pessoas entre 21 e 62 anos, a maioria da pós-graduação (75%). Dos modelos testados, a versão de 7 fatores, denominados motivos interpessoais, relacionados à carreira, falta de suporte, desempenho acadêmico, produção científica, reconhecimento acadêmico e institucionais, foi a que apresentou melhor ajuste. Os valores de alfa dos fatores variaram de 0,61 a 0,97. Sabendo da importância da ciência para o desenvolvimento de qualquer nação, fez-se necessário o desenvolvimento deste estudo, a fim de garantir que os pesquisadores tenham condições adequadas para a conclusão dos cursos e para contribuição com a ciência e sociedade de uma forma geral.

The number of people starting and completing graduation is discrepant, even considering course duration. The aim was to adapt the Escala de Motivos de Evasão do Ensino Superior (M-ES) (Scale of drop-out reasons in higher education) to the graduation context. Two studies were carried out; in the first, the M-ES items were evaluated by judges, and new ones were constructed according to the new setting. In the second study, 639 people participated, aged between 21 and 62 years, most attending a graduation course (75%). The 7-factor version fitted better, being composed of interpersonal motives, related to career, lack of support, academic performance, scientific production, academic recognition and institutional reasons. Alpha values ranged from 0.61 to 0.97. Science is fundamental to the development of any nation and it is necessary to ensure that those involved in research might have appropriate conditions to conclude their courses in order to contribute to the desired development.

Vaccination coverage of children in tribal Narmada district of Gujarat: a cross sectional study

Background: Vaccination being one of the cheapest and safest methods of primary prevention, indicators of maternal and child healthcare are crucial. Multi-indicator cluster survey was planned to check these objectives as set up in reproductive child health (RCH)-II and National Rural Health Mission (NRHM) plan. This study was initiated to determine the vaccination coverage among the children in tribal district in Gujarat and to determine factors associated with partial immunization and non-immunization.Methods: A community based cross-sectional study was done in tribal district Narmada in Gujarat for a period of four months from May 2011 to August 2011. The study population consisted of all children aged between 12-23 months. After using cluster sampling method, assessment of vaccination programme was obtained from 346 out of total 352 children scattered across 30 clusters. A pre-tested semi-structured questionnaire was administered by interview technique.Results: Highest coverage was seen in the first dose of diphtheria, pertussis, and tetanus (DPT) 95.7% (CI 92.3-99) followed by Bacillus Calmette-Guérin (BCG) 95.4% (CI 92-98.7) and first dose of oral poliovirus vaccines (OPV) 95.4% (CI 92-98.7). The proportion of fully immunized children was 77.7% (CI 69.4-86.1), whereas 2.9% (CI 0.0-6.1) children were not vaccinated at all. The drop-out rate was 8.76% from DPT1 to DPT3 and 16% for DPT1 to measles.Conclusions: Vaccination coverage was highest for DPT first dose followed by BCG. The drop- out rate was 8.76% from DPT1 to DPT3 and 16% for DPT1 to measles. Non-awareness regarding subsequent doses of vaccines was most common reason for partial or non-vaccination.

Quality of Same-Day Sputum Smears Microscopy and Presumptive Tuberculosis Patients Drop-out at Health Facilities of Addis Ababa, Ethiopia / 결핵

Effect of baseline CD4+ T cell count on drop-out of antiretroviral therapy in HIV infected persons in Guangxi Zhuang Autonomous Region, 2008-2015 / 中华流行病学杂志

Objective To investigate the effect of baseline CD4+T cell count (CD4) on drop-out of antiretroviral therapy (ART) in HIV infected persons.Methods Retrospective cohort was conducted in this study.HIV infected persons aged≥ 18 years and receiving free ART for the first time in Guangxi Zhuang Autonomous Region (Guangxi) from 2008 to 2015 were selected from the antiretroviral treatment database of National Comprehensive HIV/AIDS Information System,with follow-up conducted till May 30,2016.Cause-specific Cox proportional hazard models were used to evaluate effect of different CD4 on the drop-out of ART in the HIV infected persons.Results A total of 58 502 eligible study participants were included in this retrospective cohort study.The average drop-out ratio was 4.8/100 person-years.After controlling the following baseline covariates:age,sex,marital status,route of HIV infection,WHO clinical stage before ART,initial/current ART regiment,ART regiment adjustment,and year of initiating ART for potential confounding,the adjusted HR of drop-out for HIV infected persons with 200-cells/μl,351-cells/μl and ≥500 cells/μl were 1.110 (95％CI:1.053-1.171,P＜0.001),1.391 (95％CI:1.278-1.514,P＜0.001) and 1.695 (95％CI:1.497-1.918,P＜ 0.001),respectively,in risk for drop-out compared with those with baseline CD4 ＜200 cells/μ 1.Among the HIV infected persons,56.0％ (1 601/2 861) of drug withdrawal was due to poor compliance with medication.Conclusions With the increase of baseline CD4 when initiating ART,the risk for the drop-out in HIV infected persons increased significantly.To further reduce the drop-out of ART,it is important to take CD4 into account in initiating ART and to strengthen the health education on treatment compliancy and training for healthcare providers.

