Efficacy, Acceptability, and Tolerability of Antipsychotics in Treatment-Resistant Schizophrenia: A Network Meta-analysis.

Importance In treatment-resistant schizophrenia, clozapine is considered the standard treatment. However, clozapine use has restrictions owing to its many adverse effects. Moreover, an increasing number of randomized clinical trials (RCTs) of other antipsychotics have been published. Objective To integrate all the randomized evidence from the available antipsychotics used for treatment-resistant schizophrenia by performing a network meta-analysis. Data Sources MEDLINE, EMBASE, Biosis, PsycINFO, PubMed, Cochrane Central Register of Controlled Trials, World Health Organization International Trial Registry, and clinicaltrials.gov were searched up to June 30, 2014. Study Selection At least 2 independent reviewers selected published and unpublished single- and double-blind RCTs in treatment-resistant schizophrenia (any study-defined criterion) that compared any antipsychotic (at any dose and in any form of administration) with another antipsychotic or placebo. Data Extraction and Synthesis At least 2 independent reviewers extracted all data into standard forms and assessed the quality of all included trials with the Cochrane Collaboration's risk-of-bias tool. Data were pooled using a random-effects model in a Bayesian setting. Main Outcomes and Measures The primary outcome was efficacy as measured by overall change in symptoms of schizophrenia. Secondary outcomes included change in positive and negative symptoms of schizophrenia, categorical response to treatment, dropouts for any reason and for inefficacy of treatment, and important adverse events. Results Forty blinded RCTs with 5172 unique participants (71.5% men; mean [SD] age, 38.8 [3.7] years) were included in the analysis. Few significant differences were found in all outcomes. In the primary outcome (reported as standardized mean difference; 95% credible interval), olanzapine was more effective than quetiapine (-0.29; -0.56 to -0.02), haloperidol (-0. 29; -0.44 to -0.13), and sertindole (-0.46; -0.80 to -0.06); clozapine was more effective than haloperidol (-0.22; -0.38 to -0.07) and sertindole (-0.40; -0.74 to -0.04); and risperidone was more effective than sertindole (-0.32; -0.63 to -0.01). A pattern of superiority for olanzapine, clozapine, and risperidone was seen in other efficacy outcomes, but results were not consistent and effect sizes were usually small. In addition, relatively few RCTs were available for antipsychotics other than clozapine, haloperidol, olanzapine, and risperidone. The most surprising finding was that clozapine was not significantly better than most other drugs. Conclusions and Relevance Insufficient evidence exists on which antipsychotic is more efficacious for patients with treatment-resistant schizophrenia, and blinded RCTs-in contrast to unblinded, randomized effectiveness studies-provide little evidence of the superiority of clozapine compared with other second-generation antipsychotics. Future clozapine studies with high doses and patients with extremely treatment-refractory schizophrenia might be most promising to change the current evidence.

Psychological therapies for panic disorder with or without agoraphobia in adults: a network meta-analysis.

