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PubMed2004

Mechanical reasoning by mental simulation.

Recent studies have provided evidence for mental simulation as a strategy in mechanical reasoning. This type of reasoning can be dissociated from reasoning based on descriptive knowledge in that it depends on different abilities and memory stores, is expressed more easily in gesture than in language, exhibits analog properties, and can result in correct inferences in situations where people do not have correct descriptive knowledge. Although it is frequently accompanied by imagery, mental simulation is not a process of inspecting a holistic visual image in the 'mind's eye'. Mental simulations are constructed piecemeal, include representations of non-visible properties and can be used in conjunction with non-imagery processes, such as task decomposition and rule-based reasoning.

Humans↗
PubMed2004

Understanding children's and adults' limitations in mental state reasoning.

Young children exhibit several deficits in reasoning about their own and other people's mental states. We propose that these deficits, along with more subtle limitations in adults' social-cognitive reasoning, are all manifestations of the same cognitive bias. This is the 'curse of knowledge' - a tendency to be biased by one's own knowledge when attempting to appreciate a more naïve or uninformed perspective. We suggest the developmental differences in mental state reasoning exist because the strength of this bias diminishes with age, not because of a conceptual change in how young children understand mental states. By pointing out the common denominator in children's and adults' limitations in mental state reasoning we hope to provide a unified framework for understanding the nature and development of social cognition.

Adult↗
PubMed2001

Propositional reasoning and working memory: the role of prior training and pragmatic content.

Working memory involvement in propositional reasoning was explored after different kinds of training. The training conditions aimed to reduce the impact of non-analytic heuristics and to enhance analytic inference processes according to mental logic theories, the mental model theory, and the theory of pragmatic reasoning schemata. Following an initial training phase, secondary task interference was investigated using concurrent spatial tapping (Experiment 1), random number generation (Experiment 2), and articulatory suppression (Experiment 3). A training condition practicing the construction and use of mental models via a truth table task increased the disruption of reasoning performance by random number generation and articulatory suppression, whereas the other training conditions did not affect susceptibility to secondary task interference. The results corroborate implications of the mental model theory of reasoning.

Adult↗
PubMed1995

Computer-assisted instruction improves clinical reasoning skills of dietetics students.

OBJECTIVE: The effects of a computer-assisted instruction (CAI) tutorial program on learning clinical reasoning skills were compared in undergraduate dietetics students. DESIGN: A drill-and-practice program to control for time on task, and tutorial program, and a simulation program, as the test vehicle, were developed. The tutorial and simulation programs presented data on a patient with cardiovascular disease. SETTING: Subjects were tested in 30 undergraduate dietetics programs. SUBJECTS: Participants were 413 undergraduate diet therapy students enrolled in a coordinated program in dietetics (CPD) or a didactic program in dietetics (DPD). INTERVENTION: After completion of lectures on cardiovascular disease, subjects were given the drill-and-practice program plus a simulation test (group 1), the tutorial plus a simulation test (group 2), or the simulation test only (group 3). MAIN OUTCOME MEASURES: Scores on the simulation test were compared. Variables included type of CAI, dietetics program, year in school, computer experience, and experience using a medical chart. Mastery of objectives related to lower- and higher-level clinical reasoning skills introduced in the tutorial program was computed. STATISTICAL ANALYSIS: One-way analysis of variance and Student-Newman Keuls tests were conducted to determine any differences among the three groups. Reliability was determined using the Kuder-Richardson Formula 20. RESULTS: The reliability coefficient of the stimulation test was 0.93. Group 2 higher on the simulation test than group 1 or group 3. As a group, the CPD students scored higher than the DPD students. When CPD and DPD students were divided into the three experimental groups, there was no significant difference between the CPD and DPD student simulation scores. Group 2 mastered all objectives for lower-level reasoning skills and the higher-level decision-making objective better than groups 1 and 3. APPLICATIONS/CONCLUSIONS: A computer tutorial program enhanced clinical reasoning skills in undergraduate dietetics students. This type of program could be used to supplement many topics taught in diet therapy and provide DPD students with experimental learning before their clinical intern practicums.

Analysis of Variance↗
PubMed2003

Reasoning with quantifiers.

