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At least 559 records · Page 31Linked to original sources
PubMed2004

Non-participants in a preventive health examination for cardiovascular disease: characteristics, reasons for non-participation, and willingness to participate in the future.

OBJECTIVE: To describe the non-participants in a preventive health examination for cardiovascular diseases and their reasons for not participating. DESIGN: A preventive health examination, self-administered questionnaire, and telephone interview. SETTING: A municipality of 6200 inhabitants in the middle of Sweden. SUBJECTS: 309 persons, 35 or 40 years of age, invited to participate in a health examination. MAIN OUTCOME MEASURES: Reasons for non-participation, willingness to participate in future health examinations, and smoking. RESULTS: The most important reason for non-participating was lack of time or hindrances at work (52%). Other important reasons were already being in contact with the health services (33%) and feeling quite healthy at present (21%). Over half of the non-participants (55%) would be willing to participate in a similar health examination in the future. The proportion of smokers was significantly higher among the non-participants than among the participants in the health examination (31.3% and 18.6% respectively). CONCLUSION: More than half of the non-responders were willing to participate in a similar health examination in the future. If special measures to encourage participation in preventive health examinations were undertaken, it would not be unrealistic to aim for a participation rate of nearly 90%.

Adult↗
PubMed2005

Parents' reported reasons for avoiding MMR vaccination. A telephone survey.

OBJECTIVE: During the second half of the 1990s and the first years of the 2000s a declining coverage for MMR vaccination in two-year-olds was observed in Sweden. The aim was to assess reasons for postponement or non-vaccination. DESIGN: A telephone survey using a structured questionnaire on parents' attitudes regarding their choice to postpone or abstain from vaccinating their child. SETTING: The County of Ostergötland in Sweden. SUBJECTS: A total of 203 parents of children who had no registered date for MMR vaccination at a Child Health Centre. MAIN OUTCOME MEASURES: Parental reasons for non-vaccination. RESULTS: In all, 26 of the 203 children had received MMR vaccination but this had not been registered. Of those not vaccinated, 40% of the parents had decided to abstain and 60% to postpone vaccination. Fear of side effects was the most common reason for non-vaccination in both groups. The main source of information was the media followed by the Child Health Centre. Parents with a single child more often postponed vaccination and those who abstained were more likely to have had a discussion with a doctor or nurse about MMR vaccine. CONCLUSION: Postponers and abstainers may have different reasons for their decision. The role of well-trained healthcare staff in giving advice and an opportunity to discuss MMR vaccination with concerned parents is very important.

Adult↗
PubMedDate not supplied

Reasons for employment or non-employment during pregnancy.

Although women's pattern of employment during pregnancy has markedly changed in the last 30 years, no research has explored the basis of contemporary women's decision making regarding employment during pregnancy. Conceptualizing pregnancy within a life span developmental perspective of adulthood, we used descriptive statistics and content analysis on data from 210 pregnant women to identify factors that influence employment decisions during pregnancy. Intrinsic reasons for working during pregnancy included self-actualization, escape from home, employment identity, and interpersonal contact. Extrinsic reasons for working included money, financial obligations, and employment setting compatibility. Intrinsic reasons for not working during pregnancy included pregnancy-related limitations, home identity, complexity, and family responsibilities. Extrinsic reasons for not working included financial juggle, job availability, and employment setting incompatibility. The results form a basis for anticipatory guidance recommendations for pregnant women.

Decision Making↗
PubMed2006

Sense of belonging as a predictor of reasons for living in older adults.

In response to the high rate of suicide among aging people, this study investigated sense of belonging as a predictor of reasons for living in an aged sample. A community sample of 104 Australians aged 61 to 95 years completed The Reasons for Living Inventory and The Sense of Belonging Instrument. Results indicated that a higher sense of belonging predicted more reasons to live overall, and child-related concerns, responsibility to family, and survival and coping beliefs, specifically. Future research should investigate if the enhancement of a sense of belonging among older adults is associated with an increase in reasons for living.

Adaptation, Psychological↗
PubMed2006

Improving the efficiency of case-based reasoning to deal with activated sludge solids separation problems.

