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PubMed1989

Validation of the reasons for living inventory in general and delinquent adolescent samples.

Two studies are reported that discuss the validation of an adult suicide prediction questionnaire for use with adolescents. The Reasons for Living Inventory (RFL; Linehan, Goodstein, Nielsen, & Chiles, 1983) was slightly modified and administered to two samples of adolescents: one from a general high school population and one from a population of juvenile delinquents receiving psychological treatment in a correctional facility. As with adults, adolescents who reported more reasons for staying alive were less apt to report past or recent suicidal thoughts or behaviors. Evidence of convergent validity emerged via correlations of RFL subscales with depression, hopelessness, and other suicide inventories. Evidence of discriminant validity emerged in that correlations with social desirability were not large. Evidence of construct validity emerged in that the RFL subscales related to suicidal thoughts and behaviors over and above depression and hopelessness. Differences between general and delinquent adolescents' reasons for living are discussed.

Adaptation, Psychological↗
PubMed1988

Interrelations of empathy, cognition, and moral reasoning with dimensions of juvenile delinquency.

The interrelations of a variety of indices of sociocognitive development (empathy, role-taking, logical cognition, and moral reasoning) were studied in delinquent and nondelinquent adolescents. Delinquent males (grouped into psychopathic, neurotic, and subcultural subgroups) and a matched nondelinquent comparison group were administered individually two empathy scales (the Davis Interpersonal Reactivity Index and the Mehrabian and Epstein Questionnaire Measure of Emotional Empathy), an adaptation of Byrne's and Flavell's role-taking tasks, two Piagetian cognitive tasks, and two of Kohlberg's structured moral dilemmas. Delinquents as a group displayed significantly more immature modes of role-taking, logical cognition, and moral reasoning than did nondelinquents. The delinquent subgroups, however, did not significantly differ from one another on these dimensions. Role-taking, logical cognition, and moral reasoning were significantly related to one another. Anticipated differences in level of empathy between the delinquent and nondelinquent adolescents failed to occur. A number of interpretations for this unexpected finding are offered.

Adolescent↗
PubMed1990

The moral reasoning of juvenile delinquents: a meta-analysis.

To test the hypothesized immaturity of juvenile delinquents' moral reasoning, the results of 15 studies of the moral reasoning of juvenile delinquents were integrated quantitatively using meta-analysis. Hedges and Olkin (1985) methods were used to (a) compute effect sizes, (b) test the homogeneity of the obtained effect sizes, and (c) test the statistical significance of the pooled mean effect size. The results supported the hypothesis that the moral reasoning of juvenile delinquents is immature. It was concluded that several other issues are in need of investigation.

Adolescent↗
PubMed1985

Results of the international field trial with the Reason for Encounter Classification.

The Reason for Encounter Classification (RFEC) was designed by a WHO Working Party to classify the reasons why patients seek care at the primary care level. It is designed along two axes: Chapters and Components. Each chapter carries an alpha-code which is the first character of the basic 3-character alphanumeric code. Each chapter is subdivided into seven "components" carrying 2-digit numeric codes. The field trial was undertaken by family physicians and nurses in: Australia, Barbados, Brazil, Hungary, Malaysia, the Netherlands, Norway and the US. 90497 RFE's were analysed. Their distribution over the chapters and components characterize the content of international primary care. Listings with the most common RFE's in the participating countries reflect the cultural differences. It is concluded that the RFEC is not only feasible to classify reasons why patients seek care but also to classify the diagnosis and the process of primary care. As a result of this, the International Classification of Primary Care (ICPC) succeeds the RFEC.

Diagnosis↗
PubMed2000

Reasons given for disclosure of maternal HIV status to children.

The purpose of this investigation was to ascertain the reasons given by mothers diagnosed with AIDS (acquired immunodeficiency syndrome) for disclosing or not disclosing their HIV (human immunodeficiency virus) status to their children, a dilemma faced by most HIV-infected parents and those who counsel them. We interviewed 29 mothers residing in one of two New York City facilities that provide housing and medical treatment for adults with AIDS. The majority of these mothers do not live with their children, but all had recent face-to-face contact with them. The two reasons most frequently considered important for disclosing to children were that disclosure was the "right thing to do" and the need to make arrangements for children's future in case of maternal death or incapacity. The reason most frequently considered important for not disclosing was maternal concern about discussing death and dying with children. These findings have significant implications for counseling of HIV-positive parents.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Physicians' reasons for failing to comply with computerized preventive care guidelines.

The objective of this study was to assess reasons for physicians' noncompliance with computer-generated preventive care reminders. In an academic general internal medicine practice, a survey of physicians' reasons for noncompliance found that 55% of reminders were not complied with. Reasons included "not applicable" in 22.6% (test done elsewhere, patient too ill, no uterus), "next visit" in 22.5% (physician too busy, patient too ill), and "patient refuses" in 9.9% (test not necessary or too costly, patient too busy or fears result). We conclude that although noncompliance with reminders is sometimes appropriate, making time for prevention and patient education may augment preventive care.

