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PubMed2005

[Suicide probability: an assessment terms of reasons for living, hopelessness and loneliness].

PURPOSE: The purpose of the current study is to specify the reasons that hold people clinging to life; to investigate their suicide probability, and to describe the relationship of these variables with other variables such as hopelessness and loneliness, taking age, education and other socioeconomic variables into consideration. METHOD: The subjects were 683, randomly chosen adolescents and adults between the ages of 15-65, residing in Ankara and Izmir. The assessment instruments were Reasons for Living Inventory, Suicide Probability Scale, UCLA Loneliness Scale, and Beck Hopelessness Scale. The data were analyzed using the SPSS for Windows 10.00. RESULTS: The analyses revealed that the group aged between 15-25 years reported fewer reasons for living, higher suicide probability, more hopelessness and loneliness, compared to older ages. Moreover, women reported more reasons for living, along with less loneliness and hopelessness. The regression analyses pointed out that age, education level, hopelessness, loneliness and reasons for living are predictive variables for suicide probability. CONCLUSION: As it was previously reported the current study also revealed that age is an important variable to be taken into consideration when suicide probability is being determined. In addition, was also found to be an important variable, at least for this Country. In parallel with the results of the studies in the relevant literature, reasons for living, hopelessness, and loneliness were found to be significant predictors of suicide probability.

Adolescent↗

PubMed2006

Reasons for wanting to quit: ethnic differences among cessation-seeking adolescent smokers.

OBJECTIVE: Enhancing adolescent cessation requires an understanding of approaches that will motivate youths to quit smoking. METHODS: We compared reasons for wanting to quit expressed by European Americans to those of African American youths. Adolescent cessation-seeking smokers completed telephone interviews regarding their smoking behavior and reasons for wanting to quit in an open-ended format. Responses were then classified into nine categories. RESULTS: Participants included 1,268 Baltimore-area adolescents (mean age 15.6 +/-1.7 years, 60% female, 58% European American, mean Fagerström Test for Nicotine Dependence 5.8 +/- 2.2). While both groups broadly cited health as the predominant reason for wanting to quit, chi-square analyses of further stratification of health into general, future, and current health concerns showed that European Americans were more likely to endorse current health reasons (P<.001), while African Americans were more likely to state general health reasons (P=.004). European Americans were more likely to state cost (P=.002) or to not give a reason for wanting to quit (P=.008), while African Americans more frequently reported a lack of positive (pharmacologic or social) reinforcement (P<.001). CONCLUSIONS: The development of culturally tailored messages may help enhance smoking cessation efforts among adolescents.

Adolescent↗

PubMed1991

Extensions to the time-oriented database model to support temporal reasoning in medical expert systems.

Physicians faced with diagnostic and therapeutic decisions must reason about clinical features that change over time. Database-management systems (DBMS) can increase access to patient data, but most systems are limited in their ability to store and retrieve complex temporal information. The Time-Oriented Databank (TOD) model, the most widely used data model for medical database systems, associates a single time stamp with each observation. The proper analysis of most clinical data requires accounting for multiple concurrent clinical events that may alter the interpretation of the raw data. Most medical DBMSs cannot retrieve patient data indexed by multiple clinical events. We describe two logical extensions to TOD-based databases that solve a set of temporal reasoning problems we encountered in constructing medical expert systems. A key feature of both extensions is that stored data are partitioned into groupings, such as sequential clinical visits, clinical exacerbations, or other abstract events that have clinical decision-making relevance. The temporal network (TNET) is an object-oriented database that extends the temporal reasoning capabilities of ONCOCIN, a medical expert system that provides chemotherapy advice. TNET uses persistent objects to associate observations with intervals of time during which "an event of clinical interest" occurred. A second object-oriented system called the extended temporal network (ETNET), is both an extension and a simplification of TNET. Like TNET, ETNET uses persistent objects to represent relevant intervals; unlike the first system, however, ETNET contains reasoning methods (rules) that can be executed when an event "begins", and that are withdrawn when that event "concludes". TNET and ETNET capture temporal relationships among recorded information that are not represented in TOD-based databases. Although they do not solve all temporal reasoning problems found in medical decision making, these new structures enable patient database systems to encode complex temporal relationships, to store and retrieve patient data based on multiple clinical contexts and, in ETNET, to modify the reasoning methods available to an expert system based on the onset or conclusion of specific clinical events.

Diagnosis, Computer-Assisted↗

PubMed1990

Reasons for replacement of Class II amalgam restorations in private practice.