The potential of Case-Based Reasoning to use the knowledge gained from past experiences to solve problematic situations has made this Artificial Intelligence technique a useful decision support tool in different environmental domains such as wastewater treatment. Case-Based Reasoning tools automatically identify similarities between present and previous situations (cases) and reuse the experiences gained from the previous situations to solve current problems. Case retrieval can be considered to be the most important step in the process of Case-Based Reasoning. In the present study we propose incorporating a relevance network in order to increase the accuracy and the efficiency of case retrieval. The result is a context-sensitive feature-weighting methodology capable of defining the model of relationships between the different attributes or features that define the context in which Case-Based Reasoning is applied. These features affect the retrieval procedure directly. The feature's degree of relevance in the network is easily translated into a set of simple rules and applied during case retrieval, specifically during the similarity calculation. The results obtained in the present study show significant improvements in the accuracy of case retrieval. With the approach presented here experts considered more than 90% of the retrieved cases to be completely relevant according to the knowledge these cases provided for dealing with solids separation problems.

Artificial Intelligence↗
PubMed2006

Using the ICF to clarify team roles and demonstrate clinical reasoning in stroke rehabilitation.

PURPOSE: The International Classification of Functioning, Disability and Health (ICF) is advocated as a tool to structure rehabilitation and a universal language to aid communication, within the multi-disciplinary team (MDT). The ICF may also facilitate clarification of team roles and clinical reasoning for intervention. This article aims to explore both factors in stroke rehabilitation. METHOD: Following a review of the literature, a summary was presented and discussed with clinicians working within stroke rehabilitation, to gather expert opinions. The discussions were informal, being part of service development and on-going education. The clinicians summarised key themes for the potential use of the ICF within clinical practice. RESULTS: Two key themes emerged from the literature and expert opinion for the potential use of the ICF in stroke rehabilitation: (i) to aid communication and structure service provision, (ii) to clarify team roles and aid clinical reasoning. Expert opinion was that clarification of team roles needs to occur at a local level due to the skill mix, particular interests, setting and staffing levels within individual teams. The ICF has the potential to demonstrate/facilitate clinical reasoning, especially when different MDT members are working on the same intervention. CONCLUSION: There is potential for the ICF to be used to clarify team roles and demonstrate clinical reasoning within stroke rehabilitation. Further experiential research is required to substantiate this view.

Activities of Daily Living↗
PubMed2003

Reasons for applying innovations for scaffolding work.

In this paper reasons for applying and for not applying technical and organisational innovations in scaffolding work are studied. In a participatory ergonomic approach these innovations were developed to reduce problems concerning physical load of scaffolders. In this study reasons for the adoption of the innovations in the scaffolding sector are evaluated in 2 studies, in 48 companies. More than half of the scaffolding sector in the Netherlands adopted the innovations. Reasons for applying innovations concerned improvement of work and health and satisfaction with usage. The reason for not applying the innovations concerned specific situations, such as offshore work, in which innovations were not applicable.

Architecture↗
PubMedDate not supplied

Automated external defibrillator (AED) utilization rates and reasons fire and police first responders did not apply AEDs.

OBJECTIVES: To determine the rate at which fire and police first responders (FRs) apply automated external defibrillators (AEDs) and to ascertain reasons for not applying them. METHODS: Twenty-one emergency medical services (EMS) systems whose FRs had been supplied with AEDs by a philanthropic foundation provided data for all out-of-hospital cardiac arrest (OHCA) patients. Data including the incidence of AED application and explanations for not applying AEDs were analyzed using descriptive statistics. RESULTS: A total of 2,456 OHCAs were reported. AED application information was available for 2,439 patients and revealed that FRs had not applied AEDs to 1,025 patients (42%). Fire FRs were more likely than police FRs to have applied AEDs (relative risk 1.87, 95% confidence interval 1.65-2.12). Reasons for not applying AEDs were listed for 664 (65%) of the OHCA patients to whom AEDs had not been applied. The predominant reason the FRs did not apply an AED was that the transporting ambulance defibrillator had already been applied (74%). However, when response times for FRs and the transporting ambulances were compared for these OHCA patients, it was found that the transporting ambulances arrived after the FRs 23% the time, simultaneously with the FRs 45% of the time, and before the FRs only 32% of the time. CONCLUSION: Fire and police FRs did not apply AEDs to a significant number of OHCA patients. Use of the transport ambulance defibrillator was the primary reason given for not applying the FR AED. Given low AED application rates by FRs, future studies are needed to determine the characteristics of communities in which equipping FRs with AEDs is the most beneficial deployment strategy, and how to increase AED application by FRs in communities with FR AED programs.

Adult↗
PubMed2002

'Reasonable' regulation of low doses in The Netherlands?

