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PubMed1995

The moral reasoning of nurse practitioners.

This qualitative research study was conducted to describe the moral reasoning utilized by participating nurse practitioners to resolve moral dilemmas in their clinical practice. Five major essential features of moral reasoning emerged from the data: the contextual framework for moral reasoning, values, influencing factors, recognizing the dilemma, and outcomes. The interrelationship of the essential features of moral reasoning provided insight into how NPs deal with moral dilemmas as well as the role that caring and the nurse-patient relationship played as a part of the moral decision making process.

Adult↗
PubMed1981

Reasons given by female virgins for not having premarital intercourse.

By analyzing reasons given by virgin women for not engaging in premarital coitus, we can attain greater insight into the decision-making process involved in maintaining virginity as well as in the transition to nonvirginity. Among virgin women, there is a subgroup who are likely to have premarital coitus if they should meet the right person. On the other hand, women who give moral reasons for not engaging in coitus are the least likely to engage in premarital coitus even if they should become involved in a love relationship. Our results suggest that counsellors and educators should be aware of the diversity of reasons for not engaging in premarital intercourse as well as factors influencing these reasons in order to gain a more complete understanding of premarital sexual decision-making.

Adolescent↗
PubMed1980

Recruitment of a clinical field trial population: reasons for nonparticipation.

Open-ended telephone interviews were conducted with 294 families who refused participation in a school-based program of professionally applied topical fluoride. While the program was conducted in a flouride-deficient community, the level of topical fluoride contact in the homes of the nonparticipants was high. The traditional antifluoridationist reasons for nonparticipation were not expressed with frequency. Instead, the most frequent reason for returning a negative consent form was that the child was already receiving topical flouride applications from the family dentist. The second most frequent reason was that the child did not wish to participate. Many of the reasons given for nonparticipation were not cogent, suggesting that if the parents had been more informed about the nature of the project and about fluoride in general their responses might have been positive.

Attitude↗
PubMed1998

Reasons for taking radiographs in general dental practice in Dar-es-Salaam, Tanzania.

This study investigated the reasons why dental practitioners at the Muhimbili Dental OPD clinic in Dar-es-Salaam take radiographs. Information was obtained from medical records at the Department of Dental Radiology for an eighteen month period, during which 28,171 patients were seen at the hospital, and of which 2,672 (9.48 per cent) were radiographed. The main reasons for taking radiographs (percentages) was to detect fractures (17.2), tumours (14.1), caries (12.5), impacted teeth (12.2), periodontal disease (11.3), and non-specific dental pain (10.4). Radiographs were also taken for orthodontic (7.0 per cent) and endodontic (6.8 per cent) reasons. Some of the reasons for taking radiographs such as hypersensitive teeth, apicectomy, neuralgia and xerostomia were previously unheard of, indicating an increasing diversity of dental services. In conclusion, there is a need to increase the utilisation of dental radiographs from the present modest level in order to meet the growing need of the increasingly informed dental population in Dar-es-Salaam.

Adolescent↗
PubMed2000

Reasons for tooth extraction in a Brazilian population.

AIM: To identify the reasons for tooth extraction in Recife, Brazil and to test whether they differ by socio-economic groups and levels of caries experience. DESIGN: Cross-sectional survey. SETTING: Ten health centres of the public health system and ten health centres of insurance companies. PARTICIPANTS: Patients attending health centres. METHODS: Ten dentists from each selected centre and two patients from each selected dentist were randomly selected from; the list of all health centres in Recife, all dentists carrying out dental extractions at each selected centre and all patients who had an appointment with the selected dentists respectively. Participants were examined by both the researcher (AC) and dentists. OUTCOME MEASURE: Reasons for tooth extraction. RESULTS: Of the 404 teeth extracted, 70.3 per cent were because of caries and its sequelae; 15.1 per cent because of periodontal disease; 6.4 per cent for pre-prosthetic reasons; 3.7 per cent wisdom teeth, 2.5 per cent for orthodontic reasons and 1 per cent for trauma and patient's request. A trend was observed for patients with less than secondary school education and lower salaries to have more tooth extraction due to caries, but the differences were not of statistical significance.