BACKGROUND Panic disorder is characterised by the presence of recurrent unexpected panic attacks, discrete periods of fear or anxiety that have a rapid onset and include symptoms such as racing heart, chest pain, sweating and shaking. Panic disorder is common in the general population, with a lifetime prevalence of 1% to 4%. A previous Cochrane meta-analysis suggested that psychological therapy (either alone or combined with pharmacotherapy) can be chosen as a first-line treatment for panic disorder with or without agoraphobia. However, it is not yet clear whether certain psychological therapies can be considered superior to others. In order to answer this question, in this review we performed a network meta-analysis (NMA), in which we compared eight different forms of psychological therapy and three forms of a control condition. OBJECTIVES To assess the comparative efficacy and acceptability of different psychological therapies and different control conditions for panic disorder, with or without agoraphobia, in adults. SEARCH METHODS We conducted the main searches in the CCDANCTR electronic databases (studies and references registers), all years to 16 March 2015. We conducted complementary searches in PubMed and trials registries. Supplementary searches included reference lists of included studies, citation indexes, personal communication to the authors of all included studies and grey literature searches in OpenSIGLE. We applied no restrictions on date, language or publication status. SELECTION CRITERIA We included all relevant randomised controlled trials (RCTs) focusing on adults with a formal diagnosis of panic disorder with or without agoraphobia. We considered the following psychological therapies: psychoeducation (PE), supportive psychotherapy (SP), physiological therapies (PT), behaviour therapy (BT), cognitive therapy (CT), cognitive behaviour therapy (CBT), third-wave CBT (3W) and psychodynamic therapies (PD). We included both individual and group formats. Therapies had to be administered face-to-face. The comparator interventions considered for this review were: no treatment (NT), wait list (WL) and attention/psychological placebo (APP). For this review we considered four short-term (ST) outcomes (ST-remission, ST-response, ST-dropouts, ST-improvement on a continuous scale) and one long-term (LT) outcome (LT-remission/response). DATA COLLECTION AND ANALYSIS As a first step, we conducted a systematic search of all relevant papers according to the inclusion criteria. For each outcome, we then constructed a treatment network in order to clarify the extent to which each type of therapy and each comparison had been investigated in the available literature. Then, for each available comparison, we conducted a random-effects meta-analysis. Subsequently, we performed a network meta-analysis in order to synthesise the available direct evidence with indirect evidence, and to obtain an overall effect size estimate for each possible pair of therapies in the network. Finally, we calculated a probabilistic ranking of the different psychological therapies and control conditions for each outcome. MAIN RESULTS We identified 1432 references; after screening, we included 60 studies in the final qualitative analyses. Among these, 54 (including 3021 patients) were also included in the quantitative analyses. With respect to the analyses for the first of our primary outcomes, (short-term remission), the most studied of the included psychological therapies was CBT (32 studies), followed by BT (12 studies), PT (10 studies), CT (three studies), SP (three studies) and PD (two studies).The quality of the evidence for the entire network was found to be low for all outcomes. The quality of the evidence for CBT vs NT, CBT vs SP and CBT vs PD was low to very low, depending on the outcome. The majority of the included studies were at unclear risk of bias with regard to the randomisation process. We found almost half of the included studies to be at high risk of attrition bias and detection bias. We also found selective outcome reporting bias to be present and we strongly suspected publication bias. Finally, we found almost half of the included studies to be at high risk of researcher allegiance bias.Overall the networks appeared to be well connected, but were generally underpowered to detect any important disagreement between direct and indirect evidence. The results showed the superiority of psychological therapies over the WL condition, although this finding was amplified by evident small study effects (SSE). The NMAs for ST-remission, ST-response and ST-improvement on a continuous scale showed well-replicated evidence in favour of CBT, as well as some sparse but relevant evidence in favour of PD and SP, over other therapies. In terms of ST-dropouts, PD and 3W showed better tolerability over other psychological therapies in the short term. In the long term, CBT and PD showed the highest level of remission/response, suggesting that the effects of these two treatments may be more stable with respect to other psychological therapies. However, all the mentioned differences among active treatments must be interpreted while taking into account that in most cases the effect sizes were small and/or results were imprecise. AUTHORS' CONCLUSIONS There is no high-quality, unequivocal evidence to support one psychological therapy over the others for the treatment of panic disorder with or without agoraphobia in adults. However, the results show that CBT - the most extensively studied among the included psychological therapies - was often superior to other therapies, although the effect size was small and the level of precision was often insufficient or clinically irrelevant. In the only two studies available that explored PD, this treatment showed promising results, although further research is needed in order to better explore the relative efficacy of PD with respect to CBT. Furthermore, PD appeared to be the best tolerated (in terms of ST-dropouts) among psychological treatments. Unexpectedly, we found some evidence in support of the possible viability of non-specific supportive psychotherapy for the treatment of panic disorder; however, the results concerning SP should be interpreted cautiously because of the sparsity of evidence regarding this treatment and, as in the case of PD, further research is needed to explore this issue. Behaviour therapy did not appear to be a valid alternative to CBT as a first-line treatment for patients with panic disorder with or without agoraphobia.