As long as it is not clear exactly what the risks of low doses are, exposures should be regulated to be 'as low as reasonably achievable' (ALARA). In radiation protection, for normal situations, this means that a projected dose reduction can only be obligatory when the efforts needed to achieve the reduction are 'reasonable' in comparison with it, economical and social aspects being taken into account. In the recent Dutch regulations, 'reasonable' values have been established for the relevant parameters used in the ALARA concept and the paper discusses the values required to calculate the doses for the critical group due to a source. In some cases, the effort expended in making the ALARA dose assessments might not be reasonable in comparison with the dose reduction to be expected. The system which has been developed in the Netherlands to avoid these 'unreasonable' dose calculations, measurements and assessments is explained.

Humans↗
PubMed2000

Reasons for use of hormone replacement therapy in women undergoing coronary angiography.

The recommendation has been made that all women be counseled about the risks and benefits of hormone replacement therapy (HRT). Use of HRT among women undergoing coronary angiography was explored to assess whether patterns of use were similar to data drawn from community samples. Using a descriptive design, a convenience sample of 414 postmenopausal women was interviewed. Fifty-eight percent had never used HRT, 18.3% were past users, and 23.7% were currently using HRT. The primary reason given for ever using HRT was for symptoms of menopause. Less than 14% of women cited coronary heart disease (CHD) or osteoporosis as their primary reason for using HRT. The most common reasons for stopping HRT were side effects and fear of cancer. The most common reasons given for never having used HRT were that their healthcare provider had never talked about it and that they had never thought about it. Use of HRT among women undergoing coronary angiography is similar to that found in community samples. The challenge is to promote patient-provider interactions that include information about HRT based on the scientific model as well as attention to women's individual concerns.

Adult↗
PubMed2004

The impact of early and late damage to the human amygdala on 'theory of mind' reasoning.

There is a burgeoning interest in the neural basis of the ability to attribute mental states to others; a capacity referred to as 'theory of mind' (ToM). We examined the effects of lesions of the amygdala which arise at different stages of development on this key aspect of social cognition. Tests of ToM, executive and general neuropsychological function were given to subjects with lesions of the amygdala arising congenitally or in early childhood ('early damage', n = 15), subjects who acquired damage to the amygdala in adulthood ('late damage' n = 11) and matched clinical (n = 14) and healthy comparison groups (n = 38). Subjects with early damage to the amygdala, particularly if the lesion was associated with childhood onset of seizures, were impaired relative to all other groups on more advanced tests of ToM reasoning, such as detecting tactless or ironic comments or interpreting non-literal utterances. These deficits held for subjects with either left or right early amygdala damage and encompassed the understanding of both the beliefs and emotional states of others. In contrast, subjects who acquired damage to the amygdala in adulthood (usually as part of an anterior temporal lobectomy) were not impaired in ToM reasoning relative to both clinical and healthy controls, supporting the position that the amygdala is not part of the neural circuitry mediating the 'on-line' performance of ToM reasoning. In line with theories which claim that ToM is an independent faculty of cognition, we found that the pattern of results held after co-varying for measures of executive function, memory and general intellectual functioning. We discuss the results in the light of recent theories which link early developmental insults to the amygdala with the ToM impairments which are thought to be a core neurocognitive deficit found in disorders such as autism. We conclude that the amygdala may play an important role in the neural systems supporting the normal development of ToM reasoning.

Adult↗
PubMed1998

Saturday night fever? Reasons for referral from health centres to hospitals during weekends in Finland.

OBJECTIVE: We aimed to examine the reasons for referral from health centres to hospitals during the weekend in Finland. METHOD: We conducted a survey of all referrals from general practice on two weekends (30 November to 6 December 1992 and 28 November to 4 December 1994) in central and northern Finland, which covered 72% of the area of the country and one-third of the population. The participants were 178 GPs from public health centres and who made 530 referrals during these weekends. The outcome measures were reasons for referrals by ICPC codes with respect to the characteristics of patients, GPs and practices. RESULTS: During the weekends studied, 530 patients were referred from out-of-hours work. More male (53%) than female patients (47%) were referred. Out of a total of 530 patients, 213 (40%) were referred to surgery, 139 (26%) to internal medicine, 48 (9%) paediatric medicine, 32 (6%) to neurology, 28 (5%) to both ear, nose and throat (ENT) and psychiatry, 25 (5%) to gynaecology and 18 (4%) to other specialities (ophthalmology, lung disease and cancer departments). Fractures requiring surgery, angina pectoris for which patients were sent to internal medicine and stroke for which patients were sent to other specialities were the most commonly reported reasons for referral. Male patients were referred 12 times more often than females for arrhythmia (atrial fibrillation or tachyarrhythmia); males experienced dislocations eight times more often and fractures three times more often than females. CONCLUSION: Our results point out the need to train GPs about those complaints that most often require a referral to specialist care during the weekend. Future research should focus on those patients who are responsible for the huge gender gap of reasons for referral during weekends.

