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Results for “Reasoning”

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At least 667 records · Page 37Linked to original sources
PubMed1999

[Low fever of unknown reason in patients undergoing autologous stem cell transplantation after hematopoietic reconstitution: a clinical analysis of 13 cases].

OBJECTIVE: To investigate the reason of low fever in patients undergoing autologous stem cell transplantation after hematopoietic reconstitution. METHODS: The reasons for low fever in 13 patients undergoing autologous stem cell transplantation after hematopoietic reconstitution were comprehensively analyzed. RESULTS: After analysis of clinical features, laboratory tests, imaging and microbiological data, no reason was found for the low fever. There was no effect on the fever with anti-microbial therapy. However the low fever was controlled by low dose prednisone 5-10 mg/d or dexamethasone 2-4 mg. CONCLUSION: The reason for the low fever is not clear; it is probably nonspecific low fever induced by high-dose radiotherapy or high-dose chemotherapy.

Adolescent↗
PubMed2001

Mental models and logical reasoning problems in the GRE.

The Graduate Record Examination (GRE) contains a class of complex reasoning tests known as logical reasoning problems. These problems are demanding for human reasoners and beyond the competence of any existing computer program. This article applies the mental model theory of reasoning to the analysis of these problems. It predicts 3 main causes of difficulty, which were corroborated by the results of 4 experiments: the nature of the logical task (Experiment 1), the set of foils (Experiment 2), and the nature of the conclusions (Experiments 3 and 4). This article shows how these factors can be applied to the design of new problems.

Educational Measurement↗
PubMed1999

Nursing students' reasoning about two fictitious elderly patient cases.

The aim of this study was to examine and describe how nursing students developed their reasoning and knowledge about the state of health of, and their possible actions regarding, two fictitious elderly patient case histories during their three-year education. The descriptions were audiotaped, transcribed verbatim and analysed by content analysis. The findings show a development in the students' reasoning concerning the more acute case, but no development in reasoning regarding the case of a confused person. This could be due either to a lack of education in gerontology and geriatrics, or to the students receiving limited guidance during their education on how to reason about and reflect upon different ways of approaching emerging problems. The findings could also be understood in the light of traditions and history in nursing education.

Aged↗
PubMed2002

Attention biases and disinhibited behavior as predictors of alcohol use and enhancement reasons for drinking.

Disinhibition is a risk factor for alcohol use that may be specifically linked to drinking to enhance positive affect (enhancement motives). In this study individual differences germane to disinhibition were assessed, and their relation to alcohol use and reasons for drinking was examined. Laboratory tasks assessed attentional biases for reward and punishment cues and disinhibited behavior. Self-reported personality, alcohol use, and reasons for drinking were included. Frequent alcohol use and frequent drinking for enhancement, but not for coping or social reasons, were associated with a bias to attend to reward cues and disinhibited behavior. Poor inhibitory control assessed by self-reports was also associated with alcohol use and enhancement reasons for drinking. Results support a positive reinforcement mechanism of alcohol use.

Adult↗
PubMed1976

The influence of moral reasoning on behavioral choices.

This study examined the ways in which exposure to moral reasoning statements affected the subsequent behavioral choices of 144 seventh-, eighth-, and ninth-grade boys at different stages of moral judgment. The subjects were divided among 4 experimental conditions, each of which attempted to isolate and relate behavioral choice and reasoning in specific ways. The presentation of reasoning had different effects on the behavioral choices of subjects at 2 different stages. The findings were considered in terms of their implications for developmental change as well as for a developmental analysis of the relationship between moral reasoning and moral behavior.

Adolescent↗
PubMed2003

Clinical reasoning. What is its nature? Can it be taught?

Clinical reasoning constitutes the core of medical practice, being the structural basis that defines the clinician as an expert. The common conviction--mostly among health care managers and politicians--that medicine is above all a scientific endeavor, and therefore all clinical decisions must be based exclusively on scientific evidence, is limited and does not take into account the inescapable need for clinical judgement in all its practical facets. The old saying "medicine is an art as well as a science" emphasizes the need to integrate the methodology of evidence-based medicine (EBM) with the methodology of the arts and humanities, seeking a medical praxis that satisfies patients as well as doctors. Clinical reasoning, as a crucial tool for medical practice, should be the subject of ongoing learning during medical school, post-graduation and continuing medical education. The teaching of clinical reasoning--in diagnosis, therapeutics and prognosis--requires from teachers an understanding of its two main aspects: its intrinsic nature and its development from novice to expert. This article discusses the nature of clinical reasoning, its evolution from student to medical specialist and its practical teaching.

Decision Making↗
PubMed2003

[The reason and prevention of upper cervical reoperations].

