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PubMed2006

Intrapartum transfer from a birth centre to a hospital - reasons, procedures, and consequences.

BACKGROUND: Investigation of the reasons for the transfer of women from a birth centre to a hospital in the course of childbirth as well as modalities and effects. PATIENTS AND METHOD: In the prospective investigation from September 1, 1999 to August 31, 2001, information was collected for all women in Berlin and Bavaria transferred intrapartum from a birth centre to a hospital concerning the reason for the transfer, stage of delivery at the start of transfer, details of the transport, accompaniment, state of mother and medical diagnosis on arrival at the hospital, further progress of delivery, and the condition of the baby postnatum. Comparison groups were formed by all birth centre deliveries in Berlin and Bavaria 1999/2000 (n = 3060) and hospital deliveries in Berlin and Bavaria 1998/1999 (selected data, n = 89 696 births). RESULTS: Three hundred and sixty transfer cases could be evaluated, and a majority of these were nulliparous. The most frequent reasons for transfer were prior premature rupture of membranes and failure to progress in labor. Fifty-seven percentages of the women who were transferred subsequently delivered spontaneously, with an episiotomy rate of approximately 30%. 1-min Apgar value < or = 7 were frequently in nulliparous and multiparous patients in the transfer group than in the comparison groups, as were 5-min Apgar values < or = 7 and pH < 7.10 in arterial cord blood in particular for nulliparous in the transfer group. Hospitalisation of neonates born to the transfer group and in particular the nulliparous was significantly more common. CONCLUSIONS: Women delivering in a birth centre represent in general a low-risk group as a result of careful preselection by the centres. However, some neonatal data and the high rate of operative deliveries (cesarean section, forceps, and vaginal extraction) indicate that the intrapartum-transferred women, in particular when nulliparous, represent than a special high-risk group.

Adult↗
PubMed2000

Trends in reasons for tooth extractions in Norway from 1968 to 1998.

The aims of this study were (i) to determine the reasons for extraction of permanent teeth in Norway in 1998 and (ii) to describe changes in reasons for extraction in time-trend and quasi-longitudinal perspectives over 30 years based on three cross-sectional studies. The 1998 data were obtained from questionnaires distributed to a national random sample of 1,500 dentists, of whom 1,008 responded (67%). A total of 1,495 teeth were extracted for 1,164 patients (age 10-92 years) during a period of 2 weeks. Caries accounted for 40% of the extractions and periodontal diseases for 24%. Caries was the primary reason in patients 10-45 years old, while periodontal diseases dominated among adults > 45 years old. In a time-trend perspective, among patients > or = 21 years, a significant decrease in the proportion of extractions because of caries was observed between 1968 and 1988, while non-significant changes were found between 1988 and 1998. Extractions because of periodontal disease accounted for about 26% in all surveys. Followed longitudinally, the three cohorts born 1923-32, 1933-42, 1943-52 showed a decrease in the proportion of extractions due to caries, and an increase in the proportion of periodontal extractions during the period, more so between 1968 and 1988 than between 1988 and 1998. The three cohorts showed a variable trend of change, which may indicate that period and age effects do not necessarily operate in the same direction.

Adolescent↗
PubMed1987

Malaria chemoprophylaxis to pregnant women provided by community health workers in Saradidi, Kenya. I. Reasons for non-acceptance.

Chloroquine prophylaxis for malaria was available free of charge to pregnant women in Saradidi, Kenya. The drug was supplied by village health helpers (VHH's). However, only 29.1% of 357 pregnant women seen in antenatal clinics from 1983 to 1984 were on chemoprophylaxis. One hundred and seven pregnant women not using antimalarial chemoprophylaxis from 22 villages were interviewed in June 1984 to determine the reasons. Age (mean 26.9 years), parity (mean 4.5 children), occupation (96.3% subsistence farmers and housewives) and education (median five to seven years) of the 107 respondents were similar to other women in the area. Previous pregnancies had occurred in 92 women; for 15 this was the first pregnancy. The last pregnancy had resulted in a live birth for 81 (88.0%), a stillbirth for nine (9.8%) and a miscarriage for two (2.2%); 21 (22.8%) of the 92 had experienced a miscarriage or stillbirth at some time (15 once, five twice and one woman four times). Malaria was the most frequent mentioned (28.6% of 21 women) cause of the last stillbirth or abortion. The major reason for not taking chemoprophylaxis was lack of awareness that the service was available (53.3% of 107 women). Other reasons were fear of chloroquine-induced itching (10.3%), the VHH had no drug (8.4%), the VHH had not advised her to take drug (8.4%), the woman was 'not sick' (7.5%), the woman was 'lazy' (6.5%), she had not been advised by clinic so was afraid to mix medicines (3.7%) and chloroquine was 'bad for pregnancy' (1.9%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Secrets and reasons for secrecy among school-aged children: developmental trends and gender differences.