Adolescent↗
PubMed2001

Knowing patients and knowledge about patients: evidence of modes of reasoning in the consultation?

BACKGROUND: The idea that the patient is in some way known to the doctor is an important one in general practice. The thrust towards patient-centred medicine, the promotion of open and negotiative consultation skills and the development of a biopsychosocial model of primary care medicine all rely on the patient providing a history composed of more than a list of facts. OBJECTIVE: Our aim was to explore the nature and importance of doctors' knowledge about patients. METHODS: Fifteen GPs audio-recorded 25-30 consultations with consecutive consenting patients. They scored each consultation according to how satisfying they found it. Semi-structured interviews based on a selection of consultations were conducted to draw out the doctor's views on the factors that were important to their satisfaction. The interviews were transcribed verbatim. Qualitative analysis was inductive and iterative. RESULTS: Within doctors' narratives, we found accounts of two ways of 'knowing' the patient. The first was a deductive mode of reasoning derived from facts about the patient. The facts that were known were specific to the context of the general practice consultation and led to biomedical and biographical knowledge. The second was an inductive mode of reasoning derived from a contextual interpretation of the facts about the patient which resulted in knowledge of their behaviour and cognitions. Both modes of reasoning gave the doctor knowledge of the patient and permitted action by the doctor in the consultation but led to different interpretations of the patient and different experiences of the consultation. CONCLUSION: 'Knowing the patient' is important to the way GPs attribute meaning to their work. Doctors were more likely to identify as 'known' those patients with whom they adopted an inductive mode of reasoning. In addition, their experience of the consultation was more likely to be positive.

Adult↗
PubMed1990

The game of bridge as an exercise in working memory and reasoning.

Fifty bridge players and 50 nonplayers, between the ages of 55 and 91, were given tests of working memory, reasoning, reaction time, and vocabulary. Data were analyzed using multivariate and univariate analyses of variance with age as a covariate. Results indicated that the players outperformed nonplayers in measures of working memory and reasoning, but not vocabulary and reaction time. Results were consistent with the hypothesis that bridge, which provides specific experience in working memory and reasoning, should enhance performance in tasks tapping these abilities and not enhance performance in unrelated abilities. Because the data were correlational, the rival hypothesis that bridge playing selects for individuals who perform better at working memory and reasoning tasks could not be rejected.

Aged↗
PubMed2006

Defining a fall and reasons for falling: comparisons among the views of seniors, health care providers, and the research literature.

PURPOSE: The purpose of this study was (a) to obtain information about the perceptions held by seniors and health care providers concerning what constitutes a fall and potential reasons for falling, and (b) to compare these perceptions to the research literature. DESIGN AND METHODS: As part of a larger telephone survey, interviewers asked 477 community-dwelling seniors to define a fall and to provide reasons for falling. In addition, we interviewed 31 health care providers from the community on the same topics. In order to capture patterns in conceptualized thinking, we used content analysis to develop codes and categories for a fall definition and reasons for falling. We reviewed selected articles in order to obtain a comprehensive overview of fall definitions currently used in the research and prevention literature. RESULTS: A fall had different meanings for different groups. Seniors and health care providers focused mainly on antecedents and consequences of falling, whereas researchers described the fall event itself. There were substantial differences between the reasons for falling as reported by seniors and the risk factors as identified in the research literature. IMPLICATIONS: If not provided with an appropriate definition, seniors can interpret the meaning of a fall in many different ways. This has the potential to reduce the validity in studies comparing fallers to nonfallers. Research reports and prevention programs should always provide an operational definition of a fall. In communication between health care providers and seniors, an appropriate definition increases the possibility for early detection of seniors in greater need of care and services.

Accidental Falls↗
PubMedDate not supplied

Medication adherence in pediatric asthma: reasoning, responsibility, and behavior.