OBJECTIVE: To discuss the reasons for the operation performed on 13 patients with upper cervical disease and to explore the management and prevention of upper cervical disease. METHODS: Thirteen patients with upper cervical disease were retrospectively reviewed. The reason for of reoperations on these patients were analyzed. The measures to reduce upper cervical operational complication and bad prognosis were discussed to avoid reoperations. RESULTS: The reasons for reoperations included 9 cases with unstable or re-dislocated atlantoaxial joint, 10 cases with residual spinal cord compression, 1 case with malposition of odontoid screw, 1 case with adjacent cervical spine regression, 1 case with occipital-cervical fusion failure, 1 case with spinal cord injury during operation, 1 case with bone-plant slipped into canales spinalis, and 1 case with demand to take out internal fixation for aggravated symptom. CONCLUSIONS: The common reasons for upper cervical reoperations were due to instability or redislocation of atlantoaxial joint and residual of spinal cord compression. Some measures such as reducing operate miss, using firm internal fixation and decompressing were advisable to decrease the incidence of reoperations.

Adolescent↗
PubMedDate not supplied

[Opportunity, satisfaction, and reasons for not using health care services in Colombia, according to the Quality of Life Survey of the DANE, 1997].

OBJECTIVES: To identify, from a user's perspective, the satisfaction and opportunity of the health care services in Colombia and the reasons for not using them, in order to determine the achievements in health care quality since the promulgation of Law 100 of 1993. METHODS: The results of the home questionnaire of the National survey on Quality of Life carried out by the National Administrative Statistics department during the second semester of 1997, with a sub-sample of 10,016 homes, representing the country's population (39,824,424 inhabitants), were analyzed. Only the variables pertinent to the research purpose were used, assigning new codes for them in order to allow performing the planned analyses. RESULTS: Opportunity and quality of the health care services were well evaluated by a part of the Colombian population. Some of the factors which determine variations in the evaluations of quality and opportunity, as well as the reasons for not using the health cares services, were determined. 64.7% of the people not using the health care services mentioned reasons associated with quality problems. Amongst the most important, were those related to accessibility: long distance to the health care provider, lack of money and lack of credibility in the health agents. CONCLUSIONS: The problems in the quality of the Social Security Services are greater than is usually considered. On the other hand, factors associated with the opportunity, quality (satisfaction) and reasons for not using health care services were identified.

Colombia↗
PubMed1992

Expert nurses' clinical reasoning under uncertainty: representation, structure, and process.

How do expert nurses reason when planning care and making clinical decisions for a patient who is at risk, and whose outcome is uncertain? In this study, a case study involving a critically ill elderly woman whose condition deteriorated over time, was presented in segments to ten expert critical care nurses. Think aloud method was used to elicit knowledge from these experts to provide conceptual information about their knowledge and to reveal their reasoning processes and problem-solving strategies. The verbatim transcripts were then analyzed using a systematic three-step method that makes analysis easier and adds creditability to study findings by providing a means of retracing and explaining analysis results. Findings revealed information about how patient problems were represented during reasoning, the manner in which experts subjects structured their plan of care, and the reasoning processes and heuristics they used to formulate solutions for resolving the patient's problems and preventing deterioration in the patient's condition.

Aged↗
PubMed1992

Development of the College Student Reasons for Living Inventory.

Two studies were carried out in an effort to develop and evaluate an instrument designed to assess suicidal risk in college students. Study 1 describes the development of the College Student Reasons for Living Inventory (CSRLI), an instrument that measures the extent to which college students place importance on various reasons for living even when contemplating suicide. The impetus for the current study was provided by Linehan et al., who in 1983 developed the Reasons for Living Inventory for use with adults. In the current study college students generated a series of 84 "reasons for living" items, which were reduced through factor analysis to a final inventory of 46 items. Six factors were extracted as follows: Survival and Coping Beliefs, College and Future-Related Concerns, Moral Objections, Responsibility to Friends and Family, Fear of Suicide, and Fear of Social Disapproval. Five of these factors reflect the same basic themes contained in the Linehan et al. (1983) study. The sixth factor (College and Future-Related Concerns) appears to be unique to college students. Linehan et al.'s Child-Related Concerns factor expectedly did not appear in this college sample. In Study 2 initial evaluation of the CSRLI was carried out through the use of correlational, confirmatory factor, and discriminant analyses. Results indicate that the CSRLI holds promise as an instrument to predict suicidal risk among college students.

Adult↗
PubMedDate not supplied

Radiologic technologists and ethical reasoning.

