Motivational Factors Affecting Patient Attrition in a Weight Reduction Program

Abstract

The study hypothesizes that the greater the satisfaction of a patient's basic motivational needs, the greater the likelihood that the patient will complete the program. Patients were given a self-report questionnaire to assess the strength of their basic motivational needs as they entered the program; and a Likert-type questionnaire concerning satisfaction of needs as they left the program. The results show that those who completed the program experienced greater satisfaction of needs than those who did not complete the program. Analysis of covariance of completion of the program and need satisfaction was significant (p < .01) thus supporting the hypothesis.

“Long-term Oral Contraceptive Use and the Risk of Breast Cancer,” THE CENTERS FOR DISEASE CONTROL CANCER AND STEROID HORMONE STUDY. Using oral contraceptives for long periods or using them when one has other risk factors has been hypothesized to increase the risk of breast cancer. To study these issues, we analyzed data from a multicenter, case-control investigation—the Centers for Disease Control's Cancer and Steroid Hormone Study. All women 20 to 54 years old with a first diagnosis of breast cancer ascertained by eight population-based cancer registries are study subjects; controls are selected at random from the general population of these eight areas. Analysis of the first 689 cases and 1,077 controls studied showed that women who had used oral contraceptives at some time in their lives had a relative risk of 0.9 compared with never-users (95% confidence interval, 0.8 to 1.2). Neither duration of oral contraceptive use nor time since first use altered a user's risk of breast cancer; women whose first use was more than 15 years ago and who used oral contraceptives for 11 years or more had a relative risk of 0.8 (0.5 to 1.4). Oral contraceptive use did not increase the risk of breast cancer among women with benign breast disease or a family history of breast cancer. Oral contraceptive use before a woman's first pregnancy did not increase her risk of breast cancer significantly more than other methods of delaying first pregnancy. This study provides no support to the hypothesis that oral contraceptive use increases a woman's risk of breast cancer. (Journal of the American Medical Association 1983;249:1591–1595.)

“Oral Contraceptive Use and the Risk of Ovarian Cancer,” THE CENTERS FOR DISEASE CONTROL CANCER AND STEROID HORMONE STUDY. Since oral contraceptives have been used by more than 40 million American women, an association between oral contraceptives and ovarian cancer could have a substantial public health impact. The Centers for Disease Control, Atlanta, is studying this relationship as part of a multicenter, case-control study—the Cancer and Steroid Hormone Study. During the first ten months of the study, we enrolled 179 women aged 20 to 54 years who had been ascertained to have newly diagnosed ovarian cancer by eight population-based cancer registries. From the general population of those eight areas, we selected as controls 1,642 women with intact ovaries. Users of oral contraceptives had an age-adjusted risk of ovarian cancer developing of 0.6 relative to those who had never used them (95% confidence interval, 0.4 to 0.9). The risk of ovarian cancer decreased with increasing duration of oral contraceptive use and remained low long after cessation of use. These results were not accounted for by parity, infertility, or other potentially confounding factors. We estimate that more than 1,700 cases of ovarian cancer are averted each year by past and current oral contraceptive use among women in the United States. (Journal of the American Medical Association 1983;249:1596–1599.)     

Integrated care and the ‘agentification’ of the English National Health Service

Integrated care is a global reform principle for improving patient access and outcomes by ensuring that healthcare organisations deliver services in a joined‐up, person‐centred way. Following reforms designed to infuse agency within English National Health Service (NHS) organisations, the agenda for integration must come to grips with the different approaches to joint working that these organisations mobilise, and the compatibility of their different agentic orientations. We build a matrix for identifying the extent to which different forms of agency orient nine NHS organisational types. Interrogating the Strategic and Operational Plans of these organisations for the period 2015–2018 based on questions derived from the matrix, we associate each organisation with one of eight generalised models. Assuming that there is greater potential for integration where organisations mobilise similar forms of agency, we discuss the incentives and potential governance changes that policy makers might consider to enhance integrative potential.     

Men Don't Put on Make-up: Toddlers' Knowledge of the Gender Stereotyping of Household Activities

Toddlers’ knowledge of the stereotyping of traditionally feminine and masculine household activities was examined in two experiments. The experiments used a generalized imitation paradigm which required toddlers (total N = 63) to select a male or female doll to imitate nine masculine, feminine and neutral activities (e.g., shaving, vacuuming, sleeping). In the first experiment, 24‐month‐old girls, but not boys, demonstrated knowledge of both feminine and masculine activities. Results from study 2 indicated that boys possess some knowledge of these stereotyped activities by the age of 31 months. The results of the two experiments suggested that knowledge about the gender stereotyping of familiar activities can be demonstrated in children as young as 24 months.     

