Treatment outcomes and predictors of drop out for problem gamblers in South Australia : a cohort study

OBJECTIVES: Recent prevalence studies in Australia, the USA and Canada have estimated 1-2% of the adult population meet the diagnostic criteria for problem or pathological gambling. The Statewide Gambling Therapy Service (SGTS) provides treatment for problem gamblers in key metropolitan and rural regions in South Australia. The aims of this study were two-fold: to analyse the short and mid-term outcomes following treatment provided by SGTS and to identify factors associated with treatment drop-out. METHOD: A cohort of treatment seeking problem gamblers was recruited through SGTS in 2008. Repeated outcome measures included problem gambling screening, gambling related cognitions and urge. Treatment drop-out was defined as participants attending three or less treatment sessions, whilst potential predictors of drop-out included perceived social support , anxiety and sensation-seeking traits. RESULTS: Of 127 problem gamblers who participated in the study, 69 (54%) were males with a mean age of 43.09 years (SD = 12.65 years) and with 65 (52%) reporting a duration of problem gambling greater than 5 years. Follow up time for 50% of participants was greater than 8.9 months and, overall, 41 (32%) participants were classified as treatment drop-outs. Results indicated significant improvement over time on all outcome measures except alcohol use for both treatment completers and drop-outs, although to a lesser extent for the treatment drop-out group. A significant predictor of treatment drop-out was sensation-seeking traits. CONCLUSION: These results will inform future treatment planning and service delivery, and guide research into problem gambling including aspects of treatment drop-out.

Drop out from behavioral management training programs for ADHD: a prospective study

To investigate dropout from parenting programs for disruptive behavior disorders, we followed 18 clients prospectively from the beginning of a manualized treatment program to three month follow-up. Using qualitative and quantitative methods, we then compared those who dropped out of the program with those who completed it. We found that in general, those participants who dropped out of the program were parents of children with more disturbed behavior, who perceived their children to be more difficult than others, and who experienced more subjective parenting stress. Those who dropped out were also not convinced that the strategies proposed in the program to help manage their children were useful. On the other hand, those who completed the program reported a determination to persevere with the strategies which they saw as assisting them to re-establish positive relationships with their adolescent children. The findings are discussed in the context of how manualized programs might be modified to increase retention.

Attrition from an internet-based psychological intervention for erectile dysfunction : who is likely to drop out?

The current study evaluated the dropout rate from an internet-based treatment program for erectile dysfunction (ED), and determined reasons for attrition from this program. Only 12 of 40 treatment group men and 19 of 20 control group men completed the post-test measures. Reasons for the men being excluded or dropping out of the study are discussed. These reasons included medical conditions that contributed to their ED, the man's partner not being interested in participating in the program, a lack of motivation from the man, or the time commitment being too demanding.

Drop-out from parenting training programmes : a retrospective study

Objective: Parent training programmes are a well-established treatment approach for children and adolescents with disruptive behaviour disorders. However, dropout from treatment is a common problem that confounds research on the efficacy of this approach, and wastes important mental health resources. This study sought to further our understanding of the reasons why parents drop out of parent training programmes.

Method: Nine parents of children with disruptive behaviour disorders who had dropped out of a parent training programme were interviewed to investigate why they discontinued the programme.

Results: Parents who dropped out of treatment believed that their children were more difficult than other children with the same disorder and may have been better suited to a child-focused intervention. The parents themselves had very stressful lives, with the majority being single mothers with little support. Dropout parents also had difficulty with the group context and putting strategies into place. Practical concerns included parking, timing of session and the length and number of sessions.

Conclusions: The findings are discussed in terms of what modifications can be made to these programmes to increase retention.

