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Results for “Self-selection”

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PubMed1992

Short- and long-term variability of selected indices related to nutritional status. II. Vitamins, lipids, and protein indices.

Five free-living women (ages 23-38 years) who consumed a self-selected diet and five women (ages 23-44 years) residing in a metabolic unit who were fed constant diet were assessed for variation in vitamin and general chemistry indices. Blood was drawn from these women once a month for five months, once a week for five weeks, and once a day for five days to assess analytical and biological variability of the indices. Analytical variability was determined by concurrently analyzing control samples prepared from plasma and serum pools. All samples were analyzed in duplicate. Of the measured indices, vitamins and lipids seemed to be the most variable. Diet had a significant effect only on ascorbic acid. We were unable to show any seasonal change for these analytes. Estimations of analytical variability, along with estimates of biological variability, and knowledge of dietary practices are essential when interpreting differences in analytes.

Adult↗

PubMed1991

A kinematic analysis of walking and physical fitness testing in elderly women.

Walking ability and physical fitness were assessed in 57 elderly Japanese women. Self-selected walking velocity at normal and fast speeds decreased markedly after age 60. The older age groups exhibited significant reductions in the lower limb joint displacements, due particularly to decreased angles at toe-off. The angular velocity of ankle plantarflexion during the stance phase declined markedly with age. A decrease in toe elevation during the swing phase and an increase in stance time in the process of aging suggested an increasing risk of stumbling over obstacles. Reductions in walking parameters with age correlated significantly with aspects of physical fitness tested, especially with items related to neuromuscular functions.

Aged↗

PubMed1992

The effects of gender-specific diagnosis on men's and women's response to infertility.

OBJECTIVE: To determine if differences could be distinguished between men's and women's emotional response to infertility based on the assignment of a gender-specific diagnosis. DESIGN: Gender-specific diagnoses were examined in relation to stigma, perception of loss, role failure, and self-esteem, using structured interviews. SETTING: Tertiary clinical care in private practice settings. PARTICIPANTS: Thirty-six self-selected volunteer couples undergoing infertility treatment. MAIN OUTCOME MEASURES: Stigma, perception of loss, role failure, and lowered self-esteem emerged from content analysis of structured interview data. RESULTS: No differences were found among women in their emotional response to infertility regardless of whether a female or male infertility factor was present, whereas men with a male factor experienced more negative emotional response to infertility than men without a male factor. CONCLUSIONS: Although both women and men are affected by infertility, their emotional response is significantly influenced by a gender-specific diagnosis. Men's response to infertility closely approximates that of women if the infertility has been attributed to a male factor but differs considerably if a male factor is not found.

Emotions↗

PubMed1992

Food intake of very obese persons: quantitative and qualitative aspects.

To document the caloric intake of very obese persons and investigate the food choices and dietary composition that maintain severe obesity, we studied the self-selected food intake required to maintain stable weight in two groups of very obese subjects: 11 inpatients with a mean weight 181% above desirable body weight and 35 outpatients with a mean weight 125% above desirable body weight. Qualitative and quantitative food intake were evaluated using records obtained on the hospital metabolic ward for the inpatients and using self-recorded food records for the outpatients. Absolute caloric intake in both groups was greater in proportion to the degree of obesity (deviation from desirable body weight); caloric intake per unit of lean body mass (kilocalories per gram urinary creatinine) was constant regardless of the degree of obesity and was essentially the same as that of normal nonobese persons. Food records indicated that the obese subjects maintained their high caloric intake by consuming mostly foods of high caloric density, with occasional binge eating. They largely avoided foods of low intrinsic energy density and modified-calorie foods, ie, foods with decreased fat, nonnutritive sweeteners, or fillers. By substituting foods of lower caloric density for usual food choices from the same food group, obese persons could decrease caloric intake by 20% and increase potential for notable weight loss.

Adult↗

PubMed1992

Maternal Type A behavior during pregnancy, neonatal crying, and early infant temperament: do type A women have type A babies?

It was hypothesized that type A behavior in pregnant women would be associated with increased neonatal crying and differential reports of infant temperament at 3 months. Type A behaviors during pregnancy were measured in a self-selected cohort of 72 healthy, primiparous, middle-class women. Their newborns were assessed at 48 hours of age and the women completed an infant temperament questionnaire at 3 months. Women who were classified as type A on the Job Involvement scale of the Jenkins Activity Survey had infants who cried more during a standardized neurobehavioral assessment compared with infants of women who were type B on the same scale. Women who were type A for Job Involvement rated their 3-month-old infants as more intense and less predictable in their responses to the environment. They were also more likely to be breast-feeding their infants at 3 months. This is the first study to examine the prevalence and nature of maternal type A behaviors during pregnancy and to show their relationship to neonatal crying behavior, to maternal report of early infant temperament, and to maternal breast-feeding.