Effect of baseline CD4+ T cell count on drop-out of antiretroviral therapy in HIV infected persons in Guangxi Zhuang Autonomous Region, 2008-2015 / 中华流行病学杂志

Objective To investigate the effect of baseline CD4+T cell count (CD4) on drop-out of antiretroviral therapy (ART) in HIV infected persons.Methods Retrospective cohort was conducted in this study.HIV infected persons aged≥ 18 years and receiving free ART for the first time in Guangxi Zhuang Autonomous Region (Guangxi) from 2008 to 2015 were selected from the antiretroviral treatment database of National Comprehensive HIV/AIDS Information System,with follow-up conducted till May 30,2016.Cause-specific Cox proportional hazard models were used to evaluate effect of different CD4 on the drop-out of ART in the HIV infected persons.Results A total of 58 502 eligible study participants were included in this retrospective cohort study.The average drop-out ratio was 4.8/100 person-years.After controlling the following baseline covariates:age,sex,marital status,route of HIV infection,WHO clinical stage before ART,initial/current ART regiment,ART regiment adjustment,and year of initiating ART for potential confounding,the adjusted HR of drop-out for HIV infected persons with 200-cells/μl,351-cells/μl and ≥500 cells/μl were 1.110 (95％CI:1.053-1.171,P＜0.001),1.391 (95％CI:1.278-1.514,P＜0.001) and 1.695 (95％CI:1.497-1.918,P＜ 0.001),respectively,in risk for drop-out compared with those with baseline CD4 ＜200 cells/μ 1.Among the HIV infected persons,56.0％ (1 601/2 861) of drug withdrawal was due to poor compliance with medication.Conclusions With the increase of baseline CD4 when initiating ART,the risk for the drop-out in HIV infected persons increased significantly.To further reduce the drop-out of ART,it is important to take CD4 into account in initiating ART and to strengthen the health education on treatment compliancy and training for healthcare providers.

Funcionalidad familiar en escolares con comportamientos de riesgo psicosocial en una institución educativa de Sincelejo (Colombia) / Family function in schoolchildren with behavioral psychosocial risk in an educational institution in Sincelejo (Colombia)

Resumen Objetivo: Determinar el grado de Funcionalidad familiar y las funciones familiares de las familias de escolares que presentan comportamientos de riesgo psicosocial en una institución educativa de Sincelejo durante 2015. Materiales y métodos: Se realizó un estudio cuantitativo, de corte transversal descriptivo para conocer el grado de funcionalidad familiar y relaciones familiares en los escolares que presentaban conductas de riesgo psicosocial. Población constituida por 440 escolares; muestra de 69 escolares con conductas de riesgo psicosociales. Se recolectó la información utilizando la Prueba de Percepción del Funcionamiento Familiar (FF-SIL) y la encuesta de comportamientos agresivos y prosociales (COPRAG) para indagar las conductas de riesgo presentadas. La tabulación se realizó a través del programa sistematizado Epi Info 3.5.4; el análisis utilizó estadística descriptiva y medidas de tendencia central. Resultados: 83 % (57) de los escolares que presentaban conductas de riesgo eran del género masculino; la mayoría de 11 años de edad; la conducta más observada fue la violencia escolar, morbilidad física y psicológica. Las principales categorías que afectaban la funcionalidad familiar fueron la cohesión y la armonía; los escolares que pertenecían a pandillas, que presentaron ausentismo escolar y algún tipo de morbilidad, provenían de familias clasificadas como disfuncionales. Discusión y conclusiones: Se puede afirmar que los escolares intervinientes en el estudio provenientes de familias disfuncionales presentaron con mayor frecuencia pertenencia a pandillas, ausentismo escolar y algún tipo de morbilidad. Además, que pueden presentar varias conductas de riesgo simultáneamente.