Cognitive-Behavioural Analysis System of Psychotherapy (CBASP), a drug, or their combination: differential therapeutics for persistent depressive disorder: a study protocol of an individual participant data network meta-analysis.

INTRODUCTION Despite important advances in psychological and pharmacological treatments of persistent depressive disorders in the past decades, their responses remain typically slow and poor, and differential responses among different modalities of treatments or their combinations are not well understood. Cognitive-Behavioural Analysis System of Psychotherapy (CBASP) is the only psychotherapy that has been specifically designed for chronic depression and has been examined in an increasing number of trials against medications, alone or in combination. When several treatment alternatives are available for a certain condition, network meta-analysis (NMA) provides a powerful tool to examine their relative efficacy by combining all direct and indirect comparisons. Individual participant data (IPD) meta-analysis enables exploration of impacts of individual characteristics that lead to a differentiated approach matching treatments to specific subgroups of patients. METHODS AND ANALYSIS We will search for all randomised controlled trials that compared CBASP, pharmacotherapy or their combination, in the treatment of patients with persistent depressive disorder, in Cochrane CENTRAL, PUBMED, SCOPUS and PsycINFO, supplemented by personal contacts. Individual participant data will be sought from the principal investigators of all the identified trials. Our primary outcomes are depression severity as measured on a continuous observer-rated scale for depression, and dropouts for any reason as a proxy measure of overall treatment acceptability. We will conduct a one-step IPD-NMA to compare CBASP, medications and their combinations, and also carry out a meta-regression to identify their prognostic factors and effect moderators. The model will be fitted in OpenBUGS, using vague priors for all location parameters. For the heterogeneity we will use a half-normal prior on the SD. ETHICS AND DISSEMINATION This study requires no ethical approval. We will publish the findings in a peer-reviewed journal. The study results will contribute to more finely differentiated therapeutics for patients suffering from this chronically disabling disorder. TRIAL REGISTRATION NUMBER CRD42016035886.

Cross-Nativity Marriages, Gender, and Human Capital Levels of Children

Because the demographic composition of todays immigrants to the US differs so much from those of natives, immigrants may be less likely to socially integrate into U.S. society, and specically less likely to marry natives. This paper explores the relationship between immigrants' marriage patterns and the academic outcomes of their children. Using 2000 Census data, it is found that while marital decisions of foreign born females do not affect their children's academic success, foreign born males that marry foreign born females are less likely to have children that are high school dropouts. These relationships remain after using various methods to control for the endogeneity of the intermarriage decision. Although we cannot disentangle whether the benefits of same-nativity marriages for foreign born males arise from a more efficient technology in human capital production within the household or from increased participation in ethnic networks, it does appear that immigrant males have better educated children when they marry immigrant females.

A descriptive study of the sociodemographic, health and developmental factors associated with slow learning in children from upper to middle social class families in Texas

"Slow Learners" is a term used to describe children with an IQ range of 70-89 on a standardized individual intelligence test (i.e. with a standard deviation of either 15 or 16). They have above retarded, but below average intelligence and potential to learn. If the factors associated with the etiology of slow learning in children can be identified, it may be possible to hypothesize causal relationships which can be tested by intervention studies specifically designed to prevent slow learning. If effective, these may ultimately reduce the incidence of school dropouts and their cost to society. To date, there is little information about variables which may be etiologically significant. In an attempt to identify such etiologic factors this study examines the sociodemographic characteristics, prenatal history (hypertension, smoking, infections, medication, vaginal bleeding, etc.), natal history (length of delivery, Apgar score, birth trauma, resuscitation, etc.), neonatal history (infections, seizures, head trauma, etc.), developmental history (health problems, developmental milestones and growth during infancy and early childhood), and family history (educational level of the parents, occupation, history of similar condition in the family, etc.) of a series of children defined as slow learners. The study is limited to children from middle to high socioeconomic families in order to exclude the possible confounding variable of low socioeconomic status, and because a descriptive study of this group has not been previously reported. ^