OBJECTIVE: To assess child adherence to preventive asthma medications; to investigate relations between knowledge, reasoning about asthma, and responsibility for management and adherence; and to determine the association between adherence and morbidity. METHODS: Participants were 106 children with asthma and their parents. Medication adherence was electronically monitored for 1 month. Participants completed self-report measures. Children were interviewed to assess reasoning about asthma. RESULTS: Children's adherence was approximately 48% of prescribed doses. Adherence was negatively related to age (r = -.21, p <.05); minority status, F(1, 98) = 7.55, p <.01; and morbidity (r = -.26, p <.01). Age was associated with increased child knowledge (r =.47, p <.001), reasoning about asthma (tau =.23, p <.01), and responsibility for asthma management (r =.44, p <.01). These variables were not associated with adherence. CONCLUSIONS: Although older children know more about asthma and assume more responsibility for disease management, their adherence is lower than that of younger children. No association was found between adherence and child knowledge, reasoning about asthma, or responsibility for asthma management.

Administration, Inhalation↗
PubMed1996

Reasons for HIV antibody test refusal in a heterosexual sexually transmitted disease clinic population.

OBJECTIVE: To evaluate acceptance of confidential HIV antibody testing and reasons for test refusal among heterosexual clients of Los Angeles County sexually transmitted disease (STD) clinics. METHODS: From January 1993 through June 1994, all blood specimens routinely collected for syphilis serology were tested blindly for HIV antibody at seven STD clinics. Patients were counseled and offered a confidential HIV test. Rate of refusal of confidential testing and primary reason for test refusal were examined by demographic group and HIV serostatus, as determined in the blinded survey, for all heterosexual clients. RESULTS: Of 20,125 persons offered confidential testing, 35.6% refused the test. Test refusal was higher among men (38.7%) than women [31.1%; adjusted odds ratio (OR), 1.4; 95% confidence interval (CI), 1.3-1.4] and among blacks (38.6%) than whites (28.6%; adjusted OR, 1.7; 95% CI, 1.5-2.0). The most common reason for refusal was 'already know my HIV status' (40.6%), followed by 'don't want to know' (23.9%), and 'not at risk' (19.4%). Confidentiality concerns were cited as the primary reason for refusal by 2.2%. Among the 180 (0.9%) persons who tested positive in the blinded survey, 99 (55.0%) refused the confidential test. Of the 44 seropositive persons who refused the confidential test because they "already knew their HIV status', 29 (65.9%) reported their previous test to be negative. CONCLUSIONS: Efforts are needed to increase acceptance of confidential HIV testing in this heterosexual population and should (1) include a client-centered counseling approach that facilitates accurate self-assessment of risk and addresses the misperception that a prior negative test result implies an absence of risk, and (2) highlight the potential benefits of early intervention medical and psychosocial services.

AIDS-Related Opportunistic Infections↗
PubMed2003

Child mortality associated with reasons for non-breastfeeding and weaning: is breastfeeding best for HIV-positive mothers?

OBJECTIVE: To estimate child mortality associated with reasons for the non-initiation of breastfeeding and weaning caused by preceding morbidity, compared with voluntary weaning as a result of maternal choice. METHODS: Demographic and Health Surveys were analysed from 14 developing countries. Women reported whether they initiated lactation or weaned, and if so, their reasons for non-initiation or stopping breastfeeding were classified as voluntary choice or as a result of preceding maternal/infant illness. Rates of child mortality and survival analyses were estimated, by reasons for non-breastfeeding or weaning. RESULTS: Mortality was highest among never-breastfed children. Child mortality among women who never initiated breastfeeding was significantly higher than among women who weaned. Preceding maternal/infant morbidity was the most common reason for not breastfeeding (63.9%), and the mortality of children never breastfed because of preceding morbidity was higher than in children not breastfed as a result of maternal choice; 326.8 per 1000 versus 34.8 per 1000, respectively. Mortality among breastfed children who were weaned because of preceding morbidity was higher than among those weaned voluntarily; 19.2 per 1000 versus 9.3 per 1000, respectively. Failure to initiate lactation was significantly more frequent among women reporting complications of delivery and with low birthweight infants. CONCLUSION: Child mortality as a result of the voluntary non-initiation of breastfeeding or voluntary weaning was lower than previously estimated, and this should be used as a benchmark when counselling HIV-positive mothers on the risks of non-breastfeeding or weaning to prevent mother-to-child transmission of HIV.

Breast Feeding↗