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PubMed1992

Adolescents' reasons for smoking.

Part of the Hutchinson Smoking Prevention Project, this study provides information on reasons reported by adolescents for their smoking behavior. A total of 1,615 10th grade students in 20 rural and suburban school districts in Washington state were asked why they currently smoke and why they first smoked. For beginning smoking, curiosity, social norms, and social pressure were the most frequently given reasons for smoking. For current smoking, pleasure and addiction were mentioned most often. A number of gender differences occurred with 10th grade students beginning and current smoking. More females than males reported social norms and social pressure as reasons for beginning to smoke, whereas for currently smoking, pleasure was given as a reason more frequently by females than males. When developing interventions, smoking prevention programs need to consider students' current and past smoking behavior, and the reasons they give for smoking.

Adolescent↗
PubMed1999

Dentist reliability in classifying disease risk and reason for treatment.

OBJECTIVES: The reliability of practicing dentists' classifications of patients' caries risk and periodontal disease risk and reason for treatment for individual teeth were determined. The risk classification protocols had been in use in a group practice for more than a year, and the reason-for-treatment protocol had been introduced six months previously. METHODS: Eight dentists' classifications for caries (n = 66) and periodontal disease risk (n = 66), and six dentists' classifications for reason for treatment (n = 73) were compared to those of a nominal standard examiner. Reliability was expressed as percent agreement and kappa values. RESULTS: Percent agreement was 76 percent, 83 percent, and 74 percent for caries, periodontal disease, and reason for treatment, respectively, with kappa values of 0.56, 0.70, and 0.69. CONCLUSIONS: Dentists can attain reasonable levels of reliability using simple classification protocols with little formal training, although misclassification may be problematic for specific administrative or research-related purposes.

Decision Making↗
PubMed1997

The effect of self-referent material on the reasoning of people with delusions.

People with delusions have been shown to have both generalized (Huq, Garety & Hemsley, 1988) and content-specific biases in reasoning (Bentall, 1994). Our concern here was whether the hastiness that has been found when people with delusions reason on relatively abstract tasks would be present on a more realistic task. A second concern was whether reasoning with salient or emotional material would increase the hastiness bias in people with delusions. Two versions of a probabilistic reasoning task were used to study the data gathering of people with delusions. The first version employed realistic but emotionally neutral material. People with delusions requested less evidence before making a decision than psychiatric and normal comparison groups. Therefore, the hastiness found previously with abstract materials was seen to generalize to a more realistic task. In the second version participants were required to reason with material that had an emotional content and may have been regarded as being personally meaningful. In this condition all groups reduced the amount of evidence requested before making a decision.

Adult↗
PubMed1986

Differences in reasons for taking overdoses in high and low hopelessness groups.

Thirty-five people admitted to hospital following deliberate self-harm by overdose were interviewed. Patients rated several 'reasons' for making the attempt on 0-10-point scales. The 'reasons' used were those derived by Bancroft and his associates (e.g. find out if someone loved me, make people understand how desperate I was feeling). The patients also completed Beck et al.'s Hopelessness Scale. High hopelessness was associated with an increased wish 'to die' and 'to get relief from a terrible state of mind' but high and low hopelessness did not differentiate between other reasons, even the traditionally 'manipulative' ones. The intercorrelations between reasons suggested that in low hopelessness interpersonal reasons were the most central constructs, whereas in the high hopelessness patients, the escape motive was the most central.

Adolescent↗
PubMed1997

Partial and impartial ethical reasoning in health care professionals.

OBJECTIVES: To determine the relationship between ethical reasoning and gender and occupation among a group of male and female nurses and doctors. DESIGN: Partialist and impartialist forms of ethical reasoning were defined and singled out as being central to the difference between what is known as the "care" moral orientation (Gilligan) and the "justice" orientation (Kohlberg). A structured questionnaire based on four hypothetical moral dilemmas involving combinations of (health care) professional, non-professional, life-threatening and non-life-threatening situations, was piloted and then mailed to a randomly selected sample of doctors and nurses. SETTING: 400 doctors from Victoria, and 200 doctors and 400 nurses from New South Wales. RESULTS: 178 doctors and 122 nurses returned completed questionnaires. 115 doctors were male, 61 female; 50 nurses were male and 72 were female. It was hypothesised that there would be an association between feminine subjects and partialist reasoning and masculine subjects and impartialist reasoning. It was also hypothesised that nurses would adopt a partialist approach to reasoning and doctors an impartialist approach. No relationship between any of these variables was observed.