Nonpurging binge eaters versus nonbinge eaters and treatment retention for adult obesity

Dropout from obesity treatment has been a major factor associated with weight control failure, with few reliable predictors of dropouts or completers. Previous studies have tended to treat obese people as a homogeneous group with standard behavior modification-based interventions. Current research indicates there may be subgroups within the obese population, binge eaters and nonbinge eaters, who have different dropout rates. Current studies also recommend focusing on the subset of this subgroup that does not engage in purging (vomiting, laxative abuse, or excessive exercise) to compensate for binge eating. This research uses a secondary dataset (N = 156) from a prospective study in which participants were randomized to a Food Dependency (FD) and a Behavioral Self-Management (BSM) group for weight reduction. Criteria for subjects in the original study included (1) scoring higher on the existing Binge Eating Scale (BES) in order to ensure enrollment of more binge eaters and (2) no compensatory purging behavior for binge eating. Subjects were then reclassified in this study as binge eaters or nonbinge eaters using the more stringent proposed 1994 DSM-IV criteria for Binge Eating Disorder (BED). Subjects were followed for dropout. Variables studied were binge status, age at obesity onset, age at study baseline, class instructor, number of previous weight loss attempts, race, marital status, body mass index (BMI kg/m$\sp2$), type of intervention, work status, educational level, and social support. Stepwise backward regression Cox survival analysis indicated binge status had a consistent, statistically significant protective effect on dropout in which binge eaters were half as likely to dropout versus nonbinge eaters (p = 0.04). Cox proportional hazards analysis indicated no statistical difference in dropout by type of intervention (FD, p = 0.13; BSM, p = 0.80) when controlling for binge status. All other variables did not reach significance, which is consistent with the literature. Implications of these findings suggest that (1) the proposed 1994 DSM-IV criteria for BED is a more useful classification that the existing DSM-III-R criteria, and (2) the identification of subgroups among obese subjects is an important step in dropout and weight loss intervention research. Future research can confirm this finding. ^

