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 901 records · Page 50Linked to original sources

PubMed1994

An investigation into the management of patients with erection problems in general practice.

In a study on the diagnosis and treatment of erectile dysfunction (ED) in general practice, a self-selected sample of 90 general practitioners (GPs) (76 males, 14 females) from a predominantly urban population of 525 GPs were interviewed. It appeared that 59% would not actively interrogate a patient when an erection problem was suspected, either because of lack of time or lack of competence. A specific strategy for the management of erection problems was reported by 60% of the GPs. In practice, most GPs treated their own patients. About 60% of the GPs tried to keep up to date through reading and postgraduate courses. Impediments acknowledged in the interaction with patients were the experience of lack of knowledge and skills (63%) and emotional inhibitions to detailed questioning (49%). None of the GPs in this study had as yet utilized more recent treatment methods such as intracavernous drug injections and vacuum constriction devices. It is recommended that in postgraduate training courses GPs receive practical training in proper history taking and in the application of modern treatment methods.

Adult↗

PubMed1994

Metabolic and hemodynamic responses to walking with hand weights in older individuals.

The purpose of this study was to examine metabolic and hemodynamic responses of older adults (age = 66.2 +/- 5.6 yr) to walking with hand-held weights (HHW). Nineteen volunteers participated in eight randomly assigned, 10-min, submaximal, self-selected constant speed (CSP) or constant heart rate (CHR) exercise bouts using the following HHW conditions: no weight, W0; 0.45 kg, W1; 1.36 kg, W3; 2.27 kg, W5. Oxygen uptake (VO2) was recorded every 30 s, heart rate (HR) each minute, and blood pressure (BP) every 2 min. Mean values for the last 5 min of exercise were analyzed using repeated measures ANOVA. Contrast comparison tests were used to determine differences among means. During CS, significant differences between means (P < or = 0.05) existed for: VO2 (W0, W1 < W3, W5); HR, SBP, DBP, SBPmax, DBPmax (W0 < W1, W3, W5); HR, rate pressure product (RPP), DBPmax (W1 < W5); SBP, DBP, SBPmax, RPP (W3 < W5). During CHR, significant differences (P < or = 0.05) between means existed for: SBP, DBP, RPP (W0, W1, W3 < W5); DBP (W0 < W3; W1, W3 < W5). These results indicate that the use of HHW significantly increases metabolic responses at W3 and W5 during CS exercise in older adults, while hemodynamic responses increase significantly across HHW for both CS and CHR. Due to the increases in hemodynamic responses, the use of HHW may be contraindicated for older individuals with suspected or diagnosed cardiovascular disease.

Aged↗

PubMed1994

[Health economic analysis of the effects of offered complementary medical procedures on health insurance].

A randomized trial is being conducted to determine whether the offer of unconventional medicine as a health benefit by the health insurance funds has a substitutional or additional effect on the use of conventional medicine. For this purpose, a stratified random sample of 5000 enrollees of the largest Swiss health insurance fund is receiving, as an experiment group, an insurance supplement for unconventional medicine during the next three years free of charge. The rest of the insured population with comparable health insurance but without coverage of unconventional medicine is the control group. The third group to be examined are insured persons who have already chosen the unconventional health insurance supplement on their own account. Data of inpatient and outpatient costs and use of conventional and unconventional health services will be collected and analyzed. The third group with self-selected insurance supplement for unconventional medicine will be compared systematically with the other two groups. A further random sample of persons from each of the three groups will be interviewed at different points of time about their health perceptions.

Complementary Therapies↗

PubMed1993

Effects of early discharge from hospital after surgery for primary breast cancer.