Adult↗

PubMed1991

Does estrogen replacement therapy protect against rheumatoid arthritis?

The incidence of rheumatoid arthritis (RA) was compared in 2 cohorts of women aged 35-64. One consisted of 1,075 estrogen replacement therapy (ERT) users and the other was 3,251 women from general practice registers. Screening detected 32 cases; 8 postmenopausal control and 6 ERT women developed RA during the study period 1982-1986. This produced incidence rates of 19.7/10,000 and 12.3/10,000 years of observation for ERT and controls, respectively. The relative risks for ERT was 1.62 (95% CI 0.56-4.74) and reduced towards unity after adjustment for potential confounders. Despite the wide confidence interval, our data do not support the previous observation of a 4-fold reduction in RA incidence in ERT users. Indeed the incidence rate in the exposed group in this study exceeded current population estimates of RA incidence in postmenopausal women. We believe that the high incidence rates could be best explained by the self-selection for estrogen therapy at the menopause of those with undiagnosed joint symptoms. These findings underscore the difficulties in elucidating the relationship between ERT and RA.

Adult↗

PubMed1991

Fluid intake during an ultramarathon running race: relationship to plasma volume and serum sodium and potassium.

To assess the relationship between self-selected fluid intake patterns and changes in plasma volume and serum electrolytes during prolonged exercise, five men completed ultramarathon runs ranging from 50 to 100 km. There was a significant relationship between fluid intake and plasma volume changes but no changes occurred in either serum sodium or potassium. Subjects who ingested the most fluid during the race had a modest hemodilution without any changes in serum or potassium. This response may have been influenced by the consumption of beverages containing osmotically active solutes such as sodium and glucose.

Exercise↗

PubMed1991

Decreases in resting plasma beta-endorphin and depression scores after endurance training.

That endurance training changes resting plasma beta-endorphin (BE) at the same time that there are improvements in non-clinical depression was tested in medically healthy middle-aged men (40-60 years). Subjects were self-selected based on compliance into treatment (T, n = 10) and placebo (P, n = 6) groups. T attended an eight month fitness program. P had less than 50% attendance in the program. Treadmill tests at the pre and post program were used to estimate the Physical Fitness Score (PFS). The Minnesota Multiphasic Personality Inventory (MMPI) was used to measure depression. All psychological scores were within non-pathological, normal limits. BE was measured with the subjects fasting and resting in the early morning. BE, detected by radioimmunoassay, decreased (p less than .005) from pre 48.53 +/- 3.32 (SE) to post 31.73 +/- 4.43 pg/ml in T. The MMPI depression score also decreased in T (p less than .05) from pre 58.90 +/- 2.81 (SE) to post 53.20 +/- 1.48 T-score units. In contrast, the PFS increased in T (p less than .005) from pre 254.57 +/- 18.62 (SE) to post 304.94 +/- 15.95 PFS units. No pre to post program changes were detected in P. In conclusion, endurance training of eight months duration appeared to decrease the resting plasma BE concentrations and the MMPI depression scores of the middle-aged men in the present study.

Depression↗

PubMed1991

A clinical trial of the American Heart Association step one diet for treatment of hypercholesterolemia.

BACKGROUND: Although diet therapy is the primary treatment for hypercholesterolemia, a trial to determine the effectiveness of the new American Heart Association Step One Diet (AHA diet) in lowering cholesterol has to our knowledge never been carried out. METHODS: A clinical trial was conducted to assess the plasma lipids response and adherence to the AHA diet in 120 men and women with hypercholesterolemia. All subjects were advised to follow the AHA diet for 18 weeks. RESULTS: After 6 weeks of the AHA diet intervention, there were modest but significant reductions in plasma total cholesterol (-2.6%) and low-density lipoprotein (LDL) cholesterol (-3.5%), but no further significant reductions were observed thereafter. Rather, there was a tendency to return to and even exceed baseline levels of total cholesterol and LDL cholesterol over the subsequent 12 weeks, in spite of the subjects' reported continued adherence to the AHA diet and maintenance of weight loss throughout the entire study period. Nevertheless, 51% of the subjects had experienced improvement (-0.2% to -26.3%) in their plasma LDL cholesterol levels by the end of the study. CONCLUSIONS: A probable reason for the limited response of the diet was low baseline levels in intake of saturated fat and cholesterol by participants. The subjects who were older and had higher levels of plasma LDL cholesterol and total fat intake at baseline experienced better plasma LDL cholesterol response to the AHA diet. Thus, practicing physicians should consider assessing the baseline dietary fat and cholesterol intake of patients with hypercholesterolemia before starting the AHA diet, since patients may already be following a relatively prudent self-selected diet. Additional dietary gains in lipid management might well require a more severe restriction of dietary fats and cholesterol. Long-term efficacy of the AHA diet should also be evaluated clinically with periodic lipid profiles.

