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PubMedDate not supplied

A prospective evaluation of the relationship between reasons for drinking and DSM-IV alcohol-use disorders.

Previous research has demonstrated an association between self-reported reasons for drinking and alcohol consumption. The most consistent relationships have been demonstrated between alcohol consumption and drinking for positive affect enhancement and coping with negative affect. However, most of the results have been from cross-sectional research designs that have not controlled for diagnostic status. The present study was a prospective investigation of the relationship between reasons for drinking and the Diagnostic and Statistical Manual of Mental Disorders (4th ed.), diagnoses of alcohol abuse and dependence. Subjects consisted of 508 community residents (264 male and 244 female) who did not meet DSM-IV criteria for an alcohol-use disorder at a baseline interview, who completed a completely structured interview (AUDADIS) and a self-report assessment battery, and who were re-interviewed approximately 1 year later. Results indicated a significant relationship between baseline reasons for drinking and follow-up diagnostic classification. Drinking to reduce negative affect predicted having a DSM-IV alcohol dependence diagnosis at follow-up, but not a diagnosis of alcohol abuse. No significant association was demonstrated between the baseline motive of drinking for positive affect enhancement and a follow-up DSM-IV alcohol-use disorder.

Adult↗
PubMed2002

Reasons for not performing refractive surgery.

PURPOSE: To analyze the reasons that laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) were not performed in patients who requested surgical correction of their refractive errors. SETTING: Minamiaoyama Eye Clinic, Tokyo, Japan. METHODS: This retrospective review comprised 2784 consecutive patients who visited our clinic between June 1997 and August 2000. The reasons they did not receive refractive surgery (PRK or LASIK) were analyzed. RESULTS: Among the 2784 patients who requested surgery for refractive errors, 2079 patients (74.7%) had PRK or LASIK and 705 patients (25.3%) did not. The most common reasons for not treating patients surgically were myopia greater than -12.0 diopters and/or high astigmatism (20.7%), insufficient corneal thickness (8.2%), keratoconus (6.4%), cataract (5.7%), and hyperopia and/or hyperopic astigmatism (4.1%). CONCLUSIONS: Patients who request surgery have a variety of problems. Attention must be given to these individual problems, and the indications must be considered.

Adolescent↗
PubMed2002

Defining the content of patient questionnaires: reasons for seeking laser in situ keratomileusis for myopia.

PURPOSE: To determine the relative importance of patients' motives for having laser in situ keratomileusis (LASIK) for myopia. SETTING: The Corneal Diseases and Excimer Laser Research Unit, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland. METHODS: Twenty-one cards printed with potential reasons for having LASIK and 3 blank cards for respondents to include additional motives were posted to 71 patients who had myopic LASIK. The cards were ranked by each respondent in order of personal importance and returned for analysis. RESULTS: The response rate was 77.5%. The mean age of the 19 male and 37 female respondents was 41.7 years +/- 9.3 (SD) and the mean preoperative spherical equivalent, -9.26 +/- 4.58 diopters. The primary reasons for seeking treatment (percentage of respondents ranking topic within the top 5) were improvement of unaided social vision (69.1%), intolerance to spectacles/contact lenses (65.5%), and freedom from spectacles/contact lenses (61.8%). Almost 70% of respondents ranked 1 of these reasons as the most important. General inconvenience of spectacles/contact lenses and the desire to pursue sports and leisure activities also ranked high (52.7% and 36.4%, respectively). CONCLUSIONS: Consistent with previous work, better unaided vision, combined with the inconvenience of or intolerance to spectacles or contact lenses, provided the main incentives to have LASIK for myopia, while improved cosmesis was relatively unimportant (29.1%). The results of this study will allow the design of satisfaction questionnaires that are better directed toward establishing satisfaction of specific, relevant functional and psychological aspects of refractive surgery that are important to patients.

Adult↗
PubMedDate not supplied

Structure and coherence of reasoning ability in Down Syndrome adults and typically developing children.

The present study investigates the ability of Down Syndrome (DS) adults to reason: (a) deductively with transitivity (linear and reverse relations) and categorical syllogisms (all-some relations); (b) inductively with classical verbal analogies and non-verbal analogical reasoning (Raven's Coloured Progressive Matrices); and (c) to retain information in short-term memory. The results have shown that: (i) The Down Syndrome adults did not differ from typically developing children, matched on expressive and verbal ability, in transitivity and non-verbal analogical thinking; (ii) they differed in categorical reasoning, classical verbal analogies and short-term memory. Application of a structural model demonstrated that, despite differences in slope means in the three measures, the structure of functioning within-and-across all domains of cognition tests and its growth pattern, equally reliable and coherent, goes in parallel for the Down Syndrome adults and the typically developing children. The results are discussed within the context of the two-group developmental and difference approach.

