SEARCH · PubMed Health

Results for “Self-selection”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 379 records · Page 21Linked to original sources

PubMedDate not supplied

Effects of music and imagery on physiologic and self-report of analogued labor pain.

Two studies were conducted to examine the effects of music on analogued labor pain using volunteer nulliparous subjects who were randomly assigned to treatment groups (n = 10 per group). Assessments of the treatments were made in a 1-hour session involving twenty 80-second exposures to a laboratory pain stimulus patterned to resemble labor contractions. In the first experiment, it was hypothesized that subjects listening to easy-listening music would report lower pain ratings and cardiovascular responses than subjects listening to rock music, self-selected music, or a dissertation (placebo-attention) and subjects in a no-treatment control group. No significant group effects were found; significant time effects were found for heart rate, systolic and diastolic blood pressure. Subjects spontaneously reported using imagery as a pain reduction technique. In the second study a combination of music and imagery was examined by randomly assigning subjects to one of five groups: self-generated imagery with music (SIM), guided imagery with music (GIM), self-generated imagery without music (SI), guided imagery without music (GI), or no-treatment control. Again, no significant group effects were obtained. Significant time effects were obtained for heart rate, systolic and diastolic blood pressure.

Adult↗

PubMed1989

Quality of care in family practice: does residency training make a difference?

As the proportion of physicians who enter residency training in family practice steadily increases, so does the need to evaluate the impact of their training and postgraduate education on the quality of care in their practices. We audited the practices of 120 randomly selected family physicians in Ontario, who were separated into four groups: nonmembers of the College of Family Physicians of Canada (CFPC), members of the CFPC with no certification in family medicine, certificated members without residency training in family medicine and certificated members with residency training in family medicine. The practices were assessed according to predetermined criteria for charting, procedures in periodic health examination, quality of medical care and use of indicator drugs. Generally the scores were significantly higher for CFPC members with residency training in family medicine than for those in the other groups, nonmembers having the lowest scores. Patient questionnaires indicated no difference in satisfaction with specific aspects of care between the four groups. Self-selection into residency training and CFPC membership may account for some of the results; nevertheless, the findings support the contention that residency training in family medicine should be mandatory for family physicians.

Adult↗

PubMed1989

Public cholesterol screening: motivation for participation, follow-up outcome, self-knowledge, and coronary heart disease risk factor intervention.

We used a mailed questionnaire and telephone interviews with 1717 shopping center screenees whose total serum cholesterol was greater than 200 mg/dl. Our specific aim was to assess the subjects' motivations for participation in cholesterol screening, their follow-up outcome, their self-knowledge, and any coronary heart disease risk factor intervention. Of 1717 questionnaires mailed, 507 (30%) were returned; 64 of 100 subjects randomly selected for telephone interview could be contacted, and 61 were interviewed. Responses to the questionnaire and telephone interview were congruent, indicating little self-selection response bias. Before the cholesterol screening, 50% and 67% of questionnaire and telephone interview subjects knew their cholesterol levels. The nine most commonly cited reasons for cholesterol screening participation were: a desire to "watch" health (72%), convenience (70%), low cost (64%), to recheck previously measured total cholesterol (54%), publicity (34%), curiosity (30%), a relative with premature coronary heart disease (27%), the subjects' obesity (26%), and a relative's high cholesterol level (25%). As a result of cholesterol screening, 65% and 63% of questionnaire and telephone interview subjects, respectively, followed up with their doctors; 67% and 56%, respectively, had total cholesterol remeasured, but 17% and 18%, respectively, were told to "do nothing." At their doctors' follow-up, 74% and 51% of questionnaire and telephone interview respondents, respectively, began a low-saturated fat, low-cholesterol diet; 10% and 15% started taking a cholesterol-lowering drug. As a result of cholesterol screening, 76% and 85% of questionnaire and telephone interview subjects, respectively, changed their diets; 78% and 84% lowered their dietary cholesterol intakes, 62% and 74% increased their fiber intakes, 49% and 57% tried to lose weight, and 44% and 43% increased their exercise. Of questionnaire subjects, 94% thought that by lowering cholesterol, coronary heart disease risk could be reduced; 95% had become more aware of cholesterol in the last 5 years. Of telephone interview subjects, 91% concluded that cholesterol screening had motivated them to reduce cholesterol levels. Public cholesterol screening is convenient, inexpensive, facilitates self-knowledge about cholesterol, stimulates follow-up, and motivates physician and subject-guided dietary changes to reduce cholesterol levels and coronary heart disease risk.