OBJECTIVE: To evaluate the effects of early discharge from hospital on women being operated on for primary breast cancer. DESIGN: Open study in self-selected patients. SETTING: Karolinska and Sabbatsberg Hospitals, Stockholm. SUBJECTS: 169 consecutive patients operated on for primary breast cancer. MAIN OUTCOME MEASURES: All patients were asked to fill in a questionnaire about their perception of their disease and factors associated with the operation. RESULTS: 118/169 patients participated, and of these 28 (24%) chose early discharge with the drain still in place. They were compared with the 90 patients (76%) who were discharged without a drain. The median stay in hospital for those who chose early discharge was 2 days, and for those who remained in hospital until the drain was removed, 6 days. There were no differences between the groups in type or incidence of complications, and the groups were equally satisfied with their length of hospital stay and their treatment in hospital. Those who opted for early discharge were significantly younger than those who did not (mean SD) 52 (14) compared with 62 (13) years, p = 0.001). CONCLUSION: Early discharge from hospital with the drain still in place after operation for primary breast cancer was not found to be associated with any untoward events.

Age Factors↗

PubMed1993

Personality types of oncology nurses.

Personality type influences the choice of occupation. The breadth of specialty areas within oncology nursing allows for divergent activities and relationships and, thus, the accommodation of different personality characteristics. This exploratory study examined personality types for a convenience sample of oncology nurses predominantly employed in hospitals. According to the personality typology defined by Carl Jung, a person demonstrates a preference among four dimensions, i.e., extraversion/introversion, sensory/intuition, thinking/feeling, and judging/perceiving. The type with the strongest self-selection for these oncology nurses was ISFJ, where feeling is introverted and perception is practical, so that helping others is both a responsibility and a pleasure. The discussion relates the personality types to Jung's theory and their impact in clinical practice. Strengths and weaknesses of each personality type are described.

Adult↗

PubMed1993

Combined mother and baby care: does it meet the needs of families?

Combined mother/baby care is thought to be an effective way to prepare a family for the changing roles and added responsibilities that the arrival of a new baby entails, but few studies have evaluated this care delivery system. Therefore, the postpartum staff at Sudbury General Hospital conducted a post-test control group study design with a self-selected sample of postpartum mothers when the unit was changing from traditional to combined mother/baby care. One hundred and three mothers who received traditional care and 102 who had combined mother/baby care completed a questionnaire to assess perceptions of their own competence and satisfaction with the type of care administered. There were no significant differences between the two study groups. Factors that may have confounded the results include: insufficient time between institution of the program and its evaluation, and the quality of prenatal education received. Multiparous mothers scored higher on self care, infant care, and maternal competence than did primiparous mothers regardless of the care delivery system. Maternal concerns related to immediate needs. Future research should take the differences between primiparas and multiparas into account, and focus on the less immediate needs of mothers.

Adolescent↗

PubMed1993

Comprehensive analysis of energy storing prosthetic feet: Flex Foot and Seattle Foot Versus Standard SACH foot.

This study compared the mechanical and biomechanical functions, metabolic demand, and shock absorption of two dynamic elastic response (DER) prosthetic foot designs with the SACH foot. Nine individuals who had undergone unilateral below knee amputation were studied. Mechanical properties of the feet were related to gait biomechanics. Forefoot compliance is greatest for the Flex Foot and least for the SACH foot, hence, Flex Foot demonstrates (1) the longest midstance phase, (2) the greatest ankle angle range, and (3) greater forward movement of the center of pressure. There was some evidence that the DER feet produced a better push-off. However, neither the self-selected walking speed nor the metabolic rate or efficiency over a spectrum of walking speeds (73 to 120m/min) and running speeds (140 to 200m/min) was significantly different. Because no energy savings resulted for the DER feet, the release of stored energy in the flexible feet may not occur at the proper time to assist in ambulation as a result of the natural frequency of oscillation.

Adult↗

PubMed1993

A comparison of university and community-based family practice physician educators.

BACKGROUND: Differences in satisfaction with training and perceived preparation for practice have been observed among residents trained in community and university family practice residency programs. Our study was undertaken to determine the degree to which faculty training, experience, or practice patterns may contribute to these different resident experiences. METHODS: Questionnaires addressing prior training, experience, current practice content, motivation for entering academic medicine, and satisfaction with current teaching position were sent to full-time physician faculty at 60 family practice residency programs. RESULTS: The 208 faculty responses showed no differences in faculty at various types of residency programs with respect to demographic factors, prior training, or past experience. Only small differences were found in the proportion of time devoted to most professional activities or in the content of clinical practice. CONCLUSIONS: Few differences were found between faculty at university- and community-based family practice residency programs. This implies that differences in residents' perceptions of training may be due to other factors, such as institutional philosophy or self-selection. However, qualitative differences in family practice faculty activities that were not measured in this research cannot be ruled out as factors influencing residents' perceptions of their training experiences.