Prognostic significance of foveal capillary drop-out and previous panretinal photocoagulation for diabetic macular oedema treated with ranibizumab

AIMS To investigate the prognostic significance of macular capillary drop-out and previous panretinal laser photocoagulation in diabetic macular oedema treated with intravitreal ranibizumab. METHODS Retrospective observational case series. Treatment-naive patients with diabetic macular oedema that had been treated with intravitreal ranibizumab as per the RESTORE study protocol for at least 12 months were included. Some patients (n=15) had previous panretinal laser photocoagulation. Best-corrected visual acuity and central retina thickness were recorded monthly. The foveal avascular zone and the perifoveal capillaries were quantitatively and qualitatively assessed on fluorescein angiography on two occasions during the observational period. RESULTS From the 46 eyes (46 patients) in this study, 13 (28%) had evidence of perifoveal capillary drop-out. Central retinal thickness was significantly thinner at baseline (p=0.02) and throughout the study period in these eyes compared with those with normal perifoveal capillaries. Both groups responded with a significant gain of best-corrected visual acuity to ranibizumab treatment (7.6±3.3 and 6.3±1.3 ETDRS letters, respectively). Eyes with previous panretinal laser photocoagulation displayed a comparable final outcome regarding function and morphology, requiring a similar intensity of intravitreal injections. CONCLUSIONS Perifoveal capillary drop-out did not limit the gain of visual acuity from intravitreal ranibizumab treatment. The reduction of central retina thickness was similar to that seen in eyes with normal perifoveal capillaries. Central retinal thickness in eyes with perifoveal capillary drop-out was generally reduced. However, this did not affect their benefit from treatment. Ranibizumab did not increase the amount of perifoveal capillary loss.

A preliminary, qualitative exploration of the influences associated with drop-out from cognitive-behavioural therapy for problem gambling : an Australian perspective

It has been estimated that 80% of Australians engage in some form of gambling, with approximately 115,000 Australians experiencing severe problems (Productivity Commission 2010). Very few people with problem gambling seek help and, of those who do, large numbers drop-out of therapy before completing their program. To gain insights into these problems, participants who had either completed or withdrawn prematurely from an individual CBT-based problem gambling treatment program were interviewed to examine factors predictive of premature withdrawal from therapy as well as people's 'readiness' for change. The results indicated that there might be some early indicators of risk for early withdrawal. These included: gambling for pleasure or social interaction; non-compliance with homework tasks; gambling as a strategy to avoid personal issues or dysphoric mood; high levels of guilt and shame; and a lack of readiness for change. The study further showed that application of the term 'drop-out' to some clients may be an unnecessarily negative label in that a number appear to have been able to reduce their gambling urges even after a short exposure to therapy.

Vocational students??? intention to drop out in Flanders : the role of teacher beliefs

Monogr??fico con el t??tulo: "??De nuevo con el abandono escolar? : un an??lisis de pol??ticas, pr??cticas y subjetividades"

Why do young women drop out of sport and physical activity? A social ecological approach

This study explored significant individual, social, and environmental factors and how they interact to influence participation in physical activity for adolescent young women. These factors were explored at two transitional life stages: from primary to secondary school and from middle to upper years at secondary school. Ten focus groups with young women and 10 interviews with teachers were conducted and multiple, interrelated themes emerged. Our findings indicated that there are a number of strategies that could be undertaken to increase the participation of young women in physical activity. These include: (1) enhancing intrinsic motivation for sport and physical activity; (2) appealing to young women’s need for socialising through opportunities for informal physical activity; (3) educating parents about the benefits of sport and physical activity; (4) overcoming gender stereotypes about what is acceptable behaviour for young women; (5) improving physical education teachers’ understanding of gender issues and motivating less physically active students; (6) the provision of accessible sport and physical activity facilities, programs, and services in schools; and (7) prioritorisation of sport and physical activity in the school curriculum. These strategies are not ‘quick fixes’, but rather require a whole-ofcommunity approach and, in some cases, a reorientation of societal values.

Why do bidders drop out from a sequential auction

In actual sequential auctions, 1) bidders typically incur a cost in continuing from one sale to the next, and 2) bidders decide whether or not to continue. To investigate the question "why do bidders drop out," we define a sequential auction model with continuation costs and an endogenously determined number of bidders at each sale, and we characterize the equilibria in this model. Simple examples illustrate the effect of several possible changes to this model.