Restauración del sonido fílmico

La restauración fílmica del audio es un proceso bastante complejo y se ha indagado poco en este campo. Antes de restaurar cualquier archivo, se debe preservar y conservar los archivos de la mejor manera posible. La preservación son las medidas que se deben tomar para garantizar el acceso permanente y la conservación asegura le existencia del archivo en su forma más original. Mientras que la restauración se basa en el estudio de los posibles deterioros que sufren los soportes fílmicos en el tiempo y los procesos que existen para corregirlos. La restauración siempre debe conservar la mayor originalidad posible, es decir debe mantener el audio como originalmente se expuso por primera vez. En la primera etapa, se identifican los posibles deterioros que se producen en los archivos, si conocemos en qué momento fue grabada la películas y cómo fue grabada, es decir con que máquina se realizó la grabación y el soporte fílmico en el que está grabado. Tanto las máquinas como los soportes han ido evolucionando a lo largo de la historia. El estudio de los soportes fílmicos nos permite conocer las degradaciones que sufren a lo largo del tiempo los archivos y por consecuencia, conocer las posibles restauraciones. Para intentar evitar degradaciones mayores, se intenta preservar y conservar en condiciones óptimas para el soporte. Según el soporte del archivo, tendrá unas condiciones típicas de temperatura, humedad, ventilación… en las cuales el material se conserva de la mejor manera. Tras estos pasos, se procede a restaurar. La restauración más típica es con materiales fotoquímicos, pero es bastante compleja y por tanto, en el proyecto se analiza la restauración tras digitalizar los archivos fílmicos. Para poder digitalizar correctamente los archivos, debemos tener presentes las normas y reglas de digitalización que están establecidas. La digitalización permite identificar las alteraciones típicas que aparecen en los materiales fílmicos, gracias a la herramienta del espectrograma podemos conocer las posibles soluciones de restauración para cada alteración. Las alteraciones que podemos encontrar e identificar son: · Zumbidos e Interferencias. · Siseo y Silbido. · Crujidos. · Pops y Clics. · Wow. · Lagunas o Abandonos. · Ruidos intermitentes. · Reverberación. La última parte del proyecto, una vez que se tienen todas las alteraciones típicas de los archivos fílmicos identificadas, se procede al estudio de cada una de ellas con las herramientas del espectrograma y se realiza el estudio de una manera más técnica. Con el espectrograma se determinan las herramientas que solucionan cada alteración como Reverb para la reverberación, Decrackle para los crujidos… y en el marco técnico se determina las características que tiene cada herramienta, es decir el tipo de filtro, ventana… que se puede utilizar para poder restaurar el audio de cada alteración. La restauración digital es un campo aún por investigar, pero se debería de empezar a concienciar que es una solución factible. Que este tipo de restauración puede mantener el sonido original y no va a modificar los archivos, como muchas veces se piensa. Ya que el paso del tiempo, poco a poco, ira degradando y destruyendo los soportes fílmicos en los que se encuentran, y el principal objetivo que se pretende conseguir es que los materiales fílmicos perduren a lo largo de la historia. ABSTRACT. The film audio restoration is a fairly complex process and little research has been done in this field. Before restoring any files, you must preserve and keep the files in the best way possible. The preservation is the measures to be taken to ensure continued access to and preservation ensures existence of the file in its original form. The restoration is based on the study of possible damage suffered by the film media in time and the processes that exist to correct them. The restoration must always retain the most original as possible, i.e. to keep the audio as originally discussed for the first time. In the first stage, potential impairments that occur in the files are identified, if you know what time it was recorded the movies and how it was recorded, i.e. that machine recording and film media on which is recorded took place. Both machines as media have evolved throughout history. The study of film media lets us know the suffering degradations over time and result files, make possible restorations. To try to prevent further degradation, are intended to preserve and keep in good condition for support. Depending on the media file, will have typical conditions of temperature, humidity, ventilation... in which the material is preserved in the best way. After these steps, we proceed to restore. The most typical is with photochemical restoration materials, but is rather complex and therefore the restoration project is analyzed after scanning film archives. To successfully scan the files must be aware of the rules and regulations are established digitization. Digitization allows identifying the typical alterations that appear in the film materials, thanks to the tool spectrogram we know the possible restoration solutions for each alteration. The alterations that can find and identify are: · Buzz and Interference. · Hiss and Hissing. · Crackle. · Pops and Clicks. · Wow and Flutter. · Audio Dropouts. The last part of the project, when we have all the typical alterations identified film archives, proceed to the study of each of them with the tools of spectrogram and the study of a more technical way is done . With the spectrogram tools that solve every alteration as Reverb for reverb, Decrackle for cracks... and the technical framework the features that each tool is determined, i.e. the type of filter, window... that can be used are determined for to restore the audio of each alteration. Digital restoration is an area for future research, but should start aware that it is a feasible solution. This type of restoration can keep the original sound and will not modify files, as is often thought. Since the passage of time, gradually degrading and destroying anger film media in which they are, and the main objective to be achieved is that the film materials endure throughout history.

O BÔNUS PROFESSOR

Esta dissertação de mestrado fundamenta-se na pesquisa qualitativa e tem como objetivo a análise da ideologia do Bônus Mérito, instituído para os servidores públicos do Estado de São Paulo no início da década de 2000. Limitamos nossa análise à docência do ensino fundamental. As transformações econômicas, ocorridas a partir da década de 1980 nos países altamente industrializados, passam a exigir a melhoria do ensino dos países emergentes. Em conseqüência, a educação volta a ser revalorizada e a ter papel de destaque para os investimentos externos, através das agências e órgãos internacionais tais como: Bird, Unesco, Banco Mundial, PNUD. A ideologia do Bônus Mérito é um exemplo típico de transferência para o âmbito educacional de modelos de gestão das empresas privadas. Esta ideologia afeta a atividade docente, cujo desempenho é, doravante medido através de pontos, divisão de trabalho, impessoalidade, requalificação profissional etc. Efetivamente, em meio à globalização da economia e ao contexto político neoliberal, o governo do Estado de São Paulo optou, no período analisado, por seguir as determinações das grandes potências econômicas. O repasse de recursos financeiros recebidos pelo Estado para a efetivação das mudanças educacionais (diminuição da evasão, universalização das matrículas, aumento do número de alunos com aprovação) esteve condicionado às exigências das referidas agências e órgãos internacionais. Como é demonstrado neste trabalho, essa política relega a segundo plano o docente e sua prática de ensino. A explicitação do fundamento da ideologia do bônus no interior da escola pública visa demonstrar, em primeiro lugar, que o Bônus Mérito é um aparente benefício ao docente; e, em segundo lugar, que sua implantação não é outra coisa que o domínio econômico sobre o projeto educacional.