Adult↗

PubMed1989

[Physiological responses to heat and effort and complaints of hyperperspiration].

The sensation of hyperperspiration is a common complaint in hot, humid climates. 54 men and 20 women, 18-47 years old, who had this complaint and 27 male control subjects were examined at rest and after 1 hour of mild exercise (40W) under conditions of heat stress (37 degrees C, 50% relative humidity). During exposure to heat rectal and skin temperatures and heart rate were measured every 15 min. Sweat rate was calculated for the entire period of exposure and sweat gland density was measured at 0, 60 and 120 min. Only insignificant deviations from baseline values were noted at rest. During exercise the sweat rate of the men with the complaint was within normal limits and similar to that of the control men (285 +/- 75 ml/m2 vs 272 +/- 48). Matching for age and V02 max revealed no significant differences in physiological responses of men with and those without the complaint. Women with the complaint lost 25-30% less fluid (226 +/- 67 ml/m2) and their concentrations of active sweat glands were lower than in either of the male groups. 2 men and 1 woman with the complaint and 1 control lost 400-425 ml/m2 during exercise, the upper limit of normal. Only 1 subject showed hyperperspiration (855 ml/m2) during the test. All physiological parameters examined in these 5 subjects were within normal limits. It is concluded that the complaint of hyperperspiration in our self-selected group is basically a subjective feeling and has no pathological basis. None of the subjects was heat intolerant.

Adult↗

PubMed1989

Correlates of certification in family medicine in the billing patterns of Ontario general practitioners.

There is conflicting evidence as to whether physicians who are certified in family medicine practise differently from their noncertified colleagues and what those differences are. We examined the extent to which certification in family medicine is associated with differences in the practice patterns of primary care physicians as reflected in their billing patterns. Billing data for 1986 were obtained from the Ontario Health Insurance Plan for 269 certified physicians and 375 noncertified physicians who had graduated from Ontario medical schools between 1972 and 1983 and who practised as general practitioners or family physicians in Ontario. As a group, certificants provided fewer services per patient and billed less per patient seen per month. They were more likely than noncertificants to include counselling, psychotherapy, prenatal and obstetric care, nonemergency hospital visits, surgical services and visits to chronic care facilities in their service mix and to bill in more service categories. Certificants billed more for prenatal and obstetric care, intermediate assessments, chronic care and nonemergency hospital visits and less for psychotherapy and after-hours services than noncertificants. Many of the differences detected suggest a practice style consistent with the objectives for training and certification in family medicine. However, whether the differences observed in our study and in previous studies are related more to self-selection of physicians for certification or to the types of educational experiences cannot be directly assessed.

Canada↗

PubMed1986

Ethanol drinking by vervet monkeys (Cercopithecus pygerethrus): individual responses of juvenile and adult males.

Unrestricted access of vervet monkeys to a palatable solution of ethanol resulted in chronic intake or abstinence. Self-selected dose averaged 4.42 g/kg body mass/day. Growth of juveniles was not grossly affected. In plasma, chronic ethanol intake was associated with lower average K and Cl values, increased gamma glutamyl transpeptidase in some adults, and higher average total cholesterol. Neither hepatic histology nor haematology were affected by chronic ethanol intake.

Age Factors↗

PubMed1989

Energy intake and dietary macronutrient content in women with anorexia nervosa and volunteers.

This study was designed to compare the dietary intakes of patients with anorexia nervosa and normal controls. Twenty-four patients hospitalized for treatment of anorexia nervosa were compared with 10 normal controls. Patients ate a self-selected diet and maintained their admission weight to within 1.0 kg during this period (19 +/- 3 days). Food chosen by each subject was weighed before and after meals, and intake was determined to be the difference. Intakes of food energy, protein, fat, and carbohydrate were calculated. Patients were closely monitored to ensure that no disposal of food occurred. Patients with anorexia nervosa had a mean daily energy intake of 1,017 +/- 54 kcal (mean +/- SEM), significantly lower than the mean energy intake for controls (1,651 +/- 108 kcal). Similarly, mean intakes of macronutrients (41 +/- 4 gm protein, 34 +/- 2 gm fat, and 136 +/- 9 gm carbohydrate) were significantly lower for patients than for controls (68.5 +/- gm protein, 65 +/- 6 gm fat, and 204 +/- 13 gm carbohydrate). However, when protein, fat, and carbohydrate were assessed as a percent of total calories, there were no significant differences between patients and controls. There were also no significant differences in calories consumed per kilogram body weight. Underweight patients with anorexia nervosa who maintain their weight on an unrestricted hospital diet have energy intake per kilogram body weight and dietary macronutrient content indistinguishable from those of normal women.