The effect of local livestock population changes on auction market viability—a spatial analysis

This paper examines the relationship between auction market closures over the period 1980–2000 and livestock population changes, as recorded in the agricultural and horticultural census. Auction market locations and census data were collated within a Geographical Information System and changes in livestock populations examined by region and by market catchment. Regionally, auction market closures during the 1980s were significantly associated with concurrent reductions in cattle numbers, with market reductions following loss of cattle in eastern lowland areas. No such association with livestock numbers was found during the 1990s. Within these agricultural regions, individual market closures were not associated with changes in local livestock numbers within their catchments. Thus, the historical evidence suggests that whilst a substantial loss of livestock within a region puts pressure on its network of auction markets, the viability of individual markets within the region is decided by other factors. Such factors include the capital costs of modernising market facilities and meeting new regulatory requirements, the effect of unpaid debt on market cashflow, and the market's ability to diversify into other areas of business. The recent outbreak of foot and mouth disease may lead to further market closures, both directly as a result of livestock culls and indirectly as farmers continue to use alternative marketing channels developed when auction markets were closed during the outbreak.     

A Three-factor Model of Teasing: The Influence of Friendship, Gender, and Topic on Expected Emotional Reactions to Teasing during Early Adolescence

This research examined the effects of three factors (friendship, gender, and topic of teasing) on adolescents’ predicted emotional reactions to hypothetical teasing episodes regarding appearance and academic competence. The 8th graders (n =131) in Study 1 made predictions regarding the negative emotions and humor experienced when teasing occurred in a same‐sex dyad of either friends or classmates. The 6th and 8th graders (n=211) in Study 2 responded to hypothetical teasing interactions between same‐sex or cross‐sex dyads of friends or classmates. The results revealed that teasing by friends was interpreted with a more benevolent frame than that accorded to classmates. Overall, girls expected greater negative affect to result from the teasing than did the boys, especially when teasing was regarding weight. Although 8th graders reported more frequent teasing at school among same‐sex peers, there were few grade differences in the predicted emotional reactions. For all students, teasing about weight was predicted to generate the most negative affect and least humor. The results support the relevance of the three factors for understanding the interpretation of teasing.     

Physical,sexual and psychological abuse in high school dating relationships: Prevalence rates and self-esteem issues

The present study examined the rates of victimization by physical, sexual and psychological abuse in adolescent dating relationships, with self-esteem being explored as a mediating variable. Subjects included 257 students from a coed, ethnically diverse, religiously affiliated high school. Information was obtained using a self-report questionnaire on teenage dating behaviors. Of the 114 male and 118 female subjects who had dating experience, 59% had been victimized at least once in some past or current dating relationship by physical violence, 96% had experienced some form of psychological maltreatment and 15% had been forced to engage in sexual activity. Significantly more males than females reported experiencing physical abuse overall. Significantly more males than females experienced acts of moderate physical abuse, while there was no significant gender difference in the experience of acts of severe physical abuse. Thirteen percent of the subjects stated they had remained in a physically abusive relationship at one time, with females being more likely to remain than males. Self-esteem was not a factor in the level of physical abuse sustained in dating relationships, nor was there a significant difference in the levels of self-esteem between subjects who remained in, terminated, or never were involved in, physically abusive dating relationships. For all subjects, self-esteem negatively correlated with the level of psychological maltreatment sustained in dating relationships, but separate analysis by gender found the correlation was significant only for female subjects.     

Life Course Heterogeneity in the Transition from Adolescence to Adulthood Among Adolescent Mothers

Longitudinal data were used to examine pathways taken by 227 adolescent mothers during the transition from adolescence into adulthood. Latent profile analysis identified three sub‐groups of adolescent mothers from 6 months to 6 years postpartum: a problem‐prone profile (15%), a psychologically vulnerable profile (42%), and a normative profile (43%). Group membership was related to long‐term adult outcomes (adult status markers, health‐risk and deviant behaviors, substance use, mental health, and intimate relationships) when respondents were nearing age 30. The psychologically vulnerable group reported greater health and mental health problems, relational problems, and substance use than the normative profile group. Only the problem‐prone profile group, taken together, reported serious problems in all domains of adult outcomes examined including financial, relational, behavioral, and health and mental health problems. Results confirm the existence of different pathways through adolescent parenthood that are associated with adult functioning 12 years postpartum.