This study examines levels of ethical reasoning in students and practitioners in radiologic technology. Results of quantitative analysis revealed few differences in levels of postconventional ethical reasoning among 3 groups: beginning students, graduating students and practitioners 3 to 5 years postgraduation. There were, however, significant differences in 3 schemas of ethical reasoning based on the new Defining Issues Test (DIT2). This study suggests that integrating ethical instruction into the curriculum could have a positive effect on higher levels of postconventional reasoning in both students and graduates in radiologic technology.

Adolescent↗
PubMed2004

Reasons for discontinuation of sildenafil citrate after successful restoration of erectile function.

AIM: To investigate the reasons for discontinuations of sildenafil after the successful restoration of erectile function. METHODS: One hundred fifty six patients, whose scores of erectile function domain of the 15-item International Index of Erectile Function (IIEF) increased to 26 or more after sildenafil medication, were included in this study. Six-months after the first sildenafil prescription, compliance to medication and the reason for discontinuity were reviewed by chart or surveyed by telephone. RESULTS: Fifty-four (34.6 %) of the 156 successfully treated patients discontinued sildenafil medication. The reasons for discontinuance were shortcomings in the partners' or patients' emotional readiness for the restoration of sexual life after long-term abstinence (37.0 %), fear of possible side effects (18.5 %), recovery of spontaneous erection (14.8 %), postponement of ED treatment because of co-morbid disease treatment (11.1 %), unwillingness to accept drug-dependent erection (7.4 %), high drug cost (3.7 %), unacceptability of planned sexual activity (3.7 %) and lack of sexual interest (3.7 %). CONCLUSION: The reasons for discontinuing sildenafil medication were primarily emotional or relationship-oriented, which indicates that simple recovery of a rigid erection is insufficient to restore sexual activity. More education about the effects of drug and the counseling of both partners is recommended to promote the successful recovery of sexual activity.

Adult↗
PubMed2004

[Study on the characteristics and reasons for mistakes in some orthodontic cases].

PURPOSE: To evaluate the characteristics and reasons for mistakes in some orthodontic cases. METHODS: 37 cases after or during treatment in other hospitals with mis-treatment were chosen, their original records as well as the records when they came to our hospital were collected, their original and present malocclusions were classified and the characteristics and reason of mistakes were analysed. RESULTS: Among the 37 cases, 26 cases had class-III malocclusion which account for 70.27% of the group, especially for the malocclusions began in mixed dentition and the problems developed from anterior dental crossbite to severe skeletal crossbite with dentofacial asymmetry and openbite. The main reasons lie in the mistakes of diagnosis and treatment planning, preventive treatment,appliance fabrication,use of extraoral arch and elastics, treatment processes, et al. CONCLUSIONS: There are various characteristics and reasons of treatment mistakes, but the problems lie mainly in class-III malocclusion especially during mixed dentition which indicates that we should pay more attention to the treatment of class-III malocclusion.

Adolescent↗
PubMed2004

[Clinical reasoning in neurology].

There is much neurological literature on clinical, pathological, technical aspects of diagnostic or therapeutic aspects, however there are few articles about clinical-neurological reasoning. This paper analyzes the psychological processes by which neurologists solve complicated diagnostic problems. Clinicians can use a variety of reasoning, such as model (pattern), exhaustive, probabilistic, deterministic (categorical), and hypothetical-deductive reasoning mechanisms. The neurologist must be aware of what kind of reasoning is being used at a given time as well as the errors that can occur. Most of these errors are found in the probabilistic setting and can be grouped into three categories: representativeness errors, availability or adjustment and anchoring biases. Most of them occur due to an inadequate intuitive judgement by the physician to handle the probabilities. There are other sources of error, related with the diagnostic process or with the environmental circumstances in which they develop. The most important ones as well as their theoretical and practical implications are described. In the evidence based medicine era, it is important for the clinical neurologists to be aware of this terminology and concepts for an adequate practice of neurology.

Decision Making↗
PubMed1996

Reasons for proficiency testing failures in clinical chemistry and blood gas analysis: a College of American Pathologists Q-Probes study in 665 laboratories.

OBJECTIVE: To determine the reasons for proficiency testing (PT) failures from 41 chemistry and blood gas analytes using data collected to benchmark performance. DESIGN: Self-administered survey requesting number of challenges by analyte encompassing nine PT events. When the challenge resulted in a self-defined failure, further information was requested concerning the magnitude of the failure (as a standard deviation index) and categorization of the type of failure into six major groups (Methodologic, Technical, Clerical, Survey, Unexplained, or Other) and then into subgroups. PARTICIPANTS: Laboratories enrolled in the 1992 College of American Pathologists Q-Probes program. MAIN OUTCOME MEASURES: Rate of PT failures and reasons for failure. RESULTS: Proficiency testing data from 670,489 challenges performed in 665 laboratories revealed 9268 (1.4%) unacceptable results. Failure types were distributed as follows: Methodologic, 33.5%; Technical, 17.4%; Clerical, 11.1%; Survey, 7.8%; Unexplained, 25.7%; and Other, 7.4%. CONCLUSIONS: Individual analyte PT failure is a common event in the participating laboratories, but failures in successive or alternate events are rare. Analysis of the reasons for failed events indicates that most identified reasons occurred in either the Methodologic or Technical categories (50.9%). Analysis of the failure types suggested investigation pathways based on the magnitude of the failure that could reduce the 25.7% rate of unexplained failures.

