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 127 records · Page 7Linked to original sources

PubMed1992

Effect of thermal biofeedback-assisted relaxation training on blood circulation in the lower extremities of a population with diabetes.

OBJECTIVE: Investigate the effect of relaxation training/thermal biofeedback on blood circulation in the lower extremities of diabetic subjects. RESEARCH DESIGN AND METHODS: Diabetic subjects (n = 40) aged 17-73 yr were volunteers recruited through the University of Wisconsin-La Crosse, the local ADA Chapter, and a medical clinic. A within-subjects experimental design was used. During phase 1, all subjects used a self-selected relaxation method and recorded toe temperatures daily. During phase 2, subjects were taught a biofeedback-assisted relaxation technique designed to elicit sensations of warmth in the lower extremities and increase circulation and temperature. Subjects relaxed at home with the use of a designated relaxation tape. They measured and recorded toe temperatures. Each phase lasted 4 wk. RESULTS: Toe temperature and blood volume pulse (BVP) data were gathered at the beginning and end of phases 1 and 2. Paired t tests compared the means of temperature percent change scores between 1 and 2. Mean temperature change scores were 8.73% (phase 1) and 31.38% (phase 2) (t = -8.00, df = 39, P less than 0.001). Mean BVP change scores were 2.33% (phase 1) and 22.47% (phase 2) (t = -9.24, df = 35, P less than 0.001). Based on eta squared, 71% of the BVP increase in phase 2 was attributed to the relaxation technique. A multiple regression analysis indicated that none of the other examined variables affected by diabetes were significant predictors of BVP increase. CONCLUSIONS: Data indicate that diabetic patients show significant increases in peripheral blood circulation with this technique. This noninvasive method could serve as an adjunct treatment for limited blood flow in some complications of diabetes.

Adolescent↗

PubMed1977

Neuroticism and proxemic behavior.

The relationship between proxemic behavior and neuroticism was examined. 50 male and 43 female subjects individually self-selected seats in a classroom where they were administered the Eysenck Personality Inventory by one of four experimenters (two male, two female). A significant relationship was found between proxemic distance and both neuroticism and experimenter's sex.

Female↗

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↗

PubMed1992

Glucocorticoid-remediable aldosteronism in a large kindred: clinical spectrum and diagnosis using a characteristic biochemical phenotype.

OBJECTIVE: To define the clinical spectrum of glucocorticoid-remediable aldosteronism (GRA) in a large kindred. DESIGN: Screening all at-risk relatives of a proband for GRA using a specific biochemical phenotype and collecting of medical histories of kindred members from five generations. SETTING: Outpatient General Clinical Research Centers and patients' homes. MEASUREMENTS: Screening was done while patients were on a self-selected diet and included blood pressure determinations; serum potassium and plasma renin activity and aldosterone measurements; and 24-hour urinary tetrahydroaldosterone, 18-oxotetrahydrocortisol, and 18-hydroxycortisol measurements. RESULTS: Diagnosis of GRA was established on the basis of a previously described specific biochemical abnormality, overproduction of the cortisol C-18 oxidation products (18-oxotetrahydrocortisol and 18-hydroxycortisol) in urine and their ratio relative to tetrahydroaldosterone. Glucocorticoid-remediable aldosteronism was diagnosed in 11 additional patients spanning three generations; this group included the youngest patient (3 months old) ever diagnosed with GRA. Complete penetrance of the biochemical abnormality is likely, with 11 of 18 at-risk patients displaying the phenotype. All patients with GRA had elevated blood pressure. Affected adult patients had been diagnosed as hypertensive before reaching 21 years of age (n = 7 mean, 16.1 +/- 3.4 years). All affected patients were normokalemic (4.3 +/- 0.3 mmol/L). CONCLUSION: Hypertension is a characteristic feature of GRA. Elevated blood pressure in this kindred developed at an early age and often was severe. Because a normal potassium level does not exclude the diagnosis of GRA, the disorder may be underdiagnosed. The value of a specific cortisol C-18 oxidation phenotype in the diagnosis of GRA has been confirmed.

Adolescent↗

PubMed1975

The public seminar as a nutrition education approach. An evaluation.