Adult↗
PubMed2004

Why wait? Reasons for delay and prompts to seek help for mental health problems in an Australian clinical sample.

BACKGROUND: The initial delay to seek treatment accounts for a significant proportion of the unmet need for treatment of common psychiatric conditions. This study aimed to examine the barriers to initial help-seeking and factors that facilitate help-seeking for anxiety and depression. METHODS: Help-seeking history was retrospectively self-reported by 233 patients at a specialist anxiety clinic, all of whom had delayed seeking professional treatment for at least one month. Data gathered included age at onset, age at help-seeking, primary reason for the delay, prompt to seek help and first professional contacted. RESULTS: The most frequently endorsed reasons for the delay related to lack of knowledge about mental illness or available treatment. Increasing illness severity or disability was the primary prompt to seek help for the majority of respondents. Reason for the delay showed some relationship with length of the delay, but prompt to seek help did not. A general medical practitioner (GP) was the first professional contacted in 71 % of cases. CONCLUSIONS: Lack of public 'mental health literacy' contributes to slow problem recognition. Increasing illness severity eventually facilitates problem recognition and prompts help-seeking. Structural barriers to initial help-seeking are relatively unimportant within the Australian health care system. General practitioners play an important role as gate-keepers to appropriate mental health care.

Adolescent↗
PubMed1999

'No-show' for initial screening at a community mental health centre: rate, reasons and further help-seeking.

INTRODUCTION: The aim of this study was to investigate aspects of the phenomenon of 'no-show' for initial screening in a community mental health centre (CMHC). First, the 'no-show' rate was assessed and possible differences between the 'show' and 'no-show' populations were studied. The 'no-show' individuals were then approached to ask about their reasons for their no-show and about any subsequent help seeking. METHODS: Included in this study were all adults referred to the Maastricht CMHC between December 1995 and April 1997. The 'no-show' rate was assessed for the referrals in 1996. In May 1997 a brief questionnaire, concerning the 'no-show' reason and further help-seeking was sent to all 202 individuals who failed to keep the first appointment in the 15-month period. RESULTS: The 'no-show' rate in 1996 was 9.6% (165 out of 1716 individuals). The most prevalent reasons for 'no-show' were the waiting list, lack of motivation and resolution of the mental health problem. The presenting complaint was still present in 78.7% of the 'no-show' subjects. Most of them had received treatment from their GP, social worker or a private practice. Despite persistence of their problem, 29% didn't seek further treatment. An equal number of subjects solved their problem before the screening interview. CONCLUSIONS: The 'no-show' rate in this population was very low. Measures to reduce this rate (e.g. reducing the waiting list, sending appointment reminders) may be counterproductive as they can discourage successful active problem coping. Additionally, it is doubtful whether if these measures increase the show-rate of less motivated individuals.

Adult↗
PubMed2005

Reasoning deficits in ecstasy (MDMA) polydrug users.

RATIONALE/OBJECTIVES: Previous research has shown that ecstasy users are impaired in thinking and reasoning. The present study sought to explore the possibility that syllogistic reasoning errors in ecstasy users were due to an inability to construct a model of the premises due to working memory limitations. METHODS: Twenty-nine ecstasy users and 25 nonecstasy user controls completed abstract syllogistic reasoning problems varying in difficulty. Pairs of premises were provided, and participants were required to generate conclusions that followed necessarily from them. RESULTS: On the easier problems, both groups performed at well above chance although nonusers achieved significantly more correct responses. Consistent with existing research, on the more difficult problems, errors by nonusers were characterised by incorrect conclusions suggesting that while nonusers have the working memory capacity to construct a single model of the premises, this is not an exhaustive representation and usually results in an erroneous conclusion. On the other hand, for all problem types, ecstasy users, rather than produce incorrect responses, were more likely to fail to generate a conclusion. CONCLUSIONS: The present results are consistent with the possibility that ecstasy users with their reduced working memory capacity may experience difficulty in constructing even a single model of the premises. While this might be attributable to the effects of 3,4-methlylenedioxymethamphetamine neurotoxicity, many of the ecstasy users in the present study were polydrug users. Thus, the possibility that other drugs including cannabis and cocaine might contribute to the present results cannot be excluded.

Adult↗
PubMed1999

Health reasons for leaving the profession as determined among Finnish hairdressers in 1980-1995.