Attitude of Health Personnel↗

PubMed1993

Wellness testing. Design and experience of an established program.

Consumers have responded to available information and generated a large demand for self-initiated testing. Carefully planned testing can provide significant benefits to these self-selected subjects. Most notable examples include using sensitive and specific tests for iron metabolism and thyroid dysfunction. Cholesterol and lipid concerns are also motivators for testing. Nutrition and laboratory professionals must get involved with self-initiated testing to assure proper design, proper methods, proper reporting, and proper follow-up. It is hoped that this article and accompanying references will aid the implementation of effective wellness testing.

Adult↗

PubMedDate not supplied

[The prevalence of caries in marginal rural and peripheral urban areas].

A descriptive study of caries prevalence in peripheral urban and rural underprivileged groups was undertaken in self-selected populations demanding basic dental therapy in seven states of Mexico. Dental therapy services were delivered as part of a mobile oral health care program in the Mexican countryside implemented by the Dental School of Universidad Nacional Autónoma de México, during 1990 and 1991. Partial examination of clinical histories of 2,596 patients (mean age 21.8 years) revealed a mean DMFT (the sum of decayed, missing and filled teeth) of 9.21. Only 6.3 per cent of patients had DMFT = 0 and 10.7 per cent were caries-free. The largest component of DMFT were decayed teeth and the smallest one filled teeth. In general, results suggested that caries prevalence was high within the study populations, highlighting the little restorative treatment previously undertaken. The convenience of implementing oral health care schemes to deal with caries morbidity is discussed from the perspective of both the traditional dental treatment approach and preventive public health policies, taking into account the background of complex treatment needs present in these population groups.

Adolescent↗

PubMed1993

Frequency and determinants of screening for breast cancer in primary care group practice.

BACKGROUND: Many studies reporting the frequency of breast cancer screening have been based only on physician and patient surveys or on data from quality assurance studies and do not assess the reliability of information obtained from these various sources. METHODS: To obtain more complete data we studied mammography performed in a 3-year period, 1988 through 1991, in 24 nonacademic primary care group practices by both auditing the medical records and obtaining questionnaire responses from 1819 women aged 53 to 62 years and from their 98 physicians in the nonmetropolitan Midwest. RESULTS: Medical record data indicated that mammography was performed in all 3 years in 16.7%, in at least two of 3 years in 49.8%, and in at least one of 3 years in 81.7% of women. While patient reports of a family history of breast cancer, health insurance coverage for mammography, and greater annual household income were each significant predictors, a patient report that a clinic staff member had discussed mammography was the strongest predictor of greater frequency of mammography. CONCLUSIONS: In this study of self-selected physicians and their patients, record-documented mammographic examinations were considerably more frequent than has been reported in some studies, but occurred at rates consistent with quality assurance data for the region. These data suggest that clinic staff initiatives with screening mammography have a large impact.

Breast Neoplasms↗

PubMed1977

Enrollment choice in a mutli-HMO setting:the roles of health risk, financial vulnerability, and access to care.

Results of an analysis of enrollment decisions in HMO-type plans are reported. Previous studies concern dual-choice situations; this paper deals with a quadruple-choice situation involving one open- and two closed-panel HMO-type plans as well as Blue Cross/Blue Shield (BC/BS). The risk-vulnerability hypothesis is disaggregated into its components and the results show that there is no adverse health risk self-selection in an employed population. The hypothesis of economic vulnerability is maintained when tested in terms of per capita income rather than the previously used measure of family income. It is shown that those who enroll in any HMO-type plan are younger and have younger and larger families and lower per capita income than those who do not. No meaningful differences in terms of health status, health concerns, or prior utilization are found. Of the few differences found between those who enroll in closed- and open-panel HMO-type plans, having a private physician as the usual source of care is the most significant: those with an established physician relationship who join any HMO-type plan tend to follow their physician into the open-panel plan. The results should not be generalized to situations involving premium differences since the premium cost to subscribers in any of the plans considered here was fully paid by the employer. The validity of the results in terms of nonfinancial factors, on the other hand, is enhanced by the removal of cost considerations.