Blood Gas Analysis↗
PubMedDate not supplied

Chronic osteomyelitis of long bones: reasons for delay in presentation.

BACKGROUND: Chronic osteomyelitis is a common orthopaedic infection and a major medical problem in developing countries. Time is a critical factor in the evolution of the chronic disease as most of our cases are a progression from acute haematogenous osteomyelitis. Our patients present very late. OBJECTIVE: To identify the reasons for this delayed presentation and suggest possible solutions. METHOD: Over three years (2000-2003) in a multi-centre study (2000-2003), we prospectively evaluated patients with both clinical and radiological diagnosis of chronic osteomyelitis. Besides personal data, mode of onset, duration of illness, father's educational status and occupation and reasons for delayed presentation were documented using a questionnaire. Previous surgery was an exclusion criterion. RESULTS: One hundred and thirty-six patients comprising 81 males and 55 females with a mean age of 17.7(2-55) years were recruited. The mean duration between onset of disease and presentation for treatment was 13.3(2-120) months. Sixty-one (44.9%) presented to a health facility were misdiagnosed and inappropriately treated; ignorance was the reason in 37(27.2%) and lack of finances in 32(23.2%). There was no statistically significant association between the father's educational status and occupation and the attitude to hospital attendance. CONCLUSION: Misdiagnosis, ignorance and poverty are the reasons for delayed presentation in patients with chronic osteomyelitis in this environment. A high index of suspicion, accurate diagnosis and appropriate therapy offer the only hope in containing the acute phase. Continuing medical education, improvement in social and medical amenities and the national health insurance scheme are possible ways of overcoming undue delay in presentation for specialist consultation.

Adolescent↗
PubMed2005

Reasons for the problems faced by patients in government hospitals: results of a survey in a government hospital in Karachi, Pakistan.

OBJECTIVE: To assess the reasons for the problems faced by patients in the government hospitals to make an emphasis on higher authorities for identification of problems and implementation of effective measures. METHODS: A questionnaire-based doctor's survey was conducted at Jinnah Postgraduate Medical Centre (JPMC). The survey included 10 doctors each from 5 wards of JPMC. Informed consent was taken from study participants and ethical considerations were fulfilled. All the doctors were asked questions related to the problems created by hospital management, due to the irresponsibility and concerns of the doctors and also due to the patients themselves. The responses were evaluated separately. RESULTS: A total of 50 doctors participated, out of which, 19 were males and 31 females. Out of all the reasons listed, 84% doctors favored the reason of inadequate salary to doctors & paramedical staff by government while other two reasons favored by 80% doctors were lack of facilities and security for doctors and illiteracy and poverty of patients. CONCLUSION: This hospital based study showed that the causes were related mainly to hospital management, doctors' attitude and responsibility and also to patients' illiteracy and poverty. This calls for adequate measures by higher authorities to rectify the situation.

Attitude of Health Personnel↗
PubMedDate not supplied

Disease prevalence among women attending a sexually transmitted disease clinic varies with reason for visit.

Prevalence of sexually transmitted diseases (STD) and selected behavioral and demographic variables were evaluated in 279 women attending a Baltimore STD clinic, using a standardized questionnaire and cultures for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis. Stratified by reason for clinic visit, 102 (37%) of 279 women attending the clinic stated that they were recent contacts to men with STDs with the majority (59 out of 102, or 58%) reporting gonorrhea contact as their reason for visit. Another 124 women (44%) came to the clinic for symptom evaluation, and 53 (19%) for other reasons. Prevalence of STDs was higher among those attending as contacts than among noncontacts: 35% versus 15% for N. gonorrhoeae; 26% versus 16% for C. trachomatis; and 27% versus 15% for T. vaginalis (P less than 0.05 for each). Furthermore, multiple infections were found in 23% of those attending as contacts but only in 10% of noncontacts (P less than 0.001). In general, patients reporting contact with an infected person were also less likely to report symptoms (43% versus 34%, P less than 0.001), despite increased disease prevalence. These data suggest that multiple STDs are often present in women attending STD clinics, irrespective of reason for visit. Merely treating women for reported exposure without further evaluation will fail to identify a substantial number of women coinfected with other organisms.

Adolescent↗