Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Intuition”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 613 records · Page 34Linked to original sources
PubMedDate not supplied

Diagnostic accuracy would be improved by developing more categories of "non-disease".

Studies on the ways in which doctors think have shown the importance of intuitive processes in the formulation of a diagnosis. They have also suggested that intuitively generated diagnoses are used to aid the memory of relevant clinical facts during a clinical consultation. Only some symptoms and signs can be ordered into or subsumed under a diagnostic label. Others, which have not been thought of as constituting a disease, will tend to be lost from memory. If a diagnosis were to be thought of, not as the label of a disease but as a mental construct by means of which data are ordered and remembered, that is, as an invention whose utility is to be judged by the degree to which clinical thinking is facilitated, it would become reasonable to develop diagnoses to cover larger areas of clinical phenomenology. Some examples of the usefulness of such diagnoses of "non-disease" are given ant it is suggested that clinical thinking might be improved by the wider use of the concept.

Diagnosis↗
PubMed1992

Improving task comprehension in the measurement of health state preferences. A trial of informational cartoon figures and a paired-comparison task.

Information concerning people's relative preferences for health care outcomes is usually obtained using questionnaires which ask subjects to imagine health states of various kinds. When using illness- or treatment-specific states, elaborate descriptions of patients' quality of life may adequately convey to the rater a sense of the real situation. Such descriptions are not possible with generic questionnaires, which frame outcomes in general terms, such as pain, limits on activities, etc. This study evaluated two methods for facilitating task comprehension with generic preference-assessment instruments: (1) use of informational figures that provide visual representations of the described health state, and (2) measurement of preferences by means of a paired-comparison task. The use of figures did not change rating variance or the number of counter-intuitive ratings, but did improve one-week test-retest reliability. Paired comparisons had reliability comparable to the direct rating tasks and reduced the number of counter-intuitive ratings, although not to a statistically significantly extent.

Adult↗
PubMed2004

Magical food and health beliefs: a portrait of believers and functions of the beliefs.

The aims of the present two studies were to delineate a portrait of people who are attracted to magical beliefs about food and health and to study the self-reported functions for the beliefs. Participants were Finnish men and women ranging in age from 15 to 66 years (N=3261 in study 1 and N=189 in study 2), and they filled in either an Internet-based or a paper questionnaire. The believers were more often women than men, vegetarians than omnivores, and they relied more on alternative medicine, thought in a more intuitive way, and demonstrated more eating-disordered thinking than the nonbelievers. Additionally, the believers had experienced slightly more negative life events than the nonbelievers in study 1 but contrary to our hypothesis, they did not differ in their desire for control. The believers reported value-expressive function as the most important one served by their beliefs, followed by the control and utilitarian functions. The emotional, intuitive nature of food beliefs and their connection to values and identity are discussed.

Adolescent↗
PubMed2006

An electrophysiological study of mood, modal context, and anaphora.

We investigated whether modal information elicited empirical effects with regard to discourse processing. That is, like tense information, one of the linguistic factors shown to be relevant in organizing a discourse representation is modality, where the mood of an utterance indicates whether or not it is asserted. Event-related potentials (ERPs) were used in order to address the question of the qualitative nature of discourse processing, as well as the time course of this process. This experiment investigated pronoun resolution in two-sentence discourses, where context sentences either contained a hypothetical or actual Noun Phrase antecedent. The other factor in this 2x2 experiment was type of continuation sentence, which included or excluded a modal auxiliary (e.g., must, should) and contained a pronoun. Intuitions suggest that hypothetical antecedents followed by pronouns asserted to exist present ungrammaticality, unlike actual antecedents followed by such pronouns. Results confirmed the grammatical intuition that the former discourse displays anomaly, unlike the latter (control) discourse. That is, at the Verb position in continuation sentences, we found frontal positivity, consistent with the family of P600 components, and not an N400 effect, which suggests that the anomalous target sentences caused a revision in discourse structure. Furthermore, sentences exhibiting modal information resulted in negative-going waveforms at other points in the continuation sentence, indicating that modality affects the overall structural complexity of discourse representation.

