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Results for “Self-selection”

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PubMed1979

The role of counseling in infertility.

Sixty-two couples with infertility received infertility counseling along with the infertility investigation and treatment. At the end of the study a questionnaire was sent to all patients in order to evaluate the incidence of psychologic symptoms associated with their infertility and their response to counseling. The study confirmed the presence of a high incidence of emotional symptomatology in the self-selected patients. It showed that male partners are also affected, but less so. Finally, it has demonstrated that infertility counseling serves to enhance the quality of life in many patients who have become the victims of their "infertility crises."

Anger↗

PubMedDate not supplied

Inner-city housing and respiratory disease in children: a pilot study.

This cross-sectional pilot study, designed to examine problems and methodology of studies on the relationship of housing and health, focused on respiratory disease in inner-city black children in Baltimore. Public housing was contrasted to the older row private housing. History of illness, familial, and demographic characteristics were obtained by questionnaire, and a small subsample of children received physical examinations. The condition of the indoor environment was evaluated and measurements of indoor temperature, volume, relative humidity, and carbon monoxide were made. Children in public housing had higher illness rates than those in private housing. Evidence of self-selection into housing type was found. Carbon monoxide levels were found to be greater inside than outside the homes. Preliminary analysis suggests public housing-private-housing classification is less important than other variables, including socioeconomic variables.

Black or African American↗

PubMed1979

Effects of behavioral and pharmacological weight loss programs on nutrient intake.

Behavior therapy is a widely used method for short-term weight control. Formal nutrition counseling is not included in many behavioral programs. To determine what types of diets were self-selected by patients and to see how they compared with individuals participating in a relaxation group with anorectic medication, the eating diaries compiled by participants in such a program were analyzed for 20 different nutrients. In general, pretreatment intakes were nutritious and typical for Americans. Both the behavioral and a relaxation-medication treatment produced weight loss and reduction in calorie intake. Both treatments were associated with the consumption of a fairly nutritious diet not much different from the pretreatment intake except for a reduction in the amount eaten.

Adult↗

PubMed1979

The retention of calcium, iron, phosphorus, and magnesium during pregnancy: the adequacy of prenatal diets with and without supplementation.

Vitamin and mineral supplementation is often prescribed by physicians to meet the additional nutrient requirements of pregnancy. In order to partially ascertain the effectiveness of these prenatal supplements, the retention of calcium and iron was determined in pregnant women consuming supplemented or unsupplemented self-selected diets. The retention of phosphorus and magnesium, minerals not included in the prenatal supplements, was also determined. Seven-day metabolic balance experiments spaced periodically throughout the pregnancy were conducted on 10 healthy pregnant white women. The retention of calcium by the supplemented group was comparable to that of the unsupplemented group, while the retention of iron was more dependent on the magnitude of the iron intake than on its source. Although no supplement contained phosphate, the intake of phosphorus met the recommended allowances for this mineral. Significantly related to the intake of dietary calcium, the adequate phosphorus intakes reflected diets providing adequate calcium. The mean magnesium intake was only 60% of the recently established recommended dietary allowance. Although the calcium and iron salts provided by the prenatal supplements were well utilized, the intakes of phosphorus and magnesium indicate that the reliance on the effectiveness of mineral supplements should not lessen the emphasis by the physician on the importance of a good prenatal diet.

Adult↗

PubMed1979

The meaning of voluntary association participation to older people.

Studies have indicated little association between participation in voluntary associations by older people and well-being. This may reflect self-selection by well-to-do older people who are "joiners" or a lack of truly involving group roles. From interviews with 323 persons over 60, it was found that active group participation yielded more "meaningful" reasons for enjoyment, and card-playing less meaningful reasons. Such reasons for group participation as contacts with others and passing the time were associated with lower satisfaction. On the whole, however, type of activity and reasons for participation had little relationship to life satisfaction, since they largely reflected health and socioeconomic status differences.

Aged↗

PubMed2026

A reanalysis of the Hitachi cohort study evaluating the effectiveness of low-dose CT screening for lung cancer.

The effectiveness of low-dose thoracic computed tomography (CT) screening for lung cancer for non-smokers or light smokers has been unclear. The results of the Hitachi cohort study performed by the conventional multivariable analysis suggested the reduction of lung cancer mortality by thoracic CT screening, but also revealed the lower all-cause mortality in the CT group, which indicated the existence of self-selection bias. Because the background of the subjects in the CT screening group and that in the X-ray screening group were very different, it is critical to adjust appropriately the confounding factors. In this brief report, we describe a re-evaluation of the results of the Hitachi Cohort Study performed by using more flexible methods, propensity score matching and inverse probability weighting.

epidemiology/public health↗

PubMed1975

Comparison of male and female physician's associate program applicants.