A health seminar seemed to modify knowledge, attitudes, and reported behavior of a self-selected audience which was already well informed and motivated to change. Therefore, the health seminar appears to be a useful educational approach in this context. The question remains: How can those who are neither informed nor motivated be reached? This study suggests that the public seminar may not be an efficient vehicle for this purpose.

Attitude to Health↗

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↗

PubMed1992

Dietary methods in cardiovascular disease critique.

It is planned that a wide variety of questions related to nutrient intake and cardiovascular disease will be addressed in NHANES III. Given the scope of these questions and the number of different types of designs that may be utilized--cross-sectional, cohort, and case control--several different dietary methodologies will probably be needed within NHANES III. Assessment and ranking of current intake is a primary objective to the overall NHANES III design. The 24-hour recall will provide this assessment and maintain comparability with the previous extensive NHANES. In many instances, however, information on usual intake or past intake will be necessary to better elucidate a nutrient-disease relationship, either because of temporal exposure concerns or because of the variability of the nutrient intake. A food history or quantitative frequency method for the specific nutrient(s) would best address these needs. Information on specific foods or other diet constituents (such as fish, dairy foods, alcohol, or water intake) in addition to nutrient levels will be of interest not only for cardiovascular disease but, with some food items, for cancer and osteoporosis as well. A history or quantitative frequency method would be appropriate for this purpose. The question of serial and multiple measures needs to be addressed. For adequate classification of individuals, several nonconsecutive measures would be most appropriate. The actual number of measures would be determined by the estimate of the most acceptable reduction in variance that could be achieved with multiple measures, balanced by the feasibility and cost of such measures. The use of multiple measures would necessitate the use of alternative interview techniques, most likely by telephone. It is clear that, if this type of methodology is adopted, further validation and extensive pretesting would need to be conducted. A subsample approach could also be utilized. Automated coding of dietary data and computer-prompted immediate data entry interview techniques may facilitate the use of these dietary data collection methods. Whichever methods are utilized, standardization of the coding procedures and additions to the nutrient data base, particularly for sodium, are essential. Finally, there is considerable interest in evaluating any deleterious effects of dietary modification on health and mortality outcome. For example, there is concern that a fat-modified diet may increase cancer mortality in some or that a low-sodium diet may be unpalatable and lead to a lowered dietary intake and potential nutrient deficiencies. It would be useful in this regard for NHANES III to be able to ascertain if altered dietary levels were due to self-selected dietary practices, to prescription of a therapeutic diet, or to a disease state or illness that lowered overall food intake.

Alcohol Drinking↗

PubMed1992

Urinary calcium excretion in essential hypertension.

Patients with essential hypertension have been reported to have higher levels of urinary calcium excretion (UCaV) than normotensive persons. We tested the hypothesis that the calciuria of hypertension is due to dietary factors and evaluated several alternate mechanisms. UCaV was studied in 15 patients with essential hypertension compared with 16 age- and gender-matched normotensive control subjects. For subjects taking self-selected, free-living diets, the difference in UCaV between normotensive (130 +/- 14 mg/day) and hypertensive subjects (201 +/- 37 mg/day) was not significant (p = 0.1). However, in a controlled diet with moderately restricted sodium intake (88 mEq), urinary calcium excretion was significantly higher (p = 0.02) in the hypertensive than in the normotensive group receiving 400 mg calcium (204 +/- 25 vs 132 +/- 13 mg/day) and 1400 mg calcium (272 +/- 31 vs 187 +/- 25 mg/day). Twenty-four-hour UCaV was directly and significantly correlated with blood pressure (r = 0.63 for standing systolic blood pressure; p < 0.001). A 1000 mg oral calcium load caused similar changes in UCaV (0.12 +/- 0.11 vs 0.12 +/- 0.07 mg per 100 ml glomerular filtration) and serum ionized calcium level (0.06 +/- 0.08 vs 0.06 +/- 0.02 mmol/L) in normotensive and hypertensive subjects, respectively, suggesting that there was no difference in intestinal calcium absorption between the groups. Fasting UCaV did not differ between the hypertensive (8.9 +/- 4.5 mg per 2 hours) and normotensive groups (10.9 +/- 11.5 mg per 2 hours).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

Carbohydrate-electrolyte replacement improves distance running performance in the heat.

