Does Menstrual Cycle Phase Influence the Gender Specificity of Heterosexual Women’s Genital and Subjective Sexual Arousal?

Unlike men, heterosexual women’s genital arousal is gender nonspecific, such that heterosexual women show relatively similar genital arousal to sexual stimuli depicting men and women but typically report greater subjective arousal to male stimuli. Based on the ovulatory-shift hypothesis—that women show a mid-cycle shift in preferences towards more masculine features during peak fertility—we predicted that heterosexual women’s genital and subjective arousal would be gender specific (more arousal towards male stimuli) during peak fertility. Twenty-two naturally-cycling heterosexual women were assessed during the follicular and luteal phases of their menstrual cycle to examine the role of menstrual cycle phase in gender specificity of genital and subjective sexual arousal. Menstrual cycle phase was confirmed with salivary hormone assays; phase at the time of first testing was counterbalanced. Women’s genital and subjective sexual arousal patterns were gender nonspecific, irrespective of cycle phase. Cycle phase at first testing session did not influence genital or subjective arousal in the second testing session. Similar to previous research, women’s genital and subjective sexual arousal varied with cues of sexual activity, but neither genital nor subjective sexual arousal varied by gender cues, with the exception of masturbation stimuli, where women showed higher genital arousal to the stimuli depicting male compared to female actors. These data suggest that menstrual cycle phase does not influence the gender specificity of heterosexual women’s genital and subjective sexual arousal.     

Does Competition Have an Effect on Price and Quality in Physiotherapy?

We estimate the effect of competition on quality and prices in physiotherapy organised and financed by the Social Insurance Institution of Finland for disabled individuals. Within the physiotherapy market, firms participate in competitive bidding, prices are determined by the market, services are free at the point of use and firms are allowed to react to patient choice only by enhancing quality. Firm‐level data (n = 854) regarding quality and price were analysed. Using 2SLS estimation techniques, we analysed the relationship between quality and competition, and price and competition. Our study found that competition has a negative (yet weak) effect on quality. Prices on the other hand are not affected by competition. The result is likely caused by imperfect information, because it seems that the Social Insurance Institution of Finland has provided too little information for patients to make adequate choices about proper service providers. We argue that by publishing quality information, it is possible to ease the decision‐making of patients and influence the quality strategies of firms active in the physiotherapy market. Moreover, we found that competition appeared as an exogenous variable in this study. Copyright © 2016 John Wiley & Sons, Ltd.     

Does a Medical Home Influence the Effect of Low Birthweight on Health Outcomes?

The objective of this study was to investigate the possible modifying effect of medical home on the association between low birthweight and children’s health outcomes. The analytic sample included children 5 years and under from the 2007 National Survey of Children’s Health whose mothers were the primary respondents and who had non-missing covariate information (n = 19,356). Controlling for sociodemographic factors, logistic and ordinal regression models estimated the presence of developmental, mental/behavioral or physical health outcomes, condition severity, and health status by birthweight, medical home, and their interaction. Prevalence estimates of physical, developmental, mental/behavioral and severe conditions among those with any conditions as well as fair/poor overall health were 8.9, 6.8, 2.4, 41.6, and 2.5 %, respectively. Overall, low compared to normal birthweight children had a higher prevalence of physical and developmental conditions and fair/poor health (15.2 vs. 8.3 %, 11.1 vs. 6.4 %, 4.5 vs. 2.3 %, respectively). Medical home did not significantly modify the effect of birthweight on health outcomes; however, prevalence of all outcomes was higher for children without a medical home. Adjusted models indicated that low birthweight children were almost twice as likely as normal birthweight children to have a physical or developmental condition and poorer overall health, regardless of having a medical home. Having a medical home was associated with equally improved health outcomes among normal and low birthweight children. Adequacy and frequency of medical home care should be investigated further, especially among low birthweight children.     

Does budget-holding have a long-term effect on expenditure, staff and patients?

Kupat Holim Clalit (KHC), Israel's largest sick fund, initiated a unique demonstration program to transform primary care clinics into autonomous budget-holding units. The program was accompanied by an evaluation study that examined the influence of the program on clinic staff, level of expenditure, quality of service and patient satisfaction. Few studies have empirically examined the influence of a budget-holding program in relation to such a wide range of expected outcomes. A longitudinal study was conducted from 1991 to 1994 employing two methodologies: (a) a controlled case study of one experimental and one control clinic and (b) monitoring of all nine budget-holding clinics over time, compared to other clinics in the district. Multiple research tools were used: staff surveys, patient surveys, in-depth interviews, and analysis of financial data. The findings indicate that the budget-holding program has the potential to achieve cost containment without injuring staff morale, the service to patients or patient satisfaction. However, the KHC program did not lead to the expected improvement in staff motivation and attitudes, clinic services and clinic responsiveness to patients' needs. Implications for the literature on organization and management and for organizations considering the implementation of budget-holding programs are discussed.     