Attitude of Health Personnel↗
PubMed1996

Automated reasoning system in histopathologic diagnosis and prognosis of prostate cancer and its precursors.

OBJECTIVE: This article presents the rationale and options offered to diagnostic and prognostic decision support systems for prostate pathology by automated reasoning capabilities. METHODS: The symbolic information used in diagnostic decision-making is systematically ordered, compared, numerically assessed in its probability, and combined such that a conclusion can be drawn. The framework for the processing of such symbolic information may be an expert system, an inference network or a case-based reasoning system. Automated reasoning is implemented by the use of a rule base and information flow control modules. RESULTS: Automated reasoning allows decision support systems to follow highly adaptive decision sequences, capable of handling contradictory evidence, exceptions in diagnostic clue expression, and nonmonotonic decision-making. CONCLUSIONS: Automated reasoning capability in diagnostic and prognostic decision support systems allows highly flexible decision development, very close to human decision procedures.

Artificial Intelligence↗
PubMed2003

Reasoning, models, and images: behavioral measures and cortical activity.

The goal of this study was to investigate the neurocognitive processes of mental imagery in deductive reasoning. Behavioral studies yielded four sorts of verbal relations: (1) visuospatial relations that are easy to envisage both visually and spatially; (2) visual relations that are easy to envisage visually but hard to envisage spatially; (3) spatial relations that are hard to envisage visually but easy to envisage spatially; and (4) control relations that are hard to envisage both visually and spatially. In three experiments, visual relations slowed the process of reasoning in comparison with control relations, whereas visuospatial and spatial relations yielded inferences comparable to those of control relations. An experiment using functional magnetic resonance imaging showed that in the absence of any correlated visual input (problems were presented acoustically via headphones), all types of reasoning problems evoked activity in the left middle temporal gyrus, in the right superior parietal cortex, and bilaterally in the precuneus. In the prefrontal cortex, increased activity was found in the middle and inferior frontal gyri. However, only the problems based on visual relations also activated areas of the visual association cortex corresponding to V2. The results indicate that cortical activity during reasoning depends on the nature of verbal relations. All relations elicit mental models that underlie reasoning, but visual relations in addition elicit visual images. This account resolves inconsistencies in the previous literature.

Acoustic Stimulation↗
PubMed1985

A survey of the reasons for dental extractions in France.

3516 French dentists, selected at random, were asked to record every tooth they extracted during January, 1984. They were also asked to give the reason for extraction in each case. These were assigned to eight groups: caries, periodontal diseases, eruption problems, prosthetics, trauma, orthodontics, occlusal problems, and other reasons. Data were received from 910 dentists (25.3%) relating to a total of 14,621 extractions. Overall, caries was the most frequent cause for extraction (49%), followed by periodontal diseases (32.4%) and orthodontics (8.4%). In the age group under 50, dental caries was the main reason for extraction. However, in the age group over 50, periodontal diseases became the principal reason for extraction. Orthodontic extractions were most prominent in the 6-12 and 13-20 age groups, with respective frequencies of 72.6% and 24.8% of all extractions. Eruption problems contributed most frequently in the 13-20 and 21-30 age groups, their respective percentages being 8.7% and 12.3%. Extractions resulting from trauma were most frequently noted in the under-6 age group (frequency of 8.8%). As far as the type of tooth was concerned, first and second molars taken together made up 29.6% of extractions. These were followed by pre-molars, anterior teeth, and third molars at levels of 25.8%, 29.9%, and 14.7%, respectively. The teeth most frequently extracted because of caries were the molars (40.9%); because of periodontal disease, the anteriors (49.1%); and, for prosthetic reasons, again the anteriors (57.5%). Extractions from the various regions of France showed important variations. Percentage frequencies for caries and periodontal extractions were inversely linked.