Abstract Objetive: Establish the degree of Family Functionality and the family functions of the families of schoolchildren who present behavior of psychosocial risk in an educational institution of Sincelejo, during the year 2015 Materials and methods: A quantitative, descriptive cross-sectional study was carried out to determine the distribution of family functionality and family relationships in schoolchildren with behavioral psychosocial risk. Population constituted by 440 school children, sample of 69 school children with psychosocial risk behaviors. Data were collected using the FF-SIL Family Function Perception Test and the survey of aggressive and prosocial behaviors COPRAG the risk behaviors presented. The tabulation was performed through the Epi Info 3.5.4 system, the analysis used descriptive statistics and measures of central tendency. Results: 83 % (57) of schoolchildren who presented risky behaviors were males, most of them 11 years of age, the most observed behavior was school violence, physical and psychological morbidity. The main categories that affected family functionality were cohesion and harmony, Schoolchildren who belonged to trainees, who presented school absenteeism and some type of morbidity, came from families classified as dysfunctional. Discussion and conclusions: It can be affirmed that the students involved in the study from dysfunctional families showed more frequent gang membership, school absenteeism and some type of morbidity. In addition, they may present several risk behaviors simultaneously.

Correlation between insufficient methadone dosage and morphine positive urine on drop out of treatment in patients with access to methadone maintenance treatment / 中华流行病学杂志

Objective To estimate the incidence of drop out of treatment in patients with access to methadone maintenance treatment and explore the correlation and interaction between insufficient methadone dosage and morphine positive urine on the drop out in Guangxi Zhuang Autonomous Region.Methods Face to face interview was conducted in 1 031 patients at 3 methadone maintenance treatment clinics in Guangxi.Results The study included 1 031 participants,40.6％ of them (419/1 031) had stopped treatment.The drop out rates in urine morphine positive group and methadone dosage ＜ 100 mg/d group were 57.6％ (99/172) and 37.4％ (347/929) respectively,higher than those in urine morphine negative group and methadone dosage ≥ 100 mg/d group (42.3％,363/ 859,and 26.5％,27/102).Orderly logistic regression analysis results showed that after adjusted factors,such as gender,age,marital status,ethnic group,patients who received a dosage less than 1 00 mg/day (OR=3.05,95％CI:1.84-5.06) and had morphine positive urine (OR=2.25,95％CI:1.59-3.19) were more likely to drop out of the treatment.Interaction analysis showed that dosage less than 100 mg/d and morphine positive urine during treatment had additive interaction (RERI=256.46,AP=0.87,S=8.05) and multiplication interaction (OR=2.45,95％CI:1.71-3.49).Conclusion Insufficient dosage and morphine positive urine were significantly correlated with drop out of treatment in patients with access to methadone maintenance treatment.

Correlation between insufficient methadone dosage and morphine positive urine on drop out of treatment in patients with access to methadone maintenance treatment / 中华流行病学杂志

Objective To estimate the incidence of drop out of treatment in patients with access to methadone maintenance treatment and explore the correlation and interaction between insufficient methadone dosage and morphine positive urine on the drop out in Guangxi Zhuang Autonomous Region.Methods Face to face interview was conducted in 1 031 patients at 3 methadone maintenance treatment clinics in Guangxi.Results The study included 1 031 participants,40.6％ of them (419/1 031) had stopped treatment.The drop out rates in urine morphine positive group and methadone dosage ＜ 100 mg/d group were 57.6％ (99/172) and 37.4％ (347/929) respectively,higher than those in urine morphine negative group and methadone dosage ≥ 100 mg/d group (42.3％,363/ 859,and 26.5％,27/102).Orderly logistic regression analysis results showed that after adjusted factors,such as gender,age,marital status,ethnic group,patients who received a dosage less than 1 00 mg/day (OR=3.05,95％CI:1.84-5.06) and had morphine positive urine (OR=2.25,95％CI:1.59-3.19) were more likely to drop out of the treatment.Interaction analysis showed that dosage less than 100 mg/d and morphine positive urine during treatment had additive interaction (RERI=256.46,AP=0.87,S=8.05) and multiplication interaction (OR=2.45,95％CI:1.71-3.49).Conclusion Insufficient dosage and morphine positive urine were significantly correlated with drop out of treatment in patients with access to methadone maintenance treatment.