Women’s Sexuality,Well-Being,and the Menstrual Cycle: Methodological Issues and Their Interrelationships

Although many studies report that women’s sexual behavior varies across their menstrual cycles, the research findings remain inconsistent. In this study, we addressed two methodological issues in research on the menstrual cycle: how ovulation is measured/inferred and whether data using menstrual cycles or participants’ scores averaged across cycles as units of analysis yield similar results. We also employed an abstinent comparison group in addition to examining how emotional well-being was related to libido and sexual behavior through factor and regression analysis. Data were obtained from 97 participants. There were no significant differences in the results of analyses performed using cycles with known LH surges to determine ovulation versus cycles based on backward counts. However, we concluded that statistical power might be compromised when the known timing of ovulation was less accurate. Likewise, we found few overall differences in the results when we analyzed data using cycles with known LH surges compared to participants’ averaged data across cycles. Women, including those in the abstinent group, reported increased sexual behavior prior to ovulation. Allosexual behavior was positively related to libido, and negatively related to positive and “premenstrual” emotional factors. Autosexual behavior was predicted by libido and an energetic/creative emotional factor. Our findings support hypotheses that women’s sexual behavior is related to both mating and pair-bond formation.     

A Compensatory Effect on Mate Selection? Importance of Auditory,Olfactory, and Tactile Cues in Partner Choice among Blind and Sighted Individuals

Human attractiveness is a potent social variable, and people assess their potential partners based on input from a range of sensory modalities. Among all sensory cues, visual signals are typically considered to be the most important and most salient source of information. However, it remains unclear how people without sight assess others. In the current study, we explored the relative importance of sensory modalities other than vision (smell, touch, and audition) in the assessment of same- and opposite-sex strangers. We specifically focused on possible sensory compensation in mate selection, defined as enhanced importance of modalities other than vision among blind individuals in their choice of potential partners. Data were obtained from a total of 119 participants, of whom 78 were blind people aged between 16 and 65 years (M = 42.4, SD = 12.6; 38 females) and a control sample of 41 sighted people aged between 20 and 64. As hypothesized, we observed a compensatory effect of blindness on auditory perception. Our data indicate that visual impairment increases the importance of audition in different types of social assessments for both sexes and in mate choice for blind men.     

Effect of psychiatric illness and labour market status on suicide: a healthy worker effect?

STUDY OBJECTIVE: To describe the association between labour market status and death by suicide with focus on admission with a psychiatric disorder. DESIGN: Nested case-control study. Data from routine registers. SETTING: Entire Danish population. PARTICIPANTS: 9011 people aged 25-60 years who committed suicide during 1982-1997 and 180 220 matched controls. MAIN RESULTS: In the general population, not being fully employed is associated with a twofold to threefold increased relative risk of death by suicide, compared with being fully employed. In contrast, fully employed people who have been first admitted to a psychiatric hospital within the past year are at increased suicide risk. Patients who are unemployed, social benefits recipients, disability pensioners, or otherwise marginalised on the labour market have a suicide risk of 0.60 (95% CI: 0.46 to 0.78), 0.41 (0.23 to 0.74), 0.70 (0.45 to 1.08), and 0.86 (0.53 to 1.41), respectively. Although a similar risk decrease is found in women, men, people younger than 30 years, people older than 45 years, and in people who become unemployed, the reversed effect attenuates with time since admission, and little association is seen when a marginal structural model is applied. CONCLUSIONS: Although the results show an increased suicide mortality associated with unemployment and labour market marginalisation in the general population, the results suggest little or an inverse association between unemployment and suicide in people with psychiatric illness. The associations seen suggest the need to consider healthy worker selection effects when studying the causal pathway from unemployment and psychiatric illness to suicide.     

Do Coparenting and Social Support Have a Greater Effect on Adolescent Fathers Than Adult Fathers?

This study examined whether coparenting support and social support had a stronger effect on father engagement with 3‐year‐olds among adolescent fathers compared with adult fathers. Using data from the Fragile Families and Child Wellbeing Study (N = 1,540), we found that coparenting support and paternal social support had a significantly stronger positive effect on adolescent fathers than adult fathers. The associations among coparenting, social support, and adolescent father engagement did not depend on whether the father and mother were romantically involved with each other. The results support the idea that programs for adolescent parents should focus on coparenting and social support as a way to help fathers to stay involved with their children.     

