According to the main international guidelines, patients with obesity and psychiatric/psychological disorders who cannot be addressed to surgery are recommended to follow a nutritional approach and a psychological treatment. A total of 94 patients (T0) completed a battery of self-report measures: Symptom Checklist-90-Revised (SCL-90-R), Barratt Impulsiveness Scale-11 (BIS-11), Binge-Eating Scale (BES), Obesity-Related Well-Being Questionnaire-97 (ORWELL-97), and Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Then, twelve sessions of a brief psychodynamic psychotherapy were delivered, which was followed by the participants completing the follow-up evaluation (T1). Two groups of patients were identified: Group 1 (n = 65), who fully completed the assessment in both T0 and T1; and Group 2-dropout (n = 29), who fulfilled the assessment only at T0 and not at T1. Machine learning models were implemented to investigate which variables were most associated with treatment failure. The classification tree model identified patients who were dropping out of treatment with an accuracy of about 80% by considering two variables: the MMPI-2 Correction (K) scale and the SCL-90-R Phobic Anxiety (PHOB) scale. Given the limited number of studies on this topic, the present results highlight the importance of considering the patient\'s level of adaptation and the social context in which they are integrated in treatment planning. Cautionary notes, implications, and future directions are discussed.

Background: Retention in treatment is crucial for the success of interventions targeting alcohol use disorder (AUD), which affects over 100 million people globally. Most previous studies have used classical statistical techniques to predict treatment dropout, and their results remain inconclusive. This study aimed to use novel machine learning tools to identify models that predict dropout with greater precision, enabling the development of better retention strategies for those at higher risk. Methods: A retrospective observational study of 39,030 (17.3% female) participants enrolled in outpatient-based treatment for alcohol use disorder in a state-wide public treatment network has been used. Participants were recruited between 1 January 2015 and 31 December 2019. We applied different machine learning algorithms to create models that allow one to predict the premature cessation of treatment (dropout). With the objective of increasing the explainability of those models with the best precision, considered as black-box models, explainability technique analyses were also applied. Results: Considering as the best models those obtained with one of the so-called black-box models (support vector classifier (SVC)), the results from the best model, from the explainability perspective, showed that the variables that showed greater explanatory capacity for treatment dropout are previous drug use as well as psychiatric comorbidity. Among these variables, those of having undergone previous opioid substitution treatment and receiving coordinated psychiatric care in mental health services showed the greatest capacity for predicting dropout. Conclusions: By using novel machine learning techniques on a large representative sample of patients enrolled in alcohol use disorder treatment, we have identified several machine learning models that help in predicting a higher risk of treatment dropout. Previous treatment for other substance use disorders (SUDs) and concurrent psychiatric comorbidity were the best predictors of dropout, and patients showing these characteristics may need more intensive or complementary interventions to benefit from treatment.

This study investigates the role of social capital within the university context in retaining working students. It specifically examines the effects of university social capital factors-such as teacher-student relationships, peer networks, and support services-on the dropout intentions of working students, emphasizing the mediating role of employability trust. Using a sample of 1902 working students from the Eurostudent VII survey, this study employed factor analysis techniques and structural equation modeling to derive its findings. The results indicated that university social capital significantly reduces dropout intentions among working students. Strong teacher-student relationships, satisfaction with support services, robust peer networks, and high employability trust positively influence this social capital. There is a statistically significant negative association between teacher-student relationships, peer networks, employability trust, and dropout intentions. Furthermore, the findings reveal that without enhancing students\' employability trust, the effectiveness of support services might be limited. These findings not only contribute to the discourse on student retention and the development of university social capital but also provide practical insights for higher education strategies aimed at supporting working students.

OBJECTIVE: A multidisciplinary approach to Inflammatory Bowel Disease (IBD) has recently demonstrated a positive impact in pediatric patients, reducing dropout rates and facilitating the transition to adult care. Our study aims to evaluate how this approach influences disease activity, dropout rates, and transition.
METHODS: We conducted a longitudinal observational study including all patients diagnosed with IBD during pediatric-adolescent age, with a minimum follow-up period of 12 months. For each patient, endpoints included therapeutic approach, need for surgery and transition features.
RESULTS: We included 19 patients: 13 with Ulcerative Colitis (UC) and 6 with Crohn\'s disease (CD). Most patients required multiple lines of therapy, with over 50% in both groups receiving biological drugs. Compliance was good, with a single dropout in each group (10, 5%). The need for surgery was significantly higher in the CD group compared to the UC group (16% vs. 7.7%, p < 0.01). Mean age at transition was significantly higher in the UC group compared to the CD group (19.2 ± 0.7 years SD vs. 18.3 ± 0.6 years SD, p < 0.05).
CONCLUSIONS: In our experience, the multidisciplinary approach to IBD in transition-age patients appears effective in achieving clinical remission, offering the potential to reduce therapeutic dropouts.