Adult↗
PubMed1999

Reasoning under uncertainty in deluded schizophrenic patients: a longitudinal study.

Several current hypotheses consider the process of attribution of importance to stimuli and the integration of actually perceived reality with experience as a cognitive base for the genesis of delusions. We tested these models by a comparison of deluded schizophrenics, healthy controls, and anxious patients on reasoning under uncertainty. Reasoning under uncertainty was examined in currently deluded schizophrenics (n = 29), in 16 of them also in remission, in normal control groups (n = 35), and in anxious patients (n = 31) using a probabilistic inference task. Acutely psychotic schizophrenics were less ready than normal subjects, anxious patients, and schizophrenics, in remission to modify their judgement in probabilistic situation confronted with potentially disconfirmatory data. They were also less prone than anxious patients and schizophrenics in remission to correct their estimate confronted with confirmatory data. The data support the hypothesis of a weaker influence of incoming stimuli on reasoning under uncertainty as a cognitive base of the maintenance of delusions.

Acute Disease↗
PubMed1997

Combining a neural network with case-based reasoning in a diagnostic system.

This paper presents a new approach for integrating case-based reasoning (CBR) with a neural network (NN) in diagnostic systems. When solving a new problem, the neural network is used to make hypotheses and to guide the CBR module in the search for a similar previous case that supports one of the hypotheses. The knowledge acquired by the network is interpreted and mapped into symbolic diagnosis descriptors, which are kept and used by the system to determine whether a final answer is credible, and to build explanations for the reasoning carried out. The NN-CBR model has been used in the development of a system for the diagnosis of congenital heart diseases (CHD). The system has been evaluated using two cardiological databases with a total of 214 CHD cases. Three other well-known databases have been used to evaluate the NN-CBR approach further. The hybrid system manages to solve problems that cannot be solved by the neural network with a good level of accuracy. Additionally, the hybrid system suggests some solutions for common CBR problems, such as indexing and retrieval, as well as for neural network problems, such as the interpretation of the knowledge stored in a neural network and the explanation of reasoning.

Artificial Intelligence↗
PubMed2000

A multi-modal reasoning methodology for managing IDDM patients.

We present a knowledge management and decision support methodology for insulin dependent diabetes mellitus (IDDM) patients care. Such methodology exploits the integration of case based reasoning (CBR) and rule based reasoning (RBR), with the aim of helping physicians during therapy planning, by overcoming the intrinsic limitations shown by the independent application of the two reasoning paradigms. RBR provides suggestions on the basis of a situation detection mechanism that relies on formalized prior knowledge; CBR is used to specialize and dynamically adapt the rules on the basis of the patient's characteristics and of the accumulated experience. When the case library is not representative of the overall population, only RBR is applied to define a therapy for the input situation, which can then be retained, enriching the case library competence. The paper reports the first evaluation results, obtained both on simulated examples and on real patients. This work was developed within the EU funded telematic management of insulin dependent diabetes mellitus (T-IDDM) project, and is fully integrated in its web-based architecture.

Bayes Theorem↗
PubMed2003

Collaborative environment for clinical reasoning and distance learning sessions.

BACKGROUND: The medical curriculum has changed with the adoption of the student-centered learning paradigm. Clinical reasoning learning (CRL) is used in order to develop and improve students' clinical reasoning and problem-solving skills. PURPOSE: We have observed that, in complement to traditional CRL sessions, students commonly consult resources available on the internet. Based on this observation, our objective is to create computer tools to coordinate CRL sessions at distance, integrating these electronic resources at every step of the reasoning process. MATERIAL AND METHODS: In order to create the system, we elaborated an object-oriented model of a computer-supported collaborative learning environment. The proposed system includes a local web-server to store electronic resources and a relational database to store their electronic addresses (urls). JAVA was used as the programming language. RESULTS: We developed a set of cooperative platform-independent tools. This environment includes a communication tool. Multimedia data exchange is possible. Information is shared thanks to an electronic notepad and whiteboard tools. PERSPECTIVES: This learning environment will be integrated in the French Virtual Medical University project, and is intended to be used for undergraduate, internships, residency or continuing medical education.

Computers, Handheld↗
PubMed2001

Reasons for increased postnatal length of stay & women's perceptions of length of stay.