Adult↗

PubMed1991

The interrelation of urinary calcium and sodium intake in healthy elderly Japanese.

To evaluate whether habitual excess sodium intake is significant as a risk factor for calcium loss in elderly Japanese, a relationship between calcium excretion and sodium excretion was studied in 39 male and 44 female Japanese, aged 60 and over. They are healthy, free-living and consuming a self-selected diet. A significant positive correlation between urinary calcium excretion and sodium excretion per 24-hour was observed both in males (r = .415, p less than 0.01) and in females (r = .330, p less than 0.05). The relationship was still significant even after adjustment for sex, age, body mass index, alkaline phosphatase levels and protein as well as calcium and phosphorus intake. It was estimated that the increase in urinary calcium excretion was about 1.0 mmol/day per 100 mmol increase in urinary sodium excretion.

Aged↗

PubMedDate not supplied

The energy expenditure index: a method to quantitate and compare walking energy expenditure for children and adolescents.

We used heart rate and walking speed to calculate an energy expenditure index (EEI), the ratio of heart rate per meter walked, for 102 normal subjects, age 6-18 years. Heart rate was measured at self-selected slow, comfortable, and fast walking speeds on the floor and on a motor-driven treadmill. At slow walking speeds (37 +/- 10 m/min) the EEI was elevated (0.71 +/- 0.32 beats/m), indicating poor economy. At comfortable speeds (70 +/- 11 m/min) the EEI values decreased to the maximum economy (0.47 +/- 0.13 beats/m). At fast speeds (101 +/- 13 m/min), the EEI increased (0.61 +/- 0.17 beats/m), indicating poor economy relative to comfortable speeds. A graph of the EEI versus walking speed provides a way to evaluate and compare energy expenditure in a clinical setting.

Adolescent↗

PubMed1991

[Cardiovascular risk factors of visitors to a mass-screening booth].

The attitude towards mass screening of serum cholesterol is controversial. In order to characterize the volunteers of such screenings and to test the representativity of its findings, we compared the data of 1686 adult health-screening participants collected during a trade fair in the city of Basel, Switzerland, with the results of two population-based studies, the Basel City Risk Factor Survey and the MONICA Project in Western Switzerland. Among those screened, there was an over-representation of women and older persons. The age-specific medians of blood cholesterol and proportions of hypercholesterolemic persons were consistently higher in female screenees--and marginally so in males--than in the reference populations, whereas higher proportions of persons with ideal cholesterol level in those screened were also observed, especially in younger males. Higher systolic blood pressure, lower relative body weight and less regular smoking were found consistently among the screenees. This cross-sectional study shows that the participants of such mass screening actions are a selective group of older, more frequently female health-conscious persons with a specific risk-factor pattern. Mass screenings of self-selected volunteers can, therefore, not be used for a reliable prediction of risk-factor distributions in the general population. Moreover, suggested further steps for those screenees with both health-conscious behavior and elevated biological risk-factor levels, such as second measurement, medical consultation and counselling, cannot be assured in the setting of a trade fair. The objectives and intentions of such mass screening activities should be reconsidered and discussed.

Adult↗

PubMed1991

An American clinic for traditional Chinese medicine: comparisons to family medicine and chiropractic.

Patient self-selection delimits the kinds of disorders treated by practitioners of acupuncture and other traditional Chinese modalities in the United States. Based upon a questionnaire administered to 200 first-time patients in a teaching clinic for traditional Chinese medicine (TCM) in California, it was determined that practitioners of TCM attract patients whose health problems would also be appropriate for management by family physicians, chiropractors or mental health professionals. Approximately one-third of presenting complaints can be categorized as presumed organic disorders (many of which may have been medical treatment failures); one-third comprise musculoskeletal problems and headaches; and one-third appear to be psychological or psychosomatic in nature.