BACKGROUND: Selection into and out of a profession is a known phenomenon in jobs such as hairdressing, in which the workers are exposed to agents and conditions capable of causing work-related symptoms and diseases. OBJECTIVE: To assess the risk for departure from the profession due to health and other reasons among hairdressers as compared with women engaged in commercial work. METHODS: We used a self-administered questionnaire to provide data on 3484 female hairdressers and 3357 referents with regard to their reasons for leaving the profession during the 15-year follow-up period of 1980 1995, for which the relative risks (RR) and 95% confidence intervals (CI) were calculated. The data were collected in August 1995. RESULTS: Of the reasons studied, only the concern for health increased the risk of leaving the profession (RR 1.33; 95% CI 1.16-1.52) among hairdressers. The risk of hairdressers having to leave the profession (1) because of asthma or hand eczema was 3.5 times as great as that found among the control group, (2) because of a strain injury of the wrist or elbow was 2.7 times as great, and (3) because of diseases of the neck or shoulders was 1.7 times as great. The risk of leaving the profession was approximately 20% higher for hairdressers who had suffered at some point in their lives from an atopic disease. CONCLUSIONS: Hairdressers suffering from atopic diseases, hand eczema, and strain injuries of the elbow and wrist are at higher risk of leaving the profession. Active modes of intervention are needed to maintain their working ability. The tools available in the occupational health service are: information on hazards, optimization of working conditions, personal protection, and timely medical care and rehabilitation.

Adult↗
PubMed2001

Construction and validation of the mealtime and dysphagia questionnaire: an instrument designed to assess nursing staff reasons for noncompliance with SLP dysphagia and feeding recommendations.

The lack of compliance of nursing staff with SLP recommendations may be an important contribution to the swallowing and feeding problems of the elderly and the consequent elevated probability of aspiration pneumonia and other sequelae. There is a need to study the prevalence of noncompliance with SLP recommendations for swallowing and feeding and the reason for nursing staff noncompliance for dependent feeders. This researcher constructed and validated a 21-item instrument designed to assess the reasons for staff noncompliance with SLP recommendations using a sample of 180 nursing staffers in a nursing home. The instrument, entitled the Mealtime and Dysphagia Questionnaire (MDQ), was demonstrated to have adequate reliability and concurrent validity. In addition, analyses were conducted that suggested that RNs were less compliant than CNAs. RNs indicated that they had less knowledge and regarded feeding of patients as more of a nuisance than CNAs. The major reason for RNs' noncompliance was lack of knowledge and CNAs' noncompliance was disagreement with the SLP's recommendations. The implications for SLP and nursing practice were discussed.

Analysis of Variance↗
PubMed2002

Reasons for failure to construct the colonic J-pouch. What can be done to improve the size of the neorectal reservoir should it occur?

PURPOSE: The aim of this study was to determine first, the reasons for failure to construct a neorectal reservoir after anterior resection and coloanal anastomosis for rectal adenocarcinoma and the rate at which it occurred and second, to determine whether the adoption of a new "coloplasty" pouch-anal anastomosis improved this failure rate. METHODS: From the colorectal cancer database of a single institution, a single surgeon's patients who underwent resection and coloanal anastomosis from March 1990 to June 1999 were identified. After thorough chart review those patients who underwent straight coloanal anastomosis, J-pouch-anal anastomosis, and coloplasty pouch-anal anastomosis could be identified. In each case of straight coloanal anastomosis, the cause of the failure to create a neorectal reservoir was sought. The study group was further subdivided into those who had their operation either before or after the introduction of the coloplasty pouch-anal anastomosis. RESULTS: Of 107 patients who fitted the criteria for study, 66 (61.7 percent) had a J-pouch-anal anastomosis, and 13 (12.1 percent) had a coloplasty pouch-anal anastomosis. Twenty-eight patients had a straight coloanal anastomosis when a neorectal reservoir could not be constructed, an overall failure rate of 26.2 percent for the total period of study. Seven reasons were identified for this failure, of which there were a total of 31 episodes. These reasons were 1) technical (narrow pelvis, bulky anal sphincters or need for mucosectomy, diverticulosis, insufficient colon length or pregnancy) and 2) nontechnical (complex surgery or distant metastases present). Failure to construct a neorectal reservoir for the period of study before the introduction of coloplasty pouch-anal anastomosis occurred in 27 of 88 (30.7 percent) patients. This was reduced to 1 of 19 (5.3 percent) patients in the later period of study, a significant improvement (P = 0.022). CONCLUSIONS: Seven factors have been identified which may result in the failure to construct a neorectal reservoir after rectal resection and coloanal anastomosis. This may occur in a sizable minority of patients. The introduction of coloplasty pouch-anal anastomosis has resulted in a significant improvement in this failure rate.

Adenocarcinoma↗
PubMed2006

Reasons for not taking an HIV-test among untested men who have sex with men: an Internet study.