O BÔNUS PROFESSOR

Esta dissertação de mestrado fundamenta-se na pesquisa qualitativa e tem como objetivo a análise da ideologia do Bônus Mérito, instituído para os servidores públicos do Estado de São Paulo no início da década de 2000. Limitamos nossa análise à docência do ensino fundamental. As transformações econômicas, ocorridas a partir da década de 1980 nos países altamente industrializados, passam a exigir a melhoria do ensino dos países emergentes. Em conseqüência, a educação volta a ser revalorizada e a ter papel de destaque para os investimentos externos, através das agências e órgãos internacionais tais como: Bird, Unesco, Banco Mundial, PNUD. A ideologia do Bônus Mérito é um exemplo típico de transferência para o âmbito educacional de modelos de gestão das empresas privadas. Esta ideologia afeta a atividade docente, cujo desempenho é, doravante medido através de pontos, divisão de trabalho, impessoalidade, requalificação profissional etc. Efetivamente, em meio à globalização da economia e ao contexto político neoliberal, o governo do Estado de São Paulo optou, no período analisado, por seguir as determinações das grandes potências econômicas. O repasse de recursos financeiros recebidos pelo Estado para a efetivação das mudanças educacionais (diminuição da evasão, universalização das matrículas, aumento do número de alunos com aprovação) esteve condicionado às exigências das referidas agências e órgãos internacionais. Como é demonstrado neste trabalho, essa política relega a segundo plano o docente e sua prática de ensino. A explicitação do fundamento da ideologia do bônus no interior da escola pública visa demonstrar, em primeiro lugar, que o Bônus Mérito é um aparente benefício ao docente; e, em segundo lugar, que sua implantação não é outra coisa que o domínio econômico sobre o projeto educacional.

Examining Adolescent Sport Dropout and Prolonged Engagement from a Developmental Perspective

This study examined youth sport dropout and prolonged engagement from a developmental perspective focusing on physical and psychosocial factors. Twenty-five dropout and 25 engaged adolescent swimmers, matched on key demographic variables, participated in a retrospective interview. Results indicated that dropouts were involved in fewer extra-curricular activities, less unstructured swimming play, and received less one-on-one coaching throughout development. Dropouts reached several developmental milestones (i.e., started training camps, started dry land training, and were top in club) earlier than engaged athletes. Dropouts were more likely to have had parents who were high-level athletes in their youth, were more likely to be the youngest in their training group, and were less likely to have a best friend at swimming. Findings are discussed in relation to past research; future directions and implications for researchers, sport programmers, coaches, and parents are suggested.