In the semantics of natural language, quantification may have received more attention than any other subject, and one of the main topics in psychological studies on deductive reasoning is syllogistic inference, which is just a restricted form of reasoning with quantifiers. But thus far the semantical and psychological enterprises have remained disconnected. This paper aims to show how our understanding of syllogistic reasoning may benefit from semantical research on quantification. I present a very simple logic that pivots on the monotonicity properties of quantified statements--properties that are known to be crucial not only to quantification but to a much wider range of semantical phenomena. This logic is shown to account for the experimental evidence available in the literature as well as for the data from a new experiment with cardinal quantifiers ("at least n" and "at most n"), which cannot be explained by any other theory of syllogistic reasoning.

Cognition↗
PubMed1999

Goal attribution without agency cues: the perception of 'pure reason' in infancy.

The proper domain of naive psychological reasoning is human action and human mental states but such reasoning is frequently applied to non-human phenomena as well. The studies reported in this paper test the validity of the currently widespread belief that this tendency is rooted in the fact that naive psychological reasoning is initially restricted to, and triggered by, the perception of self-initiated movement of agents. We report three habituation experiments which examine the necessary conditions under which infants invoke a psychological principle, namely the principle of rational action, to interpret behaviour as goal directed action. Experiment 1 revealed that the principle of rational action already operates at 9 (but not yet at 6) months of age. Experiment 2 demonstrated that perceptual cues indicating agency, such as self-propulsion, are not necessary prerequisites for interpreting behaviour in terms of the principle of rational action. Experiment 3 confirmed that this effect cannot be attributed to generalisation of agentive properties from one object to another. These results suggest that the domain of naive psychology is initially defined only by the applicability of its core principles and its ontology is not restricted to (featurally identified) object kinds such as persons, animates, or agents. We argue that in its initial state naive psychological reasoning is not a cue-based but a principle-based theory.

Age Factors↗
PubMed1997

Deductive and inductive reasoning in Parkinson's disease patients and normal controls: review and experimental evidence.

In the present study, fifty-four subjects were tested; twenty-seven with idiopathic Parkinson's disease and twenty-seven normal controls matched in age, education, verbal ability, level of depression, sex and socio-economic status. The subjects were tested on eight tasks. Five of the tasks were the classic deductive reasoning syllogisms, modus ponens, modus tollendo tollens, affirming the consequent, denying the antecedent and three-term series problems phrased in a factual context (brief scripts). Three of the tasks were inductive reasoning, including logical inferences, metaphors and similes. All tasks were presented to subjects in a multiple choice format. The results, overall, have shown nonsignificant differences between the two groups in deductive and inductive reasoning, an ability traditionally associated with frontal lobes involvement. Of the comparisons performed between subgroups of the patients and normal controls concerning disease duration, disease onset and predominant involvement of the left and/or right hemisphere, significant differences were found between patients with earlier disease onset and normal controls and between bilaterally affected patients and normal controls, demonstrating an additive effect of lateralization to reasoning ability.

Adult↗
PubMed2000

Determinants of long-term hormone replacement therapy and reasons for early discontinuation.

OBJECTIVE: To identify factors associated with long-term hormone replacement therapy (HRT) and reasons for early discontinuation of it. METHODS: A cross-sectional study was conducted in four United Kingdom group general practices. Six hundred fifteen past or present HRT users (representing a response rate of 66%) responded to questionnaires on HRT and potential determinants of long-term use. Main outcome measures were long-term HRT use (at least 6 years) as opposed to short-term use (at most 2 years) and self-reported reasons for discontinuation. Odds ratios (ORs) of long-term use were adjusted for age and other variables, in the same groups, calculated by logistic regression and 95% confidence intervals (CIs). RESULTS: Ovariectomy (OR 2.59, 95% CI 1.12, 5.97), hysterectomy (OR 2.28, 95% CI 1.37, 3.79), previous oral contraceptive use (OR 1.76, 95% CI 1. 03, 3.01), HRT prescription to prevent osteoporosis (OR 1.81, 95% CI 1.04, 3.13), opinion that HRT prevents health problems (OR 3.22, 95% CI 1.57, 6.63), opinion that HRT is associated with health risks (OR 0.23, 95% CI 0.08, 0.65), and opinion that HRT has cosmetic benefits (OR 2.52, 95% CI 1.45, 4.40) were statistically significantly associated with long-term HRT. Women surveyed most often reported side effects and weight gain (each about 30%) as reasons for discontinuation, followed by possible health risks and dislike of menstrual bleeding or hormones (each about 15%). CONCLUSION: Ovariectomy, hysterectomy, and opinions about benefits and disadvantages of HRT were the most important determinants of long-term use, whereas women themselves mentioned side effects and weight gain most frequently as reasons for discontinuing it.