Adolescent↗
PubMed1995

Reasons for homicide and suicide in episodes by dyadic death in Yorkshire and Humberside.

Fifty-two episodes of homicide-suicide were examined to determine the reasons behind the episodes. Forty-nine of the assailants were male. The major reason for homicide-suicide was breakdown in a relationship (46%), the victim usually being the spouse. Mental illness was the second commonest reason (21%). Physical ill health (11%) and financial stress (10%) were important reasons in older couples. Criminal behaviour was the reason in 11% of cases. Alcohol was detected in 15 (29%) of assailants, with 10 (19%) having a blood-alcohol level over 100mg/100ml. The results are compared with other published studies.

Female↗
PubMed2003

Clinical reasoning in experienced nurses.

As an essential component of nursing practice, clinical reasoning is used to assimilate information, analyze data, and make decisions regarding patient care. Little is known about the reasoning strategies of experienced nurses who are not yet experts. This qualitative descriptive study explored the cognitive strategies used by experienced nurses as they considered assessment findings of assigned patients. To date, few studies of nurses' clinical reasoning have been conducted in a practice setting during actual patient care. A small group research design was employed using the think-aloud (TA) method with protocol analysis. A total of 15 experienced nurses were asked to "think aloud" about patient assessment findings. Data were audiotaped, transcribed, and analyzed using the three steps of protocol analysis. The results suggest that experienced nurses used a conceptual language to reason about assessment findings and used heuristics to reason more quickly and efficiently.

Adult↗
PubMed2003

Characterizing reasons for breastfeeding cessation throughout the first year postpartum using the construct of thriving.

The authors examined whether 4 factors derived from the construct of thriving--Physical Adjustment, Infant Nutritional Status, Psychosocial Distress, and Lifestyle Patterns--explain reasons behind breastfeeding cessation. Factor analysis of longitudinal 1993-1994 data showed that mother's concern about her milk supply, wanting to leave the infant, or wanting someone else to feed the infant were the predominant reasons cited for breastfeeding cessation in the first 5 months. The 4 factors accounted for 97% of reasons given in the first 2 months, 86% of reasons given in months 3 to 5, and 58% of reasons from months 6 to 12. An additional factor--expectation regarding appropriate age for breastfeeding cessation--was also important in later months.

Adult↗
PubMed2005

Relational spatial reasoning by a nonhuman: the example of capuchin monkeys.

The authors review spontaneous manipulation and spatial problem solving by capuchin monkeys to illuminate the nature of relational reasoning (wherein two or more elements of a problem or situation are considered together to arrive at a course of action) that these monkeys use in goal-directed activity. Capuchin monkeys master problems with one, two, or three spatial relations, and if more than one relation, at least two relations may be managed concurrently. They can master static and dynamic relations and, with sufficient practice, can produce specific spatial relations through both direct and distal action. Examining capuchins' spatial problem-solving behavior with objects in the framework of a spatial relational reasoning model leads to new interpretations of previous studies with these monkeys and other nonhuman animals. The model produces a variety of testable predictions concerning the contribution of relational properties to spatial reasoning. It also provides conceptual linkages with neurological processes and cognitive analyses of physical reasoning. Understanding relational spatial reasoning, including tool use, in a wider view is vital to informed, principled comparison of problem solving and the use of technology across species, across ages within species, and across eras in human prehistory.

Animals↗
PubMed2005

General practitioners' reasoning when considering the diagnosis heart failure: a think-aloud study.

