Causal interpretations from cross-sectional data. An examination of the stochastic processes involved in the relationship between a personality characteristic and coronary heart disease.
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Biomedical subjects
Publications and source records attributed to S Cobb.
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Changes in health and in behavior related to health-illness were described in men whose jobs were abolished because of a permanent plant closing. Fluctuations in several measures based on a 2 week health diary (Days Complaint, Days Disability, Percent Days Complaint That Are Also Days Disability, Days Saw Doctor, Days Used Drugs), as well as in other indicators (Symptoms, Depression, Dissatisfaction with Social Support) were analyzed as the men went through the various phases of anticipation, plant closing, unemployment and re-employment. Differences in the objective and subjective severity of the experience, in the social setting of the plant closing (urban vs. rural) and in selected personal characteristics were also examined for their influence on the changes in the various health-related measures.
Social support is defined as information leading the subject to believe that he is cared for and loved, esteemed, and a member of a network of mutual obligations. The evidence that supportive interactions among people are protective against the health consequences of life stress is reviewed. It appears that social support can protect people in crisis from a wide variety of pathological states: from low birth weight to death, from arthritis through tuberculosis to depression, alcoholism, and the social breakdown syndrome. Furthermore, social support may reduce the amount of medication required, accelerate recovery, and facilitate compliance with prescribed medical regimens.
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The frequency of rectal infections is increased in patients with acute leukemia. Complications associated with rectal lesions may be severe enough to cause life-threatening septicemia. Clinical research evaluating the effects of preventive perirectal skin care is scarce. This study's purpose was to determine whether using chlorhexidine gluconate (CHG) in a prophylactic perirectal skin-care regimen decreases perirectal infections and whether it produces more skin irritation than a nonmedicated skin cleanser. The sample consisted of 40 patients, 16 of whom were randomized to use chlorhexidine and 24 of whom were randomized to use nonmedicated skin cleanser. Chi-square and t-tests were used to analyze the incidence of skin breakdown and rectal infections; the correlation between the two factors; a positive history of rectal infections, fissures, or hemorrhoids; presence of hemorrhoids; severity of diarrhea; and duration and severity of granulocytopenia. A positive relationship was found between the severity of granulocytopenia and the incidence of rectal infections (p = 0.02). No significant difference was seen in the occurrence of perirectal infections (p = 0.35) or skin breakdown (p = 0.18) between the two groups. The data suggest that CHG does not offer increased protection against perirectal infections in patients undergoing intensive chemotherapy, nor is it more irritating than a nonmedicated skin cleanser. Further studies are needed to examine the efficacy of hygienic measures such as using skin disinfectants to prevent infections in patients who are immunocompromised.
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