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Biomedical subjects

C S Rand

Publications and source records attributed to C S Rand.

At least 73 records · Page 4Linked to original sources

Contingent payment procedures for smoking reduction and cessation.

We assessed the ability of a combined contingent reinforcement and intensive monitoring procedure to promote and sustain temporary smoking cessation among 34 hired research volunteers, and the ability of a smoking reduction test to predict the subsequent initiation of abstinence. During the 5-day cutdown test, subjects were paid from $0 to $6 per day depending on the extent of reduction from baseline CO levels. During the abstinence test, breath samples were obtained three times daily and subjects were paid $4 for each CO reading less than or equal to 11 ppm. Sixty-eight percent of subjects initiated abstinence. Of the breath samples collected during the abstinence test (91% of scheduled samples), 96.5% were less than or equal to 11 ppm and 80.5% were less than or equal to 8 ppm. Subjects who earned more money during the cutdown test were more likely to abstain (r = -0.51, p less than .001). Contingent reinforcement and intensive monitoring procedures appear to have usefulness for analog studies of smoking reduction and cessation.

Adult↗

Gastric bypass surgery for obesity: weight loss, psychosocial outcome, and morbidity one and three years later.

In two nonoverlapping cohorts of consecutive patients receiving gastric bypass for obesity, we interviewed 100 patients one year after operation and 60 patients at three years. Weight loss among patients in both cohorts averaged 45 kg; all had improved physical and emotional health, had stable marriages, and had made satisfactory eating adjustments. Factors contributing to successful outcome include the technical skill and experience of the surgical team, adequate preoperative patient preparation, extensive postoperative instruction, medical and dietary follow-up, and patient support groups. Gastric bypass was found to be a safe, effective procedure without the medical morbidity associated with jejunoileal bypass.

Adult↗

Obesity and post-operative pain.

Patients underwent elective abdominal surgery for morbid obesity (mean = 154 kgs, n = 55) or cholecystectomy (mean = 71 kgs, n = 54). Post-operative narcotics were transformed into morphine equivalent units (ME). Morbidly obese patients received significantly fewer total doses than cholecystectomy patients and less total mg ME/kg over a five-day period. Sedative use for both groups was comparable. In the morbidly obese patients, preoperative psychiatric and drug usage data predicted 67% of the variance in number of doses and 69% of the variance in total mg ME/kg.

Adult↗

Obesity and psychoanalysis: treatment and four-year follow-up.

Psychoanalysts provided information about 84 obese patients and 63 patients of normal weight at the beginning of this study, 18 months later, and 4 years later. Treatment lasted from 3 to more than 7 years. Although obesity was the chief complaint of only 6% of the obese patients, their weight loss and maintenance of it compared favorably with results reported for other psychological treatments for obesity. Severe body image disparagement was present in 39% of the obese patients at the beginning of treatment but in only 18% at the 4-year follow-up. Most patients improved in their chief complaint and presenting symptoms. The study indicates that large-scale collaborative research in psychoanalysis is feasible.

Adolescent↗

The effect of an educational intervention on the rate of neonatal circumcision.

Despite the absence of verifiable indications, routine circumcision of the male neonate remains one of the most common surgical procedures in the United States. A sample of obstetric clinic patients in a large urban hospital was tested to determine whether spoken educational intervention would reduce the rate of circumcision. The results showed that the rate was lowered significantly (94.4% circumcised in the control group versus 72% circumcised in the study group). Nevertheless, the majority of the study mothers requested circumcision for their sons despite the educational intervention, suggesting the presence of strong social motives. The authors conclude that many mothers in this population chose circumcision because of inadequate medical information or strong social motives. Both must be addressed if the rate of elective circumcision is to be reduced.

Adult↗

Surgery for obesity and marriage quality.

Before surgery for obesity, most of 54 morbidly obese patients considered their marriage to be good, although marked problems were higher than for a comparison group. One year later, a majority still rated their marriage as good; many reported better relations with their spouses. Sexual function was enhanced. Three years postoperatively (n=30), the incidence of marital harmony had risen to the same level as for the comparison group and sexual functioning continued to be improved. The divorce rate during the three years, however, was somewhat higher, particularly in those marriages originally found to be troubled before surgery. The implications of these findings for the decision to undertake surgery for obesity are discussed.

Adolescent↗

Reactions of infants and young children to a stranger in an unfamiliar setting.

Reactions of infants and young children to a stranger in an unfamiliar laboratory setting were examined to determine (a) variability in responses at six, 12, 24, and 36 months; (b) consistency of six and 12 month infants' responses to specific stranger behaviors; and (c) possible determinants of responses to strangers. The reactions of 136 male and female infants and children to a female stranger were recorded both when the stranger was actively trying to interact with the child and when the stranger sat quietly nearby after giving him a toy to play with. Both positive and negative reactions were observed at all ages, with one-year-olds showing greater distress than other age groups. Consistency was found in infant reactions to intrusive stranger behaviors. It was suggested that stangers are more likely to elicit curious-affiliative than cautious-avoidance behaviors from chidren if they are both attentive and appropriately to the child on the basis of his communications.

Child Behavior↗

Comparative immunology of Galapagos iguana hemoglobins.

The antigenic properties of the major hemoglobin component of the Galapgaos iguanas were studied using second-approximation qualitative and quantitative immunochemical techniques. Phylogenetic distances, relative to the Galapagos marine iguana. Amblyrhynchus cristatus, were established on the basis of immunological cross-reactions.

Animals↗