Using personality measures, the author examined Physician's Associate Program applicants at the Duke University School of Medicine, comparing male and female applicants and the outcome for these applicants in terms of acceptance into paramedical training. The perecentage of women accepted into training was similar to the percentage who applied for training. However, women invited for interview were more aggressive, autonomous, impulsive, playful, and flexible than the males invited to interview, suggesting self-selection by women in applying for paramedical training. Women accepted for training were more "feminine" in the conventional sense, and bias against female applicants less accepting of social mores and the traditional female role was revealed. The implications of these findings are discussed.

Personality Inventory↗

PubMed1979

Alternative designs to study outcomes: the tonsillectomy case.

This article explores the impact of the tonsillectomy operation using a large data base and several different approaches. The likely range of effects of the surgery and various threats to validity are studied from a quasi-experimental perspective. Information on possible patient self-selection for tonsil surgery is provided. Selection is dealt with from another viewpoint by comparing the outcomes of patients under the care of physicians having a "high propensity to operate" with those going to physicians who tend to operate less. Finally, a computer simulation studies the extent to which the measured results of tonsil surgery might be explained by particular selection mechanisms working in conjunction with random processes of episode generation. The "savings" in respiratory episodes estimated by the various approaches ranges from 0.1 episodes to approximately 0.8 episode for the year following surgery.

Adenoidectomy↗

PubMed1979

Consumer impact of a Cold Self-Care Center in a prepaid ambulatory care setting.

A Cold Self-Care Center was developed to be an alternative to professional care and to encourage more active involvement of consumers in their own care. A sample of the self-selected user population (n = 74) was studied by comparison with a random sample of plan members (n = 104), and the program was evaluated for cost, consumer satisfaction, and impact on behavior, knowledge and attitudes. Users demonstrated higher levels of knowledge about cold care than non-users, indicated more dependency on professional resources, and differed in health-related attitudes and cold-care behavior. The Cold Self-Care Center appears to have had little impact on self-medication behavior. However, it did affect care-seeking behavior. Knowledge of criteria for seeking professional care was greater than in non-users; 20 per cent sought professional care, and 6 per cent anticipated seeking professional care for future colds. General satisfaction with the program was quite high. Speed and ease of use were cited most often as reasons for satisfaction. The Center also was demonstrated to have a favorable impact on clinic costs. A flexible system which is convenient to use and which retains access to professional care when appropriate both can relieve clinic overload and meet the needs of a large percentage of cold patients.

Common Cold↗

PubMed1979

Sibship asymmetries of rhesus blood groups in the presence of maternal antibodies.

The genotypes of the children of R1r, R2r, and R1R2 fathers, and Rh-immunized rr mothers, were examined. R1r fathers had an excess of R1r over rr children, and R1R2 fathers had an excess of R1 r over R2r children. These asymmetries confirm the findings of a previous study. The possibilities of artefactual self-selection, of genotyping errors, and of errors in assigning paternity, were examined and excluded. Alternative models of genetic transmission and of antigenic structure were studied, but no basis for explaining the findings was found or formulated. Three possible biological explanations were formulated including (a) asymmetric segregation of the rhesus genes, (b) selective early fetal loss, and (c) a selective effect upon the performance of sperms bearing different haplotypes. The first of these three appeared unlikely. The data did not provide a basis for supporting or rejecting or differentiating the other two.

ABO Blood-Group System↗

PubMed1977

Marathon running and immunity to atherosclerosis.

This is an interim report of an on-going study of deaths in 42-km men. The absence of fatal ASCVD in these athletes can not be construed as evidence for the protective role of exercise alone. The ability to run 42 km depends on many factors. Exercise is only one. Avoiding tobacco is another. Dietary factors also play a role. It has not been feasible to remove one of these factors while maintaining the ability to cover the 42 km distance. Some 42-km men claim that megadoses of ascorbic acid protect them from collagen injury. This is supported by animal studies that show increased collagen synthesis proportional to ascorbic acid intake up to dosage levels that would equal 10 grams per day for humans. Their self-selected macrobiotic diet contains a high ratio of peanuts:steak resulting in a high P/S ratio (polyunsaturates/saturates). Dietary manipulation quickly effects their ability to train. Smoking is so rare among these runners that it must be related to specific effects, such as a catalytic agent in tobacco smoke converting linoleic acid into a toxic lipid oxide. Noakes and Opie recently confirmed again (May, 1976) that no cases of "death due to coronary atherosclerosis" have been recorded in marathon finishers. If this holds true for the second 10-year period of this study, then marathon runners will have joined the longshoremen by earning life-long protection against ASCVD. These longshoremen burned 1,876 kcals on the job, equivalent to a 30-km run. Roberts and Straus suggest that many factors can cause atherosclerosis. Only time will tell whether the marathoner is protected from all of them.