Adolescent↗
PubMed2005

Variants of uncertainty in decision-making and their neural correlates.

When leaving the tidy world of rules and people start judging probabilities on an intuitive basis, it revealed that they have some intuitions to choose from. One could refer to them as a family of subjective probability concepts or following Kahneman and Tversky, as variants of uncertainty. The authors distinguished between external and internal attributions of uncertainty and could show that the perceived reason of uncertainty determines the selected coping strategy. To investigate whether variants of uncertainty can also be distinguished on the cerebral level, two functional magnetic resonance imaging studies were conducted. Participants had to predict events (abstract visual stimuli) under parametrically varying degrees of (un-)certainty. In the first experiment, uncertainty was induced by the manipulation of event probability (externally attributed uncertainty). In the second experiment, uncertainty depended on participants' knowledge of valid rules of event occurrence, as trained before the experimental session (internally attributed uncertainty). As a result, parametric analyses revealed that activation within the posterior fronto-median cortex, particularly within mesial Brodmann area (BA) 8, increased with increasing uncertainty, no matter for which reason uncertainty emerged. Furthermore, it was found that different variants of uncertainty entailing different coping strategies can be dissociated due to additionally activated networks. Concluding, increasing activation within mesial BA 8 reflects that we are uncertain, additional networks what we do to resolve uncertainty in order to achieve future rewards. Hence, the phenomenological distinction between processes related to externally and internally attributed uncertainty is paralleled on the cerebral level.

Adaptation, Psychological↗
PubMed2006

Analysis of cost outliers within APR-DRGs in a Belgian general hospital: two complementary approaches.

CONTEXT AND OBJECTIVES: The objective of this study was to find factors that could explain high and low resource use outliers, by associating an explanatory analysis with a statistical analysis. METHOD: High resource use outliers were selected according to the following rule: 75th percentile + 1.5* inter-quartile range. Low resource use outliers were selected according to: 25th percentile - 1.5* inter-quartile range. The statistical approach was based on a multivariate analysis using logistic regression. A decision tree approach using predictors from this analysis (intensive care unit (ICU) stay, high severity of illness and social factors associated with longer length of stay) was also tested as a more intuitive tool for use by hospitals in focussing review efforts on "not explained" cost outliers. RESULTS: High resource use outliers accounted for 6.31% of the hospital stays versus 1.07% for low resource use outliers. The probability of a patient being a high resource use outlier was higher with an increase in the length of stay (odds ratios (OR) = 1.08), when the patient was treated in an intensive care unit (OR = 3.02), with a major or extreme severity of illness (OR=1.46), and with the presence of social factors (OR = 1.44). The probability of being a low outlier is lower for older patients (OR = 0.98). The probability of being a low outlier is also lower without readmission within the year (OR = 0.55). The more intuitive decision tree method identified 92.26% of the cases identified through residuals of the regression model. One quarter of the high cost outliers were flagged for additional review ("not justified" on the basis of the model), with nearly three-quarters "justified" by clinical and social factors. CONCLUSION: The analysis of cost outliers can meet different aims (financing of justifiable outliers, improvement of the care process for the outliers not justifiable on medical or social grounds). The two methods are complementary, by proposing a statistical and a didactic approach to achieve the goal of high quality care using fewer resources.

Adolescent↗
PubMed2006

Eating disorder nutrition counseling: strategies and education needs of English-speaking dietitians in Canada.

The purpose of this study was to profile nutrition counseling strategies for eating disorders that English-speaking Canadian registered dietitians (RDs) use and to explore their educational needs in this area. A cross-sectional survey consisting of open- and closed-ended questions on nutrition counseling strategies was developed and administered via mail. Types of strategies included assessment, rapport-building, educational, and behavior-change strategies. Sixty-five of the 116 eligible RDs who were members of the Dietitians of Canada Eating Disorder Network responded to the survey. Descriptive statistics, chi(2), and Spearman correlation statistics were used. P values less than 0.05 were considered significant. Canadian RDs used strategies that were familiar and strategies they considered useful. Content-oriented or "doing" strategies were used more often than strategies that involved some process-oriented or "thinking" strategies. Reading and intuition were the most frequently reported learning routes. Seventy-one percent of respondents were dissatisfied with the educational opportunities available to RDs in this area in Canada. In Canada, both generalist RDs and specialist eating disorders RDs work with clients with eating disorders. In the absence of a formal nutrition counseling education program, there seems to be a reliance on informal learning routes such as reading or intuition, which may be suboptimal. To optimize eating disorders nutrition practice in Canada, formal coordinated programming that accounts for the educational needs of specialist RDs as well as generalist RDs is needed.

