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Prospective Cohort Design (prospective + cohort_design)
Selected AbstractsAttendance at Narcotics Anonymous and Alcoholics Anonymous meetings, frequency of attendance and substance use outcomes after residential treatment for drug dependence: a 5-year follow-up studyADDICTION, Issue 1 2008Michael Gossop ABSTRACT Aims This study investigates the relationship between frequency of attendance at Narcotics Anonymous and Alcoholics Anonymous (NA/AA) meetings and substance use outcomes after residential treatment of drug dependence. It was predicted that post-treatment NA/AA attendance would be related to improved substance use outcomes. Methods Using a longitudinal, prospective cohort design, interviews were conducted with drug-dependent clients (n = 142) at intake to residential treatment, and at 1 year, 2 years and 4,5 years follow-up. Data were collected by structured interviews. All follow-up interviews were carried out by independent professional interviewers. Findings Abstinence from opiates was increased throughout the 5-year follow-up period compared to pre-treatment levels. Clients who attended NA/AA after treatment were more likely to be abstinent from opiates at follow-up. Abstinence from stimulants increased at follow-up but (except at 1-year follow-up) no additional benefit was found for NA/AA attendance. There was no overall change in alcohol abstinence after treatment but clients who attended NA/AA were more likely to be abstinent from alcohol at all follow-up points. More frequent NA/AA attenders were more likely to be abstinent from opiates and alcohol when compared both to non-attenders and to infrequent (less than weekly) attenders. Conclusions NA/AA can support and supplement residential addiction treatment as an aftercare resource. In view of the generally poor alcohol use outcomes achieved by drug-dependent patients after treatment, the improved alcohol outcomes of NA/AA attenders suggests that the effectiveness of existing treatment services may be improved by initiatives that lead to increased involvement and engagement with such groups. [source] The National Treatment Outcome Research Study (NTORS): 4,5 year follow-up resultsADDICTION, Issue 3 2003Michael Gossop ABSTRACT Aims ,The National Treatment Outcome Research Study (NTORS) is the first prospective national study of treatment outcome among drug misusers in the United Kingdom. NTORS investigates outcomes for drug misusers treated in existing services in residential and community settings. Design, setting and participants,The study used a longitudinal, prospective cohort design. Data were collected by structured interviews at intake to treatment, 1 year, 2 years and at 4,5 years. The sample comprised 418 patients from 54 agencies and four treatment modalities. Measurements, Measures were taken of illicit drug use, injecting and sharing injecting equipment, alcohol use, psychological health and crime. Findings, Rates of abstinence from illicit drugs increased after treatment among patients from both residential and community (methadone) programmes. Reductions were found for frequency of use of heroin, non-prescribed methadone, benzodiazepines, injecting and sharing of injecting equipment. For most variables, reductions were evident at 1 year with outcomes remaining at about the 1 year level or with further reductions. Crack cocaine and alcohol outcomes at 4,5 years were not significantly different from intake. Conclusions, Substantial reductions across a range of problem behaviours were found 4,5 years after patients were admitted to national treatment programmes delivered under day-to-day conditions. The less satisfactory outcomes for heavy drinking and use of crack cocaine suggest the need for services to be modified to tackle these problems more effectively. Despite differences between the United Kingdom and the United States in patient populations and in treatment programmes, there are many similarities between the two countries in outcomes from large-scale, multi-site studies. [source] The Role of Youth Problem Behaviors in the Path From Child Abuse and Neglect to Prostitution: A Prospective ExaminationJOURNAL OF RESEARCH ON ADOLESCENCE, Issue 1 2010Helen W. Wilson Behaviors beginning in childhood or adolescence may mediate the relationship between childhood maltreatment and involvement in prostitution. This paper examines 5 potential mediators: early sexual initiation, running away, juvenile crime, school problems, and early drug use. Using a prospective cohort design, abused and neglected children (ages 0,11) with cases processed during 1967,1971 were matched with nonabused, nonneglected children and followed into young adulthood. Data are from in-person interviews at approximately age 29 and arrest records through 1994. Structural equation modeling tested path models. Results indicated that victims of child abuse and neglect were at increased risk for all problem behaviors except drug use. In the full model, only early sexual initiation remained significant as a mediator in the pathway from child abuse and neglect to prostitution. Findings were generally consistent for physical and sexual abuse and neglect. These findings suggest that interventions to reduce problem behaviors among maltreated children may also reduce their risk for prostitution later in life. [source] Validation of the WHOQOL-BREF among women following childbirthAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2010Joan WEBSTER Background:, There is increasing interest in measuring quality of life (QOL) in clinical settings and in clinical trials. None of the commonly used QOL instruments has been validated for use postnatally. Aim:, To assess the psychometric properties of the 26-item WHOQOL-BREF (short version of the World Health Organization Quality of Life assessment) among women following childbirth. Methods:, Using a prospective cohort design, we recruited 320 women within the first few days of childbirth. At six weeks postpartum, participants were asked to complete the WHOQOL-BREF, the Edinburgh Postnatal Depression Index and the Australian Unity Wellbeing Index. Validation of the WHOQOL-BREF included an analysis of internal consistency, discriminate validity, convergent validity and an examination of the domain structure. Results:, In all, 221 (69.1%) women returned their six-week questionnaire. All domains of the WHOQOL-BREF met reliability standards (alpha coefficient exceeding 0.70). The questionnaire discriminated well between known groups (depressed women and non-depressed women. P , 0.000) and demonstrated satisfactory correlations with the Australian Unity Wellbeing index (r , 0.45). The domain structure of the WHOQOL-BREF was also valid in this population of new mothers, with moderate-to-high correlation between individual items and the domain structure to which the items were originally assigned. Conclusion:, The WHOQOL-BRF is a well-accepted and valid instrument in this population and may be used in postnatal clinical settings or for assessing intervention effects in research studies. [source] Waiting time for rehabilitation services for children with physical disabilitiesCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2002D. Ehrmann Feldman Abstract Background Early rehabilitation may minimize disability and complications. However, children often wait a long time to gain admission to rehabilitation centres. Objectives To describe waiting times for paediatric physical and occupational therapy and to determine factors associated with these waiting times. Research Design The study was a prospective cohort design. Patients were followed from 1 January 1999 to 1 March 2000. Subjects All children with physical disabilities, aged 0,18 years, referred in 1999 from the Montreal Children's Hospital to paediatric rehabilitation centres. Measures Data on date of referral, date of first appointment at the rehabilitation centre, age, gender, diagnosis, region and language were obtained from the rehabilitation transfer database. Primary family caregivers of children who were transferred to a rehabilitation facility participated in a telephone interview regarding their perceptions of the transfer process. Results There were 172 children referred to rehabilitation facilities. The mean age of the children was 2.5 years. Average waiting time was 157.4 days (SD 57.1) for occupational therapy and 129.4 days (SD 51.6) for physical therapy. Decreased waiting time was associated with living in the city as opposed to the suburbs (hazard ratio = 1.77; 95% confidence interval = 0.92,3.41) and inversely associated with age (hazard ratio = 0.46; 95% confidence interval = 0.34,0.62). Among the 41 primary family caregivers who participated in the survey, higher empowerment scores were associated with shorter waits for rehabilitation. Conclusion Waiting time for rehabilitation services needs to be reduced. Empowered parents appear to manoeuvre within the system to reduce waiting times for their children. [source] | ||||||||||