How Insecurity impacts on school attendance and school drop out among urban slum children in Nairobi

This paper discusses how perceptions of personal security can impact on school enrolment and attendance. It mainly focuses on threats to physical harm, crime, community and domestic violence. These security fears can include insecurity that children suffer from as they go to school, maybe through the use of unsafe routes; insecurity that children feel at school; and the insecurity they suffer from in their homes. Although poverty is an indicator of insecurity, this paper does not focus solely on poverty as it is well covered elsewhere in the literature. The paper relies on qualitative data collected in Korogocho and Viwandani slum areas in Nairobi, Kenya between October and November 2004. The paper analyses data from individual interviews and focus group interviews and focuses on the narrative of slum dwellers on how insecurity impacts on educational attainment. The conclusion in this paper is that insecure neighbourhoods may have a negative impact on schooling. As a result policies that address insecurity in slum neighbourhoods can also improve school attendance and performance.

An extended Herschel drop-out source in the center of AS1063: a normal dusty galaxy at z=6.1 or SZ substructures?

In the course of our 870 μm APEX/LABOCA follow-up of the Herschel Lensing Survey we have detected a source in AS1063 (RXC J2248.7-4431) that has no counterparts in any of the Herschel PACS/SPIRE bands, it is a Herschel “drop-out” with S_870/S_500 ≥ 0.5. The 870 μm emission is extended and centered on the brightest cluster galaxy, suggesting either a multiply imaged background source or substructure in the Sunyaev-Zel’dovich increment due to inhomogeneities in the hot cluster gas of this merging cluster. We discuss both interpretations with emphasis on the putative lensed source. Based on the observed properties and on our lens model we find that this source may be the first submillimeter galaxy (SMG) with a moderate far-infrared (FIR) luminosity (L_FIR < 10^12 L_⊙) detected so far at z > 4. In deep HST observations we identified a multiply imaged z ~ 6 source and measured its spectroscopic redshift to be z = 6.107 with VLT/FORS. This source may be associated with the putative SMG, but it is most likely offset spatially by 10−30 kpc and they may be interacting galaxies. With a FIR luminosity in the range [5−15] × 10^11 L_⊙ corresponding to a star formation rate in the range [80−260] M_⊙ yr^-1, this SMG would be more representative of the z > 4 dusty galaxies than the extreme starbursts detected so far. With a total magnification of ~25 it would open a unique window to the normal dusty galaxies at the end of the epoch of reionization.

L’abandon du traitement de jeunes toxicomanes ayant séjourné en communauté thérapeutique et leur condition post-traitement

De nombreux jeunes sont aux prises avec un problème de consommation de substances psychoactives. Bien que plusieurs traitements soient reconnus efficaces, les taux d’abandon chez les jeunes toxicomanes sont élevés et cela influence leur condition post-traitement. L’identification des caractéristiques des jeunes liés à l’abandon et à la condition post-traitement est donc nécessaire pour permettre d’adapter nos interventions en fonction des besoins des jeunes. La relation entre l’abandon du traitement ainsi que la condition post-traitement et diverses caractéristiques prétraitement a été examinée chez un échantillon de 215 clients adolescents admis à Portage entre 2003 et 2008, évalués avec l’instrument Indice de gravité d’une toxicomanie pour les adolescents (Germain, Landry, & Bergeron, 2003, 1999). Les relations entre l’abandon du traitement et des variables concernant leur consommation, leur état de santé, leurs problématiques liées à leurs occupations, leur état psychologique, leurs difficultés vécues auprès des proches et dans la famille ainsi que leurs difficultés socio-judiciaires ont été testées. Ces mêmes variables ont été utilisées pour chercher à prédire la condition post-traitement. Les régressions logistiques montrent qu’un premier séjour en communauté thérapeutique et les difficultés interpersonnelles prédisent l’abandon du traitement. Une fois les analyses réalisées de façon séparée selon le sexe, ces relations ne demeurent significatives que pour les filles. Les résultats des régressions linéaires multiples réalisées pour étudier la condition post-traitement ne permettent pas de retrouver les variables prévisionnelles rapportées dans les écrits scientifiques pour les clientèles adultes. Des questions sont soulevées quant à la pertinence de l’Indice de gravité d’une toxicomanie pour les adolescents (Germain, Landry, & Bergeron, 2003, 1999) pour prédire l’abandon et la condition post-traitement.