BACKGROUND: Diagnosing chronic heart failure is difficult, especially in mild cases or early in the course of the disease, and guidelines are not easily implemented in everyday practice. The aim of this study was to investigate general practitioners' diagnostic reasoning about patients with suspected chronic heart failure in comparison with recommendations in European guidelines. METHODS: Think-aloud technique was used. Fifteen general practitioners reasoned about six case vignettes, representing authentic patients with suspected chronic heart failure. Information about each case was added successively in five steps. The general practitioners said their thoughts aloud while reasoning about the probability of the patient having chronic heart failure, and tried to decide about the diagnosis. Arguments for and against chronic heart failure were analysed and compared to recommendations in guidelines. RESULTS: Information about ejection fraction was the most frequent diagnostic argument, followed by information about cardiac enlargement or pulmonary congestion on chest X-ray. However, in a third of the judgement situations, no information about echocardiography was utilized in the general practitioners' diagnostic reasoning. Only three of the 15 doctors used information about a normal electrocardiography as an argument against chronic heart failure. Information about other cardio-vascular diseases was frequently used as a diagnostic argument. CONCLUSIONS: The clinical information was not utilized to the extent recommended in guidelines. Some implications of our study are that 1) general practitioners need more information about how to utilize echocardiography when diagnosing chronic heart failure, 2) guidelines ought to give more importance to information about other cardio-vascular diseases in the diagnostic reasoning, and 3) guidelines ought to treat the topic of diastolic heart failure in a clearer way.

Cognition↗
PubMedDate not supplied

Self-reported reasons men decide not to participate in free prostate cancer screening.

PURPOSE: To determine the reasons why men fail to participate in a free prostate cancer screening. DESIGN: Survey and secondary analyses using correlational design. SETTING: Community sites in the Southeastern United States. SAMPLE: The sample (N = 241) ranged in age from 40-68 years. Mean age was 50 years (SD = 7.4). Most of the men were African American (79%) and married (70%). Almost half of the subjects (44%) earned between $9,601 and $25,020 per year. METHOD: Telephone survey of men who did not participate in initial prostate cancer screening after educational program. MAIN RESEARCH VARIABLES: Demographics, self-reported reasons men decided not to participate in a free screening following a prostate cancer educational program, and predictors for subsequent participation in screening. FINDINGS: The main self-reported reason for not participating in a free prostate cancer screening opportunity was time problems. A significant relationship between income and physician problems existed among the men who did not participate. Twenty-one percent of the 241 men participated in a second opportunity for free prostate cancer screening. Men who cited "lost packet" as their reason for not participating in the first free screening were more than twice as likely to go for the second opportunity for free screening when offered another packet or voucher for a free screening with their physician of choice. CONCLUSIONS: "Time problems" was the most frequent self-reported reason men gave for failure to participate. Providing a follow-up phone call and vouchers a second time for reimbursement of the cost associated with a screening increased participation. Men often need assistance with locating physicians and nurse practitioners who will file for financial reimbursement. Appointment reminders are critical. IMPLICATIONS FOR NURSING: The findings of this study of the significant relationship between income and "physician problems" for not participating has implications for healthcare providers. Future programs could provide telephone follow-up with men and remail vouchers, as needed. In addition, men could be encouraged to designate one place in their households for health-related papers (for safekeeping).

Adult↗
PubMed2005

Reasons for using the emergency department: results of the EMPATH Study.

OBJECTIVES: Emergency Medicine Patients' Access To Healthcare (EMPATH) was a cross-sectional, observational study conducted to identify the principal reasons why patients seek care in hospital emergency departments (EDs) in the United States. METHODS: Twenty-eight U.S. hospitals, stratified by geographic region and hospital characteristics, participated in this study. Demographic, clinical, and insurance data were collected for a 24-hour period at each site, using chart reviews and a structured interview administered to all consenting adult patients seeking treatment during that period. Patients' reasons for presenting to the ED were assessed by their level of agreement (on a three-point Likert scale) with 21 carefully worded statements designed to capture a range of possible reasons for seeking care in the ED. Factor analysis was used to consolidate highly correlated responses and to identify the principal factors explaining patients' reasons for coming to the ED. RESULTS: A total of 1,579 patient interviews and 2,004 chart reviews were obtained from a diverse sample that was 55.4% female, 58.3% white, 28.3% African American, 7.0% Hispanic, and 6.0% other ethnic groups. This exploratory analysis yielded five factors characterizing patients' principal reasons for seeking ED care, with medical necessity the most frequent, followed by ED preference, convenience, affordability, and limitations of insurance. CONCLUSIONS: Use of the ED is, for most people, an affirmative choice over other providers rather than a last resort; it is often a choice driven by lack of access to or dissatisfaction with other sources of care.