Adult↗

PubMed1989

Relation of family physician or specialist care to obstetric interventions and outcomes in patients at low risk: a western Canadian cohort study.

To determine the relation of family physician or specialist care to intrapartum interventions and outcomes, we carried out a historical cohort study of 1456 obstetric patients at low risk admitted between Nov. 15, 1984, and Mar. 15, 1986, to a western Canadian teaching hospital. The patients were classified as being at low risk on admission by means of chart review. Family physicians and specialists were found to have similar rates for most of the interventions measured, although the interventions for which significantly different rates were found suggest a less interventionist style of intrapartum care by family physicians. There were no significant differences in maternal or neonatal outcomes except for a higher proportion of infants weighing less than 2500 g among primigravid women cared for by family physicians compared with those under the care of specialists. Self-selection of physician specialty by patients resulted in differences in the demographic characteristics of the two patient populations. The findings support the continued involvement of family physicians in the provision of obstetric care.

Adolescent↗

PubMedDate not supplied

The life space drawing as a measure of social relationships.

The life space drawing was prospectively assessed as a predictor of 12-month morbidity in 27 white female participants of a clinical trial. Women who subsequently experienced a high rate of self-reported morbidity (greater than or equal to 3 restricted-activity days per month) had a higher proportion of interpersonal relationships characterized by poor communication than did women with less than or equal to 2 restricted activity days per month. The quality of the relationship with a spouse/significant other appeared to be a particularly strong predictor of morbidity in this small self-selected group of women.

Adult↗

PubMed1986

Cocaine treatment outcome: cocaine use following inpatient, outpatient, and no treatment.

Based upon a sample of 83 cocaine users self-selected into one of 3 programs, several conclusions seem possible. There seems to be little difference in Ss populations who choose hospital, outpatient or self-help/no treatment. Current hospital aftercare programs may not be appropriately oriented for cocaine users. It appears the hospital program in this study retained fewer than 30% of the Ss in aftercare. Outpatient treatment for cocaine dependency is a viable form of treatment which Ss will participate in for up to 6 months on a fee for service basis. Only about 20% of the Ss who were referred to self-help groups attended more than one meeting. Preliminary outcome data suggest that outpatient treatment may result in a lower relapse rate to cocaine than hospital or no treatment. However, this conclusion is extremely guarded due to a large number of methodological issues and the short follow-up period. Relapse to cocaine use is higher among Ss who returned to alcohol or marijuana.

Cannabis↗

PubMedDate not supplied

Monitoring the levels and trends of HIV infection: the Public Health Service's HIV surveillance program.

A comprehensive, multifaceted approach to HIV surveillance is needed to provide the information necessary for public health management and policy. Because HIV infection is not readily or uniformly ascertained, survey methods and sentinel surveillance approaches must be used. At least some of the surveys must be blinded, that is, anonymous and unlinked to identifiable persons, to avoid the uninterpretable impact of self-selection bias that could lead to both significant underestimates and occasional overestimates of HIV prevalence. Other surveys must be nonblinded, with careful interviews of volunteer participants to evaluate risk factors for HIV infection. These various surveys must continue over time to evaluate trends in infection. A comprehensive family of complementary HIV surveys and studies and a national household-based HIV seroprevalence survey have been undertaken by the Public Health Service in collaboration with other Federal agencies, State and local health departments, blood collection agencies, and medical research institutions. These projects focus on accessible segments of the general population, childbearing women, persons at high risk for HIV, and persons in special settings such as prisons and colleges. This comprehensive surveillance approach will help monitor the levels and trends of HIV infection in the United States and help prioritize, target, and evaluate HIV prevention activities.

Acquired Immunodeficiency Syndrome↗

PubMed1988

An evaluation of sampling methods within communities and the validity of parasitological examination techniques in the field.