In a series of postgraduate courses in Cariology for dentists in the period 1980-84, a total of 102 private practitioners participated in a study of the reasons for replacing amalgam restorations. Twelve reasons were specified on a form and the dentist was asked to mark one or more of them for each filling replaced. The total number of fillings evaluated was 2033. In 87.9% of the restorations only one reason was given for the replacement; two, three, four and five reasons were registered in 10.5, 1.1, 0.4 and 0.1%, respectively. The six most frequent reasons were: "secondary caries" (34.0%), "fracture of the filling" (15.5%), "primary caries" (12.1%), "fracture of the tooth" (10.2%), "marginal ditching" (7.2%), and "caries under the filling" (5.6%). The restorations replaced for a combination of two reasons (N = 213) were studied separately. The three most frequent combinations were: "secondary caries + fracture of the filling" (17.8%), "secondary caries + marginal ditching" (14.1%), and "secondary caries + caries under the filling" (11.3%). - Thus, the main conclusion from this study is that approximately half of the replacements of class II amalgam restorations were occasioned by caries disease.

Dental Amalgam↗

PubMed1989

Values, moral reasoning, and ethics.

The purpose of this exchange was to explore the domains of values, moral reasoning, and ethics. Values and moral reasoning reflect the "is." Moral reasoning is the mental process that nurses set in motion to come to some decision of right or wrong in any moral dilemma. Values are motivational preferences or dispositions. Moral values are those preferences that are integral to any moral reasoning process. Ethics reflect the oughts. It is the art-science that critically evaluates the "is." As such, ethics identifies the norms or standards of behaviors that either are or can become the values that are implemented through moral reasoning. Nursing is just beginning to identify its moral values and reasoning. Nevertheless, nursing seems to be further along in the identification of the "is" than it is with the "ought." The further development of nursing ethics will be of great benefit to nurse researchers and educators. The greatest benefit will be, however, to the practicing nurse as she/he struggles with giving excellent nursing care consistent with a positive nursing ethic.

Beneficence↗

PubMed1989

[Diagnosis and treatment in general practice. 3. Reasons for contact and diagnoses in episodes of medical care].

The object of this article is to describe the reasons for contact and the diagnoses in general practice by following the course of health problems in a random sample of patients (group 1 in the National Health Insurance System) for three months. In 55 general practices in the County of Copenhagen, all contacts concerning a given health problem in the single individuals were registered. This totalled 1,974 episodes of medical care in approximately 1,200 persons who formed 47% of the random sample. This investigation assessed the various classifications of reasons for encounter with primary health care as regards employability for central coding, information value and agreement with the general medical disease model. Employing the Reason for Visit Classification (USA) supplemented by classifications elaborated by the authors, three dimensions of the concept of "reasons for encounter" could be described: symptoms, the patient's wishes for contact with the doctor and reasons for the current problem. Health problems are described as episodes of one or more contacts. In single-contact episodes, the symptoms and diagnoses are most frequently those of respiratory diseases whereas multi-contact episodes are most frequently found where musculo-skeletal diseases are concerned. It is concluded that a multi-dimensional description of the reasons for contact and a description of the disease pattern on the basis of episodes of medical care can provide more differentiated knowledge about health problems in general practice.

Adolescent↗

PubMed1995

Diagnosis of chronic liver disease from liver scintiscans by fuzzy reasoning.

UNLABELLED: We investigated the possibility that fuzzy reasoning might be used to standardize diagnosis of liver disease based on scintigraphic results and compared the results with those obtained when scintiscans were scored conventionally. METHODS: Seventy-five patients with chronic liver disease (11 patients had chronic persistent hepatitis, 26 had chronic aggressive hepatitis and 38 had cirrhosis) and 25 controls were studied. Another 75 patients with hepatitis or cirrhosis were examined to test the effectiveness of the membership functions. Liver scintiscans were taken 20 min after the intravenous injection of 111 MBq of 99mTc-phytate. Fuzzy reasoning was used to evaluate the following five items: the ratio of the sizes of the left and right lobes, splenomegaly, radioactivity in the bone marrow, deformity of the liver and distribution of radioactivity in the liver. The degree of conformity to each of the three liver diseases being investigated was substituted into the membership function for the conclusion. The center of gravity for each patient's results was calculated. Conventional scoring was made with three levels for each of the five items examined by fuzzy reasoning. RESULTS: Distinctions between chronic persistent hepatitis and chronic aggressive hepatitis were difficult to assess with fuzzy reasoning and conventional scoring. The diagnostic accuracy was 95% for patients with cirrhosis and 88% for patients with chronic hepatitis with fuzzy reasoning. With conventional scoring the accuracy was 86% for patients with cirrhosis and 75% for patients with chronic hepatitis. When fuzzy reasoning was used to examine the other 75 patients with chronic liver diseases, the accuracy was 93% for patients with cirrhosis and 86% for patients with chronic hepatitis. CONCLUSION: The method is simple and can be used routinely in clinical settings.