Adult↗
PubMed1994

Analysis of a referral-based endodontic practice: Part 1. Demographic data and reasons for referral.

There is little information in the dental literature regarding endodontic practice profiles and the reasons for referral to endodontic specialists. This study was undertaken to analyze various details of 2000 patients referred to an endodontist in Perth, Western Australia. The 2000 patients were comprised of 1295 (64.8%) females and 705 (35.2%) males. They were referred by 405 different dentists, clinics, or hospitals. The main reasons for referral were: management of pain (24.1% of patients), calcified/blocked canals (17.7%), endodontic retreatment (15.0%), trauma (12.9%), surgery (6.5%), and perforations (6.0%). Other reasons for referral included root resorption, fractured instruments, combined endodontic-periodontal lesions, second opinions, nervous patients, and medical complications. There were 312 people that did not require endodontic treatment, resulting in 1688 patients having treatment on 2221 teeth. Review appointments were attended by 50.2% of those patients due for recall examinations. The wide range of treatment procedures required and the high number of cases referred for diagnostic reasons indicate that endodontists must be highly skilled in all aspects of diagnosis, treatment planning, and treatment procedures.

Dental Pulp Diseases↗
PubMed2002

Influenza and pneumococcal vaccination in Scottish nursing homes: coverage, policies and reasons for receipt and non-receipt of vaccine.

A national survey was carried out to determine the coverage of influenza and pneumococcal vaccines, policies, reasons for receipt, non-receipt of vaccine and strategies to improve vaccine coverage in Scottish nursing homes. Of the 550 nursing homes, 72% (394) participated in the study. Overall coverage was 85% for influenza vaccine in 2001-2002 season and 11% for pneumococcal vaccine in the last 5-year period. Only 6% (23/394) of homes were reported to have a systematic immunization record. The most frequently stated reasons for improved coverage of both vaccines were clear immunization policies (76%), awareness and education for staff and residents (68%), and consent on behalf of the incompetent residents (66%). The presence of vaccination policies was higher for influenza vaccine than pneumococcal vaccine expressed as verbal agreement (27% versus 3%), written policies with set target (24% versus 5%) and written policies without set target (17% versus 2%). Advice from the members of the community health care team was the principal reason for the receipt of both vaccines. The predominant reasons for non-receipt of vaccine were refusal by residents and family members (both vaccines) and lack of advice from general practitioners (pneumococcal vaccine). The substantial disparity in coverage of influenza and pneumococcal vaccine reflects the lack of national recommendations and policies for reimbursements for pneumococcal vaccination. These data suggest that greater efforts are needed to improve prevention behaviors of health care professionals and the public, organized vaccine delivery strategies and systematic vaccination documents to increase influenza and pneumococcal vaccination rates in nursing homes and other long-term care facilities.

Bacterial Vaccines↗
PubMed1998

An examination of the renal transplant evaluation process focusing on cost and the reasons for patient exclusion.