Anorexia Nervosa↗
PubMed2006

Impact of robotics and laparoscopy on surgical skills: A comparative study.

BACKGROUND: This study objectively surveyed and compared the ability of participants to perform laparoscopic and robotic tasks, and attempted to determine the key advantages of each modality. STUDY DESIGN: A task-based training course was developed that included laparoscopic and robotic task modules. Twenty-two participants (6 faculty members, 6 fellows, and 10 residents) completed a pretask and posttask questionnaire concerning 3 tasks, using both laparoscopy trainer and the daVinci robotic system (Intuitive Surgical, Inc). All tasks were timed and values were recorded. The surveys were completed by each participant to assess both pre- and posttask experiences. RESULTS: In the pretask survey, 55% of subjects reported participating in more than 20 laparoscopic cases, and only 27% had ever worked at a robotic console. The median number of beads threaded in 5 minutes was similar for the 2 methods, but the median time to complete 5 beads was 98 seconds for the laparoscope compared with 160 seconds using the robot (p = 0.001). The median number of loops completed in 5 minutes was greater (p < 0.001) using the robot (7.5 versus 2). Only 9% of subjects completed 9 loops in 5 minutes using the laparoscope; 50% did so using the robot (p < 0.05). The percentage of subjects completing 3 knots in 5 minutes was similar when using the laparoscope (45%) and robot (68%). Familiarity and tactile feedback were the primary advantages with laparoscopy, and EndoWrist (Intuitive Surgical, Inc) and stereoscopic visualization were perceived as advantages of the robot. CONCLUSIONS: As with any new technology, skills must be mastered to use robotic technology for the most benefit. The EndoWrist action and stereoscopic visualization were the most valued advantages of the robot. Most fellows and residents would seek additional training in robotics if given the opportunity.

Clinical Competence↗
PubMed2006

Insights into synergistic interactions in binary mixtures of chemical permeation enhancers for transdermal drug delivery.

Chemical permeation enhancers (CPEs) are known to increase skin permeability to therapeutic drugs. Single chemicals, however, offer limited enhancements of skin permeability. Mixtures of chemicals can overcome this limitation owing to their synergistic interactions. However, identification of potent mixtures of chemicals requires screening of a large number of formulations. Discovery of CPE mixtures can be significantly accelerated by identifying patterns that occur in the existing data on CPEs. In this study, we systematically mine through a huge database on skin permeabilizing effect of over 4000 binary formulations generated by high throughput screening and extract general principles that govern the effect of binary combinations of chemicals on skin's barrier properties. Potencies and synergies of these formulations are analyzed to identify the role played by the formulation composition and chemistry. The analysis reveals several intuitive but some largely non-intuitive trends. For example, formulations made from enhancer mixtures are most potent when participating moieties are present in nearly equal fractions. Methyl pyrrolidone, a small molecule, is particularly effective in forming potent and synergistic enhancer formulations, and zwitterionic surfactants are more likely to feature in potent enhancers. Simple but invaluable rules like these will provide guiding principles for designing libraries to further speed up the formulation discovery process.

Administration, Cutaneous↗
PubMed2006

Detection and visualization of storm hydrograph changes under urbanization: an impulse response approach.