Adolescent↗
PubMed1978

Delinquency and the development of moral reasoning.

A sample of 34 incarcerated male delinquents aged 16-17 and a matched group of controls were compared on self-report measures of delinquency, on Rest's (1975) Defining Issues Test (DIT) of moral reasoning, and on measures of logical operational ability. The mean levels of self-reported delinquency of the incarcerated group were substantially higher than those of the controls. There was no significant difference between the groups in logical operational ability but the mean P score (index of mature moral reasoning) was significantly higher in the control group. However, no relationship was found between moral reasoning and levels of self-reported delinquency. It was concluded that degree and seriousness of involvement of delinquency is unrelated to immaturity of moral reasoning and that the utility of the cognitive developmental approach to moral socialization may therefore be more restricted than has previously been claimed.

Adolescent↗
PubMed1996

Analogical reasoning and the nature of context: a research note.

Recent theorising about children's reasoning has tended to move towards a 'contextualist' view of cognition and away from the idea of an overall, context-free, mechanism, varying in efficiency, which is the presupposition underlying traditional standardised reasoning tests. An earlier study suggesting improved reasoning performance among children on socio-cognitively meaningful versions of Raven's Matrices tended to support this shift. The main purpose of the study reported here was to observe whether a similar improvement would be found with contextually-based analogical reasoning problems as well. Ten analogy items from a standardised test were administered to 11-year-olds together with 10 structurally-equivalent knowledge-based items. The results reflected improved performance on the latter, overall, and additional analyses led to further suggestions about the nature of the 'contextual advantage' and the origins of item difficulty.

Attention↗
PubMed1995

Reasons for non-uptake of measles, mumps, and rubella catch up immunisation in a measles epidemic and side effects of the vaccine.

OBJECTIVE: To investigate the reasons for poor uptake of immunisation (non-immunisation) and the possible side effects of measles, mumps, and rubella vaccine in a catch up immunisation campaign during a community outbreak of measles. DESIGN: Descriptive study of reasons for non-immunisation and retrospective cohort study of side effects of the vaccine. SETTING: Secondary schools in South Glamorgan. SUBJECTS: Random cluster sample of the parents of 500 children targeted but not immunised and a randomised sample of 2866 of the children targeted. MAIN OUTCOME MEASURES: Reasons for non-immunisation; symptoms among immunised and non-immunised children. RESULTS: Immunisation coverage of the campaign was only 43.4% (7633/17,595). The practical problems experienced included non-return of consent forms (6698/17,595), refusal of immunisation (2061/10,897 forms returned), and absence from school on day of immunisation (1203/8836 children with consent for immunisation). The most common reasons cited for non-immunisation were previous measles infection (145/232), previous immunisation against measles (78/232), and concern about side effects (55/232). Symptoms were equally common among immunised and non-immunised subjects. However, significantly more immunised boys than non-immunised boys reported fever (relative risk 2.31 (95% confidence interval 1.36 to 3.93)), rash (2.00 (1.10 to 3.64), joint symptoms (1.58; 1.05 to 2.38), and headache (1.31 (1.04 to 1.65)). CONCLUSIONS: Many of the objections raised by parents could be overcome by emphasising that primary immunisation does not necessarily confer immunity and that diagnosis of measles is unreliable. Measles, mumps, and rubella vaccine is safe in children aged 11-15.

Adolescent↗
PubMed2000

Delay in calling for help during myocardial infarction: reasons for the delay and subsequent pattern of accessing care.