A medical evaluation of prospective renal transplant recipients is performed to identify conditions that may exclude patients from transplantation because of unacceptable risks. Protocols for evaluating potential transplant candidates are available, but there is little information about reasons for excluding patients from transplantation. To assess the effectiveness and cost of our renal transplant-recipient evaluation process, we retrospectively reviewed patients excluded from renal transplantation between January 1993 and December 1995 to categorize the reasons for exclusion. We also examined the costs of the evaluation. The study group included all adults referred for kidney-only transplantation during the study period who were excluded from transplantation (n=125). Demographics of the 160 patients with end-stage renal disease (ESRD) who underwent renal transplantation during the study period were also examined. Compared with the patients who underwent transplantation, the excluded patients were older (48+/-14 v 43+/-12 years; P=0.006) and more likely to be women (66 of 125 patients; 53% v 57 of 160 patients; 36%; P=0.005) and diabetic (59 of 125 patients; 47% v 30 of 160 patients; 19%; P=0.005). The most common reason for excluding patients was medical contraindication (46%), followed by patient declined (25%), obesity (10%, defined as a body mass index [BMI] > or = 35), patient death (6%), and insurance/financial (5%). The medical reasons for exclusion were heart disease (38%), noncompliance (28%), miscellaneous (22%), and cancer (12%). Tests performed after the initial evaluation included cardiac testing (stress thallium or echocardiography and coronary angiography) in 50 patients, Doppler studies of the lower extremities in 28 patients, and hepatitis C polymerase chain reaction (PCR) or recombinant immunoblot assay (RIBA) assays in 8 patients. The cost of standard pretransplantation blood work for selected tests (ABO blood group typing, HLA, hepatitis B and C, and cytomegalovirus) was $709. Deferring such routine pretransplantation blood work until after the patient education session and history and physical examinations by nephrology and surgery in the 31 patients (25%) who declined transplantation at the initial visit would have resulted in considerable savings. Our evaluation process now includes prereferral information on a prospective recipient's medical problems, height and weight, and basic screening laboratory tests. This protocol has resulted in a more efficient and cost-effective evaluation process. Further examination of the cost-effectiveness of the transplant evaluation process is warranted.

Adult↗
PubMed1999

Drug related negative side-effects is a common reason for poor compliance in hormone replacement therapy.

OBJECTIVES: The reasons for poor compliance with hormone replacement therapy (HRT) and, in particular drug-related reasons, have not yet been fully elucidated. In this study, a cohort of peri- or postmenopausal women--mainly workers from a small town and surrounding rural area--was studied. The aim of the study was to investigate why some women never start or discontinue HRT, even when great effort has been made to inform and fulfill the demands of the patient. METHODS: All women who were given a HRT prescription at a gynecological practice between September 1991 and December 1992 participated in a longitudinal study. A written questionnaire was mailed to these patients in 1996. Data from the questionnaire was supplemented with information from the medical records. Care of patients included initial information, follow-up within 4 months, yearly visits supplemented with contacts on demand. RESULTS: 356 women received the questionnaire, among which 92% replied. A total of 2% never started HRT. Seventy-five percent continued the therapy for more than 3 years. Reasons for discontinuing HRT were negative side-effects (35%), desire to find out if climacteric symptoms had ended (26%), fear of cancer and thrombosis (25%), weariness of bleeding (19%) and a wish to deal with the problems 'naturally' (15%). CONCLUSIONS: Compliance with HRT can be high if adequate information is given and follow-ups are made. The main reason for poor compliance was negative side-effects, most likely progestin-related. The results of this study suggest that the future challenge will be to minimize negative side-effects of HRT.

Adult↗
PubMedDate not supplied

Referral reasons for psychological services for adults with mental retardation.

This study examined 391 adult referrals made to a mental health clinic serving individuals with mental retardation, in order to explore the relationship between referral source and referral reason. Each referral was categorized into 1 of 8 referral sources (e.g., vocational placements, day treatment programs) and into 1 of more of 10 behavior categories (e.g., depression, externalizing behavior problems). Externalizing behaviors were the most common overall referral reason. However, referral reason did vary as a function of referral source. Also, sex and mental retardation level were associated with referral reason. Implications for assessment practices and future research are considered.

Adult↗
PubMed1997

Anxiety sensitivity and self-reported reasons for drug use.