Factores psicológicos y/o psiquiátricos presentes en pacientes desertores de protocolo de preparación para cirugía bariátrica / Psychological and/or psychiatric factors present in patients who abandoned the preparation protocol for bariatric surgery

Resumen: INTRODUCCIÓN: La obesidad severa es la enfermedad crónica con mayor prevalencia en el mundo, afectando la calidad de vida de los pacientes. Aunque existe una variedad de tratamientos para ella, las tasas de abandono de los mismos se encuentran entre el 40-80%. OBJETIVO: Identificar los factores psicológicos y/o psiquiátricos que presentaron en la evaluación inicial los pacientes con obesidad severa que desertaron del protocolo de preparación para la cirugía bariátrica y establecer diferencias con los pacientes que no desertaron. MÉTODO: Se llevó a cabo un estudio analítico observacional de casos (desertores) y controles (no desertores), retrospectivo, transversal, con una muestra de 286 expedientes de pacientes candidatos a cirugía bariátrica del Hospital General Dr. Manuel Gea González en la Ciudad de México, con IMC de 44.77 ± 7.47 kg/m2 y una edad de 37.45 ± 9.94 años y que fueron seleccionados por muestreo no probabilístico por conveniencia. RESULTADOS: Se encontraron diferencias significativas: género (los hombres desertan más), los pacientes desertores mostraron una mayor prevalencia en el trastorno por estrés postraumático, trastorno por déficit de atención e hiperactividad, trastorno por atracón, aislamiento, deterioro de las funciones cognitivas y mayor disfunción familiar y social que los no desertores. Un análisis multivariado sobre los mismos factores demostró que el ser hombre, tener poco apoyo social, presentar trastorno por atracón y tener un mayor número de faltas a sus citas durante el tratamiento, son factores contribuyentes para la deserción. DISCUSIÓN Y CONCLUSIÓN: Existen variables psicológicas/psiquiátricas que podrían establecerse como factores de riesgo en la deserción y como consecuencia incrementar la posibilidad de afectar el bienestar físico y emocional del paciente.

Abstract: INTRODUCTION: Severe obesity is the chronic disease with the highest prevalence around the world. It affects the life quality of patients in terms of physical and mental health. Although there are a variety of treatments for severe obesity, dropout rates are between 40% to 80%. OBJECTIVE: To identify the psychological and/or psychiatric factors presented in the initial evaluation of patients with severe obesity who deserted the preparation protocol for bariatric surgery and stablish differences between them and those who didn't defected. METHOD: An analytical observational open study of cases (deserters) and controls (non deserters), retrospective, transversal, with a sample of 286 files of patients candidates for bariatric surgery from General Hospital "Dr. Manuel Gea Gonzalez" in Mexico City selected by simple random sampling fulfilling desertion variable, with a BMI of 44.77 kg/m2 ± 7.47 and 37.45 ± 9.94 years old and were selected by non-probabilistic convenience sample. RESULTS: Significant differences were found: gender (men drop out more), deserters patients showed a higher prevalence in post-traumatic stress disorder, attention deficit hyperactivity disorder, binge eating, isolation, impaired cognitive function and greater family and social dysfunction than non-deserters. A multivariate analysis of these factors showed that being male, having little social support, present a binge eating disorder, have a greater number of absences to appointments during treatment, are factors contributing to attrition. DISCUSSION AND CONCLUSION: There are psychological/psychiatric variables that could be established as risk factors for dropping out, increasing the possibility of affecting the patient's physical and emotional well-being.

Identification and exploration of the needs for health care in tuberculosis patients dropping out from therapy in Malang city: A qualitative phenomenological study.

Background: Tuberculosis (TB) is a chronic infectious disease that remains a major public health issue in the world, including Indonesia. Various efforts have been made by governments to cope with increase of TB. However, various obstacles are found that hinder the goal of the treatment program, such as patients dropping out from treatment. Phenomenological study on TB patients dropping out from treatment in Malang City was greatly required and could be achieved through exploration of perceptions and experiences of TB patients dropping out from treatment. Objective: The purpose of this study is to identify requirements for health care among TB patients dropping out from treatment, based on the perspective of TB patients in Malang City. Materials and Methods: The study is of a qualitative phenomenological design in which samples were drawn using convenience sampling technique. In-depth interviews were used for collection of data by asking semistructured open-ended questions during 6 months from March to August 2014. Results: Problems that induce the failure of TB therapy are delay of treatment, inability to complete sufficient therapy, and various internal and external factors that affects patients' compliance. Conclusion: It was concluded that there were themes in the requirements of health care to prevent and deal with dropping out from therapy: More attention from health workers, accurate examination, clinic opening hours and availability of health workers at working hours, anti-TB drugs of branded patent granted for free, and other drugs in addition to those already known.