Urbanization often alters catchment storm responses, with a broad range of potentially significant environmental and engineering consequences. At a practical, site-specific management level, efficient and effective assessment and control of such downstream impacts requires a technical capability to rapidly identify development-induced storm hydrograph changes. The method should also speak specifically to alteration of internal watershed dynamics, require few resources to implement, and provide results that are intuitively accessible to all watershed stakeholders. In this short paper, we propose a potential method which might satisfy these criteria. Our emphasis lies upon the integration of existing concepts to provide tools for pragmatic, relatively low-cost environmental monitoring and management. The procedure involves calibration of rainfall-runoff time-series models in each of several successive time windows, which sample varying degrees of watershed urbanization. As implemented here, only precipitation and stream discharge or stage data are required. The readily generated unit impulse response functions of these time-series models might then provide a mathematically formal, yet visually based and intuitive, representation of changes in watershed storm response. Nominally, the empirical response functions capture such changes as soon as they occur, and the assessments of storm hydrograph alteration are independent of variability in meteorological forcing. We provide a preliminary example of how the technique may be applied using a low-order linear ARX model. The technique may offer a fresh perspective on such watershed management issues, and potentially also several advantages over existing approaches. Substantial further testing is required before attempting to apply the concept as a practical environmental management technique; some possible directions for additional work are suggested.

Models, Theoretical↗
PubMed2006

Ranking and selecting dangerous crash locations: correcting for the number of passengers and Bayesian ranking plots.

INTRODUCTION: In this paper a sensitivity analysis is performed to investigate how big the impact would be on the current ranking of crash locations in Flanders (Belgium) when only taking into account the most serious injury per crash instead of all the injured occupants. RESULTS: Results show that this would lead to a different selection of 23.8% of the 800 sites that are currently considered as dangerous. CONCLUSIONS: Considering this impact quantity, the researchers want to sensitize government that giving weight to the severity of the crash can correct for the bias that occurs when the number of occupants of the vehicles are subject to coincidence. Additionally, probability plots are generated to provide policy makers with a scientific instrument with intuitive appeal to select dangerous road locations on a statistically sound basis. Impact on industry Considering the impact quantity of giving weight to the severity of the crash instead of to all the injured occupants of the vehicle on the ranking of crash sites, the authors want to sensitize government to carefully choose the criteria for ranking and selecting crash locations in order to achieve an enduring and successful traffic safety policy. Indeed, giving weight to the severity of the crash can correct for the bias that occurs when the number of occupants of the vehicles are subject to coincidence. However, it is up to the government to decide which priorities should be stressed in the traffic safety policy. Then, the appropriate weighting value combination can be chosen to rank and select the most dangerous crash locations. Additionally, the probability plots proposed in this paper can provide policy makers with a scientific instrument with intuitive appeal to select dangerous road locations on a statistically sound basis. Note that, in practice, one should not only rank the crash locations based on the benefits that can be achieved from tackling these locations. Future research is also needed to incorporate the costs of infrastructure measures and other actions that these crash sites require in order to enhance the safety on these locations. By balancing these costs and benefits against each other, the crash locations can then be ranked according to the order in which they should be prioritized.

Accidents, Traffic↗
PubMed2005

Concerns for the worse off: fair innings versus severity.

The original fair innings argument is about claims on length of life. Alan Williams has suggested that the argument also should apply to quality of life. His 'generalised fair innings approach' on the one hand, and the severity approach on the other, are two ways of incorporating concerns for fairness in economic evaluation of health care. They are based on different ethical arguments and therefore partly lead to different results. Both approaches incorporate concerns for current and future severity. There is strong support for this in formal theories of justice and government guidelines, and a number of public surveys even indicate the strength of these concerns. The generalised fair innings approach additionally incorporates concerns for past suffering. Intuitively, this is not unreasonable, but there is at this point little ethical theory or empirical evidence to suggest the strength of such concerns. The fair innings argument can be decomposed in an 'equal innings argument' and a 'sufficient innings argument'. When the fair innings argument is applied to quality of life, its sufficient innings component implies that young people should have priority over old people when it comes to functional improvements and symptom relief for non-fatal conditions. This runs counter to both moral intuitions and official goverment guidelines in Norway and Sweden.

Age Factors↗
PubMed2003

Robotic mitral valve repair: experience with the da Vinci system.