The present paper focuses on reasons for not taking an HIV-test among untested men who have sex with men (MSM). From an MSM web-based survey, 1627 MSM who had never tested for HIV were selected for the reported analyses. Results show that fear of a positive test result and the perceived consequences thereof, are reported as the most important reasons for not taking an HIV-test among at-risk respondents. The most important reasons for not taking an HIV-test among no-risk respondents are related to perception of low risk for HIV-infection. Implications for future interventions to promote HIV-testing are discussed.

Adolescent↗
PubMed2005

Reasonable partiality in professional relationships.

First, two aspects of the partiality issue are identified: (1) Is it right/reasonable for professionals to favour their clients' interests over either those of other individuals or those of society in general? (2) Are special non-universalisable obligations attached to certain professional roles? Second, some comments are made on the notions of partiality and reasonableness. On partiality, the assumption that only two positions are possible--a detached universalism or a partialist egoism--is challenged and it is suggested that partiality, e.g. to family members, lies between these two positions, being neither a form of egoism, nor of impersonal detachment. On reasonableness, it is pointed out that 'reasonable' is an ambiguous concept, eliding the notions of the 'morally right' and the 'rational.' Third, a series of practical examples are taken from counselling, medicine, law, education and religious practice and some common principles are abstracted from the cases and discussed. These include truth-telling, confidentiality, conflicts of interest between clients and particular others and between clients and society. It is concluded that while partiality can be justified as a useful tool in standard cases, particular circumstances can affect the final verdict.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Once-a-month injectable contraceptives: efficacy and reasons for discontinuation.

Reports of the phase III clinical trials on four combined progestogen-estrogen once-a-month injectable contraceptives, Deladroxate, Cyclofem, Mesigyna and Chinese Injectable No. 1, are reviewed focussing on efficacy and reasons for discontinuation. Deladroxate, currently used in many Latin American countries has proved to be highly effective and well accepted. However, this combination was withdrawn by the original manufacturer because the progestogen component of this drug induced a high number of breast cancers in dogs and very curious pituitary hyperplasia in rats. Cyclofem and Mesigyna were found to be highly effective and highly acceptable drugs. Side-effects were minimal and were of minor importance. The Chinese Injectable No. 1 had unacceptably high failure rates with a monthly injection schedule. After doubling the dose in the first month of use, the efficacy was satisfactory. It was found that all monthly injectable contraceptives provided better cycle control than the every 3 months depot-medroxyprogesterone acetate, although abnormal bleeding was still the main drug-related complaint and reason for discontinuation. Missed appointment is another reason for discontinuation which might reflect the problem of frequent injection schedule, thus indicating the need for proper selection of the users and good counselling.

17 alpha-Hydroxyprogesterone Caproate↗
PubMed1985

An analysis of physicians' reasons for prescribing long-term digitalis therapy in outpatients.

We examined by medical-record review why long-term digitalis therapy was prescribed in 150 outpatients, the reasons were: supraventricular tachyarrhythmias (35): supraventricular tachyarrhythmias and heart failure (33); and heart failure with sinus rhythm (82). In the patients without supraventricular tachyarrhythmias we scrutinized the diagnosis of heart failure using a clinicoradiographic scoring system and found the diagnosis unlikely in 32 patients. When these 32 patients are combined with the 31 patients who had only one occurrence of supraventricular tachyarrhythmias or heart failure, 42% of the patients were on long-term digitalis therapy for a questionable reason. We conclude that a substantial fraction of general medical outpatients might benefit from digitalis withdrawal, if evidence for heart failure is lacking or if the reason prompting digitalis therapy is isolated to the distant past.

Aged↗
PubMed1990

Effect of vitamin and mineral supplementation on verbal and non-verbal reasoning of schoolchildren.

In a randomised controlled trial the effect of vitamin and mineral supplementation for seven months on performance in tests of reasoning was studied in 86 schoolchildren aged 11-13. A small, non-significant difference between the control and supplementation groups was found in a non-verbal test. The net difference in change in scores between the active and placebo groups was 2.4 units (95% CI-1.5 to 6.3). This direction of effect was not consistently seen with three other tests of non-verbal reasoning. Vitamin and mineral supplementation does not improve the performance of schoolchildren in tests of reasoning.

Administration, Oral↗
PubMed1988

Coping strategies, reasons for driving, and the effect of self-monitoring in drinking-driving situations.

Male and female volunteers, who were drinking regularly but had not been convicted of DUI, were recruited for interviews about their past drinking episodes in a variety of locations and the reasons why they had or had not driven after drinking. The results of the initial interviews were used to compile a catalog of reported strategies and reasons for not driving after drinking, reported reasons for driving after drinking, and reported strategies to avoid detection or arrest when driving after drinking. Following the initial interview, each subject was randomly assigned to either a self-monitoring group or a no self-monitoring control group for three monthly follow-up interviews. The results of the follow-up revealed no apparent effect of self-monitoring on a variety of both drinking and drinking-and-driving measures.

Accidents, Traffic↗