Two studies examined the relationships between anxiety sensitivity (AS), drug use, and reasons for drug use. In Study 1, 229 university students (57% F) completed the Anxiety Sensitivity Index (ASI) and a drug use survey, assessing use of a variety of drugs within the last month, and coping reasons for drug use. Consistent with a modified tension-reduction hypothesis, ASI scores were positively correlated with the number of both anxiety- and depression-related reasons for drug use endorsed. In Study 2, 219 university students (74% F) completed the ASI and a drug use survey, assessing use of several drugs (e.g., alcohol, cigarettes, caffeine, and marijuana/hashish) within the last year, and primary reasons (coping, affiliative, or enhancement) for the use of each drug. Marijuana/hashish users reported lower ASI scores than non-users supporting a negative relation between AS and the use of cannabis. ASI scores were positively correlated with the use of alcohol primarily to cope, and negatively correlated with the use of alcohol primarily to affiliate, among both gender groups, and ASI scores were positively correlated with the use of nicotine primarily to cope among the females. Implications of these findings for understanding risk for abuse of stress-response-dampening drugs by high AS individuals are discussed.

Adaptation, Psychological↗
PubMedDate not supplied

Integrating model-based decision support in a multi-modal reasoning system for managing type 1 diabetic patients.

We present a multi-modal reasoning (MMR) methodology that integrates case-based reasoning (CBR), rule-based reasoning (RBR) and model-based reasoning (MBR), meant to provide physicians with a reliable decision support tool in the context of type 1 diabetes mellitus management. In particular, we have implemented a decision support system that is able to jointly exploit a probabilistic model of the glucose-insulin system at the steady state, a RBR system for suggestion generation and a CBR system for patient's profiling. The integration of the CBR, RBR and MBR paradigms allows for an optimized exploitation of all the available information, and for the definition of a therapy properly tailored to the patient's needs, overcoming the single approaches limitations. The system has been tested both on simulated and on real patients' data.

Artificial Intelligence↗
PubMed1997

A process-oriented reasoner about physiology.

This paper presents the RAP system: a reasoner about physiology. RAP performs two tasks: (1) it infers the behaviour of a complex physiological process using the behaviours of its subprocesses and the relationships between them; (2) it reasons about the effect of introducing a fault into the model. In order to reason about the behaviour of a complex process, RAP uses a mechanism which: (i) represents how subprocesses behave; (ii) establishes how these subprocesses affect each others behaviors; (iii) 'aggregates' these behaviors together to obtain the behavior of the top level process; (iv) gives that process a temporal context in which to act. RAP uses limited common sense knowledge about faults to reason about their effect in terms of the generation of new processes and the misbehavior of existing ones. The effects are then propagated throughout the model to obtain the overall effect of the fault.

Artificial Intelligence↗
PubMed2001

The probabilistic approach to human reasoning.

A recent development in the cognitive science of reasoning has been the emergence of a probabilistic approach to the behaviour observed on ostensibly logical tasks. According to this approach the errors and biases documented on these tasks occur because people import their everyday uncertain reasoning strategies into the laboratory. Consequently participants' apparently irrational behaviour is the result of comparing it with an inappropriate logical standard. In this article, we contrast the probabilistic approach with other approaches to explaining rationality, and then show how it has been applied to three main areas of logical reasoning: conditional inference, Wason's selection task and syllogistic reasoning.

Journal Article↗
PubMed2006

Referrals for movement disorder surgery: under-representation of females and reasons for refusal.

OBJECTIVE: Referral of movement disorder patients for deep brain stimulation surgery was examined to determine whether referred patients were representative of gender proportions in our population, and reasons why patients do not proceed to surgery. METHODS: Demographic information on referrals to the surgical program was retrospectively reviewed from our database and from a detailed chart review. RESULTS: Although almost equal numbers of movement disorder patients are male and female, of the 91 patients referred for surgery, only 31% were female. Sixty-one percent of referred patients did not undergo surgery. Of these, the majority were denied for medical reasons, including cognitive decline (21%), psychiatric concerns (5%) and neurological reasons (42%). CONCLUSIONS: Almost one-third of patients referred for movement disorder surgery were denied for medical reasons. This underscores the importance of evaluation of all potential patients by a multidisiplinary team to fully assess suitablity for stereotactic surgery. Interestingly, women were under-represented in those referred. In order that all appropriate patients have the opportunity to consider surgery, education of both physicians and patients, and different strategies to approach females regarding surgery may allow more patients to benefit from this treatment.

Deep Brain Stimulation↗