Adult↗

PubMed1993

Moral reasoning and political conflict: the abortion controversy.

We argue that the abortion controversy has one major source--religion--and two less important ones--attitudes towards sexual permissiveness and women's employment. Traditional Christianity promotes opposition to abortion using three distinct modes of moral reasoning: through deductive moral reasoning, by the Christian world view's implication that abortion violates the sanctity of life and is a rebellion against God's design; through authoritative moral reasoning by appeal to Catholic dogma; and through consequentialist moral reasoning, as a means of control over sexuality and as a means of confining women's activities to the home. Even aside from Christian belief, adherence to traditional morality promotes opposition to abortion on these consequentialist grounds. We posit a model in which religious belief, anti-feminism, sexual permissiveness, and attitudes towards abortion are distinct concepts (a four-factor model) rather than all simply aspects of a single conservatism factor. We develop reliable, multiple item attitude scales; show that our four-factor model fits the data much better than the one-factor alternative; and test our hypotheses on new data from a large, representative national sample of Australia (N = 4540). Using maximum likelihood structural equation methods, we find that deductive reasoning from Christian belief is the most important source of opposition to abortion, with strong effects both direct and indirect. Exposure to the authority of the Catholic hierarchy is a real but weaker source of opposition. Consequentialist reasoning from traditional moral views on sex--partly buttressed by religion, partly independent of it--is also influential. But views on women's employment matter only a little, contrary to received wisdom.

Abortion, Legal↗

PubMed1993

Various reasons for permanent tooth extractions in a Caribbean population--Antigua.

A study was undertaken in September 1990 to investigate the reasons for permanent tooth extractions in Antigua. Eight out of 10 dentists on the island were requested to record permanent tooth extractions, including tooth type and reasons for extraction, during a 6 week study period. All 8 dentists provided data which indicated that 471 teeth were Extractions for orthodontic and impaction reasons comprised 4.3 per cent of tooth extrac-irregularly attending dental services. The principle reason for extractions was caries (61.6 per cent). Periodontitis (29.9 per cent) was the next most frequent reason for extractions and it became the predominant indication for tooth loss after 40 years of age. Extractions for orthodontic and impaction reasons comprised 4.3 per cent of tooth extraction, but these causes disappeared after 30 years of age. Restorable teeth were not commonly removed. The tooth types most frequently extracted due to caries were lower first molars and upper molars. Most commonly extracted, periodontally involved teeth were lower central incisors and upper third molars.

Adolescent↗

PubMed2026

The impact of artificial intelligence on critical thinking and clinical reasoning in health professions education: A systematic review and meta-analysis.

BACKGROUND: Critical thinking and clinical reasoning underpin healthcare professionals' ability to navigate uncertainties and deliver safe and effective care. With artificial intelligence (AI) advancement and growing adoption, AI-based educational tools are increasingly used to support these cognitive competencies' development. OBJECTIVE: To synthesize randomised and controlled clinical trials on AI-based educational tools in health professions education and examine their effects on critical thinking and clinical reasoning among health professions students. METHODS: Six electronic databases were searched from January 1, 2014 to July 28, 2025 was reviewed: PubMed, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, Embase and Web of Science. Two independent reviewers performed data extraction and quality assessment using standardized JBI checklists. The GRADE approach was used to assess the certainty of evidence. Studies were pooled via random-effects meta-analyses or narrative syntheses. RESULTS: Fourteen randomised controlled trials and seven controlled clinical trials were included (n = 21). Meta-analyses revealed small to medium effect sizes for the surrogate clinical reasoning outcomes of performance-based assessment scores (SMD 0.68; 95% CI [0.38, 0.98], p-value = 0.00; I2 = 38%) and knowledge test scores (SMD 0.39; 95% CI [0.09, 0.69], p-value = 0.01; I2 = 79%). Critical thinking and clinical reasoning skills and dispositions were narratively synthesized, with majority of included studies favouring AI-based interventions but the evidence had low to very low certainty. CONCLUSION: AI-based educational interventions may improve critical thinking and clinical reasoning among health profession students, but the evidence is very uncertain. This review offers preliminary insights but does not allow identification of optimal interventions or discipline-specific recommendations due to small sample sizes and substantial intervention heterogeneity. Further research is required to draw definitive conclusions. PROTOCOL REGISTRATION: CRD42025634074.