A quality improvement project was conducted by a major maternity provider (3000 births per year) in the western suburbs of Melbourne. The first part of the project explored the reasons for increased length of stay (LOS), beyond the average timeframe for women receiving postnatal care. The perceptions of 100 women on their length of stay was also measured in the second part of the project. Two information audits were conducted to explore reasons for increased LOS. These reasons were varied, and by the time of the second audit, there was a demonstrated reduction in LOS. A Length of Stay Questionnaire was used to investigate women's perceptions of their LOS on discharge from hospital, and by telephone follow-up 14 days post-discharge. Perceptions varied between women and related to issues such as individual health complications, models of care, postnatal education, and degree of support at home. This project has implications for postnatal midwifery care in relation to discharge planning and women's expectations of care following birth.

Female↗
PubMedDate not supplied

Heuristics reasoning in diagnostic judgment.

Heuristics inquiry is an exciting new approach to understanding diagnostic reasoning. Heuristics are short-cut mental strategies that streamline information. Although heuristics allow for faster processing of information than analytic methods, they can lead to errors because not all information is considered. This article describes three heuristics particularly relevant to diagnostic reasoning: accessibility, similarity, and anchoring and adjustment. Specific factors thought to influence heuristic reasoning are reviewed and analyzed. Last, interventions to be tested for both practice and education are presented.

Clinical Competence↗
PubMed1999

Community perceptions of reasons for preference for consanguineous marriages in Pakistan.

Although the recent Pakistan Demographic and Health Survey (DHS) show that two-thirds of marriages in Pakistan are consanguineous, the sociocultural determinants of such marriages remain largely unexplored. This paper examines the relative importance of the three commonly perceived reasons for such marriages: religious, economic and cultural. The analysis is based on qualitative data collected in 1995 from multi-ethnic and multi-religious communities in Karachi, the largest city of Pakistan. Results show that consanguineous marriages are preferred across all ethnic and religious groups to a varying degree, and that parents continue to be the prime decision-makers for marriages of both sons and daughters. The major reasons for a preference for consanguineous marriages are sociocultural rather than any perceived economic benefits, either in the form of consolidation of family property or smaller and less expensive dowries. Among Muslims, following religious traditions is the least commonly cited reason for such marriages. Despite the reported sociocultural advantages of consanguineous marriages, such unions are perceived to be exploitative as they perpetuate the existing power structures within the family.

Adolescent↗
PubMed1982

Smoking, personality and reasons for smoking.

The relationships, reasons for smoking and personality were investigated in 98 cigarette smokers. Contrary to the usual findings, smoking did not relate to extraversion (E) but related instead to psychoticism (P). It is suggested that this relation is the true one, and previous findings have been due to a contaminated measure of E. Neuroticism (N) was related to the amount smoked, and particularly to a willingness to give reasons for smoking. There was no relation between the Reasons for Smoking Questionnaire, and attempts or success at giving up smoking. Smokers who rolled their own cigarettes were more introverted than others. No measures showed significant relations with the nicotine content of cigarettes.

Adolescent↗
PubMed1997

Probabilistic reasoning in deluded, depressed and normal subjects: effects of task difficulty and meaningful versus non-meaningful material.

BACKGROUND: Research indicates that deluded patients 'jump to conclusions' on probabilistic reasoning tasks. Two experiments were carried out with patients suffering from persecutory delusions and depressed and normal controls in order to determine whether this response bias is affected by task difficulty and the meaningfulness of the materials. METHODS: Tasks were variants of those employed by Huq et al. (1988) and Garety et al. (1991). In Experiment 1, subjects judged which of two bags a sequence of coloured beads had been taken from. Difficulty was manipulated by varying the ratios of coloured beads in the bags. In experiment 2, a neutral condition required judgements about coloured beads drawn whereas, in meaningful conditions, subjects had to judge whether personality characteristics described one of two individuals. RESULTS: In Experiment 1, estimates of certainty varied with task difficulty, and there was no evidence of 'jumping to conclusions' in the deluded group. In Experiment 2, all groups reached an initial level of certainty and reduced their estimates of certainty following disconfirmatory evidence more quickly in the meaningful conditions. Both clinical groups expressed higher certainty levels in early trials, and a greater magnitude of reduction in certainty following disconfirmatory information. These group differences were more evident in the meaningful conditions than in the neutral conditions. CONCLUSIONS: Probabilistic reasoning is affected by task difficulty and meaningfulness of materials in both deluded and depressed subjects. Observed reasoning abnormalities were not specific to the deluded group.

Adult↗
PubMed1999

Reasoning about apparent contradictions: resolution strategies and positive-negative asymmetries.

