Factors Affecting De Novo Urinary Retention after Holmium Laser Enucleation of the Prostate

Objective Patients can experience urinary retention (UR) after Holmium laser enucleation of the prostate (HoLEP) that requires bladder distension during the procedure. The aim of this retrospective study is to identify factors affecting the UR after HoLEP. Materials and Methods 336 patients, which underwent HoLEP for a symptomatic benign prostatic hyperplasia between July 2008 and March 2012, were included in this study. Urethral catheters were routinely removed one or two days after surgery. UR was defined as the need for an indwelling catheter placement following a failure to void after catheter removal. Demographic and clinical parameters were compared between the UR (n = 37) and the non-urinary retention (non-UR; n = 299) groups. Results The mean age of patients was 68.3 (±6.5) years and the mean operative time was 75.3 (±37.4) min. Thirty seven patients (11.0%) experienced a postoperative UR. UR patients voided catheter free an average of 1.9 (±1.7) days after UR. With regard to the causes of UR, 24 (7.1%) and 13 (3.9%) patients experienced a blood clot-related UR and a non-clot related UR respectively. Using multivariate analysis (p<0.05), we found significant differences between the UR and the non-UR groups with regard to a morcellation efficiency (OR 0.701, 95% CI 0.498–0.988) and a bleeding-related complication, such as, a reoperation for bleeding (OR 0.039, 95% CI 0.004–0.383) or a transfusion (OR 0.144, 95% CI 0.027–0.877). Age, history of diabetes, prostate volume, pre-operative post-void residual, bladder contractility index, learning curve, and operative time were not significantly associated with the UR (p>0.05). Conclusions De novo UR after HoLEP was found to be self-limited and it was not related to learning curve, patient age, diabetes, or operative time. Efficient morcellation and careful control of bleeding, which reduces clot formation, decrease the risk of UR after HoLEP.

It takes an institution's village to retain a student: A comprehensive look at two early warning system undergraduate retention programs and administrators' perceptions of students' experiences and the retention services they provide students in the early warning system retention programs

Institutions have implemented many campus interventions to address student persistence/retention, one of which is Early Warning Systems (EWS). However, few research studies show evidence of interventions that incorporate noncognitive factors/skills, and psychotherapy/psycho-educational processes in the EWS. A qualitative study (phenomenological interview and document analysis) of EWS at both a public and private 4-year Florida university was conducted to explore EWS through the eyes of the administrators of the ways administrators make sense of students' experiences and the services they provide and do not provide to assist students. Administrators' understanding of noncognitive factors and the executive skills subset and their contribution to retention and the executive skills development of at-risk students were also explored. Hossler and Bean's multiple retention lenses theory/paradigms and Perez's retention strategies were used to guide the study. Six administrators from each institution who oversee and/or assist with EWS for first time in college undergraduate students considered academically at-risk for attrition were interviewed. Among numerous findings, at Institution X: EWS was infrequently identified as a service, EWS training was not conducted, numerous cognitive and noncognitive issues/deficits were identified for students, and services/critical departments such as EWS did not work together to share students' information to benefit students. Assessment measures were used to identify students' issues/deficits; however, they were not used to assess, track, and monitor students' issues/deficits. Additionally, the institution's EWS did address students' executive skills function beyond time management and organizational skills, but did not address students' psychotherapy/psycho-educational processes. Among numerous findings, at Institution Y: EWS was frequently identified as a service, EWS training was not conducted, numerous cognitive and noncognitive issues/deficits were identified for students, and services/critical departments such as EWS worked together to share students' information to benefit students. Assessment measures were used to identify, track, and monitor students' issues/deficits; however, they were not used to assess students' issues/deficits. Additionally, the institution's EWS addressed students' executive skills function beyond time management and organizational skills, and psychotherapy/psycho-educational processes. Based on the findings, Perez's retention strategies were not utilized in EWS at Institution X, yet were collectively utilized in EWS at Institution Y, to achieve Hossler and Bean's retention paradigms. Future research could be designed to test the link between engaging in the specific promising activities identified in this research (one-to-one coaching, participation in student success workshops, academic contracts, and tutoring) and student success (e.g., higher GPA, retention). Further, because this research uncovered some concern with how to best handle students with physical and psychological disabilities, future research could link these same promising strategies for improving student performance for example among ADHD students or those with clinical depression.