Understanding Dropout and Prolonged Engagement in Adolescent Competitive Sport

Objectives: The purpose of this study is to gain understanding of training patterns and roles of significant others (i.e. coaches, parents, peers, and siblings) in adolescent swimmers’ sport participation patterns. Design: The developmental model of sport participation [Côté, J., Baker, J., & Abernethy, B. (2003). From play to practice: A developmental framework for the acquisition of expertise in team sport. In J. Starkes, & K. A. Ericsson (Eds.), Recent advances in research on sport expertise (pp. 89–114). Champaign, IL: Human Kinetics; Côté, J., & Fraser-Thomas, J. (2007). Youth involvement in sport. In P. R. E. Crocker (Ed.), Introduction to sport psychology: A Canadian perspective (pp. 266–294). Toronto: Pearson Prentice Hall] was used as a framework. Method: Ten dropout and 10 engaged swimmers, matched on key demographic variables participated in a semi-structured qualitative interview. Results: Groups had many similar experiences (e.g. early training, supportive and unsupportive coaches, involved parents). However, only dropouts spoke of early peak performances, limited one-on-one coaching, pressuring parents during adolescence, lack of swimming peers during adolescence, and sibling rivalries. In contrast, only engaged athletes spoke of clubs’ developmental philosophies, coaches’ and parents’ open communication, school friends’ support, and siblings’ general positive influences. Conclusions: Findings highlight the importance of appropriately structured programs and the fragility of athletes’ relationships with significant others during the adolescent years. Implications for sport programmers, coaches, and parents are discussed.

Adesão e desistência de programas de treino personalizado.

Este estudo pretendeu analisar as determinantes (demográficas, indicadores/ perceção de saúde, socioeconómicas e motivacionais) da adesão e desistência de programas de treino personalizado. Fizeram parte da amostra de conveniência adultos de ambos os géneros, oriundos de academias da cidade de Pelotas-Brasil, que ofereciam programas de treinos personalizados, sendo100 praticantes e 42 desistentes. Foram medidas as variáveis género, idade, cor da pele, índice de massa corporal, tabagismo, autoperceção de saúde, situação conjugal e nível socioeconómico. Para avaliar a motivação, foi utilizado o Inventário de Motivação à Prática Regular de Atividade Física, constatando-se que a maioria dos praticantes e desistentes de treino personalizado foram mulheres jovens, de nível socioeconómico elevado. As dimensões consideradas como mais motivadoras para a prática do treino personalizado foram: “Controle de Estresse”, “Saúde”, “Estética” e “Prazer”. Por outro lado, os motivos mais prevalentes para desistência foram a “Falta de Tempo” e a “Falta de Motivação” para a prática.

Fatores de influência na evasão escolar : um estudo de caso em três cursos técnicos subsequentes do Campus Brasília do Instituto Federal de Brasília

Dissertação apresentada para obtenção do grau de mestre no âmbito do Mestrado em Educação Social e Intervenção Comunitária da Escola Superior de Educação do Instituto Politécnico de Santarém.

Efficacy of an Internet-based, individually tailored smoking cessation program: A randomized trial

Introduction: Self-help computer-based programs are easily accessible and cost-effective interventions with a great recruitment potential. However, each program is different and results of meta-analyses may not apply to each new program; therefore, evaluations of new programs are warranted. The aim of this study was to assess the marginal efficacy of a computer-based, individually tailored program (the Coach) over and above the use of a comprehensive Internet smoking cessation website. Methods: A two-group randomized controlled trial was conducted. The control group only accessed the website, whereas the intervention group received the Coach in addition. Follow-up was conducted by e-mail after three and six months (self-administrated questionnaires). Of 1120 participants, 579 (51.7%) responded after three months and 436 (38.9%) after six months. The primary outcome was self-reported smoking abstinence over four weeks. Results: Counting dropouts as smokers, there were no statistically significant differences between intervention and control groups in smoking cessation rates after three months (20.2% vs. 17.5%, p¼0.25, odds ratio (OR)¼1.20) and six months (17% vs. 15.5%, p¼0.52, OR¼1.12). Excluding dropouts from the analysis, there were statistically significant differences after three months (42% vs. 31.6%, p¼0.01, OR¼1.57), but not after six months (46.1% vs. 37.8%, p¼0.081, OR¼1.41). The program also significantly increased motivation to quit after three months and self-efficacy after three and six months. Discussion: An individually tailored program delivered via the Internet and by e-mail in addition to a smoking cessation website did not significantly increase smoking cessation rates, but it increased motivation to quit and self-efficacy.

Dropout rates in the United States, 1988 /

"September 1989."