BACKGROUND: As part of a Food and Drug Administration trial, mitral repairs were performed in 38 patients using the robotic da Vinci surgical system (Intuitive Surgical, Inc, Mountain View, CA). Prospectively, we evaluated safety and efficacy in performing both simple and complex mitral repairs. METHODS: Eligible patients had nonischemic moderate to severe mitral insufficiency. Operative techniques included peripheral cardiopulmonary perfusion, a 4- to 5-cm mini-thoracotomy, transthoracic aortic occlusion, and antegrade blood cardioplegia. Transesophageal echocardiograms were done intraoperatively with three-dimensional reconstructions. Successful repairs were defined as mild or less residual regurgitation. RESULTS: Enhanced three-dimensional visualization of mitral leaflets and the subvalvar apparatus allowed safe, dexterous intracardiac tissue manipulation. All patients had successful valve repairs including quadrangular resections, sliding plasties, and edge-to-edge approximations, as well as both chordal transfers and replacements. There were no operative deaths, strokes, or device-related complications. One patient required valve replacement for hemolysis and 1 was reexplored for bleeding. There were no incisional conversions. Both robotic repair and total operating times decreased significantly from 1.9 +/- 0.1 and 5.1 +/- 0.1 hours (mean +/- standard error of the mean) for the first 19 patients to 1.5 +/- 0.1 (p = 0.002) and 4.4 +/- 0.1 hours (p = 0.04) for the last 19 operations, respectively. Total hospital length of stay for patients was 3.8 +/- 0.6 days. Of all patients, 31 (82%) had a 4-day or less length of stay. Seven patients (18%) had stays between 5 and 9 days (6.4 +/- 1.0). CONCLUSIONS: This study shows that the da Vinci surgical system (Intuitive Surgical, Inc) has few limitations in performing complex valve repairs. Articulated wrist-like instruments and three-dimensional visualization enabled precise tissue telemanipulation. Future robotic design advances and adjunctive suture technologies may promote continuing evolution of robotic cardiac operations.

Cardiac Surgical Procedures↗
PubMedDate not supplied

Distributional regularity and phonotactic constraints are useful for segmentation.

In order to acquire a lexicon, young children must segment speech into words, even though most words are unfamiliar to them. This is a non-trivial task because speech lacks any acoustic analog of the blank spaces between printed words. Two sources of information that might be useful for this task are distributional regularity and phonotactic constraints. Informally, distributional regularity refers to the intuition that sound sequences that occur frequently and in a variety of contexts are better candidates for the lexicon than those that occur rarely or in few contexts. We express that intuition formally by a class of functions called DR functions. We then put forth three hypotheses: First, that children segment using DR functions. Second, that they exploit phonotactic constraints on the possible pronunciations of words in their language. Specifically, they exploit both the requirement that every word must have a vowel and the constraints that languages impose on word-initial and word-final consonant clusters. Third, that children learn which word-boundary clusters are permitted in their language by assuming that all permissible word-boundary clusters will eventually occur at utterance boundaries. Using computational simulation, we investigate the effectiveness of these strategies for segmenting broad phonetic transcripts of child-directed English. The results show that DR functions and phonotactic constraints can be used to significantly improve segmentation. Further, the contributions of DR functions and phonotactic constraints are largely independent, so using both yields better segmentation than using either one alone. Finally, learning the permissible word-boundary clusters from utterance boundaries does not degrade segmentation performance.

Adult↗
PubMed1998

Similarity and rules: distinct? Exhaustive? Empirically distinguishable?

The distinction between rule-based and similarity-based processes in cognition is of fundamental importance for cognitive science, and has been the focus of a large body of empirical research. However, intuitive uses of the distinction are subject to theoretical difficulties and their relation to empirical evidence is not clear. We propose a 'core' distinction between rule- and similarity-based processes, in terms of the way representations of stored information are 'matched' with the representation of a novel item. This explication captures the intuitively clear-cut cases of processes of each type, and resolves apparent problems with the rule/similarity distinction. Moreover, it provides a clear target for assessing the psychological and AI literatures. We show that many lines of psychological evidence are less conclusive than sometimes assumed, but suggest that converging lines of evidence may be persuasive. We then argue that the AI literature suggests that approaches which combine rules and similarity are an important new focus for empirical work.