Effect of pets on human health: is there a correlation?

Is there a Relationship? Despite an increasing number of studies devoted to the health benefits of interacting with pets, the empirical evidence of such an effect still remains weak. Many reports comparing health-related variables in pet owners and non-owners do not find significant differences. Some studies find a statistical correlation between pet ownership and better health, but they do not adequately demonstrate that the better health is a result of the pet. There is experimental evidence suggesting that the presence of animals is associated with a lowering of cardiovascular responses to stressors. Accordingly, pets could be used in the therapy of stress-related diseases. Nevertheless, no consistent clinical studies testing this hypothesis have been carried out. Moreover, neither evolutionary nor learning hypothesis for the observed decrease in cardiovascular reactivity have been tested till now. Research on the benefits of pet ownership still are in its preliminary steps. Further studies are needed for the understanding of the underlying psychological mechanisms of human/animal relationship and its therapeutic possibilities.     

Does Adherence to the Mediterranean Diet Have a Protective Effect against Asthma and Allergies in Children? A Systematic Review

Dietary pattern may potentially impact on the pathogenesis of asthma and allergies. The Mediterranean Diet (MD) has significant health benefits due to its antioxidant and anti-inflammatory properties. The aim of this systematic review was to investigate the effectiveness of adherence to the MD against asthma and allergies in childhood. Hence, a systematic literature search was conducted on PubMed, ESBCO (Cinahl), Scopus, and the Cochrane Library databases up to 26 January 2022. The total number of articles obtained, after the initial search on the databases was conducted, was 301. Twelve studies were included, after the removal of duplicates and screening for eligibility. Our findings indicated a protective role of the MD against childhood asthma, but they also imply that the MD probably does not affect the development of allergies. Nevertheless, the heterogeneity and limitations of the studies highlight the need for randomized controlled trials that will focus on the pediatric population and hopefully provide more robust evidence.     

Does anorexia nervosa occur on a continuum? Subgroups of weight-preoccupied women and their relationship to anorexia nervosa

Psychological traits of patients with anorexia nervosa were compared with those of weight-preoccupied women from samples of college and ballet students. Weight-preoccupied subjects were selected on the basis of extreme scores on the Drive for Thinness subscale on the Eating Disorder Inventory (EDI). Results indicated that on the Ineffectiveness, Interpersonal Distrust, and lack of Interoceptive Awareness subscales, relatively few of the weight-preoccupied women from the nonclinical group scored above the anorexia nervosa median. Using cluster analysis procedures, the weight-preoccupied women were divided into two subgroups. Cluster 1 was characterized by elevated scores on all EDI subscales, indicating significant psychopathology. Cluster 2 had elevated scores only on Drive for Thinness, Body Dissatisfaction, and Perfectionism and could be described as “normal dieters.” These findings were interpreted as indicating that although there are some highly weight-preoccupied females who display psychopathology quite similar to anorexia nervosa, others only superficially resemble patients suffering from serious eating disorders. These results underscore the importance of a multidimensional evaluation of psychopathology in those suspected of anorexia nervosa.     

Does non-responder bias have a significant effect on the results in a postal questionnaire study?

Background and aim: In epidemiological questionnaire studies results can be influenced by non-responder bias. However, in respiratory epidemiology this has been analysed in very few recently published papers. The aim of our paper is to assess if the results found in our previous postal questionnaire study in an adult population in Northern Finland were biased by non-response. Methods: A random sample of 385 persons from the 1284 non-responders in a previous postal questionnaire study was examined. The same questionnaire as in the original study was again mailed to these persons, and those still not answering were contacted by phone. Results: Totally 183 complete answers (48%) were collected. Lack of interest (56%) and forgetting to mail the response letter (22%) were the most common reasons to non-response. Typical non-responders were young men and current smokers who less frequently reported respiratory symptoms in exercise and asthma than the responders in the original study. Answers collected by phone gave for some questions higher prevalence rates than postal answers. Conclusion: Firstly, in this population the response rate (83.6%) in the original study was high enough to provide reliable results for respiratory symptoms and diseases, only the prevalence of current smoking was biased by non-response. Secondly, the methods used for collecting responses in a non-response study may influence the results.     

Does difference matter? Diversity and human rights in a hospital workplace

The urban hospital workplace is a dynamic environment that mirrors the cultural and social diversity of the modern city. This paper explores the literature relating to diversity in the workplace and then describes an urban Canadian teaching hospital's comprehensive approach to the promotion of an equitable and inclusive diverse environment. With this goal, four years ago the hospital established an office of Diversity and Human Rights staffed by a social worker. The office provides education, training, policy development and complaints management. The administration also convened a hospital-wide committee to advise on the outcomes, and to plan a process for diversity and human rights organizational change. The committee worked with a social work research consultant to design a qualitative focus group study, currently ongoing, to explore the perspectives of hospital staff. The lessons learned from the process have the potential to increase overall cultural competency of staff that can translate into more sensitive work with patients.     