Humans↗

PubMed1997

Reasons for reporting adverse drug reactions--some thoughts based on an international review.

A pilot study was made to explore positive reasons for physicians and pharmacists taking time to report adverse reactions, rather than reasons for failing to report which has been studied by many authors. The 34 national drug monitoring centres participating in the international programme at the time of the study were asked by letter from the WHO Collaborating Centre for International Drug Monitoring, Uppsala to investigate the reasons why adverse reactions were reported. National Centres were asked to write to 20 consecutive reporters, sending each a copy of their own report, asking why they had chosen to report that particular reaction, and asking for more general comment. Twelve countries responded with information about the habits and views of the reporters of 177 cases. Since this was an explorative pilot study the letter to reporters deliberately had only an open question about reason for reporting. Categories were developed by the WHO Centre from the responses given. Reasons for reporting fell into a total of 14 categories with the great majority in the top six: motivation to contribute to medical knowledge, reaction previously unknown to reporter, reaction to new drug, all significant reactions reported, known association between drug and reaction, and severity of reaction.

Journal Article↗

PubMed1976

Spatial vs. nonspatial reasoning ability in chronic schizophrenics.

Forty chronic male VA schizophrenics were matched with veterans who were seeking educational counseling, and both groups were tested on a 32-item measure of spatial and matched nonspatial reasoning questions. Schizophrenics were inferior in spatial reasoning not only when compared to controls, but also when compared to their own level of functioning on nonspatial reasoning, which suggests that spatial reasoning may be selectively more impaired than general reasoning ability in male chronic schizophrenics.

Adult↗

PubMedDate not supplied

'I got a letter...' a qualitative study of women's reasoning about attendance in a cervical cancer screening programme in urban Sweden.

OBJECTIVE: This explorative study aims at investigating how 'healthy' women describe and reason about participation in a cervical cancer screening programme in Sweden. The study is part of a multidisciplinary research project studying a population-based cervical cancer-screening programme from the perspective of different actors. SETTING AND METHODS: Data collection took place at three ante-natal health centres (ANHCs) in demographically diverse areas in the Stockholm region in spring 1995. Interviews were conducted and audiotaped with 66 'healthy' women at the ANHCs immediately before taking a Papanicolau test. Open questions such as 'Why have you come here today?' and 'What kind of test will you take?' were used to initiate the interview. Verbatim transcripts were analysed with a modified phenomenographical method to identify and describe qualitatively different ways of understanding cervical cancer screening. RESULTS: Four different ways of reasoning about cervical cancer screening are described, with only one similar to the biomedical rationale for screening with focus on attending for the test/results. Two types of reasoning refer to the invitation letter as a catalyst, with one emphasizing benefits in attendance and the second emphasizing hinders to attendance. A final way of reasoning focuses on the individual's own proactive role in prevention. Common themes are also identified. IMPLICATIONS: This study complements the research literature by providing a better knowledge base of the variations in reasoning among women attending screening, often seen as a homogenous group. It can contribute to better adapting the screening situation to the varied needs and expectations of the women who attend.

Adult↗

PubMed2005

The effect of social content on deductive reasoning: an fMRI study.

Psychological studies of deductive reasoning have shown that subjects' performance is affected significantly by the content of the presented stimuli. Specifically, subjects find it easier to reason about contexts and situations with a social content. In the present study, the effect of content on brain activation was investigated with functional magnetic resonance imaging (fMRI) while subjects were solving two versions of the Wason selection task, which previous behavioral studies have shown to elicit a significant content effect. One version described an arbitrary relation between two actions (Descriptive: "If someone does ..., then he does ..."), whereas the other described an exchange of goods between two persons (Social-Exchange: "If you give me ..., then I give you ..."). Random-effect statistical analyses showed that compared to baseline, both tasks activated frontal medial cortex and left dorsolateral frontal and parietal regions, confirming the major role of the left hemisphere in deductive reasoning. In addition, although the two reasoning conditions were identical in logical form, the social-exchange task was also associated with right frontal and parietal activations, mirroring the left-sided activations common to both reasoning tasks. These results suggest that the recruitment of the right hemisphere is dependent on the content of the stimuli presented.