Adolescent↗

PubMed1993

Gastrointestinal effects of sugarbeet fiber and wheat bran in healthy men.

Gastrointestinal effects of feeding 20 g total dietary fiber as wheat bran (WB) and sugarbeet fiber (SBF) were compared in 17 healthy men in a randomized cross-over design. The fibers were milled to similar particle sizes and consumed as supplements to the subjects' self-selected diets (SS). Transit times were similar among the diets. Fecal wet and dry weights were greater on the fiber diets compared to the SS diet (P < 0.05); wet weights were similar with WB and SBF; dry weights were greater with WB than SBF (P < 0.001); and moisture content was lower with WB than SBF (P < 0.01). Fecal pH was lower with WB than SBF (P < 0.025). WB and SBF provided similar fecal bulking effect; however, the contribution of fecal dry matter and fecal water content to increased bulk differed between fibers.

Adult↗

PubMedDate not supplied

Restrained patients: an important issue for critical care nursing.

OBJECTIVE: To determine practice and attitudes of acute-critical care nurses toward the use of physical restraints. DESIGN: Survey with a self-administered anonymous questionnaire. SUBJECTS: A self-selected sample of 235 acute-critical care nurses from 17 states who were enrolled in critical care review classes. MEASUREMENTS: Data were gathered by use of a questionnaire developed by the researchers. The questionnaire was designed to elicit information regarding demographic and professional characteristics, nursing practice, and attitudes toward the use of restraints. Nurses responded to the practice items on a three-point Likert Scale as to whether they "always," "sometimes," or "never" carried out the procedure. To obtain information on attitudes, nurses were asked to respond on a three-point Likert Scale as to whether they "agreed," were "undecided," or "disagreed" with the statement. RESULTS: Responses indicated 78% of the sample "always" try alternative nursing measures before restraining the patient. However, when units were believed to be understaffed there was more reliance on restraints. Thirty-eight percent of the sample would "always" rather sedate patients than physically restrain them. The overall score on the attitude component of the questionnaire reflected positive or acceptable attitudes toward the use of restraints. Most (62%) "agreed" that a patient suffers a loss of dignity when placed in restraints. Significant relationships did exist between select demographic and professional characteristics and practice and attitudes regarding the use of restraints. The longer the respondents had worked in critical care the more appropriate (positive) their attitudes toward the use of restraints (r = -.211, p < .01). CONCLUSIONS: In general, nursing practice and attitudes regarding the use of physical restraints indicated that respondents were using restraints in accordance with accepted practice. There is a need for additional research in this area, especially regarding the use of alternative measures to physical restraints.

Adult↗

PubMed1993

Sex preselection through albumin separation of sperm.

OBJECTIVE: To determine if passage of sperm through columns of liquid albumin before their use in artificial insemination could affect the sex ratio at birth. DESIGN: Sperm were isolated by layering over columns of liquid albumin. The isolated fractions were inseminated into the uterus on the presumptive day of ovulation. SETTING: Patients were treated in 65 clinical practices (Sperm Centers) located both in this country (57) and abroad (8). PATIENTS: Individuals were self-selected by their desire to have a child of a specified sex. MAIN OUTCOME MEASURE: The sex of offspring resulting from the insemination of isolated sperm. RESULTS: Insemination with sperm isolated to enhance male sex preselection produced 71% and 76% males depending on the technique. Use of isolated sperm in women who were taking clomiphene citrate was associated with a 69% birth of females. CONCLUSIONS: Separation of sperm on columns of liquid albumin can affect the sex ratio at birth.

