This intervention may have the potential to improve parenting and increase the identification of infants at risk of abuse and neglect in vulnerable families. Further investigation is needed, along with long-term follow-up to assess possible sleeper effects.
Women with inadequate prenatal care were recruited to a multi-component parenting intervention study. Because it was anticipated that this high-risk population might present challenges to retention, a variety of strategies were employed to maintain their participation in the study. This report reviews the results of these retention efforts and compares the population that completed the study versus those that terminated prior to study completion. Two hundred and eighty-six women were randomized to an intervention or control group. Careful tracking of the mothers, offering incentives for completing various study activities and providing a culturally competent staff were among the strategies employed to maintain participation. Comparison was made of those mothers terminating before study completion versus those retained, and of those terminating early in the study period versus later. Despite retention efforts, attrition at a level of 41% occurred. A few characteristics of mothers terminating early from the study were significant including older maternal age, a larger number of children, and incidence of no prenatal care. Despite comprehensive tracking procedures, some mothers were lost to follow up after change of residence. Other reasons for attrition included child outplacement and refusal of services or data collection procedures.
The objective of this study was to determine the effect of place and type of initial treatment on survival from acute lymphocytic leukemia (ALL). Every one of the 327 children under 15 years of age diagnosed with ALL from 1970 to 1975 in a 31-county area designated the Greater Delaware Valley, were studied. Treatment according to protocol was associated with improved survival, yielding a 4 year survival of 60% vs 19% for nonprotocol treated patients (p less than 0.001). There was also a significantly improved survival rate among patients treated in a cancer center, especially for those with a low white blood count (WBC) at diagnosis. The prognostic importance of WBC, age, and sex was confirmed.
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