Does tailoring matter? The impact of a tailored guide on ratings and short-term smoking-related outcomes for older smokers

There is new evidence that smokers of all ages benefit from cessation of smoking. Although most older smokers, like younger smokers, prefer to quit on their own, at the time this project was started, there were no materials or programs targeted to older smokers. Using the literature, focus groups with older smokers and a national survey of older smokers, we created Clear Horizons, a self-help guide for older smokers, and a telephone counseling protocol tailored to the needs of older smokers (age 50-74). Smokers were recruited from around the United States and assigned randomly to a control guide, Clearing the Air, Clear Horizons alone or Clear Horizons and two counselor calls. Follow-up of nearly 2000 smokers was conducted by telephone 3, 6, 12 and 24 months after delivery of the self-help guides. This report focuses primarily on results at 3 months because that was the measurement for reactions to the interventions. At the 3 month interview, those in the tailored interventions rated their guides more highly than did those in the control group. They also read more of their guides and were more likely to reread them. Quit rates were significantly higher among smokers who received a combination of the tailored guide and telephone counseling. At 3 months, the combination of the guide and telephone counseling was most effective in helping smokers to quit. By 12 months, both the tailored guide alone and the tailored guide and calls groups had higher quit rates than the control guide but were not statistically different from one another.     

The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?

Background: The present research aimed to evaluate the effect on outcomes of immunonutrition (IMN) enteral formulas during the intensive care unit (ICU) stay. Methods: A multicenter prospective observational study was performed. Patient characteristics, disease severity, nutritional status, type of nutritional therapy and outcomes, and laboratory parameters were collected in a database. Statistical differences were analyzed according to the administration of IMN or other types of enteral formulas. Results: In total, 406 patients were included in the analysis, of whom 15.02% (61) received IMN. Univariate analysis showed that patients treated with IMN formulas received higher mean caloric and protein intake, and better 28-day survival (85.2% vs. 73.3%; p = 0.014. Unadjusted Hazard Ratio (HR): 0.15; 95% CI (Confidence Interval): 0.06–0.36; p < 0.001). Once adjusted for confounding factors, multivariate analysis showed a lower need for vasopressor support (OR: 0.49; 95% CI: 0.26–0.91; p = 0.023) and continuous renal replacement therapies (OR: 0.13; 95% CI: 0.01–0.65; p = 0.049) in those patients who received IMN formulas, independently of the severity of the disease. IMN use was also associated with higher protein intake during the administration of nutritional therapy (OR: 6.23; 95% CI: 2.59–15.54; p < 0.001), regardless of the type of patient. No differences were found in the laboratory parameters, except for a trend toward lower triglyceride levels (HR: 0.97; 95% CI: 0.95–0.99; p = 0.045). Conclusion: The use of IMN formulas may be associated with better outcomes (i.e., lower need for vasopressors and continuous renal replacement), together with a trend toward higher protein enteral delivery during the ICU stay. These findings may ultimately be related to their modulating effect on the inflammatory response in the critically ill. NCT Registry: 03634943.     

Does use of a government service depend on distance from the health facility?

To reduce mortality from common childhood illnesses such as diarrhoea and upper respiratory infections, it is important that health services are available and used appropriately. Physical accessibility to a health facility may influence its use, particularly in rural areas. We assessed whether use of government services for treatment of the three most common acute childhood illnesses (fever, diarrhoea and upper respiratory infections) was influenced by the physical accessibility of the government primary health care centres. We analyzed data from a household survey which was collected between November 1992 and January 1993, from 139 randomly selected villages located around 14 government facilities in Thatta, a rural district of Pakistan. There were 691 children under 5 years of age who suffered from the three acute illnesses; 85% of these children used either a government or a private service. Children living at less than 4 km from a government facility made 22% less use of that facility than those living 4 km or more away. After controlling for the effects of distance from a private facility and treatment cost in a multiple logistic regression model, children living less than 4 km from a government facility were no more likely to use the facility than those living 4 km or more away (Adjusted Odds Ratio: 1.01, 95% Confidence Interval: 0.68-1.50). These results suggest that factors other than distance are the primary determinants of use of government services for treating children in the Thatta district. To increase the use of government health services, policymakers should assess carefully the factors determining the use of existing facilities, before they plan the building of more health facilities. Further studies are needed to examine the management of health facilities and the clients' perception of health-care providers.