OBJECTIVE: To determine the reasons for delay in calling for help during acute myocardial infarction and the reasons for choice of first medical contact. DESIGN: Review of routine medical records and one to one semi-structured interviews. SETTING: Community survey in city of Glasgow, north of the river Clyde. PATIENTS: 228 men and 85 women aged between 25 and 65 years, respectively, who survived acute myocardial infarction between October 1994 and December 1996. RESULTS: Only 25% of the subjects made a call for help within one hour of the onset of coronary symptoms; in 40% the delay was greater than four hours. Symptoms were not recognised as coronary in origin in the majority of cases. In all cases where delay was more than one hour the main reasons for the delay were thinking that symptoms would go away or that they were not serious. Requesting the attendance of a general practitioner was the first course of action in the majority of cases (55%); the main reason given was that the patient believed this should always be the first course of action. Reluctance to call the emergency services reflected the belief that the symptoms were not serious enough to warrant an ambulance. CONCLUSIONS: Strategies to reduce patient delay times in this deprived urban population must focus on educating the public on the recognition and diversity of coronary symptoms and the benefits of presenting promptly to hospital by way of the emergency ambulance service.

Adult↗
PubMed2005

[Impact of common reasons for consultation on the feeling of vitality and the physical performance of the over-65s].

OBJECTIVES: To measure two functional dimensions (vitality and physical function) involved in the quality of life of the over-65s and to find what relationship they maintain with the commonest reasons for consultation. DESIGN: Cross-sectional, descriptive study. SETTING: Primary care. PARTICIPANTS: Randomised sample of 179 patients over 65 from 14 primary care clinics in Navarra. METHODS: SF-36 quality-of-life questionnaire and most common reasons for consultation. Personal and family details and ongoing drug prescription were also recorded. RESULTS: The most common reasons for consultation were insomnia (31.8%), arthrosis (48%), and urinary symptoms (16.2%). The greatest differences in the SF-36 scales occurred in patients with insomnia. In the multiple regression models, inverse associations were found for each of the reasons for consultation with the vitality and physical function dimensions. Vitality was associated with urinary symptoms, with an adjusted beta coefficient of -11.2 points (95% CI, -18.6 to -3.7). Insomnia was associated with significant decline in vitality and physical function, with beta of -7.7 points (95% CI, -13.9 to -1.5) and -10.3 points (95% CI, -19.1 to -1.6), respectively. Arthrosis symptoms behaved in a similar way. CONCLUSIONS: The most common pathologies or symptoms causing primary care consultations in the over-65s affect significantly the quality-of-life dimensions relating to the pursuit of normal daily life.

Age Factors↗
PubMedDate not supplied

[Reasons for consultation between primary care and the second level].

OBJECTIVE: To identify the reasons causing most referrals from primary care to specialist clinics in our health area. In addition, we analysed the quality of compliance in the inter-clinic forms. DESIGN: Descriptive and observational study. SETTING: Primary care in the Toledo Health Area. POPULATION: Inter-clinic forms (ICF) issued by doctors in 17 primary care teams (PCTs) during 2 weeks in November 2002. Measurements. Age and sex of patient, PCT, type of referral (first time, check-up), referral path (normal, preferential), specialty, reason for referral, ICF quality. MAIN RESULTS: 1610 ICFs from 125 doctors were analysed. 64.6% belonged to women. Average age was 43.5 (95% confidence interval [CI], 42.4-44.6). 74.6% (95% CI, 72.2-76.5) were new consultations. 12.9% (95% CI, 11.3-14.7) were preferential referrals. Specialties with most referrals were: Gynaecology (20.2%), traumatology (17.4%), and Ophthalmology (14.9%). The early diagnosis of gynaecological cancer (13.01%; 95% CI, 11.4-14.8), reduction in visual sharpness (6.95%; 95% CI, 5.8-8.3) and benign skin tumours (4.18%; 95% CI, 3.3-5.3) were the 3 reasons for most referrals. ICF quality was thought good in 13.1% of cases, acceptable in 82.8%, and poor in 4.1%. CONCLUSIONS: A high number of referrals were due to reasons that could be resolved at the primary care level. Most inter-clinical referrals were to medical-surgical specialists. Inter-clinical forms are still open to considerable improvement.

