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Purpose: Due to the ethical concern around involuntary treatment, this study sought to investigate if youth participants in wilderness therapy who were transported to the program experienced different rates of change than those not transported. Methods: Multilevel modeling techniques were used to investigate rates of change for youth between transported and nontransported youth over 5 points until 6 months postdischarge. In addition, repeated measures analyses of variance investigated parent reports of change over time across transport status, gender, and diagnosis. Results: The findings showed no differences between transported and nontransported youth in changes over time. Overall, all youth improved significantly with changes maintained postdischarge regardless of transport status. Discussion: This study shows that transporting youth to treatment does not appear to interfere with the treatment outcome; however, more research is needed to understand clients’ perception of the transport process.

Background: Totally implantable port systems are generally recommended for prolonged central venous access in diverse settings, but their risk of complications remains unclear for patients with advanced cancer. Aim: The aim of this study was to assess the risk of port system failure in patients with advanced cancer. Design: We conducted a retrospective cohort study in a comprehensive cancer centre. Setting/participants: A detailed chart review was conducted among 566 patients with 573 ports inserted during January–June, 2009 (average 345.3 catheter-days). Cox regression analysis was applied to evaluate factors during insertion and early maintenance that could lead to premature removal of the port systems due to infection or occlusion. Results: Port system-related infection was significantly associated with receiving palliative care immediately after implantation (hazard ratio, HR = 7.3, 95% confidence interval, 95% CI = 1.2–46.0), after adjusting for probable confounders. Primary cancer site also impacted the occurrence of device-related infection. Receiving oncologic/palliative care (HR = 3.0, P = 0.064), advanced cancer stage (HR = 6.5, P = 0.077) and body surface area above 1.71 m2 (HR = 3.4, P = 0.029) increased the risk of port system occlusion. Conclusions: Our study indicates that totally implantable port systems yield a higher risk of complications in terminally ill patients. Further investigation should be carefully conducted to compare outcomes of various central venous access devices in patients with advanced cancer and to develop preventive strategies against catheter failure.