Cell Separation↗

PubMed1993

An examination of narcissistic personality traits as seen in a military population.

Various studies examining the prevalence of personality disorders in civilian inpatient and outpatient populations have consistently found narcissistic personality disorder to be one of the least common. In striking contrast to this, a recently published study showed narcissistic personality features to be among the most common personality features in a military outpatient clinic population. This paper examines several possible explanations for this finding. This surprisingly high relative incidence of narcissistic personality features may be related to a self-selection bias on the part of persons choosing a military career. Narcissistic personality traits may confer adaptive advantage in certain military professional roles. Kohut's theory of specific transference requirements in individuals with narcissistic character structure serves as a useful explanatory model for these findings.

Humans↗

PubMed1993

Curriculum focus: traditional dental education confronts the new biology and social responsibility.

The traditional dental education base does not suggest that graduates are prepared only for private general practice. It promises much, much more. It is the beginning of what any graduate may wish or want it to be. In fact it is necessary for new graduates contemplating private practice to seek more in the way of practice management if they plan to be successful in that model. Such is also the case for additional study if one wants to pursue a specialty; further training in the scientific method to undertake research; or further study in education for a teaching career. The predoctoral program promises to be just a beginning, but a sound and sensible beginning. The current foundation model of the predoctoral curriculum continues to serve society and the profession very well. It provides the necessary grounding in the fundamentals of basic medical sciences, clinical biological sciences, and behavioral sciences upon which any graduate can build and pursue a career beyond what is thought to be the traditional role model of the private practice of general dentistry. Faculty members and dental programs can choose, if they desire, to tailor mission statements to reflect a changing emphasis. This could help dental applicants become more thoughtful and self-selective in considering one of many different career options available. Given the emerging demographic profile and trends in needs, the curriculum emphasis could be altered to encourage a change in the balance or proportion of graduates who undertake career options in a postdoctoral experience, in public health, research, teaching, administration, the military, hospital, or specialty practice.(ABSTRACT TRUNCATED AT 250 WORDS)

Curriculum↗

PubMed1993

Sentinel surveillance for HIV-1 infection: how representative are blood donors, outpatients with fever, anaemia, or sexually transmitted diseases, and antenatal clinic attenders in Mwanza Region, Tanzania?

OBJECTIVE: To assess the validity of extrapolation from sentinel data by comparing the HIV-1 prevalence of various sentinel groups with that of the general population in Mwanza Region, Tanzania. METHODS: In a population survey, 4161 individuals were selected in a stratified random cluster sample. Sentinel groups (all in the age group 15-54 years) included blood donors (n = 1090); patients examined at district hospitals for the presence of malaria parasites (n = 1488), anaemia (n = 1339), or syphilis (n = 33); and antenatal clinic attenders (n = 1193). The HIV-1 serostatus of individuals selected from the population survey was tested using enzyme-linked immunosorbent assay (ELISA) and Western blot; 51% of the blood donors were tested using HIVCHEK, and all others using ELISA. HIV-1 prevalence was standardized for age, sex, and urban/non-urban location. RESULTS: HIV-1 prevalence (standardized by age, sex, and residence) in Mwanza Region was 4.0% (3.0% in non-urban areas and 11.3% in town). The standardized HIV-1 prevalences in the sentinel groups were: blood donors, 4.5%; patients with fever, 11.6%; patients with anaemia, 8.9%; urban sexually transmitted disease patients, 27.1%; urban antenatal clinic attenders, 11.8%. The crude prevalence in blood donors was 6.0%. CONCLUSION: Blood donors who are related to blood recipients appear to be a representative sentinel group in this region, provided that data are standardized for age, sex, and urban/non-urban location. Patients with fever and antenatal clinic attenders may reflect trends, but data from patients with fever markedly overestimate, and data from antenatal clinic attenders underestimate, population HIV-1 prevalence. Because self-selection of blood donors may become more pronounced, this comparison should be repeated later or elsewhere, should the opportunity arise.

Adolescent↗