UNASSIGNED: Psychotherapeutic failures involve situational, relational, and personal factors. Dropout refers to a patient\'s unilateral termination of treatment without the therapist\'s knowledge or approval. Premature termination occurs when therapy is discontinued before achieving a sufficient reduction in initial problems.
UNASSIGNED: This study explores the role of therapist\'s emotional response (countertransference), gender, psychotherapeutic orientation, and patient diagnosis in the context of psychotherapeutic failures.
UNASSIGNED: A mixed-method approach was used. Fifty-nine Italian psychotherapists, practicing mostly privately with at least 5 years of experience, were recruited through Italian professional internet websites. The Therapist Response Questionnaire and the Impasse Interview were administered to each psychotherapist. Each therapist was asked to reflect on their last dropout patient. Quantitative (MANOVA) and qualitative analyses (textual content analysis) were conducted with SPSS and T-LAB, respectively.
UNASSIGNED: The quantitative analyses revealed that the most frequent countertransference response was Helpless/Inadequate, with female therapists experiencing this more frequently than male therapists. The qualitative analyses identified two main factors explaining most of the variance in countertransference responses: Parental/Protective versus Hostile/Angry, and Positive/Satisfying versus Helpless/Inadequate, with Helpless/Inadequate central. Additionally, the qualitative analysis of treatment interruption methods revealed two factors explaining over 50% of the variance. Lack of communication was linked to negative themes, while mediated and direct communication were associated with positive terms. Direct communication was characterized as useful, while mediated communication was linked to dropout and attachment figures.
UNASSIGNED: Under pressure, psychotherapists\' anxiety levels increase, often managed ambivalently or avoidantly. These results suggest that awareness of psychotherapist emotional responses is important to limit psychotherapeutic failures. These findings offer valuable insights for clinical practice.

BACKGROUND: The attrition rate of Chinese medical students is high. This study utilizes a nomogram technique to develop a predictive model for dropout intention among Chinese medical undergraduates based on 19 individual and work-related characteristics.
METHODS: A repeated cross-sectional study was conducted, enrolling 3536 medical undergraduates in T1 (August 2020-April 2021) and 969 participants in T2 (October 2022) through snowball sampling. Demographics (age, sex, study phase, income, relationship status, history of mental illness) and mental health factors (including depression, anxiety, stress, burnout, alcohol use disorder, sleepiness, quality of life, fatigue, history of suicidal attempts (SA), and somatic symptoms), as well as work-related variables (career choice regret and reasons, workplace violence experience, and overall satisfaction with the Chinese healthcare environment), were gathered via questionnaires. Data from T1 was split into a training cohort and an internal validation cohort, while T2 data served as an external validation cohort. The nomogram\'s performance was evaluated for discrimination, calibration, clinical applicability, and generalization using receiver operating characteristic curves (ROC), area under the curve (AUC), calibration curves, and decision curve analysis (DCA).
RESULTS: From 19 individual and work-related factors, five were identified as significant predictors for the construction of the nomogram: history of SA, career choice regret, experience of workplace violence, depressive symptoms, and burnout. The AUC values for the training, internal validation, and external validation cohorts were 0.762, 0.761, and 0.817, respectively. The nomogram demonstrated reliable prediction and discrimination, with adequate calibration and generalization across both the training and validation cohorts.
CONCLUSIONS: This nomogram exhibits reasonable accuracy in foreseeing dropout intentions among Chinese medical undergraduates. It could guide colleges, hospitals, and policymakers in pinpointing students at risk, thus informing targeted interventions. Addressing underlying factors such as depressive symptoms, burnout, career choice regret, and workplace violence may help reduce the attrition of medical undergraduates.
BACKGROUND: This is an observational study. There is no Clinical Trial Number associated with this manuscript.