The effects of a 7% carbohydrate-electrolyte drink (CE) and an artificially sweetened placebo (P) on performance and physiological function were compared during a 40-km run in the heat. Eight highly trained male runners completed two runs on a measured outdoor course. The first 35 km of each run was performed at self-selected training pace and the last 5 km at race effort. Under a counterbalanced, double-blind design, subjects consumed 400 ml of either CE or P 30 min prior to exercise, and 250 ml every 5 km thereafter during the run. Rectal temperature, heart rate, rating of perceived exertion, sweat rate, and respiratory exchange ratio were similar during the run for CE and P. Serum Na+, K+, Cl-, total protein, osmolality, blood lactate, urea nitrogen, and % change in plasma volume were also similar for both drink conditions; however, blood glucose was significantly higher (P less than 0.01) with CE. Running performance in the last 5 km was significantly faster (P less than 0.03) during CE (21.9 min) compared with P (24.4 min). Subjects reported no differences in stomach upset, bloating, or nausea between P and CE. Results indicate that CE replacement elicits similar thermoregulatory and physiological responses during prolonged running in the heat but increases run performance and blood glucose when compared with P.

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↗

PubMedDate not supplied

The effect of family planning participation on prenatal care use and low birth weight.

Data on approximately 45,000 North Carolina women who gave birth in 1989 and 1990 and received prenatal care in public health facilities were studied to assess the effects in a low-income population of prior family planning services on low birth weight and adequacy of prenatal care. Women who had used family planning services in the two years before conception were significantly more likely than those who had not used such services to have a birth-to-conception interval of greater than six months. They were also more likely to receive early and adequate prenatal care and to be involved in a food supplement program and maternity care coordination. In addition, the family planning participants were less likely than the nonparticipants to be younger than 18 and were somewhat less likely to deliver a low-birth-weight infant. Though the results of this retrospective study must be interpreted with caution because of such factors as self-selection into family planning programs, they suggest that family planning services may improve birth weight and use of prenatal health services among low-income women.

Adolescent↗

PubMedDate not supplied

Medical findings in nickel-cadmium battery workers.

Thirty-eight workers from a factory producing nickel-cadmium and other types of batteries came to us for medical evaluation. They included 21 women and 17 men (seniority 2-20 years, age range 31-63 years), and represented a self-selected subset of 700-900 ever-employed and 200+ recently or currently employed workers in the factory. Thirty-four worked on the nickel-cadmium assembly line. Symptoms and signs included: headache in 34; weakness, fatigue and lassitude in 26; dizziness in 16; pruritus and skin eruptions in 37; gingivitis, teeth loss and caries in 34; nasal congestion, nosebleeds and anosmia in 30; cough, phlegm production, wheezing and shortness of breath in 26; "asthma" in 14; bone pain in 18; urinary frequency, beta 2 microglobulinuria and kidney stones in 17; and sterility or multiple abortions (33) in 8 of 21 women. One additional patient had died from an "amyotrophic lateral sclerosis-like syndrome", while CT scans in six workers revealed brain atrophy. One other worker had leukemia, and two had died from cancer (lung and pancreas). Those who had worked for more than 10 years had more symptoms and signs than shorter-term employees, especially neurological illness, bone pain and urinary tract problems, including beta 2 microglobulinuria. Past blood and urinary cadmium levels were in the range of 1.6-8.7 micrograms/dl and 8-306 micrograms/l, respectively. Our findings indicated that: a) health risks for workers were not confined to the nickel-cadmium assembly line or to older workers, b) hazardous exposures still existed and illness appeared in new workers after a clean-up and intervention program, and c) exposures involved increased risks for renal disease and cancers. Finally, there is a need to control exposures and determine health risks in the full cohort of those ever employed, in the workers' children, and in the surrounding environment (air, ground, water) due to the dumping of waste from the plant.

Adult↗

PubMed1992

[Reference values of selected parameters of lung functions in the population of Bogdanka coal miners].