Adolescent↗
PubMed2006

Reasons for tooth extraction in Kuwait.

OBJECTIVES: To investigate reasons for tooth extraction and its association with age and gender in Kuwait. SUBJECTS AND METHODS: A record of all tooth extractions performed in 21 general dental practice centers during a 1-month period was logged on specially designed study forms. The patient's age and gender, number of teeth extracted, and the reason(s) for the extraction were recorded. RESULTS: A total of 2,783 teeth were extracted in 1,604 patients (1.73 +/- 0.07 teeth per patient). Caries and periodontal disease were responsible for 43.7 and 37.4% of extractions, respectively. Caries was the principal cause for extraction in patients < or =40 years old (60.7%), while periodontal disease was the main cause of extractions in patients > or =40 years of age (63.0%). Extractions for caries and orthodontic reasons were more common in females, while extractions for periodontal disease were more prevalent in males. Molars and maxillary premolars were more commonly extracted due to caries, while mandibular premolars, and maxillary and mandibular anterior teeth (canines and incisors) were more commonly extracted due to periodontal disease. CONCLUSIONS: The data show that caries is the principal cause for extractions in younger patients, while periodontal disease accounts for the majority of tooth extractions in patients older than 40 years. Furthermore, this study indicates that more teeth per patient are lost to periodontal disease than for any other reason.

Adolescent↗
PubMed2006

FMRI evidence for a three-stage model of deductive reasoning.

Deductive reasoning is fundamental to science, human culture, and the solution of problems in daily life. It starts with premises and yields a logically necessary conclusion that is not explicit in the premises. Here we investigated the neurocognitive processes underlying logical thinking with event-related functional magnetic resonance imaging. We specifically focused on three temporally separable phases: (1) the premise processing phase, (2) the premise integration phase, and (3) the validation phase in which reasoners decide whether a conclusion logically follows from the premises. We found distinct patterns of cortical activity during these phases, with initial temporo-occipital activation shifting to the prefrontal cortex and then to the parietal cortex during the reasoning process. Activity in these latter regions was specific to reasoning, as it was significantly decreased during matched working memory problems with identical premises and equal working memory load.

Adult↗
PubMed2000

Protective factors against suicidal acts in major depression: reasons for living.

OBJECTIVE: Over 30,000 people a year commit suicide in the United States. Prior attempted suicide and hopelessness are the most powerful clinical predictors of future completed suicide. The authors hypothesized that "reasons for living" might protect or restrain patients with major depression from making a suicide attempt. METHOD: Inpatients with DSM-III-R major depression were assessed for depression, general psychopathology, suicide history, reasons for living, and hopelessness. Of the 84 patients, 45 had attempted suicide and 39 had not. RESULTS: The depressed patients who had not attempted suicide expressed more feelings of responsibility toward family, more fear of social disapproval, more moral objections to suicide, greater survival and coping skills, and a greater fear of suicide than the depressed patients who had attempted suicide. Scores for hopelessness, subjective depression, and suicidal ideation were significantly higher for the suicide attempters. Reasons for living correlated inversely with the combined score on these measures, considered an indicator of "clinical suicidality." Neither objective severity of depression nor quantity of recent life events differed between the two groups. CONCLUSIONS: During a depressive episode, the subjective perception of stressful life events may be more germane to suicidal expression than the objective quantity of such events. A more optimistic perceptual set, despite equivalent objective severity of depression, may modify hopelessness and may protect against suicidal behavior during periods of risk, such as major depression. Assessment of reasons for living should be included in the evaluation of suicidal patients.

Adaptation, Psychological↗
PubMed2005

Perceived reasons for loss of housing and continued homelessness among homeless persons with mental illness.