Adult↗
PubMed2000

The reasoning behind decisions not to take up antiretroviral therapy in Australians infected with HIV.

A substantial minority of HIV-infected Australians are not taking antiretroviral drugs. This study investigated the reasons behind their decision not to do so. Anyone who was HIV-infected but not taking antiretroviral drugs could participate. A self-administered, anonymous questionnaire was used, the principal recruitment method being through insertion of the questionnaire into gay community newspapers in Sydney and Melbourne. All respondents were asked questions covering demographics, previous AIDS-defining illnesses, T-cell and viral load monitoring, and previous use of antiretroviral drugs. In addition, respondents who had considered going on antiretroviral treatment, but then decided not to do so, were given a list of possible reasons for their decision and asked to indicate how much each played a role in their thinking. Of the 270 respondents, the great majority were gay men. One-eighth had experienced AIDS-defining illnesses. Two-thirds had recently had T-cell and viral load tests. One-third had taken antiretroviral drugs previously. Over two-thirds had considered antiretroviral therapy, most having given the matter quite some thought. Reasons for not taking up therapy did not differ greatly at different stages of HIV disease. The most common individual reason was fear of side effects. Important themes that emerged from factor analysis of the reasons data included distrust of conventional medical approaches to treatment, practical problems associated with taking antiretroviral drugs, unpleasant thoughts that being on therapy would evoke, and acceptance of the idea of dying. The findings can be used by doctors and counsellors to help patients clarify and evaluate their concerns about antiretroviral therapy.

Adolescent↗
PubMed2004

The Reasons for Depression Questionnaire (RFD): UK Standardization for clinical and non-clinical populations.

Recent research into reason giving for depression has illustrated the importance of client beliefs about the cause of their depression. Reasons given have been found to be associated with level of depression, perceived credibility of treatments and therapy outcome. It has been suggested that giving reasons for depression is a form of rule-governed behaviour and as such can cause the depression to be harder to treat (i.e. the reasons become functionally true for the individual). This study investigates the reliability and validity of the Reasons for Depression Questionnaire (RFD; Addis, Truax, & Jacobson, 1995), a 48-item self-report measure developed to measure explanations for the causes of depression. The study provides preliminary normative data for both clinical (n = 123) and non-clinical (n = 105) UK samples. The data indicate high reliability for all subscales including a further subscale (biological) added since the measure was initially developed. Certain subscales correlate significantly with level of depression and specific aspects of self-esteem. This supports the validity of the measure and suggests that it is measuring a distinct concept rather than significantly overlapping with individuals' general beliefs about themselves.

Adolescent↗
PubMed2002

Reasons for not using condoms among female sex workers in Indonesia.

The aim of this study was to gather data on condom use among brothel-based female sex workers in Indonesia and to study the reasons for not using condoms in order to provide new and existing condom promotion programs with information to improve their performance. Quantitative data were gathered by KABP surveys (n = 1450) and a condom diary with a sample of 204 female sex workers. Qualitative data were collected by conducting focus group discussions and in-depth interviews among female sex workers and pimps. Around 53% of sexual intercourses were reported to be protected, and 12% of these protected intercourses were preceded by clients' argumentation against it. Only 5.8% of sex workers consistently used condoms for a 2-week period of observation, and this figure decreased to 1.4% for a 4-week period. Reasons for not using condoms from the clients' side, as mentioned by the sex workers, were perceived less pleasure due to the condom and the belief that clients that are acquainted with the sex workers do not need protection against sexually transmitted diseases (STDs) or AIDS. The main reasons of female sex workers for not using condoms were the beliefs that boyfriends, native Indonesians and healthy-looking clients cannot spread STDs. Another reason stated was that sex workers had already taken other preventive measures, like taking antibiotics. The research also showed that pimps were not very supportive of condom use programs in Indonesia. Condom unacceptability is an important reason for not using condoms for both clients and female sex workers, whereas pimps, who are in the best position to encourage condom use, unfortunately consider condom use as a threat to their business. For the successful introduction of consistent condom use, it is necessary to design interventions for both sex workers and clients and to provide appropriate educational materials and preferred brands of condoms. Also, pimps must be involved in intervention programs.

Adolescent↗