Correlation of contract nurse′s organizational commitment and intention to drop out / 现代临床护理

Objective To study the correlation between organizational commitment of nurses and their intention to drop out. Methods Toally 304 contract nurses were recruited in this investigation. The questionnaires including demographic data, scale of organizational commitment and intention to drop out scale were used. Results The score of intention to drop out was 16.94 ± 2.16. The score on organizational commitment was 71.19 ± 6.65. There was a positive correlation between intention to drop out and organizational commitment among the contract nurses. Conclusions Improving contract nurses′organizational commitment can be an effective mean to reduce contract nurses′intention to drop out. It is an important means to promote the development of the nurse team and provide a reference for the scientific development of nursing.

Study on drop-out from antiretroviral therapy among adult HIV-infected individuals in Dehong ;prefecture,Yunnan province / 中华流行病学杂志

Objective To examine the proportion and reasons of drop-out from antiretroviral therapy(ART)among 8 367 adult HIV-infected individuals in Dehong prefecture,Yunnan province. Methods All adult HIV-infected patients receiving ART before September 30 of 2014 were examined for the situation of drop-out from ART. Results The proportion of drop-out from ART among adult HIV-infected patients in Dehong prefecture was 14.4%(1 202/8 367). Results from the univariate logistic regression analyses indicated that drop-out from ART was significantly correlated with factors as:living area,gender,age,marital status,HIV transmission route,baseline CD4+T cell counts and initial treatment regimen of the patients. After adjusted for potential confounding variables by multiple logistic regression model,drop-out from ART was significantly correlated with residential area,marital status,HIV transmission route,baseline CD4+T cell count and initial treatment regimen of the patients. HIV-infected patients who were living in Mangshi city,Lianghe county or Yingjiang county,being married or living with partner,HIV infection through sexual contact,with baseline CD4+T cell counts≤200 cells/mm3,and ART included in the initial treatment regimen etc.,were less likely to drop out from ART. The proportion of drop out from ART was significantly decreasing along with the increasing time of ART. Data from specific investigation revealed that among the 1 202 patients who dropped out from ART,704(58.6%)were lost to follow-up,303(25.2%) did not adhere to treatment,74(6.2%)moved out the region,64(5.3%)were Burmese that had returned to Burma,29 (2.4%) stopped the treatment according to doctors’advice,18(1.5%)were incarcerated and 10 (0.8%) were under other reasons. Reasons for the drop-out varied,according to the situation of patients. Conclusion The proportion of drop-out from ART varied significantly according to the characteristics of HIV-infected patients in Dehong prefecture that underscoring the needs for tailored responses to reduce drop-out of ART. Focus should be targeted on reducing the loss to follow-up and improving the treatment adherence.

Study on drop-out from antiretroviral therapy among adult HIV-infected individuals in Dehong ;prefecture,Yunnan province / 中华流行病学杂志

Objective To examine the proportion and reasons of drop-out from antiretroviral therapy(ART)among 8 367 adult HIV-infected individuals in Dehong prefecture,Yunnan province. Methods All adult HIV-infected patients receiving ART before September 30 of 2014 were examined for the situation of drop-out from ART. Results The proportion of drop-out from ART among adult HIV-infected patients in Dehong prefecture was 14.4%(1 202/8 367). Results from the univariate logistic regression analyses indicated that drop-out from ART was significantly correlated with factors as:living area,gender,age,marital status,HIV transmission route,baseline CD4+T cell counts and initial treatment regimen of the patients. After adjusted for potential confounding variables by multiple logistic regression model,drop-out from ART was significantly correlated with residential area,marital status,HIV transmission route,baseline CD4+T cell count and initial treatment regimen of the patients. HIV-infected patients who were living in Mangshi city,Lianghe county or Yingjiang county,being married or living with partner,HIV infection through sexual contact,with baseline CD4+T cell counts≤200 cells/mm3,and ART included in the initial treatment regimen etc.,were less likely to drop out from ART. The proportion of drop out from ART was significantly decreasing along with the increasing time of ART. Data from specific investigation revealed that among the 1 202 patients who dropped out from ART,704(58.6%)were lost to follow-up,303(25.2%) did not adhere to treatment,74(6.2%)moved out the region,64(5.3%)were Burmese that had returned to Burma,29 (2.4%) stopped the treatment according to doctors’advice,18(1.5%)were incarcerated and 10 (0.8%) were under other reasons. Reasons for the drop-out varied,according to the situation of patients. Conclusion The proportion of drop-out from ART varied significantly according to the characteristics of HIV-infected patients in Dehong prefecture that underscoring the needs for tailored responses to reduce drop-out of ART. Focus should be targeted on reducing the loss to follow-up and improving the treatment adherence.