OBJECTIVE: The objective of this study was to examine the reasons for the most recent loss of housing and for continued homelessness as perceived by homeless persons with mental illness. METHODS: A total of 2,974 currently homeless participants in the 1996 National Survey of Homeless Assistance Providers and Clients (NSHAPC) were asked about the reasons for their most recent loss of housing and continued homelessness. The responses of participants who had mental illness, defined both broadly and narrowly, were compared with responses of those who were not mentally ill. The broad definition of mental illness was based on a set of criteria proposed by NSHAPC investigators. The narrow definition included past psychiatric hospitalization in addition to the NSHAPC criteria. RESULTS: A total of 1,620 participants (56 percent) met the broad definition of mental illness, and 639 (22 percent) met the narrow definition; 1,345 participants (44 percent) did not meet any of these criteria and were categorized as not having a mental illness. Few differences in reasons for the most recent loss of housing were noted between the participants with and without mental illness. Both groups attributed their continued homelessness mostly to insufficient income, unemployment, and lack of suitable housing. CONCLUSIONS: Homeless persons with mental illness mostly report the same reasons for loss of housing and continued homelessness as those who do not have a mental illness. This finding supports the view that structural solutions, such as wider availability of low-cost housing and income support, would reduce the risk of homelessness among persons with mental illness, as among other vulnerable social groups.

Adolescent↗
PubMed2006

The belief in a just world and immanent justice reasoning in adults.

Deciding that negative experiences are punishment for prior misdeeds, even when plausible causal links are missing, is immanent justice (IJ) reasoning (Piaget, 1932/1965). Three studies examined a just world theory analysis of IJ reasoning in adults (Lerner, 1980). Studies 1 and 2 varied the valence of a target person's behavior prior to them experiencing an unrelated negative (car accident, Study 1) or positive (lottery win, Study 2) outcome. Participants viewed the outcomes as the result of prior behavior most when they fit deservingness expectations (good person won the lottery, bad person injured in automobile accident), suggesting that just world concerns influenced IJ reasoning. The lottery-winning finding (Study 2) also extends IJ reasoning to positive experiences. A third study found that a manipulation of just world threat in one context (prolonged or ended suffering of an HIV victim) influenced IJ responses in a subsequent unrelated context (automobile accident scenario).

Adolescent↗
PubMed2006

The relationship between moral reasoning, provictim attitudes, and interpersonal aggression among imprisoned young offenders.

This study examined the relationship between moral reasoning, provictim attitudes, and interpersonal aggression among imprisoned young offenders. The participants were 60 imprisoned male young offenders from a young offender institution or remand centre. Using the Direct and Indirect Prisoner Behaviour Checklist, the offenders were categorised as one of four groups: perpetrator, victim, perpetrator-victim, or not involved. Participants in the four groups were compared on measures of provictim attitudes and sociomoral reasoning. The results showed that the majority of the participants were involved in victimising behaviours, with 43.3% falling into the perpetrator-victim category. Victims had significantly more empathic attitudes toward victims than did those in the perpetrator-victim group. No significant differences were found among the four groups on the sociomoral reasoning measure, nor was there a significant correlation between sociomoral reasoning and provictim attitudes. The results are discussed in terms of previous research and their implications for practice.

Adolescent↗
PubMed2004

Innate spatial-temporal reasoning and the identification of genius.

The teaching of mathematics is invariably language-based, but spatial-temporal (ST) reasoning (making a mental image and thinking ahead in space and time) is crucial to the understanding of math. Here we report that Big Seed, a demanding ST video game, based upon the mathematics of knot theory and previously applied to understanding DNA structure and function, can be used to reveal innate ST reasoning. Big Seed studies with middle and elementary school children provide strong evidence that ST reasoning ability is not only innate but far exceeds optimistic expectations based on age, the percentage of children achieving exceptional ST performance in less than 7 h of training, and retention of ability. A third grader has been identified as a genius (functionally defined) in ST performance. Big Seed may be used for training and assessing 'creativity' (functionally defined) and ST reasoning as well as discovering genius.

Adolescent↗