Acupuncture Therapy↗

PubMed1991

Medical audit: a Well Woman Clinic in the Royal Naval training practice, Gibraltar.

In order to assess the effectiveness of patient self-selection, and the value of dedicating surgery time to a specific clinic, attendances at a Well Woman Clinic were compared with attendances for the same reasons at other times. During the nine month audit period the opportunity was also taken to overhaul the Age/Sex Register, and assess the uptake of Cervical Screening at the Garrison Medical Centre. This unit is part of the Royal Naval Training Practice in Gibraltar.

Ambulatory Care Facilities↗

PubMed1991

The substance-abusing family: consideration for nursing research.

Investigations to explore and document the characteristics of addicted families are possible for nurse researchers in a variety of settings. Addicted families can be identified through hospitals, clinics, or community substance abuse treatment centers. Confidentiality issues must be addressed with carefully designed consent forms. A thorough understanding of addicted family systems is essential. System, role, and family theories provide a framework for understanding the influence of substance abuse on all family members. Anticipation of common social, economic, and criminal crises of addicted families will assist the researcher to avoid conflicts between research and service. Methodological limitations are common in research with addicted families, but well-designed, descriptive studies with small- to moderate-sized self-selected samples can add greatly to our nursing knowledge base over time.

Confidentiality↗

PubMed1978

Update of naltrexone treatment.

To summarize, then, our work with naltrexone in a multi-modality treatment program indicates that it appeals to about 5-10 percent of narcotic addicts--those who conciously want to obtain drug-free status. It does significantly attentuate the effect of narcotics to the extent that they lose their reinforcing properties, and it has minimal side effects. Although we treated a self-selected population, it is noteworthy that about 10 percent of those who remained on naltrexone for more than a week were still opiate free 6 months after cessation of treatment. For some it appeared to be a turning point in their lives. It was the first time in years that they could live in their neighborhood and not be either intoxicated or occupied with the pursuit of narcotics. Our behavioral studies have identified a number of conditioned psychophysiological responses associated with the self-injection ritual. So far, although we have succeeded in extinguishing some of these responses, this has not resulted in an improved clinical outcome. We are currently working on more comprehensive behavioral treatments, but the clinical significance of these conditioned responses is uncertain at present.

Adult↗

PubMed1979

Potential effect of demographic and other variables in studies comparing morbidity of breast-fed and bottle-fed infants.

Comparing the morbidity of breast-fed and bottle-fed infants is confounded by inherent differences in breast-feeding and bottle-feeding mothers and their infants. Self-selection introduces complex variables encompassing much more than milk source used for infant feeding. Reasons for selecting breast or bottle feeding relate to demographic, socioeconomic, educational, ethnic, cultural, and psychological factors, as well as maternal and infant physical and emotional health. Many of the differences in the maternal populations may affect infant care practices, access to medical care, and infant health status. Studies published to date have not quantified these confounding effects and other potential biases in comparing morbidity to breast- and bottle-fed infants and the relationship between milk source and incidence of infantile disease remains in question. There is need for more cautious use of the available data and investigators must seek ways to design future studies to take into account the differences between breast-feeding and bottle-feeding mothers that affect both reported and actual infant morbidity.

Bottle Feeding↗

PubMedDate not supplied

[Treatment of the sick elderly in households accommodating several generations].

Multigenerational households with widowed persons aged 70 and more have been studied in order to determine the relationship between the following two groups of variables: (a) variables in the aged person describing the existence and degree of an organic mental impairment due to a dementive process and of other signs of physical illnesses. (b) variables in her daughter or daughter in law consisting of selfratings of psychosomatic complaints and of attitude-scales. Results were as follows: (a) If there were indications of personality changes due to an organic brain syndrom the relatives had a lower degree of life-satisfaction and more frequently suffered from psychosomatic symptoms and interpersonal stress than those, whose old relatives showed an unaltered personality. (b) A great number of comparisons failed to show any statistical differences. Especially severe physical illness, organic brain syndrome and the need for physical care were not related to life satisfaction, psychosomatic complaints, stress due to emotional involvement and the attitude towards home-care. Our attempt to explain the missing correlations led to the following factors: the small size of the sample, self-selection of the sample and possibly inappropriate operationalisation and measurement of variables. In respect to these results the ongoing study will be modified in some details: There will be a qualitative analysis of transcribed semi-structured interviews. The proportion of families with severely demented relatives will be increased. In an additional step we shall examine families, who have decided to transfer their old member into an institution.

Aged↗