Assessment of immunization status of 1000 children attending pediatric OPD of a teaching hospital in Ahmedabad.

Objective: Assessment of immunization status of children attending Pediatric OPD of a tertiary care hospital and the common causes for not giving the vaccines on time. Methods: A cross sectional study was performed with the help of a semi- structured questionnaire. Vaccination status was confirmed referring to the records of immunization available with the mothers. Site and age-specific details of the vaccines administered were also probed to ascertain the vaccine given whenever required. Results: Immunization coverage was 52.7% which was less than the national average of 61%. Coverage was highest for BCG and OPV zero vaccines (94.4%). Significant reductions in the coverage of the first and third doses of DPT, OPV and Hepatitis B vaccine were observed. There was absolutely no coverage of dT/ TT vaccine. Most common reasons for denial of vaccination were found to be negligence (35.8%) and ignorance (14.8%). The immunization coverage was higher in residents of rural areas (72.32%) and in children of literate mothers (76%). There was no significant reduction in eventual booster doses of DPT. Conclusions: Day by day, universal immunization is increasing but gaps are still visible even at tertiary care settings. Efforts are needed to strengthen the already existing policies. Aggressive sensitization and behaviour change drives targeting mothers can go a long way in achieving the same.

Group Counseling for Medical Students with Drop-Out Experiences / 한국의학교육

PURPOSE: The purpose of this research was to describe our group counseling methods for medical students with drop-out experiences. METHODS: Group counseling was offered to 11 medical students with drop-out experiences in their previous second semester. All subjects provided written informed consent before participating and completed a 2-day group counseling program using the Gestalt approach. The self-assertiveness training group counseling program consisted of 6 sessions, each of which lasted 90 minutes. Experience reports by participants after the program and data from semi-structured qualitative interviews were qualitatively analyzed. RESULTS: Program participants reported that they were moderately satisfied with the program regarding its usefulness and helpfulness on self-awareness, understanding, and reminding them of attempts to change behavior. Most students showed heightened levels of sincerity perceptions and positive attitudes in every session. The results demonstrated significant changes in experience in self-esteem, self-recognition, and interpersonal relationships. CONCLUSION: A group counseling program using the Gestalt approach could help medical students with drop-out experiences to adjust with 1 year their juniors, enhance their self-esteem, contribute to their psychological well-being, and prevent student re-failure through effective stress management and improved interpersonal relationships.

Preimplantation genetic diagnosis for Charcot-Marie-Tooth disease / 대한생식의학회지

OBJECTIVE: Preimplantation genetic diagnosis (PGD) is an assisted reproductive technique for couples carrying genetic risks. Charcot-Marie-Tooth (CMT) disease is the most common hereditary neuropathy, with a prevalence rate of 1/2,500. In this study, we report on our experience with PGD cycles performed for CMT types 1A and 2F. METHODS: Before clinical PGD, we assessed the amplification rate and allele drop-out (ADO) rate of multiplex fluorescent polymerase chain reaction (PCR) followed by fragment analysis or sequencing using single lymphocytes. We performed six cycles of PGD for CMT1A and one cycle for CMT2F. RESULTS: Two duplex and two triplex protocols were developed according to the available markers for each CMT1A couple. Depending on the PCR protocols, the amplification rates and ADO rates ranged from 90.0% to 98.3% and 0.0% to 11.1%, respectively. For CMT2F, the amplification rates and ADO rates were 93.3% and 4.8%, respectively. In case of CMT1A, 60 out of 63 embryos (95.2%) were diagnosed and 13 out of 21 unaffected embryos were transferred in five cycles. Two pregnancies were achieved and three babies were delivered without any complications. In the case of CMT2F, a total of eight embryos were analyzed and diagnosed. Seven embryos were diagnosed as unaffected and four embryos were transferred, resulting in a twin pregnancy. Two healthy babies were delivered. CONCLUSION: This is the first report of successful pregnancy and delivery after specific PGD for CMT disease in Korea. Our PGD procedure could provide healthy babies to couples with a high risk of transmitting genetic diseases.