In order to enable the assessment of schistosomiasis control, it has to be monitored. The methods and techniques employed for monitoring have to be validated in turn. In the Malian National Schistosomiasis Control Programme, only samples of the village population are examined. For practical and economic reasons, the sampling procedure is not free of bias from self-selection. When rates of samples are compared with results of examining the whole population no significant difference between the rates was found. Infection rates were precise to about +/- 5%. The sensitivity and specificity of laboratory technicians put to the task of identifying and counting the eggs of Schistosoma haematobium or S. mansoni in urine or stool samples differed considerably. The lowest scores were obtained by a laboratory technician from a district health centre who accompanied the central control team for a month. The predictive values of samples read positive dropped significantly below a general prevalence of 20%. The technician from the district centre would read samples falsely positive in more than 70%. However, the same person would read only 10% of slides falsely negative, once prevalence has dropped below the threshold of 20%, when maintenance depends on the performance of basic health services. The amount of stool used for a Kato-Katz preparation is only a 25th of one gram. The distinction between light and intensive infections with S. mansoni is therefore based on counting 1 to 3 or 4 or more eggs in a preparation. In a poisson distribution with mean 1, the difference between 1 and 4 is not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

PubMed1988

Profiling of wife assaulters: preliminary evidence for a trimodal analysis.

A review of the experimental literature on wife assault causation indicates that differing "profiles" of wife assaulters have been developed by different research strategies. Profiles based on interviews with victims suggest a tyrannical, personality-disordered type of wife assaulter. Clinical assessments reveal several profiles, only one of which is consistent with this view. Other types of wife assaulters are dependent and unassertive. By comparing the emerging data on wife assaulters with the initial clinical descriptions, an assessment is made of the contribution of empirical studies to date. While the potential for a major contribution to our understanding of wife assaulters exists through use of systematic empirical methods, it is concluded that this potential has not yet been fulfilled. Some suggestions are made for future research strategies to improve empirical capabilities in furthering this understanding, including a more thorough assessment of early trauma as a major causative factor affecting a large subcategory of wife assaulters and greater attention to the self-selection of wife assault samples.

Aggression↗

PubMed1988

[Problems in using survival data of cancer patients as a method of gauging the effectiveness of cancer control efforts].

Survival rates of cancer patients have been widely used as a method of gauging the effectiveness of cancer control efforts. Sometimes, however, they cannot be considered reliable indicators due to many biases, such as a lead time bias, a length bias, a self-selection bias and an overdiagnosis bias. Instead, cancer mortality rates should be used for evaluating screening programs and for assessing the recent progress against cancer, although some problems are encountered in the accuracy of death certificates.

Humans↗

PubMed1988

The association of health with stressful life changes, social supports, and coping.

Cross-sectional associations of social stressors, social supports, and coping strategies with health status were explored in a self-selected sample of 157 white adults. Using a mailed questionnaire, stressful life changes were assessed by a 40-item version of the Social Readjustment Rating Scale, social supports were measured by a 13-item index, and health status was assessed by the 63-item Duke-UNC Health Profile (DUHP). Responses to a recent stressful event were categorized by method of coping and by focus of coping. In a multivariate analysis controlling for the effects of age, gender, and education level, higher 12 month life change score was related to lower composite DUHP score. The use of active-cognitive coping was directly associated and the use of avoidance-coping was inversely associated with health status. When interaction terms were included in the multivariate analysis, avoidance-coping potentiated the adverse health effect of stressors and weak social supports potentiated the harmful effect of avoidance-coping on health. The findings suggest that the propensity to engage in avoidant behavior in response to a stressful experience is associated with health impairment, particularly when social supports are weak.

Adaptation, Psychological↗

PubMed1988

Referrals and notifications by British optometrists.

1031 British optometrists completed a questionnaire to give information on their rates of referral and notification to the medical profession. Data were collected in relation to the conditions concerned, the age and sex of the patient, and the spectacle correction. Major causes of referral were cataract, glaucoma, fundus changes, headaches/migraine/eye pain and lowered visual acuity; 6.5% of all patients seen were referred to their general medical practitioner notified, and of this group it was estimated that 25-30% could have managed with reading glasses which comprised spherical lenses of equal power. If such glasses could be self-selected, without reference to a medical practitioner or optometrist, a significant number of people would not benefit from the health screening aspects of the eye examination.

Adolescent↗

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↗