Predictors of client retention in alternative to prison substance abuse programs

Increased treatment retention among substance abusing individuals has been associated with reduced drug use, fewer arrests, and decreased unemployment, as well as a reduction in health risk behaviors. This longitudinal study examined the predictors of client retention for alternative to prison substance abuse treatment programs through assessing the roles of motivational factors and the client-worker relationship. The sample was comprised of 141 male felony offenders who were legally mandated to community based long-term residential drug treatment programs. The primary measures used in the study were the consecutive days a participant remained in treatment, Stages of Change Readiness Model and Treatment Eagerness Scale (SOCRATES), the Working Alliance Inventory (WAI), and The Readiness Ruler. Hierarchical multiple regression analysis was conducted for four hypotheses (a) participants who are more motivated to change at the time of entry will remain in treatment longer, (b) participants who have a strong therapeutic alliance will remain in treatment a greater number of consecutive days than participants who have weaker therapeutic alliance, (c) motivation to change, as measured at treatment entry, will be positively related to therapeutic alliance, (d) during the course of treatment variation in motivation to change will be predicted by the therapeutic alliance. Results support the following conclusions: Among clients in alternative-to prison programs the number of days in treatment is positively related to their motivation to change. The therapeutic alliance is not a predictor of the number of days in treatment. Motivation to change, particularly recognition of a drug problem, is positively related to the therapeutic alliance. Changes in motivation to change in response to treatment are positively related to the therapeutic alliance among clients in an alternative to prison substance abuse treatment programs. These results carry forward prior research and have implications for social work practice, research, and social welfare policy.

The effects of required/sequenced preparatory courses on academic success and retention at a community college

This dissertation had two purposes: first, to analyze how required sequenced college preparatory courses in mathematics, reading, and writing affect students' academic success and, second, to add to a theoretical model for predicting student retention at a community college. Grade point average, number of degree credits earned, and reenrollment rate were measured as determinants of academic success. The treatment group had a significantly higher grade point average than the control group. There was no significant difference in the number of degree credits earned or re-enrollment rate for the groups. A series of logistic regressions used the independent variables E-ASSET scores in math, reading, and writing; number of college prep areas required; credits earned; grade point average; students' status; academic restrictions/required course sequencing; sex; race; and socio-economic status to determine the predictor variables for retention. The academic variable that showed the greatest potential as a predictor for retention was grade point average. Overall, receiving financial aid was the greatest predictor for reenrollment. For a financial aid recipient the odds of reenrollment were 2.70 times more likely than if no financial aid was received.

Retention and special education referral practices before and after the implementation of high-stakes testing

The rewards and sanctions associated with high-stakes testing may induce educators to participate in practices that will ensure the elimination of the scores of low-achieving students from the testing pool. Two ways in which scores may be eliminated is through retention or referral to special education. This study examined the use of these practices at 179 elementary schools in Miami-Dade County Public Schools, the 4th largest school district in the country. Between- and within-subjects designs were analyzed using repeated measures analysis of variance to compare retention and referral to special education practices over a five-year period of time, two years prior to and two years after the implementation of Florida's high-stakes test, the Florida Comprehensive Assessment Test, FCAT. Significant main effects for referral and retention over time were demonstrated. The use of retention steadily increased over the first three years, with its usage maintained during the fourth year. While the use of referral actually decreased from the first to second years, a significant change occurred after the implementation of the FCAT. Examination of the use of these practices according to student and school characteristics revealed significant differences. Increases in the use of referral across time was significant for Black, non-Hispanic and Hispanic students, all limited English proficiency population categories, medium and low socioeconomic status category schools, all grade levels, and for schools with accountability grades of A, C, D and F with the most striking absolute increase occurring for F schools. Increases in the use of retention across time were significant for all ethnic groups, limited English proficiency categories, and socioeconomic status categories, for grades kindergarten through four and by gender. Significant increases occurred for schools with accountability performance grades of C, D and F; however the most dramatic increase occurred for the F schools. A direct relationship between performance category grade of school and their use of retention was demonstrated. The results suggest that schools changed their use of referral and retention in response to the implementation of the FCAT.

Physical therapy recruitment and retention strategies of hospitals in the US

Hospitals are seeing a reduction of physical therapy (PT) staff due to increased opportunities and competition. Planning effective recruitment and retention strategies for PTs in hospital settings may play an important role in reducing the problem. The primary purpose of this descriptive research was to compile information on recruitment and retention strategies used for physical therapists working in hospital settings. Four hundred surveys were mailed nationwide to hospital-based physical therapy managers. Strategies most commonly used were: attractive benefit package, interdisciplinary teams, competitive salaries, and student employment. The least used strategies used were: sign-on bonus, incentive pay programs, recruitment and retention committee and temporary staffing. It was concluded that hospital administrators need to analyze current strategies used and future recruitment and retention staffing trends, in order to institute successful strategies appropriate to their departments to effectively recruit and retain their staff.