The aim of the study was to construct and test new equations for calculating FEV1, ITGV and FVC predictive values. Our examined population consisted of 2058 coal miners working underground in Bogdanka colliery (Lublin Basin). The following persons were excluded from out considerations: 1. smokers, 2. miners with pulmonary or allergic diseases history, 3. patients with chronic cough, sputum production or symptoms of chronic rhinitis, 4. persons with bronchial hyperreactivity. Finally, our standard group consisted of 353 coal miners. On the basis of our standard group data, new equations for calculating predictive values were formulated using the multiple regression model. According to these new equations and to equations elaborated by other authors, we calculated predictive values for FEV1, FVC and ITGV in our standard population and expressed results of measurements in percentages of different predictive values. Our predictive values in the standard population were significantly higher than the other authors' values. Percentages of predicted values were lower in the same comparison. We believe that observed differences are linked to a possible self-selection phenomenon in occupationally exposed population, relatively small maximum age of our standard group, possible differences in anthropometric features among examined populations and excluding hyperreactives. Our results seem to emphasize the need of greater attention to the paid on more restrictive use of the specially formulated equations in separate age compartments.

Adult↗

PubMed1992

A cholesterol reduction demonstration project: results from a challenge between two cities.

A competition was conducted between Jackson, MS and Lansing, MI to reduce blood cholesterol levels among self-selected individuals who were generally at high risk for elevated coronary heart disease. Baseline plasma cholesterol levels were measured and risk factor data were recorded for 13,710 participants in Jackson and 6,719 in Lansing (6.8% and 5.1% of the total populations, respectively). A six month educational campaign was conducted in both cities which included nutritional seminars, television shows, newspaper advertisements etc. From Jackson, 6,244 participants returned for the follow-up screening, and 2,404 from Lansing (46% and 36%). Subjects who reported changes in their diets had an average cholesterol reduction of 19 mg/dl (9%) in Jackson, and 2 mg/dl (1%) in Lansing (after adjustment for sex, baseline level, and age, P less than 0.01). In Lansing, participants were less likely to have college degrees, and were more likely to have participated because of concern with previously determined elevated cholesterol levels than Jackson participants.

Adolescent↗

PubMed1992

Economic benefits of secondary and tertiary cardiac rehabilitation: a critical study.

At least seven criticisms have been advanced to those suggesting economic benefit from secondary and tertiary rehabilitation: (i) many existing data sets are weak, (ii) many analyses have been limited to self-selected exercise participants, (iii) the distribution of benefits between different sectors of the economy has been ignored, (iv) programme participation is not necessarily synonymous with economic benefit, (v) the discount rate has been neglected, (vi) opportunity costs have not been considered, and (viii) possible increases in pension costs could outweigh supposed benefits. Although there are limitations in the original calculations of economic benefit, there are also weaknesses in their critique. Cost-effectiveness analysis has some attractions over cost-benefit analysis, because areas of fiscal and ethical uncertainty are avoided. Given that patients who develop chronic diseases will require some form of treatment, exercise offers an attractive option for both secondary and tertiary prevention, particularly if programmes have low facility and opportunity costs, and attention is directed to high-risk segments of the population. The challenge to incorporate the lessons from such analyses into governmental and corporate-decision making.

Cardiac Rehabilitation↗

PubMed1992

The effects of hospice coverage on Medicare expenditures.

This article reports on the findings of a study of the effects of the hospice program on Medicare Part A expenditures during the first three years of the program. The analysis compared treatment costs between hospice beneficiaries and nonbenefit patients with diagnosis of malignant cancer during their last seven months of life. It was estimated that during the first three years of the hospice program, Medicare saved $1.26 for every dollar spent on Part A expenditures. While the methodology included use of data from Medicare claims to adjust for confounding factors, including self-selection bias, our estimated savings might still have been overstated due to persistent selection effects. The extent of savings also varied according to the hospice's organization. Freestanding hospices, in contrast to those affiliated with either a hospital, nursing home, or home health agency, achieved the greatest savings by utilizing home care more extensively. However, we note that payment rates are increasing and the limits on the benefit period are being lifted, making it possible that the savings related to the hospice program found in this study will not continue. Of greater importance may be the long-term access and quality effects engendered by the benefit's preference for home care.

Age Factors↗

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↗