Cognition↗
PubMed2001

Animation of in vitro biomechanical tests.

Interdisciplinary communication of three-dimensional kinematic data arising from in vitro biomechanical tests is challenging. Complex kinematic representations such as the helical axes of motion (HAM) add to the challenge. The difficulty increases further when other quantities (i.e. load or tissue strain data) are combined with the kinematic data. The objectives of this study were to develop a method to graphically replay and animate in vitro biomechanical tests including HAM data. This will allow intuitive interpretation of kinematic and other data independent of the viewer's area of expertise. The value of this method was verified with a biomechanical test investigating load-sharing of the cervical spine. Three 3.0 mm aluminium spheres were glued to each of the two vertebrae from a C2-3 segment of a human cervical spine. Before the biomechanical tests, CT scans were made of the specimen (slice thickness=1.0 mm and slice spacing=1.5 mm). The specimens were subjected to right axial torsion moments (2.0 Nm). Strain rosettes mounted to the anterior surface of the C3 vertebral body and bilaterally beneath the facet joints on C3 were used to estimate the force flow through the specimen. The locations of the aluminium spheres were digitised using a space pointer and the motion analysis system. Kinematics were measured using an optoelectronic motion analysis system. HAMs were calculated to describe the specimen kinematics. The digitised aluminium sphere locations were used to match the CT and biomechanical test data (RMS errors between the CT and experimental points were less than 1.0 mm). The biomechanical tests were "replayed" by animating reconstructed CT models in accordance with the recorded experimental kinematics, using custom software. The animated test replays allowed intuitive analysis of the kinematic data in relation to the strain data. This technique improves the ability of experts from disparate backgrounds to interpret and discuss this type of biomechanical data.

Biomechanical Phenomena↗
PubMed1989

Does Hamilton's rule describe the evolution of reciprocal altruism?

On intuitive grounds, many have felt that Hamilton's Rule, br greater than c, should describe the evolution of reciprocal altruism and "green beard" genes. However, difficulties have been encountered in applying the rule to situations in which the benefits an individual receives are a function of his own phenotype as well as that of his partner. These difficulties are resolved by recognising that there are two important coefficients of genetic relatedness: r1 is the coefficient already familiar to sociobiologists from the applications of Hamilton's Rule to kin selection; r2 is the coefficient of genetic relatedness between individuals who express the same phenotype. It is shown that the r in Hamilton's Rule is a weighted average of these two coefficients. The weights, along with r1 and r2, are intuitively meaningful. A remarkable fact is that r2 = 1, regardless of how genotype determines phenotype.

Altruism↗
PubMed1999

Endoscopic coronary artery bypass grafting with the aid of robotic assisted instruments.

OBJECTIVE: The development of endoscopic coronary artery bypass grafting has been limited because of poor visualization and increased technical difficulties in carrying out operations through ports. We investigated whether the use of robotic assisted instruments could minimize these difficulties. METHODS: After a period of technical development and training on cadavers (n = 8) with the Intuitive Surgical system (Intuitive Surgical, Inc, Mountain View, Calif), the first clinical application in coronary artery surgery was performed in 4 male patients (mean age 59 +/- 6 years) with the indication of grafting the left internal thoracic artery to the left anterior descending coronary artery. Robotic assisted 3-dimensional endoscopes and instruments were introduced into the left side of the chest through 3 intercostal ports. The Heartport system (Heartport, Inc, Redwood City, Calif) was used for arresting the heart during the anastomosis. RESULTS: In 2 patients, the harvesting of the left internal thoracic artery was completed endoscopically with robotic assisted instruments and the anastomosis to the left anterior descending artery was performed through a minithoracotomy with conventional instruments. In 2 other patients, the entire operation was completed endoscopically with robotic assisted instruments. Early postoperative coronary angiography demonstrated the patency of the grafts in all cases. At 6-month follow-up, all patients were free of symptoms. CONCLUSIONS: Robotic assisted instruments make endoscopic coronary bypass possible and open a new era in minimally invasive surgery.

Anastomosis, Surgical↗