Apparent contradictions, e.g. Did Susan like her supper?--Yes and no, involve asserting and denying the same proposition. They therefore violate the classical law of non-contradiction, suggesting the use of non-classical interpretive structures in natural language and reasoning. Experiment 1 explores the range of such interpretive structures available to adults (n = 24) in their reasoning about an apparent contradiction. Experiment 2 uses a similar task to study the emergence of these interpretive structures in young children's reasoning (3;6 to 8;4, n = 48). Results suggest an early facility with resolution strategies relating to object structure (as in, Maybe Susan liked one part of supper but didn't like another part) and an initial tendency to focus on the negative by referring to it first (as in, Maybe Susan didn't like one part of supper but did like another part). We discuss the results in terms of the natural logic of objects and their properties, and the logical resources available to young children.

Adult↗
PubMed2003

Working memory and relational reasoning in Klinefelter syndrome.

Klinefelter syndrome (KS) is a sex chromosome abnormality associated with male infertility and mild cognitive deficits. Individuals with KS have been reported to have impaired verbal ability, as well as deficits in executive function. To further understand the nature of their deficits, we assessed specific elements of frontal lobe function such as working memory and relational reasoning. Men with KS exhibited a deficit in a transitive inference task in which participants ordered a set of names based on a list of propositions about the relative heights of the people named. This deficit was present even for items in which the propositions were given in order, so a chaining strategy could be used. Men with KS are also impaired on the n-back task, which uses letters as stimuli. In contrast, these men performed as well as controls in nonverbal reasoning (Raven's Progressive Matrices). These results suggest that men with KS have intact nonverbal reasoning abilities, but that a difficulty in encoding verbal information into working memory may underlie their executive and linguistic impairments.

Adult↗
PubMed1997

Characteristics of non-participants and reasons for non-participation in a population survey in Kin-Hu, Kinmen.

The aim was to characterize non-participants and to investigate reasons for non-participation in a health survey in Kin-Hu township, Kinmen, Republic of China. The non-participants represented 25.6% of the target population of 4,451 registered residents aged 30 and older. Baseline demographic characteristics and two-year mortality for the participants and non-participants were compared. A house-to-house visit was attempted to all of the non-participants for reasons of refusal. The mean age of the non-participants was significantly older than that of the participants (54.3 versus 48.5 years, p < 0.001). The response rate for women was significantly higher than that for men (77.2% versus 71.6%, p < 0.001). The probability of death was significantly different between the two groups (1.2% versus 8.8% for participants and non-participants, respectively, p < 0.001). Major reason for not having participated in the health survey was 'not notified or informed of the examination' (32.7%). These data suggest that non-participants were less healthy.

Adult↗
PubMed1998

The reasonable woman standard: a meta-analytic review of gender differences in perceptions of sexual harassment.

Courts and legislatures have begun to develop the "reasonable woman standard" (RWS) as a criterion for deciding sexual harassment trials. This standard rests on assumptions of a "wide divergence" between the perceptions of men and women when viewing social-sexual behavior that may be considered harassing. Narrative reviews of the literature on such perceptions have suggested that these assumptions are only minimally supported. To test these assumptions quantitatively, a meta-analytic review was conducted that assessed the size, stability, and moderators of gender differences in perceptions of sexual harassment. The effect of the actor's status relative to the target also was evaluated meta-analytically, as one alternative to the importance of gender effects. Results supported the claims of narrative reviews for a relatively small gender effect, and draw attention to the status effect. In discussing legal implications of the present findings, earlier claims are echoed suggesting caution in establishing the reasonable woman standard, and one alternative to the RWS, the "reasonable victim standard," is discussed.

Adult↗
PubMed2004

The HIV Medication Self-Reported Nonadherence Reasons (SNAR) Index and its underlying psychological dimensions.

The purpose of this paper is to report on the construction of the HIV Medication Self-Reported Nonadherence Reasons (SNAR) index and its psychological correlates. Data were derived from a sample of 193 Swedish HIV-seropositive women and men receiving antiretroviral medications. Participants who reported dosing and/or scheduling and/or dietary instructions nonadherence in the past 7 days were presented with a modified AACTG list of 18 reasons for nonadherence. From these data, two conceptually and statistically independent factors were obtained, which accounted for 39% of the variance in the data. These factors were used as the basis for constructing two composite measures composing the SNAR index: the Medication concerns scale and the Routine disruption scale. The Medication concerns scale correlated significantly to suboptimal dose and scheduling adherence and Routine disruption scale with poorer dietary instructions adherence. Psychological distress was the best predictor of the SNAR index. The SNAR index has a clearly interpretable factor structure that allows the derived scales to be useful as multi-item measures of self-reported reasons for nonadherence to HIV antiretroviral medications. The psychological factors found to be associated with the index may imply a number of mental-health-related interventions to improve adherence, which deserve further exploration.

Adaptation, Psychological↗