The substance and dynamics of secrets were elicited and analyzed for 180 children at three grade levels, to examine developmental trends and gender differences. The recorded frequencies were subjected to loglinear analyses. The results, which revealed a grade effect regarding topics of secrets, indicated a developmental shift in topics with age from secrets pertaining to possessions to secrets pertaining to interpersonal relations, heterosexual involvement, and moral transgressions. A grade effect also emerged regarding reasons for secrecy; a shift was indicated from need for exclusiveness typical of younger children to socially embedded reasons for secrecy characteristic of older children. A gender main effect regarding topics of secrets indicated that boys more often than girls bear secrets pertaining to possessions and moral transgressions, whereas girls tend more often than boys to bear secrets pertaining to family issues. No gender effect was evident, however, in regard to reasons for secrecy. The developmental trends in both aspects of secrecy investigated may be conceived in the framework of a dual shift from separateness to relatedness and from true latency to late latency.

Adolescent↗
PubMed1985

Hypnotic age regression and moral reasoning.

Moral reasoning was assessed with two dilemmas from the Kohlberg Moral Judgment Interview (1976) in 7 adults who were hypnotically age regressed to four ages: 15, 12, 9, and 6 years. Seven adults in a control group under task-motivation instructions were age regressed to the same ages and administered the dilemmas. Age-regressed moral maturity scores for both groups were compared to pretest scores, to data for actual 15-, 12-, 9-, and 6-year-olds from other studies, and to each other. Both groups were able to lower their moral reasoning scores when given age-regression instructions; however, hypnosis subjects not only scored lower than task-motivation subjects but also more closely resembled the levels of reasoning used by children at these ages. The results provide some support for a distinction between age regression through hypnosis and age regression through task-motivation instructions.

Adolescent↗
PubMed2006

Reliability of reasons for early termination of breastfeeding: application of a bivariate probability model with sample selection to data from surveys in Malaysia in 1976-77 and 1988-89.

Although extensively collected, data on people's reasons for their behaviour provided retrospectively have been met with some scepticism on the grounds that they may be subject to biases and errors that jeopardize their usefulness. This study investigates, for a sample of 1,327 births, the reliability with which women in Peninsular Malaysia recalled, at intervals 12 years apart, reasons for not initiating or for stopping breastfeeding less than 3 months after a birth. Overall, we find low to moderate reliability of recall. Levels of reliability are relatively high for some reasons (the child died and no or insufficient milk) but low for some others (child ill, breastfeeding inconvenient). Results from selection models show that reliability does not vary with the length of time since the child's birth but is inversely related to socio-economic status (proxied by education and employment). Social status, social norms, and health-related factors appear to be significant influences on women's consistency of reporting.

Breast Feeding↗
PubMed1996

Conceptual reasoning as a mediator of verbal recall in patients with multiple sclerosis.

A number of intercorrelated factors, including level of neurologic impairment, age, and conceptual reasoning, appear to be related to memory performance among patients with Multiple Sclerosis (MS). A battery of neuropsychological tests was administered to 131 patients with MS ranging in age from 19 to 76 years, with a mean symptom duration of 12.3 years and an overall mild level of MS-related neurologic impairment. Regression analyses indicated that neurologic impairment and age each contributed uniquely to the prediction of delayed free recall of a word list. Furthermore, when the effect of conceptual reasoning was accounted for, neither neurologic impairment nor age were significantly related to recall. Thus, a mediated relation was confirmed, supporting the idea that a significant portion of neurologic-impairment-related and age-related differences in recall are due to differences in conceptual reasoning that are important for optimal performance on tests of recall. Additional analyses failed to support a similar mediated relation using recognition rather than recall as the measure of memory performance.

Adult↗
PubMed2002

Syllogistic reasoning and cognitive ageing.

Gilinsky and Judd (1994) demonstrated that age-related impairment in syllogistic reasoning was in part due to reduced working-memory capacity. A total of 30 older (average age 66 years) and 34 younger persons (average age 24 years) were tested on syllogisms of various types as well as on other measures. Syllogistic reasoning was significantly correlated with education, processing speed, word span, and word fluency. Correlations with visuo-spatial processing and random letter generation were just short of significance. Syllogistic reasoning performance declined with age, although the deficit was no longer statistically significant following control for age-related differences in information-processing speed. On the other hand the inclusion of word fluency as an additional covariate boosted the apparent age effect, returning it to statistical significance. Thus it is possible that cognitive processes outside of working memory might underpin at least part of the apparent age deficit. This possibility is evaluated in the light of neuropsychological evidence implicating the prefrontal cortex in both the processing of syllogisms and more generally in cognitive ageing.