Adult↗

PubMed1992

Reasons for non-entry in randomized clinical trials for breast cancer: a single institutional study.

Reasons for patient non-entry in randomized clinical trials (RCTs) assessing oncologic treatment modalities are not well documented in the literature. We have prospectively recorded reasons for RCT non-entry in breast cancer patients at St. Michael's Hospital, Toronto. From September 1984 to November 1989, 592 consecutive patients were evaluated through the clinical trials office. One hundred six out of the 592 patients were placed into a RCT (17.9%). Protocol ineligibilities accounted for 273 non-entries (46.1%) and protocol eligible but not entered patients accounted for 213 (36.0%) non-entries. The most common reason for protocol ineligibility was advanced age (94 patients). The most common reason for protocol eligible but not entered patients was patient refusal (148 patients). A total of 272 patients in both non-entered groups were identified as having reasons for non-entry that were potentially correctable. In summary, protocol ineligibilities account for the majority of non-entered patients, but patient refusal accounted for the single largest group of potentially correctable non-entries. More dissemination about the merit of RCTs in the lay press and amongst primary care physicians must take place if we are to expediently and efficiently answer important oncologic questions.

Breast Neoplasms↗

PubMed1999

The probability heuristics model of syllogistic reasoning.

A probability heuristic model (PHM) for syllogistic reasoning is proposed. An informational ordering over quantified statements suggests simple probability based heuristics for syllogistic reasoning. The most important is the "min-heuristic": choose the type of the least informative premise as the type of the conclusion. The rationality of this heuristic is confirmed by an analysis of the probabilistic validity of syllogistic reasoning which treats logical inference as a limiting case of probabilistic inference. A meta-analysis of past experiments reveals close fits with PHM. PHM also compares favorably with alternative accounts, including mental logics, mental models, and deduction as verbal reasoning. Crucially, PHM extends naturally to generalized quantifiers, such as Most and Few, which have not been characterized logically and are, consequently, beyond the scope of current mental logic and mental model theories. Two experiments confirm the novel predictions of PHM when generalized quantifiers are used in syllogistic arguments. PHM suggests that syllogistic reasoning performance may be determined by simple but rational informational strategies justified by probability theory rather than by logic.

Algorithms↗

PubMed2000

Sex differences in spatial cognition, computational fluency, and arithmetical reasoning.

Alternative explanations for the male advantage in arithmetical reasoning, as measured by the ability to solve complex word problems, include a male advantage in spatial cognition and a male advantage in computational fluency. The current study was designed to test these competing hypotheses. To this end, 113 male and 123 female undergraduates were administered arithmetical computations and arithmetical reasoning tests, along with an IQ test and a test of spatial cognition. There was no sex difference on the IQ test, but males showed significantly higher mean scores on the arithmetical computations, arithmetical reasoning, and spatial cognition measures. A series of structural equation models indicated that individual differences in arithmetical reasoning were related to individual differences in IQ, spatial abilities, and computational fluency. Moreover, the results suggested that the male advantage in arithmetical reasoning is mediated by the male advantages in both computational fluency and spatial cognition.

Adolescent↗

PubMed1990

[Reasons for athletic activity versus inactivity of urban population of Basel-Stadt 1988].

A representative sample of 778 inhabitants of Canton Basel-Stadt aged 16 to 75 years were asked about their exercise habits and reasons for participating in or abstaining from sports (Response rate: 81%). 56% of the responders took part in a sport more than once a month; the percentage was higher among younger adults and markedly lower among obese subjects. For 27% of the "active" respondents, the most important single motivation for sports was "fun, pleasure und well-being", in 20% of the cases "fitness", in 16% "health" and in 12% "compensation for work and relaxation". For 32% of the "inactive" group, the main reason for abstaining from sports was "lack of time", for 22% "no interest" and in 16% of the cases "sickness or disability"; "no clubs or sports-facilities" was hardly ever mentioned as a reason for being physically inactive (1%). Some significant differences were found when sociodemographic subgroups were analysed. For example, "health" was more often given as a reason for sports by the elderly, and "compensation for work and relaxation" was more often mentioned as the level of education rose. "Lack of time" was a more frequent reason for being physically inactive among young adults, whereas "sickness" was more important among the elderly. A better knowledge of the relative importance of the motivation for leisure time physical activity is likely to be significant for effective sports-promotion.

Adolescent↗