Adult↗

PubMed1979

Comparison of respiratory variables in grain elevator workers and civic outside workers of Thunder Bay, Canada.

We compared respiratory variables in 441 grain elevator workers with 180 civic outside laborers in Thunder Bay. The grain handlers had a lower frequency of both positive skin reactions to pollens and molds and a family history of asthma, which suggests that they may have been self-selected for a decreased tendency to develop allergic respiratory disease. There was a higher frequency of cough and rales and a small decrease in forced vital capacity and forced expiratory volume in one sec among the grain handlers, as compared to the civic workers matched for smoking. However, these differences between grain and nongrain workers were small in comparison to those between smokers and nonsmokers. There was no clear indication of a worsening of respiratory functions that could be attributed specifically to duration of employment as a grain elevator worker.

Adult↗

PubMed1977

Analysis of clinically occult and mammographically occult breast tumors.

Findings by xeromammography and clinical examination were compared in 16,000 self-selected women aged 45-64 who participated in a voluntary breast cancer screening program. A total of 138 malignancies were detected: 108 (78%) by mammography and 78 (57%) by clinical examination. Mammography was more effective for large breasts, fatty breasts, and in older women. Conversely, clinical examination was more effective for small breasts, dense breasts, and retroareolar lesions. Clinical detection decreased strikingly for lesions with negative lymph nodes, in situ and microinvasive lesions, deeply situated lesions, and lesions where microcalcifications were the sole mammographic finding.

Age Factors↗

PubMed1978

Serological evidence for a high incidence of transmission of Rickettsia tsutsugamushi in two Orang Asli settlements in Peninsular Malaysia.

Two communities of Orang Asli (aborigines) in Peninsular Malaysia were observed for evidence of Rickettsia tsutsugamushi infection over periods of 1-8 mo. Sequential sera were examined for antibody by the indirect immunofluorescence test. The incidence of infection in the two self-selected populations in the two communities was calculated to be 3.9% per month and 3.2% per month.

Adolescent↗

PubMed1979

Dietary manipulation of serum triglycerides.

A group of children who had been treated for protein-energy malnutrition with a high-energy, high-faty diet, presented very low levels of fasting serum triglycerides (50.8 +/- 5.9 mg/dl). When the diet was changed to a high-energy, low-fat formula, these levels increased rapidly to normal values (104.9 +/- 19.2 mg/dl). Reversing the dietary change produced the opposite effect within 2 days. This effect was also studied in 14 normal adults, who received a high-fat diet ad libitum during 5 days. Meals were prepared from common foodstuffs with a high fat content. The hypotriglyceridemic effect occurred in all volunteers. A close relationship was observed between the initial triglyceride concentration and the decrement produced by the high-fat diet (r = 0.97), which did not affect serum cholesterol levels. No consistent response of serum free-fatty acids was detected, while serum proteins remained within normal values. Despite the rather high energy intake, most subjects lost weight during the experimental period. The level of fasting serum triglycerides of the adult volunteers was negatively correlated to the fat content of their self-selected diets. These results are discussed in relation to current ideas about fat requirements.

Adult↗

PubMed1976

Observations on the analgesic effects of needle puncture (acupuncture).

The present study was undertaken in order to investigate the analgesic effect of needle puncture in a small self-selected group of patients with chronic or acute pain, and to examine the factors which determine success or failure of this treatment modality. We have found that in chronic painful conditions, needle puncture may be very effective in producing at least transient analgesia. It also can produce permanent relief of acute (self-limited) pains. Needle puncture was not helpful in the management of pain resulting from nerve damage. High score on psychometric indicators of anxiety and depression is a significant predictor os successful needle puncture analgesia in patients with chronic pain. Comparison of our results to studies of counterirritation indicate that the analgesia produced by needle puncture involves a mechanism similar to that of counterirritation-induced analgesia.

Acupuncture Therapy↗

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↗