Adult↗
PubMed2004

Mental model construction in linear reasoning: evidence for the construction of initial annotated models.

According to the mental model theory, reasoners build an initial model representing the information given in the premises. In the context of relational reasoning, the question arises as to which kind of representation is used to cope with indeterminate or multimodel problems. The present article presents an array of possible answers arising from the initial construction of complete explicit models, partial explicit models, partial implicit models, a single "isomeric" model, or a single annotated model. Predictions generated from these views are tested in two experiments that vary the problem structure and the number of models consistent with the premises. Analyses of the premise processing times, answering times and accuracy show that the annotated model yields the best fit of the data. Implications of these findings for the mental model theory as developed for relational reasoning are discussed.

Humans↗
PubMed2004

Working memory and syllogistic reasoning.

The purpose of this study was to examine the relation between working memory span and syllogistic reasoning performance. In addition, performance for the reasoning task was compared to predictions made by mental model theory and the probability heuristics model. According to mental model theory, syllogisms that require the use of more mental models are more difficult. According to the probability heuristics model difficulty is related to the number of probabilistic heuristics that must be applied, or (for invalid syllogisms) inconsistencies between the derived and correct conclusion. The predictions of these theories were examined across two experiments. In general, people with larger working memory capacities reasoned better. Also, the responses made by people with larger capacities were more likely to correspond to the predictions made by both mental model theory and the probability heuristics model. Relations between working memory span and performance were also consistent with both theories.

Adult↗
PubMed2005

Categorical reasoning from multiple diagrams.

Syllogistic reasoning from categorical premise pairs is generally taken to be a multistep process. Quantifiers (all, no, some, some ... not) must be interpreted, representations constructed, and conclusions identified from these. Explanations of performance have been proposed in which errors may occur at any of these stages. The current paper contrasts (a) representation explanations of performance, in which errors occur because not all possible representations are constructed, and/or mistakes are made when doing so (e.g., mental models theory), and (b) conclusion identification explanations, in which errors occur even when information has been correctly and exhaustively represented, due to systematic difficulties that people may have when identifying particular conclusions, or in identifying conclusions in particular circumstances. Three experiments are reported, in which people identified valid conclusions from diagrams analogous to Euler circles, so that the first two stages of reasoning from premise pairs were effectively removed. Despite this, several phenomena associated with reasoning from premise pairs persisted, and it is suggested that whereas representation explanations may account for some of these phenomena, conclusion identification explanations, which have never previously been considered, are required for others.

Adolescent↗
PubMed2005

Effects of directionality in deductive reasoning: II. Premise integration and conclusion evaluation.

Previous research (Oberauer & Wilhelm, 2000) has shown an inherent directionality between the two terms linked in premises of typical deductive reasoning tasks. With three experiments we investigated the effect of inherent directionality on the time to integrate two premises and for the derivation of a conclusion. We varied figure (i.e., order of terms in the premises) and direction of inference (i.e., order of terms in the conclusion) in deduction tasks from various domains (propositional reasoning, syllogisms, spatial, temporal, and linear order reasoning). Effects of figure on premise reading times varied with the directionality of the relations. Effects of direction of inference reflected the same directionality for a subset of relations. We propose that two factors are jointly responsible for a large part of observed directionality effects in premise integration: the inherent directionality of relational statements and a general advantage for a given-new order of terms in the second premise. Difficulty of deriving a conclusion is affected by the directionality or relations if and only if the relation is semantically asymmetric, so that the directionality must be preserved in the integrated mental model.

Humans↗
PubMed1999

Central assessment of bilateral phlebograms in a major multicentre thromboprophylactic trial. Reasons for inadequate results.

PURPOSE: To determine the cause of inadequate bilateral phlebograms at central assessment. A major antithrombotic trial was evaluated to identify and apply corrective measures for reducing inadequate results in future multicentre trials. MATERIAL AND METHODS: The inadequate results in 253 out of 1,827 patients having undergone bilateral phlebography following total hip replacement were reviewed by two central assessors using strict criteria for evaluability. The reasons for inadequate findings were assessed and ranked. RESULTS AND CONCLUSION: Insufficient contrast filling, especially of the anterior tibial, common femoral and iliac veins, was the most common reason for disqualifying examinations. Unilateral examinations and obscuring metallic devices were the second and third most common reasons, respectively. Efforts should be made to standardize the phlebography technique, to use a large volume of contrast without tourniquets, and to obtain an appropriate number of views to visualize the deep veins.