This article investigates the phenomenon of sports abandonment among young scholars aged between 8 and 13 years. Regardless of the growing awareness of the importance of sport and physical activity during childhood and adolescence, this theme must be adequately explored in the scientific literature. Our study addresses this gap through a cross-sectional research design, tracking and analyzing data from a cohort of young athletes over one year. The main objective of our study is to identify the determinants leading to sports dropout in this specific age group. We looked at several possible causes through a multivariate analysis, including social pressures, parental expectations, time conflicts, physical and psychological stress, and lack of enjoyment. The results show a significant attrition rate, with psychosocial factors emerging as the most influential in determining whether a young person will continue or stop their participation in sport. Furthermore, our study highlights the importance of targeted interventions and preventive strategies that promote a positive, inclusive, and balanced sports environment for adolescents. These interventions can be particularly effective when implemented by coaches, parents and others involved in youth sports education. Finally, this paper discusses the implications of the findings for sports professionals, physical educators, and public policy makers. It highlights the need for more effective support policies and innovative pedagogical approaches to promote sporting persistence during adolescence. Our findings can serve as a starting point for further research in this field, helping to build a future where young people can enjoy the many benefits of sport and physical activity.

School teachers\' sickness absence has been shown to affect student achievement in the short run. However, we know little about whether socioeconomic backgrounds may compensate for reductions in instructional quality and to what extent teacher absence effects persist over time. This paper examines the socioeconomic differences in the short- and long-term effects of teacher absence. We use population-wide Norwegian register data to study the effects of certified teacher absence during lower secondary school (grades 8-10) on non-completion of upper secondary education by age 21 (i.e. school dropout) as well as academic achievement in 10th grade. In a school fixed effects model, we find that an increase in teacher absence of 5 percentage points reduces students\' examination grades by 2.3% of a standard deviation and increases the dropout probability by 0.6 percentage points. However, the teacher absence effects vary considerably by family background, with large effects for low-SES students driving the overall effects. Overall, our findings indicate that reductions in instructional quality increase social inequality in long-term educational outcomes. This result highlights that studying heterogeneous impacts of contextual exposures is needed to understand the role of schools in shaping inequality.

UNASSIGNED: Vaccination is a cost-effective public health program that helps reduce significant morbidity and mortality in children under the age of five. Worldwide, the number of vaccine-preventable causes of child death has significantly decreased since the Expanded Program of Immunization (EPI) was introduced. However, for a variety of reasons, 23 million children did not have adequate access to vaccines in 2020. Therefore, this study aimed to evaluate the determinants of pneumonia conjugate vaccine (PCV) dropout among children aged 12-23 months in Ethiopia.
UNASSIGNED: The study analyzed cross-sectional data obtained from the 2019 mini Ethiopian demographic and health survey. Multilevel binary logistic regression analysis was utilized, and the best fit model was chosen using the Akaike Information Criteria. The study comprised a weighted sample of 989 children aged 12 to 23 months. The study presented the Adjusted Odds Ratio (AOR) along with a 95% Confidence Interval (CI) to identify the significant factors influencing PCV dropout.
UNASSIGNED: The PCV dropout rate was reported at 20.2% in this study. In the multilevel analysis, possession of a health card (AOR = 0.076, 95% CI: 0.019, 0.04), vaccination for PCV 2 (AOR =0.002, 95% CI: 0.023, 0.263), and region 7 (AOR = 6.98, 95% CI: 10.1, 48.31) were significantly associated with children\'s PCV dropout.
UNASSIGNED: Having a health card, having received the PCV 2 vaccinations, and region were significant predictors of PCV dropout. Consequently, health education on immunization for all mothers and region-specific, customized public health interventions are needed to reduce the vaccination dropout rate.

Music education often struggles to sustain students\' long-term commitment, with many perceiving lessons as frustrating or unengaging, leading to discontinuation. To address this gap, our study aimed to elucidate the primary reasons for dropout from the perspectives of various stakeholders, including students, parents, teachers, and principals. Drawing upon the self-determination theory, our research comprehensively investigated external and internal factors contributing to dropout. Among external factors, competing extracurricular commitments, music theory and solfége lessons, and teacher\'s approach emerge as the most prominent. Among internal factors, our findings highlighted the critical role of autonomy, competency, and relatedness in shaping students\' decisions to continue or discontinue music education. Inadequate teacher-student relationships, limited peer interactions, and uninspiring classroom atmospheres significantly impacted dropout. Moreover, challenges in the music school curriculum, such as difficulties with music theory and solfège, resource limitations, and excessive workloads, emerged as prominent barriers to student engagement. By addressing these multifaceted issues, our study underscores the importance of fostering supportive environments that cater to individual needs and interests, ultimately enhancing the overall music education experience and reducing dropout rates. This research represents the first systematic empirical study in Slovenian music education, laying the groundwork for future quantitative investigations to advance education practices in Slovenia.