Arthroplasty, Replacement, Hip↗
PubMedDate not supplied

Beliefs about fact retrieval and inferential reasoning across the adult lifespan.

This study deals with beliefs about question-answering processes involving "world knowledge" utilized by young, middle aged, and older adults. Questions intended to induce either fact retrieval or inferential reasoning were shown to younger (n = 37), middle aged (n = 37) and older (n = 37) adults in both a multiple choice and true/false format. Increasing age level was not related to decreased confidence in either fact retrieval or inferential reasoning. Global assessments about these question-answering processes involving "people in general" and self evaluations were taken from the same individuals. In contrast to personal confidence ratings, adults of all ages generally believed in declining fact retrieval abilities in old age. Inferential reasoning, however, often was believed to remain stable or even increase in ability level with increasing age. This was especially true in the assessments generated by older adults and in self evaluations. Thus, negative global beliefs about memory and aging may be present even when such global beliefs contradict item-specific judgments and personal beliefs about one's own cognition.

Aging↗
PubMed2002

Weighing the cons and pros: women's reasons for discontinuing hormone replacement therapy.

As a greater proportion of U.S. women move into midlife, there has been increased interest in meeting their preventive health needs. Although hormone replacement therapy (HRT) may not be an option for all postmenopausal women, it has been documented as prolonging life expectancy and protecting against osteoporosis. Despite its advantages for many women, often those who initiate HRT discontinue its use within a short time. The purpose of this qualitative study is to gain insights into women's reasons for discontinuing HRT. We collected data by semistructured interview from three diverse samples: 10 women who had been on HRT for two years or less, 11 health care providers of women, and 34 women who had gone off HRT. Reasons for discontinuing fell into seven broad categories: general Gestalt, somatic complaints, mind (knowledge, emotion), not being heard, hassles, indecisive medical community, and cons outweighed pros. Results indicate that women who discontinue HRT do so for a variety of reasons, many of which are connected to the health care system and its providers. Outcomes also suggest that sharing in decision making along with increased education, support, and individualized care are necessary to better address the preventive health care needs of postmenopausal women.

Adult↗
PubMedDate not supplied

Women's reasons for leaving abusive spouses.

Research has focused on factors associated with leaving physically abusive relationships, yet little is known about what the woman thinks when she leaves. Fifty-one formerly battered women from rural and metropolitan areas in two midwestern states described 86 reasons for leaving a physically abusive relationship. During open-ended interviews, women who rated themselves as severely abused spontaneously emphasized leaving as a process. Content analysis resulted in reasons categorized as safety, dependency, and personal growth. Self-report retrospective data from a nonrandom sample limit generalizability of results; however, the awareness and reasoning of the women, coupled with their emphasis on leaving as process and personal growth, suggest the importance of education and support programs for abused women and women at risk for abuse.

Adult↗
PubMed1994

Scientific methodology in temporomandibular disorders. Part III: Diagnostic reasoning.

Temporomandibular disorders (TMD), as a cluster of individual diseases and disorders, pose new intellectual challenges to the diagnostic skills of dentists. New technologies enable dentists to avail themselves of paraclinical data such that diagnosis can and should be disease specific or etiology specific. The importance of logic in diagnostic reasoning is discussed. Studies of the reasoning process of doctors with reputations for having good clinical judgement have resulted in protocols of diagnostic reasoning. Three specific strategies are presented and discussed-probabilistic, causal and deterministic. The difference between intellectual and managerial decisions are explained relative to utility of the strategies.

Algorithms↗
PubMed1994

Reasons for entry into and understanding of HIV/AIDS clinical trials: a preliminary study.

Thirty-two men who participated in a trial of Zidovudine (> 500 CD4 cells/10(6) L) were surveyed regarding their reasons for participation in clinical trials. The major source of influence to enter the trial was the clinic doctor, and importance for self in participation was rated as the least important reason. Medical science and medical researchers were seen as the major beneficiaries. Being seen to do something about one's illness was also seen as being important and probability of delaying AIDS was rated lowest. Chance of occurrence of risks of treatment were rated as slightly below 50%. Results of Flesch and Fry tests of informed consent documents suggested that they were written in the style of a scientific article, required the readability level of a university graduate and that recall was imperfect. Those who saw more benefits in their trial participation appeared to be most knowledgeable. These data suggest that participation in this clinical trial was based on altruistic, rather than personal reasons and that participants had realistic perceptions of outcomes.

Acquired Immunodeficiency Syndrome↗